This week The Lancet launched its first open access (and online only) publication, The Lancet Global Health. Zoë Mullan, editor-in-chief of the new Lancet publication, also started an interactive Global Health blog. The idea is to focus a bit more on country experiences (rather than the helicopter perspective often adopted for global health articles in the main journal).
This week WHO also kicked off its ‘financing dialogue’, and a UNAIDS Board meeting took place in Geneva (for background documents, see here). A number of Lancet articles & viewpoints also focus on Turkey & UHC this week. More analyses of UHC & the post-2015 health agenda will also be covered in this newsletter. Obama was/is in the news as well, as you know, with a much anticipated speech on climate change, and his visit to Africa. Obama will no doubt have been briefed about two new reports: Amnesty International reports rising levels of homophobia in Sub-Saharan Africa, and a recent ONE report shows that sub-Saharan Africa suffered disproportionately from cuts to aid spending by EU member states. Will be interesting to watch what comes out of his second visit to the continent.
Tim Evans joined the World Bank Group this week, as the new Director of Health, Nutrition and Population. In the coming year, he plans to visit each region of the world to see the World Bank work on the ground. He will also blog regularly on his travels and about global health developments. Watch the Bank’s Investing in Health blog.
We also want to draw your attention to the social media launch of Systems Thinking for Capacity in Health (ST4C Health). This is a group of health professionals, students, and concerned citizens dedicated to the strengthening of health systems in low income countries around the globe. The Doris Duke Charitable Foundation (DDCF) provided funding. The social media launch, on Twitter, Facebook, and the blog, is scheduled for July 1st. The group is also preparing a number of white papers, short engaging documents that explain systems thinking concepts to specific audiences such as policy makers, researchers, and practitioners. Make sure you follow them!
In this week’s guest editorial, Dr Corine Karema from the Rwanda Ministry of Health and Dr Agnes Binagwaho, Rwanda’s Minister of Health, give some of the key messages of a presentation given during one of the last sessions at the recent Global Health Metrics and evaluation conference in Seattle. The presentation, given by Paulin Basinga, was based on the findings of this Lancet abstract. The incorporation of country-derived data into international models should be accompanied by country consultations, they emphasize. Countries should be engaged as partners in identifying the most robust and timely primary data sources.
Enjoy your reading.
Kristof Decoster, Ildikó Bokros, Peter Delobelle, Basile Keugoung & Wim Van Damme
Rwanda at the Global Health Metrics and Evaluation conference in Seattle
Dr Corine Karema, Head of the Malaria and Other Parasitic Diseases Division (equivalent to National Malaria & NTDs Control Program) in the Rwanda Biomedical Center of the Rwanda Ministry of Health.
Dr Agnes Binagwaho. Minister of Health – Republic of Rwanda.
From June 17th to 19th 2013, Seattle hosted the Global Health Metrics and Evaluation (GHME) conference. The conference highlighted innovative methods, the latest debates in measurement, and the translation of data into effective policy to improve population health globally. A very well organized conference, no doubt, as it was co-hosted by institutions with extensive experience in both planning and running such event: the Institute for Health Metrics and Evaluation, The Lancet, the London School of Hygiene & Tropical Medicine, Harvard School of Public Health, and the University of Melbourne School of Population and Global Health.
Participants included researchers, academic leaders, students, policymakers, non-governmental organizations, foundations, country offices of health statistics, and national and multinational health organizations.
Dr Agnes Binagwaho, the Rwanda Minister of Health was invited to speak in the conference and share country level perspectives on health metrics, use of the Rwanda health information system, how they are being locally contextualised and how they inform effective policy for improved population health.
Unfortunately, the Rwanda Minister was unable to join the conference due to a last minute conflicting agenda and she asked Dr Paulin Basinga, Rwandan health expert, to share the Minister’s and collaborators’ results of an abstract that was published in the Lancet GHME conference proceedings.
