Dear Colleagues,


This week, members of the maternal health community said loud and clear the time is now to end preventable maternal deaths (in the Lancet Global Health). In the run-up to the UN Assembly meeting in September,  various post-MDG related analyses, papers, calls and blogs are being published around the world, and this week’s selection zooms in on some of them.  We also pay quite some attention to NCDs and more in particular to tobacco, considered by Horton and others as ‘the next big epidemic in Africa’ after a new publication in the Lancet. The battle with Big Tobacco is far from over, see for example what’s going on in the  Trans-Pacific Partnership negotiations. In Beijing, the Ministerial forum of China-Africa health development took place, an event which should interest quite some of our readers.


In this week’s (somewhat provocative) guest editorial, we’re happy to offer you a first reaction on the 2013 World Health Report by our colleague Werner Soors. As most of us know, the man is not easily pleased. He lives up to the expectations in this editorial, highlighting three gaps and one ‘clear and present’ danger.


From the global health world over to the ugly world we witness every day in the newspapers. It’s quite a shock to go from the very balanced post-MDG analyses (like the one covered in this newsletter this week, by Ilona Kickbusch and Callum Brindley,  ‘Health in the Post-2015 Development Agenda’, which takes a helicopter view on the planet’s challenges) to the messy real world, where just this week, Bradley Manning was sentenced, in a mockery of Obama’s electoral transparency promise, and the UK government intimidated the Guardian. Meanwhile, Bo Xilai’s trial in China makes the Middle Kingdom look almost more transparent than the US, even if that is probably only appearance.  And of course, there was the horrific gas attack in Syria, and the by now predictable reactions by the international community.


You’ve got to be naïve to believe that the likes of Obama, Putin, Cameron, Merkel, Barroso or Xi Jinping will clinch a post-MDG deal in 2015 that really addresses the global ecological and  social justice challenges in a comprehensive way.  On a daily basis, these men and women seem happy to play in a sequel of ‘Dumb and Dumber, called ‘Ugly & uglier’. Some people would say this is just the way politics is done, and that we have voted for (at least some of) them, and they might be right, even if many of us vote for these people because we fear the alternatives are even worse.


But the point I want to make here is this one. We, in the global health community, and many other ordinary citizens, increasingly feel schizophrenic, as we work diligently in our institutions and organizations, ostensibly trying to build a better world, while playing by the rules of an economic system which seems to put the planet firmly on the road towards destruction. Although we are all trying to comply with the ‘bigger, stronger, faster’ mantra of this era, in line with the incentive structures in place in our institutions and in society, hoping that this will lead to more excellence and eventually a more productive and better world, while also trying to provide for our families in the process, deep in our heart many of us know the system is fundamentally flawed. It comes thus as no surprise that nobody seems able to stop this slow- motion train of eco-destruction, a train which is increasingly speeding up by the way, as there’s more and more evidence coming out on some of the notorious ‘feedback loops’ scientists are so worried about (see last week’s scientific report on leaves of trees which seem to absorb less CO2 than before, thus speeding up climate change). Oh, by the way, this week Earth Overshoot Day was also ‘celebrated’, again earlier than last year.


In spite of all the rhetoric, economic growth is still considered more important by most decision makers than sustainable development, the so called ‘new paradigm’. The ‘commercial determinants of health’, as Ilona Kickbusch likes to call them, unsustainable patterns of consumption and production, still rule our world. Horizon 2020 is just the latest case in point as Martin McKee and others noted in a Lancet Comment from earlier this year: “…The Commission has responded to the recession by focusing in Horizon 2020 on a particularly narrow interpretation of the health and wealth agenda, regarding health research as a lever for economic growth through patentable technological advances, exploitable intellectual property, and the industrialisation of invention and innovation. Health systems and policy research, which will rarely result in patentable intellectual property, tend to be excluded even though such research has been shown to contribute to economic growth in many other ways.” No surprises there.


The global health community is divided, as you know, in what you might call (1) a “yes, we can” segment of people who try very hard to make progress, while acknowledging the political constraints in which they and especially politicians work and the flaws of human beings, and who are willing to work with the private sector if there seem clear opportunities, and (2) a bunch of people (with the People’s Health Movement being perhaps the most prominent example) who basically think the whole system is crooked, and leading us to hell, if we don’t manage to transform it in a structural way. I happen to agree with the latter camp, although I appreciate very much all the good the first camp has achieved in recent decades  – unlike Obama, they can actually show some results, and they haven’t betrayed their principles. I also don’t really see a way to get to this profound structural transformation we need. Of course, the distinction between the two camps is not as sharp as I describe it, there is some overlap.


