1
|
Viegas LL, Ventura DDFL, Ventura M. A proposta de convenção internacional sobre a resposta às pandemias: em defesa de um tratado de direitos humanos para o campo da saúde global. CAD SAUDE PUBLICA 2022; 38:e00168121. [DOI: 10.1590/0102-331x00168121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/17/2021] [Indexed: 11/21/2022] Open
Abstract
Em novembro de 2021, a Organização Mundial da Saúde (OMS) deu início à negociação de uma convenção, acordo ou outro instrumento internacional sobre a resposta às pandemias. Neste ensaio, defendemos e justificamos a tese de que o novo pacto deve ser um tratado de direitos humanos, como condição indispensável para a prevenção de novas pandemias e eficiência da resposta global quando elas ocorrem. Após o breve resgate da origem das negociações, apresentamos os principais conteúdos normativos que correspondem a um enfoque de direitos humanos: a instituição da regra de indissociabilidade entre medidas quarentenárias e de proteção social; e a regulamentação do acesso a tecnologias farmacêuticas. A seguir, em seção dedicada ao tema da efetividade do futuro tratado, classificamos as propostas existentes em ajustes tecnocráticos, como alterações no procedimento de declaração de emergências; mecanismos de transparência e controle, a exemplo da adoção de um mecanismo de Revisão Periódica Universal (RPU), similar ao do Conselho de Direitos Humanos das Nações Unidas, para monitorar obrigações dos Estados relacionadas à saúde; poderes coercitivos que seriam outorgados à OMS ou outra agência, tais como inspeções nos territórios nacionais realizadas por cientistas independentes; e mecanismos de coordenação política, como a criação de um Conselho Global de Ameaças à Saúde. Concluímos que há risco de adoção de um sistema mais eficiente de vigilância para alertar o mundo desenvolvido sobre ameaças oriundas de países em desenvolvimento, em lugar de um tratado capaz de contribuir para evitar que populações mais vulneráveis continuem sendo devastadas por pandemias cada vez mais frequentes.
Collapse
|
2
|
|
3
|
Siedner MJ, Gostin LO, Cranmer HH, Kraemer JD. Strengthening the detection of and early response to public health emergencies: lessons from the West African Ebola epidemic. PLoS Med 2015; 12:e1001804. [PMID: 25803303 PMCID: PMC4371887 DOI: 10.1371/journal.pmed.1001804] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Mark Siedner and colleagues reflect on the early response to the Ebola epidemic and lessons that can be learned for future epidemics.
Collapse
Affiliation(s)
- Mark J Siedner
- Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, D.C., United States of America
| | - Hilarie H Cranmer
- Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America
| | - John D Kraemer
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, D.C., United States of America; Department of Health Systems Administration, Georgetown University, Washington, D.C., United States of America
| |
Collapse
|
4
|
Fehr A, Razum O. The German government's global health strategy--a strategy also to support research and development for neglected diseases? Glob Health Action 2014; 7:24565. [PMID: 25079287 PMCID: PMC4116622 DOI: 10.3402/gha.v7.24565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/17/2014] [Accepted: 06/18/2014] [Indexed: 11/14/2022] Open
Abstract
Neglected tropical infectious diseases as well as rare diseases are characterized by structural research and development (R&D) deficits. The market fails for these disease groups. Consequently, to meet public health and individual patient needs, political decision makers have to develop strategies at national and international levels to make up for this R&D deficit. The German government recently published its first global health strategy. The strategy underlines the German government's commitment to strengthening global health governance. We find, however, that the strategy lacks behind the international public health endeavors for neglected diseases. It fails to make reference to the ongoing debate on a global health agreement. Neither does it outline a comprehensive national strategy to promote R&D into neglected diseases, which would integrate existing R&D activities in Germany and link up to the international debate on sustainable, needs-based R&D and affordable access. This despite the fact that only recently, in a consensus-building process, a National Plan of Action for rare diseases was successfully developed in Germany which could serve as a blueprint for a similar course of action for neglected diseases. We recommend that, without delay, a structured process be initiated in Germany to explore all options to promote R&D for neglected diseases, including a global health agreement.
