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Dear Colleagues,

The Busan conference on aid effectiveness is drawing near. In the run-up to this high-profile conference, Emerging Voice Vincent Okungu from Kenya wonders whether health aid actually helped address the OOP issue in developing countries.

Has health aid failed to mitigate out-of-pocket expenditure in developing countries?

Estimated donor commitments on global health efforts tripled from $15 billion in 2000 to $45 billion in 2006. Many sub-Saharan African countries also increased their expenditures on health care, particularly after the 2001 Abuja summit that asked African governments to commit 15% of their total budgets to health care. However, health care in Sub-Saharan Africa continues to lag behind the rest of the world despite decades of foreign assistance.

Read the rest of this editorial

Enjoy your reading.

David Hercot, Kristof Decoster, Josefien Van Olmen, Basile Keugoung & Wim Van Damme

Global Fund

1.Global Fund Board cancels round 11

The big news this week obviously concerns the Global Fund and its Board meeting. In this issue of GFO, the editors cover the cancellation of round 11 and the strategy for the next five years, among other things.

Somehow, this sad news reminds us of the song “Those were the days, my friend, we thought they’d never end …” And yet, they will have to.

Sarah Boseley already commented on her Global Health blog.

2.MSF (press release) – MSF response to GF board meeting

MSF calls on the Global Fund and donors to immediately raise the resources necessary for the minimum lifeline the Fund has extended to countries otherwise facing disruptions this year, as well as providing a new regular funding opportunity.


3.UNAIDS report – Nearly 50% of people who are eligible for antiretroviral therapy now have access to lifesaving treatment

By some tragic coincidence, in the same week that the GF financing crisis became strikingly obvious, a new report by UNAIDS showed that 2011 was actually a game changing year for the AIDS response with unprecedented progress in science, political leadership and results. The report also showed that new HIV infections and AIDS-related deaths have fallen to the lowest levels since the peak of the epidemic.

Nevertheless, the Economist reckonsthe Aids community (and UNAIDS in particular) should get its act together, as there are two UN reports on AIDS this year, closely following upon each other.

4.Dialogue4Health – PEPFAR Opens the Door: Integrating HIV/AIDS with an NCD

Jeff Meer;

Meer dwells on the significance of the Pink Ribbon Red Ribbon initiative.

In related news, and good to know for some of our readers, is that George W. Bush is going to a few African countries in December.

Some more positive PEPFAR news: the U.S. government recently announced the Nursing Education Partnership Initiative (NEPI) in Lilongwe, Malawi. The PEPFAR initiative aims to “strengthen the quality and capacity of nursing and midwifery education institutions, increase the number of highly skilled nurses and midwives, and support innovative nursing retention strategies in African countries.” This is a clearexample of how PEPFAR is engaging in health systems strengthening.

With respect to human resources for health, we also encourage you to read the series on governance and human resources in Human Resources for Health. An editorial kicks off the series.

5.Effectiveness and acceptability of delivery of antiretroviral treatment in health centres by health officers and nurses in Ethiopia

Yibeltal Assefa, Abiyou Kiflie, Betru Tekle, Damen Haile Mariam, Marie Laga, Wim Van Damme;

Some of our colleagues were involved in this article. They conclude ART delivery in Ethiopian health centres, based on health officers and nurses is feasible, effective and acceptable. However, issues related to regulation, remuneration and cost need to be addressed for the sustainable implementation of these delivery models.

Another ITM colleague, Bob Colebunders, sent a Letter to the Lancet on the role of concurrency in generalized HIV epidemics. The debate is far from finished, it appears (see the Lancet Correspondence this week).

6.CGD – Comments from Laurie Garrett on the AIDS Transition

Mead Over;

Mead Over published a reply from Laurie Garrett to his ideas on how to achieve an AIDS transition. She argues that his approach is highly unlikely to succeed by referring to the trend of the epidemic in the US.

Health policy and financing

7.Lancet (editorial) – Climate and health in a post-Kyoto world

There’s not only Busan next week, the climate boys and girls also get together again, in Durban, South-Africa, this time. This Lancet editorial notes that, unlike at previous climate summits, the global health community is slowly getting its act together. That was about time.

8.Lancet – Making new vaccines affordable: a comparison of financing processes used to develop and deploy new meningococcal and pneumococcal conjugate vaccines

James R. Hargreaves et al.;

This Lancet review article (already online in June) zooms in on two innovative mechanisms to accelerate the development of low-price supply lines for conjugate vaccines, a push (the Meningitis Vaccine Project) and a pull mechanism (AMC). The authors also propose recommendations for GAVI.

9.BMJ Comment –  Transparent pricing of vaccines would help poor as well as rich countries

Robert Hecht et al.;

The authors argue for transparent pricing of vaccines and give an overview of recent trends. The questions of how much taxpayers’ money is being spent on vaccines, and which companies are winning the public tenders, are becoming ever more important as science and industry develop a new generation of life saving vaccines, they claim.

