Health and development

Credit: WHO/Jesse Hoffmann

The 63rd World Health Assembly, the gathering of the decision-making body of World Health Organization (WHO), opened in Geneva today. Health Ministers and officials from across the world will meet until 21 May 2010 to discuss the implementation of the International Health Regulations (IHR).

There are 194 countries across the globe, including all the member states of the World Health Organization (WHO) who are State Parties to the IHR, a binding, international legal instrument. The aim of these global rules is to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide.

The IHR, for example, require countries to report certain disease outbreaks and public health events to WHO and also to strengthen their existing capacities for public health surveillance and response.

This year’s World Health Assembly will also focus on monitoring the achievements of the health-related Millennium Development Goals. In the year 2000, 189 countries committed their nations to a new global partnership to reduce extreme poverty. They set out a series of targets to be reached by 2015. These have become known as the Millennium Development Goals (MDGs) and include halving extreme poverty, halting the spread of HIV and providing universal primary education.

The World Health Assembly is attended by delegations from all WHO member states yearly to focus on specific health agenda. Last year’s Assembly focused considerable attention on the widespread outbreak of influenza A (H1N1) and the most effective responses to the potential pandemic, including preparedness, access to vaccines and sharing of influenza viruses.

Global health Governance: The Scholarly Journal for the New Health Security Paradigm

The next issue of Global Health Governance will focus on Global Health Governance and the AIDS Response. Michel Sidibé, Executive Director of the United Nations Joint Programme on HIV/AIDS (UNAIDS) and Kent Buse, Senior Policy Advisor to the Executive Director, will serve as guest editors for this issue.

This special issue will explore the contributions of the global AIDS response over the last 30 years to innovations in governance principles, paradigms, and practice. It will outline present challenges, opportunities and future directions for improving both the global governance of the AIDS response and governance approaches to human development, security and dignity more generally. AIDS governance at global, national and community levels has not only transformed the nature of health systems governance, but also shed light on a number of socio-political issues with significant implications for human development. The editors seek a balance of theoretical/conceptual and empirical pieces from a wide variety of disciplinary perspectives including public health, political science and international relations, international law, philosophy, history, anthropology, business and public administration to better understand and improve this exciting area of practice and enquiry.

The focus of manuscripts must be on the governance of the AIDS response and/or lessons it offers for Global Health Governance. The range of possible article topics is vast and may include, but is not limited to, the following:

• Enhancing effectiveness and legitimacy of global governance mechanisms and institutions;
• Systems for inclusive policy-making as well as the engagement of civil society and the private sector in planning, accountability, oversight of national responses;
• Innovations, successes, failures and potential of transparency/accountability mechanisms—including within the multilateral system;
• Process of establishing/validating/disseminating/enforcing novel global norms—particularly concerning sexual and human rights, punitive laws, inclusive policy making, accountability, ethical trials, access; gender;
• Country institutions for governing national responses, such as NACs and CCMs;
• Tensions between concepts of national ownership and global cosmopolitan citizenship and social justice;
• Cross-border civil society interest group formation for policy change and supranational citizenship building;
• Politics of punitive laws—and the role of civil action, networks, partnerships in their repeal;
• Framing and discourse in relation to global priority setting;
• Innovations in communication technologies for global governance;
• AIDS in the context of global and national security as well as global solidarity and justice;
• Lessons from the AIDS response for realizing the right to health through development of novel norms and enforcement processes concerning universal access;
• Role of AIDS activists/networks in development of intellectual property rights discourse/regimes and practice and implications for access to essential health commodities;
• The politics of innovative financing and resource allocation;
• Governance implications of taking the AIDS response out of relative isolation and linking to other efforts to achieve the MDGs;
• Lessons from AIDS partnerships: governance, ethics, politics, public-private interplay.

In addition to academic papers, the Guest Editors will solicit commentaries from thought leaders on topical issues and future directions of global health governance.

Authors should alert the journal of their intention to submit a manuscript, including the proposed title of the paper, the names of the author(s) and an abstract of no more than 250 words no later than 15 March 2010. The abstract should include the research question(s), methods, findings, main argument and implications. The letter should be submitted to Sonja Tanaka, tanakas@unaids.org. The deadline for submissions is 15 June 2010. The provisional date of publication is October 2010.