The talk highlighted three discrepancies in Rwandan international estimates data that may have important policy implications:
First, as the Ministry was trying to evaluate national progress towards MDG 4, they found that there were serious differences in the numbers published by various groups working on Rwanda child mortality estimates. The Inter Agency Group on Child Mortality Estimation, using all of the latest data and most transparent methods, estimated that Rwanda reduced child mortality by 70% between 2000 and 2011, from 183 to 54 deaths per 1,000 live births.
However, other UN agencies had not updated their model inputs for several years, missing important new data that became available in 2009 and 2011 collected in the Rwanda DHS (2007-8 and 2010). They published these estimates in 2011 while their calculations’ estimates were based on data collected in 2004 and 2005!
Rwanda has been very proactive in using strategic information and evidence to guide any policy decision and is thus constantly checking updated available estimates, questioning some methodologies … after this discovery, it will be important to understand how many other countries have experienced the same thing. This kind of confusion is partially the result of limited data, but it is also connected to simple errors that could be fixed with a more collaborative approach to global health metrics and evaluation….
Second, the Ministry of Health in Rwanda observed that reports from international health agencies including WHO, UNICEF, and GAVI indicated a decline in vaccination coverage in Rwanda among infants under 12 months old. They knew that these figures were the result of modeling procedures seen as placeholders until Rwanda’s 2012 Census data is released. Due to the fact that Rwanda had introduced three new vaccines since 2009 and meticulously conducted assessments tied to these grants, they were quite confident that the coverage of vaccination among the infants under 12 months was above 95%. Yet, the international estimates showed coverage for Rwanda declining from the high 90s to approximately 80% — in just two years.
Attempting to understand the source of discrepancy, the team in Rwanda hypothesized that this was due to an artificially high denominator for the calculation: the number of children born each year in Rwanda. Upon close examination of the data, field evaluation, post vaccination assessment and methodologies, they observed that this was the case. The estimated birth cohorts used to calculate vaccination coverage did not take into account Rwanda’s increases in family planning uptake or reductions in total fertility rate over the past decade.
Just to be clear here, this discrepancy is not because of any lack of commitment to child survival by anyone in these agencies or in Rwanda; simply because of delayed updating of estimates, it was reported that Rwanda was failing to vaccinate 20% of its children — children who did not exist.
Using social media, a tweet went from the Minister’s account in June 2012, asking why there was a discrepancy between DPT3 coverage on the GAVI website and the DHS 2010 estimate.
The tweet led to several high-level phone calls, and shortly afterwards a technical delegation from WHO and UNICEF traveled to Kigali to revise the estimates in collaboration with the Ministry of Health’s EPI statistical team.
Routine dialogue and consultations over the inputs for estimates between countries and international organizations are crucial to ensure timeliness and accountability over key estimates.
Lastly, Rwanda has been one of the countries that warmly welcomed the publication of the 2010 Global Burden of disease study. The 2010 GBD and the continually updated GBD 2.0 offer an unprecedented opportunity to accelerate progress in tackling the right issues that contribute to important loss of DALYs. In a briefing on the country-level GBD results in Kigali in February 2013, the study was compared to the landmark achievement of landing a man on the moon for its potential to completely transform the way science and accountability in global health work.
As a result the GBD results are in active use in Rwanda, it has already contributed to a new program to avail more than 1 million new clean cookstoves across Rwanda in 2013, after GBD 2010 showed that household air pollution was the leading risk factor for DALYs.
But there remains great room for improvement. The most important area will be introducing real collaborations with country stakeholders in identifying the most relevant and up-to-date sources of data, as this will maximize accuracy and impact.
Independence and partnership are not mutually exclusive.
As one example, the GBD 2010 estimates for Rwanda show malaria as the leading cause of death for both men and women. IHME estimated that Rwanda had nearly 10,000 malaria deaths in 2010, but the Rwanda Health Management and Information System derived from data at the community and health facility level produced a WHO-validated estimate of only 670 deaths in 2010, down to 360 in 2011. The Ministry estimates are certainly not perfect, but they are certainly not off by more than an order of magnitude.
These discrepancies are due to the fact that regional averages were simply applied to all countries in East Africa, owing to a lack of easily accessible data for the researchers conducting the African malaria analysis: involving the Malaria control programs in countries would have prevented this error.