But the picture, anno 2013 is clear: we are all schizophrenics now, pretending (hoping?) we’re working towards a better world, and taking care of our families, while knowing that the generations after us will more than likely live on a worse off planet, because of the very economic system we all play a role in.


On this cheerful note, I wish you a happy reading.



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





The 2013 World Health Report: several missed opportunities, one imminent danger


By Werner Soors (ITM)

Let me start with three truisms: “Universal health coverage cannot be achieved without evidence from research”, “research into health services and systems gets relatively little support and tends to be narrowly focused”, and “there is a particular need to close the gap between existing knowledge and action”. No health policy or health systems researcher would disagree with any of these quotes from the World Health Report 2013: Research for Universal Health Coverage. But what kind of evidence is most needed, how can a systems perspective be brought to the fore, and how will the research advocated for really improve health for all? In my opinion, the present World Health Report falls short in answering these questions, in the first place because it is narrowly focused itself.

The core of the report (pages 31-89 of 146) consists of the feel-good message that “research for health is on the rise worldwide”, followed by 12 examples “of studies that show how research can address some of the major questions about achieving universal health coverage”. The promise is made that these examples “rang(e) from the prevention and control of specific diseases to the functioning of health systems”. At first sight, the promise is held: six case studies are directly related to disease control and six are more related to health systems. But the report articulates none of these from within a systemic perspective that is beyond ‘programmatic advantages’ and takes into account the interactions of actors and interventions, which is a little surprising to say the least.

Wasn’t it WHO that four years ago published Systems thinking for health systems strengthening, rightly recognizing health systems as complex adaptive systems and promoting systems thinking as “an essential approach for strengthening health systems”? Or just about a year ago, Health policy and systems research – a methodological reader, 474 pages of advice to improve the evidence base for health policy making and health systems strengthening? And is systems thinking not “key for policy and decision makers dealing with universal health coverage”, as – among others – MMI argues?

A second missed opportunity is the very fragmentary coverage of social determinants as part and parcel of research for universal health coverage. Social determinants are mentioned sporadically, yet not explicitly in the examples, and equity is treated only superficially. Yes, “indicators should be disaggregated”, but when will we start unpacking processes that reproduce inequity? Will categorical data be enough to “measure and understand the problem (of health inequities) and assess the impact of action”, as argued by WHO and for Developing an evidence base for political action? Will this be sufficient for an equity-focused research agenda in support of truly universal health coverage?

Equally under-addressed is research on Health-in-All policies, in spite of being a promising way forward to tackle health inequities and to arrive at fair or at least proportionate universalism. The World Health Report 2013 recognizes the need “to develop research that can enhance understanding of how intersectoral policies can improve health”, but only as “an additional and complementary challenge” and by adding that “because many more questions can be asked than answered, it is vital to set priorities”.

These three missed opportunities are interrelated. What unites them is a lack of people centeredness. At best, uptake of the report might lead to more of the same. There is however a risk that worse will happen. Research for Universal Health Coverage makes a strong call for “finding local answers to local questions”. Admittedly, coverage gaps and health inequities have local manifestations, worthy of research. But doesn’t the combination of a more-disease-than-people-centred approach and local priority setting encompass a peril: chances are that universal health coverage then gets stuck in selective health coverage, just like comprehensive primary healthcare watered down to selective primary healthcare three decades ago? We all know what that meant. The world deserves better, and we should feel obliged to research deeper and broader.


