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Dear Colleagues,

This week, Shishir Dahal, Emerging voice from Nepal, looks back on the ICASA conference he attended last week in Ethiopia. One person was warmly cheered at the opening session of the conference. You all know who. Whether geopolitics (or more precisely, drones) had anything to do with it is anybody’s guess, but the applause he got was deserved. In some cases, it’s good to ‘stay the course’.  

An unlikely hero

The 16th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) was  held in Addis Ababa, Ethiopia, from the 4th till the 8th of December 2011. The theme of the conference was Read the rest of this editorial here.


Enjoy your reading.

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

ICASA conference

1. IHP blog – Missing in Action – Europe and ICASA

Rachel Hammonds;

Our colleague Rachel Hammonds also attended the ICASA conference. Noticing that the Americans were there in full force (see above), she wonders where the Europeans were.

As for the European financial contribution for the HIV response in the recent past, you might want to read this AFGH paper, presented at an ICASA session:  “Methodology to assess volumes and patterns of official development assistance (ODA) for health and HIV services: the reality of European governments’ financial contributions for the HIV response in developing countries in the period of 2007-2009”.

Even for the near future, things don’t look that bleak; the European Commission announced they are resuming their GF disbursements. Sounds comforting. But if we were the GF board, we wouldn’t want to rely too much on the EU. Of the two institutions, it’s not clear which one is actually in the worst shape.

Global Fund

2. Science Speaks – Global Fund explains “Transitional Funding Mechanism” — No funding for HIV treatment scale up

Meredith Mazzotta;

The Global Fund released an “Information Note” explaining the Transitional Funding Mechanism that the Fund Board recently decided would replace a Round 11 funding cycle. The information note and accompanying documentation are meant to aid applicants in the development of proposals for TFM funding.

Science Speaks also reports on a new MSF report on the threat of funding shortages. “There is a real risk of losing ground in the fight against global HIV/AIDS if funding for key programs is not increased”, according to the new report “Reversing HIV/AIDS? How Advances are being Held Back by Funding Shortages.”  Funding shortages threaten to set back progresses made in many countries as national treatment programs are under threat of being severely curtailed.

Speaking of the Global Fund, the Global Fund Observer also has two new issues this week. A lot is going on at the GF, as well as at the GFO itself.

Global Health Policy & Financing

3. Health Affairs – The Global Financial Crisis Has Led To A Slowdown In Growth Of Funding To Improve Health In Many Developing Countries

Katherine Leach-Kemon et al.;

The empire strikes again.  The Murray team crunched the numbers once more. This is their conclusion: the growth rate of development assistance for health declined from a 17 percent increase between 2007 and 2008 to 4 percent annually from 2009 to 2011. So DAH is still growing, but slowing down.

Sarah Boseley already commented in the Guardian: so far global health funding seems to be weathering the storm. But that is obviously not true for every global health actor. And the storm is only beginning…

4. Health Financing in Africa: le blog – Value for money in the health sector – not just a donor agenda

Bruno Meessen;

In this blog, Bruno Meessen argues that the ‘value for money’ agenda is also an African one. His blog is a reply to a blog post from former BTC technical assistant Marcus Leroy, published on the Broker online last week. Focusing on the health sector, Meessen emphasizes that a key test for Performance-Based Aid schemes will be the extent to which they consolidate reform initiatives already taken at country level.

Somewhat related to this whole debate, you find an interesting civil society perspective on the Health Affairs blog. It’s written by Martha Kwataine; she also dwells on the importance of accountability and ‘democratic ownership’. Speaking about Malawi, she puts it like this: “Development partners from the US, the UK, Norway and others tend to work with government very closely when everything is okay, leaving out civil society. But at the moment that government fails to meet its obligations, donors then rush to civil society to strengthen their oversight functions. I find this behavior unacceptable, since it is based on frustration rather than trust. DFID wanted to prove to its host country that their aid had worked wonders in Malawi, so they wanted to avoid any contrary view from the civil society. As civil society, we appreciate the role that donors play. But it is our obligation not to twist reality to please a donor or any development country. If we make such a mistake, we lose credibility in the sight of the Malawians that we represent.

5. Lancet (Correspondence) – A framework convention on obesity control?

Lawrence O Gostin et al.;

Replying to a Lancet editorial on the need for a framework convention on obesity control, the authors argue for a bolder approach: a framework convention on global health to establish a post-MDG framework to reduce health inequities and strengthen global governance grounded in the human right to health.

6. Lancet (Correspondence) – Public health: a need to think outside the box

Peter Delobelle;

The author emphasizes that public health as a movement based on the principles of equity and social justice is not necessarily tied to the leadership capacity and commitment of academic “experts”. It is also largely related to the advocacy efforts of civil society and non-profit organisations committed to the goal of health for all.

7. Wellcome Trust – Macroeconomics and global heath: ten years past and future

Jimmy Whitworth;

At the turn of the millennium, a Commission established by the WHO concluded that health is a creator and pre-requisite of development. With spending on global health rising from $6 billion to $30 billion in the last 10 years, Jimmy Whitworth examines progress over the last decade, and future directions for global health and research.

