Values, Policies and Rights

DRAFT Astana Declaration on Primary Health Care
WHO: Draft for review for the Global Conference on Primary Health Care, World Health Organisation, Geneva, 2018

On 25-26 October 2018, the world will come together to renew a commitment to strengthening primary health care to achieve universal health coverage and the Sustainable Development Goals. The World Health Organisation (WHO) have received over 500 comments on the Draft Declaration on Primary Health Care and incorporated them in this updated draft. This draft describes the need for Primary Health Care to address today’s health challenges. WHO are reopening the public consultation to ensure that voices of a broad range of stakeholders are included and has circulated a draft declaration for comment. It goes to in-person member state consultation in early August. The proposed text is provided at the website.

From health for all to universal health coverage: Alma Ata is still relevant
Raj Pandey K: Globalization and Health 14(62), doi:, 2018

With increasing adoption of universal health coverage (UHC), the health for all agenda is resurgent globally. This commentary discusses the origin of the health for all agenda in the 1970s and the influence of global politico-economic forces in shaping that agenda and its demise. The author proposes that it has resurged in the form of UHC in the twenty-first century, but also discusses UHC’s focus on finances and the increasing role of market economy in health care, and the need to regulate the market based provision of healthcare, and incorporate more of the people and community centred ethos of the PHC of 40 years ago.

Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials
Jacobs A: The New York Times, July 2018

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered in Geneva for the World Health Assembly. Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes. The United States delegation was however reported to have embraced the interests of infant formula manufacturers and to have upended the deliberations. Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States. In the end, the Russian delegation stepped in to introduce the measure — and the Americans did not oppose.

Teenager at centre of Kenyan court case over botched abortion has died
Ratcliffe R: The Guardian, July 2018

A teenager whose botched abortion was at the centre of a high court case in Kenya has died. The girl, who was raped aged 14 and then left with horrific injuries after a backstreet termination, had been the subject of a controversy over the liability of the Kenyan government in her case. The girl’s mother and a group of campaigners had filed a case against the government, claiming it had failed to offer the girl – known as JMM – adequate post-abortion care. They called for the government to reinstate guidelines on safe abortions. JMM’s mother, as well as the Federation of Women Lawyers-Kenya and two human rights advocates, filed the case in the Kenyan high court in 2015. Campaigners say that if successful it could save the lives of thousands of women a year. The hearings are expected to conclude in July 2018. Access to abortion was widened under Kenya’s 2010 Constitution, which allowed for the procedure in cases where the health or life of a pregnant woman is at risk, and in cases of emergency. But the government has since withdrawn standards and guidelines designed to make legal abortions safer and banned health workers from undergoing training on abortion. In 2012, nearly 120,000 women were admitted to public health facilities for abortion-related complications. The author reports that women seeking post-abortion services face stigma and discrimination in health facilities, particularly poor or young women. The court decision is expected before the end of the year.

Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage
Nelson E; Bloom G; Shankland A: Institute of Development Studies (IDS) Bulletin 49(2), doi:, 2018

In July 2017, IDS hosted a workshop on ‘Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity’, with the aim of generating dialogue and mutual learning among activists, researchers, policymakers, and funders working towards more equitable health systems and a commitment to Universal Health Coverage (UHC). This issue of the IDS Bulletin is based around three principal themes that emerged from the workshop as needing particular attention. First, the nature of accountability politics ‘in time’ and the cyclical aspects of efforts towards accountability for health equity. Second, the contested politics of ‘naming’ and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology. For the first time in IDS Bulletin history, themes are explored not only in text but also through a selection of online multimedia content, including a workshop video, a photo story and a documentary. This expansion into other forms of communication is explicitly aimed at galvanising larger numbers of people in a movement towards UHC and the linked agenda of accountability for health equity. The articles and multimedia in this IDS Bulletin reflect the fact that while the desired outcome might be the same – better health for all – accountability strategies are as diverse as the contexts in which they have developed.

