According to this report, forcing 'development' or 'progress' on indigenous people does not make them happier or healthier. The authors argue that indigenous peoples' well-being is primarily affected by whether their land rights are respected. Where this is not the case, and where indigenous people are not given a role in guiding development actions, they suffer poorer health outcomes, with increased rates of obesity and malnutrition, drug addiction, alcoholism, and with a change to Western diets, diabetes. The report links identity, freedom and mental health and argues that mental health problems, notably suicide, increase dramatically when a group’s identity and freedom is taken away.
Values, Policies and Rights
Protection of human participants in health research: A comparison of some US federal regulations and South African research ethics guidelines
Cleaton-Jones P and Wassenaar D: South African Medical Journal 100(11): 710-716, November 2010
In response to criticism of ethical review of a South African clinical trial, this study contrasts aspects of the United States (US) Common Rule with South African research ethics requirements. In the US the Common Rule does not apply to all health research and allows many exemptions from ethics review and waivers of informed consent. The study found that, at a structural level, research ethics review in South Africa is in many cases equivalent to the US institutional review board (IRB) and Office for Human Research Protections (OHRP) oversight system, is wider reaching, and has no exclusions.
Statement from the People's Health Movement on the Global Symposium on Health Systems Research
People's Health Movement: 18 November 2010
This statement was released by the People’s Health Movement (PHM) in response to the Global Symposium on Health Systems Research, held from 16-29 November 2010 in Montreux, Switzerland. It raises a number of issues and suggestions for the future. It identifies some areas of relative neglect that may be rectified in the next Symposium, such as: the role of the health system in promoting primary health care, including the involvement of communities and intersectoral action; the place of people and participatory research in the field of health systems research; the challenge of balancing equity with universal coverage; and the roles of and interrelationship between public financing and insurance. PHM detects a tacit approval for the expansion of private financing and insurance models, which they consider problematic. While the importance of political and ideological factors were mentioned several times, PHM believes that more discussion could be had to discuss and determine the political, normative and ideological views of the community of health systems researchers. Health systems policy should be informed by research, but it needs to be shaped by normative principles and values first. At the Symposium, PHM notes that there was inadequate discussion about the way the HSR is shaped by university/academic context and the publishing industry and no discussion about the political economy of HSR and the biases in the research agenda that exist. Finally, PHM urges leaders and civil society not to tolerate the ‘myth of scarce resources’, and instead insist on equal focus and emphasis on the structural and macro-economic context of health systems.
A magic bullet for the ‘African’ mother? Neo-imperial reproductive futurism and the pharmaceutical ‘solution’ to the HIV/AIDS crisis
Booth KM: Social Politics 17(3), Fall 2010
On the basis of an analysis of popular and medical texts which address a debate over the ethics of clinical drug trials designed mainly for sub-Saharan Africa, this paper argues that the international public health discourse about infant HIV infection in Africa reflects and legitimates a anti-reproductive justice ideology. The author argues that the texts most commonly advance the view that biomedicine, funded from outside Africa with medicines from outside the continent, is the magic bullet that addresses mother and child HIV, avoiding issues of domestic advance in reproductive and sexual rights. This dominant focus is argued to give greater control over HIV to biomedical perspectives and to strengthen right-wing movements against advances in reproductive rights.
A methodology for human rights impact assessment (draft version): Systematically identifying, predicting and responding to projects' potential impacts on human rights
Nomogaia Foundation: 2008
The goal of this methodology is to assist in the creation of valid, useful and ultimately meaningful human rights impact assessments. This followed the United Nation’s Special Representative on Human Rights and Business Professor John Ruggie's presentation to the Human Rights Council with a framework for delegating human rights and responsibilities between governments and companies. The process of creating and using HRIA is still in its early phases. Their relevance will depend on a continuing improvement of method, capacity and result which can only be accomplished through the sharing of experience and information between companies and assessors. The methodology looks at HRIA assessment sources, goals, and types. It covers basic concepts and looks provides five steps for implementation: gather project contexts and company information; drawing up a preliminary list of impacted rights; drawing up a preliminary list of impacted right holders; special topics; and inquiry guided by topic catalogue. The methodology offers recommendations for policies, procedures, structures and action. It also provides an appendix of other tools and selected best practices.
