Dear Colleagues,

The world (or was it part of the Western world and media only?) was concerned / enraged about a number of issues, countries and institutions this week. The rise of cancer worldwide, Female Genital Mutilation, the Vatican, anti-gay laws in Russia  and elsewhere, corruption in the EU, corruption in Russia,  global trade agreements, the mess in South-Sudan and the Central-African Republic,  Egypt, the horror in Syria, yet another awful law in Afghanistan,  … and we obviously forget many sorry hotspots and causes. All of these causes are extremely important ones, and in many cases a matter of life or death for hundreds of thousands of people. But how do we, human beings, manage to focus? How do we avoid that people read something and say – yes, it’s true and it’s a shame – and then move on to the next horror item online or in their newspaper? At some point people just switch off and focus on their own lives, hoping that activists and world leaders take care of these issues (but probably knowing better). Or they just watch their favourite show or series on tv.

True, you can also think of a similar series of encouraging news items this week – from Morocco, or Rouhanicare, to Google’s worldwide Sochi message,  where brave activists, bold politicians and even big corporations make a difference. But they often feel like drops in the ocean. (by now you probably think I just need to read Seligman)

Anyway, you get the point. The same seems true for the grand ideas and frameworks for the post-2015 era, like UHC, the SDGs, the Grand Convergence, … People say, yes it’s true, we should absolutely do this, but how do you manage to sustain the momentum in an era where people are so easily distracted online – to the extent that some trendwatchers now even talk about the need for “slowcial media”, to mitigate the apparently dreadful impact social media have on the attention span of most of us. I still remember the time I waited for a bus, somewhere in Himachal Pradesh, India, about 10 years ago. I had to wait for 5 hours somewhere in the middle of nowhere, and there was nothing: no smartphone, no other people to talk to, I didn’t even have a pocketbook from my favourite mystic with me; there were just a few bad smelling goats wandering in the street ….  And it was divine. These days are long gone, now I’m back in the “civilized” world.

So how do you get people focused and mobilized to move a new social and ecological agenda forward, fit for the 21st century, in a world of information overload and so many competing priorities, distractions, fragmentation of interests and media, with all this frantic branding of  different initiatives, … and how can you sustain these movements (if you manage to create them in the first place)? I wouldn’t know.  Even the best analyses, by some of the smartest and most committed people around, just seem to drown in an endless ocean of information, framing and/or spin. It’s something of a miracle that out of this cacophony the world still seems to have made progress in recent decades, even if that progress is now in danger.

In Belgium a very successful politician of the nineties declared a while ago he didn’t feel like a politician fit for the new age of social media, 24 hour news cycles etc. And sure enough, when they asked him to come back, as the “savior”, he failed. The question is: do they actually exist, politicians who can cope with the new times? Or do they all feel like David Cameron, who said that being a prime minister is pretty much like standing in an asteroid shower? Not that it’s much different for captains of industry and scientists these days – just think of the broken peer review system for the latter – they also have to think of new ways to survive in a more unstable and fast changing era. Check out this nice article by Jason Priem  from last year (in  Nature ) on the imminent changes in science, with advanced algorithms to filter, rate and disseminate scholarship. If all these categories of people, who presumably know better how to deal with information overload than others, already struggle – what can you expect from the average citizen, then?  

And to come back on these politicians, can we really expect them to hammer out a visionary post-MDG/SDG deal with so many conflicting messages reaching them? And that’s just for the politicians who have some long term vision themselves – as we know, there are plenty of others in the game. (Yes, I’ll read Seligman, I promise)

In this week’s guest editorial, in the international debate on homophobia, we offer you an Indian perspective. After a sub-Saharan EV view (last week), Mridula Shankar (EV 2012) and colleagues discuss the very controversial Section 377 of the Indian penal code, the backdrop for the LGTB discussion in this BRICs country, and what donors and international stakeholders can do.


Enjoy your reading.

Kristof Decoster, Werner Soors, Peter Vermeiren, Basile Keugoung & Wim Van Damme



Section 377 of the Indian Penal Code: Justice at Stake


Mridula Shankar (EV 2012) with inputs from Radhika Arora (EV2012), BL Himabindu &  Prashanth NS (EV 2010)


At the Global Day of Rage against the re-criminalization of homosexuality in India, a protester’s placard reads, “Went to bed in 2013, woke up in 1860.”

