Dear Colleagues,

 

Everybody must be back from holidays by now … and is thus slowly changing gear again (or swiftly, depending on your boss). Anyway, welcome back to all of you!

 

The Syria conundrum was in the news this week, for all the reasons you know. I guess most of us agree that not just the chemical attacks but the entire situation in that country is morally obscene. The one billion dollar question is, though: what to do about it? For once, I wouldn’t like to be in Obama’s big shoes. In the process, new pundit terms are being coined, like ‘intervention lite’, probably inspired by ‘democracy lite’ – the latter pertaining to the EU polity. Meanwhile, the health crisis in Syria is anything but ‘lite’, as a Lancet editorial reports in this week’s issue.  The crisis is still deepening.

 

This week was also the  50th anniversary of Martin Luther King’s famous ‘I have a dream’ speech. My humble dream for the post-2015 era is that philantrocapitalists like Gates and co begin to understand fast food workers when they take to the streets (as is happening now in the US), and connect the dots.

 

The Journals are also back from holidays and this week’s newsletter will thus cover, among others, the Lancet Global Health September Issue, which features articles on  female condoms (and their need for an international day of their own, September 16) and on HIV counselling and testing, among others. This week, The Lancet also features some articles on the global impact of mental and substance disorders, based on GBD 2010. We also pay attention to the interesting Globalization and Health collection on reverse innovation in global health systems. ( but if you want to read all this, you will no doubt sooner or later join the global mental health statistics).

 

We start by covering the GIZ Forum in Bonn on UHC. The Forum allowed policymakers, practitioners and academia to discuss practical approaches to addressing the challenges related to the various dimensions of UHC. Experts from the private and public sectors, development agencies and the research community explored what the focus on UHC means for their work, and what evidence and practical examples they can learn from. The event focused on actual implementation and the delivery of tangible solutions. Some of our colleagues (and Emerging Voices)  played a role in the session on UHC & research, which kicked off the second day. This week’s guest editorial is written by three EVs about this session: Beverly Ho, Raoul Bermejo & Isidore Sieleunou. Recommended reading, especially in view of the recent World Health Report on the same topic.

 

 

Enjoy your reading.

 

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

 

 

Editorial

 

UHC and research: Emerging Voices in a lively session in Bonn

 

Beverly Ho, Raoul Bermejo & Isidore Sieleunou  (EVs 2010, 2012)

 

Earlier this week, at the GIZ forum in Bonn, Germany on UHC, ‘Universal Health Coverage: From Promise to Practice ‘  (hashtag: #uhcforum ) (26-27 August), we took part in a session on UHC and research.  The session kicked off the second day of the conference.  As Emerging Voices from the Philippines & Cameroon, we had been invited by professor Wim Van Damme (ITM), who gave an introductory keynote speech, to offer country and regional illustrations (as well as challenges) of some of his key messages. Former EV Walaiporn Patcharanarumol from Thailand did much the same, and some of our Heidelberg colleagues (also former EVs, Mohammed Shafiu and Gilbert Abiiro) participated as initiators of the following fishbowl session and rapporteurs.  Manuela de Allegri (University of Heidelberg) facilitated the fishbowl.

 

It was lovely to get together again, 9 months after the Beijing Health Systems Research symposium, and attend a wonderful workshop on UHC in the process.  Wim’s keynote was organized around three themes (see below). The fishbowl turned out to be a lively affair: at some points 8 chairs (instead of the usual 5) were filled, so participants were more than eager to get their voices heard. They generally reacted well to the country examples provided by us in the keynote. For the ones who couldn’t make it to the session in Bonn, we summarize some key messages from the keynote and fishbowl below.

 

Wim first dwelled on UHC in context, zooming in on global framing of UHC (as described in different publications and by different institutions), as well as national adaptation and implementation. His overall message, that UHC is both a technical and political process, resonated with the audience, and was also heard in other sessions, for example in a keynote by a former Ugandan Vice President, Dr. Speciosa Wandira-Kazibe.

 

Why does UHC appear on the national agenda in many LMICs? In a number of countries, we can see that UHC easily fits into a populist rhetoric or good governance platform – as is the case in the Philippines (see the Aquino Health Agenda on UHC). In Thailand, the Universal Coverage scheme was continued even with (plenty of) changes in leadership (a total of 6 prime ministers, 10 health ministers, 6 permanent secretaries for the MOPH, in just 10 years).

