Dear Colleagues,

Margaret Chan was in a somewhat apocalyptic mood, recently, when she gave a lecture to the Women’s international Forum on the rise of NCDs, “a ‘slow-motion’ disaster”. What we’re now witnessing in LMICs is just the first wave, she said, the second (presumably more devastating one) is yet to come.  Having some sympathy for apocalyptic messengers, we tend to agree with her. Thank God the private sector is ready to help the world out, at least if  Derek Yach is to be believed (in a Huffington Post op-ed).  

End of September, so there’s plenty of news, this week, not just on the rather unexpected ‘postponement’ of the World Health Report, but also on various UN meetings and side events in New York. In a few weeks from now, the global health action will be in Beijing though. For the ones who already want to get in the mood for the Beijing HSR symposium (provided they get hold of a Chinese visa in time), the symposium now has a Twitter hashtag:  #hsglobal. (I hope the organizers will also start a Sina Weibo account and hashtag in the coming weeks, just like Snoop Dogg did, to get their message out in mainland China.)

This week’s guest editorial is written by ITM visitors Anne Muendi Musuva (from Kenya) and Innocent Turate (from Rwanda) and discusses the growing threat of MDR-TB.


Enjoy your reading.


Kristof Decoster, David Hercot, Ildikó Bokros, Peter Delobelle, Basile Keugoung &Wim Van Damme



Multidrug Drug Resistant Tuberculosis: A growing threat to TB control efforts

by Anne Muendi Musuva (MD, MPH from Kenya) and  Innocent Turate (MD, MScPH from Rwanda)


World Health Report: not to be in 2012

1.    Plos Medicine (Editorial) – The World Health Report 2012 That Wasn’t

The PLOS Medicine Editors comment on the WHO’s latest World Health Report, originally planned for publication in 2012, and the outcomes of the journal’s collaboration with WHO on the intended theme of “no health without research.”  (surprising news, definitely, calling for some investigative journalism – let’s do that in BeijingJ )

You find the Plos collection of papers here.


2.    Plos – who sets the global health research agenda? The challenge of Multi-Bi financing

Devi Sridhar;

As part of the cluster of articles critically reflecting on the theme of “no health without research,” Devi Sridhar discusses a major challenge in the governance of research funding: multi-bi financing that allows the priorities of funding bodies to dictate what health issues and diseases are studied.  (whether the weird term ‘multi-bi-financing’ will take off in the coming years, remains to be seen though)


New York,New York…

3.    Lancet – Women’s and children’s health: no time for complacency

Richard Horton;

Horton comments on the first report of the iERG, the independent Expert Review Group set up by the Commission on Information and Accountability for Women’s and Children’s Health, that has to report annually on progress for women’s and children’s health, assess the delivery and transparency of commitments made, identify good practices and obstacles to health, and make recommendations to improve accountability. This first report was published this week, and the picture is gloomy, in spite of the progress made over the last decade, not in the least because there are worrying signs that donor and country financial commitments to women’s and children’s health are declining. You find the executive summary here.

4.    Lancet (Offline) – Positive and negative

Richard Horton;

Horton does not share the optimism on the decreased child and newborn mortality figures (covered worldwide a few weeks ago). For a number of reasons, he finds the upbeat picture in the press unbalanced and misleading.

5.    KFF –  U.N. Presents Plan To Improve Access To Contraception, Releases Report On Maternal, Child Health

The UN on Wednesday presented a plan to make life-saving health supplies more accessible. With its new plan, the U.N. Commission on Life-Saving Commodities for Women and Children aims to improve access and use of essential medicines, medical devices and health supplies that effectively address causes of death during pregnancy, childbirth and into childhood. Prices for long-acting contraception will be halved for 27 million women in the developing world through the new partnership.

Some other UN General Assembly related global health news:

  • African leaders met on the sidelines of the 67th session of the UN General Assembly, and called for innovative solutions to accelerate the response to AIDS, tuberculosis and malaria and to advance health for people on the continent.
  • Obama and Romney both addressed the Clinton Global Initiative, each focusing on how theUnited States can better promote prosperity and human rights abroad and at home. Obama focused on human trafficking, Romney laid out his vision on Foreign aid (see below, Development & Aid section).
  • World Bank president Jim Yong Kim announced a new special funding mechanism to enable donors to scale up their funding to meet the urgent needs related to MDGs 4 and 5, leveraging the International Development Association (IDA), the World Bank’s fund for the poorest. He announced the special funding mechanism during his remarks at the ‘Every Woman, Every Child’ event at the UN General Assembly.
  • Bill Gates spoke briefly on polio eradication, and Humanosphere’s Tom Paulson dwells on the importance of Bill’s high-profile commitment, even more so because most of the world doesn’t care much about polio:  “… But I think Gates is right on the money: The real reason the international community has to succeed in polio eradication is that to fail would risk causing a crisis of confidence that will ripple through the global health, aid and development community. To fail at polio eradication sends the wrong signal, Gates says, a signal that could undermine the many other, more apparently complex and ambitious efforts aimed at improving health and fighting poverty.”

