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Washington, D.C., The National Academies Press, 2008 Dec 15.  p.At this historic moment, the incoming Obama administration and leaders of the U.S. Congress have the opportunity to advance the welfare and prosperity of people within and beyond the borders of the United States through intensified and sustained attention to better health. The United States can improve the lives of millions around the world, while reflecting America's values and protecting and promoting the nation's interests. The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area.
Journal of Internal Medicine. 2008 Nov; 264(5):504-8.Had there been a strong African voice contributing to World Bank decisions, it is unlikely that deliberate sidelining of HIV by health sector reforms would have taken place. However, given Bank's architecture and processes, an adequate response to the crisis was a nonstarter; unlike mediocre responses to Africa's other health needs, it has been less easy for the IDC to duck its responsibility and place the blame on its so-called African partners. Nevertheless, the lack of an African voice distorts historical analyses of the crisis often reflecting a western perspective, emphasizing the lack of political will and African governments' failure to act, whilst underplaying the IDC's shortcomings. The notion itself that the epidemic is 25 years old rather than the more accurate 75 years old reflects this distortion. Most of the responsibility rests with the Bank's Board and top management. OED reports that it 'could find no evidence that other top management raised the issue with borrowers or pushed the issue to a higher level internally'. Where there was positive response by the bank at the country level, 'the initiative for AIDS strategies and lending came primarily from individual health staff in the regional and technical operational groupings of the Bank, but not in any coherent way from the Bank's HNP leadership or top-level management. The current initiative by the British House of Commons Committee for International Development to reform the World Bank effectively reverses the notion that the reform was all but impossible because it was a zero sum game. Today, however, its donor members may find the demonstrable unfairness and ineffectiveness less tolerable. It is unlikely that the next president of the Bank will be chosen solely by the United States. Reformers will now need to revise its constitutional rules, their balancing of stakeholder rights, their decision-making rules and practices and their staffing and expertise. The course of the HIV epidemic means that the status quo is no longer acceptable. (excerpt)
American Journal of Public Health. 2008 Sep; 98(9):1594-7.In 1948, after its first World Health Assembly, the WHO took action to form a Secretariat in Geneva. It was given space for its initial years in the Palais des Nations, which had been the last home of the League of Nations. As stated in Chapter I of its Constitution, WHO was "to act as the directing and coordinating authority on international health work." This was a much broader scope than any other international agency in the orbit of the UN. (excerpt)
The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.
Lancet. 2007 Sep 22; 370(9592):1018-1020.On Sept 5, the International Health Partnership (IHP) was launched by the UK, and on Sept 26, Women and Children First: the Global Business Plan for Maternal, Newborn and Child Health will be launched by Norway. These two new efforts, along with the Canadian Catalytic Initiative to Save a Million Lives, have been packaged as part of a broader Global Campaign for the Health Millennium Goals (MDGs). Such an explosion of proposals, which is meant to accelerate action for achieving MDGs 4, 5, and 6, should be welcomed by the world's health community. The proposals are further recognition of the continued commitment by high-income countries to address key health challenges in low-income and middle-income countries. Building on a decade of expanding work in global health, we can hope that these high-profile initiatives will sustain interest and address major obstacles to improving the health of the poorest people in the magnitude and time-frame demanded by the MDGs. Nevertheless, as is often the case with new policy efforts, the main operative aspects of the proposals and their likely consequences can be difficult to identify. We frame questions on five key issues that these announcements highlight. (excerpt)
Support to mainstreaming AIDS in development. UNAIDS Secretariat strategy note and action framework, 2004-2005.
Geneva, Switzerland, UNAIDS, . 10 p.Twenty years into the pandemic, there is now ample evidence for the complex linkages between AIDS and development: development gaps increase people's susceptibility to HIV transmission and their vulnerability to the impact of AIDS; inversely, the epidemic itself hampers or even reverses development progress so as to pose a major obstacle to the achievement of the Millennium Development Goals. The growing understanding of this two-way relationship between AIDS and development has led to the insight that, in addition to developing programmes that specifically address AIDS, there is a need to strengthen the way in which existing development programmes address both the causes and effects of the epidemic in each country-specific setting. The process through which to achieve this is called 'Mainstreaming AIDS'. In recognition of this, the 2001 United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS requires countries to integrate their AIDS response into the national development process, including poverty reduction strategies, budgeting instruments and sectoral programmes. (excerpt)
The Maputo report. WHO support to countries for scaling up essential interventions towards universal coverage in Africa.
