Category: Policy and Advocacy

US Political Party Platforms on Global Health Development – A Summary by Jeff Meer/PHI

by ihsection, posted in Guest Blog, Policy and Advocacy

2012 is an election year, so political rhetoric is at an all-time high. While every possible issue under the sun is being debated and bandied back and forth, sometimes global health and development can get lost in the fray. Jeff Meer/PHI put the following document together. It contains some of the elements of the draft Democratic Party 2012 Platform, now under discussion in Charlotte. It is interesting to contrast these sections with similar ones from the Republican Party Platform, included below.

DEMOCRATIC PARTY PLATFORM:

Climate Change. The national security threat from climate change is real, urgent, and severe. The change wrought by a warming planet will lead to new conflicts over refugees and resources; new suffering from drought and famine; catastrophic natural disasters; and the degradation of vital ecosystems across the globe. That is why…the President and the Democratic Party have steadily worked to build an international framework to combat climate change. We will seek to implement agreements and build on the progress made during climate talks in Copenhagen, Cancun, and Durban, working to ensure a response to climate change policy that draws upon decisive action by all nations. Our goal is an effective, international effort in which all major economies commit to reduce their emissions, nations meet their commitments in a transparent manner, and the necessary financing is mobilized so that developing countries can mitigate the effects of climate change and invest in clean energy technologies…It is also why we have worked regionally to build clean energy partnerships in Asia, the Americas, and Africa…”

Global Development. As the United States works with allies and partners to establish an international order that advances peace and prosperity, President Obama and the Democratic Party will continue to build three key pillars of American global leadership: a prosperous and inclusive economy, our unsurpassed military strength, and an enduring commitment to advancing universal values.

President Obama recognizes that promoting global development is a strategic, economic, and moral imperative for the United States. Development expands markets for American products and creates American jobs. Strong and prosperous regional partners are critical to addressing global challenges, ending regional conflicts, and countering the spread of global criminal networks. And good governance and stability cannot take root, and basic human dignity cannot be protected, where poverty reigns and people lack access to the food, basic education, clean water, and medicine they need to survive.

For these reasons, the President this year announced a new strategy toward sub-Saharan Africa that commits to…we believe that the private sector will be the engine of prosperity in the developing world. The administration continues to work to promote opportunity and development in sub-Saharan Africa by improving the region’s trade competitiveness, encouraging economic diversification, and ensuring that the benefits from growth are broad-based…

HIV/AIDS and Infectious Disease. Recognizing that health is a prerequisite for development, the President has made unprecedented progress in the global fight against HIV/AIDS and other infectious diseases. Building on the strong foundation created during the previous administration, the President’s Emergency Plan for AIDS Relief (PEPFAR) has expanded its prevention, care, and treatment programming. As a result, PEPFAR now has made significant investments in more than 30 countries, and we set a goal to roughly double the number of lifesaving anti-retroviral treatments we provide by the end of 2013. With his latest budget, the President is fulfilling his historic commitment to request $4 billion over three years for the Global Fund, and the President remains committed to robust funding for PEPFAR and the Global Fund in the future. And President Obama lifted the 25-year ban that prevented non-citizens living with HIV from entering the United States, allowing the world’s largest group of HIV/AIDS researchers, policymakers, medical professionals, and advocates to convene in Washington to continue their efforts to improve prevention and treatment.

Our efforts to combat HIV/AIDS are part of a broader commitment to address the challenges posed by infectious disease. Over the past four years, the administration has leveraged billions of dollars in commitments from donors to meet the demand for new vaccines, making it possible to immunize millions of children and prevent premature deaths…

Women’s Rights. As we work to advance universal values and human dignity, the President and the Democratic Party understand the critical importance of expanding protections and opportunities for women and girls around the world. Ensuring full equality and providing women and girls the opportunity to learn, earn a livable wage, and participate in public decision-making are essential to reduce violence, improve economies, and strengthen democracy. To continue to make progress at home and advance women’s rights and opportunities abroad, we will urge ratification of the Convention for the Elimination of All Forms of Discrimination Against Women (CEDAW).

