1,434,324 research outputs found

    Ebola: Towards an International Health Systems Fund

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    The current outbreak of Ebola virus disease (EVD) in West Africa is spiraling out of control, but it never had to happen. What can the international community do now to bring the epidemic under control, and how can we prevent the next one? The counties most affected by Ebola (Guinea, Liberia, and Sierra Leone), rank among the lowest in global development, lacking essential public health infrastructure. If the affected countries had adequate public health systems, they probably would have contained Ebola within rural settings, avoiding the first outbreak in major urban areas. More than 130 health workers have died from Ebola during the current outbreak, depleting already scarce human resources. Hospitals lack personal protective equipment and safe isolation facilities, becoming amplification points for transmission. The absence of basic public health infrastructure means that countries have instead often resorted to military-led cordons sanitaires, without ensuring access to basic necessities, such as food, clean water, and health care. This article proposes an International Health Systems Fund, encompassing both emergency response capabilities and enduring health-system development. The WHO’s Ebola response roadmap estimates than an initial US$490 million in global resources over 6 months would be needed to curb the outbreak, although the total costs are likely to be considerably higher. What is needed is a standing crisis fund to ensure surge capacity in the event of a WHO declared Public Health Emergency of International Concern. To prevent future epidemics, and to provide health services for the entire population, we also urgently need a sustainable International Health Systems Fund to build long-term capacity. This fund, however, would require multibillion-dollar investment. Although large, the international community has mobilized before on this scale through PEPFAR and the Global Fund. The West African Ebola epidemic should spark a badly needed global course correction that would favor strong health infrastructure. It would encourage high-income countries to meet their International Health Regulations obligations to mobilize financial resources and provide technical land logistical support to develop, strengthen, and maintain public health capacity, especially in lower-income countries. Although the scale of investment would be substantial, it is a wise and affordable investment in containing global health hazards, and moving towards a right-to-health based universal health coverage

    Changing international health policy and changing international development goals

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    The World Health Organisation (WHO) was founded in 1948 with a remit to promote public health around the world. The WHO’s constitution sets out its objective as ‘the attainment by all peoples of the highest possible level of health’ (WHO, 1948). The paper raises broad questions over the aspirations and practice of international health policy in its international political and development context. The paper explores how international health policy has been informed by evolving international development strategies, from the earlier modernisation approaches to the sustainable development approaches of recent decades. The final part considers international health policy today in a world of continuing international inequalities

    Gender-based violence and reproductive health in five Indian states

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    Gender-based violence is a multi-faceted public health problem with numerous consequences for an individual’s physical and mental health and wellbeing. This collection develops a comprehensive public health approach for working with gender-based violence, paying specific attention to international budgets, policies and practice and drawing on a wide selection of empirical studies

    Global Health Law: A Definition and Grand Challenges

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    It has been only recently that scholars have engaged in a serious discussion of public health law. This academic discourse examines the role of the state and civil society in health promotion and disease prevention within the country. There is an important emerging literature on the international dimensions of health, but no similar systematic definition and exposition of a field we call global health law. In this article we aim to fill this gap by defining global health law and characterizing the grand challenges. Given the rapid and expanding globalization that is a defining feature of today\u27s world, the need for a coherent system of international health law and governance has never been greater. We begin with a discussion of the health hazards posed by contemporary globalization on human health and the consequent urgent need for global health law to facilitate effective multilateral cooperation in advancing the health of populations equitably. We then offer a definition of the emerging field of global health law. After explicating the central features identified in our definition, we turn to an examination of the grand challenges – legal, political, and social – to reaching the full potential of global health law to advance human health in just and effective ways. Our definition of global health law follows, and the remainder of this section explains the salient aspects of the definition: Global health law is the study of the legal norms, processes, and institutions needed to create the conditions for people throughout the world to attain the highest possible level of physical and mental health. The field seeks to facilitate health-promoting behaviour among the key actors that significantly influence the public\u27s health, including international organizations, governments, businesses, foundations, the media, and civil society. Global health law should stimulate investment in research and development, mobilize resources, set priorities, coordinate activities, monitor progress, create incentives, and enforce standards. The field should be guided by the value of social justice, and seek equitable distribution of health services, particularly to benefit the world’s poorest populations. The domain of global health law primarily is concerned with (1) formal sources of public international law, including, for example, treaties establishing the authority and responsibility of states for the health of their populations and duties of international cooperation, and (2) formal subjects of international law, including states, individuals, and public international organizations. However, to be an effective global health governance strategy, global health law must evolve beyond its traditional confines of formal sources and subjects of international law. It must foster more effective collective global health action among governments, businesses, civil society and other actors. Accordingly, our definition of global health law is prescriptive as well as descriptive: it sets out the sort of international legal framework needed, but still unavailable, to empower the world community to advance global health in accordance with the value of social justice

