The Istanbul Declaration was adopted by consensus at the conclusion of the two-day Global Human Development Forum, a gathering of more than 200 leading development experts, civil society activists, government ministers, private sector representatives and UN officials from all regions of the world. The Declaration stresses the need for global and national development strategies to put “strong emphasis on social inclusion, social protection, and equity, in recognition of the fact that economic development has too often gone hand in hand with environmental degradation and increased inequality.” Achieving those goals will require better-coordinated “mobilization of global capital and local resources,” good governance on the local and global level, and full empowerment of women “through access to education, health care, basic services and their participation in the labour force.” The declaration calls for a post 2015 MDG framework that addresses all three dimensions of sustainable development (social, economic and environmental), and their interconnections.
Equity in Health
The theme of the Prince Mahidol Award Conference – held in Bangkok, Thailand on on 24-28 January 2012 – was “Moving towards universal health coverage: health financing matters”. At the close of the meeting, a 10-point declaration recognised universal health coverage (UHC) as fundamental to the right to health, and marked the commitment by more than 800 delegates to translate the rhetoric of UHC into better, more equitable health outcomes. Similar endorsements of UHC have been made before, including at the World Health Assembly in 2011. What makes the Bangkok Statement any more likely to hasten and widen the implementation of UHC? One answer may be the power of the Prince Mahidol Award Conference and its sponsors to draw global health enthusiasts from a wide variety of disciplines and health systems. Delegates from 68 countries included external funders and recipients of aid, managers and front-line health workers, ministers, economists, and consumers. From these many perspectives came the realisation that whether one seeks to provide access to health care for the one billion people who lack it, or to protect the 100 million people who end up in poverty every year as a result of medical costs, or to accelerate progress towards the Millennium Development Goals: UHC provides a common mechanism – and common cause.
Despite a high disease burden, mental illness has thus far not achieved commensurate visibility, policy attention, or funding, the authors of this study note. They found that, while significant progress has been made in terms of prioritising mental health globally, debates around the definition of mental illness, and the continued impact of stigma, remain. The authors make five recommendations to increase the visibility and policy priority of mental health as a global issue. 1. Greater community cohesion and international governance structures need to be developed to contribute to a more unified voice regarding global mental health. 2. A common framework of integrated innovation is needed to ensure that global mental health speaks in the language of national and international policy makers. 3. For global mental health to gain significant attention, a coherent evidence base for scalable interventions that can be shown to have an impact at the structural level - on economic development and human well-being - is central. 4. A social justice and human rights approach is important. 5. Current innovative strategies for addressing stigma need to be evaluated and expanded.
Development progress in the world's poorest countries could be halted or even reversed by mid-century unless bold steps are taken now to slow climate change, prevent further environmental damage, and reduce deep inequalities within and among nations, according to projections in the 2011 Human Development Report. In the report the United Nations Development Programme (UNDP) argues that environmental sustainability can be most fairly and effectively achieved by addressing health, education, income and gender disparities together with global action on energy production and ecosystem protection.
The deadline for meeting the Millennium Development Goals (MDGs) is quickly approaching. While progress has been made on a number of the goals, it is already clear that many targets will not be reached. Policy makers have been reluctant to start discussions of what comes after the 2015 deadline, fearing that negotiating a new framework would detract from efforts to meet the Millennium Development Goals (MDGs). While there seems to be broad support for a post- 2015 framework, there is not yet agreement on what this could look like. The United Nations and the World Health Organisation have started discussions on the issue, and it appears that sustainable development goals may be the way forward. In a survey of developing countries by the Institute of Development Studies, respondents overwhelmingly agreed that although the MDG framework has shortcomings, it is desirable to have an internationally agreed framework in place. Eighty percent of the respondents agreed that the post- 2015 arrangement should be target based, in part because it allows monitoring of progress.
Researchers in this study systematically collected all available data for malaria mortality for the period 1980–2010, correcting for misclassification bias. They found that global malaria deaths increased from 995,000 in 1980 to a peak of 1,817,000 in 2004, decreasing to 1,238,000 in 2010. In Africa, malaria deaths increased from 493,000 in 1980 to 1,613,000 in 2004, decreasing by about 30% to 1,133,000 in 2010. The researchers estimated more deaths in individuals aged 5 years or older than has been estimated in previous studies: 435,000 deaths in Africa and 89,000 deaths outside of Africa in 2010. In conclusion, the researchers assert that the malaria mortality burden is larger than previously estimated, especially in adults. There has been a rapid decrease in malaria mortality in Africa because of the scaling up of control activities supported by international funders. They argue that external funder support needs to be increased if malaria elimination and eradication and broader health and development goals are to be met.
While attention has focused on the rapid pace of urbanisation as the sole or major factor explaining the proliferation of informal settlements in developing countries, this paper argues that there are other factors that may have an effect. The paper accounts for differences in the prevalence of informal settlements among developing countries using data drawn from the recent global assessment undertaken by the United Nations Human Settlements Programme. The empirical analysis identifies substantial inter-country variations in the incidence of these settlements both within and across the regions of Africa, Asia as well as, Latin America and the Caribbean. Further analysis indicates that higher GDP per capita, greater financial depth and increased investment in infrastructure reduces the incidence of slums. Conversely, external debt burden, inequality in the distribution of income, rapid urban growth and the exclusionary nature of the regulatory framework governing the provision planned residential land directly contribute to the prevalence of informal settlements.
This study aimed to examine the longitudinal contributions of four political and socioeconomic factors to the increase in life expectancy in less developed countries (LDCs) between 1970 and 2004. Researchers collected 35 years of annual data for 119 LDCs on life expectancy at birth and on four key socioeconomic indicators: economy, educational environment, nutritional status and political regime. Results showed that the LDCs' increases in life expectancy over time were associated with all four factors. Political regime had the least influence on increased life expectancy in initial years but increased over time, while the impact of the other socioeconomic factors was initially stronger and decreased over time. Though authors argue that socioeconomic factors have strong impact on life expectancy, but the long-term impact of democracy should not be underestimated.
A number of key challenges to reproductive health in Namibia are identified: high fertility, especially among the poorest people and adolescents; an unmet need for contraception at 21%; women not using modern contraceptives because of health concerns or fear of side effects; and an increase in HIV among adults aged 15–49 years from 4% in 1992 to 20% in 2006. Knowledge of HIV prevention methods was found to be high. Key actions to improve reproductive health outcomes in Namibia were identified in this report as strengthening gender equality; reducing high fertility; highlighting the effectiveness of modern contraceptive methods and properly educating women on the health risks and benefits of such methods; and reducing maternal mortality and the prevalence of STIs/HIV/AIDS.
There are limited means to monitor the occurrence of cancer in developing countries and planning for prevention relies largely on estimates. This paper summarises priorities in cancer prevention in developing countries and the underlying evidence base, and addresses some of the challenges. The author concludes that cancer control calls for interventions that are kept logistically simple, integrated within systems and gradually building the infrastructure to bring care to the population at large. Given serious budgetary constraints, cancer control programmes need to maximise the efficacy of their investments. Of all possible interventions to reduce the cancer burden, the author argues that comprehensive programmes to prevent tobacco smoking are the most cost-effective, so that tobacco prevention should be a priority. Immunisation of infants against hepatitis B virus (HBV) is probably the second most cost-effective option in regions where the infection is still endemic. The author further argues that the uncontrolled use of carcinogens in industrial processes need to be addressed any cancer control programmes.