In this assessment of the World Social Forum (WSF), which took place in Dakar, Senegal, from 6–11 February 2011, the author highlights an important trend in global activism: activists arrived already well prepared and networked among them and with local partners and with a key concern about further strengthening regional and global alliances on shared issues. Those convergences, at the heart of WSF’s mission, proved exceedingly successful, beyond activists’ expectations even, and for some seem to indicate a clear trend towards consolidation of struggles at the global level. The convergence of the Assembly of Social Movements, a regular event at the forums since the first edition, saw the participation of thousands of activists from all around the world. The success of the assemblies moved in the direction of addressing some of the long standing concerns of some WSF organisers and critics, namely the fragmentation of the programme and the atomisation of the different strands of global activism with the perceived outcome of weakening the resistance against neoliberalism and reducing the impact of imaginations and practices aimed at building a new, more equitable world.
Governance and participation in health
Innovation in biomedicine is a global enterprise in which 'Rising Power' states (emerging states) figure prominently, and which undoubtedly will re-shape health systems and health economies globally, the authors of this paper argue. Against this background, they present an overview of a range of approaches that have potential for advancing understanding of governance of global life science and biomedical innovation, with special reference to the 'Rising Powers'. The authors’ analysis indicates significant convergences and complementarities between the approaches discussed, concluding that the role of the national state itself has become relatively neglected in much of the relevant literature. They call for a new approach that enables innovation and governance to be seen as 'co-producing' each other in a multi-level, global ecology of innovation, taking account of the particular, differing characteristics of different emerging scientific fields and technologies.
In this article, the author examines the potential role of health information technology (IT) in addressing healthcare disparities among racial and ethnic minority populations. The author’s overview of health IT utilisation among healthcare providers reveals that use of health IT among racial and ethnic minorities carries significant promise and potential. Yet realising the potential will not come without surmounting several significant technical, practical and human challenges. In order to measure success or failure, he argues for ongoing surveillance and monitoring of progress at a national level. However, because of the great diversity in the types of technologies, types of users, and settings in which health IT may be employed, obtaining accurate estimates of adoption and utilisation will be a significant challenge. In addition, the development of the ‘meaningful use’ criteria and the linking of meaningful use to provider reimbursement will help, the author adds. As patients become more involved in accessing, managing, and using their health information, a need to develop ‘meaningful patient use’ criteria may arise, he predicts, which will help refine systems.
The authors of this study conducted a print media analysis in 44 countries in Africa, the Americas, Asia and the Eastern Mediterranean to find out whether and how policymakers, stakeholders, and researchers talk in the media about three topics: policy priorities in the health sector, health research evidence, and policy dialogues regarding health issues. In their literature review, the authors identified approximately five times more articles describing health research evidence compared to the number of articles describing policy priorities. Few articles describing health research evidence discussed systematic reviews (2%) or health systems research (2%), and few of the policy dialogue articles discussed researcher involvement (9%). News coverage of these concepts was highly concentrated in several countries like China and Uganda, while few articles were found for many other jurisdictions. The authors conclude that, in many countries of the countries reviewed, the print media (as captured in a global database) are largely silent about these three topics central to evidence-informed health systems. These findings suggest the need for proactive-media engagement strategies.
Developing countries have highlighted a number of concerns over the reform agenda of ‘The Future of Financing for WHO’, which was unveiled by the Director-General of the World Health Organization (WHO) at the 128th session of the organization's Executive Board held from 17-25 January. Several developing countries pointed out that health cannot be de-linked from socio-economic development, and voiced strong support for the WHO's role in development and its leadership on global health issues. There was also a call for a transparent process to discuss the reform. While the reform agenda was initially instigated by the need to ensure more predictable and sustainable financing for WHO, proposals for reform that are contained in Director-General Margaret Chan's report suggest a more far-reaching agenda that could lead to significant changes in the role of WHO on matters of public health at the global level. In depating the proposals representatives of several low and middle income countries pointed out that health cannot be de-linked from socio-economic development and WHO cannot be reduced to being a mere technical agency. They also expressed strong support for WHO's role in development and its leadership in global health issues. Civil society groups, including the People’s Health Movement cautioned that public health should not take a back seat to market-led initiatives. Mozambique, on behalf of the African group, stated that reform of the organisation should maintain WHO's leadership position in international health, adding that any debate on financial aspects deserves a wider discussion.
