Dear Colleagues,

 

Over the last few weeks, a number of Emerging Voices 2014 have been selected from all corners of the world. In the coming weeks, you’ll get to know more about this year’s venture and Voices. Just like all of you, we reckon they’re increasingly ‘in the mood for Cape Town’!  In this week’s guest editorial, one of these new EVs, Swati Srivastava from India, reflects on this year’s World No Tobacco day theme, ‘raise taxes on tobacco’.

The world paid some attention to an international conference on inclusive capitalism in London, but by and large ignores the annual Bilderberg  secretive capitalist “get together”, in Copenhagen.  Mozambique hosted an Africa rising  conference, but for our purposes, Stephen Harper’s ‘Saving Every Woman Every Child’ summit  probably deserves most attention this week. I’m sure Stephen agrees. So we invited Rachel Hammonds (ITM colleague and Canadian citizen) to give her impressions. You find them below.

“What should we make of the 28-30 May Global Summit in Toronto, Canada, in support of Every Woman Every Child? The Summit’s host, Canadian Prime Minister Stephen Harper, aims to regalvanise efforts to reduce the preventable deaths of newborns, women and children younger than the age of five in developing countries. That sounds great to me, but as a lapsed Canadian I am no longer willing to blindly believe that Canada is a force for good on the international scene.  Why?

First, Harper’s government is socially conservative and for his political base women’s health is generally understood as maternal health. What is more troubling to sexual and reproductive rights advocates is the limited view that the Harper government has taken of advancing access to reproductive rights internationally, an international obligation that Canada has committed itself to achieving.

Second, given the Harper government’s track record on prioritising its international development obligations, Harper’s motives for stepping back into the international spotlight deserve to be questioned. My initial reaction to Harper’s hosting the Summit was the same as that of a recent transplant to Canada, Alan Whiteside, head of global health policy for the Centre for International Governance Innovation, Waterloo, Canada: “I find it quite troubling that at the same time as you have the maternal and child health initiative, we have a government that shuts down the Canadian International Development Agency. … It could be a form of political gamesmanship.”

For those not familiar with Canadian trivia Harper’s government has frozen international aid at 0.3% of GDP (far from the 0.7% advocated by former Canadian PM Lester B Pearson) and has merged the Canadian International Development Agency (CIDA, launched during the government of another great Canadian PM, Pierre Trudeau) into the Department of Foreign Affairs. The stated aim of the amalgamation was to improve policy coherence.  Unfortunately, policy coherence has improved, as Canadian policy now fully embraces the economic growth and investment model. Addressing the structural causes of global poverty or structural obstacles faced by poor people in accessing their human rights is no longer the focus of Canadian policy. Canada now focuses on increasing private sector engagement in development as the main approach to addressing global poverty or as one analysis notes “providing the poor with opportunities to meet the needs of businesses.”

Third, Canada is the country that brings us the blessings of  tar sands (or if you are a supporter “oil sands” ). For better or for worse, the Canadian mining industry is a global leader. The Harper government is actively supporting the growth of the extractive industry in Canada and overseas yet only supports enhanced corporate social responsibility, and not legally enforceable mechanisms, to regulate the  environmental and health consequences of extractive industries that impact the world and global health.

I would certainly argue that Every Woman Every Child needs fresh momentum and if Harper is willing to play the role Bush Jr. did for access to treatment for HIV/AIDS then maybe I should hold my tongue and give credit where credit is due. After all, in 2010 Harper launched the Muskoka Initiative focusing on health, nutrition and disease and funded it. In Toronto he has pledged  an additional 3.5 billion which is great news. What remains to be seen is if other countries will meet their pledges and if the policies they fund will move beyond prioritizing women who are mothers and push for international attention and funding for reproductive rights, including access to family planning and abortion.

In summary, Harper deserves to be praised for his commitment and I hope that others will follow his lead and meet their funding commitments. However our praise should not be blind. We should continue to ask questions to better understand how this money will be channeled and track this funding over time. A restricted focus on women’s health as maternal health is not an advance for sexual and reproductive rights advocates nor for women. We should also take note of the new orientation of Canadian engagement with the developing World.”

Nicely put, Rachel.

 

Enjoy your reading.

 

The editorial team

 

 

Editorial

 

 

World No Tobacco Day 2014: Raise taxes on tobacco, a proven weapon of mass destruction!

