This paper is part of a series of outputs from the research project on The Politics of Domestic Resource Mobilisation for Social Development. It examines the linkages between resource mobilisation and social outcomes by looking at institutions that play a key role with respect to resource mobilisation and social spending in Uganda. It looks at three institutions—the Uganda Revenue Authority (URA), Kampala Capital City Authority (KCCA) and the Ministry of Health (MoH)—which were selected because they are key organisations in either revenue collection or social service delivery or both, and all three were targets of reforms with varying degrees of success. The paper analyses how these institutions compare with respect to political prioritization, and in particular, to what extent they benefit from key institutional reforms and organizational capacity. The analysis reveals how varying political interests in, and priorities of, public institutions serve to explain differences in the delivery of public services and their organizational capacity. It illustrates the bigger picture that only politically important organizations—those perceived to be key for the political survival of the ruling elite—are well equipped with resources. The findings also stress the point that organizations that tend to perform better do so because they are politically prioritized and offered political protection.
Governance and participation in health
With the recent adoption of a new global development agenda for the next 15 years and negotiations on a new climate regime ongoing, what’s changed for governance of the global economy in the last two decades, and what have we learned? This article maps the shifting context for trade, investment, and sustainable development. It puts global governance efforts into historical context of a globalised economy with lesser attention paid to questions of equity and social inclusion, and an underestimation of persistent and deep-rooted asymmetries in capabilities among countries at different levels of development and perilous levels of inequality among and within most countries around the world. The author suggests that global governance will continue to be a matter of striking the balance between global direction-setting, monitoring the ongoing leadership role of government policy, and supporting the subsidiary implementation of commitments at ground level. The paper points to aligning national policies and ensuring trade and investment systems work for sustainable development rather than funding discrete projects. The author argues that policies, their frameworks and the institutions needed to implement them constitute the most powerful lever for change.
South Africa has continued to face questions about the recent xenophobic violence directed at African immigrants. The issue was raised during a discussion on migration on the side-lines of the 37th Session of the South African Development Community (SADC) Parliamentary Forum meeting at Zimbali north of Durban. Lawmakers, experts and government officials were among those who participated in the discussion on migration. At least seven people were killed and thousands others displaced from their homes during attacks on foreign nationals that started in KwaZulu-Natal in April. Speakers called for the movement of people around the continent - including of South Africans - to be encouraged. The Director of the United Nations African Institute for Economic Development and Planning, Professor Adebayo Olukoshi, argued that African countries need to take a developmental approach to migration policies - in the same way that countries like the US have done. A South African provincial special reference group led by former UN Human Rights Chief Navi Pillay is looking into the causes of xenophobic violence and what should be done to prevent it from re-emerging. The group is expected to conclude its work in October.
The author argues that the report on the WHO’s Ebola response fails to adequately address the problems in global health governance it exposed. The Ebola outbreak was a disaster for the International Health Regulations (IHR)—the main international legal rules supporting global health security. The outbreak highlighted dismal compliance with IHR obligations on building national core public health capacities. During the outbreak, WHO failed to exercise authority it has under the IHR. Many WHO member states violated the IHR by implementing travel measures more restrictive than WHO recommended under the IHR and that lacked scientific and public health rationales as the IHR requires. The final report of the Ebola Interim Assessment Panel asserted that ‘the global community does not take seriously’ its IHR obligations. However the panel’s IHR recommendations are argued by the author to be largely recycled old, ineffective ideas and to reflect weak analysis of the outbreak, difficulties the IHR experienced before Ebola, and challenges confronting IHR reform after this crisis.
The author argues that responses to the recent outbreak of Ebola in West Africa were varied and many ineffective. More generally, the author suggests that it stems from a failure of international health justice as articulated by a range of legal institutions and instruments, and that it should prompt us to question the state and direction of approaches to the governance of global public health. This paper queries what might be done to lift global public health as a policy arena to the place of prominence that it deserves. It presents critical reasons for the failings of the global public health regime, including the marginalisation of health and equity in current economic individualist, monetised, market-focussed models and goals, and a fragmented, patchwork and ad hoc nature of the global public health architecture, with wide dispersion of the authority to act and a treatment-oriented and disease-specific focus. The paper articulates a new way forward, identifying three courses of action that might be adopted in realising better health outcomes and global health justice, namely value, institutional and legal reform.
