EQUINET NEWSLETTER 174 : 01 August 2015

1. Editorial

Choosing impertinence to provoke debate: global cartoonists express the SDGs
Editor, EQUINET newsletter

At Rio+20 in 2012, country leaderships promised to strive for a world that is just, equitable and inclusive, and committed to work together to promote sustained and inclusive economic growth, social development and environmental protection for the benefit of all. They set a mandate to develop a set of sustainable development goals (SDGs) for consideration by the UN General Assembly at its 68th session in 2013. These SDGs should be coherent with and integrated into the UN development agenda beyond 2015.

The 17 Sustainable Development Goals are:
• Goal 1 End poverty in all its forms everywhere
• Goal 2 End hunger, achieve food security and improved nutrition and promote sustainable agriculture
• Goal 3 Ensure healthy lives and promote well-being for all at all ages
• Goal 4 Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
• Goal 5 Achieve gender equality and empower all women and girls
• Goal 6 Ensure availability and sustainable management of water and sanitation for all
• Goal 7 Ensure access to affordable, reliable, sustainable and modern energy for all
• Goal 8 Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
• Goal 9 Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
• Goal 10 Reduce inequality within and among countries
• Goal 11 Make cities and human settlements inclusive, safe, resilient and sustainable
• Goal 12 Ensure sustainable consumption and production patterns
• Goal 13 Take urgent action to combat climate change and its impacts
• Goal 14 Conserve and sustainably use the oceans, seas and marine resources for sustainable development
• Goal 15 Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss
• Goal 16 Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels
• Goal 17 Strengthen the means of implementation and revitalize the global partnership for sustainable development

They are simple statements with great intent. They respond to a harsh reality of spectacular progress and spectacular inequality.

How widely are these goals known by those most affected by the situations they seek to address? The SDGs add to many other current global commitments: the Universal Declaration of Human Rights, the Programme of Action for the Least Developed Countries for the Decade 2011-2020 (the Istanbul Programme of Action), the political declaration on Africa’s development needs, the Doha Declaration on Financing for Development, the United Nations Framework Convention on Climate Change and the Millennium Development Goals, amongst others. Over the years these statements of international cooperation have built a growing vocabulary of aspiration. No doubt the 17 goal statements will also attract many words and terms, targets and data, discussions, interpretations and explanations.

If words and targets begin to mystify intent and to obscure reality, particularly for those most directly affected, we may need other tools. Cartoonists from sixteen countries globally in the Cartooning for Peace network have, for example, portrayed their lens on the 17 SDGs in a book published in June 2015, and found at http://fr.calameo.com/read/002524839b003362c3438 . They present images of the goals for sustainable development as “work that is still precarious”. Visit the link and you will see some that are aspirational, and many that are picture codes, communicating without a word the contradictions that exist in the face of the SDGs.

Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For information on the SDGs see https://sustainabledevelopment.un.org/focussdgs.html . Cartooning for Peace is an initiative born in 2006 that now brings together 125 cartoonists globally. For more information see http://www.cartooningforpeace.org/?lang=en.

2. Latest Equinet Updates

Contributions of global health diplomacy to equitable health systems in east and southern Africa
EQUINET: Harare, July 2015

Do global health platforms provide meaningful opportunities to advance equitable health systems and population health in east and southern Africa? What factors have supported effective negotiation of African policy goals on health systems within international and global health diplomacy? This brief outlines, with hyperlinks to the relevant reports, the findings and proposals for follow up policy review, action and research from a three year EQUINET led policy research programme with government officials, technical institutions, civil society and other stakeholders and in association with the East, Central and Southern Africa Health Community (ECSA –HC). The first two pages provide the broad findings, proposed actions and research agenda. Subsequent text presents the findings and proposals from the specific themes investigated in the programme.

3. Equity in Health

Inequalities in health: definitions, concepts, and theories
Arcaya M; Arcaya A; Subramanian S: Global Health Action 8 (27106), June 2015

This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. The authors describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behaviour, environmental, and selection explanations. Concepts of relative versus absolute; dose–response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. The authors close by reflecting on what conditions make health inequalities unjust, and consider the merits of policies that prioritise the elimination of health disparities versus those that focus on raising the overall standard of health in a population.