 

Swati Srivastava (Public Health Foundation of India & EV 2014)

May 31st of every year is celebrated as World No Tobacco Day (WNTD) by the World Health Organization (WHO) and affiliated partners. The aim of the WNTD is to highlight the adverse risks associated with tobacco consumption, and to mobilize individuals, civil society and policy makers alike on key themes in tobacco control. Now that George Bush is no longer at the helm of affairs, the WHO might want to capitalize on a more lucrative acronym- WMD, for tobacco actually is a proven weapon of mass destruction.

Various themes addressed in the past WNTDs include gender and tobacco and marketing to women; “tobacco kills”; bans of tobacco advertising, promotion and sponsorship, among others. The theme for this year’s WNTD is “Raise taxes on tobacco”, to levels that are effective to reduce consumption.  It includes increasing existing tax rates, moving away from import duties, adopting a simpler tax system, reducing tax differentials amongst tobacco products, and reducing illicit trade.

Price increase, by means of increased taxation or otherwise, is considered to be the single most effective method to decrease consumption and encourage tobacco users to quit. The implementation of tax and price policies to reduce tobacco consumption is recommended by the Framework Convention on Tobacco Control (FCTC), WHO (Article 6, 2005). Consistent evidence demonstrates the effects of higher prices on tobacco products on decreased consumption and initiation of use, above all among adolescents and persons belonging to lower socio-economic strata.  In high income countries, estimates of the price elasticity of cigarette demand range from −0.25 to −0.50, while those from low- and middle-income countries range from −0.50 to −1.00, suggesting that a 10% increase in cigarette prices will lead to reductions in cigarette consumption of 2.5-5% in high income countries and 5-10% in low income countries. Low income countries are important to focus on for other reasons: a larger, younger demographic; lax laws and policies; and being the focus of multinational tobacco companies looking to expand their markets.

While there are almost 6 million deaths attributed to tobacco use every year across the world (with 600,000 of these occurring in non-smokers due to second hand smoke), only 8% of the world’s population lives in countries with tobacco taxes at recommended levels. More than 80% of total tobacco deaths are among people living in low-and middle-income countries. According to WHO figures, in 2012 only 32 countries in the world had complete policies in line with guidelines recommended in the FCTC. Tellingly, 104 countries had minimal or no tobacco taxation policies in place. When we break up countries by income status, the picture is even gloomier, with only 11 middle-income and 1 low income countries meeting the recommended benchmark of the total tax on cigarettes constituting 75% of the total retail price. Again, 96 middle income and 30 low income countries have cigarette taxes less than 50% of the total retail price.

Raising tobacco taxes has to go hand in hand with improving measures to increase tax compliance and governance, especially for indigenous tobacco products such as chewed forms of tobacco, bidis, kreteks, etc which have been traditionally subsidized, excluded from taxes or taxed very low in comparison to cigarettes. Also, tax increases must be both indexed to inflation and account for the rise in incomes in growing economics, if they are to be effective, as was seen in the case of Brazil between the years 2007-11.

The tobacco industry, their front groups and governments which are stakeholders in the tobacco supply chain have become more vocal in the run-up to this year’s WNTD. In Bahrain, a move by the government to triple cigarette taxation has been criticized by industry as a violation of the Free Trade Agreement (FTA) that Bahrain has signed with the US. Ten days ago, tobacco company representatives reportedly met a visiting US Trade Department official to discuss the planned increase in taxes. Another study from Australia released a week ago suggests smuggling of tobacco will increase due to the regular increases in tax proposed by the government. Other reasons for concern include the global push to reduce trade restrictions, including those on tobacco. The Transatlantic Trade and Investment Partnership and the Trans-Pacific Partnership give tobacco companies “a new place to take disputes — a tribunal that stands separate from and above domestic legal systems.” Tobacco companies took governments in Uruguay and Australia to court; and on the other side of the fence, Indonesia, Ukraine, the Dominican Republic, Honduras, and Cuba have challenged what they have perceived to be discriminatory practices for their tobacco products in the World Trade Organization.

Increase government revenue from tobacco taxation provides an innovative financing mechanism for health, especially if the revenues are earmarked for specific health goals. In India, the total central excise (excluding state revenues) accrued from all tobacco products in 2010-11 amounted to nearly 80% of the total actual expenditure on health and family welfare by the central government, and total tobacco revenues can be used to fund health programs. At present, India levies certain taxes to fund the National Rural Health Mission, but the rates of these are very low. Costa Rica has been a world leader in implementing a phased tax increase with revenue earmarked for tobacco control and other health initiatives. However, the basis of increased taxation must be for the goal of deterring consumption, regardless of revenue generation, which is an additional bonus.

