Dear Colleagues,

 

It’s International Day of the World’s Indigenous people today (9 August).  The focus of this year’s International Day is “Indigenous peoples building alliances: Honouring treaties, agreements and other constructive arrangements.” On the website, we find: “The theme aims to highlight the importance of honouring arrangements between States, their citizens and indigenous peoples that were designed to recognize indigenous peoples’ rights to their lands and establish a framework for living in proximity and entering into economic relationships. Agreements also outline a political vision of different sovereign peoples living together on the same land, according to the principles of friendship, cooperation and peace.” And as David Legge mentioned on Twitter, perhaps we can also learn a thing or two from the indigenous people if we want to save this planet.

 

World Breastfeeding Week was also celebrated this week in the global health community. In addition, there was quite some commotion about virus related patent issues and a suggestion by top-notch scientists to genetically engineer a lethal strain of bird flu to understand how it could mutate in nature and trigger a catastrophic pandemic. However, for some reason the world paid a lot more attention to the first lab-grown burger, also known as the Google Burger.

 

The Obamas visited Africa some weeks ago, so members of the  Clinton family reckoned they couldn’t stay behind, to advance Clinton Foundation & Clinton Global Initiative goals. We also noted some high-profile appointments recently in the fight against HIV: Michel Sidibé appointed the First Lady of Mozambique as a Patron of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive, and Ban Ki Moon appointed former Ugandan Vice President Speciosa Wandira-Kasibwe as his special envoy for HIV/AIDS in Africa.

 

Over to Europe then. Now that Mr. “Bunga Bunga” is more or less silenced, a UKIP politician in the UK found the time ripe to come up with the term ‘Bongo Bongo land’. Some Europeans still seem confused about the century/millennium they’re living in. Anyway, in the silly season, this already led to a number of nice reads.

 

Far away in Asia, China is considering an end to its one child policy, but the picture is still murky. Meanwhile, in the FT, Andrew Jack and others report on the widening drugs industry inquiry by the Chinese. Some other western multinationals have been facing inquiries by the authorities.

 

Last but not least, next week, on August 15, the long awaited World Health Report, “Research for universal health coverage”,  will be released.

 

In this week’s guest editorial, ITM colleagues Luc Van Leemput and Gorik Ooms draw your attention to an upcoming event in which they are involved, a satellite session linked to the 8th European Congress on Tropical Medicine and International Health in Copenhagen. The session is scheduled for September 9 and will also be livestreamed. In the session, Go4Health consortium members will present their view (and a proposal) on post-MDG health goals and targets, as well as on elements of the underlying global social contract needed to help realize the right to health for all. 

 

Enjoy your reading.

 

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

 

 

Editorial

 

A new health goal for humanity, and a global social contract: Realising the right to health for everyone

 

(Satellite session linked to the 8th European Congress on Tropical Medicine and International Health, Monday 9 September, Copenhagen)

 

Luc Van Leemput & Gorik Ooms (on behalf of the Go4Health consortium)

 

Go4Health[1], a collaboration of academics and civil society tasked with offering scientific evidence to the European Commission on the next set of global health goals, will organize a satellite session at the 8th European Congress on Tropical Medicine and International Health in Copenhagen, to present and discuss a new health goal for humanity and a supportive global social contract.

 

Go4Health stands for goals for global health and for governance for global health. Goals and governance are the essential elements of a social contract. The Millennium Declaration can be understood as an emerging global social contract. Its preamble sets forth a bold vision for a common humanity, advancing global responsibilities without diminishing national responsibilities: “We [heads of States and Government] recognize that, in addition to our separate responsibilities to our individual societies, we have a collective responsibility to uphold the principles of human dignity, equality and equity at the global level.” This requires a contract between governments, and between citizens of the world. The key aim of the Go4Health project is to advance and improve upon the concept of a global social contract as articulated in the Millennium Declaration, proposing goals and a governance structure centered on a framework of shared but differentiated responsibilities.

 

The Go4Health consortium has identified key elements for post-MDG  health  goal(s) and targets and a supportive global social contract, based on evidence from four different research streams, including community consultations of marginalized communities in 8 countries on their health needs. Taking into account the gaps and tensions identified, we have formulated a first proposal of a new health goal for humanity and the elements of a supportive global social contract. We propose the right to health as the overarching health goal, with targets on health care and a healthy environment.

