Dear Colleagues,

 

This week Remco van de Pas flew back and forth between the Netherlands (European elections), Antwerp (ITM) and Geneva (World Health Assembly), and he mailed me it’s been a gruelling week. Read below some of his first comments on the WHA, or ‘The World Health Theatre’, as he calls it.  More might follow early next week.

… And finally it has arrived, The World Health Assembly in Geneva! This is something of an annual ritual for me. One full week of following the policy debate at the World Health Assembly, visiting side events on several health topics, and occasionally organizing one. The event I was involved in this year focused on Free Trade Agreements, policy space for health and WHO’s position in this area. It inspired a lively and heated debate. Margaret Chan provided a good push for this debate as she mentioned in her opening speech at the Assembly: “In my view, something is fundamentally wrong in this world when a corporation can challenge government policies introduced to protect the public from a product that kills.” (Yes, Margaret, apparently we don’t live in a Disney world.)  Anyway, coming from the WHO boss, these are powerful words. Whether it will lead to equally powerful action by WHO remains to be seen.

I even had a bigger surprise when I didn’t bump into a lookalike of Bill Gates, but actually saw his wife Melinda on stage – she was invited as a guest speaker to the World Health Assembly.  NGO alliances like the People’s Health Movement were ‘not amused’ by her presence, to say the least. What struck me mainly is the almost ‘iconic’ way she (as well as Bill and the foundation, actually ) is perceived by many, and presents herself. In her speech, she said: “Since you first heard about our foundation, our core values haven’t changed—and they never will. We will always do this work because we despise inequity, and because we believe in the power of innovation to solve problems.”  

It is true that without the Gates Foundation, many large global health institutions and stakeholders, like WHO, but also GAVI, the Global Fund and many others active in global health would be (severely) cash-strapped. The Foundation is the second largest donor in financing global health programs (after the US).  However, the public image these kinds of modern global health ambassadors have and project, reminds me somehow of the ‘icons’ and saints of the Catholic Church. After a week of travelling, I’m a bit exhausted, so maybe that’s why I now see in front of my eyes a statue of Maria Magdalena emerging, taken around in procession before Easter Sunday … Like religious institutions, modern philanthropy has a large role in shaping values in social norms and standards (well, I think so, but do contact me if you see it differently). There are also rather similar questions about legitimacy within religious institutions and philanthropy. Would the same then apply to an old saying of a notorious 19th century political  economist, ‘Religion is the opium of the people’ ? In other words, does a 21st century analogy hold: “Philantropy is the cocaine or XTC of the masses” ?

…. Well, perhaps it’s my sleep deprivation, caffeine overdose, or frantic traveling between Geneva, Antwerp and Utrecht this week that provoked these wild thoughts. Or maybe I am still excited about having exercised my democratic right, by voting for the European Parliament.  In the Netherlands about 37% of the electorate showed up (and this was considered a decent result…  good I showed up, then J) The Netherlands as a country is not so eurosceptic after all (at least if you don’t count the millions of people who didn’t bother to vote), while the results of the British electorate are not yet known at this time of writing (Remco wrote this yesterday evening). One will be able to find the results here, with the rest of the European countries to follow over the weekend. But who worries about Europe, when the Thai people face such a difficult period these days?

 

In this week’s guest editorial, Asmat Malik, Shishir Dahal & Asm Shahabuddin,  Emerging Voices and young researchers from Pakistan, Nepal and Bangladesh reflect on the implications of the Modi landslide victory in India for the wider region. They are also worried.

 

Enjoy your reading.

 

The editorial team

 

 

Editorial

 

 

Dealing with a more ‘muscular’ India: What are the implications for human development and health in the region?

 

Asmat Ullah Malik (Director Research and development, Integrated Health Services, Islamabad, Pakistan),  Shishir Dahal (EV 2010, from Nepal), Asm Shahabuddin ( ITM Pre-doctoral Researcher,  from Bangladesh)   

 

 

If the country looks strong, then even its companions will change, neighbors will change and the atmosphere will change’.  This  is how Narendra Modi unfolded his long term agenda when his party was gunning to reshape the political and ideological landscape in India. After an electoral landslide, an emboldened Modi is  expected  to rise above of the national issues in order to play a major role at the global level.

It is a bit early to predict how this massive political change will influence regional politics. However, if words are the only means to gauge future ambitions,  neighbouring countries could possibly see themselves pitched  against a rather ‘muscular’ India.  We focus here on Pakistan, Bangladesh and Nepal.