4. Values, Policies and Rights

Hidden in Plain Sight: A statistical analysis of violence against children
UNICEF: Geneva 2014

Interpersonal violence has a grave effect on children: Violence undermines children’s future potential; damages their physical, psychological and emotional well-being; and in many cases, ends their lives. This report sheds light on the prevalence of different forms of violence against children, with global figures and data from 190 countries. Where relevant, data are disaggregated by age and sex, to provide insights into risk and protective factors.

Investing in the future we want: What will it require?
ECOSOC High Level Political Forum on Sustainable Development: Brief for Session 11b, New York, July 2015

The post-2015 development agenda will have at its core the sustainable development goals (SDGs). The SDGs are a set of universal goals covering a range of sustainable development issues. The challenge for the international community will be to match this agenda with adequate means to implement it. This translates into large financing needs. In its report issued in August 2014, the Intergovernmental Committee of Experts on Sustainable Development Financing estimated the investment requirements in different sectors. More recently, a group of multilateral development banks and the IMF have coined the term 'from billions to trillions' to characterise the financing demand. Globally, they estimate that achieving the proposed SDGs will require US$ 135 billion in ODA, and nearly 1 trillion in philanthropy, remittances, South-South flows and other official assistance, and foreign direct investment that needs to be used effectively for the SDGs.

Post-2015 Development Agenda: New draft out for final negotiations
TWN: Info Service 28 July 2015

The Co-facilitators of the Post-2015 Development Agenda talks have released what could be the near-final version of the Post-2015 Development Agenda. This will set the stage for the final round of hectic negotiations at the United Nations headquarters in New York in end July.
The “Outcome Document for the UN Summit to Adopt the Post 2015 Development Agenda: Draft for Adoption” attempts to resolve some of the still remaining thorny issues. However, whether and how quickly the Member States agree to the final document remains to be seen. The document is likely to undergo some changes as negotiations continue, and the final document will be adopted when there is consensus among member states.

Public health, universal health coverage, and Sustainable Development Goals: can they coexist?
Schmidt H; Gostin L; Emanuel E: The Lancet, June 2015

The UN General Assembly is currently considering proposals for Sustainable Development Goals (SDGs). SDG 3, focusing on health, specifically includes universal health coverage (UHC) among its targets. The authors argue that while UHC is timely and important, its promotion also entails substantial risks. A narrow focus on UHC could emphasise expansion of access to health-care services over equitable improvement of health outcomes through action across all relevant sectors—especially public health interventions, needed to effectively address non-communicable diseases (NCDs). The challenge for policy makers is observed to be to not merely to improve clinical services, but to achieve equitable health outcome improvements through genuine integration of individual and population-level health promotion and preventative efforts with curative services. Future UHC evaluations should include assessments of the extent to which this integration is accomplished—with particular attention to the distribution of benefits across groups—and not, as major current work be limited to the clinical side.

SADC Gender Protocol 2015 Barometer: Botswana
Glenwright D; Botswana Council of NGOs: Botswana Council of NGOs, Gaberone, June 2015

Botswana has made good progress against the targets of the Southern African Development Community (SADC) Protocol on Gender and Development set for 2015, according to this report. However, President Ian Khama of the Republic of Botswana said that Botswana would not sign the SADC Gender Protocol because the government considers some its time frames unrealistic, and some of its measures to have serious resource implications that the state cannot guarantee. Progress is noted in the report on the health sector, with trained personnel delivering more than 90% of births and 84% of the population living within five kilometres of a quality health facility. However, the maternal mortality rate is noted to have increased and only 44% of the population access contraception. Although Botswana has one of the world's highest HIV prevalence more than 95% of HIV-positive pregnant women access the prevention of mother-to-child transmission programme. In spite of these achievements, this report also reveals obstacles for the country on the road to gender equality, including a failure to address contradictions between formal and customary laws, with the latter discriminating against women, especially widows and divorced women.

