Dear Colleagues,

 

I’ll keep it short in this week’s intro. Earlier this week, I visited an old friend of mine, a now 39-year old woman who is terminally ill and has two little kids. Maybe it’s because I’m not a medical doctor, unlike many of the subscribers of this newsletter, but the visit taught me more than a thousand books.

In this week’s guest editorial, Radhika Arora (MPH student & EV 2012) & Pieter Van Wolvelaer (MPH student) wrote on a topic related to International Women’s Day, positive discrimination, both from an Indian and western perspective. 

 

Enjoy your reading.

 

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

 

Editorial

 

Positive discrimination towards women in the 21st century: does the buck stop here?

 

Radhika Arora (MPH student & EV 2012) & Pieter Van Wolvelaer (MPH student), with inputs from Werner Soors and Ildikó Bokros (both ITM)

In a recent letter to Lego, seven-year old Charlotte Benjamin wrote to the company requesting them to make more girl-Lego figures – Lego girls who didn’t just go shopping or hang out at the beach, but girls who “went on adventures, worked, saved people, and had jobs.”

Read the rest here


 

Post-2015 & UHC

 

1.    Lancet (Manifesto) – From public to planetary health: a manifesto

Richard Horton et al.;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60409-8/fulltext?_eventId=login

These days Richard Horton and manifestoes are almost one and the same. This manifesto for transforming public health calls for a social movement to support collective public health action at all levels of society. The aim of the manifesto is to respond to the multiple threats we face: threats to human health and wellbeing, threats to the sustainability of our civilisation, and threats to the natural and human-made systems that support us. Horton et al’s vision is for a planet that nourishes and sustains the diversity of life with which we co-exist and on which we depend. The goal is to create a movement for planetary health. If you would like to sign the manifesto, please register your agreement. (we warmly encourage you to do so! Whether we manage to get such a movement in the coming years and decades, will most likely determine the fate of this planet).

 

In a related BMJ blog post, David McCoy says why doctors need to take climate change seriously. He focuses more on the British situation in this post.

 

2.    BMC International Health and Human Rights – The emergence of a global right to health norm – the unresolved case of universal access to quality emergency obstetric care

Rachel Hammonds & Gorik Ooms;

http://www.biomedcentral.com/1472-698X/14/4/abstract

The global response to HIV suggests the potential of an emergent global right to health norm, embracing shared global responsibility for health, to assist policy communities in framing the obligations of the domestic state and the international community. Research by my colleagues Hammonds & Ooms explores the extent to which this global right to health norm has influenced the global policy process around maternal health rights, with a focus on universal access to emergency obstetric care. They conclude that despite UN recognition of maternal mortality as a human rights issue, the relevant policy communities have not yet managed to shift the policy agenda to prioritise the global right to health norm of shared responsibility for realising access to emergency obstetric care. The experience of HIV advocates in pushing for global solutions based on right to health principles suggest potential avenues for utilising right to health based arguments to push for policy priority for universal access to emergency obstetric care in the post-2015 global agenda.

3.    Health Financing in Africa – A Global Fund for Health: towards truly shared responsibility

Interview with Gorik Ooms;

http://www.healthfinancingafrica.org/3/post/2014/03/a-global-fund-for-health-towards-truly-shared-responsibility.html

In a recent Chatham House working group paper, the same duo,  Gorik Ooms & Rachel Hammonds explored whether a Global Fund for Health is a realistic option in the medium term, from the perspective of so called “donor” & “partner” countries. CoP Financial Access facilitator Isidore Sieleunou had an interview with Gorik. He zooms in on some of the key messages, political trade-offs involved and implications. Feel free to comment on the interview, under the blog post.

 

4.    A blog on bioethics – Lancet/Oslo Commission on Global Governance for Health: Preliminary Response

Stephen Latham;

http://ablogonbioethics.blogspot.no/2014/02/lancetoslo-commission-on-global.html

The author of this blog post is one of many people to comment on the recent Lancet/Oslo Commission on GG4H. “On the whole, the report’s recommendations strike me as an unrealistic wish-list for ideal global governance, entirely divorced from consideration of the political and legal constraints under which real countries and international associations operate.”  

5.    BMJ (blog) – Why the political origins of health inequity haven’t been tamed yet

G V R Singh;

bmj blog;

Guddi VJ Singh is equally critical of the Commission’s report. “It would have made more sense for the commission to demand specific changes in the policies of national governments—such as the City of London’s tax haven status in the UK, which literally steals hundreds of billions of dollars from the developing world each year, or to suggest reforms of the key international structures—such as the global tax secrecy network—whose governance and policies are supposedly being criticised. The commission’s principal recommendations—a talking shop and a monitoring mechanism—are disappointingly pedestrian for a report that calls for radical change to address the fundamental global inequities harming health.”

 

I think both commentators are a bit too harsh. Global awareness of the need for global governance for health still needs to grow, as Gorik mentioned before, and more insight into the complexity of globalization and its impact on health is needed (for an example well worth reading, see Ann Pettifor on “money”) before you will be able to get a critical mass of people behind a political agenda to move things forward. A monitoring mechanism with annual reports could contribute a lot in my opinion, even if it will no doubt be very controversial.  But these days, nothing is uncontroversial…

 

6.    WHO – Arguing for universal health coverage

http://www.who.int/health_financing/UHC_ENvs_BD.PDF?ua=1

This document is intended for CSOs involved in health financing policy debates. The tool articulates the pro-UHC arguments, and presents relevant evidence and examples. It is designed to support policies that promote equity, efficiency and effectiveness, and ensure that the rights of the most vulnerable are not forgotten. The handbook also sets out some of the areas where CSOs can most effectively bring pressure to bear in order to advance the UHC agenda.

