Suchergebnisse

In passing resolutions on HIV/AIDS, Ebola and COVID-19, the Security Council has shown at least a passing interest in health, and calls have been made to give it a more central role in global disease response. In this contribution, reflecting on two decades of the UNSC's engagement with health emergencies, I suggest we should be cautious about making the Security Council too central to pandemic response. I focus on three problems with the Council: that it is highly politicised and deeply divided in ways that mean it cannot be relied on to act when needed most; that when it does act it tends to do so too late, once an emerging problem has already become a global crisis; and that it does not in any case necessarily have the tools at its disposal to make a meaningful contribution. Instead, I argue, it is precisely its role as a 'health outsider' that enables the UNSC to occasionally make a contribution. It would be risky indeed to hand such a body real responsibility for crisis response. That is a task much more likely to be performed assiduously (if often imperfectly) by a body such as the WHO.

Since 2000, health issues have increasingly been discussed at the UN Security Council (UNSC) without consensus being built on how and when the Council address health topics, or on its role in global health governance. As the contributions in this issue show, high-profile infectious disease outbreaks as well as the disruption of healthcare delivery and assistance in conflict settings have driven the health agenda at UNSC debates, but that agenda has remained ad hoc. Health topics seem most likely to be put on the agenda when the P5 perceive a particular health issue as a threat to international peace and security, or when the social and economic consequences of a health crisis potentially destabilise countries or regions. That raises another political question, however: under what circumstances are they likely to perceive health issues in those terms, and whose interests are being prioritised in such a determination?

This paper uses a graph-theoretical approach to investigate the properties of the observed network of disease transmission in the 2001 foot-and-mouth epidemic in the United Kingdom. This analysis revealed both global and local heterogeneity in the contact pattern between the infected premises in the first 3 weeks of the disease. In particular, the global heterogeneity contributed to the failure of the culling strategy imposed by the UK government. However, a more effective strategy targeting selective deletion of key premises in the network was not available once the epidemic had begun. We recommend that post-hoc analyses of this sort should become part of preventative and proactive policy rather than part of a reaction to an ongoing crisis.

Purpose The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. Materials and methods This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. Results AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Conclusions Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. IMPLICATIONS FOR REHABILITATION Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and ...

Social capital is widely regarded as a key element in recovery from and resilience to disasters. Yet, little attention has been paid to the specificities of what supports or undermines remote rural communities' social capital in disasters. Here, we examine how bonding, bridging, and linking social capital operated after the 2015 earthquake in three remote Nepali communities of Sindhupalchok and Gorkha Districts, which have varying degrees of access to infrastructure, relief and recovery programmes. We draw on community-based qualitative research conducted in 2018 (including data from participatory videos, focus group discussions and Key Informant Interviews) to show how different forms of social capital 'matter' more in different phases of recovery. Immediately after the earthquake, high levels of bonding and bridging social capital among residents reduced barriers to collective action, and helped efforts to rescue and support affected individuals. This dissipated, however, once external relief arrived. Already-marginalized groups with low social capital of all types were less able to access relief items and funding for rebuilding compared with those of higher social status or with political links. Pre-existing socio-cultural inequalities, including those driven by weak bonding relationships in families, gender inequalities and the remoteness of villages, further undermined communities' social capital and their resilience to the earthquake. Disaster relief programmes should target women and the elderly to improve resilience of marginalised communities to future disasters. For long-term resilience, disaster programmes should consider social capital in terms of power and pre-existing inequalities, so that linking capital would not just serve elite groups.

The concept of 'resilience' has been subject to a number of critiques. In this paper, we examine three of the most common: i) that resilience is a 'top‐down' policy discourse that pays too little regard to local specificities; ii) that resilience policy represents a neoliberal shift towards the responsibilization of communities and a retreat of the state from its role in providing protection; and iii) that the focus on resilience tends to divert attention away from the underlying social, political, and economic causes of vulnerability. Using data collected in post‐earthquake Nepal from Barpak, the village at the epicenter of the 2015 Gorkha earthquake, the District Headquarters, and at the national level in Kathmandu, we argue that these critiques have mixed salience in this particular context, but that the first and third in particular point to important problems in the ways in which the Government of Nepal and its international partners have approached the task of enhancing the resilience of Nepalese communities. We argue that while there are benefits to considering resilience at the community level, it is important to recognise the inequalities within communities, how these might be reflected in differential levels of vulnerability, and how they might be reinforced through resilience building programmes.

Objective/context: the article proposes to analyze the political scope and the methodological challenges involved in the territorial social dialogue (DST) in Buenaventura ( Colombia ), where the daily struggles of the communities revolve around the defense of their right to live in peace . and with dignity in their territories. Methodology: the reflection is based on a case study that was part of a participatory investigation between 2019 and 2020 in Buenaventura , around the relationship between social dialogue and reconciliation. The analysis draws on theoretical contributions from the local turn of peace , studies on conflict transformation , dialogue studies and the decolonial turn . Conclusions: despite being fertile in practical terms, social dialogue has been prone to conceptual indefinition; For this reason, this article, based on this case study , concludes that: i) the DST is an ontological, political and historical resource that can be used by various social sectors and local communities to confront the hegemonic imagination and planning on development and territory; ii) the DST is characterized by political and methodological virtues, as well as by gray areas yet to be explored. Originality: the article analyzes the little explored experience of territorial social dialogue in Buenaventura . In addition, it warns about its challenges and difficulties when both the social agreement to live in peace and dignity in the territory as certain antagonistic actors and/or traditionally reluctant to dialogue .

The authors examine how health governance is being transformed amid globalization, characterized by the emergence of new actors and institutions, and the interplay of competing ideas about global health. They explore how this has affected the governance of specific health issues and how it relates to global governance more broadly.

A new coronavirus disease (COVID-19) caused by a novel pathogen (SARS-CoV-2) spread rapidly around the world in the early months of 2020, and was declared a pandemic by the World Health Organization (WHO) on 11 March. COVID-19 has, and continues to have, large implications for individuals, societies, and for national health systems across the globe. Due to its novelty and impact, it has challenged all health care systems where the virus has taken hold. The ways in which governments and health systems have responded have varied widely across the world. In the case of Nepal, the pandemic represented a major test for the newly decentralised health system, created as a result of the implementation of the 2015 federal constitution. This paper, which forms a part of our large on-going study of the decentralisation of the health system in the country, presents some of the early evidence on the effectiveness of the actions taken by Federal, Provincial and Local Governments and the levels of cooperation and coordination between them.

A new coronavirus disease (COVID-19) caused by a novel pathogen (SARS-CoV-2) spread rapidly around the world in the early months of 2020, and was declared a pandemic by the World Health Organization (WHO) on 11 March. COVID-19 has, and continues to have, large implications for individuals, societies, and for national health systems across the globe. Due to its novelty and impact, it has challenged all health care systems where the virus has taken hold. The ways in which governments and health systems have responded have varied widely across the world. In the case of Nepal, the pandemic represented a major test for the newly decentralised health system, created as a result of the implementation of the 2015 federal constitution. This paper, which forms a part of our large on-going study of the decentralisation of the health system in the country, presents some of the early evidence on the effectiveness of the actions taken by Federal, Provincial and Local Governments and the levels of cooperation and coordination between them.