Topics in this article:
Water and sanitation, Access to medicine, HIV and Aids, Health Care, Changemaker's campaigns
Health is a primary need of all humans and one of the areas where global injustice is most visible. Millions are dying due to lack of adequate health care. It is an issue for all of humanity, a fundamental issue of injustice, and an obvious impediment to development.
After AIDS, tuberculosis or malaria affects large parts of the employable population in developing countries, hindering development. Over one billion people lack clean water, and 40% of the world's population does not have adequate sanitation. International rules for patenting and trade make medicine prices extremely high, leading to unnecessary suffering and death in developing countries. Another problem is that the rich countries in the West actively recruit much needed health workers from the South. At the same time "non-Western" diseases are given very little attention from Western researchers and pharmaceutical companies.
The global health problem presents challenges that run through all of Changemaker’s themes. We see that the improvement of global health is not possible through the efforts of the health sector alone but also depends on access to clean water and healthy food, cheaper medicines, an environment free from harmful contaminconditions, mostly in developing countries. Lack of access to clean drinking water and adequate sanitation is a major impediment to development.
To the top
|
Water and sanitation is a primary example of the injustice in global health. Today the problem is not that clean water does not exist, but the big difference in access and pricing. Privatization of water in the poor parts of the world means that the price of water in the south rises.
According to figures from the World Health Organization (WHO): more than 1 billion people are living without access to clean water, 42% of the world's population lacks access to adequate sanitation, and more than 2.2 million people die annually due to diseases related to lack of water and poor sanitary conditions, mostly in developing countries.
Lack of access to clean drinking water and adequate sanitation is a major impediment to development. |
 |
| To the top |
Photo: Heidi Opseth/NCA |
Access to medicine is an essential part of the human right to health. But about one third of the world’s population has poor access to necessary medical treatment. High prices, low quality and inaccurate treatment means that patients in poor countries often get little or no health benefits. Essential medicines should be accessible to all people, and that requires a functioning health care system and good infrastructure.
| The drug industry is also at fault for lack of access to medicine. Patent legislation stemming from the WTO’s TRIPS Agreement of 1994 states that there must be a patent on the drug product, rather than just the production process. This gives the patent holder sole manufacturing rights for 20 years, during which time the price skyrockets, making it unavailable to the world’s poor. |
 |
|
Photo: Hege Opseth/NCA |
The World Health Organization’s Doha Declaration of 2001 ensured that governments may issue compulsory licenses on patents for medicines, or take other steps to protect public health. However, parallel imports from other countries often are met with strong trade sanctions, making this instrument ineffective in practice.
Another problem is that the drug industry is incentivized to research drugs that will sell in western countries, because that will earn the most money. In the United States, only about 10% of the research funds are used to investigate 90% of the world’s health problems. This “10/90 gap” is a huge source of injustice.
To the top
HIV and AIDS is one of the greatest humanitarian catastrophes of our time. 33 million people are infected with the virus, and the majority of them live in poor countries. In November of 2009, WHO released a report stating that AIDS is now the leading cause of death and disease for women ages 15-44 worldwide. HIV and AIDS is an injustice problem because people with power and resources do not invest in the fight against it, despite the fact that we have real opportunities to subdue the pandemic.
Prevention
The first step is prevention. Changemaker believes funds must be set aside for research into medicines, vaccines and alternative contraception to halt the spread in the long term. Many focus on the ABC model: Abstain, Be faithful, use Condoms, but often the first two are over-emphasized, particularly by the United States and the Catholic Church. Changemaker believes it’s vital to increase knowledge about how the virus is contracted and distribute and inform about contraception. WHO has stated that, globally, unsafe sex is the single leading risk factor contributing to deaths among women of reproductive age. Women’s position in society must be strengthened, as they currently have less access to information and little ability to protect themselves. We must look beyond the ABC model to one that gives women real freedom of choice and not use moralizing to reinforce hierarchy.
Global players
In the worldwide fight to combat HIV and AIDS Changemaker believes there must be clear leadership, and the Global Fund to fight Aids, Tuberculosis and Malaria (GFATM) is an important step. The Fund is dependent on the broad financial support, which has been reduced now that the United States started its own fund: PEPFAR (Presidents Emergency Plan for Aids Relief). PEPFAR’s projects follow the ABC model, with emphasis given to abstinence and fidelity, a method that has been proven not to work. Changemaker believes Norway should increase its support to the Global Fund, both to achieve a coordinated, diverse and just fight against the epidemic, and to show opposition to PEPFAR’s methods.
