Recently, there has been a growing push for countries to achieve universal health coverage (UHC) in order to strengthen health systems and improve health equity and access to health services. Importantly, not all potential paths to a universal health system are consistent with human rights requirements. Simply expanding health coverage, especially if it continues to exclude poor and vulnerable communities, is not sufficient from a human rights perspective. The author in this paper presents the requirements that a human rights approach to UHC imposes. These include locating UHC within the context of a national effort to provide equitable access to the social determinants of health; making access to essential health services and public health protections a legal entitlement, with redress for failures to provide these benefits; paying explicit attention to equity in the design of the universal health system, including in health financing. There should be opportunities for consultation with and the participation of the population in the design of the path to UHC and the determination of benefits packages. The process for pursuing the progressive realisation of UHC should first expand coverage for high-priority services to everyone, with special efforts to ensure that disadvantaged groups are reached. The author notes that the goal of achieving UHC can generally be realised only in stages, through a long process of gradual realisation, given limitations in resource availability and administrative capacity, and that this imposes difficult trade-offs along the way.
Values, Policies and Rights
This presentation of the ECSA strategic plan provides a situation analysis of the trends in health affecting the region, and health services trends, including a continued inadequacy of human resources for health and high level of out-of-pocket expenditure on health, above 30% of total health expenditure in most countries in the region. The strategic plan seeks to contribute to the health status in the ECSA region by providing leadership towards attainment of the Sustainable Development Goals (SDGs). The plan covers six strategic areas. It includes measures to support and promote efforts to build human resources for health and human capacity development; to strengthen health systems towards Universal Health Coverage and to assist countries to develop capacity to implement reproductive and maternal and child health strategies. It seeks to reduce communicable and non-communicable diseases, chronic conditions, injuries and all forms of malnutrition, and to promote the generation, management and utilisation of knowledge to inform decision making and programming in health. A final objective for the ECSA health community in the plan is to set a regional health policy agenda and foster strategic partnerships and collaboration towards achieving of international commitments, including of the SDGs. Several enabling factors are identified, including continued support from the member states as shown through ownership of ECSA resolutions and activities and the remittance of subscriptions; and a diversified funding base through securing new funders and income generation activities such as training.
This research assessed the extent to which the occupational safety and health act in Kenya safeguards the safety and health of workers in its coal mines. From a comparison with law in other countries, the author identifies gaps and recommends that Kenya should enact more comprehensive clauses for occupational safety and health of coal mine workers, should revise the compensation amounts provided for by the Work Injury Benefits Act; set guidelines and directions encompassing duties of employers and employees in mining and provide for medical services in coal mines.
At an official side event of the 34th Session of the Human Rights Council, panelists discussed how people’s sexual and reproductive health rights (SRHRs) around the world could be better protected and promoted. This report presents perspectives raised on challenges and good practices in ensuring full access to SRHRs, environmental dimensions of family planning, the linkages between a human rights-based social protection framework and access to these rights, and current global trends, and what these mean for implementation of the SDGs and their achievement by 2030. Men, women and gender non-conforming persons are all entitled to SRHRs and require these services. And while everyone is affected by limited access to these rights, individuals from already marginalized groups such as children and adolescents, lesbian, gay and trans persons, men who have sex with men, sex workers, drug users, indigenous peoples, and people living in poverty were reported to be the most affected, sometimes fatally.
This joint UNDP-UNRISD report reviews recent trends in six areas that are fundamentally important to achieving the 2030 Agenda. These six “mega-trends” relate to (i) poverty and inequalities, (ii) demography, (iii) environmental degradation and climate change, (iv) shocks and crises, (v) development cooperation and financing for development, and (vi) technological innovation. The report explores whether these trends are having positive or negative effects on development and discusses policy implications for the implementation of the 2030 Agenda. The report raises that some of the trends displayed currently are positive and supportive, including in the reduction of absolute poverty and technological innovation. Yet negative trends in several of the other target areas pose a significant risk to the realisation of the SDGs. They suggest that evidence-generating processes should be designed so as to take interactions between areas into account, whether that be through the use of interdisciplinary teams who can bring different insights to research, or through modelling and simulations of complex interactions. The potential for policy coherence manifests itself in two ways in the 2030 Agenda. First, there is a need to pursue progress across goals at the same time (e.g. employment guarantee programmes that focus on the provision of the safeguarding of environmental goods and services), while recognising and minimising the negative interactions. Second, there is the issue of coherence at different levels of decision-making and implementation, primarily local, national, regional and global—for example, whether local policies on education service provision are supported by fiscal policies at the national level, especially the decentralisation of tax policy. All of the issues discussed in the report are argued to point to the need for collective action so as to maximise the positive dynamics in these areas and minimise risk, and for processes that build trust and inclusiveness of participation.
