Dear Colleagues,


We’re very pleased to start this newsletter with an Indian section today, compiled by EV 2012 Radhika Arora (currently studying at ITM), together with NS Prashanth, Upendra Bhojani and Swati Srivastava.  The selection covers recent health (policy) issues in the land of Bollywood and Mr. Modi. Swati also wrote this week’s guest editorial on the tobacco endgame in her country,  or at least the strategies that are being considered to eradicate ‘tobacco as we know it’. Just today, for example, BMJ also has a viewpoint on a media campaign for tobacco control in India. The rest of the newsletter focuses, as usual, on global health policy & financing news.


The key news of the week was the end of the shutdown and the political deal in the US. I never thought my birthday – 17 October – would be of worldwide interest, but for some reason this year it almost became ‘The Day The World Financial System Collapsed’. Then,  we would probably all have grinned, ‘I love the smell of financial napalm in the morning…’ in a forthcoming movie, but it wasn’t to be. Moderate Republicans still exist, even if they are a dying species. A few days ago, Warren Buffet said the debt limit is a ‘political weapon of mass destruction’. That might be true, but let’s face it, the financial sector in its entirety is now a weapon of mass destruction for the planet, as ‘the markets’ tend to cheer whenever there’s growth, with the planet as collateral damage. The whole system is as insane as the average Tea Party member. Anyway, I hope to live long enough to see a US Minister of State make this case, one day, in the Security Council. On the bright side, unlike the financial whizzkids, the military already gets it, see this Project Syndicate view: “Climate change is the greatest global security threat of the twenty-first century.”


Humanosphere ran a few posts on Jeffrey Sachs this week, including an interesting interview with the economist, in which he responds to some of the (many) criticisms he receives (pretty much like you and me swat flies, though). By now Jeffrey is the development economics equivalent of a national football coach, the man everybody loves to hate. Next year there will no doubt be hundreds of millions of people who think they can do a far better job in Brazil than the likes of Wilmots, Hodgson, Löwe et al, and there are probably also plenty of smart people who think they can do a better job than Jeffrey. But just like in the first case, they’re mostly wrong, because they’re not, like Jeffrey, the ‘posh white bloke who’s trying to save the world’ archetype, but more importantly, they lack the ego and drive necessary to do what he has done (together with a few other people): help the world realize that ending world poverty doesn’t need to be ‘fantasy’,  by backing up his case with numbers. This is perhaps his key achievement, as Tom Paulson rightly argues. So, in a few years from now, at least we can hum “Feed the wo – o – o – rld, good to know Jeff did the ma- a – th… ”  while marching to the food banks in our own countries. Aah, the wonders of globalization and convergence…   


World Food Day was celebrated this week, and the same was true for Global Handwashing day. In this newsletter, we also pay some attention to the WHO consultation on non-state actors, GAVI’s mid-term review, and there was – inevitably  – more debate on the post-2015 health agenda. And oh yes,  the Gates foundation joined IATI, great news.


Next week we hope to report from the Harare +25 conference in Dakar.


Enjoy your reading.


Kristof Decoster, An Appelmans, Peter Delobelle, Basile Keugoung & Wim Van Damme





Eliminating tobacco in a country of contrasts: “The Endgame”


Swati Srivastava (Research Associate Public Health Foundation of India, currently studying at ITM)