 

The consortium looks forward to presenting and discussing this proposal during its satellite session, which will take place on Monday 9 September 2013, 5-7 pm in Tivoli Hotel, and will be followed by a reception. The event will also be live-streamed, details of which will follow early September. We hope to see many of you there.

 

Programme:

 

  • Introduction by Rafael Vilasanjuan Sanpere, Director ISGLobal, moderator of the session
  • Presentations by Go4Health:
    • Albrecht Jahn, University of Heidelberg
    • Walter Flores, CEGGS
    • Lisa Forman, Dalla Lana School of Public Health
    • Devi Sridhar, University of Edinburgh
    • Gorik Ooms, Institute of Tropical Medicine Antwerp
  • Respondents:
    • Joe Thomas, Partners in Population and Development
    • Mayowa Joel, Southern IHP+ civil society representative
    • Marleen Temmerman, WHO
  • Discussion
  • Reception (7-9 pm): Foyer Tivoli Hotel and Congress Centre, ground floor.

 

 

 


World Breastfeeding Week & women’s health

 

 

I realize I’m sort of committing the ultimate sin in global health, making a link between World Breastfeeding Week and women’s health. But hey, that’s what we men are for.

 

1.    Devex – Breastfeeding needs more aid

Arun Gupta;

https://www.devex.com/en/news/breastfeeding-needs-more-aid/81555

As mentioned in the intro, World Breastfeeding Week was celebrated from August 1 to 7. In this Op-ed, Arun Gupta provides statistics about breastfeeding globally, discusses the health benefits for newborns and examines a lack of international funding for breastfeeding initiatives. He ends his piece with the following recommendation: “All countries, donors and development agencies should allocate at least 10 percent of the child budget to strategies for increasing breastfeeding.”

 

On the World Breastfeeding week website, you find that this year’s theme was: ‘Breastfeeding support: close to mothers’. The theme highlights Breastfeeding Peer Counselling.

 

Nevertheless, there’s still a long way to go before we live in ‘Breastfeeding Nirvana’. By way of example, read this recent BMJ news article on the situation in India: “Large food manufacturers are breaking official rules by tempting mothers away from breastfeeding to give their babies produced food, claims a group of leading charities in India.

 

2.    WHO Bulletin (early online) – Measuring maternal health: focus on maternal morbidity

Tabassum Firoz et al.;

http://www.who.int/bulletin/online_first/13-117564.pdf

Members of the Maternal Morbidity Working Group (MWWG) argue that a forceful global response – akin to that generated by maternal mortality – is needed to

better explore the causes of maternal morbidity and its epidemiological characteristics and to reduce its frequency. The working group leads and carries out a project to improve the scientific basis for defining, measuring and monitoring maternal morbidity. WHO’s Department of Reproductive Health and Research

initiated this project, with support from the Gates Foundation. “Relying solely on maternal mortality to assess a country’s status in the area of maternal health overlooks the importance of maternal morbidity, which is not only a precursor to maternal mortality but also a potential cause of lifetime disability and poor quality of life. As we move towards 2015 and beyond, it is important that we recalibrate the global goals focused on mortality to address maternal morbidity and its long-term outcomes.”

 

We also want to draw your attention to a few Letters in this week’s Lancet issue, on maternal ‘near miss’ criteria. Jonathan Specter expressed his concern about the applicability of criteria developed by WHO for identifying near miss, in poor-resource settings. The authors of the earlier piece reply.

 

3.    Thomson Reuters Foundation – Millions of girls in Africa to gain access to family planning

http://www.trust.org/item/20130802160120-5mhx0

Eight African countries will get support to improve access to reproductive health education and services for millions of adolescent girls, UNFPA said last Friday. Over the next three years, the agency will work with the governments of the Democratic Republic of Congo, Ethiopia, Mozambique, Niger, Nigeria, Sierra Leone, South Sudan and Tanzania to develop programmes for marginalised girls and young women aged 15–19 to ensure they have access to age-appropriate sexual education that will prepare them for adult life.

 

4.    Lancet (Editorial) – Leadership change and health at UN Women

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61695-5/fulltext

This Lancet editorial zooms in on the leadership change at UN Women, with Mrs. Bachelet leaving and Mrs. Phumzile Mlambo-Ngcuka taking her place.

 

5.    UNAIDS – Building momentum to stop new HIV infections among children and keep their mothers alive

http://www.unaids.org/en/resources/presscentre/featurestories/2013/august/20130802mnch/

As part of on-going efforts to improve the health of women and children across Africa, the African Union recently convened an international conference on maternal, newborn and child health in Johannesburg, South Africa. The conference (which took place from 1 to 3 August) addressed a number of important issues including service delivery and quality of service, access to medicines, family planning and task shifting. It also looked specifically at the impact of HIV on women and children and how to ensure increased access to essential HIV services.

