Dear Colleagues,

Thérèse Delvaux, an ITM colleague from the Women and Child Health Research Centre, wrote this week’s guest editorial. She links findings from last week’s Guttmacher-UNFPA report, “Adding It Up: Costs and Benefits of Contraceptive Services – Estimates for 2012”, with the upcoming family planning summit in London.

Enjoy your reading.
Kristof Decoster, David Hercot, Ildikó Bokros, Basile Keugoung & Wim Van Damme




New data on contraception and the upcoming Family Planning summit in London


Thérèse Delvaux (Public Health Department, Woman and Child Health Research Centre ITM, Belgium)

New data on contraception released last week  show that “an estimated  222 million of women have an unmet need for modern contraception. The proportion of married women using modern contraceptives in the developing world as a whole barely changed between 2008 (56%) and 2012 (57%). However, there were significant regional variations.  Substantial increases occurred in Eastern Africa (from 20% to 27%) and Southeast Asia (from 50% to 56%), while there was little change in Western Africa and Middle Africa, regions where fewer than 10% of married women use modern contraceptives” (Guttmacher – UNFPA report).

Read the rest of the editorial here


US – Supreme Court decision


1. Financial Times – US court rules for Obama on healthcare

Anna Fifield and Stephanie Kirchgaessner;

On Thursday, the US Supreme Court upheld the core components of Barack Obama’s healthcare law, aka ‘Obamacare’, handing the president a significant legal victory while enraging conservative opponents of the policy (admittedly, we’ve never seen an enraged Mitt Romney, but we wonder how this would affect his hairstyle ). Upcoming episodes in the saga are scheduled for 11 July (in Congress), and, of course, in November (presidential elections).

The Economist has an article on the Supreme Court decision, and there’s an interesting Washington Post blog post on the decision, putting it in international (UHC) perspective. Richard Horton also dedicated a couple of lines to the controversy over the US health care reform in his weekly Offline article, wondering whether there is a specific historical explanation for America’s antipathy towards the right to health. “That would imply poor prospects for securing US support for universal health coverage as a larger global goal.”

Conversely, Laurie Garrett emphasizes that the Supreme Court decision on the Affordable Care Act opens the possibility that the United States may now begin to implement domestic policies that foreign aid agencies and the Department of Defense have long supported as elements of U.S. foreign policy. Put differently, the US government has long funded other countries’ efforts to build up universal care systems while the American health system has stubbornly resisted universal coverage. That contradiction may now end – that is, at least until November.


Rio+ 20


2. KFF – U.S. Secretary Of State Clinton Defends Women’s Reproductive Rights At Conclusion Of Rio+20 Conference

On the last day of Rio+20, Hilary Clinton applauded the final document’s endorsement of women’s sexual and reproductive health but made it clear that she objected to the omission of specific language on reproductive rights. A WHO statement highlights additional health-related measures adopted in the outcome document, stating, “‘The Future We Want’ conference outcome document … highlights the fact that better health is a ‘precondition for, an outcome of, and an indicator of sustainable development’.


Ban Ki-moon also launched the ‘Zero Hunger Challenge’ at the summit, a five-point food security campaign aimed at a future where all enjoy ‘a fundamental right to food’. The EU could be off to a decent start, at least if it follows the recommendations of a new report on EU and nutrition development policy that calls on the Commission to raise funds for nutrition from €418m to €1bn in its next budget, from 2014 to 2020. Rumour has it that strong majorities in the EU council of member states and the European parliament endorse the report’s recommendations.


Family planning summit in London


3. RH reality check – The 2012 Global Family Planning Summit: Will Issues Be Adequately Addressed?

Marianne Møllmann (Amnesty International)

Like Thérèse Delvaux in the guest-editorial, Møllmann looks ahead to the upcoming Family Planning summit in London. On the Guardian Global Health blog, Sarah Boseley also had her say, commenting on a recent ‘Save the Children’ report. The report goes beyond the logistical issues, and also addresses the issue of teenage pregnancy.


As already mentioned in the guest-editorial, the summit background document has proved quite controversial and been revised recently.




4. Lancet (Editorial) – Pre-exposure HIV prophylaxis: the world is waiting

This week’s Lancet issue focuses on HIV, ahead of the International AIDS Society meeting in Washington, DC, on July 22—27. There are plenty of Comments, and articles outlining further efforts to make treatment better and improve patients’ adherence. Another article shows the benefits of antiretrovirals when given to either mothers or infants to prevent HIV transmission via breastfeeding. The issue of antiretrovirals for prevention, specifically pre-exposure prophylaxis, is presently under intense debate, as you probably know.