Timeline

• February 15th—Call for Proposals
• March 15th—Deadline for submissions of Abstracts
• June 15th—Deadline for submission of Manuscripts
• August 10th—Accept/Reject decisions communicated to authors
• September 10th—Deadline for submission of revised Manuscripts
• October—Provisional publication of 2010 Fall issue

There are no submission fees.

More information about the Journal can be found at the Journal web site.

Executive Director of UNAIDS Michel Sidibé addressed the Ministerial Review Meeting of the IHP+ which took place in Geneva 4-5 February 2009.
Credit: World Health Organization

Meeting in Geneva last week, participants in the first Ministerial Review Meeting of the International Health Partnership and related initiatives (IHP+) adopted a document laying out bold and concrete commitments to push forward the objectives of the Partnership.

The official communiqué notes that the current severe global economic downturn will put pressure on the development budgets of donor countries and make it difficult for developing countries to sustain domestic funding for health.

“We agreed that this increases the importance of our objectives to secure more effective and predictable financing, as well as additional resources to achieve the health MDGs.”

"We reaffirmed our commitment to maintaining levels of development aid and domestic health budgets. We also commit to delivering predictable financing, and ensuring the effective use of all domestic and external resources. This is critical to achieving results and attracting additional resources."

Addressing the meeting, the executive director of UNAIDS Michel Sidibé pledged UNAIDS’ full support to the IHP+ process. “I see the Partnership as an important instrument to help achieve universal access and to stand by those in need of HIV services,” said Mr Sidibé.

The Review Meeting of the IHP+ took place 4-5 February 2009 to take stock of progress, review lessons, and examine ways to maintain commitment and momentum.

The IHP+ is a partnership which includes partner countries, United Nations agencies including UNAIDS, bilateral donors, civil society and private sector partners. Launched in September 2007, the partners aim to increase coordination in health and to strengthen health system in order to make progress on achieving the health-related Millennium Development Goals.

(from right) Executive Secretary of the UN Economic Commission for Africa Mr Abdoulei Janneh and Executive Director of UNAIDS Michel Sidibé, 9 November 2009.
Credit: UNAIDS

The Executive Director of UNAIDS Michel Sidibé met with the Executive Secretary of the Economic Commission for Africa (ECA) Mr Abdoulei Janneh earlier today in Addis Ababa, Ethiopia.

They held broad-ranging discussions on the relationship between health and development and the need to find innovative ways to generate financial resources to fund future HIV treatment for people in need. The importance of resource monitoring and evaluation of results for the Millennium Development Goals was also underlined.

Mr Abdoulei Janneh also updated Mr Sidibé on the Coalition for Dialogue in Africa (CoDA) which was launched earlier this year as a joint venture between the African Development Bank and the ECA to stimulate discussions on African socioeconomic issues and explore new ways for Africa development.

(from left) Executive Director of UNAIDS Michel Sidibé and the Executive Secretary of the UN Economic Commission for Africa Mr Abdoulei Janneh held discussions on health financing, 9 November 2009.
Credit: UNAIDS

The CoDA initial advisory board includes Dr Frene Ginwala, Former Speaker of the National Assembly of South Africa; Mr Mo Ibrahim, Chair, Mo Ibrahim Foundation; Dr. Spciosa Wandira Kazibwe, former Vice President of the Republic of Uganda; and The Right Honourable, Mr. Paul Martin, former Prime Minister of Canada.

While in Addis this week Mr Sidibé is attending the board meeting of the Global fund to Fight AIDS, TB and Malaria.

ECOSOC events are organized in the Economic and Social Council Chamber.
Credit: ECOSOC

The high-level segment of the annual session of the Economic and Social Council (ECOSOC) opened this morning in Geneva with addresses by Sylvie Lucas, President of the Economic and Social Council; Ban Ki-moon, Secretary-General of the United Nations and Hans-Rudolf Merz, President of Switzerland.

The focus of the 2009 Annual Ministerial Review (AMR), which takes place during this high-level segment of ECOSOC will focus on "Implementing the internationally agreed goals and commitments in regard to global public health."

UNAIDS Executive Director Michel Sidibé participated in a session this afternoon on “Partnerships in health – lessons from multi-stakeholder initiatives.”

Mr Sidibé spoke about the prominent role of partnerships in the success of the AIDS response and the importance of collaboration with civil society, faith-based groups and the private sector as “partnerships are the life blood of the AIDS response.”

