This week’s newsletter offers highlights and some in-depth analysis of the 66th World Health Assembly. Global health has its own ‘comeback kid’ now, Jim Kim. By the way, it’s amazing how many articles, blogs and tweets have been dedicated to a severely underfunded institution. Somehow, WHO should turn this increasing attention into an innovative financing mechanism – how about this, for example: each time WHO is being mentioned in a tweet, the institution would get a euro (the euro seems as sustainable as the average tweet). For a real article or a blog post on WHO, the institution would get 1 Swiss franc. Social media staff at WHO would have a nice incentive and the financing dialogue wouldn’t be necessary anymore!
The smokers among you probably know that World No Tobacco Day is being celebrated today, on May 31st. On World No Tobacco Day, WHO is calling for countries to ban all forms of tobacco advertising, promotion and sponsorship to help reduce the number of tobacco users. Tobacco use kills nearly 6 million people every year. WHO tweets are very positive about Turkey – which banned tobacco advertising. Will be interesting to see how WHO interprets current alcohol advertising trends in this country…
The 3rd “Women Deliver” conference in Kuala Lumpur also kept the global health community busy this week (as well as a couple of princesses, a supermodel and former US presidents’ daughters). Some observers (like Karen Grepin) noted there’s now a maternal health social movement not unlike the AIDS movement in the early 2000s. That’s great news, obviously.
However, in line with a recent Lancet viewpoint which argued that men are sorely overlooked by the global health architecture, we think such high profile conferences are also urgently needed for men, more in particular for men belonging to the so-called “Precariat”, a new and potentially dangerous social class. The term “precariat” was coined by Guy Standing and refers to the “growing number of people across the world living and working precariously, usually in a series of short-term jobs, without recourse to stable occupational identities or careers, stable social protection or protective regulations relevant to them.” Hopefully a couple of sexy supermodels and adorable princesses will also attend these conferences. I guess you smell a conflict of interest by nowJ. Whether the powers that be would want to boost this sort of social movement is another matter, though.
In New York, the whole world (well, the wonk part of it) impatiently awaited the High-Level panel report on the post-2015 development agenda – and when it finally materialized, initial reactions were quite positive. In the health realm, so far UHC is lacking, though. ‘Ensuring healthy lives’ is suggested as an illustrative goal.
Bill Gates and Dambisa Moyo shortened their own lives this week as they were engaged in an ‘animated discussion’/ugly row. Gates even said Moyo’s book ‘Dead Aid’ promoted evil! Back in the old days, Microsoft used to be the evil empire. Moyo already hit back on her own blog, naturally.
We also want to draw your attention to an upcoming international colloquium in Paris (17-18 June) on ‘Foreign policy and global health diplomacy’. It will take place at the Collège de France. The programme was put together by professor Dominique Kerouedan and looks very exciting – so we hope many of you can make it (see also below, in the section ‘global health announcements’). There’s some tough competition from Seattle though.
In this week’s guest editorial, Eric Friedman makes the case for a Framework Convention on Global Health and reports on a recent meeting in Geneva, just before the World Health Assembly. An FCGH network will be launched later this year.
Enjoy your reading.
Kristof Decoster, Ildikó Bokros, Peter Delobelle, Basile Keugoung & Wim Van Damme
Reinvigorating the Right to Health through a Framework Convention on Global Health
Eric A. Friedman, O’Neill Institute for National and Global Health Law, Georgetown University Law Center
The distance between binding global norms and reality could hardly be greater than in health. It has been well over 60 years since the WHO Constitution and Universal Declaration of Human Rights first put the right to health into international law, and approaching 40 years since the International Covenant on Economic, Social and Cultural Rights (ICSECR), with its universal right “to the highest attainable standard of physical and mental health,” took effect. A sizeable majority of the world’s national constitutions now include the right to health.
Yet gaping health inequities stubbornly persist. There is nearly a two generation gap in life expectancy between people born today in Sierra Leone (47 years) and Japan (83 years) (World Health Statistics 2013). The health gaps between rich and poor within countries parallels that among countries. In the United States, Native Americans on the Pine Ridge Reservation in South Dakota have a life expectancy some 30 years below the U.S. national average.
