Dear Colleagues,

 

The new IPCC report on climate change was published, today in Stockholm (or at least the summary for policymakers, see here), but for most of the week New York was the center of the world. That included the global health community. Discussions on the acceleration of progress towards the MDGs, more debate on the post-MDGs and health (in the ‘Special Event’ on Wednesday), with UHC featuring prominently in  General Assembly sessions but also in various side events, the annual gathering of the Clinton Global Initiative, the launch of the report ‘More Health for the money’ by CGD, the launch of the Save the Children/Rockefeller foundation/UNICEF/WHO report on UHC & equity, big financial announcements by the UK and the World Bank, renewed confidence at the Global Fund, a new comprehensive approach to tackle malaria, … and much more. In sum, New York was the place to be this week for global health news watchers.  This newsletter will provide some of the detail.

As usual, New York was also a good place for some informal chatting, networking in the corridors and catching up with old friends and colleagues. World Bank president Jim Kim even said he intends to “hang out” for a while with Margaret Chan, trying to figure out how to measure UHC. Could the first “UHC romance” be in the air? Kim also tweeted that Japan has demonstrated its firm commitment to UHC and has helped put UHC on the development agenda – he refrained from suggesting a UHC trio with Shinzo Abe, though. Blunt as always, Laurie Garrett tweeted on Japan’s UHC commitment: “It feels like a political tsunami pro-UHC post 2015 led by Japan is plowing over UN,  SDGs & other health agendas for post-MDGs.”  (As for the health equivalent of Fukushima, read Laurie’s brand new paper on the 5 existential challenges to global health – it’s the read of the week).  Meanwhile, über-diplomat Tim Evans said the Bank feels UHC is critical towards ending extreme poverty.                   

Unlike Tim, we’re no Zhou Enlai, but rather the global health equivalent of Donald Rumsfeld (well, in this weekly intro at least), so let’s move quickly towards our weekly “agitprop” paragraphs, this time by carefully selecting quotes and tweets emerging from New York. And what could be a better place for this sort of biased exercise than the annual Clinton celebrity party?

At this year’s Clinton Global Initiative meeting, there was, evidently, lots of talk about multi-stakeholder ‘partnerships’ – the new Dutch king would probably refer to these as a key element of the brave new ‘participatory society which has to replace the old welfare state in OECD countries. But Bill and partners, that’s like George Bush and war, or Margaret Chan and UHC, so let’s give the former US president a break. Also, we do agree some of these partnerships have true merit (our inner Zhou is speaking now). Tom Paulson tweeted, though: “Tired of hearing ‘private sector’ is crucial to fighting poverty. Akin to saying banks crucial to financial stability. Cuts both ways ….”.  Enter Joris Luyendijk, The Guardian’s blogger at the City, who said this week in an interview (in Dutch, unfortunately) that a new, more horrific financial crisis, is almost unavoidable. Instead of firefighters, he expects to see tanks in the streets then (here’s Donald!).

 

But back to the Clinton meeting: in one session, Mo Ibrahim, founder and chairman of the Mo Ibrahim Foundation, said he was frustrated with the image of Africans as corrupt people and that the focus on better governance cannot move forward without better governance globally. “For every corrupt leader, there are 50 corrupt business people,” Ibrahim said. “Half of them are sitting here.”  (business leaders present were probably assuming they were watching stand-up comedy)

 

As for Bono, the “rock star-turned-humanitarian warrior”,  he impersonated  Bill Clinton this week, quite successfully by the way (and he didn’t even need a cigar). Bono admitted he’s not exactly an anti-corporate critic, but he also spoke out. More in particular he said that he is concerned by the American Petroleum Institute’s lawsuit to stop a law requiring companies to publish what they paid for oil and mining contracts in the developing world. He called on oil giants Exxon and Chevron, which he said are doing good work, to exert pressure on APE to allow for rules that would improve transparency and accountability. “You can’t have it both ways,” said Bono. “You can’t give alms to the poor on one level and have your hands to their throat on another.”  (yes, this is the same Bono who  lashed out this week at the ‘cranky left’ for daring to ask some questions about U2’s shady tax arrangements).

 

We all lead inconsistent lives – myself included, big time (Zhou again). The question is: when does inconsistency become hypocrisy? That’s a question we can only answer for ourselves, nobody else can do that for us. Which is probably a good thing.

 

Finally, Obama handed male tobacco addicts all over the world a way to kick the habit of smoking – getting married. Once you’re scared of your wife – and sooner or later, we all are – tobacco becomes a “no go” zone, a red line you cannot cross, so to speak. At last, Obama’s global health credentials are ensured! Thank you, Michelle!

 

In this week’s guest editorial, Emma Chademana-Munodawafa (School of Public Health, University of the Western Cape) covers the first day of the PHASA/AFPHA Conference in Cape Town.

 

Enjoy your reading.

 

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

 

 

Editorial

 

Beyond the MDGs: A review of the Public Health Association of South Africa & African Federation of Public Health Association Conference, 2013

 

Emma Chademana-Munodawafa (PhD Candidate, Centre for Research in HIV/AIDS, School Of Public Health, University Of the Western Cape)

This year’s Public Health Association of South Africa (PHASA) conference was convened in Cape Town, 26-27 September 2013 and was a joint collaboration with the African Federation of Public Health Association (AFPHA). The conference kicked off with a full day Student Symposium where Public Health students presented and shared their work and had an opportunity to learn from experienced Public Health professionals.

The theme of the conference was ‘Africa’s Public Health Legacy: Beyond the MDGs’, looking at how far public health has come since the MDGs and the way forward after 2015. Discussions were centered on strategies and actions needed to move beyond the MDGs. The National Department of Health gave a presentation on South Africa’s implementation of the Health in All Policies (HiAP) approach to achieve health equity in the country. “HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts, in order to improve population health and health equity” WHO, 2012.

Specific discussions were on building new and strengthening existing leadership in the Health system, and strengthening the Health System. The necessity to enhance the capacity of young and emerging public health professionals was highlighted in presentations on teaching research skills to undergraduate medical students and on developing the next generation of health policy researchers.

The implementation of South Africa’s Primary Health Care (PHC) re-engineering strategy was a predominant feature throughout the conference. The re-engineering initiative was largely informed by Brazil’s hailed Health Sector Reform where health outcomes were improved by expanding the role of community workers in health teams. A question raised was whether South Africa can replicate Brazil’s success; participants thought South Africa’s PHC re-engineering can be successful if the under-lying causes of ill-health and health human resource shortages are addressed. Furthermore, community participation was highlighted as a vital component of the PHC reengineering strategy.

Other recommendations for the success of the PHC re-engineering strategy were increasing the number of CHWs in the country while at the same time widening their scope of practice, allowing them to provide more health care services. It was advocated that CHWs be able to treat specific diseases such as childhood pneumonia prescribing antibiotics as they can successfully perform these tasks as evidenced in other countries.

Community participation was further echoed in a presentation of the Operation Sukuma Sakhe initiative in South Africa’s KwaZulu-Natal Province. Operation Sukuma Sakhe- which translates as “Let us all stand up and build”­- is a community partnership programme initiated by the KwaZulu-Natal department of Health whit the aim of addressing the social determinants of ill health in the province.

Overall, the main recommendations moving beyond 2015 were greater community involvement in healthcare provision, a re-organization of Community Health Workers tasks, intersectoral approaches in government with an appreciation of public health as an essential component of South Africa’s health system.


UNGA in New York & global health

1.    Meeting on 23 September – “MDG Success: Accelerating Action and Partnering for Impact”

http://www.un.org/apps/news/story.asp?NewsID=45935&Cr=&Cr1=%23.UkFuALzqU_M#.UkQxPoazKuJ

Ban Ki-moon gathered on Monday at U.N. headquarters heads of state and representatives of business, civil society and philanthropic organizations to fuel a final push to propel the MDGs across the finishing line. The day-long meeting generated some $2.5 billion in pledged funds towards boosting MDG achievement.  This article gives an overview of some of the commitments (by the UK, World Bank, Norway, Ikea, …) –( see also further in this newsletter). Ban emphasized the importance of multi-stakeholder partnerships, among other issues.

2.    Launch of the Save the Children/ Rockefeller Foundation/Unicef/WHO report at the Rockefeller foundation

http://www.livestream.com/paho/video?clipId=pla_bea8d014-bb41-47d6-9028-4bb9e34f5ef3&utm_source=lslibrary&utm_medium=ui-thumb

This side event took place at the Rockefeller foundation on September 23 – the launch of the report “UHC – A commitment to close the gap”, a collaborative product of 4 institutions. It’s well worth to watch this video (1.5 hrs), with discussants like Tim Evans, Seth Berkley, Nils Daulaire, Margaret Chan, and many others.

 

Themes that popped up, in addition to the obvious emphasis on equity as a fundamental part of UHC, were the need for progressive realization of UHC, starting first with primary care, the need for goals, metrics and indicators on UHC (with Tim Evans floating the first two WB targets – 0 people impoverished by health expenditure by 2030; and an “80/40” target: 80 % coverage of interventions for primary care/MDGs & NCDs for the 40 % most deprived), the need for strong accountability mechanisms; that strong political will is necessary but also that UHC is in many countries a bottom-up demand too (in other words, UHC is not just “cooked up” in international fora like the one in NY), that UHC is an important dimension of equity and social justice (and thus, according to Margaret Chan, ‘the midwife of UHC’ (in the words of the moderator), not just a means, but also an end in itself), that UHC fits nicely with the ‘make poverty history’ & ‘leave no one behind’ mantras; that quality is critical,… etc. There were also views from the US (Nils Daulaire) and from Japan, among others.

 

3.    Guardian – Global Fund’s $15bn must buy results rather than rhetoric

Amanda Glassman;

http://www.theguardian.com/global-development/poverty-matters/2013/sep/27/global-fund-results-aids-malaria-tuberculosis

On September 25, CGD launched its report ‘More health for the money: Progress and Potential at the Global Fund’ (which was already published a few weeks ago). In this Guardian article, Amanda Glassman gives some of the key messages. She admits the GF is an effective fundraiser (see also below), but lives saved are the true measure of its success in tackling Aids, TB and malaria, she says.

 

Humanosphere’s Tom Paulson  also interviewed her on the report.

 

4.    KFF – U.N., Partners Launch New Comprehensive Malaria Approach

http://kff.org/news-summary/u-n-partners-launch-new-comprehensive-malaria-approach/

The United Nations and a coalition of partners on Tuesday (September 24) launched a comprehensive approach to fighting malaria. “With the participation of world leaders gathered in New York for the 68th General Assembly, the Roll Back Malaria Partnership (RBM) and the U.N. Development Programme (UNDP) launched the Multisectoral Action Framework for Malaria, which calls for greater coordinated action among different development sectors to tackle the disease. The framework identifies actions to address the social and environmental determinants of malaria, and calls for current malaria strategies to be complemented by a broader development approach, according to a UNDP news release.

 

5.    KFF – U.N. Holds First-Ever High-Level General Assembly Session On Disability And Development

http://kff.org/news-summary/u-n-holds-first-ever-high-level-general-assembly-session-on-disability-and-development/

Ban Ki-moon opened a historic U.N. meeting of world leaders Monday “to break barriers and open doors for the more than one billion disabled people around the world”. The goal of the first-ever high-level General Assembly meeting was to spur international action to ensure that the disabled can contribute to the global economy.  “The rights of persons with disabilities must be directly addressed by the post-2015 development agenda,” United Nations officials urged at the high-level meeting of the General Assembly, where world leaders pledged to work together on national and international policies that enhance and promote disability-inclusive development.

 

6.    Science Speaks (blog) – U.S. to host Global Fund replenishment meeting in December

Rabita Aziz;

http://sciencespeaksblog.org/2013/09/25/u-s-to-host-global-fund-replenishment-meeting-in-december/

Secretary of State John Kerry announced at the United Nations General Assembly meeting that the next replenishment meeting of the Global Fund will be held in Washington D.C. around World AIDS Day in December. With the United Kingdom’s recent announcement that they will double their current commitment to the Global Fund by contributing $1.61 billion over the next three years, there’s great momentum and promise going into the organization’s fourth replenishment period.”  (see also Aidspan on this new momentum for the Fund replenishment).

 

 

For some more detail on the UK announcement, see also the The Global Fund Observer (part of the new GFO issue) and the Guardian.   Britain’s pledge, which is dependent on other donors dedicating enough to reach the $15 billion goal, is the second-largest by any government so far.

 

In other GF news, in the run-up to New York, the GF announced new mid-2013 results that show significant gains in the treatment of people living with HIV and in the prevention of mother-to-child transmission of the virus. See the Global Fund’s press release on this.

 

7.    WHO et al – Joint Statement on the financing of health MDGs and for malaria

http://www.who.int/mediacentre/news/statements/2013/mdgs_20130925/en/index.html

This joint Statement was released by WHO, UNFPA, UNAIDS, UNICEF and the UN Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria on the Occasion of the 68th General Assembly of the United Nations. “This week, an unprecedented US$ 1.15 billion has been freshly mobilized to reach MDGs 4 and 5 – the largest amount ever mobilized for those goals. Funds of this magnitude fill a substantial portion of the remaining financing gap.”

 

8.    Guardian – New UN development goals must focus on rights and apply to all countries

Liz Ford;

http://www.theguardian.com/global-development/2013/sep/25/new-development-goals-un-general-assembly

The Special event on the MDGs on September 25, which kicked off the next two years of bargaining on the post-MDG & SDG agenda, produced an outcome document, which was accepted by all countries. This Guardian article gives some of the key messages of the meeting and document. “In the outcome document on the concluding day of talks on global development at the UN’s general assembly in New York this week, member states committed themselves on Wednesday to accelerating progress to achieve the eight MDGs by 2015, and then begin the process on creating a new set of targets that put poverty eradication and sustainable development at their centre.”   Devex also has a good analysis of the outcome document on the post-MDGs, saying it embraces ‘flexible goals for all’.

 

As for the press statement after the special event, see here. In the document, countries agreed to hold a high‐level Summit in September 2015 to adopt a new set of goals that will balance the three elements of sustainable development – providing

economic transformation and opportunity to lift people out of poverty, advancing social justice and protecting the environment. The Secretary‐General said that the post‐2015 framework “must be bold in ambition yet simple in design, supported by a new partnership for development. It needs to be rights‐based, with particular emphasis on women, young people and marginalized groups. And it must protect the planet’s resources, emphasize sustainable consumption and production and support action to address climate change.” The press release also includes the highlights of commitments made in support of the MDGs during this high-level week of the 68th session of the UN General Assembly.

 

The outcome document was generally well received, EU officials for example applauded the fact that it sets out a road-map to 2015, and they also supported the establishment of the High Level Political Forum,  “which will have a key role in future follow up and review progress in the implementation of the sustainable development commitments within the context of the post 2015 agenda.”

 

9.    MDGs-Bulletin – Briefing note on the special event towards achieving the Millennium development goals

http://www.iisd.ca/mdgs/se/html/crsvol153num10e.html

This excellent briefing note is for the ones who want to have a (very) detailed account of the whole day, including the roundtable sessions. Everything said and done throughout the day.

 

10. PMNCH report 2013 – Analysing Progress on Commitments to the Global Strategy for Women’s and Children’s Health

http://www.who.int/pmnch/knowledge/publications/2013_pmnch_report/en/index.html

The Global Strategy for Women’s and Children’s Health, launched by Ban Ki-moon in September 2010, aims to save 16 million lives in the 49 poorest countries by 2015 through enhanced financing, strengthened policy and improved service delivery. The Every Woman Every Child movement was established at the same time to mobilize and intensify the international and national action needed to advance the Global Strategy. The direct costs and the health systems costs for programmes and services targeting women and children in the 49 countries were estimated to be US$ 88 billion for 2011-2015 (excluding costs for scaling up to meet other health MDGs).

This report is the third annual report produced by the Partnership for Maternal, Newborn & Child Health (PMNCH) analysing the commitments made by countries and development partners to the Global Strategy and Every Woman Every Child. It was also launched in New York early this week. The main objective of this year’s report is to assess the extent to which the 293 stakeholders who have made commitments to the Global Strategy since its launch in 2010 (up to June 2013) have implemented their commitments, and the extent to which implementation is contributing to reaching the goals of the Global Strategy.

11. Lancet – Offline: Failing women and failing them badly

Richard Horton;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61971-6/fulltext

As for Richard Horton’s assessment of this report, see here. (A must-read.)

 

12. Our man in New York – tweets from Richard Horton

http://taxeela.blogspot.ch/2013/09/our-man-in-new-york-tweets-from-richard.html

More bittersweet reflections (tweets) on global health from Richard Horton, after observing the UNGA circus. (must-read, bis)

 

13. World Bank – World Bank Group to Invest $700 Million by 2015 to Improve Women and Children’s Health in Poor Countries

http://www.worldbank.org/en/news/press-release/2013/09/23/world-bank-group-invest-700-million-2015-improve-women-children-health-poor-countries

Jim Kim announced that the Bank Group projects at least $700 million in financing through the end of 2015 to help developing countries reach the MDGs for women and children’s health. This new funding comes from the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and will enable national scale-ups of successful pilot reproductive, maternal, and child health projects that were made possible by support from the Bank Group’s Health Results Innovation Trust Fund (HRITF) and IDA. This announcement follows President Kim’s September 2012 commitment to help scale up funding for MDGs 4 and 5 as part of the UN Secretary General’s Every Woman Every Child global partnership.

 

As for the focus on Results Based financing, see also this  blog post by Monique Vledder  (on the World Bank’s Investing in Health blog).

 

In other maternal & child financing news, at a U.N. panel on maternal and child health on Wednesday, Canadian Prime Minister Stephen Harper announced the country would spend $200 million over five years to fund nine maternal and child health projects in developing countries that will help to pay for more immunizations, provide basic health care and set up community services to ease the dangers of childbirth and pregnancy. The money detailed Wednesday is part of Canada’s commitment of nearly $3 billion over five years to the issue of maternal and child health, part of the Muskoka Initiative on Maternal, Newborn and Child Health launched by G8 partners at the Muskoka Summit in 2010.

 

14. BMJ (news) – Strong government accountability is crucial to meeting millennium development goals, UN assembly is told

Anne Gulland;

http://www.bmj.com/content/347/bmj.f5823

The introduction of accountability and oversight at government level is key to achieving the MDGs, a meeting at the United Nations General Assembly has heard. Joy Phumaphi, who co-chairs a group tasked by the UN with looking at accountability in relation to the MDGs, said that the few countries that were due to meet targets on both infant and maternal mortality had all introduced strong oversight and accountability mechanisms.

 

In related news,  in a guest post on Humanosphere, Katie Leach-Kemon (IHME) quotes Global Burden of Disease researcher Katrina Ortblad. “While the MDGs have helped saved millions of lives by mobilizing political will and funding to fight child and maternal mortality, HIV/AIDS, and malaria around the world, Global Burden of Disease Researcher Katrina Ortblad argues that future global health campaigns could be made even more effective by setting absolute instead of relative goals.”

 

Ortblad recently presented her ideas at IHME’s Global Health Metrics and Evaluation Conference. “While countries have made impressive progress by striving to achieve the MDGs, we need more ambitious goals to define what are humane and equitable levels for childhood, maternal, HIV/AIDS, TB, and malaria mortality, and we need to measure how far countries are from achieving these levels,” said Ortblad. To define these levels of mortality, she imagines a world where all countries achieve the percent declines in mortality seen in top-performing developing countries over the last decade (for example Vietnam).

15. SDSN Thematic group report on Health in the Framework of Sustainable Development

K. Reddy et al.;

http://unsdsn.org/files/2013/09/SDSN_Report_DRAFT_Sep15_final.pdf

We already covered this – vital – report in last week’s IHP newsletter, but it’s good to draw attention to it again this week, as  ‘The Thematic Group Report on Health in the Framework of Sustainable Development’ is seeking input from academics, researchers, civil society, the private sector, government officials, and the general public. It’s important, among other reasons, because it seems now likely that the SDG negotiations will matter more (also for health) than the HLP report during the next two years.

 

Submissions will be accepted through October 15, 2013. The comment form can be downloaded at the above link and emailed to info@unsdsn.org.

 

16. Development Progress – Achieving the MDGs in Africa: should we accelerate?

Charles Abugre Akelyira;

http://www.developmentprogress.org/blog/2013/09/19/achieving-mdgs-africa-should-we-accelerate

Charles Abugre, Africa regional director for the United Nations Millennium Campaign, stresses we cannot “quick-fix” maternal or child mortality or income poverty. These issues have to be addressed structurally. “For children to survive and thrive they don’t only need mosquito nets, vaccination or medicines, they also need nutrition, education, and for their mothers to be healthy, educated and non-poor. We cannot side step under-development and structural inequalities. Africa cannot eradicate poverty without development. The current MDGs should not be misconstrued as Africa’s development agenda. Why lose valuable time on the status quo when we can use the time to transit into a more ambitious and appropriate development agenda?”

 

17. Clinton Global Initiative annual meeting

 

Devex has quite some – neutral – coverage on the Clinton Global Initiative gathering. Check the daily digests (for example here, or  here,   here ).

 

 

You can also find excellent UNGA daily digests  here (on the post-2015 website).

 

18.  General Assembly – Endorsement of declaration on sexual violence in conflict

http://www.unmultimedia.org/tv/unifeed/2013/09/ga-sexual-violence-in-conflict/

More than half of the Member States endorsed a high level declaration toward eliminating sexual violence.  The declaration, launched on the sidelines of the United Nations General Assembly in New York, was endorsed by 113 countries and contains a set of practical and political commitments to end the use of rape and sexual violence as a weapon of war, which terrorises and destroys communities during conflict.

The countries endorsing it will agree, for the first time, that serious sexual violence in conflict constitutes grave breaches of the Geneva Conventions. This will mean that suspects can be apprehended wherever they are. It contains a pledge not to allow amnesties for sexual violence in peace agreements, so that these crimes can no longer be swept under the carpet. The declaration promises a new International Protocol by the middle of 2014: to help ensure that evidence produced can stand up in court and more survivors can see justice, and to place the safety and dignity of victims at the heart of investigations into rape and other sexual crimes in conflict zones.”

 

19. Action for Global Health – How the next Global development framework must deliver for Health: A Proposal By Action for Global Health

http://www.actionforglobalhealth.eu/fileadmin/user_upload/Puplications/Global-Development-Framework-Proposal_AfGH-Sept-13.pdf

AFGH reckons it is essential that health is understood to be at the heart of sustainable

development. The right to achieve the highest attainable standard of

health is a universal right belonging to everyone, everywhere. Action for global Health supports a single, universal, comprehensive and rights-based post-2015 sustainable development framework, founded on the three dimensions of sustainable development (economic, social and environmental). Realising the right to health is critical to achieve equitable sustainable development. in order to ensure that this is a key priority, the post-2015 framework must include a strong and outcome-focused health goal. it must also include health-related targets and indicators under the other

appropriate global objectives, as health cuts across most sectors.

 

20. Lancet Global Health (October issue) – Closing gaps and tracking change for sustainable development

Zoë Mullan;

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70108-6/fulltext

In this Lancet Global Health editorial, Zoë Mullan gives an overview of the new October issue, with a focus on women and children’s health. She also emphasizes: “The post-2015 discussions at the General Assembly mark a new era in development—sustainable development—and women’s and children’s health must be at the very heart of that.”

 

 

Maternal health

 

21. WHO – Statement for Collective Action for Postpartum Family Planning

http://www.who.int/reproductivehealth/topics/family_planning/Statement_Collective_Action.pdf

On World contraception day (26 September 2013), WHO and partners have issued a statement on postpartum family planning.

 

 

This weekend (28 September) is also the International day of action on decriminalization of abortion. Check it out here, as well as a WHO document  on preventing unsafe abortion.

22. BMJ (Editorial) – Female genital mutilation/cutting

Henrietta Moore; http://www.bmj.com/content/347/bmj.f5603

Editorialist  Henrietta L Moore examines Unicef’s recent report on female genital mutilation/cutting, which studied the largest ever number of nationally representative surveys from all 29 countries where these practices are concentrated. Moore finds that although the tone of the report is resolutely upbeat, the reality on the ground seems more uncertain and fragile.

 

Health Policy & Financing

 

23. Laurie Garrett – Existential challenges to global health

http://cic.nyu.edu/sites/default/files/garrett_challenges_global_health.pdf

You have people who focus on the nuts and bolts in the field;  people who look at the big picture; and then there’s Laurie Garret for the galactic picture. Her paper on 5 existential challenges to global health is part of a series. The New York University Center on International Cooperation recently published this study, titled “United Nations Development at a Crossroads,” which includes several case studies on development issues. “Any effort to improve the impact of the U.N. development system, and make it relevant to today’s challenges, must have as a starting point the recognition of the need for change by a critical mass of stakeholders.

(Needless to say: if you only read one paper this week, let it be Laurie Garrett’s.)

 

24. Lancet Global Health – Safer primary care for all: a global imperative

Aziz Sheikh et al.; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70030-5/fulltext

Paradoxically, although primary care is the setting in which most care is provided, in the context of deliberations on patients’ safety and reduction of the burden of iatrogenic harm, most attention has hitherto been focused on specialist care settings. Promotion of universal health coverage has recently emerged as a key priority for WHO and its member states, and provision of accessible and safe primary care is regarded as essential to meet this important international policy goal. The release of the deliberations from WHO’s inaugural Safer Primary Care Expert Working Group is intended to help redress this imbalance by signifying WHO’s intention to stimulate international action to support the delivery of safer primary care.” (Aziz Sheikh is the Chair of the WHO Safer Primary Care Expert Working Group.)

25. Lancet – The Global Health Innovative Technology (GHIT) Fund: financing medical innovations for neglected populations

BT Slingsby et al.; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70055-X/fulltext

The newly launched Global Health Innovative Technology (GHIT) Fund, which is multisectoral, interdisciplinary, and not for profit, aims to expedite the generation of novel medical technologies and drugs to diagnose, prevent, and treat high-prevalence infectious diseases worldwide. The GHIT Fund represents the first public—private partnership to involve a national government, a UN agency, a consortium of pharmaceutical companies, and an international philanthropic foundation (founding partners are the Japanese Ministry of Foreign Affairs; the Japanese Ministry of Health, Labour and Welfare; the UN Development Programme; Astellas Pharma; Daiichi Sankyo Company; Eisai Company; Shionogi & Company; Takeda; and the Bill & Melinda Gates Foundation). The initial targets are key poverty-exacerbating diseases prevalent in developing nations.”

26. KFF – JPMorgan Chase & Co., Gates Foundation Form Investment Fund To Back Development Of Global Health Technologies

http://kff.org/news-summary/jpmorgan-chase-co-gates-foundation-form-investment-fund-to-back-development-of-global-health-technologies/

JPMorgan and the Gates Foundation formed an investment fund that will back late-stage development of technologies to fight killer diseases in low-income countries. It’s supposed to be a socially orientated private equity fund as it “aims to offer investors a modest return on their capital over 10 years while supporting innovations to tackle diseases that struggle to attract sufficient support from private investors or aid agencies. The hybrid mechanism taps new sources of funding for late-stage testing and approval of drugs, vaccines, diagnostics and other products designed to tackle infectious diseases such as HIV, malaria, tuberculosis and diarrhea in low-income countries.”

The Canadian and German governments and the Children’s Investment Fund Foundation committed $94 million to the fund, whose investors include the International Finance Corp., GlaxoSmithKline, Merck, and a number of other actors.

27. Sarah Boseley (Guardian) on new UNAIDS report – UNAIDS: HIV control gains threatened by rise in risky behaviour

http://www.theguardian.com/society/sarah-boseley-global-health/2013/sep/23/aids-and-hiv-unitednations?CMP=twt_gu

The new UNAIDS report applauds progress against HIV, but warns of unsafe behaviour in sub-Saharan Africa, faltering prevention efforts and a funding gap, Boseley says. You find the UNAIDS report  here.

28. KFF/UNAIDS report – Kaiser/UNAIDS study finds no real change in donor funding for HIV

http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prfinancing/

In this report, titled “Financing the Response to AIDS in Low- and Middle-Income Countries: International Assistance from Donor Governments in 2012”, the Kaiser Family Foundation and UNAIDS jointly evaluate international efforts to finance the response to the AIDS epidemic.   “The annual funding analysis finds donor governments disbursed $7.86 billion toward the AIDS response in low-and middle-income countries in 2012, essentially unchanged from the $7.63 billion level in 2011 after adjusting for inflation. Overall, donor government funding for HIV has stayed at about the same level since 2008 — a plateau that followed a period of dramatic growth that saw donor nation support increase more than six-fold between 2002 and 2008.”

29. Lancet (World Report) – Rheumatic heart disease back in the limelight

John Maurice;  http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61972-8/fulltext

Ahead of World Heart Day on Sept 29, a Lancet World Report focuses on rheumatic heart disease. 15-20 million people are believed to have rheumatic heart disease and nearly 300 000 new cases and 233 000 deaths occur every year, mostly in sub-Saharan Africa, central Asia, the Pacific Islands, and among indigenous populations in Australia and New Zealand. After much neglect internationally, rheumatic heart disease is drawing renewed attention from the health community and from the low-income countries most burdened by the disease.

30. KFF – House, Senate Lawmakers Introduce Legislation To Extend PEPFAR

http://kff.org/news-summary/house-senate-lawmakers-introduce-legislation-to-extend-pepfar/

Senior U.S. lawmakers introduced legislation in the Senate and House of Representatives on Wednesday to extend PEPFAR.  “The bill requires coordination by the Inspectors General to develop oversight and audit plans; extends reporting requirements for cost studies; caps U.S. participation in the Global Fund; requires a robust annual report; and protects funding for treatment for orphans and vulnerable children.”  (this is just a first step, but it can be an important one)

 

31. Lancet (Editorial) – Antibiotic resistance: a final warning

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62008-5/fulltext

This Lancet editorial comes back on the CDC report ‘Antibiotic Resistance Threats in the United States, 2013’. The editorial wonders: “Raising the profile of the problem of antimicrobial resistance is always welcome, but it begs the question of why we are still facing an issue identified decades ago?

 

However, momentum on this issue seems to be building (better late than never). On Sept 19—20, there was a meeting of WHO’s Strategic Technical Advisory Group on antimicrobial resistance, with the purpose of identifying the key issues and options that will feed into a new global strategy.

 

32. Change@WHO (September issue)

http://www.who.int/about/who_reform/change_at_who/change_at_who_sept2013.pdf

With some of the latest news on the WHO reform, including on the financing dialogue, etc.

 

33. UHC forward – Latin America’s Lessons for UHC

Joe Kutzin; http://uhcforward.org/blog/2013/sep/25/latin-americas-lessons-uhc

In a nice blog post, Joe Kutzin draws some lessons from Latin America for the current UHC drive elsewhere in the world.

34. Speaking of Medicine – Partnerships of Peril: Keeping Food, Alcohol and Beverage Industries Out of Global Health Governance

Heather Wipfli; http://blogs.plos.org/speakingofmedicine/2013/09/25/partnerships-of-peril-keeping-food-alcohol-and-beverage-industries-out-of-global-health-governance/

Heather Wipfli, from the University of Southern California, highlights the lack of consensus regarding the role of private industry in efforts to control the burden of non-communicable diseases.

35. APSA Special: Social movements and the politics of markets

Joshua Bushby; http://blogs.shu.edu/ghg/2013/09/25/apsa-special-social-movements-and-the-politics-of-markets/

Bushby unpacks the argument of this new book (with Ethan Kapstein as co-author), entitled “AIDS Drugs for All: Social Movements and Market Transformations”. In their book, they seek to answer the general question, “Under what conditions can social movements transform markets?  In the blog post, he then applies his ideas on the AIDS fight a decade ago and on the climate change fight – unfortunately, he considers climate change “the least likely case from our perspective for successful market transformation”.

36. Health Policy & Planning – Global health in foreign policy—and foreign policy in health? Evidence from the BRICS

Nicola F. Watt et al.;

http://heapol.oxfordjournals.org/content/early/2013/09/25/heapol.czt063.short?rss=1

This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines.

 

 

Global health bits & pieces

 

 

  • New book: ‘Reimagining global health’ (by Paul Farmer, Jim Kim et al.)

 

  • MERS: A WHO Emergency committee on Wednesday asked  countries to step up monitoring for the Middle East Respiratory Syndrome coronavirus (MERS-CoV) as Muslim pilgrims from around the world return home from the annual hajj in Saudi Arabia, home to most of the victims so far. Despite the concerns over MERS-CoV addressed during the meeting, “the committee decided against calling the outbreak a ‘Public Health Emergency of International Concern’: a situation that requires a certain level of immediate, coordinated international action.”

 

Global health announcements

 

 

Research

 

37. Globalization & Health – Does investment in the health sector promote or inhibit economic growth?

Aaron Reeves, Sanjay Basu, Martin McKee, Christopher Meissner and David Stuckler;

http://www.globalizationandhealth.com/content/9/1/43/Abstract

Is existing provision of health services in Europe affordable during the recession or could cuts damage economic growth? This debate centres on whether government spending has positive or negative effects on economic growth. In this study, authors evaluate the economic effects of alternative types of government spending by estimating “fiscal multipliers” (the return on investment for each $1 dollar of government spending).

38. Health Research Policy & systems – Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

Di McIntyre et al.;

http://www.health-policy-systems.com/content/11/1/36

Although UHC is a global health policy priority, there remains limited evidence on UHC reforms in LMICs. This paper provides an overview of key insights from case studies in the  thematic series, ‘Promoting universal financial protection’, undertaken in seven LMICs (Costa Rica, Georgia, India, Malawi, Nigeria, Tanzania, and Thailand) at very different stages in the transition to UHC.

 

Miscellaneous

 

39.  Post-2015 – Why another approach is needed

Jan Vandemoortele;

http://www.dhf.uu.se/publications/other-publications/post-2015-%E2%80%93-why-another-approach-is-needed-development-dialogue-paper-on-post-2015-perspectives/

Will the new development agenda make a real difference? No, not necessarily writes Jan Vandemoortele. Only strong leadership on the part of the UN Secretariat can prevent an overloaded and fuzzy development agenda. More consultations and intergovernmental negotiations alone will not make it.

 

 

  •  ODI publication – ‘Listening to 1 million voices: analysing the findings of the first one million MY World votes’ (by Claire Melamed et al)

 

 

  • The Guardian reports on a new study which shows that lots of foreign aid never reaches recipients.

 

 

  • New book by Angus Deaton,  ‘The Great Escape: Health, Wealth, and the Origins of Inequality’, in which he argues that international aid has been ineffective and even harmful. He suggests alternative efforts–including reforming incentives to drug companies and lifting trade restrictions–that will allow the developing world to bring about its own Great Escape.

 

 

  • Nancy Birdsall (CGD) has some nice reflections on an OECD dispute with Norway (over ODA).

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