In January 2017, President Trump signed an executive order that denied U.S. assistance to any foreign-based organization that performs, promotes or offers information on abortion. A similar policy was in effect under past Republican presidents. In 2017 it was expanded exponentially to apply not just to around $600 million in overseas family-planning funds, but to the entire $8.8 billion in annual U.S. global health aid. It will take years to gauge the full impact of the policy, which will affect aid groups as they renew grants or seek new U.S. funding. More broadly, the policy has created a wave of uncertainty in aid-dependent countries. For the first time, groups that treat HIV, malaria and other illnesses will also have to pledge to have no role in promoting abortion — or forgo American aid. Academics have questioned whether the policy effectively decreases abortions. A 2011 study by Stanford University researchers suggested the policy has actually been “associated with increases in abortion rates in sub-Saharan African countries.” One possible reason the researchers gave for this was that some organizations that had provided contraceptives lost funding, which may have led to more unwanted pregnancies. While most foreign health groups have committed to following the new rules., a small group , including the International Planned Parenthood Federation and Marie Stopes, have refused to sign.
Values, Policies and Rights
The World Health Organization’s Framework Convention on Tobacco Control, enforced in 2005, was a watershed international treaty that stipulated requirements for signatories to govern the production, sale, distribution, advertisement, and taxation of tobacco to reduce its impact on health. This paper describes the timelines, context, key actors, and strategies in the development and implementation of the treaty and describes how six sub-Saharan countries responded to its call for action on tobacco control. A multi-country policy review using case study design was conducted in Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo. It involved document review and key informant interviews. Multiple stakeholders, including academics and activists, led a concerted effort for more than 10 years to push the WHO treaty forward despite counter-marketing from the tobacco industry. Once the treaty was enacted, Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo responded in unique ways to implement tobacco policies, with differences associated with the country’s socio-economic context, priorities of country leaders, industry presence, and choice of strategies. All the study countries except Malawi have acceded to and ratified the WHO tobacco treaty and implemented tobacco control policy. Reviewing how six sub-Saharan countries responded to the treaty to mobilize resources and implement tobacco control policies provided insight for how to utilise international regulations and commitments to accelerate policy impact on the prevention of non-communicable diseases.
In August 2018, the Center for Health, Human Rights and Development (CEHURD), Nnamala Mary and Simon Kakeeto took the Government of Uganda to the Constitutional Court for failing to put in place shelters for women who have been raped or defiled. CEHURD challenged the unequal punishments that the law provides for sexual offenders as being unjust. Men charged with rape are liable to suffer a maximum penalty of death whereas the law provides for the offense of ‘defilement’ for persons between the ages of 14-17 and sexual offenders against girls of that category are only given a few years of a jail term. This difference in penalties towards perpetrators who commit the same offense was argued to be unjust and to offend the principle of equality and non-discrimination before the law. It was also observed to have an effect of increasing sexual violence against girls in that particular age group. Women who survive sexual violence need safe spaces, shelters and refuge. The Ugandan Constitution mandates the State to put in place facilities to enhance the welfare of women to enable them to realise their full potential and advancement. It was thus CEHURD's contention that failure by government to construct and finance these shelters is a clear violation of women’s rights guaranteed under article 33(2) of the 1995 Constitution of Uganda.
The author presents the argument that Zimbabwe is at a critical juncture for health reform and argues that this reform should focus on repairing relationships with the international community by focusing on human rights and eliminating corruption; strengthening the health workforce through retention strategies, training, and non-specialist providers and strengthening community engagement to grow local leadership and ensure that interventions are socially and culturally sensitive.
When Malala Yousafzai turned 18, she opened a school for Syrian refugee girls, calling on leaders from around the world to provide “books not bullets.” It was at 18 that Cleopatra became ruler of Egypt, in 51 B.C.E., and Victoria the queen of Great Britain, in 1837. By the time she was 18, Britney Spears had had two No. 1 albums on the Billboard chart, and Serena Williams had won the U.S. Open. Emma Gonzalez, 18 now, has become a global leader in the movement to end gun violence. No pressure, right? Eighteen is an age. But it’s also something more. It’s a moment, a rite of passage, a gateway to adulthood.In the United States, 18 means you can finally vote, sign a lease on an apartment, obtain a credit card and buy a Juul. In China and parts of Canada, 18 grants you entrance to a pub, while for most Israelis, it means a mandatory draft into the military. By 18, one in five women across the globe will be married. Millions will enter college or university. “This is 18” aims to capture what life is like for girls turning 18 in 2018 across oceans and cultures. The editors asked young women photographers to document girls in their communities — taking the photos and conducting the interviews themselves. Each photographer was paired with a professional mentor to guide them through the process. The result is a celebration of girlhood around the world — across 12 time zones and 15 languages, featuring 21 subjects and 22 photographers. #ThisIs18 — a look at girls’ lives, through girls’ eyes.
