This weekend the Aids conference ‘Turning the tide together’ kicks off in Washington. This newsletter pays quite some attention to “the” global health event of this summer. It remains to be seen whether there is indeed reason for ‘cautious optimism’ in this ‘era of austerity’ / ‘de-leveraging decade’ (pick your preferred neoliberal term). The good news is that Africa is increasingly picking up the baton.
In this week’s editorial, the Emerging Voices team provides an update on the EVs 2012 competition. The winners have been selected.
Enjoy your reading.
Kristof Decoster, David Hercot, Ildikó Bokros, Basile Keugoung &Wim Van Damme
Emerging Voices 2012: And the winners are ….
The Emerging Voices team
Around the end of June, fifty people from all parts of the world were selected to have their voices heard in Beijing as Emerging Voices 2012. You may know some of them already as ten Emerging Voices 2010 will continue the venture as mentors and coaches. And now the real work starts: the Emerging voices will get a 10-day skills and content training in Beijing prior to the symposium, to help them finalize a number of expected outputs during and after the symposium – respectively, a poster/oral presentation and a peer-reviewed publication. If you want to find out more, their profiles will be published soon at http://www.ev4gh.net/.
In the meantime, you can already enjoy a couple of video interviews with EVs 2010 (Lungiswa, Taufique, Victoria, Mabel) about their experiences with the program, the opportunities it created for hem, what they learned, etc. Check out also some of the recent EVs 2010 publications. And if you really can’t get enough of it, there’s a nice EV “promo” Youtube video as well!
By the way, all of you can follow the EVs2012 from the front row. We warmly invite all young health system researchers to join the emerging voices at the preconference that will take place on the campus of Peking University on 29 and 30 October 2012. Be it as a participant or as a presenter, this is a unique opportunity to team up with peers and other young voices and to share your message in front of a bigger audience ahead of the symposium. Take a look at the preconference draft programme at www.ev4gh.net: the event promises to be an interesting two days of presentations and interactive discussion sessions. If you think you have an important message for the global health community, please do not hesitate to register as an individual or a group for the preconference by sending an email to firstname.lastname@example.org. Mention ‘Registration Preconference – your name’ in the subject line and indicate whether you just want to participate in the discussions (as part of the audience) or whether you would like to reserve a time slot for your presentation. Places are limited to 150 seats and 50 presenters with interactive discussions in fish bowls and breaker sessions. Available places will be assigned on a ‘first come first served’ basis. Don’t miss this opportunity.
We hope to have the voices of many of you heard in Beijing with reverberations all over the globe!
Aids conference – AIDS 2012
A) Viewpoints, Perspectives & Op-Eds on HIV in 2012
1. NEJM (Perspective) – The beginning of the end of AIDS?
Diane Havlir et al.; http://www.nejm.org/doi/full/10.1056/NEJMp1207138
The authors explore the roadmap to what Hillary Clinton called in a 2011 speech an ‘AIDS-free generation’.
2. Globalization & Health (Editorial) – AIDS: Ushering in a new era of shared responsibility for global health
Kent Buse and Greg Martin; http://www.globalizationandhealth.com/content/8/1/26/abstract
For the first time since AIDS erupted as worldwide emergency, global leaders, the scientific community, activists and people living with HIV are venturing to speak about the end to the pandemic. This progress embodies global solidarity to bring about an AIDS-free generation. Shared responsibility and global solidarity represents a normative ideal to which both individual stakeholders and the global community must subscribe. The idea of shared responsibility and global solidarity needs to goes further than raising and investing resources and extend to the level of control countries take of their AIDS response. This editorial explores five areas that require specific attention.
3. Lancet (Editorial) – Sex workers and HIV—forgotten and ostracised
In Washington, one group of people will be absent due to US travel restrictions: sex workers. In response to this exclusion and to ensure that sex workers’ voices are heard, Kolkata, India, will host an alternative event named the ‘Sex Worker Freedom Festival’. (we refrain from commenting)
4. Lancet (Offline) – Offline: Why the world should consider a UN Africa
Horton dwells on Peter Piot’s time at UNAIDS, on how UNAIDS should perhaps reinvent itself as ‘UN Africa’, and on the emerging (although still virtual) Fund for family planning.
5. CGD – Storm Clouds and Silver Lining around US Funding for AIDS
At least four big issues will impact US support for the global response to the epidemic over the coming year, according to Ottenhoff. In a CGD wonkcast, Jenny Ottenhoff and Mead Over discuss the upcoming Aids conference.
