For Africa, there is the urgent and desperate need for a radically different approach to understanding and tackling regional challenges post-2015, argues the author of this article. Africa’s greatest challenge is creativity, and innovation founded on indigenous knowledge and indigenous resources. The continent needs homegrown, creative solutions and breakthroughs in governance, science and technology, economic policies, curriculum, health and wellness, and just about any area of human existence covered and not covered by the Millennium Development Goals (MDGs). What is absent in Africa are ideas rooted in Africa’s indigenous material and non-material resources, ranging from mineral, environmental, herbal and ecological resources to agricultural practices, social organisation, political processes, medical knowledge, and numerous others. Africa’s own knowledge systems and ideas are the most valid, inexpensive and rely on easily accessible resources that will bring about advancement for the continent, the author argues. The formulators of the numerous development plans superimposed on Africa have had little or no regard for the continent’s indigenous knowledge, and because of that Africans themselves hold their knowledge and abilities in contempt.
Equity in Health
This report brings together a series of policy briefs and is aimed at policy-makers and others interested to improve health equity by acting within the health system and on broader governmental policy. The report provides an update and overview of the vast amount of evidence produced during the Commission on Social Determinants of Health and identifies policy options to implement the main recommendations of the Commission. It draws from the extensive work of the nine global knowledge networks set up by WHO to generate evidence for the Commission. It first considers the essential role of the health sector in reducing inequities in five areas: working towards universal coverage; public health programmes; measuring inequities in health; facilitating mobilisation of people and groups; and intersectoral action. Second, it discusses how the health sector can work with other sectors that are also vital to this task in seven additional areas: early child development; urban settings; globalisation; employment and working conditions; policy and attitudes towards women; inclusive policies; and engaging civil society. The report ends by outlining a methodology to put together a national action plan addressing these issues, in light of the different starting points and priorities found in each country.
The purpose of this report is to present a summary of the main themes and messages that have emerged from the Global Consultation on Health and to make recommendations to inform the deliberations of the High-Level Panel of Eminent Persons and the UN Secretary-General’s report to the General Assembly in May 2013. The report describes the consultation process, detailing the processes that were used to reach out to different constituencies, explains why health should be at the centre of the post-2015 development agenda and summarises the inputs about the successes and shortcomings of the MDGs, many of which were unintended and only became apparent with the benefit of hindsight. It then presents guiding principles for the post-2015 development agenda and the various options for health goals and indicators that were put forward during the consultation and gives recommendations on how to frame the future agenda for health. The contributors to this consultation are looking in the same general direction: all agree that the new development agenda needs strong and visible health goals supported by measurable indicators. The report concludes by suggesting concrete actions that could be taken between now and 2015 by those advocating for health to feature prominently in the next development agenda.
The aim of this study was to develop a model for identifying areas at high risk for sporadic measles outbreaks based on an analysis of factors associated with a national outbreak in South Africa between 2009 and 2011. Data on cases occurring before and during the national outbreak were obtained from the South African measles surveillance programme, and data on measles immunisation and population size, from the District Health Information System. Model projections were used to identify emerging high-risk areas in 2012. A clear spatial pattern of high-risk areas was noted, with many interconnected (i.e. neighbouring) areas. An increased risk of measles outbreak was significantly associated with both the preceding build-up of a susceptible population and population density. The risk was also elevated when more than 20% of infants in a populous area had missed a first vaccine dose. The model was able to identify areas at high risk of experiencing a measles outbreak in 2012 and where additional preventive measures could be undertaken. In conclusion, the South African measles outbreak was associated with the build-up of a susceptible population (owing to poor vaccine coverage), high prevalence of HIV infection and high population density. The predictive model developed could be applied to other settings susceptible to sporadic outbreaks of measles and other vaccine-preventable diseases.
This Mapping Report presents an overview of the social determinants of health (SDH) landscape in Tanzania. It specifically looks at SDH's conceptualisation and role in addressing health inequalities, SHD-related policies, research trends, priorities and capacity needs. The report is based on a desk review of available SDH-related research from 2005 onwards, complemented with in-depth interviews with 34 individuals from a cross-section of institutions. Results showed that conceptualisation of SDH varied, but most interviewees linked it to inequities or inequalities. A number of organisations in the country are working towards achieving health equity, some involved in research and others in disseminating information. Nationally there is no SDH-specific research and/or policy portfolio. While there are no policies, programmes or legislation related to SDH, reducing inequities is central to Tanzania’s Vision 2025 and the National Strategy for Growth and Reduction of Poverty. Interviewees suggested strengthening Tanzania’s health system by establishing an SDH consortium to manage and consolidate various aspects of SDH research.