The right to health needs to be re-energized, strengthened in both form and substance. It needs to be re-imagined with clear standards, an expanded scope of immediate obligations, unambiguous principles of national and global health funding responsibilities, and strong mechanisms for accountability and enforcement at local, national, and global levels. The right needs the clarity to enable the public to better understand it and claim it. And it must be tuned to our globalized world, where forces beyond a single state’s control, including other international legal regimes (e.g., trade, investment), powerful transnational corporations, and mobile capital and people, significantly impact people’s right to health.
A Framework Convention on Global Health (FCGH) can be this vehicle for change, for giving new force to the right to health, to closing gross health inequities.
The two animating principles of an FCGH are global health equity (within and between countries) and the right to health. The treaty would establish standards to make the right to health more concrete, measurable, and enforceable, bringing precision to right to health and other economic and social rights requirements that states spend “the maximum of [their] available resources” towards and progressively realize these rights. It would codify and quite possibly go beyond standards in General Comment 14 of the Committee on Economic, Social and Cultural Rights, including expanding on the concept of immediate state obligations.
Beyond further defining the right to health, the FCGH would strengthen right to health accountability structures and processes, nationally (e.g., transparency and justiciability requirements) and internationally. It could enhance public, NGO, government, and media capacities for right to health understanding, advocacy, policymaking, and monitoring.
And an FCGH would create responsibilities for our interconnected world. It would include directives on how countries must respect – or even advance – the right to health as they engage other international legal regimes such as trade, investment, and the environment. Similarly, within countries, the treaty would promote Health in All Policies, possibly setting standards for conducting right to health assessments.
Advancing equity, the FCGH would provide guidance and set standards to ensure for all people the conditions required for health, including health care, public health, and social determinants of health, while establishing a national and global financing framework with well-defined obligations, providing sufficient funds for, at least, health care and public health (e.g., nutritious food, safe water, and adequate sanitation). Universal standards alone are unlikely to be enough to overcome deep-rooted inequities and marginalization. The FCGH would also need to directly address inequities that marginalized populations face, such as through measures to reduce barriers to health care access and requiring national strategies for addressing the health needs of marginalized populations.
The treaty’s targets and directives would need a careful balance between global requirements and country level flexibility, as the FCGH must respond to countries’ particular circumstances and enable their populations to participate in advancing the mandates under the FCGH. Issues not fully covered by the FCGH itself could be addressed in future protocols.
Earlier this month, more than thirty health advocates from around the world met to explore the possibilities of an FCGH and develop a strategy to advance it. Discussion and debate revolved around the exact nature and scope of the FCGH, its added value in light of the existing internationally codified right to health, the proper forum to adopt the treaty (WHO, the UN, or a third way, such as an innovative approach that could include non-state actors as parties), and potential risks of such a treaty. Participants powerfully raised the need for the process of developing an FCGH to empower people in today’s campaigns to advance the right to health, linking and ensuring the treaty’s relevance to national struggles and social justice movements, including unions. A full report of the meeting will soon be available.
What next? The Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI), a global coalition exploring and advocating for an FCGH, is organizing a drafting committee to develop a framework for an FCGH to further clarify and build a consensus around the treaty’s principles and contents. The committee will seek inputs to strengthen the framework. The framework will form the platform for an FCGH network of individuals and organizations to further examine, develop, and advocate for an FCGH. This network should launch later in 2013. With the framework in place, widespread consultation on the FCGH will begin.
66th World Health Assembly
WHA highlights and key messages
1. WHO – Sixty-sixth World Health Assembly closes with concern over new global health threat
This WHO press release gives a good overview of the WHA key messages, outputs (including 24 resolutions), and action plans.
You also find five “take-away messages” in this Devex article: the WHO 2014-2015 budget, neglected tropical diseases (NTDs), non-communicable diseases, mental health, and leadership priorities.
Addressing participants at the closing ceremony, Margaret Chan expressed her concern about the new coronavirus (MERS). She stressed the need for countries to work together to adequately address the threat posed by the rare illness (see below for more analysis).
For a more detailed overview of daily activities and debates, we refer to the WHO daily notes on proceedings (see here ) and the (daily) summaries made by the WHO watchers (here). IP Watch also has plenty of coverage on the WHA – see here.
