Dear Colleagues,


Four more years. Suddenly the world looks a bit brighter again, although the overwhelming feeling after Obama’s re-election was one of relief. We will never know what a Romney administration would have implied for the US and the world, but we do know what his radicalized party stands for. And let’s face it, Mitt, Obama’s family is way more glamourous than your offspring.

Although climate change is not among the five global health  priorities Amanda Glassman sees for the re-elected president, we hope Obama will now take climate change seriously.  We’re far from the only ones. Check out for example this recent blog post by Simon Maxwell –  what would happen if leaders like Obama, Singh and Merkel really believed, viscerally, that climate change was something they had to fix as a top priority or the letter to Obama from the least developed countries. Doha would be a good place to start.

In this week’s guest editorial, our colleague Ildikó Bokros takes a thorough look at the female vote in the US. Women are indeed the smarter gender, it turned out once again.


Enjoy your reading.


Kristof Decoster, David Hercot, Ildikó Bokros, Peter Delobelle, Basile Keugoung &Wim Van Damme





Obama wins – did the women’s vote make the difference?


by Ildiko Bokros (ITM)

As 87% of the votes have been processed by Wednesday afternoon European time, I took a look at the composition of the voters as shown in the exit polls. It has been predicted all along that more women would vote than men, and that became true: women made up 52%, men made up 48% of the voters. But let’s focus on another, more striking figure: 47% of the men and a stunning 58% of the women voted for Obama. I began to wonder: did the women’s vote make Obama president?

Read the full editorial here


UHC & Second Global Symposium Beijing


1.    BMJ (news) – Development of health systems and universal coverage should be evidence based, says WHO

Trish Groves;

The WHO launched the first global strategy on research into health policy and systems last week inBeijing. The strategy calls for a more prominent role for such research, as many countries are aiming to strengthen their health systems and develop universal and equitable health coverage. The global symposium focused on the current state of health systems research; research collaborations between different sectors of academia and policy making; development of robust methods to assess the effects of healthcare reforms; and the use of such research to accelerate countries’ uptake of effective universal health coverage. The symposium committee produced a lengthyBeijingstatement.


2.    Adam Wagstaff (blog) – When the snow fell on health systems research: a symposium sketch

Adam Wagstaff wrote a hilarious post on the closing plenary and Richard Horton’s prominent role in it.


3.    Lancet (Offline) – The advantages of Universal Health

Richard Horton;

Richard Horton in the Lancet – this must be the advocacy/visionary section of the newsletter 🙂

And sure enough, Horton lives up to the expectations he raised in Beijing: “Is what we are really seeking post-2015 a commitment to Universal Health? Universal Health Coverage is part of the overall strategy towards Universal Health. It is a means to an end, but not the end in itself. This distinction seems important. Universal Health is an aspirational vision for a better world in an era of sustainable development.  … Unexpectedly, now is a moment when we can be truly radical and ambitious in our vision for the future, a future that could be described by Universal Health.” By the way, we totally agree.


4.    World Bank (blog) – Economic downturn and health systems: Assess, track, and mitigate!

Edith Velényi;

After attending the Symposium inBeijing, Edith Velényi started wondering: Could a global tool for assessing health system vulnerability help to strengthen health systems and move toward universal health coverage in countries? Yes indeed. Nice blog post.


5.    Emerging Voices at Beijing opening & closing plenary


6.    Lancet Correspondence on UHC

This week’s Lancet issue has a number of letters related to UHC, for example one

on the importance of the health workforce, one on user fees, and a few on the UHC rollback in some European countries.


7.    BMJ (Feature) – Protecting India’s poorest from unaffordable medical bills

Patralekha Chatterjee;

Government schemes are bringing healthcare insurance to some ofIndia’s poorest people, reports Patralekha Chatterjee. But are these schemes alone the solution to the debt and destitution that medical bills can bring?
Meanwhile, dengue is spreading over India and causing more and more panic, the NYT reported.
Some other UHC news:

Funded by the Rockefeller Foundation and led by Management Sciences for Health (MSH), “Health for All: The Campaign for Universal Health Coverage (UHC)” will support existing government initiatives towards universal health coverage and equitable health reform in four African nations:Ethiopia,Nigeria,Kenya, andGhana. For more information, visit




8.    CGD – Top five for next four in global health

Amanda Glassman et al.;

Glassman lists five things that should be at the top of the President’s global health agenda for the next four years. (As already mentioned, climate change is not among them – although CGD fellows pay a lot of attention to the issue, for some reason they still don’t seem to consider climate change part of the ‘global health’ agenda.)


9.    BMJ (news) – Implementing health care reform in US may still be difficult despite Obama win

Janice Hopkins Tanne;

Although widespread health insurance is now a certainty for theUnited States, implementing the health reform act may not be smooth and easy.


10. BMJ (editorial) – The re-election of US President Barack Obama

Robert Steinbrook;

This BMJ editorial makes more or less the same case, but considers also the longer term.


