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Public-Private Partnerships
in Health, Policy and Management

Fall/Winter Newsletter
Devember, 2004

In this edition:

Message from the President

Washington, DC, Around Town

  • Society for International Development - Washington (SID-W) Conference
  • Million Lives Saved: Proven Successes in Global Health (CGD)
  • An Evening in Celebration and Conversation on New Partnership for Africa's Development (NEPAD)
  • Ambassador John C. Danforth, US Permanent Representative to the United Nations receives Award for Distinction in the Conduct of Diplomacy
  • Center for Strategic and International Studies (CSIS) and the Washington Africa Ambassadorial Corps Launch World AIDS Day: Reaching Women and Girls

Pan American Health Organization (PAHO) 45th Directing Council

The Legal Importance of Healthcare, Human Rights and HIV/AIDS


Message from the President

The 2004 year has brought many challenges for the world, our countries, our colleagues and families. Yet through it all we hold these truths: Humanity allows us hope for another day, peace allows us to hope to prosper, and family allows us hope for love. May our new year bring us humanity, hope and love.\

Washington, DC Around Town (attended by ACI Staff)

Society for International Development - Washington (SID-W) Annual Conference on Effective Economic Growth for People

On 1 December, World AIDS Day, the SID-W Conference opened with welcoming remarks from Enrique Iglesias, President, SID International and President of the Inter-American Development Bank. The highlights of the conference included: The commentary by Asil Shaikh, President of SID-W and President and CEO of the International Resource Group. The opening session by Sebastian Mallaby of the Washington Post and the author of The World's Banker (The story of the World Bank President James Wolfensohn), and the keynote address by Andrew Natsios, Administrator, US Agency for International Development. The afternoon's session included a talk on effectiveness on policy reform by Ajay Chibber, Director, World Bank-OED. Panel discussions were moderated by Janet Ballantyne of ABT Associates, Inc., Yolonda Richardson, JD, MPH, President of CEDPA, Aaron Williams of RTI International and Ronald Ivey of Chemonics International. The Speakers for the panel discussions included Ambassador Edwardo Ferrero, Ambassador of Peru to the US, Ambassador Amadou Ba, Ambassador of Senegal to the US, Dirk Dijkerman and Cynthia Watson both of the National War College, Melinda Kimble of the United Nations Foundation, and Alan P. Larson, Under Secretary for Economic, Business and Agricultural Affairs, US Department of State.

The Society of International Development (SID) was founded in Washington, DC in 1957, and is a global forum of individuals and institutions concerned with sustainable economic, social and political development. SID has members in 125 countries. SID's international Secretariat is in Rome, Italy. For more information see www.sidw.org.

An Evening in Celebration and Conversation on New Partnership for Africa's Development (NEPAD)

The Leon H. Sullivan Foundation was the gracious hosts of an evening to celebrate "the leaders of the African Diaspora and recognize once again that Africa is truly a Continent of possibilities" stated Hope L. Sullivan, the President and CEO of the Leon H. Sullivan Foundation (LHSF) as she welcomed all on 2 December 2004.

The evening of celebration and Conversation on New Partnership for Africa's Development (NEPAD) was a unique unscripted discussion by World leaders that included the Honorable Andrew Young, the Chairman of the LHSF, His Excellency Olusegun Obasanjo, President of the Federal Republic of Nigeria, and the Chairman of the African Union; James Wolfensohn, President of the World Bank Group and Joe Clark, Former Prime Minister of Canada. A special video message was sent from President Bill Clinton, who was unable to attend due to recent surgery.

"When in the presence of great leasers, we are duty bound to just listen… as we listen in while these great architects of history discuss the issues of today, I hope you will leave feeling energized, encouraged and optimistic about the future. I am certain you will leave knowing you have witnessed something very special" stated Hope Sullivan.

"Nigerian President Olusegun Obasanjo, South African President Thabo Mbeki and Algerian President Abdelaziz Bouteflika initiated the concept of a special effort to promote African progress in the 21sr century." Later, Senegalese President Abdoulaye Wade joined and together they created the New Partnership for Africa's Development (NEPAD). "NEPAD was established as a program of the African Union to address some of the most serious problems facing Africans today: continuing deep poverty, lack of consistently sustainable growth, the continents marginalization in the globalization process and the remaining obstacles of the empowerment of women."

