We’re back from holidays and ready for covering another year of global health policy & financing news. We hope you’re ready for going through the wealth of material on offer this week. If you’re still recovering from end of the year festivities, scanning might do too, though 🙂
In this week’s guest editorial, David Hercot’s successor, Peter Delobelle, who already joined our editorial team a few months ago, argues for incorporating health promotion in the post-2015 health & development agenda.
The Editorial Team wishes you a fruitful and healthy 2013!
Enjoy your reading.
Kristof Decoster, Ildikó Bokros, Peter Delobelle, Basile Keugoung & Wim Van Damme
Health in the post-2015 agenda: What about health promotion?
By Peter Delobelle (ITM)
Health is key to human development, no doubt about it. Health is a precondition, an outcome, and an indicator of all three dimensions of sustainable development, and should hence be part of the post-2015 development agenda. The adoption of the UN Resolution on Global Health and Foreign Policy, which supports the implementation of universal health coverage (UHC) in the fight against health inequality and poverty, is hence commended by many institutions and organizations to be included in the post-MDG agenda. While UHC in itself is a laudable goal, however, it falls short of pursuing another, equally important goal: addressing the underlying determinants of health. Providing access to quality and affordable health care is one thing, providing a healthy social and physical environment another.
UHC & Post-2015
1. WHO Bulletin – Universal health coverage anchored in the right to health
Gorik Ooms et al.;
The brand new January issue of the WHO Bulletin features this editorial examining UHC and the right to health. Gorik Ooms et al. feel that the right to health and its imperative of narrowing health inequities should be central to the post-2015 international health agenda. They take this stand as members of Go4Health, a consortium of academics and members of civil society tasked with advising the European Commission on the international health-related goals to follow the MDGs.
2. Equinet (Discussion paper) – Health service financing for universal coverage in East and Southern Africa
Di McIntyre believes that an explicit value base should be applied to interpreting the goal of UHC, particularly the values of universality and social solidarity. In this Equinet discussion paper, elements of the design of health systems are considered, and how these elements relate to moving towards UHC in the context of Africa. The paper focuses particularly on health financing issues (revenue collection, pooling and purchasing), but also raises health service delivery and management issues.
Check out also McIntyre’s editorial in the new Equinet newsletter issue. In the edito, she explores what the options are for east and southern African (ESA) countries to reach the goal of UHC if they keep in mind an equity perspective.
Health Policy & Financing
3. Lancet (Editorial) – Global polio eradication: not there yet
Lancet editors comment on the devastating setbacks suffered recently by the global effort to eradicate polio. Read also Sania Nishtar’s stance on the terrible news coming from Pakistan, in a Huffington Post op-ed.
4. Lancet (Editorial) – Sexual violence: a global awakening, from India
Even more shocking news came from India just before the end of the year. Sexual violence is not confined to India, though. Rape and other forms of violence against women and girls are a feature of all societies. Sexual violence needs to be acknowledged as a reality by all of us, and its causes discussed. As advocates for women’s health, health professionals have a special role in defeating rape, the Lancet editors argue. It’s time we exercised our voice more strongly…
5. Lancet – Offline: 2013, an anniversary, and a time to take stock
Richard Horton reflects on the seminal WB publication “World Development Report 1993: Investing in Health” and its impact on global health policy in the past two decades.
6. Global Health Governance – issue Fall 2012: special issue on Human security & health
A new issue of Global Health Governance is available online and features articles focused on human security and health. It offers a wealth of interesting articles, so it’s definitely worth to go to the website and check them out for yourself. In an opening Comment, Jack Chow explores the new agenda of global human security. We also want to draw your attention to an article on the (negative) impact of the Helms-Biden legislation on WHO governance and an article (co-authored by our colleague Gorik Ooms) on the contribution the right to health can make to sustaining and extending international assistance for health. There’s also an interesting piece on Brazilian global health diplomacy in the area of access to essential medicines. And much more, of course.
7. Social Science & Medicine – A United Nations Global Health Panel for Global Health Governance
Tim K. Mackey & Brian A. Liang;
The WHO now relies upon voluntary contributions tied to specific projects, underwriting 75% of operations. A resulting cacophony of non-governmental, foundation, and private sector actors have emerged overlapping and fractionating WHO programs. In this expanding world of “global health organizations,” WHO’s role must be redefined, the authors argue. The authors propose a United Nations Global Health Panel to re-establish WHO and improve global health governance. The proposal would provide greater policy coherence, advocacy, and potentially improve financing for global health.
A number of people reacted to the Mackey article in the same SS&M issue – among them, Gilles Dussault and Devi Sridhar.
