The author of this article examines the availability and strength of evidence on climate change, economics and health outcomes for policy makers to draw on in making health policy decisions. Eighteen available economic studies were included in the study. The author found that in those studies that put a value on the predicted increased mortality from climate change, the health damages represented an important fraction of overall economic losses. Equally health impacts were important in considering broader measures affecting the economics of climate change beyond the health sector such as agriculture and water supply. Global adaptation cost studies carried out so far indicate costs to the health sector of roughly US$2-5 billion annually (mid-estimates). However, these costs are argued to be an underestimate of the true costs, due to omitted health impacts, omitted economic impacts, and the costs of health actions in other sectors. No published studies compare the costs and benefits of specific health interventions to protect health from the negative effects of climate change. The authors suggest that until further climate change-specific economic studies have been conducted, decision makers should selectively draw on published studies of the costs and benefits of environmental health interventions.
Values, Policies and Rights
This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. All four national policies addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Only the Zambian policy presented a clear vision, with the other three countries spelling out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. The authors recommend strengthening capacity of key stakeholders in public (mental) health and policy development, the creation of a culture of inclusive and dynamic policy development, and coordinated action to optimise use of available resources.
In this article, Horace Campbell charts Africa’s exploitative history of ‘aid’ and the struggle to establish a new global system rooted in dignity, equality and genuine social justice. Throughout Africa, Asia and Latin America the author argues that international capitalism has plundered the resources of the planet. Today, ‘international plunderers’ work with local African allies and sometimes their governments in extracting resources. The author argues that some African leaders have been compromised by their “development partners” and have remained silent in the face of intensified exploitation of Africa. The continued plunder of resources by oil companies and others has grown in this period, and observers have pointed to the constant interconnections between wars, violence and economics. Similarly, as Africans move into the twenty-first century there is increased interest in the genetic resources and fresh water of Africa, especially the water resources of the Congo River and its tributaries. Thus far there is not enough work on how this century will impact the lives of Africans.
This strategy is a detailed and comprehensive guide to how health sectors can most effectively tackle the HIV and AIDS epidemic. Data shows that the epidemic has been halted and that the spread of HIV is beginning to be reversed. New infections have fallen by almost 20% in the last ten years and between 2003 and 2009 there was a 13-fold increase in treatment coverage. However, in 2009 only a third of people in need of treatment received it and the demand for resources is still outstripping supply. The Strategy is intended to optimise progress towards universal access and the attainment of the Millennium Development Goals. It aims to promote tailored responses to national and regional epidemics and analyses the underlying socio-economic and cultural determinants contributing to the spread of the virus. The strategy seeks to reduce vulnerability and structural barriers to accessing good quality services. It also demonstrates how HIV programmes can play a role in broader health outcomes and recognises the importance of strong health and community systems to guarantee a sustainable response. WHO will make five key contributions to the Global Health Sector Strategy: scale up innovation in prevention; optimise treatment and care; support health for women and children; promote strategic health-sector information and planning; and provide leadership in addressing health equity and HIV (examining inequities in access to HIV services).
The Joint Meeting of SADC Ministers responsible for Youth and Ministers Responsible for Vulnerable Children was held in Windhoek, Namibia, from 1-3 June 2011. The meeting was attended by delegates from all SADC Member States, except Seychelles. It was convened to discuss common ways of addressing the increasing problems and concerns of vulnerable children and youth in the SADC Region which include diseases such as HIV and AIDS, malaria, and tuberculosis; poverty; hunger and malnutrition; social and political conflicts; disability among children and youth; and the growing problems of pregnancy among teenagers and unemployment among the youth. Ministers adopted common plans and actions for the region that will help to accelerate the delivery of basic services and needs for vulnerable children and youth such as the provision of safe drinking water, health care, education and skills that enable youth to earn income and to create jobs for themselves, protection from abuse, and the provision of housing and family care. Other basic services include those relating to improving the capacity of children and youth to cope with the stresses of life, and to be able to live in harmony with others in society. Ministers agreed to set up the necessary structures required to fully implement their decisions and improve the lives of children and youth in the region. In order to address issues more effectively, they agreed that in future they would meet separately as Ministers responsible for children, and those responsible for youths. Before ending their meeting, Ministers agreed to meet again in 2012 to follow up progress on the implementation of their decisions.
