IHSJ Reader, November 4, 2011

IHSJ Reader     November 2011     Issue 11         

Note: Triple asterisk (***) indicates subscription-only sources.

SOCIAL DETERMINANTS OF HEALTH

Rio Political Declaration on Social Determinants of Health (World Health Organization, October 21, 2011)
At the World Conference on Social Determinants of Health in October, the World Health Organization convened Heads of State and representatives from over 100 governments to discuss how social, economic, and environmental conditions could be improved to reduce the health inequities within and between countries. The Rio Political Declaration illustrates five key action areas that are critical to addressing health inequities, including implementing the “Health In All Policies” framework to integrate health priorities across all sectors of society. Though the Declaration reaffirms official commitments to addressing the social determinants of health, some civil society members  have criticized the Declaration for not identifying what policies need to be changed and who is accountable for health inequities, especially in the context of the global financial crisis, increasing food insecurity, neo-liberal policies, and challenges posed by climate change.

Protecting the Right to Health Through Action on the Social Determinants of Health (Declaration, Public Interest Civil Society Organizations and Social Movements, October 18, 2011) 
The People’s Health Movement issued an “Alternative Declaration by Public Interest Civil Society Organisations and Social Movements” in conjunction with the World Conference on Social Determinants of Health. The Alternative Declaration identifies specific political and economic interventions that are needed to reduce the unequal distribution of wealth and power in the world, as well as policies that could mobilize public resources for robust, equity-oriented health systems. Action areas include: progressive domestic and international tax mechanisms such as the financial transaction tax, equity-based social protection systems, and health impact assessments to document the ways international trade and unregulated corporate activity violate the right to health.

Social Protection Floor for a Fair and Inclusive Globalization (Advisory Group, chaired by Michelle Bachelet, International Labor Organization, October 2011)
A new report released by the International Labor Organization (ILO) advocates for the implementation of social protection floors worldwide. The social protection floor, a concept developed by the ILO and endorsed by Heads of State and Government in the 2010 Millennium Development Summit, is an integrated set of policies that guarantee social services and income security to all, paying particular attention to vulnerable populations. A social protection floor is not only critical to guaranteeing the right to health for all, but is also a key driver of economic growth and stability.

Social Justice in the OECD – How Do the Member States Compare? (Bertelsmann Stiftung Foundation, October 27, 2011)
In a recent report by the Bertelsmann Stiftung Foundation of Germany about social justice in those countries which constitute the Organization for Economic Cooperation (OECD), the USA ranked among the bottom five countries for basic fairness and equality. Taking into consideration various social justice metrics, including poverty prevention, access to education, health, social cohesion and nondiscrimination, intergenerational justice, and labor market inclusion, the authors found that there is considerable variation among the OECD countries.

TUBERCULOSIS 

Time for Zero Deaths From Tuberculosis (Salmaan Keshavjee, Mark Harrington, Gregg Gonsalves, Lucy Chesire, Paul Farmer, The Lancet, October 22, 2011)
Almost 130 years after the tuberculosis bacillus was identified, TB remains the world’s leading curable infectious killer, taking more than 1.7 million lives each year.  More and better coordinated advocacy from the multilateral agencies as well as civil society is necessary to garner more resources to reduce deaths from TB to zero. In addition, better leadership and more ambitious vision and goal-setting are needed from the agencies leading the efforts including the WHO, GFATM and others.

Global Funding for Infectious Diseases: TB or not TB? (The Lancet, October 22, 2011)
Progress made in TB treatment over the past few decades, such as China’s achievement of reducing tuberculosis mortality rates by 78% in the past 20 years, will slow if global funding does not increase. At least $2 billion is needed in 2011 to meet the goal of halving TB prevalence and deaths by 2015--but only $600 million is expected to be funded. More than 80% of donor funding for TB control comes from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which is itself facing a severe funding shortfall. Success, as in China, is possible, but international donors and communities must take action to address TB in the most challenging settings and close the enormous gap between what is needed and what is actually available to fight TB.

HAITI

After A Half-Million Cholera Cases, Vaccination Will Begin In Haiti (Richard Knox, National Public Radio, October 20, 2011)
It’s been over a year since the first cases of cholera were detected in Haiti and since then, the epidemic has afflicted nearly half a million people. Partners In Health plans to introduce a cholera vaccine early next year to slow the illness. Despite the $4.6 billion that the international community pledged after the earthquake in January 2010, funding for cholera vaccination, treatment, and prevention has been slow to come. The vaccine will alleviate the suffering of hundreds of thousands of Haitians as part of a comprehensive approach to the cholera response that includes strengthening water and sanitation infrastructure and increasing access to safe drinking water.

