Posts Tagged ‘global health’

Tomorrow Bill and Melinda Gates will present their Living Proof Project in Washington D.C.  This is a new, multimedia initiative which shows the ‘living proof’ that US-funded global health funding is making a positive difference through the first hand success stories of people who have been helped and, in turn, empowered to help themselves.

The project is based on research showing that the lion’s share of media coverage around global health is negative, and further research showing that Americans want to hear the flipside of this - as described on the Living Proof website, “stories about progress, optimism and opportunity”.

Within the global health community, it has been commonplace to promote success, advocate for proven solutions, and ensure that positive images of the beneficiaries of their work are used.  Case studies like those in the Living Proof Project are very common to see on websites and in annual reports.  This makes me wonder about the apparent disconnect between what NGOs therefore put out, and the research that provided a rationale for this project.  Why was media coverage found to be generally negative when proactive communications from the global health community is generally positive?

One reason that comes to mind is a challenge of newsworthiness that faces many NGOs.  Good news is often less appealing to the media than bad news, and therefore for us PRs, a harder sell.  Another is the importance of setting up the problem or the unmet need in order to provide a context and an urgency for a solution.  This is a delicate balance that continues to challenge communicators.  How the Living Proof Project might succeed where others have failed, or only experienced moderate success, is through its ever newsworthy philanthropist backers.

A study published in The Lancet recently has shown there is no consistent correlation between ratification of human rights treaties and a change in health status or social outcomes.

This struck me as odd, given that you would think a country which ratifies a treaty would be more likely to comply with its treaty obligations (in this case, human rights) and integrate these into its laws and policies.  Obviously there is a role for Governments in promoting the right to health through legislation, allocation of resources and devising health programmes.  There is also a role for lawyers in using treaty obligations to argue for the human right to health (such as the right to essential medicine) and a role for civil society “to change health policy and programes…through advocacy and involvement of international partners”*.

However, experts agree that discourse and debate on what constitutes the human right to health is something which must be had.  A 2002 meeting on Advancing The Dialogue on Health and Human Rights also states that this should involve an interdisciplinary group of economists, development practitioners, public health professionals and epidemiologists.

It is clear that for the human right to health to be understood on a level playing field with other human rights, such as the right to freedom of expression, we must all be involved, and not just in terms of thinking about how it should be clarified.  Those of us working in health should look around us, see what others like the WHO are doing, what guidance is already out there, engage others in the debate, raise awareness, think about how the right impacts on health programmes or health services and integrate this thinking and these tools into our work.

We need to consider the human right to health when designing health programmes and communication strategies so that slowly but surely people around the world, whether it is a nurse working in a community health centre in Uganda, or a patient in a hospital in the United Kingdom start claiming the right to the health - the right to the highest attainable standard of health.

What do you think?

* http://linkinghub.elsevier.com/retrieve/pii/S0140673609602312

On Wednesday, the Malawi High Commissioner to the United Kingdom, His Excellency Dr Francis Moto addressed the All-Party Parliamentary Group for Pneumococcal Disease in the Developing World (APPG) at their Annual General Meeting (AGM).

Dr Moto’s presentation was harrowing at best.

It should go without saying that Malawi is not the richest nation in the world. It is in fact, one of the poorest nations in Sub-Saharan Africa. So, it’s not surprising that there were a number of disturbing statistics that came out of that meeting. The most surprising and, in fact, utterly shocking, was the number of Malawian trained doctors currently working in Malawi, a country of 13 million.

How many doctors would you think there are? 10,000? 5,000? Keep going down.

150

According to the High Commissioner, there are only 150 Malawian trained doctors to treat a nation of 13 million. A nation with a 12-13% HIV rate. A nation where 90% of those HIV patients will suffer from pneumonia, mostly caused by pneumococcal disease. According to DFID, Malawi has a life expectancy rate 37 years and an infant death rate of 133 per 1000 children.

And only 150 doctors.

I’m sure it was no surprise that every jaw in the room dropped.

Only 20 medical grads graduate from the Malawian University each year, but according to those numbers, if each doctor stayed, in just 7 years, the entire medical fraternity would more than double. Unfortunately, many of these new grads are enticed overseas. Dr Moto then went on to explain that the old joke that there were more Malawian doctors in Manchester than in Malawi was actually once based in fact.

On the positive side, Malawi has a stable government who are actively engaging with groups like GAVI, PneumoADIP and the APPG, in an attempt to fix the problem of health systems and infant mortality. Malawi has also expressed interest in introducing the pneumococcal disease vaccine according to the Advance Market Commitment programme. That hopefully shows there is some light at the end of a very long tunnel.

A few years back, if you were hosting a dinner party of key global health stakeholders, you wouldn’t have dreamed of inviting Big Business. Big Business was a little bit brash and unsophisticated and had shown little interest in global health. It is fair to say that the global health community was somewhat wary of Big Business. If anything, you would gather at your dinner party and talk about Big Business behind his back – how his obsession with lowering costs was driving poverty in the developing world or how his preoccupation with profits blinded him of his responsibility to society.

But over the last few years, things have started to change. Big Business is starting to take an interest in global health. These days you would invite him along to your evening soiree, without fear that it would turn into slanging match. He’s also been busy building relationships – cosying up to UN agencies, humanitarian aid organisations and even campaigning NGOs. This week Barclays announced a long-term partnership with UNICEF, Fedex patted itself on the back for its sterling contribution to disaster relief and Dell and Microsoft announced more (RED) products. Friendly gestures? Maybe. Meaningful relationships? Not quite. You may invite Big Business to your dinner party but he is your squash buddy at best, hardly your life partner.

The courtship between Big Business and the rest of the global health community is intriguing, but both sides are still very wary and cautious of each other. BA may be proud of its £25 million Change for Good programme but it cannot escape criticism from those who feel the investment is misplaced. What we really need is for Big Business and the global health community to embrace each other’s values to reach a common goal – something game-changing that capitalises on each other strengths to become greater than the sum of its parts, something resembling a real relationship, a marriage of sorts. Then, you could say Big Business will have arrived.