 

7.    The Economist explains what other countries are copying from Britain’s NHS

Economist;

Many other countries—especially fast-growing ones in the developing world—are copying the NHS and importing some of its key ideas to help transform their health services. In this short article, The Economist gives a few examples, like UHC, NICE, …

 

8.    Global health hub – How can the private sector support universal health coverage goals?

Serufusa Sekidde;

http://www.globalhealthhub.org/2014/03/03/how-can-the-private-sector-support-universal-health-coverage-goals/

Lovely first paragraph – but the rest is also well worth reading. “There seems to be a tectonic shift in the attitudes of health and international development practitioners in their approach to and engagement with the private sector in health. This is quite revealing, especially since it was only a few years ago that most international development practitioners looked at the private sector in health as if it was an institutional reincarnation of Lord Darth Vader. Some still do”.

9.    Results for development – Integrating the Primary Health Care (PHC) and Universal Health Care (UHC) movements – the Time Is Now!

Shan Shoe-Lin et al.;

http://r4d.org/blog/2014-03-02/integrating-primary-health-care-phc-and-universal-health-care-uhc-movements-%E2%80%93-time-n

Although both the PHC and UHC movements have been recognized as vitally important to health and human development, the goals of PHC and UHC activities have often worked independently of each other, and sometimes even in conflict.  The authors of this blog post see opportunities to integrate the two in ways that will yield benefits for all involved, but especially vulnerable individuals in low-income settings. It’s the first blog of a series. (but trust me, as long as public health people keep insisting on using the phrase ‘the time is now’, we can forget about a worldwide movement for planetary health, UHC or any other cause)

 

10. MSH – A Global UHC Campaign Launches: Health for All Post-2015

Jonathan Jay;

http://www.msh.org/blog/2014/03/04/a-global-uhc-campaign-launches-health-for-all-post-2015

On March 4, a global civil society campaign, Health for All Post-2015, was launched, specifying human rights and public health principles that should guide UHC at the global and country level. The campaign’s call to action reflects discussions among NGOs, particularly meetings in Dakar last month with civil society representatives from 23 countries and in New York last September with a cross-section of health constituencies. While perspectives differ—in particular, some NGOs in Latin America have vigorously opposed the UHC movement—there is reasonable consensus around the concepts on which civil society demands firm commitment from UHC policymakers. With these commitments, civil society would become a powerful partner in the UHC movement.”  Jonathan Jay is coordinator of the Health for All Post-2015 campaign (see also below for the Campaign’s Call to action).

11. IHP – Health as a universal right – Civil Society hopes and struggles

Tim Roosen;

http://archief.internationalhealthpolicies.org/archives/health-universal-civil-society-hopes-struggles/

Earlier this week, Tim Roosen (AFGH) wrote  this blog post on the civil society discussions in Dakar (17-19 February). One of the issues that came out strongly: “All participants firmly rejected the notion of a “minimum floor”, instead calling for 100% targets – on universal access to health services.

 

12. A call for UHC post-2015

http://healthforallcampaign.org/health-for-all-post-2015/call-to-action/

The civil society organizational members of the Health for All Post-2015 campaign, call upon the UN Member States to incorporate UHC as an integral component of the post-2015 development framework, as specified by a number of principles of human rights and public health. For the list of HR principles, see the document.

 

The campaign was “soft-launched” the week of February 17 in Dakar, Senegal, and this week was the “hard launch”, March 4.

 

Meanwhile, we learnt on Twitter that Germany proposes “Maximizing health for all through achieving UHC” as 1of 12 post-2015 goals. (Merkel already tried to improve Putin’s mental health, this week.)

 

13. PAHO – From ‘health for all by 2000’ to Universal Health Coverage

http://www.paho.org/hq/index.php?option=com_content&view=article&id=9346%3Afrom-health-for-all-by-2000-to-universal-health-coverage&catid=1443%3Anews-front-page-items&lang=en&Itemid=1926

The evolution of the concept of UHC since the 1978 call for “Health for all in the year 2000” was the subject of the third in a series of seminars on UHC sponsored by  PAHO, on March 3. See this blog post for some similarities and differences between ‘Health for all by 2000’ & ‘UHC’. You also find the recording of the seminar on the blog.

 

14. WHO Bulletin (early online) – The men’s health gap: Men must be included in the global health equity agenda

Peter Baker et al.;

http://www.who.int/bulletin/online_first/BLT.13.132795.pdf?ua=1

A must-read, especially today. Read why boys & men should be included in the global health equity agenda, post-2015.

 

Global Fund, PEPFAR, GAVI, …

 

15. Global Fund Observer – new issue

http://www.aidspan.org/gfo_article/global-fund-releases-eligibility-list-2014

Aidspan published Issue 238 of its Global Fund Observer. The issue includes an article on the fund’s concern about the public health implications of the new anti-gay law in Uganda and  a commentary on transparency within the fund, among other articles.

