This week many of us were in Cape Town, to assist the Emerging Voices 2013 in making an impact on the 17th ICASA conference. They presented, tweeted (if the rather unreliable internet connection allowed it at the conference and in our hotel) and blogged, while networking their way through the conference. This IHP issue will have a special EV section on ICASA, with a number of blogs by EVs, and also the guest editorial of the week comes from an EV 2013. If you go through them, you’ll get a fairly good overview of the conference, the highlights, the gaps, key messages, etc. Check out also the hashtag of the conference, #icasa2013 and the Emerging Voices hashtag, #ev4gh. It was the first time I attended an ICASA conference (still find it a pity I missed George Bush’s speech two years ago in Addis), so I also wrote a blog post on Tuesday with some early impressions. I was quite baffled by the swipe at China during the opening plenary by prof. Robert Soudre, when he declared China urgently needs to live up to its status as second economic power of the world, when it comes to contributing to the Global Fund Replenishment. Very cheap, I think, if at the same time the conference carefully avoids global political economy and global financial justice debates, by and large. ICASA ended on Wednesday, and Mark Dybul and Edwin Cameron were among the people addressing the plenary on the final day. I have to say Dybul (and the Global Fund people in general) left quite an impression on me. Not everybody feels the same though, and the proof of the cake will be in the eating, as always. We will thus see in the coming years how sincere the so called ‘donors’ are when they speak about the end of paternalism and a new era of partnership. “We are all the Global Fund”, Dybul said at some point, ‘the Global Fund is not just a bunch of people running around in Geneva’. The Global Fund’s new Funding Model seems to find a good balance, at least in theory, between human rights concerns and a smart investment approach. Again, not everybody is convinced (including some of my colleagues who work in the DRC for example), but although complex, I think the NFM contains a lot of good things.
During the ICASA conference, there were commemorations of Nelson Mandela’s life all over South Africa, with the one on Tuesday – with the leaders of the world, including an inspired Obama – as the main event. At some point, apparently, the master of ceremony at the stadium told the South-Africans in the local languages to be a bit more quiet and behave themselves “as there were foreign leaders around”, which caused quite some giggling among the South-Africans in the room at the conference, where the event was broadcast.
The rest of the newsletter contains the usual health policy & financing articles and news, focusing among other things on the World Innovation Summit for Health (WISH) meeting in Doha, the WHO/WB discussion paper on monitoring progress towards UHC at country and global levels, and more.
Enjoy your reading.
Kristof Decoster, An Appelmans, Peter Delobelle, Basile Keugoung & Wim Van Damme
Ending AIDS in my generation? Some reflections from ICASA
By Charles Birungi (EV 2013)
As I prepare to return home this week after the ICASA conference in Cape Town, the heated discussions on the “end of AIDS” remain vivid in my mind. Is the “end of AIDS” a myth or reality? At this year’s World AIDS day, the UNAIDS Executive Director, Michel Sidibe noted that: “For the first time we can see an end to an epidemic that has wrought such staggering devastation around the world. For the first time we can say that we are beginning to control the epidemic and not that the epidemic is controlling us.”
IHP – EV 2013 blogging from ICASA
In a blog post earlier this week our colleague Kristof, as an HIV newbie, already shared some early reflections about the 17th ICASA conference in Cape Town. Without doubt, Nelson Mandela’s memorial service was the talk of town: it caused unprecedented political stardust: no less than 53 presidents and 16 prime ministers gathered in J’burg’s soccer city to pay their last respects.
Through blog posts Emerging Voices reported live from the conference. Mandela’s legacy in HIV/AIDS work was most highlighted in the speeches. Michel Sidibé, Head of UNAIDS praised Mandela as a dedicated advocate of the HIV movement at times that his co-leaders still promoted garlic and beetroot as a response to the disease. Especially after 2005 when his son died of AIDS Mandela boosted the global response. The Emerging Voices address some other hot HIV topics that found reverberations at ICASA:
- Arsène Kpangon from Benin reports in his blog post From Theory to Practice: the (difficult) art of ART about a roundtable discussion among 5 global health experts looking into the art of ART. The urgent need to scale up viral load monitoring in Africa is hampered by the lack of budget. The reduction of corruption and fiscal revenue improvement are proposed as ways forward.
- Abubakar Muhammed Kurfi, a public health physician who works with the national insurance scheme in Nigeria, testifies in his blog post Donor coordination in Nigeria, a critical step towards getting to zero how lack of coordination of donor aid refrains his country from moving forward in the HIV/AIDS fight. In another blog post Expanding the fiscal space in Africa through innovative PPP mechanisms to improve the delivery of HIV/AIDS services he reflects on PPP as a way to expand the fiscal space and improve HIV/AIDS services delivery
- Stephanie M. Topp, an Australian research associate and health systems adviser in Zambia, finds hopeful signs of a growing recognition of key populations and willingness to engage with them in the HIV response. However, the title of her blog post To boldly go where no man has gone before – Will African countries respond to the needs of key populations? implies that the reality in Zambia is still far from the rhetoric.
Health Policy & Financing & Global Health
1. WHO/WB – Monitoring progress towards UHC at country and global levels: a framework
This joint WHO/World Bank Group discussion paper combines stakeholders’ feedback to fine-tune a common framework for monitoring progress towards UHC at country and global levels. The joint effort to come up with this framework fits in WHO and Worldbank’s intentions to achieve their global goals, the MDGs and the post-2015 development agenda. To address the common approach, the framework should 1) comprise two inter-related UHC measures (essential health service coverage and financial protection for the population), 2) encompass the full population across the life-cycle and 3) capture all levels of the health system.
