Highlights of the week
Ebola
Ebola outbreak resources & hubs
In recent weeks, the Ebola outbreak in West-Africa has also sparked an outbreak of coverage in media and in peer reviewed journals, covering all possible angles on the issue, as well as the entire political spectrum. Most of it is free access. Below you get a brief overview – in case you want to spend the entire weekend on Ebola related reading.
- Yesterday, The Lancet launched anEbola resource centre. This new online resource brings together existing Ebola content from The Lancet journals and Cell Press, and will host the latest Ebola research as it is published. The resource centre is intended to be a comprehensive Ebola resource for clinicians, public health professionals, and anybody else who needs access to existing Ebola research and latest developments; all content on the site is free to access.
In the Lancet, we particularly want to flag the
Viewpoint ‘
Ethical considerations of experimental interventions in the Ebola outbreak’, with as one of the key messages “Researchers and health authorities need to ensure that experimental drugs to treat Ebola are distributed fairly, and in the context of randomized controlled trials”. There’s also a brand new Lancet
Editorial, ‘
Ebola: a failure of international collective action’. There’s also a Lancet
World Report, ‘
Experimental Ebola drugs enter the limelight’. Despite cautious optimism, Ebola drug candidates remain unproven and too thin on the ground to provide much relief in the west African outbreak, say experts.
- The NEJM also has a number of Ebola reads on its Ebola Outbreak page, including a viewpoint by Margaret Chan, Thomas Frieden et al, … (all open access).
- MMI hub on Ebola: We also want to draw your attention to, in the words of Thomas Schwarz (MMI) the “plenty of sound and inspiring analysis by colleagues who use the Ebola epidemic as what it also is: a great magnifying glass on structural crises and issues which otherwise could not be seen so clearly. And as things might move easier in times of crisis, I share the hope that “something useful might emerge from tragedy”, as Ilona Kickbusch put it. I therefore invite you to have a look at the selection of “Ebola voices” below and at the reports on how some MMI Network members are involved in the fight against the epidemic.” For an overview of some of these Ebola voices – see MMI.
More Ebola debate & viewpoints
It’s impossible to give a full overview of all these Ebola viewpoints (in other fora than peer reviewed journals – see above ). It’s been a very rich debate so far. Below you find some of the ones we’d recommend reading, for various reasons. (Last week we already pointed about the many questions raised about WHO (including its underfunding) in this respect).
· Foreign Policy – You are not nearly scared enough about Ebola
Laurie Garrett;
http://www.foreignpolicy.com/articles/2014/08/14/you_are_not_nearly_scared_enough_ebola_vaccine_west_africa_outbreak
As you probably already know, we have a soft spot for
Laurie Garrett, even if her view on the crisis is not shared by everybody ( see Tom Paulson for example). She thinks the international community still vastly underestimates the potential consequences of this outbreak. (
must-read)
· Humanosphere: Ebola outbreak’s negative impact on maternal mortality
l
http://www.humanosphere.org/news-rounds/2014/08/news-humanosphere-ebola-outbreaks-negative-impact-maternal-mortality/s
This is just one of the many pieces pointing out the enormous toll the Ebola outbreak increasingly also has on other causes of (maternal, child, … ) mortality – as health systems are breaking down in West-Africa. Whatever one might think of the possible impact in the North, the situation in West-Africa is very dire (and in some cases resembles a war zone) – including the worrying pictures of force and violence used by police.
· Global health hub: Why did it take an Ebola outbreak to realize the importance of health systems?
http://www.globalhealthhub.org/2014/08/21/take-ebola-outbreak-realize-importance-health-systems/
Good question, raised by
Jason Nickerson. I’m afraid we know the answer.