While running an intense election campaign, the Bhartiya Janata Party (BJP) leadership argued for a strong focus on economic growth and development, rooting out corruption and addressing weaknesses in the governance system. The BJP leaders also stirred up  nationalism via political slogans of protecting national boundaries  and  stopping cross-border terrorism, by taking an aggressive approach towards China and Pakistan respectively. Most ordinary people in countries in the region have no problem with the BJP leadership’s nationalist sentiment but its religious sentiment is quite controversial and has turned Modi into a polarizing figure.

His silence during communal riots while being the Chief Minister of the Indian State of Gujarat, his home state, in 2002, and his notorious Rashtriya Swayamsevak Sangh (RSS ) credentials, already created a strong anti-Modi sentiment in some neighbouring countries with a predominantly Muslim population, especially in Pakistan and Bangladesh. Modi’s campaign rhetoric, where he spoke against illegal immigrants from Bangladesh, mostly Muslims, has further fueled this sentiment.  It will be difficult to overcome this sentiment while making efforts to resolve the bilateral conflicts India has with Pakistan (Jammu and Kashmir and the Indus Water Treaty) and Bangladesh (Teesta river ‘sharing water’ accord, rationalization of the international border and exchange of enclaves). There’s also a sizeable Muslim population in India, as is well known. In a situation where none of the newly elected BJP Members of Parliament are Muslim, it is difficult see who will advocate for the concerns of Indian Muslims.

The BJP’s controversial religious stance is not limited to its opposition to Muslims alone. In Nepal, a civil war that had lasted for ten years and claimed thousands of lives finally ended with a 12-point peace agreement between Maoist rebels and seven political parties in 2006, under mediation of the Indian government.  Maoist rebels, who almost controlled more than 50% of the country’s territory at the time, laid down their arms and participated in two democratic elections. Many people in Nepal and India including some people very close to Modi believe this peace accord was a conspiracy against Majority Hindus crafted by nonbelievers (Maoist) and infidels – Sonia Gandhi (Catholic) and Manmohan Singh (Sikh) – with a key role for the EU and the US as well. Some BJP leaders have openly expressed their disapproval  of Nepal’s decision to abolish the Hindu kingdom and establish a secular republic. Because India has a great interest in and influence over Nepalese politics (and thus in the decision making process as well), it is likely that the nature of Modi’s foreign policy in the coming years will determine the fate of the Nepalese peace process.

Against this backdrop of regional tensions and reservations, Modi will be eyeing major economic reforms. He is also expected to emerge as a new global leader. Even if nobody knows the future, let’s already ponder potential implications for human development and global health. Investments in the pharmaceutical industry, health innovations and medical tourism industry are the areas which will suit his economic policies just fine. India is already  the largest vaccine manufacturer in the world. Its huge pharmaceutical industry has also helped in bringing down the prices of HIV/AIDS drugs. However, as far as leadership in human development and health is concerned, these are areas where India does not enjoy a good track record. India’s health indicators lag far behind many of its neighbours’. There is widespread poverty and millions of Indians lack access to basic health care. India has the highest global burden of TB, some other infectious diseases, and persistent maternal, neonatal and child health problems.

Whether Modi’s economic policies will substantially improve India’s human development and health statistics, remains to be seen.  His many fans surely believe so, his opponents have serious doubts. They worry – like us – that the BJP’s reform policies will be primarily being driven by an economic (i.e. GDP focused) agenda, with little attention for inequality, in spite of the fact that trickle-down economics has been strongly refuted in recent years. Human rights of marginalized people might suffer too, in the process. So we have our doubts whether the new government will be able play a substantial role for human development in India, and beyond, or will show new leadership in the health sector.

In any case, as we explained before, the pre-election rhetoric of a ‘muscular India’ has already made some neighbours nervous. They may actually think twice before joining hands with the new Indian government.  So it seems that Modi has already lost some ground even before taking the first step. Time will tell whether India will become a role model in the region, or, instead, a muscular neighbour that is more feared than admired.

 

 

 

Highlights of the week

 

1.    The 67th World Health Assembly

Without any question, the WHA is the global health highlight of the week. We dedicate a lengthy section to this annual global health fest (see below). But we already flag that you can find great coverage and videos on the WHO website, Global Health Watch and  IP Watch website. It’s obvious WHO has now fully embraced social media as well.

A great resource is the People’s Health Movement extensive  Commentary on the agenda of the 67th WHA, to get an in-depth overview of the agenda points, the historical background, and the contentious points  (must-read).

2.    WHO – Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage

http://apps.who.int/iris/bitstream/10665/112671/1/9789241507158_eng.pdf?ua=1

This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC.

