Dear Colleagues,

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This week’s global health headlines definitely include the recent global fund board’s decisions. Among them the decision to include proposals that would incorporate Mother Neonatal and Child Health (MNCH) interventions provided they fall within the window of the three main diseases. Another important decision to us is the possibility to submit funding requests on “Health System Strengthening” alone.


EU India talks on trade agreement did not end up successfully. I wonder if this time also Louis Michel will say that Indians like Africans do not understand the benefits of free trade rules that the EU wants to impose in order to help them develop faster. Or do they? We find it rather positive that such negotiations are harder to conclude than the EU would have expected. Does this illustrate some kind of empowerment of Global South politicians and diplomats? The unsuccessful trade agreement meeting between EU and India at least came to one important decision: Genuine generic drugs en route to developing countries will not be confiscated anymore in European harbours.


And finally we would like to highlight the debate in the < ?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />US about rationing access to health care. Discussing rationing is a difficult topic and brings to the front issues that we prefer to hide at the back when in the front stage we talk about universal health care. Rationing is a constant in every health system. We support the idea that we rather think about ethical and societal implications of different options rather than letting “non decisions” make choices for us.


Enjoy your reading.


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

Global Fund

1. Lusaka Times – Zambia: Global Fund gives US$1.1 million to ZNAN

Dimboni Mafweto;

It seems that despite the disruption of the support to programmes due to alleged corruption, the GFATM tries to remain accountable towards the patients it serves by nevertheless providing funding to ensure the provision of live saving drugs. In the same time the GF appealed to international donors to join them in an effort to fight medicine theft.

2.  AIDSPAN – Main Decisions Made at the Board Meeting

David Garmaise;

The board of the Global Fund is just over and AIDSPAN is providing the international health community with a summarized report of the decisions and discussions that took place in Sofia. In this article, Garmaise reports the main decisions points. In the next article Rivers gives some thoughts on what happened and did not happen in Sofia. Finally if you are interested in a more extensive description of the results of the board related to grant approval and rolling out of Round 11 of the GFATM, you should read the issue 135 of the Global Fund Observer.

3. AIDSPAN – Report from Sofia – Good News, Bad News

Bernard Rivers;  

See comment supra.

Global Health

4. KFF – EU, India Talks End With Resolution On Drug Seizures, Little Progress On Free Trade Agreement

The talks between EU and India did not yet come to an end, especially not on the intellectual property rights that could affect pricing and availability of low cost generic drugs in the rest of the Global South. At least an agreement has been reached on the transit of Indian produced generic drugs via European harbors to the rest of the world. One step forward, but still many potential steps backwards waiting behind the door.

5. Guardian – World Bank announces increase in donor funding

Larry Elliott;

While GFATM and especially GAVI did not realize their wishes in terms of replenishment, it seems that the IDA World Bank has been more successful last week. Donor countries voting with their dollars? Note the entrance of middle income countries at the table of donor countries. Something the GFATM did not really succeed at yet.

6. MMI network- December Newsletter

In its December newsletter, Medicus Mundi International is discussing non communicable diseases and the genuine growing interest to increase the attention to these often neglected diseases in low and middle income countries’ health systems. They highlight some upcoming events and resource on that topic.

Health Financing

7. KFF – GAVI Alliance Launches Pneumonia Vaccine Project In Nicaragua

The first implementation of the pneumococcal vaccination programme funded under the GAVI run Advanced Market Commitment has now been launched in Nicaragua. 19 to 39 countries should benefit from this “lower priced” vaccine in the future. KFF, discusses on the content of the deal and some of the issues at stake. At the same time Reuters examines GAVI’s bonds as a way to fund vaccines today with money governments pledged to give tomorrow KFF Reports. A way to use tomorrow’s aid today or to make aid more predictable on the long run?


8. KFF – WHO Report Shows Significant Progress In Global Malaria Fight, Highlights Need for Continued Funding

The annual Malaria report is out. No surprise, the need for continued funding is put forward. A leitmotiv in global health reports nowadays.

9. Lancet – Artemisinin resistance—the clock is ticking

Nicholas J White;

White, who is the co-chair of the WHO GMP malaria prevention and treatment technical expert group, calls for a more aggressive response to the emergence of artemisinine resistance at the Thai Cambodian border.

Health Systems

10.    Lancet (letter) – A plea for investment in district hospitals

Caris Grimes, Christopher Lavy;

Replying to the report by The Lancet Commission on The Millennium Development Goals, Grimes and Lavy make a plea for investing in district hospitals as a good way to reach MDGs 4, 5 and 6 in an integrated manner. The essay by Ellen M Einterz adds another dimension by describing the life in a remote rural district hospital in Northern Cameroon before concluding that health systems should build on the integrated health district model and that health aid programmes should be designed bottom up, instead of being guided from Geneva and New York.


On the other extremity of the health systems strengthening’s possible approaches  UNFPA is building a partnership with the Millenium village to add the life savings reproductive health services  to the package of quick wins provided to 500 000 Africans living in millennium villages in order to get them to the MDG for “only” 110 USD per person a year.


Ellen Einterz ’s essay is one of the three essay’s selected for the Wakley prize. The winning essay depicts the loneliness of elder people in UK while another one reports from a night in a Teheran hospital emergency ward. Those three essays are a very powerful description of the reality faced by hospital practitioners in each of their settings. Looked at from some distance, they provide an interesting contrast between diverging but dare realities faced in London, Teheran or Northern Cameroun hospitals.

11.    CGD – Who lives? Who decides? Examining the “How” of Health Care Rationing

Amanda Glassman;“how”-of-health-care-rationing.php

Amanda Glassman puts the PRI’s “The World” report on rationing that will be aired in the US shortly in perspective.

Emerging Voices

12.    SCIDEVnet – African academics ‘slow to use online journals’

Mercy Adhiambo;

Adhiambo reports on a survey in East and South Africa about the use of available electronic journals. Internet access is improving but bottlenecks prevail beyond access to the journals. Food for thoughts for our emerging voices initiative.

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