“People affected by HIV have always been at the heart of the response,” said Mr Sidibé. He also called for a broadened vision, an “AIDS+MDG movement” to address global health and development challenges.

He was joined on the panel by Philippe Douste-Blazy, Special Advisor on Innovative Financing for Development and Chair of the Board of UNITAID Michel Kazatchkine, Executive Director, Global Fund to Fight Aids, Tuberculosis and Malaria.

On Tuesday, Mr Sidibé will participate in a satellite on injecting drug use and a ministerial meeting on AIDS vaccines.

The high-level segment is a forum for Ministers and executive heads of international institutions and high-ranking officials, as well as civil society and private sector representatives to discuss key issues on the international agenda in the area of economic, social and environmental development.

It provides an opportunity to:
1. Assess the state of implementation of the United Nations Development Agenda;
2. Explore key challenges in achieving the international goals and commitments in the area of global public health;
3. Consider recommendations and proposals for action, including new initiatives.

The Economic and Social Council

ECOSOC was established in 1945 under the United Nations Charter as the principal organ to coordinate economic, social, and related work of the 14 UN specialized agencies, functional commissions and five regional commissions. The Council also receives reports from 11 UN funds and programmes. It serves as the central forum for discussing international economic and social issues, and for formulating policy recommendations addressed to Member States and the United Nations system.

The gathering runs until 9 July at the Palais des Nations in Geneva, Switzerland.

The 2009 report of the Global Campaign of the Health MDGs: Leading by Example - Protecting the most vulnerable during the economic crisis.

The United Nations Secretary-General Ban Ki-moon and the Foreign Minister of Norway Jonas Gahr Støre launched the 2009 report of the Global Campaign of the Health MDGs, Leading by Example - Protecting the most vulnerable during the economic crisis. The launch coincided with the High-Level Forum on Advancing Global Health in the Face of Crisis which was held on 15 June at United Nations Headquarters, New York.

The report highlights that recent actions from governments, international agencies and civil society have started to show positive impact on the health of mothers and children. This has given hope for accelerating progress towards the Millennium Development Goals (MDGs) 4 & 5 —aiming to reduce child mortality by two-thirds and maternal mortality by three-quarters by 2015. However, this progress is now threatened by the most severe global economic crisis since the 1930s, especially in low-income countries.

According to the report, more money is needed to accelerate the progress towards the health goals and more specifically to save millions of mothers and their newborn babies.

The Network of Global Leaders, which includes twelve leaders from developing and donor countries, contributed to the report and they urged leaders to take measure to protect the vulnerable, especially women and children, from the economic downturn. "The global economic crisis demonstrates how inter-dependent we have become as a global community. This is the time to honour our commitments and invest in our common future," say the leaders in their signed overview of the report.

The Global Campaign for the Health MDGs was launched by Prime Minister Stoltenberg with other global leaders in New York in September 2007. The aim of the campaign is to increase and sustain the political and financial commitment for the health MDGs, in particular those protecting the most vulnerable, women and children.

The Network of Global Leaders is a group of international leaders that provide political backing and advocacy at the highest possible level for the Global Campaign for the Health MDGs.

A short report by UNAIDS on AIDS and Global Health examines the role that the health sector should play in helping to attain the goal of universal access to HIV prevention, treatment, care and support. Credit: UNAIDS/P.Virot

The High-Level Forum on Advancing Global Health in the Face of Crisis is taking place at United Nations Headquarters on Monday, 15 June 2009. The Secretary-General is hosting the day long forum in order to elevate the global health debate and engage multisectoral representatives from around the world.

A short report by UNAIDS on AIDS and Global Health made available for this event examines the role that the health sector should play in helping to attain the goal of universal access to HIV prevention, treatment, care and support. Over the past decade the AIDS response has played a major role in producing better health outcomes for people in developing countries and has mobilized a whole range of stakeholders in efforts to build health systems worldwide. However, much work still needs to be done.

The AIDS epidemic is part of the global health landscape, just as the global health agenda is part of the AIDS response. The new report shows that the response to AIDS is an opportunity to improve health systems worldwide. Also discussed is that other areas that contribute to health solutions, such as human rights, the law and education, need to be embraced if we are to maximize outcomes, and that health equity must be addressed.