In related news, Richard Horton dwells on the Chatham House event on Macroeconomics and health held last week in London, starring Jeffrey Sachs and others. Apparently Sachs was not in a apologetic mood. “The Commission may not have succeeded in everything, but (and here Sachs quoted his experiences in the Oval Office and 10 Downing Street) it “definitely accomplished a lot”, it was “a bit of a breakthrough”, and it did “play a fundamental role” in shaping political debates around health. The Commission was nothing less than “science-based politics” in “a world that was doing almost nothing”. Horton seems to agree and gives Sachs credit for this, in spite of his tendency to oversimplify at times.

8. BMJ (news) – Drug industry is considering more use of differential pricing, conference hears

Elizabeth Sukkar;

The drug industry is indicating that it is more willing to participate in differential pricing to improve access to its products.

9. BMJ (news) – High cost of essential drugs forces millions into poverty every year

Peter Moszynski;

Two billion people are unable to access essential drugs, and the high cost of drugs pushes 150 million people below the poverty line each year, according to the organisers of the third international conference on improving use of medicines (ICIUM). The conference took place last month in Antalya, Turkey. The conference recommended that there needed to be more use of generic drugs, more transparency over pricing and availability of drugs, and better regulation of prescribing, particularly among doctors and pharmacists in the private sector. The lack of affordable drugs for NCDs in LMICs was also a hot issue.

10.    BMJ (news) – Control efforts aren’t enough for malaria targets in millennium development goals to be met, warns WHO

Peter Moszynski;

Although last year saw a further decline in numbers of cases of and deaths from malaria and greater roll out of malaria control measures, progress has been slower than anticipated and the available funds less than needed to meet the MDG targets, finds the latest World Malaria Report. The current GF turmoil is again part of the reason.

11.    Foreign Policy – The Bioterrorist Next Door

Laurie Garrett;

Luckily there’s still Laurie Garrett to make an excellent case for more global health funding. Read this frightening piece; apparently we’re almost in “Twelve Monkeys” territory. The crazy bunch of GOP presidential contenders will know what to talk about in Iowa and elsewhere.

Recent Research

12.    BMC Health Services – Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

Savitha Subramanian et al.;

The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve “learning by doing” in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

13.    HP&P – How to do (or not to do) . . . Tracking data on development assistance for health

Karen E. Grepin et al.;

The authors review the available datasets on development assistance for health and summarize the strengths and weaknesses of each of these datasets to help researchers make the best choice of which to use to inform their analysis.

14.    Journal of Epidemiology & Community health – Global health governance as shared health governance

Jennifer Prah Ruger;

A framework of social agreement based on ‘overlapping consensus’ is contrasted against one based on self-interested political bargaining. A global health constitution delineating duties and obligations of global health actors and a global institute of health and medicine for holding actors responsible are proposed.

Development & Aid

15.    Development Policy Review – new issue

Articles in the latest issue explore financing of social protection, challenges to poverty monitoring and assessment systems, and MDG achievements and policies in education and health.

16.    CGD (paper) – More Money or More Development: What Have the MDGs Achieved? – Working Paper 278

Charles Kenny & Andy Sumner;

What have the MDGs achieved? And what might their achievements mean for any second generation of MDGs? The authors argue that the MDGs may have played a role in increasing aid and that development policies beyond aid quantity have seen some limited improvement in rich countries (the evidence on policy change in poor countries is weaker). Further, there is some evidence of faster-than-expected progress improving quality of life in developing countries since the Millennium Declaration, but the contribution of the MDGs themselves in speeding that progress is difficult to demonstrate even assuming the MDGs induced policy changes after 2002.

Pundits and experts still comment on Busan:

* Owen Barder wrote an excellent piece summarizing Busan: “Busan was an expression of new geopolitical realities, but despite high level representation, it has done little to shape the future of development cooperation. I think there were perhaps four important outcomes from Busan, in addition to which I noted five other topics of discussion which may prove important in future.

* on the CGD blog, Rita Perakis sketches a post-Busan results agenda.


* and Jonathan Glennie reckons it’s time to link the Busan and Durban agendas.


Experts also assessed COP 17 in Durban:

A few examples:

  • This piece  by Jan von der Goltz, on the CGD blog, reckons Durban would have been a great result, ten years ago.
  • The lawyers among you might want to read Mark Lynas’ final assessment. He is more nuanced, and he seems to love acronyms.
  • Finally George Monbiot on banks and climate change, and why bail-outs for the former (funnily) seem to go much smoother than for the latter, in spite of the huge sums involved. He doesn’t mention global health, but the figures are even lower than for climate change.


Some other reads we found noteworthy this week, on development & aid issues:

* on Global Dashboard, Andy Sumner explores the policy narrative of inequality

* There’s already an outline available of the next World Development Report, on  Jobs (scheduled for 2013).

* on the ODI website, you can find a blog post on the (preferred) WTO role in the 21st century.

* and finally, the Guardian’s Poverty Matters blog reports on a new ‘Global Financial Integrity’ study.   ( notice how weird that sounds: ‘global financial integrity’; it feels a bit like mentioning ‘Newt Gingrich’ and ‘chastity’ in the same sentence).


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