The path towards advancing sexual rights of Indians has been far from linear. On December 11, 2013, India’s Supreme Court (SC) reinstated Section 377 of the Indian Penal Code, drafted 153 years earlier under British colonial rule. The law deems “carnal intercourse against the order of nature with any man, woman or animal” criminal, thereby prohibiting any non-procreative forms of sexual intercourse. The weight of the law has fallen squarely on male homosexual sex. While this law may have been infrequently used in court judgments, its very existence is used as a basis for bullying and threats of arrest of gay men and transgender persons, harassment of NGOs working with sexual minorities and stigma and discrimination of these populations.   In one instance, staff from two NGOs (Bharosa trust and the Naz foundation) engaging in HIV/AIDS prevention work with sexual minorities were arrested under section 377 and remanded in custody for 48 days for “encouraging young persons and abetting them for committing the offence of sodomy.”

In 2009, in an internationally applauded judgment, the Delhi High Court (HC) ruled in favor of “reading down” Section 377,  thus de-crimininalizing adult consensual sexual acts in private.  This judgment, and the run-up to it are significant for the following reasons. First, key arguments in the case centered around the law’s violation of the fundamental rights of equality, liberty and non-discrimination enshrined in the Indian constitution, and its grave implications on the health of MSM (men having sex with men) populations, specifically in the context of HIV prevention and treatment. Second, the movement in support of repealing Section 377 saw the coming-together of diverse civil society groups (“Voices against Section 377”) working and advocating for human rights and social justice, forging national solidarity and bringing the issue of sexual rights into public domain, generating dialogue through awareness building and publicity campaigns.

As a reaction to the HC judgment however, a rare coalition of Hindu, Muslim and Christian groups formed to oppose the verdict and challenge it in the SC.  Their arguments were nothing new: homosexuality is a western construct; it fundamentally goes against the moral grain of Indian culture; sexual relations outside those shared between a man and a woman are sinful. Such sentiments reflect the uneasiness, or sometimes, downright denial of the role that sex and sexuality have played in the culture and history of the sub-continent. The Khajuraho monuments built in the 10th and 11th centuries and known for their erotic sculptures, depict sexual positions between individuals of the same sex; Vatsyayana’s Kamasutra- an ancient Sanskrit text on human sexual behavior, illustrates in detail homosexual acts between men, women, and eunuchs.  Vatsyayana himself expresses a certain level of disdain towards individuals engaging in these acts, however, at the very least, there is acknowledgment and some tolerance of homosexual behavior. Stories of male gods and men metamorphosing into women and vice-versa in the Indian classical works (Mahabharata and the Puranas among other epics) depict the plurality and fluidity of sexualities within ancient Indian society. (For more on this, see here) While the lens of hetero-normativity has never been cast aside entirely, criminalization of sexual practices came along with colonial conquest and has remained through independence, adding an additional layer of discrimination in a deeply patriarchal society where gender norms and relations of power operate through multiple mechanisms to subordinate girls, women and sexual minorities.

The December 2013 judgment of the SC comes as an offense to human dignity and equality and is in conflict with the ideals of justice. In January 2014, the SC refused review of this verdict, posing a dead-end to those seeking a judicial route to correct an archaic and discriminatory law. The consequences are enormous and will also be felt by the already marginalized transgender hijra communities across the country. The “unnatural practices” criminalized by the SC form an integral and visible component of their identity, sexuality and often livelihoods. They  will now face further harassment and humiliation by the police and greater insensitivity at the hands of an already unsympathetic healthcare system.

With national elections around the corner and in the current political and social climate, this human rights issue will not receive the due attention and priority needed for members of Parliament to agree upon and push for corrective legislation. While some political parties have publicly voiced their disappointment with this ruling, the BJP (the major party sitting in the Opposition) and its front-running candidate for the prime ministerial post, Narendra Modi, among others, are conspicuous in their silence on this issue. A parliamentary route to amend Section 377 in the near term appears bleak. In this milieu the role of international governments and donors is not to threaten sanctions or restrict international aid, but instead to be vocal about their dissent against the law. Further, India can and should be made accountable for violating the International Covenant on Civil and Political Rights, which it has signed and ratified, by having a national law that is discriminatory on the basis of sexual orientation of its citizens. This matter should be called to attention in public fora such as in multilateral global meetings, international sporting events, in the UN, and elsewhere. Donors and governments can also direct aid to improve access and the removal of barriers to healthcare for discriminated groups, while also funding civil society groups in the country to demand and push for the restoration of the fundamental rights of a significant section of the Indian population.



