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What we need is a sustainable politics of life
... Such an approach to the SDGs, however, does not reflect what the SDGs are about, namely, understanding and acting upon the many ways that all 17 goals are interconnected and underpinned by social and environmental justice. Precisely, 'if we are to take the UNs Sustainable Development Goals (SDGs) seriously' then we must heed their imperative call 'to acknowledge the social determinants of health and to understand health in the broadest of contexts' [28]. ...
... There is certainly potential for a veritable paradigm shift here, though we also know for well that these require fundamental changes in our basic concepts, understandings and approaches of ourselves, the world we live in, and those we share it with [35,36]. To bring about such a paradigm shift, it will undoubtedly be critical to recognise that, to paraphrase an argument recently made [28], addressing environmental issues and 'doing away with health disparities and social inequality is not just social justice' and environmentalism, but 'indeed pandemic preparedness' and healthcare at its best. The question then is simply how physiotherapy will participate in such best practice as we go forward. ...
... The coronavirus crisis, which has resulted from a combination of biological, cultural, and environmental forces, offers once more a paradoxical case in point. 12 It has become increasingly evident that a treatment for coronavirus disease cannot be exclusively pharmacological (Sandset, Heggen, and Engebretsen 2020). Even though "none of the ten highest COVID-19 case-notifying countries reported data related to ethnicity," Black, Asian, and minority ethnic people have, as we note above, suffered from the disease disproportionately (Pareek et al. 2020(Pareek et al. , 1421. ...
This article tests the hypothesis that all pandemics are inherently translational. We argue that translation and translation theory can be fruitfully used to understand and manage epidemics, as they help us explore concepts of infectivity and immunity in terms of cultural and biological resistance. After examining the linkage between translation and coronavirus disease from three different yet interlinked perspectives—cultural, medical, and biocultural—we make a case for a translational medical humanities framework for tackling the multifactorial crisis brought about by the SARS-CoV-2 infection. This innovative entanglement of perspectives has the merit of carving out a new space for translation research at the intersection of the sciences and the humanities, providing sustainable ways to conceptualize the production of science at times of crisis, and challenging conventional views of translation as a primarily linguistic and cultural phenomenon that traditionally does not engage with science.
... Un exemple actuel du lien entre notre impact sur l'environnement et la santé est celui de la COVID-19 (9) . Cette maladie zoonotique, pouvant se transmettre de l'animal à l'homme ou de l'homme à l'animal, semble résulter de la destruction de l'habitat par l'activité humaine, d'espèces poussées à des contacts humains auparavant absents (10) . ...
Contexte : La santé des populations et la crise environnementale sont intimement liées. Le monde de la santé a la responsabilité d’inclure la problématique environnementale
dans ses actions. Objectif : L’objectif de cet article est de proposer des pistes de réflexion pour intégrer les questions environnementales et de durabilité dans la pratique de la physiothérapie. Développement : Des actions visant à promouvoir des soins
à haute efficacité, communiquer sur la problématique environnementale avec les patients afin de favoriser les moyens de déplacement actifs, développer leurs compétences (self-management) et les traitements en groupe peuvent amener des effets positifs sur le climat, tout en garantissant la qualité des thérapies. Néanmoins, des actions systémiques permettraient des bénéfices plus larges. Favoriser les traitements conservateurs au détriment de traitements chirurgicaux, promouvoir l’interdisciplinarité et développer les rôles de prévention et de promotion de la santé au niveau communautaire auraient un impact beaucoup plus important sur la santé et le climat. Discussion : De nombreuses possibilités d’agir en faveur d’un système de santé plus durable existent pour les physiothérapeutes. Les actions qui auraient le plus d’effet nécessitent cependant des changements au niveau du rôle des physiothérapeutes dans le système de soins. Ces changements passent par des efforts importants au niveau de la formation, du lobbying et des associations professionnelles. Conclusion : La promotion de la physiothérapie comme un acteur essentiel d’un système de santé durable est une opportunité importante de développement de la profession. Cela va de pair avec le développement de nouveaux rôles pour la profession qui intègrent l’importance des composantes environnementales et sociales pour la santé.
Context: Population health and environmental crisis are intimately linked. The health care community has an important responsibility to integrate environmental issues
into its actions. Objective: This article proposes approaches to integrate environmental and sustainability issues into physiotherapy practice. Development: Actions aiming at promoting high-value care, communicating about environmental issues with patients to
encourage active mobility, and developing self-management and group treatments can produce positive effects on the climate while guaranteeing high-quality care. Nevertheless, systemic actions would bring broader benefits. Favoring conservative treatments over surgical ones, promoting interdisciplinarity, and developing prevention and health promotion roles at the community level would have a much greater impact on health and climate. Discussion: Numerous opportunities for action toward a more sustainable health care system exist for physiotherapists. However, the actions that would have the greatest impact require changes in the role of physiotherapists in the health care system. These changes require significant efforts in education and lobbying from professional associations.Conclusion: The promotion of physiotherapy as a key player in a sustainable health care system is an important opportunity for the development of the profession. This goes hand in hand with the development of new roles for the profession that incorporate the importance of environmental and social components of health.