The Africa Mining Vision (AMV) signed in 2009 by African Ministers responsible for mineral resources development throughout the continent, and its accompanying policy framework, Minerals and Africa’s Development, provide a comprehensive strategy for mineral and other natural resource extraction to be used in manufacturing within the continent, rather than exported from Africa for the industrial development of other continents. The authors note that while comprehensive and bold, it does not incorporate the effects of such a development strategy on African women, even though extraction primarily affects rural populations and particularly women. They note the mounting drought in the continent and other consequences of climate change attributing it in part to excessive, worldwide extraction and combustion of minerals and fossil fuels. Showcasing seven community based studies in sub-Saharan Africa, this paper aims to fill this gap. The authors argue from the evidence in the case studies that mineral and oil-based development undervalues community wealth, food production systems and female labour. They make two policy recommendations: Firstly in order to enable meaningful public participation in the policy framework and vision provided in the AMV they call on the African Union to make public the number of displacements estimated for the African continent over the next half-century. They estimate that as many as 90 million displaced across the continent. Secondly, they call on African states to carry out national studies of the socioeconomic, environmental and thus human impacts of existing and abandoned mineral and oil-based development projects post-independence period, with active participation of women’s organisations, mining affected communities, policy think tanks, and academics in the fields of social and human development.
The Extractive Industries Transparency Initiative (EITI) Standard is in its fifth version since the first principles were agreed in 2003. The principles on which the EITI is based state that the wealth from a country’s natural resources should benefit all its citizens and that this requires high standards of transparency and accountability. Revenue transparency remains a fundamental aspect of the EITI. The requirements follow the extractive value chain order and cover: first oversight by the multi-stakeholder group, then legal and institutional frameworks, exploration and production, revenue collection, revenue allocation, and finally social and economic spending and outcomes. It encourages countries to make use of existing reporting systems for EITI data collection and make the results transparent at source, with recommendations on the actions to take and the plans for taking them. It raises that the identity of the real owners – the ‘beneficial owners’ – of the companies that have obtained rights to extract oil, gas and minerals will have to be disclosed from 2020. It introduces a new validation system which aims to better recognise efforts to exceed the EITI requirements and sets out fairer consequences for countries that have not yet achieved compliance.
Under the Millennium Development Goals (MDGs), United Nations Member States reported progress on the targets toward their general citizenry. This focus repeatedly excluded marginalised ethnic and linguistic minorities, including people of refugee backgrounds and other vulnerable non-nationals that resided within a States' borders. The Sustainable Development Goals (SDGs) aim to be applied to all, nationals and non-nationals alike. Global migration and its diffuse impact has intensified due to escalating conflicts and the growing violence in many countries. This massive migration and the thousands of refugees crossing borders in search for safety led to the creation of two-tiered, ad hoc, refugee health care systems that have added to the sidelining of non-nationals in reporting frameworks. The authors have identified four ways to promote the protection of vulnerable non-nationals' health and well-being in States' application of the post-2015 SDG framework: In setting their own post-2015 indicators states should explicitly identify vulnerable migrants, refugees, displaced persons and other marginalised groups in the content of such indicators. The authors’ recommend that communities, civil society and health justice advocates vigorously engage in country's formulation of post-2015 indicators and that the inclusion of non-nationals be anchored in the international human right to health, which in turn requires appropriate financing allocations as well as robust monitoring and evaluation processes that can hold technocratic decision-makers accountable for progress.
This report aims to raise awareness about the role that the reform of public health laws can play in advancing the right to health and in creating the conditions for people to live healthy lives. By encouraging a better understanding of how public health law can be used to improve the health of the population, the report aims to encourage and assist governments to reform their public health laws in order to advance the right to health. The report highlights important issues that may arise during the process of public health law reform. It provides guidance about issues and requirements to be addressed during the process of developing public health laws. It also includes case studies and examples of legislation from a variety of countries to illustrate effective law reform practices and some features of effective public health legislation.
In 2016, a hundred-strong group of young Port Elizabethans gathered at the Athenaeum in Central, for the city’s first YOUNGURBANISTS meeting. A historic building and national monument situated on the corner of Castle Hill and Belmont Terrace, the Athenaeum is not a typical art gallery. It has reinvented itself as a community hub for emerging creatives in Nelson Mandela Bay and surrounds. Set in the heart of the ‘old city,’ the Athenaeum sets out to be a tangible example of a reimagined, multi-use urban space – a fitting location for a Young Urbanists event. Speakers included Oyama Vanto, project leader in Development and Infrastructure for the Mandela Bay Development Agency (MBDA), who introduced the audience to the MBDA’s goals of reversing urban decay and attracting people and businesses back into the inner city, and to its current projects: the resurrection of Zola Nqiri Square, the development of Vuyisile Mini Square and the extension of Route 67. Oyama’s passion for the democratization for city spaces resonated clearly in his talk, and he called out for a safer city for women and children as the starting point in enabling a more inclusive city. The audience were invited to share their vision for the future of our city, and to record it on a piece of paper and placed into a box. Young urbanists in attendance voiced their ideas and their concerns, calling for clear objectives through which they could move Nelson Mandela Bay forward as a model for future cities. One issue in particular was to identify the many pockets of multidisciplinary communities in our cities, with the hope of promoting synergy and fostering a participatory environment. Grand visions in place, the attendees are reported to now be reflecting on the ways that they can begin to take steps towards making such visions a reality, and dwell on the question of how, as young urbanists of PE, they can collectively propel a momentum shift and foster a culture of pride in their city.