Stephen Morrison, Director Global Health Policy Center at CSIS also reflects on the upcoming aids conference, from an American point of view. Nellie Bristol and Sarah Boseley both zoom in on Aids in the US, the latter with a recent and rather sad tale of AIDS and immigration. Boseley also commented on the recent (and controversial) approval of Trubada, a daily pill to protect people at risk of HIV from infection, by the US food and drug administration. Elsewhere, the UN High commissioner for human rights, Navi Pillay, emphasized human rights are essential in the fight against Aids.
Hillary Clinton will speak at the Aids conference. Meanwhile, 60 organizations and one archbishop – Desmond Tutu – have presented the Obama administration with a modest proposal. The “Call for a US Government AIDS-Free Generation Strategic Plan” asks the Obama administration to put Mrs. Clinton in charge of a task force to complete a strategy in time to be announced by the next World AIDS Day – Dec. 1, 2012. (by then, the HIV community will probably have to convince Mitt – how about some innovative offshore HIV financing ? )
B) Some Reports, Series and other publications in the run-up to the Aids conference
6. Lancet HIV Series – HIV in Men Who Have Sex with Men
Despite great progress in tackling the HIV epidemic worldwide in the past two decades, the epidemic continues to grow in men who have sex with men (MSM), across countries of all incomes. A new Lancet Series explores the unique aspects of the HIV epidemic in MSM, showing that it is factors such as the biology of anal sex, the characteristics of MSM networks, and known behavioural factors that are driving the epidemic in this population. The Series addresses the unique challenges faced by black MSM around the world, and discusses initiatives that reduce infectiousness of HIV that could have a huge impact in curbing the HIV epidemic in MSM and other populations. In a Comment, Pamela Das & Richard Horton point to the vast cultural challenge of HIV/AIDS.
* JAIDS has released three supplements to its most recent issue ahead of the conference. We want to draw your attention to Supplement 2 (on seven essential steps toward an AIDS-free generation), and Supplement 3 (which focuses on the vision, achievements and new direction of PEPFAR).
* Speaking of Pepfar: on the eve of AIDS 2012, a new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines PEPFAR. The brief accompanies the new Health Affairs’ issue on PEPFAR (see last week’s newsletter).
7. KFF – ARV Drug Resistance Levels Steady In Low-, Middle-Income Countries, WHO Report Says
More widespread use of ARVs to treat HIV infection has led to drug resistance in low- and middle-income countries, but the level “is not steep enough to cause alarm”, said a survey released by the World Health Organization on Wednesday. In LMICs, drug resistance stood at 6.8 percent in 2010.
In other WHO news on HIV, new WHO proposals stress that more strategic use of antiretroviral HIV medications can significantly reduce the transmission of the virus. The WHO proposals will be presented at the international AIDS Conference in Washington, DC on Sunday.
8. Science Speaks – Two reports highlight: While epidemic marches on, funding remains in 2008
Barton reports on two new reports on HIV and HIV financing: (1) an analysis jointly released by the Kaiser Family Foundation and UNAIDS, Financing the Response to AIDS in Low-and Middle-Income Countries: International Assistance from Donor Governments in 2011 (showing that donor government support for AIDS has remained flat since 2008. ) and (2) a new UNAIDS report entitled Together we will end AIDS today showing the number of people living with HIV continued to rise to an estimated 34.2 million people in 2011.
The good news is, in the words of UNAIDS executive director Michel Sidibe: “We are tipping the dependency balance, internal expenditures in the fight against HIV now exceed international investments for the first time.” The totals are $8.6bn and $8.2 bn respectively. Check out also the IPS article on the UNAIDS report: “In several African countries, including Kenya, Namibia, Sierra Leone and Uganda, domestic spending on HIV/AIDS rose by more than 100 percent between 2006 and 2011. In Botswana, Comoros, Mauritania, Mauritius, the Seychelles and South Africa, domestic investment accounted for more than 70 percent of AIDS funding. … … Domestic spending by African governments has been uneven. In Malawi, which has an ambitious plan to put half a million people on ARVs by 2014, the treatment programme is almost entirely donor-funded – the government foots just five percent of its HIV bill – and the country’s Global Fund grant comes to an end in 2014.”
The UNAIDS report also highlighted that six countries in sub-Saharan Africa are in danger of failing to meet the UN target of cutting child HIV infections by 90%
9. Sarah Boseley – A cure for AIDS?
Scientists launch a strategy to co-ordinate efforts focused on a cure for Aids, which they say they believe is feasible and the only way to end the epidemic. Boseley comments on the new optimism, partly inspired by the so-called “Berlin patient”.
C) The Program
There are numerous sessions and side-events planned at AIDS 2012. We draw your attention to the Global Fund events and satellite sessions at the conference, and to a session in which our colleague Gorik Ooms is involved: Show Me the Money: Political Commitment, Resources and Pricing at AIDS 2012. The session also features Michel Kazatchkine & Kent Buse (the latter as a co-chair). This special session will be held on Thursday 26 July, 11:00 – 12:30 in Session Room 1 at the Walter E. Washington Convention Center (WCC).
