This article evaluates progress in implementing the United Nation’s Global Strategy on Women and Children’s Health since it was released in September 2010. The Commission on Information and Accountability for Women’s and Children’s Health was created in December 2010 to oversee the implementation of the Global Strategy. Since then it has met with stakeholders twice and developed a strategic plan of action. Feedback from those meetings indicate that developing countries – in particular, African countries – face major obstacles in gathering birth and maternal mortality data. The future of the Commission remains uncertain, however, with stakeholders expressing skepticism about whether or not external funders will meet their commitments. In order to succeed in reducing maternal mortality, a combination of interventions is needed, including education on reproductive health issues; access to effective birth control and safe abortion; universal prenatal care; diagnosis and referral of high-risk pregnancies; a high percentage of births overseen by skilled attendants; and safe motherhood protocols for managing normal and high-risk births. However, reaching a consensus on which interventions should be funded is complicated, the article concludes, given the sensitive nature of maternal health issues, specifically family planning and safe abortion, which are opposed by conservatives.
Governance and participation in health
Civicus argue that the Southern African Development Community (SADC) region is experiencing a major backslide in democratic freedoms. Recent restrictions on civil society in the region, whether through regressive laws, policies or vigorous persecution of activists, are argued to fly in face of the SADC treaty which calls upon its 14 members to uphold human rights and the rule of law and promote common political values through democratic, legitimate and effective institutions. The article cites examples from countries in the region, including from Zimbabwe, Malawi, Swaziland, Angola, DRC and South Africa.
According to CIVICUS, in 2011, the existing institutions of global governance failed to provide people-centred responses to the current global economic, social, political and environmental crises. Too often in key multilateral meetings and processes, the narrow national interests of states prevailed. The Durban climate change summit of 2011 (COP17) fell short of the decisive action required, as did the 2011 G20 meeting of the world’s most powerful economies. On the positive side was the launch of the new United Nations body, UN Women, as well as the Busan High-Level Forum on Aid Effectiveness, and many of the stances adopted by the UN Human Rights Council in Geneva, particularly during the Universal Periodic Review, its peer-reviewed assessment of human rights in UN member states. In Busan and in Geneva, the space guaranteed to civil society enhanced the credibility and quality of the process, and these procedures should be regarded as minimal standards that should be extended to other arenas. A predicament for both states and civil society alike is the fact that disconnected summits purport to address intertwined issues such as economic growth, development effectiveness, climate change and human rights in silos. Civil society organisations must combine to advocate for a multilateral system that has the reach and ambition to tackle connected challenges and the imagination to put global interests first.
In December 2011, the Global Health Security Initiative (GHSI) celebrated its 10th anniversary with a ministerial meeting in Paris, France. This article chronicles the achievements of the Initiative in global health security, namely the development of globally common methods for the assessment of global health threats and risks, such as the H1N1 flu virus, and the mainstreaming of a multidisciplinary approach on health security. The Initiative has been involved in: setting up information-sharing networks, such as a contact emergency network for communication among health officials; the establishment of general guidelines for risk communications; the design of a ‘risk incident scale’ for global health emergencies; and the development of evidence-based research for policy making related to human decontamination. Although the Initiative is limited to only the eight countries, the network is working with the World Health Organisation to share the best practices with the broader global health community.
The aim of this paper is to support all stakeholders who are developing or researching universal health care (UHC) reforms and who wish to conduct stakeholder analysis to support evidence-informed pro-poor health policy development. It presents practical lessons and ideas drawn from experience conducting stakeholder analysis around UHC reforms in South Africa and Tanzania, revealing that differences in context and in reform proposals generate differences in the particular interests of stakeholders and their likely positioning on reform proposals, as well as in their relative balance of power. It is, therefore, difficult to draw cross-national policy comparisons around these specific issues, the authors caution. Nonetheless, they argue that cross-national policy learning is possible with regard to choosing approaches to policy analysis and management of policy processes, but stakeholders should avoid generalisations when comparing UHC reform packages and should rather focus on how to manage the reform process within a particular context. The authors emphasise that stakeholder analyses can be used both to think through the political viability of new policy proposals and to develop broader political management strategies to support policy change.