3.    Joint WHO/WB paper – Monitoring Progress towards Universal Health Coverage at Country and Global Levels: Framework, Measures and Targets

http://www.who.int/healthinfo/universal_health_coverage/en/

Monitoring progress towards UHC is critical globally and especially in countries, including intervention coverage, financial risk protection, both with an equity dimension. This paper was written on the basis of consultations and discussions with country representatives, technical experts and global health and development partners, including an online consultation based on a draft paper.

4.    Two Chatham House reports – What’s the World Organization For?’ & companion paper ‘Shared Responsibilities for Health: A Coherent Global Framework for Health Financing’

 

  • Chatham House paper 1: What’s the World Health Organization For? Final Report from the Centre on Global Health Security Working Group on Health Governance

http://www.chathamhouse.org/publications/papers/view/199537

In 2011 the Centre on Global Health Security at Chatham House convened a major conference to mark the 10th anniversary of the Commission on Macroeconomics and

Health (CMH) chaired by Jeffrey Sachs. The meeting reviewed the significant changes in international health policies, institutions and financing that had occurred in the previous decade, and considered what should be the future priorities for improving health outcomes internationally, given today’s very different economic and political

circumstances. As a result of this conference, the Centre established two

working groups – on health governance and on financing, respectively.

The first one, The Chatham House Working Group on Health Governance, in the institute’s Centre on Global Health Security, was formed to considerthe role of the World Health Organization in the international system that supports global health. This is their final report. It was launched this week on Wednesday evening, in Geneva, together with its companion paper (see below).

 

See also Charles Clift’s blog post, ‘Reform of the WHO: Is It on the Right Track?’ And on the same topic (WHO reforms), you might also want to read this new Lancet   Letter (by Philippa Saunders & Mogha Kamal-Yanni), “WHO reforms: on course but core functions still require reliable support”. For a chronology of the whole WHO reform so far (including all key documents, see this MMI compilation).

 

  • Chatham House paper 2: Shared Responsibilities for Health A Coherent Global Framework

for Health Financing – Final Report of the Centre on Global Health Security Working Group on Health Financing

http://www.chathamhouse.org/publications/papers/view/199542

This report presents the findings and recommendations of the Working Group on Health Financing in the Centre on Global Health Security at Chatham House, shows how common challenges put such progress at risk in countries across the world, and

particularly in low- and middle-income countries. These challenges are common not only because they happen to be present throughout these countries, but also because

globalization means the underlying causes and transitions know no borders. This calls for collective action on a global scale. Specifically, the report calls for an agreed coherent global framework for health financing capable of securing sufficient and sustainable funding and of both mobilizing and using these funds efficiently and equitably

Both reports are must-reads, but we have a feeling that the second one will be the most popular one, judging from early Twitter comments.

 

5.    Lancet every newborn series

http://www.thelancet.com/series/everynewborn

Following The Lancet Neonatal Survival Series in 2005, this Every Newborn Series presents the clearest picture so far of the ongoing slow progress in newborn survival, provides new focus beyond survival, and combines research and reality in countries to set target for post-2015 to ensure that every newborn has a healthy start in life. Every year, 2·9 million newborn babies die from largely preventable causes, and 2·6 million more are stillborn.

 

The five papers advocate a specific focus: facility-based care around the time of birth. This is the time when most deaths occur and when most lives can be saved, and long-term disabilities averted, through higher coverage of effective interventions. This strategy requires responsive health systems that are equipped with lifesaving commodities and staffed with health workers who can deliver high-quality and timely skilled care, including emergency obstetric care and interventions for small and ill newborn babies.

(this Series was also big news at the WHA; see also coverage by Sarah Boseley in the Guardian)

 

6.    Reuters – Vaccines group seeks $7.5 bln to protect 300 million children

http://www.reuters.com/article/2014/05/20/health-vaccines-gavi-idUSL6N0O54SE20140520

In Brussels, the GAVI global vaccines alliance issued a plea on Tuesday for $7.5 billion to help immunise another 300 million children against life-threatening diseases between 2016 and 2020 and save up to 6 million more lives.  The 2015 replenishment conference will take place in Germany (see also the section below on GAVI).

7.    Global Health Action – 4 papers by Jocalyn Clarke on the medicalization of global health

http://www.globalhealthaction.net/index.php/gha/article/view/23998

Jocalyn Clarke critically examined the medicalization of global health, in a general paper and three papers on respectively UHC, NCDs and global mental health. I’m a big fan of the series. You should probably read them all (and especially if you’re a medical doctor or a philantrocapitalist).