 

16. CGD – Unanswered Questions on the Global Fund’s New Allocation Methodology

Amanda Glassman & Victoria Fan;

http://www.aidspan.org/gfo_article/global-fund-releases-eligibility-list-2014

Glassman & Fan examine unanswered questions on the allocation methodology in the Global Fund’s new funding model. They also offer recommendations for different approaches to allocation in a draft paper.

 

17. Global Fund – Global Fund Board Meeting to Finalize New Funding Model

http://www.theglobalfund.org/en/mediacenter/newsreleases/2014-03-05_Global_Fund_Board_Meeting_to_Finalize_New_Funding_Model/

In Indonesia, The Board of the Global Fund got together this week (6-7 March). Ahead of the meeting, it expected to make decisions “to launch a 21st century approach to funding with more predictability, more inclusive country dialogue and a greater impact to defeat AIDS, TB and malaria.” The meeting was led by Chair of the Board of the Global Fund, Dr. Nafsiah Mboi, who is also Indonesia’s Minister of Health. Finalizing a new approach to funding, with several components of a new funding model, was the primary focus. See also the Jakarta Post.

 

18. Global Fund – Global Fund Board Moves Forward on New Funding Model

http://www.theglobalfund.org/en/mediacenter/newsreleases/2014-03-07_Global_Fund_Board_Moves_Forward_on_New_Funding_Model/

As for the outcomes of the Board meeting: the Board approved strategic, financial and operational components of the new funding approach. Read the details in this press release. Gender equality will be central to the GF’s next steps.

 

You find the Board decisions   here.

 

19. Science Speaks – Obama 2015 budget fails to restore global HIV funding

http://sciencespeaksblog.org/2014/03/04/obama-2015-budget-fails-to-restore-global-hiv-funding/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+ScienceSpeaksHivTbNews+%28Science+Speaks%3A+HIV+%26+TB+News%29

Obama was hanging on the phone with Putin for most of the week, but his administration’s proposed fiscal year 2015 budget was still released this week. The Global Fund was fairly happy – with a request by the Obama Administration of 1.35 billion, plus an additional increase of 300 million through the new Opportunity, Growth & security initiative, if enacted by Congress. GAVI was pleased as well (Obama requested 200 million in its fiscal year 2015); PEPFAR is less happy, with stagnant funding  (The proposed budget includes $4.35 billion for the PEPFAR — the same amount allocated under fiscal year 2014.) Worries about further scale-up are increasing.

 

For a very nice visual illustration of where US foreign aid goes, geographically, see

this graph.

 

20. CGD – Three Questions for PEPFAR Nomination Hearing

Jenny Ottenhoff;

http://www.cgdev.org/blog/three-questions-pepfar-nomination-hearing

The President’s nominee for US Global AIDS Coordinator, Dr. Deborah Birx appeared before the Senate Foreign Relations Committee on Thursday for a confirmation hearing. CGD’s Ottenhoff had a few questions for her ready, ahead of the meeting, related to improving PEPFAR’s accountability and transparency, ownership, coordination with other donors….  Erin Hohlfielders (on the blog One), even had 6 questions ready for Deborah Brix (see here). See also the webcast of the hearing.

21. KFF  – UNICEF, GAVI, Others Announce More Accessibility To Inactivated Polio Vaccines

KFF;

Media outlets report on several groups’ announcement that they will make inactivated polio vaccines (IPVs) more accessible and available to developing countries.

 

See also Bill Gates himself on the Impatient Optimists blog:

“…Thanks to a new arrangement announced last week, which was made in partnership among GAVI, our foundation and the pharmaceutical industry, a major barrier to global vaccination with inactivated polio vaccine (IPV) is erased now with the availability of IPV at a significantly-reduced price for the world’s poorest countries. … GAVI is working together with the Global Polio Eradication Initiative to help these 73 poorest countries purchase and deliver these vaccines to all their children. This new collaboration between organizations created to work on routine immunization and polio eradication is symbolic of the fact that polio eradication will help us get better at global health in general. … This is a big step toward polio eradication — and a big step toward global health equity.”

 

On a personal note, Bill is again the richest men in the world, according to Forbes. Whether the global health community should be happy about that, is another question.

22. UNAIDS – IFRC and UNAIDS join forces to reach 15 million people with HIV treatment by 2015

http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2014/march/20140304ifrc/

The International Federation of Red Cross and Red Crescent Societies (IFRC) and UNAIDS  have signed a Memorandum of Understanding to advance efforts in scaling up access to HIV testing and treatment. The IFRC and UNAIDS will combine expertise and capacity to support the implementation of UNAIDS’ Treatment 2015 initiative and develop a community model for delivering scaled-up access to HIV treatment.

23. Don’t get stuck with HIV

Simon Collery;

http://dontgetstuck.wordpress.com/2014/03/02/unaids-dubious-claims-about-hivaids-2013/

Harsh criticism of UNAIDS and the mainstream approach to HIV in high-prevalence countries, focusing on sexual transmission. A must-read. “UNAIDS risk missing their target of reducing “sexual transmission of HIV by 50% by 2015“. But there is a way of meeting that target, and they could meet it by tomorrow. If they belatedly admit that HIV is far more easily transmitted through unsafe healthcare, they could begin to estimate the contribution of things like reuse of needles, syringes and other equipment that comes into contact with blood and other bodily fluids.”

