Dear Colleagues,

This week a few global health voices zoomed in on the question whether China still deserves to be a recipient of the Global Fund, given the fact that it spends 80 billion a year on defense and has over 2 trillion of foreign currency reserves (not to mention the amount of money the country “needs” for domestic stabilization). In this week’s newsletter we pay some attention to this ongoing debate.


Neighbors Pakistan and India also get a fair amount of global health attention these days. The flooding catastrophe and the difficult funding of relief in Pakistan are all over the press now, and rightly so. India’s medical tourism has also sparked more than a few articles in recent weeks, see for example pieces in the Lancet and the New York Times today. The “superbug”-controversy only partly explains this increasing interest in India. Another story that is increasingly being covered by media outlets is the eagerness of Big Pharma to venture into emerging markets, and India is of course a prime example. This week the Wall Street Journal had a piece on the Indian activities of Abbott.


Finally, in Africa, some encouraging news came from Uganda. It appears funding caps from PEPFAR have been lifted recently. Maybe the campaign by MSF, the NYT and many others has paid off? Or is this good news also linked to the July bombings in Kampala by an Al-Quaeda affiliated militia group? We’ll probably never know. The American government moves in mysterious ways, as it usually does.


Enjoy your reading.


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

Global Health

1. JAMA – The president’s global health initiative

Lawrence O. Gostin;

A recent commentary in JAMA by Gostin discusses Obama’s GHI. He worries global health reform will turn out illusory. That would be a mistake, he contends, as global health is vital to US national interests.

2. Globalization and health – Framing health and foreign policy: lessons for global health diplomacy

Ronald Labonte & Michelle Gagnon;

Labonte & Gagnon review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. They focus in their analysis on the goal of improving global health equity. Their conclusion: “most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the ‘high politics’ of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional ‘low politics’ of foreign policy, are present in discourse but do not appear to dominate practice.”

3. HPP – The evolution, etiology and eventualities of the global health security regime

Steven J Hoffman;

Hoffman sketches four historical periods of global health security governance. The final regime, characterized by the hegemonic leadership of the WHO, is now challenged by globalization, changing diplomacy, new tools, and possible shocks and vulnerabilities. The author elaborated four possible future configurations of power.

4. FP – China & the Global Fund: a rebuttal

Drew Thompson And Jia Ping ;

In a Foreign Policy viewpoint, intended as a rebuttal to an earlier piece by Jack Chow, Thompson and Ping argue that the Global Fund should continue to support China.

5. GHP – Should China Continue to Receive Aid?

Devi Sridhar;

In a blog post, Sridhar comments on Thompson and Ping’s stance. She reckons their case rests on three arguments: the fact that development assistance is not a zero-sum game; that Global Fund money can bypass government obstacles to improving health; and that it’s about diplomacy rather than about aid. All three of these arguments are debatable, she contends.

6. Irin – UGANDA: Optimism as PEPFAR increases funding

PEPFAR committed to increase its support of Uganda’s treatment program. Goosby had announced this encouraging news in a recent blog post.

7. Lancet – Health and philanthropy—the tobacco connection

Simon Chapman;

Bill Gates should reconsider his philanthropy cooperation with Carlos Slim, if he is serious about his recently embraced tobacco-control agenda.

8. HPP – The World Health Report 2000: expanding the horizon of health system performance

Julio Frenk;

Frenk revisits the World Health Report 2000, ten years after its launch. He sees a number of conceptual contributions of the report. He also summarizes some of the key concerns expressed by governments and the rationale for the WHO leadership to move ahead with this exercise.

9. HPP – WHR 2000 to WHR 2010: what progress in health care financing?

Di McIntyre; 

In another HP&P Comment that looks back on the WHR 2000, McIntyre focuses on some of the conceptual frameworks and guidance on directions to take to boost health systems performance, notably with respect to the issue of health care financing. Plenty of challenges remain.


10.    AJPH – Innovative Approaches to Reducing Financial Barriers to Obstetric Care in Low-Income Countries

Fabienne Richard, Sophie Witter and Vincent de Brouwere;

Richard et al. explore innovative approaches to reducing financial barriers to obstetric care in low-income countries, and draw some lessons from 8 case studies.


11.    CGD – Who Are the MDG Trailblazers? A New MDG Progress Index – Working Paper 222

Benjamin Leo and Julia Barmeier;

A CGD working paper introduces an MDG progress index to assess the extent to which countries are on or off track toward MDG targets. They come to interesting conclusions, for example on the better than usually acknowledged performance of quite a few sub-Saharan African countries. Laggards seem to be countries devastated by conflict over the last decades.

12.    IPS – Gender Equality Goals Miss the Mark, Women’s Groups Say

Hannah Rubenstein;

A month ahead of the MDG+ summit, some women’s groups are voicing concern that member states’ commitment to women’s issues is insufficient and slowing progress towards gender parity worldwide. The problem is “the entire approach towards understanding and addressing problems of gender inequality. Focusing on individual women’s issues, such as maternal mortality and access to education, fails to take the larger picture into consideration – the symptoms are being treated while the infection spreads.”

AIDS and Church

13.    M&G – Pastor’s ‘Jesus had HIV’ sermon angers SA Christians

In a controversial move, a South-African pastor has preached a sermon entitled “Jesus was HIV-positive” to break the – what he calls – ‘conspiracy of silence’ by the South African church. HIV is routinely being stigmatized as evil and a sin by the church, he said. To hammer his message home, he chose a provocative title. In many parts of the Bible, God put himself in the position of the destitute, the sick, the marginalized,” he said. “When we attend to those who are sick, we are attending to him. When we ignore people who are sick, we are ignoring him.”

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