The United Nations Special Rapporteur on the human right to water and sanitation, Léo Heller, and the Chair of the UN Committee on Economic, Social and Cultural Rights, Waleed Sadi, welcomed the explicit recognition of the ‘human right to sanitation’ as a distinct right, together with the ‘human right to safe drinking water’ by the UN General Assembly in December. Over 2.5 billion people still lack access to improved sanitation - the sanitation target under Goal 7 has been missed by one of the widest margins of all the 18 targets under the Millennium Development Goals. One billion people practise open defecation, nine out of ten in rural areas across the world. The experts explained that while sanitation does not necessarily have to be water-borne, governments tend to focus on this type, rather than on-site sanitation such as pit latrines and septic tanks, which are still widely used. As a result, individual households which rely on on-site sanitation often have to operate the entire system themselves, including collection and disposal, without government support. “The right to sanitation also requires privacy and dignity,” the experts stressed. In the UN General Assembly resolution, adopted by consensus on 17 December 2015, Member States recognized that ‘the human right to sanitation entitles everyone, without discrimination, to have physical and affordable access to sanitation, in all spheres of life, that is safe, hygienic, secure, socially and culturally acceptable and that provides privacy and ensures dignity.’ “We urge all Member States, in both their national budgeting and international development cooperation, to target the allocation of resources to sanitation in particular to the most marginalised and disadvantaged groups and individuals, as those living in urban informal settlements and in rural areas,” the experts said.
Poverty and health
Agenda 2063 - The Africa We Want is a flagship campaign of the African Union. This policy argues for using the opportunity offered by urbanisation and the demographic shift to fulfil the vision of an African renaissance. With urbanisation firmly on the agenda across Africa there is a need for a constructive policy dialogue on what exactly urbanisation in Africa might mean. To support such a process the Cities Alliance secretariat has awarded a grant to the African Centre for Cities (ACC) at the University of Cape Town to establish an independent think tank dedicated to this issue. In this video Gustave Massiah, an Urban Specialist with the United Cities and Local Governments of Africa, discusses the key challenges facing African urbanisation in a post-industrial period. Gustave sees the main challenges of African urbanisation to be those faced by the continent as a whole: inequality, unemployment and the resistance of external exploitation. He proposes a new conception of informality based on the dynamism and power of the individual. With no obvious answer to informality, society then has to review its definition of informal and to better understand people's own experience of their conditions.
The author argues that psychological violence of colonialism today only exists as a re-enactment, or a reframing of the original physical warfare between colonialist and colonized bodies. He argues that contemporary images and representation still repeat the violence within popular culture, within academic curricula, literature, mainstream music, art, architecture, theatre, that pervades the contemporary world in ways that continue to suppress imagination.
The author raises that the covert violence, the risk, the uncertainty and the possibility of daily life in Kinshasa resides in the gap between official visions and unofficial reality. Using two cases in which water is being turned into land, Filip De Boeck reveals the need to envision a ‘near future' that hyphenates dream and reality; a plan predicated on incremental transformation rather than destructive, radical, exclusionary change.
Agricultural experts and policymakers have formed a new institution to promote sustainable food systems in Sub-Saharan Africa and to deal with the challenges posed by climate change. The African Ecosystem Based Adaptation for Food Security Assembly (EBAFOSA) which aims to advocate for sustainable ecosystem-friendly agricultural systems was formed during the 2nd Africa Ecosystem Based Adaptation for Food Security Conference held in Kenya on 30-31 July, 2015. Africa loses about six million of productive land a year through deforestation, with almost 65 per cent of the continent’s land being under pressure from land degradation, the conference heard. The EBAFOSA will work towards achieving food security, ecological productivity, job creation, poverty reduction, value addition and sustainable industrial development in Africa.
