[afro-nets] Politics is nothing but medicine at a larger scale: reflections on public health's biggest idea

General afro-nets
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Cross posted from: EQUIDAD@listserv.paho.org

  *Politics is nothing but medicine at a larger scale: reflections on public health's biggest idea*

*Prof. Johan P. Mackenbach, Department of Public Health
*Erasmus MC - University Medical Center Rotterdam - The Netherlands
*J Epidemiol Community Health 2009;63:181–184. doi:10.1136/jech.2008.077032*

*Abstract*<http://jech.bmj.com/cgi/content/abstract/63/3/181?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Mackenbach&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT&gt;
* *Website: http://jech.bmj.com/current.dtl

".......This essay retraces the historical origins and contemporary resonances of *Rudolf Virchow's famous statement* *"Medicine is a social science, and politics nothing but medicine at a larger scale*". Virchow was convinced that social inequality was a root cause of ill-health, and that medicine therefore had to be a social science. Because of their intimate knowledge of the problems of society, doctors according to Virchow also were better statesmen.

Although Virchow's analogies between biology and sociology are out-of-date, some of his core ideas still resonate in public health. This applies particularly to the notion that whole populations can be sick, and that political action may be needed to cure them. Aggregate population health may well be different from the sum (or average) of the health statuses of all individual members: populations sometimes operate as malfunctioning systems, and positive feedback loops will let population health diverge from t he aggregate of individual health statuses.

There is considerable controversy among epidemiologists and public health professionals about how far one should go in influencing political processes. A "ladder of political activism" is proposed to help clarifying this issue, and examples of recent public health successes are given which show that some political action has often been required before effective public health policies and interventions could be implemented........"

*Commentaries* *Virchow, a model for epidemiologists*
Rodolfo Saracci
J Epidemiol Community Health 2009; 63: 185. doi:10.1136/jech.2008.083204
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/185&gt; *Why is epidemiology necessary to policy-making?*
Paolo Vineis and Paul Elliott
J Epidemiol Community Health 2009; 63: 186-187. doi:10.1136/jech.2008.082941
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/186&gt; *Is epidemiology nothing but politics at a different level?*
Alfredo Morabia
J Epidemiol Community Health 2009; 63: 188-190. doi:10.1136/jech.2008.083162
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/188&gt;

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Mrs. Ana Lucia Ruggiero (WDC)
mailto:ruglucia@paho.org

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The 4 below publications have now been posted on the website of the Human Rights Centre, University of Essex, at
http://www2.essex.ac.uk/human_rights_centre/rth/projects.shtm.

International Assistance and Cooperation in Sexual and Reproductive Health: A Human Rights Responsibility for Donors

Judith Bueno de Mesquita and Paul Hunt

States' obligations under some international treaties extend beyond their national borders to international assistance and cooperation for human rights, including the rights to sexual and reproductive health, in other countries. This publication focuses on what is expected of donors in the context of this responsibility. It shows how many donors are taking important steps towards fulfilling this duty through measures they are taking to integrate the rights to sexual and reproductive health into their policies and programmes, but also argues that many donors can also do more. The publication concludes with a set of recommendations addressed to donors and their developing country partner governments.

Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines: the Sexual and Reproductive Health Context

Rajat Khosla and Paul Hunt

When Paul Hunt was UN Special Rapporteur (2002-2008), a recurrent theme in his work was access to medicines. For the most part, he - and colleagues in the Right to Health Unit - looked at the duties of States in relation to access to medicines e.g. his report to the UN General Assembly A/61/338, dated 13 September 2006. However, States reported that when endeavouring to enhance access to medicines the policies and practices of some pharmaceutical companies were a very considerable obstacle. Thus, he was urged to prepare access-to-medicines guidelines for pharmaceutical companies. After extensive research and wide-ranging consultations over some years, Paul Hunt and Rajat Khosla wrote 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines'. These Guidelines were published by the UN General Assembly in A/63/263, dated 11 August 2008. The present publication briefly discusses medicines and sexual and reproductive health, in particular medicines, HIV/AIDS and the human papillomavirus (HPV) - HPV being responsible for over 99% of cervical cancers. In this context, the publication then introduces, and reproduces, the 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines' that were published by the General Assembly in 2008.

Participation and the right to the highest attainable standard of health

Dr Helen Potts

Active and informed participation is an integral component of health systems, as well as the right to the highest attainable standard of health. Despite its critical importance, health and human rights have not given participation the attention it deserves. While some health researchers have made more headway than those working in human rights, neither community has a widely accepted understanding of what the process of participation means in practice. The monograph is an accessible, practical, timely and original introduction to the process of participation; the need for a variety of participatory mechanisms; the relationship between fairness and transparency of the process; the relationship between participation and accountability and participation in accountability. The publication of the monograph was supported by the Ford Foundation.

Conscientious Objection: Protecting Sexual and Reproductive Health Rights

Judith Bueno de Mesquita and Louise Finer

Healthcare providers' conscientious objection to involvement in certain procedures is grounded in the right to freedom of religion, conscience and thought. However, such conscientious objection can have serious implications for the human rights of healthcare users, including their sexual and reproductive health rights. This briefing paper examines the implications of conscientious objection, by healthcare providers, for the protection of sexual and reproductive health rights, and concludes with a set of recommendations for States' policies and laws.

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Bueno De Mesquita, Judith R
mailto:jrbuen@essex.ac.uk