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Copyright
© 2004 Ariel Consulting, Inc.
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Public-Private
Partnerships
in Health, Policy and Management
Fall/Winter Newsletter
Devember, 2004
In
this edition:
Message
from the President
Washington,
DC, Around Town
-
Society for International Development - Washington (SID-W) Conference
-
Million Lives Saved: Proven Successes in Global Health (CGD)
-
An Evening in Celebration and Conversation on New Partnership
for Africa's Development (NEPAD)
-
Ambassador John C. Danforth, US Permanent Representative to the
United Nations receives Award for Distinction in the Conduct of
Diplomacy
-
Center for Strategic and International Studies (CSIS) and the
Washington Africa Ambassadorial Corps Launch World AIDS Day: Reaching
Women and Girls
Pan
American Health Organization (PAHO) 45th Directing Council
The
Legal Importance of Healthcare, Human Rights and HIV/AIDS
Message from the President
The
2004 year has brought many challenges for the world, our countries,
our colleagues and families. Yet through it all we hold these truths:
Humanity allows us hope for another day, peace allows us to hope
to prosper, and family allows us hope for love. May our new year
bring us humanity, hope and love.\
Washington, DC Around Town (attended by
ACI Staff)
Society
for International Development - Washington (SID-W) Annual Conference
on Effective Economic Growth for People
On
1 December, World AIDS Day, the SID-W Conference opened with welcoming
remarks from Enrique Iglesias, President, SID International and
President of the Inter-American Development Bank. The highlights
of the conference included: The commentary by Asil Shaikh, President
of SID-W and President and CEO of the International Resource Group.
The opening session by Sebastian Mallaby of the Washington Post
and the author of The World's Banker (The story of the World Bank
President James Wolfensohn), and the keynote address by Andrew Natsios,
Administrator, US Agency for International Development. The afternoon's
session included a talk on effectiveness on policy reform by Ajay
Chibber, Director, World Bank-OED. Panel discussions were moderated
by Janet Ballantyne of ABT Associates, Inc., Yolonda Richardson,
JD, MPH, President of CEDPA, Aaron Williams of RTI International
and Ronald Ivey of Chemonics International. The Speakers for the
panel discussions included Ambassador Edwardo Ferrero, Ambassador
of Peru to the US, Ambassador Amadou Ba, Ambassador of Senegal to
the US, Dirk Dijkerman and Cynthia Watson both of the National War
College, Melinda Kimble of the United Nations Foundation, and Alan
P. Larson, Under Secretary for Economic, Business and Agricultural
Affairs, US Department of State.
The
Society of International Development (SID) was founded in Washington,
DC in 1957, and is a global forum of individuals and institutions
concerned with sustainable economic, social and political development.
SID has members in 125 countries. SID's international Secretariat
is in Rome, Italy. For more information see www.sidw.org.
An
Evening in Celebration and Conversation on New Partnership for Africa's
Development (NEPAD)
The
Leon H. Sullivan Foundation was the gracious hosts of an evening
to celebrate "the leaders of the African Diaspora and recognize
once again that Africa is truly a Continent of possibilities" stated
Hope L. Sullivan, the President and CEO of the Leon H. Sullivan
Foundation (LHSF) as she welcomed all on 2 December 2004.
The
evening of celebration and Conversation on New Partnership for Africa's
Development (NEPAD) was a unique unscripted discussion by World
leaders that included the Honorable Andrew Young, the Chairman of
the LHSF, His Excellency Olusegun Obasanjo, President of the Federal
Republic of Nigeria, and the Chairman of the African Union; James
Wolfensohn, President of the World Bank Group and Joe Clark, Former
Prime Minister of Canada. A special video message was sent from
President Bill Clinton, who was unable to attend due to recent surgery.
"When
in the presence of great leasers, we are duty bound to just listen…
as we listen in while these great architects of history discuss
the issues of today, I hope you will leave feeling energized, encouraged
and optimistic about the future. I am certain you will leave knowing
you have witnessed something very special" stated Hope Sullivan.
"Nigerian
President Olusegun Obasanjo, South African President Thabo Mbeki
and Algerian President Abdelaziz Bouteflika initiated the concept
of a special effort to promote African progress in the 21sr century."
Later, Senegalese President Abdoulaye Wade joined and together they
created the New Partnership for Africa's Development (NEPAD). "NEPAD
was established as a program of the African Union to address some
of the most serious problems facing Africans today: continuing deep
poverty, lack of consistently sustainable growth, the continents
marginalization in the globalization process and the remaining obstacles
of the empowerment of women."