· Newsclick - Ebola Epidemic Exposes the Pathology of the Capitalist System
Amit Sengupta;
http://newsclick.in/international/ebola-epidemic-exposes-pathology-capitalist-system
A piece that pushes our buttons. “
Why then are we confronted with an Ebola epidemic in regions of West Africa? The answer lies not in the pathology of the disease but in the pathology of our society and the global political and economic architecture. It is not an accident that the present Ebola epidemic has affected three of the poorest countries in the world. Liberia, Guinea and Sierra Leone number 175, 179 and 183, respectively, out of 187 countries on the United Nation’s Human Development Index. Their health systems are ineffective and almost non-existent in many regions. The present epidemic is an epidemic brought upon by poverty, which in turn is a consequence of the kind of extreme inequity that is fostered by the present capitalist system.” And so on. Great stuff.
· Karen Grepin (blog) – Do we really need a new drug or vaccine for Ebola?
http://karengrepin.com/2014/08/do-we-really-need-a-new-drug-or-vaccine-for-ebola.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+KarenGrepin+%28Karen+Grepin%27s+Blog%29
Excellent blog post
. “There is a relatively effective treatment for Ebola already on the market: well functioning health systems.” “Ebola is spreading throughout West Africa not because there is no known treatment, but rather because of the lack of investment in the health facilities, health workers, and health information systems that are required to detect, contain, and deal with Ebola.” (must-read)
Guardian – World leaders 'failing to help' over Ebola outbreak in Africa
http://www.theguardian.com/society/2014/aug/19/western-leaders-ebola-outbreak-africa-medecins-sans-frontieres
Earlier this week, the
MSF chief, Brice de la Vigne
,claimed response to catastrophe is 'almost zero', with nations most concerned with self protection. Fortunately, that seems to be changing, now – but it’s late.
Other pieces we want to flag:
- Lauren Wolfe explores inForeign Policy why so many women are dying from Ebola.
- For acomplexity view on the Ebola outbreak, we can count on Ben Ramalingam (‘Ebolanomics’)
- Scidev.net also had a very balanced view on the Ebola outbreak, linking it also to the priorities for the SDG framework. “But to deal with it as purely a short-term or isolated crisis means missing one of the more important questions it asks of the health and development community: how many warnings does it take to get serious about fixing global health systems?”
- Jim Kim & Zuma (no, not that one …) alsowrote about how to stop Ebola.
- Foreign Policy also covered the likely economic impact of the Ebola outbreak for the West African region.
- Of course, the most poignant pieces come from people on the ground. For example, in Speaking of Medicine, a Liberian medical student.
Some of the latest news on Ebola
- Last week, WHO reported that Ebola was vastly underestimated. See also UN News centre.
- Drug companies & governments speed up R & D on Ebola drugs and vaccines (see for example The Hill. For example: “an emergency research call has been launched to help fight the world's worst Ebola outbreak in West Africa, with the British government and the Wellcome Trust medical charity pledging a combined $10.8 million.”
- David Nabarro, the UN system coordinator on Ebola, travelled to West-Africa this week to address issues surrounding the Ebola outbreak (see AP).
- The situation in Liberia is especially dire (with barricading of slums, clashes with the police,…) (see also the Guardian on the very tense situation in Liberia)
- Worries about potential signs of Ebola in Congo (see the Hill ).
- The Hill also reported that at least 30000 people need access to medication to stop the current outbreak, according to British scientists.
- On 4–5 September, WHO will host a consultation on potential Ebola therapies and vaccines in Geneva. The consultation has been convened to gather expertise about the most promising experimental therapies and vaccines and their role in containing the Ebola outbreak in west Africa.
- WHO now provides daily updates & situation assessments on the Ebola situation. See the WHO Ebola news hub. WO made some recommendations that Ebola-hit countries screen outbound travelers at border crossings, exit screening at airports, …. There is some ‘Anecdotal evidence about experimental therapies’ (21 August).
- The African Development Bank pledged $60 mn to fight Ebola.
- WHO reported encouraging signs in Nigeria & Guinea.
- The two American health staff with Ebola were allowed to leave the hospital.