Below we zoom in on some of the key WHA outputs and contentious issues.
2. BMJ (news) – WHO to probe claims that Dutch scientists restricted access to novel coronavirus
WHO is to investigate claims by Saudi Arabia that a Dutch laboratory’s patenting of a novel coronavirus variant is hindering research into the pathogen that has claimed more than 20 lives in several countries. (for some reason, we’re not surprised it’s the Dutch who are being involved in this messy affair).
Laurie Garrett wrote an expert brief for CFR on the matter (MERS-CoV) and the role played by Fouchier (Erasmus Medical Centre, Netherlands), and also a lengthy blog post (in her series of 7 blog posts, related to the WHA). This is a hugely important issue, and she explains in detail why Chan & WHO feel so sensitive about it.
3. BMJ (news) – WHA calls for five demonstration projects on health research relevant to the developing world
The WHA has moved a step further to creating a global convention on stimulating research and development in the health problems of developing countries. This week’s assembly agreed that the WHO should establish a global health observatory to monitor and analyse relevant information on research and development. It also called for five health demonstration projects to fill research gaps that disproportionately affect developing countries. See also an IP Watch article on this news (and the apparent shift in US policy): “The willingness to discuss a pathway toward a treaty seemed to be a departure from what has been the US policy since the CEWG first presented its report in April 2012. James Love, director of Knowledge Ecology International (KEI), told Intellectual Property Watch, “The US came into this meeting telling people they couldn’t change anything about the resolution, that not a single comma could be changed.” “Then they posed basically a new resolution last Friday. It just shocked everyone. So, one message you have is that apparently the US can decide whether or not you can re-negotiate the terms of reference because what happened was a significant change. That said, we agreed with the significant change and are happy the US did it.”
4. BMJ (news) – WHO agrees to set up body to act on non-communicable diseases
Health officials from 194 countries have agreed a global action plan on the prevention and control of NCDs. Delegates agreed nine targets and 25 indicators on reducing risk factors associated with the four main NCDs. The assembly also agreed that by the end of 2013, WHO would set up a mechanism to coordinate activities and promote engagement on non-communicable diseases on a global scale. So it seems fair to talk about an “NCD momentum”.
In a BMJ blog post on NCDs, Richard Smith explains why the young generation will be vital in the struggle against NCDs – and how much needed they are to drag global health from the 19th to the 21s century.
5. BMJ news – Doctors call for countries to step up the fight against rheumatic heart disease
Greater efforts are needed to prevent rheumatic heart disease (RHD), a meeting at the World Health Assembly was told last week. Largely eradicated in wealthy countries as a result of effective treatment of its cause, rheumatic fever, RHD remains the commonest acquired heart disease in children in the developing world—“a disease of poverty that kills children, adolescents, and young people in their most productive years,” said K Srinath Reddy, president of the World Heart Federation. The meeting held at the assembly was designed to reawaken interest and ensure that control of rheumatic fever and RHD should become an integral part of national health planning.
The World Health Assembly also adopted a resolution on Neglected Tropical Diseases.
In-depth analysis of WHA & global health architecture
6. Laurie Garrett – The Survival of “Global Health” – Part Four: The New Global Health Architecture Does Not Match Its Emerging Mission
Laurie Garrett continued her series of blog posts, related to the WHA and titled ‘the survival of global health’. She wrote about climate change in this one, for example, but the fourth one on the new global health architecture is definitely a must-read.
Laurie also introduced her series of blog posts in this Humanosphere article. “… The most frequently discussed targets for health in this new (i.e. post-2015) algorithm are overall health systems development and provision of family bankruptcy-sparing health coverage for all. Governments in such schemes would be responsible for the health of their people, less reliant on external financial support, and far more dependent on technical advice regarding such things as insurance, pharmaceutical purchasing and processing, healthcare worker training and sustainable health infrastructure creation.
