Annex 2 of the International Health Regulations (IHRs) outlines decision-making criteria for State-appointed National Focal Points (NFP) to report a potential public health emergency of international concern to the World Health Organisation (WHO), and is a critical component to the effective functioning of the IHRs. The aim of this study was to review and evaluate the functioning of Annex 2 across WHO-reporting States Parties. The evaluation found that the IHR's Annex 2 is perceived as useful for guiding decisions about notifiability of potential public health emergency of international concern. There is scope for the WHO to expand training and guidance on application of the IHR's Annex 2 to specific contexts. Continued monitoring and evaluation of the functioning of the IHR is reported to be imperative to promoting global health security.
Values, Policies and Rights
Article 14(2)(c) of the Protocol to the African Charter on the Rights of Women enjoins States Parties to take appropriate measures "to protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus." This paper considers the implications of Article 14 for access to safe, legal abortion. It is submitted that Article 14 has the potential to impact positively on regional abortion law, policy and practice in three main areas. First, it takes forward the global consensus on combating abortion as a major public health danger. Second, it provides African countries with not just an incentive, but also an imperative for reforming abortion laws in a transparent manner. Third, if implemented in the context of a treaty that centers on the equality and non-discrimination of women,Article 14 has the potential to contribute towards transforming access to abortion from a crime and punishment model to a reproductive health model.
In this paper, the authors describe an economic framework, including demand- and supply-side factors, for approaching the analysis and planning of health system reform in South Africa, in order to avoid piecemeal debates. They argue that there is an urgent need to re-engineer the way health facilities are internally organised to achieve better productivity and responsiveness. They further argue that funding is not the central problem of the South African public health system but rather the enormous inefficiencies in management and low productivity; and that separating the purchase from the supply side is a critical component of making significant efficiency gains. Finally, they suggest that income inequalities and a divided health system in South Africa are departure points for reform initiatives. The government must build on the strengths of the South African health system in preparation for the eventual achievement of a more homogeneous health-care system across the public and private sectors.
UNESCO’s Universal Declaration on Bioethics and Human Rights (2005) was drawn up by an independent panel of experts (the International Bioethics Committee) and negotiated by member states. UNESCO aimed for a participatory and transparent drafting process, holding national and regional consultations and seeking the views of various interest groups, including religious and spiritual ones. Furthermore, reflecting UNESCO’s broad interpretation of bioethics, the IBC included medics, scientists, lawyers and philosophers among its membership. Nevertheless, several potential stakeholders - academic scientists and ethicists, government policy-makers and NGO representatives - felt they had not been sufficiently consulted or even represented during the Declaration’s development.
The author of this article points to research suggesting that rape by non-military actors in the Democratic Republic of Congo may account for up to 40% of cases in the DRC, that not all rapists are men and not all victims women. She also points to the need to maintain a focus on comprehensive health care needs, noting that a humanitarian focus on rape alone creates perverse incentives, undermines more comprehensive service delivery and feeds into negative stereotypes, undermining recognition and measures to address the political crisis or areas of failure of service delivery.
As COP 17, the latest round of UN climate talks in South Africa, drew to a close Greenpeace declared that it was clear governments across the world listened to the carbon-intensive polluting corporations instead of listening to the people - people who want an end to global dependence on fossil fuels and real and immediate action on climate change. Negotiators blocking the imperative to set concrete goals, led by the United States, have succeeded in inserting a vital get-out clause that could easily prevent the next big climate deal being legally binding, according to Kumi Naidoo, Greenpeace International Executive Director. And the deal is due to be implemented 'from 2020' leaving almost no room for increasing the depth of carbon cuts in this decade when scientists say we need emissions to peak. Naidoo said that the global climate regime amounts to nothing more than a voluntary deal that’s being put off for a decade. Greenpeace campaigners decried the failure of political leadership to prosecute polluters and provide a fair, ambitious and legally binding agreement, thereby ignoring the poor in Africa and other parts of the world that stand to be most severely affected by climate change.
In this study, researchers investigated the prevalence, patterns and associated factors of intimate partner violence against women in Western Ethiopia. A cross-sectional, population based household survey was conducted from January to April 2011, using the World Health Organisation’s standard multi-country study questionnaire. A sample of 1,540 ever married/cohabited women aged 15-49 years was randomly selected from urban and rural settings of East Wollega Zone, Western Ethiopia. Results indicated that lifetime and past 12 months prevalence of intimate partner violence against women stood at 76.5% and 72.5%, respectively. The overlap of psychological, physical and sexual violence was 56.9%. Abduction, polygamy, spousal alcoholic consumption, spousal hostility and previous witnesses of parental violence were factors associated with an increased likelihood of lifetime intimate partner violence against women. The authors of the study call for immediate action at all levels of societal hierarchy, including policymakers, stakeholders and professionals, to alleviate these extremely high levels of domestic violence.
In a speech to a plenary session of the 2011 International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Ethiopia in December 2011, Stephen Lewis, Co-Director of AIDS-Free World, pointed to the failure globally to apply knowledge to prevent vertical transmission, and expressed concern that the same not happen in relation to the elimination of pediatric AIDS. He pointed to the profound influence of gender inequality on the spread of HIV and in the burden placed on women to manage the epidemic. He noted the cancellation of the Global Fund's Round Eleven as a "punch below the belt" that will cost Africa lives, and not acceptable at a time when funds are available to finance wars or bail out banks. He called for a high-level crisis meeting on the funding situation for HIV and AIDS, to challenge any 'right to withdraw' in those funding the Global Fund. He argued that "If the MDGs are as important as everyone says, then AIDS must be subdued".
Seychelles has one of the most extensive social policy programmes in the developing world, and has been identified as a model for the rest of Africa. This book provides comprehensive analysis of social policy development in the country from the colonial era onward, focusing on the political and economic developments that have led to the current situation. The challenge now is to maintain current levels of social policy interventions in the face of severe indebtedness and stagnant economic growth. Since the Primary Health Care convention at Alma Ata in 1978, the provision of primary healthcare for all has been achieved in the Seychelles. Private healthcare has been abolished. Public health services are comprehensive with specialised in-patient and out-patient services provided by the main hospital in Victoria. Among the most significant improvements in healthcare was the drop in maternal and child deaths, from 50 per 1000 live births in the 1960s to an average of 10 in the 2000s. Maternal deaths have become a rare occurrence. There has been continued and increasing investment in the health system throughout the past two decades, largely in response to soaring healthcare costs and changing patterns of disease.
In this study, researchers aimed to determine whether the Mexico City Policy, a United States government policy that prohibits funding to non-governmental organisations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country’s exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy’s reinstatement in 2001. The study included 261,116 women aged 15 to 44 years. A comparison of 1994–2000 with 2001–2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy. There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. In conclusion, the induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception, the authors argue. Regardless of one’s views about abortion, the findings may have important implications for public policies governing abortion.