 

UHC also seems to be a good way to respond to increasing demands for better social services, as can be observed in the Arab Spring, and the recent unrest in Brazil. China is another case in point – people who attended the Beijing Health Systems Research Symposium last year will remember how the Chinese Minister of Health explicitly linked UHC to social stability. In particular, UHC also seems to be about balancing the health care situation of the rural with the urban one in China. In India, expanding care to the poor is the main objective.

 

All agreed that context is indeed important … but what about the context is so important then? Is it the income level of countries, or fiscal and decision space? Burden of disease? Culture?  Last but not least, context is no doubt also about issues of power and politics, how decisions are made, and about the numerous actors who play a role as stakeholders in this political and technocratic ‘game’.

 

Also, if context is so important, is everything contextual then? In other words, is there still room for lessons learning and is it still possible to transfer lessons to other settings? Joe Kutzin, for one, thinks so. He emphasized in a recent WHO Bulletin viewpoint that NOT anything goes on the road towards UHC. We happen to agree.

 

In a second part of the keynote, the focus was on the diversity of actors in UHC and the importance of brokering. ‘Brokers’ act as bridges between researchers (producers of knowledge) and policy makers (consumers), although of course the picture is more complicated than that. Brokering is about identifying and synthesizing what type of evidence to use, when, and for whom. Good brokers can be individuals (many of us know some examples of effective brokers…), institutions (for example the Finance Ministry played this role in the recent Sin Tax Reform in the Philippines), Communities of Practice (increasingly effective knowledge broker platforms in Sub-Saharan Africa, as elaborated by one of us), social movements and civil society (as is the case for UHC in Thailand), international organizations, and we no doubt forget some.  In many countries though, different actors wear different hats and researchers may be brokers themselves.

 

An important stakeholder (if not the most important one) often left out from the high-level policy dialogue is the general population; even more overlooked are marginalized populations in most countries.  Can researchers  play a role in making sure that their needs and (crucial) voices are heard and that their perception of UHC gets incorporated into the UHC definition & dialogue ? The answer will follow post-2015.

 

The third part of the keynote tried to offer some suggestions to make research more relevant and timely for efforts to achieve UHC. This again triggered a very lively debate, perhaps because the latest World Health report also has the same aim.

Among other suggestions, Wim emphasized the importance of a comprehensive, systems view if health research is to have added value. All participants agreed on the need for evidence-informed policy but also recognized that research time frames are very different from policy time frames. Often, the picture is one of ‘policy-based evidence’ rather than ‘evidence-informed policy’, as policy makers need to make decisions ASAP in many cases, for example when they see a narrow window of opportunity. This reality was really emphasized throughout the fishbowl. Sadly, evidence is also often used to defend a policy once the decision has already been taken.

 

Researchers, if they are given the opportunity to work in ministries of Health, shouldn’t be afraid to become ‘co-opted’ by the system, it was also pointed out. This can help them become better researchers over time, as they will understand how the decision making system functions. As with accompanying/embedded research, though, it is vital to remain critical. Easier said than done, perhaps.

 

A key challenge for researchers seems to be finding the right balance between ‘fast science’ (relevant, reactive to the needs of policy makers, but with the obvious risk that the scientific community might have some doubts about this ‘research’) and ‘slow science’ (more rigorous, complying with the demands of the academic environment, but perhaps less responsive and relevant in the short term). So researchers need to learn to work in two different ways – a fast, reactive way, and a slower, more rigorous way. Whether the same people can be used for the two purposes, is another question, though.

 

As for the role of development partners, they should streamline their efforts and support countries instead of fragmenting them. For some reason, participants still have to emphasize this at this sort of Forum, unfortunately, many years after the Paris Declaration. Participants also stressed that a key role for development partners is to build capacities, and supporting institutions is perhaps even more important than supporting individuals (as even talented individuals need an enabling place to let them flourish, and more importantly stay as civil servants or work for the benefit of their country).

 

Researchers should also take into account that UHC is a long term goal, and that dialogue between the many stakeholders is crucial to move things forward in all countries. In this respect, a key question is, for example, how to use research in order to balance social cohesion and solidarity with the pluralistic health system reality in many countries.

 

A final remark struck a chord too, especially among the researchers in the room: a participant pointed out that researchers sometimes shy away from more important/relevant research questions, as they seem harder to research – read: they are potentially more controversial. Why is that nobody is studying the impact of ‘disappearing diamonds in Africa’ on development efforts, for example? Why does hardly anybody study taxation of sugar drinks, junk food and fast food chains? Is it because these are more powerful industries and many researchers don’t really want to offend these influential forces?

