Global Advocacy Efforts Research Articles

Human Rights and Mental Health: A Review of Current Awareness and Emerging Developments

Human rights are universal fundamental protections worth of all individuals, including those with mental health conditions. However, these rights are often observed violated in mental health care settings, where individuals may face forced treatment, isolation, and degrading conditions. Despite global advocacy efforts, to ensuring that these rights are respected, continues to be a challenge for healthcare professionals and the general public. This review examines the current awareness of human rights among mental health professionals and the public, identifies the knowledge gaps, and highlights the recent developments in policy and practice aimed at improving human rights in mental health care. A comprehensive search of academic databases identified relevant studies published between 2019 and 2024. Findings suggest a promising level of public knowledge about human rights, yet negative attitudes and stigma persist. While improvements in mental health services have been observed among healthcare professionals; resource limitations and a lack of social support remain challenging. A gap between knowledge and practice is evident, necessitating further education and training to ensure a deeper understanding of human rights complexities in mental healthcare. Overall, this review underscores the importance of continued efforts to raise awareness and advocate for the human rights of individuals with mental health conditions. By implementing educational and sensitization programs, a supportive environment can be created that empowers them to seek help without fear of discrimination.

Seeing the pandemic through children's eyes: Exploring Turkish children's views on COVID-19 pandemic by focus-group discussions.

The direct and indirect effects of the COVID-19 pandemic on children and youth people are well documented. Little is known about children's experiences of the pandemic in their own words. We aimed to explore Turkish children's experiences and views about the pandemic, across private and public educational systems. Six focus group discussions were conducted online with 30 children aged between 7 to 18 years in 2021. Children were enrolled through snowball sampling technique according to developmental age groups. A thematic analysis was conducted. We identified five themes: Compliance with public health measures about preventing the spread of COVID-19, changes in daily routines, emotional responses to the pandemic, distance education, and adaptive responses. Overall, children were well informed and receptive to the public health preventive measures with the exception of older children's tendency to disregard physical distancing with friends. They reported frustration with those who did not comply with measures and believed that the authorities should strictly enforce public health requirements. Emotional responses comprised fear of family members and themselves being infected, anxiety produced by the uncertainty of the virus, and the loss of social support. There was a perceived disparity between students from public and private schools regarding academic self-competence. Positive aspects of the pandemic included positive interactions with family members and the acquisition of new hobbies. Although most children acknowledged the support of their parents to deal with challenges, children of health workers were particularly isolated in terms of emotional support. Our findings offer additional insights and validate previous research on the negative and positive effects of COVID-19 from the child's perspective across private and public educational systems. This study contributes to global advocacy efforts aimed at understanding the impact of the pandemic on children.

Governance for global integration: Designing structure and authority in international advocacy NGOs

We examine the design of governance in international nongovernmental organizations (INGOs) engaged in global advocacy. A central governance challenge facing INGOs is how to integrate their global advocacy efforts across diverse country units and memberships, in the face of limited authority and weak ownership over those units. Through a qualitative multi-case study of ten organizations, we analyze governance reforms intended to enhance global integration. We identify and discuss: a) four distinct governance structures for enabling more coherent global decision making (federation, confederation, network, constituency backbone); b) various mechanisms of formal and informal authority employed by headquarters in order to integrate the diverse interests and actions of their units; and, c) decision rights allocated to units or members to secure commitment to global goals. We synthesize these findings to offer a contingency perspective on designing governance for global integration. We hope this research will not only help to advance scholarship on governance in complex global organizations, but will also be useful to the leadership and boards of international organizations in strengthening the collective voice of their diverse constituencies.

The Power of Advocacy: Advancing Vision for Everyone to Meet the Sustainable Development Goals.

Advocacy is instrumental to achieving significant policy change for vision. Global advocacy efforts over the past decades enabled recognition of vision as a major public health, human rights, and development issue. The United Nations General Assembly adopted its first-ever Resolution on vision: “Vision for Everyone—Accelerating Action to Achieve the Sustainable Development Goals (SDGs)” on 23 July 2021. The Resolution sets the target and commits the international community to improve vision for the 1.1 billion people living with preventable vision impairment by 2030. To fulfill their commitments, governments and international institutions must act now. Advocacy remains instrumental to mobilize funding and empower governments and stakeholders to include eye health in their implementation agenda. In this paper, we discuss the pivotal role advocacy plays in advancing vision for everyone now and in the post-COVID-19 era. We explore the link between improved eye health and the advancement of SDGs and define the framework and key pillars of advocacy to scaling-up success by 2030.