Brazzaville, Congo, WHO, 2006. 33 p. (WHO/CCO/06.02)The African region accounts for 10% of the world's population yet is confronted with 20% of the global burden of disease. African nations are faced with high levels of poverty, with 39% of the population below the poverty line; and slow economic growth, with annual per capita expenditure on health in most countries limited to between US$ 10 and US$ 29. Other well-documented challenges to the region include limited financial and human resources, uncoordinated and inconsistent policy action on the determinants of health, limited use of knowledge and evidence to inform policies, and frequent occurrences of natural and man-made disasters. Although much has happened, WHO requires radical new approaches for how it does business in the region. The 21st century presents extensive opportunities for improving health in the region -- building on the momentum of the Millennium Development Goals (MDGs), resolutions of the WHO World Health Assembly (WHA) and the Regional Committee, coordinated work of the African Union, and the strategic framework of the New Partnership for Africa's Development (NEPAD) -- offering opportunities for the mobilization of political, technical and other resources for the region. In addition to health investments from national, bilateral and multilateral sources, commitments are being crystallized in distinct initiatives such as the Millennium Challenge Account, the Presidential Emergency Plan for AIDS Relief (PEPFAR), the Report on the Commission for Africa, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM), and the Global Alliance for Vaccines and Immunizations (GAVI). These initiatives come at a time when international agreements such as the Paris Declaration reaffirm the importance of countries taking the lead in their own health agendas in regards to international development assistance. (excerpt)
Charters, declarations, world conferences: practical significance for health promotion practitioners "on the ground" [editorial]
IUHPE - Promotion and Education. 2005; 12(1):6.We are on the cusp of the twentieth anniversary of the Ottawa Charter for Health Promotion. In 2005 in Bangkok, the World Health Organization will lead a re-examination of the Ottawa Charter, and the Bangkok Charter on health promotion will have been launched. At the International Union for Health Promotion and Education’s global conference in Vancouver in 2007, the Ottawa Charter will again be in the spotlight, as will, for that matter, the new Bangkok Charter. One might wonder about the need for a new Charter, and what impact such documents have on the practical work of health promotion practitioners, if any. The need for a new Charter is the subject of lively debate at the time of this writing, a sign that the Ottawa Charter continues to have significance, even though the world has changed remarkably in the twenty years since its adoption. Perhaps the best test of the Bangkok Charter’s impact will be the degree of attention it receives in 2025, when the young readers of this book have aged into the vanguard of health promotion leadership. That still leaves the question of if, and how, the high level political machinations which culminate in health promotion Charters and Declarations have significance for the day-to-day work of health promotion practitioners. For a start, it is clear that health promotion provides common ground for many health professionals, which enhances the quality and effectiveness of cross-discipline team work. Education in health promotion stimulates and enables cross-discipline dialogue, respect, and eagerness for collaboration. (excerpt)
Lancet. 2003 Sep 13; 362(9387):841.The media focus on continuing instability in Iraq following the unseating of Saddam Hussein earlier this year has all but obliterated coverage of the first armed-conflict casualty in the post-September 11 war on terrorism—Afghanistan. Media coverage of the collapse of the Taliban in late 2001 ensured that the parlous state of Afghanistan’s health became very familiar, with the world’s fourth highest infant and under-5 mortality rates and the highest ever recorded maternal mortality rate. Subsequent media coverage has concentrated on the continuing lack of security, with only passing reference to the poor health status. Scratch the surface of Afghanistan’s depressing health statistics, however, and an impressive example of post-conflict reconstruction is revealed. Afghanistan has risen to the challenge to provide for its people’s health and in so doing has set up a challenge for other similarly affected countries to follow suit. (excerpt)
East African Medical Journal. 2003 Jun; 80(6 Suppl):S1-S20.Health sector reform is 'a sustained process of fundamental changes in national health policy, institutional arrangements, etc. guided by government and designed to improve the functioning and performance of the health sector and, ultimately, the health status of the population'. All the forty six countries in the African Region of the World Health Organisation have embarked on one form of health sector reform or the other. The contexts and contents of their health reform programmes have varied from one country to another. Health reforms in the region have been influenced largely by the poor performance of the health systems, particularly with regard to the quality of health services. Most countries have taken due congnizance of the deficiencies on their health systems in the design of their health reform programmes and they have made some progress in the implementation of such programmes. Indeed, some countries have adopted sector-wide approaches (SWAps) in developing and implementing their health reform programmes. Since countries are at various stages of implementing their health reform programmes, there is a lot of potential for countries to learn from one another. This paper is a synthesis of the experiences of the countries of the Region in the development and implementation of their health sector reform programmes, it also highlights the future perspectives in this important area. (author's)