Written in response to the United Nation’s High Level Political Declaration on UHC in September 2019, this issue has a focus on universal health coverage (UHC). Written before the COVID-19 pandemic, the articles reiterate that robust health systems matter and that the implications of a system’s universality, accessibility and quality reach far beyond any particular nation. The articles are open access for a limited period of time. This paper in the series examines the experience of advancing UHC in East and Southern Africa, drawing in part on learning from work in EQUINET. Underpinning the UHC agenda is the belief that access to health care is a fundamental human right that advances equality and safeguards human dignity. Achieving UHC is a huge endeavour and requires buy-in at all levels of the system. It calls for strategic leadership, evidence and review. There has been a significant expansion in the technical information and knowledge available to support UHC. Making progress towards achieving it is, however, not simply a technical issue: it is an issue of power, political choice and leadership.
Latest Equinet Updates
The ability of African countries to mount effective and equitable responses to COVID-19 reflects in part the access that countries have to reliable, sustained, distributed supplies of diagnostics (antigen and antibody test kits and equipment for decentralised laboratories) and health technologies (personal protective equipment (PPEs), oxygen and constant positive airway pressure equipment). As medicines and vaccines are developed and approved for COVID-19 they too need to be available at mass scale and locally distributed. Currently, African countries, like many others, face shortfalls in all of these essential commodities relative to need. Various global, multilateral and bilateral arrangements have been proposed to address innovation in and access to these technologies. This brief shares information on initiatives related to diagnostics, health technologies, medicines and vaccines, the issues for African countries and options for addressing them in the dialogue and negotiations at global fora. It covers African interests and options in relation to (i) securing solidarity-based bilateral and multilateral resource streams for supply needs; (ii) using existing TRIPS flexibilities (iii) enabling open innovation and sharing of intellectual property and (iv) enabling open manufacturing and distributed and local production of these technologies. The pressure is thus growing for all COVID-19 related drugs, diagnostics, vaccines and health products, existing or future, to be considered global public goods, as expressed by the UN Secretary General on 24 April. At the same time, the brief argues that the way to make these products available to everyone, everywhere, must be by structurally linking open innovation and open manufacture to distributed production and access. Current experience suggests that any other approach may fall short on delivering timely and equitably distributed access for African countries.
This desk review, commissioned by EQUINET through TARSC as part of the ongoing work on the extractive sector in the region aims to inform public sector professionals, policy-makers, civil society and parliamentarians on the population health impacts of large- and small-scale mining activities in East and Southern Africa. The paper specifies the known health risks for the different types of small- and large-scale mines in the ESA region. Poor communities are likely to be more affected as they have limited choices for employment, sub-optimal housing and limited access to safe drinking water. People living close to mining sites or near mine dumps and those whose livelihoods are tied to rivers for domestic and agriculture water are exposed to polluted environments due to mining wastes and contaminated air and drinking water. Discrepancies exist between what is documented and known about the health risks of mining globally and documented levels of these health outcomes in the ESA region. The author presents various reasons for this. Health impacts assessments are not always done before mines are licensed. After mines are licensed, these health outcomes may be poorly monitored. Information on the numbers and health status many living and working in mining and of ex-miners remains limited.
This information sheet aims to assist by bringing together information and links to resources from various sources on a range of issues related to COVID-19 covering: 1: Basic information on the virus and its health impact 2: The level and growth of the pandemic 3: What individuals and communities can do to prevent and respond to COVID-19 4: What workplaces and organisations can do to prevent and respond to COVID-19 5: Protection and support of health and other frontline workers 6: What countries are doing to prevent and respond to COVID-19. While the specific focus intends to be on east and southern Africa, this first information sheet provides information drawn from other regions and more mature epidemics that may be useful for those in the ESA region or that may raise issues to discuss and plan for in the region.
This is the second information brief from EQUINET to summarise and provides links to official, scientific and other resources as of April 1st 2020 to support an understanding of and individual to regional level responses to COVID-19. This brief complements and does not substitute information from your public health authorities. This brief covers: 1: Developments in the COVID-19 epidemic 2: The health system response 3: Policy, politics and rights 4: Support for and in different communities 5: The macro-economic challenges 6: What does this all mean for equity?
