Deaths of children aged under five years old have dropped by 27% globally since 1990, according to the latest World Health Organization (WHO) estimates. But, in WHO’s first progress report on the health-related Millennium Development Goals, released in the World Health Statistics 2009, other results are mixed. Areas where there has been little or no movement are notably maternal and newborn health. In many African countries – and in low-income countries generally – progress has been insufficient to reach the Millennium Development Goal target that aims for a two-thirds reduction in child mortality by the year 2015. ‘While data is patchy and incomplete, it appears that the regions with the least progress are those where levels of maternal mortality are the highest. The challenges ahead are those presented by weak health systems, those associated with noncommunicable chronic conditions and emerging health threats such as pandemics and climate change,’ said WHO.
Equity in Health
Recent claims have been made that system-wide approaches, and primary health care for all, are universally agreed-upon goals. So why haven’t these goals been fulfilled? Certainly much of the problem has been lack of real commitment to a comprehensive approach to reducing health risks and improving primary care. The prevailing neoliberal economic model of development, the so-called 'Washington Consensus', which -emphasised liberalisation, privatisation and fiscal austerity, displaced ‘Primary Health Care for All’ with ‘Primary Health Care for Some’.
The current economic downturn will diminish wealth and health, but the impact will be greatest in the developing world. The world can be grateful that health officials are recommitting themselves to primary health care, the surest route to greater equity in access to health care. Much of the blame for the essentially unfair way our world works rests at the policy level. Time and time again, health is a peripheral issue when the policies that shape this world are set. When health policies clash with prospects for economic gain, economic interests trump health concerns. Time and time again, health bears the brunt of short-sighted, narrowly focused policies made in other sectors. Equity in health matters. It matters in life-and-death ways. The HIV/AIDS epidemic taught us this, in a most visible and measurable way. We see just how much equity matters when crises arise.
Deaths of children aged under five years have dropped by 27% globally since 1990, according to the latest WHO estimates. But in WHO’s first progress report on the health-related Millennium Development Goals (MDGs) released today in the World Health Statistics 2009, other results are mixed. An estimated nine million children aged under five years died in 2007, significantly fewer than the 12.5 million estimated to have died in 1990. However, in many African countries and in low-income countries generally, progress has been insufficient to reach the MDG target, which aims for a two-thirds reduction in child mortality by the year 2015. ‘The decline in the death toll of children under five illustrates what can be achieved by strengthening health systems and scaling up interventions,’ said Dr Ties Boerma, Director of WHO’s Department of Health Statistics and Informatics.
The 62nd session of the World Health Assembly took place in Geneva during 18-22 May 2009. At this session, the Health Assembly discussed a number of public health issues, including: pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits;
implementation of the International Health Regulations; primary health care, including health system strengthening; social determinants of health; and monitoring the achievement of the health-related Millennium Development Goals. The Health Assembly also discussed the programme budget, administration and management matters of WHO. The proceeedings and resolutions can be found at the website provided.
The 62nd session of the World Health Assembly took place in Geneva during 18-22 May 2009. At this session, the Health Assembly discussed a number of public health issues, including pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits, implementation of the International Health Regulations, primary health care (including health system strengthening), the social determinants of health and monitoring the achievement of the health-related Millennium Development Goals. The Health Assembly also discussed the programme budget, administration and management matters of the World Health Organization.
This paper examines the health status of residents in a major urban centre in Kenya and reviews the effects of selected social determinants on local health. Through field surveys, focus group discussions and a literature review, this study canvasses past and current initiatives and recommends priority actions. Areas identified that unevenly affect the health of the most vulnerable segments of the population were: water supply, sanitation, solid waste management, food environments, housing, the organisation of health care services and transportation. The use of a participatory method proved to be a useful approach that could benefit other urban centres in their analysis of social determinants of health.
The 62nd World Health Assembly in May 2009 adopted a resolution strongly reaffirming the values and principles of primary health care, including equity, solidarity, social justice, universal access to services, multisectoral action and community participation as the basis for strengthening health systems. It calls on WHO to reflect the values and principles of the Declaration of Alma-Ata in its work and that the overall organizational efforts across all levels contribute to the renewal of primary health care and to strengthen the Secretariat’s capacities to support this. Full text is found at the website provided.
The People’s Health Movement has warned that the current global economic recession is a threat to the world’s health. It demands immediate measures by the international community and individual governments to ensure adequate resources to revitalise public health systems, pay urgent attention to the needs of the poor rather than reviving failed big commercial banks, allocate funds for the restoration of jobs and livelihood opportunities in low-income communities and strengthen social welfare programmes in developing countries. It urges those in power not to use the economic crisis downturn as an excuse to cut funds for welfare-related programmes and calls upon the World Health Assembly to adopt the final recommendations of the Commission on Social Determinants of Health immediately.
Developing countries need to deepen their ownership of the development process by engaging local governments, civil society, and parliaments – what could be called 'the basic body of democratic responsibility'. If they identify areas where their capacity is weak, they can develop plans to address those areas. Leadership is required in managing the development process, working out a sensible division of labour among the donors that are active in their countries. They need to improve their ability to gather and use statistical information, so that they know – and can report to their citizens – what results they are achieving. Donors should also make sure that the aid they give is properly managed and that it reaches those who need it most, namely the poor and underserved.