As we approach the end of 2025 we hope that you have the opportunity to re-energise, reflect, and re-invigorate for the year ahead. In a year that has seen dehumanising genocide, crises and inequality, we know that the most harmful consequence of injustice is when people lose the confidence and understanding that they have the power to produce change. As EQUINET we have learned and been nourished with ideas and a sense of the possible, for our region and globally, by the diversity of people, perspectives, experiences and knowledge in our various exchanges, work and partnerships. Thank you, and we wish you buen vivir, wellbeing and progress in struggles for a more just world in 2026.
Editorial
A wish to all for a healthier and more just 2026
EQUINET steering committee
How do we deliver equity in this age of inequality, extraction and impunity?
EQUINET Steering committee
In our August newsletter we asked what constitutes a just response when our global political economy is generating deepening deprivation, conflict and inequality, and when powerful actors fuelling and gaining from these conditions appear to be able to act without penalty? You contributed on the realities we are facing and what a just response demands.
From different countries in east and southern Africa you pointed to global issues- conflict, climate extremes, and economic shocks - that are deepening inequality and insecurity. You noted that intensified extraction of minerals and biodiversity and rising debt burdens in the past decade are depleting public funds for health, education and other services, and that households are struggling with food security. Of the 6.6 million Zambian children, 71% are suffering from multiple dimensions of deprivation. Poverty conditions are associated with crime, gender-based violence (where rates in South Africa are among the highest in the world), discrimination and other forms of conflict.
Informal workers make up a large share of producers in our region. In Zimbabwe they are around 80% of the labour force, contributing about 60% of GDP. They work in harsh, often hazardous conditions for minimal fluctuating income, trading health for survival. Many are young people, facing insecure futures and bearing the brunt of climate impacts and economic shocks, with minimal social or institutional protection. Many small-scale miners in our region are extracting lithium and cobalt used in green transition technologies in high income countries, harming their health while generating wealth largely earned outside the region.
This situation represents daily violations of rights to health and its determinants, and a gap in the implementation of laws and policies that protect these rights. Those most affected are largely excluded from the national, international and corporate systems that are planning, accumulating, distributing and using the wealth from resources in the region.
Violence and rights violations reach their extreme when people are caught in military conflict. Not surprisingly this is often in areas of significant resources for wealth extraction. A humanitarian crisis and genocide in Sudan that has been ongoing since 2019 was profiled in October, with report of thousands of people massacred, and over 20 000 fleeing Al-Fashir alone. Of 40 million Sudanese people, over 20 million are reported to be nearing starvation and 10 million forced to leave their homes. Uganda, the largest refugee-hosting country in Africa, shelters over 1.6 million displaced people, despite its systems already being overstretched. In Sudan, cholera, malaria, dengue and malnutrition have escalated. Health services have not escaped violence. The World Health Organization reports that 460 patients and their companions were killed at the Saudi Maternity Hospital in El Fasher in October 2025. Director-General Tedros Ghebreyesus said that prior to this latest attack, WHO had verified 285 attacks on healthcare in Sudan with at least 1204 deaths and over 400 injuries of health workers and patients since the start of the conflict.
In 2018, Sudanese women, youth, workers, and professionals protested en masse against economic hardship and authoritarian rule, with demands for freedom, peace, and justice. Yet interests in Sudan’s significant gold resources by countries and military forces contradict these social demands for equitable revenue distribution. Violence appears to serve, rather than disrupt extraction, with gold, livestock, and agricultural exports continuing, and in some cases increasing, during the conflict, despite the social devastation and rhetorical commitments to peace.
What is the response to these various dimensions of injustice?
One response has been as protest. In Madagascar in September, young Gen Z protesters took to the streets to demand economic opportunities, a leadership that will improve their quality of life, and to participate in the decisions that affect their lives. Disillusioned with the government, protestors rejected government calls for talks, demanding the president’s resignation. The president fled in October, and the military took power, forming a transitional committee with the promise to restore civilian rule. Whether this will produce the change that motivated the protests remains to be seen.