 

Overall, we had the feeling the session and its structure were well appreciated – with lots of room for discussion around themes and issues covered in an introductory keynote. Most other sessions at the conference were so packed with presentations that there was very little opportunity for discussion. Good we did our share in ‘brokering’ knowledge! Having said that, the overall feeling we had in Bonn was one of very interesting sessions. We’re happy to take all this new knowledge back home, where we will try to put it to good use.

 


GIZ forum on UHC in Bonn

 

As already mentioned in the intro, the two-day workshop in Bonn featured a number of great presentations and sessions. You find a summary of the sessions on this webpage. The webpage will be further updated in the coming days, when the rapporteurs will have sent their summary.

 

You can also find some interviews with people like Tim Evans, Ben Bellows and Dr. Speciosa Wandira-Kazibe. The interview with Tim Evans is a must-read (as he dwells on the WB & UHC, also post-2015)  (see also UHC Forward).

 

UHC & Post-MDGs

 

1.    Euractiv – Universal health coverage within reach for developing countries

http://www.euractiv.com/development-policy/universal-health-coverage-longer-news-529958#.UhxRaUsibGM.twitter

Once seen as a distant objective, economic growth and political will are now bringing universal health coverage within reach for the developing world, this Euractiv article says. But as we know all too well, great financial and social challenges still remain to be addressed before the vision becomes reality.

2.    ODI development progress – Health and development: bridging the gap

Fiona Samuel;

http://www.developmentprogress.org/blog/2013/08/27/health-and-development-bridging-gap#.Uhye3h1lEIg.twitter

Samuel summarizes an ODI development progress blog series on health, reviewing the issues and themes that have emerged. Authors were invited to share their perspectives on one key question: what role have the MDGs played in keeping health issues on the global agenda – what have they helped and what have they hindered?  The work of Development Progress and the Overseas Development Institute is helping to bridge the gap between health and broader issues of development and poverty that too often remain siloed in current debates.

 

3.    Lancet Global Health (September issue) – with a focus on female condoms, and more …

http://www.thelancet.com/journals/langlo/issue/current

The September Issue from the Lancet Global Health features, among others, an editorial by Zoë Mullan on Empowerment and protection, in which she focuses on the second Global Female Condom Day (scheduled for September 16 – we sense the Clinton family could make a difference here).

 

Why do female condoms need their own global day and are things set to change? Well, “Female condoms are listed by the UN Commission on Life-Saving Commodities for Women and Children as one of the “essential but underutilised” commodities necessary to accelerate improvements in reproductive, maternal, child, and newborn health. The Commission describes the female condom as “the only barrier contraception that gives women and adolescent girls greater control over protecting themselves from HIV, other STIs and unintended pregnancy”. See also the  Comment on Female condoms (by Maria F. Gallo et al), assessing a new and encouraging RCT study  in the Lancet. Although there is progress, familiar challenges and questions remain, however.

 

But do check out all the content of the September issue (see also below). In the Editorial, Mullan also summarizes some of the other articles. (remark: many articles already appeared online earlier, and were covered in previous issues of this newsletter)

 

4.    Lancet – Offline: Neurons, neighbourhoods, and the future for children

Richard Horton;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61779-1/fulltext

Horton zooms in on ‘early child development’ and its apparent omission (for now) in the post-MDG health negotiations. “Yet in many parts of the world, especially in sub-Saharan Africa, there are no national programmes in early child development. The High-Level Panel on the Post-2015 Development Agenda did not mention early child development at all. Louise Zimanyi, from the Consultative Group on Early Child Care and Development, argued this week that there should be a Sustainable Development Goal on early child development: to reduce by 50% by 2030 the 200 million children currently not reaching their full potential. Some paediatricians say that early child development is “the basic science of paediatrics”. If true, the global health community has omitted a vital element for the future of children, adolescents, and adults.”  Horton also discusses the launch of the Coalition of Centres in Global Child Health, last month.

