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Possible
focus areas
from international agreements
Questions:
·
Which of the following focus areas are priorities for effective joint
stakeholder action?
·
Which are missing?
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Possible
action towards governments and official WSSD process (Type
1 outcomes)
Questions:
·
Are there specific agreements / commitments / targets missing from the
intergovernmental agreements at the WSSD?
·
Who should do what to achieve such inclusions?
NB
Lobbying for Type 1 outcomes will need to be completed by Bali PrepCom
(27 May) |
Possible
joint stakeholder action towards implementation
Questions:
·
Which of these ideas should be developed further into IC outcomes?
·
How can these actions focus on Africa?
·
Which existing programmes & experiences
should be brought into the IC to broaden their scope and impact?
·
What is the appropriate workgroup size and
composition for each idea?
NB
Bold type below indicates action plan in draft on this subject |
Possible
participants (groups/organisations/ individuals)
Questions:
·
Who should be included to achieve widest possible impact?
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Communicable
Diseases |
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HIV/AIDS:
Numerous
HIV/AIDS initiatives, but much remains to be done; esp. in Sub-Saharan
Africa, E Europe, Asia and the Caribbean. Emphasise implementation of
the UNGASS AIDS Conference commitments.
Need
for networking / communication tools for stakeholders to exchange best
practice and experience; empower stakeholders to find their own solution
and build responses and capacity organically.
Need
for reduced stigma and discrimination and targeted educational/
behavioural interventions, eg men, truckers, health workers.
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·
Persuade governments to accept the moral responsibility to inform /
demystify their populace re. the disease, transmission and protection
and to implement proven effective means of tackling existing problems.
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·
Educate re HIV/AIDS and provide support systems for sufferers (school,
workplace, community), following ILO Code of Practice. Targeted,
specific interventions for eg truckers and healthcare workers (others?)
·
Identify community-driven solutions (non-pharmaceutical) and promote
exchange, through ‘model community / programme’ to disseminate best
practice (rural, urban settings?). Replicate at national level through
understanding and sharing successes of eg Uganda (others?)
·
Facilitate the creation of a networking tool to
share knowledge and enhance communication between people working on
HIV/AIDS.
·
Extend awareness/ cultural campaign under World AIDS Campaign banner
(e.g. I care…do you?) using large group facilitation techniques to
mobilise change – e.g. existing programmes in South Africa
|
·
WHO, UNAIDS, governments, oil companies (Africa); ILO, Trade Unions,
·
WHO, NEPAD, Gates Foundation, Community leaders, physicians, grassroots
groups, business community, ILO, educators, micro credit institutions,
NGOs
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Malaria
Initial
multi-sector approach to tackling malaria: education (school/
workplace), housing (house by house monitoring, rapid response with
nets, sprays and medicine), ecosystem (water, sanitation) management and
farming, within health and environment ministry structures.
|
|
·
Replicate best practice examples, particularly regarding effective
communication from local, regional or national programmes championing
community involvement towards eradication of the disease and elimination
of DDT.
·
Add environmental awareness / management into sustainable education
curricula at schools (tie into / extend WHO’s School Health
Programme), extend training network of IUHPE (Health Promotion and
Education)
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·
Roll Back Malaria, GEF, PAHO, farmers, grassroots groups, rural unions,
educators, DDT proponents, care providers, health and environment
ministries)
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Water
borne diseases
1
billion without access to water; 2.4 billion without access to
sanitation; 1.5 million children die each year from diarrhoea.
|
|
·
Identify health/ water overlaps with Freshwater issue; eg hygiene
practice, oral rehydration campaign, and opportunities to improve
effective communication
·
Promote best practice, eg Bangladesh example, education of women with
infants in areas of poor water quality
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·
Bangladesh Centre for Health and Population
|
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Non-communicable
diseases |
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Smoking:
Alarming
growth rate of tobacco consumption; rising prevalence rates, especially
among children, youth and women. Prevention of new smokers is the key. |
·
Lobby for commitment to Framework Convention on Tobacco Control ("FCTC")
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·
Support the Tobacco Free Initiative and maintain the momentum towards
the FCTC, building on the WHO campaign network around FCTC
·
Support World Bank efforts in developing countries promoting ‘polluter
pays’ principle by raising tobacco taxes
·
Employ ‘strategy of small wins’ approach: target groups of women
(successful WHO, NGO campaigns in Japan), children (smoking at home),
employees (in workplace), journalists (to expose companies), other?
|
·
IUHPE, Physicians for Smoke Free Canada, World Heart Federation, others…
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Obesity
The
shift in many countries to a more ‘Western’ (meat-based) diet is
inefficient and unhealthy.
