Dear Colleagues,

We’ll keep it short this week, as this is a holiday week for many of you. We would first like to thank the people that sent us their spontaneous or explicitly requested feedback (the latter by filling in the evaluation form). We hope that many of the people who received an explicit request (Kim sent a reminder yesterday), but didn’t find the time yet, will follow suit in the coming days.

Back to the news then. In the UK, Cameron sort of “vetoed”  Gordon Brown as the next chief of the  IMF, stressing that  “the organisation needs someone who understands the dangers of excessive debt, excessive deficit“.  As Easter Sunday is approaching, we’ll refrain from commenting. Or maybe not, as Jesus himself would surely agree with this: we reckon the next IMF boss should be somebody who understands that just taxation, reining in tax havens, and full transparency of multinationals’ financial streams are all vital to achieve macroeconomic stability of countries and provide global public goods. Cameron had a point though when he said the next IMF boss should perhaps come from Latin America, Africa or Asia. Besides, 2011 could still turn out to be the year of innovative financing, in the words of UN special advisor Douste-Blazy.

In India, the Supreme Court granted bail to human rights activist and physician Binayak Sen, jailed for alleged Maoist links. For the ones who would like to know a bit more about the conviction of Sen, recently an article appeared in Social Science & Medicine, covering neocolonialism, political violence and the political economy of health in the Central Indian tribal belt. Sen’s release is definitely good news.

Enjoy your reading.

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


1.      Lancet – Pay-for-performance and the Millennium Development Goals

Dominic Montagu, Gavin Yamey;

Montagu & Yamey comment on a new impact study by Paulin Basinga et al. in the Lancet. According to Basinga et al., P4P financial performance incentives in Rwanda  improve both the use and quality of maternal and child health services, and could thus be a useful intervention to accelerate progress towards the MDGs for maternal and child health. We quote Montagu & Yamey: “Basinga and colleagues’ study provides a welcome piece of good news, showing that pay-for-performance can increase the uptake of maternal and child health services. If this uptake is sustained in the long run and translates into reduced mortality rates, particularly in the most vulnerable populations, pay-for-performance will surely take its place as an important tool for accelerating progress towards the MDGs.”

2.      KFF – Countries Agree To Draft Framework On Virus Sharing, WHO Says

Last weekend, the WHO reached an agreement on sharing flu virus samples. Thenew framework includes certain binding legal regimes for WHO, national influenza laboratories around the world and industry partners in both developed and developing countries that will strengthen how the world responds more effectively with the next flu pandemic.

3.      PLOS – A Call for Action: The Application of the International Health Regulations to the Global Threat of Antimicrobial Resistance

Didier Wernli, Thomas Haustein, John Conly, Yehuda Carmeli, Ilona Kickbusch, Stephan Harbarth;

Harbarth and colleagues argue that the International Health Regulations should be applied to the global health threat of antimicrobial resistance. In a related Plos Perspective article Adam Kamradt-Scott critiques this proposal.

4.      Lancet – Improving tuberculosis diagnostics and treatment

Katharina Kranzer;

Among other things, Kranzer comments on the new TB rapid diagnostic test, the MTB/RIF test.

In another (early online) Lancet piece, Sliwa & Stewart dwell on a new low-cost solar-powered blood pressure device. They wonder whether this humble device will become key in turning the tide against the epidemic of cardiovascular disease in low-income and middle-income countries.

5.      KFF – MSF Calls On African Governments, WHO To Switch To Newer, More Expensive Treatment For Severe Malaria

Nearly 200,000 deaths from severe malaria could be averted if African governments replaced the low-cost antimalarial quinine with the more expensive but more effective drug artesunate, according to a new MSF report.

6.      Lancet – Improving treatment outcome for children with HIV

Alexandra L. Calmy & Nathan Ford;

Calmy & Ford reckon paediatric HIV/AIDS is a neglected disease, and argue why.

7.      BMC Health Services – Outcomes of Antiretroviral Treatment Program in Ethiopia: Retention of Patients in Care Is a Major Challenge and Varies Across Health Facilities

Yibeltal Assefa, Abiyou Kiflie, Dessalegn Tesfaye, Damen Haile Mariam, Helmut Kloos, Wouters Edwin, Marie Laga  and Wim Van Damme;

Our colleague Yibeltal wrote this article on ART retention in Ethopia; other ITM staff were also involved.

8.      TMIH – Of silver bullets and red herrings: invited commentary to Fisk et a

O. Razum, J. Schaaber, K. R. Nayar;

Razum et al wrote a commentary on a TMIH viewpoint by Fisk et al. on “relative and absolute addressability of the global disease burden in maternal and perinatal health by in-vestment in R&D.”  In the words of Razum et al.: “By enthusiastically promoting investment in R&D for new drugs and diagnostic techniques, Fisk et al. divert attention from the top priorities in maternal and perinatal health in low- and middle-income countries. These priorities are (as Fisk et al. state in their paper): providing access to comprehensive reproductive health services, to skilled care during and immediately after childbirth, and to emergency care when life-threatening complications develop.”

