This study was carried out to understand the role social determinants and health seeking behavior among rice farming and pastoral communities in Kilosa District in central Tanzania. The study involved four villages; two with rice farming communities while the other two with pastoral communities. In each village, heads of households or their spouses were interviewed to seek information on livelihoods activities, knowledge and practices on malaria and its preventions. A total of 471 individuals were interviewed. Only 23.5% of the respondents had adequate knowledge on malaria. Fifty-six percent of the respondents could not associate any livelihood activity with malaria transmission. Majority (79%) of the respondents believed that most of fevers were due to malaria; this was higher among the pastoral (81.7%) than rice farming communities (76.1%). Cases of fever were significantly higher in households with non-educated than educated respondents. Women experienced significantly more episodes of fever than men. Fever was reported more frequently among pastoral than rice farming communities. Treatment seeking frequency differed by the size of the household and between rice farming and pastoral communities. In conclusion, education, sex, availability of health care facility and livelihood practices were the major social determinants that influence malaria acquisition and care seeking pattern in central Tanzania. The authors argue for an ecohealth approach to address the links of livelihoods and malaria transmission among rural farming communities.
Health equity in economic and trade policies
As pharmaceutical firms experience increasing civil society pressure to act responsibly, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. The author’s sought to understand how multinational pharmaceutical companies currently engage in CSR activities in developing countries and their motivations for doing so. They conducted a small-scale, exploratory study combining (i) in-depth review of publicly available data on pharmaceutical firms’ CSR with (ii) interviews of representatives from 6 firms, purposively selected, from the highest earning pharmaceutical firms worldwide. Corporate social responsibility differed for each firm. Across the firms studied, the common CSR activities were: differential pharmaceutical pricing, strengthening developing country drug distribution infrastructure, mHealth initiatives, and targeted research and development. Primary factors that motivated CSR engagement were: reputational benefits, recruitment and employee satisfaction, better rankings in sustainability indices, entrance into new markets, long-term economic returns and improved population health. CSR strategies ranged from philanthropic donations to integrated business models. The authors indicate that the study points to the need to (i) develop clearer definitions of CSR in global health (2) strengthen indices to track CSR strategies and their public health effects in developing countries and (iii) undertake more country level studies that investigate how CSR engages with national health systems.
Modern trade negotiations have delivered a plethora of bilateral and regional preferential trade agreements (PTAs), which involve considerable risk to public health, thus placing demands on governments to strengthen administrative regulatory capacities in regard to the negotiation, implementation and on-going management of PTAs. In terms of risk management, the administrative regulatory capacity requisite for appropriate negotiation of PTAs is different to that for the implementation or on-going management of PTAs, but at all stages the capacity needed is expensive, skill-intensive and requires considerable infrastructure, which smaller and poorer states especially struggle to find. It is also a task generally underestimated. If states do not find ways to increase their capacities then PTAs are likely to become much greater drivers of health inequities. Developing countries especially struggle to find this capacity. In this article the authors set out the importance of administrative regulatory capacity and coordination to manage the risks to public health associated with PTAs, and suggest ways countries can improve their capacity.
The author argues that the outcome of the last WTO Ministerial, the 'Nairobi Package', was in fact a slap in the face for the peoples of the South. He observes it to be especially egregious that the US used the 10th Ministerial, with the help of the Kenyan leadership, to undermine the future of Pan-African trading relations and to drive a wedge between the BRICS societies and those that the US wants to manipulate in the poor countries. He further argues that the 10th Ministerial has hastened the demise of the WTO in an article which charts the various trade agreements and roles played by state actors in the North and South in achieving unfair and unequal global agreements.
