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Global Health, Science and Practice. 2018 Mar 21; 6(1):8-16.Add to my documents.
Under-served and over-looked: prioritizing contraceptive equity for the poorest and most marginalized women and girls.
London, United Kingdom, IPPF, 2017 Jul. 40 p.This report is a synthesis of evidence revealed from a literature review, including 68 reports from 34 countries. The results are dire: the poorest women and girls, in the poorest communities of the poorest countries are still not benefitting from the global investment in family planning and the joined up actions of the global family planning movement. Women in the poorest countries who want to avoid pregnancy are one-third as likely to be using a modern method as those living in higher-income developing countries.
[Washington, D.C.], FP2020, 2016. 139 p.This report marks the halfway point of the FP2020 initiative, and reflects the substantial progress made to date: 1) There are now more than 300 million women and girls using modern contraception in the world’s 69 poorest countries—a milestone that has taken decades to achieve. 2) More than 30 million of those users have been added since 2012, when FP2020 was launched. 3) In Eastern and Southern Africa, for the first time ever, more than 30% of women and girls are using a modern method of contraception. 4) In West Africa, where contraceptive use has been historically low, the Ouagadougou Partnership has surpassed its goal of reaching 1 million additional users between 2011 and 2015, and is now aiming to reach 2.2 million additional users between 2015 and 2020.
[New York, New York], United Nations General Assembly, 2016 Apr 1.  p. (A/70/811)This new report warns that the AIDS epidemic could be prolonged indefinitely if urgent action is not implemented within the next five years. The report reveals that the extraordinary acceleration of progress made over the past 15 years could be lost and urges all partners to concentrate their efforts to increase and front-load investments to ensure that the global AIDS epidemic is ended as a public health threat by 2030. The review of progress looks at the gains made, particularly since the 2011 United Nations Political Declaration on HIV and AIDS, which accelerated action by uniting the world around a set of ambitious targets for 2015. The report outlines that the rapid treatment scale-up has been a major contributing factor to the 42% decline in AIDS-related deaths since the peak in 2004 and notes that this has caused life expectancy in the countries most affected by HIV to rise sharply in recent years. The report underlines the critical role civil society has played in securing many of the gains made and the leadership provided by people living with HIV. Community efforts have been key to removing many of the obstacles faced in scaling up the AIDS response, including reaching people at risk of HIV infection with HIV services, helping people to adhere to treatment and reinforcing other essential health services.
Promoting access to medical technologies and innovation. Intersections between public health, intellectual property and trade.
Geneva, Switzerland, World Health Organization [WHO], 2012.  p.Medical technologies -- medicines, vaccines and medical devices -- are essential for public health. Access to essential medicines and the lack of research to address neglected diseases have been a major concern for many years. More recently, the focus of health policy debate has broadened to consider how to promote innovation and how to ensure equitable access to all vital medical technologies. Today’s health policy-makers need a clear understanding both of the innovation processes that lead to new technologies and of the ways in which these technologies are disseminated in health systems. This study captures a broad range of experience and data in dealing with the interplay between intellectual property, trade rules and the dynamics of access to, and innovation in, medical technologies. The study is intended to inform ongoing technical cooperation activities undertaken by the three organizations (World Trade Organization, World Intellectual Property Organization and World Health Organization) and to support policy discussions. Based on many years of field experience in technical cooperation, the study has been prepared to serve the needs of policymakers who seek a comprehensive presentation of the full range of issues, as well as lawmakers, government officials, delegates to international organizations, non-governmental organizations and researchers.
Geneva, Switzerland, UNAIDS, 2010 Dec.  p. (UNAIDS/10.12E/JC2034E)This Strategy has been developed through wide consultation, informed by the best evidence and driven by a moral imperative to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
Millennium Development Goal 8, The Global Partnership for Development: Time to deliver. MDG Gap Task Force Report 2011.
New York, New York, United Nations, 2011.  p.The objective of MDG 8 is to assist all developing countries in achieving the goals through a strengthened global partnership for international development cooperation. The present report describes how that partnership is producing significant results on many fronts, but notes that many important gaps between expectations and delivery remain. (Excerpt)
[Wellington, New Zealand], Family Planning International, 2006 Dec. 27 p.This report focuses on the relationship between policies implemented by the World Trade Organisation, World Bank, and the International Monetary Fund, and access to health, particularly sexual and reproductive health. .