Implications of the Adelaide Statement on Health in all policies
Krech R, Valentine NB, Reinders LT and Albrechta D: Bulletin of the World Health Organization 88(10): 720, October 2010
Data presented at the United Nations Summit in September in New York has revealed that many countries are unlikely to achieve all the health targets of the Millennium Development Goals (MDGs) by 2015. The simultaneous and interrelated challenges of poverty, health, food security, energy, the global economic crisis and climate change should be viewed by the global community as a unique opportunity to develop innovative approaches to achieve sustainable growth without compromising health equity. One such innovative approach is the concept of working across many sectors to improve governance for health and well-being. The 2010 Adelaide Statement on Health draws on the increasing body of knowledge on “joined-up” government to propose a new way for governments to engage multiple sectors in the joint goal of improving health and well-being. The article calls for an accountability mechanism between governments and their citizens, to ensure that global commitments on health are honoured. The shortfalls in progress towards the MDGs have occurred not because they are unreachable, it argues, but rather due to unmet commitments, inadequate resources, lack of focus and insufficient interest in sustainable development.
MDGs, women and peace: Towards uMunthu
Sharra S: Pambazuka News (497), 23 September 2010
For the empowerment of women to make a real difference in the promotion of peace, the discussion needs to shift from one of competing forces to one of cooperation and collaboration, according to this article. Feminist scholars argue that both men and women possess characteristics that are considered, for lack of more refined language, masculine as well as feminine. The difference lies in the way we are socialised. We grow up being taught to behave in a particular way due to what society perceives gender differences to mean and to require. Social norms compel us to reinforce these perceptions and expectations, and then to undermine them when we use those very perceptions and expectations to blame one gender for being collaborative rather than competitive, accommodating rather than uncompromising, submissive rather than aggressive, gentle rather than violent. This article argues that it is in peace education and peace studies that a more meaningful perspective on gender equality has been developed. Such a perspective might enable leaders to promote uMunthu (belief that all humans are connected and therefore deserve respect), peace and social justice at the local and global level, making them much more relevant to the majority of people around the world.
National and global responsibilities for health
Gostin LO, Heywood M, Ooms G, Grover A, Røttingene J and Chenguang W: Bulletin of the World Health Organization 88(10): 719-719A, October 2010
The World Health Organization is establishing the Joint Learning Initiative (JLI) on National and Global Responsibilities for Health to articulate an overarching, coherent framework for sharing the responsibility for health that goes further than the United Nations Millennium Development Goals. The Initiative forges an international consensus around solutions to four critical challenges: defining essential health services and goods; clarifying governments’ obligations to their own country’s inhabitants; exploring the responsibilities of all governments towards the world’s poor; and proposing a global architecture to improve health as a matter of social justice. The first challenge for the JLI is to determine essential health services and goods that every person has a right to expect. The JLI aims to launch a wide participatory process involving all major stakeholders, including international organizations, governments, industry, philanthropists and civil society, and emphasises a bottom-up approach to decision making.
Provisions for consent by children to medical treatment and surgical operations, and duties to report child and aged persons abuse
McQuoid-Mason D: South African Medical Journal 100(1): 646-648, October 2010
New sections of the Children’s Act and the Children’s Amendment Act in South Africa came into effect on 1 April 2010. The Children’s Act dealing with the capacity of children to consent to HIV testing and to access contraceptives have been in effect since 1 July 2007 and the new sections now allow children of 12 years of age to consent to medical treatment, and to surgical operations with the assistance of their parent or guardian. The provisions allowing consent to termination of pregnancy by girls of any age in the Choice on Termination of Pregnancy Act are not affected by this Act.
UN human rights chief welcomes MDG summit outcome and notes some gaps
United Nations News Room: 23 September 2010
Navi Pillay, the United Nations High Commissioner for Human Rights, has described as ‘a very significant advance’ the outcome document of the UN’s Millennium Development Goals (MDGs) summit, but noted a number of gaps in some aspects of the global plan of action to eradicate poverty and end social-economic inequality. During the summit, she emphasised that States should take a human rights-based approach to the MDGs, which would mean that development and aid policies should explicitly prioritise the needs of the poorest and most excluded people. But she stressed that, with their emphasis on global average targets, the MDGs often neglect large segments of the world’s population, and may unwittingly exacerbate existing inequalities. The principle of participation, for example, is reflected strongly in relation to the empowerment of women, but there is no explicit recognition of participation as a right, and no specific commitments to guarantee freedom of expression and association or other human rights guarantees necessary for active, free and meaningful participation. Issues of accountability, good governance and the rule of law are referred to in a number of contexts, she said, but in relation to MDG 8, which mandates a global partnership for development, there is still a critical accountability defect because it lacks time-bound targets.