Friday 2 December 2022
Sunday 18 March 2018
Big Tobacco is funding the anti-smoking lobby – but leaked documents reveal the real reason why
Interesting article by Andrew Rowell on how the big tobacco companies undermine the struggle to make the world free from ciggarate smoking. The article published in "The Conversation" provides the inside story on the tricks used by lobby organizations to reach their goals. Reacting to the article, Travs Bowditch gives an example that , a virus aims at replicating but harms the human being on the way, so are tobacco industries that aim at making profits but harm human beings on the process, thus eliminating the virus or the tobbaco campanies may be the ultimate solution but it is not easy.
Friday 9 October 2015
Universal health coverage and election manifestos: Insights from the upcoming general elections in Tanzania
Progress towards achieving Universal Health Coverage
(UHC) has been slow in many low income countries, especially in Sub-Saharan
Africa (SSA). In these settings, poor communities continue to suffer from
financial hardship due to catastrophic health expenditures and many people succumb
to morbidity and premature death as a result of poor quality health services. It’s
clear, however, that there could be much more progress if relevant stakeholders
such as governments, civil society organizations, development partners and citizens expressed themselves forcefully and
publicly on the need to (further) design and implement UHC policies. The
priorities set in election manifestos and related campaign pledges could serve
as litmus test for (meaningful) commitment to UHC policies of political parties
in Tanzania, including the incumbent party. The increasing engagement
of the young in political campaigns in SSA already
sparks more discussion on UHC, among others thanks to the social media which
help ignite the UHC fire, but a lot more is needed. Hopefully the young can
also push SSA (and Tanzanian) politicians to kickstart implementation of the Sustainable Development
Goals (SDGs).
As Tanzania prepares for general elections scheduled later this month (25th
October), some insights on how the UHC-agenda features (or does not feature) in
party manifestos will give you a clearer idea on current UHC developments and
support in Tanzania.
But first things first, what does the political
constellation in Tanzania look like for the moment? Recently, four political
parties joined forces as an opposition coalition, the “Coalition
of Peoples Constitution” (UKAWA)
led
by the Chama
cha Demokrasia na Maendeleo (CHADEMA). A new party, ACT-wazalendo,
saw the light in 2014. They face the ruling
party - Chama
Cha Mapinduzi (CCM) – in this election. In addition to
UKAWA, CCM and ACT-wazalendo, four other parties will also participate in this
year’s election. UKAWA is the main challenger of CCM, though,
in this contest, and ACT-wazalendo perhaps an outsider.
Regardless of the outcome of the (tough) political
battle later this month, what would be the (likely) implications for the design
and implementation of UHC policies in Tanzania – i.e. in terms of covering the
whole population (health for all), providing financial protection and ensuring access
to quality health services. Would they add value to the ongoing efforts to
develop a new health
financing strategy for UHC in Tanzania, if in power? As stated above, key steps in this respect for
the political parties are (1) to include UHC as a priority in their election
manifesto (and subsequent campaign pledges) and (2) later on implement their
pledges, as pledges without follow-up are just empty promises.
When you go through the manifestos, you notice quite
some pledges promising to set up or boost existing prepayment mechanisms (health
insurance) - see the respective manifestos of CCM,
UKAWA
and ACT
–wazalendo. CCM pledges to look for feasible ways to
strengthen the available prepayment mechanisms, the formal sector’s health
insurance through the National Health Insurance Fund ( NHIF ) and the
informal sector’s Community
Health Funds (CHFs). They are however not very explicit
on how this is going to happen, unfortunately, especially given the failure to reach
30% enrollment in health insurance as per targets of their 2010 election
manifesto. The UKAWA coalition recognizes the massive problem of catastrophic
health expenditures resulting from out-of-pocket payments and pledges to
establish a public health insurance system. Their promise however also fails to
provide a clear picture on how this will happen. Their manifesto doesn’t
provide concrete steps to tackle the current fragmentation of the health
financing system (which relies way too much on out-of-pocket spending). The
ACT-wazalendo manifesto plans to revisit the NHIF
law (which
made health
insurance for public servants mandatory), expanding coverage;
however, a detailed account on the modus operandi is missing as well.
All key parties in this election promise to
strengthen curative health care services, more in particular by making sure
that health facilities are close to the people. CCM, for example, promises to
construct a health facility in every village in the country! Investments will go to ensuring availability of
medicines, diagnostic equipment and training of health care workers. All
parties touch on maternal and child health services but none of the manifestos prioritize
non-communicable diseases. Prevention of diseases and promotion of healthy
lifestyles is not a focus of the manifestos and ongoing campaign rallies. CCM
only emphasizes malaria (distribution of insecticide-treated mosquito nets) and
HIV/AIDs (prevention of mother to child transmission in particular) but does
not really talk about other diseases or steps to foster health promotion. UKAWA
and ACT-wazalendo touch on health promotion, but only ACT-wazalendo puts an explicit
focus on prevention, without going much into detail though.
