IN THE SPOTLIGHT: column by Pietro Dionisio

As part of the research project PEAH (Policies for Equitable Access to Health),this column turns the spotlight on health access burning issues from a governance and trade perspective involving policies, strategies and practices 

Pietro’s Corner

Dementia in Elderly People: an European Priority Non Ruled by a Communitarian Strategy

The world’s population is rapidly ageing and the number of people suffering from non-communicable diseases (NCDs), and dementia in particular, is increasing thus producing an ever more stress on public budgets and policies.

Despite good intentions and the financing of programmes such as Horizon 2020 and the “Third Health Programme”, Europe (28) has not yet implemented a common “European Dementia Strategy”. Each member states still have great discretion for the design of policies and strategies thus causing relevant discrepancies in the way the disease is addressed, sometimes even among regions in the same Country. A major effort and political will is needed from EU institutions to properly tackle dementia and provide a common European plan to address a disease that does not just reduce people quality of life but represents a relevant economic burden for member states

Haiti Healthcare Sector: Hard Recovery From Disastrous Years

The current Government in Haiti seems unable, owing to political instability, natural disasters and funds mismanagement, to address the high rate of communicable diseases such as HIV-AIDS, cholera and tuberculosis, as well as to improve the primary healthcare sector and achieve Universal Health Coverage. A more accurate management of financial and human resources bound-up with a higher public investment in the health sector could help overcome the impasse 

Uganda: the Big Challenge of Maternal and Child Health

Uganda has made progress towards improving health of children, newborns, adolescent boys and girls, women and men in the country. However, Uganda  still ranks among the top 10 countries in the world with high maternal, newborn and child mortality rates. Many policies have been implemented over the last 20 years trying to improve maternal and child health. The related health indicators are progressing but there is still much to do

The alarming collapse of the Venezuelan healthcare system

The healthcare situation in Venezuela has  worsened. In the first three months of 2018 a decay of all indices has been registered, and the forecasts are dismal for the future. Hospitals lack basic staff and people suffer malnutrition. The country is facing the re-emergence of diseases such as malaria and tuberculosis considered “under control”. How many people have to die before the trend will be reversed?

The Uncertain Status of UHC and the Latent Balance of the Social-Justice Approach to Health

Universal Health Coverage (UHC) is a human right deeply rooted in the social-justice approach to health. Unfortunately, in several Low and Middle Income Countries (LMICs) it is still a mirage at a time when its achievement is not obvious in the High Income Countries (HICs) either. As such, UHC rests on everyday fight with uncertain results

Brazil Crippled by Corruption

Brazil is paralyzed by corruption. The fight against it is expensive and the Country doesn’t seem able to win the battle since many political exponents are involved in corruption. Bribery is at all levels and in all areas, but is particularly damaging the health sector. The anti-corruption program is a valuable instrument but the effects on health are conflicting

The Venezuelan Powder Keg Floods in the Neighboring Countries

As the country is running downhill day by day, Venezuelans are migrating searching salvation and healthcare necessities in neighboring countries, such as Brazil and Colombia. This diaspora  is causing rising tension in the region because of the inability of those countries to face the migrants’ requests due to their political fragility

Unsung heroes: Community Health Worker lessons in Sierra Leone post-Ebola

Community Health Workers (CHWs) are a critical component of the health workforce in low-resource settings, but they do not get – at least for now – due recognition in many of these settings. After the Ebola outbreak in Sierra Leone, the government laid the foundation to formalize and concretely recognize the work of CHWs. Could this revised plan be used as a “best practice” template which could be scaled up and transferred to other countries of the African region? 

