This strategy is a detailed and comprehensive guide to how health sectors can most effectively tackle the HIV and AIDS epidemic. Data shows that the epidemic has been halted and that the spread of HIV is beginning to be reversed. New infections have fallen by almost 20% in the last ten years and between 2003 and 2009 there was a 13-fold increase in treatment coverage. However, in 2009 only a third of people in need of treatment received it and the demand for resources is still outstripping supply. The Strategy is intended to optimise progress towards universal access and the attainment of the Millennium Development Goals. It aims to promote tailored responses to national and regional epidemics and analyses the underlying socio-economic and cultural determinants contributing to the spread of the virus. The strategy seeks to reduce vulnerability and structural barriers to accessing good quality services. It also demonstrates how HIV programmes can play a role in broader health outcomes and recognises the importance of strong health and community systems to guarantee a sustainable response. WHO will make five key contributions to the Global Health Sector Strategy: scale up innovation in prevention; optimise treatment and care; support health for women and children; promote strategic health-sector information and planning; and provide leadership in addressing health equity and HIV (examining inequities in access to HIV services).
Values, Policies and Rights
The Joint Meeting of SADC Ministers responsible for Youth and Ministers Responsible for Vulnerable Children was held in Windhoek, Namibia, from 1-3 June 2011. The meeting was attended by delegates from all SADC Member States, except Seychelles. It was convened to discuss common ways of addressing the increasing problems and concerns of vulnerable children and youth in the SADC Region which include diseases such as HIV and AIDS, malaria, and tuberculosis; poverty; hunger and malnutrition; social and political conflicts; disability among children and youth; and the growing problems of pregnancy among teenagers and unemployment among the youth. Ministers adopted common plans and actions for the region that will help to accelerate the delivery of basic services and needs for vulnerable children and youth such as the provision of safe drinking water, health care, education and skills that enable youth to earn income and to create jobs for themselves, protection from abuse, and the provision of housing and family care. Other basic services include those relating to improving the capacity of children and youth to cope with the stresses of life, and to be able to live in harmony with others in society. Ministers agreed to set up the necessary structures required to fully implement their decisions and improve the lives of children and youth in the region. In order to address issues more effectively, they agreed that in future they would meet separately as Ministers responsible for children, and those responsible for youths. Before ending their meeting, Ministers agreed to meet again in 2012 to follow up progress on the implementation of their decisions.
According to this paper, the gap between practice and policy - those providing health services to migrants versus those making policies about migrants' entitlements - is increasingly evident. At the same time that clinicians are treating more diverse migrant groups, policy-makers are attempting to implement restrictive or exclusive immigration-related health policies that contradict public health needs and undermine medical ethics that operate on the ground. Policies that respond to the diversity of migrant groups and their differential health risks and service access must be developed and implemented, the authors of this paper argue. Moreover, to make real advances in the protection of both individual and public health, interventions must target each stage of the migration process and reach across borders. Services should be based on human rights principles that foster available and accessible care for individual migrants.
According to this article, the International Monetary Fund is deepening poverty in developing countries, especially for women who make up 70% of the world’s poor. By means of ‘structural adjustment programmes’ (SAPs), it pushes for lower tariffs and cuts in government programmes such as welfare and education. IMF-mandated government austerity measures may require cutting public sector jobs, which disproportionately impact women, as women hold most of the lower-skilled public sector jobs, so are often the first to be cut. As social programmes like caregiving are slashed, women are expected to take on additional domestic responsibilities that further limit their access to education or other jobs. In exchange for borrowing US$5.8 billion from the IMF and World Bank, Tanzania agreed to impose fees for health services, which led to fewer women seeking hospital deliveries or post-natal care and naturally, higher rates of maternal death. In Zambia, the imposition of SAPs led to a significant drop in girls’ enrollment in schools and a spike in ‘subsistence sex’ as a way for young women to continue their educations, the authors note.
In this paper, the authors evaluate the effectiveness of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda, focusing on socio-cognitive determinants of safe sex behaviour, namely delay, condom use and non-coercive sex. A survey of 1,864 students was conducted, which showed significant positive effects of WSMW on beliefs regarding what could or could not prevent pregnancy, the perceived social norm towards delaying sexual intercourse, and the intention to delay sexual intercourse. Furthermore, significant positive effects of WSWM were found on attitudes, self-efficacy and intention towards condom use and on self-efficacy in dealing with sexual violence (pressure and force for unwanted sex). However, all significant positive effects disappeared for those schools that only implemented up to 7 out of 14 lessons in the programme. The authors conclude that the effectiveness of WSWM could be improved by giving more systematic attention to the context in which such a programme is to be implemented.
At the High-level Meeting on AIDS, held 8–10 June 2011 in New York, 3,000 participants gathered to chart a path for the future of the AIDS response, including 30 heads of State and government, along with senior officials, representatives of international organisations, civil society and people living with HIV. The declaration adopted by Member States of the General Assembly contains clear, measurable targets, including targets to halve sexual transmission of HIV by 2015, to reduce HIV transmission among people who inject drugs by 50% by 2015, to ensure that by 2015 no child will be born with HIV, to increase universal access to antiretroviral therapy, to get 15 million people onto life-saving treatment by 2015, and to halve tuberculosis deaths in people living with HIV by 50% by 2015. Member States also pledged to close the global resource gap for AIDS and work towards increasing funding to between $22 and $24 billion per year by 2015. Paul De Lay, Deputy Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS) noted that the declaration clearly outlines the urgent need to increase access to HIV services for people most at risk of infection, including men who have sex with men, people who inject drugs and sex workers. The pledge to eliminate gender inequality, gender-based abuse and violence and to empower women and girls must be fulfilled without delay, he added.
This report focuses on the specific needs and challenges of girls and women at risk of, or living with non-communicable diseases (NCDs). The authors contend that NCDs impact on women’s health and development across the lifecycle, causing morbidity and mortality, and compromising their socio-cultural status in communities. In light of this, the authors argue that failure to act now on NCDs will undermine development gains made to date, including progress made on women’s empowerment. They argue that recognition of the importance of women’s contribution to society in their productive and reproductive roles as well as consumers and providers of healthcare will enable real progress in turning back the global epidemic of NCDs. In conclusion, the authors note that there is lack of awareness around this critical issue for women's health and thus call for attention to NCDs as a priority for women’s health and development, policy dialogue on the particular issues related to girls and women and evidence-informed actions by all partners to improve the health and lives of girls and women worldwide.
Ministers of Health and Heads of Delegation of the WHO African Region, having convened at a Regional Consultation on the Prevention and Control of Noncommunicable Diseases (NCDs) in Brazzaville, Congo, from 4-6 April 2011 in preparation for the 28-29 April 2011 Moscow Ministerial Meeting on Healthy Lifestyles and NCDs; and the United Nations High-Level Summit on NCDs, to be held in New York, USA, in September 2011; made this statement on Noncommunicable Diseases prevention and control in Africa.
A coalition of civil society organisations and academics is initiating a Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI) to research key questions involving health rights and responsibilities, with the goal of securing a global health agreement and supporting social mobilisation around the right to health. A Framework Convention on Global Health would inform post-Millennium Development Goal global health commitments, be grounded in the right to health, help resolve unconscionable global health inequities, and ensure universal health coverage. JALI seeks to clarify the health services to which everyone is entitled under the right to health, the national and global responsibilities for securing this right, and global governance structures that can realise these responsibilities and close major health inequities.
Uganda's Anti-Homosexuality Bill and HIV Prevention and Control Bill are likely to be carried over to the new session of parliament, despite international and local pressure. David Bahati, the Member of Parliament who introduced the Anti-Homosexuality Bill in 2009, said he fully intended to re-introduce the bill into the next session. The new parliament was sworn in on 16 May 2011. Men who have sex with men (MSM) are considered by the Uganda AIDS Commission to be a "most at-risk population", but because homosexual acts are illegal, there are no policies or services targeting HIV interventions towards them. AIDS activists say the bill would only drive an already stigmatised population further underground, leaving them even more vulnerable to HIV. Amid international condemnation in 2010, President Yoweri Museveni said he would not back a bill with either death penalty or "aggravated homosexuality" provisions. Nevertheless, activists say a weaker version of the bill would retain the illegal nature of homosexuality and keep homosexual people in the closet while encouraging dangerous stigma against them in society.