As for young people in Madagascar, the responses to our question in August showed clear aspirations for a more just society: One that invests in secure jobs, livelihoods, communities and services, where people access affordable water, housing, clean energy, infrastructures and services; that prioritises social development over individual wealth accumulation and respects human rights. The call is also for dehumanising violence to end. As WHO noted in relation to the military attacks in Sudan, “All attacks on healthcare must stop immediately and unconditionally,” and health workers and civilians should be protected under international law.
These changes call for communities everywhere to be protected, organised, empowered and heard, in a culture of solidarity and accountable, democratic governance. Recognising people as active agents in inclusive, locally-grounded approaches is seen to be an essential foundation for building a fairer, just future. This demands a clear strategy to rebuild societies from the damage of neoliberalism, debt, structural adjustment, extraction and violence. Without this, protest simply brings new hands on the steering wheel, while the inequity continues.
The responses pointed to the role of regional solidarity, self-determination, strategies and standards in generating more inclusive economies, providing space and accountability for policy innovation. They indicate confidence that we have the assets, capacities and social demand in the region to build a fairer alternative, if we reclaim resources, states, and collective values.
However, whether locally, nationally or regionally, people struggle within global systems that protect existing privilege and wealth, and that encourage leaderships to do the same.
Hence the disappointment that multilateralism and United Nations institutions have failed to enforce international law, or to set a global political economy framework that confronts inequality. Of the 140 targets in the Sustainable Development Goals (SDGs) set in 2015 to be met by 2030, only 12% are said to be on track, 50% to be moderately or severely off track, and 30% have either stagnated or regressed. While some point to a funding barrier, and there is indeed a reported $4 trillion yearly funding deficit to meet the SDG targets, there is a deeper critique. There is no shared vision of the alternative global political economy that can embed such development goals, and an unwillingness to disrupt powerful economic interests. So global financial institutions and private lenders continue to prioritise fiscal wellbeing over social or planetary wellbeing, UN institutions fail to protect vulnerable populations against deprivation, exploitation and even genocide, and powerful actors globally spin narratives that hide the realities on the ground.
Issa G. Shivji, the prominent Africa thinker asks: will naming and shaming over these violations shake power into action? Or if power is amoral, how do you confront it? His answer is to keep unmasking a capitalist political economy that trumps morality, values and humanity in its relentless pursuit of profit and insatiable thirst for accumulation. Samir Amin argues for ‘delinking’ and building sufficient political power in the region to construct self-determined development strategies that are not in servitude to global value chains. Some point to China, with its large public sector and high levels of public investment that override private corporate interests in the economy. Others point to successful wellbeing economies. There are options. They demand social debate at all levels, and accountability to public interest.
Neither can we let multilateralism off the hook, given its role in transnational taxes, pricing, financial flows, trade, intellectual property and other global processes affecting the region. While the UN is being weakened and subjugated by market forces and power imbalances, it cannot be lost to drivers of inequity. When established in October 80 years ago, the UN aimed to promote peace, human rights and international co-operation. This mandate is still undelivered. One commentator observed that if the UN was disbanded on a Friday, it would be reinvented by Monday. Protecting what is democratic, such as the one state, one vote in the WHO and the General Assembly, and changing what is not, such as the undemocratic composition of the Security Council or health-harming intellectual property rules are part of that reinvention.
The most harmful consequence of injustice is when people lose the confidence and understanding that they have the power to produce change. However, your responses highlight that inequality, extraction and impunity are not inevitable. There are building blocks, ideas, strategies, alliances and diverse terrains of action that show this.
We welcome your feedback or queries on the issues raised in this oped – please send them to the EQUINET secretariat.
Can equity survive in an age of impunity?