... Public-and private-sector health care institutions, organizations, and individual actors should establish transparent guidelines to evaluate and allocate emerging treatments in an ethical, evidence-based manner. Responses should also consider the broader context in which the pandemic has taken place and capitalize on this opportunity to critically examine and address social and political factors that reinforce inequities and support equitable and sustainable advancements throughout the COVID-19 pandemic (38,39). ...
Objective
The coronavirus disease 2019 (COVID‐19) pandemic has led to rapid research and reporting on potential preventatives and treatments for the disease, including the drug hydroxychloroquine (HCQ). Despite a lack of robust evidence to support the use of HCQ for treatment of COVID‐19, it was publicly endorsed and received widespread media coverage and public interest. The purpose of this report is to describe and contextualize the surges in public interest, demand, and adoption of HCQ for treatment of COVID‐19 and outline implications for future public health policy and practice.
Methods
Using national and global events and Google Trends data as a measure of public interest, we describe the timeline and trends in the emergence of, interest in, and adoption of HCQ as a treatment of COVID‐19. We additionally review reports on public demand for HCQ for treatment of COVID‐19 and impacts on medication access among patients with indicated uses.
Results
Public interest and demand for HCQ surged in the United States and globally following endorsements from public officials and enaction of policies to facilitate off‐label use of HCQ for treatment of COVID‐19. Surges in demand for HCQ led to multiple documented shortages and barriers to accessing HCQ treatment for patients with indicated uses for HCQ. Although there have been reversals in policies to support HCQ use for treatment of COVID‐19 in some regions, others have continued or expanded recommended uses.
Conclusion
Insights from the global response to HCQ and COVID‐19 can be used to inform prudent decision‐making in the future to prevent premature action and promote informed and equitable responses to promote public health.
Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven. Although the health sector has a crucial role in addressing health inequalities, its efforts often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals. This is the starting point of The Lancet-University of Oslo Commission on Global Governance for Health. With globalisation, health inequity increasingly results from transnational activities that involve actors with different interests and degrees of power: states, transnational corporations, civil society, and others. The decisions, policies, and actions of such actors are, in turn, founded on global social norms. Their actions are not designed to harm health, but can have negative side-effects that create health inequities. The norms, policies, and practices that arise from global political interaction across all sectors that affect health are what we call global political determinants of health. The Commission argues that global political determinants that unfavourably affect the health of some groups of people relative to others are unfair, and that at least some harms could be avoided by improving how global governance works. There is an urgent need to understand how public health can be better protected and promoted in the realm of global governance, but this issue is a complex and politically sensitive one. Global governance processes involve the distribution of economic, intellectual, normative, and political resources, and to assess their effect on health requires an analysis of power. This report examines power disparities and dynamics across a range of policy areas that aff ect health and that require improved global governance: economic crises and austerity measures, knowledge and intellectual property, foreign investment treaties, food security, transnational corporate activity, irregular migration, and violent conflict. The case analyses show that in the contemporary global governance landscape, power asymmetries between actors with conflicting interests shape political determinants of health. We identified five dysfunctions of the global governance system that allow adverse eff ects of global political determinants of health to persist. First, participation and representation of some actors, such as civil society, health experts, and marginalised groups, are insufficient in decision-making processes (democratic deficit). Second, inadequate means to constrain power and poor transparency make it difficult to hold actors to account for their actions (weak accountability mechanisms). Third, norms, rules, and decision-making procedures are often impervious to changing needs and can sustain entrenched power disparities, with adverse eff ects on the distribution of health (institutional stickiness). Fourth, inadequate means exist at both national and global levels to protect health in global policy-making arenas outside of the health sector, such that health can be subordinated under other objectives (inadequate policy space for health). Lastly, in a range of policy-making areas, there is a total or near absence of international institutions (eg, treaties, funds, courts, and softer forms of regulation such as norms and guidelines) to protect and promote health (missing or nascent institutions). Recognising that major drivers of ill health lie beyond the control of national governments and, in many instances, also outside of the health sector, we assert that some of the root causes of health inequity must be addressed within global governance processes. For the continued success of the global health system, its initiatives must not be thwarted by political decisions in other arenas. Rather, global governance processes outside the health arena must be made to work better for health. The Commission calls for stronger cross-sectoral global action for health. We propose for consideration a Multistakeholder Platform on Governance for Health, which would serve as a policy forum to provide space for diverse stakeholders to frame issues, set agendas, examine and debate policies in the making that would have an eff ect on health and health equity, and identify barriers and propose solutions for concrete policy processes. Additionally, we call for the independent monitoring of how global governance processes aff ect health equity to be institutionalised through an Independent Scientific Monitoring Panel and mandated health equity impact assessments within international organisations. The Commission also calls for measures to better harness the global political determinants of health. We call for strengthened use of human rights instruments for health, such as the Special Rapporteurs, and stronger sanctions against a broader range of violations by nonstate actors through the international judicial system. We recognise that global governance for health must be rooted in commitments to global solidarity and shared responsibility through rights-based approaches and new frameworks for international financing that go beyond traditional development assistance, such as for research and social protection. We want to send a strong message to the international community and to all actors that exert influence in processes of global governance: we must no longer regard health only as a technical biomedical issue, but acknowledge the need for global cross-sectoral action and justice in our eff orts to address health inequity.
Life: a critical user's manual.
- Fassin D