UHC & post-2015


1.    WHO Bulletin (Editorial) – No universal health coverage without strong local health systems

Bruno Meessen & Belma Malanda for the Community of Practice “Health Service Delivery;

The new February issue of WHO Bulletin features, among other articles, this editorial about the continued importance of strong local health systems and the need for an update of the health district strategy, also with a view on turning UHC into reality. Africa is moving towards a “Health District 2.0” era, characterized by more pluralism, broad actor mobilization and constant learning. The agenda has been set, Bruno Meessen and Belma Malanda argue, the next stage is now to work with countries to realize this vision. Check out also the other articles in the Bulletin.


As a reminder, you can still comment on the December 2013 Discussion paper by WHO and the World Bank proposing a framework for the monitoring of UHC at country and global levels. Send your comments before February 15 to


2.    Equinet – Universal health coverage: uncovering the neoliberal agenda

Amit Sengupta, National Co-convenor, Jan Swasthya Abhiyan, India

Some titles just turn me on. This title – the Equinet editorial from this month’s issue – is one of them. Yet, as with Bill Gates (see last week’s newsletter), I still think the benefits of a global UHC agenda still outweigh possible drawbacks. By far, actually, if done well.


3.    Lancet Global Health (blog) – Universal health coverage in Africa: where is civil society?

Biodun Awosusi;

A strong civil society is essential for realizing the lofty goal of achieving UHC, argues B Awosusi. While the ongoing global discussions around UHC have largely focused on the role of government and development partners in designing and implementing risk pooling mechanisms that have the potential to improve access to essential health services, there has been little discussion on the key role that local civil society organizations play to ensure various communities support UHC and hold governments accountable.


As for the latest on some country UHC experiences, read the World Bank’s Tim Evans on UHC & Myanmar, the World Bank on lessons learned from Indonesia’s Jamkesmas scheme to achieve UHC in the country, and check out the funny tweet from the Iranian leader on Wednesday, on his plans to extend health care to all Iranians – aka “Rouhanicare”.


4.    Morning Star – Rethinking the MDGs for the world of today

Sarah Edwards (Health Poverty Action);

This week, the UN’s Open Working Group (OWG) came together on the Sustainable Development Goals, in its eighth and final session. OWG is due to draw out a set of concrete proposals to submit to the General Assembly, which is expected to hammer out the parameters of a new global development framework next September. In this article, Sarah Edwards explains how the goals can be made more meaningful for women in developing countries.


For more info on this eight session of the Open Working Group on SDGs, see here.



Global Fund & GAVI


5.    Global Fund observer new issue

The new GFO issue reports on the signing of a first regional grant under the new funding model, bringing $100 million to the Greater Mekong sub-region for a wide-ranging initiative to avert the spread of artemisinin resistance within five malaria endemic countries; it also has an article on the transition of Russia from recipient to donor of Global Fund grants, which prompts concerns from civil society about potential gaps in service delivery, specifically related to prevention and harm reduction activities; there’s a short article about a new review paper which explores the nature of the relationship between Local Fund Agents and the Fund and the lessons learned over the last 12 years; and more.




In other GF related news, the Fund accepted recommendations of its Sanctions Panel to reprimand two international suppliers of mosquito nets and to set mandatory terms for continued engagement in the future.


6.    Global Public Health – new articles on GF, HIV-scale up, …

Global Public Health released a number of articles this week related to the Global Fund, HIV-scale up in general, ownership, Aids policy responsiveness in Africa, etc.

Check out for example the following articles:

  • After the Global Fund: Who can sustain the HIV/AIDS response in Peru and how?
  • Elusive accountabilities in the HIV scale-up: ‘Ownership’ as a functional tautology
  • Evidence and AIDS activism: HIV scale-up and the contemporary politics of knowledge in global public health
  • Meaningful change or more of the same? The Global Fund’s new funding model and the politics of HIV scale-up
  • AIDS policy responsiveness in Africa: Evidence from opinion surveys


7.    GAVI news


A GAVI press release was dedicated to World Cancer Day (see below), saying that an estimated 206,000 girls in 10 developing countries are expected to benefit from the introduction of human papillomavirus (HPV) vaccine, which protects against the leading cause of cervical cancer.


Dr Robert Newman was appointed head of policy & performance.