 

 

Viruses & patent issues

 

6.    KFF – Researchers Plan To Genetically Modify H7N9 Virus To Better Understand Mutations

http://kff.org/news-summary/researchers-plan-to-genetically-modify-h7n9-virus-to-better-understand-mutations/

It’s not really a key focus of this newsletter, as you know, but this week you can’t escape Laurie Garrett’s core business. In letters in the journals Science and Nature, Ron Fouchier of Erasmus University in the Netherlands and colleagues from a dozen research centers in the U.S., Hong Kong and Britain outlined plans for what’s called ‘gain-of-function research’ — creating potentially stronger strains. This research proposal just followed on the reporting by Chinese scientists of  the first probable case of person-to-person transmission of the H7N9 virus. “Some of the world’s leading flu researchers argue that genetically altering the H7N9 virus in high-security labs is key to studying how it might mutate in the wild to become a bigger threat to people, maybe even the next pandemic.” Check out also the Economist on the same issue.

 

A Lancet Global Health blog post earlier this week, by Alimuddin Zumla, argued for equitable partnerships for tackling killer infectious diseases. “The appearance of a new infectious disease with high mortality rates can ignite fierce scientific and political competition. A rush by scientists to be first to discover the virus and to claim patents and commercial rights can ensue. The global events surrounding the new killer virus Middle East respiratory syndrome coronavirus (MERS-CoV) appear no different, as recent political and scientific controversies illustrate. How can we get scientists to work together with unity of purpose to tackle killer infectious diseases? How can we create collaborative international multidisciplinary partnerships and get scientists to move away from self-centred agendas towards more altruistic intentions? Is it possible for scientists and health-policy-making institutions such as WHO to work together without instruction or dictation, to protect global health security through effective amiable partnerships? …

 

7.    Lancet (World Report) – Gene patents remain controversial in biomedical research

Carrie Arnold;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61698-0/fulltext

A recent US Supreme Court ruling and the outbreak of a novel coronavirus has put gene patenting under the spotlight. Carrie Arnold asks researchers their views about this contentious issue.

Post-MDGs

 

8.    BMJ (editorial) – What will follow the millennium development goals?

Charles Kenny & Amanda Glassman;

http://www.bmj.com/content/347/bmj.f4431?utm_&&&

In a BMJ editorial from a few weeks ago, CGD fellows Kenny & Glassman think the High Level Panel’s (ambitious) recommendations on health deserve support. “The energies of the global health community might be better spent (i.e. in the next two years) in trying to protect the most important of the panel’s goals and targets, as well as lobbying for the support needed to meet them, rather than complaining that the goals and targets don’t go far enough.”

 

9.    BMJ (Feature) – Data briefing – Does good healthcare score as highly with the public as education and protection from crime?

John Appleby;

http://www.bmj.com/content/347/bmj.f4705

What do people across the world rate most highly in their economic, social, and political life? John Appleby dissects the findings of a massive survey by the UN, the “My world” survey. (The survey will continue, till 2015. So you can still have your say, to improve upon the underwhelming 800.000 people who already participated so far.)

 

10. Lancet (World Report) – New goals in sight to reduce poverty and hunger

John Maurice;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61642-6/fulltext

Efforts to meet the 2015 deadline for the MDGs have reduced poverty and hunger. A new set of goals to complete the work on MDG 1 is about to be unveiled. John Maurice reports (in last week’s Lancet).

 

In other MDG related news, US News & World Report reports on a new study (by a statistician with UNFPA, while on a sabbatical), which suggests that the MDGs did not accelerate developmental progress globally after they were announced in September 2000.  There is a whole history behind the (publication of the ) study – it took a while – and not everybody agrees with it, obviously.   The article also features reactions from Charles Kenny and Jeffrey Sachs, among others.

 

 

WHO

 

11. Journal of Public Health Policy – WHO reform: A personal perspective

Ilona Kickbush;

http://www.palgrave-journals.com/jphp/journal/v34/n3/pdf/jphp201323a.pdf

In this Perspective, Kickbusch suggests that WHO’s role in the provision of global public goods, “smart sovereignty” by member states willing to pool responsibilities, and new financing mechanisms for global public goods for health become the three focal issues that civil society needs to prioritize in the context of WHO reform.