Global Public Health. 2009; 4(2):131-49.Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today.
Pediatrics. 2008 Apr; 121(4):e984-92.Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival, and that inequities in quality may be as important as inequities in access. There is now substantial global experience of strategies and interventions that improve the quality of care for children in hospitals with limited resources. The World Health Organization has developed a toolkit that contains adaptable instruments, including a framework for quality improvement, evidence-based clinical guidelines in the form of the Pocket Book of Hospital Care for Children, teaching material, assessment, and mortality audit tools. These tools have been field-tested by doctors, nurses, and other child health workers in many developing countries. This collective experience was brought together in a global World Health Organization meeting in Bali in 2007. This article describes how many countries are achieving improvements in quality of pediatric care, despite limited resources and other major obstacles, and how the evidence has progressed in recent years from documenting the nature and scope of the problems to describing the effectiveness of innovative interventions. The challenges remain to bring these and other strategies to scale and to support research into their use, impact, and sustainability in different environments.
International Journal of Gynecology and Obstetrics. 2007 Jun; 97(3):227-228.The Alliance for Women's Health is a FIGO-based interagency consortium, comprising the World Health Organization, United Nations Population Fund, World Bank, UNICEF, International Planned Parenthood Federation, International Confederation of Midwives and International Pediatric Association. In conjunction with the XVIII World Congress of Gynecology and Obstetrics in Kuala Lumpur in November 2006, the Alliance held a precongress workshop examining access in five priority emerging issues: human papillomavirus vaccine/cervical cancer screening, emergency contraception, adolescent reproductive health, emergency obstetric care and sexually transmitted infections. Reports from the five working groups, published in this and subsequent issues of the International Journal of Gynecology and Obstetrics, provide current evidence-based recommendations on improving access to sexual and reproductive health services supported by applicable rights. The World Bank presented a framework for the discussion during theopening plenary session. The importance of sexual and reproductive health services is well recognized and was articulated in the Programme of Action of the International Conference on Population and Development which was held in Cairo in 1994. However, the inclusion of universal access to reproductive health as a target for the Millennium Development Goals (MDGs) only occurred in October 2006 after prolonged negotiations reflecting the reluctance, in circles of influence, to provide support where there are certain sociopolitical sensitivities. (excerpt)
Durban, South Africa, Health Systems Trust, 2004. 61 p.This case study presents an overview of the Stop TB Partnership operating in the South African context. It offers an analysis of the activities and impact of the Partnership in South Africa. Its overarching objective is to collect a set of baseline data on the functioning and operational aspects of the Partnership and to assess whether such initiatives contribute to the development of equitable health services in the public health sector. Tuberculosis is a priority disease in South Africa: the cure rate for new patients of 64% is still way below the World Health Organization (WHO) target of 85%. In some provinces, the cure rate is as low as 40%. The estimated incidence of TB per 100 000 population is 526, and an estimated 60% of adults with TB are also HIV positive. South Africa is ranked third in the WHO AFRO region by the number of TB cases, and ninth globally. Funded by WEMOS, this review is part of a multi-country study. It aims to augment the existing body of knowledge on Global Public Private Initiatives in Health (GPPIs) and to generate a body of country-based evidence relating to the effect of GPPIs on health policies and health systems. (excerpt)
Social Science and Medicine. 2007 Jan; 64(2):287-291.This article builds on a previous study which found low numbers of patent applications for HIV antiretroviral drugs in African countries. A high level of variation was noted across individual countries, and consequently, the present study has sought to account for sources of the variation through statistical analyses. First, a correlation between the number of patents and HIV infection rate was observed (r = 0.448, p < 0.001). T-tests identified significantly higher numbers of patents in national members of two intellectual property organizations (IPOs)--African Regional Intellectual Property Orginisation (ARIPO) and the Organisation Africaine de la Proprie´ te´ Intellectualle (OAPI)--than in countries who did not belong to an intellectual property organization. The relationship between IPO membership and number of patents was also statistically significant in a multivariate Poisson regression. These findings demonstrate that higher numbers of patents are found in countries where they are more easily filed. This has important policy implications given the worldwide trend toward increased recognition of pharmaceutical patents. (author's)
HIV / AIDS and human rights: international guidelines. Third International Consultation on HIV / AIDS and Human Rights, Geneva, 25--26 July 2002. Revised Guideline 6: Access to prevention, treatment, care and support.