World Health Assembly

 

Remco calls it the ‘World Health Theatre’, for me it feels more like ‘Kill Bill’ if I want to keep track of everything that’s going on there, from a distance. So before I succumb, let’s just flag some of the key coverage resources and events.

8.    WHO – Sixty-seventh World Health Assembly

http://www.who.int/mediacentre/events/2014/wha67/en/

You find daily press releases, videos of speeches (among others, from Margaret Chan & Melinda Gates this year), social media  videos (with plenty of interviews with important people in global health) and daily wrap ups.

Obviously there’s a lot of emphasis on Chan’s opening speech (in which she announced a new initiative to end childhood obesity (To gather the best possible advice on dealing with the crisis of childhood obesity, Chan has established a high-level Commission on Ending Childhood Obesity); and on Melinda Gates’ speech – Melinda talked about neonatal health, among other issues.

As already mentioned, the PHM and other civil society organisations weren’t very pleased with the forum Melinda got. Read their Letter to know why. (By the way, I disagree, even if I share a lot of their arguments)  For other PHM statements, see their website.

9.    IP Watch – Coverage of the World Health Assembly

http://www.ip-watch.org/category/who/

Absolutely brilliant coverage by IP Watch correspondents of everything that’s going on in Geneva. In-depth, so a number of articles are definitely must-reads. Read all about innovation and access to medicines (in BRICs & MICs), what WHO plans to do in terms of dealing with non-state actors (an evergreen), resolutions on hepatitis and combating TB, SSFFC efforts, AMR, destruction of smallpox stocks,  maternal and child nutrition, a mechanism to coordinate the NCD response, and much more.

Devex also had some ok coverage (see here and here).

10.NGOs – Statements by NGOs in official relations with WHO at the WHO governing body meetings

https://apps.who.int/ngostatements/content/sixty-seventh-world-health-assembly-a671-0

This resource website gives a good overview of the NGO stances on agenda points at the WHA.

11.UN foundation – 5 big stories from the WHA

http://unfoundationblog.org/5-big-stories-from-the-world-health-assembly/

Short and good article of some of the key messages emerging from Geneva.

 

Below we provide some articles which zoom in on some key issues at the WHA.

12.Global Health Governance – MDR-TB crisis is a key concern at the WHA

Tara Ornstein; http://blogs.shu.edu/ghg/2014/05/18/mdr-tb-crisis-is-a-key-concern-at-the-67th-world-health-assembly/

Read why.

13.Nature – Policy: An intergovernmental panel on antimicrobial resistance

Mark Woolhouse & Jeremy Farrar ;

http://www.nature.com/news/policy-an-intergovernmental-panel-on-antimicrobial-resistance-1.15275

Drug-resistant microbes are spreading. A coordinated, global effort is needed to keep drugs working and develop alternatives, say Mark Woolhouse and Jeremy Farrar.They  call for the creation of an organization similar to the Intergovernmental Panel on Climate Change (IPCC) to marshal evidence and catalyse policy across governments and stakeholders.  (IPCC style proposals are mushrooming these days)

By the way, it was tweeted that AMR commotion last year at the WHA was advocacy, now it’s about action.

14.Nature – Activists sound alarm on tiered drug prices

http://www.nature.com/news/activists-sound-alarm-on-tiered-drug-prices-1.15265

Tiered drug prices were also a hot topic also at the WHA. Before the Assembly, on 13 May, a coalition of 220 non-governmental organizations condemned a proposal from the Global Fund that promotes ‘tiered pricing’, in which drug companies offer the same medicines at vastly different prices in different countries. The GF already backtracked by now, at least to some extent.

15.WHO – Health in the post-2015 development agenda: Draft resolution reflecting the outcome of a drafting group

http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_ACONF4Rev1-en.pdf

Possible overarching post-2015 health goal: to ensure healthy lives & universal health coverage at all ages

 

16.Medicus Mundi – Prevention and control of non-communicable diseases in the face of free trade and market deregulation: How to preserve policy space for public health?

http://www.medicusmundi.org/en/contributions/events/2014/prevention-and-control-of-non-communicable-diseases-in-the-face-of-free-trade-and-market-deregulation-how-to-preserve-policy-space-for-public-health/view

At this WHA, several actors active within global health have raised their concerns about free trade agreements and market deregulation. A side event at the WHA organized by the Medicus Mundi International Network and Wemos Foundation together with the NGO Forum for Health (see also this week’s intro) underlines the potential loss of policy space that governments have to address the increasing global health threat of NCDs. Check out the debate.