Post-MDGs & health


1.    WHO – Health in the Post- Health Development Agenda – An analysis of the UN-led thematic consultations, High-Level Panel report and sustainable development debate in the context of health

Ilona Kickbusch & Callum Brindley;

This document dates from July already, but it’s a must-read. “Health in a wider sense, including the social determinants of health, needs to be prominently positioned in the post-2015 development framework. That is the expectation of the global health community.” As you know, eleven UN-led thematic consultations recently prepared thematic reports on health, governance, conflict and fragility, inequalities, food security and nutrition, water, energy, economic growth and employment, education and population. In this paper the authors reviewed the 10 non-health thematic papers. They analyzed the extent to which they refer to the global health agenda – in particular the extent to which they make reference (directly or indirectly) to the social determinants of health. In order to review the post-2015 development debate comprehensively, they have also analyzed the High-Level Panel’s report and the sustainable development goals debate, including the declaration of the Rio +20 summit. (Kickbusch & co are quite critical of the HLP report, by the way).


2.    Lancet Global Health – Ending preventable maternal deaths: the time is now

Flavia Bustreo et al.;

As countries and international platforms engage in post-2015 planning, now is the time to envision the ending of preventable maternal deaths, as stressed in a recent manifesto for maternal health”, the authors of this Comment say. They stress ending of preventable maternal death is not a dream. “… Mahmoud Fathalla, past president of the International Federation of Obstetricians and Gynaecologists and former Chair of the WHO Advisory Committee on Health Research, said: “Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving.” The good thing is, momentum to value women’s lives is growing. Let’s capitalize on this, post-2015.


3.    Lancet Global Health – A data revolution for disability-inclusive development

Sophie Mitra;

7 years after the Convention on the Rights of Persons with Disabilities was adopted, disability is still largely absent from data collection and monitoring mechanisms in international development and global health. However, some isolated data collection efforts have documented the experiences of people with disabilities in a few low-income and middle-income countries. The upcoming High-Level Meeting of the United Nations General Assembly on Disability on Sept 23, 2013, and the ongoing preparation of the post-2015 development agenda provide a unique opportunity to integrate disability in data collection mechanisms in development and global health.”


The Lancet Global Health (online) also features another article, related to disability & the global health agenda, ‘Inclusive nutrition for children and adults with disabilities’. Nora Groce and colleagues zoom in on the (often neglected ) intersection of nutrition and disability.


4.    International journal of Epidemiology (Editor’s choice) – The truth, the whole truth and nothing but the truth

Jane E. Ferrie;

In this article, Ferrie describes the two editorials in this month’s issue of IJE. Both discuss the monitoring of MDG4 (reduction in under-5 mortality).  In a first editorial, Mikkel Oestergaard and colleagues discuss problems with tracking the progress towards MDG4 using the annual rate of change in the under-5 mortality rate. In a second editorial, Corsi and Subramanian argue that progress can be better monitored by maintaining a focus on the absolute level of the under-5 mortality rate rather than relying exclusively on the rate of change. They then discuss four issues critical to the successful monitoring and delivery of MDG4: estimating child mortality, intergenerational perspectives, appropriate levels for target setting and the role of health systems (using India as an example).


5.    Lancet (Correspondence) – Health after 2015: a human right?

Vachagan Harutyunyan;

The biggest gap in the (HLP) report is its inability to position health as human right”, this author says. “In the goal “Ensuring healthy life for all”, health is seen as a mere precondition for development, and not the right in and of itself. This view contrasts with the previous commitments made by the international community to uphold health as an inalienable human right. …” “The next development framework should explicitly recognise health as human right.”


6.    Intrahealth – Human Resources for Health in the 21st Century: Make HRH Part of the Upcoming Global Governance for Health Discussions

Richard Seifman;

This blog post gives a nice update of what’s going on in the Human Resources for Health community. “… The human resources for health community is now rightly focused on two important global conferences: the Third Global Forum on HRH in November 2013 (Recife, Brazil) and the Prince Mahidol Award Conference on “Transformative Learning for Health Equity” in January 2014 (Bangkok, Thailand). However, leading up to these events, high-level, intensive discussions about the global health architecture will be generated by the forthcoming publications and recommendations of the Oslo Commission (on Global Governance for Health)  and the American Journal of Public Health symposium (which will also focus on revisiting the global health architecture, under the guidance of Lawrence Gostin). The recommendations and discussions could spell out a new approach to health development, and the HRH community knows that health workforce strengthening must be central to that approach.