Clean Air, Smart Cities, Healthy Hearts: Action on Air Pollution for Cardiovascular Health.

More than twenty percent of all cardiovascular disease (CVD) deaths are caused by air pollution — more than three million deaths every year — and these numbers will continue to rise unless the global community takes action. Nine out of ten people worldwide breathe polluted air, which disproportionately affects those living in low-resource settings. The World Heart Federation (WHF) is committed to reducing the impact of air pollution on people’s health and has made this a priority area of its global advocacy efforts. In pursuit of this goal, WHF has formed an Air Pollution Expert Group to inform action on air pollution for CVD health and recommend changes to public health policy. This policy paper lays out the health impacts of air pollution, examines its position on the global policy agenda, demonstrates its relevance to the cardiovascular community, and proposes actionable policy measures to mitigate this deadly risk factor to health. The paper considers the important roles to be played by the Members of WHF, including scientific societies and the physicians that constitute them, heart health foundations, and patient advocacy groups. The paper concludes with a detailed table of recommendations for the various sub-target groups at the global, national, local, and patient level.

The challenges of donor engagement with faith-based organizations in Cameroon's health sector: a qualitative study.

Substantial global advocacy efforts have been made over the past decade to encourage partnerships and funding of faith-based organizations in international development programmes in efforts to improve social and health outcomes. Whilst there is a wealth of knowledge on religion and development, including its controversies, less attention has been payed to the role that donors might play. The aim of this study was to describe and analyse the engagement between donors and faith-based organizations in Cameroon’s health sector, following the implementation of the Cameroon Health Sector Partnership Strategy (2012). Forty-six in-depth interviews were conducted in selected regions in Cameroon. The findings show that global advocacy efforts to increase partnerships with faith-based organizations have created a space for increasing donor engagement of faith-based organizations following the implementation of the strategy. However, the policy was perceived as top down as it did not take into account some of the existing challenges. The policy arguably accentuated some of the existing tensions between the government and faith-based organizations, fed faith-controversies and complicated the health system landscape. Moreover, it provided donors with a framework for haphazard engagement with faith-based organizations. As such, putting the implications of donor engagement with FBOs on the research map acknowledges the limitations of efforts to collaborate with faith-based organizations and brings to the surface still-remaining blinkers and limited assumptions in donor definitions of faith-based organizations and in ways of collaborating with them.

From Freedom of Religion or Belief (FoRB) advocacy to interreligious engagement in foreign policy

ABSTRACT In recent years, Western governments have strengthened their foreign policy tools, global advocacy efforts and international coordination to protect Freedom of Religion or Belief (FoRB). There is, however, a growing feeling that the current FoRB promotion approaches appear overall to be failing, as religious persecution and discrimination continue to increase in many parts of the world. Criticizing the secular policy mindset embedded in the current approaches, this article argues for a new postsecular foreign policy of religious engagement and advocates a distinctive strategy of “interreligious engagement” illustrating how interreligious dialogue and collaboration can be crucial policy tools to promote FoRB. This strategy is designed to break away from the predominant view among politics-makers in which religious actors are seen either as perpetrators or victims of FoRB violations. Instead, I argue, they should also be seen as responsible partners in combatting intolerance and discrimination based on religion or belief.

Engaged Buddhism as Human Rights Ethos: the Constructivist Quest for Cosmopolitanism

As the fundamental authority of universal rights claims are contested in a declining liberal international order, constructivists seek to transcend the limits of the Western, rationalist rights ethos and explore humanistic spiritual alternatives. This essay will evaluate the promise of a leading non-Western cosmopolitan ethos: engaged Buddhism. Buddhism offers a vision of universal compassion and moral responsibility that has shaped influential global advocacy efforts, with the potential to address a significant sector of the world community. But the Buddhist ethos has functioned as both a source of and a challenge to state power and nationalist identity in an era of globalization. Through examining a range of contemporary movements of engaged Buddhism in Tibet, Burma, Thailand, and Taiwan, we will see how this form of religious cosmopolitanism can play a role in constructing a rights ethos—if and when it maintains critical autonomy and Buddhist spiritual detachment from worldly power.

Role of Patients and Parents in Pediatric Drug Development.