There needs to be clear leadership in the fight against HIV and AIDS; millions who are infected suffer while world leaders debate sexual morality. This moral stigmatization takes the focus away from what’s really important: human rights, fighting poverty, access to medicine, and prevention. Norway must dare to criticize poor leadership and take a clear stand in the fight against HIV and AIDS.
HIV-positive rights
Changemaker believes always in the maintenance of human dignity and therefore works against the stigmatization of those who are infected with HIV. Ostracization from family, employment and society is just another way that people suffer from HIV. Stigma is one of the biggest obstacles to fighting the virus, because it prevents open dialogue and spread of knowledge.
To the top
The global shortage of health care personnel means that we are less able to combat the AIDS epidemic in poor counties or meet all of the Millennium Development Goals. 4.3 million more health workers are needed in the world, mostly in the global south. Extreme shortage of health professionals in these countries severely weakens the health care system. There are many solutions needed to combat HIV and AIDS, and quality health workers in a functional health care system is fundamental.
Currently, there is a huge amount of migration of health care professionals from the global south to the global north. Changemaker is not critical of people’s desires to move to find a better life and believe they should be able to settle where they wish. However, we are very critical of rich countries who only open their borders to immigrants who have training or expertise that is desirable to them. This is called “brain theft” or “brain drain” when rich countries are given the first right to health workers from countries who have far more health problems. We call it “theft” because health care workers constitute significant resources, which rich countries don’t repay.
Changemaker believes that Norway should impose binding rules for the employment of trained health personnel from other countries in order to regulate the problem. Active recruitment from developing countries must be prohibited and poor countries must receive compensation for the loss of health care personnel, compensation which should not be substituted for aid money. As always, Norway can be a world leader, and work to introduce this legislation internationally.
To the top
2001: Medicine campaign
A primary example of the issue of access to medicine is the pharmaceutical industry's unfair prices for HIV / AIDS medicines. There are many drugs that can prolong the lives of people living with HIV, but they have been patented by major drug companies who price them high enough that they are unaffordable for poor people. So in 2001, Changemaker designed a rolling pharmacy booth that we took to various festivals. People could send condom postcards from the pharmacy telling the government, “Do not let Norwegian AIDS policy be like a condom with a hole”, which challenged them to take the medication issue seriously.
The pressure from this campaign contributed to drug companies dropping lawsuits against the South African government, who can now manufacture cheap copies of AIDS medicines for its citizens.
2003: Be HIV-positive
 |
| The previous Changemaker leader, Tale Hungnes, in conversation with bishop. |
To fight stigmatization, Changemaker launched the POSITIVE campaign. Because stigmatizing someone means labelling them, we had people stamp themselves with a POSITIVE stamp – labeling them HIV positive. The campaign both highlights prejudices in how we label others and allowed people to show solidarity with those living with HIV. People could also stamp their schools or churches POSITIVE.
The biggest success of the campaign was the furor we caused when over 100 changemakers stood outside the Nidaros Cathedral before a Sunday service holding a banner stating “The Bishop is HIV-positive.” Churchgoers were shocked at the sign, and many angry that we would say something like that about the Bishop. But inside, Bishop Wagle, who was in one the campaign, preached about the stigmatization of those who are HIV-positive. After the service, people understood why we were there, and we were met with appreciative smiles and nods.
We viewed the campaign as a great success in fighting prejudice in Norway, and it has now been taken worldwide, as several other countries have copied it.
2008: Stop Brain Theft
 |
| One of the local groups demonstrating a brain being hijacked. |
Changemaker promoted our beliefs in many actions throughout the year. Our local groups throughout the country were highly involved doing stunts such as forming long lines to represent the lines for hospitals and health care in poor countries. We also set up recruitment stands in which we asked for nurses who were willing to go to Africa. Overall, we collected 8,000 signatures supporting our demands, a record for Changemaker.
That same year, partly as a result of our campaign, the Norwegian government stated that we should not engage in the active recruitment of health personnel. We had good contact with the Director of Health Affairs, Bjørn-Inge Larsen, who is also chairman of WHO Europe. He said that Norway must ensure binding agreement on ethical recruitment of health personnel, and will raise the debate internationally in WHO-Europe.
To the top