The Royal Society – Reflections on the development of health economics in low- and middle-income countries
Anne Mills;
http://rspb.royalsocietypublishing.org/content/281/1789/20140451.full
Essential reading, not just for health economists. “
In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. …”
Devex - When simple is successful: Gates Foundation on UHC
https://www.devex.com/news/when-simple-is-successful-gates-foundation-on-uhc-84156
What does the Gates foundation really think about UHC and its place in the SDG agenda ? Check out Mark Suzman’s view, on behalf of the Foundation. A few excerpts from the Devex interview:
“
According to Mark Suzman, the organization’s president for global policy and advocacy, the Gates Foundation favors something simpler and easier to measure (i.e. than UHC). “Our view is very strongly that what works in goals is keeping them very simple, very easy to understand — including to the general public, wherever possible,” The view that everyone should have access to the health care they need without being financially out of pocket as a result is “a powerful and persuasive vision — and we agree with that,” Suzman said. The Gates Foundation, he explained, considers UHC valuable as a means and even “essential for long-term success,” but “less helpful as an overarching goal compared with updated MDGs around child and maternal mortality, and other more clearly measurable and politically resonant targets.” This is partly due to the fact that UHC still means different things to different people, which makes it “quite difficult to measure, because people have different views on what’s the basic intervention they need, what’s the definition of ‘out-of-pocket’ if you’re lower income, versus middle income,” Suzman said. … “A Gates Foundation paper published last year pointed to a “lack of robust evidence of links between UHC ... and the desired impact of improved health outcomes.” That’s no doubt a crucial factor for an organization known to be obsessed with figures. … For Suzman, the lesson is clear. “The easiest, most measurable, most visceral” goals work, he explained, because “people get it. The importance of saving kids’ lives is something everyone will agree on, no matter what side of the political spectrum you are on.” That doesn’t take away from a broad approach to well-being. Indeed, the Gates Foundation supports work on UHC, funding a knowledge-sharing platform for countries working to get those systems in place. And his organization’s overarching vision is one in which people can live a healthy and productive life, Suzman highlighted. “
Open Medicine (Editorial) – The Trans-Pacific Partnership agreement and public health: Why we should be concerned
Ashley Schram, Ronald Labonte & Kapil Khatter;
http://www.openmedicine.ca/article/view/646/559
You probably already know why, but a good read nevertheless, even if it focuses on Canada.
Scidev – Tackling climate change as a single SDG could backfire
http://www.scidev.net/global/climate-change/opinion/climate-change-sdg-backfire.html
Important reading ahead of the WHO conference on climate change & health (next week, in Geneva).
For a related piece, on the Ecohealth conference (11-15 August), see this
Scidev.net article.
Health Systems Global (blog) – A new era for the WHO health system building blocks?
Jeffrey Lazarus & Tim France;
http://healthsystemsglobal.org/GetInvolved/Blog/TabId/155/PostId/21/a-new-era-for-the-who-health-system-building-blocks.aspx
The authors suggest an update of the famous WHO “Building blocks” framework. “
The nature of information-sharing and communication systems has changed dramatically since the WHO health systems framework was introduced. Similarly, knowledge and thinking about “patient engagement” in health care has greatly evolved. People who are actively involved in their own health care tend to have demonstrably better outcomes. While it would be impossible to integrate all multidimensional aspects of the information age and of patient engagement directly into the WHO building blocks model, the changes do warrant a revision of the framework to include some acknowledgement of these two broad dimensions as part of health systems monitoring. With this in mind, we propose a modification of the framework, highlighting general points of influence of communication and patient engagement.” Feedback is welcome they say.
back to topGlobal Health Initiatives
MSF Issue Brief: "Pushing the envelope: Does the Global Fund’s New Funding Model foster country ambitions?"
