Dear Colleagues,


You will agree with me that this has been quite a week, and not just because ‘la Nina’ had a massive impact on countries all over the world.


In Sudan, the referendum is still ongoing, and as the country is not the only artificial state, we probably ain’t seen nothing yet. A recent viewpoint in Foreign Policy concurs. Some people in Belgium no doubt also agree.  


One year after the earthquake in Haiti, many people and agencies are looking back on the relief and reconstruction effort. We recommend you read an overview article in the Guardian of all the progress reports from NGOs and aid agencies.  Conflicting things have been said on the impact of the relief effort on the health system in Haiti, both negative and positive things.  The NEJM features a perspective on public health in Haiti and the challenges ahead and the progress made.  Slightly related to this, the journal Global Public Health published an article on the cost of promoting emergency medical care systems in the developing world.


Also across the ocean, the US witnessed yet another shock event. We won’t go into the ensuing debate on whether political polarisation, heated political rhetoric and media vitriol have gone too far in the States. You know what we think about that, unfortunately it’s not all that different here in Europe. What amazed me though, is the fact that psychiatrists were quick to call the shooter a schizophrenic – among other reasons because he believed in different levels of consciousness. We spent enough time in India to know that you can’t become a decent spiritual guru (be it in India or in California) if you don’t believe in evolving levels of consciousness… (And for what it’s worth, I think there is something to it). Anyway, it was a sad and tragic event. We hope Obama’s speech brings back some of the spirit of 2008, when it seemed that America would become again an inspiring country for people all over the world.


Last but not least, we celebrate our 100th IHP newsletter! The institute organizes a timely New Year’s party here in Antwerp this evening. We’ll see whether we can turn the event into an appropriate ‘booze & dirty dancing’ party. Too bad David is on holidaysJ. In the meantime, we would like to draw your attention to a thought-provoking Emerging voice blog contribution. Seye Abimbola, from Nigeria, wrote an interesting viewpoint on the BMJ blog on the non-existent health system. Check it out.


Enjoy your reading.


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

Lancet series on India: towards UHC

A new LancetSeriesof papers on India’s path to full health coverage reveals that a failing health system is perhaps India’s greatest predicament. The papers sketch the full extent of opportunities and difficulties in Indian healthcare, by examining infectious and chronic diseases, availability of treatments and doctors, and the infrastructure to bring about universal health care by 2020. As it is a democracy, India is well positioned to put health high on the political agenda. 


1.Lancet – Indian health: the path from crisis to progress

Richard Horton, Pam Das;

Horton & Das comment on the series. There’s an opportunity to be grasped, but it won’t be easy.

2.Lancet – Universal health care in India: the time is right

Vikram Patel et al;

After three years of study, this Series calls for immediate actions to promote universal access to health care in India. The time is definitely right.


All in all, the series features seven articles, the last one being the one with the call to action (with 2020 as the deadline). There are also plenty of insightful comments, some of which are even more ambitious than the call itself. We would like to draw your attention to a comment by Binayak Sen and one by Amartya Sen who compares the public health experiences of China and India. Amartya Sen says they should inspire each other, although India could probably learn more from China than the other way around. His perspective is not part of the series though.



In the meantime, there’s an ongoing debate on the rationale of UK aid to India. After Andy Sumner’s piece, there were reactions by Oxfam’s Duncan Green and an article by Madeleine Bunting on the Guardian Poverty matters blog.  Would an offended India refuse UK aid altogether?


Global Health policy and financing

3.Lancet – Sharing research data to improve public health

Mark Walport & Paul Brest;

Global funding agencies commit to enhancing access to research data to improve public health. See also on the Welcome trust website.


4.TMIH – The interface between health systems and vertical programmes in Francophone Africa: the managers’ perceptions

Basile Keugong et al;

Tropical Medicine and International Health has a new issue. Online you can already find this article by some colleagues of ours on health managers’ perceptions in Congo.


There is also an insightful editorial on the rational use of antibiotics in the era of test-based management of malaria.


5.BMJ (news) – WHO unveils plan to stop artemisinin resistance “dead in its tracks”

The world risks losing its most effective treatment for Plasmodium falciparum malaria unless prompt steps are taken to prevent the development and spread of drug resistant parasites, says a global action plan released by the World Health Organization and the Roll Back Malaria partnership.


You can find the plan here.


6.KFF – News Outlets Examine Reaction To WHO Plan To Contain Drug-Resistant Malaria

In follow-up coverage of WHO’s announcement, news outlets examined the scope of the problem, reactions to the plan and speculations of how the anticipated $175 million annual cost would be funded.


7.Human resources for health – Health workforce skill mix and task shifting in low income countries: a review of recent evidence

Brent D Fulton, Richard M Scheffler, Susan P Sparkes, Erica YOONKYUNG Auh, Marko Vujicic  and Agnes Soucat;

Task shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing the number of services provided at a given quality and cost. Future studies should examine the development of new professional cadres that evolve with technology and country-specific labour markets. To strengthen the evidence, skill mix changes need to be evaluated with a rigorous research design to estimate the effect on patient health outcomes, quality of care, and costs.

8.Global Fund Observer – Launch of HSS Pilot Expected Shortly

David Garmaise;

The Global Fund has approved the design of a pilot to allow 4-5 countries to submit funding requests for HSS based on jointly-assessed national health strategies. Under the approved design for the pilot, applicants will be able to submit joint or separate funding requests to the Global Fund and GAVI.


In related news, Kazatchkine was appointed to a second term as executive director of the Global Fund. Goosby looked back on last year for PEPFAR. 


9.On Philantropy – Pablo Eisenberg: Unintended Consequences of Giving Pledge’s Good Intentions

Pablo Eisenberg;

Pablo Eisenberg is not very fond of initiatives like the Giving Pledge, and explains why.


Philantrocapitalist Bill Gates spent some time in China in September last year, and he returned to the US impressed by the local vaccine makers.  


Maternal and neonatal health

10.    Plos – Setting Research Priorities to Reduce Almost One Million Deaths from Birth Asphyxia by 2015

Joy E. Lawn et al;;jsessionid=7E1A0C2ACE4D848EC2F3434F3E665161.ambra01

This paper uses a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality from intrapartum-related neonatal deaths by the year 2015, in order to advance MDG 4 for child survival.


11. – U.N. Women Superagency Opens, But Just Barely

U.N. Women opened its doors on January 3 without any fanfare. The new “superagency” still lacks a budget, staff completion and detailed programs. Observers are now eyeing a delayed, formal launch in late February.


Horton already referred to it in last week’s Offline article (Lancet); this week we provide the link to a document written by Jo Cox in December last year on maternal health campaigning in 2011.


Development and aid

12.    Guardian (Poverty matters blog) – Poverty reduction is not development

Rick Rowden;

The Guardian Poverty matters blog is a great resource. This nice piece was written by Rick Rowden, theauthor of ‘The Deadly Ideas of Neoliberalism: How the IMF has undermined public health and the fight against AIDS’.


13.    Guardian – The dangers of fast economic growth in developing countries

Another piece dwells on the World Bank report for 2011 prospects which sees sluggish growth in the developed world, and a shift in economic power from west to east. The change has three risks attached.


We also recommend an interview with Ben Ramalingam on Complexity and aid, and a global report on dynamic social security as the way to go for the world.


Emerging voices

14.    BMJ (blog) – Seye Abimbola : Reflections on the non-existent health system

Finally, Seye Abimbola’s thought experiment, based on his experience in Nigeria and elsewhere, is a must-read!

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