This week, China played ‘hard to get’ at the Busan conference. The UK’s Andrew Mitchell played a key role in bringing them back to the table. Our guest-editor, Emerging Voice Anar Ulikpan from Mongolia, already looks ahead.
Can the Paris Declaration still remain relevant after Busan?
A changing aid environment marked by the arrival of new donors, new forms of cooperation and an increasing demand for results has challenged the application, generalizability and sustainability of the Paris Declaration after Busan. While it is important to welcome new approaches, it is also worth remembering that ‘’a new thing is often a somewhat forgotten old one’’.
Enjoy your reading.
David Hercot, Kristof Decoster, Josefien Van Olmen, Basile Keugoung & Wim Van Damme
AIDS and Global Fund
1. FT – Combating disease: A stretched safety net
Andrew Jack; www.financial times.com
Andrew Jack (Financial Times) was one of the many global health watchers deploring the GF funding crisis this week. As we already mentioned last week, the timing of the GF financing crisis – clear for all to see, just before World Aids day – is perhaps unfortunate. On the other hand, the awkward timing can perhaps help inspire a new or reinvigorated Aids movement? Let’s hope so.
In the Lancet, Richard Horton (in his weekly Offline article) emphasizes that the Global Fund Board is to blame too for the GF crisis.
2. CGD – A Tale of Two Tipping Points – HIV/AIDS and USG Funding for Global Health
Jenny Ottenhoff; blogs.cgdev.org/globalhealth/
CGD’s Jenny Ottenhoff dwells on two tipping points. “It seems we have reached a “tipping point” where the science, technology and know-how are available to realistically talk about creating an AIDS free generation. …”
“But in the current U.S. political and fiscal environment, it’s becoming increasingly clear that this kind of support for AIDS funding may have also reached a “tipping point” and will be increasingly difficult to maintain in coming years.”
3. Laurie Garrett (blog) – Failure Is Not Acceptable on World AIDS Day — But Neither is Staying the Course
Laurie Garrett; lauriegarrett.com/
Laurie Garrett puts things in perspective. AIDS shouldn’t be forgotten but there are other important health issues, and we need to face the dire reality: global health funding will probably decrease in the coming years. To some extent this is already the case due to the changing exchange rates of the USD, Euro and Swiss Franc (just ask WHO and the GF).
4. BMJ (news) – Middle income countries need to “share the burden” of the fight against HIV and AIDS
Anne Gulland; bmj.com/
Middle income countries must increase the amount of money they spend on fighting AIDS and HIV, a senior figure from WHO has said, as WHO, UNAIDS, and Unicef released their annual progress report on the disease for world AIDS day on 1 December. (The Progress report 2011 reviews progress made until the end of 2010 in scaling up access to health sector interventions for HIV prevention, treatment, care and support in low–and middle-income countries.)
On World Aids day, Obama renewed the US HIV/AIDS commitment. As a politician, he must be keenly aware that next year’s Aids conference will take place in the US. Nevertheless, it’s great to see him give a speech on HIV (a first as a president).
5. Plos Medicine – Series on voluntary medical male circumcision
This sponsored Collection of nine articles comprises four reviews and five research articles that together show scale-up of Voluntary Medical Male Circumcision to be a cost-effective HIV prevention measure in eastern and southern Africa. The Collection is produced with support from UNAIDS and PEPFAR.
In related news, the Financial Times reported that male circumcision is a practice that – despite the evidence – has yet to be adopted as much or as fast as experts had hoped.
“International organizations have publicly endorsed the importance of circumcision, and a number of guidelines have been established, but the response so far has been haphazard and funding remains modest.” “One reason has been that much government donor and philanthropic support for HIV prevention work was focused instead on more ‘high-tech’ alternatives such as vaccines and microbicides“.
Macro-Economic Commission on Health, Social Determinants and Health as a Right
6. Lancet World Report – The Commission on Macroeconomics and Health: 10 years on
Pamela Das, Udani Samarasekera; Full Text
To mark the 10th anniversary of the report of WHO’s Commission on Macroeconomics and Health, Pamela Das and Udani Samarasekera asked global health experts about the publication’s legacy.
7. Lancet – The Commission on Macroeconomics and Health: was it the right recipe?
Ronald Labonté, Arne Ruckert; Full Text
With hindsight, Labonte and Ruckert have mixed feelings about the 2001 report of the Commission on Macroeconomics and health.
8. Lancet – Africa’s health and the Commission on Macroeconomics and Health
Donald Kaberuka; Full Text
The President of the African Development Bank looks back on the 2001 WHO Commission report and implications for African health. He also looks ahead, and is rather optimistic.
This week, WHO released a new tool on Social Determinants of Health. Following the recent World Conference on Social Determinants of Health in Rio, WHO has created a virtual discussion platform aiming to sustain and reinforce discussion and debate regarding action on the social determinants of health. Supported by strong information content developed in collaboration with key WHO partners, the new platform is intended to serve as a clearing house for members from across government and society to share experiences and views.
There was also a BMJ news article on Global Health Watch 3 this week: “The current global economic model needs fundamental change if the goal of health equity worldwide is ever to be reached, the third edition of the Global Health Watch report warns. A return to ‘health as a right’ is needed to reduce inequalities.”