For more information go to www.leonsullivanfoundation.org

Ambassador John C. Danforth, US Permanent Representative to the United Nations receives the 2004 Jit Trainor Award for Distinction in the Conduct of Diplomacy

Ambassador John C. Danforth, US Permanent Representative to the United Nations, who announced his resignation just four days earlier, on December 6th accepted the annual Jit Trainor Award for Distinction in the Conduct of Diplomacy, presented by the Institute for the Study of Diplomacy in the Walsh School of Foreign Service at Georgetown University. Ambassador Danforth spoke on 'Multilateralism and the United Nations.'

Ambassador Danforth has had a long career in public service. Before he became U.S. Permanent Representative to the United Nations last summer, he has been Special Envoy for Peace to Sudan, representing the U.S. government in peace talks to help settle the seventeen-year old civil war between northern and southern Sudanese.

These assignments followed three terms in the U.S. Senate, where Danforth represented the State of Missouri form 1976 to 1994. A fifth generation Missourian, Ambassador Danforth graduated with honors from Princeton and later received a Bachelor of Divinity degree from Yale Divinity School and a Bachelor of Laws degree from Yale Law School. Before seeking public office and after he left the Senate, he practiced law. As an ordained clergyman, he officiated at the funeral of former President Reagan at the National Cathedral earlier this year.

Past recipients of the Jit Trainor award include Secretary General Amre Moussa, His Excellency Kofi Annan, General Wesley K. Clark, Honorable Lakhdar Brahimi, and James D. Wolfensohn, on behalf for the World Bank Group.

Million Lives Saved: Proven Successes in Global Health

The Center for Global Development launched Million Lives Saved: Proven Successes in Global Health on 7 December.

"Mothers no longer worry about their children contracting polio. Vast regions of Africa are now habitable because river blindness is under control. In Thailand, a health initiative successfully headed off what seemed destined to be a massive AIDS epidemic. And in Sri Lanka, women can now give birth without fear of dying. From the elimination of measles in Southern Africa, to the reduction of child diarrheal death in Egypt, these successes are among the seventeen large-scale, successful health interventions documented in Million Lives Saved: Proven Successes in Global Health a new book from the Center for Global Development (CGD). Those launching the book included, Nancy Birdsall, President of CGD, Sir George Alleyne, Former Director of the Pan American Organization (PAHO), Ruth Levine, Senior Fellow and Director of Programs, CGD, Dr. Boakye Boatin, Manager, ARV Program, World Health Organization, and Former Director, Onchocerciasis Control Program, Allen Moore, Deputy Chief of Staff and Policy Director, Office of Senator Bill Frist, Dr. Rajiv J Shah, Deputy Director for Policy and Finance, Bill and Melinda Gates Foundation, and Jackie Judd, the moderator, Vice President and Senior Advisor of Communications for the Kaiser Family Foundation.

The Center for Global Development is an independent, non-partisan, non-profit think tank dedicated to reducing global poverty and inequity through policy orientated research and engagement with the policy community and the public. (www.cgdev.org).

Center for Strategic and International Studies and the Washington Africa Ambassadorial Corps Launch World AIDS Day: Reaching Women and Girls

The Center for Strategic and International Studies (CSIS) and the Washington Africa Ambassadorial Corps Launch World AIDS Day: Reaching Women and Girls on 30 November.

HIV/AIDS in Women and Girls

  • Of the 37.3 million adults (15-49) half are female
  • Sub-Sahara Africa 60% of infected persons are female
  • Every day 6000 young people (15-24) become infected, of these 4000 are female
  • In some African settings, girls have HIV rates 6 times higher than boys
  • Women bare the greatest burden of caring for family members with HIV/AIDS
  • Women often have limited access to treatment
  • HIV+ women are 2.68 times more likely to experience violence
  • Globally 2.2 million children under 15 years are HIV positive
  • In 2003, more than 15 million children under 18 have lost at lease one parent to AIDS

In recognition of World AIDS Day: Reaching Women and Girls, the welcoming remarks were made by Ambassador Mary M. Kanya, Embassy of the Kingdom of Swaziland and J. Stephen Morrison, Executive Director, CSIS Task Force on HIV/AIDS, and Director, CSIS Africa Program. The Panel Discussion was moderated by Janet Fleischmann, Chair of the Gender Committee, CSIS. Presenters included Ambassador Lapologang Lekoa, embassy of the Republic of Botswana, Constance Carrino, Director of HIV/AIDS programs, U.S. Agency for International Development, spoke about the President's Emergency Plan for AIDS Relief (PEPAR) and Gender; Jen Kates, Director of HIV/AIDS Policy, Henry J. Kaiser Family Foundation talked about Prevention Strategies, Phillip Nieburg, Senior Associate, CSIS Task Force on HIV/AIDS talked about Routine Testing: Special Risks for Women and Girls, and Michelle Gavin, Office of Senator Russ Feingold presented a Congressional Perspective.