Let’s see whether Mr. Modi thinks likewise in India. But in any case, it doesn’t seem to be mainstream thinking in the global health community – who tend to link sin taxes more and more to financing of Universal Health Coverage in LMICs.

 

 

Highlights of the week

 

1.    67th World Health Assembly

Below, we dedicate a short section to the latest World Health Assembly  (further coverage and analysis, in addition to last week’s). Here we already refer to IP Watch’s excellent coverage of the week in Geneva, and an assessment of the week by Remco van de Pas (IHP).

2.    WHO – Migration of health workers: The WHO Code of Practice and the Global Economic Crisis

http://www.who.int/hrh/migration/migration_book/en/

In 2010, the World Health Assembly adopted the Global Code of Practice on the international recruitment of  Health Personnel. This publication by WHO’s human resources for health department provides a comprehensive overview of current trends of health workforce migration in several parts of the world, explains how the Code of Practice is implemented so far to address imbalances in the available workforce, and examines its potential for future work on migration and retention of health personnel. On the path towards UHC, scaling up the health workforce is of crucial importance. This book provides country studies and suggests how to address the global maldistribution of health workers from a health systems and human rights perspective. WHO’s global code of practice is a crucial tool in managing health workforce mobility both at a regional and global level”.  This publication was launched on May 22nd, as part of the WHA.

 

3.    The Globe and Mail – Ottawa commits $3.5-billion to improve maternal health

http://www.theglobeandmail.com/news/politics/ottawa-commits-major-new-funding-for-maternal-health/article18913095/

Coverage and analysis of the maternal & child health summit in Toronto.

4.    Global Fund Observer – Issue 244, with focus on New Funding Model

http://www.aidspan.org/gfo_article/transition-nfm-marred-unanticipated-consequences

This week’s GFO issue has got (dueling) commentaries from David Garmaise and Mark Eldon Edington & Seth Faison (from the Global Fund Secretariat) about the challenges and misconceptions that emerged from the transition to, and roll-out of the New Funding Model (NFM).

 

David Garmaise says it’s unfortunate that the transition from the rounds-based system has added complications and has had some unanticipated consequences.  In a rebuttal to this, the Global Fund says the new funding model is designed to optimize use of all available funding, from all sources, so that partners can work together to find the most effective solutions to health challenges. The new funding model was set up to adjust to change, not to block it, Edington & Faison say.  All in all, an interesting discussion which might stimulate debate at the country level and beyond.

 

5.    Lancet (Comment) – Rethinking the foundations of global governance for health: the youth response

Unni Gopinathan et al. ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60766-2/fulltext

On May 26, 2014, The Lancet—University of Oslo Youth Commission on Global Governance for Health, released its report, “Advancing Health by Enhancing Capabilities: An Agenda for Equitable Global Governance”, which builds upon the work of the Lancet Commission on GG4H and offers a parallel assessment of the relation between global governance and human health. A key message of the report is that the concept of global governance for health requires stronger philosophical and theoretical foundations to help it balance the importance of public health among competing interests. “Global governance for health, supported by (Amartya Sen’s) capability approach, could raise the prominence and legitimacy of health on the global stage and provide a meaningful benchmark for weighing health against other important interests.”   So Sen’s capability approach, but also intergenerational solidarity, more structural involvement of civil society (including representatives of the marginalized) in global decision making, … are key themes, among others, in the report.

 

World Health Assembly

 

6.    Coverage & analysis – IP Watch, WHO, Devex, …

You find great coverage on the WHO website, IP Watch  (about 15 articles, so almost as many as resolutions passed !), Devex, …

Nice to know is also that WHA Committees A and B as well as plenary meetings will be webcast from next year on. Will attract a crowd, no doubt. And even better news, it looks as if the Geneva Headquarters will be renovated in the coming years. Was about time – the headquarters started to resemble Ground Zero.

Analysis and general assessments of the WHA you find on Devex (9 important takeaways from the WHA, WHO (WHA closes), and  UHC forward( 20 resolutions)

7.    IHP – The record breaking 67th World Health Assembly: reflections from one of the survivors

Remco van de Pas ; http://archief.internationalhealthpolicies.org/archives/record-breaking-67th-world-health-assembly-reflections-survivors/

Remco survived a World Health Assembly that was record breaking in a number of respects. He draws some key messages, on AMR, climate change & health, engagement with non-state actors, and other pressing global health priorities.