 

12. Lancet (Comment) – A milestone in the response to non-communicable diseases

Oleg Chestnov et al.;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61457-9/fulltext

WHO staff members consider the Global Action Plan for Prevention and Control of Non-communicable Diseases 2013—20, adopted on May 27 by Ministers of Health of 194 WHO member states, a milestone in the NCD response.

 

13. International Journal of Health Services – Noncommunicable Diseases: Global Health Priority or Market Opportunity? An Illustration of the World Health Organization at its Worst and at its Best

Alison Rosamund Katz;

http://baywood.metapress.com/app/home/contribution.asp?referrer=parent&backto=issue,4,13;journal,1,171;linkingpublicationresults,1:300313,1

This article you might want to read together with the previous one, as they both relate to the NCD challenge (as well as to WHO’s role in the response).

 

Katz contrasts the “hard sell” of NCDs as the global health priority in the first decades of the 21st century, a stance increasingly in vogue (including in some slick WHO documents), with the more sober style of the WHO’s Global Burden of Disease report. The latter presents a more nuanced picture of mortality and morbidity and different implications for global health priorities. “The current promotion of NCDs provides an excellent illustration of WHO at its worst and at its best. In simple terms, WHO is at its worst when directed by private interests and at its best when directed by its constitutional mandate and all rather than some of its member states.”

 

The same journal’s latest issue also features another neat article, ‘Primary Health Care, Now and Forever? A Case Study of a Paradigm change’, by Mrigesh Bhatia and Susan Rifkin. PHC is still relevant, more than thirty years after Alma Ata. Why is this the case? The authors used Kuhn’s Theory of Paradigms to explore why PHC remains on the global health agenda. They argue there is evidence to suggest an emerging shift in how we understand health improvements, from focusing on control of diseases and infirmities based on biomedical interventions alone to understanding biomedical interventions in a context of social determinants.

 

Health Policy & Financing

 

14. UiO- Health, Social Injustice and Global Action – reflections from the Commission chair Ole Petter Ottersen

Ole Petter Ottersen;

http://www.med.uio.no/helsam/english/research/global-governance-health/news/reflectionschair.html

The work of The Lancet-UiO Commission on Global Governance for Health is soon coming to an end. In this short news article you can read some of the Commission chair’s reflections on the process and outcomes here. As you know, the Commission focuses on “the causes of the causes of the causes”, or the political determinants. (my humble suggestion to the chair: don’t ever use the term ‘causes of the causes of the causes’ when talking to a politician, as he/she might get dizzy.)

 

The Commission report is set to be published in The Lancet this autumn. In it, “we propose a number of recommendations that offer concrete steps towards addressing the identified dysfunctions of global governance. The report  will send a strong message to the international community and to all actors that exert influence in processes of global governance:  we must not any longer regard health solely as a technical and biomedical issue but recognize the need for cross-sectoral action and distributive justice in our efforts to address health equity.”  (yes, that fits nicely with the message of the previous article)

 

15. World Bank (report) – The challenge of non-communicable diseases and road traffic injuries in Sub-Saharan Africa : an overview

http://documents.worldbank.org/curated/en/2013/06/17997739/challenge-non-communicable-diseases-road-traffic-injuries-sub-saharan-africa-overview

This report draws on a comprehensive review of the literature and on input from policy makers, researchers, and practitioners to address four questions: (1) how is the growing burden of NCDs and road traffic injuries (RTIs) changing the epidemiology of Sub-Saharan Africa? (2) What determines and drives this burden, and what are the commonalities with communicable diseases? (3) What is the rationale for public intervention? (4) How could resource-constrained governments approach NCD prevention and treatment and road safety in a comprehensive, effective and efficient way?

 

For a quick assessment of this new WB report, see this Guardian article.

 

16. Lancet – Offline: Challenging America’s hegemony in global health

Richard Horton;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61641-4/fulltext

Before going on holidays (?), Horton lamented America’s hegemony in global health (in last week’s Lancet), perhaps inspired by a recent visit to Cuba. (We don’t fully understand though why he argues it’s time France reclaims its rightful place at the leadership table of global health. France, huh ? Why not Belgium then? )

 

17. Lancet (Comment) – GBD 2013: open call for collaborators

Christopher Murray;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61692-X/fulltext

Speaking of America’s hegemony in global health, Christopher Murray clearly wants to do something about it. He thus issued a call for (more) collaborators on GBD 2013, to be published in 2014 if all goes well. “Following the model of the GBD 2010, we are building and sustaining an even larger and more diverse network of individuals worldwide with expertise in specific diseases, injuries, risk factors, and impairments; the epidemiological profile of individual countries; and all-cause mortality estimates. By expanding the network contributing to the GBD to encompass experts with broad knowledge of the epidemiology of a particular country, we hope to strengthen country-level assessments.”