As for a few more general MDG & post-MDG articles, we want to draw your attention to:

  • A Report  by Ban Ki Moon: “A life of dignity for all”. Ahead of the upcoming special General Assembly event next month on efforts by UN Member States to meet the MDGs and to define a new universal development agenda, Ban Ki-moon has released this report, containing his updates on the goals and vision for the road ahead. The report was released on August 14 to government delegates.  The new report takes stock of the progress that has been made and of the steps that are needed to go forward. (see also coverage by The Guardian, which zoomed in on Ban Ki Moon’s worries about declining ODA).
  • Thomas Pogge & Mitu Sengupta said accountability will be key to effective development goals (in a Guardian Op-Ed ).



Ministerial Forum of China-Africa Health Development



7.    KFF – Positive Impact Of China-Africa Health Cooperation Discussed At Forum

KFF reports on the recent Ministerial Forum of China-Africa Health Cooperation in Beijing, with UNAIDS Executive Director Sidibé in a prominent role. The event culminated in the Beijing Declaration (scroll down). A UNAIDS feature article  zoomed in on the opening by Xi Jinping.


Tobacco & NCDs


8.    The Hill – Obama administration retreats on tobacco control in Pacific trade talks

For some reason, when Obama’s name pops up in the news, the sentence always seems to contain words like ‘retreat’, ‘detachment’, etc., whether the topic is tobacco control & the Trans-Pacific Partnership, Syria or something else. This article reports on the Obama administration backing away from (earlier) plans to protect U.S. tobacco-control measures from legal challenges (in the ongoing TPP negotiations). Obviously, public health groups aren’t very happy…


This week’s Lancet issue also contains a few Letters on Tobacco control and taking on corporate interests in the past and now (see here  and the reaction by Ronald Labonté  here).


9.    Guardian Global Development Professionals – Rating the food and drink industry on its commitment to nutrition

Inge Kauer;

A new index, the global access to nutrition index, launched earlier this year, intends to incentivise the private sector to do more to tackle obesity and undernutrition. But will it name and shame or simply provide food for thought?


10. International Health Promotion – Health wash in Helsinki

Fran Baum & Ronald Labonté;

At the recent Global health promotion conference in Helsinki, the fourth plenary session featured speakers from the World Bank and World Economic Forum and apparently they caused quite some commotion. Baum & Labonté attended the session and had the following to say about it, in this Perspective: (The session) “… immediately reminded us of corporate ‘green wash’ whereby

companies grossly exaggerate their environmental sustainability credentials to gain social credibility and consumer comfort. In Helsinki we witnessed a similar ‘health wash’, in which the private sector was portrayed as an essential and beneficent ‘partner’ in promoting health by providing its expertise and much needed resources.”  (‘healthwashing’ … lovely concept).


11. BMJ (news) – Roche’s decision to drop Herceptin patent in India opens way for generics

Matthew Limb;

The Swiss drug producer Roche has confirmed that it will not pursue a patent application in India for its breast cancer drug trastuzumab (which it markets as Herceptin). The decision could pave the way for manufacturers of generic drugs to make copies of the drug in India, although it could be several years before any of these versions reach patients, Matthew Limb reports.


12. Lancet (Editorial) – Lung cancer: a global scourge

Worldwide, lung cancer killed about 1·5 million people in 2010. Lung cancer has an extremely poor prognosis. To achieve a substantial reduction in lung cancer mortality, global action and progress in prevention, early detection, and treatment are crucial, this editorial argues. (This week, The Lancet and The Lancet Respiratory Medicine highlight several papers on lung cancer, topics include immunotherapy, screening for earlier diagnosis, patient management, and tumour biomarkers and genetics).

13. WHO – Building back better – Sustainable mental health care after emergencies

Emergencies, in spite of their tragic nature and adverse effects on mental health, are unparalleled opportunities to build better mental health systems for all people in need. This WHO publication shows how this was done in 10 diverse emergency-affected areas. This is important because mental health is crucial to the overall well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies.

14. JAMA viewpoint – Reconsidering the Politics of Public Health

Dave A. Chokshi et al.;

In a viewpoint focusing more on the situation in developed countries (but with obvious implications also for developing countries in the not too distant future), the authors ask: what are the prospects for the ‘regulatory’ approach to improving public health, giving the fractious politics of public health? They present 5 linked avenues toward a realistic, potentially durable political solution.