8.    MSH – Principle Meets Pragmatism on Universal Health Coverage

Jonathan Jay; http://www.msh.org/blog/2014/05/28/principle-meets-pragmatism-on-universal-health-coverage

Must-read. Jonathan Jay coordinates Health for All Post-2015, a worldwide campaign of over 30 civil society organizations advocating for UHC as an essential component of the post-2015 health agenda. He and many others were surprised last week when WHO proposed a global goal of achieving UHC by 2030—specified by, among others, a target of at least 80 percent coverage with key health services. (On politics versus principle.)

IP Watch & the People’s Health Movementalso paid some attention to the 135th Executive Board meeting of WHO.

 

Global Fund & PEPFAR

 

9.    Global Fund Observer (issue 244)

http://www.aidspan.org/gfo_article/five-key-recommendations-icaso-civil-society-global-fund-country-dialogue

 

See above (highlights of the week), for the discussion on the transition to the NFM. But we also want to refer to this article. In a second guidance note as part of its Navigating the New Funding Model series, the International Council of AIDS Service Organizations (ICASO) has developed a series of five key recommendations for better engagement in country dialogue by civil society organizations and representatives of key affected populations.

 

10.Devex – How the new Global Fund-WHO partnership will work

https://www.devex.com/news/how-the-new-global-fund-who-partnership-will-work-83567

As already mentioned in last week’s IHP newsletter, WHO experts will be providing technical assistance to country teams and civil society groups looking to secure grants from the Global Fund. At the WHA in Geneva, the two groups announced they had struck up a partnership as part of which WHO will extend its technical expertise to Global Fund applicants that request help in their planning. The partnership ends in December 2015.

11.Science Speaks – Ambassador Deborah Birx on Uganda, and why she doesn’t say “country ownership”

http://sciencespeaksblog.org/2014/05/28/ambassador-deborah-birx-on-uganda-and-why-she-doesnt-say-country-ownership/

Science Speaks interviewed PEPFAR’s new leader, Deborah Brix, looking at impact, accountability, transparency in a sustainable response. You find the second part of the interview here. Terminology matters, more than ever. Birx doesn’t like the word ‘country ownership’, and neither does she like ‘transition’. Read why (and much more).

 

UHC, post-2015 & global governance for health

 

12.Lancet – Offline: WHO offers a new future for sustainable development

Richard Horton;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60889-8/fulltext

WHO has made its definitive statement about the future it envisions for the post-2015 era of sustainable development. At a standing-room only technical briefing during last week’s WHA, Margaret Chan, launched the agency’s position. WHO is seeking a single overarching health goal—“Ensure healthy lives and universal health coverage at all ages”. By placing so much emphasis on UHC post-2015, WHO has responded to an extraordinary demand by countries, even if some donors were less convinced. WHO also sets out four subgoals. Horton also examines how WHO’s stance was perceived.

13.Times of India – New doctor in town promises health insurance for all

http://m.timesofindia.com/india/New-doctor-in-town-promises-health-insurance-for-all/articleshow/35653814.cms

Over to the land of Modi. ‘Health insurance for all’ will be the top priority of the Modi government, said Dr Harsh Vardhan, who took charge as Union health minister on Tuesday. Wait and see, we guess.

14.Center for Global Health and Diplomacy – videos of presentations and panels on financing for health post-2015

http://www.cghd.org/index.php/forums/past-forums/world-health-assembly/financing-for-health-post-2015

At a WHA event, leading global thought leaders were brought together to

advance consensus solutions to the challenge of financing health in the post-2015 era.

 

You can find a number of videos here, as well as the keynote speech by Mr Sidibé, ‘leveraging the new realities of global health financing’, an apt title for this sort of high-level meeting.

 

 

Infectious diseases

 

15.Guardian – Immune children raise hopes of malaria vaccine breakthrough

http://www.theguardian.com/global-development/2014/may/23/malaria-pfsea-1-vaccine-immune-children

From last weekend: researchers’ discovery of an antibody that halts the progress of malaria by caging its parasites in red blood cells, has raised fresh hopes of a vaccine against the deadly disease.

16.IPS – Divided opinions on feasibility of Kenya’s Option B+ Roll out

http://www.ipsnews.net/2014/05/divided-opinions-feasibility-kenyas-option-b-roll/

Kenya’s health sector has been facing significant challenges, ranging from a shortage of health care providers to a series of labour strikes. The problems have not only disrupted health services, but have HIV experts divided on whether to roll out Option B+ nationwide or just to pilot it in high volume facilities such as major referral hospitals.  Option B+ is the latest treatment option recommended by the World Health Organisation for HIV positive mothers.”