 

Infectious Disease

 

24. KFF – Early HIV Treatment Might Have Prompted Remission In Second Infant, Researchers Report At CROI

kff;

Media sources report on findings reported this week at the Conference on Retroviruses and Opportunistic Infections, taking place this week in Boston. Researchers reported on another case of possible HIV remission in an infant and several other study findings.  Science Speaks also has a number of articles on this conference.

 

News outlets also reported on a study published Wednesday in the New England Journal of Medicine showing gene therapy for HIV infection is safe and possibly effective – but we gather you already heard this via the media.

 

25.  Reflections – What have we learnt from the last ten years of ART?

Francois Venter;

http://www.sajhivmed.org.za/index.php/sajhivmed/article/viewFile/1029/916

Short reflection but a must-read according to my boss (Wim Van Damme) – from a special issue on ART in South-Africa.

 

Admittedly, subheadings like ‘We’ve taught chronic diseases a thing or two about adherence’, ‘We may have saved the world from old-fashioned public health specialists’, … make us all salivate.

26. Global Public Health – ‘Mobile men with money’: HIV prevention and the erasure of difference

Peter Aggleton et al.;

http://www.tandfonline.com/doi/abs/10.1080/17441692.2014.889736#.UxhM7Pl5OuI

Mobile Men with Money’ is one of the latest risk categories to enter into HIV prevention discourse. Used in countries in Asia, the Pacific and Africa, it refers to diverse groups of men (e.g. businessmen, miners and itinerant wage labourers) who, in contexts of high population movement and economic disparity, find themselves at heightened risk of HIV as members of a ‘most-at-risk population’, or render others vulnerable to infection. How adequate is such a description, the authors of this paper wonder.

 

27. Guardian – Climate change could mean more malaria in Africa, study says

http://www.theguardian.com/environment/2014/mar/07/climate-change-malaria-africa-study?CMP=twt_gu

Future global warming could lead to a significant increase in malaria cases in densely populated regions of Africa and South America unless disease monitoring and control efforts are increased, researchers said on Thursday.

28. KFF – Bomb Targets Pakistan Polio Team, Kills At Least 11

http://kff.org/news-summary/bomb-targets-pakistan-polio-team-kills-at-least-11/

Above we learnt about some encouraging news to tackle barriers to polio vaccination, but this was very sad news from Pakistan.

29. Social Science & Medicine – Surviving polio in a post-polio world

Nora Ellen Groce et al.;

http://www.sciencedirect.com/science/article/pii/S0277953614001282

This paper reviews what is currently known about disabled survivors of polio and highlights areas of need in public health research, policy and programming.

 

30. Lancet Correspondence – WHO disapproves Kochon prize for Tibetan TB Programme

Kunchok Dorjee;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60441-4/fulltext

« The nomination by the Kochon selection committee of the Tibetan Tuberculosis Control Programme based at Delek Hospital, Dharamsala, India, for the Stop TB Partnership-Kochon Prize 2013 award  for its work for more than 30 years to control tuberculosis in Tibetan refugees is a recognition of an important public health work in a vulnerable population. … However, WHO Director General Margaret Chan disapproved this nomination and deprived the health-care workers and patients at Delek Hospital from a vital source of inspiration, hope, and funding, which could have all promoted excellence within the programme.”  It’s not often Chan finds herself in the role of villain, but here you are. Next week you will no doubt read about WHO staff demonstrating in the streets of Geneva.

 

For WHO’s – rather formal – reply on this Letter, see  here.

 

31. Guardian – Hepatitis C medicines must be made accessible faster than HIV drugs were

Philippe Douste-Blazy;

http://www.theguardian.com/global-development/poverty-matters/2014/mar/07/hepatitis-c-medicines-hiv-aids-drugs

On the emerging international showdown around Hepatitis C medicines.P Douste-Blazy explains why it’s important to avoid a stand-off like with HIV, more than a decade ago.

 

Homophobia

 

 

The Dalai Lama said this week he’s ok with gay marriage and worries about increasing violence against LGTBs.

32. BMJ (news) – Financial donors warn Ugandan government over anti-gay law

Anne Gulland;

http://www.bmj.com/content/348/bmj.g1862

Most of the reactions by donors so far were covered in last week’s newsletter, but this BMJ news article gives a nice overview of warnings by foreign monetary donors for the government of Uganda that they may withdraw funding after the signing of an anti-homosexuality law in February.

 

33. NYT – Antigay Laws Gain Global Attention; Countering Them Remains Challenge

NYT;

The issue of gay rights has catapulted up the diplomatic agenda in recent years, as international organizations have extended rights protections to gays and lesbians and donor nations have faced new challenges in dealing with governments that discriminate. This NYT article gives an overview. (must-read)

34. Science Speaks – Uganda anti-homosexuality law silence prompts call for UN Special Envoy for HIV/AIDS in Africa to step down

http://sciencespeaksblog.org/2014/03/03/uganda-law-silence-prompts-call-for-un-hiv-africa-envoy-to-step-down/

On the commotion around the UN Special Envoy for HIV/AIDS in Africa – see last week’s IHP newsletter. “In an interview with Science Speaks, Lewis, …  said that signing a letter is a small gesture, with relatively little impact, compared to the potential the Special Envoy post offers to elucidate issues and amplify pressure through press conferences and meetings. But, he added, the problem prompting the letter was not Kazibwe’s performance but the conflicted interests of her positions and the constraints they put on her performance that he says, were demonstrated in the course of the law’s passage.”

