The health of prisoners is among the poorest of any population group and the apparent inequalities pose both a challenge and an opportunity for country health systems. The high rates of imprisonment in many countries, the resulting overcrowding, characteristics of prison populations and the disproportionate prevalence of health problems in prison should make prison health a matter of public health importance, the authors of this paper argue. Women prisoners constitute a minority within all prison systems and their special health needs are frequently neglected. The urgent need to review current services is clear from research, expert opinion and experience from countries worldwide. Current provision of health care to imprisoned women fails to meet their needs and is, in too many cases, far short of what is required by human rights and international recommendations. National governments, policy-makers and prison management need to address gender insensitivity and social injustice in prisons. There are immediate steps which could be taken to deal with public health neglect, abuses of human rights and failures in gender sensitivity.
Values, Policies and Rights
In preparation for the United Nations (UN) High-Level meeting on non-communicable diseases (NCDs) in New York from September 19-20, 2011, the UN released an Outcome Document, called the ‘Zero Draft’, which affirmed the UN’s commitment to combat non-communicable diseases (NCDs). Civil society has voiced concern over the Zero Draft though, saying their input at the 16 June 2011 Informal Interactive Hearing on NCDs was not taken into account. Concerns include the lack of concrete targets and goals, the lack of specific mechanisms for resource mobilisation, and the lack of substantial follow-up to the meeting within the draft document. The role of the private sector in preventing NCDs is also another point of contention, and particularly the role of regulatory approaches, vs the adoption of the voluntary guidelines and targets favoured by the food and beverage industry representatives.
In 1978, at the Alma‐Ata Conference, ministers from 134 member countries in association with WHO and UNICEF declared ‘Health for All by the Year 2000’ selecting Primary Health Care as the best tool to achieve it. Unfortunately, the health status of third-world populations has not improved, according to the People’s Health Movement (PHM). In this Charter, PHM lays five health principles that may be applied globally. First, the attainment of the highest possible level of health and well‐being is a fundamental human right, regardless of a person's colour, ethnic background, religion, gender, age, abilities, sexual orientation or class. Second, the principles of universal, comprehensive Primary Health Care (PHC), envisioned in the 1978 Alma Ata Declaration, should be the basis for formulating policies related to health. Now more than ever an equitable, participatory and intersectoral approach to health and health care is needed. Third, Governments have a fundamental responsibility to ensure universal access to quality health care, education and other social services according to people’s needs, not according to their ability to pay. Fourth, the participation of people and people's organisations is essential to the formulation, implementation and evaluation of all health and social policies and programmes. Finally, health is primarily determined by the political, economic, social and physical environment and should, along with equity and sustainable development, be a top priority in local, national and international policy‐making.
The United Nations General Assembly adopted by consensus the resolution titled "Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases" (document A/66/L.1). The declaration calls for the development of multisectoral public policies that create equitable health-promoting environments that empower individuals, families and communities to make healthy choices and lead healthy lives. It commits governments to accelerate implementation of the WHO Framework Convention on Tobacco Control (FCTC) and encourages countries, which have not yet done so, to consider acceding to the FCTC. In addition to price and tax measures to reduce tobacco consumption, governments committed to steps that include curbing the extensive marketing to children of foods and beverages that are high in saturated fats, trans-fatty acids, sugars, or salt. Other measures seek to cut the harmful consumption of alcohol, promote overall healthy diets and increase physical activity. It calls for countries to promote, establish or strengthen by 2013, and to implement multisectoral national policies and plans for the prevention and control of NCDs, taking into account, as appropriate, the 2008-2013 WHO Action Plan for the Global Strategy for the Prevention and Control of NCDs.
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).
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.