17.Scidev.net – View on Gender: A menu of choices for HIV prevention

 

http://www.scidev.net/global/hiv-aids/analysis-blog/view-on-gender-a-menu-of-choices-for-hiv-prevention.htmlGiving sex workers HIV drugs before they are at risk of infection — pre-exposure prophylaxis (PrEP) — is showing promise as a public health strategy.  What’s less clear is how best to make these drugs available. “Behavioural scientist Ana Wheelock, who is based at Imperial College London, United Kingdom, has spent several years investigating this question. She says clinical trials have already proven that the treatment is effective, but what is now needed is to explore whether people will find the treatment regimes workable in real-life settings.” There are now at least six projects in developing nations to assess this.

18.Reuters – West Africa Ebola outbreak still spreading, ‘situation serious’: WHO

http://www.reuters.com/article/2014/05/28/us-ebola-westafrica-idUSKBN0E81IQ20140528?feedType=RSS&feedName=healthNews
Guinea’s capital Conakry has recorded its first new Ebola cases in more than a month, while other previously unaffected areas have also reported infections in the past week, according to the World Health Organization”. “The situation is serious, you can’t say it is under control as cases are continuing and it is spreading geographically,” Dr Pierre Formenty, a WHO expert who recently returned from Guinea, told a news briefing in Geneva on Wednesday.”

19.Laurie Garrett (blog) – Polio and the CIA

http://lauriegarrett.com/blog/2014/5/23/polio-and-the-cia

Already covered last week, but of course, Laurie is the authority, so if you want the detail, see this blog post. “On Friday, May 16, the United States National Security Council sent a letter to thirteen deans of schools of public health in the United States vowing to never again deploy fake “vaccinators” as a component of counterintelligence operations. I obtained a copy of the letter and the e-mail thread verifying its authenticity, both of which are posted below.”

There’s also a Lancet  Editorial on the same topic.

20.NEJM (Perspective) – Embracing Oral Cholera Vaccine — The Shifting Response to Cholera

Jean William Pape et al.;

http://www.nejm.org/doi/full/10.1056/NEJMp1402837?query=featured_home

 

Cholera is a disease of poverty, linked to poor sanitation and a lack of potable water. Establishment of an adequate sanitation and potable-water system is the most definitive way to prevent and limit its spread. However, the cost of instituting adequate sanitation systems, one of the United Nations Millennium Development Goals, is prohibitive for the countries that are affected by cholera. Water, sanitation, and hygiene (WASH) practices are the cornerstones of cholera prevention and control.  What role should oral cholera vaccine (OCV) play, in combination with WASH practices, in epidemic conditions?”

 

“Since 2010, some major obstacles preventing the use of OCV have been overcome. Shanchol, the cheapest and easiest-to-administer vaccine, is being stockpiled. OCV has been used in 13 countries on three continents (Asia, Africa, and the North American Caribbean) and in three risk settings. The new  study  by Luquero et al. (in NEJM) provides further evidence in favor of using OCV in emerging outbreaks.”

 

NCDs

 

21.WHO – WHO calls for higher tobacco taxes to save more lives

http://www.who.int/mediacentre/news/releases/2014/no-tobacco-day/en/

As already mentioned in the guest editorial this week, on World No Tobacco Day (31 May), WHO calls on countries to raise taxes on tobacco to encourage users to stop and prevent people from becoming addicted to tobacco. Based on 2012 data, WHO estimates that by increasing tobacco taxes by 50%, all countries would reduce the number of smokers by 49 million within the next 3 years and ultimately save 11 million lives.

Meanwhile, good to know that children as young as 12 are eligible to work in tobacco growing farms in some US states as per existing labor laws – seea Human Rights Watch report, ‘Tobacco’s hidden children’.  Disgusting, and even more so if you see the side-effects.

22.BMJ (news) – Tobacco control policies should embrace harm reduction products, nicotine experts say

http://www.bmj.com/content/348/bmj.g3604

A group of international experts has urged the World Health Organization to support the use of tobacco harm reduction strategies, where smokers switch from tobacco to low risk nicotine based products such as electronic cigarettes (e-cigarettes) or snus (an oral tobacco), in discussions later this year on setting international tobacco control policy.