The African Peer Review Mechanism (APRM), a tool designed to promote good governance on the continent, is built on the belief that the continent does not lack ideas to advance its development, but that states have struggled to live up to their principles and implement their policies. The APRM rests on the fundamental belief that good governance is a precondition for taking Africa out of its spiral of conflict, underdevelopment, poverty and increasing marginalisation in a globalised world. Looking back almost a decade after the APRM was first conceived, Grappling with Governance explores how this complex process has evolved from theory to practice in a variety of contexts. In a combination of case studies and transversal analysis, multiple voices from different African civil society actors - mainly analysts, activists and journalists - examine the process from their specialised perspective. The chapters tease out what can be learned about governance in Africa from these experiences, and the extent to which the APRM has changed the way that governments and civil society groups engage. This book demonstrates that undergoing review through the APRM can be messy, haphazard and full of reversals. Like any tool, the APRM’s effectiveness depends on the suitability of its design for the task at hand, the situation in which it is used, and the skill of its user. The different authors reflect on these characteristics as users of this tool. While it is ill-advised to draw universal conclusions, this book nevertheless demonstrates that the APRM has added value, sometimes in unexpected ways.
With the current World Health Organization (WHO) Director-General’s term of office ending in June 2012, WHO members have set up a drafting group to try to reconcile divergent views on the process leading to the election. At the WHO Executive Board meeting, which ran from 17-25 January 2011, some countries were in favour of geographical rotation, citing over 60 years of no representation from their regions, while others objected that rotation should not override more important selection criteria such as expertise and experience, as it could endanger the organisation’s future. A draft resolution on the rules of procedure for the appointment of the WHO Director-General (DG) was proposed by Burundi on behalf of the member states of the African region, asking for the Executive Board to approve the principle of geographical rotation of the post of DG among the six regions of WHO, namely Africa, the Americas, South-East Asia, Europe, the Eastern Mediterranean and the Western Pacific. In this draft resolution, Burundi stressed the need for further strengthening of guarantees of transparency and equity among the six geographical regions of the WHO in the process of nominating and appointing the DG. The proposed document stirred a debate that some countries said has been on the table since 2006.
Civil society activists say Uganda's presidential candidates have not placed sufficient emphasis on how they plan to tackle the HIV and AIDS epidemic should they come into office, despite rising HIV prevalence and major funding problems. Critics maintain there is not enough focus on HIV and AIDs in the election, with candidates’ manifestos mostly making general statements on health. Local civil society activists have lobbied all major political parties to commit to a ‘ten-point platform’ to fight HIV and AIDS, which includes commitments to fully fund the fight against HIV, increase the number of health workers and end corruption in the health sector.
In this article, some of the factors that contribute to poor performance in achieving population health goals are examined, such as lack of shared responsibility for outcomes, lack of co-operation and collaboration, and limited understanding of what works. It also considers challenges to engaging stakeholders at multiple levels in building collaborative partnerships for population health. It outlines twelve key processes for effecting change and improvement, such as analysing information, establishing a vision and mission, using strategic and action plans, developing effective leadership, documenting progress and using feedback, and making outcomes matter. The article concludes with recommendations for strengthening collaborative partnerships for population health and health equity. These include establishing monitoring and evaluation systems, developing action plans that assign responsibility for changing communities and systems, facilitating natural reinforcement for people working together across sectors and ensuring adequate funding for collaborative efforts. Governments should also provide training and technical support for partnerships, establish participatory evaluation systems and arrange group contingencies to ensure accountability for progress and improvement.
This book articulates a vision of women and men in communities everywhere who are equipped with education, enjoy good health, have rights, dignity and a voice – and are in charge of their own destinies. What is required to achieve that is nothing less than a global new deal – a redistribution of power, opportunities, and assets. The report considers the alternative of a world of ever-deepening gulfs between the ‘haves’ and the ‘have-nots’ as unsustainable. Based on its experience in more than 100 countries around the world, Oxfam argues that the necessary redistribution can best be accomplished through a combination of active citizens and effective nation states. Markets alone cannot meet the challenges of poverty, inequality and environmental degradation. Effective states and active citizens must ensure the market delivers growth that benefits poor people. An economics for the twenty-first century is needed that provides tools to enable countries to achieve growth that is environmentally sustainable. This new economics will recognise the importance of unpaid work, predominantly by women and target poverty and inequality. It discusses case studies, including the Treatment Action Campaign in South Africa.