    Viewpoint: filovirus haemorrhagic fever outbreaks: much ado about nothing?

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    The recent outbreak of Marburg haemorrhagic fever in the Democratic Republic of Congo has put the filovirus threat back on the international health agenda. This paper gives an overview of Marburg and Ebola outbreaks so far observed and puts them in a public health perspective. Damage on the local level has been devastating at times, but was marginal on the international level despite the considerable media attention these outbreaks received. The potential hazard of outbreaks, however, after export of filovirus from its natural environment into metropolitan areas, is argued to be considerable. Some avenues for future research and intervention are explored. Beyond the obvious need to find the reservoir and study the natural history, public health strategies for a more timely and efficient response are urgently needed

    Studies Needed to Address Public Health Challenges of the 2009 H1N1 Influenza Pandemic: Insights from Modeling

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    In light of the 2009 influenza pandemic and potential future pandemics, Maria Van Kerkhove and colleagues anticipate six public health challenges and the data needed to support sound public health decision making.The authors acknowledge support from the Bill & Melinda Gates Foundation (MDVK, CF, NMF); Royal Society (CF); Medical Research Council (MDVK, CF, PJW, NMF); EU FP7 programme (NMF); UK Health Protection Agency (PJW); US National Institutes of Health Models of Infectious Disease Agent Study program through cooperative agreement 1U54GM088588 (ML); NIH Director's Pioneer Award, DP1-OD000490-01 (DS); EU FP7 grant EMPERIE 223498 (DS); the Wellcome Trust (DS); 3R01TW008246-01S1 from Fogerty International Center and RAPIDD program from Fogerty International Center with the Science & Technology Directorate, Department of Homeland Security (SR); and the Institut de Veille Sanitaire Sanitaire funded by the French Ministry of Health (J-CD). The funders played no role in the decision to submit the article or in its preparation

    Human Rights for Health across the United Nations

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    The United Nations (UN) plays a central role in realizing human rights to advance global health. Looking beyond state obligations, the UN has called on all its specialized agencies to mainstream human rights across all their activities. With globalization compelling these UN institutions to meet an expanding set of global challenges to underlying determinants of health, human rights are guiding these international organizations in addressing public health. These international organizations within the UN system are actively engaged in implementing health-related human rights—in both their mission and their actions to carry out that mission. Through this mainstreaming of human rights, global health institutions have embraced human rights treaty obligations as a framework for global governance. Given the dramatic development of human rights law through the UN and the parallel proliferation of UN institutions devoted to global health and development, there arises an imperative to understand the implementation of human rights in global health governance. This special section analyzes the evolving UN focus on health and human rights in global governance, examining an expansive set of UN institutions that employ human rights in responding to public health challenges in a rapidly globalizing world. To understand the ways in which human rights are implemented, this special section examines the role of institutions across the UN system in the realization of human rights for public health. Drawing from our recent Oxford University Press volume on Human Rights in Global Health: Rights-Based Governance for a Globalizing World, this special section brings together several of the contributors to analyze ongoing efforts to reform UN institutions to mainstream human rights. These contributors—from academia, nongovernmental organizations, and the UN system—explore (1) the foundations of human rights as a framework for global governance, (2) the work of UN organizations across a range of health-related human rights, (3) the influence of rights-based economic governance on public health, and (4) the advancement of health through UN human rights institutions. Looking beyond the chapters in Human Rights in Global Health, this special section examines how international institutions are changing to meet the Sustainable Development Goals (SDGs), with sweeping implications for the mainstreaming of human rights for health across the UN
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