23.Lancet (Comment) – Reducing the global prevalence of overweight and obesity

Klim McPherson; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60767-4%20%20/fulltext

The latest analysis from the GBD 2013 shows there has been a startling increase in rates of obesity and overweight worldwide—in both adults (28% increase) and children (up by 47%) in the past 33 years. The number of overweight and obese people has increased from 857 million in 1980 to 2·1 billion in 2013. In a Comment, Klim McPherson calls for a political solution stating that policy needs to solve the problem of rising obesity.

24.Lancet (Editorial) – Hypertension: an urgent need for global control and prevention

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60898-9/fulltext

That goes without saying. The Lancet has three papers on this important issue this week.

 

NTDs

 

25.Plos Neglected Tropical diseases (Viewpoint) – The Gulf Coast: A New American Underbelly of Tropical Diseases and Poverty

Peter J. Hotez; http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002760

The recent finding that dengue fever has emerged in Houston, Texas—the first major US city in modern times with autochthonous dengue—adds to previous evidence indicating that the Gulf Coast of the Southern US is under increasing threat from diseases thought previously to affect only developing countries. “Houston, we have a problem…”

26.Speaking of Medicine (blog) – The Blue Marble Health Collection: Redrawing Boundaries that Disease has Already Crossed

http://blogs.plos.org/speakingofmedicine/2014/05/29/blue-marble-health-collection-redrawing-boundaries-disease-already-crossed/

Peter J. Hotez & Larry Peiperl elaborate on a new PLOS Collection that highlights a shift in current thinking about global health. You find the ‘Blue Marble Health: the mismatch between national wealth and population health’  Collection  here. “Blue marble health” is a recent concept that recognizes a paradoxical disease burden – particularly the burden of NTDs – among poor people living in G20 and other wealthier countries, requiring these nations to take greater ownership for both disease control and research and development into NTDs.

27.Lancet Global health – Progress in treatment and diagnosis of yaws: hope for eradication?

Lola V. Stamm; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70248-7/fulltext

Yaws is the most common of the endemic treponematoses and is prevalent in poor rural communities in remote tropical areas of Africa, Asia, and the Pacific Islands. Yaws was one of the first diseases targeted by WHO for eradication – The Global Yaws Control Program ran from 1952 to 1964, treated 50 million individuals, and reduced the prevalence of yaws by more than 95%. Unfortunately, the disease re-emerged in the late 1970s after control efforts waned.

In March, 2012, WHO convened a meeting in Morges, Switzerland, to develop a new strategy for eradication of yaws by 2020. The Morges strategy is based on initial mass treatment of endemic communities followed by resurveys every 6 months to detect and treat remaining cases. Although the task of yaws eradication is daunting, two advances have rekindled hope for success.

 

Maternal and child health

 

The main news here was the ‘Saving Every Woman, Every Child’ summit in Toronto. (see ‘Highlights of the week), with the 3.5 billion pledge by the Harper administration.  The summit focused on reducing the preventable deaths of newborns, women and children younger than the age of five in developing countries, and brought together global leaders and Canadian experts to galvanize support for the next phase of efforts and ensure that maternal, newborn and child health (MNCH) remains a global priority. Seth Berkeley, Melinda Gates, … they were all there. We don’t want to withhold you Harper’s welcoming statement.

Vaccination was rather big at the event, Richard Horton wondered why the press was shut out, …

28.Thomson Reuters Foundation –  Kenya gets “game changing” record donation for fistula treatment

http://www.trust.org/item/20140522171818-irqsb/

 

A ‘game changing’ $2 million donation will help Kenyan surgeons to give 1,200 women life-transforming surgery to cure incontinence caused by fistula, a hole in the birth canal, and will train more specialists to perform the operation. Not sure the average Premier League football player would be impressed.

29.Lancet Global Health – Herd protection induced by pneumococcal conjugate vaccine

Keith P Klugman;

http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70241-4/fulltext

Do herd benefits exist in developing countries and how best can we study herd protection in settings that do not have microbiological confirmation of invasive pneumococcal disease, much less the serotyping of isolated strains, and also do not have electronic International Classification of Diseases to record pneumonia hospital admissions and deaths?” Klugman, a former Big Pharma consultant, explores the question.

 

The world also celebrated the International Day of Action for Women’s Health 2014 this week, as well as the first  Menstrual hygiene day (28 May).  A coalition including Water Aid, Save the Children, the Institute of Reproductive Health, International Rescue, and Plan launched the world’s first menstrual hygiene day on 28 May to draw attention to the many girls forced to miss school each month because of inadequate toilet or washing facilities and insufficient access to sanitary towels.

