This week’s guest editorial is from Seye Abimbola, Emerging Voice and currently research fellow at the National Primary Health Care Development Agency, Abuja, Nigeria. You can find this piece also on the BMJ blog. This week was again very rich in thoughtful comments around ICASA’s AIDS conference, vaccines, global fund, global health policy,… as you will see.
Enjoy your reading.
David Hercot, Kristof Decoster, Josefien Van Olmen, Basile Keugoung & Wim Van Damme
Edito – On David Cameron, Homosexuality and HIV/AIDS in sub-Saharan Africa
“All truth passes through three stages: First, it is ridiculed; Second, it is violently opposed; and Third, it is accepted as self-evident.” — Arthur Schopenhauer
Global Health Policy & Financing
1. KFF – Obama Administration To Promote And Protect LGBT Rights Through Foreign Aid, Diplomacy
In the first U.S. government strategy to deal with human rights abuses against lesbian, gay, bisexual and transgender (LGBT) citizens abroad, President Obama issued a presidential memorandum on Tuesday instructing agencies to use foreign aid to promote such rights.
2. Lancet (online) – Why we need a Commission on Global Governance for Health
Ministers of Foreign Aﬀairs of Brazil, France, Indonesia, Norway, Senegal, and Thailand; http://www.lancet.com/journals/lancet/article/PIIS0140-6736(11)61854-0/fulltext
5 years ago, the foreign ministers of Brazil, France, Indonesia, Norway, Thailand, Senegal, and South Africa, launched the Global Health and Foreign Policy Initiative
in recognition of the central importance of health and its connection to multiple global governance processes. Now they argue why they welcome the creation of the independent academic Commission on Global Governance for Health organised by The Lancet, the University of Oslo, and the Harvard Global Health Institute.
3. CGD (paper) – An Index of the Quality of Official Development Assistance in Health
Denizhan Duran and Amanda Glassman; http://www.cgdev.org/doc/blog/QuODAH_Draft_Dec6_PeerReview.pdf
While many people stress the importance of aid effectiveness, there are limited quantitative analyses of the quality of health aid. In this paper, the authors apply Birdsall and Kharas’ Quality of Official Development Assistance (QuODA) index methodology to rank donors across 23 indicators of aid effectiveness in health.
4. China Daily – China, Gates Foundation to boost cooperation
China’s Minister of Science and Technology held talks on Tuesday with Bill Gates in a bid to boost strategic cooperation between China and the Gates Foundation in modern agriculture and the health industry. (it’s not just Mark Zuckerberg cozying up to the Chinese).
AIDS – ICASA Conference in Addis
The 16th International Conference on AIDS and STIs in Africa (ICASA) took place in Addis Ababa this week. You find an overview of the most important speeches and events at the ICASA website, as well as on the SAFAIDS website.
– George W. Bush was a keynote speaker (and got a standing ovation, apparently, for his global health track record)
– The cancellation of round 11 by the Global Fund was the talk of the town, obviously. People reacted to this news in various ways: (1) many participants said African governments should now step up (“they needed this wake-up call from the donor community”) and own, scale up and sustain the HIV response; (2) Stephen Lewis, co-director of AIDS-free world, warned western donors and compared with US spending on defense (need we say more?); (3) Sidibé (UNAIDS) raised the option of innovative taxes.
– UNAIDS and PEPFAR announced a 5-Year Action Framework to scale up voluntary medical male circumcision for HIV prevention.
– The Global Fund is ‘here to stay’, said GF deputy executive director Zewdie.
Next week we will feature some more in-depth pieces from colleagues on this even
6. Nature – Cutbacks threaten HIV gains
Meredith Wadman; http://www.nature.com/news/cutbacks-threaten-hiv-gains-1.9581 Wadman explores the reductions in contributions to global research and treatment programmes by wealthy nations. Only the UK seems to be an exception, when it comes to research funding for neglected diseases
Meanwhile, CGD’s Mead Over shows the way forward in a Foreign Affairs article on the Aids transition needed.
7. GFO (2 new issues) – issue 169 and issue 170
Very productive people there at the Global Fund Observer. But of course the times are such that one could make a GFO issue almost every day. You find issue 169 here; in issue 170 we would like to draw your attention especially to the first two commentaries. An analysis of why the GF cancelled round 11; and a delicious viewpoint by Bernard Rivers in which he says the GF is very transparent, unless when it really matters.
8. Science Speaks – Sachs on Global Fund Round 11 cuts: “It’s game over for the Millennium Development Goals
Like most people, Jeffrey Sachs was pretty shocked last week, after getting the news of the cancellation of round 11. Jeff is in London now, for a Chatham house conference on the Commission on macroeconomics and health – ten years on.
The ‘Financing Health in Africa’ blog also featured a post on the cancellation (by Isidore Sieleunou), in which he explored what could be possible lessons for developing countries. The post already sparked quite some debate, for example on ‘why the Global Fund and not GAVI?’