GLOBAL HEALTH FINANCING

User Fee Removal in Low-Income Countries: Sharing Knowledge to Support Managed Implementation (Bruno Meessen, Lucy Gilson, Abdelmajid Tibouti, Health Policy and Planning, September 20, 2011)
User Fee Removal in the Health Sector in Low-Income Countries: Lessons from Recent National Initiatives (Health Policy and Planning Supplement, November 2011)
The Health Policy & Planning journal dedicated a supplemental publication to the issue of user fees for health. Though there is a growing consensus that user fees for essential health care in developing countries discriminate against the poor, the broader package of health financing reforms necessary for achieving universal access to free care remains controversial. These articles draw from diverse perspectives to explore challenges related to the design and implementation of user fee removal policies. The Meeesen et al. editorial finds that “policies aiming to reduce financial barriers can be very effective in improving health service utilization, provided they are well designed, funded and implemented”. Partners In Health supports the removal of user fees for health and is committed to expanding access to high quality health care to the poor.

Five Lives: How a Financial Transaction Tax Could Support Global Health (Médecins Sans Frontieres, October 2011)
In this issue brief, MSF argues that the financial transaction tax (FTT) could save millions of lives if a percentage were allocated to global health. The European Commission has proposed a Europe-wide FTT on bond and stock trades that could raise hundreds of billions of dollars a year to help address poverty, fund sustainable job policies and strengthen public services.  The MSF report highlights successful global health programs which could save millions more lives if a portion of the FTT were directed to global health.

Gender Equality and Social Justice: Why Foreign Assistance Matters (Representative Jim Moran, Huffington Post, October 28, 2011)
In October, the Nobel Peace Prize was awarded to three women leaders from Liberia and Yemen. Representative Moran (D-VA) calls on Americans to recognize the importance of these awards in the midst of foreign assistance budget discussions. He writes that these women and the communities and countries they are from are proof that foreign aid works by saving lives, fostering stronger communities, and expanding economic opportunities. Most importantly, Rep. Moran argues, foreign assistance is moral and that Congress must continue its obligation to be part of the solution to poverty, discrimination, and oppression everywhere. 

H.R. 3159 - Foreign Aid Transparency and Accountability Act of 2012 (Rep. Poe, October 12, 2011)
Poe and Kolbe: Shedding More Light on U.S. Foreign Aid (Rep. Ted Poe and former Rep. Jim Kolbe, Roll Call, October 20, 2011)
Congressman Ted Poe (R-TX) introduced the Foreign Aid Transparency and Accountability Act of 2012 with a lengthy list of bipartisan co-sponsors. The legislation calls for creating guidelines and requiring comprehensive reporting to measure the impact of U.S. foreign assistance programs and to ensure that this increased transparency is accessible to the public.

NON-COMMUNICABLE DISEASES

***A Global Scope for Global Health – Including Mental Health (Bepi Raviola, Anne Becker, Paul Farmer, The Lancet, October 17, 2011)
The past few decades have seen remarkable advances in treating chronic diseases, from HIV/AIDS to cancer, and health systems improvements that have encouraged poor countries to develop the infrastructure capable of treating these disorders. Unfortunately, mental health services have been absent from these advances with 75% of patients in low-resource communities left untreated. The barriers that prevent patients from seeking treatment, where it’s available, are pervasive, and range from structural obstacles to social stigma. But, other health movements have surpassed similar barriers. Instead of creating a competing vertical system, current health care systems could be strengthened by integrating quality mental health care.

GLOBAL HEALTH INITIATIVE

The U.S. Global Health Initiative and Sexual Reproductive Health and Rights: Integration (Center for Health and Gender Equity, October 2011)
Sexual and Reproductive Health and Rights and the U.S. Global Health Initiative (Center for Health and Gender Equity, October 2011)
CHANGE launched a series of policy briefs examining the strengths of the Global Health Initiative (GHI), and recommendations for tangible policy and program change. The most recent brief focuses on the critical need for the integration of women’s health and HIV programs worldwide. Key recommendations for the Obama Administration and GHI country teams include: operationalizing a rights-based approach that addresses the needs of all populations, especially marginalized and hard to reach youth; addressing gender inequality and other socio-economic barriers to health, investing in health worker training, and eliminating harmful policy restrictions such as the Helms amendment and the Anti-Prostitution Loyalty Oath.

MULTIMEDIA AND ADDITIONAL RESOURCES

Haiti Grapples With Highest Cholera Rate In World (Tell Me More, NPR News, October 24, 2011)
In this episode of Tell Me More, Michel Martin examines the cholera epidemic in Haiti, highlighting what cholera is, the upcoming vaccine campaign, and the efforts that should be taken by Haiti’s new government to educate communities and strengthen the public health system. 

Treating Pulane, MDR-TB Treatment, PIH Lesotho (Partners In Health, October 2011)
This video introduces the specialized tuberculosis work done at Botsabelo Hospital in Lesotho, as Pulane, a young girl, is examined and treated for life-threatening multidrug-resistant TB. IHSJ Reader, October 21, 2011.