Canadian priorities for post-2015 development agenda
http://www.international.gc.ca/development-
developpement/priorities-priorites/mdg-
omd_consultations.aspx?lang=eng
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http://www.ualberta.ca/~tkeating/ELLA2.pptx
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everyone has the right to a standard of living adequate for
health and wellbeing of himself and his family, including food,
clothing, housing, medical care and the right to security in the
event ofsickness, disabilityMotherhood and childhood are entitled
to special care and assistance. (UN Declaration of Human Rights,
1948, Article 25, paragraphs 1 and 2)
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health security at its simplest level, can be illustrated by
reference to premature and unnecessary loss of life which can be
avoided by provision of and access to health care implying state
responsibility for empowering people through national and
international mechanisms to protect themselves from poor health at
the local level.
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Increased interest in the relationship between health, human
security and human development by the international community and
governments is rooted in the need to protect people from the risks
and insecurities brought about by health deficiencies and hazards,
often due to particular circumstances of underdevelopment and
poverty and conflict.
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At Least 30% of Human Deaths are due to poverty-related causes,
cheaply preventable through safe drinking water, better sanitation,
more adequate nutrition, vaccines or other medicines. diarrhea and
malnutrition perinatal and maternal conditions childhood diseases
tuberculosis, meningitis, hepatitis, malaria and other tropical
diseases, respiratory infections- mainly pneumonia, HIV/AIDS,
sexually transmitted diseases (WHO: World Health Organization,
Global Burden of Disease: 2004 Update, Geneva 2008, Table A1, pp.
54-59) (WHO: World Health Organization, Global Burden of Disease:
2004 Update, Geneva 2008, Table A1, pp. 54-59) 2
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Linkages
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Human causes of health insecurity: investment/private vs.
public policy conflicts antibiotic resistance food borne diseases -
ecoli; BSE bioterrorism
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the burden of disease in low-income countries is further
compounded by a litany of chronic, non communicable ailments
striking around the globe, notably diabetes, heart disease, and
cancer.
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2001 United Nations Security Council resolution identified
HIV/AIDS as a security threat, a position reiterated in the served
to raise the profile of the health crisis that was the HIV/AIDS
epidemic and to elevate it to a security concern, and a human
security concern in the broader sense The 2001 UN Security Council
resolution placed responsibility for health and human security
squarely with national governments, but a subsequent General
Assembly declaration dispersed this responsibility among non-state
actors as well.
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these represented a shift from a health system-wide approach to
a problem-focused, specific disease-oriented one; second, they
ushered in the establishment of cross-sectoral and broad based
partnerships (public private, philanthropy, and civil society) in
the planning, coordination, and governance of global health; third,
they saw the emergence of demand-driven funding and exploitation of
market dynamics to stimulate investment in research and production
capacity for drugs and other medical products; and fourth, they
emphasized results and evidence-based outcomes as a basis for
allocation of global health resources.
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Between 1990 and 2010, global health funding grew
exponentially, from approximately $5.6 billion to over $28 billion
(IHME, 2012 ) Increased activity in the health arena has resulted
in: over 40 bilateral donors, 25 UN agencies, 20 global and
regional funds, and 90+ global initiatives that target health
issues this has led to overlapping mandates and competition for
limited (and in many cases dwindling) resources and seeking to
influence the content and execution of the global health and human
security agenda (Council on Foreign Relations, 2013 ).
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Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global
Fund) which was established in 2002 as a financing mechanism with
the support of the G7, specifically to combat those three diseases;
US President s Emergency Plan for AIDS Relief (PEPFAR) established
in January 2003 at the behest of then US President George W. Bush,
initially committed US$15 billion3 (renewed in 2008 at US$48
billion (H.R. 5501, 2008 )) expressly to combat HIV/AIDS in select
low-income countries; and Global Alliance for Vaccines and
Immunization (GAVI), launched in 2000 with an initial $750 million
grant from the Bill and Melinda Gates Foundation.
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Millennium Development Goals: Globally, the number of deaths of
children under 5 years of age fell from 12.6 million in 1990 to 6.6
million in 2012. In developing countries, the percentage of
underweight children under 5 years old dropped from 25% in 1990 to
15% in 2012. While the proportion of births attended by a skilled
health worker has increased globally, fewer than 50% of births are
attended in the WHO African Region. Globally, new HIV infections
declined by 33% between 2001 and 2012. Existing cases of
tuberculosis are declining, along with deaths among HIV-negative
tuberculosis cases.
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Worldwide, Africa accounts for 9 out of every 10 child deaths
due to malaria, for 9 out of every 10 child deaths due toAIDS, and
for half of the worlds child deaths due to diarrhoeal disease and
pneumonia. In low-income countries, the leading cause of death is
pneumonia, followed by heart disease, diarrhoea, HIV/AIDS and
stroke. In developed or high- income countries, the list is topped
by heart disease, followed by stroke, lung cancer, pneumonia and
asthma or bronchitis. Men between the ages of 15 and 60 years have
much higher risks of dying than women in the same age category in
every region of the world. This is mainly because of injuries,
including violence and conflict, and higher levels of heart
disease. The difference is most pronounced in Latin America, the
Caribbean, the Middle East and Eastern Europe. Depression is the
leading cause of years lost due to disability, the burden being 50%
higher for females than males. In all income strata, alcohol
dependence and problem use is among the 10 leading causes of
disability.
