Dear Colleagues,


Next week we will at last find out whether Gordon Brown’s gaffe cost him the UK elections, but anyhow, the three main contenders all seem to support the UK’s current influential role in global health issues.

In addition to the UK elections and the Euro mess, the opening of the World Expo in Shanghai is set to capture the attention of the world next week. In a timely contribution, Plos features this week an article on China’s smooth health diplomacy of recent years. The lifting of the decades-old ban on visitors with HIV, a few days before the event kicks off, was just the latest example.

Enjoy your reading.

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

Global Health

1. Lancet – Research out of Africa

The Lancet ; Full Text

The Lancet refers to a report (Global research report- Africa) that provides an overview of current research activity in Africa. Africa’s research output is still relatively limited, but it is hoped that in the next decade this will change. The Lancet presents a report that has assessed how much publications came out of Africa over the last years. This initiative is very important to show how much efforts are still needed to increase the research capacity in Africa.

2. Lancet – The unconscionable health gap: a global plan for justice

Lawrence Gostin Full Text

Gostin argues in the Lancet that the international community should do more than just lament the health inequalities. It is time to act. A global plan for justice that would guarantee a universal package of essential services, is urgent, and would comprise three components: essential vaccines and medicines, basic survival needs and adaptation to climate change.

3. IHP+: little progress in accountability or just little progress?

Ronald Labonte, Anna Marriott ; Full Text

Labonte and Marriott assess IHP+, 3 years into the Partnership. They claim IHP+ signatories should do three things, if the intent of IHP+ is to be realised, and to address the current Partner accountability gap. An element that is particularly missing, is the foreign policy coherence issue.

Although the IHP+ is now launched since 3 years, little or no results have been noticed. This might be due to insufficient data available. The Civil Society group calls for a more transparent monitoring that will hold signatories accountable for their engagements and for increased coherence across policies that affect health.

4. Four social theories for global health

Arthur Kleinman ; Full Text

The anthropologist Kleinman sketches four social theories that could be used to make sense of case studies in global health: the Merton theory of unintended consequences of purposive action; the social construction of reality (introduced by Berger and Luckmann); the theory of social suffering; and finally, Foucault’s notorious concept of biopower. But there are plenty of others that could be equally useful for global health (like Weber’s theory on bureaucratic rationality).

5. Lancet – Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis

Julie Knoll Rajaratnam, Jake R Marcus, Alison Levin-Rector, Andrew N Chalupka, Haidong Wang, Laura Dwyer, Megan Costa, Alan D Lopez, Christopher JL Murray ; Summary

The Lancet features an article that analyzes worldwide adult mortality over the last four decades. Adult mortality varied substantially across countries and over time. The authors emphasize that the prevention of premature adult death should be just as important for global health policy as the improvement of child survival.

The prevention of premature adult death is just as important for global health policy as the improvement of child survival. Routine monitoring of adult mortality should be given much greater emphasis.

6. Lancet – What do we really know about adult mortality worldwide?

Ai Koyanagi, Kenji Shibuya ; Full Text

Koyanagi and Shibuya comment on the landmark study by Rajartnam et al. in this week’s Lancet on adult mortality. They see at least three methodological breakthroughs.

In addition, they point out common theories behind health transition are being challenged by the analysis, as much of the variation in adult mortality can not be explained by the combination of economic development, the HIV epidemic, and child mortality. This will no doubt spark debate on alternative theories (and the roles of social determinants, health systems, and medical technologies).

7. PLOS – China’s Engagement with Global Health Diplomacy: Was SARS a Watershed?

Lai-Ha Chan et al. ;

This article in the PLOS series on global health diplomacy shows China’s changing attitude towards global health, in the aftermath of the SARS crisis. Its increased support to the WHO, the only “increasingly more influential” UN agency, and to African health systems, are obvious examples of this ‘new-style’ Chinese Health Diplomacy. One could add this week’s news item on the lifting of a travel ban for foreign visitors with HIV, a few days before the World Expo kicks off in Shanghai. Pretty good timing.

8. KFF – G8 Development Ministers Agree On ‘Guiding Principles’ For Child And Maternal Health Initiative

G8 Development Ministers have agreed on a plan for the Child and Maternal health initiative that “leaves flexibility for countries to ‘build their basket of initiatives’". This kind of formulation leaves some flexibility for abortion programmes to be included (or not). Only in June we will see whether new financial commitments accompany the plan.

AIDS financing

9. Newsweek – AIDS Programs Hit Setbacks in Africa

Katie Paul ;

Newsweek examines why, in spite of Obama’s new GHI, advocacy groups are raising the alarm about HIV treatment shortages in Africa. For many AIDS advocates, ‘pragmatic’, the word commonly used to typify Obama’s new GHI approach, is quickly turning into a euphemism for ‘cheap’. Anyhow, the PEPFAR momentum seems gone. Newsweek says part of the reason lies in the fact that policymakers are beginning to realize that the world can’t treat its way out of the AIDS epidemic. And as could be expected, when covering the question of aid effectiveness, the Murray article is already being cited as well…

10.    BMJ – More people face treatment rationing as AIDS funding is cut

A report of the International Treatment Preparedness Coalition sketched the current global pullback on commitments to fight AIDS which is already resulting in restrictions on the number of people being enrolled into treatment programmes, more frequent drug shortages, and reduced national AIDS budgets.

Aid effectiveness

11. Owen – Can aid create incentives for politicians in developing countries?

Owen points out two things about the use of aid to create incentives for politicians in developing countries. Donors cannot create effective incentives through aid. Nevertheless, COD is a smart idea, but not because it creates stronger incentives in developing countries, but because it will create better incentives for donors.

Bill and Melinda Gates Foundation & HSS

A number of articles dwell on the doubts of the Gates foundation on whether it should engage into health systems strengthening or stick to a disease specific approach. In AFP news published on Yahoo, Kazatchkine argues that during a difficult replenishment year the time is probably not right to broaden the mandate of the Global Fund. He hints that the Gates Foundation was “strongly opposed” to an expansion. On the other hand, the Wall Street Journal features a long article on Gates’ recent trip to Nigeria to support the fight against polio in a context of resurgence of polio in some countries. Polio control will, in the long run, need functioning health systems, it appears. So Gates’ advisors aren’t sure whether they have to recommend more funding for polio eradication in this context or move towards a more integrated health system approach. Owen, commenting on this article on his blog, also noticed the WSJ article, and points out sarcastically: “Gates discover[ed] (at last) that vertical health programs don’t work.

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