In his speech on UHC in Tokyo, Jim Kim moves beyond the conceptual framework by addressing lessons learnt and real examples from 11 countries moving towards UHC in a newly released case study synthesis. The quest to UHC is not only a demand for better health – it’s a demand for equity (We could not agree more).
2. Alan Whiteside – Responding to Health Challenges: the role of domestic resource mobilization
In this paper Alan Whiteside and Gavin Surgey put domestic resource mobilization at the heart of the conditions to meet current health challenges. Their analysis ends with ten recommendations to move to better health and enhance domestic financing, a.o. the need for better data, political engagement and leadership, revisiting the role of all stakeholders…
3. IHP – Exemption/subsidy policies for maternal health in Africa: the need for a country-specific approach
In his blog post Isidore Sieleunou, CoP facilitator and Technical Assistant for AEDES, reports on a conference of the Financial Access to Health Services Community of Practice (FAHS CoP) in Burkina Faso where fee exemption policies for maternal health in Africa were assessed. In his view, the debate should no longer center on whether one is “for or against” fee exemptions, but should take a country-by-country approach instead.
4. Global Fund
The Global Fund News Flash highlights the GF’s Fourth Replenishment launch where $12 billion were pledged for the next three years with an unprecedented contribution of funds by African countries “showing that we are all in this together”, according to Mark Dybul, Executive Director of the Global Fund.
5. World Innovation Summit for Health (WISH) – Global Diffusion of Healthcare innovation
On Dec 10 and 11th, policy makers gathered at a prestigious WISH summit in Doha, Qatar to discuss global health challenges such as the global obesity pandemic. During the summit a Global Innovation Diffusion study was unveiled providing an assessment of eight countries and how their systems contribute toward transformative change. But what made Doha really worthwhile, according to Richard Horton, was Aung San Suu Kyi’s keynote calling leaders worldwide to view innovation in health care from a spiritual standpoint.
6. Third World Quarterly – Beyond TRIPs: Why the WTO’s Doha Round is unhealthy
In this paper Scott & Harman seek to explore the wider health implications of the Doha Round. It dwells on its negative on state capacity to provide and regulate health services in low-income countries, and the impact it will have on livelihoods among the poor and their ability to access health services. They make a case for greater engagement from the health community with the WTO and the Doha Round negotiations beyond the usual focus on intellectual property rights.
7. HP&P – December 2013 Issue
The December Issue of Health Policy & Planning as usual offers interesting reads covering the entire global health range. Our eyes fell upon the article by Bertone & Meessen who study the link between institutions and health systems performance. They offer a framework nicely illustrated with the analysis of two performance-based financing schemes in Burundi.
8. HP&P – Unmasking the open secret of posting and transfer practices in the health sector
Schaaf & Friedman’s article focuses on the practices of granting posts and transfers to health system workers without taking into account the best health outcomes. They suggest principles for future research to come towards a better understanding and practice.
9. NEJM – Global Maternal, Newborn, and Child Health – So Near and Yet So Far
This article stresses the need to link the maternal and child health agenda with social determinants of health and long-term development issues.
10. THE LANCET
Like many, the Lancet editorial pays tribute to Nelson Mandela. A must-read for all of us who want to understand Mandela’s legacy to the world in general and health more specifically and our moral duty to take it further.
Why not start with global dementia as put forward by Fox & Petersen in their reflections about the World Dementia Summit?
Or what about the Lancet Commission on Global Surgery?
Time for the next Mandela to stand up now WHO Afro is looking for a new leader!
11. The LANCET GLOBAL HEALTH
In the Lancet Global Health we find some interesting stuff on HIV
- A plea for TASP: Test and treat All as Soon as Possible
- Sustainable and cost-effective monitoring of patients on ART
12. BMJ – Scientists want G8 countries to quadruple funding for dementia research within 10 years
In the run-up to the Dementia Summit, BMJ News reports that researchers are of the opinion that the G8 need to quadruple funding for dementia. Yet another global health challenge beyond country boundaries as confirmed by Peter Piot in The Guardian this week.
13. Third Global Symposium on Health Systems Research
A must-watch: the youtube video featuring Marie-Paule Kieny, WHO Assistant Director-General talks about the Third Global Symposium and Health Systems Global (HSG). The call for applications (including Emerging Voices Applications) is open. Take a look at the accepted HSG thematic working groups, a.o. PSI (Private Sector in Health), SHaPeS (social sciences approaches for research and engagement in health policy and systems)…
14. WHO – Monitoring the achievement of the health-related MDGs
The report by the WHO Executive Board summarizes the progress towards the achievement of the health-related MDGs and proposes an action plan on the health of newborns.
15. WHO – Malaria Report 2013
The Malaria Report 2013 shows major progress in fight against malaria but calls for sustained financing. (Show us the money)
16. WHO – Launch of the MiNDbank
WHO launched a MiNDbank, an easy-to-use platform to facilitate debate, dialogue, advocacy and research on mental health, to improve care and to promote human rights across the globe, according to Dr Funk from WHO’s department of mental health and substance abuse.