Dear Colleagues,
With the exception of this tiny West-European country, the world is moving at breakneck speed these days. There’s the ongoing Libya conundrum – with lots of things happening in the media limelight as well as behind the scenes – and there’s Ivory Coast which seems to be heading now towards the endgame, after a stand-off of several months. Wish we could say the same here in Belgium – although preferably with other means.
Speaking of stand-offs, the US might be heading for one itself, with the budget showdown. Meanwhile, Devex  reports that the international community is tackling this “challenging” environment with two key approaches. “First, prominent actors of the international aid community are fighting a media war to dispel myths about the current level of U.S. foreign assistance in the hope that the American public will react against potential cuts by Congress. Second, members of the aid community are meeting with staffers on Capitol Hill to raise awareness about the current state of U.S. assistance overseas.” Nevertheless, it seems likely that US development assistance will be cut drastically, as Rajiv Shah admitted yesterday. 
As for more specific global health news, the WHO is getting most of the attention this week, and its future role in global health governance. This newsletter features a few interesting articles and documents in this respect. If you feel like having your say in this debate,  or just want to reply to Sridhar & Gostin’s JAMA comment, you can perhaps do so here. Here’s one vision, recently voiced by a rather influential person in the global health community: “When I feel really gloomy, sometimes I’d wish the WHO could start all over again. We definitely need a strong WHO, but not in the current form.” Well, at the very least, the debate has started.
Enjoy your reading.
David Hercot, Kristof Decoster, Josefien Van Olmen, Basile Keugong & Wim Van Damme

Global Health Governance

1.      JAMA – Reforming the World Health Organization

Devi Sridhar and Lawrence Gostin offer five proposals for reestablishing the agency’s leadership in global health.

2.       Global Health Governance and WHO – summary report of ad hoc advisory meeting of 11 March 2011

The purpose of this informal advisory meeting was to focus on Global Health Governance: specifically, to review the potential of different approaches for securing greater coherence in global health, and to explore the role that WHO can play in line with its primary function as “the directing and coordinating authority on international health work”. In an annex, you also find a background paper on global health governance and WHO.

3.      Lancet – Offline

Richard Horton;
In this week’s issue of the Lancet, Richard Horton also comments on the current WHO predicament.

Global Health Policy & Financing

4.      IPH Working Paper Series 1/2011, Bangalore

The Institute of Public Health in Bangalore, India has started a working paper series. The first paper in the series is one by our colleague, Werner Soors. The paper reviews all the background papers of the 2010 world health report for Indian policy makers. The paper provides a one page summary of each of the background papers and is very useful for all (= not just Indian) practitioners, researchers and policy makers who are interested in a quick overview of the background papers.

5.      Humanosphere – Why is mental illness so low on the global health agenda?

Interesting question. In the words of Vikram Patel: “Given its contribution to the global burden of disease, mental illness receives nowhere near the kind of attention and resources it deserves.” That is not likely to change soon, even taking into account the current drive for more attention for NCDs. In our opinion, to push this vital cause up the global health agenda, a global ‘champion’ is needed. Perhaps Khaddafi could consider a second career. (Not that we actually think he is deluded, he’s just good at pretending he is.) Admittedly, there’s some heavy competition from the Sarkozy’s of this world.

6.      Lancet – A better understanding of mortality in young people

Resnick comments on a study by Viner and colleagues on the problem of mortality in adolescents and young adults. “They show that mortality in young people aged 10—24 years has proved less responsive to the international alliances and interventions that have so effectively reduced early childhood mortality worldwide, emphasising the need for a vigorous global focus on the health and mortality of adolescents and young adults.”

7.      Jama (Commentary) – US Global Health Strategy -Promoting Healthy Development

The author comments on the Global Health initiative: “The United States needs a new, forward-looking global health strategy that sustains progress against traditional priorities while confronting emerging impediments to global development.” He elaborates on the latter in this comment.

8.      WHO report – The Abuja declaration – ten years on

WHO reports that ten years after the Abuja declaration, only two African countries have actually reached that target. Overall, 27 have increased the proportion of government expenditures allocated to health and seven have reduced it since 2001. In the other 12, there is no obvious trend up or down. Current donor spending varies dramatically, from US$ 115 per person in one country, to less than US$ 5 per person in 12 others.