 

5.    Health Poverty Action (Report) – World Indigenous People’s Day: New report on the health of ethnic minorities

http://www.healthpovertyaction.org/news/world-indigenous-peoples-day-new-report-on-the-health-of-ethnic-minorities/

From earlier this month, but important in the run-up to the UN meeting in September: to mark the International Day of the World’s Indigenous People (August 13), Health Poverty Action published a report on how to improve the health of the world’s marginalised ethnic minorities, many of whom are indigenous. “Health Poverty Action is calling for the measurement of any new goals on health and wider development to be broken down by ethnicity in the run up to the UN high level meeting on the new framework for international development in September.”  (not sure all political leaders will fancy such breakdown by etnicity, though, including some of the donor darlings)

 

In related news, the Guardian Global Development Professionals network reported on another ‘inconvenient truth’, this one related to the lacklustre leverage of African women. At a 2012 TEDxChange conference in Berlin, African women’s development fund CEO Theo Sowa emphasized that “African women may be the focus of many development campaigns, but they are rarely represented as drivers of the discussion”. It’s still not too late, though.

 

 

Infectious Diseases

 

6.    UNAIDS – Southern African Development Community leaders meet for special session of AIDS Watch Africa

http://www.unaids.org/en/resources/presscentre/featurestories/2013/august/20130822sadc/

Heads of State and Government from countries in the Southern African Development Community (SADC) met on 18 August in Lilongwe, Malawi to discuss the progress made and the challenges that the region is facing regarding HIV, tuberculosis and malaria.

 

7.    Safaids – Civil Society Cautions Against Mandatory HIV Testing

http://safaids.net/content/civil-society-cautions-against-mandatory-hiv-testing

The AIDS and Rights Alliance for Southern Africa (ARASA), a partnership of 73 southern and eastern African NGOs, has cautioned that the proposal by several SADC leaders to introduce mandatory HIV testing might negate the gains made in the AIDS response over the past decade. (During a Heads of State and Government on AIDS Watch Africa held on 17 August on the sidelines of the 33rd SADC summit, several leaders proposed that HIV testing should be mandatory in all its member states in a bid to curb the spread of the virus.)

 

8.    Lancet Global Health (Comment) – Less and more: condensed HIV counselling and enhanced connection to care

Elizabeth Marrum et al.;

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70052-4/fulltext

A randomised trial in Uganda shows that abbreviated HIV counselling and testing is as efficacious as the traditional approach, Marrum comments on the study. “Overall, this study provides evidence that HIV testing can be integrated or normalised into routine health care without a lengthy counselling session, but, crucially, that patients who test HIV positive need more intensive counselling and follow-up to ensure enrolment in care and timely treatment initiation. If widely applied in the countries prioritised by UNAIDS and WHO, these modifications will help improve and expand two of the key actions needed to achieve the goal of 15 million on treatment by 2015: normalising and increasing HIV testing in health facilities, and effective linkage to care and treatment.”

 

9.    UNITAID report – Hiv Preventives – Technology and Market Landscape

http://www.unitaid.eu/images/marketdynamics/publications/UNITAID-HIV_Preventives_Landscape-1st_edition.pdf

For the techies among you, this UNITAID report from August offers everything you always wanted to know about HIV preventive devices (or not), i.e. not just about PrePex and female condoms, but also about lovely devices like the “Shang Ring” from China, the “Ali’s Klamp” from Turkey, and more. The report looks at the availability, acceptability and affordability for products targeting HIV transmission and acquisition, including thus female condoms, male circumcision devices, …

 

10. KFF – DfID To Spend $214.5M Over 5 Years On Public-Private Partnerships To Fight Infectious Diseases

http://kff.org/news-summary/dfid-to-spend-214-5m-over-5-years-on-public-private-partnerships-to-fight-infectious-diseases/

DfID plans to invest $214.5 million over the next five years “with nine public-private partnerships to support development of drugs, vaccines, insecticides, diagnostic tools and microbicides, all to prevent, diagnose or treat disease.

11. Plos – Pediatric AIDS in the Elimination Agenda

Scott Kellerman et al.;

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001503;jsessionid=7308D03DE90B72A9AD1B4A797911312B

Scott Kellerman and colleagues argue that the scope of the current HIV elimination agenda must be broadened in order to ensure access to care and treatment for all children living with HIV.

12. New KFF reports on TB & malaria

http://kff.org/global-health-policy/report/mapping-the-donor-landscape-in-global-health-series/

The Kaiser Family Foundation released two new reports in its “Mapping the Donor Landscape in Global Health” series. This series of reports examines donor nations and multilateral organizations involved in addressing different global health challenges in recipient countries worldwide. The reports seek to provide perspective on the geographic presence of global health donors, and to enable more effective coordination and delivery of services globally and within individual recipient nations.    The two new reports address funding for malaria and tuberculosis. The analysis on HIV/AIDS was already released in June. Still to come: family planning and reproductive health assistance.