President Obama, Secretary of State Hillary Rodham Clinton, and the State Department are committed to advancing the rights of women and girls as a central focus of U.S. diplomatic, development, and defense interests. We will continue to promote the full engagement of women in the political and economic spheres. We will work to address underlying socio-economic problems, including women’s access to health, education, and food security. And we will ensure that women are equal participants in reconciliation and development in areas affected by conflict.

International Family Planning. President Obama and the Democratic Party are committed to supporting family planning around the globe to help women care for their families, support their communities, and lead their countries to be healthier and more productive. That’s why, in his first month in office, President Obama overturned the ‘global gag rule,’ a ban on federal funds to foreign family planning organizations that provided information about, counseling on, or offered abortions. And that is why the administration has supported lifesaving family planning health information and services…

REPUBLICAN PARTY PLATFORM:

Under “A Failed National Security Strategy,” the draft platform states that the Administration’s current National Security Strategy “subordinates our national security interests to environmental, energy, and international health issues, and elevates “climate change” to the level of a “severe threat” equivalent to foreign aggression.”

Under “Sovereign American Leadership in International Organizations,” the draft platform states that “the United Nations Population Fund has a shameful record of collaboration with China’s program of compulsory abortion. We affirm the Republican Party’s long-held position known as the Mexico City policy, first announced by President Reagan in 1984, which prohibits the granting of federal monies to non-governmental organizations that provide or promote abortion.” It also states that “Under our constitution, treaties become the law of the land. So it is all the more important that the Congress – the Senate through its ratifying power and the House through its appropriating power – shall reject agreements whose long-range impact on the American family is ominous or unclear. These include the U.N. Convention on Women’s Rights, the Convention on the Rights of the Child, the Convention on the Rights of Persons with Disabilities, and the U.N. Arms Trade Treaty as well as the various declarations from the U.N. Conference on Environment and Development.”

Under “America’s Generosity: International Assistance that Makes a Difference,” the draft platform states, “Americans are the most generous people in the world. Apart from the taxpayer dollars our government donates abroad, our foundations, educational institutions, faith-based groups, and committed men and women of charity devote billions of dollars and volunteer hours every year to help the poor and needy around the world. This effort, along with commercial investment from the private sector, dwarfs the results from official development assistance, most of which is based on an outdated, statist, government-to-government model, the proven breeding ground for corruption and mismanagement by foreign kleptocrats. Limiting foreign aid spending helps keep taxes lower, which frees more resources in the private and charitable sectors, whose giving tends to be more efficient and effective.

Foreign aid should serve our national interest, an essential part of which is the peaceful development of less advanced and vulnerable societies in critical parts of the world. Assistance should be seen as an alternative means of keeping the peace, far less costly in both dollars and human lives than military engagement. The economic success and political progress of former aid recipients, From Latin America to East Asia, has justified our investment in their future. U.S. aid should be based on the model of the Millennium Challenge Corporation, for which foreign governments must, in effect, compete for the dollars by showing respect for the rule of law, free enterprise, and measurable results. In short, aid money should follow positive outcomes, not pleas for more cash in the same corrupt official pockets.

The effectiveness of our foreign aid has been limited by the cultural agenda of the current Administration, attempting to impose on foreign countries, especially the peoples of Africa, legalized abortion and the homosexual rights agenda. At the same time faith-based groups – the sector that has had the best track record in promoting lasting development – have been excluded from grants because they will not conform to the administration’s social agenda. We will reverse this tragic course – encourage more involvement by the most effective aid organizations, and trust developing peoples to build their futures from the ground up.

Under “Advancing Hope and Prosperity in Africa,” the draft platform states “PEPFAR, President George W. Bush’s Plan for AIDS Relief, is one of the most successful global health programs in history. It has saved literally millions of lives. Along with the Global Fund to Fight AIDS, TB, and Malaria, another initiative of President Bush, it represents America’s humanitarian commitment to the peoples of Africa, though these are only one aspect of our assistance to the nations of the continent. From Peace Corps volunteers teaching in one-room schools to U.S. Seabees building village projects, we will continue to strengthen the personal and commercial ties between our country and African nations.”