Patient engagement in health care has been an emerging priority in the global effort and move toward the consideration of patients as experts of their own conditions. However, the input of pediatric patients and their families have not been consistently requested nor regarded as valuable when deriving protocols for, as well as assessing the outcomes of, pediatric clinical trials. Extending this mutual collaboration further upstream is important, especially in the area of pediatric drug development where the lack of formalized trials for children and adolescents result in the increased use of off-label prescribing and risk of adverse effects. While recent changes to European and North American legislation contributed to the inclusion of children and youth in pediatric drug development, the lack of systematic guidelines and methodologies in literature serve as barriers for practical application. When combined with the work of external pediatric advocacy and patient advisory groups, the hope is that pediatric patient voices can be brought forward for the future. This article brings together international experts to review current best practices, progress from regulatory agencies, as well as global advocacy efforts to involve patients and families in the pursuit of drug development processes that value the voice of children and youth.

Should I stay or should I go? Explaining variation in nonstate actor advocacy over time in global governance.

The past decades have been characterized by a growing number of nonstate actors (NSAs) involved in global governance. However, despite this growth, only a small number of NSAs have been able to maintain a prolonged global presence over a substantial period of time. To explain why some NSAs are more active, we rely on resource dependence theory. We demonstrate that sustained advocacy over time can be explained by a density dependence mechanism, namely the more NSAs mobilize, the lower the chance that individual NSAs will prolong their global advocacy efforts. Analysis of data stemming from a unique data set of 5,627 NSAs active at the global climate conferences demonstrates that much advocacy in this field is indeed of an incidental nature, namely a large number of groups attend once and never return.

Gender-Affirming Surgery in Persons with Gender Dysphoria.

The landscape of gender dysphoria has changed dramatically in recent years secondary to increased societal acceptance, legislative changes, and medical providers' increased awareness of the associated psychosocial burden associated with the diagnosis. National and global advocacy efforts, in conjunction with expanded third-party insurance coverage, have resulted in new health care opportunities for patients suffering from gender dysphoria. Delivering quality, streamlined health care to these patients requires a complex multidisciplinary approach, involving multiple medical and mental health disciplines, including plastic surgeons. To accommodate the expanding demand for gender-affirmation surgery, academic medical centers specializing in these procedures are gradually emerging. Advancing surgical techniques in the setting of rising patient demand encourage plastic surgeons to increasingly provide high-quality health care to this diverse patient population in an effort to optimize psychosocial functioning and minimize the burden of gender dysphoria. Although the current literature is replete with the evolving surgical and technical approaches to gender-affirming surgery, there remain critical gaps in the plastic surgery literature describing the delivery of comprehensive care to these patients. To address these gaps, the authors establish a framework that plastic surgeons can use to guide their management of patients with gender dysphoria to optimize surgical and psychosocial outcomes. First, the authors describe a timeline of events that have shaped present-day transgender medicine and characterize the current role of the plastic surgeon in the management of gender dysphoria. Subsequently, the authors discuss psychosocial and ethical considerations surrounding gender dysphoria. Finally, the authors discuss the future scope of transgender medicine.

Global Tobacco Control Advocacy, Towards Post-2015: An Evaluation of Challenges, Analysis Within the Public Policy Context, and Recommendations Moving Forward

Public health advocacy at the global level requires strategic relationship-building with governments, non-governmental organizations, and private sector leaders to increase awareness, and incentivize funding and resource accumulation, and spur action devoted to global health and development priorities. The UNAIDS and Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) represent perhaps the most influential global health advocacy campaign to date. For years, UNAIDS and the Global Fund have been able to maintain political, private and public awareness about HIV/AIDS, as well as stimulate high-profile championing and increased-funding in support of the cause. The global tobacco control (global TC) regime – currently comprised of intergovernmental organizations like the World Health Organization (WHO), NGOs, international philanthropic organizations, member state governments, businesses and individuals – has realized remarkable success despite the relative youthfulness of its global advocacy efforts, which includes the completion of the WHO Framework Convention on Tobacco Control (FCTC), the WHO’s first and only international treaty. Despite its early success, however, global TC faces considerable challenges to continued and maintained achievement. As with other health-related issues, heading into the post-Millennium-Development-Goals development era, the global TC regime stands to benefit from assessing its current global advocacy efforts. The objective of this report is thus twofold: a. To systematically evaluate global TC regime advocacy challenges; and b. To make recommendations on how to both bolster current TC advocacy efforts and address the identified challenges. This objective is executed within the context of lessons learned from other major global public health campaigns and issues, as well as contemporary public policy and administration theory and practice.

Counting children: comparing reporting for paediatric HIV and tuberculosis

“All women, men and children who need TB diagnosis and care have a right to it – no matter who they are or where they live – and they should be able to access TB services free of charge and in a manner that respects their dignity.”1 Although the World Health Organization’s (WHO’s) latest report on tuberculosis2 provides welcome news on falling numbers of cases, children are still being neglected despite the fact that they represent approximately 15–20% of the global burden of tuberculosis.3,4 Indeed, the neglect of mothers and children in tuberculosis initiatives was the topic of a major symposium by WHO’s Stop TB department at the recent 42nd Union World Conference on Lung Health.5 The Global Plan to Stop TB 2011–20151 includes the objectives of early diagnosis and treatment of all cases including children. However, current reporting on tuberculosis in children falls far short of what is required to measure and pressure progress. As Director-General of WHO, Margaret Chan, said in her inaugural speech: “what gets measured gets done”.6 To assess efforts to track progress in scaling-up services for paediatric tuberculosis, we compared reporting against that for another global epidemic for which scaling-up paediatric services is a priority: HIV. We used three indicators – disease burden, treatment and prevention – to compare paediatric data in the tuberculosis report2 with those in the 2010 UNAIDS Report on the Global AIDS Epidemic.7 This comparison is summarized at: http://tinyurl.com/d3o68wa. There are many constraints to diagnosing and treating tuberculosis in children. Definitive, simple diagnostic tests do not exist, while treatment is complicated by a lack of appropriate fixed-dose combinations for children.8 In contrast with HIV, there is limited reporting of the burden of disease and treatment for paediatric tuberculosis. Globally, the only indicators for children aged less than 15 years are the number of children orphaned by tuberculosis and the notification of smear-positive cases. This latter indication is of limited value since, except for advanced disease, most tuberculosis in children is smear-negative.9 For 22 high-burden countries, 157 135 cases of tuberculosis in children were reported in 2010. These countries have an estimated total prevalence of 9.97 million cases, meaning that at conservative estimates we should expect the number of paediatric cases to range from 498 500 (5%) to 1.49 million (15%). Even at the lowest estimate of 5%, this means that at least 341 365 cases were not diagnosed or reported in these countries. Within the 22 high-burden countries, the proportion of estimated paediatric cases varies considerably within the same region: in Asia from 0.1% (Viet Nam) to 9.6% (Indonesia) and in Africa from 1.4% (Nigeria) to 15% (South Africa). Other commentators have estimated higher proportions.10 Without specific paediatric disease estimates, it is hard to interpret whether programmes with low proportions of children are performing well (i.e. early infectious case-finding and treatment) or badly (not including children). The drive to increase access to treatment and prevention for people living with HIV/AIDS has been supported by clear reporting of need. The “antiretroviral treatment gap” has been the foundation of global advocacy efforts directed at donors to increase funding and countries to increase commitments, both for adults and children,11 and has led to ambitious political commitments to eliminate paediatric HIV by 2015.12 By contrast, current tuberculosis reporting gives little indication of unmet need and thus there is no way of judging how far we have to go. Better reporting could provide the foundation for a much-needed drive to increase political commitment to tuberculosis funding mirroring the success of HIV activism.3 The need for special efforts to ensure that children are not neglected in global health efforts has long been recognized. It is essential to include children in outcome indicators of plans and strategies for scaling-up tuberculosis services so as to ensure that paediatric tuberculosis is no longer left behind.

Rethinking the Impact of Transnational Advocacy Networks

This comparative longitudinal study of efforts to promote the environmental sustainability of the Brazilian and the Ecuadorian Amazon regions re-examines the theory of transnational advocacy networks (TANs). In particular, this study challenges the assumption that local advocacy groups participating in TANs are empowered by the experience. As we enter a second decade of accumulated knowledge about transnational advocacy networks, empirical evidence suggests a murkier portrait of the impact of TANs on local activism. Local groups may indeed gain political power and technical capacity as a result of their participation in a TAN. They may also experience a reversal of their initial empowerment gains. Finally, local activist groups may undergo complete demobilization in the aftermath of their participation in a TAN. This study underscores the possibility that participation in global advocacy efforts may entail a variety of consequences for local activist organizations and attempts to explain this variance.