Rwanda has seen the potential of the GBD and the use of strategic information to support a new era of country ownership, transparency, and evidence based action. When these key ingredients are added together, they offer powerful ways to deliver on the promise of global health equity…. thus true collaboration between international organizations and country level policy makers is crucial to produce estimates that effectively inform country policies.
Launch of The Lancet Global Health Journal & blog
As already mentioned in the introduction, The Lancet Global Health was launched this week, an open access online journal, a first for the Lancet. The first issue contains a diverse selection of research articles and associated comments on maternal and child anemia, intrauterine growth restriction, cataract surgery, and causes of non-malarial fever in a malaria-endemic setting.
1. Lancet (Editorial) – Introducing The Lancet Global Health
Zoë Mullan introduces the new open access publication. She also gives an overview of the articles and comments in this inaugural issue. (The Youtube video, in which she and Horton explain the philosophy of the new journal, is a bit – how can I say – British…)
2. Lancet (comment) – Malaria eradication: is it possible? Is it worth it? Should we do it?
Jenny Liu et al.;
Three good questions by Richard Feachem and colleagues, which they all try to answer. Feachem et al are financially supported by the Gates foundation, as Humanosphere’s Tom Paulson pointed out. (Nevertheless, if you only read one article this week from this inaugural issue, and favour a helicopter perspective, let it be this one.)
Alongside the journal content, an interactive global health blog was also kicked off. This week the blog features special guest posts from PAHO Director Carissa Etienne who applauds the Lancet’s first open access publication (‘Encouraging research, promoting equity’), and Sweden’s Global Health Ambassador Anders Nordström (‘changing the perspective: from disease control to healthy people’). (The latter is a must-read, as far as we are concerned).
Launch of WHO’s financing dialogue
On 24 June, WHO met in Geneva with Member States and other contributors to embark on a financing dialogue. See here for some background documents, including one on the key principles for the dialogue, and Chan’s opening remarks.
The objectives of the 24 June meeting were:
- for WHO to share additional information on the programming, budgeting, and financing of WHO’s 2014-15 Programme Budget;
- for participants to discuss expectations for, and help shape, the financing dialogue process, including the second meeting planned for November 2013;
- for participants to provide indications of how they are considering financing WHO and opportunities and challenges they face in securing predictable financing aligned with the priorities of WHO.
The Lancet on Turkey & UHC
3. Lancet (Comment) – Turkey’s democratic transition to universal health coverage
Richard Horton et al.;
A decade ago, Turkey launched policies to achieve UHC, an initiative the Turkish Government called its Health Transformation Program. The analysis The Lancet published this week (by Rifat Atun et al.) attempts to evaluate this programme—its design, implementation, impact, the reasons for its success, lessons from its failures, and the challenges it faces in coming years.
Turkey’s experience is not only of domestic interest, Horton argues in this Comment. The country’s history of health provides valuable evidence for the international community to consider as it discusses the importance of UHC post-2015. The Health Transformation Program retains as a core principle that health is a fundamental right, and one that is inextricably linked to civil and political rights. A few days ago, Horton tweeted: “I have been asked not to let the events of Taksim Square overshadow the good news about Turkey’s health success story. But the 2 are linked.”
(how about Brazil, Richard?)
Post-2015 & UHC
4. UN Global Compact – Corporate Sustainability and the United Nations Post-2015 Development Agenda
The UN Global Compact is the world’s largest corporate responsibility initiative with over 7,500 business signatories in more than 140 countries, as you probably know. Participating companies commit to align their operations and strategies with ten universally accepted principles in the areas of human rights, labour, environment and anti-corruption, as well as to take actions in support of broader UN goals such as the MDGs. Launched in 2000, the mission of the UN Global Compact is to advance the practice of corporate sustainability globally, recognizing that responsible business actions can underpin economies with values essential for more sustainable and inclusive growth.