10.   BMJ Editorial: The financial cost of physician emigration from sub-Saharan Africa

James Buchan;

A ‘whole government approach’ is needed to mitigate the impact of the brain drain. This editorial comments on recent research by Edward J. Mills et al.

11.   Global Health Governance (fall issue)

Great new (Fall) issue of Global Health Governance. There’s an article wondering whether the good times are over for global health, for example.

They also started a brand new blog on global health governance.

We would also like to draw your attention to a number of Harvard Global Health review online columns on recent global health (policy) trends.

12.   Bloomberg – Clinton’s Global AIDS Fight May Be Hurt by U.S. Trade Initiative

Nicole Gaouette;

Last week, Hilary Clinton championed a U.S.-led global effort to thwart HIV/AIDS. Meanwhile, the Obama administration pursues trade policies that critics warn will curtail access to life-saving drugs.

In the Huffington Post, MSF’s Tido von Schoenangerer looks backon a decade of double standards in trade and public health issues.

Intellectual Property Watch also looks back on 10 years of TRIPS and Public Health.

13.   Foreign Affairs – Setting the Record Straight on WHO Funding

Christy Feig; Sonia Shah;

Christy Feig, Director of Communications at the WHO, was not exactly amused when she read Sonia Shah’s article in Foreign Affairs last week. Her swift response to the Shah article is followed by yet another reply from Shah.

14.   Financing health in Africa (le Blog) – Free health care: a new field of action for Amnesty International?

Bruno Meessen; http://healthfinance – Africa – le blog

In January 2010, Amnesty International released a report “Giving life, risking death: Fighting maternal mortality in Burkina Faso”. With this report, the ngo ventured further into its new field of action, social rights. During a workshop in Bamako last week, the actions of the NGO were hotly debated in one of the sessions. Our colleague Bruno Meessen interviewed the two most vocal debaters, Dr. Sankara Salif and Roger Minoungou. You find the post both in English and in French; the latter also has a number of comments.


15.   CGD – Our Short Wish List for the Busan High-Level Forum on Aid Effectiveness

As we already mentioned in our introduction, the Busan High-Level Forum on Aid effectiveness is approaching. So far, the world seems to pay more attention to the upcoming event than expected (as compared to media attention for the Paris and Accra meetings), and this is all the more remarkable given the heavy competition from the Durban summit and the ongoing Euro horror saga.

Nancy Birdsall wrote this nice blog post on the CGD website, with her wish list for Busan. In it, she argues for example that it’s time to get rid of the term ‘aid effectiveness’, and talk about ‘development effectiveness’ instead.

The Guardian’s Mark Tran offers an explainer on Busan and what’s at stake there. Gideon Rabinowitz of the UK Aid network does pretty much the same on the website of Oxfam’s Max Lawson.

Action for Global Health also provides some Busan related information, for example a poster on IHP+, a position paper for Busan, and a blog post in which Olga Golichenko wonders where health remains in the Busan outcome document.

Some other Development and Aid issues

16.   CGD (working paper) – Brave New World – A Literature Review of Emerging Donors and the Changing Nature of Foreign Assistance

Julie Walz and Vijaya Ramachandran;

This paper investigates the scale and scope of emerging donors, many of which are developing economies themselves.

Finally, some interesting pieces:

* In the Guardian, Bill Easterly emphasized it’s vital to redirect US foreign aid from defence. (Well, if the Republicans get their way, that should be a piece of cake as nothing will be left of foreign aid. Apparently, even Mitt Romney thinks (on Fox) that American people have no common interests whatsoever with people elsewhere in the world).

* A FT opinion piece (by Andrew Jack) examined the challenges of family planning in some poorer countries, where public health programs “risk adding to population pressures and inadvertently setting back development,” writing, “In a number of countries, notably in central and western Africa, health programs have contributed to cutting infant mortality rates, but birth rates have continued to remain stubbornly high. The unintended consequence is a fast-growing population that adds further pressure on poor families and fragile environments.”

* An ODI blog post on DFID and tackling corruption, with some reflections on the ICAI first report on UK aid.

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2 Responses to IHP News 145 – Did health aid mitigate OOP expenditure in developing countries?

  1. Redgi De Deken says:

    Every one would live in a better world if every one would have sufficient ressources in order to address the OOP issue. Where do the donors have to lay the focus on in order to reach this objective? Do they have to increase further their global health support?

    • admin says:

      The World Health Report 2010 on Universal Health Care has put the reduction of OOP again at the centre of priorities to progress toward UHC. But, the strategy to achieve this depends mainly on the level of resources in a country. Low or middle-income will not have the same leeway. Gorik Ooms’ researches, like others, have shown that low income countries might not have the means to act on OOP without foreign assistance.

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