This literature review highlights the causes, effects and potential mitigation measures of adult obesity in Africa. The major factors that contribute to obesity include over-nutrition, physical inactivity, change of dietary habits, modernisation, consumption of high-fat, high-carbohydrate foods and increased urbanisation. Despite African women tending to be more obese than men, they are less prone to hypertension, heart disease and type 2 diabetes than men before they reach menopause due to their fat deposition being predominantly sub-cutaneous rather than abdominal. The defining metabolic changes in obesity are decreased glucose tolerance, decreased sensitivity to insulin, hyperinsulinemia and reduced life expectancy. The author highlights that obesity is a controllable behavioural disorder, with regular exercise and sensible eating being the best ways to regulate body fat percentage and maintain a healthy body weight. As it is difficult to treat obesity, efforts in Africa should be directed towards prevention in order to keep it in check.
The corroboration of scientific evidence across disciplines has confirmed that global warming is occurring and that this will have potentially negative consequences for health, such as respiratory diseases from polluted air, the spread of tropical diseases and increased malnutrition due to drought and floods. The author of this paper argues that it is time for public health advocates to draw on their past successes in tackling the health consequences of pollution, and to draw the link between the causes of global warming and pollution. In addition, strategies that link stakeholders and current development goals and provide feedback data from climate change adaptation and mitigation approaches are needed as we move forward to face the health consequences of global warming.
The High-Level Panel of Eminent Persons on the Post-2015 Development Agenda has been tasked by United Nations Secretary-General Ban Ki-Moon to develop a framework for a post-2015 development agenda. This Communiqué reports on the Panel’s third meeting in Monrovia, Liberia from 30 January to 1 February 2013, where members took stock of the progress achieved so far towards the fulfilment of the Panel’s mandate. Members agreed to make every effort to achieve the Millennium Development Goals by 2015, while also framing a single and cohesive post-2015 development agenda that integrates economic growth, social inclusion and environmental protection. Economic growth alone is not sufficient to ensure social justice, equity and sustained prosperity for all people. The global community must pursue economic and social transformation leading to sustained and inclusive economic growth at the local, national and global levels. The protection and empowerment of people is crucial. Achieving structural transformations through a global development agenda will involve: sustainable growth with equity, creating wealth through sustainable and transparent management of natural resources; and partnerships with many actors, unified behind a common agenda.
Placing health at the heart of the post-2015 development agenda will not only save lives and advance economic development, it will also protect environmental sustainability, and advance wellbeing, equity and social justice, according to this report. It makes a number of recommendations. Health goals should be equitable, holistic and people-centred. The post-2015 development agenda should be direct explicit attention to reducing health inequities between and within all countries, especially when considering the needs of the poor, marginalised, and those whom the efforts of the Millennium Development Goals (MDGs) have not reached. The right to health means that governments must generate conditions in which everyone can be as healthy as possible. A hierarchy of goals is needed to capture the increasing complexity of priority health challenges and the reality that efforts to prevent disease and disability and improve health and well-being require policies and actions both within the health sector and across many other sectors. Indicators need to measure impact, coverage of health services and health systems. Some qualitative indicators may be needed to measure quality of life and well-being, while assessing quality of health services may require qualitative as well as quantitative indicators. The MDG targets and indicators as well as those in other internationally agreed agendas should be revised for the post-2015 era and included under the relevant goals.
The commitment toward achieving universal coverage understood as access to quality, individualized healthcare for all, in a human rights framework, has been profiled as the Goal of the Post 2015 Development Agenda on the topic of Health. For this reason, the Pan American Health Organization proposed a consultation of the key social actors in this process and to hear their voices. The present document summarizes the debate and the agreements assumed by the representatives of civil society organizations, municipal authorities or mayors, indigenous authorities, afro descendants, and other civil society representatives.