People living longer and healthier lives but COVID-19 threatens to throw progress off track

People living longer and healthier lives but COVID-19 threatens to throw progress off track

GENEVA-All over the world, the COVID-19 pandemic is causing significant loss of life, disrupting livelihoods, and threatening the recent advances in health and progress towards global development goals highlighted in the 2020 World Health Statistics published by the World Health Organization (WHO) today

“The good news is that people around the world are living longer and healthier lives. The bad news is the rate of progress is too slow to meet the SDGs and will be further thrown off track by COVID-19,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“The pandemic highlights the urgent need for all countries to invest in strong health systems and primary health care, as the best defence against outbreaks like COVID-19, and against the many other health threats that people around the world face every day. Health systems and health security are two sides of the same coin.”

WHO’s World Health Statistics — an annual check-up on the world’s health — reports progress against a series of key health and health service indicators, revealing some important lessons in terms of the progress made towards the SDGs and gaps to fill.

Life expectancy and healthy life expectancy have increased, but unequally.

The biggest gains were reported in low-income countries, which saw life expectancy rise 21% or 11 years between 2000 and 2016 (compared with an increase of 4% or 3 years in higher income countries).

One driver of progress in lower-income countries was improved access to services to prevent and treat HIV, malaria and tuberculosis, as well as a number of neglected tropical diseases such as guinea worm. Another was better maternal and child healthcare, which led to a halving of child mortality between 2000 and 2018.

But in a number of areas, progress has been stalling. Immunization coverage has barely increased in recent years, and there are fears that malaria gains may be reversed. And there is an overall shortage of services within and outside the health system to prevent and treat NCDs such as cancer, diabetes, heart and lung disease, and stroke. In 2016, 70 per cent of all deaths worldwide were attributable to NCDs, with the majority of deaths (85%) occurring in low and middle-income countries.

This uneven progress broadly mirrors inequalities in access to quality health services. Only between one third and one half the world’s population was able to obtain essential health services in 2017. Service coverage in low- and middle-income countries remains well below coverage in wealthier ones; as do health workforce densities. In more than 40% of all countries, there are fewer than 10 medical doctors per 10 000 people. Over 55% of countries have fewer than 40 nursing and midwifery personnel per 10 000 people.

The inability to pay for healthcare is another major challenge for many. On current trends, WHO estimates that this year, 2020, approximately 1 billion people (almost 13 per cent of the global population) will be spending at least 10% of their household budgets on health care. The majority of these people live in lower middle-income countries.

“The COVID-19 pandemic highlights the need to protect people from health emergencies, as well as to promote universal health coverage and healthier populations to keep people from needing health services through multisecotral interventions like improving basic hygiene and sanitation,” said Dr Samira Asma, Assistant Director General at WHO.

In 2017, more than half (55%) of the global population was estimated to lack access to safely-managed sanitation services, and more than one quarter (29%) lacked safely-managed drinking water. In the same year, two in five households globally (40%) lacked basic handwashing facilities with soap and water in their home.

The World Health Statistics also highlight the need for stronger data and health information systems. Uneven capacities to collect and use accurate, timely, and comparable health statistics, undermining lower income countries’ ability to understand population health trends, develop appropriate policies, allocate resources and prioritize interventions.

For almost a fifth of countries, over half of the key indicators have no recent primary or direct underlying data, another major challenge in enabling countries to prepare for, prevent and respond to health emergencies such as the ongoing COVID-19 pandemic. WHO is therefore supporting countries in strengthening surveillance and data and health information systems so they can measure their status and manage improvements. 

“The message from this report is clear: as the world battles the most serious pandemic in 100 years, just a decade away from the SDG deadline, we must act together to strengthen primary health care and focus on the most vulnerable among us in order to eliminate the gross inequalities that dictate who lives a long, healthy life and who doesn’t,” added Asma. “We will only succeed in doing this by helping countries to improve their data and health information systems.”

Comment on NCDs policy draft concept note April 2019

An NCDs concept note, that is set to inform the expired national NCDs policy, is up for comment following a stakeholder consultation in April 2019.
Its purpose is to frame and inform South African NCDs policy for the next 5 years. It is the first policy developed in the Sustainable Development era (2015-2030).

Sustainable development goal (SDG) 3 = health.  Target SDG3.t is to reduce early NCDs deaths by 1/3 by 2030

At the stakeholder meeting, NCDs civil society participation was limited at the stakeholder consultation due to 5 days notice. A Zoom connection was supplied but not audible. The link of an audio recording of the meeting is available here. Duration 2 hours.

WHO consultant Melvyn Freeman developed and presented concept noted. He the former Chief Director, NCDs at the South Africa National Department of Health.

Your comments are needed to inform the process.

NHI Bill being pushed for elections?

November 27, 2018

The revised NHI Bill was presented to Cabinet’s social cluster sub-committee on 27 November 2018  before going to Cabinet, according to the health department.

However, the department failed to answer a number of other questions including why it was pushing the Bill through the legislative pipeline so fast – when even Health Director-General Precious Matsoso admitted last week that she had not seen the latest draft.

Civil society organisations have called on Cabinet to “send the NHI Bill back to the Department of Health and to require a proper and thorough consultation process and consideration of options available for improvement of access to and quality of health care services in the country”.

Professor Olive Shisana, the NHI advisor in the Presidency, is driving the NHI process and has allegedly changed a number of clauses, according to insiders.