9.      ODI – The feasibility of financing sectoral development targets

Jessica Hagen-Zanker & Anna McCord;
Before we blame African countries for not respecting their Abuja commitments, maybe it’s good to check out this ODI project briefing, which sheds some light on the affordability of sector targets (like the Abuja commitment), based on the analysis of five SSA countries, and on the implications of sectoral targets for good public finance management and the current donor approach to development financing.
The ODI website also features a blog post by Zanker on this issue.

10.   Sarah Boseley – US Republicans move to block abortion services in poor countries

Sarah Boseley worries about US Republicans who want US funding cut from family planning organisations that promote abortion. A new ugly episode in the battle over the Global Gag rule is looming. One consolation perhaps: more and more people in the US seem to be getting tired of the Tea Party radicals, according to our sources.

11.   Lancet – Ageing faster with AIDS

Edward J. Mills et al.;
Older people are neglected in the AIDS response. It’s about time this changes.

12.   UNAIDS (press release)-  UN Secretary-General outlines new recommendations to reach 2015 goals for AIDS response

United Nations Secretary-General Ban Ki-moon released a report this week on the global AIDS epidemic outlining the progress against the pandemic to date and calling on all stakeholders to endorse the report’s recommendations and use them to work towards six global targets by 2015. The recommendations will be reviewed by global leaders at a U.N. General Assembly High Level Meeting on AIDS, 8-10 June 2011.
On the website of Smart Global Health, Margaret Reeves sketches what should be the focal points of this upcoming UN High Level meeting on HIV.
To end this section on Global Health Policy and Financing, we would like to draw your attention to:
  • A new issue of the Health and Foreign Policy Bulletin, a monthly publication of the Norman Paterson School of International Affairs. Do check it out.
  • features a series of articles on counterfeit medicines and examines how technology and regulation can help developing countries counter the threat.  See for the editorial here.


13.   Health Research Policy & Systems – Indicators of sustainable capacity building for health research: analysis of four African case studies

Imelda Bates et al.;
The authors arrived at indicators of sustainable capacity building for health research, based on the analysis of four African case studies.

14.   Plos – On the Path to Global Open Access: A Few More Miles to Go

Plos Medicine editors;
In the words of the Plos editors: “Now that the heat of the HINARI debate has died down, it is an opportune time to consider how this dispute, and others like it, can be used constructively to move toward a position where universal Open Access to the medical literature becomes the norm.”

15.   Plos – Towards Open and Equitable Access to Research and Knowledge for Development

Leslie Chan et al;
The authors of this interesting essay plead for open and equitable access to research and knowledge for development. In their opinion, open access is sustainable and research driven and builds independence and the capacity to establish a strong research base; it is already converting local journals to international journals.
However, as open access becomes the norm, standards for the assessment of journal quality and relevance remain based on Northern values that ignore development needs and marginalise local scholarship.

Development & Aid

16.   CGD Working Paper – TrAid+ Channeling Development Assistance to Results – Working Paper 247

Alex Ergo & Ingo Puhl;
A new CGD working paper works out the concept of TrAid+: this is a new mechanism that aims to address typical problems of development assistance by creating a market for certified development outputs-outputs for which both the delivery and the quality have been verified. By ensuring that these outputs, such as safe deliveries or gas connections, meet certain standards, trAid+ would act as a third-party stamp of approval that donors, tax payers, recipient-country governments, service providers, and beneficiaries can trust to know that their aid is being used effectively and is contributing to the development objectives of the recipient country.

17.   Bond for international development (report) – Finding frames: new ways to engage the UK public in global poverty

Andrew Darnton & Martin Kirk;  or PDF (124 p, 1MB)
This report argues that there is a problem in terms of the UK public’s levels of engagement with global poverty. The authors suggest to apply values and frames theory to the question of how to re-engage the public.

18.   ODI background note – After 2015: progress and challenges for development

Claire Melamed & Lucy Scott;
This ODI background note maps out current thinking on the impact of the Millennium Development Goals and options for the future.
In a CGD brief, Andy Sumner discusses the implications (for development aid) of the fact that most of the world’s poor now live in MICs. Later, he will work this out in a CGD working paper. 
Finally, the Irish NGO Trocaire also published a report, “Leading edge 2020 – critical thinking on the future of international development”.
We agree the timing is a bit off though.

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