Dear Colleagues,


Everybody is watching Cairo for the moment, and hoping for the best. Pundits across the world are commenting on what’s happening or waiting to happen on Tahrir square. These are truly historic times, and nobody can really predict how the transition will unfold in the coming days and weeks.  Nevertheless, Fox commentators are trying really hard, while being flabbergasted at the same time. Meanwhile, although it’s still early days, CGD’s Nancy Birdsall draws some lessons for US development. It is obvious that (former?) ally Egypt and the US support for Mubarak’s regime in the last decades will spark a debate in the aid community and beyond.  In other words: to be continued.


Then there is the ongoing US health reform saga. Republicans didn’t get their way in the Senate, but the Economist points out today that Obama’s health reform was dealt a fierce blow by the courts earlier this week. And a blog post by Gavin Yamey, on the Plos ‘Speaking of medicine’ blog, describes why the future of the US health reform currently lies in the hands of one man, Justice Anthony Kennedy, of the US Supreme Court.  


Obviously, climate change is so far the story of this century. Last week Ban Ki Moon himself reckoned the world economic model amounts to ecological suicide. By now you probably know we do not disagree. In an editorial in this week’s issue, The Lancet urges the international aid community to take a longer term view for natural disasters. Definitely worth a read is also Volume 3 in the series “Patterns of potential human progress”: Improving global health: forecasting the next 50 years. One of the chapters tries to take into account different climate change scenarios.


Enjoy your reading.

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

Performance Based Financing


1.WHO Bulletin –  Performance-based financing: just a donor fad or a catalyst towards comprehensive health-care reform?

Bruno Meessen, Agnès Soucat & Claude Sekabaraga;

In the words of health economist Paul Shaw: “This is a superb, readable, and appreciably short representation of the possible virtues of PBF/RBF for enhancing performance of health systems in LICs.”  Check it out for yourself.


Global Fund Commotion


The Global Fund tries to contain the fallout of the media storm started by an  Associated Press article (23 January). The Fund just announced further measures to enhance financial safeguards and strengthen fraud prevention, in a press release.

2.Aidspan – Donor Timidity

Bernard Rivers;

The last ten days have shown how timid some of the Global Fund’s donors can be when the going gets tough. Clearly, the task of detecting fraud is more challenging than the Fund recognised until last year. But at least the Fund is tackling the issue forcefully and openly. Yet the Fund has been severely penalised, by the media and some of its donors, for doing what similar institutions have not had the courage to do.”


Pretty much in the same vein is a Lancet editorial this week.


Earlier this week, BMJ also featured a news story on the case, quoting Kazatchkine’s reiteration of the zero tolerance policy of the Fund. And the Guardian’s Sarah Boseley was one of the many global health watchers who wondered whether the Fund will be able to survive the current media storm. Several donors have suspended payments by now, but so far there’s no evidence of a real domino effect.  


In related news, malaria expert Bill Brieger argued that the Fund could use a new business model.

Polio eradication

3.Sarah Boseley – Polio vaccines: extra government funding comes with strings attached

Britain will double the amount of money it contributes to the effort to stamp out polio, from £20m to £40m a year over the next two years. David Cameron announced this in Davos. However, the commitment comes with strings attached. Two, in fact.


4.KFF – Bill Gates’ Annual Letter Calls For Focus On Eradicating Polio, Governments To Sustain Foreign Aid

Gates’ annual letter had a double focus, reports KFF. Meanwhile, experts question whether polio eradication is possible. The NYT also had a piece on – what they initially called “Gates’ polio eradication obsession”. Later, the newspaper changed the title of the article, putting it a bit more diplomatically.

On her blog, Karen Grepin thinks the gamble is worth trying, and points out that Gates became a rich entrepreneur by taking risks. The polio eradication campaign is definitely a risky investment.


On the CGD website, Amanda Glassman also had some advice related to the polio eradication campaign:  maybe a fragile states vaccine-preventable disease outbreak response fund could be established.


Global Health Policy and Financing

5.Lancet (Comment) – Stemming the global tsunami of cardiovascular disease

Sonia S. Anand, Salim Yusuf;

The authors hope that a high-level commitment to mass remedies for cardiovascular disease will be made by world leaders at the UN General Assembly on chronic non-communicable diseases in September, 2011.

6.Lancet – Offline

Richard Horton;

Richard Horton attended Harper’s visit to the WHO Geneva headquarters last week. Harper’s message to maternal and child health advocates and experts? Keep it simple.


7.Lancet – GAVI takes steps to address funding woes

Ann Danaiya Usher;

The GAVI Alliance is trying to roll out new vaccines amid a massive funding shortfall (of US 3.7 billion) but it will have to make operational changes to do so. Ann Danaiya Usher reports on the agency’s plans. In the months ahead, the new chair of GAVI, the Norwegian Dagfinn Høybråten will be travelling around the world talking to key donors. The Lancet also features a profile of the new GAVI board chair in this week’s issue.

