This presentation given at the second regional meeting of the African Civil Society Coalition on the Intergovernmental Working Group (IGWG) on Public Health, Innovation and Intellectual Property in Arusha, Tanzania, 3-4 April 2008 provides an introduction to the workings of the IGWG and gives international context for its operations. Drug development and application processes are explained and much of the report is devoted to an evaluation of the IGWG's fixed-dose artsunate-based combination therapy (FACT) project for the treatment of malaria.
Values, Policies and Rights
Regulatory issues focus: Registration and artesunate amodiaquine
Amuasi, JH
Is the declaration of Alma Ata still relevant to primary health care?
Gillam S: British Medical Journal 336:536-538, 8 March 2008
After years of relative neglect, the World Health Organization has recently given strategic prominence to the development of primary health care. This year sees the 30th anniversary of the declaration of Alma Ata. Primary health care 'based on practical, scientifically sound and socially acceptable methods and technology made universally accessible through people’s full participation and at a cost that the community and country can afford' was to be the key to delivering health for all by the year 2000. Primary health care in this context includes both primary medical care and activities tackling determinants of ill health.
UNAIDS starts Task Team on HIV related travel restrictions
Global Network of People Living with HIV/AIDS, 11 March 2008
Since the beginning of the HIV epidemic, governments and the private sector have implemented travel restrictions with regard to HIV positive people wishing to enter or remain in a country for a short stay (e.g. business, personal visits, tourism) or for longer periods (e.g. asylum, employment, immigration, refugee resettlement, or study). UNAIDS has set up an international task team to heighten attention to the issue of HIV-related travel restrictions (both short-term and long-term) on international and national agendas and move towards their elimination.
Women and the Right to Food: International Law and State Practice
Food and Agriculture Organization of the United Nations, 2008
In the light of Millennium Development Goals No.1 – to eradicate extreme poverty and hunger – and No.3 – to promote gender equality and empower women – the present study provides a cross-cutting analysis of the right to food from a gender perspective, examining relevant international instruments as well as State practice. The analysis of these documents will give an idea of what is today’s level of awareness of women’s right to food and related issues, how much is covered by law and how much is missing.
Gates Foundation’s Influence Criticized
McNeil DG: The New York Times, 16 February 2008
The chief of malaria for the World Health Organization has complained that the growing dominance of malaria research by the Bill and Melinda Gates Foundation risks stifling a diversity of views among scientists and wiping out the world health agency’s policy-making function. In a memorandum, the malaria chief, Dr. Arata Kochi, complained to his boss, Dr. Margaret Chan, the director general of the W.H.O., that the foundation’s money, while crucial, could have “far-reaching, largely unintended consequences.”
Right to Health through litigation?
Gloppen S, Gargarella R, Maestad O, et al: Chr. Michelsen Institute
Can court enforced health rights improve health policy and priority setting in poor countries? This multidisciplinary project aims to systematically investigate whether litigation can make health policies and -systems in poor countries more equitable by forcing policy-makers and administrators to take seriously their human rights obligations. Most of the world's governments are obliged through international treaties or national constitutions, or both, to respect, protect, promote and fulfill the human right to health. In most cases, this has not been an enforceable legal right. However, cases regarding the right to health care are increasingly brought before the courts. In a number of low- and middle-income countries - first in Latin America, later in Africa and Asia, court decisions have granted access to certain forms of medical treatment. These are decisions with potentially great implications for how health sector resources are prioritised and allocated, but so far there is little systematic knowledge of the actual effect of such cases on health policy formation, implementation and spending. Do they have a significant effect in practice? And, if so, do they contribute to more - or less - justice in health service delivery?
Sexual and Reproductive Health and Rights Indicators - A case study from South Africa
UNGASS draft report, February 2008
A workshop was held in July 2007 hosted by MOSAIC at which the participating South African organisations reviewed goals set by UNGASs on reproductive health rights, discussed identified indicators, refined these and shared research and findings. In South Africa in 2007 Government in collaboration with many stakeholders (civil society, the private sector) launched the HIV and AIDS and STI National Strategic Plan 2007 – 2011. While there is substantive discussion noting key areas of gender and gender based violence, cultural attitudes and practices, sexual concurrency and sex workers, there is no overall conceptual lens unpacking sexual and reproductive health and rights. Currently reproductive health is not on the essential health priority list. This leaves gaps in terms of the continuum of care and there is a lack of integration, for example, HIV positive women’s sexual and reproductive intentions are not provided for, abortion services are not regulated
within HIV care, sexual violence is not part of the STI syndromic approach.
From chloroquine to artemether-lumefantrine: The process of drug policy change in Zambia
Sipilanyambe N, Simon JL, Chanda P, et al: Malaria Journal 7(25), 29 January 2008
Following the recognition that morbidity and mortality due to malaria had dramatically increased in the last three decades, in 2002 the government of Zambia reviewed its efforts to prevent and treat malaria. Convincing evidence of the failing efficacy of chloroquine resulted in the initiation of a process that eventually led to the development and implementation of a new national drug policy based on artemisinin-based combination therapy (ACT). All published and unpublished documented evidence dealing with the antimalarial drug policy change was reviewed. These data were supplemented by the authors observations of the policy change process. Study results suggest that drug policy changes are not without difficulties and demand a sustained international financing strategy for them to succeed. The Zambian experience demonstrates the need for a harmonized national consensus among many stakeholders and a political commitment to ensure that new policies are translated into practice quickly.
Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study
Molla M, Berhane Y and Lindtjorn B: BMC Public Health 8(9), 9 January 2008
Delaying sexual initiation has been promoted as one of the methods of decreasing risks of HIV among young people. In traditional countries, such as Ethiopia, retaining virginity until marriage is the norm. However, no one has examined the impact of this traditional norm on sexual behaviour and risk of HIV in marriage. This study examined the effect of virginity norm on having sex before marriage and sexual behaviour after marriage among rural Ethiopian youth. Maintaining virginity is still a way of securing marriage for girls, especially in rural areas; the odds of belief and intention to marry a virgin among boys was 3-4 times higher among rural young males. As age increased, the likelihood of remaining a virgin decreased. There was no significant difference between married and unmarried young people in terms of number of partners and visiting commercial sex workers. Married men were twice more likely to have multiple sexual partners than their female counterparts. Although virginity norms help delay age at sexual debut among rural Ethiopian youth, and thus reduces vulnerability to sexually transmitted infections and HIV infection, vulnerability among females may increase after marriage due to unprotected multiple risky sexual behaviours by spouses. The use of preventive services, such as VCT before marriage and condom use in marriage should be part of the HIV prevention and control strategies.
Health and Human Rights: A resource guide
Open Society Institute and Soros Network, June 2007
This Resource Guide brings together two of the Open Society Institute’s largest priorities: public health and numerous law and human rights initiatives.