5. Health equity in economic and trade policies

Bretton Woods Institution Narratives about Inequality and Economic Vulnerability on the Eve of South African Austerity
Bond P: International Journal of Health Services . 45(3) 415-42, 2015

In South Africa, at a time when National Health Insurance should be generously funded (7 years after its approval as public policy by the ruling party), the author argues in this paper that state fiscal austerity appears certain to nip the initiative in the bud. The World Bank and the International Monetary Fund issued separate reports about South Africa in late 2014, following a new finance minister's mid-term budget speech. In justifying austerity, they revealed 2 important conceptual blockages regarding inequality and international financial relations, giving neoliberal policy advocates intellectual weaponry to impose deeper austerity. In contrast, it is suggested that a "united front" of labour, community-based and social movement activists, along with a vigorous left opposition party in Parliament, could ensure that the class struggle ratchets up in intensity in the years ahead.

BRICS: The strategic road map
Klomegah K: Pambuzuka News 735, July 2015

After three days of high-level summit deliberations, the BRICS group of emerging nations (Brazil, Russia, India, China and South Africa), have laid out the strategic road map that will tackle development and infrastructure projects, and seek close economic cooperation under a 'Strategy of Economic Partnership' that will run till 2020. The Strategy identifies priority areas of BRICS cooperation - in power, manufacturing, mining, agribusiness, innovative technologies and other areas. It is aimed at expanding multilateral business cooperation with the goal of stepping up social and economic development, and increasing the competitiveness of BRICS countries in the global economy. The document refers to collaboration in developing technology and innovation in pharmaceuticals in 'mutually beneficial joint projects'.

Technology, innovation and health equity
Fong H; Harris E: Bulletin of the World Health Organization 93 (7), July 2015

Innovative technologies have enormous potential to improve human well-being. However, technological progress does not guarantee equitable health outcomes. As advances in technology redefine the ways people, systems and information interact, resource-poor communities are often excluded. Where technological fixes have been imposed on communities, the results have included abandoned equipment, incompatible computer programs and ineffective policies. A shift in values among leadership, communities and the creators of technology is argued to be critical to implementing technology sustainably and equitably. Numerous examples are outlined where technological applications undermine equity, fairness and human rights: for example, the use of high-tech medical interventions in preference to simpler preventive measures or terminator genes that prevent the re-use of seeds for food crops. To ensure equitable outcomes, the authors note that the design and implementation of technology needs to respect ethical principles and local values. Decisions on the use of new technology should be made by local users, and implementation needs long-term commitment and local ownership. In this article, the authors discuss features of technology implementation that can promote health equity, using a range of examples from the health, agriculture and economic sectors.

6. Poverty and health

Coping with the Challenges of Urbanization in Low Income Areas: An Analysis of the Livelihood Systems of Slum Dwellers of the Wa Municipality, Ghana
Abubakari Abu-Salia R; Kanton Osmannu I; Ahmed A: Current Urban Studies 3(2), 2015

In Ghana, unplanned and spontaneous urbanization has trapped many in slum dwellings with its attendant poverty, insecurity, and poor housing and general environmental conditions. Slum dwellers’ choices of livelihood activities are restricted under various socio-economic and planning constraints. Using mixed methods, this paper explored the conditions under which slum dwellers can maximize the prospects of their environment and minimize the challenges therein. The findings indicate that slum dwellers have a diversity of livelihood assets and potentials, yet limited access to planned adaptation remains a main challenge. Many dwellers result to autonomous supplementary occupations to cope with the challenges of urbanization. The authors argue for a redefinition of the mandate of urban planning, as a response to spontaneous urbanization, and for tools for sustainable livelihood at the local level.