5. BMJ (Editorial) – Promoting long term adherence to antiretroviral treatment

Edward J. Mills et al.;

The authors of this BMJ editorial argue that patient support and community interventions are probably the best interventions to promote long term adherence to antiretroviral treatment.  Technology can also be harnessed to provide reminders, support, or monitoring systems for adherence.


6. KFF – Vatican Official Calls On International Community To Provide ‘Free, Efficient’ HIV Treatment In Africa

Cardinal Tarcisio Bertone, the Vatican’s secretary of state and number two official, called on the international community to provide ‘free and efficient treatment’ for AIDS in Africa, starting with pregnant women, mothers and their babies.

(It’s been an excellent week for Italy, as you know, both at the EU summit and in the clash with the German team at Euro 2012. And the week isn’t over yet – let’s see whether Mario Balotelli can fire off another rocket against the Spanish on Sunday….  by the way, we have a suggestion for Van Rompuy & co to boost the dwindling EU citizenship feelings: how about an “all-star” EU football team, selected through European wide internet polls? This team would have to face a South-American ‘all star’ team every year, let’s say in Wembley (as the English for the moment don’t have a player good enough to make the team). Can you imagine a team with the likes of Iniesta, Özil, Balotelli and Ronaldo (to make a smooth link with the commercials)  playing against Messi and co?). Can’t wait.


7. KFF – Efforts To Fight Illegal Drugs Contributing To Spread Of HIV, Report Says

The Global Commission on Drug Policy (GCDP) on Tuesday published a report  titled “The War on Drugs and HIV/AIDS: How the Criminalization of Drug Use Fuels the Global Pandemic,” which “condemns the drug war as a failure and recommends immediate, major reforms of the global drug prohibition regime to halt the spread of HIV infection and other drug war harms.” The GCDP urges the U.N. to ‘acknowledge and address the causal links between the war on drugs and the spread of HIV/AIDS and drug market violence.'” Instead of arresting and imprisoning people who use drugs but do no harm to others, government should focus on evidence-based drug-reduction interventions, such as safe injection sites and prescription heroin programs.


8. IHP – HIV Medicines Alliance: Lip Service Move To Get Rid Of The Medicines Patent Pool?

Daniele Dionysio;

The newly launched HIV Medicines Alliance (HMA) initiative commendably seeks enlarged brand, generic industry collaboration to optimize, enhance access to HIV treatments by developing world populations. But it raises concerns about implications for the freedom of India’s pharma companies, good faith in helping the greatest number of patients, and impact on the Medicines Patent Pool. These compound criticism that, as a lip service move to get rid of the Pool, HMA could fall short of a staunch commitment to affordable prices and availability.


Health Policy & Financing


9. Global Health Governance – Spring issue

Excellent new GHG issue, with an interesting Comment on the evolving global landscape on Health Systems Strengthening, for example.


10.   BMC public health – Special issue on universal coverage

BMC Public Health published a new supplement that focuses on universal health coverage. The supplement presents a compilation of select papers from the International Symposium on Universal Health Coverage in Malaysia, convened by Global Public Health at the School of Medicine and Health Sciences on 3 – 4 October 2011. The papers attempt to examine the concept of UHC from a series of different perspectives: equity and vulnerability, insurance and financing, coverage and satisfaction, and implementation. The proceedings of the symposium are also expected to feed into the background papers for the Second Global Symposium on Health Systems Research to be held in Beijing, later this year.


11.   Globalization & Health – Global health and national borders: the ethics of foreign aid in a time of financial crisis

Mira Johri, Ryoa Chung, Angus Dawson and Ted Schrecker;

The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health.


12.   Plos – Global Health Governance and the Commercial Sector: A Documentary Analysis of Tobacco Company Strategies to Influence the WHO Framework Convention on Tobacco Control

Heide Weishaar et al.;

Heide Weishaar and colleagues analysed internal tobacco industry documents together with other data and describe the industry’s strategic response to the WHO Framework Convention on Tobacco Control.

From Big Tobacco to Big Food is only a small step these days. In a new article in the Plos series on Big Food, Ray Patel examines the concept of food sovereignty, which aims to address inequalities in power that characterize the global food system and fuel hunger and malnutrition.

Epi-analysis features this blog post, based on new data in a Plos Policy Forum. The author wonders whether it’s time to argue for a global nutrition treaty.