9. Plus News – SWAZILAND: Contesting the Global Fund audit
Swaziland disagrees with an OIG fraud report: “You cannot use rules from 2010 to assess spending done in 2003” is the gist of their defense.
10. BMJ (news) – Developing countries are not making the most of TRIPS flexibilities because of political pressure
Rachel M Hermann; http://www.bmj.com/content/343/bmj.d7706?etoc=
The flexibility given to developing countries to provide medicines more cheaply to those in need is not being exploited to its full capacity, a legal expert on public health has said.
11. WHO Bulletin – Putting the priorities first: medicines for maternal and child health
Suzanne R Hill ; http://www.who.int/bulletin/online_first/11-088658.pdf
WHO, the United Nations Children’s Fund and the United Nations Population Fund have identified a list of the top 30 medicines for MCH based on burden of disease and evidence of benefit, as recommended in current WHO treatment guidelines. These medicines need to be made available as appropriately packaged, affordable quality products, for use throughout the health system. The author sketches also a “wish list” of products that could make a difference, if they were available.
12. Plos (essay) – The Primacy of Public Health Considerations in Defining Poor Quality Medicines
Paul Newton et al.; http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001139
Paul Newton and colleagues argue that public health, and not intellectual property or trade issues, should be the prime consideration in defining and combating counterfeit medicines, and that the WHO should take a more prominent role.
13. CGD (blog post) – Separating the Good from the Bad on HPV
Amanda Glassman raises an important question in her blog post on HPV vaccine uptake by GAVI. Yes, the vaccine is effective at preventing cancer but is it the “next best buy” for governments in low income countries looking for improved health outcomes when basic drugs of decent quality are not even available? Put differently: is GAVI supporting Big Pharma interests or people’s health? Shouldn’t GAVI expand support for existing measles and meningitis vaccines rather than introduce new and expensive ones? When talking about Pneumococcus and rotavirus, they obviously have a point, as these vaccines target big killers; HPV, however, kills reportedly less than 700 women per year in Rwanda – compare with the more than 35 000 children under 5 dying of diarrhea yearly. If you had five million USD where would you put your money?
But check out also this Lancet letter, on the same issue – HPV vaccination in Rwanda. The authors (with among them Rwanda’s Minister of Health) reply to a previous article in the Lancet, but would probably also fiercely oppose Glassman’s reasoning – “Ouedraogo and colleagues’ argument reminds us of nihilistic claims against provision of antiretroviral therapy in Africa.”
CSIS just published two reports on vaccines and immunization. Cochi explores the future of global immunization. He sees ten challenges. Nieburg and MacLaren tentatively prepared a list of key technical aspects to take into account for policy makers before and during the implementation of vaccine programmes. A tool to resist donor pressure?
14. Alertnet – Family planning ‘effective’ but unpopular climate change solution
Laurie Goering from Alertnet (reporting from the climate conference in Durban) points out family planning can be an effective way to combat climate change and its social consequences. Mary Robinson has emphasized this is particularly the case in a number of hotspots like India, West and Central Africa.
15. Sarah Boseley – Why sex is a dirty word
If it wasn’t for donors’ moral opinions, family planning would be much higher on the agenda of developing countries, Sarah Boseley implies. Do you agree with her?
16. WHO Bulletin – Health research systems: promoting health equity or economic competitiveness?
Bridget Pratt & Bebe Loff;
International collaborative health research is expected to help reduce global health inequities. Investment in health policy and systems research in developing countries is essential to this process but, currently, funding for international research is mainly channelled towards the development of new medical interventions. This imbalance is largely due to research legislation and policies used in high-income countries.
17. Pakistan Journal of Public Health – Power Politics: researching the informal social networks in Health Policy Analysis
Asmat Malik et al.; http://bit.ly/vFlZPl
Our Emerging Voice from Pakistan, Asmat Malik, recently published his EV essay on the Punjab Integrated PHC programme model and the influence of informal social networks in decision making processes. You find the pdf here.
Development & Aid
- The Busan conference (and the Busan outcome document) provoked a number of comments, assessments and other feedback. Charities were somewhat disappointed with the voluntary nature of the new aid agreement, BMJ news reported. Jonathan Glennie wrote another piece on health sector aid effectiveness in the Guardian. And the Broker also featured excellent posts on “value for money or a results obsession disorder” and two speed aid effectiveness. On the CGD website, OECD-DAC chair Brian Atwood reflects on Busan progress.
- Claire Melamed explores what a post-2015 agreement on development could be for (on Global Dashboard).
- Then there is the COP17 conference in Durban, of course. Things don’t look good over there, according to the latest news. But you might want to read this ODI blog post on climate finance nevertheless.
- Finally, we think this piece (in the New Inquiry) on Nicholas Kristof, the acclaimed NYT columnist, is worth reading. Human rights researcher Elliott Prasse-Freeman wants us to be aware of Kristof’s anti-political stance.