There has been growing policy interest in social justice issues related to both health and food. The authors sought to understand the state of knowledge on relationships between health equity and food systems, where the concepts of ‘food security’ and ‘food sovereignty’ are prominent. Combinations of health equity and food security (1414 citations) greatly outnumbered pairings with food sovereignty (18 citations). Prominent crosscutting themes that were observed included climate change, biotechnology, gender, racialization, indigeneity, poverty, citizenship and HIV as well as institutional barriers to reducing health inequities in the food system. The literature indicates that food sovereignty-based approaches to health in specific contexts, such as advancing healthy school food systems, promoting soil fertility, gender equity and nutrition, and addressing structural racism, can complement the longer-term socio-political restructuring processes that health equity requires. The authors’ conceptual model is argued to offer a useful starting point for identifying interventions with strong potential to promote health equity.
Transforming Our World, the 2030 Agenda for Sustainable Development, which is likely to be adopted by UN Member States, contains astonishingly bold and ambitious aspirations for transforming global health. The Agenda includes a series of “zero targets” to be achieved by 2030, including to “end preventable deaths of newborns and children under 5 years of age” and to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.” The author argues that such targets are simply unattainable unless there’s a massive scale-up in research and development (R&D) for conditions that disproportionately affect poor communities in low- and middle-income countries (LMICs). Unfortunately, the SDGs as currently written say way too little on the essential role of scientific innovation in achieving SDG 3 (the health goal) and they say nothing at all about the crucial importance of monitoring progress in global health R&D. A compelling August 2015 report by Policy Cures, an independent research group, made the case that the SDG 3 targets “will not be achieved without R&D to develop new health technologies—such as new and improved drugs, vaccines, diagnostics, and other critical innovations—and to improve our understanding of how to best target the tools we already have.” The author argues that the SDG health targets are a fairytale without a renewed global commitment to meet the R&D needs—and rights—of the world’s poor people.
Youth are a rapidly growing percentage of the Sub-Saharan African population, and many are economically vulnerable. Financial inclusion for youth, particularly the promotion of savings behaviour, is associated with a number of positive social and economic outcomes and is an international priority. However, the majority of youth in Sub-Saharan Africa are not saving, and limited qualitative research exists to aid understanding of the possible explanations. This paper aims to increase the understanding of factors that facilitate and obstruct youth saving by exploring the savings behaviour of youth participating in the YouthSave Project in Ghana and Kenya. The authors conducted in-depth interviews with four triads comprised of youth, a parent or caregiver, and a school stakeholder in each country to develop case studies for the YouthSave Project. Findings indicate that support from parents, school staff, and financial institutions is conducive to youth participation in saving, even though youth participants struggle with limited financial resources and conflicting demands for money.
Cardiovascular disease is a rising health burden among the world’s poor with hypertension as the main risk factor. In sub-Saharan Africa, hypertension is increasingly affecting the urban population of which a substantial part lives in slums. This study aims to give insight into the profile of patients with hypertension living in slums of Nairobi, Kenya. Socio-demographic and anthropometric data as well as clinical measurements including BP from 440 adults with hypertension aged 35 years and above living in Korogocho, a slum on the eastern side of Nairobi, Kenya, was be collected at baseline and at the first clinic visit. The study population showed high prevalence of overweight and abdominal obesity as well as behavioural risk factors such as smoking, alcohol and a low vegetable and fruit intake. Furthermore, the majority of hypertensive patients do not take anti-hypertensive medication and the ones who do show little adherence.
According to the latest estimates from the World Health Organization/United Nations Children’s Fund Joint Monitoring Programme for water and sanitation (JMP), 2.5 billion people worldwide do not have access to any type of improved sanitation. Current definitions do not account for the diversity of shared sanitation: all shared toilet facilities are by default classified as unimproved by JMP because of the tendency for shared toilets to be poorly managed and unhygienic. However, the authors argue that shared sanitation should not be automatically assumed to be unimproved. They also argue that it is necessary to have a new look at how we define shared sanitation and to use specific subcategories including household shared (sharing between a limited number of households who know each other), public toilets (intended for a transient population, but most often the main sanitation facility for poor neighbourhoods) and institutional toilets (workplaces, markets etc.). This sub-classification will, it is argued, identify those depending on household shared sanitation, which the authors consider to be only a small step away from achieving access to private and improved sanitation. This subcategory of shared sanitation is, therefore, worth discussing in greater detail. The authors argue that the focus for future sanitation programmes should be on improving the hygienic standards of shared facilities to a level that satisfies and protects sanitation users.