The Center for Strategic and International Studies (CSIS) is an independent, nonpartisan public policy research organization based in Washington, DC. (www.csis.org)

Pan American Health Organization (PAHO) 45th Directing Council Attended By Representative of the International Council of Women

The ministers of health of all the countries of the Americas (Latin America, Canada, Caribbean and the US) gathered for the annual meeting of the Directing Council of the Pan American Health Organization (PAHO). The meeting was from 27 September to 1 October 2004. The International Council of Women was represented by Dr. Ariel R. King, the UN Representative for Washington, DC and Geneva.

PAHO serves as the Regional Office for the Americas of the World Health Organization and has been working for over 100 years with all the countries of the Americas to improve health and raise the living standards of their peoples. PAHO, established in 1902, today includes all 35 member states in the Americas. France, the United Kingdom, Northern Ireland, and the Netherlands are participating states, while Puerto Rico is an Associate Member, and Portugal and Spain are Observer States. In addition, Inter-Governmental Organizations (IGOs) several Non-Governmental Organizations (NGOs) were invited observers.

The Directing Council, the governing body of PAHO, met to analyze the health situation in the region, to make new policy decisions, and to adopt key resolutions on important public health problems of the region. The sessions were marked by comments by PAHO Director Mirta Roses, U.S. Secretary of Health and Human Services Tommy Thompson, World Health Organization Director-General Jong-Wook Lee and Secretary General of the Organization of American States Miguel Angel Rodriguez.

Dr. Roses stated, "Behind every item on our region's unfinished agenda in health there are real people, real families and real communities with urgent needs. We cannot ignore them or delay our efforts to address their needs."

Primary Health Care and Millennium Development Goals

Member States called for a renewed interest in Primary Health Care. In addition, PAHO held a special commemoration of the 25th Anniversary of the Alma-Ata Declaration from 1978; a commitment to Primary Health Care (PHC) as the essential tool to achieve equity in health; and "health for all" by 2000. Primary Health Care prevention and treatment are essential for accessible and affordable health care for all in the community at all stages of life.

Dr. Mirta Roses stated that "there is a synergy between health and development. Health is a key contributor to development, but it is also influenced by other factors of development, including social and environmental determinants."

The new Secretary General of the Organizations of American States, Miguel Angel Rodriguez, told the ministers of health, that "health is a fundamental human right" and that we can not afford to "remain indifferent to situations such as poverty and underdevelopment in the Americas. In this light, "Haiti deserves special attention because of the pain and suffering of its people."

The Millennium Development Goals are a commitment by the world's countries to improve the quality of life of the poorest populations with core strategies such as investing in health. The Millennium goals include reducing poverty, infant and maternal mortality; combating HIV/AIDS, malaria and other infectious diseases; and access to essential drugs, and safe drinking water by 2015.

Infant and Maternal Mortality
Infant mortality varied in 2003 from 5.3 per 1,000 live births in Canada to 80.3 per 1,000 live births in Haiti. A recent study by PAHO shows that if current trends continue, the region will succeed in reducing child mortality by only 54%, falling short of the 66% stated in the Millennium goals.

Maternal mortality rates vary widely from 16 per 100,000 live births in Cuba to 680 per 100,000 live births in Haiti.

HIV/AIDS and Malaria Secretary
Thompson suggested that PAHO convene annual meetings on AIDS, TB and Malaria to look at ways to redouble efforts and be more efficient in dealing with these diseases.

Director-General Lee said that in addition to generosity, unity is essential for equity. With the "3 by 5" initiative to bring antiretroviral drugs to more people than ever before, the prices have dropped to $140 per year.

Currently 31% of the population resides in potential malaria risk areas and 80% of reported cases originate in nine countries that share the Amazon tropical rainforest in South America.

