This study aimed to investigate the contribution made by health policy analysis institutes in low- and middle-income countries to health policy agenda setting, formulation, implementation and monitoring and evaluation; and assess which factors, including organisational form and structure, support the role of health policy analysis institutes in low- and middle-income countries in terms of positively contributing to health policy. Six case studies of health policy analysis institutes in Bangladesh, Ghana, India, South Africa, Uganda and Vietnam were conducted including two NGOs, two university and two government-owned policy analysis institutes. Some key messages merged. Under the right conditions, health policy analysis institutes can play a positive role in promoting evidence-informed decision making in government. Factors critical in supporting effective policy engagement include: a supportive policy environment, some degree of independence in governance and financing, and strong links to policy makers that facilitate trust and influence. Motivation and capacity within government to process and apply policy advice developed by a health policy analysis institute was found to be key to the institute’s ultimate success.
Values, Policies and Rights
The current system for the research and development (R&D) of new medicines does not adequately meet the needs of the majority of the world's population, argue the authors of this paper. There is a lack of new medicines for the “neglected diseases”, namely those that primarily affect populations with little purchasing power, and therefore offer an insufficient incentive for industry to invest in R&D. Despite the emergence of many new approaches to generating R&D that meets the needs of poorer populations, efforts remain ad hoc, fragmented, and insufficient. The authors discuss how an R&D treaty could complement and build on existing initiatives by addressing four areas where the system remains particularly weak: affordability, sustainable financing, efficiency in innovation, and equitable health-centered governance. They argue that effective tools for global governance are required to generate medical R&D as a global public good, based on the understanding that a politically and financially sustainable system will require both fair contributions from all, and fair benefit-sharing for all.
This book focuses on how health policy is developed nationally and globally, clearly explaining the key concepts from political science with examples. This edition is fully updated to reflect new research and ways of thinking about the health policy process. The book covers a range of topics: health policy analysis; power and policy making; public and private sector; agenda setting; government roles in policy; interest groups and policy; policy implementation; globalisation and policy process; policy research and evaluation; and doing policy analysis. It is intended as a resource for students of public health and health policy, public health practitioners and policy makers.
The World Health Organisation's Commission on Social Determinants of Health has stated that health inequities result from inequities in power, money, and resources, which in turn are based on a combination of unfair economic arrangements, poor policies and programmes and bad governance. In other words, a focus on health equity should shift to the causes of the causes. According to this article, putting health equity at the heart of policy making is a perfectly feasible goal. While there is fierce debate over economic policy in the face of huge debts faced by rich countries, with some economists calling for economic growth and others calling for reduced deficit spending, the criterion of success seeming to be a return to growth of gross domestic product (GDP). The author argues here that what is actually required are broader measures of social and economic progress than simply GDP. He calls for examination of the effects of economic policy choices on the lives people are able to lead, and hence the likely effect on health equity. When governments cut social expenditures, the effect is greatest on those at the lower end of the social hierarchy, namely those who are most dependent on cash and in-kind government expenditures. It should be of the highest priority to ensure that government policies do not unfairly increase avoidable health inequalities.
Global crises not only impact the economy and people's livelihoods, they also unsettle basic ideas and assumptions about the meaning and drivers of development. This collection of theoretical and empirical studies contributes to the global debate about the substance and politics of policy change three years into the 2007-2008 crisis. The authors examine the challenges and dynamics involved from the perspective of development and developing countries, engaging with some of the most pressing and contested issues. To what extent does the crisis provide an opportunity for moving away from the doctrines and policies that reinforced inequality and vulnerability? What new directions in policy, especially social policy, are required, and are developing countries moving in such directions? Are social forces and political coalitions supportive of transformative change able to mobilise? While the political underpinnings of policy change conducive to social reform - contestation, social mobilisation and coalition politics - are energised in the context of crises, the book shows that the nature of demands and the responsiveness of elites can vary considerably.
