Dear Colleagues,

As you know, Mitt Romney was thoroughly “unzipped” this week. However, that doesn’t imply he cannot win anymore. Robert Reich gives  four reasons why the GOP contender still has a decent chance in the presidential race. I would like to add a fifth one, the ‘Foxification’ of part of the voters. By way of example: apparently 15 % of the Ohio Republicans think Romney was the one who took out Osama Bin Laden… And only slightly less disturbing: 47 % was unsure whether it was Obama or Romney.  GOP voters may be less “dependent on the government”, but that doesn’t make them more knowledgeable, apparently.

Enough said. In this week’s guest editorial, Paulin Basinga and Kedest Tesfagiorgis (both from the Gates Foundation) invite African researchers to take part in the Grand Challenges Explorations grant program. It’s a global program, but Africans are warmly encouraged to apply. Speaking of the Gates Foundation, you might also want to check out a recent essay by Gates on catalytic philanthropy, as well as a Forbes article  that compares philanthropy contributions made by Gates and Buffett. Meanwhile, the ‘Giving Pledge’ initiative got a few more bigwigs on board this week.  

Enjoy your reading.

Kristof Decoster, David Hercot, Ildikó Bokros, Peter Delobelle, Basile Keugoung &Wim Van Damme




An Invitation to African Innovators

By Paulin Basinga & Kedest Tesfagiorgis (Bill & Melinda Gates Foundation)

The Grand Challenges Explorations grant program seeks bold ideas from innovative thinkers to solve the greatest challenges in health and development.  One great idea. Two pages to fill out.  That’s all it takes.

Read the rest of the editorial here.


Lancet Countdown to 2015 & series on Child equity


With the 67th UN General Assembly taking place this week, there is a growing sense of urgency that some of the poorest countries in the world will not reach 2015 targets for maternal, neonatal, and child survival. This week, The Lancet published a few papers highlighting how development aid is stalling (for MNCH), despite an increase in the number of donors. (In the Guardian, Sarah Boseley also commented on the worrying news).

The Lancet also featured some good news from Niger, though. Child mortality is substantially decreasing over there. Horizontal universal access, vertical campaigns and nutrition programmes have proved key strategies.

The Lancet also published a new two-part Series on Child Equity which presents a new analysis by UNICEF to challenge the assumption that reaching the remote, the poorest, and most-in-need children is too costly and difficult to pursue.

In a Comment, Anthony Lake, Executive Director of UNICEF, writes “For decades, many have believed that reaching the remote, the poorest and most-in-need children is a moral imperative … however, it has often been considered by policymakers as too costly, time-consuming and difficult to pursue with the limited purses of international aid and public finance.”  The Lancet’s two-part Series presents an analysis by UNICEF to challenge this assumption.

The first Series paper examines bottlenecks that prevent interventions from reaching poor people in low-income and middle-income countries, and subsequently identifies evidence-based strategies to overcome these issues. The second Series paper builds on these recommendations by using a mathematical modelling approach to predict the effect and cost-effectiveness of maternal and child-health strategies. The authors show – through the use of modeling tools like MBB and LiST – that an equity focused approach is as effective as business-as-usual to reduce child mortality, and potentially cheaper. Great news.


Global Fund


1.    GFO – issue 195 & issue 196

The Global Fund reform is in full swing. Two new GFO issues this week, need I say more?  Bookmark the site, subscribe to the newsletter, use RSS feeds, … if you haven’t done so yet.

In the newsletters, there is a lot of attention for the new (and still to be finalized) GF funding model. Some of the other Board decisions you can find in this news article.

The Global Fund issued its 8th news flash. Apart from the new Funding model, the issue also pays some attention to AMFm (which the GF will host for another year), and the new code of conduct for Recipients.


2.    KFF – First Phase Of Global Fund-Managed AMFm Shows Success In Bringing Malaria Drugs To Clinics

“The Affordable Medicines Facility-malaria (AMFm) brought more than 100 million doses of malaria drugs to clinics and pharmacies in 2011 and also increased access to the top malaria medicines by 26 to 52 percent in six countries,” according to results from the first phase of the program. The results of the evaluation, released on Wednesday in Washington, D.C., do not estimate how many lives were saved.


NCDs – 1 year after the UN high level meeting


3.    Lancet (Editorial) – NCDs and the UN: danger of a missed opportunity

The global health movement to tackle NCDs is at a pivotal point. This week is the first anniversary of the watershed high-level UN meeting on NCDs. The meeting was a crucial step for putting diseases such as cancer and cardiovascular disease high on the global health agenda. However, little action, other than more talking, has been taken since. Luckily we have the Lancet. In the coming months, the journal will set out its views of what the NCD targets should be. Additionally, the upcoming fourth Lancet Series on NCDs will cover sustainability, accountability, country action, access to interventions, health systems, inequality, and diet—all areas that are largely neglected in current debates.

Both CGD (Victoria Fan) and CFR (Thomas Bollyky) offer interesting reflections on the anniversary of the NCD meeting. Fan is more pessimistic than Bollyky, it seems.

