Dear Colleagues,


We bet most readers of this newsletter agree family planning is a vital issue – our typical audience doesn’t really “think” like GOP presidential contenders at a debate.

A recent expert forum in Washington, chaired by Mary Robinson, advocated more contraception aid  for poor countries, for example. So we invited Tamrat Assefa, Emerging Voice from Ethiopia, to give his perspective on this important issue.

Humanity welcomes the 7 billionth individual at the end of this month. Nicolas Sarkozy and his wife did their best, but Giulia just arrived too early to be a contender. The arrival of the 7 billionth person is cause for profound global concern (and not just because he or she will be born around Halloween).

Read the rest of this editorial

Enjoy your reading.

David Hercot,Kristof Decoster,Josefien Van Olmen, Basile Keugong &Wim Van Damme



1.    NEJM (editorial ) – A Vaccine for Malaria

Nicholas J. White;

White comments on the malaria vaccine breakthrough, and assesses whether it will be a game changer or not.


Elsewhere, the Guardian’s Sarah Boseley  and Humanosphere’s Tom Paulson (who also commented on the Gates Malaria forum) asked similar questions, like for example “where’s the money going to come from”? The Economist also has a nice piece on it today. Many commentators emphasize: great scientific feat, but its real public health use will only become clear overtime.


Wim Vandamme, our colleague in charge of this newsletter reckons the bottomline is: There is now a malaria vaccine with similar effectiveness as a bednet. Several issues need to be considered now:

* Sequencing: it is entirely different to introduce a vaccine in an area with a lot of malaria (with few bednets and bad curative services, using chloroquine or Fansidar) versus to introduce the vaccine on top of full bednet coverage & good curative services, with ACT. The preferred sequencing will depend on many issues, including price. But, if there is already a national program for bednets & good access to ACT, the issue becomes: what is the marginal effectiveness or cost-effectiveness on top of that? Which obviously brings us to the price issue.  

* Price:  what will be the price for the vaccine; and who will pay for it?

* What about its use for malaria elimination? It is conceivable that in an area like Pailin in Cambodia (the heartland of malaria resistance in that country) adding the vaccine to the mix of other malaria control measures may help reaching a ‘tipping point’ whereby local transmission becomes very difficult. In circumstances like these, price is less important. (Of course, the vaccine then needs to be tested among adults, with only occasional exposure to malaria infection, which will involve new trials).

‘Good Health at low cost’ 25 years on


2.    BMJ (news) – Continuity and good management are key to better health outcomes in poor countries

Jacqui Wise;

BMJ news gives some of the key conclusions of the follow-up study “Good Health at low cost” 25 years on. Vision and long term planning, together with effective managers and continuity, have enabled some poor countries to achieve better health outcomes than others with similar incomes. The report follows up an influential report from the Rockefeller Foundation published in 1985. The new report, put together by a team from the London School, revisits the four places of 1985 (Sri Lanka, Costa Rica, China and the Indian state of Kerala) and also assesses five other states or countries—Bangladesh, Ethiopia, Kyrgyzstan, Tamil Nadu in India, and Thailand—all of which have made substantial improvements in health and access to essential services.


You find the study here. It’s a must-read.


Lancet Mental Health Series

3.    Lancet (Comment) – A renewed agenda for global mental health

Vikram Patel et al.;


The Lancet Series on Global Mental Health 2011 follows up on the pioneering set of papers published by the journal in 2007. It tracks progress over the past four years, and adds information to provide an indispensible resource for health workers and policymakers. (which obviously raises the following question for the latter: now that they have the information, will they act upon it and provide adequate resources? )



Global Health and climate change


4.    BMJ – Act now to tackle the health and security threat of climate change, say experts

“Climate change poses an immediate, grave and escalating threat to the health and security of people around the globe and must be tackled urgently”, warned leading experts at a high-level meeting hosted by the BMJ in London earlier this week.


Fiona Godlee is equally worried in her BMJ editorial. “The greatest risk to human health is neither communicable nor non-communicable disease, it is climate change.” (We totally agree.)

5.    BMJ (editorial) – Assessing the health benefits of tackling climate change

Anita Charlesworth et al.;

Charlesworth and co-authors (including Nicholas Stern) assess some of the health benefits of tackling climate change, and give some suggestions on how to proceed.


Rio conference on social determinants


The Rio summit on social determinants is wrapping up. From our own perspective, the world hasn’t paid much attention to this so called “Alma Ata bis” conference. All attention seems focused on the EU financial troubles and the financial “bazooka” that presumably will be put in place at the EU summit next week. That bodes ill for the social determinants agenda.  On the bright side though, there’s plenty of attention for Occupy Wall Street (and thus on global and national social injustice…).


6.    Lancet – Building of the global movement for health equity: from Santiago to Rio and beyond

Michael Marmot et al.;

The purpose of this article is to report on activity that has taken place worldwide after the report by the Commission on Social Determinants of Health.



