Three-quarters of the 68 countries most in need of improving mother and child mortality rates have made little, if any, progress in meeting internationally set goals over the past three years, according to a series of new reports. The Countdown to 2015 for Maternal, Newborn and Child Survival, an international group that monitors these goals, still holds hope that progress can be made quickly in these underachieving nations, according to reports in a special edition of The Lancet. The medical journal looks at the group's efforts in 68 "priority" or "countdown" countries, where 97 percent of the maternal and child under-5 deaths occur worldwide. The group has set goals to reduce child mortality rate by two-thirds and maternal deaths by three-quarters by 2015.
Equity in Health
Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report published today. The report presents findings from the largest global survey to date on the scale of drug resistance in tuberculosis. The report also found a link between HIV infection and MDR-TB.
It is increasingly recognised that different axes of social power relations, such as gender and class, are interrelated, not as additive but as intersecting processes. This paper has reviewed existing research on the intersections between gender and class, and their impacts on health status and access to health care. The review suggests that intersecting stratification processes can significantly alter the impacts of any one dimension of inequality taken by itself. Studies confirm that socio-economic status measures cannot fully account for gender inequalities in health. A number of studies show that both gender and class affect the way in which risk factors are translated into health outcomes, but their intersections can be complex. Other studies indicate that responses to unaffordable health care often vary by the gender and class location of sick individuals and their households. They strongly suggest that economic class should not be analysed by itself, and that apparent class differences can be misinterpreted without gender analysis. Insufficient attention to intersectionality in much of the health literature has significant human costs, because those affected most negatively tend to be those who are poorest and most oppressed by gender and other forms of social inequality. The programme and policy costs are also likely to be high in terms of poorly functioning programmes, and ineffective poverty alleviation and social and health policies.
In this paper, authors present the trends in life expectancy in Malawi since independence and offer possible explanations regarding inter-temporal variations. Descriptive analysis reveals that the life expectancy in Malawi has trailed below the Sub Saharan African average. From the 1960s through to the early 1980s life expectancy improved driven mainly by rising incomes and the absence of HIV/AIDS. In the mid 1980s life expectancy declined tremendously and never improved due to the spread of HIV/AIDS, the economic slump that followed the World Bank's Structural Adjustment programmes (SAP) and widespread corruption and poor governance in the era of democracy. At the turn of the new millennium, Malawians were no healthier than their ancestors at the dawn of independence though this improved after 2004. If Malawi is to meet its health Millennium Development Goals by 2015, good governance, improved agricultural performance and an increase in health expenditure should be at the heart of its development policies.
Climate-sensitive impacts on human health are occurring today, attacking the pillars of public health and providing a glimpse of the challenges public health will have to confront on a large scale, WHO Director-General Dr Margaret Chan warned during World Health Day. She said although climate change is a global phenomenon, its consequences will not be evenly distributed. Climate change can affect problems that are already huge, largely concentrated in the developing world, and difficult to control.
This paper reviews theories and empirical findings on inequality and finds evidence for a liberal shift in international development. While the reduction of absolute poverty has become the centre of attention in international development any concern for inequalities and relative poverty has been excluded and(re)distribution of incomes has disappeared from the agenda. However, there are numerous economic and political reasons for which inequality should be seen as a more important and urgent problem, including the violation of social and economic rights due to inequality. These factors combined with the emergence of a global civil society and the dwindling legitimacy of the Bretton Woods institutions may open up a window of opportunity for putting inequality back at the heart of a UN led development cooperation. Authors argue that a 'Global Fund' for globalisation and/or development could play an important role in spreading the concept of world public finances, in proposing global taxes and in organising global redistribution, based on the idea of a global welfare state.
Tuberculosis (TB) is a major cause of illness and death worldwide, especially in Asia and Africa. Globally, 9.2 million new cases and 1.7 million deaths from TB occurred in 2006, of which 0.7 million cases and 0.2 million deaths were in HIV-positive people. Population growth has boosted these numbers compared with those reported by the World Health Organization (WHO) for previous years. More positively, and reinforcing a finding first reported in 2007, the number of new cases per capita appears to have been falling globally since 2003, and in all six WHO regions except the European Region where rates are approximately stable. If this trend is sustained, Millennium Development Goal 6, to have halted and begun to reverse the incidence of TB, will be achieved well before the target date of 2015. Four regions are also on track to halve prevalence and death rates by 2015 compared with 1990 levels, in line with targets set by the Stop TB Partnership. Africa and Europe are not on track to reach these targets, following large increases in the incidence of TB during the 1990s. At current rates of progress these regions will prevent the targets being achieved globally.
This paper sets out an initiative by African Development Bank, UNAIDS, UNFPA, UNICEF, WHO and the World Bank that aims to tackle barriers to scaling up health in Africa. The ‘Harmonisation for Health in Africa’ initiative HHA is a regional mechanism through which collaborating partners agree to focus on providing support to the countries in the African region for reaching health MDGs. The HHA initiative aims to: support countries to identify, plan and address health systems constraints to improve health related outcomes; develop national capacity through training, planning, costing and budgeting, harmonisation and stimulating peer exchange; promote the generation and dissemination of knowledge, guidance and tools for specific technical areas including strengthening health service delivery and monitoring health systems performance; support countries to leverage predictable and sustained resources for the health sector; ensure accountability and assist in monitoring performance, of national health systems, aid effectiveness and the performance of the International Health Partnership; and enhance coordination to support nationally owned plans and implementation process, helping countries to address the country level bottlenecks arising from constraints within international agencies.
The latest global maternal death statistics indicate that of the 536,000 women that died in 2005 of childbirth related complications, about half or 261,000 were African women. The recently released 2005 figures also indicate that Africa is the only region where maternal deaths have increased since 1990 up from 205,000. Maternal deaths dropped in every other continent over the same period. In Europe from 4,800 to 2,900, and in the America’s from 21,000 to 16,000. The prevalent maternal death risk also reflects a much bleaker picture of overall reproductive health in Africa. The Africa Public Health Rights Alliance “15% Now!” Campaign has developed a scorecard based on the 2005 figures and available comparable global health financing and health systems data. The scorecard shows that in the bottom 10 countries globally - all of which are African except Afghanistan, maternal death risk is between 1 in 7 (Niger) and 1 in 15 (Mali). In the top 10 the risk is between 1 in 47,600 (Ireland) and 1 in 13,800 (Switzerland). Possibly every family in the bottom 10 countries will suffer 1 maternal death. Overall 1 in 23 African women have a lifetime risk of maternal death compared with 1 in 2,300 in Europe.
World Health Day, on 7 April, marks the founding of the World Health Organization and is an opportunity to draw worldwide attention to a subject of major importance to global health each year. In 2008, World Health Day focuses on the need to protect health from the adverse effects of climate change. The theme “protecting health from climate change” puts health at the centre of the global dialogue about climate change. WHO selected this theme in recognition that climate change is posing ever growing threats to global public health security. Through increased collaboration, the global community will be better prepared to cope with climate-related health challenges worldwide. Examples of such collaborative actions are: strengthening surveillance and control of infectious diseases, ensuring safer use of diminishing water supplies, and coordinating health action in emergencies.