Dear Colleagues,


Plenty of news again this week, as these are turbulent times indeed. You probably already know by now that it hasn’t exactly been a wonderful week for the Global Fund. Neither was this a week to remember for people like Hosni Mubarak and Silvio Berlusconi. Far more important, it was also reported that child malnutrition in Pakistani flooded areas is still enormous, months after the flooding. And sadly, David Kato, a gay activist from Uganda, was also murdered earlier this week.


Strangely enough, the bizarre human species called “Davos man” seems more upbeat than last year, although he is a bit worried about the ongoing social and political turmoil in the Middle East and North-Africa. Global food security is now – with a bang – high on the international agenda, and that probably won’t change soon.  Lord Nigel Crisp conveyed a message to global leaders and big shots attending the World Economic Forum in Davos from the health worker conference in Bangkok. Bill Gates was trying hard to spread polio awareness in the Swiss resort, while fending off attacks on the Global Fund. Bill should keep in mind that we live now in a “G Zero” world, a world without direction and coordination whatsoever. Meanwhile, Nicolas Sarkozy still lives in a G20 world, considering himself the new poster boy for the Robin Hood Tax. More in general, some smart and influential people would like to see the world (re)act in a more pro-active way to long term trends instead of just reacting to crises. In that respect, two blog posts (by Alison Evans and Dirk Willem Te Velde) on the ODI website are definitely worth a read, see here and here. 


Another very smart and influential person addressed his Congress in the US, for the yearly State of the Union. Obama delivered a trademark speech that struck a chord among US voters, but it was disappointing to see that he did not pay much attention to foreign affairs. As Tom Paulson stated on the Humanosphere website, such lack of attention might further open the door to the current push by “you know whom” in Congress to cut back on foreign aid. Worse, a USA Today/Gallup poll released on Wednesday found that a majority of Americans oppose spending cuts when asked about specific programs, except for foreign aid. So, Paul Miller  and Rajiv Shah will have their work cut out, if they really want the Republicans not to cut foreign aid. In case you want to help, and urge US senators to vote against 2008 funding levels for global health, this place is a good start.


We would also like to draw your attention to a new (and timely) discussion on our IHP blog: on health systems in LMICs and corruption. Prashanth NS kicked off the debate, based on the Comment he wrote last week for the Lancet on Karnataka. Obviously he could not foresee the turmoil around the Global Fund when he wrote his Comment. We hope many of you will contribute by reacting to the blog post and sharing experiences from your countries.


Enjoy your reading.

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

Lancet series on health in South East Asia


The health of 10 countries analysed in the Lancet Series on Southeast Asia concerns the health of 580 million people. The series highlights key health issues: infectious disease control, maternal and child health, reducing the impact of chronic diseases, and the finance and human resource issues that need to be addressed to improve health and health equity in this diverse region of the world.


1.Lancet – Health in southeast Asia

William Summerskill, Richard Horton;

Until public health trumps private wealth, progress in health across the region will be disjointed and inequitable. Only by placing human rights at the heart of development will the right of the region’s 580 million people to the highest attainable standard of health be realised.”  So concludes this Comment summarizing this series about health in Southeast Asia.


2.Lancet – Southeast Asia: an emerging focus for global health

Jose Acuin et al;

In many ways, Southeast Asia is a microcosm of global health The region presents daunting health challenges; health-systems developments in these countries have challenged existing regimes and stimulated much debate. However, much greater regional cooperation would advance the health of people in the region.


We would also like to draw your attention to a Seriesarticlein which a Cambodian colleague of ours, Ir Por, was involved, an article on health financing reforms in the region.


Second Global Forum on Human Resources for Health in Bangkok

3.Lancet – Commitment and action to boost health workforce

Mubashar Sheikh;

Sheikh comments on the Second Global Forum on Human Resources for Health, scheduled to end tomorrow in Bangkok, January 29.