Access to Essential Drugs
Access to essential drugs has increased throughout the world from 2,100 million people to 4,000 million between 1997 and 2003. The purchase of drugs continues to consume 25% to 60% of household spending. In the Americas only 53% of people with HIV/AIDS who require treatment with antiretroviral drugs have access to these drugs despite a significant drop in the cost of treatment for three consecutive years.

Safe Drinking Water and Sanitation
In Latin America and the Caribbean in 2002, 89% of the population had access to safe drinking water, while 75% had access to adequate basic sanitation. Approximately 59 million people did not have access to safe drinking water and 134 million people lacked adequate basic sanitation.

For more information on these topics go to www.paho.org or www.who.int

The Legal Importance of Healthcare, Human Rights and HIV/AIDS
Shelu Patel*

Human Rights and HIV/AIDS currently have accountings that show that certain basic human rights have been denied to people living with HIV or AIDS status. HIV/AIDS is a litmus test for the enjoyment of human rights, of discovering how a country treats its citizens suffering from HIV/AIDS or those at risk provides an important insight of how a country respects, protects and fulfils the right of the society as a whole. In general HIV positive people are not living longer because of the challenges they face everyday. HIV/AIDS is more than a historic health crisis. Beyond the individual sufferers, the epidemic threatens the very essential part of society, destroying families and livelihoods. The key is to uphold the human rights of the individuals who are living with HIV, or who may be at risk of infections, starting with the basic right to healthcare.

Governments have been slow in fulfilling their obligations to protect, respect and fulfill the human right to health through planning, funding, and implementing programs to provide comprehensive prevention, treatment, and care. Highly effective treatment and prevention regimes exist to contain HIV/AIDS, but while most people living in developed countries have access to these treatments, the vast majority of those living in developing countries do not. Making prevention and treatment regimes available to all human beings is not a matter of charity, but should be a basic right.

International assistance and cooperation are imperatives of human rights as set out in international human rights law. The right to health can be evaluated by understanding the history behind the law and the litigation that accounts for the law. The Universal Declaration of Human Rights set out in 1948 was provided to establish the "rights and freedoms…by progressive measures, national and international…among the peoples of Member States themselves and among the peoples of territories under their jurisdiction." The right to health is given to individuals by article 25, which states that "Everyone has the right to a standard of living adequate for the health and the well-being of himself and of his family, including food, clothing, housing, and medical care and necessary social services…sickness, disability…or other lack of livelihood in circumstances beyond his control." These rights given are only accounted for through litigation, because legally not all of the Member States have signed the document, for establishment purposes. Further, in 1966 the right to health was again established as a human right in the International Covenant on Economic, Social, and Cultural Rights by article 12 where "The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health," specifically, today for HIV/AIDS it can be used for "(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases…(d) The creation of conditions which would assure to all medical service and medical attention." These relevant international instruments are put into place in order to have an indisputable proper power, and provide direction to Member States through their laws, governmental structures, and programs.

People living with AIDS face numerous challenges on a daily basis, in relation to acquiring health care, specifically for HIV/AIDS. Individuals often voice their frustration with a system in an established government system. Generally, the role of litigation starts at the international level in that rights are given through international instruments. Then these instruments can only be accounted for when looking at the policy law within each Member State's legal system.

In addition, the individual HIV/AIDS and human rights cases at the State level provide an example to the international legal community. Sometimes, litigating a challenge does not always prove favorable and can often discourage other people living with HIV/AIDS from not reporting particular issues. This is because people and even the players in the legal system feel that their case will also yield the same results in the same system. However, this is not always the case; previous litigation in HIV/AIDS and human rights should be used as a learning tool and not as a limiting agent. Therefore, it is important to evaluate and learn from litigation that affects the issues of HIV/AIDS, law, and human rights internationally. Issues that reflect upon HIV/AIDS litigation deal with aspects of government legislation, contaminated blood donations, HIV/AIDS testing, employment discrimination, healthcare professional duties, HIV/AIDS prisoners, HIV/AIDS asylum seekers, confidentiality, and other forms of healthcare in respects to human rights worldwide. Protecting the rights of those infected is crucial in fighting the illness; however, it is not a means to an end in the challenges suffered. This is due to the fact that challenges can be instituted into a system, and one can act blindly in such systems. The development of new challenges results in the ever changing global world on a daily basis.

*Shelu Patel is a law student who worked with UNAIDS in Human Rights in Geneva, Switzerland and currently works as a marketing consultant for the Global Defense Institute in San Diego. Contact her at shelu06@hotmail.com

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