New York, New York, United Nations, 2003 Mar. 25 p.The Commission on Human Rights, at its fifty-second session, in its resolution 1996/43 of 19 April 1996, requested that the United Nations High Commissioner for Human Rights, inter alia, continue the efforts, in cooperation with UNAIDS and nongovernmental organizations, as well as groups of people living with HIV/ AIDS, towards the elaboration of guidelines on promoting and protecting respect for human rights in the context of HIV/AIDS. At the same time, the Commission requested that the Secretary-General of the United Nations prepare for the consideration of the Commission at its fifty-third session a report on the above-mentioned guidelines, including the outcome of the second expert consultation on human rights and HIV/AIDS, and on their international dissemination. (excerpt)
Bulletin of the World Health Organization. 1949; 2:139-154.International action on venereal diseases was considered urgent by the Interim Commission of WHO, which decided that a survey of the scientific, practical and other aspects of the problem should be made, with a view to developing practical plans for the international combating of venereal diseases. On the basis of a preliminary worldwide survey by the Secretariat with regard to the nature and extent of the problem, an expert committee was established, and at its first session outlined the principles and scope of an international venereal-disease programme, which subsequently became the basis for the programme approved by the first Health Assembly. Particular emphasis was placed on the continuation of the work on serological standardization of the Health Organization of the League of Nations, the establishment of norms for venereal-disease treatment, the promotion of wider availability of anti-venereal drugs, and the co-ordination of the WHO programme with those of other international organizations. (excerpt)
Making it real. Universal access to reproductive health care is difficult to measure and even more difficult to achieve.
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):92-95.The International Conference on Population and Development was, fundamentally, about making sure that everyone could get the reproductive health services they wanted or needed—“universal access”. This goal seems straightforward, if by no means easy to achieve—especially for the poor and those in isolated rural areas. But ensuring access is not only about mobilising the political will and financial resources to make services available. It is also about making sure people know what and where the services are; that they can physically get to them; and that they can afford to pay for them. Finally, it is about ensuring that people want to use the services—because their families and communities support their choices, and because they feel welcome and accepted at service sites. (excerpt)
Population 2005. 2002 Mar-Apr; 4(1):12-15.In a world where demand for secure reproductive health commodities far exceeds supply, leaving people vulnerable to unwanted pregnancies and diseases, a report from the United Nations Population Fund calls for a secure supply of commodities and effective protection to curb the spread of diseases like HIV/AIDS. The report draws up a "shopping list" of commodities that save lives: pills that allow couples to plan for pregnancy, soap, plastic sheets and razor blades to cut umbilical cords, antiseptics and medical equipment for inserting intrauterine devices, and condoms for protection from HIV/AIDS. Commodity shortages threaten the health and lives of millions in developing countries. Each $1 million shortfall in commodity support for contraceptives means an estimated 360,000 more unwanted pregnancies, 150,000 additional induced abortions, 800 maternal deaths, 11,000 infant deaths and 14,000 additional deaths of children under 5, the report says. Overall, only one third of what the donors promised in Cairo at the International Conference on Population and Development (ICPD) is available now. Specifically, the shortage in funds to purchase contraceptives is projected to reach hundreds of millions of dollars by 2015 – a shortage so severe that it threatens to reverse or stall the world’s progress in reproductive health and rights. (excerpt)
Population 2005. 2002 Mar-Apr; 4(1):2.More than 70 nongovernmental organizations have endorsed a declaration in support of a global event on population and development in 2005, which was prepared by the executive board of Population 2005 in February 2002. The statement was presented to the United Nations Commission on Population and Development at its 35th session in New York in April. The declaration reads as follows: In its Program of Action, the International Conference on Population and Development (ICPD) held in Cairo in 1994 set three sets of specific goals for: 1) provision of family planning and other reproductive health services 2) reduction of infant, child and maternal mortality, and 3) universal access to primary education, with particular attention to the girl child. (excerpt)
[Sexual and reproductive health and reproductive rights. A question of human rights] Saúde sexual e reprodutiva e direitos reprodutivos. Uma questão de direitos humanos.