Taking a Pill: Not So Counted On in South Africa

Despite noteworthy improvements in its public health system, South Africa is still facing huge problems in fighting diseases such as TB  and HIV/AIDS. Among several reasons, the poor patient adherence to medical prescription stands out.  Though the Government is trying to address the issue, the desirable results still lag behind. Future years look brighter than today’s, but additional efforts are required to pull the final goal off

2016: One of the worst years ever for the Venezuelan Health sector

A dramatic 2016 is finally over. In Venezuela, the year brought with it sinking health and social indicators, and 2017 does not bode well either. Previously-eradicated diseases such as malaria and diphtheria have resurfaced. Maternal and pediatric healthcare services are steadily collapsing, and malnourishment among children is on the rise. The Maduro administration is trying to mask numbers, but leaked media reports have made public a real humanitarian crisis

Kenya in a Bad Shape about Open Defecation Free Goal 

Even though the national law establishes the right to “reasonable standards of sanitation”, some Kenyan people are denied them. Especially in rural areas, the worst-off people face poor living conditions due to open defecation. The Government is implementing a four year strategy to fight against this scourge, but corruption, misappropriation and mismanagement risk to frustrate the efforts

The US presidential: Threatening future to health

The Affordable Care Act (“Obamacare”) was implemented in 2010 by the Obama administration. Since then the number of insured people has increased by 20 million individuals bringing down the uninsured rate by 43 percent compared to 2010. The incoming Presidential election endangers the reform. Mr. Trump, the Republican candidate, and Mrs. Clinton, the Democratic candidate, view health differently and this threatens to undermine what has been achieved up to now. What future awaits US healthcare?

International Pressure on India’s Drug Industry: the Hide-and-Seek Game of Modi’s Administration

India’s pharmaceutical industry is among the biggest ones in the world and plays a major role in the market especially for less developed countries. Regulatory warnings and bans on Indian drug factories for failing manufacturing standards are hitting the sector since several years. The government is making a political move to accomplish with international blames but how much concrete the change will be still remains unclear

The shortage of medicines in Venezuela is a humanitarian crisis

Venezuela is a powder keg. A major objective of the Chavez government after the Bolivarian revolution was to improve healthcare for the Venezuelan people, and they built thousands of new clinics, hospitals, and diagnostic centres across the country. But now there is a grave risk that all this progress will vanish and those living in poverty will suffer more than anyone else

Something is moving in Mexico! Steps towards Universal Health Coverage

“Seguro Popular” has improved healthcare in Mexico providing health coverage to millions of Mexicans. Since 2003/2004 noteworthy achievements have been reached. Unfortunately, many challenges are still at stage. The healthcare system is still too fragmented forcing individuals to face unbelievable out of pocket payments. Since the last June the Government has implemented a new regulation aiming at promoting further cooperation between the various Mexican healthcare service providers. Will this be sufficient to improve access to services and their quality?

Rio de Janeiro Olympic Games: Mixed Blessing in Badly Running Country

At a time when the Olympic Games in Brazil are in the offing, the Country appears not to be ready since its economy and political situation are disastrous. All over the Country, the public health system does not work owing to a shortfall in the relevant budget sector allocations. Though the removal of President Dilma Roussef and the establishment of a new government can be a solution, every measure must be taken quickly since the press on the population is heavier than ever

Gaza Strip: the Press of War on People’s Health

The last war in the Gaza Strip has left many people in bad conditions. Their health, food, home security and living conditions as a whole got worse in the last year. The situation is unbearable and cannot improve without Israel pressure relief combined with not hypocrite help by the international system

China’s Pharmaceutical Sector and the IP Puzzle

Despite impressive growth, the pharmaceutical sector in China still relies on generic drug production since the majority of domestic companies cannot compete with country-based foreign corporations. Currently, following WTO pressure to oblige China to comply with IP regulations, more and more patented drugs are entering the market. Unfortunately, in spite of a newly introduced IP friendly bill, a puzzling situation persists

Illegal Migrant Status and the Littleness of the European Health System

Values such as respect for human rights, human dignity and equality are at the heart of European Union (EU) mission. Yet, even a patchy survey shows that the healthcare system built to assist illegal immigrants does not couple with these concepts since each country gets its own system. Owing to the lack of a shared agenda, across the board improvement perspectives still lie beyond the EU grasp

India and the issue of open defecation: An ongoing battle

The issue of open defecation persists in India leaving millions vulnerable to disease. Is India’s Swacch Bharat Abhiyan (SBA) or Clean India Mission the solution to this deeply entrenched social and structural issue?

