Against the backdrop of the World Summit on Sustainable Development (WSSD) in Johannesburg, South Africa, over 70 African AIDS activists from 21 countries met in Cape Town from 22-24 August to inaugurate the Pan-African HIV/AIDS Treatment Access Movement (PHATAM). PHATAM's co-founders are two of the world's leading AIDS activists, Zackie Achmat of the Treatment Action Campaign (TAC) in South Africa and Milly Katana, lobbying and advocacy officer of the Health Rights Action Group in Uganda and member of Board of the Global Fund to Fight AIDS, TB, and Malaria. PHATAM is dedicated to mobilising communities, political leaders, and all sectors of society to ensure access to antiretroviral (ARV) treatment, as a fundamental part of comprehensive care for all people with HIV/AIDS in Africa.
Governance and participation in health
I Rusike, R Loewenson, CWGH, TARSC.
Equity in health is a long stated policy goal in Southern Africa, and some significant advances were made often through joint and complimentary action between the public health sector and communities. However, the health and health care gap between communities is still wide or widening, with differences based on gender, geographical area, income, access to public or private services, education and other factors. More recently,the combined impact of AIDS, structural adjustment, and real reductions in the health budget and in household incomes, has reversed many health gains. The quality of health care has declined and health workers and their clients have become demoralised. While these issues demand technical responses, reversing inequities depends in the main on social and political factors. This goes beyond the fact that social networking is important for service outreach and health seeking behaviour, and that social exclusion as a dimension of deprivation or poverty affects health outcomes. What we argue is that unless people affected by ill health have greater control over the resources needed for health care or to be healthy, equity goals will remain a dream. Equity without this socio-political dimension is not equity.
This was an NGO/CSO Regional Consultation on Governance in Africa, published in 1997. UNDP and ECA shared responsibility under the UNSSIA for improving coordination in the areas of capacity building, peace-building, conflict resolution and national reconciliation, and strengthening civil society for development, all linked to the governance agenda. Effective good governance and sustainable development is predicated on efficient public sector management systems and practices; establishment of appropriate legal frameworks that guarantee the rule of law; instalment of systems that ensure both economic and financial accountability; and ensure transparency. The consultation noted both the state and non-state sectors must reach a consensus on a common definition, priority agenda and practical modalities for popular participation in governance. It also noted that defining the nexus between popular participation, governance, peace, and development must invariably include the collaborative initiatives of various actors including ECA, UNDP, and the OAU on one hand and representative African governments, African NGOs and other civic organizations in the continent.
Swaziland's mayors are adopting a novel method in the fight against HIV/AIDS. They are reversing the usual top-down approach and are being led instead by their constituents, ordinary Swazis. "The voice of the people will determine how we will combat AIDS in the towns," explained chairman of the Ezulwini town board, Nokuthula Mthembu. The first woman to hold the top government post in her municipality, Mthembu is chair of the Executive Council of the Alliance of Mayors' Initiative for Community Action on AIDS at the Local Level (AMICAALL). "There has never been a project like this one," Mthembu told PlusNews. "But we absolutely must have an innovative approach to combat the deadly disease that is attacking our municipalities. We desperately need fresh ideas."
The Global Initiative on AIDS, Inc. and the Global Initiative on AIDS in Africa is calling on African journalists, writers, physicians, scientists, researchers, health care providers, grassroots activists and citizens in general who are involved on every level of the struggle against HIV/AIDS in African and throughout the Diaspora to submit articles, issues, opinions, research findings, and news about HIV/AIDS related matters. GIAA will publish "The Voice of the People," An International Journal Chronicling the Battle Against HIV/AIDS from the Perspective of Africans, African-Americans, African-Carribeans and Africans Around the World. Anyone interested in submitting articles and/or contributing to this effort should contact Angele Kwemo or Patricia Okolo.
Narayan, Deepa and Patti Petesch, 2002. Voices of the Poor: From Many Lands. New York, N.Y: Published for the World Bank, Oxford University Press. "From Many Lands," the third and last volume of the Voices of the Poor series, presents 14 country case studies in Africa (Ghana, Malawi, Nigeria), South and East Asia (Bangladesh, India, Indonesia), Europe and Central Asia (Bosnia, Bulgaria, Kyrgyz Republic, Russia), and Latin America and the Caribbean (Argentina, Brazil, Ecuador, Jamaica). Using participatory and qualitative research methods, the study presents the realities of poor people's lives directly through their own voices, with a concluding chapter on an empowering approach to development.
25 April 2002 | Geneva | To meet the 2010 target of cutting malaria deaths in half - agreed in Abuja by African leaders on this day two years ago - community mobilization is essential in controlling the disease and providing prompt access to treatment. Powerful new combination therapies, including the Chinese herb derivative artemisinin, are highly effective against malaria and the parasite does not easily develop resistance to them. New financial arrangements are needed so that developing countries can make use of these medicines, which are much more expensive than conventional, increasingly ineffective ones.
The Third Forum of the World Alliance of Cities against Poverty (WACAP) held in Huy, Belgium, from 10-12 April, provided an opportunity for representatives to develop partnerships. Participants from 96 countries shared experiences on how they are becoming increasingly involved in addressing the impact of HIV/AIDS, particularly on women. The Alliance of Mayors Initiative for Community Action on AIDS (AMICAALL), set up with support from UNAIDS to help translate the goals of the IPAA into concrete actions, is multisectoral and emphasises partnerships between local government, civil society, including the private sector and communities, mayors and municipal leaders in Africa. Through their strategy they are working through exiting cities' networks as well as with other partners and networks to ensure that HIV/AIDS is integrated into municipal agendas. For more information please contact Mina Mauerstein-Bail.
With the support of the Robert Wood Johnson Foundation, Health Services Research (HSR) is planning a special issue focusing on the social determinants of health, to provide a forum for presenting the latest research and policy analysis to a broad audience of researchers, practitioners, and policymakers. There is ample evidence that most health policymakers, both at state and federal levels, do not understand how policy relating to non-medical determinants of health can be incorporated into health policy. Conversely, policymakers in such fields as education, transportation, or housing rarely see that there are major health implications to the choices that they make. Education is needed in both directions. Topics of interest include but are not limited to social inequalities in health by socioeconomic position, race/ethnicity, gender, etc.; the role of a broad range of psychosocial factors in health at the level of individuals, neighborhoods, and communities, and broader sociopolitical units; the interconnections and interactions between and among social and biological-chemical-physical determinants of health; and implications of social determinants of health for health care or health services research, practice, and policy. Jim House, Nicole Lurie, and Catherine McLaughlin will serve as co-editors of the special HSR issue. September 1, 2002 is the deadline for submission. The planned publication date is July 2003.
Claudio Schuftan
The People's Charter for Health (PCH), The PHM's manifesto, is one and a half years old. It has been disseminated quite widely world-wide.
2. The world has moved on since. But, clearly, for the worse in almost all fronts the PHM has strong feelings about. Most worrisome is the fact that most of the world's shifts for the worse have become so depressingly predictable, and nobody seems to be succeeding in doing much about them.
3. The PCH's 'Call for Action' predicted much of what we are witnessing; we were "on the dot". So, to continue to be "on the dot", we simply have to reassess where we are and what we have, and have not, achieved. Just to make yet further predictions of doom would be to utterly fail all that and those we stand for.