Sexualidade & Planeamento Familiar. 2001 Nov-Dec; (32):45-52.There is currently an international consensus that reproductive rights are human rights. In the work, it is defended that, although the governments have taken some steps to guide and broaden the services in order to better satisfy the sexual and reproductive health needs of the populations, to advance equality and parity between the sexes and to promote reproductive rights, it is necessary to do much more to make health and reproductive rights a reality for women and men in the entire world. The UN Conference and the agreement about reproductive health (RH) and reproductive rights (RR). Any of the global Conferences that the UN holds in this decade - each one focusing on an important, different and particular question - amplifies the same common message: that to have success, the development efforts should be centered on the people. Ensuring human rights and satisfying the basic necessities of the people are the first critical steps in the resolution of global problems. The right to development itself included key elements such as broadening the access of the population to basic social services and sustaining means of life, balancing the interaction between people, resources and the environment and equitably reconciling the needs of the present with those of future generations. (excerpt)
Canadian HIV / AIDS Policy and Law Review. 2002 Dec; 7(2-3):80-84.Health is a fundamental right, not a commodity to be sold at a profit, argues Irene Fernandez in the second Jonathan Mann Memorial Lecture delivered on 8 July 2002 to the XIV International AIDS Conference in Barcelona. Ms Fernandez had to obtain a special permit from the Malaysian government to attend the Conference because she is on trial for having publicly released information about abuse, torture, illness, corruption, and death in Malaysian detention camps for migrants. This article, based on Ms Fernandez presentation, describes how the policies of the rich world have failed the poor world. According to Ms Fernandez, the policies of globalization and privatization of health care have hindered the ability of developing countries to respond to the HIV/AIDS epidemic-The article decries the hypocrisy of the industrialized nations in increasing subsidies to farmers while demanding that the developing world open its doors to Western goods. It points out that the rich nations have failed to live up their foreign aid commitments. The article concludes that these commitments - and the other promises made in the last few years, such as those in the United Nations' Declaration of Commitment on HIV/AIDS - can only become a reality if they are translated into action. (author's)
Global AIDSLink. 2001 Apr-May; (67):9.For many years, I have worked for access to treatment for people living with AIDS in the developing world. In a well-circulated 1997 article I wrote, “While thousands die of AIDS in the developing world, their brothers and sisters in Europe and North America are taking medication and getting back to the business of focusing on life instead of death.... I think in fifty more years, people will be asking the same questions about the AIDS epidemic as they did about the Holocaust. How was it possible that so many people with resources and intelligence, who knew so much about AIDS, sat passively by and watched their brothers and sisters die for lack of the same medications that everyone knows can prevent the deaths of people with AIDS?” Nearly four years later, I continue to work in Central America promoting treatment access for people with AIDS. The panorama has changed somewhat since 1997. But the realities of every day life for people with AIDS have changed very little in my part of the world, and, I would venture to say, in most of the developing world. (excerpt)
Bulletin of the World Health Organization. 2003 Jul; 81(7):539-545.Those concerned with poverty and health have sometimes viewed equity and human rights as abstract concepts with little practical application, and links between health, equity and human rights have not been examined systematically. Examination of the concepts of poverty, equity, and human rights in relation to health and to each other demonstrates that they are closely linked conceptually and operationally and that each provides valuable, unique guidance for health institutions’ work. Equity and human rights perspectives can contribute concretely to health institutions’ efforts to tackle poverty and health, and focusing on poverty is essential to operationalizing those commitments. Both equity and human rights principles dictate the necessity to strive for equal opportunity for health for groups of people who have suffered marginalization or discrimination. Health institutions can deal with poverty and health within a framework encompassing equity and human rights concerns in five general ways: (1) institutionalizing the systematic and routine application of equity and human rights perspectives to all health sector actions; (2) strengthening and extending the public health functions, other than health care, that create the conditions necessary for health; (3) implementing equitable health care financing, which should help reduce poverty while increasing access for the poor; (4) ensuring that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged; and (5) monitoring, advocating and taking action to address the potential health equity and human rights implications of policies in all sectors affecting health, not only the health sector. (author's)