The authors report that the world’s poorest countries are losing billions of potential tax revenue each year as a result of illicit financial flows and the tax dodging schemes associated with them. These complex and shadowy tax dealings are robbing developing countries of revenue they need to spend on essential public services. Making a Killing analyses one part of the web of illicit financial flows, the ‘misinvoicing’ of international trade – a way of hiding the true value of imports and exports, shifting profits and evading taxes. The figures are staggering. The sums being lost are comparable to the amounts currently missing from the health budgets of very poor countries – lost money that could boost total budgets and pay for desperately needed doctors, nurses, clinics, hospitals and medicines, and provide the basic minimum of decent healthcare to mothers and children. If the world is to meet its ambitious targets on health and child survival, let alone the broader objectives of the Sustainable Development Goals, illicit financial flows must be urgently addressed. This reports sets out recommendations for action by the international community.
The importance of the pharmaceutical industry in Sub-Saharan Africa, its claim to policy priority, is rooted in the vast unmet health needs of the sub-continent. Making Medicines in Africa is an open access online book that is a collective endeavour, by a group of contributors with a strong African and more broadly Southern presence, to find ways to link technological development, investment and industrial growth in pharmaceuticals to improve access to essential good quality medicines, as part of moving towards universal access to competent health care in Africa. The authors aim to shift the emphasis in international debate and initiatives towards sustained Africa-based and African-led initiatives to tackle this huge challenge. The authors argue that without the technological, industrial, intellectual, organisational and research-related capabilities associated with competent pharmaceutical production, and without policies that pull the industrial sectors towards serving local health needs, the African sub-continent cannot generate the resources to tackle its populations' needs and demands.
In a response to critiques of the 2016 Alternative Mining Indaba, the Bench Marks Foundation asserts their commitment to a popular movement of workers and poor people in contesting corporate power and elite control over mining processes. The authors define their approach as evidence or research-based activism, accompanied by community organising and monitoring of corporate conduct with the view of challenging corporate power and continuing to agitate wherever power lies. To date, they have followed an advocacy strategy built on research, community organising, building alliances with organised workers and other communities. The organisers of the Alternative Mining Indaba argue that it is a time for governments to rededicate themselves with concrete deeds to protect and prevent harm for poor people.
The impacts of climate change are currently being felt by people and communities. However, many of the most severe impacts will be felt in the decades to come. Significant barriers emerge in an effort to achieve long-term development objectives, particularly in sub-Saharan Africa, a region with low capacity to adapt to the future impacts of climate change. Factoring medium- to long-term climate information into investments and planning decisions is therefore an important component of climate-resilient development. We know little about how climate information is used in Africa to make decisions with long-term consequences, or how effective it is. We know even less about the barriers to – and opportunities for – using climate information in decision-making. How, then, should governments, businesses and donors strive for climate information to achieve Africa’s long-term development objectives? The Future Climate For Africa (FCFA) programme explores these questions and seeks to challenge many of the assumptions that underlie them. To guide the programme, six case studies investigated how climate information was being used in decision-making in sub-Saharan Africa. These comprised four country case studies: Malawi, Rwanda, Zambia and a combined study of Accra, Ghana and Maputo, Mozambique; and two desk-based studies focused on long-lived infrastructure in the ports sector and the large hydropower sector. This report presents the results of the scoping phase.
Just when health care financing in Africa is expected to pick up due to perceptible improvements in many economies, including those of Ethiopia, Rwanda, and Angola, the global financial crisis gathers momentum for contagion. This paper examines how the financial crisis is undermining access to health care in Africa, and offers some suggestions to help improve the situation. The paper sees access as a multifaceted concept, imbued with various social, economic, and geographic characteristics. The study found that the revenue constrictions wrought by the ongoing financial crises (e.g., through reductions in donor funding, tourist bookings, and remittance to Africa) have affected the supply of health care services, put pressure on personal finances, and compelled many households to reduce their demand for formal health care services.
Africa is fast becoming the go-to continent for countries wanting access to the vast and rich resources. But can the continent harness its potential, negotiate effectively and have the confidence to take charge of its own future, without allowing global financial giants to ride rough-shod over it? This article discusses the current state of investment into the region, the influence of China and America and the implications for Africans.