11. UN Dispatch – With Obama’s Re-election, “Global Health Diplomacy” Will Get Its First Test

Alanna Shaikh;

Done well, an office of Global Health Diplomacy could re-establish American leadership on global health and get middle-income countries to take health seriously as part of their path to prosperity.” Alanna Shaikh is obviously less negative about the office of Global Health Diplomacy than some other global health watchers. She explains why in this blog post.




12. Plos Medicine (Policy forum) – Chinese-Style Decentralization and Health System Reform

David Hipgrave et al.;

David Hipgrave and colleagues discuss health system reform inChinaand argue that parallel reforms in governance, financing, and accountability are also needed to ensure health equity.

In a Health Affairs article, the Chinese minister of health discusses the early results of the health care reform.

A must-read is a recent book by CFR fellow Yanzhong Huang: “Governing health in contemporaryChina”. This book examines the political and policy dynamics of health governance in post-MaoChina. It argues that reform-induced institutional dynamics, when interacting with Maoist health policy structure in an authoritarian setting, have not only contributed to the rising health challenges in contemporaryChina, but also shaped the patterns and outcomes ofChina’s health system transition. It also sheds critical light onChina’s important role in global health governance.


Global Fund & other Global Health Initiatives


13. GFO (new issue)

The new GFO issue has an article on a brand new Aidspan report, written by David McCoy and Nele Jensen which discusses the limitations of the methodologies used by the Global Fund to quantify lives saved through programmes that it supports. There is also an article on the potentially dire implications of the new funding model for countries in Latin America and theCaribbean.
Global Fund news flash 11 is also out, and there’s yet another GF campaign: ‘Here I am’.


14. Lancet (Correspondence) – Global Fund at risk of alienating civil society

Alvaro Bermejo;

“Civil society engagement makes the Global Fund very different from other multilateral institutions, and has allowed it to substantially alter the trajectory of the three epidemics. However, over the past few months, some of the reforms that have taken place in the name of creating a less bureaucratic Fund with a more flexible and strategic way of doing business—such as the removal of a dedicated civil society team—have been detrimental in that they have made civil society’s engagement with the Secretariat more difficult.”


15. KFF – Negative Effects Of Global Health Initiatives On Developing Countries’ Health Systems Exaggerated, Review Shows

“An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated.” Rifat Atun is the main author of this systematic review, published about 10 days ago. Will surely trigger debate in the coming weeks.


Global Burden of Disease




16. Sarah Boseley – Cancer doctors pledge to take prevention and treatment to the poor

Aids doctors joined activists to lead the fight for treatment in the developing world. Cancer doctors are taking the first tentative steps towards adopting their mantle. (Guess which global health ‘activist’ was egging them on…)


17. Guardian – Why Zimbabwe’s tobacco industry is unhappy with WHO

The WHO says its guidelines aim to alert governments to declining demand for tobacco. But producers say they put farmers’ livelihoods at risk. Interesting story, and probably the first of many.


18. Lancet (editorial) – The right to cervical cancer services in southernAfrica

A new report by the Southern Africa Litigation Centre (SALC), which promotes and advances human rights in the region, assessed the issue of cervical cancer, examining policies and services for cervical cancer inNamibiaandZambia. Neither country is doing well. The report concludes that failure to provide access to cervical cancer services results in the violation of fundamental rights and recommends that southern African countries develop comprehensive national policies on cervical cancer management.




19. AidsAlliance(Discussion paper) – How the HIV community can shape the future HIV and development agenda post-2015

The International AIDS Alliance, in collaboration with the Stop AIDS Alliance and STOP AIDS NOW!, has published a discussion paper to help the HIV community to engage in discussions surrounding the post-2015 development agenda. The paper addresses issues such as UHC, human rights and equity, and financing, and it offers suggestions on ways to engage with consultations.


20. Guardian – In Africa, we must do the most good with each pound spent on Aids-HIV

Bjorn Lomborg;

With donor money to fight HIV and Aids falling, spending in sub-SaharanAfricamust be targeted to get the best results, argues Lomborg, in an op-ed based on his book ReThink HIV.




The Lancet has published two online articles on the Affordable Medicines Facility – malaria (AMFm), in view of the pending Global Fund Board’s decision on the future of AMFm. In the first article, Sarah Tougher and colleagues report the results of an independent evaluation of an 18-month AMFm pilot in seven SSA countries, indicating that the program has met or exceeded benchmarks for availability, price, and market share of quality-assured ACTs.

In their comment, Kenneth Arrow and others, who served on the US Institute of Medicine committee that recommended a subsidy to producers to make the live-saving drugs inexpensive, which in turn resulted in the creation of AMFm, argue that the integration of AMFm into the regular Global Fund model will kill the programme.