This report of the assessment panel which the WHO commissioned on its response to the Ebola outbreak was meant to review the roles and responsibilities at the three levels of the organization (headquarters, regions, countries) and the WHO’s actions in the course of the outbreak. The report and recommendations fall under the following three headings: the International Health Regulations (2005); WHO’s health emergency response capacity; and WHO’s role and cooperation with the wider health and humanitarian systems. It found Member States have largely failed to implement the core capacities, particularly under surveillance and data collection, which are required under the International Health Regulations (2005); in violation of the Regulations, nearly a quarter of WHO’s Member States instituted travel bans and other additional measures not called for by WHO, which significantly interfered with international travel, causing negative political, economic and social consequences for the affected countries; and significant and unjustifiable delays occurred in the declaration of a Public Health Emergency of International Concern (PHEIC) by WHO. The Panel concluded that WHO be the lead health emergency response agency but that this requires that a number of organizational and financial issues be addressed urgently. The Panel considered that during the Ebola crisis, the engagement of the wider humanitarian system came very
late in the response.
'Enhancing Regional Disaster Preparedness and Response' was the theme of the first extra-ordinary Meeting of Ministers Responsible for Disaster Risk Management and Ministers of Finance, held on June 26, 2015 in Harare, Zimbabwe. The SADC Region is exposed to a wide range of hazards and disasters that frequently result in heavy loss of lives and livelihoods, displacement of large populations, disruption of economic activities, destruction of assets and loss of investment. The Hazards that affect the Region include floods, drought, snow, volcanic eruption landslides, tsunamis, tropical cyclones, storms, wild fires and earthquakes. These hazards increase the risk of shortages of water, outbreaks of diseases such as Malaria, cholera and other diarrhoeal diseases, malnutrition and stunted growth, foot and mouth diseases in animals and other negative impacts. The meeting was organised by the SADC Secretariat specifically by the Disaster Risk Reduction Unit under the auspices of the Directorate of the Organ on Politics, Defence and Security Affairs in collaboration with the Government of Zimbabwe. The Ministers directed the SADC Secretariat to develop a comprehensive regional disaster risk reduction strategy which should include regional response mechanisms and a humanitarian assistance framework. They also agreed to the establishment of a regional disaster preparedness and response fund and development of an integrated early warning system to ensure effective information dissemination on hazards faced by the region.
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. It drew renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? This paper describes some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed but their common goal is a more sustainable and resilient society for human health and wellbeing.
In the area of health, the Southern African Development Community (SADC) has conducted important work in understanding how poor health and poverty coincide, are mutually reinforcing, and socially-structured by gender, age, class, ethnicity and location, demonstrated by the key health policy documents that have been facilitated by the secretariat. Yet the time lapse between the formulation of guidelines and policies and their implementation has at times been uneven. This brief describes the Poverty Reduction and Regional Integration indicator-based monitoring system addressing health priorities for the region, under the institutional leadership of the SADC secretariat and with the support from its Member States that are the main beneficiaries of the process.
In this paper, the authors analyse regional to national-level data flows with the use of two case studies focusing on UNASUR (Bolivia and Paraguay) and SADC (Swaziland and Zambia). Special attention is given to pro-poor health policies, those health policies that contribute to the reduction of poverty and inequities. The results demonstrate that health data is shared at various levels. This takes place to a greater extent at the global-country and regional-country levels, and to a lesser extent at the regional-global levels. There is potential for greater interaction between the global and regional levels, considering the expertise and involvement of UNASUR and SADC in health. Information flows between regional and national bodies are limited and the quality and reliability of this data is constrained by individual Member States’ information systems. Having greater access to better data would greatly support Member States’ focus on addressing the social determinants of health and reducing poverty in their countries. This has important implications not only for countries but to inform regional policy development in other areas. By serving as a foundation for building indicator-based monitoring tools, improving health information systems at both regional and national levels can generate better informed policies that address poverty and access to health.