Global Health in the Post-2015 Framework
April 7, 2013 in MDG 4 (Child Mortality), MDG 5 (Maternal Health), MDG 6 (Health)
Today is World Health Day, which marks the founding of the World Health Organization (WHO) in 1948. The Millennium Development Goals have tackled health issues in the past, and the post-2015 agenda is shaping up to tackle them in the future.The first set of MDGs contained a number of goals aimed at improving health that can be divided into three categories:
1. Demographic goals: These were concerned with improving the health of certain populations.For example, the health of pregnant women and young children in Goals 4 and 5 (Child Mortality and Maternal Health, respectively).
2. Disease specific goals: The first set of goals focused on “the big three:” HIV/AIDS, malaria and TB. Everything else pertaining to health concerns was put under the blanket term of “other diseases”.
3. Wider determinants of health: This includes things like how being lifted out of extreme poverty will improve your access to food and nutrition, and thus improve your health in general.
Overall, the achievement of these goals has been hit and miss. For example, the roll out of anti-retroviral (ARV) therapy in large parts of the world has reduced the number of people dying from HIV/AIDS. However, many people still cannot access the necessary drugs. Child mortality has reduced in some countries, but is still quite terrible in sub-Saharan Africa. You can read more about these issues here in the UN’s Development Report, and also in the independently produced and very excellent Global Health Watch 3.
However, many people felt this level of specificity focuses programmes and funding on a few specific populations and diseases, to the neglect of many others. This has given rise to specific campaign movements to have other diseases included in the global health agenda, such as the Neglected Tropical Diseases (NTDs), Non-Communicable Diseases (NCDs), and Global Mental Health. Not to mention the extreme need for drugs, hospitals and staff in many places in the world. All of these deserve international recognition and funding.
So how do you tackle a problem like health in the post-2015 framework?
Dividing health down into disease and demographic groups has distorted the funding landscape and left millions of people without access to healthcare . Health is a problem affecting a whole population and encompassing a spectrum of disease. If you try and cherry-pick what health issues to tackle, you will always leave someone out. It is no good being able to get ARVs for HIV and then dying of appendicitis. There are two themes that appear in the current post-2015 discussions:
1. Universal health coverage: At the most basic level, this is the principle that everyone, everywhere should be able to access healthcare when they need it. This is obviously quite complicated and you can click here to find out more from the WHO. This has recently been highlighted by Ban Ki-Moon, the UN secretary General.
2. Prevention, the social determinants of health: Too many people become ill unnecessarily and much more must be done to prevent common diseases. This approach involves tackling the “causes of the causes of ill health.” For instance, the environment in which people are born, grow up, and die significantly impacts their health. This includes things like living conditions, economic development, wealth distribution, education, and more. This approach has been developed and championed by Michael Marmot, and you can read more about it here.
Both strategies need to be adopted in the post-2015 framework. The global health and international development community needs to work together to see how this can be achieved. This may prove difficult due to the vested interests of both the negotiators and the lobbyists, but remains an ethical imperative and one that young people should be advocating for.
Prevention is always better than cure, unless you are already sick.
This goal deals with an integral issue, which solution should involve concepts related to development from all its approaches; its accomplishment depends on many factors, like empowerment of the communities and implementation of entrepreneurship programs, along with financial assistance, in order to attack the issue from the root, rather than only diminishing its consequences. Furthermore, involvement from the civil society constitutes an essential factor in the quest for equality and social justice, along with the political will of government representatives of any kind and level; they should be encourage to build a reliable database using empirical evidence, that will allow those in charge of resources to properly allocate them. We strongly suggest the leaders throughout the world to become involved in the solution of this issue, taking into account that every person has dignity and is entitled to the right t food and development.
The following are actions taken around the globe, which can be more broadly utilized, to implement Goal 2 of the Millennium Development Goals; to ensure that by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. Remove fees associated with attending school, including the cost of tuition, books, supplies, uniforms, and transportation. Provide amnesty for undocumented, migrant, and refugee children to attend school with out deportation or other consequences. Provide two meals a day to encourage families facing poverty to send their children to school. Address gender barriers, especially in rural areas. Provide feasible transportation to children, or adopt mobile schools.
It become evident in the group discusions that the 8 MDG is not recognised and the information around the issues that it affects is not well recognised. This goal deals with developing an open finance system and non discriminatory trading practices. After much delibaration some points were agreed upon as to how this MDG could be improved to suit a system based approach of how the MDG’s should be implemented. Overally the group felt the MDG was articulated on a top down approach and very much western centric.Thus not representing the real issues of all countries. Firstly the use of ‘partners’ in wording of the MDG should be replaced with ‘stakeholders’ as this word is more inclusive of all the actors in achieving this MDG. There was a consesus that debt problems is not only on developing countries thus it should change focus and include all countries and also include debt owing to international monetary organisations. Also that the issue of tarrifs should be reduced or removed as countries for example the UK places high tariifs on products from Africa of which the collect more money then the one the give aid to the African continent. Much needs to be done on this MDG in order to achieve its targets.
The Millennium Development Goals (MDG) are the world’s time bound and quantified targets for addressing extreme poverty, hunger, disease, lack of adequate shelter and exclusion while promoting gender equality, education and environmental sustainability. There are eight goals and this article focuses on MDG 6 which targets to combat HIV/AIDS, Malaria and other diseases.
Bangladesh, being geographically positioned at the receiving end of perhaps the largest river system, and owing to other concomitant factors like the deltaic formation history and low-line coastal morphology has become the most disaster prone region on earth. Processes embedded in the nature, caused by multitudinous factors, constitute hazards to the environment of this region having severe aftermath on local lives, property and livelihoods of the population, and eventually, impeding the overall socio-economic development of Bangladesh. The (co)occurrence of these natural events are often coupled and multiplied with the high base vulnerabilities of the individuals, households and communities results in disasters that further drive the country towards greater environmental degradation, hunger, poverty, social deprivation and political conflicts, thereby impeding the development of Bangladesh. Therefore, over the last few decades, both national and international communities have been engaged in counteracting the negative developmental impacts of disasters as well as ensuring that development interventions do not exacerbate vulnerability to hazards.
It become evident in the group discusions that the 8 MDG is not recognised and the information around the issues that it affects is not well recognised. This goal deals with developing an open finance system and non discriminatory trading practices. After much delibaration some points were agreed upon as to how this MDG could be improved to suit a system based approach of how the MDG’s should be implemented. Overally the group felt the MDG was articulated on a top down approach and very much western centric.Thus not representing the real issues of all countries. Firstly the use of ‘partners’ in wording of the MDG should be replaced with ‘stakeholders’ as this word is more inclusive of all the actors in achieving this MDG. There was a consesus that debt problems is not only on developing countries thus it should change focus and include all countries and also include debt owing to international monetary organisations. Also that the issue of tarrifs should be reduced or removed as countries for example the UK places high tariifs on products from Africa of which the collect more money then the one the give aid to the African continent. Much needs to be done on this MDG in order to achive its targets.