17.Plos – Ethical Alternatives to Experiments with Novel Potential Pandemic Pathogens

Marc Lipsitsch & Alison Galvani;

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001646;jsessionid=C45F8684F941BC1766D006BECD72C663

Marc Lipsitch and Alison Galvani argue that the public health risk associated with experiments involving the creation of novel potential pandemic pathogens is too high and that safer alternatives exist. See also coverage in the Guardian.

18.Action for global health – Accountability Under Universal Health Coverage: Determining What Role Civil Society Must Play

http://www.actionforglobalhealth.eu/index.php?id=229&tx_ttnews[tt_news]=642&cHash=d0f6bbc33f3db091990b11a26ae08f63

Action for Global Health, in coordination with the Global Health Council, convened a civil society meeting at the WHA highlighting the role of civil society in holding governments accountable for the provision, coverage and quality of care under UHC. The event entitled; “Accountability under Universal Health Coverage: Determining what role civil society must play” addressed three key messages:

 

19.UN Special  – Special issue on global health diplomacy

http://www.unspecial.org/2014/05/where-health-and-diplomacy-come-together/

UN Special magazine dedicated its May issue to global health diplomacy in light of the WHA this year.  With an interview with the (inevitable) Ilona Kickbush, etc.

 

GAVI Replenishment

 

20.GAVI – investing together for a healthy future: details of the GAVI Alliance vision and investment opportunity for 2016-2020

http://www.gavialliance.org/replenishment-launch/investment-opportunity/

This document lays out the ‘investment’ case made in Brussels, at an event to kickstart replenishment of GAVI, which leads up to a replenishment conference in Germany (in 2015).  7.5 billion is needed (see also the ‘Highlights of the week’).

21.One – Going for goal: Immunisation and the case for GAVI

http://one.org.s3.amazonaws.com/pdfs/going_for_goal_report_en.pdf

If you like football, you’ll like this document – it draws a comparison between GAVI funding & the world cup football. Let’s hope Belgium will do better at the world cup than in terms of GAVI financing.

22.Devex – Why the EU ‘likes’ GAVI

https://www.devex.com/news/why-the-eu-likes-gavi-83534?UTM_source=twengagement&UTM_medium=twtweet&UTM_campaign=twdailypost

Unlike Belgium, the EU likes GAVI. Piebalgs, Barroso and others are a just a few of the fans.  Read why. On Tuesday, the European Commission announced it will contribute €175 million to fund the GAVI Alliance’s global immunization efforts over the next six years.

 

UHC & post-2015

 

23.Globalization & Health (Debate) – Beyond health aid: would an international equalization scheme for universal health coverage serve the international collective interest?

Gorik Ooms et al.; http://www.globalizationandhealth.com/content/10/1/41/abstract

Brilliant article, even if you don’t agree. Must-read.

24.Lancet (Editorial) – Neglected tropical diseases in the post-2015 health agenda

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60875-8/fulltext

I guess we all agree NTDs need to be part of the post-2015 health agenda. Peter Holmes, on behalf of the WHO Strategic and Advisory Group on Neglected Tropical Diseases, makes the case.

Infectious Diseases

 

25.IP Watch – WHO Report Compares Prices, IP Status Of HIV Treatment In Middle-Income Countries

http://www.ip-watch.org/2014/05/16/who-report-compares-prices-ip-status-of-hiv-treatment-in-middle-income-countries/

A new WHO report concludes that prices of HIV treatments vary greatly between middle-income countries (MICs), often depending on patent landscape, licensing agreements, whether drugs were sourced from originator companies, and regulatory approval. For third-line treatments, the price of drugs remains a challenge for all, with newer products more likely to be patented in key countries of production. The report titled “Increasing Access to HIV Treatment in Middle-Income Countries: Key data on prices, regulatory status, tariffs and the intellectual property situation,” is available here.

May 18 was also World Aids vaccine day, an annual event to focus attention on the need for a vaccine to prevent HIV infection and AIDS.

 

In very sorry news, it was reported that Rosemary Namubiru, a 64 year old nurse and HIV positive, was sentenced by a Ugandan court to three years in jail  (after finding her guilty of criminal negligence for allegedly trying to infect her patient with HIV).

26.Global Fund – WHO and Global Fund Strengthen Partnership

http://www.theglobalfund.org/en/mediacenter/newsreleases/2014-05-20_WHO_and_Global_Fund_Strengthen_Partnership/

The World Health Organization and the Global Fund strengthened their partnership with a new technical agreement to support countries in developing more strategic investments in the fight against HIV, tuberculosis and malaria.