 

 

NCDs

 

35. Lancet – Challenges in rolling out interventions for schizophrenia

Derrick Silove et al. ;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60085-4/fulltext

Silove et al Sudipto comment on a new study in the Lancet by Chatterjee and colleagues, a multicentre, randomised controlled Community care for People with Schizophrenia in India (COPSI) trial. The study represents a milestone by showing the benefits of a collaborative community-based care plus facility-based care model compared with conventional facility-based care alone for treatment of moderate to severe schizophrenia. Sustaining of mental health initiatives, particularly in low-resource settings, needs a comprehensive, multisectoral approach based on genuine engagement with the community.

 

36. BMJ (Feature) – Should healthcare be guaranteed for cancer but not diabetes?

Andrew Jack;

http://www.bmj.com/content/348/bmj.g1812

As healthcare costs spiral, debate is growing over whether countries should limit their healthcare coverage to certain medical conditions. Andrew Jack examines why Chile’s attempt is meeting a mixed reception and looks at the other options. (must-read)

37. WHO – Draft Guideline: Sugars intake for adults and children

http://www.who.int/nutrition/sugars_public_consultation/en/

Was all over the press, this week. The objective of this guideline is to provide recommendations on the consumption of free sugars to reduce the risk of NCDs in adults and children, with a particular focus on the prevention and control of weight gain and dental caries. With public consultation till 31 March.

38. Health Policy – Public–private partnerships with large corporations: Setting the ground rules for better health

Gauden Galea & Martin McKee;

http://www.healthpolicyjrnl.com/article/S0168-8510(14)00048-7/abstract

Public–private partnerships with large corporations offer potential benefits to the health sector but many concerns have been raised, highlighting the need for appropriate safeguards. In this paper the authors propose five tests that public policy makers may wish to apply when considering engaging in such a public–private partnership. (appropriately, gated)

 

 

 

International Women’s day & child, adolescent & maternal health

 

39. Lancet (Editorial) – An inspired change—stopping sexual violence against women

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60428-1/fulltext

International Women’s Day, this year themed ‘Inspiring Change’ – for Christ’s sake, who invents these bland themes?, falls on March 8 (see also this week’s guest editorial). For more than a century, this event has marked women’s achievements in a world where the sexes are far from equal in many countries. In promoting the education, health, and success of women, the Day has addressed the distressing but key topic of violence against women more than once. This Lancet Editorial addresses this vital topic again.

40. Smart Global Health – How the U.S. Can Honor International Women’s Day

Janet Fleischman;

http://www.smartglobalhealth.org/blog/entry/how-the-u.s.-can-honor-international-womens-day/

To mark International Women’s Day, First Lady Michelle Obama participated in the 2014 International Women of Courage awards ceremony at the State Department on March 4. The honorees, representing ten countries, were recognized for their extraordinary work on behalf of women and girls — from combatting gender-based violence and acid attacks, to advancing reproductive health and human rights.” Instead of screaming like a kid that doesn’t get his way about the mess in the Ukraine and making silly comparisons with World War 2 (just like Hillary Clinton, by the way), Secretary Kerry should now take concrete steps to demonstrate the U.S. commitment to prioritizing women’s and girls’ health and development in U.S. policy. Fleischman gives some suggestions.

 

To mark International Women’s Day this year, Marie Stopes compiled a list of 12 women and one man (!) who’ve inspired change and helped to improve the lives of women either in their community or at a global level. (see psi impact)

 

41. WHO – Ensuring Human Rights in the provision of contraceptive information and services – Guidance and recommendations

http://www.who.int/reproductivehealth/publications/family_planning/human-rights-contraception/en/

In advance of International Women’s Day on 8 March 2014, WHO is launching new guidance to help countries ensure human rights are respected in providing more girls, women, and couples with the information and services they need to avoid unwanted pregnancies. … The guidance recommends that everyone who wants contraception should be able to obtain detailed and accurate information, and a variety of services, such as counseling as well as contraceptive products. It also underlines the need for no discrimination, coercion or violence, with special attention given to assuring access to those who are disadvantaged and marginalized…,” a WHO press release stated.

 

42. Economist – Fertility treatment – Birth rates are not falling in Africa as fast as they did in Asia. More contraception would help

http://www.economist.com/news/leaders/21598648-birth-rates-are-not-falling-africa-fast-they-did-asia-more-contraception-would

On the same topic: African countries should ensure universal access to contraception, if not, they might miss out on the demographic dividend, the Economist argues this week. Which, we bet, is not good for economic growth. For more detail, see also this Economist  piece on African demography.

 

43. PM convenes Canadian experts and global leaders in maternal, newborn and child health

http://pm.gc.ca/eng/news/2014/03/06/pm-convenes-canadian-experts-and-global-leaders-maternal-newborn-and-child-health

Canadian Prime Minister Stephen Harper announced that Canada will host a high-level Summit on maternal, newborn and child health from May 28-30, 2014, in Toronto.