 

Murray also emphasizes the importance of annual updates, from a political point of view.

 

18. Lancet – The global pandemic of peripheral artery disease

Alan T. Hirsch et al.;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(13)61576-7/fulltext

Hirsch et al. comment on a Lancet study by Gerald Fowkes and colleagues, in which they provide the first conservative estimate of the global burden of peripheral artery disease, which affects more than 202 million individuals. They conclude: “Peripheral artery disease has been documented to be a key component of the global burden of non-communicable diseases; this burden is higher in LMIC than in HIC, is increasing in every region, and does not differ between sexes. Future progress in the improvement of global health will require a global strategic plan for peripheral artery disease. When any disease affects more than 200 million people, it is time to take action to prevent and control its global burden.

 

19. BMJ (Personal view)  – Africa could learn from India’s burgeoning pharma sector

Sakthivel Selvaraj;

http://www.bmj.com/content/347/bmj.f4235?etoc=

Prohibitive drug costs are leading some African countries to try to enter the generic market. They would do well to look at India’s model, says Sakthivel Selvaraj.

 

20. Lancet Global Health – Governments are legally obliged to ensure adequate access to health information

Soumyadheep Bhaumik et al.;

http://www.lancet.com/journals/langlo/article/PIIS2214-109X(13)70043-3/fulltext

The authors call on governments worldwide “to publicly acknowledge the fact that they are, under international human rights law and treaties, legally obliged to take steps to improve the availability and use of health-care knowledge for their citizens and health professionals.” (Access to ‘reliable, relevant and implementable health-care information’ is indeed vitally important, I noticed myself over the last days. And if things deteriorate further, next week I might tell you more about the worldwide need for access to morphine and other forms of pain reliefJ).

21. BMJ (Editorial) – India’s new policy to protect research participants

Jeremy Sugarman et al.;

http://www.bmj.com/content/347/bmj.f4841

Sugarman et al. argue a new policy in India, known as the “Drugs and Cosmetics (First Amendment) Rules 2013,” (from a few months ago), aimed at protecting research participants, has some unintended consequences.

22. BMJ Comment – Tranexamic acid in trauma: we need stronger global health policy

José Caballero Alvarado et al.;

http://www.bmj.com/content/347/bmj.f4593

Tranexamic acid substantially reduces death in bleeding trauma patients. So why are the World Health Organization, the United Nations, the World Bank, and Unicef not ensuring global implementation, ask Ian Roberts and colleagues.

 

23. Plos (Policy Forum) – Public Engagement in Health Priority Setting in Low- and Middle-Income Countries: Current Trends and Considerations for Policy

Katarzyna Bolsewicz Alderman et al.;

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001495;jsessionid=01B1E3F1293F6157C0C72A69C161E7F7

David Hipgrave and colleagues argue that we must find more effective, equitable, feasible, and affordable ways to engage the public in health priority setting in developing countries.

 

24. CSIS – A greater Mekong health security partnership

J. Stephen Morrison et al.;

https://csis.org/files/publication/130719_Morrison_GreaterMekongHealth_WEB.pdf

From the Executive Summary: “The CSIS Task Force on Health and Smart Power in Asia has concluded that a unique opportunity exists to advance U.S. interests in the Asia-Pacific while addressing major regional health issues. We recommend expanded health engagement, focusing on the Greater Mekong River sub region of Southeast Asia. Timely implementation of this initiative could take advantage of unique geopolitical and resource opportunities while advancing health security in the region. The CSIS Task Force recommends that the White House and Department of State initiate a Greater Mekong Health Security Partnership. Its goal is to build health security, with special focus on Myanmar, expanded engagement in Vietnam, Cambodia and Laos, and active collaboration with China and Thailand. It will concentrate on pandemic preparedness, malaria control, noncommunicable diseases, and women’s health and child survival.”