If the UN opts to follow this course for Global Health, pressure to provide technical support for a broad swath of diseases, prevention and wellness efforts, medical education and infrastructure will fall on the existing Global Health super structure. It is doubtful significantly more funding will support that added mandate. As Dr. Margaret Chan noted in her remarks to the Assembly, the new agenda for her WHO is more likely to put the agency in conflict with sources of great wealth, as broad principles of wellness add the food and beverage industries to tobacco and pharmaceuticals to the list of Fortune 500 corporations whose products may be deemed by WHO unhealthy for human consumption.”
7. Chatham House (Expert Comment) – WHO, the World Bank and Universal Health Coverage
Charles Clift was one of the many experts voices who contemplated Jim Kim’s performance at the WHA. The World Bank president made an impassioned speech, in which he signalled fundamental changes in the World Bank’s approach to health policy and lending, significant for WHO as well as his own institution.
8. Lancet – Offline: The capture, incarceration, and release of Jim Kim
Horton explains Kim is back – with a vengeance. (Kim should hire Bruce Willis one of these days.)
9. IHP – The 66th World Health Assembly: Re-enforcing WHO’s role in global health?
Remco van de Pas;
Remco van de Pas (Wemos) was a careful observer of the 66th World Health Assembly, and assesses the prospects for WHO and the World Bank. He’s not very happy with some aspects of the WHO reform, but was impressed by Jim Kim’s speech. The proof of the pudding is in the eating, though: “Will the World Bank and WHO be leaders in advancing strong, equitable health systems under the umbrella of UHC, or will the powerful political powers in this world again interpret UHC in their very own way and use the Bank and WHO as convenient vehicles?” Wait and see.
Action for Global Health network coordinator Tim Roosen noted:
“At the World Health Assembly last week, a move towards Universal Health Coverage (UHC) was claimed, or at least referred to, by a majority of Member States addressing the assembly. For many Latin American, African and South-East Asian countries, including BRICS, the notion of universality is appealing because countries then determine for themselves health priorities, models of service delivery and the appropriate models of financing. The enthusiasm of these states for UHC is in contrast to the more tepid support in the outcome of the UN’s thematic consultation on health in post-2015 and the overall reluctance of the High Level Panel on the Post-MDGs to push strongly for UHC. …” (see below – indeed, UHC seems absent in the current HLP “illustrative proposal” for health)
10. Devex – Adapting to austerity: WHO remodels for 2014
Maxine Builder & Laurie Garrett;
“If one thing is clear from these first few days of the World Health Assembly, it is that the WHO of tomorrow will not be the same hegemonic health powerhouse of the past. It will likely be more decentralized, placing a greater share of the responsibility for health on individual nations. Countries will be compelled to carry the onus for provision of health, including epidemic control, on their own shoulders, increasingly based on domestic revenues. But WHO still has an important role to play in providing technical support, especially in times of crisis.” The authors of this blog post list three recommendations for how the organization can adapt to an uncertain economic and political environment, without putting the world at risk of a disease outbreak: fully implement the 2005 International Health Regulations; keep a strong institutional safety net for outbreaks of communicable disease; and find sustainable funding sources and close the wealth gap
11. The Atlantic – The New Idealism of International Aid
There’s a new IHP+ momentum – evident at the just finished WHA. Abrams zooms in on the US: the US signed on to the IHP+ initiative last week.
Nellie Bristol (CSIS) also reports on this new IHP+ momentum, and on the important role of Jim Kim in this respect. “World Bank Group President Jim Yong Kim made a strong case May 21 for increasing alignment between donors and countries to improve delivery of health services, citing the International Health Partnership (IHP+) as a helpful vehicle.”
As we already mentioned in the introduction, The Women Deliver 2013 conference opened on Tuesday in the Malaysian capital of Kuala Lumpur, with “organizers calling it the largest global meeting of the decade on the health and well-being of women and girls”. You find all Guardian coverage on the event here.
12. Guardian – Malaysia meeting on women’s rights attracts policymakers and princesses
Liz Ford gave the general backdrop for the Women Deliver conference and mentioned why it’s so relevant – with the post-MDG development framework coming up. Humanosphere also had its own correspondent in Indonesia.
