International AIDS conference leaves 2010 goal of universal access at risk, Oxfam says

The International AIDS Conference concluded yesterday without a clear plan or any new impetus to reach the 2010 target of universal access to HIV/AIDS prevention, treatment and care, said international agency Oxfam. “To say we are disappointed is an understatement. Has the AIDS Conference become just another expensive gab-fest?” asked Robert Fox of Oxfam International. “Rather than rally the troops, officials from government and UN agencies talked about 2015 as being good enough and seemed happy to let the 2010 goal slide. How many will suffer and die if that happens?”

In 2005, the G8 set the goal of achieving universal access to HIV/AIDS services by 2010, which was endorsed and expanded by African leaders to cover malaria and tuberculosis the following year. Yet AIDS 2008 ended without a plan to achieve it. Annie Lennox, singer and Oxfam global ambassador, said: “AIDS is an emergency. There is no time to waste. Millions of the world’s most vulnerable people are counting on governments to make good on the promise for 2010. In Vienna two years from now, the world will ask: ‘What have you done to end this calamity?’” Lennox implored. “How many people will you have placed on treatment? How many female condoms will you have distributed? How many health workers will you have trained?”

“That we have achieved progress in expanding treatment and prevention is welcome news,” Fox said. “But the air of complacency from officials is profoundly disturbing. The message from people on the front lines of this pandemic stands in sharp contrast. They know that funding is inadequate, health systems are weak, and medicines are far too expensive. And the reason is lack of political will among donors, developing country governments and the big pharmaceutical companies.” Oxfam health adviser Dr. Mohga Kamal-Yanni said: “Officials tried to gloss over the real problems of getting AIDS-specific funding to strengthen health systems, which was the major policy outcome in Toronto two years ago. Universal access must mean access to comprehensive health services for all.”

Health insurance is no substitute for rich country aid, NGOs say

As governments from all over the world meet in Paris to discuss social health protection in developing countries, a group of NGOs has issued a report warning that health insurance continues to exclude the poor. The argument that health insurance could fill financing gaps to ensure health care in poor countries is now being strongly promoted by northern governments and international institutions. The paper, Health insurance in low income countries: Where is the evidence that it works?, says that while these insurance schemes can have a positive effect on the accessibility and on reducing catastrophic health expenditure for parts of the population, they can also pose a threat to equity and efficiency of health systems.

In its report, the NGOs argue that even insurance mechanisms made specifically for developing countries often exclude the poorest and most vulnerable groups. NGOs argue that most health insurance schemes developed for the poor seem unable to finance a comprehensive benefits package. Therefore poor people often continue to depend on the ability to pay 40% of their health needs – out-of-pocket – even when they are a member of an insurance scheme. “Far from being a magic bullet, health insurance schemes can exclude the poorest from health services. The money for health must not come from the pockets of poor people. The best way for countries like France and Germany to provide healthcare for the poor is by delivering on the aid they’ve promised,” said Luc Lampriere of Oxfam France - Agir Ici.

NGOs also call on countries and donors to respect their commitment to boost investments in health care. Only about a third of sub-Saharan African countries are allocating ten per cent or more of their national budgets to the health sector – despite a previous commitment known as the Abuja target, to invest 15 percent spending on health. The report says that all countries and donors should evaluate insurance mechanisms not just in terms of advantages to the populations they serve but also with regards to the contribution they make towards universal access.

“Health Insurance mechanisms are often promoted based on the assumption that they can fill financing gaps and contribute positively to universal coverage. But without significant public funding for the health sector and strong government stewardship, insurance mechanisms can actually increase inequity,” said Nicolas Guihard of Médecins du Monde. A specific focus is needed, the report continues, on the needs of vulnerable groups, such as women, poor and elderly people, and people living with HIV, who are most likely to be excluded by insurance mechanisms must also remain at the centre of any schemes and the overall debate.

Oxfam: Six million more teachers, doctors and nurses needed

Oxfam launched a global call for "Health and Education For All" in New Delhi last week, calling for investment for six million more teachers, nurses and doctors around the world. Oxfam is urging developing country governments to allocate an increased proportion of their annual budgets into providing these essential services, and demanding that rich countries support poorer nations with an increased and long-term aid commitment targeting the health and education sectors. According to an Oxfam briefing universal education and health is possible in even the poorest countries, if the investments are made. The brief reveals how Uganda and Brazil have doubled the number of children in school, halved AIDS deaths and extended safe drinking water and sanitation to millions of people. In Sri Lanka, where even though one-third of the population lives below the poverty line, public clinics with free medical treatment and qualified nurses are within walking distance.

