In this statement, a group of international civil society organisations welcomes the appointment by the UN Secretary-General of a diverse High-level Panel to advise on a post-2015 development agenda. However, the statement also expresses concern the Panel does not include the voices of people living in poverty, and their representative associations. The current composition of the Panel is largely state-centric with insufficient civil society representation, the organisations argue, and the Panel should include people from women's associations, farmers cooperatives, indigenous groups, workers or organisations of the impoverished. They highlight the fact that such voices must be represented as part of any effort to tackle poverty and in building a just, equitable and sustainable world.
Governance and participation in health
This review investigated international cooperation in health, particularly between developed and developing nations. Standard database and web-based searches were conducted for publications in English between 1990 and 2010, from which 65 articles were included in the final analysis. While some articles identified intangible benefits accrued by developed country partners, most pointed to developing country innovations that can potentially inform health systems in developed countries. Ten key health areas in which developing countries led the way were identified, such as rural health service delivery, skills substitution, decentralisation of management, creative problem-solving and innovation in mobile phone use, and health financing. The authors argue that combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is still basic and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardised method for reporting partnership benefits is needed for realising the full potential of international cooperation between developed and developing countries.
In 2008, South Africa’s National Tuberculosis Programme (NTP) implemented a community mobilisation programme in all nine provinces to trace TB patients that had missed a treatment or clinic visit. The objective of this study was to assess the impact of the NTP’s TB Tracer Project on treatment outcomes among TB patients. The study population included all smear positive TB patients registered in the Electronic TB Registry from Quarter 1 2007-Quarter 1 2009 in South Africa. Results for all provinces combined suggested that, in tracer districts, fewer patients defaulted on their treatment and there was an increase in successful treatment outcomes. However, the results were not consistent across all provinces, and significant differences in treatment default were observed between tracer and non-tracer sub-districts over time in five of nine provinces. The authors conclude that community mobilisation of teams to trace TB patients that missed a clinic appointment or treatment dose may be an effective strategy to mitigate default rates and improve treatment outcomes. Additional research is called for to identify best practices and elucidate discrepancies across provinces.
While the official Rio+20 outcome from June 2012 was a disappointment, a smaller side event saw the initiation of a host of Peoples’ Sustainability Treaties, dealing with a range of issues and actions, starting from the very local, going all the way up to the global level. Peoples’ Sustainability Treaties are aimed at coalescing the thinking of civil society organisations in the direction of a strong social movement towards an alternative and desirable future. A network of Treaties is being created, with each Treaty being driven by a collaboration of partners, and with all the Treaty circles being linked together through a loose coalition structure. By the time Rio+20 commenced, 14 Treaties were already established and from these a common Manifesto emerged, which contained an action plan identifying the issues of equity and sustainability for all as the foundation of any collective global response. Localising our economic systems, decentralising governance, and advancing sustainable lifestyles and livelihoods are promoted in the Manifesto. Localism was a major theme emerging from stakeholders, linked to the principles of devolution and decentralisation, and they argued in favour of turning localism into a world-wide movement.
This brief provides a summary of the events from mid June until mid July at the Peoples Health Assembly in Cape Town.
More than one thousand activists, academics and students from over 60 different countries gathered at the historic University of Western Cape for the third global assembly (PHA3). Walter Flores Gutaemala provided his insights on the Assembly in this opnion piece. He noted that the best plenary took place on the last day. Prof. Jaime Breilh from Ecuador gave a devastating account of how current public health programs and goals, such as the ones addressing nutrition and food security, are lagging so far behind of the ongoing acceleration of accumulation of capital that is destroying and contaminating water and food sources around the world. Large-scale land grabbing in the southern continents by large corporations is making the goal of food sovereignty implausible. The assembly concluded with a call for action that did not satisfy all participants. Clearly, some people wanted more concrete actions and less rhetoric. He comments that although a “call for action” is important, it does not mobilize people on its own, and notes that a clear goal and a path for action, combined with collective indignity and solidarity makes us move.
With evolving South African legislation supporting community involvement in the health system, early policy developments focused on Community Health Committees (HCs) as the principal institutions of community participation. Formally recognized in the National Health Act, the Act deferred to provincial governments in establishing the specific roles and functions of HCs. As a result, stakeholders developed a Draft Policy Framework for Community Participation in Health (Draft Policy) to formalize participatory institutions in the Western Cape province. With the Draft Policy as a frame of analysis, the researchers conducted documentary policy analysis and semi-structured interviews on the evolution of community participation policy. Moving beyond the specific and unique circumstances of the Western Cape, this study analyzes generalizable themes for community participation in the health system. Framing institutions for the establishment, appointment, and functioning of community participation, the Draft Policy proposed a formal network of communication – from local HCs to the health system. However, this participation structure has struggled to establish itself and function effectively as a result of limitations in community representation, administrative support, capacity building, and policy commitment. Without legislative support for community participation, the enactment of superseding legislation is likely to bring an end to HC structures in the Western Cape. The authors conclude that attempts to realize community participation have not adequately addressed the underlying factors crucial to promoting effective participation, with policy reforms necessary: to codify clearly defined roles and functions of community representation, to outline how communities engage with government through effective and accountable channels for participation, and to ensure extensive training and capacity building of community representatives. Given the public health importance of structured and effective policies for community participation, and the normative importance of participation in realizing a rights-based approach to health, this analysis informs researchers on the challenges to institutionalizing participation in health systems policy and provides practitioners with a research base to frame future policy reforms.
After two years of participatory engagement and planning, the People’s Health Movement gathered 800 people from 90 countries for the 3rd People’s Health Assembly. The Assembly strengthened and deepened solidarity; expressed outrage at the continuing global health crises that are embedded in myriad structural and socio-political inequities; developed principles for alternative economic, political and social orders; and re-committed delegates to work towards the world envisioned by the movement. The Assembly reaffirmed commitment to the People’s Charter for Health and the Cuenca Declaration which are the foundational documents to the Call to Action drafted at the Assembly reported here. The Call to Action guides the movements work until the fourth People’s Health Assembly is held.
PlusNews reports that at least a hundred protesters arrived at South Africa's parliament on 11 July 2012 to demonstrate their disapproval of the ongoing court case by Swiss pharmaceutical company Novartis against the Indian government over its patent laws. As the case draws to a close, health organizations say a win for the pharmaceutical company will be a loss to the developing world, which sources the bulk of its generic medicines from India. Novartis approached the Indian government six years ago, seeking to register a cancer drug already commonly marketed under the name Gleevec. The patent was denied and a long-running court battle ensued, but at each step Indian courts have ruled against Novartis and the company has appealed. India has laws against “evergreening”, a term used to describe instances where drug companies maintain artificially high prices on medicines for longer by continually extending patent protection for minor modifications to existing drugs. India's Supreme Court is expected to hand down the judgment that will draw the legal saga to a close on 22 August. This could not only limit the country's ability to produce generics, but also set a precedent in other countries - like South Africa - looking to revamp patent laws.
Studies in rural and urban development since the 1970s have found high correlations between project performance and levels of community participation in many Third world countries. Relevant examples of such
correlation include the agricultural extension services in Kenya, the control of infectious diseases in Israel and the rural water supply and irrigation projects in Asia Region. This paper examines the major
limitations in participatory health development in Nigeria. The author finds that even though most of the assertions in literature about the health behaviour of the rural dwellers in community-based health programmes are upheld, there are exceptions. For example the
health behaviour of people in traditional societies is found to always be an economic rational one. This is in contradistinction to the view in most literature that posits that the health behaviour of the traditional people is almost always determined by socio-cultural and magico-religious considerations.