In September 2008 world leaders convened in Accra, Ghana for Third High-Level Forum on Aid Effectiveness to sign what is now popularly called the Triple A (the Accra Agenda for Action). It is actually a prepackaged condensation of evaluations of implementation of the Paris Declaration and consultations about them conducted between 2006 and 2008 in all the regions of the world. It charts the broad actions that will occupy many development actors between now and December 2011 when the Fourth High Level Forum on Aid Effectiveness takes place. This paper attempts to show how and why the text of the Triple A had to be different from the Paris Declaration and notes that gender is absent from the agenda. The custodians of the Paris declaration say the Triple A does not overtake, override nor overwrite the Paris Declaration. The former only reasserts the latter, which does not help gender issues.
Values, Policies and Rights
The overriding message of this guide is that human rights are not merely add-ons or luxuries that only a few countries may be able to afford – they must be integral to developing health workforce strategies in all countries. Plans should be accountable to human rights obligations and other health goals and commitments. Broad participation in developing the plan will help ensure that it is accountable to those it serves. Planners may need to provide incentives for health workers to stay and should make sure their response to the health workforce crisis is comprehensive, covering aspects of the workforce such as numbers, distribution, quality of training, productivity, management, and information systems. Finally, health workforce strategies must be sustainable, so that countries provide their populations with ever-improving levels of health services, and maintain and enhance commitments to equality. This requires setting priorities that will ensure that essential health services, including those in underserved areas, can continue even if there are funding shortfalls beyond the country’s control.
Although the ethical principles of justice, beneficence and respect for autonomy/persons should be upheld in research, their application in emergency situations may differ from non-emergency situations. Just like in non-emergency situations, research in emergency situations should be conducted in the best interest of the victims or future victims. The research should not unnecessarily expose human subjects and the researcher to careless harm, and should be of adequate scientific rigour. Victims of emergency situations are vulnerable populations that need special protection from exploitation. Researchers should conduct a fair risk-benefit assessment in order to come up with a risk management plan, and be culturally sensitive to the needs of the victims of the humanitarian crisis. In emergency situations, the roles of Institutional Review Boards (IRBs) may have to be modified without compromising the ethical standards that health researchers have globally attempted to achieve.
In this article, the author takes a rights-based view of the current crisis of restricted access to the results of scientific and medical research. Such research is conducted in the interests of the public, and yet the results are largely kept out of the public domain by traditional corporate publishers who own them, subject them to extremely tight copyright restrictions and sell them in a market worth about US$5 billion annually. The results of biomedical research have unfortunately been privatised, monopolised, and concentrated in the hands of a tiny number of multinational corporations.
This paper provides arguments for discussions about the role of property rights for food security and child nutrition in rural Africa. The results are drawn from a case study in the Kafue Flats of Zambia. They show that unclear jurisdictional boundaries and weak authorities facilitated re-negotiations of property rights related to natural resources in the context of the Southern African food crisis of 2002–2003. Access to natural resources was skewed towards the more powerful. On average, food intake was temporarily 50% lower than the annual mean, compared to a less than 10% decrease in the lean season of 2003–2004. Large inequalities existed between different clusters of villages, according to the history of immigration and ethnicity. Yet variability was greatest within villages. Households which reported increasing difficulties with access to natural resources had less diversified income-generating activities, lower food intake and more children showing impaired growth. Discussions addressing the growing disparities in rural areas should focus on a realistic implementation and enforcement of property rights in the context of local power-relations and the harmonisation of different tenure systems related to natural resources.
This booklet addresses the benefit of treating sanitation in human rights terms,the legal basis of the right to sanitation, state obligations and standards for differing environments, and priority actions for governments and other stakeholders. While there has been some progress on the recognition and implementation of the right to water, the same is not true of sanitation services. The current International Year of Sanitation presents an opportunity to address the lack of attention paid to sanitation and hygiene in human rights terms. This publication is a call to recognise sanitation as a crucial aspect of the right to an adequate standard of living, setting out the most important strategies and measures that stakeholders and decision-makers can prioritise in order to ensure that sanitation is accessible and affordable to all. It is an advocacy tool to encourage more funding for sanitation, more debate and more research into the barriers to accessing affordable sanitation and how to remove them.
This paper describes how maternal and neonatal mortality in the developing world came to be seen as a public-health concern, a human rights concern, and ultimately as both, leading to the development of approaches using human rights concepts and methods to advance maternal and neonatal health. It describes the different contributions of the international community, women's health advocates and human rights activists.
Prior to 2007, forced sex with male children in South Africa did not count as rape but as "indecent assault", a much less serious offence. This study sought to document prevalence of male sexual violence among school-going youth. Teams visited 5162 classes in 1191 schools, in October and November 2002. A total of 269,705 learners aged 10-19 years in grades 6-11. Of these, 126,696 were male. Schoolchildren answered questions about exposure in the last year to insults, beating, unwanted touching and forced sex. They indicated the sex of the perpetrator, and whether this was a family member, a fellow schoolchild, a teacher or another adult. Respondents also gave the age when they first suffered forced sex and when they first had consensual sex. Some 9% (weighted value based on 13915/127097) of male respondents aged 11-19 years reported forced sex in the last year. Of those aged 18 years at the time of the survey, 44% (weighted value of 5385/11450) said they had been forced to have sex in their lives and 50% reported consensual sex. Perpetrators were most frequently an adult not from their own family, followed closely in frequency by other schoolchildren. Some 32% said the perpetrator was male, 41% said she was female and 27% said they had been forced to have sex by both male and female perpetrators. Male abuse of schoolboys was more common in rural areas while female perpetration was more an urban phenomenon. This study uncovers endemic sexual abuse of male children that was suspected but hitherto only poorly documented. Legal recognition of the criminality of rape of male children is a first step. The next steps include serious investment in supporting male victims of abuse, and in prevention of all childhood sexual abuse.
Two hundred-and-five African and global organisations and networks have called on the Assembly of Heads of State of the African Union to ensure the Implementation Plan of the AU Africa Health Strategy is urgently and adequately funded, and for the AU Abuja 15% Commitment to health to be implemented by all member states. The Implementation Plan was adopted by African Ministers of Health on the 17 May 2008 following presentation of the Health Strategy last year by the AU Commission Social Affairs Division. It provides guidelines for implementing various African health frameworks, health MDGs and global universal access targets including on TB, HIV and AIDS, malaria, child and maternal health.
Many organisations work to eliminate undernutrition in children and pregnant and lactating women in developing countries. These organisations - international organisations, donors, academia, civil society and private sector - are loosely linked as an international nutrition system. However, this system is fragmented and dysfunctional. Individual organisations and the system as a whole must examine their strategies, resources and motivations. Organisations must significantly improve their links with national level processes, so that country level priorities are better reflected in international guidance, donor funding, research and training.