1
billion globally are overweight. Obesity enhances chronic diseases,
effectively ‘handicapping’ people and burdening health care systems.
Global
population with diabetes projected to double to 300 million by 2025, 75%
of increase in poor countries (Source: Novo Nordisk)
|
·
Promote awareness of diet and nutrition and the known scientific links
between diet, obesity and ill health.
|
·
Work with FAO/ILO/WHO to develop long-term strategy for significant
reduction of meat in human diet
·
Promote physical activity, replicate "Move for the World"
campaign, tie into Olympics, other?
·
Promote specific campaigns of youth and elderly
·
Develop/support campaign for diabetes sufferers.
·
Extend access to diabetes diagnosis, drugs and care in developing
countries
·
Consider interventions: reduce subsidies to agriculture (esp meat),
campaign for foods to be taxed based on their nutrient value per calorie
|
·
FAO, ILO, WHO, nutritionists, farmers, private sector, World Heart
Federation
|
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Work
related illnesses:
Claim
similar numbers to the ‘big killers’ each year
|
|
·
TBD in discussion with ICFTU, ILO
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·
ILO, ICFTU
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POPS/PICS
and related diseases:
POPs
are harmful to humans and environment. Prior Informed Consent ("PIC")
relates to the clear labelling and regulation of hazardous chemicals, to
help curb illegal trade. Asbestos remains a major threat.
|
·
Promote the rapid ratification and implementation of the Rotterdam
Convention on PIC and the Stockholm Convention on POPs
|
·
Work with International POPs Elimination Network (IPEN). Support WIT in
helping with Stockholm ratification
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·
TBD
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Indoor
Domestic Air pollution:
3
billion people rely on biomass fuels and coal-burning for household
energy needs. Indoor air pollution is a major source of illness,
particularly with young children.
What
of workplace pollution as a health hazard – how to address? |
|
·
Share best practice in stove building
techniques for cooking/ ventilation. Create models for effective
replication and community level exchange. Discuss with Energy
coordinator
·
Extend and promote existing networks
·
Toxicity measurement (indoor and out, by region) needed to understand
health impact
|
·
WHO, Energy companies, educators, NGOs
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Lead:
Improvements made in reducing lead in gasoline (85% of supply is
currently lead-free) but significant pockets remain, esp. LDCs and
China.
|
·
Lobby for worldwide commitment to remove lead from fuel, with timetable
|
·
Facilitate the implementation of the recommendations of the Bangalore
International Conference on Lead Poisoning, Prevention and Treatment
·
Extend existing networks
·
Pressure oil companies to upgrade refineries (higher octane fuel needed
in absence of lead additive) in all countries
·
Encourage tax incentives to altering demand, identifying benefits to
governments.
·
Toxicity measurement (indoor and out) needed to understand environmental
impact on health
|
·
Oil companies, OCTEL (lead additive producer), governments (esp China,
Africa), youth, medical profession,
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Health
care systems |
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Medical
staff employment ethics
Healthcare
professionals (doctors, nurses, midwives, medical educators, dentists)
feel push and pull factors; poorer regions are suffering shortages of
trained staff and loss of investment in training. |
|
·
Promote multi stakeholder discussion to address
the ethical and practical problems involved; recommend potential
solution (transfer pricing, taxation, incentives, global clearing
house?)
·
Ensure appropriate medical education regarding environmental triggers to
ill health
|
·
WMA, WHO, ILO, IMO (migration), medics, health ministers, ILO, trade
unions, educators
|
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Abuse
of Antibiotics:
The
abuse of antibiotics in both human disease treatment and livestock is
threatening humanity`s ability to treat diseases in the future |
|
·
Multi-stakeholder campaign in support of the WHO Global Strategy for
Containment of Anti-microbial Resistance to educate and influence the
main groups involved: patients, pharmaceutical companies, doctors, food
producers and farmers
|
·
Physicians, farmers, pharmaceutical companies
|
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Access
to health care, healthy environments and healthy living conditions |
|
Non-pharmaceutical
Well-being
requires satiation of basic needs. The primary causes of premature
mortality and high morbidity can be managed by known and proven
measures. The challenge is to make healthcare a national priority, and
to involve existing stakeholders in new, more effective partnerships.