Shortfall in health resources

Investment in global health has increased significantly in recent years, and investment in the AIDS response has grown from US$ 300 million in 1996 to nearly US$ 14 billion in 2007. However, resources are still falling short for all health needs, and AIDS is no exception. With 7400 new HIV infections each day, the shortfall grows ever greater, and to achieve universal access in 2010 will require US$ 25 billion: US$ 11 billion more than is available today. Advocates for global health must therefore find ways to increase sound investments in health and the AIDS response.

Community services strengthened

It has been shown that there are many beneficial effects from an increase in AIDS resources being spent on health and community systems. A case study described in the report looks at how increased funding for HIV in Nigeria has trickled down to improvements at the local level in a whole range of areas, which in turn helps in the fight against many other diseases. Focusing on a hospital in Jengre, Nigeria, the case study shows that AIDS funding has helped provide free services for children and pregnant mothers enrolled in antenatal care, in addition to enabling major improvements in the hospital’s infrastructure and its ability to tackle the other poverty diseases: tuberculosis and malaria.

Linking AIDS treatment and HIV prevention to other health issues, such as sexual reproductive health, tuberculosis and safe motherhood, has meant that they themselves receive more attention. AIDS responses have also strengthened hospital infection control and improved blood safety and transfusions. The issue of paediatric AIDS has contributed to the debate on better medicines for children, and new opportunities have emerged to challenge those social norms that contribute to ill health.

HIV: health issue and social issue

AIDS and global health notes that HIV is both a health issue and a social issue. By involving the education, agriculture, business, media, labour and other social service sectors, the AIDS response has been able to leverage better health outcomes, just as efforts to eradicate polio and reduce tobacco use have done in recent years. HIV has highlighted the underlying causes of poor health: social determinants such as gender inequality, stigma, migration and lack of education. A lesson learned is that social determinants must be addressed when addressing global health needs.

Sections of the report on tuberculosis and HIV, climate change and HIV and A (H1N1) influenza stress the diverse areas that global health and AIDS cut across.

In conclusion, the report reminds us that much has been accomplished under the emergency conditions of the past 25 years, but that the global response is at a crossroads. The AIDS response and the health response should not work in isolation, but should be united around one common goal: results for people.

UNAIDS Executive Director Mr Michel Sidibé participated in the Forum on African Dialogue where he delivered a presentation on the challenges of pandemics for Africa’s development. Credit: UNAIDS

Africa Day, the official day of the African Union, is observed every 25 May. It is an opportunity to celebrate African diversity and success, but also a time to reflect on the challenges remaining in Africa’s road to development.

To mark the 46th anniversary of Africa Day, the African Union Permanent Representation in Geneva organized the First Forum on African Dialogue which took place on the 27 May 2009, under the theme “Africa’s Development: Whose Responsibility?”

The Chairperson of the African Union Commission (AUC), Mr Jean Ping, officially launched the dialogue forum. The Dialogue brought together representatives of the Swiss government, Ambassadors of permanent missions in Geneva, United Nation Organizations, private sector and other development organizations including the African Development Bank.

UNAIDS Executive Director Mr Michel Sidibé also participated in the forum where he delivered a presentation on the challenges of pandemics for Africa’s development. Mr Sidibé highlighted the role that infectious diseases play in Africa’s underdevelopment. Africa is the region where 11% of the world population live, and is home to 60% of people living with HIV. More than 300,000 children are born every year with HIV when vertical transmission (transfer of HIV from mother to child) has virtually disappeared from most European countries.

“If Africa is to progress with its development, we need to transform health from being Africa’s greatest challenge into being its greatest resource,” said Mr Sidibé. “But we desperately need a pan-African vision on how to get there. We need to engage all partners, from governments to civil society, and development partners, to make a decisive contribution to the health of current and future generations” he added.

Mr Sidibe pointed out that AIDS has shown the need for an institutionalized response in Africa, that is owned and lead by national partners from government and civil society.

During his intervention, Mr Sidibé emphasized the need for a continental vision on how Africa will lead in the response to its epidemics. According to Mr Sidibe, the actions required to transform approaches to health and development are to improve systems for resource management; use human resources effectively; redefine and reorient programmes for research and development to make sure they address Africa’s health priorities; and address trade issues, between Africa and the rest of the world, and within Africa so access to commodities is permanent and sustainable. He called for a greater leadership and mutual accountability to expand universal access to HIV prevention, treatment, care and support to all in Africa.