25. East West Center – Rebalancing NGO Contributions to Public Health in Asia

Yanzhong Huang;

http://www.eastwestcenter.org/sites/default/files/private/apb224.pdf

Still on Asia, CFR fellow  Yanzhong Huang, writes in a (short) new article: “In Asia, the capacity of NGOs to contribute to public health, both within individual countries and at the regional level, has steadily expanded. NGOs that work on public health issues could potentially have a greater role in enhancing regional security throughout Asia than is currently acknowledged.” He says for NGOs to realize their full potential, a dual track approach is needed.

 

Speaking of NGOs and public health in Asia, a  World Report in the Lancet this week highlights the difficult situation for Thailand’s migrant and trafficked sex workers. Campaigners are calling for the same access to health services for migrant sex workers (as for Thai sex workers).

 

26. Equinet August newsletter (editorial) – We cannot afford to leave the for-profit private health sector unregulated in Africa

Jane Doherty;

http://equinetafrica.org/newsletter/index.php?issue=150#1

The private for-profit sector in east and southern African (ESA) countries cannot be ignored. With private health insurance growing, considerable out-of-pocket payments at point of service, rising investment in private for-profit hospitals including for medical tourism and a widening spread of informal providers, ESA countries need to pay attention to this sector as part of measures towards achieving universal health coverage (UHC).”

 

27. Equinet discussion paper – Annotated literature review: African actors, global health governance and performance-based funding

Garrett Wallace Brown et al.;

http://www.equinetafrica.org/bibl/docs/Diss%2098%20PBF%20Lit%20Rev%20June%202013.pdf

This annotated literature review has been prepared for the research programme led by

the Regional Network for Equity in Health in East and Southern Africa (EQUINET) on Global Health Diplomacy and the specific focus on African actors and global health governance. Despite the predominance of PBF within the global health lexicon, there remain several contentious and underdeveloped aspects related to its use in supporting health system strengthening as well as its ability to foster increased participation from stakeholders. This review highlights the key strengths and weaknesses associated with PBF schemes in their use in low- and middle-income countries. It illustrates the theoretical thinking behind PBF implementation. It also seeks to draw out analysis of the role of African actors in global health diplomacy and decision-making surrounding PBF.  ( a must-read for the PBF community and beyond)

 

 

PEPFAR, Global Fund & HIV

 

28. KFF – Experts Discuss Future Of PEPFAR, Potential For Reauthorization

http://kff.org/news-summary/experts-discuss-future-of-pepfar-potential-for-reauthorization/

Experts agree the chance of PEPFAR being reauthorized is slim, but they also say that Congress does not need to reauthorize the program. “Reauthorization is not imperative as long as the State Department continues to implement PEPFAR, which celebrated its 10-year anniversary two months ago, and Congress maintains the sort of funding levels for the program that it has received over the last decade.” Other experts say additional funding is necessary, though. Apart from funding, Congress should also keep asking how things are going with the goal of an AIDS-free generation, experts say.

 

29. Global Fund Observer (issue 224)

http://www.aidspan.org/gfo_article/identifying-monitor-viet-nam%E2%80%99s-drug-treatment-centres-becomes-condition-global-fund-supp

The new GFO issue includes an interview with Alvaro Bermejo, executive director of the International HIV/AIDS Alliance, who recently stepped down as a member of the Global Fund Board representing Developed Country NGOs, an article examining how changes in World Bank income classification levels may affect applicants, and more.

 

 

30. Speaking of Medicine – Africa’s Lowest Cost AIDS Prevention Strategy?

Peter Hotez;

http://blogs.plos.org/speakingofmedicine/2013/08/01/africas-lowest-cost-aids-prevention-strategy/

A new paper from PLOS NTDs suggests mass drug administration for schistosomiasis represents a highly cost-effective and even cost-saving approach for reducing HIV transmission in Africa. Hotez, always quick to jump upon this sort of research, says there are thus compelling reasons to recast schistosomiasis MDA as a back door AIDS prevention strategy. “For me, a key take home message is that the major organizations committed to HIV/AIDS prevention in Africa, such as PEPFAR and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, as well as the ONE Campaign, must embrace schistosomiasis MDA and support its expansion throughout the affected areas of Africa in order to prevent or reduce the burden of Female Genital Schistosomiasis.”

 

31. Guardian Global Development – Wanted: a standard model of HIV and Aids diagnostics for Africa

Emilie Filou;

http://www.theguardian.com/global-development-professionals-network/2013/aug/06/hiv-aids-diagnosis-tests-africa

Filou talks about a new body, the Pan-African Harmonisation Working Party (PAHWP), that will create a harmonised regulatory framework for diagnostics, first of all focusing on HIV diagnostics, but apparently PAHWP is  building regulatory capacity in Africa that will be applicable to just about any diagnostic in the future.