 

44. WHO Bulletin (Editorial) – From concept to measurement: operationalizing WHO’s definition of unsafe abortion

Bela Ganatra et al.;

http://www.who.int/bulletin/volumes/92/3/14-136333.pdf?ua=1

From this month’s new WHO Bulletin issue. WHO defines unsafe abortion as a procedure for terminating a pregnancy performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical standards, or both. This definition embodies concepts first outlined in a 1992 WHO Technical Consultation. Although widely used, it is inconsistently interpreted. In this editorial the authors discuss its correct interpretation and operationalization.

45. Global Public Health – Maternal and child mortality indicators across 187 countries of the world: Converging or diverging

Srinivas Goli et al.;

http://www.tandfonline.com/doi/full/10.1080/17441692.2014.890237#.UxhNNPl5OuI

For the statistical whizzkids (or nerds) among you. Or for über-nerd Larry Summers, now that he chairs  CGD’s Board.

Access to Medicine

 

46. WHO Bulletin – Compulsory patent licensing and local drug manufacturing capacity in Africa

Olasupo Ayodeji Owoeyea;

http://www.who.int/bulletin/volumes/92/3/13-128413.pdf?ua=1

The Doha Declaration on the TRIPS Agreement and Public Health gives member states of the WTO the right to adopt legislation permitting the use of patented material without authorization by the patent holder, a provision known as “compulsory licensing”. For African countries to take full advantage of compulsory licensing they must develop substantial local manufacturing capacity. Because building manufacturing capacity in each African country is daunting and almost illusory, an African free trade area should be developed to serve as a platform not only for the free movement of goods made pursuant to compulsory licences, but also for an economic or financial collaboration towards the development of strong pharmaceutical manufacturing capacity in the continent. Most countries in Africa are in the UN list of least developed countries, and this allows them, under WTO law, to refuse to grant patents for pharmaceuticals until 2021. Thus, there is a compelling need for African countries to collaborate to build strong pharmaceutical manufacturing capacity in the continent now, while the current flexibilities in international intellectual property law offer considerable benefits, the author of this piece argues.

 

In a related article, Moses Molumba (Equilibri) discusses the situation in the East African Community region. “Due to a number of bottlenecks, the generic pharmaceutical manufacturers in the East African Community region produce at a cost disadvantage compared to their large-scale Asian counterparts. This article highlights some of the key areas where civil society has engaged and can still engage with local pharmaceutical industries to address these challenges.”

 

47. BMJ (news) – US drug regulator rejects accusations that it unfairly targets Indian generic firms

Sanjeet Bagcchi;

http://www.bmj.com/content/348/bmj.g1845

The US drugs regulator has defended its actions against Indian generic drug manufacturers who flout safety and quality standards. The regulator said that product safety was its top priority and that it would take any action deemed necessary to protect consumers.

 

48. Reuters – U.S. fears for patents on next-generation drugs in India

http://www.reuters.com/article/2014/03/06/us-india-us-pharma-idUSBREA250OB20140306?feedType=RSS&feedName=healthNews

The United States on Thursday voiced concern over protection of patents on safer and more effective next-generation medicines in India amid fears that authorities are considering allowing more Indian firms to make new varieties of cheap generic drugs still on patent…”.  You know that Big Pharma is getting itchy when they start to see “Damocles Swords”. Maybe they can watch ‘300: Rise of the Empire’  to get even more in the mood.

 

49. The BRICs  post – India to take US to WTO if targeted over IPR

http://thebricspost.com/india-to-take-us-to-wto-if-targeted-over-ipr/#.UxVyGvl5Nz7

The country’s IPR (intellectual property rights) laws are fully compliant with WTO. If America has any issue with our laws, they can raise that in the WTO,” an Indian official was quoted.

 

50. World Bank – TPP & TTIP: More Questions Than Answers

Miles McKenna;

https://blogs.worldbank.org/trade/tpp-ttip-more-questions-answers?cid=EXT_WBBlogSocialShare_D_EXT

Even World Bank staff have more questions than answers about TPP & TTIP, at this point in the negotiations. Read why.

 

 

Human Resources for Health

 

51. NEJM (Global health Review article)– Global Supply of Health Professionals

Nigel Crisp & Lincoln Chen;

http://www.nejm.org/doi/full/10.1056/NEJMra1111610

There is a global crisis of severe shortages and marked maldistribution of health professionals that is exacerbated by three great global transitions — demographic changes, epidemiologic shifts, and redistribution of the disability burden. Each of these transitions exerts a powerful force for change in health care systems, the roles of health professionals, and the design of health professional education. Every country will have to respond to these global pressures for change.”

 

Health Policy & Financing

 

52. WHO Bulletin (Editorial) – The difficulty of making healthy choices and “health in all policies”

Pricivel Melendez Carrera;

http://www.who.int/bulletin/volumes/92/3/13-121673/en/

From the same new WHO Bulletin issue. Healthy choices are difficult choices (just ask me: being Belgian, I usually celebrate sending out this newsletter with some French fries).

 

The recognition that health promotion and disease prevention play a crucial role in the control of chronic diseases and their re-engineering into the health system have been major breakthroughs in health and health care. If the Health in all Policies approach is to preserve these hard-fought gains and have a palpable impact, policies will need to rely on strategic plans and creative programmes that enable the individual, family and community to make the healthy choice. A concerted effort towards this end will take us from “health in all policies” to health in everyday practice.”