Links: February 2016 Meetings

Secondhand Smoke in Lawless Japan

Japan has the highest life expectancy worldwide but its leadership could come to an end since the country ranks third for smoking rate in Asia and the lack of strong legislation on passive smoking puts lots of people at health risk. The 2020 Olympic and Paralympic games are giving an impetus to the relevant debate and more fitting regulations could be ready by 2019

Female Genital Mutilation (FGM) is a worldwide plague affecting 29 countries at least. In Africa it is ingrained in the society. Nigeria's Government outlawed it in May 2015, but doubts remain whether this will actually improve on Nigerian women's conditions and refresh the African debate on FGM

A causa dei cambiamenti climatici la nostra salute è messa in pericolo ogni giorno. Un'aria satura di gas nocivi e fenomeni atmosferici sempre più imprevedibili e violenti danneggiano noi e l'ambiente in cui viviamo. Il recente Accordo COP21 siglato a Parigi lo scorso 12 Dicembre è un primo passo volto a ridurre l'emissione di gas effetto serra e quindi la presenza di quei fenomeni che ne sono diretta conseguenza. Ma, l’Accordo è davvero un impegno concreto da parte degli Stati? O la discrezionalità di questi ultimi ancora prevale?

South Africa's achievements towards a National Health Insurance (NHI) whole country system implementation need strengthening now that only 17 per cent of the population can access well sourced private health services, whereas most people have to rely on understaffed and overstretched public facilities. A refined NHI- related white paper, reportedly close to presentation to Cabinet for approval could be a milestone for all South Africans’ non-discriminatory access to health

Il libero accesso a fonti di acqua potabile e ad idonei servizi igienici è un diritto universale. Sfortunatamente, la realtà che riscontriamo ci racconta una storia diversa. Milioni di persone muoiono ogni anno per le difficoltà che alcuni Governi riscontrano nel garantire tale diritto. Il Kenya è fra questi. Molto è stato fatto da questo Governo, ma maggiori sforzi devono essere profusi

The path to Universal Health Coverage (UHC) is difficult for any country, but especially so for one such as India – a country struggling to provide even basic, essential care to its people; a  country where, even as UHC is exhibited as being a top priority, it risks being just a mirage

China has made good progress in universal health coverage (UHC) over the past decade, with a significant increase in health care utilization especially for the poor. However, a number of challenges still exist, including how to close the gaps in service coverage between people settled in urban and rural areas. Though substantial results have been achieved by implementation plans, additional efforts are required for the rural health sector

Farmaci Contraffatti: Una Piaga Africana

Ogni anno, circa 800.000 persone muoiono nel mondo per aver utilizzato farmaci contraffatti. Molte di queste vittime sono Africani. A causa di governi corrotti, un tessuto sociale instabile e una povertà dilagante, queste persone sono sempre più frequentemente preda di questo mercato. Purtroppo, il fenomeno è sempre più in espansione a causa di una debole volontà politica e di forti interessi contrastanti

Universal Health Coverage, Millennium Development Goals and Post-2015: The Improvable Way Forward

The negotiating process to achieve post-2015 development goals has clarified the agenda that governments ought to follow until 2030. Unfortunately, due to vague terms and the lack of unequivocal definitions, a number of relevant issues still lie in uncertainty

The reasons Behind the Flop of Alma-Ata Principles

The Alma-Ata Declaration was endorsed by the 32nd World Health Assembly held in Geneva in 1979, which approved a resolution acknowledging the key role of primary health care (PHC) for the attainment of  acceptable health levels for all. However, despite the initial enthusiasm, it was difficult to implement healthcare in accordance with Alma-Ata principles.This article turns the spotlight on the relevant reasons

China-Africa Agricultural Cooperation: for the Sake of Whom?

Despite the relevant Chinese commitment in Africa, concern still remains about the actual Chinese efforts, but also about the effectiveness of the Chinese agricultural projects in Africa. These weak points are strengthened by the fact that regional stakeholders often complain about the lack of coordination and governance of the projects financed by China all over Africa. In addition, even if investment in agriculture seems to be intended to solve Africa's hunger issues, many still view China as engaged in a self-interested, exploitative grab for resources to feed its fast-paced growth