This article assesses factors that contributed to the success of the farm input support programme in Malawi in 2005–15, and the lessons from this experience in relation to climate change adaptation. Important factors were the ability to balance external and internal drivers that affected policy formulation, national ownership and prestige that influenced and motivated implementation capability, creation of conducive conditions its demand-driven nature. However, the flooding in 2015 and the drought in 2016 revealed that Malawi needs more effective measures to reduce long-term vulnerability to future adverse impacts of climate change. The authors argue that the lessons learned from this social protection programme can prove useful in relation to efforts to achieve sustainable responses to climate change that could reduce the need for humanitarian assistance.
Values, Policies and Rights
These short videos provide an overview of the history of human rights; health and human rights; and health, human rights and development. They were developed to make human rights more accessible to non-lawyers and non-academics. The videos are accompanied by tools for further learning, including an annotated bibliography, glossary of terms, timeline of key events, and fact sheet on universal health coverage. The first video provides an explanation on what human rights are and why they are important. The second video offers a brief history of health and human rights since World War II. The third video gives a description of how health-related human rights developed during the era of the Millennium Development Goals (2000-2015) and the Sustainable Development Goals (2016-2030). The series concludes by considering the vital role that human rights plays in diverse political environments.
In a letter to his five children written en route to Bolivia, Ernesto Che Guevara said: “Always be able to feel deep within your being all the injustices committed against anyone, anywhere in the world. This is the most beautiful quality a revolutionary can have.” This article about Che Guevara, 50 years after his execution, explores Che’s story and legacy. His tutelage in revolutionary thought came from his experiences among the leprosy patients of Venezuela and the tin miners of Bolivia, among the revolutionaries of Argentina and the 1954 coup in Guatemala. Reality radicalised him. Mario Terán Salazar, the soldier who shot Che, went into hiding. Many years later, in 2006, the Cuban government operated on Che’s killer to remove a cataract from his eye without charge. The author points to this to highlight that Che’s legacy was not revenge, but doctor’s love for humanity.
With adolescents and youth constituting a quarter of the global population – for a total of 1.8 billion people – it has never been more critical that their human rights be fully recognised and realised within global arenas and at the regional, national, and community level. This publication sets forth the barriers adolescents face in realising their sexual and reproductive health and rights, discusses recent critical developments in the human rights framework underpinning these rights, and proposes a way forward for guaranteeing all adolescents the full exercise of their sexual and reproductive health and rights.
The authors argue that applying a robust human rights framework would change thinking and decision-making in efforts to achieve Universal Health Coverage (UHC), and advance efforts to promote women's, children's, and adolescents' health in East Africa, a priority under the Sustainable Development Goals. They point to a gap between global rhetoric of human rights and ongoing health reform efforts,. and seeks to fill part of that gap by setting out principles of human rights-based approaches, and then applying those principles to questions that countries undertaking efforts toward UHC and promoting women's, children's and adolescents' health, will need to face. The paper focuses in particular on ensuring enabling legal and policy frameworks, establishing fair financing; priority-setting processes, and meaningful oversight and accountability mechanisms. In a region where democratic institutions are argued to be weak, the authors argue that the explicit application of a meaningful human rights framework could enhance equity, participation and accountability, and in turn the democratic legitimacy of health reform initiatives being undertaken in the region.
All roads lead to universal health coverage—and this is the top priority at WHO, Dr Ghebreyesus the WHO director general has asserted. The key question of universal health coverage is an ethical one. Should fellow citizens die because they are poor? Or should millions of families be impoverished by catastrophic health expenditures because they lack financial risk protection? Universal health coverage is a human right. The world has agreed on universal health coverage in Sustainable Development Goal 3.8. He asserts that universal health coverage is ultimately a political choice and responsibility of every country and national government. Countries have unique needs, and tailored political negotiations will determine domestic resource mobilisation. He indicates that WHO will catalyse proactive engagement and advocacy with global, regional, and national political structures and leaders including heads of state and national parliaments. Beyond benchmarking, countries learn from their peers, especially those they see as having similar political or economic contexts. WHO will thus document best practices in universal health coverage at the country level. Once this learning has occurred, countries may request technical assistance and WHO should be prepared to provide technical assistance to countries based on their specific needs, across the full range of health-related Sustainable Development Goals. He further posits that universal health coverage and health emergencies are cousins—two sides of the same coin. Strengthening health systems is the best way to safeguard against health crises. Outbreaks are inevitable, but epidemics are not and strong health systems are the best defence to prevent disease outbreaks from becoming epidemics. Achieving universal health coverage will require innovation. Given that what is measured is managed, data matters and WHO will track progress on how the world is meeting the health-related Sustainable Development Goal indicators. Finally he observes that universal health coverage is not an end in itself: its goal is to improve all health-related Sustainable Development Goals.