 

Global Health Initiatives

 

13. GFO (new issue)

http://www.aidspan.org/gfo_article/funding-approved-another-10-interim-applicants

The Global Fund Observer has a new issue – with lots attention for the transition phase of the new funding model, and decisions taken by the Board.

 

14. Lancet (Global Health) –  Why is it so difficult for the Global Fund to show value for money?

Robert Soeters;

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70051-2/fulltext?rss=yes

Firebrand Robert Soeters acknowledges Victoria Fan et al’s new Lancet article, “Performance-based financing at the Global Fund to fight AIDS, Tuberculosis and Malaria: an analysis of funding practice, 2002—11”   does a good job in describing the problem with disbursement mechanisms at the Global Fund.

The Global Fund’s present performance-based funding system does not adequately convey incentives for performance to recipients, and the organisation should redesign this system to explicitly link a portion of the funds to a simple performance measure in health coverage or outcomes, measured independently and robustly, Fan argues. (see also the CGD policy paper).

 

Robert thinks, however, that Fan et al did not really analyse the underlying reasons for this poor linkage between funding and performance and did not provide practical suggestions about what should be improved. He offers some suggestions. “In summary, the Global Fund should assist recipients with: (a) setting up decentralised contract development, verification, and coaching agencies that feed into the national level; (b) assuring the separation of functions between regulation, provision, contract development, and payment at all levels of the health system; (c) stimulating competition between health facilities for scarce government or aid agency resources; and (d) moving away from central and monopolistic input financing towards a system whereby health facilities buy their own inputs from competitive distributors.”

 

15. Devex – Can GAVI’s new partnership model crack ‘mhealth pilotitis’ while opening new markets for Vodafone?

https://www.devex.com/en/news/can-gavi-s-new-partnership-model-crack-mhealth/81668

In this blog, Stephanie Hanson examines a new partnership model being implemented by the GAVI Alliance. “According to David Ferreira, managing director for GAVI’s innovative finance department, GAVI began to consider new ways of partnering with private-sector companies, and where previously those companies had made primarily financial commitments, now GAVI wanted to tap into their core business expertise.” The article focuses on how the telecom company Vodaphone is teaming up with the GAVI Alliance to manage vaccine supply.

 

The article also mentions the problem of ‘pilotitis’: it’s been relatively easy to get a small mHealth program started, but much more difficult to take it to scale. Presumably, the GAVI-Vodafone partnership would help “immunize” this pilotitis.

 

16. CSIS report – U.S. health engagement in Africa: a decade of remarkable achievement – now what?

Stephen J. Morrison;

http://csis.org/files/publication/130822_Morrison_USHealthEngageAfrica_Web.pdf

A new report by J. Stephen Morrison, a senior vice president at the Center for Strategic & International Studies and director of the CSIS Global Health Policy Center, highlights achievements of U.S. global health programs over the past decade and the challenges that remain.

 

 

NCDs

 

17. NYT – Why Is Obama Caving on Tobacco?

Michael Bloomberg;

http://www.nytimes.com/2013/08/23/opinion/why-is-obama-caving-on-tobacco.html?ref=todayspaper&_r=0

It ain’t easy for Obama these days. Most of the time, his critics say he’s caving (in this case, on tobacco), and if he doesn’t (like on Syria), people say he looks more and more like George Bush.

 

Anyway, in this op-ed which already appeared last week in the New York Times, New York mayor Bloomberg said “The Obama administration appears to be on the verge of bowing to pressure from a powerful special-interest group, the tobacco industry, in a move that would be a colossal public health mistake and potentially contribute to the deaths of tens of millions of people around the world.” Hitting him hard, he continued: “Although the president’s signature domestic issue has been health-care reform, his legacy on public health will be severely tarnished — at a terrible cost to the poor in the developing world — unless his administration reverses course on this issue.” He was talking, of course, about the fact that the Obama administration removed from the Trans-Pacific Partnership a “safe harbor” clause “protecting nations that have adopted regulations on tobacco because of ‘the unique status of tobacco products from a health and regulatory perspective.'”

 

We have a hunch that Bloomberg has a great future in global health (and rightfully so). As for Obama, we have our doubts.