This is the third information brief from EQUINET to summarise and provides links to official, scientific and other resources as of April 14 2020 to support an understanding of and individual to regional level responses to COVID-19. This brief complements and does not substitute information from your public health authorities. This brief covers: developments in the COVID-19 epidemic; a discussion on population evidence and models; initiatives on health technologies; an update on the African engagement on releasing resources from debt and various resources.
This is the fourth information sheet on COVID-19 from EQUINET. It summarises information from and provides links to official, scientific and other resources as of end April 2020 on 1: Developments in the COVID-19 epidemic 2: Rolling back lockdowns- when and what next? 3: What COVID-19 has meant for the risks and returns from migration 4: An update on access to medicines and vaccines, and 5: Resources, COVID-19 and the creative economy.
This is a call for a desk review of public private partnerships (PPPs) in the health sector (health services) in east and southern African countries commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper aims to inform public sector professionals, policy makers, civil society and parliamentarians on the health sector and health equity impacts of PPPs in health services in the countries of east and southern Africa. It will cover the full spectrum of services provided in the health sector, viz promotive, preventive, curative and rehabilitative in East and Southern African countries.. The paper will be drafted, reviewed and final version produced between March and end July 2020. EQUINET will organise internal and external review. The commissioned author will be paid a gross fee of US$6000 for the paper. See the website for further detail.
EQUINET, SATUCC, SADC CNGO and Benchmarks Foundation have co-operated on regional engagement on extractives and health at the Alternative Mining Indaba, and with the Southern African ex mineworkers Association met in a regional meeting on health literacy in the mining sector in March 2019 to form a mining and health group to strengthen alliances and co-operation in the grassroots to regional and global engagement on the issue. The March 2019 meeting agreed to hold a follow up meeting at the time of the Alternative Mining Indaba (AMI) in February 2020 to follow up on the agreed actions, exchange information and widen the alliances and health literacy activities and processes in the region. The meeting was organised by TARSC / EQUINET and held in co-operation with SATUCC, SAMA and Benchmarks. It was held in Cape Town in the two days before the AMI to enable delegates to also engage in the AMI. It was supported by Medico International and OSF and by TARSC and all the organisations involved who also contributed own resources to their participation. The meeting aimed to i. Share information on mining and health in the region in terms of the risks, responses, rights and actions ii. Review activities on health literacy in mining and use of the EQUINET health literacy module on Mining and health iii. Review the work of the mining and health working group and its members in various platforms and proposed work on extractives and health equity in the region and identify priorities, alliances, actions and roles for follow up and iv. Identify issues to take forward in the AMI and other regional platforms. This report presents the information shared and discussions at the meeting and the plans for follow up work.
This paper reflects on experience from over two decades of EQUINET research practice to promote health equity in east and southern Africa. The paper was written by members of the EQUINET steering committee and the newsletter team. It draws examples and research features from EQUINET publications available online, a search of publications in the 221 issues of the EQUINET newsletter, and papers, reports, blogs, articles and editorials obtained from key word searches in Google. Despite policy commitments and gains in selected aspects of health, conditions in the region are increasingly driven by a global economy and a regional response that is generating instability, environmental and social costs; intense extraction of natural resources; rising levels of precarious labour, social deficits and weakened public institutions, disrupting social cohesion, solidarity and collective agency. These conditions call for certain features and forms of research. The paper describes diverse research on the costs to health equity of social deficits, inequitable resource outflows and the commodification of public services, as well as research on alternatives and policies on food security, health services, environment and rights that confront these trends. The paper describes specific features of research that respond more directly to the understanding that power relations are central to inequities in health. These research processes explain and show alternatives to disempowering narratives of the inevitability of the status quo and generate knowledge in ways that intend to empower those affected. They pay attention to who defines the research questions, who designs, implements and uses the research. This implies designs and methods that involve people in affirming and validating their realities, generating reflection on causes and building analysis, self-confidence and organisation to act and to learn from action. It presents specific examples of research approaches and the role of a consortium network in advancing them, while noting the ways in which many researchers face the double task of investigating inequities, while also challenging inequity in a global research system.