Environmental health risks especially affect women and children, because they are more vulnerable socially and because exposures to environmental contaminants create greater risks for children’s developing bodies and cognitive functions. According to the 2016 World Health Organisation (WHO) estimates, modifiable environmental risk factors cause about 1.7 million deaths in children younger than five years and 12.6 million total deaths every year. The sustainable development goals (SDGs) offer opportunities for countries to create healthier environments for women, children and adolescents. This paper explores how the SDGs can be used to reduce environmental health risks and enhance the health of women, children and adolescents. In particular, the authors focus on drivers for urbanisation and sustainable development (e.g. transport, housing, urban design and energy provision) that can advance the global strategy, but have not traditionally been a focus of health policy-making. They frame the discussion around the three pillars of the global strategy: survive, thrive and transform, while recognising the inevitable overlap between these objectives.
At the 70th World Health Assembly, the “BRICS countries” – Brazil, the Russian Federation, India, China and South Africa – convened a side event sponsored by China. The aim was to share experiences and innovations on people-centred reforms as a means to making progress towards universal health coverage, The Executive Deputy Director, Office of State Council Healthcare Reform Leading Group in China, Dr Liang Wannian highlighted the importance the Chinese government has placed on providing improved primary health services, by transforming the primary service model and enhancing division and cooperation to build an integrated health service system. For Brazil, Mr Ricardo Barros, Minister of Health shared the aspiration that “what we want is to have 80% of problems resolved in primary-level care so that people don’t need to go to the hospital”. He noted that “(delivering) primary-level care is the great challenge that we have” and that although “we have resources available for health, we don’t use them very wisely, so we are trying to improve that.” Dr Veronika Skvortsova, Minister of Health of the Russian Federation also highlighted the important role of designing a patient-focused system for health care based on accessibility and quality. For India, Mr Sanjeev Kumar, Additional Secretary, Ministry of Health and Family Welfare highlighted that the country had adopted a new national policy linked to universal health coverage in March 2017. Dr Aaron Motsoaledi, Minister of Health of South Africa, concluded the series of country presentations by returning the conversation to the importance of reorienting the model of care to focus on primary care. He shared South Africa’s “ideal clinic” innovation, which encourages the development of more attractive primary care clinics to draw patients away from tertiary care centres.
Instead of being locked in crowded camps surrounded by barbed wire, the 1.2 million refugees in Uganda are given large plots of land in sprawling settlements to build homes or, if they like, small farms. If agrarian life isn’t for them, they can move freely around the country, traveling to towns or to the bustling capital of Kampala, which 95,000 refugees call their home. The distinguished scholar and humanitarian activist Noam Chomsky characterizes European attitudes towards refugees “[as] among the signs of the severe moral-cultural crisis of the West that is mislabeled a ‘refugee crisis.’” The five wealthiest countries [the U.S., China, Japan, the U.K. and Germany]— which make up half the global economy — are hosting less than 5 percent of the world’s refugees, while 86 percent of refugees are in poorer developing countries that are often struggling to meet the needs of their own people. The authors argues that Uganda points the way forward and that the country is a good model for compassionate hospitality towards refugees. It is however noted that the country is reaching a breaking point due to increasing demands for accommodation of the large numbers of refugees. What was promised for Uganda from external funders at the 2016 high level summit in New York has not been forthcoming. Supporting viable resettlement programs and working towards durable solutions is argued to be the only way to resolve the crisis. This involves using leverage to promote human rights and good governance in refugee producing countries.
Activists from organisations in North Africa met in Tunis in July 2017 to set up the North African Network for Food Sovereignty. The network’s charter states that food sovereignty is the human right of peoples as individuals and communities to define their own food systems. Food sovereignty is tied to the right of people to self-determination at the political, economic, social, cultural and environmental levels. It means, working with nature and protecting resources to produce sufficient, healthy and culturally appropriate food by giving priority to local production and staple food, putting in place popular agrarian reforms, guaranteeing free access to seeds, protecting national produce and by involving people in elaborating agricultural policies. The charter identifies that this is undermined by extractivist policies implemented in the name of development and by neoliberal adjustment policies. In order to address this the North African Food Sovereignty Network was formed to achieve food sovereignty, climate and environmental justice, through critical studies; campaigns, workshops, direct actions as well as networking, coordination and solidarity with movements that share objectives.