27.MSF scientific day – 23 May

Speaking of Medicine;

A lot of attention for infectious diseases on the annual MSF scientific day. It’s being livestreamed. The programme you find here.

28.UCSF Global health group – The impact of the Global Fund’s new funding model on the 34 malaria-eliminating countries

UCSF briefing;

In an effort to understand the impact of the Global Fund’s NFM on the 34 malaria-eliminating countries,  the UCSF Global Health Group’s Malaria Elimination Initiative analyzed the change in available funding, if any, for each of the countries.

 

29.Lancet (Editorial) – MERS-CoV: address the knowledge gaps to move forward

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60864-3/fulltext

There are still huge knowledge  gaps for MERS-CoV, after two years. Something needs to be done. See also the Lancet  World Report, ‘MERS-CoV enigma deepens as reported cases surge’ (by David Holmes).

And a Reuters special report examines why Saudi-Arabia gets so much flak for the spread of MERS. (not sure why Wilders hasn’t jumped on the issue yet)

 

NCDs

 

30.WHO – Global status report on alcohol and health 2014

http://www.who.int/substance_abuse/publications/global_alcohol_report/en/

The Global status report on alcohol and health 2014 presents a comprehensive perspective on the global, regional and country consumption of alcohol, patterns of drinking, health consequences and policy responses in Member States. It represents a continuing effort by the WHO to support Member States in collecting information in order to assist them in their efforts to reduce the harmful use of alcohol, and its health and social consequences. The report was launched in Geneva on Monday 12 May 2014 during the second meeting of the global network of WHO national counterparts for implementation of the global strategy to reduce the harmful use of alcohol.

31.Euractiv – UN says diet a greater threat to health than tobacco

http://www.euractiv.com/sections/health-consumers/un-says-diet-greater-threat-health-tobacco-302218

News from last weekend. The UN Special Rapporteur on the right to food, Olivier De Schutter, has called for a global agreement to promote healthy eating habits, saying “unhealthy diets are now a greater threat to global health than tobacco.”

32.Lancet (Editorial) – Seizing the opportunity to rethink renal research

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60863-1/fulltext

This Editorial is linked to a themed issue of The Lancet, published ahead of a Congress in Amsterdam. The global burden of kidney disease is increasing, but kidney disease gets little attention from policy makers. “In a Comment last year we called for a global target of 0 by 25: zero deaths of patients with untreated acute kidney failure in low-income countries by 2025. To meet this objective the nephrology community must refocus research on the areas that need it most.”

33.Lancet (Letter) – What have economists ever done for global health?

Stephen Jan et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60872-2/fulltext#

Episiode 56 in the fight between Richard Horton & economists. Even if I presume the authors of this article are economists, I agree with their stance (for once). “In response to The Lancet’s persistent attack on economics and economists, we offer the view that the lack of progress in addressing the global epidemic of chronic diseases is largely failure to recognise it as mainly an economic problem. We would contend that a major reason for little progress in addressing chronic illness is that not enough economics has been involved in the development of interventions and, instead, such tasks have hitherto been taken over by narrow medical and public health perspectives.”

34.Globalization & Health (Commentary) – Research to stop tobacco deaths

Derek Yach et al.; http://www.globalizationandhealth.com/content/10/1/39/abstract

In 2003, governments adopted the Framework Convention on Tobacco Control, the world’s first global health treaty. In the decade since the treaty was adopted by 178 member states of the World Health Organization, there have been substantial achievements in reducing tobacco use around the world. Research and evidence on the impact of interventions and policies have helped drive this policy progress. An increased and sustained focus on research is needed in the future to ensure that the gains of the global tobacco control movement are maintained, particularly in LMICs, which are affected most strongly by the tobacco epidemic. In addition to current priorities, greater attention is needed to research related to trade agreements, prevention among girls, and the appropriate response to nicotine-based noncombustibles (including e-cigarettes), Yach et al argue.

Maternal, child health & adolescent health

 

35.Global Post – Canada focused on maternal, child health ahead of summit in Toronto

global post;

 

A week before an international conference on maternal and child health care opens in Toronto, the Harper government is rolling out announcements on what it sees as its signature issue on the world stage.”   (I like that – “rolling out announcements …”)

 

36.Global Health Science & Practice – May issue

Global Health: Science and Practice Journal;
The new issue of the “Global Health: Science and Practice Journal” focuses on maternal and child health. Check out for example the Editorial  ‘Taking Exception. Reduced mortality leads to population growth: an inconvenient truth’, and the Commentary ‘Getting family planning and population back on track’.