 

In related news (also on HIV diagnostics), this week, Plos Medicine featured a research article on an RCT which examined whether a CD4-based monitoring and treatment switching strategy provides a similar clinical outcome compared with the standard viral load-based strategy for adults with HIV in Thailand.

 

32. Science Speaks – Study finds more asymptomatic HIV patients staying in care than estimated; mortality of those untreated “not unsubstantial”

Antigone Barton;

http://sciencespeaksblog.org/2013/08/07/study-finds-more-asymptomatic-hiv-patients-staying-in-care-than-estimated-mortality-of-those-untreated-not-unsubstantial/

A study released this week examining the outcomes of Ugandan patients considered “lost to follow-up” counters a widely held assumption that people entering care for HIV while still relatively healthy are not sufficiently motivated to follow medical directions and to remain in care.

 

In other HIV related research news, Nature examined research efforts to find the optimal dose of the antiretroviral drug efavirenz. “At last month’s International AIDS Society conference in Kuala Lumpur, Malaysia, researchers presented preliminary results from a clinical trial that showed a lower dose of the commonly used antiretroviral drug efavirenz was just as effective as the approved higher dose and seemed to cause fewer side effects in study participants.” Lower-dose pills thus become likely.

 

Global health bits & pieces

Polio:  The UN News Centre reported that an emergency contribution from Japan will enable UNICEF and its partners to tackle a polio outbreak in Somalia. Britain will also provide about 15 million dollar.

 

Haiti and cholera: a Yale university report says the UN peacekeeping mission in Haiti should be held accountable for introducing cholera into the Caribbean nation.

 

Rotavirus: Scidev.net reports on a new study in the Journal of Clinical investigation, which says a strain of rice genetically engineered to protect against diarrhoeal disease could offer a cost-effective way to protect children in developing countries.

 

Malaria Vaccine: there’s also some encouraging news on this front, covered in Nature. “A malaria vaccine has become the first to provide 100% protection against the disease, confounding critics and far surpassing any other experimental malaria vaccine tested. It will now be tested further in clinical trials in Africa. The results are important because they demonstrate for the first time the concept that a malaria vaccine can provide a high level of protection, says Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, adding that the findings are cause for “cautious optimism“.

 

Research

 

33. Health Research Policy & Systems – Embedding health policy and systems research into decision-making processes in low- and middle-income countries

Adam D. Koon et al.;

http://www.health-policy-systems.com/content/11/1/30/abstract

Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries. An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. Four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others.

 

34. Health Planning & Management – Advancing universal coverage of healthcare in China: translating political will into policy and practice

Shenglan Tang, Hana Brixi, Henk Bekedam;

http://onlinelibrary.wiley.com/doi/10.1002/hpm.2207/abstract

China launched its new health system reform plan in 2009 to advance its universal coverage of healthcare, after more than 4 years’ consultations and discussions with various stakeholders including the public. This paper aims to introduce and discuss the context and process of China’s current health system reform and analyse how political will in China has been translated into policy practice over the past decade. The paper also shares the insights of World Health Organization’s contribution to China’s health system reform, as the authors advised the Chinese government on the reform options and process. Furthermore, the paper describes and discusses key challenges in the implementation of the reform plan over the past 3 years and draws lessons for other countries. (great read)

 

35. ODI (paper) – Why neglected tropical diseases matter in reducing poverty

Fiona Samuels et al.;

http://www.developmentprogress.org/why-neglected-tropical-diseases-matter-reducing-poverty

Neglected tropical diseases have a direct impact on the achievement

of the MDGs. Without addressing these diseases, the broader aim of poverty alleviation is unlikely to be achieved, Samuels et al argue. Check out also the blog post on this paper.

 

36. WHO (resource book) – The Economics of the Social Determinants of Health and Health Inequalities

http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=15&codcch=856

This WHO resource book on the economics of social determinants of health and health inequalities seeks to begin to build a bridge between two approaches (i.e. Commission on Macroeconomics and health, resp. the Commission on Social Determinants of Health)  by explaining, illustrating and discussing the economic arguments that could (and could not) be put forth to support the case for investing in the social determinants of health on average and in the reduction in socially determined health inequalities.