In addition, in her blog post, CGD’s Victora Fan tries to make sense from all the noise about the effectiveness of AMFm in view of its continuation, arguing that the debate has not been fully grounded in operational realities, but instead centered on perceptions about rights, norms and ideals (see e.g. Oxfam’s position on AMFm).

While the malaria community anxiously awaits the Global Fund Board’s decision, the threat of further spread of resistance due to use of artemisinin monotherapy and non-quality-assured ACTs meantime continues unabated…


21. NEJM (editorial ) – Malaria Vaccine Trials — Beyond Efficacy End Points

Johanna P. Daily;

According to new trial results, reported in NEJM, the candidate malaria vaccine RTS,S/AS01 seems to be much less effective for infants of 6 to 12 weeks than for children 5 to 17 months of age. Earlier, encouraging preliminary results had been reported about the latter.

Trust Alertnews also has an article on this disappointing news.


Health Policy & Financing


22. Global Public Health – Framing global health: The governance challenge

Colin McInnes et al.;

With the emergence of global health come governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of a special supplement: the framing of global health issues and the manner in which this impacts upon GHG. (we already covered most articles of this supplement in the past). Key frames operating in global health are: evidence-based medicine, human rights, security, economics and development.


23. Multi-stakeholder Technical Meeting on Implementation Options Recommended by the WHO Consultative Expert Working Group on Research & Development (CEWG): Financing and Coordination at the Rockefeller Foundation Bellagio Center

John-Arne Rottingen et al.;

In October 2012 the International Health Policy Programme, Ministry of Public Health,Thailand, and the Forum on Global Governance for Health, Harvard Global Health Institute,USA, jointly organized an experts’ meeting at theRockefellerFoundationBellagioCenterto explore technical implementation options for the CEWG report recommendations. This is the meeting report.


24. CGD – Governance of New Global Partnerships: Challenges, Weaknesses, and Lessons

Keith A. Bezanson and Paul Isenman;

New global partnerships (such as the Global Fund) have been very successful at mobilizing advocates and resources, but they also face critiques. In this policy paper, Keith A. Bezanson and Paul Isenman focus on the challenges inherent in the governance of new partnerships. Using evidence from independent evaluations, they find four frequent shortcomings.


25. Plos – Donor Funding for Newborn Survival: An Analysis of Donor-Reported Data, 2002–2010

Cathérine Pitt et al.;

Donor attention to newborn survival has increased since 2002, but it appears unlikely that donor aid is commensurate with the 3.0 million newborn deaths and 2.7 million stillbirths each year.


26. Health Financing inAfrica‘le blog’ – series of interviews on community participation

For the 25th anniversary of the Bamako Initiative and the Harare Declaration, the blog ‘Health Financing inAfrica’ invited the historian and economist Jean-Benoît Falisse to conduct a series of interviews about community participation. In this first article, he introduces the topic.
Jean-Benoît also conducted a first interview (in French) with Susan Rifkin from theLondon school.


27. World Bank – Delivering on Development: Harnessing Knowledge to Build Prosperity and End Poverty

Jim Kim;

At the World Knowledge Forum last month, World Bank President Kim emphasized the importance of ‘practical knowledge’ to improve delivery.




28. BMC Health services research – Toward a typology of health-related informal credit: an exploration of borrowing practices for paying for health care by the poor inCambodia

Ir Por et al.;

The authors explore borrowing practices for paying for health care by the poor inCambodiaand provide a typology, associated conditions, and the extent of the phenomenon.




  • Sumner published a new CGD paper on the ‘Buoyant Billions’: he wonders how ‘middle class’ the new middle classes in developing countries actually are.
  • An ODI blog post lists 6 ‘climate change’ points for Obama to focus on in the next four years.
  • Claire Melamed published a paper on the road ahead for the post-2015 framework, with three key options. She also reflects on the high-level meeting held inLondon last week.
  • The UK announced (via Greening) it will stop financial assistance toIndia in 2015.
  • Perhaps Greening and others should read the following article. Martin Ravaillon wrote an interesting blog post on the dated LIC/MIC distinction. A country’s ‘capacity for redistribution’ is an important variable to look at, he argues.
  • Jonathan Glennie makes a case for public spending at a global level for global goods, just like we do at a national level, for national goods.
  • A while ago, David Cameron published an op-ed in the WSJ in which he laid out his “golden thread” vision of development and foreign aid.  CGD’s Justin Sandefur commented on this. So did Chris Blattman. The latter was more critical.
  • Zeynep Erdal investigates in a new paper “China’s recipe for successful development: Challenging the traditional notions of aid in Africa
    why traditional donors´ aid policies have had limited success in developing recipient states, and how the traditional notions of the concept of development have influenced this process. The paper then discusses how the Chinese aid policy differs from those of traditional donors, and how these differences have affected traditional notions of donor-recipient relationships.
  • Finally, it’s always worthwhile to surf to – this week there are a few interesting articles on the lack of science capacity threatening Africa’s development, and on the need for donors to focus on national R & D funds.

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