 

18. Trust women – Smoke Out Tobacco from the TPP

http://trustwomen.civicactions.org/smoke_out_tobacco_from_the_tpp

Meanwhile, the Malaysian government has taken a historic step for public health, and introduced a proposal to carve out tobacco from the Trans Pacific Partnership (and thus tobacco control from vulnerability to trade challenges by corporations). For some more coverage, see this article on Inside Trade (not open-access though). (You find a petition to support this carve out on the following webpage).

 

19. WSJ – Health Battle Over Soda Flares in Mexico

http://online.wsj.com/article/SB10001424127887323407104579037320321621280.html?mod=wsj_share_tweet

Over to the battle against soda. The public-health battle over sugary soft drinks, punctuated by Bloomberg’s failed attempt to ban big sodas in New York, has spread to Mexico, long a stronghold of Coca-Cola Co.

 

20. Lancet (Comment) – The global burden of drug use and mental disorders

Michael T. Linskey et al.;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61781-X/fulltext

The authors of this Lancet Comment assess the findings of a new analysis from the GBD 2010, which highlights how mental and substance use disorders were the leading cause of non-fatal illness worldwide in 2010. Data was analysed on the 20 mental and substance disorders included in GBD 2010 to model the prevalence, premature death, and non-fatal illness caused by these disorders in 187 countries. The studies show how mental and substance use disorders were the fifth leading contributor to death and disease worldwide. Linskey et al point out there is a relative  “lack of information about the prevalence of mental and drug use disorders, and the harms associated with these disorders”, and that this “emphasises the need not only for continued and ongoing efforts to refine the methods used in the current project but also for increased efforts to quantify both the prevalence of mental and drug use disorders and the risks posed by these conditions.”

 

Check out also the neat Humanosphere analysis by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation, who comments on the  illegal drug use paper and what it says about the policies in various countries.   She quotes IHME Professor Theo Vos, one of the co-authors on the study: ““There is much debate about the different factors that are driving these differences across countries. According to the latest scientific studies, countries who have successfully implemented harm-reduction strategies like needle exchanges, opioid substitution treatment, and HIV antiretroviral therapy tend to  have less premature death and disability from illicit drug use. Tackling drug addiction using a public health approach seems to be more effective than a punitive approach.”

 

Leach-Kemon (I’m pretty sure her friends often call her names) continues: “You can use the GBD research and data visualization tools to track health progress over time and see which countries are making the most progress against different diseases, injuries, and risk factors such as drug addiction. You, the users of these tools, can play an essential role in explaining the context behind the data. What kinds of policies and other factors could explain differences in disease burden from drug use across countries?”

 

Globalization & Health new thematic series on reverse innovation in global health systems: learning from low-income countries

 

Can “developed” countries learn from the lessons of “developing” countries? How can we move away from the fatuous ideas associated with being labelled a ‘developed’ or ‘developing’ country? These are but a few questions that Globalization and Health’s new thematic series, ‘Reverse innovation in global health systems: learning from low-income countries’ will address to enhance our understanding in this subject. The series aims to move beyond the narrow constraints of traditional thinking to promote bi-directional learning that challenges and rethinks traditional practice within global health systems.

 

A first collection of articles was published today, including an  editorial, commentaries, debates, …. (and also a   Commentary authored by Agnes Binagwaho et al, in which she presents examples of programmatic, technological, and research-based innovations from Rwanda, and offers reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.)

 

Health Policy & Financing

 

21. Ban recommended on MNC acquisition of Indian pharmaceutical companies

http://twnside.org.sg/title2/intellectual_property/info.service/2013/ipr.info.130803.htm

Last week, India’s Parliamentary Standing Committee on Commerce recommended a blanket ban on the acquisition of Indian pharmaceutical companies by pharmaceutical multinational corporations. This article has the detail.

 

22. Global Health Governance – Global Health Governance Goes “Green:” Integrating Health and Climate Change

Cecilia Zvosec;

http://blogs.shu.edu/ghg/2013/08/29/global-health-governance-goes-green-integrating-health-and-climate-change/

By more effectively communicating the impacts of climate change, contributing to the development of comprehensive adaptation and mitigation strategies, and many other efforts (including more participation by Global health governance bodies in climate change discussions), global health workers, leaders, and institutions can strengthen the argument for urgent and immediate action to combat climate change. “By actively involving itself in climate change discussions at all levels – including multilateral bilateral, and institutional negotiations – global health governance can not only aim to develop more effective and compelling climate change strategies, but can also emphasize comprehensive support of global health programs and interventions in the process.