 

37. HP&P – Health impact of external funding for HIV, tuberculosis and malaria: systematic review

Thyra E De Jongh et al.;

http://heapol.oxfordjournals.org/content/early/2013/08/05/heapol.czt051.short?rss=1

Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis and malaria control. The authors undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these investments.

 

38. Global Public health – Ageing as a global public health challenge: From complexity reduction to aid effectiveness

Daniel E. Esser et al.;

http://www.tandfonline.com/doi/abs/10.1080/17441692.2013.817598#.UgJbtpJM__M

Since 2002, ageing populations worldwide have received increasing attention by global policy-makers. However, resources committed by inter-governmental donors and US-based private foundations in support of ageing-related policies and interventions in non-OECD countries have remained minimal during this decade and, where mobilised, have rarely responded to actual country-level demographics and institutional capacities. The authors argue that this lag between issue recognition and effective resource mobilisation, while mirroring known dynamics in global agenda-setting, has also been caused by a depiction of ageing as a uniform trend across the Global South. They develop and apply a comprehensive analytical framework to assess the state of ageing dynamics at the country level and uncover substantial regional and sub-regional variation.

 

39. Global Health: Science and Practice – new articles

http://www.ghspjournal.org/content/early/recent

Global Health: Science and Practice has published a number of advance access articles on its webpage. Check them out. Issue 2 of this journal will come out later this month.

40. WHO Bulletin (early online) – Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Inke Mathauer et al.;

http://www.who.int/bulletin/online_first/12-115931.pdf

This paper provides a comprehensive overview of payment systems based on

diagnosis-related groups (DRGs) in LMICs. It also explores design and implementation issues and the related challenges countries face.

 

41. BMC Public Health (Commentary) – Advancing maternal survival in the global context: are our strategies working?

Omar A. Khan et al.;

http://www.biomedcentral.com/1471-2458/13/689

There have been significant gains in improving maternal mortality over the last two decades. Researchers have suggested a variety of interventions and mechanisms to explain these improvements. While it is likely that much of what has been done in research and programs has contributed to this decline, the evidence regarding what works in the settings in which women deliver continues to face many challenges. The authors of this Commentary review the evidence for these improvements and suggest that there remain areas to focus on, particularly the births which currently take place in an unsupervised or substandard environments. They highlight the main areas where more evidence is needed, and end with a call to determine which of our interventions seem to have the most benefit; which do not; and where to invest future resources.

42. Plos NTDs (Policy Platform) – Addressing Ethical, Social, and Cultural Issues in Global Health Research

James V. Lavery et al.;

http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002227

The purpose of this paper is to encourage reflection among the global health research community and the research ethics community about how a wide range of ethical, social, and cultural (ESC) influences on the conduct, success, and impact of global health research can best be addressed by consultation services in research ethics (CSRE). The authors draw on lessons they have learned during experiences with the ESC Program of the Grand Challenges in Global Health initiative to propose key features of CSRE that may prove useful for those designing or implementing similar programs.

 

Miscellaneous

 

43. World Bank – Building or bypassing recipient country systems : are donors defying the Paris declaration ?

http://econ.worldbank.org/external/default/main?pagePK=64165259&piPK=64165421&theSitePK=469372&menuPK=64166093&entityID=000158349_20130423150349&cid=decresearch

This report already dates from April. The 2005 Paris Declaration on Aid Effectiveness sets targets for increased use by donors of recipient country systems for managing aid. It also calls for donors to be more responsive to the quality of recipient country systems: the optimal level of their use, in terms of maximizing the development effectiveness of aid, is believed to vary with their quality. This study investigates the degree to which donors’ use of country systems is in fact positively related to their quality, using indicators explicitly endorsed for this purpose by the Paris Declaration and covering the 2005-2010 period. The results of these tests strongly confirm a positive and significant relationship. … These findings contradict several other studies that claim there is no relation and imply that donors in this respect are failing to live up to their commitments under the Paris Declaration.

 

Finally,

 

  • Slum people were asked about the post-MDGs (see the   Guardian), intended as a reality-check before September’s UN meeting.

 

  • The head of the African Development Bank says aid to Africa must have a sell-by date (in the  Guardian).

 

  • Simon Maxwell blogged on the possibility that the EU seems to be making an argument to transform aid, and perhaps end it (and whether it’s right).


[1] Go4Health is a research project funded by the European Union’s Seventh Framework Program, grant HEALTH-F1-2012-305240; the Australian Government’s NH&MRC-European Union Collaborative Research Grants, grant 1055138; and Canadian CIHR. More information on www.go4health.eu

 

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