In the intro of the article, they depict the challenge: “A central dilemma in public health is reconciling the role of the individual with the role of the government in promoting health. On the one hand, governmental policy approaches—taxes, bans, and other regulations—are seen as emblematic of “nanny state” overreach. In this view, public health regulation is part of a slippery slope toward escalating government intrusion on individual liberty. On the other hand, regulatory policy is described as a fundamental instrument for a “savvy state” to combat the conditions underlying an inexorable epidemic of chronic diseases. Proponents of public health regulation cite the association of aggressive tobacco control, physical activity, and nutritional interventions with demonstrable increases in life expectancy.” Check it out.


15. Lancet Correspondence – Investment in cancer studies in countries of low and middle income

Nicholas Andre et al.;

Both the USA and Europe have, in the past decade, adopted policies to improve the development of drugs for children by establishing a system of incentives and obligations for pharmaceutical companies.” “… Transposition of such policies to research for cancer treatments in LMICs could help to reduce the gap between LMICs and HICs in terms of cancer care. In exchange for the development and support of clinical studies and programmes by pharmaceutical companies for patients with cancer in LMICs, government institutions could provide participating pharmaceutical companies with an extension of patent protection for a drug of their choice in HICs….”  (interesting/provocative proposal…)


16. Speaking of Medicine – The Global Challenges of Noncommunicable Diseases: A PLOS Medicine Collection: The First Installment

Margaret Winker;

Winker gives some more info on the first installment of the PLOS Medicine Collection “The Global Challenges of Noncommunicable Diseases,” (see also last week’s IHP Newsletter). The (open-access) collection features, for the moment, 38 articles, from research to essays.  The research ranges from policy to public health to translational medicine, with plenty of clinical medicine in between. As for potential authors, the call for papers is still open through the end of 2013. The collection is being updated on a regular basis.





17. Lancet (Comment) – Does the CHER trial open up new therapeutic perspectives?

Bob Colebunders et al.;

Our colleague Colebunders comments on the final results of the Children with HIV Early Antiretroviral  (CHER) trial, now published (early online) in the Lancet and says it opens up new therapeutic perspectives. He concludes: “Early ART in infants is undoubtedly beneficial, but our knowledge about the consequences of treatment interruptions remains incomplete. Presently, such a strategy is programmatically difficult to implement in resource-poor settings because of the requirement for CD4 count monitoring. However, in the future, straightforward point-of-care tests, such as a combined RNA—DNA test, will probably become available for very early infant diagnosis. Together with new methods to monitor the infection, cessation of ART after a prolonged course of a highly effective treatment regimen could become an option.


Health Policy & financing


18. Global Health: Science and Practice (Editorial) – The 6 domains of behavior change: the missing health system building block

James D. Shelton;

The August 2013 issue of the “Global Health: Science and Practice” journal is now available online. The issue includes an editorial about making the most of food aid to help prevent child and maternal deaths (focusing on the US (food aid) situation), and a number of other articles, obviously it’s well worth to have a look at the website.

In this Editorial, James Shelton, editor-in-chief of the journal, emphasizes that behavior is crucial throughout global health interventions. “The discipline of behavior change offers distinct expertise needed across 6 different domains of behavior. Such expertise is in short supply, however. We will not have effective and sustainable health systems, nor achieve our ambitious global health goals, without seriously addressing behavior change.


19. Health Promotion International – The financial crisis and global health: the International Monetary Fund’s (IMF) policy response

Arne Ruckert & Ronald Labonté;

This article was already published in April 2012, and might thus need an update, as a lot has happened since then on the global stage, but it’s still a good read and most conclusions probably still hold. In this article, the authors interrogate the policy response of the International Monetary Fund to the global financial crisis, and discuss the likely global health implications, especially in low-income countries.


20. Lancet – Offline: Norway and September 9

Richard Horton;

Horton, judging from his Twitter activity back from holidays, thinks the coming Norway elections are very important, not just for Norway but also for the global health world. He is very worried about a possible defeat by the current prime minister, Stoltenberg.

21. Lancet (World Report) – €70 billion on the horizon for European researchers

John Maurice;

The European Union’s Horizon 2020 research programme will offer researchers a generous source of funds for projects to resolve the challenges of today’s society. It is to be launched in mid-December by the European Commission, and will be operational starting Jan 1, 2014. John Maurice lists the aims and structure of Horizon 2020. Biomedical and health research under the new programme will have a considerably larger budget than previous framework programmes—a proposed €8 billion.


