The 2018 edition of the Canadian Conference on Global Health (CCGH) will examine the theme of Fragile Environments and Global Health: Examining drivers of change. This topic has received increased attention amongst the global health community as we struggle to understand drivers, experiences and practices. Recognized knowledge gaps include, but are not limited to, a lack of empirical evidence, a dearth of credible population data, weak linkages between health and other sectors, insufficient collaboration between humanitarian and development efforts, and an absence of equitable programs and policies, particularly for vulnerable populations such as women and children, adolescents, and older persons. CCGH 2018 seeks to highlight and examine the drivers of change that may address these gaps as we strive to identify positive and transformative change that disrupt the status quo solutions.
The CCGH draws on the OECD definition of fragility as: the combination of exposure to risk and insufficient coping capacity of the state, system, communities and/or individuals to manage, absorb or mitigate those risks (OECD (2016), States of Fragility 2016: Understanding Violence, OECD Publishing, Paris,http://dx.doi.org/10.1787/9789264267213-en.), and will consider the five dimensions of fragility:
- Economic (e.g., unemployment);
- Environmental (e.g., climate change);
- Political (e.g., instability, weak governance);
- Societal (e.g., intimate partner violence, income inequality); and
- Security (e.g., crime, conflict).
The OECD reports that 22% of the world’s population – or 1.6 billion people – are currently living in fragile contexts. The report makes a series of recommendations, including:
- Using a violence informed lens – power, capacity and marginalization – to design and deliver programming;
- Recognizing the critical role of gender in addressing fragility; and,
- Learning and building the evidence base: bringing together a broad range of research and policy fields.
Health systems in these fragile environments are failing, resulting in emergencies such as Ebola, as well as persistent public health concerns such as cholera, HIV/AIDS, tuberculosis and polio. Basic access to health is jeopardized, inequality increases, and the very vulnerable suffer most with peaks in infant mortality, acute malnutrition and maternal mortality. Fragile states are at greater risk of experiencing problems such as conflict, terrorism, drugs and human trafficking, absolute poverty, corruption, infectious and chronic disease, food security and genocide. While there have been few successes, there are some regions that have adapted to fragility through the (nascent) construction of resilient health systems. Others have developed small, but replicable, models of innovative programming that are promising in local settings and potentially beyond.
With the overall theme being Fragile Environments and Global Health, the subthemes that will emerge in programming will include:
- Advancement of women and children’s health and rights
- The politics of global health (governance, corruption, access and accountability, role of private sector and civil society)
- SDGs and intersectoral collaboration for health (environment, food security, education, employment, etc.)
- Facilitating the humanitarian-development-health nexus
- Social and economic inclusion and populations at risk (aging, disability, vulnerable groups, etc.)
- Indigenous populations
This is not an exhaustive list of issues that may be explored within the framework of Fragile Environments and Global Health; rather is a list of key contemporary topics that CCGH 2018 would examine as part of its contribution to Global Health agenda.
Cross cutting themes that will be explored include:
- Innovation in programming design and delivery
- Building the evidence base for research, policy and program delivery
- Gender equity