13.   Smart Global Health – Child Survival Campaign Highlights Shifts in Global Health Strategies

Nellie Bristol & Janet Fleishman;

This blog post gives a good summary of the discussions at the child survival summit from a few weeks ago.


14.   BMJ (Observation) – The crusade for health equity

Tessa Richards;

The financial crisis makes it increasingly urgent for countries to protect the most vulnerable people, and social movements are setting the pace. This Observation already looks ahead to the 3rd PHM’s Global Assembly in Cape Town, while making the link with the health sector carnage in Greece and other Southern European countries.


15.   Health & Human Rights – Pillars for progress on the right to health: Harnessing the potential of human rights through a Framework Convention on Global Health

Eric A. Friedman & Lawrence O. Gostin;

The authors propose a four-part approach to accelerating progress towards fulfilling the right to health: 1) national legal and policy reform, incorporating right to health obligations and principles including equity, participation, and accountability in designing, implementing, and monitoring the health sector, as well as an all-of-government approach in advancing the public’s health; 2) litigation, using creative legal strategies, enhanced training, and promotion of progressive judgments to increase courts’ effectiveness in advancing the right to health; 3) civil society and community engagement, empowering communities to understand and claim this right and building the capacity of right to health organizations; and 4) innovative global governance for health, strengthening World Health Organization leadership on health and human rights,…. They offer specific steps to advance each of these areas, including how a new global health treaty, a Framework Convention on Global Health, could help construct these four pillars. (see also JAMA, 16 May)




16.   Global Health Action – Scaling-up and rooting-down: a case study of North-South partnerships for health from Tanzania

J. Hope Corbin, Maurice B. Mittelmark and Gro Th. Lie;

North-South Partnership (NSP) is the mandated blueprint for much global health action. Northern partners contribute funding and expertise and Southern partners contribute capacity for local action. Potential Northern partners are attracted to Southern organizations that have a track record of participating in well-performing NSPs. This often leads to the rapid ‘scaling up’ of the Southern organization’s activities, and more predictable and stable access to resources. The purpose of this study is to examine how scaling up affects a Southern partner’s organizational functioning, in a Southern grassroots NGO with 20 years of scaling up experience, Kiwakkuki.


Development & Aid


17.   ODI working paper – Reassessing aid to middle-income countries: the implications of the European Commission’s policy of differentiation for developing countries

Sian Herbert;

The new EC policy of ‘differentiation’ aims to recalibrate its development cooperation with middle-income countries, and introduces two significant changes: (1) new aid allocation criteria; and (2) differentiated development partnerships for different categories of countries. This ODI working paper explains the Commission’s new policy and looks at its implications for developing countries.


18.   Development Policy review – Bilateral Donors’ Efforts to Assess and Manage UN Agencies’ Effectiveness: Seeking a Balance between Paris Principles and Domestic Accountability

Koen De Koster & Nathalie Holvoet;

Results orientation and performance measurement have become buzzwords in development aid in recent years. Bilateral donors are increasingly concerned about the effectiveness of core-funded UN specialised agencies, funds and programmes, through which they channel a substantial part of their funds. This article discusses two major initiatives to harmonise and align bilateral assessments, using case-study material from three bilateral donors (Belgium, the Netherlands and the UK) with clearly diverging performance-management cultures, and exploring the extent to which they rely upon joint and aligned initiatives.


Other Development & Aid stuff you might want to read:

  • A brand new IPRR/ODI report on UK public opinion on aid and development, drawing on results of deliberative workshops around the UK.
  • A Project Syndicate Op-ed by Robert Skidelsky on ‘full employment’.
  • Claire Melamed wrote a nice blog post on inequality, more precisely on the two global conversations going on about inequality at the moment.
  • The Rio+20 outcome document was disappointing for most analysts, including human rights advocates, but the Guardian’s John Vidal saw nevertheless five reasons to be cheerful.
  • Jonathan Glennie reckons Western donors could learn a couple of things from Brazil’s new brand of development aid. Rather than advising governments on what should work, as we tend to do, Brazil exports success – its south-south co-operation is based directly on what has already worked.
  • Somewhat surprisingly, Dambisa Moyo has fallen in love with China, it appears, at least as far as China’s investment in Africa is concerned. “China’s motives for investing in Africa are actually quite pure.” (Op-Ed in the New York Times).
  • Jamie Drummond argues for crowdsourcing the MDG 2.0 goals  (TED).

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