Health impacts of household energy use: indicators of exposure to air pollution and other risks
Williams K; Northcross A; Graham J: Bulletin of the World Health Organization 93 (7) 507-508, 2015

Recent evidence of the negative impact of household air pollution on health suggests that it is time to upgrade national surveys to inform decision-making on improved fuels and cookstoves. More than 40% of the world’s population rely on solid fuels such as wood, crop residues or dung for their cooking and heating needs. Household air pollution, caused by cooking indoors with solid fuels, is the third leading risk factor for morbidity and mortality globally. In 2010, 3.5 million deaths and 4.3% of global disability adjusted life years were attributable to household air pollution. Pollutants from inefficient combustion of solid fuels, especially black carbon particles, also contribute to global climate change. This study discusses the implications of cooking apparatus, fuel collection practices, air pollution exposure and fuels for other purposes. The morbidity and mortality linked to cooking with solid fuels are significant, with particular implications for women and children. The impetus for assessing new indicators is motivated by a need to more fully understand how the household energy sector is changing in low- and middle-income countries. The information gained from improved indicators has the potential to better inform the targeting of resources and design of strategies for reducing household air pollution.

Rising through cities? A look at Ghana
Paller J: Africa Research Institute, 9 June 2015

A new report by the World Bank- Rising through Cities in Ghana-analyses the rapid transformation of a country whose urban population has grown from 4 million in 1984 to more than 14 million today. 51% of Ghanaians now live in cities. Over the same period annual GDP growth has averaged 5.7%, the number of industrial and service jobs has increased by 21% and the capital city, Accra, has registered a 20% reduction in poverty. In August 2014, a fiscal debt crisis forced the government to request financial assistance from the International Monetary Fund. In May 2015, Accra residents peacefully protested the failure to resolve a three-year long electric power crisis that has sapped businesses and hindered economic growth. The World Bank has presented a report with data on urban development in Ghana and this paper provides a critical analysis of the report and a link to the original publication.

7. Equitable health services

Ensuring universal health coverage for key populations
UNAIDS: Geneva 2015

Without addressing HIV among marginalized populations and human rights, this report argues that it will not be possible to end the AIDS epidemic as a public health threat by 2030. A high-level panel, which included UNAIDS Executive Director Michel Sidibé, called on health ministers to remove structural barriers to accessing HIV services and health care for all. Ensuring that marginalized populations are not excluded from the universal health coverage target of the next sustainable development goals was noted to be vital, noting a risk that countries could seek to advance progress towards universal health coverage by focusing on easier to reach populations. In order to ensure that no one is left behind, the report argues that measures will be needed to reduce the discrimination facing all marginalized groups and to ensure their meaningful participation in the development and implementation of health strategies.

Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition
Oni T; Unwin N: International Health 7(4), June 2015

In today’s globalised world, rapid urbanisation, mechanisation of the rural economy, and the activities of transnational food, drink and tobacco corporations are associated with an increased risk of chronic non-communicable diseases (NCDs). As a result, population health profiles are rapidly changing. Many low and middle income countries (LMICs) are undergoing rapid changes associated with developing high rates of NCD while concomitantly battling high levels of communicable diseases. This review synthesises evidence on the overlap and interactions between established communicable and emerging non-communicable disease epidemics in LMICs. The review focuses on HIV, TB and malaria and explores the disease-specific interactions with prevalent NCDs in LMICs. The authors highlight the complexity, bi-directionality and heterogeneity of these interactions and discuss the implications for health systems. It is argued to require breaking down barriers between departments within
health ministries that have traditionally designed services and
programs for communicable and NCD separately and integrated multi-sectoral action addressing determinants across the life course.

8. Human Resources

Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi
Lorenzo T; van Pletzen E; Booyens M: The International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy 15(2), 2015

This article analyses the work of community disability workers (CDWs) in three southern African countries to demonstrate the competencies that these workers acquired to make a contribution to social justice for persons with disabilities and their families. It points to some gaps and then argues that these competencies should be consolidated and strengthened in curricula, training and policy. Purposive sampling was used to select and interviews held with 16 CDWs who had at least 5 years experience of disability-related work in a rural area. Three main themes emerged, related to the integrated management of health conditions and impairments within a family focus; disability-inclusive community development and coordinated intersectoral management systems. The CDWs were found to facilitate change and manage the multiple transitions experienced by the families at different stages of the disabled person’s development. Disability-inclusive development is argued to require a workforce equipped with skills to work intersectorally and in a cross-disciplinary manner to operationalise the community-based rehabilitation guidelines that are designed to promote delivery of services in remote and rural areas. The author argues for their recognition as a CDWs as a cross-disciplinary profession.