This report gives their take on the post-2015 development agenda and a set of SDGs – which includes UHC (see page 15), unlike the HLP report. (if Rob Yates didn’t exist, we would never have known)
5. Adam Wagstaff – Health and the post-2015 development agenda: Stuck in the doldrums?
Wagstaff regrets the HLP report’s lackluster treatment of health, but stresses it’s not too late to modernize the health angle to the post-2015 agenda.
6. Get involved in global health – The seven sins and the seven virtues of Universal Health Coverage
Adriano Cattaneo, Giorgio Tamburlini, Angelo Stefanini, Eduardo Missoni, Gavino Maciocco, Gianni Tognoni, Carlo Resti, Claudio Beltramello, Chiara Bodini, and Nicoletta Dentico, Italian Global Health Watch;
UHC is likely to become the backbone on which the health development agenda beyond 2015 will be constructed, Cattaneo et al say. However, to avoid unintended effects, UHC should keep away from committing seven sins and should try to practice seven virtues, they argue.
7. Foreign Policy – Does it take a village?
In a Foreign Policy analysis piece, journalist Paul Starobin examines the debate surrounding American economist Jeffrey Sachs’s Millennium Villages Project. “As critics see it, Sachs botched his project by not putting in place a system by which progress (or lack thereof) at the Millennium Villages could be objectively measured, evaluated, and compared with trends in surrounding rural communities.” Sachs has been trying to make up for this, lately. (A must-read for people who follow the MVP debate.)
Obama on climate change & visit to Africa
8. CGD – What Obama Didn’t Say About Climate — But Could Have
At last, Obama gave a speech on climate change and released an action plan. Not nearly enough, obviously, but it’s a start. CGD’s Kevin Ummel offers five quick observations plus a general comment on the president’s political strategy with respect to climate change. (See also the Guardian’s coverage, and an article in the Economist – the latter basically says we need a carbon tax, and new policies announced in the US, China and the EU are way too timid). A New York Times analysis also advocates a carbon tax, and explains why Congress needs to act. As you know, it won’t, at least not in the short term. We first need an epiphany on the part of the Republicans (and some Democrats).
By now, Obama has started his visit to Africa, and he’ll no doubt hope Nelson Mandela manages to stay alive for a few more weeks. Ahead of his visit, KFF, CGD fellows (Sarah Jane Staats for example) and many others told the world what we could reasonably expect. Staats: “The White House and U.S. development agencies have been unusually quiet prior to departure, but some things are sure to be on the agenda: economic growth, trade, investment, democracy, youth, food security, and health. … Based on his administration’s global development policy work to date, we can expect three themes — economic growth, trade and investment; democracy gains, youth and women’s empowerment; and the initiatives: food security, global health and climate power.”
USA Today pointed out that Obama will have to walk a tightrope on the issue of gay rights. His administration cautiously promotes gay rights in Africa, see also this LGBT Health opinion piece by Nils Daulaire, assistant secretary for global affairs at the U.S. Department of Health and Human Services, focusing on the barriers for lesbian, gay, bisexual, and transgender persons to accessing the health care they need simply because of their sexual orientation or gender identity.
9. KFF report – Mapping the donor landscape in global health: HIV/AIDS
The Kaiser Family Foundation is undertaking a series of analyses to describe the global health “donor landscape.” Using three years of data from the OECD, the KFF maps the geographic landscape of global health donor assistance, looking both at donor presence and magnitude of donor assistance by issue area, region, and country. The effort is intended to shed new light on donor presence within and across recipient countries, and to produce a set of figures and tools that stakeholders can use in both donor and recipient countries. This is the first report in this series of analyses. It focuses on international assistance for HIV. Future analyses are planned for donor landscapes in the areas of tuberculosis, malaria, and family planning and reproductive health assistance.
10. Reuters – Seven African countries cut child HIV infections by half
Seven countries in sub-Saharan Africa, the world’s worst-hit region in the global AIDS epidemic, have cut the number of new HIV infections in children by 50 percent since 2009, UNAIDS said on Tuesday. For the report, see here.