Member states at the World Health Assembly (WHA) was held from 21-26 May 2012 in Switzerland supported the concept of universal health coverage as an indispensable precondition for sustainable human development and a fair society. Some of them presented their experiences in implementing universal access to healthcare. Among the tools suggested were mainstreaming health in all national policies, sharing costs between public and private sectors, and offering subsidies and health insurance. Member States expressed their support for a stronger WHO as the organisation has a critical role to play in prevention, equitable access and efficiency in public health.
Increased persecution of homosexuals in Africa has drawn the attention of international funders recently. Western external funders are reported by the author to be considering making aid to African countries conditional on decriminalising homosexuality and upholding the rights of homosexual communities. While intended to show support for an otherwise vulnerable minority, the author suggests that withholding aid would have adverse effects on all Africans, including homosexual Africans. Threatening to withdraw foreign aid, it is argued, only reinforces the argument that homosexuality is a Western construct and would result in a local backlash. Further aid itself cannot be a tool for social justice given its roots in imequitable power relations. In contrast the author calls for an emerging movement that seeks to locate gender and sexuality, including that of homosexual people, within the broad spectrum of social and economic issues that affect all Africans.
This study focuses on the African Mining Vision (AMV), which was adopted by the African Union in 2008, an agreement that seeks to shift mineral policy beyond a focus on extracting minerals and sharing revenue. Instead, it relates mineral policy to the transformation of Africa’s economies and views an industrialisation strategy anchored on minerals and other natural resources as critical for achieving the Millennium Development Goals, eradicating poverty and securing sustainable growth. The study looks at regulation of artisanal and smallscale mining in Africa, the increasing importance of corporate social responsibility initiatives in the mining sector, and perspectives on capturing, managing and sharing mineral revenue for the befit of all. It highlights the fact that policy design works best when instruments are available to carry it out, and for much of Africa, that plan remains part of the rhetoric of official declarations, dissociated from real policy. So far, the policy position of stakeholders, especially government, is limited to short-term responses to immediate concerns or focused on extracting and exporting unprocessed natural resources. The AMV and this report affirm the need for Africa to transform its mining sector from an enclave of raw material supplies to an integrated industry that will help drive the continent's socio-economic development.
April 2012 marked the start of South Africa's new five-year strategy on HIV, STIs and TB. The plan has several broad goals: to reduce new HIV infections by at least 50%; to start at least 80% of eligible patients on antiretroviral treatment; to reduce the number of new tuberculosis infections and deaths by 50%; to ensure a legal framework that protects and promotes human rights to support implementation of the plan; and to reduce self-reported stigma related to HIV and tuberculosis by at least 50%. Additionally, a major strategic objective of the plan will be to address the social and cultural barriers to HIV, sexually transmitted infection, and tuberculosis prevention and care. The plan states that key vulnerable populations (eg, women between the ages of 15 years and 24 years, people from low socioeconomic groups, and men who have sex with men) will be targeted with different but specific interventions under each goal to achieve maximum impact. The strategy endorses a new focus on tuberculosis (TB), which is much needed, as South Africa has 482,000 TB sufferers, 70% of whom are co-infected with HIV.
This report presents findings from a qualitative and quantitative survey of present and future efforts by Brazil, Russia, India, China and South Africa to improve global health. It examines these roles within the broader context of international development and foreign assistance. BRICS foreign assistance spending is still relatively small when compared to overall spending by the US and Western European countries, but in recent years it has been increasing rapidly. Today, among the BRICS, China is by far the largest contributor to foreign assistance, and South Africa is estimated to be the smallest by a significant margin. Brazil and Russia prioritise health within their broader assistance agendas, while China, India and South Africa tend to focus on other issue areas. Though their health commitments vary significantly in both size and scope, each of the BRICS has contributed to global health through financing, capacity building, dramatically improved access to affordable medicines, and development of new tools and strategies. In this context, BRICS policymakers themselves have recognised their potential to have even greater global health impact when they committed in 2011 to ‘support and undertake inclusive global public health cooperation projects, including through South-South and triangular co-operation’.