13. Report – Investing in women’s reproductive health: closing the deadly gap between what we know and what we do
Karen Grepin & Jeni Klugman;
Karen Grepin also attended the conference. Her aim: to present the findings from a new report that she co-authored with Jeni Klugman, the Director of Gender and Development, at the World Bank. In the report, titled “Investing in women’s reproductive health: closing the deadly gap between what we know and what we do”, they summarize the evidence on what is known about the economics maternal health in developing countries. “Lack of reliable data is hampering progress on improving reproductive health services for women and ‘must be seriously addressed’ at global and national levels. The report outlines the health, social and economic benefits of improving women’s reproductive care, but says insufficient data makes it difficult to monitor progress and improve services. … There needs to be much greater investment in collecting accurate and timely data on reproductive health.” (see the Guardian for a summary of the report).
In a blog post (on her own blog), Grepin was very pleased with the maternal health ‘movement’, obvious in Kuala Lumpur – but she regretted the relative absence of researchers.
- Another report was released at the conference by the Guttmacher Institute, titled “Adding It Up: The Need for and Cost of Maternal and Newborn Care, Estimates for 2012.” The report provides new regional data on the unmet need for maternal and newborn care. A soundbite that kept coming back was this one – by Jeni Klugman (WB) for example: “Investing in reproductive health and family planning is not just the right thing to do; it’s smart economics.”
- “On the second day of Women Deliver 2013, the largest conference on girls and women of the decade, global leaders announced progress and new commitments toward expanding contraceptive access for women in developing countries,” a Global Health Strategies press release/AllAfrica.com reported. Melinda Gates was one of many to speak, and she noted she had seen plenty of progress in many countries, including in Senegal, Zambia, Indonesia, Bangladesh and the Philippines in terms of scaling up health care and education access for women and girls. But many other, particularly developing, countries still have their work cut out.
14. PSI Impact magazine – special issue on girls and women (coinciding with the Kuala Lumpur conference)
In a special issue of its Impact magazine, produced in partnership with Women Deliver and the Skoll Foundation, PSI focuses on one of the most effective ways to lift families, communities and countries: investment in the health and rights of girls and women. The Letter from the Editor, by Editor-in-Chief Marshall Stowell, summarizes the magazine’s content.
AFGH also announced it will soon publish a discussion paper on UHC & sexual and reproductive rights.
HLP report & post-2015
You find the (just released) Report of the High-Level panel of ‘Eminent persons’ here. It includes – in the annex – the illustrative proposal to “ensure healthy lives”.
Early analysis, amongst others, of the whole report, by Charles Kenny, Alex Cobham (both CGD fellows). Claire Melamed (ODI) describes the good, bad and ugly according to her (in the Guardian). And Mark Tran also gives his view in the Guardian. Global health watchers will probably chip in next week, focusing on health. Duncan Green (Oxfam) has his own assessment (in the Guardian).
In related news, probably good to have a look at the powerpoint presentation by Anders Nordstrom at a WHA breakfast meeting on health in the post-2015 agenda – outcomes of the global health thematic consultation. (see here ). It includes a framework for post-MDG health goals.
15. New UNAIDS and Lancet Commission to explore HIV and global health in the Post-2015 debate
UNAIDS and The Lancet have convened a new commission of political and health leaders to explore the post-2015 agenda of AIDS and global health. Malawi President Joyce Banda, African Union Commission Chairperson Nkosazana Dlamini Zuma and London School of Hygiene and Tropical Medicine Director Peter Piot will co-chair the new UNAIDS and Lancet Commission: From AIDS to Sustainable Health.
The first meeting of the Commission will be hosted by President Banda in Lilongwe, Malawi on 28-29 June.
16. Lancet – Our common vision for the positioning and role of health to advance the UN development agenda beyond 2015
Pascal Canfin et al., for the Foreign Policy and Global Health group;
Since the 2007 Oslo Ministerial Declaration, the Foreign Policy and Global Health group, comprising the governments of Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand, has been committed to raising attention to global health issues in the international agenda, and to promoting foreign policies that respond to the various challenges of global health. Here they give their view on what global health should involve, post-2015 (with a prominent role for UHC), and which lessons need to be drawn from the MDG experience.