Ministers of Health of the Association of Southeast Asian Nations (ASEAN) gathered for an informal meeting on the sidelines of the World Health Assembly (WHA) on 19 May 2009 in Geneva, Switzerland.. Credit: UNAIDS/P. Virot

Ministers of Health of the Association of Southeast Asian Nations, or ASEAN, gathered for an informal meeting on the sidelines of the World Health Assembly (WHA) on 19 May 2009 in Geneva, Switzerland.

The main objective of the meeting was to discuss issues of common interest during the WHA, such as ASEAN’s strategies to address the A(H1N1) flu outbreak and prevent a pandemic as well as to discuss with UNAIDS Executive Director Mr Michel Sidibé strategies to achieve universal access to HIV prevention, treatment, care and support.

The meeting was chaired by Honorable Dr Francisco T. Duque III, Secretary of Health of the Philippines and supported by UNAIDS. It was a follow-up to the 2nd ASEAN-UN summit that took place in New York on 13 September 2005. In the New York meeting, participants adopted a Joint Communiqué stating the need for ASEAN members to have a voice in global forums such as the World Health Assembly and participate in global decision-making regarding allocation of funds for HIV prevention and control.

Mr Michel Sidibé, Executive Director of UNAIDS and Under Secretary-General of the United Nations presented his vision to the ASEAN countries and restated UNAIDS’ commitment to support countries in achieving universal access.

Mr Michel Sidibé, Executive Director of UNAIDS and Under Secretary-General of the United Nations presented his vision to the ASEAN countries and restated UNAIDS’ commitment to support countries in achieving universal access.

Mr Sidibé also outlined how a number of countries in the region have made significant progress in ensuring that the most vulnerable communities, including sex workers and their clients, men who have sex with men and injecting drug users, are a priority in national AIDS responses.

Mr Sidibé underscored the importance of government leadership in order to achieve the universal access targets and praised the commitment demonstrated by the ASEAN countries in responding to the AIDS epidemic as seen in their adoption in 2007 of the ASEAN Declaration on HIV and AIDS and the Declaration on the Protection and Promotion of the Rights of Migrant Workers.
At the end of the meeting, Health Ministers produced a Joint-ASEAN Ministerial Statement on ASEAN’s position in pandemic preparedness for avian, human and A(H1N1) influenza, particularly on cross-border collaboration, sharing of information and  viral specimens, and universal access on HIV prevention, treatment, care and support.

Photo (60th WHA)
Credit WHO/Peter Williams

This year’s World Health Assembly is set to focus considerable attention on the widespread outbreak of influenza A(H1N1), as Health Ministers and officials of more than 190 countries gather in Geneva from 18-22 May to discuss the most effective responses to the potential pandemic, including preparedness, access to vaccines and sharing of influenza viruses.

According to the latest World Health Organization (WHO) statistics, there are now 39 countries reporting a cumulative total of 8480 cases of A(H1N1) (17 May update). The virus represents a serious and growing health threat. WHO Director-General Dr Margaret Chan has called for “global solidarity” in the face of this unpredictable threat and the sixty-second World Health Assembly will provide an opportunity for such solidarity.

The World Health Assembly, convened by the Director-General of the World Health Organization, will also follow its broad remit to review progress and set new priorities for the WHO. Other issues to be examined will include primary health care and health system strengthening; exploring the social determinants of health and monitoring the achievement of the health-related Millennium Development Goals. There will also be room for the discussion of the programme budget for the next two years and internal management matters.

A key element of the meeting is the consideration of the revised version of the Medium-term strategic plan 2008-2013 which has 13 objectives including the reduction of the health, social and economic burden of communicable disease; mitigating the health consequences of emergencies, disasters, crises and conflicts; ensuring improved access, quality and use of medical products and technologies, and challenging the spread of AIDS, tuberculosis and malaria.

Delegates hope to build on the success of previous meetings. For example, in 2008 the assembly endorsed a public health, innovation and intellectual property strategy which promoted new approaches to drug research and development and championed the removal of barriers, enhancing access to medicines, especially for less developed nations. The gathering also adopted a resolution urging Member States to take decisive action to address the health impacts of climate change.

It is clear that the World Health Assembly is expected to explore a complex array of issues that transcend the sphere of health, touching on and interconnecting with a broad range of other sectors with the aim of mounting an effective challenge to global health threats.

During the week, UNAIDS Executive Director Michel Sidibé will participate in a range of side events including meetings with national ministers of health from around the world.