Action for Global Health assesseshow farwe have come since the adoption of the Kampala Declartion in 2008. The organization also launched a new report on ‘Adressing the Global Health Workforce Crisis: challenges for France, Germany, Italy, Spain and the UK’. The report compares the foreign and domestic policies on health workers in the five AfGH European countries, looks at the causes of health shortages in both source and destination countries and explores what needs to be done to fulfil the requirements of the WHO Code of Practice and to strengthen health systems in developing countries.


Rhona McDonald wondered – on the Plos “Speaking of Medicine” blog – whether the Forum would discuss the potential exodus of a group of health workers who played a substantial role in keeping weak health systems from falling apart— Cuban doctors.


Global Fund controversy


4.Global Fund – How the Global Fund protects its grant money

Michel Kazatchkine;

Obviously Kazatchkine had to react to the turmoil caused by the AP article, especially now that Sweden, Denmark and Germany have put their contribution to the GF on hold. The article also refers to several interesting pieces on the investigation and misuse of Global Fund monies.


5.Aidspan – Corruption by Global Fund Grant Implementers

Bernard Rivers;

Over the last few days, there have been news stories worldwide about corruption in the implementation of Global Fund grants. Bernard Rivers reviews the stories and the underlying facts, and makes some recommendations.


Lots of global health bloggers paid attention to the GF news. Several blog posts on the CGD website are worth a read, see for example here, and here, and here. Science Speaks also picked up the story.


Global Health policy and financing

6.Concluding remarks from Margaret Chan on the future of WHO financing, at the Executive Board

Margaret Chan;

We provide a summary of the concluding remarks from the WHO director-general to the Executive Board on the future of WHO financing. Among other things, she  pleads for a more central role for WHO in global health governance.


In his Offline contribution in the Lancet, Richard Horton also referred to Chan’s report to the Executive Board of WHO last week. “She signalled what has now become a perilous situation for one of these institutions, WHO. Dr Chan’s words were shockingly direct. WHO is “over-extended”, the demands on the organisation are “overwhelming”, it is “not functioning at the level of top performance that is increasingly needed, and expected”, it is not well-funded, and it needs “to undergo some far-reaching reforms.” No Director-General in WHO’s history has presented a report card of such devastating honesty. She expressed in public what many say in private. She called on her member states to look closely at the “purpose and unique contribution” of WHO. The agency cannot do everything. It needs to make choices about what it should leave to others. As the World Health Assembly approaches in May, and as Dr Chan prepares to stand for a second term as Director-General of WHO, the organisation is poised for a period of radical reassessment.”


Meanwhile, the Plos Medicine Editors Tikki Pang and Robert issued a

call for papers for a joint WHO/PLoS collection on the theme of the 2012 World Health Report, Research for Health. 


7.Lancet – Dengue vaccine prospects: a step forward

Bruno Guy, Jeffrey Almond , Jean Lang;

Several promising dengue vaccine approaches are being investigated in both academic and industrial laboratories.


8.KFF – Merck, Wellcome Trust Back Project To Develop Improved Rotavirus Vaccine For Developing Countries

“A joint venture between U.S. drugmaker Merck and Britain’s Wellcome Trust charity said on Monday it is working on an oral rotavirus vaccine designed to be cheaper and easier to use than current shots,” Reuters reports.

9.Plos Neglected diseases – The Cholera Pandemic, Still with Us after Half a Century: Time to Rethink

Edward T. Ryan;;jsessionid=0F14432B1F0315F9B9F83B4AB6E1AA9F.ambra01

The recent outbreaks of cholera in Haiti, Pakistan, and Zimbabwe suggest that our current global action plans against cholera are failing,” writes Edward Ryan in an editorial where he describes how vibrio cholerae has evolved in a manner that allows it to linger, allowing for longer outbreaks of the disease.


Meanwhile, governments called on WHO to improve cholera control. They want the organization to take the lead on measures to control and prevent cholera, in response to the ongoing outbreak of the disease in Haiti.

