In fact, recent debates on the topic of pharmaceutical patents and the TRIPS Agreement Trade-Related Aspects of Intellectual Property Rights , clearly compromise universal access to medicines and other critical healthcare inputs. Citizens have growing expectations regarding health insurance. People expect free access to medicines and services, and demand quality.
Global Action Plan for the Prevention and Control of NCDs 2013-2020
People want to be cared for by people who care. One of the core questions each country must address is who is responsible for universal coverage?
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Who pays the bill? The OMS General Director completed her presentation by mentioning an article by the Lancet about universal health coverage 8. The result of this careful strategy is that the MDG agenda has been embraced by all member states and civil society. However, the simplicity of its approach is also its weakness. In narrowing down the goals to a limited number, many elements were left out, notably the rising tide of non-communicable diseases, fostering fragmented initiatives and vertical programs to face them.
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Still according to this editorial, many MDG targets involve increasing or decreasing by a set proportion the population beyond a certain threshold. Therefore, investments have been channeled towards those individuals nearest the threshold, thus contributing to greater inequity in some areas. Given the lessons learned from the MDG, and in line with the conceptual simplicity of this global strategy, The Lancet editorial asks the question: how can we bear in mind and include, in the movement around the social determinants of health, a people-centered, not disease-centered, approach, and one that is centered on human rights, with equity at its heart?
Based on these strategic themes, how can we create a global program of post targets? Claiming that universal health coverage is an approach that does not consider the social determinants of health, which are difficult to measure and compare between countries, and that reflects the health status of a given area only indirectly, the editorial proposes arguments in favor of an approach defended by Cesar Victora et al.
The IEA initiative identifies three indicators: survival including material and infant survival disease burden including non-communicable diseases and others not covered by the MDG , and risk factors smoking and basic sanitation, among others. Universal Health Coverage UHC and access to basic healthcare services such as immunizations and access to medicines remain the targets through which healthy life expectancy will be achieved.
Reduced out-of-pocket expenditure, and strengthened health systems are proposed indicators for this goal, according to the IEA. In addition to support progress made and protect the investments to achieve the MDGs, the presence of health in the new post agenda will address three macro issues: an inconclusive agenda, new challenges and health as part of the development agenda. The agenda of challenges includes chronic non-communicable diseases CNCD , access to all of the services needed and actions that extend to the social, economic and environmental determinants of health, and not just the biomedical causes of disease.
We call attention to how difficult it is to have all of these dimensions reflected in goals or targets. Competition between them would have a negative impact on health.
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Hundreds of government and civil society representatives from across the region participated in this forum. Among the many themes discussed were hot to monitor progress of MDG in the region, priority themes post, how to reduce vulnerability in particular for the small island states in the Caribbean , and more robust governance and financial infrastructure to support sustainable development. In fact, in considering the huge differences between countries in the region in terms of sustainable development, and the multiple and growing incentives by government, private and non-government organization in Latin America and the Caribbean, one must recognize that the theme of shared coordination and management of actions and policies, and the strategies used to fund them, are at the core of creating an agenda that can continue to address the challenges post Daring and creative attitudes must be taken by governments in Latin America and the Caribbean along a number of initiatives, such as developing capabilities at all levels to adopt a horizontal governance model, to strengthen the consistency of inter-sector and inter-institutional policies for s, to seek approaches to funding and actions that focus on reducing the huge social inequalities within and between the countries in the region.
For three days, the conference discussed Sustainable Development in Latin America and the Caribbean, and the need to invest in the MDGs became evident, as did the need to be less dependent on the traditional cooperation models and for the countries in the region to continue to pressure multilateral agencies. These international agencies must recognize and consider the differences and unique characteristics of the countries in the region In the current scenario of a global movement in defense of universal health coverage, it is not by chance that other sectors cover the area, and the political commitments and strategy to strengthen health institutions around universal access to services and inputs.
It is well known however, that while health includes guaranteed universal access to medical-sanitary care, it is not limited to this. Health policies require concrete actions on the social determinants of health, and firm measures regarding factors that affect the quality of life of populations. To this end, the March forum made recommendations that have had a direct impact and require short and long term changes.