Nearly 300 children joined actor Rahul Bose and award-winning classical dancer Geeta Chandran to launch the 'For All' campaign call. The children wore doctors, nurses and teachers outfits to symbolise the 6 million health and education workers which Oxfam estimates are needed worldwide to provide basic health care and primary education for every child. New footage released at the event showed Hollywood actress Scarlett Johannson visit to Indian schools earlier this year where she met, and was inspired by child campaigners for education (see video).



"As India becomes a stronger global player, it is ironic that we still do not provide schooling or health care for millions of our children," said Bollywood actor and Oxfam's Global Ambassador Rahul Bose. " 'For All' is calling not only on the Indian government but every government in the world to take the responsibility for providing quality basic services for all its citizens. Rich nations too need to increase aid to health and education, where necessary, to help poor country government reach their goals."

The Oxfam briefing paper says India is a country of extremes: 'World Class' advanced medical treatment for the wealthy and `medical' tourists but Maternal Mortality and Infant Mortality rates worse than sub-Saharan Africa in India's poorest districts; 'World class' economists, scientists, engineers, IT Professionals, but the largest number of people in any country in the world without access to education. It shows that Indian government spending on health, as a percentage of GDP, is 18th from the bottom among 177 countries. But the report also shows that success is possible, and that parts of India are making good progress on essential services. Government's initiative in the Indian state of Himachal Pradesh, for instance, provides an outstanding example where high rates of literacy have been achieved despite hilly terrain, lack of access to water, extreme weather and high poverty. Himachal's literacy rate was 19% in 1951; by 2001 it had gone up to 77% - with 96% for the 15-19 age group. Where state governments have invested in more teachers, lower teacher-pupil ratio, more classrooms and fewer single-teacher schools, the overall educational achievements are much better. Working with allies around the world, the "For All" will hold developed and developing countries to account to ensure that they keep their promises to ensure that health and education for all becomes a reality.

Members of European Parliament complain over Commission stance on cheap medicines

MEPs look set to complain to Peter Mandelson, the European trade commissioner, over his efforts to curtail Thailand from boosting the supply of affordable medicines by routinely circumventing patents held by drug firms. Mandelson recently wrote to several Thai ministers after Bangkok decided to overrule patents on three medicines by issuing compulsory licenses. Mandelson expressed concern over reports that Bangkok “may be taking a new approach to access to medicines” by stating that “if drug companies wish to do business in Thailand, they should offer their drugs for no more than 5% above” the cost of generic versions of the products in question. According to Mandelson, “this approach would be detrimental to the patent system and so to innovation and the development of new medicines” and “it risks forcing more drug companies to abandon their patents.”

Many MEPs have taken exception to Mandelson’s letter as they believe he should not be seeking to exert pressure over developing countries which overrule drug patents in order to address public health needs. Helmuth Markov, the German MEP who chairs the Parliament’s committee on international trade, has confirmed to the on-line journal Intellectual Property Watch that he intends to send a written complaint to Mandelson. – (EuroStep News)

New health initiative to bolster G8 promises

When Gordon Brown, UK prime minister, will announce details of the new International Health Partnership initiative later this week, he will have the backing of relevant non-governmental organisations. The programme has already presented during Angela Merkel’s, visit to London on 22 August. The plans for an International Health Partnership are part of a global campaign on health and are designed to co-ordinate international funding for health systems in poor countries. It will bring together major donor countries together with international agencies like the World Bank and World Health Organisation (WHO).



In a joint statement with German Chancellor Angela Merkel following bilateral talks in Downing Street, Gordon Brown said that addressing healthcare and aid provision was now a "development emergency". The new Partnership, which will launch formally on 5 September, will drive forward work on Millennium Development Goals involving the reduction of child and maternal mortality and the tackling of specific diseases such as HIV/AIDS (see video).

Alison Woodhead, head of Oxfam's international campaign for health and education, said on 22 August, "This is a great initiative that deserves widespread international support. Brown and Merkel should be congratulated for following through on their G8 promises to improve health care. The challenge for them now is to make sure other countries get on board to ensure maximum impact. There are women, men and children in developing countries who are dying because they don't have access to healthcare or any doctors or nurses to attend to them. This Partnership could literally save lives, by coordinating investment in healthcare that is free, public, and well staffed."