 

37.Lancet – Offline: How many women die in India?

 

Richard Horton; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60839-4/fulltext

 

Horton seems to think Narendra Modi actually cares about the difference between the UN estimate of how many women die during pregnancy and childbirth in India  (50 000) and the Institute for Health Metrics and Evaluation (IHME) estimate (71 792).  He concludes strengths and weaknesses of not just the GBD estimates but also of UN estimates need to be examined. If this happens, Modi will be less confused, he reckons.

38.Lancet (Correspondence) – Investing in obstetric surgery and anaesthesia to close the gap in maternal mortality

Anna J Dare et al. ;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60876-X/fulltext

Failure to include hospital-based obstetric surgical and anaesthetic services, and to support infrastructure such as blood banks within maternal health investment frameworks for LMICs, underestimates the true investment required to reduce maternal mortality to acceptable global standards. Furthermore, such an approach weakens investment in secondary care services generally, threatening progress towards a diverse range of health and development goals in the medium to long term.”

 

39.Lancet Global health (Comment) – Seizing the moment to end obstetric fistula

Babatunde Osotimehin;

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70251-7/fulltext

On May 23, the International Day to End Obstetric Fistula, the author calls on the worldwide community to make the transformative shift of leaving no one behind, even those invisible in society, by seizing the moment to end fistula forever.

 

40.Smart Global Health  – Why It’s Time to Put Women’s Issues at Center of Foreign Policy

Janet Fleishman;

http://www.smartglobalhealth.org/blog/entry/why-its-time-to-put-womens-issues-at-center-of-foreign-policy/

 

Starting from the horrific Boko Haram inflicted suffering, Fleishman says it’s time to put women’s issue at the center of US foreign policy.

 

Health Policy & Financing

 

 

41.Lancet Global Health (June issue)

The new issue of the Lancet Global Health comprises this – summarizing –  introduction by Zoë Mullan  (Cost-effectiveness and classification)  and a wealth of other articles.

Mullan notices so far Global Surgery hasn’t made it onto the WHA agenda. But that will probably change in the near future, with, among others, a Lancet Commission on Global Surgery coming up. See also this early online Lancet viewpoint, ‘Global surgery: defining an emerging global health field

The Lancet Global Health issue also features a number of Letters on polio eradication in Nigeria, among others one from EV Seye Abimbola. In another Letter, IFMSA members express their anger about the last WHO Executive Board meeting’s failure to reach consensus on the adoption of a provisional agenda on improving the health and wellbeing of LGBT people.

Check out also the call  on Europe to invest more in operational research in LMICs. The authors of this Comment refer to the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the WHO/TDR, that in their opinion could serve as a global springboard for country-level capacity building. “SORT IT programmes support countries to undertake operational research in accordance with their own priorities, develop adequate and sustainable operational research capacity in public health programmes, and create an organisational culture of policy and practice being informed by operational research, leading to improved programme performance.”

 

42.BMJ (Feature) – Cannabis regulation: high time for change?

http://www.bmj.com/content/348/bmj.g3382

Cannabis is widely available despite its use and production being illegal in most countries. Rebecca Coombes looks at recent moves (in countries like Uruguay, but also 2 US States)  to regulate production and the potential effects on public health. Apparently Uruguay is the example to follow. The country sure has an interesting president.

43.CGD – Is there such a thing as too much verification?

Amanda Glassman & Kate McQueston; http://www.cgdev.org/blog/there-such-thing-too-much-verification

Starting from a recent article in the New York Times that describes an exchange between the Against Malaria Foundation (AMF) and GiveWell on the value of spending to verify distribution and use of insecticide-treated bednets, Amanda Glassman & Kate McQueston notice it’s not often the problem seems to be too much verification in global health projects. Interesting blog post.

 

44.AFP – UN eyes Africa oil levy to fight disease

AFP;  The United Nations has begun talks with African leaders over a levy on oil that could rake in huge sums to fight disease in developing countries, a top official said Tuesday.”This year I will be working with African leaders for a tax on natural resource extraction, a very important development,” said Philippe Douste-Blazy, chairman of UNITAID. Indeed. Now we still have to convince the oil companies.

 

45.CGD – White House Bans CIA Use of Vaccine Programs as Cover

Charles Kenny; http://www.cgdev.org/blog/white-house-bans-cia-use-vaccine-programs-cover

Pretty big news, even if Tom Paulson thought it doesn’t go far enough.

 

46.Global Health Check – Have pharmaceutical companies changed?

