4th Conference on Global Health and Vaccination Research

More than 200 participants recently attended the 4th Conference on Global Health and Vaccination Research in Oslo.

by Peris Jones, Siri Bjerkreim Hellevik and Aadne Aasland

The theme for this year’s conference was ‘Meeting the Challenges of the Millennium Development Goals and beyond- Health research and policy’, 30 November to 2 December.

Critical themes

NIBR participated in two sessions, of which the first was a joint symposium organised by NIBR and the Centre for International Health of the University of Bergen addressing new approaches and considerations in prevention of HIV/AIDS. Drawing mainly on material funded through the Norwegian Research Council, several presentations cited critical themes in rethinking prevention: such as the role of culture in local interpretations of illness and disease, and the importance of community participation in design of health research. NIBR’s own presentations highlighted the need to rationalise governance of responses to HIV/AIDS by critically assessing which structures were improving coordination of a crowded aid environment. While some structures were now in place, a success in itself, the challenges of multi-level governance of HIV/AIDS was shown. The importance of strengthening local, district level capacities was also highlighted, but findings also showed mixed results, namely, problems of continuity in financing and also top-down nature of policy setting and structures from national level.

Moralism vs. HIV prevention

An additional NIBR presentation, with colleagues from Russia, highlighted the particularly difficult nature of excluded groups’ (in this case, injecting drug users) access to HIV prevention services. Targeted interventions were being forfeited to avoid confronting moralistic attitudes directed at drug users. Overall the session illustrated a mixed picture of success concerning HIV prevention, and one again, reinforced the critical need for joint multidisciplinary research required to better understand what makes successful prevention more likely to succeed.

Millennium goals

Peris Jones from NIBR participated in the final session that looked at the role of human rights and research in the context of meeting the millennium goals (MDGs). Jones spoke to the central paradox in his recent book, AIDS treatment and Human Rights in Context, to ask why – at the height of rights-based success in getting people access to medical treatment against AIDS – is the treatment era turning out to be less than satisfactorily reciprocal to human rights? This session raised many of the successes of the MDGs, for example, the political momentum generated and also with evidence of some increase in budget (re)allocations to meet the MDGs. But problems associated with the MDGs, not least, quality of the data used to measure them, as well as the need to broaden attention to the national level political and policy implementation were also raised.

The contribution of human rights

The specific contribution of human rights was presented as

• conceptually, to build a more holistic framework of understanding the health related MDGs, and also

• the specific contribution in terms of the role of litigation in furthering health, which although difficult to always achieve, especially for poorer more excluded citizens, did suggest some important outcomes in terms of access to drugs in particular when successful (albeit in mainly middle income countries).

For Peris Jones’ book AIDS Treatment and Human Rights in Context, click here

For more information about NIBR research projects on HIV/AIDS, click here.

For more information on the Global Health and Vaccination Research Programme of the Research Council of Norway, click here.

..

The Waves of Development Aid

Wither Decentralization and Local Government Reform? Back to old local politics and business as usual?

by Siri Bjerkreim Hellevik

Since the mid-90s, a wave of decentralization has swept over countries in the South. Being part of the good governance approach of multilateral and bilateral donors, most decentralization reforms have included transfering decision-making authorities to elected government bodies at the local level, establishing new forums of popular participation at the local level, and transfering responsibilities for service delivery to local government. All these measures were to contribute to improved democratization of countries, in many cases implying the transformation of local politics.

Research from different cases have shown the challenges to this transformation at the local level and in central-local relations, but studies have also demonstrated some pockets of success, in facilitating increased popular participation and improved service delivery (Kerala, Porto Allegre, Ceara). Having been involved in decentralization reforms for several years, bilateral and multilateral donors have given remarkably little attention to the overall agenda of decentralization and the role of local government in recent years, a paradox given that now, after some years of experience with decentralization and local government activity, we would be able to assess at least some of the results on the ground. Are we moving into sector-based attention to decentralization and local government among bilateral and multiateral donors (with focus on SWAPs, basket fund modalities, etc) or are we seeing a ‘decentralization fatigue’ due to the expected results not materializing on the ground?

Stay tuned for more reflections in the weeks to come by NIBR researchers, based on the extensive research NIBR has conducted over the last decade in decentralization and local government in the South.

City Council building, Dar es Salaam, Tanzania (photo: Berit Aasen)

New Book from NIBR Researcher

Jones, Peris S: AIDS Treatment and Human Rights in Context (2009, Palgrave Macmillan: New York)

The global AIDS epidemic has challenged states and societies in profound ways. The era of treatment now represents the hopes of millions of people living with HIV/AIDS. But it also poses significant challenges. How treatment programs interact with the underlying context of the epidemic and human rights approaches that define global responses is a critical area for enquiry. In this important book, Jones looks at the difficulties in delivering treatment in a political, cultural and socio-economic context. Why, for example, might people not necessarily want to take antiretroviral treatment? AIDS Treatment and Human Rights in Context explores some of these paradoxes in a case study from a local community setting in South Africa.

Challenging and thought-provoking, this deeply reflective text considers the conceptual and practical issues in the long struggle for AIDS treatment. From a human rights vantage point, this exploration of the personal, economic, social, cultural and political dimensions of access to AIDS treatment in South Africa offers important insights useful to all country contexts.”

– Sofia Gruskin, Director of the Program on International Health and Human Rights, Harvard School of Public Health

An important book. Jones skillfully argues that treatment is replete with paradoxes for both treatment programs and human rights. In South Africa, where his case study is located, ARV rollout has been hotly contested. This is an intriguing and thought provoking book.”

– Professor Alan Whiteside, Director of Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban

For more information on Peris Jones’ book AIDS Treatment and Human Rights in Context, click here