For
more information go to www.leonsullivanfoundation.org
Ambassador
John C. Danforth, US Permanent Representative to the United Nations
receives the 2004 Jit Trainor Award for Distinction in the Conduct
of Diplomacy
Ambassador
John C. Danforth, US Permanent Representative to the United Nations,
who announced his resignation just four days earlier, on December
6th accepted the annual Jit Trainor Award for Distinction in the
Conduct of Diplomacy, presented by the Institute for the Study of
Diplomacy in the Walsh School of Foreign Service at Georgetown University.
Ambassador Danforth spoke on 'Multilateralism and the United Nations.'
Ambassador
Danforth has had a long career in public service. Before he became
U.S. Permanent Representative to the United Nations last summer,
he has been Special Envoy for Peace to Sudan, representing the U.S.
government in peace talks to help settle the seventeen-year old
civil war between northern and southern Sudanese.
These
assignments followed three terms in the U.S. Senate, where Danforth
represented the State of Missouri form 1976 to 1994. A fifth generation
Missourian, Ambassador Danforth graduated with honors from Princeton
and later received a Bachelor of Divinity degree from Yale Divinity
School and a Bachelor of Laws degree from Yale Law School. Before
seeking public office and after he left the Senate, he practiced
law. As an ordained clergyman, he officiated at the funeral of former
President Reagan at the National Cathedral earlier this year.
Past
recipients of the Jit Trainor award include Secretary General Amre
Moussa, His Excellency Kofi Annan, General Wesley K. Clark, Honorable
Lakhdar Brahimi, and James D. Wolfensohn, on behalf for the World
Bank Group.
Million
Lives Saved: Proven Successes in Global Health
The
Center for Global Development launched Million Lives Saved: Proven
Successes in Global Health on 7 December.
"Mothers
no longer worry about their children contracting polio. Vast regions
of Africa are now habitable because river blindness is under control.
In Thailand, a health initiative successfully headed off what seemed
destined to be a massive AIDS epidemic. And in Sri Lanka, women
can now give birth without fear of dying. From the elimination of
measles in Southern Africa, to the reduction of child diarrheal
death in Egypt, these successes are among the seventeen large-scale,
successful health interventions documented in Million Lives Saved:
Proven Successes in Global Health a new book from the Center for
Global Development (CGD). Those launching the book included, Nancy
Birdsall, President of CGD, Sir George Alleyne, Former Director
of the Pan American Organization (PAHO), Ruth Levine, Senior Fellow
and Director of Programs, CGD, Dr. Boakye Boatin, Manager, ARV Program,
World Health Organization, and Former Director, Onchocerciasis Control
Program, Allen Moore, Deputy Chief of Staff and Policy Director,
Office of Senator Bill Frist, Dr. Rajiv J Shah, Deputy Director
for Policy and Finance, Bill and Melinda Gates Foundation, and Jackie
Judd, the moderator, Vice President and Senior Advisor of Communications
for the Kaiser Family Foundation.
The
Center for Global Development is an independent, non-partisan, non-profit
think tank dedicated to reducing global poverty and inequity through
policy orientated research and engagement with the policy community
and the public. (www.cgdev.org).
Center
for Strategic and International Studies and the Washington Africa
Ambassadorial Corps Launch World AIDS Day: Reaching Women and Girls
The
Center for Strategic and International Studies (CSIS) and the Washington
Africa Ambassadorial Corps Launch World AIDS Day: Reaching Women
and Girls on 30 November.
HIV/AIDS
in Women and Girls
-
Of the 37.3 million adults (15-49) half are female
-
Sub-Sahara Africa 60% of infected persons are female
-
Every day 6000 young people (15-24) become infected, of these
4000 are female
-
In some African settings, girls have HIV rates 6 times higher
than boys
-
Women bare the greatest burden of caring for family members with
HIV/AIDS
-
Women often have limited access to treatment
-
HIV+ women are 2.68 times more likely to experience violence
-
Globally 2.2 million children under 15 years are HIV positive
-
In 2003, more than 15 million children under 18 have lost at lease
one parent to AIDS
In
recognition of World AIDS Day: Reaching Women and Girls, the welcoming
remarks were made by Ambassador Mary M. Kanya, Embassy of the Kingdom
of Swaziland and J. Stephen Morrison, Executive Director, CSIS Task
Force on HIV/AIDS, and Director, CSIS Africa Program. The Panel
Discussion was moderated by Janet Fleischmann, Chair of the Gender
Committee, CSIS. Presenters included Ambassador Lapologang Lekoa,
embassy of the Republic of Botswana, Constance Carrino, Director
of HIV/AIDS programs, U.S. Agency for International Development,
spoke about the President's Emergency Plan for AIDS Relief (PEPAR)
and Gender; Jen Kates, Director of HIV/AIDS Policy, Henry J. Kaiser
Family Foundation talked about Prevention Strategies, Phillip Nieburg,
Senior Associate, CSIS Task Force on HIV/AIDS talked about Routine
Testing: Special Risks for Women and Girls, and Michelle Gavin,
Office of Senator Russ Feingold presented a Congressional Perspective.