17. CSIS report – Do UN Global Development Goals matter to the US?
The UN MDGs are an effective tool for rallying resources for and attention to priority development issues worldwide. While other donors and many developing countries explicitly use the goals as an organizing framework for foreign assistance delivery and application, they have had less effect on U.S. global health policy, Nellie Bristol argues. The goals sometimes played a behind the scenes role in U.S. funding decisions, but U.S. programs have retained their own identities—most recently, for example, Feed the Future, AIDS-Free Generation, and the Child Survival Call to Action—rather than joining in campaigns around specific MDGs. Nonetheless, U.S. development assistance feeds into progress on the MDGs, including goals 1 and 4 through 6, as they reflect long-standing U.S. commitments to food security, maternal and child health, and combating infectious diseases. As the process gets under way to develop successor goals to the MDGs, U.S. involvement is critical to ensure UN goals continue to reflect U.S. strategies, to generate U.S. input into the future development agenda, and to foster political buy-in into growing development needs that are likely to go beyond traditional U.S. priorities. (Read: NCDs and UHC. These are harder to sell politically – US lawmakers prefer programs that show specific accomplishments for dollars spent…)
18. Future UN Development System (FUNDS) Brief – Why We – Especially the West – Need the UN Development system
Western countries have created a UN development system that is underfunded and hamstrung by politics. As the relative power of the West declines, these countries should invest more in the UN to ensure global stability, Mahbubani argues. As we move into an era of great convergence, the West must fundamentally rethink its policy that its long-term interests are served by keeping institutions of global governance weak. With only 12 percent of the population of the global village and a declining share of economic and military power, the West’s long-term geopolitical interests will switch from trying to preserve its “dominance” to safeguards to protect the West’s “minority” position in a new global configuration of power. (The author focuses quite a bit on WHO ‘s underfunding as a case in point).
19. CSIS report – Replenishing the Global Fund in 2013: Options for U.S. diplomatic support
The Center for Strategic & International Studies (CSIS) released a new report that examines options for the replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria as it seeks pledges of $15 billion to support planned activities for 2014-2016. David Garmaise summarizes the report in an Aidspan article.
20. UNAIDS – African leaders pledge to intensify efforts towards ending AIDS, TB and Malaria
Heads of State attending the African Union summit in Addis Ababa, Ethiopia, on Monday, the final day of the meeting, made a commitment to increase efforts to improve the continent’s health indicators. The Heads of State, along with another 50 leading figures from world organizations analyzed the level of implementation of the so-called Road Map on Shared Responsibility and Global Solidarity to respond to AIDS, tuberculosis, and malaria in Africa, adopted last July.
Lancet series on global kidney disease
A new Lancet Series on Global Kidney Disease highlights the increasing prevalence of chronic kidney disease (CKD) and acute kidney injury. The papers in the Series focus on the worldwide differences in the burden of kidney disease, risk factors and causes of CKD, the importance of maternal and fetal health in preventing kidney disease in later life, and the cardiovascular risk in patients with CKD. The final paper in the series discusses the goals for nephrology over the next decade, focusing on closing the divide between high and low income countries.
21. Lancet Comment – Equity and economics of kidney disease in sub-Saharan Africa
Valerie A. Luyckx et al.;
Luyckx et al give some priorities for addressing the unmet need for treatment of kidney failure in sub-Saharan Africa.
- KFF published a factsheet that provides a snapshot of global polio eradication efforts and examines the U.S. government’s role in addressing polio worldwide, including current programs, funding, and key issues.
- “The WHO on Tuesday withdrew polio-vaccination teams from the northwestern Pakistani city of Peshawar after two volunteers were shot, in another setback to eradicating the crippling disease that remains resilient in the region” (see the Wall Street Journal ).
Health Policy & Financing
22. TMIH (Editorial) – Applying the ICMJE authorship criteria to operational research in low-income countries: the need to engage programme managers and policy makers
R. Zachariah et al.;
Interesting TMIH editorial on the dissonance between applying the ICJME authorship criteria and the Operational Research goal of translating research findings into policy and practice, and how the criteria may be better applied to address this issue.
23. Lancet (Editorial) – Children with disabilities—invisible no more
This editorial zooms in on UNICEF’s annual State of the World’s Children report.
