This article highlights the devastating impact of sexual violence on women and girls in Sudan's ongoing conflict, focusing on the humanitarian crisis that has displaced over 11 million people. The author, drawing from a personal visit to a refugee camp in Renk, South Sudan, shares the harrowing story of Afrah, a 15-year-old who was raped by soldiers while protecting her younger siblings, exemplifying the widespread weaponization of sexual violence in the conflict. The narrative underscores the urgent need for African leaders to take concrete action, emphasizing that the systematic rape of women and girls has become a common war tactic with virtually no accountability. By centering the experiences of survivors like Afrah, the article calls for immediate international intervention, humanitarian access, and comprehensive support for victims, arguing that addressing the plight of women and girls is crucial to Sudan's potential path to healing and peace.
Values, Policies and Rights
This paper explored stakeholders’ perspectives on the challenges of implementing Namibia's National School Health Policy (NSHP) in schools using a specifically designed interview guide. A total of 20 stakeholders participated, including educators, nurses, principals, and health program administrators from three regions in Namibia. The study identified significant barriers to effectively implementing the school health policy, including staffing shortages, inadequate resources, limited learner awareness of health rights, and insufficient teacher well-being. Additional challenges involve resource constraints, a lack of monitoring and evaluation, and limited coordination between the education and health sectors. The analysis emphasizes the need for increased resource allocation, comprehensive training, collaborative policy development, and initiatives to improve teacher well-being, and highlights the importance of strong leadership, stakeholder involvement, and adequate funding to support the policy goals.
Solidarity is one of the emerging values in global health ethics, with some bioethics papers linking it to decoloniality. However, conceptions of solidarity in global health ethics are influenced primarily by Western perspectives, suggesting any inclusion of decolonial ideas need to include non-Western perspectives. This article explores a decolonial interpretation of solidarity. It employs a palaver approach, typical of African (Yorùbá) relational culture, developing a conception of solidarity grounded in a beehive metaphor. Through this approach, the authors posit that a beehive metaphor allegorically symbolises solidarity, embedding it in relational virtues and duties that foster harmony, particularly for people with whom one shares similar circumstances for harmonious well-being through concerted efforts. The authors address five potential objections to this account of solidarity in global health ethics and explores what an African account of solidarity means for global health research funding, including for expanding conceptual perspectives on solidarity in global health ethics.
Digital inclusion in health technologies remains a critical global challenge, with significant barriers preventing equitable access across diverse populations. The authors argue that achieving meaningful digital health inclusion requires more than technological advancements, demanding a comprehensive, multisectoral approach that addresses complex social and technical interconnections. The authors propose a novel concept of "universal design for decision-making" as a strategic framework to overcome existing limitations. This approach emphasizes multilevel collaboration, involving stakeholders from individual users to governments, and focuses on creating an ecosystem where inclusivity is naturally embedded in technological design, policy development, and health interventions. By integrating sociotechnical methods with universal design principles, the approach aims to develop digital health solutions that accommodate the diverse needs of all populations. The research highlights seven critical dimensions for optimizing inclusive digital health, ranging from policy development and technology design to addressing the needs of underserved groups and ensuring secure, trustworthy systems. The authors underscore that achieving true digital health equity is a continuous, transformative process requiring collective efforts, adaptive governance, and a deep understanding of human diversity across technological, social, and policy landscapes.
The World Health Organisation participated in the recent hearings on the climate crisis at the International Court of Justice earlier this month. This issue of Geneva health files presents WHO’s statements at the hearing.
The advancement of digital technologies has stimulated immense excitement about the possibilities of transforming healthcare, especially in resource-constrained contexts. For many, this rapid growth presents a ‘digital health revolution’. While this is true, the authors note that there are also dangers that the proliferation of digital health in the global south reinforces existing colonialities. Underpinned by the rhetoric of modernity, rationality and progress, many countries in the global south are pushing for digital health transformation in ways that ignore robust regulation, increase commercialisation and disregard local contexts, which risks heightened inequalities. The authors propose a decolonial agenda for digital health which shifts the liner and simplistic understanding of digital innovation as the magic wand for health justice. In the proposed approach, they argue for both conceptual and empirical reimagination of digital health agendas in ways that centre indigenous and intersectional theories. This enables the prioritisation of local contexts and foregrounds digital health regulatory infrastructures as a possible site of both struggle and resistance. Their decolonial digital health agenda critically reflects on who is benefitting from digital health systems, centres communities and those with lived experiences and finally introduces robust regulation to counter the social harms of digitisation.