 

23. Guardian – Philanthropists and aid donors must join forces in these straitened times

Michael Green;

http://www.theguardian.com/global-development/poverty-matters/2013/aug/30/philanthropists-official-donors-aid-effectiveness

“The new global partnership, under the post-MDG framework, or as an emanation of the efforts of the post-Busan global partnership for effective development co-operation, must reflect the reality that governments are going to have to work more closely with philanthropic organisations and private actors to solve big global problems.”  (yeah, right)

 

Arguably, Green offers some valid points, but his article should be complemented by this one, in ‘Nonprofit quarterly’ (by Sharon Gary-Smith), ‘We need more philantropists who listen’. She comes back on the commotion after the by now notorious Peter Buffet article on the ‘charitable industrial complex’ from a while ago, and has some great suggestions.

 

24. Science Speaks – Brief: Flat funding of biomedical research costs lives, slows progress, hurts economy, and diminishes America’s leadership

Rabita Aziz;

http://sciencespeaksblog.org/2013/08/28/brief-flat-funding-of-biomedical-research-costs-lives-slows-progress-hurts-economy-and-diminishes-americas-leadership/

A decade-long trend of diminished investment in medical research, exacerbated by budget-standoff driven “sequester” cuts are showing immediate and long term impacts: in stymieing promising studies, and in thwarting the development of the next generation of scientists, according to a brief from amfAR.

 

Similar complaints were heard in a Huffington Post interview with NIH Director Francis Collins, who spoke about the effects of sequestration on the agency’s budget. Among other issues, he said: “if sequestration is not fixed over the next decade, I think we’ll be no longer the world leader in the production of science, technology and innovation”.

 

25. CGD – China-Africa Health Cooperation: A New Era?

Victoria Fan;

http://international.cgdev.org/blog/china-africa-health-cooperation-new-era

Great blog post by CGD’s Victoria Fan on the Beijing Ministerial Forum on China-Africa health development (see also last week’s IHP newsletter).  She gives her view on the Beijing Declaration and much more ( indispensable reading).

 

26. Lancet Correspondence – The panjandrums of global health

Ngozi Okonjo-Iweala;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61822-X/fulltext

Okonjo-Iweala, Coordinating Minister for the Economy and Minister of Finance of Nigeria, co-Chair of the Global Partnership for Effective Development Co-operation, and member of the UNAIDS—Lancet Commission, disagreed with Richard Horton’s Offline Comment from July which suggested that recent international commitments on development cooperation have done more harm than good for health-care in Africa.

 

She does think, however, that Horton’s conclusion “that our global health panjandrums need better feedback from beneficiaries on the ground” is sound. We now have a window of opportunity to get things right, she says.

27. Lancet (Comment) – An inclusive rights-based foreign policy for health

Joseph D. Tucker et al.;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61462-2/fulltext

Inclusive rights are defined by Tucker et al as ‘civil, social, and health rights independent of sexual orientation or gender’. In 2011, in recognition of the importance of an inclusive rights-based foreign policy, Barack Obama issued a memorandum that raised LGBT rights to the status of a foreign policy priority. Obama declared: “The struggle to end discrimination against LGBT persons is a global challenge, and one that is central to the United States commitment to promoting human rights. I am deeply concerned by the violence and discrimination targeting LGBT persons around the world whether it is passing laws that criminalize LGBT status, beating citizens simply for joining peaceful LGBT pride celebrations, or killing men, women, and children for their perceived sexual orientation. That is why I declared before heads of state gathered at the United Nations, ‘no country should deny people their rights because of who they love, which is why we must stand up for the rights of gays and lesbians everywhere.” Tucker & colleagues explain how an inclusive rights-based foreign policy can improve the health and wellbeing of LGBT communities by several mechanisms, and point at challenges and opposition around the world. ( Putin’s Russia is an obvious case in point) Nevertheless, an inclusive foreign policy is gaining traction.

28. Journal of Health Diplomacy – first issue

http://www.ghd-net.org/journal-health-diplomacy-volume-1-issue-1

The Journal of Health Diplomacy published its first issue, with the theme access to safe medicines.  Check it out.

 

29. Global Health Promotion (Commentary) – Health activism: the way forward to improve health in difficult times

Global Health Promotion also published its September issue, featuring, among others, an editorial (by Glenn Laverack) on the need for health activism in difficult political and economic times.