IH Website Updates

by ihsection, posted in APHA IH Section, Community-Based Primary Health Care, Policy and Advocacy

More great word from our excellent Advocacy/Policy Committee! On March 5, 2012, the Advocacy/Policy Committee sent, via APHA, a letter to Secretary Clinton regarding Syria and the US reactions to those events. You can read the letter sent in response from Robert Ford, US Ambassador to Syria, here.

For all you CBPHC fans and working group members out there, the report and associated documents have been posted to the IH website. You can access them (in PDF format) on the CBPHC-WG site here.

The Christian Connections in International Health (CCIH) 26th Annual Conference will be held this year in Arlington, VA on June 8-11, 2012. For more information, please visit the conference website.

APHA Signs on to Letter to WHO Executive Board on Protection of Health Care Workers

by ihsection, posted in APHA IH Section, Policy and Advocacy

The following message is from Peter Freeman, chair of the IH Section’s Advocacy and Policy Committee.

Since October 2011, members of the IH Advocacy & Policy Committee have been participating on a coalition, organized through IntraHealth International, whose aim is to bring global focus onto the protection of health care workers, patients and systems in areas and times of conflict.

In mid January 2012, the Executive Board of the World Health Organization (WHO) is scheduled to meet; members of this coalition will be in attendance. To move the coalition’s agenda forward, a letter is being presented to the WHO Executive Board asking to put a resolution before the WHO Assembly that would call for:
*the development and implementation of a plan to collect and report data concerning attacks on health facilities, workers and patients or other violations of medical neutrality where conflicts are taking place;
*make this data publicly available on the WHO website
*regularly update said data
The coalition has asked for agencies who have stake in the protection of global health care infrastructures to sign onto this letter.

It is greatly exciting to report that on January 13, 2012, APHA agreed to become a signatory of this letter! The Advocacy & Policy Committee is encouraged to see a growing receptiveness and response by APHA staff to give the association a voice on the global health platform and we look forward to many more advocacy victories!

Peter F Freeman, MPH
Chair, APHA-IH Advocacy/Policy Committee
pffreeman@gmail.com

Content of the letter signed on by APHA:

Dear Members of the WHO Executive Board:

We write to urge that you support action at the Executive Board to bring WHO’s expertise to the pressing problem of attacks on health care, including health care workers, during situations of conflict. The report released by the International Committee of the Red Cross last August – Health Care in Danger – concluded that, “in terms of number of people affected, violence, both real and threatened, against health-care workers, facilities and beneficiaries is one of the biggest, most complex, and yet most under-recognized humanitarian issues today.” As Director-General Margaret Chan recognized in her address to the World Health Assembly last May, the problem needs the urgent attention of the global health community. WHO is uniquely positioned to address a key need identified by the ICRC and many others, which is sound and reliable data on the magnitude and dynamics of violence against health care and health workers.

WHO’s expertise in developing an evidence base for global health policy, in health systems development and in humanitarian coordination creates an opportunity for leadership at the global level. The WHO can develop and implement methods for systematic collection of data on attacks on health facilities, workers, and transport and patients in conflict areas. This should be done in cooperation with other relevant UN agencies, intergovernmental and nongovernmental organizations.

We ask that the Executive Board adopt a resolution for consideration by the World Health Assembly that requests the Director-General to develop and implement a plan for WHO to collect and report data on attacks on health facilities, workers and patients where conflicts are taking place or other violations of medical neutrality. The data should be publicly available and periodically updated on the WHO web site.

The signatories to this letter are familiar with the tragic consequences of violence on health care. There are roles for many entities, including health workers themselves, governments, professional associations, non-governmental organizations and other UN agencies. All must do their part to increase protection. WHO’s role is limited but essential, as it is in the best position to lead the data collection process.

We therefore urge you to support action at the Executive Board to enhance protection of health in situations of conflict.

