Three countries in Southern Africa have the highest adult HIV prevalence in the world: Swaziland (25.9%), Botswana (24.8%), and Lesotho (23.6%). Fiscal policy is crucial for addressing this HIV and AIDS crisis, the authors of this paper argue. Utilising a calibrated model, they investigated the impact of fiscal policy on reducing the HIV and AIDS incidence rates in these countries. In particular, they studied the welfare impact of different taxation and debt paths in reducing the HIV and AIDS prevalence rates. This is particularly important given the current concerns about dwindling foreign aid (especially the Global Fund), and fiscal deterioration and sustainability in these countries. The results show that acting optimally has not only positive societal welfare effect but also positive fiscal effects. For example, it will alleviate the debt burden by 5%, 1% and 13% of the GDP respectively for Botswana, Lesotho and Swaziland by the year 2020. Thus, at a time of fiscal crisis in developed countries and dwindling international HIV and AIDS resources, the future of effective and efficient HIV and AIDS intervention in Africa is clearly domestic, they conclude.
Values, Policies and Rights
Understanding the health policy formulation process over the years has focused on the content of policy to the neglect of context. This had led to several policy initiatives having a still birth or ineffective policy choices with sub-optimal outcomes when implemented. Sometimes, the difficulty has been finding congruence between different values and interests of the various stakeholders. This paper attempts to conceptualise the levers of policy formulation using a qualitative participant observation case study based on retrospective recollection of the policy process and political levers involved in developing the Ghana National Health Insurance Scheme. The study finds that technical experts, civil society, academics and politicians all had significant influence on setting the health insurance agenda. Each of these various stakeholders carefully engaged in ways that preserved their constituency interests through explicit manoeuvres and subtle engagements. Where proposals lend themselves to various interpretations, stakeholders were quick to latch on the contentious issues to preserve their constituency. The paper provides lessons which suggest that in understanding the policy process, it is important that actors engage with the content as well as the context to understand viewpoints that may be expressed by interest groups.
An Intellectual Property Laws Amendment Bill passed by Parliament is awaiting signature by South African President Jacob Zuma in order for it become the law. It is an ambitious piece of legislation that aims to provide protective mechanisms for indigenous knowledge in South Africa. The bill is far-reaching and aims to: improve the livelihoods of indigenous knowledge holders and communities, benefit the national economy, prevent bio-piracy, provide a legal framework for protection and empower local communities and prevent exploitation of indigenous knowledge. Despite this legal advance, there is another view on the issue of indigenous intellectual property rights which states that the issue will always remain on the margins, given the dominant system of knowledge production which in the main takes place in universities. The article concludes that the prevailing view is that given the history of persecution of indigenous peoples under colonialism, the fight to include their voices in the protection of indigenous knowledge systems is important and necessary to inform the way forward.
The conference gathered Ministers of Finance and Health and/or their representatives from 54 African countries, African parliamentarians as well as over 400 participants from the public and private sectors, academia, civil society and media globally. The conference recommended:
1. Intensified dialogue and collaboration between ministries of finance and health and with technical and financial partners; 2. Concrete measures to enhance value for money, sustainability and accountability in the health sector to reach universal health coverage; 3. Integrating socio-economic, demographic and health factors into broader development strategies and policies in an effective manner especially in the formulation of medium term strategic plans; 4. Designing effective investments in the health sector, based on evidence-based strategies leading to the prioritization of high impact interventions, which lead to results; 5. Promoting equitable investment in the health sector; ensure that health financing is pro-poor benefiting disadvantaged areas; strengthening regulatory capacity and developing of a strong African pharmaceutical sector as a growth and job creating sector in Africa; 6. Laying out the path to universal health coverage for each country; 7. Improving efficiency in health systems, including equitable access to skilled health workers; 8. Solidifying sustainable health financing systems; 9. Strengthening accountability mechanisms that align all relevant partners, build on the growing citizens’ voice and 10. Increasing domestic resources for health.