11. Science Speaks – State Department cable to embassies: Meet with, document, and respond to civil society when building country PEPFAR plans
This blog summarizes an unclassified State Department cable sent to embassies around the world earlier this month and released Monday that discusses civil society engagement under PEPFAR. “One of the major goals outlined in the document is to increase civil society involvement in HIV/AIDS planning and implementation, both for the U.S. government and its partner countries,” the cable’s summary states.
Meanwhile, on Capitol Hill, federal budget negotiations are ungoing; there’s still a lot of uncertainty on funding for PEPFAR. (sounds like the budget negotiations between the EC and the European parliament, although these ones have at last come to an end, it seems)
12. Plos – Addressing the Wicked Problem of Obesity through Planning and Policies
In the June editorial the PLOS Medicine Editors highlight two papers and associated perspectives published recently in PLOS Medicine, including one by our colleagues, on the link between physical activity and non-communicable diseases. They discuss possible approaches to the “wicked” problem of inactivity.
13. BMJ (Observation) – Brutal pragmatism on food
We urgently need a new public health strategy on nutrition, Winkler argues in an article focused on the UK and other developed countries, but no doubt also relevant for LMICs where there’s increasingly both a malnutrition and obesity issue. “Nutrition policy has failed. Everywhere, people grow fatter and fatter. It is time to do something different, something that works.” The key reason for the failure so far is one nutritionists reluctantly admit: “Many people are not interested in healthy eating” (that would include me, when I’m enjoying a Confederations cup match on tv). One option is to make nutritionally improved popular foods available, and a second is to give consumers economic incentives to buy them; reward good choices rather than punishing bad. Winkler is obviously not a big fan of taxation of ‘bad’ foods.
You might also want to read this nice (Guardian Global Development) op-ed by Duncan Green (Oxfam), in which he wonders why road safety (and a number of other issues, like cancer, obesity, diabetes, mental health and disability), are not higher on the development agenda, at least financially speaking. His hypothesis: “My theory is that the collective development gaze skips over road deaths and others like tobacco or alcohol because they are too familiar. The world of aid and development prefers the exotic, the “other”. But if you think roads, booze and fags are tricky issues for the aid industry to tackle, try obesity – increasingly present among poor communities in poor countries, as a recent visit to South Africa brought home to me, often side by side with malnutrition. Can you imagine an aid organisation launching a fundraising appeal to tackle obesity?”
Health Policy & Financing
14. Lancet – Offline: Upping our game
Horton repeats his (passionate) plea made at the Seattle conference to bridge the gap between the health metrics and human rights communities. Why is this so necessary? A key reason, according to him, is: “Numbers are not facts. They are products of a particular political, economic, and social context. Numbers are instruments of power”. (could be a nice topic for a first blog by Tim Evans)
15. CGD – Demand Forecasting Takes Off
Amanda Glassman & Prashant Yadav;
Better demand forecasting (of key products) is “a low-hanging fruit in the quest for more health for the money”, argue Glassman & Yadav, and global health funders are well on their way. They give an overview of improvements made over the last six years. (but for some reason, this ‘low hanging fruit’ metaphor always makes me think of Adam & Eve)
16. Lancet (Editorial) – Electronic waste—time to take stock
This editorial focuses on a major emerging public health threat in the developing world — electronic waste (e-waste) recycling.
17. WSJ – Rotary and Gates Intensify Push against Polio
Rotary International and the Gates Foundation have renewed a fundraising partnership they hope will inject millions of new dollars into the final push to eradicate polio.
“Under the agreement, the Gates Foundation said it will match two to one every new dollar that Rotary commits to polio eradication up to $35 million a year over five years. That could total $525 million, including $175 million from the Rotary Foundation and $350 million from the Gates Foundation for polio immunization programs.” Meanwhile, in Nigeria a billionaire also committed one million to the fight against polio in his country.
18. Joint learning network for UHC – Update report
The Joint Learning Network for Universal Health Coverage (JLN) is a practitioner-to-practitioner learning network that is connecting LMICs with one another so that they can learn from one another’s successes and challenges with implementing UHC, jointly solve problems, and collectively produce and use new knowledge, tools, and innovative approaches to accelerate country progress and avoid ‘recreating the wheel’. The network is supported by the Rockefeller foundation and many other global health actors. This report provides an update of the vision, governance, evolution, activities,….