10. CGD – Getting to Know the Global Fund: Diagnoses from Work in Progress
Victoria Fan et al;
CGD fellows recently completed a draft background paper on the Global Fund, with particular emphasis on its resource flows, framework for funding decisions, incentive structure, and oversight mechanisms. “A first impression (i.e. on the ongoing reform): While the ongoing reform of the Global Fund is focused on the fiduciary and financial audit measures that came as a response to press reports on misuse of funds, the organization still faces major challenges that threaten the Fund’s vision, impact on disease, and fundraising potential and must be addressed head-on by the new Executive Director.:” Fan lists three key issues in this blog post.
In other GF news, the Nation reported that the GF recently opened its first business forum in Bangkok to encourage more private-sector support in combating the three epidemics. Under the theme “Investing in Asia-Pacific: Public Private Partnerships in Health“, the Global Fund Business Forum discussed various topics including the role of business in global health and business engagement in sustainable value creation. Again the (magic) hand of Jaramillo?
Issue 6 of the GF news flash mentioned that “officials from 30 African decided at a recent meeting in Johannesburg to change the way they choose their representatives on the Global Fund Board and its committees. Going forward, they will adopt a competency-based selection system to replace the current country alphabetical rotation.”
Finally, Globalization and Health published a new article on the GF, more in particular on the effects of GF financing on health governance in Brazil.
The Olympic Games in London
11. Lancet series on ‘physical activity’
The Olympic Games are only one week away now, and some of the journals are paying attention with (timely) articles.
The Lancet just published a five-paper Series about physical inactivity. Check out for example the series article on the pandemic of physical inactivity, and the global public health action that is required. As for the Games and NCDs, this quote summarizes the situation aptly: “The Games should encourage physical activity, promote healthy living, and inspire the next generation to exercise. However, marring this healthy vision has been the choice of junk food and drink giants—McDonald’s, Coca-Cola, and Cadbury’s—as major sponsors of the event.” (we don’t want to get into the controversy on the Rio Tinto gold medals, but obviously the new UK PHM branch has its work cut out).
A BMJ Feature article tells us ‘the truth about sports drinks’ (Gatorade etc.). Sports drinks are increasingly regarded as an essential adjunct for anyone doing exercise, but the evidence for this view is lacking. In the article, Deborah Cohen investigates the links between the sports drinks industry and academia that have helped market the science of hydration. (the Cameron/Johnson Games might still turn out to be the Hunger Games, but for sure athletes won’t get thirsty, at least the ones who don’t have to respect the Ramadan)
Health Policy & Financing
12. AllAfrica – Uganda to Start Exporting ARVs Within Region
The times are a-changing… Uganda is to start exporting ARV drugs in the region, officials have announced. This comes after the Kenya Pharmacy and Poisons Board (KPPB) awarded Luzira-based ARV manufacturer, Quality Chemicals factory a certificate for good manufacturing practice. Kenya’s certification follows that of the WHO which authorized the company to sell its drugs to any part of the world.
Somewhat related news then: we invited Morris Okumu (from the Pharmaceutical Society of Uganda) to comment on the recent Glaxo case (the health care fraud settlement in the US), from an LIC point of view – he describes for example the dire situation of drug regulatory agencies in LICs. Check out his blog post on our IHP website.
13. Huffington Post – Africa Offers New Partnership for Global Health
Sidibé comments on the optimism he felt at the AU summit in Addis earlier this week. “Astute African leaders are striving to ensure that this realignment (i.e. the Continent’s emerging position in the global order) delivers a new paradigm of partnership for sustainable health development — a partnership that is led by Africa, for Africans, through African-sourced solutions.” The new approach is spelled out in a “Roadmap for Shared Responsibility and Global Solidarity for AIDS, TB and Malaria and was unveiled at the Summit.
As you probably already know, the AU chose its first female leader this week.
On the sidelines of the AU meeting, “African leaders have reaffirmed their commitment to efforts to eliminate malaria, after they were informed that unprecedented success in scaling up malaria control interventions resulted in one-third reduction of malaria deaths in African in the last decade,” PANA/Afriquejet reported. The leaders made the commitment at a high-level meeting presided over by Liberian President Ellen Johnson Sirleaf, chair of the African Leaders Malaria Alliance (ALMA).