Global Health Policy & Financing
9. Reproductive health matters – Sub-Saharan Africa and the health MDGs – the need to move beyond the ‘quick impact’ model
Fabienne Richard, David Hercot, Charlemagne Ouédraogo et al.; http://www.rhm-elsevier.com/article/S0968-8080(11)38579-5/abstract
This paper examines the merits and limitations of MDG indicators for assessing progress and their relationship to quick impact interventions. It then assesses specific health interventions through both the lens of time and their integration into health care services, and examines the role of health systems strengthening in support of the MDGs. The authors argue that fast-track interventions promoted by donors and Global Health Initiatives need to be complemented by mid- and long-term strategies, cutting across specific health problems.
The fiery editorial of the same Reproductive health matters issue argues it’s time for repoliticisation of sexual and reproductive health.
In related news, Senegal hosts the second international conference on family planning.
10. AP – China prepares for big entry into vaccine market
Gillian Wong; google.com/hostednews/ap/
The world should get ready for a new “Made in China” product — vaccines. (Aid effectiveness with Chinese characteristics, one could say.)
CSIS also published a new report on China’s Emerging Global Health and Foreign Aid Engagement in Africa.
Speaking of health aid effectiveness, we would like to draw your attention to a new CGD paper on Cash on Delivery for health, as well as on a very nice blog post on PBF in Africa (on the Financing health in Africa blog) (by Louis Rusa, in French though).
11. CGD – No, British Medical Journal, the Emigration of African Doctors Did Not Cost Africa $2 Billion
Michael Clemens; blogs.cgdev.org/globaldevelopment/
Clemens trashes last week’s BMJ article on the financial cost of emigration of African doctors.
12. WHO Bulletin (editorial) – Effective aid in a complex environment
Peter Hill et al; http://www.who.int/bulletin/volumes/89/12/11-098285/en/index.html
Peter Hill and colleagues look ahead to the Busan conference (which took place this week, see our guest-editorial and below). We live in a complex world, as you might have expected from Peter. The aid effectiveness and donor coordination agenda is no different in that respect from the rest of the world. In fact, to some extent, donor coordination has added an additional layer of complexity for recipient countries.
13. Medicines for Malaria venture (Press release) – Marketing authorization for Eurartesim® announced at media roundtable
A once daily antimalarial, dihydroartemisinin-piperaquine, has been approved by the European Medicines Agency (EMA). This is the very first time that the EMA, using a centralised procedure, has granted regulatory approval to an artemisinin combination therapy (ACT) for the treatment of uncomplicated P. falciparum malaria.
14. BMJ (Analysis) – Twenty criteria to make the best of scarce health resources in developing countries
James D. Shelton; http://www.bmj.com/content/343/bmj.d7023?etoc
The needs of developing countries are so great and potential interventions so numerous that priorities are essential. James D Shelton suggests a simple checklist for deciding on priorities and improving implementation.
15. Plos One – Trends in Health Policy and Systems Research over the Past Decade: Still Too Little Capacity in Low-Income Countries
Taghreed Adam et al.; plosone.org/
Although progress has been made in both the production and funding availability for Health Policy and Systems Research, capacity to undertake the research locally has grown at a much slower pace, particularly in LICs where there is most need for this research. A firm commitment to dedicate a proportion of all future funding for research to building capacity may be the only solution to turn the tide.
Our Guest editorialist already dwelled on the Busan conference on aid effectiveness. And the Guardian’s Poverty matters blog also did an excellent job covering the conference, including the “hide-and-seek” of China, the strong statements made by people like Kagame, Hilary Clinton and Ban Ki Moon; Jonathan Glennie’s assessment of the conference, …. You find everything here.
After last minute negotiations and the insertion of a paragraph distancing non-DAC donors from concrete commitments, China, India and Brazil all endorsed the idea of working together more closely in what is being described, even by usually critical civil society representatives, as a “new global partnership“.
Before the conference, Center for Global Development’s Owen Barder had been wondering whether donors would hide behind China.
Another Center, the Center for Social and Economic rights, also blogged on Busan (and more specifically on ‘mutual accountability’). That isn’t a one way relationship, Luke Holland and Victoria Wisniewski emphasize: “… While backsliding in aid commitments, many donor governments are simultaneously making it more difficult to mobilize the maximum available resources for human rights fulfillment. Illicit financial flows out of developing countries surpass those of official development assistance by a 10 to 1 ratio, according to experts. Paradoxically, many wealthy, donor countries allow and at times actively encourage the use of their jurisdictions as tax havens, with Switzerland, the USA, Japan, Germany, the UK and Belgium amongst the top 15 on the Financial Secrecy Index. Financial secrecy and the use of tax havens in rich countries permits an international enabling environment prone more to corporate tax dodging and tax evasion and avoidance, than to human rights-based development.” (sounds like Belgium’s brand new government has some more work cut out).
Aid & Development
16. ODI – climate finance fundamentals
So far, the Durban conference has stayed a bit under the radar, but we would like to refer you nevertheless to a series of short, introductory ODI briefings on various aspects of climate financing. In light of the fast pace of developments in climate finance, the briefs allow the reader to gain a better understanding of the quantity and quality of financial flows going to developing countries.
We would also like to draw your attention to this excellent Guardian article by Jonathan Glennie on the “1% vs 99 %” issue, taking into account global inequality.
Finally, Gordon Brown called for a Global Fund for education, a few weeks ago.