Tropical Medicine and International Health. 2002 Nov; 7(11):970-976.Public–private partnerships have become central to efforts to combat infectious diseases. The characteristics of specific partnerships, their governance structures, and their ability to effectively address the issues for which they are developed are being clarified as experience is gained. In an attempt to promote access to and rational use of second-line anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant TB, a unique partnership known as the Green Light Committee (GLC) was established by the World Health Organization. This partnership relies on five categories of actors to achieve its goal: academic institutions, civil society organizations, bilateral donors, governments of resource-limited countries, and a specialized United Nations agency. While the for-profit private sector is involved in terms of supplying concessionally priced drugs it is excluded from decision-making. The effectiveness of the partnership emerges from its review process, flexibility to modify its modus operandi to overcome obstacles, independence from the commercial sector, and its ability to link access, rational use, technical assistance, and policy development. The GLC mechanism may be useful in the development of other partnerships needed in the rational allocation of resources and tools for combating additional infectious diseases. (author’s)
Geneva, Switzerland, World Health Organization, Maternal and Child Health and Family Planning, Division of Family Health, 1990. iv, 59 p. (WHO/MCH/90.11)In February, 1987, the Safe Motherhood Conference was held in Nairobi, Kenya. It was sponsored by WHO, the World Bank, the UN Fund for Population Activities (UNFPA) and joined by UNDP. The Safe Motherhood Initiative was then started. This is a worldwide attempt to reduce maternal morbidity and mortality. The goal is to reduce maternal deaths by at least 1/2 by the year 2000. Partners in the safe motherhood initiative are governments, agencies, nongovernmental organizations (NGOs) and other groups and individuals who want to take part in efforts which will reduce the number of women dying and suffering from childbearing and pregnancy. A combination of health and nonhealth schemes is being used to add to the quality and safety of women's lives. Focus is on the need for more and better maternal health services, the extension of family planning facilities, and instruments that will improve the nutritional, social, and health status of females. Activities of the Safe Motherhood Initiative are reflected in many of the World Health Assembly Resolutions. There has also been a series of WHO Regional Committee resolutions. The major approach to achieve the reduction of maternal mortality and morbidity is actions in 4 areas. The 1st area is addressing social inequities; the 2nd, ensuring family planning access; the 3rd, developing community-based maternity care; and the 4th, providing support and backup at the 1st referral level for women who need obstetric care. Epidemiologic studies have been done, as have operation research studies. Evaluations of the home-based maternal record were completed in 12 countries by the end of 1988. Information analysis and dissemination and advocacy activities are described, as are technical cooperation activities with countries. Also described are human resources development activities and other closely linked program activities. Coordination and cooperation are described in chapter 4. A description of program management and resources is given in chapter 5.
REPRODUCTIVE FREEDOM NEWS. 1996 Jul 26; 5(13):8.The United Nations Conference on Human Settlements, also known as the Habitat II conference, met in Istanbul from June 3 to 14. It was the last major UN gathering of this millennium and the first major UN meeting since 1995's Fourth World Conference on Women (the "Beijing Conference")--and thus an important opportunity for a wider international community to weigh in on agreements reached in Beijing and at the International Conference on Population and Development, held in Cairo in 1994. The final document that emerged from Habitat II, the "Global Plan of Action," affirmed crucial elements of those earlier accords. The Habitat documents calls for action to "[d]evelop and implement programmes to ensure universal access for women throughout their life-span to a full range of affordable health care services, including those related to reproductive health care, which includes family planning and sexual health, consistent with the Report of the International Conference on Population and Development." Language adopted at the Cairo meeting is also affirmed in Habitat's call for "universal access to the widest range of primary health care services." Perhaps most significantly, the Istanbul document reiterated an important declaration from the Beijing conference: "While the significance of national and regional particularities and various historical, cultural, and religious backgrounds must be borne in mind, it is the duty of all States to promote and protect all human rights and fundamental freedoms." Most of the 189 UN members and observer states that attended the conference upheld all three of these provisions. Only a small group of states--Argentina, Guatemala, Iran, Jordan, Lebanon, Malta, Qatar, Saudi Arabia, Sudan, Syria, United Arab Emirates, Yemen, and the Holy See--filed reservations on the health care sections. (full text)