Probably also good to read again the Lancet Comment by Kieran Walsche & Martin McKee (and colleagues) from March this year, ‘Health systems and policy research in Europe: Horizon 2020’ (which focuses on HPSR in Europe, though). We already referred to this article in our introduction. (we are also curious how unemployed people in Greece, Portugal and other PIGS countries will react to this figure of 70 billion…).


22. NYT – Unease at Clinton Foundation Over Finances and Ambitions

The Clinton world has always been a bit messy, and apparently things are no different at the Clinton Foundation these days. The NYT reported last week.


23. CGD – Multilateralism-lite Might Miss the Big Picture

Amanda Glassman & Jenny Ottenhoff;

In a recent blog post, it was mentioned that the Global Fund will likely surpass the World Bank’s International Development Association as the single largest foreign assistance contribution the US makes to a multilateral institution.  Scott Morris, the author of the blog, described this move as “multilateralism-lite” – or a reliance on earmarking through multilateral channels by sector or country – and suggested this isn’t an optimal approach to poverty reduction and development.

Amanda Glassman discussed the blog and says that she thinks the broader issue may actually be less about multilateral versus “multilateral-lite”, but more about prioritization across the foreign assistance budget pie. “Funding for the Global Fund may be surpassing IDA because health – and specifically AIDS – is where the United States has placed political and financial priority for the past decade.” …  PEPFAR has been a big part of US foreign assistance for a while, as we all know, and “The multilateral piece of the “health spending pie” is just finally catching up with the broader trend”, Glassman says.


24. WHO – Good Governance for Medicines Model Framework 2012

The model framework for good governance for medicines is intended to be a guideline and can be adapted by each country according to their needs. It includes the basic components required by the Good Governance for Medicines programme and steps necessary to achieve these. The first edition was published in 2008 and then revised by experts and country representatives. The 2012 version is now available for public comment until 15 October 2013.


25. IPS – Montevideo Consensus Urges Countries to Change Abortion Laws

Representatives of 38 countries of Latin America and the Caribbean meeting this week in the Uruguayan capital urged governments in the region to consider modifying their laws on abortion, which are among the most restrictive in the world. The ‘Montevideo Consensus on Population and Development’ calls on States to consider amending their laws, regulations, strategies and public policies relating to the voluntary termination of pregnancy in order to protect the lives and health of women and adolescent girls, to improve their quality of life and to reduce the number of abortions. The document was adopted at the Regional conference on Population and Development in Latin America and the Caribbean.

26. Health Promotion International – After Nairobi: can the international community help to develop health promotion in Africa?

Rachael Dixey;

The Nairobi Conference presaged a surge of interest in the development of health promotion in sub-Saharan Africa. A number of Africans have asserted that health promotion is underdeveloped in the continent, with the principles of the Ottawa Charter not widely adopted. This paper does not presume to say how health promotion could be developed in Africa, as that is for Africans to decide for themselves. Rather, it debates some issues which the international epistemic health promotion community could address in order to work in solidarity with African colleagues in taking forward the health promotion agenda in their continent. These issues include the Eurocentric nature of health promotion discourse, the different disease burden of Africa and the lack of training capacity in African universities.


27. JICA – JICA Focuses on Universal Health Coverage

JICA, Japan’s International Cooperation Agency,  places a new emphasis on ensuring universal health coverage.


Global Fund


28. Global Fund Observer – issue 225

The new issue of GFO features a Commentary by Mark Dybul (on greater value for money through enhanced pooled producement systems), a news article on a pilot project with 10 country coordinating mechanisms whereby the CCMs receive additional funding to engage key populations in the country dialogue and in concept note development, an article on African leaders taking a more active role in fundraising for the Global Fund, and more.


29. Globalization & Health – Health technology assessments as a mechanism for increased value for money: recommendations to the global fund

Yot Teerawattananon et al.;

The Global Fund is experiencing increased pressure to optimize results and improve its impact per dollar spent. It is also in transition from a provider of emergency funding, to a long-term, sustainable financing mechanism. This paper assesses the efficacy of current Global Fund investment and examines how health technology assessments (HTAs) can be used to provide guidance on the relative priority of health interventions currently subsidized by the Global Fund. In addition, this paper identifies areas where the application of HTAs can exert the greatest impact and proposes ways in which this tool could be incorporated, as a routine component, into application, decision, implementation, and monitoring and evaluation processes. Finally, it addresses the challenges facing the Global Fund in realizing the full potential of HTAs.