How to stop strikes from killing patients
Cullinan K: Health-e News, May 2018

How can patients and health workers be protected from becoming victims of a fight that is aimed an employer? Non-governmental organisations (NGOs) have asked the SA Human Rights Commission to investigate the violations of patients’ and health workers’ rights during a recent strike in South Africa and to offer guidance on how patients can be protected during future strike action. The human rights group Section 27 believes that such a solution lies in “determining essential services from non-essential services, or reaching agreement on the maintenance of some level of services during a legal dispute”. “Addressing the essential services issue is argued to have a two-fold effect. Firstly, those in the public health care system classified as non-essential services personnel would be able to exercise their right to strike. Secondly, patients’ rights would also be protected as they would be ensured of continued access to health care services as those staff properly designated as essential staff would not be striking,” according to a Section 27 opinion on strikes in the essential services.

Neglected Tropical Diseases and Equity in the Post-2015 Health Agenda
Taylor E; Smith J: Institute of Development Studies (IDS) Bulletin 49(2), doi:, 2018

The Millennium Development Goals’ focus on just three infectious diseases (HIV/AIDS, malaria, and belatedly, tuberculosis) configured the global health funding landscape for 15 years. Neglected tropical diseases (NTDs) are a group of 17 or so diseases that disproportionately afflict the world’s ‘bottom billion’. They are a symbol of global health inequities, in terms of prioritisation, research attention, and treatment. This article traces efforts to include NTDs in the Sustainable Development Goal (SDG) agenda and, having achieved that goal, lobby for an influential position in the post-2015 aid agenda. The SDGs herald a shift to a more expansive approach and there is a risk that NTDs will once again be left behind, lost in a panoply of new goals and targets. There is, however, an opportunity for NTDs to lever their ‘neglect’ and be recast as a tool of accountability, acting as both a target for and proxy indicator of health equity for the SDGs.

De-drug RSA and save the economy … why not?
Schorr D: Pambazuka News, April 2018

South Africa’s GDP is reported to have risen from US $3445 in 1994 to US $5284 in 2016, but far from ushering in overall improvement in health or well-being, the author notes that rising white collar crime, violence, small business failure , un- and underemployment and the flight of skills signpost an unhappy place. He notes that South Africa “… had the highest number of drunk driving incidents at 58 percent” in the world …”. Alcohol is said to account for 40 percent of violent crime. The author calls more regulations to ensure that alcohol companies pays for the consequences that come with heavy drinking in the country.

Press Release on the Settlement Agreement of the TB/Silicosis Compensation Class Suit
Botswana Labour Migrants Association: Botswana, May 2018

Botswana Labour Migrants Association and its members from all the four corners of Botswana, present a press release reporting the news of the finalization of the TB/Silicosis class action, by way of a settlement agreement between mineworkers and the mining companies. The settlement ceremony which was held on the 3 May 2018 in South Africa, was reported in the press release to be groundbreaking and a vindication of the dues, sweat and rights of ex-miners in the region, their spouses and children and especially the efforts of the Association and its leadership..

Further details: /newsletter/id/63446
Upholding the rights of urban refugees in Uganda
Monteith W; Lwasa S; Nsangi G; et al: International Institute for Environment and Development (IIED) Briefing, 2017

Uganda is at the centre of current debate on urban refugees. The country’s Refugees Act 2006, which establishes refugees’ rights to live, work and own land in urban areas, has been hailed as exemplary and a global model for humanitarian responses. However, new evidence on refugee livelihoods in Kampala suggests that the rights to work and move freely, and without fear, are often unmet in urban areas. In the absence of financial assistance, urban refugees often struggle to find gainful employment and report frequent cases of discrimination by both the Ugandan state and the public. This briefing outlines the barriers faced in upholding the rights of urban refugees in Uganda, and recommends ways in which these may be overcome.