9.      BMC Public Health – Health systems performance in sub-Saharan Africa: governance, outcome and equity

Anna E Olafsdottir, Daniel D Reidpath, Subhash Pokhrel  and Pascale Allotey;

This study (with cross sectional data from 46 countries in the African region of the WHO)  suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored.

10.   HP&P – Pro-sustainability choices and child deaths averted: from project experience to investment strategy

Eric G Sarriot, Eric A Swedberg and James G Ricca;

The ‘bang for the buck’ of health programmes could be greatly increased by following a pro-sustainability investment strategy, claim Sarriot et al. The authors reviewed the experience of Save the Children US in Guinea in terms of investment, approach to sustainability and impact.

11.   Lancet – How did Sierra Leone provide free health care?

John Donnelly;

Last year, Sierra Leone started free health care for pregnant women, new mothers, and young children. John Donnelly takes an in-depth look at how the war-torn nation managed it.

12.   Lancet (Correspondence) – Global health aid: raise more, spend better

Moussa Fatimata, David Hercot;

Fatimata and David reply to an earlier Perspective by Jeffrey Sachs.

13.   BMJ (letter) – Benefits of EU-India free trade agreement

Brian Ager;

The director general of the European Federation of the Pharmaceutical Industries and Associations, Brussels, reacts to what he considers to be myths in the debate on the EU-India free trade negotiations.

We would also like to draw your attention to the new issue of the monthly Health Diplomacy Monitor. Several pieces in this issue focus on agenda items of the upcoming World Health Assembly, for example on Health Systems Strengthening, and on the African production of generic drugs.

14.   Globalization and health – Indian vaccine innovation: the case of Shantha Biotechnics

Justin Chakma et al.

The Shantha case study underscores the important role the private sector can play in global health and access to medicines. Home-grown companies in the developing world are becoming a source of low-cost, locally relevant healthcare R&D for therapeutics such as vaccines.”

Meanwhile, a vaccine for dengue seems within sight, but demand is likely to exceed supply.

Brazil’s Senate approved a decree to donate a million U.S. dollars annually in 20 years to GAVI for vaccination campaigns in poor countries. Under the decree, every air traveller in Brazil will be charged a two-dollar fee, which will be donated to UNITAID.


15.   Aidspan –  U.S. Confirms Major Pledge to Fund; Some Other Donors Backtrack

Bernard Rivers;

The US will give $1.05 billion to the Global Fund this year, in line with earlier expectations and significantly more than the $0.6 billion amount proposed by House Republicans. Italy has not delivered any of its 2009 and 2010 pledges, and Spain and Ireland have significantly cut back on what they promised for 2010.

US Global Health Policy tracker provides a  summary of the FY11 full-year continuing appropriations act (H.R. 1473).

16.   Aidspan – Global Fund Poised to Do More to Promote Human Rights

David Garmaise;

Several organisations have released reports on human rights and the GF. As well, Michel Kazatchkine, the Fund’s Executive Director, has spoken publicly about this issue several times in the past year.

In related news, the Guardian reports on mounting international pressure on anti-gay laws in Africa  (both from the US and the EU).

Sir Richard Feachem, the founding director of the GF, recently discussed reform of international aid distribution to make the process more transparent and accountable. The financial crisis forces (necessary) changes, he said.

Meanwhile, GF staff no doubt have a déjà vu feeling, after AP published yet another ‘investigative’ piece, this time on drug thefts. Humanosphere’s Tom Paulsondwelled

on this news, and the GF refuted, in an official statement, the ‘misleading Associated Press article on drug theft’.


17.   Guardian – MDG poverty goals may be achieved, but child mortality is not improving

Two-thirds of developing countries are on track or close to meeting the MDG targets for extreme poverty and hunger, say the IMF and the World Bank in a new Global Monitoring report.  IMF and World Bank advocate ‘performance-related’ pay for medics to improve maternal and child mortality, but the greatest threat to MDGs remains the ‘cycles of violence’ in fragile states.

The CGD has an interesting post on the priorities and prospects of the G-20’s recently adopted development agenda. African infrastructure and global food security are set to be the central pillars of France’s development agenda for the upcoming G-20 Summit in Cannes.

The CGD also welcomes (again) Owen Barder: he will have to increase CGD engagement with Europe. On his blog, Owen comments on the rationale for taking up this new job at CGD. He sees two reasons why more of CGD’s approach is needed in Europe.

Finally, China released its first report on Foreign aid.

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