The
Center for Strategic and International Studies (CSIS) is an independent,
nonpartisan public policy research organization based in Washington,
DC. (www.csis.org)
Pan
American Health Organization (PAHO) 45th Directing Council Attended
By Representative of the International Council of Women
The
ministers of health of all the countries of the Americas (Latin
America, Canada, Caribbean and the US) gathered for the annual meeting
of the Directing Council of the Pan American Health Organization
(PAHO). The meeting was from 27 September to 1 October 2004. The
International Council of Women was represented by Dr. Ariel R. King,
the UN Representative for Washington, DC and Geneva.
PAHO
serves as the Regional Office for the Americas of the World Health
Organization and has been working for over 100 years with all the
countries of the Americas to improve health and raise the living
standards of their peoples. PAHO, established in 1902, today includes
all 35 member states in the Americas. France, the United Kingdom,
Northern Ireland, and the Netherlands are participating states,
while Puerto Rico is an Associate Member, and Portugal and Spain
are Observer States. In addition, Inter-Governmental Organizations
(IGOs) several Non-Governmental Organizations (NGOs) were invited
observers.
The
Directing Council, the governing body of PAHO, met to analyze the
health situation in the region, to make new policy decisions, and
to adopt key resolutions on important public health problems of
the region. The sessions were marked by comments by PAHO Director
Mirta Roses, U.S. Secretary of Health and Human Services Tommy Thompson,
World Health Organization Director-General Jong-Wook Lee and Secretary
General of the Organization of American States Miguel Angel Rodriguez.
Dr.
Roses stated, "Behind every item on our region's unfinished agenda
in health there are real people, real families and real communities
with urgent needs. We cannot ignore them or delay our efforts to
address their needs."
Primary
Health Care and Millennium Development Goals
Member
States called for a renewed interest in Primary Health Care. In
addition, PAHO held a special commemoration of the 25th Anniversary
of the Alma-Ata Declaration from 1978; a commitment to Primary Health
Care (PHC) as the essential tool to achieve equity in health; and
"health for all" by 2000. Primary Health Care prevention and treatment
are essential for accessible and affordable health care for all
in the community at all stages of life.
Dr.
Mirta Roses stated that "there is a synergy between health and development.
Health is a key contributor to development, but it is also influenced
by other factors of development, including social and environmental
determinants."
The
new Secretary General of the Organizations of American States, Miguel
Angel Rodriguez, told the ministers of health, that "health is a
fundamental human right" and that we can not afford to "remain indifferent
to situations such as poverty and underdevelopment in the Americas.
In this light, "Haiti deserves special attention because of the
pain and suffering of its people."
The
Millennium Development Goals are a commitment by the world's countries
to improve the quality of life of the poorest populations with core
strategies such as investing in health. The Millennium goals include
reducing poverty, infant and maternal mortality; combating HIV/AIDS,
malaria and other infectious diseases; and access to essential drugs,
and safe drinking water by 2015.
Infant
and Maternal Mortality
Infant mortality varied in 2003 from 5.3 per 1,000 live births in
Canada to 80.3 per 1,000 live births in Haiti. A recent study by
PAHO shows that if current trends continue, the region will succeed
in reducing child mortality by only 54%, falling short of the 66%
stated in the Millennium goals.
Maternal
mortality rates vary widely from 16 per 100,000 live births in Cuba
to 680 per 100,000 live births in Haiti.
HIV/AIDS
and Malaria Secretary
Thompson suggested that PAHO convene annual meetings on AIDS, TB
and Malaria to look at ways to redouble efforts and be more efficient
in dealing with these diseases.
Director-General
Lee said that in addition to generosity, unity is essential for
equity. With the "3 by 5" initiative to bring antiretroviral drugs
to more people than ever before, the prices have dropped to $140
per year.
Currently
31% of the population resides in potential malaria risk areas and
80% of reported cases originate in nine countries that share the
Amazon tropical rainforest in South America.
Access
to Essential Drugs
Access to essential drugs has increased throughout the world from
2,100 million people to 4,000 million between 1997 and 2003. The
purchase of drugs continues to consume 25% to 60% of household spending.
In the Americas only 53% of people with HIV/AIDS who require treatment
with antiretroviral drugs have access to these drugs despite a significant
drop in the cost of treatment for three consecutive years.