EQUINET Steering committee
We are daily confronted by images of vulnerable people, including children, starving and dying in situations of preventable conflict. We are weekly confronted with stories of hospitals being attacked and health workers killed in military attacks. We are constantly hearing of floods and extreme weather destroying lives and homes of already precarious communities. We keep hearing about toxic pollution of rivers, harmful emissions and extreme hazards in work that are causing injury and disability. There are international human rights norms and standards that were set to prevent and respond to these realities and new, important standards being set, but they appear to be ignored and inadequate for new challenges, including from transnational corporate control of artificial intelligence. International and national institutions that were supposed to ensure their implementation appear to be disregarded and ineffective, and solidarity resources cut and redirected to military budgets. Powerful actors who are generating these conditions and their consequences appear to be able to act without penalty. If such a global situation is taking hold, the consequences can and are impacting on our national and local realities. What is a just response? There are interesting developments, and podcasts in this newsletter and the editorial from the Global Health Watch share some proposals. Please send us your contributions and experience on this as we explore these realities and their consequences and discuss the responses further in our next issue.
Global Health Watch 7: Mobilizing for Health Justice
Ronald Labonté, Chiara Bodini, People’s Health Movement, co-editors of Global Health Watch 7
From the “shadow of the COVID-19 pandemic” that set a context for Global Health Watch 6, the Global Health Watch 7 (GHW7) is being released under a different and more ominous shadow, that of Donald Trump’s return to the US presidency. We are in the midst of a massively disruptive transition in which the former US-dominated (neo)liberal world order is being transformed into a form not yet clear. The new Trump administration is driving this change, leaving global health churning in its chaotic wake, affecting all regions including east and southern Africa. Hence the heightened imperative to continue our activist mobilizing for health justice.
GHW7 begins with the ‘big picture’ issues in the global political economy, including chapters on ecofeminisms and ancestral health knowledge systems. Together these three chapters outline a new scenario for a global economy based on planetary health and human wellbeing. A second section delves into the state of play across health systems, opening with an update on the privatization, financialization and corporatization challenges affecting health systems, and provides public health alternatives. It raises the pros and cons of the increased use of artificial intelligence (AI) in health systems, makes proposals for equitable health systems from an intersectional gender perspective, and presents an analysis of ‘abolition medicine’ which draws important connections between the social organization of prisons and health care systems. It includes a commentary on ‘decolonizing’ global health.
However, the GHW7 is not only focused on the health system, It goes ‘beyond health care’ to discuss issues that are critically important for health, beginning with the rise in conflicts globally. It includes a focus on the genocide in Gaza, but the discussion of conflicts is equally important for east and southern Africa given conflicts in Sudan and DRC. It points to the role of capitalism’s ‘military-industrial complex’ in sustaining conflict for purposes of profit and geopolitical power, and provides an analysis of the drivers of migration and displacement, which are the highest ever recorded. There is a focus on some of the core dynamics linking work, employment, and health in the context of neoliberal capitalism. This raises attention to the importance of tax justice and progressive tax reforms at national and global scales, as also advocated from Africa. In discussing the commercial or corporate determinants of health, or those commercial influences in health, it covers the capitalist consumptogenic marketing of unhealthy commodities (tobacco, ultra-processed foods, alcohol) and provides a critique of the consultancy/accountancy transnationals (the ‘Big Four’ firms) that increasingly dominate global health policy making, including for east and southern Africa.
There is a fourth ‘watching’ section in the GHW7 that looks at what is new in global governance for health. It begins with an analysis of the health of the World Health Organization (WHO), noting its declining leadership worsened by the US withdrawal of funding, albeit with the potential uptick of having reached agreement on a new Pandemic Treaty. There is an assessment of the strengths and weaknesses of the Pandemic Treaty (referred to as a Pandemic Accord), particularly in terms of the still-to-be-negotiated annexes that will deal with improved access to pandemic tools for the Global South and global financing for pandemic prevention, preparedness, and response. Some of these funding issues are explored in greater detail in a subsequent chapter that focuses on future pandemic financing models.
With the current situation demanding the activist mobilisation for health justice noted earlier.
The final chapters in GHW7 document health activism at different scales, celebrating acts of resistance (some successful, others not) and describing new activist modalities for healthful change. Its closing chapter draws from the 5th People’s Health Assembly held in Mar del Plata, Argentina, in April 2024, and its declaration calling on activists worldwide to continue advancing the struggle for liberation and against capitalism.