The Huffington Post also has a few op-eds on the same issue – Ben Grover & Felicia Knaul think the NCD battle should be reframed, if it is to gain momentum. And Princess Dina Mired asks why there’s so little attention for treatment (as compared to prevention). (well, princess, perhaps that’s because the world media tends to be more interested in princess breasts than in treating breast or other cancers. Maybe we should get Kate Middleton (and the tabloids) on board to give a boost to the NCD struggle – a PPP with the tabloids, that sure sounds innovative).


4.    Global Health Promotion – 21st century determinants of health and wellbeing: a new challenge for health promotion

Ilona Kickbusch;

Ilona Kickbush challenges health promotion to link three debates to the global health agenda: wellbeing, sustainability and social investment. She also suggests to expand the action areas of the Ottawa Charter to include the 21st century determinants of health such as unsustainable lifestyles, flow of people and stress, thereby challenging not only professionals but also politicians to find actual means for their solution.




5.    BMJ (Feature) – “World’s pharmacy” faces new challenges from Western drug companies

Andrew Jack;

As it becomes a global battleground for the fight over intellectual property rights, is India’s role as the “world’s pharmacy” under threat? And what effect will this have on affordable access to medicines? Andrew Jack reports.

Other related news articles you might want to read are a BMJ news article on the beginning of the final hearings in the legal battle over the Novartis drug, and a Scidev article that gives a nice overview of what’s at stake.

Not really related, but nevertheless nice to read – especially for the ones who like to know more about links between German pharmaceutical companies and the Nazis, is a Newsweek article of a few weeks ago on the thalidomide drug scandal.


6.    Down to earth – Universal health scare

Vibha Varshney et al.;

Varshney and colleagues’ Universal health scare in this week’s Indian magazine Down To Earth has more to offer than a catchy title. In an easy-to-read journalistic style, the article provides an overview of stakeholders’ positions and actions – a bewildering hodgepodge of conflicting powers – in India’s current construct of a roadmap towards UHC. What started as a proposal of an expert committee, using technical arguments, has become a political battle of interests, largely unhindered by evidence.

It is within this context that the Institute of Public Health, institutional partner of ITM, organizes its second bringing Evidence into Public Health Policy (EPHP) conference in Bangalore, October 5-6. The conference theme is aptly chosen: strengthening health systems to achieve universal health coverage in India. The time is right too, as India’s Planning Commission is currently rewriting the health chapter of the country’s 12th Five Year Plan. Expect your IHP Newsletter to report on the evidence presented at EPHP in two weeks from now. And hope for the policymakers to lend an ear to it. (by Werner Soors)


Health Policy & Financing


7.    BMJ (news) – China is nearly ready to produce vaccines for developing world

Ann Gulland;

The Chinese drug industry is on the verge of getting the green light to manufacture the Japanese encephalitis vaccine for the developing world, an event that will signal the emergence of a major new player in global vaccines. (will China pick up the baton from India?)


8.    Lancet – Untreated surgical conditions: time for global action

Lohfa B. Chirdan et al.;

It’s about time the surgical conditions are no longer the “neglected stepchild of global public health’. The Lancet focuses on surgery today – this article already appeared online in August.


9.    BMC public health –  Health systems frameworks in their political context: framing divergent agendas

Josefien Van Olmen et al.;

Brilliant article. It shows how health systems frameworks have evolved over the past decades, sometimes (but not always) in line with dominant political paradigms at the time.


10. Transforming Health Markets in Asia and Africa -Improving quality and access for the poor

Edited by Gerry Bloom et al.;

There has been a dramatic spread of health markets in much of Asia and Africa over the past couple of decades. The effort to bring order to these (often very chaotic) markets is almost certain to become one of the greatest challenges in global health. This book documents the problems associated with unregulated health markets and presents innovative approaches that have emerged to address them. It outlines a framework that researchers, policy makers and social entrepreneurs can use to analyse health market systems and assess the likely outcome of alternative interventions. The book presents a new way of understanding highly marketised health systems, applies this understanding to an analysis of health markets in countries across Asia and Africa and identifies some of the major new developments for making these markets perform better in meeting the needs of the poor. It argues that it is time to move beyond ideological debates about the roles of public and private sectors in an ideal health system and focus more on understanding the operation of these markets and developing practical strategies for improving their performance.


11. CGD – Trans-Pacific Partnership (TPP) as Death Star? Really?

Kimberley Ann Elliott;

Kimberley A Elliott thinks the Avaaz metaphor of the Trans-Pacific Partnership (TPP) is a bit over the top: “A top-secret, global corporate power grab of breathtaking scope,that will result in a giant global pact, with an international tribunal to enforce it that  will be brought down like a Death Star on our democracies.”


12. CGD – The Aid Fungibility Debate and Medical Journal Peer Review

David Roodman;

In a very comprehensible blog post, David Roodman comes back on last week’s Lancet Correspondence on the aid fungibility debate. He also offered some gentle recommendations for the Lancet peer review process.