The 17th Conference of the Parties to the United Nations Convention on Climate Change (COP 17) that concluded in December 2011, in Durban, South Africa produced the Durban Platform for Enhanced Action that commits governments to developing a protocol, legal instrument, or an agreed outcome to cut greenhouse gas (GHG) emissions with legal force applicable to all countries by no later than 2015. Foreign ministers and environmental ministers set and drove the conference agenda, and economic considerations underpinned all discussions. Despite climate change posing grave risks to human health, the human health perspective on climate change was relegated to side-event, although it led to a parallel inaugural Global Climate and Health Summit, and the Durban Declaration on Climate and Health and Health Sector Call to Action. The report argues that the marginalisation of human health considerations at UN Fframework Convention on Climate Change conferences is untenable and that human health must be a core, not peripheral, focus at future meetings. The report states that the health community, led by health ministers, must play a central role in climate change deliberations and that health ethics principles must be afforded equal status to economics principles in climate change deliberations.
Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programmes. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics - the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI) - has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for health, offering a new post-MDG vision. This Special Communication describes the key modalities of an FCGH to illustrate how it would improve health and reduce inequalities. The modalities would include defining national responsibilities for the population’s health; defining international responsibilities for reliable, sustainable funding; setting global health priorities; coordinating fragmented activities; reshaping global governance for health; and providing strong global health leadership through the World Health Organisation.
An survey reported by the Zimbabwean on the Constitution found that 40% of those interviewed were in favour of the Constitution preserving full rights for women to have an abortion, while fewer(39%) believed it should be preserved only in certain instances which must be clearly stated by law. Only 19% were completely opposed to the Constitution preserving any rights for a woman to have an abortion. More men than women were in favour of full rights for women to seek an abortion. The government, which says it is aware of the practice of illegal abortions, promotes safe sex as a solution, but a spokesman for the Ministry of Health and Child Welfare admitted this was a huge challenge due to the unavailability of – and cultural resistance to – contraceptives. A largely Christian society, abortion in Zimbabwe is condemned by both the church and the state. Women who do choose the abortion route say that although a safe, legal abortion is exorbitant – around US$350 – it’s still a lot cheaper than the cost of giving birth to a child in a city hospital. Pregnant women who cannot afford the legal option are reported to resort to taking herbal remedies from traditional healers.
This article poses questions about what will be achieved at Rio+20. The author argues that all global environmental problems—from climate change to hazardous waste—have separate agreements. International rules of engagement and cooperation are being discussed in parallel processes and institutions. Rio+20 has raised the green economy rather than 1992’s concept of sustainable development, but without clarifying what this is. Does it mean the world will invest in technologies to green the current economy? Or will it seriously reinvent growth so that it is not driven by cheap consumption that is costing us the earth?
In this press statement, human rights organisation Release Political Prisoners (RPP) Trust registers its support for the position taken by the Kenya National Commission on Human Rights to promote the rights of lesbians, gays, bi-sexual and transgender people as well as commercial sex workers. RPP notes that the constitution protects all Kenyans against any form of discrimination and that the bill of rights guarantees all persons, non-heterosexuals included, all rights and entitlements under that Chapter, including the right to health and education. Statistics indicate that up to 15% of new HIV infections in Kenya are attributable to gay men and 6 out every 10 gay men are in heterosexual relationships. Yet discrimination hampers access to health services for these marginalised groups. Even when they get infected, they rarely have access to treatment and are reportedly often discriminated against by health workers. RPP notes several incidences in the recent past where gay men and women have been threatened and attacked at health facilities while seeking treatment for HIV. It argues that these attacks can be directly attributed to the preaching of hatred against gays and lesbians by religious leaders, and calls on the National Cohesion and Integration Commission (NCIC) to consider investigating these religious groups for hate speech and for promoting discrimination against non-heterosexuals and commercial sex workers.
The Ugandan government has launched an HIV and AIDS workplace policy in a bid to promote freedom from stigma and non-discrimination for all employees, according to this article. The policy, spearheaded by the Ministry of East African Affairs, will address discrimination against employees living with HIV or AIDS, ensure that they are provided with antiretrovirals, promote gender equity and equality, help with management of HIV-positive employees to enable them achieve their potential, as well as guaranteeing them total confidentiality. The policy acknowledges that HIV and AIDS have continued to impact negatively on the country’s economy, through the loss of skilled labour, absenteeism from work due to stigma and increased healthcare expenditure. The policy covers all employees except the police and army, which do not recruit people living with HIV, even if they meet all other requirements.