US & health care

Various journals pay attention to the ‘health card’ played by the two presidential candidates.

The NEJM even features Perspectives by Obama and Romney. The prize for the best oneliner goes to Obama: “Supporters and detractors alike refer to the law as Obamacare. I don’t mind, because I do care.”

In a Lancet World Report, Susan Jaffe reports that comprehensive domestic health-care reform is one of the top defining issues in the campaign, overshadowing global health. A BMJ Feature article also describes how the two protagonists play the (domestic) health card.

Global health

As for US global health programmes, the threat of sequestration still looms, as this Science Speaks article emphasizes.

In a CGD blog post, Sarah Jane Staats says theUnited States would be wise to followBritain’s lead and conduct its own multilateral (or even bilateral) aid review to inform tough budget decisions ahead.

On the USAID Impact blog, Ariel Pablos Mendez, the US Assistant Administrator for Global Health, explains  that recently an Office of Health Systems was created, which will be the hub for the Agency’s worldwide leadership network of technical experts in health systems strengthening.


Universal Health Coverage

6.    BMJ (blog) – A post 2015 development goal for health – should it be universal health coverage?

Amanda Glassman et al.;

Glassman supports the notion and concept of UHC, but says it may not be a useful banner for the global health community to rally around in pushing for a post 2015 development goal, and this for 4 reasons.

In a nice CMAJ article from earlier this year, Bernard Appiah gives a good overview of the UHC situation inAfrica. It’s still rare in SSA, onlyRwanda andGhana have made significant progress towards UHC.


7.    UHC Forward – “Equity in Universal Health Coverage – reaching the poorest” workshop kicks off in Marrakech

Marilyn Heyman;

This week,  approximately 90 participants (decision makers, practicioners, experts, …) from a number of countries gathered in Marrakesh, Morocco for a workshop on “Equity in Universal Health Coverage – reaching the poorest” to discuss challenges and solutions to address this challenge. The Financial Access to Health Services Community of Practice co-organized the workshop, with the Ministry of Health ofMoroccoand JLN, the Joint Learning Network for UHC.

The Marrakech declaration on ‘access to health care for the poorest’ was just published on the ‘Health Financing in Africa’ blog. It’s a very concise declaration: less is more, in this case. If you also want to join, go to the Harmonization Health for Africa CoP’s Facebook page.


Global Fund

8.    Huffington Post – The Big Push

Arianna Huffington;

Initiated by the Global Fund, in partnership with The Huffington Post, The Big Push is a campaign to rally support to achieve global health goals that are now within reach. A collection of portraits embodies the hope and ambitions of people from around the globe who have joined The Big Push campaign. In New York, more than 1700 advocates from all over the world issued an urgent plea to world leaders to fully fund the Global Fund so that it can put an end to the three killer diseases.


Other Global Fund news and publications:

  • The Global Fund Governance Handbook was released.
  • You find Jaramillo’s report to the Board & the GF results report 2012 here.
  • The GF and Coca Cola expanded their partnership to deliver medicines in remote areas.
  • IRIN has an article with some (mostly lukewarm) civil society reactions to the new GF funding model.



9.    CGD – A global health mystery: what’s behind theUSgovernment position on AMFm?

Victoria Fan & Rachel Silverman;

The future of the Affordable Medicines Facility for Malaria (AMFm) hangs in the balance; there is much anxiety that AMFm will be terminated in 2013. Fan & Silverman explore the ‘big elephant in the room’ – the apparent lack of support from the US government. They wonder who might lose from AMFm scale-up.

10. MSF –Mali and Chad: A novel prevention programme has dramatically reduced malaria cases

A large-scale malaria prevention program through MSF gave intermittent doses of anti-malaria drugs to 175,000 children inMaliandChad; it suggests that widely distributing anti-malaria drugs to healthy children in African countries can significantly reduce the number of new cases of the disease.  Preliminary results from the program, known as seasonal malaria chemoprevention (SMC), show that the number of cases of simple malaria dropped by 65 percent in the intervention area inMali, and by up to 86 percent inChad.

More worrying malaria news – a new type of malaria-transmitting mosquito – was covered in the Lancet this week, by S. Shukla.


Health Policy & Financing

11. Health Financing inAfrica– An online debate on PBF in LMICs: still more questions than answers

Compiled & edited by Bruno Meessen;

One of the two editorials of the August issue of the WHO Bulletin was dedicated to Performance-Based Financing. Fretheim et al. reported the main findings of their Cochrane review published a few months earlier. In the weeks that followed, a discussion developed on the online discussion forum of the PBF Community of Practice (CoP). The discussion benefited from contributions by two authors of the review, Atle Fretheim and Sophie Witter. This blog post summarizes the main points of the discussion.

