Publications by Author: Leaning%2C%20Jennifer

2014
Leaning, Jennifer. 2014. The Political Origins of Health Inequity: Prospects for Change (383). The Lancet. 383rd ed. The Lancet–University of Oslo Commission on Global Governance for Health, 630–67. Publisher's Version Abstract

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 eff orts often come into confl ict 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 diff erent 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.

2013
Leaning, Jennifer. 2013. “Natural Disasters, Armed Conflict, and Public Health.” The New England Journal of Medicine 369 (19): 1836-42. Abstract

Natural disasters and armed conflict have marked human existence throughout history and have always caused peaks in mortality and morbidity. But in recent times, the scale and scope of these events have increased markedly. Since 1990, natural disasters have affected about 217 million people every year,1 and about 300 million people now live amidst violent insecurity around the world.2 The immediate and longer-term effects of these disruptions on large populations constitute humanitarian crises. In recent decades, public health interventions in the humanitarian response have made gains in the equity and quality of emergency assistance.

natural_diasters2c_armed_conflict2c_and_public_health_published_1.pdf
2012
Leaning, Jennifer. 2012. “Toward Better Aid”. Publisher's Version
2007
Leaning, Jennifer. 2007. “The Dilemma of Neutrality”. Abstract
This paper focuses on the dilemma that humanitarian non-governmental organizations (NGOs) face in their efforts to gain access to populations caught up in current wars. Narrow and broad concepts of humanitarian protection are discussed and it is argued that despite high levels of professionalism, the space for humanitarian action has constricted sharply since the events surrounding the attacks of 11 September 2001. Increasingly, aid workers are now being viewed with suspicion as agents of the great powers and assertions of humanitarian neutrality are not heeded or rejected. Non-governmental organizations have evolved a range of options to address this problem, but there is an urgent need to work collectively to find more durable and coherent solutions.
2003
Leaning, Jennifer. 2003. “Reframing HIV and AIDS”. Abstract

(From BMJ, Volume 327, 8 November 2003)

Over the past 20 years, the public health community has learnt a tremendous amount about the HIV/AIDS epidemic. Yet,despite widespread discussion about the epidemic and some measurable progress,the overall response has been insufficient: globally 42 million people are already infected with HIV, prevalence continues to rise,and less than 5% of those affected have access to lifesaving medicines. In the face of this growing crisis, the World Health Organization has made scaling up treatment a key priority of the new administration. We argue that not only is the HIV/AIDS epidemic an emergency, but its devastating effects on societies may qualify it as one of the most serious disasters to have affected humankind. As such, this crisis warrants a full disaster management response.

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2002
Leaning, Jennifer. 2002. “Was the Afghan Conflict a Just War?”. Abstract

Wars fought to redress grievous wrongs or put a stop to evil have been termed "just wars." The concept has its origins in classical and theological philosophy and was explicit in the Christian ethics of Saint Augustine. Just war theory describes narrow circumstances and tight constraints on the ends and means that are required to apply this term. Although Western law has slowly come to accept war as an inevitable instrument of national policy and turned its attention to setting standards for the conduct of war, important echoes of just war theory remain. A distinction was made at Nuremberg, and later embedded in articles 2 and 51 of the United Nations charter, between unacceptable aggressive war and acceptable wars of self defence. Contemporary arguments about particular wars still rely on the seven main principles of just war theory. Application of these principles to the conflict in Afghanistan does not settle the debate but it might help to structure the discussion.

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2000

Human security is a concept that dates back to the Enlightenment. Various strains of meaning, spanning a focus on individual rights and a preoccupation with territorial integrity of states, have accompanied its use in many settings. In the last 25 years, the term has increasingly been applied to political, social, and economic inputs required to create security for individuals and communities. Most recently there has been growing interest in assessing the usefulness of this concept in the design of policies to provide relief and stabilization in areas emerging from war and conflict.

In that transitional context this paper argues for a new definition of human security based on identifying those factors that protect and promote human well being through time. This argument builds on the capabilities analysis of Sen and Dreze, incorporates the vulnerability model described by Webb, and employs the psychosocial needs framework of Amoo. Noting that the provision of basic material supports is essential but not sufficient, the definition of human security advanced here insists on the additional importance, for individuals and communities, of fulfilling three basic psychosocial dimensions: a sense of home and safety; constructive family and social supports; and acceptance of the past and a positive grasp of the future. These three psychosocial dimensions (referred to in shorthand as home, community, and time) are evaluated in a number of settings, primarily in Africa. Suggestions are provided, based upon this concept, for humanitarian efforts in refugee and immediate post–conflict settings.

The paper further argues that ways of measuring human security along these three dimensions are more easily approached through the use of negative indices, or threats to human security. The negative indices proposed here are social dislocation (for home), dynamic inequality (for community relationships), and high discount rate (for positive sense of the future). It is noted that further methodological effort is needed to refine the metrics to be used in these indices. Whether this concept and its proposed indices could prove useful in identifying trends in human security (or threats to human security) in the immediate post (or pre) conflict setting will require further empirical work, through retrospective case studies and prospective observation and analysis.

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