At the conference, opinions differ. Margaret Chan speeched at the opening day, and did so eloquently and forcefully. (David Stuckler will have been pleased to see more of  “Chan 1this week).


On the BMJ blog, Fran Baum gives some good background information on the conference. As we already mentioned last week, the People’s Health Movement came up with an alternative civil society declaration.


The Lancet (online) also features a student’s perspective on rooting out causes of health injustice. This year, the International Federation of Medical Students’ Associations (IFMSA), which represents 1·2 million medical students worldwide, made health inequities and action on social determinants of health a key policy focus. A global campaign, ‘Root Out, Reach Out’ has been organised to coincide with the 2011 World Conference on Social Determinants of Health. The students reckon there remains a distinct lack of political commitment in addressing health inequities through action on social determinants of health, both within and between countries.


Health Policy and Financing


7.    Lancet (editorial) – Global funding for infectious diseases: TB or not TB ?

Rather than waiting for the elixir of economic success to arrive in all high-burden countries, committed action by donors, agencies, and governments in the most challenging settings is needed in the global campaign against tuberculosis.” China has shown the way.


8.    BMJ (news) – African parliamentarians commit to prioritising maternal and child health

Peter Moszynski;

The Pan African Parliament has adopted a resolution urging speakers of the continent’s 54 national parliaments to prioritise the implementation of maternal, newborn, and child health programmes.


9.    Plos – Educating a New Generation of Doctors to Improve the Health of Populations in Low- and Middle-Income Countries

Francesca Celletti et al.;;jsessionid=B714FC7371EDE5D9E36C1E900BB569DF.ambra01

Celletti and colleagues from WHO argue that a transformation in the scale-up of medical education in low- and middle-income countries is needed, and detail what this might look like.


10.                            KFF – Kaiser Family Foundation Report Examines Innovative Financing Mechanisms For Global Health

A new KFF report gives an overview of innovative financing mechanisms for global health and the US perspective and preferences (among this mix).


11.                Global Fund – Sweden announces increased three-year pledge to the GF

At last some good news for the Global Fund, now that Sweden has announced its decision to disburse its 2011 contribution to the GF in full and to announce a pledge of U.S. $300 million for 2011–2013, an increase of 11 percent over its contributions for the previous three-year period.


Meanwhile, in Mali, the GF will transfer management of an HIV/AIDS grant from Mali’s national AIDS council to a new principal recipient at the end of the year, after mismanagement of funds was discovered in the country.


12.                Globalization and Health (Commentary) – The increasing chronicity of HIV in sub-Saharan Africa: Re-thinking “HIV as a long-wave event” in the era of widespread access to ART

Stephanie A. Nixon et al.;

Nixon and colleagues rethink HIV as a long-wave event in the era of widespread access to ART. They draw upon the WHO’s International Classificiation of Functioning, Disability and Health (ICF).

Emerging voices

13.                 Economic and Political Weekly – Public-Private Partnerships and Health Policies

NS Prashanth;

Prashanth assesses the (rather scarce) research evidence on Public-Private partnerships. In the lack of it, health policy too often depends on rhetoric or single case studies. With obvious consequences.

Development & Aid


It’s increasingly clear that the western crisis is a game-changer, as Jonathan Glennie emphasizes  in the Guardian, also for poorer countries. So global health people better pay careful attention to the EU summit that will take place early next week, and to the G20 summit early November. But in this week’s ‘Development & Aid’ section, we focus on the new EU development policy (or at least the EC proposal).


14.                ODI – An Agenda for Change for EU Development Policy

Mikaela Gavas;

Following release of the EU’s ‘Agenda for Change’ and ‘Future Approach to Budget Support’, Gavas considers what these mean for development policy.


15.                ODI – EU budget support: both a ‘name changer’ and a ‘game changer’

Heidi Tavakoli;

Tavakoli points out a few laudable features of the new EC budget support approach. She emphasizes though that there are two significant changes that have considerable implications for the EC’s future approach to budget support – the first could be a real ‘game changer’ and the second simply a ‘name changer’, she believes.


And by the way, ODI also hosted a meeting with Tony Blair “on the role of visionary African leaders in transforming government and achieving development.” (for mysterious reasons, when you have ‘Tony Blair’ in a sentence, the word ‘visionary’ always seems to pop up too).


In the Guardian, Mark Tran also assessed the new EU aid plans.


16.                AFGH (news) – Health and education ‘key priorities’ in future EU development policy[tt_news]=600&cHash=ff546efe2bc1601a87454721adae5e7f

Development commissioner Andris Piebalgs has reaffirmed the crucial role of health and education in future EU development policy in a debate organised by Action for Global Health and the European Policy Centre.



Finally, as the Busan conference on aid effectiveness is approaching, you can check out the usual “Broker ” blog posts on Busan, as well as this ODI blog post on fragile states and Busan.

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