And perhaps the most encouraging news came from India: the country committed 4 million dollar to GAVI alliance vaccine programmes.





8.    Lancet (World Report) – Discrimination against LGBT people triggers health concerns

Fiona Clark;

Several countries are introducing anti-gay laws and homophobia seems to be increasing in nations usually thought of as liberal. What are the health consequences? Fiona Clark reports.


9.    Science Speaks – Nigeria Same Sex Marriage Prohibition law raises questions of donor response

Science Speaks;

The Center for Global Health Policy’s “Science Speaks” blog examines how Nigeria’s Same Sex Marriage Prohibition Act might impact foreign aid to the country.


10. CIVICUS – 25 African CSOs oppose Ugandan anti-homosexuality bill

In Uganda, the anti-homosexuality bill is currently awaiting President Yoweri Museveni’s signature. President Museveni has 30 days from 23 January 2014 when the bill was presented to him to either sign it into law or return it back to Parliament for reconsideration. CIVICUS has coordinated a joint letter by 25 civil society groups based in Africa urging President Museveni to reject the bill.

As for the actions taken by a number of clinicians, scientists, and academics in Uganda, check out this  article in Science Speaks.


Infectious Disease


11. IRIN – Connectivity and emerging infectious diseases in Southeast Asia

Irin news; “Experts sometimes describe Southeast Asia as a ‘hotspot’ for emerging infectious diseases (EIDs) because several major outbreaks have started in this region. Now, with unprecedented levels of connection between animals and people through urbanization, and of people with other people through increased air travel, scientists say the threat level for new diseases is high…”

Not really South-East Asia, but not very far away, is China. The country still grapples with H7N9 avian influenza, but the country’s health authorities have now also reported the first known human death from a different avian flu virus, type H10N8 (see this BMJ news article and also a Comment in the Lancet).


12. Amfar issue brief – The Investment Case for Global AIDS Funding: Getting Smarter, Showing Results–Getting-Smarter,-Showing-Results/

This issue brief lays out the investment case for AIDS funding. “Investing now to bring essential HIV prevention and treatment services to scale enables the global response to outpace the epidemic itself, saving both lives and money over the long run. By contrast, shortchanging HIV spending now merely allows the epidemic to expand, adding to long-term health and economic costs.”

Unfortunately, the homophobic backlash in SSA and elsewhere begins to resemble the situation (including the importance of culture, religion & politics) in countries like Nigeria, Afghanistan & Pakistan for the cause of polio eradication. Getting to the ‘end of AIDS’ will be tough. But nobody ever said the opposite.

Amfar also announced its “Countdown to a Cure” initiative, a research initiative aimed at finding a broadly applicable cure for HIV by 2020. ‘Countdown to a Cure’ is designed to intensify Amfar’s cure-focused HIV research program with plans to strategically invest $100 million in cure research over the next six years.


13. Science Speaks – PrEP should be looked at as “critical component” to address HIV among men who have sex with men, review concludes

Speaking of MSM, in a “truly watershed period for lesbian gay bisexual and transgender rights and freedoms,” in the global north, the few prevention methods that work for men who have sex with men need to rapidly be taken to scale, particularly pre-exposure prophylaxis (PrEP), Dr. Chris Beyrer writes in a new piece published in Current Opinions in Infectious Diseases.

14. NEJM (Perspective) – Ending AIDS — Is an HIV Vaccine Necessary?

Anthony Fauci;

The new issue of The New England Journal of Medicine features a perspective piece and interview exploring different strategies to prevent and treat HIV worldwide. For the interview with Dr Fauci, see here.

15. Lancet (Editorial) – Chikungunya—coming to America

It sounds like a horror movie “coming soon to a theatre near you”, and in fact it might very well be a frightening scenario.  Chikungunya was found on the Caribbean islands recently. “With no approved vaccine or antiviral treatment, millions are at risk. Chikungunya can no longer be considered an exotic disease from the tropics—it’s ready to be a household name.”


Read also a Lancet letter on the same issue, and CSIS’s Katherine Bliss’s blog post on the chikungunya outbreak in the Caribbean.