Safe
Drinking Water and Sanitation
In Latin America and the Caribbean in 2002, 89% of the population
had access to safe drinking water, while 75% had access to adequate
basic sanitation. Approximately 59 million people did not have access
to safe drinking water and 134 million people lacked adequate basic
sanitation.
For
more information on these topics go to www.paho.org
or www.who.int
The
Legal Importance of Healthcare, Human Rights and HIV/AIDS
Shelu Patel*
Human
Rights and HIV/AIDS currently have accountings that show that certain
basic human rights have been denied to people living with HIV or
AIDS status. HIV/AIDS is a litmus test for the enjoyment of human
rights, of discovering how a country treats its citizens suffering
from HIV/AIDS or those at risk provides an important insight of
how a country respects, protects and fulfils the right of the society
as a whole. In general HIV positive people are not living longer
because of the challenges they face everyday. HIV/AIDS is more than
a historic health crisis. Beyond the individual sufferers, the epidemic
threatens the very essential part of society, destroying families
and livelihoods. The key is to uphold the human rights of the individuals
who are living with HIV, or who may be at risk of infections, starting
with the basic right to healthcare.
Governments
have been slow in fulfilling their obligations to protect, respect
and fulfill the human right to health through planning, funding,
and implementing programs to provide comprehensive prevention, treatment,
and care. Highly effective treatment and prevention regimes exist
to contain HIV/AIDS, but while most people living in developed countries
have access to these treatments, the vast majority of those living
in developing countries do not. Making prevention and treatment
regimes available to all human beings is not a matter of charity,
but should be a basic right.
International
assistance and cooperation are imperatives of human rights as set
out in international human rights law. The right to health can be
evaluated by understanding the history behind the law and the litigation
that accounts for the law. The Universal Declaration of Human Rights
set out in 1948 was provided to establish the "rights and freedoms…by
progressive measures, national and international…among the peoples
of Member States themselves and among the peoples of territories
under their jurisdiction." The right to health is given to individuals
by article 25, which states that "Everyone has the right to a standard
of living adequate for the health and the well-being of himself
and of his family, including food, clothing, housing, and medical
care and necessary social services…sickness, disability…or other
lack of livelihood in circumstances beyond his control." These rights
given are only accounted for through litigation, because legally
not all of the Member States have signed the document, for establishment
purposes. Further, in 1966 the right to health was again established
as a human right in the International Covenant on Economic, Social,
and Cultural Rights by article 12 where "The States Parties to the
present Covenant recognize the right of everyone to the enjoyment
of the highest attainable standard of physical and mental health,"
specifically, today for HIV/AIDS it can be used for "(c) The prevention,
treatment and control of epidemic, endemic, occupational and other
diseases…(d) The creation of conditions which would assure to all
medical service and medical attention." These relevant international
instruments are put into place in order to have an indisputable
proper power, and provide direction to Member States through their
laws, governmental structures, and programs.
People
living with AIDS face numerous challenges on a daily basis, in relation
to acquiring health care, specifically for HIV/AIDS. Individuals
often voice their frustration with a system in an established government
system. Generally, the role of litigation starts at the international
level in that rights are given through international instruments.
Then these instruments can only be accounted for when looking at
the policy law within each Member State's legal system.
In
addition, the individual HIV/AIDS and human rights cases at the
State level provide an example to the international legal community.
Sometimes, litigating a challenge does not always prove favorable
and can often discourage other people living with HIV/AIDS from
not reporting particular issues. This is because people and even
the players in the legal system feel that their case will also yield
the same results in the same system. However, this is not always
the case; previous litigation in HIV/AIDS and human rights should
be used as a learning tool and not as a limiting agent. Therefore,
it is important to evaluate and learn from litigation that affects
the issues of HIV/AIDS, law, and human rights internationally. Issues
that reflect upon HIV/AIDS litigation deal with aspects of government
legislation, contaminated blood donations, HIV/AIDS testing, employment
discrimination, healthcare professional duties, HIV/AIDS prisoners,
HIV/AIDS asylum seekers, confidentiality, and other forms of healthcare
in respects to human rights worldwide. Protecting the rights of
those infected is crucial in fighting the illness; however, it is
not a means to an end in the challenges suffered. This is due to
the fact that challenges can be instituted into a system, and one
can act blindly in such systems. The development of new challenges
results in the ever changing global world on a daily basis.
*Shelu
Patel is a law student who worked with UNAIDS in Human Rights in
Geneva, Switzerland and currently works as a marketing consultant
for the Global Defense Institute in San Diego. Contact her at shelu06@hotmail.com
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