12. Lancet (editorial) – Wanted: a global campaign against epilepsy

The Lancet focuses on epilepsy today. This editorial says epilepsy should be part and parcel of the NCD momentum, as the prevalence and burden of epilepsy is especially high in poor countries —more than 85% of the global burden of epilepsy occurs in low-income and lower-middle-income countries. (we do appreciate the new cowboy-style ‘Calls to action’ in the Lancet).

13. World Bank ‘Let’s talk development’ blog – Should you trust a medical journal?

Adam Wagstaff;

Wagstaff explores a few recent cases and says that apparently, medical journals are having some problems judging the quality of empirical social science. Yet, Wagstaff himself experienced a very rigorous referee when submitting to the Lancet, he admits. (nice blog post, but we think the Lancet should probably return the favour, and run the following editorial next week: ‘Should you trust the World Bank?’)

14. DSW – Special: Study Launch and Panel Debate on Returns on Investment of EU Global Health Research and Development

On Wednesday, September 26th, DSW, a (German) international development and advocacy organisation, launched a specially commissioned report from Policy Cures entitled “Saving Lives and Creating Impact: EU Investment in Poverty-Related and Neglected Diseases” in the European Parliament. The report demonstrates that in addition to achieving crucial health benefits in the developing world, investment into R&D for Poverty-Related and Neglected Diseases (PRNDs) also constitutes an investment in European employment and smart growth. You can find the executive summary of the report here.



15. HP&P supplement – Systems thinking for health systems strengthening in LMICs: seizing the opportunity

Edited by Taghreed Adam & Don de Savigny;

No comment is needed here. It’s time for a paradigm shift, Adam & de Savigny argue.

Recommended reading, this supplement – and not just for the more complex minds among you.


Emerging Voices

16. IHP blog – One year anniversary of the Occupy movement: A view from the Global South

Albino Kalolo;

The Occupy movement is one year old now. Emerging Voice 2010 Albino Kalolo offers a Tanzanian perspective on Occupy’s (so far relatively limited) impact in Sub-Saharan Africa.

We also want to recommend another article on Occupy SouthAfrica, featured on the website of the New Internationalist. In this article, a NI journalist asks Joe Hani, an activist with the ‘Taking Back South Africa’ online campaign (part of Occupy South Africa) to help shed light on the movement in his country.


Global Health bits & pieces

* WHO Global Health Expenditure atlas: the global health expenditure database which WHO has maintained for the past ten years, provides internationally comparable numbers on national health expenditures. The data are updated annually, taking, adjusting and estimating the numbers based on publicly available reports and validated by Ministries of Health before publication. The database is used for the health expenditure tables in the World Health Statistics Report and the WHO Global Health Observatory.

* World Contraception day was celebrated on September 26th.

* Check out the excellent new issue of the Health Diplomacy Monitor, with articles on the (changing) post-MDG health goals debate, the People’s Health Movement’s role in global health, etc.


Development & Aid

Romney and foreign aid

We already mentioned that Mitt Romney gave a much publicized speech on foreign aid this week. His vision was partly inspired by the Millennium Challenge Corporation, but went beyond that. Check out the assessments of Romney’s vision on foreign aid by CGD’s Sarah Jane Staats (quite positive), Laurie Garrett (very negative), and the New York Times.

In her speech, Hilary Clinton laid out the Obama administration vision on shared responsibility.


UKaid debate

The UKis in the midst of a development aid debate, and consequences could be severe. For an overview, see alertnet and ODI articles.


Education first

In New York, Ban Ki Moon launched a new ‘Education First’ initiative, aimed at boosting primary education. In this Guardian article, the author stresses the importance of educating enough good teachers if this initiative is to have an impact. (the link with the importance of human resources for health is obvious).

Sidibé supports the Education First initiative, also with a view on HIV prevention (in the Huffington Post).



* In a great blog post, Simon Maxwell  argues that the post-2015 goals will only take off (=be able to mobilize public opinion worldwide) if they focus on climate change and are universal. A focus on poverty reduction will not wash anymore, he thinks, especially if the poor are mostly situated in MICs.

* Meanwhile, the high-level panel had its first meeting in NY. Claire Melamed presents the three scenarios.

* Other interesting views on the post-MDG process were offered by Brendan Cox  (Save the Children) and Paige McClanahan (in the Guardian).

You might also want to check a note by Emily O’Brien and Richard Gowan, on how to make global agreements work.



Finally, the EU partially froze its aid to Rwanda. (Spain needs the money more, now.)

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