16. Lancet Global Health – The road to 25×25: how can the five-target strategy reach its goal?

Neil Pearce et al.;

The authors propose a more comprehensive NCD approach to tackle deficiencies in the standard approach by broadening it to include morbidity, other major NCDs (eg, mental health, neurological disease, musculoskeletal disease), and other important causes of NCDs (eg, infections and occupational and environmental exposures), including the causes of the causes (eg, urban design, development, agribusiness inequality, and poverty), and by developing innovative, affordable, and sustainable health-care-system responses. This approach would address NCDs in broader social, economic, and health-care contexts, adaptable to local circumstances.

17. WHO report – World Cancer report 2014

On the eve of World Cancer Day (which aimed to debunk myths about cancer this year, one of them being that we can’t do anything about cancer),  WHO’s International Agency for Research on Cancer published this report.

For some coverage of the report, see for example the Guardian’s Sarah Boseley:

The latest World Cancer Report says it is implausible to think we can treat our way out of the disease and that the focus must now be on preventing new cases. Even the richest countries will struggle to cope with the spiralling costs of treatment and care for patients, and the lower income countries, where numbers are expected to be highest, are ill-equipped for the burden to come. The biggest burden will be in low- and middle-income countries. They are hit by two types of cancers – those triggered by infections, such as cervical cancers, which are still very prevalent in poorer countries that don’t have screening, let alone the HPV vaccine, and increasingly cancers associated with more affluent lifestyles “with increasing use of tobacco, consumption of alcohol and highly processed foods and lack of physical activity”, writes the World Health Organisation director general, Margaret Chan, in an introduction to the report.”

BMJ news also covered the WHO report  (see  here ).

In other cancer news, the Lancet published its 3- article series on the “cancer wars” now also in the print issue.

18. Lancet (book review) – NCDs: time for fewer proposals and more action

Robert Beaglehole;

Beaglehole reviewed the book ‘Noncommunicable Diseases in the Developing World. Addressing Gaps in Global Policy and Research’ (by Galambos Louis, Sturchio Jeffrey L) for the Lancet. His assessment is mixed.




19. Humanosphere – The biggest global health program you’ve never heard of – NTDs

Tom Paulson;

This article provides a nice overview of the work of the “London Declaration on Neglected Tropical Diseases”. Paulson applauds their work but thinks they need a better brand, especially as they seem to be considering to use this novel push against NTDs as a means to accomplish other related, complementary efforts aimed at helping the poorest communities (for example with respect to water & sanitation).

Access to drugs


20. Lancet (World Report) – Big pharma in the dock over patent law plot in South Africa

Adele Baleta;

Attempts to reform South Africa’s patents laws have been marred with controversy over an alleged campaign by big pharma to derail the process. Adele Baleta reports from Cape Town.


21. IP Watch – New Study Makes Case for Innovative Medicines

Julia Fraser;

A new pharmaceutical industry-backed study draws attention to the value of innovative medicines in reducing healthcare costs and to the wider society that goes beyond clinical and personal values. However, in middle income countries, national prioritisation and improvements in healthcare infrastructure are needed to maximise the value of medicinal innovation, the study found.

22. Reuters – Big Pharma pushes for U.S. action against India over patent worries

Over to India then. “Global pharmaceutical firms are pressuring the United States to act against India to stop more local companies producing up to a dozen new varieties of cheap generic drugs still on-patent, sources with direct knowledge of the matter said. An Indian government committee is reviewing patented drugs of foreign firms to see if so-called compulsory licenses, which in effect break exclusivity rights, can be issued for some of them to bring down costs, two senior government officials told Reuters.


23. Reuters – Gilead to license hepatitis C drug to lower-cost manufacturers in India

So they aren’t fans of compulsory licences. Tiered pricing is a different matter, though. “Gilead Sciences plans to license its breakthrough hepatitis C drug Sovaldi to a number of Indian generic pharmaceutical manufacturers, allowing for lower-priced sales of the medication in that developing nation, according to the company.  Although prices for the drug have not been set, company spokesman Nick Francis said in an emailed statement on Wednesday that Gilead aims to establish “tiered pricing.”


Maternal, newborn, child and adolescent health


24. 6 February – International day of zero tolerance for FGM

More than 125 million girls and woman alive today have been cut in the 29 countries in Africa and the Middle East where Female Genital Mutilation (FGM) is concentrated. Furthermore, due to migration, surprising numbers of cases of FGM are coming to light in other parts of the world as well. On 6 February, the first international day of zero tolerance to FGM was celebrated.


The Guardian launched a national and international campaign to end FGM.  We already read very interesting viewpoints on the MSH blog  and in The Guardian on the trade-off  between respect for culture and getting rid of this horrendous practice.


