International Health Policies in the news today 71

Dear Colleagues,

 

This weekend, the football players at the World cup will share the limelight with the world’s top politicians who will attend the G8 and G20 summits in Canada. In this newsletter, we pay considerable attention to the summit agendas and the requests from global health advocacy groups. Are the rich countries only ‘fair weather’ friends to the poor, as some commentators have noted, or will they acknowledge the increasing interdependence in the world?  Financially, that is.

 

Some material from the Global health conference in Brussels (10-11 June) has been released on the net.  It’s definitely worth a look.

 

Bristol-Myers Squibb has attracted scorn from global health advocacy groups for its controversial decision to close a factory in France that manufactures didanosine, crucial for baby’s with HIV/AIDS. Sarah Boseley paid attention to the company’s decision in a Guardian blogpost – have a look also at the league table with the performance of big pharma companies in terms of access to medicine for the poor. And the Lancet features an open letter from UNITAID board members, addressed to the CEO of the company, who must feel as beleaguered as the French football coach by now.

 

Enjoy your reading.

 

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

Global Health

 

1.KFF – Obama Administration Names Eight ‘GHI Plus’ Countries

http://globalhealth.kff.org/Daily-Reports/2010/June/18/GH-061810-GHI-Plus.aspx

Last Friday, the Obama administration selected 8 so-called ‘GHI plus’ countries. They will serve as learning labs for a new global health strategy and make up the first set of GHI plus countries.

 

2. HP&P – The response to flexibility: country intervention choices in the first four rounds of the GAVI Health Systems Strengthening applications

Lieve Goeman, Benedicte Galichet, Denis G Porignon, et al.

http://heapol.oxfordjournals.org/cgi/content/abstract/25/4/292

In this article the authors present an analysis of the first four rounds of countries’ applications to the GAVI Health System strengthening window. They conclude that there has been a shift to a more systemic approach but the interventions chosen are still focusing on short term fixes.

 

3. Norwegian Knowledge Centre for the Health Services – Examining the Global Health Arena: Strengths and Weaknesses of a Convention Approach to Global Health Challenges.

Balstad J, Røttingen JA

http://www.kunnskapssenteret.no/Publikasjoner/9516.cms?threepage=1

A report commissioned by the Norwegian Directorate of Health outlines the strengths and weaknesses of a convention approach to global health challenges. There are several key messages, among others, the fact that global interdependence makes the health of the world’s poorest and most marginalized people a pressing issue for everybody; and that a global health convention could indeed provide an appropriate instrument to deal with some of the intractable problems of global health. But there are challenges as well.

Health Financing

4. J int AIDS society  – Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Herbert C Duber, Thomas J Coates, Greg Szekeres, Amy H Kaji and Roger J Lewis, http://www.jiasociety.org/content/13/1/21

This study suggests that vertical programs, even one the scale of PEPFAR, may have little or no impact on health outcomes not explicitly targeted. We might however argue that comparing ‘intervention to non intervention’ is a myth at both global level and national levels (see Bryce et al. 2010 on SASDE). Each and every country/ district receives support from one or another project. More worrying is that health indicators are going backwards on average in the WHO African region.

 

5. Miller-Mc Cune – The AIDS Funding Dilemma

Paul Webster; http://www.miller-mccune.com/health/the-aids-funding-dilemma-16202/

In an interesting piece, Paul Webster sketches the emotions that are currently running high in the “AIDS exceptionalism” debate, against the backdrop of the Ugandan health care setting. The options are difficult but clear nevertheless: shift some AIDS funding to other care, or find billions in new support.

6. CGD – Could Local Public Disclosure Improve Country Ownership?

Mead Over; http://blogs.cgdev.org/globalhealth/2010/06/could-local-public-disclosure-improve-country-ownership.php

Mead Over reports on a recent workshop in Washington that focused on Country Ownership. In this blogpost, he elaborates on the intervention by Freddie Ssengooba from Uganda and Dirce Costa from Mozambique who called for more transparency of donor aid at local level to help citizens and local watchdog organizations play their role in claiming the funds allocated when talking about ways to tackle corruption.

G8&20

7. Guardian – Playing for high stakes at the G20

Sarah Boseley; http://www.guardian.co.uk/society/sarah-boseley-global-health/2010/jun/23/g20-canada

Like many other global health people, Sarah Boseley had a productive week. In this blogpost she outlines what is at stake for the global health community at the G20 summit. The summit should address the need for safe abortion and it must deliver on its former pledge to keep people with HIV/Aids in Africa alive.

8. KFF – G8 G20 MDG and Global Health

http://globalhealth.kff.org/News.aspx?dr=June-24-2010

The KFF website features several pieces on the G8 and G20 summits. A UN report says MDG targets are still attainable, in spite of the global economic situation. Ban Ki Moon asks the G20 for an additional 60 billion for maternal and child health. And KFF links to several opinion pieces addressing the Canadian government, for example to re-commit to the Global Fund.

 

In related news, the Millennium development goals report card (issued by ODI & the Millennium Campaign) provides evidence that the MDG picture in Africa is better than usually appears from (negative) media coverage. In the words of the director of the UN Millennium campaign: “Instead of lamenting that Africa might miss the MDG targets, we should be celebrating the real changes that have happened in the lives of millions of poor people, not least because of the unified effort between governments and citizens, supported by donors.”

 

The current financial situation is bleak, though, in the western world, as UN officials stress in a BMJ news piece. They worry that the speed at which rich countries are implementing austerity measures to reduce public debt will adversely affect the amount of aid earmarked for meeting the MDGs by 2015. Rich countries seem about to slash their aid budgets.

Chronic Diseases

9. Lancet – Diabetes in sub-Saharan Africa

Jean Claude N Mbanya, Ayesha A Motala, Eugene Sobngwi, Felix K Assah, Sostanie T Enoru; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60550-8/fulltext

Today’s Lancet is a special issue on diabetes, and features among others this article on the worsening diabetes situation in sub-Saharan Africa.

10.    Social determinants of diabetes and challenges of prevention

Nigel Unwin, David Whiting, Gojka Roglic; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60840-9/fulltext

Unwin et al. sketch the social determinants of diabetes and stress that most people with diabetes live now in low-income and middle-income countries. It was a mistake to exclude diabetes and related chronic diseases from the MDGs. The prevention of diabetes and related diseases should thus be at the forefront of global efforts to reduce health inequity. The summit on chronic non-communicable diseases slated for September 2011 could be a good start.

Miscellaneous

 

11.    PLOS – Maternal Health: Time to Deliver

 

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000300

This month PLoS Medicine has a series on maternal, neonatal, and child health (MNCH) in Africa. The goal of the series, authored by a group of international collaborators, is to identify scientific interventions and accelerate actions that are tailored and specific to sub-Saharan Africa. We include the editorial on maternal health: it’s time to deliver on promises to improve maternal health.

12.    SAJHIVMed – Innovative responses for preventing HIV transmission: The protective value of population-wide interruptions of risk activity.

Justin O Parkhurst, Alan Whiteside; http://www.sajhivmed.org.za/index.php/sajhivmed/article/view/612

Parkhurst and Whiteside come up with a very innovative way to prevent HIV transmission: sexual abstinence for one month, Ramadan-style. A population-wide ‘safe sex/no sex’ effort could make a significant contribution to global prevention efforts. The authors claim the impressive soccer ‘community mobilization’ of South African people during the World Cup football inspired their thinking. It could work. But it doesn’t necessarily improve the quality of the football on offer, just ask the British team, deprived of their “WAGs” by their dictatorial Italian coach.