Despite the inclusion of some important aspects of
UHC policies in manifestos, significant gaps persist. The most obvious gap is
that none of the manifestos feature a concrete pledge to increase the budget in
order to fund the UHC package properly - even the Abuja
declaration target is not mentioned. Since 2010, the
total
health expenditure in Tanzania has remained at approximately 7%
of the gross domestic product (GDP). Only ACT-wazalendo points out that they
will “ring fence” the health care budget, if in power. Moreover, it is not clear
whether some of the stated declarations will actually be converted into law(s)
to foster UHC once they are elected. Only ACT- wazalendo clearly states that they
will revisit the NHIF act. Furthermore, none of the manifestos explain how the
pledges will be reached given the lack of year to year approximate costing of
their pledges, and only UKAWA pledges to
strengthen health systems research in the country to guide implementation of
the UHC policies.
There’s already quite some research
on moving towards UHC in Tanzania that could guide inclusion
of UHC policies in election manifestos. For example, modelling by Borghi
et al emphasized: “Universal coverage would require an
initial doubling in the proportion of GDP going to the public health system.
Government health expenditure would increase to 18% of total government
expenditure”. Furthermore,
lessons from similar countries that have made substantial UHC progress in
recent years and decades stress the important role of political
push factors emanating from the citizens ( the young
demographic especially), civil society, think tanks and lobby organizations –
these lessons could serve as a guide for any party that wishes to implement UHC
policies, surfing on a UHC movement.
Nevertheless, the inclusion of key elements of UHC
policies in the election manifestos is progress. Implementation of the pledges
will be important, though, and a catalyst for wider stakeholder engagement in
this agenda, in particular from civil society,
researchers and lobby organizations that support the UHC agenda in
Tanzania.
We still have a couple of weeks to make that case.
This article is also available at International health policies (IHP) blog as a guest editorial
Thursday 23 July 2015
Tribute to Joep Lange's contribution to HIV research and treatment
 |
| Joep Lange during a conference on HIV/AIDS Photo: AFP PHOTO JEAN AYISSI |
A memorial address was held at #IAS2015 "Joep Lange Tribute - One Year Later" to carry his legacy forward.
Tuesday 6 January 2015
Personal reflection from the ``Berlin Patient ``
Timothy Ray Brown known as the ``Berlin Patient``, speaks out about his 12 years lived experiences with HIV infection. Having been cured from HIV infection in 2007 after receiving a stem cell transplant, he writes a personal reflection on experiences of living with the infection and the difficulty road to cure of his infection. He writes an article ``I am the Berlin Patient : A personal reflection ``,published in AIDS Research and Human Retroviruses, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.
Saturday 6 December 2014
Wateraid in Tanzania: The babies who die for want of clean water
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Mothers and children wait at a postnatal clinic held at the Mlali Health Centre, Tanzania Photo: Eliza Deacon
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Tuesday 2 December 2014
And the band played on.....going to the roots of discovery of HIV/AIDS
Yesterday was first of December, and
it was the World AIDS day. It was a day to reflect on
what so far has been done in fighting the HIV/AIDS pandemic. This
year's theme is "Focus, Partner, Achieve: An
AIDS-free Generation." The world was talking and is continuing to talk on
social media about the day using the hashtag #WAD2014. To
commemorate this day, I watched a movie that describes the way the HIV virus was
discovered and the whole multilayer story around reactions of the
scientific community, the gay community, the politicians and the general public
to this epidemic.
The movie presents the early years
of AIDS crisis in the US. It describes the initial efforts of the scientists at
the center for Disease control (CDC) in Atlanta to identify the cause, mode of
transmission and methods of fighting the epidemic. It presents the battles of
two scientists at CDC;Dr. Don Francis, the young lead investigator, and his
boss, Dr. Jim Curran. A second facet of the story centers on the gay
community in San Francisco, and the balancing act gay advocates and public
health officials in the city have to do to protect the gay population from what
is largely seen initially as a gay disease, yet not further stigmatize and
suppress an already largely stigmatized and suppressed gay population in the
US. A third facet of the story centers on the work by academics to identify
what many believe is a retrovirus cause of the disease.
Finally, the film deals with the
rivalry between Dr. Robert Gallo, the American virologist who previously
discovered the first retrovirus and his French counterpart at the Pasteur Institute,
Dr. Luc Montagnier, that led to disputed claims about who was first to identify
the AIDS virus. Through these three facets, personal stories of individual AIDS
victims are presented, at that early stage where there mortality rate was 100%
From the roots of the virus
(1981) to Getting to Zero ( 2013) to "Focus, Partner, Achieve:
An AIDS-free Generation ( 2014) , we might be going to the point when HIV
infection will be a history just like small pox. This needs all the actors in
the fight of the pandemic to have the same understanding on
what ’’AIDS-free generation'' means.
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