25. Lancet Global Health – Maternal mortality by age: who is most at risk?

Maria Clara Restrepo-Méndez et al.;

The authors comment on a new article on maternal mortality in The Lancet Global Health by Andrea Nove and colleagues that reports the results of an analysis of data from 144 countries, which together account for 93% of the world’s annual births. The results are quite surprising, for example with respect to the mortality rate for adolescents.


26. UNAIDS – New “Beyond Zero Campaign” to improve maternal and child health outcomes in Kenya

UNAIDS feature story;


A UNAIDS feature story examines First Lady of Kenya Margaret Kenyatta’s launch of “the ‘Beyond Zero campaign’ which is part of the initiatives outlined in the Strategic Framework for the engagement of the First Lady in HIV control and promotion of maternal, newborn and child health in Kenya that was unveiled on World AIDS Day 2013.


27. WHO – Measles deaths reach record lows with fragile gains toward global elimination

New mortality estimates from WHO show that annual measles deaths have reached historic lows, dropping 78% from more than 562 000 in 2000 to 122 000 in 2012. During this time period, an estimated 13.8 million deaths have been prevented by measles vaccination and surveillance data showed that reported cases declined 77% from 853 480 to 226 722.


28. Euractiv – EU donates €320 million to UNICEF for child health, nutrition

The European Union announced that it will give €320 million to UNICEF for projects tackling under-nutrition and infectious diseases, which are among the main causes of child mortality.


Health Policy & Financing


29. NEJM – Health Care Systems in Low- and Middle-Income Countries

Anne Mills;

Health care systems need organizational direction, physical plants, and fiscal resources to deliver services to their constituents. This article addresses how — or whether — these needs are being met in low- and middle-income countries. Must-read.


30. Lancet (Editorial) – Palliative care: a peaceful, humane global campaign is needed

“Access to palliative care at the end of life is a human right, one that should be recognised formally in all countries; formulation of plans and guidelines at national level for provision of comprehensive palliative care should follow, as part of the global movement towards universal health coverage.”


31. KFF budget analysis – The U.S. Global Health Budget: Analysis of Appropriations for Fiscal Year 2014

KFF budget analysis;

Last week, the Kaiser Family Foundation released a budget analysis that reviews the US FY 2014 omnibus appropriations act signed on January 17, 2014. Although global health funding represents less than one percent of the overall federal budget, the omnibus provides the highest historical level (approximately $9.1 billion) of U.S. funding for global health programs.



32. Lancet – Offline: Health must mean more than health

Richard Horton;

Last week, the PMAC participants had to go to Pattaya (instead of the rather insecure Bangkok). It inspired Horton’s Offline article this week: “The global lesson that Thailand surely offers is that we make a mistake if we judge a country’s health advances in health terms only. Without taking account of the broader political context in which health exists, important dimensions of society critical to sustaining not only a health system, but also related freedoms that matter to the wellbeing of a people, will continue to be ignored.”  Rocket science.

33. Medact – Medact releases first briefing on the science of climate change

Health professionals – especially those working in the field of health policy and public health protection – need some understanding of climate science as a basis for their active and assertive engagement in policy debates about how we respond to global warming. Medact (of which David McCoy is the Chair) just produced a first report on the science of climate change; more will follow. The health community will need to be a part of the change required at a wider societal level – both in the UK and globally.


34. Nature – Partnering with local scientists should be mandatory

Miriam Shuchman et al. ;

The problem of inequity in international research is perpetuated by policies that enable scientists to do research in LICs without partnering with local scientists. The WHO needs to lead in solving this problem, the authors argue in this viewpoint.


35. Humanosphere – Data love: The risk of humanitarians acting like scientists

Tom Paulson;


Tom Paulson writes about recent discussions on the effectiveness of development aid and the fondness of data in some circles. Nice article.


36. Lancet (Correspondence) – Global Health and global citizenship

Chris David Simms;

Canada has faltered as a global citizen – and not just because its government sees multilateralism as something for wussies. ( one day, we need to organize a bigot competition between the Harper and Abbott administrations)



37. Water from the eyes – The Lancet Commission on Global Surgery

Mark Shrime;

(Global) surgery is different from other health interventions, the author of this blog post argues.

38. NYT – Free Trade Disagreement

Thomas B Edsall;

Animosity over the so called ‘free trade agreements’ is rising day by day, as can be seen in this nice op-ed.