Kerstin Akerfeldt and Mit Philips from MSF published a
Commentary in the latest issue of the Global Fund Observer. You find the issue brief
here. This issue brief covers how the allocations of the new funding model cause problems and dilemmas at country level, including specific information from Malawi, Mozambique, DRC and Guinea. For a shorter version, see:
http://www.aidspan.org/gfo_article/pushing-envelope-will-global-fund%E2%80%99s-new-funding-model-foster-country-ambitions
From my own correspondence with one of the authors: “…
MSF teams see that countries struggle and that technical assistance is either ambiguous themselves or giving counterproductive advice to cut the budgets of concept notes. As a consequence there is a tendency for countries to try to make fit their concept notes into too small allocation sums. This handicaps countries' possibilities to implement catch up plans or invest smartly in highly effective or innovative strategies. This undermines the GF's strategic role in the fight against HIV/TB/malaria. Moreover, unambitious or limited concept notes do not reveal the real extent of the needs and (now missed) opportunities. This might send the wrong message to the donors of the GF, instead of insisting on fulfilling their commitments and fill the gap they created by the shortfall in replenishment end 2013. These low allocations under the NFM are essentially due to the shortfall in funding, simply a result of dividing up the available funds at that moment in time. Whatever time and effort went into creating the allocation formula, this cannot make up for an overall shortfall of 3 billion at the replenishment end 2013.”
Check out the whole
new GFO issue, for example, a piece by David Garmaise on a workshop in Geneva on 23-24 May 2014 - on managing the risks of human rights violations in Global Fund–supported programs (see
here). ‘
Global Fund urged to review its policies on human rights’.
Science Speaks – PEPFAR’s South Africa “transition”: Nearly 20 percent of patients went unaccounted for when care was transferred, study finds
http://sciencespeaksblog.org/2014/08/18/pepfars-south-africa-transiton-nearly-20-percent-of-patients-unaccounted-for-when-care-was-transferred-study-finds/
Worrying findings. The transition isn’t going smoothly, as expected.
In other GHI news, we want to draw your attention to
GAVI’s new
website & branding.
back to topUHC, post-2015 & global governance for health
We are only 500 days away from the MDG deadline – but world attention wasn’t really focused on that, this week (see my intro).
BMJ (Editorial) – Including mental health among the new sustainable development goals
Graham Thornicroft & Vikram Patel;
http://www.bmj.com/content/349/bmj.g5189?etoc=
I’m all for this, like the authors of this editorial.
Office of Health Economics – Annual lecture 2014 – Is UHC the holy grail?
Anne Mills;
http://news.ohe.org/2014/08/19/annual-lecture-2014-universal-health-coverage/
Each year, the Office of Health Economics sponsors a lecture that explores a timely issue in medicine or health economics. At the 22nd Annual Lecture, held in June 2014, the issues and challenges of universal health care coverage in LMICs were presented by
Professor Anne Mills of the London School of Hygiene and Tropical Medicine. In this article, you find a brief summary of her remarks
.
Lancet Correspondence - Global Governance for Health: what about liberal power?
Eivind Engebritsen et al.;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61390-8/fulltext
“
The Lancet—University of Oslo Commission on Global Governance for Health has identified several power disparities in global governance and their implications for health, and thereby provoked attention to political asymmetries. In their recent Correspondence (June 28, p 2207), Robert Marten and colleagues commend the Commission for creating an important discussion and they propose analytical frames to investigate power. We would like to add a perspective to this analytical framework by drawing attention to liberal forms of power characteristic of modern systems of governance.” (might also interest the PBF & RBF community)
back to topInfectious diseases
Lancet (Comment) – The end of AIDS and the NGO Code of Conduct
James Pfeiffer et al.;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61259-9/fulltext
«
In 2008, a consortium of concerned international NGOs and advocacy organisations introduced the NGO Code of Conduct for Health System Strengthening, which highlighted how disproportionate funding for NGOs, rather than for public sector health systems, has undermined public services in many developing countries. The drafters of the NGO Code of Conduct further argued that governments must meet their responsibility to ensure the right to quality health care. Although international NGOs can provide health services in niche areas, pilot new approaches, or temporarily provide services while public systems build capacity, government health systems must establish standards of care, achieve equitable coverage, and harmonise health-care planning. Health-system strengthening begins with increased support to public systems. »… “The NGO Code of Conduct outlines a set of proposed best practices for NGOs to support local public services. » Donor support for the NGO Code of Conduct is vital, the authors of this Comment say.