8.Lancet – Progress patchy on health-worker crisis

Patralekha Chatterjee;

Hundreds of health experts met in Bangkok last week for the second global conference to tackle the worldwide shortage of health workers. Patralekha Chatterjee reports from the meeting.  The key message from the second Global Forum on Human Resources for Health, held in Bangkok was troubling: national and global leaders are not treating the health-worker crisis, most dramatically evidenced in sub-Saharan Africa, as one of the most pressing issues of our times.


9.Inis communication – 2011- a perfect storm for global health

Tim France;

The author sees seven key forces that are converging this year. Everybody in the global health community should at least be aware of these seven trends, he claims.


10.    Global Health Europe – A turning point for global health governance

Ilona Kickbush;

Ilona Kickbush stresses: “The complexity of the global health challenges and the fragmentation of the many actors has now reached a stage where countries – donors and recipients alike – are keen to have WHO “act as the directing and co-ordinating authority on international health work” as stipulated in its constitution.”


In other GHG news, Blog4GlobalHealth featured a post on how global health could feature on the French G8 and G20 summit agendas. There is some reason for worry.


11.    Plos (Policy Forum) – Registering New Drugs for Low-Income Countries: The African Challenge

Mary Moran et al;

A recent shift in the drug product environment for Africa has seen a score of new products being developed specifically for diseases of the developing world, creating new challenges for regulators in Africa and elsewhere. However, it is not at all certain that African regulatory authorities currently have the capacity to meet these new demands. The authors put forth six recommendations.


12.    Global Public Health – Retreat from Alma Ata? The WHO’s report on Task Shifting to community health workers for AIDS care in poor countries 

C. Campbell; K. Scott;

This paper examines the potential of community health worker (CHW) programmes, as proposed by the 2008 WHO document Task Shifting to tackle health worker shortages, to contribute to HIV/AIDS prevention and treatment and various Millennium Development Goals in low-income countries.  The WHO seems to neglect the need for “community embeddedness” of CHW, found to be of critical importance in the past.

13.    Lancet (Letter) – Stronger guidance needed on lifelong care for chronic diseases

Raoul Andrada Bermejo, NS Prashanth, Sanjib K Sharma;

This is a letter from three Emerging Voices, in reaction to a Lancet Series article by Samb et al. on the prevention and management of chronic diseases. According to the authors, Samb and colleagues “fall short of putting forward a package of interventions that countries can take up to strengthen systems and to respond comprehensively to the chronic disease epidemic.”


US global health news

14.    KFF – The U.S. Global Health Initiative: A Country Analysis

A new report from the Kaiser Family Foundation examines funding and demographic data for countries receiving support under the Global Health Initiative (GHI), the Obama Administration’s six-year effort aimed at improving the health and lives of people in the developing world. The new analysis evaluates data from fiscal year 2010 for six programs in the GHI: HIV/AIDS; TB; malaria; maternal, newborn, and child health; family planning and reproductive health; and nutrition. The report also includes a special spotlight on the eight “GHI Plus” countries, countries selected by the Administration to serve as “learning laboratories.”  You can download the report here.  


Meanwhile, Minnesota health executive Lois Quam is going to lead the GHI.


KFF reports that Congress moves to consider foreign aid spending cuts.  Earlier this week, Politico also looked at how proposed budget cuts could affect US foreign aid, including global health funding.


A PEPFAR spokeswoman sees signs of a disturbing condom gap in many African countries confronting HIV/AIDS, as the Science Speaks website reports.


Global Health Research


15.    Plos – A Research Agenda to Underpin Malaria Eradication

Pedro L. Alonso et al;

The Malaria Eradication Research Agenda (malERA) complements the current research agenda—primarily directed towards reducing morbidity and mortality. The agenda aims to identify key knowledge gaps and define the strategies and tools that should eventually allow for eradication of malaria.


The new WHO Bulletin issue also features a nice piece on family planning in sub-Saharan Africa, as well as an article on how access to antiretroviral treatment should be measured in a country. Obviously, there’s a lot more.


Development and Aid

16.    Development and change – the MDG story – intention denied

Jan Vandemoortele;

This article essentially looks backward: it contains an insider’s view of the origin of the MDGs.


To conclude this newsletter, we would like to draw your attention to a couple of articles on the Guardian ‘Poverty Matters’ blog:


  • Andrew Mitchell explained his vision on a new development paradigm: “private sector, public benefit”.  
  • An IMF spokesperson reacted to the study by Stuckler & McKee, saying that IMF loans actually encourage poor countries to raise their health spending.
  • India takes a step forward in tackling maternal health, as Delhi‘s high court has ordered the capital’s government to build shelters for destitute pregnant women so they can receive care when giving birth. Basically the court is treating maternal mortality as a human rights violation.

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