The GHW7 is affirmative for its content and focus, However, it is also innovative for its content coming from writing groups and contributions representing the geographic breadth of People’s Health Movement (PHM).It is a co-production of PHM, ALAMES, EQUINET, Health Poverty Action, Medact, Medico International, Sama, Third World Network, and Viva Salud.In striving to have this edition be an exercise in ‘movement building’ and not simply an analytical synopsis of global health issues, writing groups were encouraged to use their chapters as opportunities to discuss and engage across these geographies, allowing activists to learn with each other. As with previous editions, scores of activists worldwide contributed to its production.
It is published by a solidarity publisher (Daraja Press) rather than a conventional academic or trade book publisher. Each chapter could thus be downloaded and distributed free of charge as soon as it was completed. With all chapters now completed, we will soon produce all as a single book, downloadable for free as a PDF or available for purchase as a printed book. It is available in both English and Spanish, partly with contribution from Latin American PHM activists in convening the 2024 5th People’s Health Assembly in Argentina. It is thus a resource for the many areas and forms of health equity activism in east and southern Africa.
Please send any feedback on and contribution to editorials to admin@equinetafrica.org. You can read more about PHM and freely access the Global Health Watch 7 chapters on the PHM website https://phmovement.org/global-health-watch, where all previous editions can also be found, and on the publisher’s website https://darajapress.com/publication/mobilizing-for-health-justice-en.
Uprooting climate-related health inequities in East and Southern Africa
EQUINET Steering committee
“Land is more than a resource in east and southern Africa. For millions of people it is their home, their culture, and their livelihood. So when we talk of the droughts, floods and unpredictable growing seasons caused by climate change it is not just an ‘inconvenient truth’ – it is a catastrophe for all those who live and depend on the land. When these communities are also losing land to multinational corporations annexing land for industrial mono-cropping, they deprive people of livelihoods, wellbeing and generations of wisdom, making people more vulnerable to challenges like climate change”.
This discussion at the sixth EQUINET webinar on climate and health equity in east and southern Africa pointed out how deep the action needs to be to uproot climate- related inequities that undermine health.
This, and the previous five webinars heard from community, national and regional/international speakers how the roots of climate change intertwine with other drivers of inequities in health, and what that means for action at all these levels. High levels of economic and social inequality in the east and southern Africa region – and globally- undermine the right to health for many, including for the many young people who make up the majority of the region’s population.
Looking across rights, laws, health systems, extractive sectors, agroecology, urban food, trade and tax systems, the webinars presented evidence of how climate change and emergencies are clearly having wide-ranging health impacts, with extreme weather disrupting environments, food and water access, expanding disease vectors and increasing injury, mental distress, communicable disease and mortality. The direct health impacts are profound in a region where a large share of the population is reliant on climate-sensitive sectors like agriculture and natural resource-dependent livelihoods and are particularly affected by water scarcity. Climate impacts have raised demand for health care, but have also damaged health infrastructures, adding to existing barriers to access. While acute disasters attract the most attention, many of these direct health impacts emerge from longstanding deficits, especially for already vulnerable communities.
Across all the webinars, climate impacts were reported to not only intersect with existing inequalities in the region, but to also widen them. Whether discussing female reproductive rights, household food security, employment and incomes and other factors affecting health, webinar speakers and participants gave examples of how climate change is exacerbating existing health disparities, widening gender inequalities and depriving already disadvantaged people of the resources for health. The numbers affected are huge: there was constant reference to poor households, women, children, young people, rural and coastal and flood-prone communities and urban informal settlement residents or workers, and others already disadvantaged in the current political economy.
