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This week the Lancet launches its “Malaria elimination series“. Indeed, there is growing consensus that it is timely and urgent to accelerate the “big push” in malaria control. In 2007 Bill Gates called for “eradication” and was cheered by many, for a variety of reasons … Others tried to correct the (blunt) language, and now the global malaria community has settled for “malaria elimination”, with a progressive “shrinking of the malaria map”. There are certainly opportunities to decrease malaria considerably, and this fits well in the ‘quick win’ approach to reaching the MDGs. However, lessons from previous attempts have learnt that if this is done exclusively in “campaign mode” then there is a big risk of “resurgence” and “rebound” (not unlike what happened in the US this week). This could lead to a backlash and hangover symptoms… To prevent this from happening (again!), long-term malaria control needs to be planned from the start, involving comprehensive health systems strengthening to use the drive and energy generated for wider health goals. But that is a tall order.
We would also like to draw your attention to a new issue in the ITM SHSO&P series, by Josefien Van Olmen and colleagues. The attention for Health Systems Strengthening (HSS) has by now resulted in an overwhelming amount of articles with HSS in the title. Most of these only add to the cacophony around the topic, unfortunately; few publications really add to the debate. The recent excellent article of Shakarishvili in Health Policy & Planning was an exception. The monograph by Van Olmen and colleagues also aims to contribute to and spice up the debate, by giving overviews, clarifications and visions. The authors outline a framework that is primarily meant for analysis of individual health systems, but can be adapted and used for analyzing specific problems modelling of effects of future interventions. The framework goes beyond the WHO building blocks approach by stressing four additional issues: (1) a focus on outcomes and goals; (2) the importance of underlying values and principles; (3) service delivery as the core building block, which needs unpacking; & (4) health systems interactions with the population and with the specific contexts in which they are embedded.
Enjoy your reading.
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1. Lancet Series – Malaria elimination series
In a Lancet series, malaria elimination is put under the microscope: what are the technical, operational, and financial challenges that confront malaria-eliminating countries?
Das & Horton comment on the series: malaria elimination is worthy, challenging and – only just – possible. But an effective vaccine would still come in handy.
In another comment, Feachem et al. set some priorities for malaria elimination for malaria-endemic countries, WHO, the GF, the research community, the pharmaceutical industry and the private sector. The time horizon? 2050.
A Lancet article dwells on the global health career of Richard Feachem, former boss of the GF. Feachem does not only have a very clear vision on malaria elimination, he is also very explicit about the role the GF should play.
Earlier this week, Sarah Boseley also commented on the Lancet series in the Guardian. In some countries, control might be the best policy.
2. BMJ (news) – Countries’ long term progress in health isn’t related to economic growth, report finds
The twentieth UN Human development report (PDF, 11 MB) was released a few days ago. BMJ columnist Moszynski looks at it from a health perspective. Most developing countries made dramatic yet often underestimated progress in health (as well as education and basic living standards) in recent decades. Many of the poorest countries saw the greatest gains.
3. SHSO&P 27 – Analysing Health Systems To Make Them Stronger
As stated in the introduction, the authors outline a framework that is primarily meant for the analysis of individual health systems, but can be adapted and used for analyzing specific problems modelling of effects of future interventions. The framework expands on the WHO building blocks approach by stressing four additional issues.
4. Global Public Health – Using global health initiatives to strengthen health systems : a civil society perspective
Jennifer Cohn; Asia Russell; Brook Baker; Alice Kayongo; Esther Wanjiku; Paul Davis; http://www.informaworld.com/smpp/content~db=all~content=a928686124~frm=titlelink
In this interesting article, the authors fill a knowledge gap by providing the civil society’s perspective regarding the effect of PEPFAR and the GF on country health systems and the added value of civil society interacting with GHIs to strengthen health systems.
5. TMIH (viewpoint) – Why do we need a point-of-care CD4 test for low-income countries?
R. Zachariah, S. D. Reid, P. Chaillet, M. Massaquoi, E. J. Schouten, A. D. Harries
In this viewpoint, the authors discuss the reasons why a point-of-care CD4 test is urgent. It is high-time that CD4 technology is simplified and adapted for wider use in low-income countries to change the current paradigm of restricted access.
6. The East African – Why the private sector must join the fight against AIDS, malaria and tuberculosis
Jeannette Kagame & Aigboje Aig-Imoukhuede; http://www.theeastafrican.co.ke/news/-/2558/1043886/-/item/0/-/oxm3doz/-/index.html
The authors (including the first Lady of
7. CGD (paper) – Where Have All the Donors Gone? Scarce Donor Funding for Non-Communicable Diseases Working Paper 228
Rachel Nugent & Andrea B. Feigl; http://www.cgdev.org/content/publications/detail/1424546
CGD released an analysis of ODA money allocated to non communicable diseases. Despite major increases over the years, the picture remains bleak..
8. AIDSSPAN – OIG Finds Serious Deficiencies in Performance of All Four PRs in
The GF story in
Last week, Andrew Harmer already commented on this disturbing news.
9. WHO Bulletin – Examining health-care volunteerism in a food- and financially-insecure world
In this viewpoint, Maes analyses the volunteerism that is often promoted by community level programmes. Something is indeed wrong when volunteers cannot meet their basic needs.