Politicizing our National Health Security

by ihsection, posted in Guest Blog, Health Systems, Policy and Advocacy

By Dr. Samir N. Banoob

In 1994, after the Republicans paralyzed the Clinton health reform proposal, I published an article in the Florida Journal of Public Health titled “Reforming health care in the US and Europe: Why we fail and they succeed.” It explained why health reforms succeed in other Western countries with policies of universal access and user-friendly systems. In our case, the Republicans sacrificed health security of all citizens to play the political game of “Repeal the Obama Affordable Health Care Act,” responding to lobbyists and funding from interest groups. Members of Congress who voted to repeal the law come from the same category of irresponsible politicians who represent special interests that opposed Social Security, Medicare and Medicaid for short political gains.

To review where we are, the American health care non-system:

  • is the only system that does not provide health security to its citizens. The uninsured population reached 46.3 million in 2008 (compared to 36 million in 1993) and is steadily increasing. If the status quo continues by repealing Obamacare, it is expected to reach 75 million in 2019.
  • is the most expensive system in the world. American healthcare expenditures made up 16.2% of our gross national income in 2008, compared to an average of 9% in Europe. Without the recently passed reforms, it will soon reach 25%, which is almost double the cost in any country of comparable national income. The cost per individual reached $7,681 in 2008.
  • has one of the lowest provider-to-population ratios and the highest administrator-to-provider ratios (8 administrators per 10 health providers) among Western nations. The administrative portion of private health insurance agency expenditures is 30%, compared to 2-4% in Medicare and governmental agencies.
  • has one of the lowest proportions of hospital beds for the population, the lowest hospital admission rate and the shortest length of hospital stay among Western nations. While European citizens use an average of 7-8 outpatient doctor visits per year, Americans use 3.8 visits per year.

These are just few features of our system that some falsely call “the best system in the world.” By technical and scientific standards, this system is ranked 37th among the 190 countries in the world. Life expectancy at birth, 78 years in the US, is among the lowest of industrial countries. Seven out of 1,000 American children die before their first birthday, a figure similar to that of Thailand and Lithuania. While many are proud of our rate of high-tech surgical procedures, research has demonstrated that about 20% of these procedures are unnecessary and are financially driven or performed to avoid litigation. The scientific measures of quality of care indicate that the American system is, at best, comparable to most Western countries.

Many opponents of the reforms cite concerns such as mandating insurance coverage or government involvement. However, health insurance is compulsory in most developed nations to avoid the costs incurred by individuals who do not pay for coverage and go to emergency rooms for care, shifting the cost to the insured. Also, the notion that the public option will increase government’s involvement in health care is false: about 45% of Americans’ health care costs are covered by governmental programs, including Medicare, Medicaid, Veterans health services, and state and local government services. Another allegation is the cost and the deficit, but this does not take into account the savings for individuals and families from reducing out-of pocket costs, as well as the cost to employers, who will either pay more or will lower health benefits or shift the cost to the employees. Others intentionally confuse the debate by bringing in political ideology or simply targeting the President and the Democratic party. This irresponsible act will hurt all Americans in the future.

It is essential at this time to focus the debate on the health system. To those fighting for repeal, please come with the alternatives first. What will happen to the escalating number of citizens who are uninsured, and those who have preexisting conditions, and the skyrocketing health care cost?

Let us play politics away from the nation’s health security.

More Information
WHO World Health Statistic 2009 Report (PDF)
OECD Health Data 2009

Samir Banoob, M.D., D.M., D.P.H., Ph.D., is the president of International Health Management, consulting firm in Florida that leads international health projects and trains scholars from more than 70 countries. He has taught as a professor of international health policy and management and has worked as a consultant to WHO, World Bank, and other international agencies on projects in 76 countries. He served as the Chair of the International Health Section from 1992 to 1994, and again from 2006 to 2008.

KFF Video Explains Health Care Reform

by ihsection, posted in Health Systems, Information and Social Media, Policy and Advocacy

The Kaiser Family Foundation has made an animated video that explains the health care reform law in plain language.  Narrated by Cookie Roberts, a news commentator for ABC News and NPR, this nine-minute video goes over public opinion about the legislation and what will be done in its two main phases.  It is fairly balanced and clears up a lot of confusion (in my opinion).  The video can be seen on the KFF website here, and there is also a PDF transcript of the narration.