S1-1 Tlou DoH Vatican
PDF Upload
23/01/2024
1
Breaking Barriers: African Nurses
Promoting and Protecting Human Rights in Medical
Research in Resource-limited settings
Prof Sheila Tlou, RN, PhD, FAAN, FCAN.
Chancellor, Botswana Open University
Co-Chair, Global HIV Prevention Coalition
Former UNAIDS Regional Director
Former Minister of Health, Botswana
1
Main Goals
• Identify health challenges , and aspects of Primary Health
Care in relation to human rights, the right to health, and
achievement of SDGs.
• Share personal experiences of advocacy and practice to ”
improve health equity through ethical medical research and
policy change”.
• Share ideas on advocacy for gendered medical research in
resource-limited settings that ensures equity and respect
for human rights.
2
23/01/2024
2
Gender, ethnicity, education, employment, housing, access to health,
Corruption, etc.
Effects of Climate change : worsening natural disasters , e.g.
hurricanes, earthquakes, wildfires, flooding, drought, extreme
temperatures…….increase in malnutrition, malaria, NTDs, etc.
“Man-made” disasters: terrorism, armed conflict/refugee crises…..
women and children are the most affected.
Epidemics of HIV/AIDS, Ebola, SARS, Zika, COVID-19, NTDs, etc. but
lack of investment in and prioritization of the safety, health and
wellbeing of health care workers.
Social Challenges to Human Rights and
Health Equity
3
Primary Health Care: Health For All by 2000
(Alma Ata, 1978….45 years ago, but still most
relevant for Human Rights)
• Accessible, acceptable, affordable, and universal, with
emphasis on Maternal, neonatal, and Child Health.
• Community participation in addressing social determinants of
health.
• Caters for vulnerable, neglected groups (women and girls,
older adults, key populations, indigenous people, etc.)
• Nurses and midwives were always the backbone for
delivering Primary Health Care in resource-limited settings.
#Great success, interested from Human rights and gender
perspective. a Human Rights/Gender perspective…
4
23/01/2024
3
What I have learned from Primary Health Care
‘Health is made in the home, Hospitals are for Repairs’.
• As Researcher and gender activist :Generated Knowledge
through research: documented impact of HIV/AIDS on the rights
of African women. Evidence led to Programs for & by women and
girls.
• As Educator and WHO CC Director, disseminated knowledge to
‘influence change’, educated nurses as Gender & AIDS activists
(Ministerial AIDS Coordinators).
• Community Participation/Activism, Society for Women and AIDS
in Africa (1988)…….enabling GIPA and self-determination for
Informed Consent , etc.
• Documented impact of community-based interventions in HIV
prevention, treatment and support.
• and support ( Great sourceof support and success as Minister).
5
What I have learned from Primary Health Care
2.
Health is a Political Choice
• With solid evidence, political leaders can invest domestic
financing to ensure ethical research, e.g. National Research
Directorate.
• Effective collaboration and partnerships in academic and clinical
settings have enhanced ethical research e.g. Botswana –Harvard
Partnership….Informed consent in local languages.
• Leadership development in health research requires education
and Community engagement (Community Advisory Boards) with
full representation of all vulnerable population groups. Local
traditional and political leaders also engaged e.g. MPs and the
Truvada study (2006}.
a scientific rather than a moral reference…
6
23/01/2024
4
Heads of State and Government
: HM King Mswati of Eswatini
7
Human Rights Advocacy in Research as
Political Leader and Decision-maker …
In 2004, appointed Minister of Health…budget 22%
• Very few medical doctors, but very well-educated nurses,
midwives, FNPs, community health workers, NGOs.
• Comprehensive Prevention, Treatment, Care and Support
Program. Still a model for Africa and the developing world.
• Applied Research evidence, plus Partnerships for the Health
& AIDS Response: within 4 years: 80% coverage, MTCT from
29% to 8%.
• Shared with other Ministers in resource-limited settings to
invest in ethical collaborative research for health equity.
8
23/01/2024
5
Conclusions :Clinical Research in Resource –limited
settings as per Helsinki Declaration requires…
• Knowledge of country concerns, e.g. vulnerable populations
• Political Commitment to Domestic Financing for Clinical
Research.
• Collaboration with local and international stakeholders in
clinical research .
• Strengthening of community systems for service provision,
social protection, and promotion of human rights.
• Education and mentoring of present and future clinical research
leaders.
• Political office for good governance, health equity &
commitment to SDGs, esp. on Human Rights and Gender-
responsive Policies and Services…
9