While there was concern that we often lose sight in climate change and policy forums on the lived experience of these local realities, speakers and participants also raised their global drivers. Commercialised agribusiness and food systems clear forests and land and degrade environments. Transnational corporations (TNCs) are extracting and exporting non-renewable minerals, in activities that are leading to water and air pollution, land subsidence, degraded environments and increasing water scarcity. A skewed global trade system compounds these impacts, as trade protectionism and patents held by high-income countries and TNCs limit the technology and resource transfers needed to manage climate change and its impacts. A global tax and financing system and weak public sector tax capacities enables significant transnational financial outflows, including to tax havens, diminishing the public resources for more inclusive, climate adapted economies, social protection or health systems. In the face of these global drivers, poorly met climate financing promises of only 12% of Africa’s estimated annual financing need of US$300 billion to prevent and mitigate climate impacts, largely provided as unpredictable aid or debt inducing loans, made it clear that global diplomacy processes are neither adequate nor equitable to address these drivers nor mitigate their consequences.
Our final webinar on March 20th on climate-related migration and health equity in the region closes the first round of our discussions and moves our focus more directly to responses to improve health equity, whether at local, national, or regional level, or in engaging globally. We welcome further evidence, views and collaboration in this next phase!
The previous webinars have pointed to options for action. Many build on existing actions to promote health equity, such as: ensuring health literacy and an informed public able to claim their rights, use laws and demand that states meet duties to implement laws and hold those harming health accountable; integrating local voice in planning integrated economies and public services that meet food, energy, waste management and water needs of the whole population; promoting health and environment impact assessments, and inclusive inter-sectoral processes to ensure longer-term planning and public control over TNCs extracting mineral and biodiversity resources to internalise health costs; investing in and ensuring equity in primary health care oriented health systems; and strengthening unified African voice and positions in global engagement.
At the same time, the way climate exacerbates existing drivers of health inequity was seen to demand additional responses, embedded within these measures for health equity, including: integrating climate literacy and specific rights and legal protections related to climate impacts across all sectors;. improving monitoring, collection and use of disaggregated evidence on climate impacts and responses; promoting exchange of promising practice; integrating health and climate considerations in democratic planning, using circular economy models that benefit local incomes and wellbeing; improving TNC tax contributions to generate climate-proofed activities, jobs, services and infrastructures; developing early warning systems and promoting climate-resilient health care practices and infrastructures; and demanding predictable and equitably distributed global tax-based climate financing in place of loans that worsen already high debt burdens.
As high income countries intensify their fossil fuel explorations and global conflicts absorb resources in military activities rather than the transformations needed to protect the planet, the global context appears to be intensifying risk. Consistently across the webinar discussions participants have observed that inclusion of the voices of affected, vulnerable communities and young people into climate planning and negotiations is essential to ground a more robust, people-driven and locally responsive approach within the region. This is seen as essential to strengthen the just demand from the region for changes in the global political economy that are critical in the face of climate change, not only for health equity, but for human survival.
We welcome your feedback or queries on the issues raised in this oped – please send them to the EQUINET secretariat. You can watch the different climate webinars and read the breaks and reports on the EQUINET website.
We invite submissions on Artificial Intelligence and health equity in east and southern Africa
Editor, EQUINET News
The expansion and embedding of Artificial Intelligence (AI) in many processes that positively and negatively affect wellbeing will clearly impact on health equity. There are interesting papers on this in this issue that flag some of the issues for this. In this time of challenging political economy changes and influential digital entrepreneurs, actors and platforms we invite and welcome published papers and reports and editorial submissions to the newsletter (email: admin@equinetafrica.org) that help to strengthen informed analysis and debate on AI and health equity from a regional lens. We look forward to hearing from you!
Freedom from hunger and violence, and safe, healthy lives is a fair demand for 2025.
EQUINET Newsletter editor
Did we make progress towards equity in 2024? Global inequities in power, wealth and human security persisted. War, occupation and abuse of human rights became the most common feature of daily news. Climate emergencies seemed to intensify. Women, children and already vulnerable and excluded people bore the brunt of these trends, and of the deficit between articulated commitments, conventions and constitutions, and the realities of daily life.
Yet 2024 has also seen inspiring and creative forms of solidarity and innovation, and a flourishing of new ideas and practices. At different levels, sustained resistance to accepting a normalisation of injustice has confronted despondency. We have shared, celebrated and learned from successes at local, national, regional and global level where they have happened.
