About JALI and a Framework Convention on Global Health
The Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI) has emerged as a response to the vast and unconscionable inequalities in health that disfigure our world. JALI seeks to deepen the recognition among people and governments in all regions of the world, in the Global South and Global North, of our mutual responsibilities for improving the health of the world’s population, especially the poorest and most disadvantaged people, and clarify these responsibilities. We will advocate for a Framework Convention on Global Health that clarifies these responsibilities — which should be rooted in the right to health — creates accountability around them, and organizes global governance for health to effectively implement these responsibilities. The Framework Convention could establish a post-Millennium Development Goals global health agenda. Our explorations will include the potential for a Framework Convention to support social movements in their efforts to advance the right to health in their communities, their countries, and around the world.
We are committed to the right to health for all and global social justice. Our broad, global partnership will need to draw on the energy and power of civil society and communities to clarify an understanding of our shared responsibilities and to transform this framework into new health realities. Our success is only possible by closely collaborating with and learning from those who share our goals. Together we strive to meet our responsibilities to turn that decades old promise of “health for all” into a global reality.
Background of JALI: Overwhelming Disease and Health Inequities1
Preventable and treatable injuries and diseases are overwhelming in sub-Saharan Africa, the Indian subcontinent, and other impoverished areas of the world. In a single year, nearly 7 million children die before age five, close to 300,000 women die in pregnancy or childbirth, and approximately 4 million people died of AIDS, malaria, or tuberculosis. By 2020, 70% of deaths in the developing world will be from non-communicable diseases. Life expectancy in sub-Saharan Africa is 56 years, almost a quarter-century less than in high-income countries. Billions of people still lack access to fundamental human needs. In 2010, 870 million people were suffering from chronic hunger, 780 million people lacked access to clean water, and 2.5 billion people did not have access to proper sanitation facilities.
A woman in sub-Saharan Africa is nearly 100 times more likely to die in pregnancy or childbirth during the course of her lifetime than a woman in a developed country, while a child born in Africa is 18 times more likely to die before she reaches age five than a child born in a high-income country.
These inequalities are replicated within countries. Those who are poor, who are disabled, who belong to indigenous populations, or other socially disadvantaged populations, are far less likely to be able to access quality health care and have their fundamental survival needs met, and consequently, their lives shorter.
It need not be this way. Such inequalities are unconscionable. It is intolerable that we know how to save millions of lives every year, but do not. It is severely unjust that one’s very survival is so fundamentally determined by the place of one’s birth and one’s economic assets. And it is all the worse because saving these lives is eminently affordable, and well within the economic capacity of nations, in partnership with the global community.
Yet the political will to address the health of poor and marginalized populations, and the proper prioritization of their lives, is inexcusably insufficient. States too often disrespect obligations to national and global health where they have been clearly defined – which is too rare. And powerful economic and political interests have shaped the global economic landscape – such as from international trade rules and norms, subsidy practices of many wealthy nations, and macroeconomic policies – in ways that reduce rather than enlarge the capacity of lower-income states to improve their people’s health.
Aim of the Joint Action and Learning Initiative
JALI began to emerge through a consensus process during an international meeting held at the Norwegian Directorate of Health in Oslo, March 17, 2010. JALI would be a collective commitment to research and share knowledge on the most constructive ways in which to redress the most prominent inequalities in global health. Further discussions among initial JALI partners, and then broader consultations in Johannesburg and New Delhi led to a decision that a central aim of JALI will be to explore the potential for and possible content of a Framework Convention on Global Health, to frame post-Millennium Development Goals global health commitments and help close these inequalities and serve as an important tool for social movements to organize a round and use to hold their governments accountable for implementing the right to health.
Behind JALI lies a recognition that fundamentally changing the current state of global health requires a broad consensus on the most essential parameters, responsibilities, and opportunities critical to realizing the right to health for all. Achieving and sustaining these changes will require mobilizing the full potential of community and civil society health movements, from grassroots initiatives to global campaigns. Fundamental changes to global health require not only agreements and policies, but also social movements to hold governments accountable.
JALI sets out to create a better understanding of the national and global responsibilities required to ensure health care and such fundamental human needs as clean water and adequate nutrition for all people. In addition, we will explore what kinds of global health governance structures would best promote such responsibilities. The end-goal is to forge a consensus around what has to be done to reinforce responsibilities, create accountability around these responsibilities in a global agreement, and facilitate needed governance reform. While the Framework Convention on Global Health is central to our goals, we will seek out and seize other opportunities to better secure national and global health responsibilities and the governance structures that will facilitate them.
We recognize that this is only possible through an inclusive, broad, and engaging partnership. Consequently, JALI is a global, cross-disciplinary partnership drawing from communities, civil society, governments, multilateral organizations, academia, health workers, foundations, and business. We encourage you to join us in this endeavor.
For more information on the mission of the JALI and the issues that it will cover, along with preliminary thoughts – subject to our learning processes – on key questions that JALI will address, please see our publications.
If you have any questions or concerns, or would like to sign up for updates and other information from JALI, please send an email to: firstname.lastname@example.org.