This study explored the relationship between the reinstatement in 2001 of a US policy requiring all nongovernmental organizations operating abroad to refrain from performing, advising on or endorsing abortion as a method of family planning if they wish to receive federal funding and the probability that a sub-Saharan African woman will have an induced abortion. The authors used longitudinal, individual data on terminated pregnancies collected by Demographic and Health Surveys (DHS) to estimate induced abortion rates. The study found robust empirical patterns suggesting that the policy was associated with increases in abortion rates in sub-Saharan African countries. Several observations were identified to strengthen this conclusion. First, the association was strong: and second, there was broad agreement among the aggregate graphical analysis and both unadjusted and adjusted statistical analyses, robust across a variety of sensitivity analyses. Third, the timing of divergence between high and low exposure countries was coincident with the policy’s reinstatement: in high exposure countries, abortion rates began to rise noticeably only after the policy was reinstated in 2001 and the increase became more pronounced from 2002 onward.
Despite 20 years of democracy, South Africa still suffers from profound health inequalities and gender roles and norms associated with vulnerability to ill-health. Gender inequality influences women’s access to health care and agency to make health-related decisions. This paper explores gender-awareness and inclusivity in organisations that advocate for the right to health in South Africa, and analyses how this knowledge impacts their work. Ten in-depth interviews were conducted with members of The Learning Network for Health and Human Rights (LN), a network of universities and Civil Society Organisations (CSOs) committed to advancing the right to health, but not explicitly gendered in its orientation. The results show that there is a discrepancy in knowledge around gender and gendered power relations between LN members. This suggests that gender is ‘rendered invisible’ within the LN, which impacts the way the LN advocates for the right to health. The authors thus suggest that even organizations that work on health rights of women might be unaware of the possibility of gender invisibility within their organisational structures.
In January 2015, South Africa ratified the International Covenant on Economic, Social and Cultural Rights (ICESCR). The South African government submitted its initial report to the United Nations Committee on Economic, Social and Cultural Rights (CESCR) in April 2017, raising the steps and measures taken to comply with the provisions of the Covenant, noting its progressive Constitution that includes socio-economic rights. A coalition of civil society organisations called “South Africa’s Ratification Campaign of the ICESCR and its Optional Protocol” (the Campaign) submitted a parallel report to the United Nations CESCR. The Campaign’s Steering Group is comprised of the Socio-Economic Rights Institute of South Africa, Black Sash, the Dullah Omar Institute, the People’s Health Movement South Africa and the Studies in Poverty and Inequality Institute. The Campaign’s parallel report provided a civil society perspective on socio-economic rights realisation in South Africa, and raised questions about areas of the state’s record in fulfilling these rights in order to promote greater accountability. The Campaign's report noted that actions to address the binding constraints to realising socio-economic rights are increasingly urgent in the South African context of severe poverty and inequality. For this reason, the authors identified the need for the state to address forced evictions and displacement; to assess the causes of under-expenditure on informal settlement upgrading; to address a lack of investment in infrastructure maintenance and services provision, and to address intergovernmental cooperation issues that impacted severely in the management of the drought in the Western Cape.
The WHO guidelines for drinking-water quality provide recommendations to support countries in developing drinking-water quality regulations and standards, as well as the associated risk management strategies. The guidelines provide an authoritative basis for the effective consideration of public health in
setting national or regional drinking-water policies and actions; provide a comprehensive preventive risk management framework for health protection, from catchment to consumer, that covers policy formulation and standard setting, risk-based management approaches and surveillance; emphasize achievable practices and the formulation of sound regulations that are applicable to low-income, middle-income and industrialized countries alike; summarize the health implications associated with contaminants in drinking water, and the role of risk assessment and risk management in disease prevention and control; summarize effective options for drinking-water management; and provide guidance on hazard identification and risk assessment.
In this journal feature, Issa Shivji, Peter Lawrence, John Saul, Natasha Shivji, Ray Bush and Ndongo Samba Sylla pay tribute to the late Samir Amin. Issa Shivji writes of Amin’s support for younger generations, ‘His intellectual works, scholarly contributions and political interventions have been sufficiently covered in dozens of tributes that are pouring in every day. I will not go over them. I wanted specifically to capture Samir’s attitude and treatment of younger generations, done as a matter of course and without pretense.’ Peter Lawrence highlights one of Amin’s key ideas, ‘Amin rejected the prevailing view in both the capitalist ‘West’ and the socialist ‘East’ that development entailed catching up with the developed capitalist countries. … The history of the world was not about followers catching up with leaders but about dominant civilizations being ‘transcended’ by peripheral ones as the former decline and the peripheral overtake them with different social organizations.’ John Saul illuminates Amin’s concept of ‘an actual and active ‘delinking’ of the economies of the Global South from the Empire of Capital that otherwise holds the South in its sway. For Amin, delinking was best defined as ‘the submission of external relations [to internal requirements], the opposite of the internal adjustment of the peripheries to the demands of the polarizing worldwide expansion of capital’. Amin saw it as being ‘the only realistic alternative [since] reform of the [present] world system is utopian.’ Ndongo Samba Sylla concludes by writing on Amin’s notion of ‘daring’ in coordinated struggles, ‘by the emergence of an anti-monopolies front [in the Global North] and in the Global South by that of an anti-comprador front' challenging subservience to neoliberal globalisation. The authors collectively highlight how through his writings, his interventions and engagement Amin profiled the perspective of the Global South 'and the wretched of the earth.’