The authors mapped the Mozambican legislative and policy responses to domestic violence to analyse their alignment with international treaties and conventions and with each other, using a critical cartography and content analysis. The authors identified a total of fifteen national domestic violence documents of which five were on laws, one on policy and nine institutional strategic/action plans. Most of the national domestic violence documents focused on strategies for assistance/care of victims and prevention of domestic violence. Little focus was found on advocacy, monitoring and evaluation. Mozambique has signed several international and regional treaties and conventions on domestic violence, but the authors found an inconsistency in the alignment of international treaties and conventions with national policies and laws, and a gap in the translation of national policies and laws into strategic plans and multi-sectoral approaches.
Values, Policies and Rights
The authors raise that the impacts of the COVID-19 pandemic have gone far beyond the disease itself. In addition to the increasing number of COVID-19 deaths, the pandemic has deepened social and economic inequalities. These indirect impacts have been compounded by pervasive gender inequalities, with profound consequences, especially for women, girls, and people of diverse gender identities. There has been an escalation in gender-based violence within households, increasing numbers of child marriages and female genital mutilation, and an increased burden of unpaid care work, with impacts on mental health. Communities of people affected by HIV are, again, at the crossroads of injustice and targeted discrimination. Measures to control the pandemic have reduced access to essential health and social welfare services, including sexual and reproductive health services, reduced employment and labour force participation, and decimated many household incomes. Here again, women have borne the brunt of marginalisation, particularly those working in the informal sector.
In South Africa, an increased risk for gender-based domestic violence against women during the COVID-19 lockdown was reported by various sources including the national gender-based violence call centre (GBVCC), the South African Police Service and the civil society. Public life, which is frequently a coping mechanism and an escape for some women and girls at risk of domestic violence, was curtailed by the lockdown rules that forbade movement. Informal sources of help for victims of abuse were limited due to closure of economic activities, and community-based services for domestic violence were not permitted to open. Some victims of domestic violence struggled with public transport to access informal help, or to visit the police, social workers and other sources of help. Some organisations offered online and telephone services and the authors suggest that the risk of violence during crisis periods could be averted by a more sustained and wider focus on reducing risk of all forms of violations against women.
This policy brief critically analyses the option of a new pandemic treaty or other international legal instrument to enhance the pandemic preparedness and response. Part I provides an account of the origin of the idea of the pandemic treaty. Part II examines whether there is any legal vacuum which prevents the needed pandemic preparedness and response. Part III deals with the fragmentation of international health response and raises the concern that the new treaty will exacerbate fragmentation instead of consolidating the response. Part IV explains what to expect from the new treaty and the major process-related issues involved in the new pandemic treaty negotiations. The authors argue that instead of developing a new international instrument it is better to strengthen or amend the existing IHR.
More than half way into the 74th World Health Assembly, a serious discussion on the efforts to address vaccine inequities is noted in this article to have been conspicuous by its absence. What has instead dominated much of the Assembly proceedings are talks for a pandemic treaty to address health emergencies in the future, and the important, but continuing push towards investigations on the origins of the virus, among other matters. In an issue that recaps the discussions at the current World Health Assembly, the Geneva Health Files in this piece notes "it seems that there has not been enough attention on the here and the now in the midst of all the discussions on preparedness. In our view, this risks looking away from and a silent acceptance to the mounting deaths from COVID-19. It also shows unwillingness to acknowledge and accept the limitations of the current mechanisms that have not met expectations on not only vaccine equity but an overall international mechanism for meeting the needs on diagnostics and treatments for COVID-19". In a packed agenda for the week long remote meeting, the question is raised of why there is no dedicated forum to discuss why vaccines have not been delivered as promised, including to seek accountability for this and to revisit assumptions made about the mechanisms set up for this, including the ACT Accelerator and COVAX.
A recent joint communiqué by 25 Heads of Government and the WHO Director-General have called for the negotiation of a pandemic treaty to enable countries around the world to strengthen national, regional and global capacities and resilience to future pandemics, as a binding instrument to promote and protect health in the context of pandemics. The authors recommend that if WHO Member States decide that an international treaty is the way forward, it would be important to have clarity from the outset on the elements and areas that will be the subject of negotiation, by identifying aspects that the current crisis has revealed are not working. They recommend building on the existing instruments, notably the International Health Regulations and discuss critical issues that should be addressed in such a treaty if negotiations are launched,given that countries differ in needs, levels of development and capacities to implement treaty obligations.
The Independent Panel for Pandemic Preparedness and Response was set up by WHO to review the state of pandemic preparedness before COVID-19, the circumstances of the identification of SARS-CoV-2 and responses globally, regionally, and nationally, particularly in the early months of the pandemic, and its health system, social and economic consequences. This report of the panel indicates that preparedness was limited and disjointed, leaving health systems overwhelmed when actually confronted by a fast-moving and exponentially spreading virus. The panel concluded addressing this gap not requires sustained investment, and new approaches to peer review of country preparedness, and to the international alert system. The panel suggests that the legally binding International Health Regulations (IHR) (2005) did not facilitate rapid action, and that the consequence of delays in response impacted most on already disadvantaged people.
In an open letter to the Ambassador Extraordinary and Plenipotentiary, Colombia, the Peoples' Health Movement urged the government to abide by the Constitution, stop the violence, and join hands with citizens in defeating COVID urgently, and enacting policies that promote people’s health, equality and social justice. The PHM wrote: "We note with deep concern the criminalisation of protest and high levels of violence perpetrated on legitimate and peaceful protestors by the Colombian government security forces and armed civilian groupings. Credible sources report the use of lethal weapons, including rifles and semi-automatic guns, against protesters around the country by police. At least 37 people have been killed; some reports give larger numbers. There are also reports of disappearances. As a result of extreme militarisation, some cities, including Cali and Palmira, are running out of food and medicine supplies; Internet signals and social networks essential for communication among citizens and communities have been blocked; and levels of fear and uncertainty are growing among the population. The protests occur against the background of the COVID-19 pandemic. COVID is exacerbating poverty and inequality. The number of Colombian people living in extreme poverty grew by 2.8 million last year. And more and more people face hunger.
The authors investigated how gender power relations within households affected women’s health outcomes in Simiyu region, Tanzania. Women who reported being able to make their own health decisions were 1.57 times more likely to use condoms. Women who reported that they decide how many children they had also reported high contraception use. Seeking care at the health facility was also associated with women’s autonomy for making major household purchases. The authors observe that the association between decision-making and other gender domains with women’s health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. They suggest that future studies should integrate and analyze gender-sensitive questions within coverage surveys.
High level speakers at the December 2020 United Nations General Assembly pointed to the growing inequalities and stress to health, social, economic and democratic systems caused by COVID-19, calling for a range of collective interest driven responses and measures for a sustainable recovery. The pandemic, lockdown and other responses, along with underfunded, poorly prepared and overstretched public sector social and health systems in many countries worsened many dimensions of health and well-being that were already facing deficits, generating a rising health and social debt in communities, the scale and long-term consequences of which are as yet unknown, especially for the most marginalised in society. Rather than ‘getting back to normal’, the authors argue that recovery and ‘reset’ demands change to tackle the inequalities, conditions, services, socioeconomic and environmental policies that made people susceptible and vulnerable to COVID-19. Economic recovery should not replicate the features of the global economy that are generating pandemic and other crises. The authors suggest further that for global aspirations to translate into benefit for communities, an equitable recovery should include significant investment in: (1) universal, public sector, primary health care-oriented health services; (2) redistributive, universal rights-based and life course based social protection; and (3) people, especially in early childhood and in youth, as drivers of change.