The Bill has not been discussed in the National Health Council established by the National Health Act to advise the Minister of Health on policy and on proposed health legislation.

Acting Director General Ismail Momoniat wrote a letter to Shisana last week saying that Treasury could not support the latest version of the Bill as it had been “very substantively amended in October”, removing various agreements reached between the Ministers of Finance and Health.

Treasury was particularly concerned about amendments to the powers of provinces to deliver healthcare, inadequate costing of functions and the relegation of medical schemes to a complementary role which was “premature” and opened the Bill to legal challenges.

However, after the letter was leaked to the media, Treasury issued a statement describing it as “part of the vibrant and ongoing engagement to ensure policy coherence”.

“We have made substantial progress on key areas and have reached agreement on most of the major issues,” added Treasury. “Many of the issues raised by Treasury have been substantively addressed. We are confident that we will soon publish this important Bill for tabling in Parliament.”

But Treasury stressed that “the NHI must be adequately funded and successfully implemented while reducing the risks involved in the implementation of such a large and complex programme”.

Civil society organisations claim that the draft Bill was prepared even before a Presidential Summit that was supposedly called to consult various parties about the NHI.

“Public comments on the NHI over the past decade do not appear to have been taken into account, either between the Green and White Papers and the Bill or after the draft Bill was published for public comment,” according to a statement from Treatment Action Campaign (TAC), SECTION27, Rural Health Advocacy Project (RHAP), People’s Health Movement (PHM) and Lawyers for Human Rights (LHR).

“This makes a mockery of public consultation as required by the Constitution and opens the Bill up to future attack and delay on these grounds.”

The organisations also argue that the current Bill “risks damage to the functional elements of the health system – public and private” and that “government needs to focus on fixing the crises in private and public health rather than on hastily passing legislation that, in its current state, takes the country in the wrong direction”.

While the health department failed to respond to the civil society statement, last week Treasury said that “the implementation of the NHI and improvements in the quality of the health system go hand in hand and are therefore being addressed concurrently.” – Health-e News

Climate Change Bill: Comment by 8 August 2018

 Note: Vicki Pinkney-Atkinson Climate action, SDG 13, is closely linked to Health SDG 3 and NCDs 

Some SDG 13 targets: 

  • Strengthen resilience &  adaptive capacity to climate-related hazards and natural disasters in all countries
  • Integrate climate change measures into national policies, strategies and planning
  • Improve education, awareness-raising and human and institutional capacity on climate change mitigation, adaptation, impact reduction and early

 

Environmental Affairs (EA) Minister Dr Edna Molewa has published the National Climate Change Bill in Government Gazette 41689 (Notice No. 636) for public comment.

“The purpose of the Bill is to build an effective climate change response and ensure the long-term, just transition to a climate resilient and lower carbon economy and society.

“This will be done within the context of sustainable development for South Africa, and will provide for all matters related to climate change,” the Department of  EA said in a statement.

The department said the Bill acknowledges that anthropogenic climate change represents an urgent threat to human societies and the environment and requires an effective, progressive and well-coordinated response.

“It further highlights that, amongst others, anticipated domestic climate change impacts have the potential to undermine the country’s development goals, and that responses to climate change raise unique challenges, thus requiring a legislative framework for the implementation of the country’s national climate change response,” the department said.

The National Climate Change Bill addresses issues related to institutional and coordination arrangement across the three spheres of government namely national, provincial and local. It also highlights the need for the spheres of government and entities, sectors as well business to respond to challenges of climate change.

The bill further addresses matters relating to the national adaptation to impacts of climate change, greenhouse gas emissions and removals, and policy alignment and institutional arrangements.

“Section 24 of the Constitution of South Africa states that everyone has a right to an environment that is not harmful to their health and well-being, and that all have the right to have the environment protected for the benefit of present and future generation, while allowing justifiable environmentally sustainable economic and social development,” the department said.

A Series of Provincial Stakeholder Engagement Workshops, where all stakeholders and interested parties will be able to comment on the National Climate Change Bill, will be hosted by the department countrywide.

The objects of the proposed Act are to:

  • Provide for the coordinated and integrated response to climate change and its impacts by all spheres of government in accordance with the principles of cooperative governance;
  • Provide for the effective management of inevitable climate change impacts through enhancing adaptive capacity, strengthening resilience and reducing vulnerability to climate change, with a view to building social, economic, and environmental resilience and an adequate national adaptation response in the context of the global climate change response;
    and to
  • Make a fair contribution to the global effort to stabilise greenhouse gas concentrations in the atmosphere at a level that avoids dangerous anthropogenic interference with the climate system within a timeframe and in a manner that enables economic, employment, social and environmental development to proceed in a sustainable manner.

Members of the public are invited to submit to the Minister, by 8 August 2018, written inputs or comments to the following addresses:

By emailBy post:  The Director-General: Department of EA, Attention:  Ms Dineo Ngobeni,  Private Bag X447,  Pretoria  0001., By hand:  Environment House, 473 Steve Biko Street, Arcadia, Pretoria, 0002

Any inquiries in connection with the National Climate Change Bill, 2018, can be directed to Mr Tlou Ramaru at +27-12 399 9252  or Ms Deborah Ramalope at +27 12 399 9160.

See a copy of  socio-economic impact assessment report and memorandum of objects

To access the National Climate Change Bill