Also
important is equity of information transfer, social reform,
infrastructure development and resource mobilisation. |
·
Promote relationship between health, poverty, prosperity and civility.
·
Analyse/ suggest improvements to draft WSSD chair's text
·
Consider lobbying for "Right to Health / Healthy
Environment" to be given legal meaning in countries where the law
may be upheld.
|
Build local capacity, empower communities for effective exchange and
promote best practice. Emphasise health of children.
·
Promote productive labour force through both "carrots" and
"sticks". Extend health care benefits by employers; empower
organized labour to secure healthcare through collective bargaining.
·
Establish linkages with Freshwater, Energy, and Food Security issue
coordinators
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·
Educators, faith communities, private sector, NGOs, micro-credit
institutions, medical staff in the field.
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Pharmaceutical
95%
of the WHO’s "Model List of Essential Drugs" are available
off-patent; over one third of the world’s population lacks access to
essential (generic) drugs (Source: Novartis study).
High
drug prices reward innovation but restrict access. This is within the
TRIPS mandate, but there is a need for specific action by relevant
stakeholders. Some pharmaceutical companies seek guidance. Tiered
pricing/ distribution has appeared exist for rich/poor countries and
rich/poor people within developed countries; this has governance
implications.
|
·
Support recommendations on Macroeconomics and Health re government
responsibilities for health care and the need for richer nations to
support developing countries.
·
Call on governments to clarify stakeholders’ responsibilities.
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·
Support the establishment of a research
institute as a partnership initiative, and extend the network of
partners to benefit from work done to address developing world diseases.
Promote effective replication through knowledge management.
·
Develop new business model where multi
stakeholder groups develop Key Performance Indicators (KPIs) of business
model for pharmaceutical companies operating in the developing world
·
Analyse the governance implications of tiered
pricing strategies being implemented by pharmaceuticals and initiate a
global debate with governments, stakeholders and international agencies
·
Jointly develop a Code of Conduct re. Access
to Drugs
|
·
Trade organisations (WTO), Private sector (pharmaceutical), Business,
Physicians, Academia, ILO, trade unions, NGO’s active in this area.
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Financing |
|
Global
Fund against AIDS, Tuberculosis and Malaria:
The
procedure of the Global Fund requires countries to prioritise their
health needs. There is a lack of clarity of Country Coordination
Mechanism (CCM) re. project selection and fund allocation.
Difficulties
in allocating funds (eg South Africa) and difficulty in effectively
getting funds to ground level.
|
·
Promote commitment of richer nations to provide funding.
·
Clarify process: 12 countries (mostly donor nations) represented on
board: clarify criteria for project selection.
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·
Work directly with one recipient country to
create a transparent multi-stakeholder process for project
identification, selection and implementation. Include monitoring ad
evaluation mechanism. Create ‘best practice’ example and/or
establish a global network of stakeholders willing to clarify procedure,
as a resource for applicants to the Fund / provider of consultancy
services where needed.
·
Encourage higher funding from rich nations,
base on per capita income and work with stakeholders to overcome source
of scepticism of donor countries.
|
·
UNDP, Global Fund, Academia, NGOs eg www.aidspan.org, Drs Sachs, Ruxin (Comm
on Macroeconomics and Health) ad Rivers
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Health
Impact Assessments ("HIAs"):
Currently
being used in multiple sectors as a tool for assessment of health
implications of projects, behaviour etc.
|
|
·
Encourage adoption of HIA approach to assess action plans (stakeholder,
government).
·
Educate governments and businesses as to methods, benefits of using HIAs
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·
Impact assessors, educators, ministers, academics
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The
Commission on Macroeconomics and Health report (Dec 2001)
highlighted the strong economic benefits of good health.
|
·
Lobby for the endorsement of the Commission’s report by the
Johannesburg Summit
|
·
Lobby individual governments to implement the recommendations of the
report.
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·
TBD
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