See also this blog post on UHC forward, ‘New report highlights a unique collaborative model designed to accelerate country progress toward universal health coverage’.
19. Journal of Public Health Policy (Editorial) – How can the public health community help to invigorate a ‘health first’ perspective in global drug development debates?
Phyllis Freeman and Anthony Robbins;
Freeman & Robbins give an overview of recent developments and say what the public health community can do. “The principal advocacy role for public health is to push our governments to live up to their pledges to improve health, particularly for neglected populations. … Public health researchers… can explain clearly the needs for health products that already benefit some, but remain unaffordable for others – if not most of those for whom they are well suited. The public health community can also contribute importantly to specifications of products yet to be developed. Both government health officials and non-government advocates can use evidence from the world of public health to challenge trade and intellectual property policies where governments have been too quick to support industry and forget the needs of people. … We need to claim priority for health over trade.” (I would argue the post-2015 negotiations will also be an excellent arena for this)
20. Financing Africa in health – The Bamako Initiative, 25 years on – a personal reflection
In another episode of the series on 25 years Bamako initiative, Sophie Witter shares some of her ideas. She ends her viewpoint in this way: “So as we look back on the Bamako Initiative, let’s reflect on some of the muddled thinking that went with it, and be glad that we are moving into an era where there is a greater commitment, nationally and internationally, to move towards universal coverage, with greater public funding of essential health services. Let us also confront the challenges of achieving greater accountability of providers and real participation – not the kind that meant having to pay if you wanted your child to survive.”
21. UN News centre – At international conference, UN chief urges intensified efforts to aid ageing people
Ban Ki-moon has urged greater efforts to support the needs of older people, particularly in developing countries. He did so in a video message at the 20th World Congress of Gerontology and Geriatrics in Seoul, Republic of Korea. In his message, Ban called for full implementation of the Madrid International Plan of Action on Aging, which focuses on three priority areas: older persons and development; advancing health and well-being into old age; and ensuring enabling and supportive environments.
22. Lancet (World report) – US Supreme Court strikes down anti-prostitution pledge
A landmark ruling by the US Supreme Court last week has been welcomed by health activists as progress in the global fight against HIV/AIDS (see also last week’s IHP newsletter). Health groups will no longer be forced by the US Government to denounce prostitution as a condition of receiving federal funding to fight HIV/AIDS around the world after the Supreme Court made a free-speech ruling on June 20. Sharmila Devi reports.
23. Scidev.net – UNICEF calls for more research on disabled children
Improved collection and analysis of research data could lead to better public policies for children with disabilities, according to a UNICEF report, ‘The State of the World’s Children 2013: Children with Disabilities‘, published in May. The report describes a lack of research in developing countries into issues such as disability among indigenous people, assistance for victims of landmines and violence towards children with disabilities. It calls for a concerted global research agenda on disability to generate the reliable and comparable data needed to guide planning and resource allocation, and to place children with disabilities more clearly on the development agenda.
Global health bits & pieces
- MERS: a BMJ news article reported that the Coronavirus will spread as long as the natural host is unknown. The Lancet also has a Comment on the virus, titled ‘New disease, old lessons’.
- The U.N. Security Council on Monday unanimously adopted a resolution strengthening ways to fight the use of sexual violence as a weapon of war.
24. Journal of Public Health in Africa – Stemming the impact of health professional brain drain from Africa: a systemic review of policy options
The purpose of this paper is to review possible policies which can stem the impact of health professional brain drain from Africa. The review identified nine policy options which were being implemented in Africa. The most common was task shifting which had success in several African countries. The review demonstrated that there is considerable consensus on task shifting as the most appropriate and sustainable policy option for reducing the impact of health professional brain drain from Africa.