Last month, India hosted the International Conference on Public Health Priorities in the 21st Century: the Endgame for Tobacco, which deliberated upon policy issues for promoting public health by reducing the consumption of tobacco. The conference was also reflective of recent changes in the international tobacco control discourse, with the debate around tobacco shifting from discussions on tobacco-related harms in terms of mortality and morbidity, to one focused on hard, time-bound targets to eradicate tobacco. The conference resolutions called for countries to espouse composite strategies … to reduce … tobacco use to less than 5%, which is a tipping point of de-normalisation, at which countries are enabled to further completely eliminate all forms of tobacco consumption.” Strategies needed for this include: adoption of national action plans to meet “Endgame” targets; sustained government commitment; ratification and full implementation of the World Health Organization Framework Convention on Tobacco Control; increasing tobacco taxes to deter use, and earmarking of their revenue for financing public health (and not limited to tobacco control); mandating plain packaging for all tobacco products (as Australia has done); licensing policies for the entire tobacco manufacturing chain, including cultivation, manufacture, distribution and sale; alternate cropping and livelihood options for tobacco farmers to phase out production; and global ratification and implementation of the first protocol to eliminate illicit tobacco trade, among others. Some other (perhaps even more idealistic, but no doubt important) goals included the addition of tobacco control targets in the post-2015 development goals; ensuring that multi- and bi- lateral trade agreements do not infringe upon tobacco control; devising means for funding global tobacco control efforts; and adoption of policies to prohibit tobacco sales to all persons born after 2000 (as already proposed by Tasmania and Singapore, with similar plans in Ireland and Finland).


Many of these strategies are both timely and revolutionary, and are reflective of the massive change in tobacco control efforts required to engage and counter the pervasiveness of tobacco. In India, the Global Adult Tobacco Survey 2010 showed that more than a third (274.9 million persons) of the country’s adult population used tobacco: 21 percent smokeless users, 9 percent smokers, and 5 percent dual users. Nearly a third of Indian children want to smoke once they grow up. Considering that one in five Indian adults consume smokeless tobacco, the judgment of the Indian Supreme Court in 2011 to ban gutkha (a form of smokeless tobacco) under the Food Safety and Standards Act of 2011, was far-reaching. The act stipulates provisions to ban any food product (as gutkha is classified) which contains harmful adulterants, such as tobacco and nicotine. Many tobacco manufacturers have challenged this, leading to differences of opinions between various stakeholders and ministries. The health ministry endorsed this ban to extend to all smokeless tobacco products a few days ago. At present the enforcement of the ban is weak, with the result that gutkha manufacturing industry has proliferated in the unregulated informal sector, and gutkha can often be bought illicitly at prices several times higher than that in pre-ban days.  It remains to be seen how India can move towards a tobacco endgame, given the inconsistent implementation of its basic national provisions.


Another recent development in India is the new Companies Act, 2013, under which the Ministry of Corporate Affairs stipulates that any company having a turnover of greater than INR 500 crore (about 60.2 million Euros) would be required to constitute a Corporate Social Responsibility Committee, and allocate every year at least 2 percent of average net profits of three preceding financial years to corporate social responsibility activities. This is seen as a way of normalizing and legitimizing the tobacco industry and their investments in the social sector. Some such efforts include the National Recycling Day celebration of the Indian Tobacco Company (ITC), and various women’s self help and farmers groups they support.


Recent international developments highlight the necessity of the endgame, as so clearly elaborated in the New Delhi conference. The European Union recently passed a Tobacco Products Directive to ban packs of ten (which are easier for younger persons to afford) and flavored cigarettes (also favored by the youth), within three years. Tobacco companies however successfully lobbied to ensure a longer phase out time (eight years) for another youth favorite, menthol-flavored cigarettes. The draft law also brought forth another debate: many lawmakers were of the opinion that electronic cigarettes should be governed by the same regulations that apply to other tobacco products; while others thought of them similar to medicinal products such as nicotine patches or gums (an opinion vociferously shared by both tobacco companies and some doctors’ associations). Further away, Indonesia (which has not ratified the FCTC) recently filed a complaint with the World Trade Organization, challenging Australia’s plain packaging legislation, citing infringements of international trade rules and intellectual property rights of brands. Ukraine, Honduras, the Dominican Republic and Cuba, which are major cigar producers, have earlier challenged Australia’s legislation with the WTO.


These developments highlight the multiplicity and complexity of the tobacco problem, and how no single control measure has been sufficient on its own. The ambitious goal of ending tobacco is especially needed in a country like India, where government ministries are mandated to promote tobacco for fiscal gains over the cost to public health.  While the “Endgame” may seem radical and totalitarian, with questions being raised on the effectiveness and feasibility of prohibition policies as well as on limits to individual choice, it connects and amplifies many different tobacco control approaches into one unified voice.

