Equity in Health

Africa’s three major killers in spotlight at AU health summit
AFP/SAPA, 4 May 2006: Awoniyi O

African leaders met in Abuja, Nigeria, in May to discuss the battle against HIV/AIDS, tuberculosis and malaria, the continent’s top three killers, at a summit organised by the African Union (AU). The pan-African body’s gathering would be attended by attended by senior government figures from at least 18 African countries including SA. Health ministers from 24 countries and finance ministers from about 10 countries had confirmed their attendance; the central theme being universal access to care for HIV/AIDS, tuberculosis and malaria across Africa by 2010.

After 2015, then what? Africa’s development agenda in post-MDGs
Ezeanya C: Pambazuka News 621, 14 March 2013

For Africa, there is the urgent and desperate need for a radically different approach to understanding and tackling regional challenges post-2015, argues the author of this article. Africa’s greatest challenge is creativity, and innovation founded on indigenous knowledge and indigenous resources. The continent needs homegrown, creative solutions and breakthroughs in governance, science and technology, economic policies, curriculum, health and wellness, and just about any area of human existence covered and not covered by the Millennium Development Goals (MDGs). What is absent in Africa are ideas rooted in Africa’s indigenous material and non-material resources, ranging from mineral, environmental, herbal and ecological resources to agricultural practices, social organisation, political processes, medical knowledge, and numerous others. Africa’s own knowledge systems and ideas are the most valid, inexpensive and rely on easily accessible resources that will bring about advancement for the continent, the author argues. The formulators of the numerous development plans superimposed on Africa have had little or no regard for the continent’s indigenous knowledge, and because of that Africans themselves hold their knowledge and abilities in contempt.

After Accra: Delivering on the Agenda for Action
Gutman J: World Bank, 2009

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.

After Ebola: What next for West Africa’s health systems?
Mcilhone M: African Brains, February 2015

As rates of Ebola infection fall in Guinea, Liberia and Sierra Leone, planning has begun on how to rebuild public health systems and learn lessons from the outbreak. Nobody is declaring victory yet. But in Sierra Leone, the worst-affected country, there were 117 new confirmed cases reported in the week to 18 January, the latest statistics available, compared with 184 the previous week and 248 the week before that. Guinea halved its cases in the week to 18 January – down to 20 – and Liberia held steady at eight. The epidemic is not over until there are zero cases over two incubation periods – the equivalent of 42 days. This article discusses the role of citizen and state, external funders and local community action in addressing the epidemic.

After the Millennium Development Goals
Rodrik D: Project Syndicate, 10 September

As the 2015 deadline for the Millennium Development Goals (MDGs) approaches, development experts are debating a new question: What comes next? In this article, the writer suggests any new global agreement that follows the MDGs should focus more on rich countries’ responsibilities, an issue that was absent from the original MDGs. It should emphasise policies beyond aid and trade that have an equal, if not greater, impact on poor countries’ development prospects. A short list of such policies would include: carbon taxes and other measures to ameliorate climate change; more work visas to allow larger temporary migration flows from poor countries; strict controls on arms sales to developing nations; reduced support for repressive regimes; and improved sharing of financial information to reduce money laundering and tax avoidance. Most of these measures are actually aimed at reducing damage that results from rich countries’ conduct. While rich countries are certain to resist any new commitments, the author notes that most of these measures do not cost money, and, as the MDGs have shown, setting targets can be used to mobilise action from rich-country governments.

Age-specific and sex-specific mortality in 187 countries, 1970—2010: a systematic analysis for the Global Burden of Disease Study 2010
Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR et al: The Lancet 380 (9859): 2071-2094, 15 December 2012

In this study, researchers estimated life expectancy and mortality rates for children under five and adults for 187 countries from 1970 to 2010. Findings showed that from 1970 to 2010, global male life expectancy increased from 56.4 years to 67.5 years and global female life expectancy increased from 61.2 years to 73.3 years. Substantial reductions in mortality occurred in eastern and southern sub-Saharan Africa since 2004, coinciding with increased coverage of antiretroviral therapy and preventive measures against malaria. Globally, 52.8 million deaths occurred in 2010, which is about 14% more than occurred in 1990, and 22% more than occurred in 1970. Deaths in children younger than 5 years declined by almost 60% since 1970. Yet substantial heterogeneity exists across age groups, among countries, and over different decades. Greater efforts should be directed to reduce mortality in low-income and middle-income countries, the authors argue. Improvement of civil registration system worldwide is crucial for better tracking of global mortality.

Aid agency to tackle disease in the developing world

The quest for drugs to fight the world's most neglected tropical infectious diseases gained fresh momentum with the formal launch of the "drugs for neglected diseases" initiative this week. Médecins Sans Frontières has teamed up with five international public organisations to promote affordable and effective drugs against leishmaniasis, human African trypanosomiasis, and Chagas' disease, among other infections that affect millions of people across Asia, Africa, and Latin America.

Aids activists plan to counter WTO

HIV/AIDS awareness campaigners from developing nations are mobilising themselves to form a strong bloc to confront the World Trade Organisation (WTO), which they claim has made it difficult for people living with the disease to access treatment. They claim that the trade body articulates interests of western nations, which have suppressed developing states, giving way to unfair trade. This, the campaigners say, has made it impossible for poor nations to obtain cheap drugs, especially antiretrovirals (ARVs).

AIDS and human security
Statement by Peter Piot, UNAIDS Executive Director

There is a world of difference between the root causes of terrorism and the impact of AIDS on security. But at some deep level, we should be reminded that in many parts of the world, AIDS has caused a normal way of life to be called into question. As a global issue, therefore, we must pay attention to AIDS as a threat to human security, and redouble our efforts against the epidemic and its impact.


Leaders of the world's richest countries agreed at the G8 summit to provide billions of dollars to help fight AIDS in Africa but, under present trade rules, much of that cash will go to multinational pharmaceutical companies. To the disappointment of pressure groups monitoring the summit, the leaders failed to make progress on new trade rules to allow poor countries to buy cheap, generic versions of new medicines - including the drugs which arrest AIDS.