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The world has changed dramatically since 1951, when WHO issued
its first set of legally binding regulations aimed at preventing
the international spread of disease. At that time, the disease
situation was relatively stable. Concern focused on only six
quarantinable diseases: cholera, plague, relapsing fever, smallpox,
typhus and yellow fever. New diseases were rare, and miracle drugs
had revolutionized the care of many well-known infections. People
travelled internationally by ship, and news travelled by telegram.
Margaret CHAN, WHO Director General, A safer future, WHO 2007 World
Health Report
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Responding to changes More than 2.5 billion airline passengers
annually Infectious diseases can not only spread faster, but are
increasing in number: since the 1970s, new diseases have been
identified at the unprecedented rate of one or more per year. More
than 1100 epidemic events have been verified by WHO the last five
years SARs epidemic 2002-3; belated reporting from China; 8273
cases, 775-835 deaths
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International Health Regulations (IHR) were revised in May
2005, and came into force on 15 th of June 2007. It includes all
diseases and health events that may constitute a public health
emergency of international concern. 194 States parties to the
revised IHR designed to have the necessary global framework to
prevent, detect, assess and provide a coordinated response to
events that may constitute a public health emergency of
international concern (Article 2 IHR)
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The Regulations now cover public health emergency of
international concern whatever their origin or source (Article
1.1), including: (1) naturally occurring infectious diseases,
whether of known or unknown etiological origin; (2) the potential
international spread of non-communicable diseases caused by
chemical or radiological agents in products moving in international
commerce; and (3) suspected intentional or accidental releases of
biological, chemical, or radiological substances.
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Ebola crisis 2 yo Guinean boy contracts virus from fruit bats
in December 2013 disease continues to spread as family members
mourn their loved ones, no sterile precautions taken August 2014,
disease spreads to Monrovia spreads exponentially WHO issued a
public health emergency call in September 2014 26,571 cases; 10,995
deaths as of April, 2015
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Why Does it Spread? traditions suspicion of outside help lack
of infrastructure
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Whether it is Ebola or another medical issue, countries will
repeatedly experience outbreaks if solutions focus on symptoms and
not the underlying need for strong local systems. The Ebola
outbreak is the result of a frail health care system. It is
imperative that international aid communities join forces with
local governments, organizations and leaders in order to contain
the virus while being cognizant of the need to also build stronger,
more resilient, health care systems - Samuel A. Worthington,
President of InterAction
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33
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the involvement of military units in public health
interventions are a potential source of concern.This type of
arrangement has been described as dual usage for public health and
military purposes (Chen 2004). some support and encourage this kind
of assistance and recommend that it be accelerated, but there is
obviously a potential for conflict of interest (Fidler 2005). it
has also been proposed that since the health services are now in
the front line... they could get support from government defence
and security budgets a recommendation supported by some within WHO
if accepted this could raise questions about the neutrality and
independence of health care providers
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Health care workers are prized by conflicting parties Health
care facilities are targeted for their resources Health care
workers overburdened in response to conflict and its aftermath
Health care systems and support facilities lack resources
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much maligned agency; heavily dependent on leadership; but also
constrained by member governments provides information and monitors
performance; http://www.who.int/gho/map_gallery/en/
http://www.who.int/gho/map_gallery/en/
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Investment in Health Care Systems: the world is now short well
over four million health-care workers, aging populations require
more medical attention, and are drawing health talent from
developing countries. 20% of practicing physicians in the United
States is foreign-trained, if current trends continue, by 2020 the
United States could face a shortage of up to 800,000 nurses and
200,000 doctors Unless it and other wealthy nations radically
increase salaries and domestic training programs for physicians and
nurses, it is likely that within 15 years the majority of workers
staffing their hospitals will have been born and trained in poor
and middle-income countries. As such workers flood to the West, the
developing world will grow even more desperate. (Garrett, Council
on Foreign Relations) Health care spending country comparisons:
http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country
http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country
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Distribution of Pharma Research Diseases accounting for 90% of
the global disease burden receive only 10% of all medical research
worldwide. Pneumonia, diarrhea, tuberculosis and malaria, which
account for over 20% of the global burden of disease, receive less
than 1% of all public and private funds devoted to health research.
Of the 1556 new drugs approved between 1975 and 2004, only 18 were
for tropical diseases and 3 for TB.
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WTO trade rules protected pharmaceutical firms through the
adoption of restrictions on copying intellectual property/patent
(TRIPS) WTO Doha Declaration on TRIPS affirmed its members right to
protect public health, but access to affordable pharmaceuticals was
blocked by the requirement that the drug in question only have its
patent removed if the state proved that the disease in question was
of epidemic and emergency proportions counterfeit drugs have
emerged as a very significant problem, representing more than 10%
of seized counterfeit products