The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH...C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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Interpeace has been working with the government and non-governmental actors in Rwanda for over 20 years, focusing on societal healing and participatory governance. Currently, Interpeace is implementing a holistic peacebuilding programme titled ‘Reinforcing community capacity for social cohesion an...d reconciliation through societal trauma healing in Rwanda’. This programme has four pillars: mental health and support; social cohesion and reconciliation; collaborative livelihoods; and prisoner rehabilitation and reintegration.
Interpeace and its partners have collaborated with national and international experts to design structured psycho-social interventions, scientifically known as ‘protocols’, which aim to support healing and peace processes. These protocols include resilience-oriented therapy, adaptations of sociotherapy, multifamily therapy, the collaborative livelihoods (COLIVE) protocol, the prisoner rehabilitation and reintegration curriculum, and the socio-emotional skills curriculum.
These protocols guide interventions in healing spaces for Genocide survivors, Genocide perpetrators, former combatants, and their descendants. They facilitate mutual healing and reconciliation, strengthen the mental resilience of individuals and communities, promote family cohesion, and address the intergenerational transmission of Genocide legacies. They also underpin initiatives to develop collaborative livelihoods and skills development, and the psychological rehabilitation and reintegration of prisoners, particularly those convicted of Genocide crimes.
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Las violencias por motivos de género atraviesan a mujeres, LGBTI+, niñeces y adolescencias con gran impacto en múltiples dimensiones de la vida y el sistema de salud tiene un rol fundamental en su detección temprana, en la evaluación del riesgo, en la prevención y la atención integral.Por... eso, desde el Ministerio de Salud de la Nación y la Organización Panamericana de la Salud (OPS/OMS) presentamos el Manual Clínico “Atención integral de la salud ante situaciones de violencias por motivos de género. Herramientas para equipos de salud”, adaptado técnica y culturalmente a nuestro país a partir de la versión original de la Organización Mundial de la Salud (OMS). El presente manual está dirigido a todas las personas que integran equipos de salud interdisciplinarios e intersaberes del sistema sanitario (formadas en Medicina, Psicología, Enfermería, Trabajo Social, asesoramiento legal, agentes sanitarios, administración, promotoras y promotores de la salud, etc.) en especial a quienes trabajan en el primer nivel de atención. Su propósito es brindarles herramientas para la atención integral a mujeres, LGBTI+» y niñas, niños, niñes y adolescentes (en adelante, NyA) que atraviesan o han atravesado situaciones de violencias por motivos de género (en adelante, VMG).
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KEY MESSAGES
Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support.
Be aware of any other available services in your area. Identify services provided by humanitarian pa...rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations.
Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no.
Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support.
Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing:
Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity.
Safety: the safety of the survivor is the number one priority.
Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone.
Non-discrimination: providing equal and fair treatment to anyone in need of support.
If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy.
Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship.
If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality.
Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors.
Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act.
Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work.
Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded.
Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc.
Share general, non-identifying information
To your team or sector partners in an effort to make your program safer.
To your support network when seeking self-care and encouragement.
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CATALYST DIALOGUE ON HEALTH FINANCING
Insights from a debate on how to increase funding for health and spend existing funds more effectively.
Catalyst Dialogue participants:
Christoph Benn, Director for Global Health Diplomacy, Joep Lange Institute • Jayati Ghosh, Professor of Economics, Univer...sity of Massachusetts at Amherst • Tom Hart, Research Fellow, ODI • Lesley-Anne Long, President & CEO, Global Business Coalition for Health • Riaz Tanoli, CEO, Social Health Protection Initiative, Health Department Khyber Pakhtunkhwa, Pakistan
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Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in t...erms of actual versus expected national domestic funding, considering resource needs and donor financing. With UNAIDS and World Bank data, we examine domestic and donor HIV program funding in relation to need in 84 low- and middle-income countries. We estimate expected domestic contributions per person living with HIV (PLWH) as a function of per capita income, relative size of the health sector, and per capita foreign debt service.
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In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the health system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with... a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
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The 2020 Financing for Sustainable Development Report, the fifth report of the Inter-agency Task Force on Financing for Development, provides a comprehensive assessment of the state of sustainable finance. Prepared by more than 60 agencies of the United Nations system and partner international organ...izations, the report brings together a wide range of expertise and perspectives. It puts forward a set of policy recommendations to mobilize financing flows, and align them with economic, social and environmental priorities. These recommendations should assist Member States and all other stakeholders as they work toward fully implementing the Addis Agenda and achieve the SDGs.
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Global growth is projected to slow significantly amid high inflation, tight monetary policy, and more restrictive credit conditions. The possibility of more widespread bank turmoil and tighter monetary policy could result in even weaker global growth and lead to financial dislocations in the most vu...lnerable emerging market and developing economies (EMDEs). Comprehensive policy action is needed to foster macroeconomic and financial stability. Among many EMDEs, and especially in low-income countries, bolstering fiscal sustainability will require generating higher revenues, making spending more efficient, and improving debt management practices. Continued international cooperation is also necessary to tackle climate change, support populations affected by crises and hunger, and provide debt relief where needed.
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Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap e...ven for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
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According to most recent data, the world economy grew by 3.1 per cent in 2022. To many, the rebound
suggested that a soft landing was possible in 2023, and that the key problems of the year 2022 – rising
prices, supply-chain disruptions and recession risks – have been addressed. As a result, t...he very first
months of 2023 were viewed with optimism by decision-makers, as it appeared that the anti-inflationary
stance of the central banks had set a path to price stabilization without causing a major disruption to
growth.
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The 2021 Report examines country health spending patterns and trends over the past 20 years, before the COVID-19 pandemic, with greater focus on public spending on health. The report also presents spending on primary health care, preliminary health expenditure in 2020 for a small set of countries (i...ncluding their health spending on COVID-19) and an analysis of high-income countries spending patterns, in particular during the global financial crisis. The report also points out the need for more public investment in health to get progress towards UHC back on track and strong health security.
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The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r...ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. T...his report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage
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Past quantitative research on health financing has focused mostly on the level and distribution of total expenditure, with little emphasis on the specific role of public funds, despite their known importance for universal health coverage (UHC). Health Accounts data do not disaggregate public expendi...ture on health by source of funding. Achieving a better understanding of public financing for health in the context of the macro-fiscal and health financing environment is of fundamental importance to the development of future health financing policy, particularly in low- and middle-income countries (LMICs).
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Since the 1970s, voluntary contributions have become an increasingly important component of WHO's budget. As voluntary contributions tend to be earmarked for donor-specified programmes and projects, there are concerns that this trend has diverted focus away from WHO's strategic priorities, made coor...dination and attaining coherence more difficult, undermined WHO's democratic structures and given undue power to a handful of wealthy donors. In the past few years, the WHO Secretariat has pushed for donors to increase the amount of flexible funding they provide.
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This report analyses the intersection of HIV, COVID-19 and public debt in developing countries. The collision between COVID-19 and a crippling debt crisis have reversed decades of progress - putting present and future investments in health and HIV at risk. Pragmatic options to address the pandemic t...riad are proposed.
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The Creditor Reporting System was analysed for official development assistance funding disbursements towards TB control in 11 conflict-affectedstates, 17 non-conflict-affected fragile states and 38 comparable non-fragile states. The amounts of funding, funding relative to burden, funding relative to... malaria and human immunodeficiency virus (HIV) control, disbursements relative to commitments, sources of funding as well as funding activities were extracted and analysed.
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There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting... and suggest improvements. Methods: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation’s Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources.
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