India focus




UHC – Critical Overview

Author of the recent report, Health and Health Care in India: National opportunities, global impacts, David Taylor takes a critical look at measures towards universal health coverage in India. He emphasizes the need for improved access to essential medicines. Given the recent ruling against Novartis’ plea for a patent on its cancer drug, Glivek, Taylor argues that it is access to low cost, but effective treatments that should be the priority.


Blog, the Wall Street Journal: Roadblocks to universal health coverage in India


UHC – research (financing):

How are public health insurance schemes contributing towards UHC in India? Authors in this recent publication study the impact of India’s Rashtriya Swashtya Bima Yojna (RSBY) – health insurance scheme for those below the poverty line – on a family’s out of pocket expenditure on health care.


Research,  Health Research Policy and Systems: Promoting universal financial protection: evidence from the Rashtriya Swasthya Bima Yojana (RSBY) in Gujarat, India


UHC – news (recent initiatives)

Plans to  pilot universal coverage for health in the southern state of Karnataka in India were announced recently, the first of its kind. The focus would be on an essential health care package (watch this space for more on this!).


News/announced, The Hindu:  Ensuring healthcare services to one and all

See also UHC Forward:


Clinical trials

Alleged irregularities in the human papillomavirus virus vaccine trials in India (following the death of two girls in 2010 and on ethical recruitment of trial participants) sparked off the issue of regulations and ethics on clinical trials in India. Further, approvals of 162 international drug trials this year reinforced the need for appropriate legislation in this area. In response, the biomedical and health research regulation bill was proposed this year.


News feature, The Hindu: At last, a Bill to control unethical practices in biomedical health research

On the trials issue, see also an article from early September in the Lancet,   India’s amended trials regulations spark research exodus, and a brand new BMJ news article,

Health activists attack Indian compensation formula for deaths attributed to clinical trials.


Violence against women

In the months that followed what was perhaps India’s most widely covered rape case (16 December 2012), the country has seen the issue of violence against women emerge into the mainstream discourse. Women are at risk of gender based violence not just outside their homes, but within the confines of what one might consider a safe space.

Researchers from the Society for Nutrition, Education and Health Action (Mumbai) and the Institute for Global Health (London) find an alarming level of acceptance towards violence against women in their recent study on Intimate partner violence against women during and after pregnancy conducted in Mumbai, India. Their findings report that one in seven women suffered intimate partner violence during or just after pregnancy with more than 30% respondents justifying acts of violence.


Research Article, BMC Public Health: Intimate partner violence against women during and after pregnancy: a cross-sectional study in Mumbai slums

Sushmita Das et al


Disease outbreaks

Dengue fever cases continue to rise after an unusually long monsoon season this year. News articles and anecdotes indicate the number of dengue cases officially reported is far below the actual numbers, adding pressure to an already strained health system.


News piece, BBC: India battles dengue fever outbreak

Features/editorial, The New York Times: New Delhi’s Dengue Fever Problem


Drug patents

In April this year, in a landmark judgment by the Indian Supreme Court, Novartis lost its patent protection for Glivec, a drug used in the treatment of cancer. The decision, a reason to celebrate for the public health community has not just allowed for affordable access to the drug, but has also impacted patent applications for other life-saving drugs such. In august this year Swiss company Roche decided not to pursue its patent application for breast cancer drug Herceptin.


Reuters: Roche gives up on India patent for breast cancer drug

News feature, Open Magazine: The Law that saved a Billion Lives

Achal Prabhala, Sudhir Krishnaswamy



Post – 2015 & UHC


1.    UNA-UK: Global Development Goals – Leaving no one behind

UNA-UK released a major development publication, with also a section on health (with a number of essays (with analysis and recommendations) related to the post-2015 agenda and financing, mainly from Go4Health contributors (like Gorik Ooms, Devi Sridhar, Albrecht Jahn, …). The publication was released in the wake of the September 2013 UN Special event on the MDGs.


Action for Global Health gave its stance on the thematic report ‘Health in the framework of Sustainable development’ – see here. The consultation finished on October 2015.


I already mentioned in the intro the two articles by Tom Paulson (Humanosphere) on Jeffrey Sachs, including one interview with him, in which he responds to the criticism. See here for the first article.


2.    CFR – Health in the Post-2015 Development Agenda for Asia and the Pacific

Yanzhong Huang et al.;

The paper discusses the key health challenges in the post-2015 development agenda for Asia and the Pacific, a highly populated, diverse region of countries with different health needs and priorities. Drawing on the regional, thematic, and subregional consultations and on expert views in and outside of the Asian Development Bank (ADB), this paper argues that the post-2015 development agenda needs to address health in a more systematic way in one global goal, and in more specific national goals that focus on country-specific health needs in and outside the health sector. The paper also provides entry points for ADB to support a post-2015 health agenda in its developing member countries, and highlights the importance of strengthening regional corporation and integration to tackle emerging health challenges.


3.    World Bank (webcast) – What Will It Take to Achieve Both Healthy Children and Healthy Economies?

This is the webcast from a World Bank event which took place on October 11. From the announcement: “Healthy and prosperous economies start with healthy children born to healthy women. Yet with fewer than 900 days left until the 2015 deadline for the Millennium Development Goals, the lives of millions of children and pregnant women remain in the balance. This World Bank forum will underscore the linkages between progress on maternal and child health and economic growth, with a focus on the importance of nutrition and family planning; showcase smart investments that countries are making; identify remaining gaps; and coordinate action around country and development partner commitments.”  See also this blog post.


4.    CGD – All Hands on Deck for a Handwashing Indicator

Victoria Fan & Rachel Silverman;

A post dedicated to ‘Global handwashing day’:  “Handwashing remains neglected among global health priorities, and has long laid in the shadows of its more prominent siblings – water and sanitation”, argue Fan & Silverman. It’s time to do something about it, for example with a handwashing indicator.


Another issue neglected on the global health agenda is the burden of injury in LMICs – check out this blog post on ‘Health Policy & Planning debated’ (by Richard Matzopoulos, from South-Africa).


5.    Oxfam – From Poverty to Power (blog) – A new consensus on universal health coverage, the threat posed by health insurance schemes and some bizarre conference dancing

Ceri Averill;

People around the world keep blogging about UHC. Oxfam health policy adviser Ceri Averill ponders the new consensus on UHC and the potential threat posed by health insurance schemes.


6.    Rockefeller Foundation – Universal Health Coverage Relevant for All Countries

Robert Marten;

Another interesting (and short!) blog post came from Robert Marten. He has two take away messages after the General Assembly, on the relevance of the Save the Children Report, and the fact that countries are taking the lead now.

7.    Asian Development Blog – Why universal health coverage needs better measurements

Susann Roth;

This blog post zooms in on Asia and the Pacific, and stresses the need for common indicators to assess progress towards UHC. The Asian development Bank will also assist developing member countries to design and implement cost-effective “hybrid” systems (combining elements from an NHS-style system & a social health insurance model).


8.    UHC forward – Extending Coverage to the Informal Sector: JLN Countries Exchange Lessons and Challenges with Indonesia

Annette Ozaltin;

The author of this blog post reports on a high level forum which took place on September 30 – October 2 in Indonesia, on how to attain health coverage for households dependent on informal sector workers. The High Level Forum on Expanding Coverage to the Informal Sector was supported by the Joint Learning Network, AusAID, GIZ, WHO and the World Bank.


9.    Foreign Affairs – Doomed From the Start – Why Obamacare’s Disastrous Rollout is No Surprise

Kimberly J. Morgan;

The fact that the White House is having trouble implementing Obamacare should not come as a particular surprise. It is not that the Obama administration is especially incompetent. Rather, the program it is charged with executing is a complex public-private hybrid that has no real precedent elsewhere in the world.”


Meanwhile, now that the shutdown is over, the Global Health Council informs us of how the US budget process will work, in the coming months, if all goes well, with a timeline. (this is the Harry Potter scenario, in other words)



WHO consultation on non-state actors


An informal WHO consultation with member states and non-state actors on WHO’s engagement with non-state actors is taking place (17-18 October). For a first impression, see MMI’s Thomas Schwarz (in a blog post ).


In the run-up to the meeting, background documents/discussion papers were released by WHO on WHO’s engagement with non-state actors  and with ngos.


The presentation by WHO,   ‘Due diligence, management of

risks & transparency – Informal consultation on WHO’s engagement with non-State actors’  you find here.


10. Democratizing Global Health Coalition – Statement of concern on the informal consultation on WHO’s engagement with non-state actors

Members of the Democratizing Global Health Coalition are worried about the dangers  that the ‘Non-State Actors Approach’ entails for health democracy. “The semantic disguise of “non-state actors” ignores this fundamental difference and blurs the lines between those that work for public health interest and those that do not.” Members of this coalition are concerned that “this October consultation – by lumping the business actors together with public interest actors in the same arena – ultimately re-proposes the same format of an open multi-stakeholder forum, a World Health Forum” (as you might remember, an idea proposed before).


For a Statement by the PHM, see here.


Infectious disease


11. Lancet Global health – Country ownership and the turning point for HIV/AIDS

Chris Collins et al.;

Increased country ownership is fundamental to long-term progress in global health, but too rapid a transition runs the very real risk of undercutting access to services and squandering the potential to accelerate progress in HIV/AIDS”, argue Collins et al. “Not all partners are ready; countries heavily affected by HIV include some middle-income countries with substantial internal resources, and some UN least-developed nations that will probably need sustained donor support and building of technical capacity for years to come. Four areas raise particular concern and deserve close attention.”

12. UNAIDS – Brazil pioneers treatment for everyone

Some 100 000 more people living with HIV in Brazil are set to receive life-saving ART under a major new initiative that will offer early treatment to all HIV-positive adults. It is estimated that between 430 000 and 520 000 people are living with HIV in Brazil — just over 300 000 of which are currently accessing treatment.


13. Lancet World Report – MIM conference focuses on malaria elimination

Adele Baleta;

Researchers gathered for the 6th Multilateral Initiative in Malaria (MIM) Pan-African Conference last week to discuss challenges to malaria elimination. Adele Baleta reports from Durban.


14. Science Speaks – Clinician scientists urge support for PEPFAR bill, while we’re reading about the high stakes of the U.S. global health response

Antigone Barton;

The Science Speaks blog provides an update on the PEPFAR Stewardship and Oversight Bill of 2013. With the slowdown, action on the bill had slowed, but it’s time to pick it up again now.  “The Center for Global Health Policy, which produces this blog, is urging support for the legislation, which 253 clinicians and scientists rallied behind, with a letter to Senate members.”


15. CGD  – Seeking Results from PEPFAR’s Orphans and Vulnerable Children Programs

Sarah Rose;

PEPFAR’s efforts to define outcomes of interest for its Orphans and Vulnerable Children programming are a big step forward for increasing learning and accountability, Rose contends, but more is necessary.

16. Lancet (Health Policy) – The Global Drug Facility and its role in the market for tuberculosis drugs

Nimalan Arinaminpathy et al.;

This article already appeared early online a while ago. Universal access to high-quality treatment is central to the Global Plan to Stop TB. The Global Drug Facility (GDF) was launched in 2001 to help to achieve this goal, through services including the supply of affordable, quality-assured drugs to countries in need. The authors assess the scale of GDF drug supplies worldwide and find that the GDF commands a substantial proportion of the market for drugs for first-line and second-line treatment regimens, having supplied, for example, first-line drugs for roughly 35% of cases reported worldwide in 2011. Significant potential remains for GDF expansion, especially in the provision of second-line drugs, which would be aided by future increases in case detection.





17. BMJ (Editorial) – The endgame for tobacco

Anita Jain;

Jain reports on the recent Tobacco Endgame conference in Delhi (see also our guest editorial this week), and on some of the endgame strategies suggested. A new Indian law  requires all television programmes and films to carry prominent anti-tobacco messages, for example. Bollywood isn’t happy.


As for the BMJ editors, the endgame has definitely begun: “In response to the tobacco industry’s deliberate attempts to propagate doubt around the harmful effects of tobacco in both scientific and popular media, we, at the BMJ, have taken a stand. The editors of the BMJ, Tobacco Control, Heart, Thorax, and BMJ Open refuse to publish research funded by the tobacco industry hereafter. In doing so, they affirm their commitment to not allow the journals “to be used in the service of an industry that continues to perpetuate the most deadly disease epidemic of our times.”  (see also here).


18. Globalization & Health (Commentary) – A new generation of trade policy: potential risks to diet-related health from the trans pacific partnership agreement

Sharon Friel, Deborah Gleeson, Anne-Marie Thow, Ronald Labonte, David Stuckler, Adrian Kay and Wendy Snowdon;

Trade poses risks and opportunities to public health nutrition. This paper discusses the potential food-related public health risks of a radical new kind of trade agreement: the Trans Pacific Partnership agreement (TPP).


19. NYT – Mexico Takes Bloomberg-Like Swing at Soaring Obesity

Mexico’s President Enrique Peña Nieto has proposed a tax on sales of all sugary drinks. “If it goes through, the tax will make Mexico a rare test case of a national soda tax directed at a severe obesity problem.” New York Mayor Michael Bloomberg’s foundation is supporting the effort. “Its three-year, $10 million grant is being used to support anti-obesity advertising campaigns, finance research at Mexico’s National Institute of Public Health and promote policies like the soda tax, nutrition labeling and controls on junk-food television advertising aimed at children. The foundation, Bloomberg Philanthropies, calls its work in Mexico a pilot project that could be adapted to other developing countries if it is successful“.  Interesting…


20. UNDP Discussion paper – Discussion Paper: Addressing the Social Determinants of Noncommunicable Diseases–addressing-the-social-determinants-of-noncommu.html

This paper offers two unique contributions to existing global and regional frameworks on multisectoral action on NCDs and their social determinants.


Human resources for Health


21. BMJ (Editorial) – Challenges posed by the global crisis in the health workforce

James Buchan et al.;

In May 2013, the World Health Assembly recognised that renewed attention to the “health workforce crisis” is central to achieving quality healthcare through universal health coverage. Next month, the Third Global Forum on Human Resources for Health will convene to agree on what can and should be done across all countries to solve the crisis. Often oversimplified as a numerical shortage of healthcare workers, the crisis also has management, quality, location, and performance dimensions. These problems have often been recognised (hence the much used phrase “right staff, right place, right time, right skills”) but rarely dealt with effectively.” This editorial mainly zooms in on what needs to be done in developed countries, to cope with all the HRH challenges in an era of austerity & ageing, but is still a good read for everybody.



GAVI mid-term review



22. Lancet (Editorial) – The GAVI Alliance—successes and ongoing challenges

This editorial zooms in on the GAVI mid- term review, which was published ahead of a mutual accountability meeting on Oct 30, in Stockholm, Sweden, to take stock of GAVI’s progress in immunisation and resource mobilisation since 2011. GAVI is on track to immunize a quarter of a billion children against killer diseases by 2015.


For the review, see here.



Health Policy & Financing


23. German global health policy – Shaping Global Health Taking Joing Action Embracing Responsibility

The draft strategy paper ‘Shaping Global Health Taking Joint Action Embracing Responsibility’ of the German Federal Government is now also available in English. The German focus is five-fold on (i) providing effective protection against cross-border threats to health (ii) strengthening health systems throughout the world (iii) increasing intersectoral cooperation and interaction with other policy areas (iv) promoting health research and the health care industry (v) strengthening the global health architecture. Will be interesting to see how Angela Merkel refers to it, next week at the World Health Summit in Berlin.


24. Impatient Optimist – Information Sharing for Impact

Jeff Raikes;

The Gates foundation joined the International Aid Transparency Initiative (IATI), which is working to make information about spending on development easier to access, understand, and use. Great news.


25. IHP – More than alive and kicking: Latin America’s People’s Health Movement gathers in Cuenca

Mauricio Torres;

Always lovely to make the switch from the Gates Foundation to the People’s Health Movement. EV 2010 Mauricio Torres and PHM activist reports on a regional People’s Health Movement Assembly, in Cuenca, Ecuador, ready to take on capitalism. That’s the spirit.


26. Lancet Global Health – Hajj: preparations underway

Ziad A Memish et al.;

Around 3 million Muslims around the world have started congregating this week in Mekka and Medina in Saudi Arabia to perform the religious pilgrimage, Hajj. The annual mass gathering has long been a public health challenge and this year WHO is invited as a special guest to learn from the Saudi experience (see WHO). The Middle East respiratory syndrome coronavirus (MERS-CoV) which recently caused several deaths may pose an extra risk to the Hajjees. Free of charge health services have been set up and pilgrim resident countries have been asked to increase their surveillance system and to install check points for returning pilgrims.




27. BMJ (news) – Burden of dengue fever is higher than previously thought

Anne Gulland;

Governments are seriously underestimating the numbers of people infected with dengue fever, a conference in London has heard.



The journal Globalization and health features a number of interesting articles, this week, including:


  • An article on ‘Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health’.  (for the ones among you who are being spammed with Viagra adverts and – in the jargon – ‘other stuff to teach hot chicks a lesson’)
  • one on ‘Strengthening the evidence-policy interface for patient safety: enhancing global health through hospital partnerships’.
  • A debate on ‘Developing global health technology standards: what can other industries teach us?’ ( This Debate article aims to convince the reader that standards can benefit global health technologies if we learn lessons from other industries. The article draws from historical examples and the authors’ experiences to suggest principles, challenges, and opportunities in developing these standards. If implemented well, standardized platforms can lower barriers to entry, improve affordability, and create a vibrant ecosystem of innovative new global health technologies.)



Reverse innovation


28. BMJ (news) – UK should adopt cheap methods of healthcare delivery from poorer countries

Gareth Iacobucci;

Across the west, the cost for healthcare is rising. That is because the systems are often focused on the most expensive resources and not always on the most efficient methods. Systems designed for LICs are now testing the upmarket models. The NHS in England can learn from advances in poorer countries to stand the test, says the healthcare regulator Monitor.


This week’s Lancet Correspondence section has a number of articles on Community Health Workers – as an opportunity for reverse innovation (see

here and here). (By the way, it also seems time for ‘governance’ reverse innovation, for the US. We welcome all viewpoints on this, for IHP.)


Global health bits & pieces


  • “The International Agency for Research on Cancer declared on Thursday that air pollution is a carcinogen, alongside known dangers such as asbestos, tobacco and ultraviolet radiation,” the Associated Press reports.


  • For the IHP+ newsletter from August & September, see  here.



29. Lancet (Editorial) – Integrity in research collaborations: The Montreal Statement

Last week, new guidance was issued as an outcome of the 3rd World Conference on Research Integrity, held in May in Montreal, Canada. The Montreal Statement on Research Integrity in Cross-Boundary Research Collaborations was developed before, during, and after the conference. Three workshop sessions at the conference were dedicated to in-depth discussions and further comments after the conference were taken into account to arrive at this version. Cross-boundary research includes collaboration between different institutions, disciplines, sectors, and countries. The Montreal Statement builds on the Singapore Statement, issued after the 2nd World Conference, which was the first international effort to set out common principles and responsibilities for research integrity.”

30. Lancet Infectious diseases – No increase in sexual risk-taking seen in partners who know they are protected from HIV transmission by prophylactic drugs

Kenneth K Mugwanya et al.;

Pre-exposure prophylaxis (PrEP), was reported in 2011 to be a new HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk of becoming infected. This risk reduction could be perverted if people using such HIV prevention strategies would be involved in increased sexual behaviour due to knowledge of PrEP efficacy for HIV prevention. An assessment by means of a longitudinal analysis, funded by the Gates Foundation and the US National Institute for Mental Health, shows that PreP, provided as part of a full prevention package, might not result in substantial changes in risk-taking sexual behavior by heterosexual couples. (in other words, they don’t start to behave like deranged actors in ‘Spartacus’)

31. WHO Bulletin – Evidence briefs and deliberative dialogues: perceptions and intentions to act on the information gleaned

Kaelan A Moat,a John N Lavis,b Sarah J Clancy,c Fadi El-Jardali,d & Tomas Pantojae for the Knowledge Translation Platform Evaluation study team;

Nice paper on knowledge translation. The objective of this paper was to develop and implement a method for the evaluation of “evidence briefs” and “deliberative dialogues” that could be applied to comparative studies of similar strategies used in the support of evidence-informed policy-making.


32. Social Science & Medicine – Brain drain: Do economic conditions “push” doctors out of developing countries?

Edward N. Okeke;

Brain-drain or human capital migration is often analyzed in terms of push and pull factors. This study analyzed data on health professionals migration from 31 African countries from 1975 to 2004. It finds a strong correlation between GDP decline and migration increase. They conclude that there is strong indication that economic conditions affect migration of doctors. (bring on the Nobel Prize economics!)

33. Health Research Policy & Systems – Health policy and system research in access to medicines: a prioritized agenda for low- and middle-income countries

Maryam Bigdeli et al.;

This article aimed to identify priority policy issues in access to medicines relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research agenda.

34. TMIH (Review) – Registering medicines for low-income countries: how suitable are the stringent review procedures of the World Health Organisation, the US Food and Drug Administration and the European Medicines Agency?

Joachim Y. Doua, Jean-Pierre Van Geertruyden;

New medicines are registered after a resource-demanding process. Unfortunately, in low-income countries, demand outweighs resources. To facilitate registration in LICs, stringent review procedures of the European Medicines Agency (EMA Article-58), Food and Drug Administration (FDA PEPFAR-linked review) and WHO Prequalification programme have been established. Only the PEPFAR-linked review gives approval, while the others make recommendations for approval. This study assessed the performance and discussed the challenges of these three stringent review procedures.

35. International Journal for Equity in health – Influence of mhealth interventions on gender relations in developing countries: a systematic literature review

Larissa Jennings and Laina Gagliardi;

Research has shown that mHealth initiatives, or health programs enhanced by mobile phone technologies, can foster women’s empowerment. Yet, there is growing concern that mobile-based programs geared towards women may exacerbate gender inequalities.

36. Speaking of Medicine – New content added to PLOS-Maternal Health Task Force Collection Year 2

The Maternal Health Task Force (MHTF) and PLOS Medicine announced the addition of 15 recently published articles for the Year 2 Collection on the theme ‘Maternal Health Is Women’s Health’. This theme was created to highlight the need to consider maternal health in the context of a women’s health throughout her lifespan.


Global Health Announcements


If you happen to be in Paris these days, The ‘Colloque de rentrée du Collège de France’, on Science and Democracy, is taking place as we speak. Videos will be available next week,  here.  For the programme, see  here.






  • France published its official position on the post-2015 era.


  • Big business is allowed to precook climate negotiations behind closed doors, and the Polish minister in charge apparently thinks this is ‘best practice’ (i.e. needs to be implemented before all future COPs, in other words).


  • Devex reports on the latest Aidwatch report by CONCORD (see  here ).

The deadline for traditional donors, including European countries, to meet their aid targets is only less than two years. But instead of moving forward, EU aid is expected to remain almost stagnant, with several countries set for further cuts in coming years.”  (meanwhile, on a more cheerful note, apparently Barroso narrowly escaped eggs at a Belgian debate )

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