25. Journal of epidemiology & community health – Improving equity by removing healthcare fees for children in Burkina Faso
Valéry Ridde et al.;
This study evaluated the effects on healthcare access inequities of an intervention exempting children under 5 years from user fees in Burkina Faso. Exempting children under five from user fees proved to be effective and helped reduce inequities of access. It benefits vulnerable populations, although their service utilization remains constrained by limitations in geographic accessibility of services.
26. International Bank for Reconstruction and Development/The World Bank (book) – Scaling Up Affordable Health Insurance : Staying the Course
Alexander S. Preker, Marianne E. Lindner, Dov Chernichovsky, and Onno P. Schellekens (Editors);
‘Scaling Up Affordable Health Insurance: Staying the Course’ describes how some countries have tried to “leapfrog” both private and public insurance by introducing legislation to give the population at large access to a free government-subsidized national health service as a basic human right. The contributing authors conclude this book with a proposal for a new paradigm for health insurance—a pluralistic multi-pillar system in which both the private sector and the state play a crucial role and in which expansion of health insurance coverage is accompanied by a parallel investment in service delivery to ensure that lofty ideals about equity are matched by access to quality services on the ground.
27. Plos One – The Global Hidden Hunger Indices and Maps: An Advocacy Tool for Action
S. Muthayya et al.;
The unified global efforts to mitigate the high burden of vitamin and mineral deficiency, known as ‘hidden hunger’, in populations around the world are crucial to the achievement of most of the MDGs. The authors developed indices and maps of global hidden hunger to help prioritize program assistance, and to serve as an evidence-based global advocacy tool. A number of countries in sub-Saharan Africa, as well as India and Afghanistan, had an alarmingly high level of hidden hunger, with stunting, iron deficiency anemia, and vitamin A deficiency all being highly prevalent. The total DALY rates per 100,000 population, attributed to micronutrient deficiencies, were generally the highest in sub-Saharan African countries. The indices and maps serve as a useful advocacy tool in the call for increased commitments to scale up effective nutrition interventions.
28. International journal of health planning & management – Reforms and emerging noncommunicable disease: some challenges facing a conflict-ridden country—the case of the Syrian Arab Republic
Kasturi Sen et al. ;
The past year witnessed considerable turbulence in the Arab world, with Syria as the most sad example. Syria is a lower middle-income country with a record of a strong public health infrastructure. This paper explores the current challenges facing its health system from reforms, civil strife and international sanctions.
The Lancet also features a World Report on Syria this week (by public health doctors Adam Coutts and Fouad M Fouad), with the latest on the health and humanitarian response to the civil war, including info on the refugees in Lebanon and Jordan.
- A ONE special report was published last week, tracking European development assistance. The new report shows that sub-Saharan Africa suffered disproportionately from cuts to aid spending by (almost all) EU member states. This could endanger the achievements of the MDGs at a critical time, says Eloise Todd (in an interview with Euractiv).
- A new CGD working paper by Nancy Birdsall et al was released, titled “Global Markets, Global Citizens, and Global Governance in the 21st Century”. In this paper, Birdsall et al argue that the politics and institutions of global cooperation have not kept up with economic globalization’s reach. There is some cause for optimism, however: citizens everywhere are becoming more aware of and active in seeking changes in the global norms and rules that could make the global system and the global economy fairer—in processes if not outcomes—and less environmentally harmful.
- Her CGD colleague, Charles Kenny, compared the HLP report with the SDSN report, and noticed they aren’t that different.
- There was some criticism of the multilateral aid review, in the UK (see The Guardian)
- Jim Yong Kim said (in Foreign Policy) that both the private sector and civil society have an important (albeit very different) role to play to end poverty.
- Very nice analysis by Moises Naim of the social commotion in Turkey, Brazil, Chile – the unrest in these different settings has 6 points in common (see Duncan Green’s blog).
- There are plans to set up a UK development bank, which raises fears of loading debt on to poor countries. Critics warn proposals to allocate more UK aid as loans could push funds towards projects that offer high returns at the expense of support for key social sectors. (see The Guardian)
- The EU budget has been agreed, at last – see Euractiv.
- Foreign Policy asked 60 experts what they think of the ‘Africa rising’ narrative.