8. KFF – FDA Grants Accelerated Approval To Drug To Treat MDR-TB
The U.S. Food and Drug Administration approved a new Johnson & Johnson’s drug to treat multidrug-resistant tuberculosis. It was approved under the FDA’s “accelerated approval” program. The drug, Sirturo (bedaquiline), will treat patients with MDR-TB and is probably a game-changer. Yet, it needs to be used sparingly, according to the FDA – the drug is to be used as part of combination therapy to treat adults with MDR-TB when other alternatives are not available. Also, the drug will carry a black box warning “to alert patients and health professionals that the drug can affect the heart’s electrical activity, which could lead to an abnormal and potentially fatal heart rhythm.” MSF and the Gates Foundation applauded the FDA’s decision. Check out also an optimistic blog post on the Gates Foundation blog, Impatient Optimists, on the issue.
9. Blog WB – Global Burden of Disease: Implications for the World Bank’s Work in Health
McLaughlin draws some lessons from the latest Global Burden of Disease study for the WB’s health team, among others the need to place a greater emphasis on intervening beyond health systems to affect health outcomes.
10. Science Speaks – Secretary of State nominee Kerry brings record of global health involvement
Hillary Clinton has just been dismissed from hospital. Science Speaks explores the global health credentials of her likely successor as Secretary of State, John Kerry.
11. New England Journal of Medicine: launch of a series of review articles on global health
The January 3 issue of the New England Journal of Medicine includes the first article – on disease eradication – in a series of review articles on global health, Harvey Fineberg of the Institute of Medicine and David Hunter of the Harvard School of Public Health write in an NEJM editorial. The series is built around articles that explain the need for global health, the challenges to achieving it, and the solutions to problems related to it.
12. Lancet (Comment) – Early-life prevention of non-communicable diseases
John M. Balbus et al.;
There is a global imperative to create and implement effective prevention strategies for NCDs, because the future costs of diagnosis and treatment are likely to be unaffordable. As scientific knowledge emerges on the role of both nutritional factors and exposures to environmental chemicals in the developmental origins of health and disease, evidence suggests that much more attention is needed on early-life interventions, optimisation of nutrition, and reduction of toxic exposures to curtail the increasing prevalence of NCDs, Balbus et al argue.
13. Journal of Global Health – How big is the next big thing? Estimating the burden of NCDs in LMICs
Kit Yee Chan et al.;
Non-communicable causes of death and disability will dominate the global health agenda for the foreseeable future. The progress in addressing their burden and achieving measurable reduction in LMICs will likely require similar steps that were effective in reducing maternal and child mortality globally: (i) defining the size of the burden and the main causes responsible for the majority of the burden; (ii) understanding the most important risk factors and their importance in different contexts; (iii) systematically assessing the effectiveness and cost of the interventions that are feasible and available in LMICs; and (iv) formulating evidence–based health policies that will define appropriate health care and health research priorities to tackle the burden in the most cost–effective way.
The first step in this process is to measure the burden of NCDs in LMICs, a challenging task to say the least. This Journal of Global Health Issue publishes several studies that attempt to summarise information on the burden of NCDs and provide estimates for the African continent.
A Plos editorial issues a call for papers on addressing global disparities in NCDs —CVD, cancer, COPD, asthma, diabetes, mental health disorders, and substance abuse — for 2013.
14. Journal of Global Health – Political priority in the global fight against non–communicable diseases
A. Maher & D. Sridhar;
In the abovementioned Journal of Global Health issue, Maher & Sridhar address the role of political priority in the global fight against NCDs, drawing upon Jeremy Shiffman’s 2009 political priority framework.
15. TM&IH (Editorial) – International aid, tobacco and the tobacco epidemic
Lal dwells on the links between international aid, the tobacco industry and the shift of the tobacco epidemic from developed countries to LMICs in just a few decades.
16. WHO Bulletin – No physical health without mental health: lessons unlearned?
Kavitha Kolappa et al;
We now have strong evidence elucidating the bidirectional relationship between mental illnesses – specifically depression and anxiety – and physical health outcomes. However, policy continues to lag behind the evidence in this regard, as demonstrated by our global NCD response, Kolappa et al. argue.
Also on mental health:
- in a Plos Medicine Policy Forum, Crick Lund et al. describe their plans for the “PRogramme for Improving Mental health care” (PRIME), which aims to generate evidence on implementing and scaling up integrated packages of care for priority mental disorders in primary and maternal health care contexts in Ethiopia, India, Nepal, South Africa, and Uganda.
- The Fall 2012 issue of the Journal of Global Health spotlights the evolving nature of modern conceptions of mental health, with a special emphasis placed on its integration into the rapidly developing facets of global health. This issue of the Journal spotlights the challenges facing contemporary mental health care and how global health’s multifarious nature can empower us to better understand and address mental health issues. Authors want us to consider how global health’s interdisciplinary nature—straddling the divide between the natural sciences and the humanities—can be utilized to translate contemporary advances in cognitive science into a more effective and informed approach to mental health issues worldwide.