 

 

 

Global health vacancies

 

30. Two health research vacancies in Cape Town

http://archief.internationalhealthpolicies.org/archives/2-health-research-vacancies-cape-town/

The Medical Research Council, South Africa’s premier organisation for undertaking and funding medical research, is seeking to appoint individuals to fill two positions. It is seeking internationally recognised leaders for dynamic teams of researchers engaged in programmes of knowledge generation that will impact substantially on health policy, innovation, services and other interventions.  More in particular, there are vacancies for:

 

  • A Unit director for the  Health Systems Research Unit, and a Unit director for the NCDs unit

Research

 

31. Lancet (Editorial) – Authorship and accountability

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61815-2/fulltext

The Lancet supports the new International Committee of Medical Journal Editors  (ICMJE) Recommendations, which have added a fourth criterion to the three already in place.

 

In other ‘Journal & publication’ news, in this week’s Plos issue, PLOS Medicine Editors discussed the potential of translational medicine to improve global health and how adherence to reporting standards and guidelines for translational research will lead to better quality studies in this field.

 

32. International Health – September Issue

http://inthealth.oxfordjournals.org/content/current

The new September issue of International health features, among others, an editorial on ‘investing in malaria research in challenging financial times’ (by William Brieger), and a Review article by some of our colleagues (Tom Decroo et al), ‘Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review’.

 

33. Health Policy & Planning – September issue

http://heapol.oxfordjournals.org/content/current

Most articles were already published before online.

34. Alliance Thematic series ‘Promoting universal protection’

The Alliance HPSR and the WHO Health Systems Financing Department have supported case-studies in seven low- and middle-income countries and have produced a Thematic Series entitled “Promoting universal financial protection”. This Thematic Series includes a paper for each of the seven country case studies as well as an overview of the key factors facilitating or hindering progress toward universal coverage. In addition to the first two country case studies (Nigeria and Tanzania) published earlier this year, three more papers were published in August. These are the case studies from India, Malawi and Thailand. The remaining papers will be published next month. You find the five country studies  here.

 

35. Knowledge Broker’s forum – Brokering knowledge and Research Information to support Development…

http://www.knowledgebrokersforum.org/blogs/item/brokering-knowledge-and-research-information-to-support-development

The BRIDGE-project (Brokering knowledge and Research Information to support the Development and Governance of health systems in Europe), led by the European Observatory on Health Systems and Policies, was to map existing initiatives, mechanisms and practices of knowledge brokering for health policy making and identify what we know about their effectiveness in bridging the gap between policy makers and the information and research being generated. It has come out with series of research reports now, which can be useful for knowledge brokers involved in the field of health systems and policies. You may find research reports at: http://www.euro.who.int/en/who-we-are/partners/observatory/bridge-series

 

For example, check out the following  policy brief, ‘How can knowledge brokering be advanced in a country’s health system?’

 

Miscellaneous

POST-MDG articles & blog posts

36. The Broker – Good job or missed opportunity?

Jan Vandemoortele;

http://www.thebrokeronline.eu/Blogs/Post-2015-shaping-a-global-agenda/Good-job-or-missed-opportunity

In a blog post from earlier this month, Jan Vandemoortele assesses the High Level Panel Report and regrets the fact that “the HLP missed the opportunity to fundamentally change the discussion on the post-2015 agenda. This is not due to it omitting any dimensions regarding the ‘what’ or the ‘how’, but because it sidesteps the debate on the ‘why’. The report devotes little attention to why we need a successor arrangement to the MDGs.”

 

37. Alex Evans – Emerging economies’ dangerous game on the post-2015 development agenda

http://www.globaldashboard.org/2013/08/28/emerging-economies-dangerous-game-on-the-post-2015-development-agenda/

Check out why the Emerging Economies are playing a dangerous game on the post-2015 development agenda.

 

CGD’s Charles Kenny is, on the other hand, quite optimistic about how things are going with the post-2015 bandwagon (see his latest post, in which he zooms in on the SDG Working Group interim report)

 

US aid & EU aid

 

  • Devex examines how aid advocates are working behind-the-scenes to attempt to secure foreign aid in the US.  Devex notes that “PEPFAR … continues to enjoy broad bipartisan support, and the same goes for humanitarian accounts — bolstered by a united concern over Syria’s deteriorating refugee crisis, which just saw its one millionth child refugee. However, the fate of poverty-focused funding remains less certain, and one program in particular, the Millennium Challenge Corporation, is a surprising potential victim of the depleted assistance funding pool.”

 

 

  • The EU is stalling on aid, according to the latest annual report.  (see the Guardian for a summary).

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