In response to the announcement that World Bank President Robert Zoellick will step down at the end of his term on 30 June 2012, a global coalition of campaigners has called for an open and merit-based process to elect the next World Bank leader, and for developing countries to determine the selection. The campaigners, including many major development organisations, have also asked the United States to announce that it will no longer seek to monopolise the Presidential position. A “gentlemen’s agreement” between Europe and the US dating back to World War II has so far ensured that the President of the World Bank is always an American, and the International Monetary Fund’s Managing Director is European. In this open letter, the campaigners demand that the new President is selected by a majority of World Bank member countries, not just a majority of voting shares, as most members are low- and middle-income countries. They also demand that the selection process be opened to anyone to apply, with interviews held in public and with open voting procedures. A clear job description and necessary qualifications should be set out, requiring candidates to have a strong understanding and experience of the particular problems facing developing countries.
China’s growing involvement in countries where peace is fragile brings new responsibilities and policy choices for Beijing, as well as a new reality for Western funders and policy makers, according to this brief. This increased involvement brings risks and opportunities for peace and stability in conflict-affected states, SAFERWORLD argues. The brief summarises the impacts of China’s growing economic, diplomatic and military engagement in conflict-affected states and analyses the implications for peacebuilding. The briefing also offers recommendations for policy makers in China and the West focused on fostering a culture of dialogue, bridging the current policy gap regarding conflict-affected states, and creating an enabling international architecture. A key conclusion is that as Beijing’s approach towards conflict-affected countries evolves, there is an unprecedented opportunity for China and the West to develop more complementary approaches in support of peace and equitable development.
In this article, the author analyses China’s trade and diplomatic relations with Africa in terms of Joseph Nye’s concept of soft power. He argues that examining China's Africa Policy, there is a motivation to change cultural perceptions about China and to influence agenda's through co-option rather than economic or military coercion. Although Chinese leaders often refer to the importance of its soft power in the world, China's policy for engagement with African countries does not mention soft power directly. Instead, it speaks in very general terms of mutual cooperation and win-win strategies. The author argues that China’s well-disguised soft power approach is not very different from the soft power component of US foreign policy.
The Fourth High Level Forum on Aid Effectiveness, held in Busan, South Korea in November 2011 again promised an opportunity for a new consensus on development cooperation to emerge. This paper reviews the recent evolution of the concept of coordination for development assistance in health as the basis from which to understand current discourses. Four distinct transitions in the understanding, orientation and application of coordination were identified: coordination within the sector, involving geographical zoning, sub-sector specialisation, external funder (donor) consortia, project co-financing, sector aid, harmonisation of procedures, ear-marked budgetary support, external funding agency reform and inter-agency intelligence gathering; sector-wide coordination, expressed particularly through the Sector-Wide Approach; coordination across sectors at national level, expressed in the evolution of Poverty Strategy Reduction Papers and the national monitoring of the Millennium Development Goals; and, most recently, global-level coordination, embodied in the Paris Principles, and the emergence of agencies such as the International Health Partnerships Plus. The transitions are largely but not strictly chronological, and each draws on earlier elements, in ways that are redefined in the new context. With the increasing complexity of both the territory of global health and its governance, and increasing stakeholders and networks, current imaginings of coordination are again being challenged. The High Level Forum in Busan may have been successful in recognising a much more complex landscape for development than previously conceived, but the challenges to coordination remain.
On 9 February 2012, 16 prominent human rights activists were arrested in Dar es Salaam, Tanzania, on the grounds of unlawful assembly. The human rights defenders, who included the executive directors of the Legal and Human Rights Centre and the Tanzania Media Women's Association, were arrested at the Muhimbili National Hospital following a doctor’s strike that had paralysed the provision of health services. The police authorities allege the small group had gathered illegally and were intending to hold an illegal demonstration, although the group maintains that they were not there to protest but to observe the dialogue between the government and health officials. The activists were detained and then later released on bail, pending confirmation of charges. The question is, did the 16 activists cause a breach of the peace, or prejudice public safety and the maintenance of public order? Crucially, were the police, by prohibiting the alleged assembly and subsequently arresting the activists, using their discretion appropriately? The authors’ answer is “No”. A public assembly held to observe (or allegedly protest) negotiations about health sector issues is unlikely to breach public order or public safety. The authors call on the Tanzanian government and police to use their discretion to limit public assemblies wisely and ensure that public assemblies called for a political purpose, which are a common and indeed vital aspect of a healthy democracy, are not arbitrarily restricted or prohibited.