Collapse
Affiliation(s)
- Angela Fehr
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany;
| |
Collapse
|
5
|
Hammonds R, Ooms G. The emergence of a global right to health norm--the unresolved case of universal access to quality emergency obstetric care. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2014; 14:4. [PMID: 24576008 PMCID: PMC3974068 DOI: 10.1186/1472-698x-14-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/19/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The global response to HIV suggests the potential of an emergent global right to health norm, embracing shared global responsibility for health, to assist policy communities in framing the obligations of the domestic state and the international community. Our research explores the extent to which this global right to health norm has influenced the global policy process around maternal health rights, with a focus on universal access to emergency obstetric care. METHODS In examining the extent to which arguments stemming from a global right to health norm have been successful in advancing international policy on universal access to emergency obstetric care, we looked at the period from 1985 to 2013 period. We adopted a qualitative case study approach applying a process-tracing methodology using multiple data sources, including an extensive literature review and limited key informant interviews to analyse the international policy agenda setting process surrounding maternal health rights, focusing on emergency obstetric care. We applied John Kingdon's public policy agenda setting streams model to analyse our data. RESULTS Kingdon's model suggests that to succeed as a mobilising norm, the right to health could work if it can help bring the problem, policy and political streams together, as it did with access to AIDS treatment. Our analysis suggests that despite a normative grounding in the right to health, prioritisation of the specific maternal health entitlements remains fragmented. CONCLUSIONS Despite United Nations recognition of maternal mortality as a human rights issue, the relevant policy communities have not yet managed to shift the policy agenda to prioritise the global right to health norm of shared responsibility for realising access to emergency obstetric care. The experience of HIV advocates in pushing for global solutions based on right to health principles, including participation, solidarity and accountability; suggest potential avenues for utilising right to health based arguments to push for policy priority for universal access to emergency obstetric care in the post-2015 global agenda.
Collapse
Affiliation(s)
- Rachel Hammonds
- Department of Public Health, Institute of Tropical Medicine, 155 Nationalestraat, Antwerp 2000, Belgium
- Law and Development Research Group, University of Antwerp, Faculty of Law, Venusstraat 23, Antwerp 2000, Belgium
| | - Gorik Ooms
- Department of Public Health, Institute of Tropical Medicine, 155 Nationalestraat, Antwerp 2000, Belgium
- Law and Development Research Group, University of Antwerp, Faculty of Law, Venusstraat 23, Antwerp 2000, Belgium
| |
Collapse
|
6
|
Bjegovic-Mikanovic V, Jovic-Vranes A, Czabanowska K, Otok R. Education for public health in Europe and its global outreach. Glob Health Action 2014; 7:23570. [PMID: 24560263 PMCID: PMC3925808 DOI: 10.3402/gha.v7.23570] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 12/05/2013] [Accepted: 12/10/2013] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. REVIEW Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. CONCLUSIONS As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice.
Collapse
Affiliation(s)
- Vesna Bjegovic-Mikanovic
- University of Belgrade, Faculty of Medicine, Centre School of Public Health and Management, Belgrade, Serbia;
| | - Aleksandra Jovic-Vranes
- University of Belgrade, Faculty of Medicine, Centre School of Public Health and Management, Belgrade, Serbia
| | - Katarzyna Czabanowska
- Department of International Health, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Robert Otok
- Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| |
Collapse
|
7
|
The evolution of human rights in World Health Organization policy and the future of human rights through global health governance. Public Health 2014; 128:179-87. [PMID: 24439475 DOI: 10.1016/j.puhe.2013.08.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/19/2013] [Accepted: 08/20/2013] [Indexed: 11/20/2022]
Abstract
The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance.
Collapse
|
8
|
Ooms G, Marten R, Waris A, Hammonds R, Mulumba M, Friedman EA. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage. Public Health 2014; 128:173-8. [PMID: 24411617 DOI: 10.1016/j.puhe.2013.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 06/20/2013] [Accepted: 06/26/2013] [Indexed: 11/29/2022]
Abstract
Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role.