13. CGD – Should UNITAID Rethink Its Raison d’Être?

Victoria Fan & Rachel Silverman;

CGD fellows were very productive this week. Here’s another health policy blog post on UNITAID, by Victoria Fan & Rachel Silverman. As UNITAID celebrates its 6th birthday, it stands at a crossroads, they contend.


14. Health Financing in Africa (blog) – Regional conference on social health protection in East African Community

Richard Alia;

In this blog post, Richard Alia reports on the recent conference on Social Health Protection in Kigali, Rwanda. He is worried that the goal of UHC may not be achieved in the near future in the East Africa Region due to weak health systems, poor road infrastructure and lack or high cost of transport to the care and treatment centers for the rural population. Besides, health expenditure is escalating – technology is one of the major reasons.


15. Global health governance and WHO reform at the 62nd session of WHO Europe

Remco van de Pas;

“Health is too big to fail”. With these words Margaret Chan addressed the 62nd regional committee meeting on 11th September in Malta. Van de Pas (Wemos) noticed Chan was very outspoken during this meeting of WHO Europe. She indicated with her interventions that she is truly at the helm of the organization, steering it to a renewed leadership position in the dense landscape of global health actors and initiatives. At least, that’s what many of us hope for.

As for the new WHO overall global health goal, Universal Health Coverage, Adam Wagstaff wrote an elegant blog post on how to measure it.


16. CGD – Wanted: global health diplomat

Amanda Glassman & Jenny Ottenhoff;

Glassman & Ottenhoff wonder what the job description might look like for the new US ‘global health diplomat’ (let’s call him or her the ‘global health commander in chief’ from now on) and whether such a job would actually be enticing.

KFF issued an issue brief on global health diplomacy.




17. BMJ (news) – Elsevier improves access to its products in 100 developing countries

Nigel Hawkes;

Researchers in more than 100 developing countries will be able to access the entire collection of books and journals published by Elsevier free or at low cost, the Access to Research and Development Programme has announced.

Check out also a ‘Speaking of Medicine’ blog post by Marina Kukso in which she discusses the challenges faced by the Open Access movement as it comes of age.


18. Health Policy & Planning – Assessing the population health impact of market interventions to improve access to antiretroviral treatment

Till Bärnighausen, Margaret Kyle, Joshua A Salomon et al.;

Despite extraordinary global progress in increasing coverage of antiretroviral treatment, the majority of people needing ART currently are not receiving treatment. Several international organizations are using interventions in ART markets to decrease ART price or to improve ART quality, delivery and innovation, with the ultimate goal of improving population health. These organizations need to select those market interventions that are most likely to substantially affect population health outcomes (ex ante assessment) and to evaluate whether implemented interventions have improved health outcomes (ex post assessment).


Development & Aid


19. MDG Gap Task Force Report 2012 – MDG 8: The Global Partnership for Development: Making Rhetoric a Reality

Mark Tran reflects on this new UN report in the Guardian. A drop in aid for the first time in many years and a rise in protectionist policies as a result of the global economic crisis risks slowing the momentum of significant development gains.


20. CGD – Global Citizens and the Global Economy

Nancy Birdsall;

Nancy Birdsall published a CGD paper on Global citizenship, adapted from a recent speech delivered to the UN General Assembly. She argues that in the absence of an activist global political entity to address some of the core global issues, the growing number of people who are coming to regard themselves as global citizens should press their own governments to adopt policies that address these problems, domestically and internationally. (a must-read, although I’m somewhat less optimistic about the rich and powerful’s inclination to side with these global citizens and the downtrodden; there are many more fat cats at Romney’s fundraising events than at the Giving Pledge…)




  • In an article related to the UN General Assembly meeting, Charles Kenny argues that what the world now needs is: reforming economic relations so that the world’s most-disadvantaged benefit further from trade, investment, and migration. Kenny also refers to an op-ed by Ben Leo (from the One campaign), in which the latter ponders the process for determining the next MDGs. In order to take the opinion of the world’s poorest citizens into account, Leo proposes a large-scale questionnaire: a standardized set of questions that would be answered globally, covering both developing and developed countries. The resulting data would help to ground official discussions in ordinary people’s daily realities and concerns, and give a serious boost of credibility and relevance to the post-2015 framework discussions. Whether this will happen, is another matter.
  • The Guardian gives a good overview of the state of international climate negotiations (ambition, legal aspects, financial assistance, alliances…).
  • In an Alertnet article, an expert mentioned that the largest health impact of climate change might be on malnutrition and hunger.
  • A big story in the UK press this week: in spite of the untying of aid, big chunks of DFID aid are still going to private (UK) companies. Read it here and here.  Value for money, UK style?
  • Finally, the EC has set out a strategy to increase the EU’s international cooperation and capacity building in science and innovation, including boosting partnerships with emerging economies and developing countries. Despite progress in the EU’s international science activities, “critical mass is lacking in many cases and the strategy driving the development of the actions is not always clear”, according to a report released by the Commission this week.  Check out the Scidev article on the new plan.

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