10.    Lancet – European academic institutions for global health

Andy Haines, Antoine Flahaut, Richard Horton;

A new organisation—the European Academic Global Health Alliance (EAGHA)—brings together a large number of academic institutions in Europe whose activities encompass a range of activities consistent with the broad scope of global health, to focus on several key objectives.

11.    KFF – Canadian PM, Tanzanian President Open Meeting To Develop Framework For $40B Maternal And Child Health Initiative

Canadian Prime Minister Stephen Harper and Tanzanian President Jakaya Kikwete were in Geneva on Wednesday to open a meeting aimed at “developing a framework” to monitor the implementation of the $40 billion U.N. maternal and child health initiative. Harper and Kikwete are co-chairs of a commission that is charged with ensuring accountability for the pledges.

12.    KFF – Bill Gates, Crown Prince Of Abu Dhabi Announce $100M Pledge For Vaccines For Afghan, Pakistani Children

Bill Gates and Sheikh Mohammed bin Zayed al-Nahayanm, the crown prince of Abu Dhabi, pledged $100 million Wednesday to deliver vaccines to children in Afghanistan and Pakistan. Gates was understandably happy with the new donor, Abu Dhabi. 


13.    KFF – U.N. Women Executive Director Bachelet Launches 100-Day ‘Action Plan’

During the inaugural meeting of U.N. Women’s executive board this week, Executive Director Michelle Bachelet laid out a 100-day action plan for the newly-launched agency. Meanwhile, Madeleine Bunting wondered on the Guardian’s Poverty Matters blog whether funding will be there for the new agency.


14.    Financial Times – Pharmaceuticals: Rich pickings at home and abroad

Amy Kazmin;

International pharmaceutical companies once looked with frustration at Indian drug makers, which were notorious for churning out low-cost, copycat versions of patented drugs and selling them to developing countries. More recently, they have been looking at India’s fast growing pharmaceutical industry in a different light though – as an increasingly integral part of the global supply chain in an environment of intensifying pressure on prices.”


15.    Owen Barder – BORN TO SHINE

Owen Barder;

Owen Barder makes some incisive comments on the new Save the Children report “No Child born to die”. You can find the report here.


16.    HP&P – How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data

Mylene Lagarde;

It is by now acknowledged that randomization to examine the impact of health policy in LMICs is not always feasible or politically acceptable. Analyses using longitudinal data series before and after an intervention can also deliver robust results and such data are often reasonably easy to access.  (this one is for the statistical geeks among you)

17.    Health Research Policy and Systems (Comment) – Research on health transition in Africa: time for action

Dermot Maher et al.

There is an urgent need for research on health transition in Africa to enable countries to respond effectively to rapidly changing health needs. 

18.    HLSP – Results based aid and results based financing: What are they? Have they delivered results?

Mark Pearson;

There is much interest in the role RBF might play in scaling up donor support and, at the same time, demonstrating the results of this aid. This paper describes the various types of results based funding, how they are supposed to work and discusses some of the lessons learned. It is based on a review of mechanisms managed by global health initiatives, donor countries, recipient countries and non state actors, including some approaches underway in OECD countries. A positive but cautious approach is needed, according to the paper. You find the paper here.


19.    Lancet Infectious Disease – Coverage of malaria protection in pregnant women in sub-Saharan Africa: a synthesis and analysis of national survey data

Anna Maria Van Eijk et al;

Despite success in a few countries, coverage of insecticide-treated nets and intermittent preventive treatment in pregnant African women is inadequate; increased efforts towards scale-up are needed.


Some other interesting new scientific articles are thisarticle in Human resources for Health (with an econometric approach to HRH and burden of disease – the relation between density health workers and DALYs) and an article in Health Policy & Planning on   “Community-based provision of injectable contraceptives in Madagascar: ‘task shifting’ to expand access to injectable contraceptives.” 


A new MDG progress map from CGD is also worth exploring.

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