Moving towards inequity or justice in 2025 is entirely within human choice. So in this abbreviated newsletter as 2025 starts we express thanks for the work done in 2024 and wish all advancing equity and wellbeing in 2025 the strength, confidence and opportunity to raise and realise a fair demand for safe, healthy lives, and freedom from hunger and violence.
Acting locally, excluded globally: Confronting broken links for urban economic, social and ecosystem wellbeing
EQUINET Urban health community of practice
Mounting piles of dumped waste; polluted air from traffic, industry and waste burning; regular floods from blocked drains; dark nights due to electricity cuts; and taps that produce no water.
This is not the image of urban life that we hope for in our region, but it is one that is often experienced, especially for the most disadvantaged residents. Our cities and towns are sites of growing challenge.
But they are also sites of growing innovation in response to these challenges.
In the EQUINET Regional Meeting on urban health in east and southern Africa (ESA) in Nairobi this year, delegates from eight east and southern African countries shared the many creative ways that local communities, local governments, professionals and other stakeholders are working together to meet these challenges. Even more, these approaches are building constructive linkages across economic, social, health and ecosystem wellbeing, particularly for disadvantaged communities, and as a response to climate change.
The initiatives showed the wealth of experiences and ideas that exist at local level in the region. They reduce, recycle and reuse mounting unmanaged urban waste to produce compost for urban agriculture, bio-energy to light schools, and a range of household products. They yield local incomes for low income groups. The work underway confronts the common aggressively marketed urban shift towards unhealthy ultra-processed foods by producing and marketing nutritious local foods as alternatives. The latter are grown in vertical gardens, hydroponics, community gardens and other forms of urban agriculture, in backyards and public spaces, including those that have been reclaimed from waste dumping. The initiatives stimulate development and use of locally produced technology to process waste and foods.
These efforts not only provide incomes and improve health. They generate more liveable urban environments. They reduce polluting waste burning, flooded drains, enrich soils and climate proof infrastructures. The communities and stakeholders working in these initiatives build new capacities and links, including in schoolchildren. Those involved gain benefits that also increase the social respect for healthy ecosystems. The experiences are diverse, and you can read them in the case studies, photojournalism and technical reports on the EQUINET website.
However, the work shared also showed the barriers and challenges that the implementers faced in securing recognition and support from the national level, and for those implementing them to have a seat and meaningful voice in global level dialogue. These barriers prevent scale-up.
Much of the work is being implemented in already disadvantaged communities by committed local authority and non-state ‘brokers of change’, but without sustainable financing. While local technologies play a key role, they lack accessible innovation funding for research and development (R&D) and field testing. There are weak or uncertain policy, legal and incentive frameworks for key areas such as urban agriculture and domestic food processing, or for health impact assessment to embed health in the design of commercial activities. Key state tools like procurement, community contracting, blended and innovation financing and social tendering that would enable these practices are weakly applied, absent or poorly accessed by informal communities.
Local communities and institutions thus need to overcome the gap between resources and needs and between demand and voice. They face a constant pressure to organise ad hoc, unpredictable funding to support what calls for sustained institutional change. African countries face a similar challenge in global processes, such as on financing for climate adaptation. African leaders have, for example, criticised the huge gap between an annual demand of US$300 billion for climate adaptation and a huge shortfall in real delivery on voluntary pledges and aid. They called in the September 2023 Nairobi Declaration for more predictable, equitable climate financing, through a global tax regime that would apply a carbon tax on the fossil fuel trade, on maritime transport and aviation, and a global financial transaction tax.
The current context clearly demands action at local, national, regional and global level. It also calls for less segmentation between these levels, including for voice to be heard from local to global levels and for resources to flow more equitably from global to local levels.
The community of practice on urban health in the EQUINET regional meeting thus made 10 recommendations to BUILD, ENABLE and AMPLIFY promising practice and policy on local climate-responsive integrated healthy urban food, waste and ecosystems in ESA, that also link these different levels.
To BUILD bottom-up change that has more direct local benefit, the recommendations include measures to expand various forms of innovative urban agriculture to produce quality healthy urban food; linked in a circular economy to widening the practice of 3Rs, - ‘reduce, recycle, reuse’ - in waste management systems, supported by domestic investment in R&D for the technologies that process waste and local foods.