30. CGD – Lasers, Refrigerators and disease modeling

Victoria Fan;

Fan dwells on a recent TED talk by Nathan Myhrvold on high-tech solutions for the global south, such as mosquito-zapping lasers, refrigerators for vaccines, etc. Fan focuses on the third one, mentioned by Myhrvold: disease modelling software. She zooms in on the Global Fund,  and gives some recommendations to the Fund, but her blog has implications for other global health actors too.


Global health bits and pieces



  • Indefinite strike of health workers in Nigeria (see ).
  • Some virus news:

The virus that causes Middle East Respiratory Syndrome (MERS) has been found in one bat in Saudi Arabia, suggesting a potential origin for the disease, according to a new study published Wednesday in the CDC’s “Emerging Infectious Diseases” journal.

In other news, Nature reported: “Researchers have traced the evolution of the H7N9 avian flu currently spreading in China, and have found evidence that it developed in parallel with a similar bird flu, H7N7, which can infect mammals.” It appears H7 avian viruses are constantly mixing and exchanging genetic material — a process known as reassortment — in Asian poultry markets.

  • The Brazilian Health Ministry signed an agreement on Wednesday with PAHO to bring 4,000 doctors from Cuba by the end of the year (see the Wall Street Journal) . This follows the social turmoil from last month. “They will participate in a program — known as Mais Medicos, or ‘more doctors’ — that the government launched in July amidst massive street demonstrations calling for better public services such as health care.”
  • For a Polio update (with the latest news from Pakistan & Israel), see  The Guardian.
  • IHME & the World Bank will jointly present regional Global Burden of Disease reports on September 4 (see  here).
  • Finally, the FT reports that Eli Lilly is the latest Western pharmaceutical company accused of kickbacks by the Chinese government. (but the government is still looking for a deluded and murderous wife to strengthen its case)



31. BMC Health services – Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda

Juliet Nabyonga et al.;

Juliet Nabyonga and colleagues in this research article describe the roles, relations and interactions among key stakeholders involved in knowledge translation in health policy development in Uganda. They point out the need to consider the perceived roles and challenges of these stakeholders and recommend to build capacity and provide links and platforms to achieve synergy in the process of knowledge translation.

32. Book – 21st Century Global Health Diplomacy

Thomas E Novotny, Ilona Kickbusch, Michaela Told;

Global health diplomacy begins with a recognition that the most effective international health interventions are carried out with sensitivity to historical, political, social, economic, and cultural differences. It focuses on the interplay of globalization, economic interdependence, social justice, and the enlightened self-interests of nations. Global health diplomacy can help sustain peace and economic stability in a globalized world, but the skills necessary for this endeavour are not taught in standard health sciences curricula or in Foreign Service academies. However, they bear directly on the success of international health cooperation, be it from the global north to the global south or south-to-south cooperation.


33. HP&P – Tobacco in the Arab world: old and new epidemics amidst policy paralysis

Wasim Maziak et al.; In this review, Wasim Maziak and colleagues discuss the three major trends with regard to tobacco use in the Arab world, as well as its contributing factors and the way forward for tobacco control in this unstable region. They point out the high prevalence of cigarette smoking among Arab men, the re-emergence of water pipe smoking in particular among youth and the failure of policy to provide adequate responses to the tobacco epidemic, taking into account the different levels of economic and political development in the region.

34. BMC Public health – The impact of Fogarty International Center research training programs on public health policy and program development in Kenya and Uganda

Sara Bennett et al.;

Sara Bennett and colleagues in this research article explore the long-term impact of research training investments by the Fogarty International Center on public health policy and program development in both countries. They identify facilitators and barriers towards policy influence and recommend to invest more in the training of policymakers, to better align research with policy needs by using targeted grants, and to address structural constraints to further the success of FIC as well as similar initiatives.



  • Norway sets an example in the audit of poor countries’ debts (see

IPS news).


  • Foreign Affairs has a nice article on Africa’s coming resource curse and how to avoid it, ‘Petroleum to the People’.

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