 

53. IHP – Health in a time of political plague: confronting the clash of ignorance !

Majdi Ashour;

http://archief.internationalhealthpolicies.org/archives/health-time-political-plague-confronting-clash-ignorance/

Majdi Ashour comments on the Lancet series on health in the Arab World. He applauds the Lancet Series for finding the right balance between zooming in on health in the “Arab world” while avoiding cheap labels and cultural generalizations. In this way, the series helps in countering the “clash of ignorance” (as coined by Edward Said in 2001).

 

54. WHO – Draft agenda for WHA & comments by the People’s Health Movement

http://apps.who.int/gb/ebwha/pdf_files/EB134/B134_46-en.pdf

For some of the first comments by the PHM on the provisional agenda of the next World Health Assembly, see here.

 

55. Equinet (Editorial) – Engaging in global health: who sets the agenda?

Bente Molenaar Neufeld;

http://equinetafrica.org/newsletter/index.php?issue=157#1

WHO states in its constitution that it aims to achieve “the attainment by all people of the highest possible level of health.” The World Health Assemblies (WHAs) provide a key opportunity to engage on the achievement of this aim. Yet in an interesting study by Kitamura et al. in May 2013 in Health Policy reviewing the agendas of the WHAs between 1970 and 2012, the authors concluded that “agenda items of the WHA do not always reflect international health issues in terms of burdens of mortality and illness.”

 

So how are countries and stakeholders shaping the WHA agenda? Neufeld lists the ways.

 

56. Development Policy – MSF on shaky ground in Myanmar after suspension order

http://reliefweb.int/report/myanmar/msf-concerned-about-fate-thousands-patients-myanmar-after-being-ordered-cease

The Myanmar government has backflipped following reports last week that it was kicking MSF out of the country, saying that it had only temporarily suspended its activities. Two days after the initial suspension, the organisation was allowed to reopen its clinics in the capital Yangon, as well as in Kachin and Shan states. Operations in troubled Rahkhine state remain on hold. The suspension was provoked by allegations that MSF was biased in favour of the Rohingya Muslim minority in Rakhine state.

 

See also this ODI op-ed in  the Bangkok Post.

 

57. PSI Impact- USAID and P&G kick-off Global Development Alliance to improve health in Myanmar

http://blog.psiimpact.com/2014/02/usaid-pg-kick-global-development-alliance-improve-health-myanmar/

Better news from USAID and P&G in Myanmar, at least if you’re the PPP type. “USAID Administrator Dr. Raj Shah helped deliver the first liter of clean drinking water under a Global Development Alliance between USAID and Procter & Gamble (P&G) to improve health in Myanmar. Over the next two years, USAID and P&G intend to make joint investments of at least $2 million on health projects aimed at providing clean drinking water through provision of P&G Purifier of Water packets, promoting better hygiene behaviors, and building capability to deliver improved health services to mothers and children.

58. Plos blog – Looking for $2 Trillion

Peter Hotez;

http://blogs.plos.org/speakingofmedicine/2014/03/04/looking-2-trillion/

The group of G20 finance ministers meeting in Australia has just announced an ambitious initiative to boost the world’s gross domestic product (GDP) by at least $2 trillion over the next five years. … So far there has been no mention of health as a means to promote economic development among the G20 nations, even though we learned more than a decade ago from the World Health Organization’s Report of the Commission on Macroeconomics and Health led by Jeffrey Sachs that diseases can actually cause poverty. Such findings provided the basis for which disease targets were added to the Millennium Development Goals,”  Hotez continues: NTD control and elimination won’t be an easy sell to the G20 finance ministers, but it is an important message to send ‘down under’ sometime before November of this year.  (to increase his chances, I think he might first help to discover which ‘neglected disease’ Tony Abbott is suffering from)

 

59. UN News Centre – UN health agency calls on countries to invest in prevention and care for hearing loss

U.N. News Centre;

WHO called on governments to invest in hearing care, as a new survey, published on the occasion of International Ear Care Day (March 3), found that many countries lack the capacity to prevent and care for hearing loss, which affects 360 million people worldwide.

 

60. Humanosphere – Seattle Biomed pioneering ‘rational’ approach to vaccines

Tom Paulson;

http://www.humanosphere.org/2014/03/seattle-biomed-pioneering-a-more-rational-approach-to-vaccines/

I don’t see how we’re going to ever develop effective vaccines against AIDS, TB or malaria without first gaining a lot more insight into how the immune system works – and how vaccines promote immunity,” said Alan Aderem, president of Seattle Biomed, a research organization that has been working on matters of global health for decades. Aderem and his colleagues are proponents of a relatively new approach to studying disease, and especially for doing vaccine research and discovery – using systems biology.

 

For a more detailed report by Tom Paulson on this new approach, see  Nature.

 

61. HP&P – Brazil’s engagement in health co-operation: what can it contribute to the global health debate?

http://heapol.oxfordjournals.org/content/29/2/266.extract

From the new HP&P March issue – the article was already online for a while.

Social Determinants of Health

 

62. Guardian – Southern African leaders fail to prioritise water and sanitation

http://www.theguardian.com/global-development/2014/mar/03/southern-africa-leaders-failing-prioritise-water-sanitation

Millions of people in southern Africa still lack access to latrines and clean drinking water, says WaterAid.