Healthcare service providers’ and facility administrators’ perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study
Lang’a E; Mwanri L: Reproductive Health 12(59), 27 June 2015

In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. The authors note that implementation of the policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitised on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and collaboration with other key stakeholders be fostered in addressing poor maternal health outcomes in the country.

9. Public-Private Mix

Modern African Remedies: Herbal Medicine and Community Development in Nigeria
Africa Research Institute, April 2015

Pax is a private sector rural manufacturing enterprise in Edo State Nigeria that is a joint endeavour of the monastic and local communities. It has professionalised the production of traditional natural remedies to demonstrate that herbal medicines can be a force for innovation and progress in health care. An estimated two-thirds of Nigerians are reported in this paper to use these products, often in tandem with other medicines. The company holds that open dialogue, scrutiny and regulation are crucial if the economic potential of the sector is to be realised, and that traditional medicine must be modern, professional and based on science if it is to contribute to improving health systems and outcomes. More than 30 Pax products are reported to be government-certified. The paper argues that traditional medicine and pharmaceutical industries could be fostered in Nigeria; but that indigenous knowledge, resources and enterprise still remain under-exploited.

10. Resource allocation and health financing

Price tag of HIV response to more than double by 2033
Schmidt H; Gostin L; Emanuel E: The Lancet, 29 June 2015

With 3.1 million people on antiretrovirals (ARV), South Africa has the world’s largest ARV programme. Sustaining it – and the HIV response – is argued to more than double in cost in the next two decades, according to new research. The research reported in this paper modelled the cost of county’s HIV response and what it will take to meet ambitious international development targets adopted by the country in 2014. The research found that South Africa’s HIV programme will cost about R40 billion each year by 2033 – more than double the R21 billion budgeted for the programme in the next financial year. The analysis also revealed the top 18 most cost-effective ways South Africa can tackle its epidemic. Top of the list was increasing condom distribution, medical male circumcision and mass communication campaigns promoting safer sex among teens.

11. Equity and HIV/AIDS

A comparative analysis of national HIV policies in six African countries with generalised epidemics
Church K; Kiweewa F; Dasgupta A; Mwangome M; Mpandaguta E; Gómez-Olivé F; Oti S; Todd J; Wringe A; Geubbels E; Crampin A; Nakiyingi-Miiro J; Hayashi C; Njage M; Wagner R; Ario A; Makombe S; Mugurungi O; Zaba B: Bulletin of the WHO 93(7) 437-512, July 2015

This study compared national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. The authors also compared the national policies with WHO guidance. There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy. Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. It is proposed that future research assess the extent of policy implementation and link these findings with HIV outcomes.

12. Governance and participation in health

Ebola Report Misses Mark on International Health Regulations
Fidler D: Chatham House, July 2015

The author argues that the report on the WHO’s Ebola response fails to adequately address the problems in global health governance it exposed. The Ebola outbreak was a disaster for the International Health Regulations (IHR)—the main international legal rules supporting global health security. The outbreak highlighted dismal compliance with IHR obligations on building national core public health capacities. During the outbreak, WHO failed to exercise authority it has under the IHR. Many WHO member states violated the IHR by implementing travel measures more restrictive than WHO recommended under the IHR and that lacked scientific and public health rationales as the IHR requires. The final report of the Ebola Interim Assessment Panel asserted that ‘the global community does not take seriously’ its IHR obligations. However the panel’s IHR recommendations are argued by the author to be largely recycled old, ineffective ideas and to reflect weak analysis of the outbreak, difficulties the IHR experienced before Ebola, and challenges confronting IHR reform after this crisis.