 

30.Lancet (Comment) – The dilemma of vaginal breech delivery worldwide

Jos Van Roosmalen et al.;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60618-8/fulltext?_eventId=login

 

Data from a 2000 trial by Hannah and colleagues in The Lancet suggested that a policy of planned caesarean section compared with a policy of planned vaginal delivery led to reduced adverse perinatal outcome. An accompanying Comment noted that there was little room left for disagreement about caesarean sections as the best option for vaginal breech delivery. Rosmalen et al now urge the global health community to look at the unintended, serious consequences that the policy changes resulting from the trial by Hannah and colleagues have had, including overwhelming many stretched health-care systems.

 

 

Health Policy & Financing

 

 

31.Lancet (World Report) – Large drug firms narrow their therapeutic interests

Asher Mullard;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60798-4/fulltext

Novartis traded its vaccine business for GSK’s oncology portfolio in a recent multibillion dollar deal. Asher Mullard reports on this latest round of pharmaceutical restructuring.

 

Not everybody is sold on such restructuring, as consolidations are ‘creating oligopolies that encourage anti-competitive markets and high cancer drug prices’, according to some observers. But the “asset-swap solution” seems less destructive than the traditional restructuring options, which are often designed primarily to save costs. Yet, Seth Berkley is concerned.

 

32.MSF – AstraZeneca and Pfizer – what hasn’t been talked about?

Bev Stringer;

http://www.msf.org.uk/article/opinion-and-debate-astrazeneca-and-pfizer-%E2%80%93-what-hasn%E2%80%99t-been-talked-about

The last word (?) on the AstraZeneca/Pfizer saga? As Pfizer made its final, failed pitch for the acquisition of Astra Zeneca, most public discussion focused on the jobs and tax implications in the UK rather than the impact this merger would have had on the development of much-needed medicines for the world’s population.  This MSF piece addresses this gap.

 

33.Lancet Global Health (blog) – Digital humanitarianism: finally catching up with John Snow

Ivan Gayton;

http://globalhealth.thelancet.com/2014/05/29/digital-humanitarianism-finally-catching-john-snow

The technology is now available to create freely available maps of most of the world, including low-income countries. This could allow medical humanitarian agencies like MSF to work more effectively by understanding the locations where diseases strike.

 

34.NYT – As His Foundation Has Grown, Gates Has Slowed His Donations

Randall Smith;

NYT;

Gates has reduced the pace of his own giving to the Bill & Melinda Gates Foundation over the last decade.

 

35.Nature – Global health: Deadly dinners

http://www.nature.com/news/global-health-deadly-dinners-1.15286

Polluting biomass stoves, used by one-third of the global population, take a terrible toll. But efforts to clean them up are failing, argues Meera Subramanian. You might remember that the Global Alliance for Clean Cookstoves, a public–private partnership, was launched in 2010 by then US secretary of state Hillary Clinton. The Global Alliance set a lofty goal of convincing 100 million households to adopt clean cooking-stoves by 2020, with an aim of eliminating deaths from cooking-stoves by 2030.  But that appears easier said than done.

 

36.Humanosphere – Visualizing what’s not there in global health data |

Katie Leach-Kemmon;

http://www.humanosphere.org/2014/05/visualizing-whats-global-health-data/

Tracking deaths through studies such as the Global Burden of Disease and other efforts around the world provides critical information for decision-making, but investing in better data collection is essential for ensuring that the global health community’s efforts are well targeted and making a difference.” Leach-Kemmon shows – for child mortality –  how better data would boost the quality of research findings produced by IHME and other global health research organizations.

 

37.IPS – U.N. Vows to Eliminate Open Defecation by 2025

http://www.ipsnews.net/2014/05/u-n-vows-eliminate-open-defecation-2025/

The UN formally launched a global campaign to help improve access to toilets for the 2.5 billion people without basic level sanitation.

 

38.International Journal of Health Planning & Management – Global implications of China’s healthcare reform

Fei Yan et al.;

http://onlinelibrary.wiley.com/doi/10.1002/hpm.2252/abstract

This report provides a multidisciplinary assessment on the global implications of the healthcare reform in China.

 

39.When People come first – Critical studies in Global Health

 

Editors:   J. Biehl & A. Petryna;

http://www.whenpeoplecomefirst.com/the-book

 

When People Come First’ critically assesses the expanding field of global health. The book brings together an international and interdisciplinary group of scholars to address the medical, social, political, and economic dimensions of the global health enterprise through vivid case studies and bold conceptual work. It demonstrates the crucial role of ethnography as an empirical lantern in global health, arguing for a more comprehensive, people-centered approach.