Mogha Kamal-Yanni;

http://www.globalhealthcheck.org/?p=1608

 

Always good to read. At least some pharmaceutical companies have a memory, Kamal-Yanni says.

47.Lancet Mass Gatherings series

http://www.thelancet.com/series/mass-gatherings-medicine

 

The Lancet has published a Series of reports about different mass gatherings: the London 2012 Olympic and Paralympic Games; the 2012 European Football Championship finals (Euro 2012), hosted jointly by Poland and Ukraine; and Hajj 2012 and Hajj 2013. These reports, led by Professor Ziad Memish, Deputy Minister of Health for Public Health in Saudi Arabia, and Professor Alimuddin Zumla, at University College London Medical School, UK, set out the planning and surveillance systems used to monitor public health risks, and describe the public health experiences and lessons learnt for the planning of future events.

 

For the upcoming World Cup in Brazil, all eyes are, among others, on dengue.

 

48.The real agenda of the Gates foundation

Jacob Levich;

http://www.rupe-india.org/57/gates.html

 

Lovely article, but you have to be a bit of a conspiracy theorist to fully enjoy it. If you don’t read the article, at least you might want to ponder this paragraph: “Gates’ willingness to carry the torch for the world’s billionaires reflected an understanding that his Foundation plays an important ideological role within the global capitalist system. Apart from the promotion of specific corporate interests and imperialist strategic aims, BMGF’s expertly publicized activities have the effect of laundering the enormous concentration of wealth in the hands of a few supremely powerful oligarchs. Through stories of Gates’ philanthropy we are assured that our rulers are benevolent, compassionate, and eager to “give back” to the less fortunate; moreover, by leveraging their superior intelligence and technocratic expertise, they are able to transcend the bureaucratic fumblings of state institutions, finding “strategic, market-based solutions” to problems that confound mere democracies. This apotheosis of Western wealth and knowhow works hand-in-hand with an implicit contempt for the sovereignty and competence of poor nations, justifying ever more aggressive imperialist interventions.

 

49.Project Syndicate – Why Jeffrey Sachs Matters

Bill Gates;

http://www.project-syndicate.org/

Speaking of Gates, in this piece he calls Jeffrey Sachs the ‘Bono of economics’. And Jim Kim explainswhat he learned from Bill Gates.I have to admit I also admire Gates’ grit, determination and sense for detail.

50.HS Global blog

http://www.healthsystemsglobal.org/Blog.aspx

New blog and every health systems and health policy researcher is encouraged to send blogs to Jeff Lazarus, in the run-up to the Symposium. Try to give your blogs a ‘people centred care’ twist.

 

 

Research

 

51.Implementation science – Reporting of context and implementation in studies of global health interventions: a pilot study

Jill Luoto et al.;

http://www.implementationscience.com/content/9/1/57/abstract?utm_content=buffer8f61c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

 

There is an increasing push for `evidence-based’ decision making in global health policy circles. However, at present there are no agreed upon standards or guidelines for how to evaluate evidence in global health. Recent evaluations of existing evidence frameworks that could serve such a purpose have identified details of program context and project implementation as missing components needed to inform policy. The authors of this article performed a pilot study to assess the current state of reporting of context and implementation in studies of global health interventions.

52.Health Policy & Planning – Equity in the allocation of public sector financial resources in low- and middle-income countries: a systematic literature review

Laura Anselmi et al.;

http://heapol.oxfordjournals.org/content/early/2014/05/16/heapol.czu034.short?rss=1

This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries.

 

53.Health Policy & Planning – Consensus and contention in the priority setting process: examining the health sector in Uganda

Sarah Colenbrander et al.;

http://heapol.oxfordjournals.org/content/early/2014/05/18/heapol.czu030.short?rss=1

With Charles Birungi, EV 2013, as co-author. Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors’ priorities differ in low-income countries, using Uganda as a case study.

 

 

54.BMC Health Services research – Developing attributes and attribute-levels for a discrete choice experiment on micro health insurance in rural Malawi

Gilbert Abotisem Abiiro et al.;

http://www.biomedcentral.com/content/pdf/1472-6963-14-235.pdf

EV 2012 Gilbert Abiiro just published two papers in BMC Health Services research. This one, and another one, ‘Gaps in universal health coverage in Malawi: A qualitative study in rural Communities’. Check them out!

Miscellaneous

 

 

55.Science  (special issue) – The Science of Inequality

A special issuewith a wealth of information. This special issue uses these fresh waves of data to explore the origins, impact, and future of inequality around the world.

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