In Search of Global Health Justice: A Need to Reinvigorate Institutions and Make International Law
Harmon S: Health Care Analysis, 26 June 2015

The author argues that responses to the recent outbreak of Ebola in West Africa were varied and many ineffective. More generally, the author suggests that it stems from a failure of international health justice as articulated by a range of legal institutions and instruments, and that it should prompt us to question the state and direction of approaches to the governance of global public health. This paper queries what might be done to lift global public health as a policy arena to the place of prominence that it deserves. It presents critical reasons for the failings of the global public health regime, including the marginalisation of health and equity in current economic individualist, monetised, market-focussed models and goals, and a fragmented, patchwork and ad hoc nature of the global public health architecture, with wide dispersion of the authority to act and a treatment-oriented and disease-specific focus. The paper articulates a new way forward, identifying three courses of action that might be adopted in realising better health outcomes and global health justice, namely value, institutional and legal reform.

Report of the Ebola Interim Assessment Panel
WHO: Geneva July 2015

This report of the assessment panel which the WHO commissioned on its response to the Ebola outbreak was meant to review the roles and responsibilities at the three levels of the organization (headquarters, regions, countries) and the WHO’s actions in the course of the outbreak. The report and recommendations fall under the following three headings: the International Health Regulations (2005); WHO’s health emergency response capacity; and WHO’s role and cooperation with the wider health and humanitarian systems. It found Member States have largely failed to implement the core capacities, particularly under surveillance and data collection, which are required under the International Health Regulations (2005); in violation of the Regulations, nearly a quarter of WHO’s Member States instituted travel bans and other additional measures not called for by WHO, which significantly interfered with international travel, causing negative political, economic and social consequences for the affected countries; and significant and unjustifiable delays occurred in the declaration of a Public Health Emergency of International Concern (PHEIC) by WHO. The Panel concluded that WHO be the lead health emergency response agency but that this requires that a number of organizational and financial issues be addressed urgently. The Panel considered that during the Ebola crisis, the engagement of the wider humanitarian system came very
late in the response.

SADC holds Ministerial Meeting on Disaster Preparedness and Response
SADC: Botswana, July 2015

'Enhancing Regional Disaster Preparedness and Response' was the theme of the first extra-ordinary Meeting of Ministers Responsible for Disaster Risk Management and Ministers of Finance, held on June 26, 2015 in Harare, Zimbabwe. The SADC Region is exposed to a wide range of hazards and disasters that frequently result in heavy loss of lives and livelihoods, displacement of large populations, disruption of economic activities, destruction of assets and loss of investment. The Hazards that affect the Region include floods, drought, snow, volcanic eruption landslides, tsunamis, tropical cyclones, storms, wild fires and earthquakes. These hazards increase the risk of shortages of water, outbreaks of diseases such as Malaria, cholera and other diarrhoeal diseases, malnutrition and stunted growth, foot and mouth diseases in animals and other negative impacts. The meeting was organised by the SADC Secretariat specifically by the Disaster Risk Reduction Unit under the auspices of the Directorate of the Organ on Politics, Defence and Security Affairs in collaboration with the Government of Zimbabwe. The Ministers directed the SADC Secretariat to develop a comprehensive regional disaster risk reduction strategy which should include regional response mechanisms and a humanitarian assistance framework. They also agreed to the establishment of a regional disaster preparedness and response fund and development of an integrated early warning system to ensure effective information dissemination on hazards faced by the region.

13. Monitoring equity and research policy

Critical Maternal Health Knowledge Gaps in Low- and Middle-Income Countries for Post-2015: Researchers’ Perspectives
Kendall, T: Paper No. 2. Women and Health Initiative, Harvard T.H. Chan School of Public Health: Boston, 2015