Lancet (Comment) – How to hinder tuberculosis control: five easy steps
Mishal Khan & Richard Coker;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61175-2/fulltext
Now this is how we like viewpoints. Instead of saying ‘the time is now to do this or that’, the authors highlight five steps, commonly taken by policy makers, that might be impeding efforts to control tuberculosis. (
must-read)
WHO (Handbook) – Understanding and using tuberculosis data
http://www.who.int/tb/publications/understanding_and_using_tb_data/en/
Country health information systems provide a rich source of data on the burden of disease caused by tuberculosis and the effectiveness of programmatic efforts to reduce this burden, both of which are crucial for public health action. However, the available data are often underused, or not used at all. At least in part, this may reflect the absence of clear guidance on recommended approaches to the analysis of such data. This handbook is designed to address this gap through detailed practical examples of the analysis of TB surveillance data, in particular TB notification data, data from surveillance of anti-TB drug resistance, and mortality data compiled in national vital registration systems. It starts from the most basic kinds of analyses, and progresses to the description of more challenging topics such as the estimation of disease burden using multiple sources of evidence, including data from special surveys.
Global Health Check – Reflections on AIDS 2014 – Stepping up the Pace and Leaving No one Behind - By Georgia Burford (CAFOD)
http://www.globalhealthcheck.org/?p=1637
For a brief overview of the AIDS conference highlights.
Lancet (Comment) – Meningococcal carriage: the dilemma of 4CMenB vaccine
Muhamed Kheir-Taga;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60935-1/fulltext?_eventId=login
Incidence of meningitis due to N meningitidis serogroup A has decreased in sub-Saharan Africa since the introduction of the 4CMenB vaccine. But there’s a dilemma (
find out all about it behind the paywall – (warning: even if you get past the paywall, it’s a bit technical)
Guardian – Humans give malaria to mosquitoes – we need a vaccine to stop this
http://www.theguardian.com/global-development/poverty-matters/2014/aug/20/humans-malaria-mosquitoes-vaccine
This article was related to ‘
World Mosquito day’. “
But on this day, let’s focus on approaching malaria in a surprising new way: a vaccine to stop humans from giving malaria to mosquitoes. A transmission-blocking vaccine (TBV) could break this often deadly cycle. This type of vaccine prevents the mosquito that bites the malaria-infected person from getting infected, thus stopping the parasite’s life cycle in its tracks. If the mosquito doesn’t get infected, it can’t give malaria to another person. Of course, vaccinating humans to protect mosquitoes from malaria might sound a little crazy. …There are potential transmission-blocking vaccines in early development.”
Plos Medicine (Essay) – Ethics, Economics, and the Use of Primaquine to Reduce Falciparum Malaria Transmission in Asymptomatic Populations
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001704
Yoel Lubell and colleagues consider ethical and economic perspectives on mass drug administration of primaquine to limit transmission of Plasmodium falciparum malaria.
Smart Global Health – A Race to Save Millions of Lives: Artemisinin Resistant Malaria
Christopher Daniel;
http://www.smartglobalhealth.org/blog/entry/a-race-to-save-millions-of-lives/
“
While the world has been preoccupied by the recent Ebola outbreak in West Africa, news emanating from Southeast Asia may portend even more severe consequences for the continent. A study published in the July 31 issue of the New England Journal of Medicine has made it increasingly clear that the world faces the threat of losing one of its most important tools in the global fight against malaria: Artemisinin.” Daniel provides the big picture: “
Even so, most researchers in the field believe that without bold and urgent measures to eliminate the parasites, it is only a matter of time before artemisinin-resistant malaria spreads and we lose the current mainstay of antimalarial treatment. Echoing comments he shared at CSIS last November, Nick White, a senior author on the Ashley study (and lead author on the KAE609 study), noted that “It may still be possible to prevent the spread of artemisinin-resistant malaria parasites across Asia and then to Africa by eliminating them, but that window of opportunity is closing fast…conventional malaria control approaches won't be enough – we will need to take more radical action and make this a global public health priority, without delay."
