Health equity in economic and trade policies

Decolonizing technology: A reading list
Martini B: Tech and Tools for Justice and Rights Blog, 2017

Today, the ways and means of technology access and usage are suggested by the author to be driven by power dynamics centering on the needs of specific demographics and experiences, channeling a colonialist exercise of control, establishing who gets to use a tool or service, and to which extent. A growing number of researchers, scholars, artists and advocates has been looking into how a colonialist approach sits at the core of how a great deal of digital technology is developed, distributed, and capitalised. This has progressively contributed to a new lens through which to analyse the subject matter, which can be referred to as the concept of decolonizing technology. With the objective to build a resource to inspire new learning and reflections on the concept of decolonizing technology, this post includes a reading list on the topic. This list represents a snapshot of some the work done to date on the concept of decolonizing technology. It aims to inspire further research and discoveries of any other possible resource and initiative delving deeper into this subject, from many more and different perspectives.

The political argument for investing in global health
Martin K; Mullan Z; Horton R: The Lancet Global Health 5(Special Issue) S1-S2, 2017

The authors argue that an insular, authoritarian wave has been on the rise that is playing on people's fears and insecurities, undermining democratic institutions that are vital to maintaining the ties of accountability between the elected and the public: and multilateral infrastructures. Global health is argued to rely on an outward-looking, internationalist stance, since the threats that are faced know no borders. So how can global health advance in an era of retreat? Politics drive policies and the public drives the political. All sectors must thus, it is argued, be politically active in order to affect the development and implementation of public policies, including academia and the knowledge it brings. To successfully advance financial and political capital investments in global health, arguments must be framed by how they improve the security and prosperity of citizens and the nation. Investing in global health and multinational actions is a path to address these threats that know no borders.

Time for a global response to labour rights violations in the manufacture of health-care goods
Bhutta M: Bulletin of the World Health Organisation 95(5) 314-314A, 2017

This document discusses guidance on ethical procurement for health and for protecting labour rights in medical supply chains. It is an update to an earlier document in response to evidence of abuse of worker rights at several factories manufacturing health-care products destined for global markets. Poor labour conditions should concern all those in health care. Work is inextricably correlated to physical and mental well-being: unsafe working conditions risk bodily injury; inadequate remuneration links to malnutrition, poor housing and lack of opportunity. Long or irregular working hours and a lack of respect at work contribute to stress, anxiety and depression. Working conditions found in the manufacture of some health-care products have been among the worse encountered anywhere. The document reports on the measures taken by other countries and that comply with the International Labour Organisation Declaration on fundamental principles and rights at work, as well as with local employment and health and safety legislation. For example for high-risk products, suppliers are contractually required to allow independent audit of manufacturing sites to identify problems and to oblige remedial action, a measure that has led to demonstrable improvements in working conditions for the people making products for the health-care system. The paper also notes that there are still limited measures for protection of health and safety in the growing global market for health-care products, estimated to soon be worth over US$ 500 billion annually.

Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania
Mrema E; Ngowi A; Mamuya S: Annals of Global Health 81(4), 538-547, 2015

This study describes the status of occupational health and safety in Tanzania and the challenges in provision of occupational health services in an expanding economy, with growth being driven by communications, transport, finance services, construction, mining, agriculture, and manufacturing. The workers exposed to hazards from these activities are found suffer from illness and injuries, but to not access adequate occupational health services, with services limited to a few enterprises that can afford it. Existing laws and regulations are reported by the authors to not cover the entire population and implementation to be weak. The authors argue for an occupational health and safety services strategy, backed by legal review, training and the necessary skills, financial and technological resources to cover the whole working population, to match the growing economy.

Tobacco growing and the sustainable development goals, Malawi
Kulik M; Bialous S; Munthali S; Max W: Bulletin of the World Health Organization 95(5) 362-367, 2017

Malawi is the world’s largest producer of burley tobacco and its population is affected by the negative consequences of both tobacco consumption and production. In producer countries, tobacco control involves control of the whole tobacco supply chain, rather than only control of consumption. The authors reviewed the impact of tobacco cultivation in Malawi to illustrate through this example the economic, environmental, health and social issues faced by low- and middle-income countries that still produce significant tobacco crops. The authors placed these issues in the context of the sustainable development goals (SDGs), particularly goal 3a, which calls on all governments to strengthen the implementation of the World Health Organisation Framework Convention on Tobacco Control. Other goals address the negative effects that tobacco cultivation has on development. The authors suggest that without external assistance, Malawi has relatively limited capacity to develop alternatives to tobacco production that are economically viable, but could benefit greatly from becoming a party to the FCTC to receive assistance through the incorporation of the FCTC into the SDGs.