Between June and October 2014, the Maternal Health Task Force (MHTF) consulted 26 international maternal health researchers to gather perspectives on the most critical and neglected areas for knowledge generation to improve maternal health in low- and middle-income countries. The MHTF asked respondents to identify research and evaluation priorities in three broad areas: 1) persistent and critical knowledge gaps that need to be filled to accelerate reductions in maternal mortality and morbidity in low-and middle income countries; 2) crucial maternal health issues that have not been given adequate attention by research and donor communities; and 3) new situations and emerging challenges that require research to improve maternal health outcomes. The report presents the results of the interview responses on issues that will shape the landscape of maternal health over the next decade. This included strengthening health service delivery; improving distribution and retention of healthcare workers; the increasing burden of non-communicable diseases among pregnant women and women of reproductive age; the persistence of social and economic inequality and vulnerability; and urbanization. The need to attend to geopolitical determinants of maternal health, such as climate change and food insecurity, the proliferation of conflict and humanitarian crises, and the rise of religious fundamentalism, was also mentioned.

Monitoring pro-poor health-policy success in the SADC region
Amaya AB; Bagapi K; Choge I; De Lombaerde P; Kingah S; Kwape I; Luwabelwa M; Mathala O; Mhehe E; Moeti T; Mookodi L; Ngware Z; Phirinyane M: PRARI Policy Brief 1, April 2015

Monitoring pro-poor health policies at the regional level can support countries and regional bodies to identify gaps in addressing poverty and health, strengthen the link between regions and member states and hold actors accountable to their commitments. The Southern African Development Community (SADC) has conducted work in understanding how poor health and poverty coincide, are mutually reinforcing, and socially-structured by gender, age, class, ethnicity and location, with health policy documents on the issues. Yet guidelines and policies have been unevenly implemented. The Poverty Reduction and Regional Integration (PRARI) project seeks to support the development of a monitoring system to measure the contribution of regional governance in the development of pro-poor health policies in collaboration with key stakeholders in the region. The paper describes the system. It builds on existing efforts in the region and focuses on policy areas such as the social determinants of health; HIV/AIDS, TB and malaria; non-communicable diseases; maternal and child health; human resources for health; pharmaceuticals; among others. Global developments such as those related to the incoming Sustainable Development Goals (SDGs) are also considered. In order for this indicator-based monitoring system to be effective and to have an impact, it is argued to require regional ownership, active participation of national and regional experts throughout the process of indicator development, implementation and evaluation and evidence that it will address health priorities for the region.

14. Useful Resources

Bridging Waters Film Series
SADC: Botswana 2015

The Southern African Development Community (SADC) region is home to more than 260 million people, with transboundary rivers, lakes and groundwater bodies: 15 great rivers with their respective river basins in Southern Africa are shared between two or more countries. Water, however, does not recognise international boundaries. The joint management, protection and utilisation of water in Southern Africa is therefore not an option - it is a necessity. Bridging Waters is a docu-drama series illustrating how water in Southern Africa is sustainably managed according to SADC's Protocol on Shared Watercourses. Narrated through the lives of those living along Southern Africa's rivers and depicting their daily challenges, Bridging Waters connects local settings with transboundary management and exemplifies the local impacts of improved cooperation between countries in the region. Shot in 10 countries over a period of two years, the series delves into the waters of the Zambezi, the Limpopo, the Kunene, the Ruvuma and the Orange-Senqu. Rivers are the lifelines of Africa, and the film shows the shared responsibility to keep them flowing: clean and jointly managed for the benefit of all.

E-Huesped: An information platform on transmissible diseases
Fundación Huésped: July 2015

e-huesped aims at communicating news about the progress made in the fields of HIV/aids, viral hepatitis and other transmissible diseases, in a swift and dynamic way using an online platform which allows the continuous collaboration and updating and information exchange with professionals throughout the world. The platform is accessible at any time and from any place. It is implemented on the Edx platform developed by MIT and Harvard with online courses to update professionals in the health team. E-huesped was developed by Fundación Huésped an Argentinean organization with projects that reach throughout Latin America responding to HIV/AIDS as both an infectious disease and a social challenge.