UNICEF says ending discrimination against children with disabilities and nurturing their abilities will benefit both the children and society as a whole. “The report emphasises that characterisation of children with disabilities as a problem is the problem itself. In much of the world, these children are simply invisible—hidden in institutions or, worse yet, neglected or abandoned. Infanticide persists. Systematic discrimination is not uncommon. The ways to remove these obstacles and barriers, as the report insists, are the inclusion and increased visibility of children with disabilities.”
24. Lancet (World Report) – Global drug policy fuels hepatitis C epidemic, report warns
The latest report by the Global Commission on Drug Policy says that the war on drugs has caused a largely hidden hepatitis C epidemic in people who inject drugs. Fiona Clark reports.
25. Lancet Correspondence – Interests conflicted?
Lovely letter, in which the author wonders what the Lancet editorial policy and business model are like: “Are you crusaders addressing inequalities in public health or salespersons for the medical devices industry?” (Both, we presume. You can’t become a Lancet editor unless you’re something of a schizophrenic)
26. CFR – Preventing Pharmageddon: Treatment Access for Noncommunicable Diseases
Thomas Bollykly should get the copyright on the term ‘Pharmageddon’ (and should, like Jim Kim, also hire Bruce Willis for the blockbuster): “A global fight over access to medicines is brewing. In the past year, India, China, and Indonesia have undertaken measures to circumvent patents on medicines for diabetes, cancer, and cardiovascular and chronic respiratory illnesses—the noncommunicable diseases (NCDs) increasing rapidly in developing countries. A decade ago, a crisis over access to patented HIV/AIDS drugs transformed global health, elevating the infectious diseases ravaging developing countries as a foreign policy issue and mobilizing billions of dollars to develop and deliver new therapies. As litigation, trade tension, and controversy mount over NCD treatment access, addressing this latest pharmageddon will require another transformation in global health, this time focusing on low-cost interventions and patient-centered, rather than country-focused, strategies.”
27. BMJ news – Indian generics manufacturer Ranbaxy agrees to pay $500m to settle US fraud and drug safety charges
Generic drug manufacturer Ranbaxy experienced its own “Pharmageddon” this week. It has agreed to pay a fine of $500m to settle US government charges of fraud at two of its Indian factories, which came to light eight years ago. The fine is the largest ever in US history to be paid by a generic manufacturer over drug safety.
28. Lancet (World Report) – Revising the Declaration of Helsinki
The Declaration of Helsinki is undergoing its seventh revision. Reaction to the first draft, out for public consultation until June 15, has been polarised. Kelly Morris investigates.
29. Science Speaks blog – Global health funding in precarious position as lawmakers “just aren’t getting it”
Science Speaks blog reports on the current talks about global health research funding in Congress: “Most lawmakers indeed are just not getting it – it being just what a critical time it is for the fight against global HIV/AIDS, the world’s biggest infectious disease killer. Research in just the last few years has proven that scaling up treatment quickly now will save not only lives, but money in the long run.”
30. Lancet – The Global Drug Facility and its role in the market for tuberculosis drugs
Nimalan Arinaminpathy et al.;
Universal access to high-quality treatment is central to the Global Plan to Stop TB. The Global Drug Facility (GDF) was launched in 2001 to help to achieve this goal, through services including the supply of affordable, quality-assured drugs to countries in need. The authors assess the scale of GDF drug supplies worldwide and find that the GDF commands a substantial proportion of the market for drugs for first-line and second-line treatment regimens, having supplied, for example, first-line drugs for roughly 35% of cases reported worldwide in 2011. Significant potential remains for GDF expansion, especially in the provision of second-line drugs, which would be aided by future increases in case detection.
31. PLOS (Editorial) – The Paradox of Mental Health: Over-Treatment and Under-Recognition
Plos Medicine editors;
The PLOS Medicine editors discuss the paradox of mental health, where over-diagnosis and treatment of some mental health issues exists alongside profound under-recognition of mental health conditions in the developing world.
32. KFF – Stunted, Malnourished Children Significantly Less Able To Read And Write, Save The Children Report Says
In addition to the serious health problems it causes, child malnutrition is costing the global economy tens of billions of dollars a year by depriving its victims of the ability to learn basic skills according to a new report released this week by Save the Children. The report says “the impact of childhood malnutrition poses a major threat to the long-term economic growth of many developing countries.” Tackling malnutrition should thus be a priority for a G8 meeting next month in Northern Ireland.