Ecological and human health risks associated with abandoned gold mine tailings contaminated soil
Ngole-Jeme V; Fantke P: PLoS One, 2017, doi: https://doi.org/10.1371/journal.pone.0172517

Studies were carried out in Krugersdorp, South Africa, to evaluate the ecological and human health risks associated with exposure to metals and metalloids in contaminated soils in mine tailings from gold mining. Human health risk was assessed using Hazard Quotient (HQ), Chronic Hazard Index (CHI) and carcinogenic risk levels, where values of HQ > 1, CHI > 1 and carcinogenic risk values > 1×10−4 represent elevated risks. Values for HQ indicated high exposure-related risk for arsenic, chromium, nickel, zinc and manganese. Children were more at risk from heavy metal and metalloid exposure than adults. Cancer-related risks associated with metal and metalloid exposure among children were also higher than in adults. The authors identify that there is significant potential ecological and human health risk associated with metal and metalloid exposure from contaminated soils around gold mine tailings dumps. They note that this could be a potential contributing factor to poor health of residents in informal settlements in the mining area, particularly for those whose immune systems are already compromised by HIV.

Environmental and health impacts of mining in Africa
Mapani B; Kribek B: Proceedings of the annual workshop IGCP/SIDA No. 594, Windhoek, Namibia, 2012

As the demand for mineral resources and fossil fuels continues to grow worldwide, the impact of mining will be an increasingly important concern. In Africa, local communities have been exposed to the detrimental effects of contamination arising from mining and its effects on public health, agriculture and the environment. The legacy of mining has left thousands of sites in Africa contaminated by mining and associated mine dumps such as tailings and slag material. The number of studies focused on the impacts of mining on the environment and human health in Africa have increased during the last decade. This paper reports on a project designed to correlate and integrate the results of multidisciplinary studies carried out in contaminated sites and areas using the best contemporary procedures for statistical analysis, management and compilation of the geochemical data; to strengthen the capacity of African institutions in environmental geochemistry, to raise public awareness of the impacts of mining on the environment and human health and to facilitate cooperation among geoscientists and medical scientists.

Mining and Risk of Tuberculosis in Sub-Saharan Africa
Stuckler D; Basu S; McKee M; Lurie M: American Journal of Public Health 101(3), 524-530, 2105

This paper aimed to investigate the relationship between mining and tuberculosis (TB) in sub-Saharan Africa. The authors used multivariate regression to estimate the contribution of mining activity to TB incidence, prevalence, and mortality, as well as rates of TB among people living with HIV, with control for economic, health system, and population confounders. Mining production was associated with higher population TB incidence rates, with an increase of mining production of 1 SD corresponding to about 33% higher TB incidence or 760 000 more incident cases, after adjustment for economic and population controls. Similar results were observed for TB prevalence and mortality, as well as with alternative measures of mining activity. Independent of HIV, there were significant associations between mining production and TB incidence in countries with high HIV prevalence and between log gold mining production and TB incidence in all studied countries. The authors conclude that mining is a significant determinant of countrywide variation in TB among sub-Saharan African nations. Comprehensive TB control strategies should explicitly address the role of mining activity and environments in the epidemic.

Revolutionary Change in Africa: an Interview with Samir Amin
Zeilig L: Review of African Political Economy, March 2017

Samir Amin is one of Africa's foremost radical thinkers. In this interview organised by African Research and Cooperation for Endogenous Development Support, Amin reflects on a life spent at the cutting edge of radical theory and practice and African politics. Amin questions what social progressive change means today. He argues that there needs to be a strengthening of socialist consciousness - instead of ‘moving up’ within capitalism, people need to orientate in the opposite direction, and intensify the contradictions between an anti-capitalist alternative and what capitalism can offer. He argues against the concept of a single ‘revolution’, preferring instead to talk about advances and changes which create the possibility of later, further advances. He also rejects the view that it is possible to produce change without political and state power. Amin notes that all the peoples of Africa are today facing a big challenge. African societies are integrated in a form of globalisation that is damaging for the continent. He argues that Africans must 'delink’ from it and reject the logic of unilateral adjustment to the needs of further capitalist and imperialist expansion, starting at national level.

The coping mechanisms of women in the mining industry
Mokotong R: University of Pretoria, South Africa, 2016, doi: http://hdl.handle.net/2263/53441

Internationally, the involvement of women working underground is a relatively new phenomenon. In South Africa, women were recently allowed to work in the underground mines. However, the challenges of women and men are different and their coping mechanisms are not the same. This research investigated how women cope under the occupational and labour culture, and health and physical demands inherent to this type of work. By means of the non-probability sampling method, ten (10) women were purposively selected and a qualitative collective case study design was used. The findings illustrate that women in the mining industry experience challenges with regard to labour, health, occupational challenges, work-life balance, sanitation facilities and sexual harassment. They were found to use different mechanisms to cope with the challenges they face on a daily basis. The authors call for the mining industry management to devise ways to meet the needs of women and offer support in response to their daily challenges.

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