In South Africa, drug and alcohol abuse should be an issue of national concern, the author of this article argues. Yet little has been done to curb the use of drugs and reduce their impact on public health outcomes. Alcohol is legal, widely available and relatively inexpensive, which makes it one of the main burdens of disease in the country, ranking third after unsafe sex and interpersonal violence. All three have contributed to the country’s high HIV prevalence rate, while alcohol abuse is increasingly becoming recognised as a key determinant of sexual risk taking and sexual violence, and as a consequence, a direct contributor to HIV transmission rates, and to challenges in HIV treatment and mitigation interventions in sub-Saharan countries. The author also indicates that heavy consumption of alcohol and regular binge drinking by people on anti-retroviral treatment (ART) is also linked to lower levels of treatment adherence and treatment efficacy. The South African government has agreed to several interim resolutions to curb alcohol abuse and better regulate the industry: possibly raising the legal age for purchasing and consuming alcohol from 18 to 21 years; limiting alcohol advertising; reviewing alcohol license fees; harmonising existing liquor legislation; imposing restrictions on the times and days of the week that alcohol can be legally sold and decreasing the number of taverns (shebeens).
Values, Policies and Rights
In the run-up to the United Nations (UN) High-level Summit on Non-communicable Diseases (NCDs) in September 2011, a number of international women’s rights organisations joined together in a global campaign - Women for a Healthy Future - to demand solutions to NCDs among women. NCDs are the leading cause of death among women, the campaign argues, estimated at 18 million deaths each year. Key NCDs include breast and cervical cancer, with heart disease the primary cause of mortality among women. Girls and women are at a particular disadvantage for getting NCDs, as 60% of the world’s poor are women, and many are malnourished and uneducated. In developing countries, women often cook over open fires and get chronic lung diseases. Women for a Healthy Future has sent a petition to the UN as the new campaign’s first step in a planned programme of action.
While neoliberal globalisation is associated with increasing inequalities, global integration has simultaneously strengthened the dissemination of human rights discourse across the world. This paper explores the seeming contradiction that globalisation is conceived as disempowering nations states’ ability to act in their population’s interests, yet implementation of human rights obligations requires effective states to deliver socio-economic entitlements, such as health. Central to the actions required of the state to build a health system based on a human rights approach is the notion of accountability. Two case studies are used to explore the constraints on states meeting their human rights obligations regarding health, the first drawing on data from interviews with parliamentarians responsible for health in East and Southern Africa, and the second reflecting on the response to the HIV/AIDS epidemic in South Africa. The case studies illustrate the importance of a human rights paradigm in strengthening parliamentary oversight over the executive in ways that prioritise pro-poor protections and in increasing leverage for resources for the health sector within parliamentary processes. Further, a rights framework creates the space for civil society action to engage with the legislature to hold public officials accountable and confirms the importance of rights as enabling civil society mobilization, reinforcing community agency to advance health rights for poor communities. In this context, critical assessment of state incapacity to meet claims to health rights raises questions as to the diffusion of accountability rife under modern international aid systems. Such diffusion of accountability opens the door to ‘cunning’ states to deflect rights claims of their populations. We argue that human rights, as both a normative framework for legal challenges and as a means to create room for active civil society engagement provide a means to contest both the real and the purported constraints imposed by globalisation.
Women suffering domestic abuse who are financially dependent on their abusers can now report the crime with the assurance that they will be able to get financial and medical support from the state, thanks to Angola’s new law on domestic violence. Women’s campaigners have welcomed the introduction of the new law, which was signed into the statue books on 8 July 2011, and which criminalises domestic violence and offers protection to victims and their families. Until now domestic violence had not been illegal in Angola – and on the rare occasions it reached court, it was prosecuted under rape, assault and battery laws. The new law guarantees support to victims, through safe houses, medical treatment and financial and legal help. In addition, violence has been designated as a ‘public crime’, which means anyone can report it to the police, not just the victim. However, no details have yet been given about how much money will be made available to victims.
