Governance and participation in health

Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4%. Social cohesion was associated with consistent condom use in the past week and with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing and using condoms with non-paying partners and was inversely associated with reported verbal or physical harassment as a result of selling sex. Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

As public health professionals devoted to global health equity, the authors express our deep concern with the The Lancet Commission Global health 2035: a world converging within a generation (Dec 7, p 1898),1 a re-run of the 1993 World Development Report, whose policies contributed to the shrinkage of government institutions and massive privatisation and fragmentation of health-care systems, effectively decreasing coverage and accessibility. The authors observe that its recommendations are based on the principle of return on investment, not on health equity, while creating a double standard: one for the rich and another for the rest of us. Any policy for the poor is by definition a poor policy. The Lancet Commission's recommendations are argued to not represent the global health community and are fundamentally flawed by neglecting the principle of the right to health. The report analyses Millennium Development Goals progress without reference to stagnant levels of health inequity: 20 million deaths each year, more than a third of all deaths, are avoidable and caused by socio-economic injustice—a number and a proportion that have not changed for the past 40 years. Every individual, organisation, or government working to promote heath equity and WHO's objective of enjoyment by all peoples of the best attainable level of health should be on their guard.

Their ubiquity in South Africa makes cellphones an easily accessible tool to use in participatory approaches to addressing HIV and AIDS issues, particularly in school contexts. In this article the authors explore a participatory visual approach undertaken with a group of rural teachers, using cellphones to produce 'cellphilms' about youth and risk in the context of HIV and AIDS. Noting that the teachers brought highly didactic and moralistic tones into the cellphilms, the authors devised a “speaking back” approach to encourage reflection and an adjustment to their approaches when addressing HIV and AIDS issues with learners. They draw on the example of condom use in one cellphilm to demonstrate how a “speaking back” pedagogy can encourage reflection and participatory analysis, and contribute to deepening an understanding of how teachers might work with youth and risk in the context of HIV and AIDS.

Civil society groups have expressed disappointment with the number of "industry groupings" that have "incorrectly gained NGO status" with the World Health Organization (WHO). There are 187 organizations or networks recognized as NGOs in official relations with the WHO. According to the International Baby Food Action Network (IBFAN), a new entrant into this WHO list of NGOs, industry groups which have been recognized as NGOs by WHO include Croplife International (representing Monsanto, Syngenta, Bayer, CropScience, Dow Agrosciences, DuPont and other companies promoting GMO technologies ) the International Federation of Pharmaceutical Manufactures and Associations, International Life Sciences Institute (representing Nestle, Coca Cola, Kellogg, Pepsi, Monsanto, Ajinomoto, Danone, General Mills and others) and the Industry Council for Development (representing Nestle, Mars, Unilever and Ajinomoto). "All are guided by market profit-making logic (whose primary interest clashes with that of WHO). Their inclusion goes against WHO's current NGO policy," said a statement issued by IBFAN.