15. Jobs and Announcements

Call for Applications: Constitution of the College of Mentors for African Post-Graduate Students
CODESRIA: Deadline: August 31, 2015

The Council for the Development of Social Science Research in Africa (CODESRIA), with support from the Carnegie Corporation of New York has recently launched a program that seeks to encourage and facilitate African Diaspora support to African universities. As part of this initiative, CODESRIA intends to constitute a ‘college of mentors’, a grouping of senior academics from the African academic diaspora who are willing to devote some time to mentoring students enrolled in post-graduate (masters’ and doctoral) programs in African universities. Mentors will be put in touch with one or several students who they would guide by reading draft chapters of their theses and dissertations, and journal article manuscripts; suggesting relevant reading material; and exposing them to scholarly debates they need to be aware of. Mentors might also be called upon to provide academic leadership in some of the initiatives that will be undertaken under the program. Interested mentors should send in a detailed current CV and a 5 page concept/ expression of interest note outlining their areas of interest and their vision in the program.

CODESRIA: Director of Publications
Closing date for applications: 10 September 2015.

The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from suitably qualified African professionals to fill the vacant position of Director of Publications in its pan-African Secretariat located in Dakar, Senegal. The position is a senior one and the successful candidate will work as a member of the Secretariat management team under the overall supervision of the Executive Secretary of the Council. The ideal candidate will be a scholar who also has a robust experience in academic publishing. African professionals who combine a robust experience in academic publishing with a solid training in the social sciences/humanities can also apply.

MPhil in Inclusive Innovation
Call for Applications: Deadline 1 November 2015

The University of Cape Town (UCT) Graduate School of Business is now inviting applications to its pioneering MPhil specialising in Inclusive Innovation in 2016 – a hands-on postgraduate degree that aims to generate practical and scalable sustainable solutions to African challenges. Inclusive innovators who take this learning journey will travel through a rigorous academic curriculum right through to practical prototyping of new business models, processes, services or products that will help create a more inclusive economy and society at large. You will work together in a “living lab” environment, where expertise, life experience, passion and innovation all converge to support new possibilities and ideas. In this rich, integrative space, commercial, technological and social innovations all combine to further Africa’s future. You will also be exposed to some of the most exciting thinkers and practitioners working in the field of social innovation and entrepreneurship at this time. Applicants should be passionate and creative individuals who have a postgraduate degree, work experience, and a passion for a better, more inclusive future.

Pan-African human rights defenders awards
Pan-African Human Rights Defenders Network: Nominations are presently open

Pan-African Human Rights Defenders Network (PAHRD–Net) has opened a call for nominations for the 2nd Edition of human rights defenders awards. The awards will honor exceptional individuals who peacefully promote and protect universally recognized rights as stated in the Universal Declaration of Human Rights and the African Charter on Human and Peoples’ Rights. Altogether six awards will be presented, one overall award and five sub-regional awards. Both individuals and organizations are eligible for the award.

Use of Evidence - Blended Learning Course
International NGO Training and Research Centre: Online course 6 October 2015 to 4 November 2015

This course seeks to help those who lack confidence using evidence in their work and facing external or internal pressure to justify the evidence that they produce. In this course delivered online participants will have the opportunity to develop their knowledge and understanding of evidence. With a practical focus, they will learn the skills to identify sources of evidence, assess the quality of evidence, and integrate the use of evidence into their own work and organisation so that it is of high quality and can be used with confidence. At the end of the course, participants will be familiar with definitions of, and approaches to, evidence in international development and the wider implications for practitioners; be able to identify and work with existing sources of evidence, addressing relevance and purposes for different activities and audiences; be able to understand different approaches to, and have built skills in, assessing the quality of evidence; be able to plan for the use of better evidence in their work; have applied their learning and have explored the challenges and how to overcome them. During the practical component of the course, participants will apply their learning to a particular area of work where they use evidence, such as advocacy, monitoring and evaluation, or programming. The course takes place over four weeks and includes self-directed learning and one-to-one coaching tailored to the needs of the participant. It is aimed at technical staff in NGOs who need to engage with evidence in their work, for example in programme, planning, monitoring and evaluation, or advocacy. Participants will have some exposure to using research evidence through academic training or work experience, but need to gain a better understanding of core concepts.


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