63. Revista Panamerica de Salud Publica – Health systems in context: a systematic review of the integration of the social determinants of health within health systems frameworks

Evan Russell et al.;

http://www.scielosp.org/scielo.php?pid=S1020-49892013001200013&script=sci_arttext&tlng=pt

The objective of this literature review was to systematically review and analyze various ways that health systems frameworks interact with the social determinants of health, as well as the implications of these interactions.

64. Open Democracy – Why the precariat is not a “bogus concept”

Guy Standing;

http://www.opendemocracy.net/guy-standing/why-precariat-is-not-%E2%80%9Cbogus-concept%E2%80%9D

The “precariat”, a class-in-the-making, is the first mass class in history that has systematically been losing rights built up for citizens. So, why is it the new dangerous class and how is it differentiated from other class groups in the evolving global labour process? In this piece, Guy Standing defends his notion of precariat, and its (increasing) relevance in our era. (It’s more than time for an International Precariat Day, if you ask me)

 

Research

 

65. WHO Bulletin – The incremental cost of switching from Option B to Option B+ for the prevention of mother-to-child transmission of HIV

Lisa O’Brien et al.;

http://www.who.int/bulletin/volumes/92/3/13-122523/en/

From the same new WHO Bulletin issue, but was already online since January (see a also previous IHP newsletter). The objective of this study was to estimate the incremental programme cost, over 5 years, of switching from policy Option B to Option B+.

66. Global Public Health – Global pharmacogenomics: Where is the research taking us?

Catherine Olivier et al.

http://www.tandfonline.com/doi/full/10.1080/17441692.2014.887137#.UxmxZPl5Nz4

Pharmacogenomics knowledge and technologies, which couple genomics information with pharmaceutical drug response, have been promised to revolutionise both drug development and prescription. One notable promise of pharmacogenomics is the potential to contribute to some of the MDGs, namely to increase justice in global health by incentivising public research laboratories and pharmaceutical companies to develop drugs for populations (e.g., in LMICs) that have been neglected by the traditional drug development model. To evaluate the credibility of this promise, the authors examined those scientific papers indexed in PubMed and published between 1997 and 2010, with a view to describing the major orientations and tendencies characterising the development of pharmacogenomics research. Their results demonstrate that pharmacogenomics research has focused on three major non-communicable categories of disease: cancer, depression and other psychological disorders and cardiovascular and coronary heart disease. Few publications – and thus, by extension, little scientific interest – concerned orphan diseases, infectious diseases or maternal health, indicating that pharmacogenomics research over the last decade has replicated the well-known 90/10 ratio in drug development. As such, the authors argue that research in the field of pharmacogenomics has failed in its promise to contribute to the MDGs by reducing global health inequalities.

 

 

67. BMC Public Health – Where is the Gap?: The contribution of disparities within developing countries to global inequalities in under-five mortality

Agbessi Amouzou et al.;

http://www.biomedcentral.com/1471-2458/14/216/abstract

Global health equity strategists have previously focused much on differences across countries. At first glance, the global health gap in health status appears to result primarily from disparities between the developing and developed regions. The authors of this article examine how much of this disparity could be attributed to within-country disparities in developing nations. Under-five mortality disparities within developing countries account for roughly half of the global gap between developed and developing countries. Thus, within-country inequities deserve as much consideration as do inequalities between the world’s developing and developed regions.

 

68. Health Research Policy & Systems – A practical and systematic approach to organisational capacity strengthening for research in the health sector in Africa

Imelda Bates et al.;

http://www.health-policy-systems.com/content/12/1/11/abstract

Despite increasing investment in health research capacity strengthening efforts in low and middle income countries, published evidence to guide the systematic design and monitoring of such interventions is very limited. The objective of this study was to use evidence to inform the design of a replicable but flexible process to guide health research capacity strengthening that could be customized for different contexts, and to provide a framework for planning, collecting information, making decisions, and improving performance. The authors used peer-reviewed and grey literature to develop a five-step pathway for designing and evaluating health research capacity strengthening programmes, tested in a variety of contexts in Africa.

 

 

69. Plos – Associations between Intimate Partner Violence and Health among Men Who Have Sex with Men: A Systematic Review and Meta-Analysis

A M Buller et al.

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001609;jsessionid=3C74572C4ADCF98C29045539987CEC30

Ana Maria Buller and colleagues review nineteen studies and estimate the associations between the experience and perpetration of intimate partner violence, and various health conditions and sexual risk behaviors among men who have sex with men.

 

Miscellaneous

 

 

  • David Miliband argued for humanitarian post-2015 goals. (see The Guardian).

 

  • CGD Senior Fellow Ben Leo examines the potential impact of the Electrify Africa Act recently passed by the House Foreign Affairs Committee. “Africa energy poverty might  be the new big, bipartisan development issue, much as PEPFAR has been for the last decade”.

 

  • Offline – the evolution of Ignorance: Richard Horton dwells on the evolution of Paul Krugman over the years and other issues in development economics, that are also relevant for the world of medicine (in  The Lancet).

* China calls on rich nations to give almost 500 billion on climate change, through 2020 ( see Bloomberg) to help poor countries adapt.   As if the Ukraine mess wasn’t enough to upset the West J.  Will be interesting post-2015 negotations (how about doing some ‘reality-tv?’ or doing an HBO series about them)

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