In the run up to the UN summit on non-communicable diseases, there are fears that industry interests might be trumping evidence based public health interventions. Will anything valuable be agreed? With only weeks to go before the summit, years of negotiations seem to be stalling. Discussions have stopped on the document that forms the spine of the summit, and charities are concerned that governments are trying to wriggle out of commitments. For example food is proving to be a sticking point again. Changes to language in the latest version of the draft document are subtle but clearly important. While the so called G77 group of lower income states—including India, China, Kenya, and Brazil—argue that saturated fat should be reduced in processed products, as well as sugar and salt, that recommendation is being resisted by the US, Canada, Australia, and the EU. Other areas of industry interest are proving contentious.
Because there has been so little research into the rape of men during war, it's not possible to say with any certainty why it happens or even how common it is, according to this article. Ugandan activists report a veil of secrecy surrounding male rape - the organisations working on sexual and gender-based violence don't talk about it and it’s systematically silenced, even in reports, the author notes. To fill the gap in data, the Refugee Law Project (RLP) in Uganda produced a documentary in 2010 called Gender Against Men, but the producer of the film alleges attempts were made to stop him by well-known international aid agencies. RLP further alleges that one of its funders refused to provide any more funding unless RLP promised that 70% of their client base was female, despite a critical shortage of health and support programmes for vulnerable men in Uganda. RLP calls on African governments, international and local aid agencies and human rights defenders at the United Nations to acknowledge male rape as humanitarian and medical crisis needing urgent attention.
According to this article, it is common in Uganda to hear arguments that men rape women because women wear indecent clothing or invite men into their homes or drink late into the night with men or accept a ride home. Much less discussion focuses on the male’s responsibility. The author of the article examines an incident ofalleged rape reported in July 2011 in Uganda’s national media. The media and the public condemned the complainant as a reckless and oversexed con-woman, the author of this article notes. Ensuing debates and responses in the media since the story broke have implied that even as rape victims, women bear sole responsibility for protecting themselves. With regard to sexual violence against women in Uganda, the author concludes it is time men started seeing women as human beings and not sexualised objects.
The authors of this article warn that new vaccines are likely to be more complex and expensive than those that have been used so effectively in the past, and they could have a multifaceted effect on the disease that they are designed to prevent, as has already been seen with pneumococcal conjugate vaccines. Deciding which new vaccines a country should invest in therefore requires not only sound advice from international organisations such as the world Health Organisation (WHO) but also a well-informed national immunisation advisory committee with access to appropriate data for local disease burden. The authors discuss how the introduction of vaccines might need modification of immunisation schedules and delivery procedures and they outline progressive methods to finance new vaccines in low-income countries.
This article reports on two women who died in the process of using or seeking maternal health services in Uganda. These cases are now subjects of a lawsuit filed in March by the Center for Health, Human Rights and Development, a Ugandan nonprofit group, who contend that the government violated the two women’s right to life by failing to provide them with basic maternal care. Dr. Olive Sentumbwe-Mugisa, a Ugandan obstetrician and adviser with the World Health Organization, participated in the Health Ministry’s investigations of the deaths of the women named in the lawsuit against the government concluded that both women arrived in time to be saved. “We are in a state of emergency as far as maternal services are concerned,” Dr. Sentumbwe-Mugisa said. “We need to focus on the quality of care in our hospitals and address it in the shortest period of time. That will mean more resources. We cannot run away from that.” While the attorney general’s office has responded that replied that “isolated acts” cited in the case “cannot be used to dim the untiring efforts in the Health Sector, ” the authors raise that the case has raised attention and debate, including amongst lawmakers, to the way government has spent its funds more widely, including on military equipment, given the poor improvement in maternal health services.
Human Rights Watch argues that migrants are also especially vulnerable to communicable disease because of substandard living environments, limited sanitation, and cultural and social dislocation, making them vital targets for public health surveillance and intervention. According to Department of Health policies, everyone in South Africa should have access to treatment for communicable disease without cost. Any barrier to prevention and treatment of communicable disease for vulnerable mobile and migrant populations is unwise from a public health perspective, but also a violation of South African and international law. South Africa has recognised the importance of access to health care for vulnerable and migrant populations in its laws and policy documents, yet continues to allow unlawful discrimination by health care staff, undermining efforts to contain disease and improve treatment outcomes. In over 100 interviews with migrants, advocates, health care and other service providers in both urban and border communities, Human Rights Watch found that South Africa’s failure to protect asylum seekers and refugees from deportation and violence leads both to increased disease and injury, and increased barriers to treatment for those conditions.