Maternal & child health
17. Lancet (Correspondence) – Reduction in child mortality in Niger
David Hercot et al.;
Our former colleague David Hercot reacted to an article by Agbessi Amouzou and colleagues on the successful reduction in the under-5 mortality rate (U5MR) in Niger. “Amouzou and colleagues suggest that universal access to primary health care, mass campaigns, and nutrition programmes are the main strategies responsible for these changes. However, there remain some unanswered questions which would benefit from a more in-depth analysis to explain the drivers of changes in child mortality in this country.”
Amouzou et al replied to David’s Letter to the Lancet, as well as to the Comments of others.
18. Lancet – Macrosomia: defining the problem worldwide
Michael Conall Dennedy et al.;
Dennedy et al. comment on a new article in the Lancet by Ai Koyanagi and colleagues which analyses data from WHO’s Global Survey on Maternal and Perinatal Health to describe the prevalence of macrosomia and its association with adverse maternal and perinatal outcomes in developing countries. The study provides both lessons for developing and developed countries.
19. BMJ (Feature) – Deworming debunked
Deworming undoubtedly improves child health but it is claimed to have far wider benefits. Nigel Hawkes finds the evidence behind these claims is often equivocal. Check out also the BMJ editorial on the deworming issue, by Fiona Godlee.
You might also want to read a Bloomberg op-ed on the ongoing battle for an international ban on the vaccine component thimerosol, and why such a ban would be a bad idea.
HIV & Global Fund
20. Tomorrow Global – 9 things to watch for in HIV this year
Parsons looks in her crystal ball and lists upcoming HIV events, donor trends and likely developments in terms of evidence base & vaccines, …
21. International Journal of Health Planning and management – Fraud at the Global Fund? A viewpoint
Jonathan C. Brown et al.;
Two former senior managers of the Global Fund contend that fraud was never a major problem; rather than imposing harsh new controls on recipient countries that might impede health outcomes, the Fund should maintain the core elements of its innovative model and make selective rather than sweeping changes in its operations, they contend.
There’s also a brand new Global Fund Observer issue, issue 207. The issue features, among others, an article on a GF Secretariat update on plans for the new funding model, sent around to civil society partners.
22. Lancet (World report) – New WHO plan targets the demise of sleeping sickness
A meeting of experts and African health officials sets in motion a campaign spearheaded by WHO to free Africa from the grip of sleeping sickness. John Maurice reports.
23. Health Economics – General Budget Support: Has it benefited the health sector?
Adelio Fernandes Antunes et al.;
This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources.
24. JAIDS – An Evaluation of PEPFAR’s Effect on Health Systems Strengthening in Sub-Saharan Africa
Robert Cohen et al.;
This study aimed to evaluate whether PEPFAR activities were associated with system-wide improvements in both proximal and distal indicators of health systems strengthening, based on a WB data set. The progressive scale-up of PEPFAR-supported activities was associated with consistent improvements in proximal indicators of health systems strengthening. It was also associated with improvements in broader measures of health system strength, most clearly life expectancy. More data need to be collected for other indicators though, the authors admit, in order to evaluate the effectiveness of the many multi-billion dollar global health initiatives.
25. Health and human rights – Human rights and health systems development: Confronting the politics of exclusion and the economics of inequality
Duncan Maru & Paul Farmer;
The social movements of the last two decades have fostered a rights-based approach to health systems development within the global discourse on national and international health governance. In this piece, Maru & Farmer discuss ongoing challenges in the cavernous “ implementation gap ”— translating legislative victories for human rights into actual practice and delivery. Using accompaniment as an underlying principle, they focus primarily on constructing effective, equitable, and accountable public sector health systems.
- EV 2010 & 2012 Jenny Mabel Carabali just published an article in Global Health Promotion on the role of social determinants of health in dengue surveillance in Colombia. In the same journal, EV 2010 Taufique Joarder co-authored an articleon Intersectoral collaboration as a novel path to promote community health promotion.
- EV 2010 & 2012 Raoul Bermejo from the Philippines wrote a piece for IHP on the vital role of women in development. A timely piece, no doubt, given recent events in Pakistan, India and elsewhere. The blog post is, appropriately, dedicated to his mother.
- The Broker published a full dossier on inequality in the world.
- In their new book, Andy Sumner & Richard Mallett coin Aid 2.0: “While Aid 1.0 has tended to be defined as follows: the “problem” is poor people living in poor countries and the “answer” is official development assistance resource transfers; in contrast, Aid 2.0 might be framed as follows: the “problem” is that poverty is a “global bad” and the “answer” is that collective global action is needed. Further, the role of “aid” in development would shift from being an external driver – filling gaps in a predictable and linear fashion – to support inclusive policy processes, co-financed global public goods, knowledge sharing/transfer and development policy coherence.”
- Check out some key trade union priorities for the post-2015 development agenda.
- Have a look at a new WB paper by Varun Gauri on new MDGs which would “nudge” all of us, post-2015. For a blog post summary, see here.
- The Red Umbrella Fund is the first global grant-making mechanism to give sex workers influence over initiatives, a Guardian article explains.