After negotiations spanning over 2 years, International Health Regulations (IHR) 2005 was amended by consensus during the 77th Session of World Health Assembly (WHA77) in the first week of June 2024 (WHO, 2024). The amendments set out the legal framework for delivery of equity in health emergency preparedness and response. One of the drawbacks of the IHR adopted in 2005 was the lack of explicit legal provisions requiring WHO and States Parties to ensure equitable access to health products to prevent disease outbreaks from becoming public health emergencies of international concern (PHEIC). The amendments adopted by WHA77 address this gap. Around 24 Articles out of 66 Articles, and 6 Annexes out of 9 Annexes were amended substantively and 2 new Articles were added. Amendments in Articles 1, 3, 13, 15-18, 44, and Annex 1 and the two new Articles, 44 bis and 54 bis, help in particular addressing the gaps relating to equitable access to health products. Article 3 now recognises equity and solidarity as principles of IHR implementation. The Amended Article 3 now mandates that the implementation of the IHRs needs to “promote” equity and solidarity. It means there should be demonstrated enhancement in the delivery of equity, in the implementation of IHR.
The East, Central and Southern Africa Health Community 73rd Health Ministers Conference was held in Arusha in the United Republic of Tanzania from June 20 -21, 2024. The Conference was attended by Honourable Ministers, Heads of Delegations, senior officials from ECSA Health Community Member States, partner organizations, research institutions, civil society organizations and other key stakeholders. The Conference was organized under the theme: 50 Years of Leadership and Excellence in Regional Health Collaboration. Deliberations at the Conference proceeded under the following sub-themes: 1. Human Resources for Health 2. Health Financing 3. Emerging and Re-emerging infectious diseases and health emergencies 4. Reproductive, Maternal, Neonatal, Child and Adolescent Health and Nutrition 5. Non-communicable, mental health and Substance use 6. Mitigating the effects of climate change on health 7. Technology and Innovations in health At the end of the conference, the Ministers considered and passed the resolutions presented in each of these areas in this document.
Food fraud (often called fake food in South Africa) or the deliberate misrepresentation or adulteration of food products for financial gain, is a growing problem in South Africa, with severe public health and financial consequences for consumers and businesses. It has generated a public outcry against food fraud practices especially in communities and reputational damage to food manufacturers. Despite the risks, food fraud often goes undetected, as perpetrators are argued to be becoming increasingly sophisticated. The precise magnitude of food fraud remains obscure, as incidents that do not cause consumer illnesses are frequently unreported and, as a result, are not investigated. Food fraud can occur at any stage of the food supply chain, from production to processing to retailing or distribution. This is due in part to the limitations of current analytical methods, which are not always able to detect food fraud. This review of food fraud in South Africa looks at several factors that may be contributing to epidemic of food fraud, including inadequate penalties, inadequate government commitment, a complex labelling regulation, emerging threats such as e-commerce, and shortage of inspectors and laboratories. The review recommends establishing a single food control/safety authority, developing more food safety laboratories, and adopting innovative technologies to detect and prevent food fraud. South Africa faces a serious food fraud crises unless decisive action is taken.
To address this question this study undertook a 4-step approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation. Policies were identified and prioritised based on their double- or triple-duty potential, synergies and trade-offs. Using participatory and transdisciplinary approaches, policies were identified to have potential if they were effective in tackling two or three of the primary outcomes of interest: (1) undernutrition, (2) obesity/NCDs and (3) environmental degradation. A final list of 44 proposed policies for healthier and more environmentally sustainable food systems created was divided into two main policy domains: ‘food supply chains’ and ‘food environments’. Of the top five expert-ranked food supply chain policies, two were perceived to have high potential: (a) incentives for crop diversification; (b) support for start-ups, and small- and medium-sized enterprises. For food environments, three of the top five ranked policies had perceived high potential: (a) affordability of healthier and more sustainable diets; (b) subsidies for healthier and more sustainable foods; (c) restrictions on children's exposure to marketing through all media.