Research

 

40.Plos (Editorial) – The Role of Open Access in Reducing Waste in Medical Research

Paul Glasziou;

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001651;jsessionid=7DD91F5A8794C7583948EDD5C6E193E2

In a guest editorial, Paul Glasziou discusses waste in medical research and how this can be ameliorated through improving post-publication access.

 

41.Human Resources for Health – Hope and despair: community health assistants’ experiences of working in a rural district in Zambia

Zulu Mumba Joseph, Kinsman  John, Michelo  Charles, Hurtig  Anna-Karin,
http://www.human-resources-health.com/content/12/1/30/abstract

 

Joseph Zulu is EV 2012. He claims in this paper that programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare.

 

42.Globalization & Health – Scaling up antiretroviral treatment and improving patient retention in care: lessons from Ethiopia, 2005-2013

Y Assefa et al;;

http://www.globalizationandhealth.com/content/10/1/43/abstract

Although ART programs in resource-limited settings have expanded treatment, inadequate retention in care has been a challenge. Ethiopia has been scaling up ART and improving retention (defined as continuous engagement of patients in care) in care. The authors analyzed the ART program in Ethiopia over the past decade.

 

43.Global Health Action – special issue: Epidemiological Transitions – Beyond Omran’s Theory

Epidemiological Transitions – Beyond Omran’s theory
From 18 May already. A series of 11 articles challenge one of the central theoretical frameworks that has guided public health policy and programs globally – Omran’s theory. The work is particularly relevant for LMICs suffering from the so-called “double burden” of both infectious and chronic diseases.

 

In this collection of papers, researchers dismiss the Omran model as relevant to contemporary developing countries and suggest the foundation for a new framework better suited for guiding and understanding past and future epidemiological changes within these populations. The framework highlights the need for multilevel life course data collections and analyses to inform understandings of the underlying mechanisms of demographic and epidemiological changes and health system responses to these.

 

44.Resyst (Working paper) – Developing leadership and management competencies in low and middle-income country health systems: a review of the literature

Judith Daire, Lucy Gilson & Susan Cleary;

Working Paper Resyst;

This paper undertakes a review of the existing management and leadership literature from LMIC settings with a view to unpacking the roles of leaders and managers, the competencies required, and the key approaches to developing these management and leadership competencies. Judith Daire was EV 2012.

45.Health Policy & Financing – The cost of a knowledge silo: a systematic re-review of water, sanitation and hygiene interventions

Michael Loevinsohn et al.;

http://heapol.oxfordjournals.org/content/early/2014/05/29/heapol.czu039.short?rss=1

 

Divisions between communities, disciplinary and practice, impede understanding of how complex interventions in health and other sectors actually work and slow the development and spread of more effective ones. The authors test this hypothesis by re-reviewing a Cochrane-standard systematic review (SR) of water, sanitation and hygiene (WASH) interventions’ impact on child diarrhoea morbidity: can greater understanding of impacts and how they are achieved be gained when the same papers are reviewed jointly from health and development perspectives?

 

Global Health Announcements

 

 

For the latest newsletter of Health Systems Global, see  here. Obviously, preparations for the Cape Town symposium are the key focus. By the way, early Bird registration ends 1 June!

 

 

Miscellaneous

 

46.Cordaid – Open development movement: co-creation leads to transformation

https://www.cordaid.org/media/medialibrary/2014/05/OpenDevPaper-MAY2014-LR_5def.pdf

 

“Sustainable development is development that starts from the bottom up. It builds on the perspectives of local communities about what matters to them most. The open development movement reinforces this bottom-up approach. Providing open access to evidence-based information and knowledge gives citizens a valuable tool to influence the policies and decisions that are meant to improve their lives. It promotes citizen engagement and strengthens social accountability. Cordaid is convinced that making information about projects and their impact available to everyone will transform development cooperation. Actively engaging stakeholders has started a process of co-creation which will contribute to a better world.” As for Open Development in Practice, check out this paper on Open RBF.

 

47.Owen Barder (CGD) – Evidence & Scaling up

http://www.owen.org/blog/7281

 

Recent speech by Owen Barder, and a brilliant one . In the speech, he talks about the importance of evidence and rigour, and the challenges of taking development programmes to scale. He backs up his argument with some new evidence about what it takes for development programmes to succeed. Sounds boring, perhaps, but wait till you read it.

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