14. Lancet (Editorial) – The pre-election health environment in the USA
This Lancet editorial zooms in on the pre-election health environment in the US, both with respect to domestic health (Affordable Care Act) and global health. For the lawyers among you, we also want to recommend this Foreign Affairs article on the Supreme Court’s ACA decision. Barry Friedman reckons Chief Justice Roberts’ opinion “removed the Court from the debate about health care and put the conversation back in the realm of politics.” (whether that’s a good thing is debatable: some US politicians seem hellbent on shooting ACA to the moon)
15. People’s Health Assembly – draft Cape Town Call to Action available for feedback
The draft Cape Town Call to Action was discussed in daily workshops throughout the People’s Health Assembly in Cape Town from July 6 to 11, 2012. The final draft was discussed in the assembly’s final plenary on July 11 and will be open for comments and suggestions for another month. You can download this version and send suggestions to: email@example.com.
16. Global Health Check – The EU says no to ACTA: to protect public health, other countries should also reject it
Bodeux points out why ACTA (the Anti-Counterfeiting Trade Agreement) is so dangerous for public health. The European Parliament seems to have gotten the message and has rejected ACTA. Parliaments in other ACTA signatories should reject it as well, Bodeux argues.
17. Thematic think piece UNAIDS/UNICEF/UNFPA/WHO – Health in the post-2015 UN development agenda
UNAIDS, UNICEF, UNFPA, WHO;
A recent think piece by UNAIDS, UNICEF, UNFPA and WHO outlines how health could factor in the post-2015 development agenda. The authors argue that a single high-level health goal will be needed for health to retain its place “at the apex of development,” followed by a hierarchy of sector and programme-specific goals. This report frames the issues in preparation for a UN global consultation on how to include health in a post-2015 development agenda, set to take place towards the end of this year.
18. Opinionator – Fighting Depression, One Village at a Time
When confronted with the overload on HIV news this week, one can get the impression that HIV is the most important global health issue of all times. So it’s good Rosenberg points to some WHO data that state that three-quarters of the world’s neuropsychiatric disorders are in low-income or low-middle income countries. There is an urgent need for access to mental health care in LMICs. Let’s see whether there will be some money left for that.
19. Laurie Garrett – Taliban attacks WHO vaccinators: thank you CIA
As Tom Paulson nicely put it, in this blog post Laurie ‘take no prisoners’ Garrett blasts the CIA after worrying news on attacks on WHO vaccinators in Pakistan. Pundits call this ‘collateral damage’ in the war on terror.
WHO said in a statement there was “no evidence to suggest that this was a deliberate or targeted attack against polio eradication efforts or WHO”. (to be continued)
20. Health Planning & Management – Why differentiating between health system support and health system strengthening is needed
Grace Chee et al.;
The authors argue that it’s important to distinguish activities that support the health system, from ones that strengthen the health system. If activities fail to produce improvements in system performance because they were incorrectly labeled as system strengthening, the value of HSS investments could quickly be discredited. Not distinguishing supportive activities from strengthening ones will lead to unmet expectations of stronger health systems, as well as neglect of critical system strengthening activities.
We also want to draw your attention to a nice Equinet Africa Policy Brief from a while ago, listing the global actors in health policy.
Development & Aid
21. Ethics & International Affairs: Beyond Charity: Helping NGOs Lead a Transformative New Public Discourse on Global Poverty and Social Justice
Northern NGOs have a mission-critical blind spot: collectively, they are unequipped to intentionally bring about the kind of long-term change in social norms, attitudes, and beliefs in their home countries that their missions and their standard rhetoric demand. They long ago lost control of the media and public narratives around global development, if indeed they ever had it, and have instead been locked in a toxic and inaccurate paradigm, described through an increasingly outmoded core “charity” story that is unrepresentative of the reality of global development and that restricts their appeal to the public. This paper wants to do something about this. (as Thomas Gebauer (MMI) put it in Cape Town at PHA3, it’s time to re-politicize Ngos).
Some other D&A related articles:
* An article in YaleGlobal points out the positive impact of a recent US law in the DRC: the Dodd-Frank Act deters US firms from using conflict minerals in supply chains. The Acts sets a precedent, and the EU might follow soon.
* The new WB president Kim dwelled on climate change and GPGs in a recent debate. A quote on climate change: “I am trained as a scientist,” he said. “I have to tell you that the data that I’m seeing about changes that are happening today that we didn’t think would happen until we got to two to three degrees , this is extremely disturbing to me.” Eldis offers some very good resources on climate change (and climate change financing).
* China doubled its loans to Africa at a summit in Beijing; Zuma expressed his worry.
* The growth in Africa turns out to be a largely ‘jobless growth’ so far. That is not good news for the many young unemployed.
* Duncan Green explores the ‘global crackdown on civil society’.
* Finally, Jonathan Glennie is as brilliant as ever in a Guardian article on the introduction of a matrix by Unctad ranking countries on how well their FDI inflows contribute to development.