Public health policies are essentially inter-sectoral policies. The international financial crisis of , made worse by a shortage of foods, the energy crisis and global warning, stressed old problems and revealed new challenges of growing intensity and complexity. Today there is not a single nation that can ensure healthcare for all its citizens and face all of its determinants without daring integration across government sectors.
In Brazil, despite the emergence of numerous tragic episodes of corruption and an almost all-encompassing crisis, the perspective of social mobility associated with wealth distribution, job creation and income policies suggest a scenario that is a challenge to the former paradox of economic growth and social development. How to design a healthcare policy that fulfills the values of the Brazilian Constitution and the Organic Health Law in a situation, where a significant portion of the population still lives below the poverty line?
How to ensure good Health and Education policies, internationally considered low politics, as opposed to the security of high politics military spending, when in situations of budget shrinkage it is the former that are cut first? The challenges to build a new horizontal, inclusive and participative governance model require strong and sovereign States.
It is urgent to organize a parliament that is transparent and committed to the sovereignty and quality of life of those it represents. The basic guidelines and overall strategies should originate in the government decision makers. The great debates between the public and private must always focus on reducing inequality, protecting citizen quality of life and promoting sustainable development. Inter-sector and inter-institutional policies involving the environment, migratory flows, trade in general, investments, the generation of jobs and income, education, health, sanitation, agriculture, and urban planning require a State that plays its role as incentivize, service provider and regulator.
Furthermore, a cooperative and supportive private sector and intense and continued involvement of civil society are also required. In fact, limiting the concept to universal coverage does not ensure the right to comprehensive, equal and quality care. Thus, the WHO focuses universality on medical care and the risk of catastrophic spending. The document goes on, stating that: It is not about a fixed minimum package but making progress on several fronts: the range of services that are available to people; the proportion of the costs of those services that are covered; and the proportion of the population that is covered In a version centered on individual and curative attention, rather than on collective attention and public health, the World Health Organization over-stresses individual care.
Therefore, while recognizing the importance of this component to comprehensive care, we must insist on the matter of public health, in particular in its regulatory function, which the document in question appears to explicitly avoid, given that it is in this function of public care where there are conflicts with other United Nations agencies such as the WTO, in particular regarding pharmaceutical patents, and the TRIPS agreement Trade-Related Aspects of Intellectual Property Rights , known to inhibit universal access to drugs and other critical health inputs.
It is in the face of this reality and with these challenges and tensions that a global agenda, common for all, would be extremely appropriate and translate into an invitation to defend life. To Dr. El futuro que queremos. The Red-Dead Canal, as envisioned by Jordan, is a kilometre, partially covered pipeline across Wadi Araba — a dry plateau stretching from the Gulf of Aqaba in the south to the Dead Sea in the north. It would carry around 1. Not only would the three-party project Jordan-Israel-the Palestinians restore most of the Dead Sea water level over time, it would generate hydroelectricity to power large desalination plants, relieving chronic fresh water shortages and helping to meet energy needs.
In addition to Dr. Majali, the former leaders of Canada, Colombia, Cyprus, New Zealand and Singapore are contributors to the wide-ranging book launched in the UK by the InterAction Council IAC , a year-old association created to pool the expertise of former world leaders and to speak out on issues of vital importance to the world community and current leaders alike. Axworthy, the new book offers authoritative views on topics ranging from the Middle East and denuclearization of Korea to the water crisis and the future of energy.
As it crosses the warm Pacific, that atmospheric river fills with water vapour.
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We now surmise that some 42 atmospheric rivers deluged California between and Research is now being conducted to determine if an atmospheric river played a role in initiating the largest single natural disaster in the history of the Canadian province of Alberta in June, This game change is not going to go away. At a recent international conference in Canada, it was demonstrated that many of our recent floods were similar in a number of ways. Each involved rotating low pressure systems that remained in the same place for an unusual period of time bringing continuous precipitation up from the south, resulting in long duration, heavy rainfall events that covered very large areas.
Researchers are also examining other anomalies. The behaviour of the storms suggests that its precipitation may have been generated by processes of raindrop formation more typical of the tropical region where the storms originated, than local temperate conditions.