Collapse
Affiliation(s)
- G Ooms
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - R Marten
- Rockefeller Foundation, New York, USA
| | - A Waris
- Law School, University of Nairobi, Nairobi, Kenya
| | - R Hammonds
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - M Mulumba
- Center for Health Human Rights & Development, Kampala, Uganda
| | - E A Friedman
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington D.C., USA
| |
Collapse
|
9
|
Sidibé M, Buse K. A framework convention on global health: a catalyst for justice. Bull World Health Organ 2013; 90:870-870A. [PMID: 23284188 DOI: 10.2471/blt.12.114371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
10
|
Ooms G, Mulumba M, Hammonds R, Latif Laila A, Waris A, Forman L. A global social contract to reduce maternal mortality: the human rights arguments and the case of Uganda. REPRODUCTIVE HEALTH MATTERS 2013; 21:129-38. [PMID: 24315069 DOI: 10.1016/s0968-8080(13)42736-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
11
|
Forman L, Ooms G, Chapman A, Friedman E, Waris A, Lamprea E, Mulumba M. What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:48. [PMID: 24289096 PMCID: PMC4220671 DOI: 10.1186/1472-698x-13-48] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 11/19/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health's contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. DISCUSSION To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable "minimum core" obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. SUMMARY We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of scarcity and inadequate international assistance, and empowering civil society to claim fulfillment of their essential health needs from domestic and global decision-makers.
Collapse
Affiliation(s)
- Lisa Forman
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Gorik Ooms
- Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Audrey Chapman
- University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, Connecticut 06030, USA
| | - Eric Friedman
- Georgetown University Law Center, 600 New Jersey Avenue NW, Washington DC 20001, USA
| | - Attiya Waris
- University of Nairobi, P. O. Box 30197 – 00100 Parklands Campus, Nairobi, Kenya
| | | | - Moses Mulumba
- Centre for Health, Human Rights and Development, Plot 614 Tufnell Drive, Kamwokya, PO Box 16617, Wandegeya, Kampala, Uganda
| |
Collapse
|
12
|
Gostin LO, Friedman EA, Buse K, Waris A, Mulumba M, Joel M, Dare L, Dhai A, Sridhar D. Towards a framework convention on global health. Bull World Health Organ 2013; 91:790-3. [PMID: 24115803 DOI: 10.2471/blt.12.114447] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 04/02/2013] [Accepted: 05/27/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University Law Centre, 600 New Jersey Avenue NW, Washington, DC, 20001, United States of America
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
D'Ambruoso L. Global health post-2015: the case for universal health equity. Glob Health Action 2013; 6:19661. [PMID: 23561031 PMCID: PMC3617874 DOI: 10.3402/gha.v6i0.19661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 02/13/2013] [Accepted: 02/13/2013] [Indexed: 11/14/2022] Open
Abstract
Set in 2000, with a completion date of 2015, the deadline for the Millennium Development Goals is approaching, at which time a new global development infrastructure will become operational. Unsurprisingly, the discussions on goals, topics, priorities and monitoring and evaluation are gaining momentum. But this is a critical juncture. Over a decade of development programming offers a unique opportunity to reflect on its structure, function and purpose in a contemporary global context. This article examines the topic from an analytical health perspective and identifies universal health equity as an operational and analytical priority to encourage attention to the root causes of unnecessary and unfair illness and disease from the perspectives of those for whom the issues have most direct relevance.
Collapse
Affiliation(s)
- Lucia D'Ambruoso
- Umeå Centre for Global Health Research, Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| |
Collapse
|
14
|
Basu S, Stuckler D, McKee M. An alternative mechanism for international health aid: evaluating a Global Social Protection Fund. Health Policy Plan 2013; 29:127-36. [DOI: 10.1093/heapol/czs141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
15
|
|
16
|
Abstract
While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors.
Collapse
|
17
|
Gostin LO, Friedman EA, Gebauer T, Grover A, Hassim A, Ooms G, Siem H, Sridhar D, Waris A. A framework convention on obesity control? Lancet 2011; 378:2068-9. [PMID: 22177508 DOI: 10.1016/s0140-6736(11)61895-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
18
|
Magnusson R, Gostin L, Studdert D. Can law improve prevention and treatment of cancer? Public Health 2011; 125:813-820. [DOI: 10.1016/j.puhe.2011.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|