The recommendations cover national measures to ENABLE such practices, including to generate and use disaggregated, relevant and community evidence and health impact assessment that is brought to inclusive multi-stakeholder forums to design and plan urban systems. This calls for another form of 3Rs- ‘relooking, realigning and revising’ policies, laws, and guidance at local and national level, harmonised at regional level, to enable, capacitate and fund these key elements of healthy integrated urban systems.
The community of practice recommended AMPLIFYING such measures across the region, to better connect local, national and regional voice, and to strengthen the region in engaging globally. Networks that connect local, national, regional and international actors, including south-south- are identified to provide important means to support the exchange of knowledge and ideas from within the region, if also backed by investments in regional knowledge, technology and ideas hubs.
We had direct experience of the role of regional networking when the local experiences from the various ESA countries were brought to the regional East Central and Southern African Health Community Best Practices Forum in June 2024. This forum, held annually, provides an important space for dialogue across local, national and regional level on challenges and promising practice. The ideas and local experiences presented and discussed in the session on climate and urban health in the 2024 forum informed the resolutions of the ECSA Regional Health Ministers Conference (ECSA/HMC73/R8) on mitigating the effects of climate change on health. (The resolutions are included in this newsletter).
Having a regional forum that brings policy actors together with local and national implementers enriches learning and action within the region, and can inform the proposals that are brought to global level, adding weight to options and demands, such as the call for more equitable and predictable global financing for responses to climate change. Currently, however, local voices and perspectives are increasingly attenuated as processes rise from local to global level, relying largely on indirect representation or reporting of lived experience and priorities in global forums. Yet increasingly literate, active and engaged local stakeholders and communities are implementing local change, and expect more direct, sustained ways of being included and heard in global discussions on issues that affect their lives.
We welcome your feedback or queries on the issues raised in this oped – please send them to the EQUINET secretariat. For more information read the urban health publications at https://www.equinetafrica.org/bibliography-search.html and watch the climate webinars on the EQUINET website at https://www.equinetafrica.org/content/meetings.html.
We find ourselves drawing inspiration from the local, and confronting the global.
Editor, EQUINET newsletter
We have many new case studies, reports and links to videos in the EQUINET updates and useful resources in this issue, and issued a special editorial on protecting health and health services in conflict in February. In this issue we thus use this editorial space briefly to invite you to read these publications. The February editorial responded to the conflict and violence in different global regions, and particularly the violations against the specific protections provided in international conventions of civilian health, health services and health workers in conflict zones. The extreme situation in Gaza, still continuing, prompted the WHO Director General Dr Tedros Adhanom Ghebreyesus to say “Without a ceasefire, there is no peace. And without peace, there is no health.”
At the same time we present in this newsletter many case studies of inspiring action in different urban sites in our region. They address the rising challenges and health risks posed by urbanisation for unmanaged waste and food insecurity, especially for low income communities. They turn challenge to opportunity, such as by linking waste recycling to incomes and to fertiliser for urban agriculture and food security. They change zones of polluting waste dumping and burning into urban green zones through ‘whole of society’ approaches. They show concretely the possibility of and measures for taking on issues such as climate justice and inclusive circular economies. For those affected they show that they can produce change.
These local level initiatives yield optimism, even as frustration and social disempowerment is fostered over global and international level actions on key challenges affecting wellbeing, such as climate, conflict and inequity. As another paper in this issue discussing the Africa Continental Free Trade Agreement asks, can we at national and regional level better protect space and support for such initiatives within our countries, rather than reproducing global trade and economic frameworks that block them? We invite you to contribute evidence and publication to the newsletter, and to explore, debate, analyse and share on these and other health equity issues with us in 2024, and wish you a year of peace, health and progress.
A special issue on health in conflict
Editor, EQUINET newsletter
This special issue of the newsletter includes only a statement from the EQUINET Steering Committee on health in conflict. The next regular newsletter issue will be published on 1 March 2024.