Global health announcements
- International colloquium in Paris (17-18 June, 2013) on foreign policy and global health diplomacy, & inaugural lesson D. Kerouedan on the geopolitics of global health: (below you find a summary of the programme in French, but for the ones who don’t know Molière’s language, there’s always Google TranslateJ)
La Chaire Savoirs contre pauvreté du Collège de France organise un colloque international les 17 et 18 juin sur le thème « Politique étrangère et diplomatie de la santé mondiale ». L’idée est de mettre en perspective les évolutions des objectifs, des financements et de l’architecture de l’aide mondiale, publique et privée, en faveur de la santé, des dix dernières années, avec l’efficacité des stratégies et des nouvelles modalités de financement sur le terrain, dont les canaux privilégient les initiatives mondiales (Fonds Mondial, Alliance GAVI), l’aide budgétaire générale et les financements innovants (dont UNITAID). L’objectif du colloque est de donner la parole aux acteurs, politiques et universitaires des pays du Sud, pauvres et émergents, de disciplines variées, en vue d’analyser en quoi le fait que la santé est devenue un sujet inscrit à l’ordre du jour du Conseil de sécurité et de l’Assemblée générale des Nations Unies, ou des Sommets du G8 et du G20, etc. s’accompagne (ou non) d’une meilleure efficacité de l’aide sur le terrain et d’une amélioration effective de l’état de santé des populations. La première journée sera consacrée à ces problématiques dans des contextes de coopération au développement. La seconde journée se propose de regarder de près la situation sanitaire et l’accès à l’aide humanitaire et aux soins médicaux des populations de pays en guerre et en sortie de crise, en nous intéressant plus particulièrement aux situations de la Syrie, du Mali et de la Côte d’Ivoire. Le colloque sera filmé et la vidéo mise en ligne peu de temps après le colloque, à l’attention de ceux qui ne pourraient y assister et des personnes sur le terrain. Le colloque est ouvert à tous, sans inscription et gratuitement. Le programme détaillé et la problématique du colloque, ainsi que la leçon inaugurale sur la « Géopolitique de la santé mondiale » (à paraître en librairie le 12 juin) et les enseignements de la Chaire Savoirs contre pauvreté, sont disponibles sur le site internet du Collège de France, ici : http://www.college-de-france.fr/site/dominique-kerouedan/index.htm.
- Another global health event will take place in Seattle, US, at more or less the same time. The GHME conference hosted by The Institute for Health Metrics and Evaluation (Seattle, WA, USA), The Lancet, the London School of Hygiene & Tropical Medicine, the Harvard School of Public Health, and the University of Melbourne School of Population and Global Health will be held in Seattle June 17-19.
33. Lancet (Comment) – Education, audit, and outreach to prevent maternal mortality
Jane Hirst et al.;
The authors comment on new research in the Lancet (by Alexandre Dumont et al). Findings confirm the evidence from observational studies in sub-Saharan Africa that maternal audit is effective. They also confirm that continuing education with ongoing outreach support changes clinical outcomes.
34. Health research policy & systems – Policymakers’ and other stakeholders’ perceptions of key considerations for health system decisions and the presentation of evidence to inform those considerations: an international survey
Joshua P Vogel et al.;
The DECIDE framework was developed to support evidence-informed health system decisions through evidence summaries tailored to health policymakers. The objective of this study was to determine policymakers’ perceptions regarding the criteria in the DECIDE framework and how best to summarise and present evidence to support health system decisions. The authors conducted an online survey of a diverse group of stakeholders with health system decision experience from 15 countries and the World Health Organization.
- A ONE report was published on MDG spending by developing countries (see the Guardian for a summary of the findings). “African countries that are allocating a greater share of government spending to health, education and agriculture are making faster progress on achieving the U.N. Millennium Development Goals (MDGs) but many nations are still failing to meet their commitments and are lagging behind. “ Euractiv also reports. And yes, you’ll see the “usual suspects”/high performers.
- Stiglitz says globalisation is about taxes too, not just about profits (in the Guardian).
Finally, a few news items via CDG’s Europe development digest: