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.
Values, Policies and Rights
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.
Attempts by the United States to prolong the retention of variola (smallpox) virus stocks have been thwarted at the World Health Assembly (WHA) that met from 16 to 24 May. The WHA instead decided to put aside the US proposal in favour of resuming the discussion at the 67th WHA in 2014. The decision followed contentious discussions on a draft resolution, proposed by the US and several co-sponsors, that would have allowed continued retention of the existing virus stocks, with a report on progress of research only in five years' time (2017), at the 69th WHA. Despite an informal working group meeting to deliberate the issue, there was no consensus and a decision was then made to defer the discussion on the draft resolution. In the final decision adopted on 24 May, the WHA decided to strongly reaffirm the decisions of previous WHA sessions that the remaining stocks of variola virus should be destroyed. It also reaffirmed the need to reach consensus on a proposed new date for the destruction of variola virus stocks when research outcomes critical to an improved public health response to an outbreak so permit. It further decided to include a substantive item "Smallpox eradication: Destruction of variola virus stocks" on the provisional agenda of the 67th WHA session.
While health has always been a part of international relations, the author of this paper argues that it is only in recent years that it has attracted much attention and started the move from an issue of ‘low-politics’ to one of ‘high-politics.’ While the strategies of most governments point to the increasing central role health plays in national strategy, health is still not yet an issue at the heart of government policy. However, research and thinking by groups such as the Chatham House Centre on Global Health and Foreign Policy and the FIOCRUZ Centre for Global Health and International Co-operation can help it became an increasingly important part of it, the author argues. Given increased globalisation and ‘convergence of interest’, there will likely be much more interaction in the future between ministries of health and other ministries, as well as increased priority given to health in foreign policy strategies. The author notes that a call was made in 2009 to the United States (US) President to highlight health as a pillar of US foreign policy, and he predicts that the United States will put more resources into developing a formal foreign relations-based health strategy.
Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy Issue, in the form of global health diplomacy, which informs foreign policy decision-making in the advancement of international co-operation in health. In this paper, the authors review the arguments for health in foreign policy that inform global health diplomacy. These are organised into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualised. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the ‘high politics’ of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional ‘low politics’ of foreign policy, are present in discourse but do not appear to dominate practice. While political momentum for health as a foreign policy goal persists, the framing of this goal remains a contested issue. The analysis offered in this article may prove helpful to those engaged in global health diplomacy or in efforts to have global governance across a range of sectoral interests pay more attention to health equity impacts.