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This book uncovers a historical dependency on smelting activities that has trapped inhabitants of La Oroya, Peru, in a context of systemic lack of freedom.La Oroya has been named one of the most polluted places on the planet by the US Blacksmith Institute.

The importance of integrating local perspectives into international debates about climate change has received increasing attention. Local perspectives on the impacts of climate change often focus on issues of loss and harm and support the widely recognized need for global responses to climate change as suggested by scientists and international institutions. Here we argue that local perspectives need to be addressed not only from outside communities but also from inside in order to understand people’s responses to climate change: their concerns, their understanding of themselves as members of particular groups and their position in the world, their view on responsibilities for causing climate change, and their perceptions of possible responses. The ethnographic work at two study sites, one in Carhuaz, Cordillera Blanca, Peru, and one in Stilfs, South Tyrolean Alps, Italy, identifies dominant perceptions on climate change at each site with a particular focus on glacier retreat. The case studies show that the view on the need for global action as response to climate change is not necessarily shared throughout the world, and thus presents a challenge to global collaboration.

Background While equity is a central concern in promoting Universal Health Coverage (UHC), the impact of social exclusion on equity in UHC remains underexplored. This paper examines challenges faced by socially excluded populations, with an emphasis on Indigenous peoples, to receive UHC in Latin America. We argue that social exclusion can have negative effects on health systems and can undermine progress towards UHC. We examine two case studies, one in Guatemala and one in Peru, involving citizen-led accountability initiatives that aim to identify and address problems with health care services for socially excluded groups. The case studies reveal how social exclusion can affect equity in UHC. Methods In-depth analysis was conducted of all peer reviewed articles published between 2015 and 2019 on the two cases (11 in total), and two non-peer reviewed reports published over the same period. In addition, two of the three authors contributed their first-hand knowledge gathered through practitioner involvement with the citizen-led initiatives examined in the two cases. The analysis sought to identify and compare challenges faced by socially excluded Indigenous populations to receive UHC in the two cases. Results Citizen-led accountability initiatives in Guatemala and Peru reveal very similar patterns of serious deficiencies that undermine efforts towards the realization of Universal Health Coverage in both countries. In each case, the socially excluded populations are served by a dysfunctional publicly provided health system marked by gaps and often invisible barriers. The cases suggest that, while funding and social rights to coverage have expanded, marginalized populations in Guatemala and Peru still do not receive either the health care services or the protection against financial hardship promised by health systems in each country. In both cases, the dysfunctional character of the system remains in place, undermining progress towards UHC. Conclusions We conclude that efforts to promote UHC cannot stop at increasing health systems financing. In addition, these efforts need to contend with the deeper challenges of democratizing state institutions, including health systems, involved in marginalizing and excluding certain population groups. This includes stronger accountability systems within public institutions. More inclusive accountability mechanisms are an important step in promoting equitable progress towards UHC.

Background Venezuelan migration has experienced an unprecedented increase in the last decade, with approximately 7.7 million Venezuelan-born individuals residing in other countries as of 2024. Our study aims to identify the potential and actual demand for healthcare services (SRH) in the Venezuelan diaspora’s four primary destinations within the Andean Countries: Colombia, Ecuador, Peru, and Chile. Methods Using official data from administrative records, censuses, and sample surveys reported by the host countries and international agencies, we estimate the annual evolution of Venezuelan-born women of reproductive age (WRA) and their offspring. Additionally, we conduct two case studies focusing on Colombia and Chile to analyse the groups most vulnerable to unmet health needs. Results The population of WRA has increased to between 5 and 6.8%, and births have risen to approximately 3–8% in host countries due to Venezuelan migration. Yet, we found a general decrease in health coverage for certain age groups of Venezuelan female migrants in host countries for the period 2017–2022, particularly in Chile. By 2022, an estimated 20% of healthcare needs remained unmet among children, girls, and younger Venezuelan women, contributing to greater health inequalities between Venezuelan-born adolescents and those from other countries of birth. Conclusions Our findings highlight the escalating demand for and limited access to healthcare services among Venezuelan WRA in their destinations. Unmet healthcare needs are particularly prevalent among younger women by 2022, underscoring the urgency for health system to incorporate gender-responsive, equitable interventions and ensuring health rights for high-risk migrant groups such as infants, children, adolescents, and younger women. Addressing these challenges remains a critical task for the regional public health agenda in Latin America.

According to the United Nations (UN) Refugee Agency, there were 79.5 million forcibly displaced people worldwide by the end of 2019. Evictions from homes and land are often linked to protracted violent conflict. Land administration (LA) can be a small part of UN peace-building programs addressing these conflicts. Through the lens of the UN and seven country cases, the problem being addressed is: what are the key features of fit-for-purpose land administration (FFP LA) in violent conflict contexts? FFP LA involves the same LA elements found in conventional LA and FFP LA, and LA in post conflict contexts, as it supports peace building and conflict resolution. However, in the contexts being examined, FFP LA also has novel features as well, such as extra-legal transitional justice mechanisms to protect people and their land rights and to address historical injustices and the politics of exclusion that are the root causes of conflict. In addition, there are land governance and power relations’ implications, as FFP LA is part of larger UN peace-building programs. This impacts the FFP LA design. The cases discussed are from Darfur/Sudan, Democratic Republic of Congo, Honduras, Iraq, Jubaland/Somalia, Peru and South Sudan.

Men who have sex with Men (MSM) are currently at marked risk for HIV infection in Low- and Middle-Income Countries (LMICs) in Asia, Africa, Latin America and the Caribbean, and in Eastern Europe and Central Asia. Estimates of HIV prevalence rates have been consistently higher among MSM than for the general population of reproductive-age men virtually wherever MSM have been well studied. Although scarce, HIV incidence data support findings of high acquisition and transmission risks among MSM in multiple contexts, cultural settings, and economic levels. Research among MSM in LMICs has been limited by the criminalization and social stigmatization of these behaviors, the safety considerations for study participants, the hidden nature of these populations, and a lack of targeted funding. Available evidence from these countries suggests that structural risks social, economic, political, or legal factors in addition to individual-level risk factors are likely to play important roles in shaping HIV risks and treatment and care options for these men. Services and resources for populations of MSM remain markedly low in many settings. They have limited coverage and access to HIV/AIDS prevention, treatment, and care services with some estimates suggesting that fewer than one in ten MSM worldwide have access to the most basic package of preventive interventions.