According to this paper, the gap between practice and policy - those providing health services to migrants versus those making policies about migrants' entitlements - is increasingly evident. At the same time that clinicians are treating more diverse migrant groups, policy-makers are attempting to implement restrictive or exclusive immigration-related health policies that contradict public health needs and undermine medical ethics that operate on the ground. Policies that respond to the diversity of migrant groups and their differential health risks and service access must be developed and implemented, the authors of this paper argue. Moreover, to make real advances in the protection of both individual and public health, interventions must target each stage of the migration process and reach across borders. Services should be based on human rights principles that foster available and accessible care for individual migrants.
According to this article, the International Monetary Fund is deepening poverty in developing countries, especially for women who make up 70% of the world’s poor. By means of ‘structural adjustment programmes’ (SAPs), it pushes for lower tariffs and cuts in government programmes such as welfare and education. IMF-mandated government austerity measures may require cutting public sector jobs, which disproportionately impact women, as women hold most of the lower-skilled public sector jobs, so are often the first to be cut. As social programmes like caregiving are slashed, women are expected to take on additional domestic responsibilities that further limit their access to education or other jobs. In exchange for borrowing US$5.8 billion from the IMF and World Bank, Tanzania agreed to impose fees for health services, which led to fewer women seeking hospital deliveries or post-natal care and naturally, higher rates of maternal death. In Zambia, the imposition of SAPs led to a significant drop in girls’ enrollment in schools and a spike in ‘subsistence sex’ as a way for young women to continue their educations, the authors note.
In this paper, the authors evaluate the effectiveness of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda, focusing on socio-cognitive determinants of safe sex behaviour, namely delay, condom use and non-coercive sex. A survey of 1,864 students was conducted, which showed significant positive effects of WSMW on beliefs regarding what could or could not prevent pregnancy, the perceived social norm towards delaying sexual intercourse, and the intention to delay sexual intercourse. Furthermore, significant positive effects of WSWM were found on attitudes, self-efficacy and intention towards condom use and on self-efficacy in dealing with sexual violence (pressure and force for unwanted sex). However, all significant positive effects disappeared for those schools that only implemented up to 7 out of 14 lessons in the programme. The authors conclude that the effectiveness of WSWM could be improved by giving more systematic attention to the context in which such a programme is to be implemented.
At the High-level Meeting on AIDS, held 8–10 June 2011 in New York, 3,000 participants gathered to chart a path for the future of the AIDS response, including 30 heads of State and government, along with senior officials, representatives of international organisations, civil society and people living with HIV. The declaration adopted by Member States of the General Assembly contains clear, measurable targets, including targets to halve sexual transmission of HIV by 2015, to reduce HIV transmission among people who inject drugs by 50% by 2015, to ensure that by 2015 no child will be born with HIV, to increase universal access to antiretroviral therapy, to get 15 million people onto life-saving treatment by 2015, and to halve tuberculosis deaths in people living with HIV by 50% by 2015. Member States also pledged to close the global resource gap for AIDS and work towards increasing funding to between $22 and $24 billion per year by 2015. Paul De Lay, Deputy Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS) noted that the declaration clearly outlines the urgent need to increase access to HIV services for people most at risk of infection, including men who have sex with men, people who inject drugs and sex workers. The pledge to eliminate gender inequality, gender-based abuse and violence and to empower women and girls must be fulfilled without delay, he added.
This report focuses on the specific needs and challenges of girls and women at risk of, or living with non-communicable diseases (NCDs). The authors contend that NCDs impact on women’s health and development across the lifecycle, causing morbidity and mortality, and compromising their socio-cultural status in communities. In light of this, the authors argue that failure to act now on NCDs will undermine development gains made to date, including progress made on women’s empowerment. They argue that recognition of the importance of women’s contribution to society in their productive and reproductive roles as well as consumers and providers of healthcare will enable real progress in turning back the global epidemic of NCDs. In conclusion, the authors note that there is lack of awareness around this critical issue for women's health and thus call for attention to NCDs as a priority for women’s health and development, policy dialogue on the particular issues related to girls and women and evidence-informed actions by all partners to improve the health and lives of girls and women worldwide.