39. Global Health Governance – Bridging the gap in health care capabilities: a case for e-health technologies

Vlad Boscor;

It’s not often we have a “Vlad” among the writers of selected items, so that’s already a good enough reason to include him in this week’s list. But we also agree with his assessment on e-health: “Given the benefits of these emerging technologies, they should be a priority of the 21st century. It is time for policy makers to put an emphasis on these technologies, and make their use a larger part of the public discourse and political dialogue.


Emerging  Voices



In South-Africa, Former EV and health economist Lungiswa Nkonki was selected to serve on a panel that will lead a market enquiry into the private health care sector.


As for the role the EV Youtube video played in that selection, of course combined with an excellent academic track record, stay tuned for her story on the IHP website (soon).





40. Haramaya law review – The justiciability and enforcement of the right to health under the African Human Rights System

Bahar Jibriel;

The right to health is a fundamental human right which is recognized in

international and regional human rights systems. The African Human

Rights System also duly recognized the right to health. Although

recognizing the right in the human rights instrument is important, the

meaningful protection of the right needs appropriate and consistent

interpretation and adequate implementation mechanisms. This article

thus tries to scrutinize the Justiciability and Enforcement of the right to health

in the African Human Rights System.


41. Insights in public health – Systems Thinking: Basic Constructs, Application Challenges, Misuse in Health, and How Public Health Leaders Can Pave the Way Forward

Deon V. Canyon;

The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the MDGs, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in Public Health, the WHO, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. The paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and public health to achieve the reason it was adopted in the first place.



Global health announcements



  • Launch of the Roux prize (IHME): 


The Institute for Health Metrics and Evaluation (IHME) at the University of Washington has launched the Roux Prize, a new US$100,000 award to recognize individuals or groups that have used Global Burden of Disease (GBD) data to take action that makes people healthier. The prize is named for David and Barbara Roux. David Roux is a founding board member of IHME and, over the past decade, has encouraged the Institute not to let GBD data sit on a shelf and go unused but to look for ways to make it accessible and useful.


The Roux Prize is intended for anyone who has applied Global Burden of Disease research in innovative ways to improve population health since the first GBD publication in 1993. Nominees may come from anywhere in the world and could include, but are not limited to, staff in government agencies, researchers at academic institutions, volunteers in charitable organizations, or health providers working in the community. Nominations are due March 31, 2014, and the winner will be announced at an event in fall 2014. The winner will receive US$100,000, making the Roux Prize the largest award focused on individuals contributing to population health.


Dave Roux’s commitment to IHME has long inspired us to look for ways to bring GBD to the wider public beyond our core audiences of policymakers, researchers, and others working in population health,” said IHME Director Dr. Christopher Murray. “The Roux Prize can transform the way that data are used to drive action that will have lasting health impact.”



Details on the nomination process and criteria are available on the IHME website at

Nominations and questions about the prize can be sent to, or mailed to: Roux Prize

c/o Institute for Health Metrics and Evaluation

2301 Fifth Ave., Suite 600

Seattle, WA 98121



  • Upcoming Alliance research calls


From the Alliance’s website :

The Alliance is developing a new programme of work with the aim of facilitating the embedding of knowledge generation and use into policy to support the learning capacity of health systems. To this end, a Consultation on learning health systems and embedded research, organised by the Alliance was held at the Wellcome Trust on 29 January in London. The objective of the consultation was to inform the design of in-depth case studies of embedded research and learning health systems . At the end of the meeting, the advisory group managed to develop a framework to guide the research as well as key questions to be addressed in the case studies. Stay tuned for more.”


Another upcoming research call is related to results-based financing. Check out this blog post on ‘Health Financing in Africa’ on a recent workshop in Geneva related to this upcoming call.


  • Many of us eagerly look forward to the launch of the Lancet Commission on Global Governance for Health – next Tuesday in Oslo. For the programme, see here.






  • Article Henk Molenaar in the Broker  (see here): “The post-MDG agenda should be based on an alternative theory of development, leading to a simple framework of only three complementary goals: reducing global inequalities, abandoning growth, and enhancing trust.”  (must-read: there’s also a longer version of the essay)
  • IDS paper from January: “Will changes to the international tax system benefit low-income countries?” (see here )


  • In Italy, a major reform of the country’s development aid and international cooperation took place. See here. You might want to brush up on your Italian first.

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