Science Speaks – Uganda’s HIV criminalization, mandatory testing bill signed into law against local and international cautions of harms to health, human rights
http://sciencespeaksblog.org/2014/08/20/ugandas-hiv-criminalization-mandatory-testing-bill-signed-into-law-against-local-international-cautions-of-resulting-harms/
The latest episode in the not very funny soap series ‘what has Museveni been up to this week’?
Panafrican Medical Journal – A systematic review of missed opportunities for improving tuberculosis and HIV/AIDS control in Sub-saharan Africa: what is still missed by health experts?
Basile Keugong et al.;
http://www.panafrican-med-journal.com/content/article/18/320/full/
From our colleague Basile, who will soon defend his phd on this important issue, synergies between HSS & disease control.
Guardian – Polio double vaccine gives better protection, study finds
http://www.theguardian.com/society/2014/aug/22/polio-double-vaccine-study-who
A double vaccine could help battle
polio in some of the world's most remote and conflict-torn regions as new research (in Science) suggests giving a single vaccine shot to children who have already had the oral vaccine greatly boosted their immunity.
back to topNCDs
Lancet (Editorial) – Doing more to prevent suicide
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61379-9/fulltext
In the aftermath of the suicide of Robin Williams, this Lancet editorial argues that more needs to be done. “
New research on psychological treatments is urgently needed. Acquisition of robust evidence on treatments for people at risk of suicide must be accompanied by public health research aimed at understanding and mitigating the social and other factors which could contribute to suicidal thoughts and behaviours. The legacy of Robin Williams's tragic death might be to help focus attention on this neglected area and strengthen research efforts for suicide prevention.”
Humanosphere - Visualizing the surprisingly massive toll of suicide worldwide
Katie Leach-Kemon;
http://www.humanosphere.org/science/2014/08/visualizing-the-surprisingly-massive-toll-of-suicide-worldwide/
More years of life are lost as a result of suicide than from homicide. For graphs on this and other suicide related stats, see this blog post.
Tobacco Control - Quantifying the influence of tobacco industry on EU governance: automated content analysis of the EU Tobacco Products Directive
Hélia Costa et al.;
http://m.tobaccocontrol.bmj.com/content/early/2014/08/10/tobaccocontrol-2014-051822.full?view=full&uritype=cgi
The tobacco industry spends large sums lobbying the European Union institutions, yet whether such lobbying significantly affects tobacco policy is not well understood. The authors (including David Stuckler & Martin McKee) of this paper used novel quantitative text mining techniques to evaluate the impact of industry pressure on the contested EU Tobacco Products Directive revision. As you might expect, the picture isn’t nice.
World Bank (Investing in Health) - U.N. Declaration on Non-Communicable Diseases: How Can We Move Faster?
Patricio Marquez;
https://blogs.worldbank.org/health/un-declaration-non-communicable-diseases-how-can-we-move-faster?utm_content=buffer4c693&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
Very nice blog, already from mid-July, written after the high-level UNGA m eeting. Among other issues, this blog dwells on the
paradigm shift described by Margaret Chan herself: “
As NCDs and road traffic injuries overtake communicable diseases as the leading causes of mortality and morbidity in most of the world, Dr. Chan advocates for a major shift from the prevailing biological, clinical and curative-oriented paradigms that have governed the way societies organize and fund health systems, to one that stresses health promotion and disease prevention. This new model would focus on social determinants of health and changing behaviors; move from short-term management of acute episodes of ill health to long-term management of chronic health conditions, with their complications and comorbidities; and be driven by concerted action involving multiple sectors, business partners, and community actors. The above shift is inescapable. As Dr. Chan noted, while health systems bear the brunt of NCDs (and road traffic injuries), they have little control over their causes. Indeed, as she said, “The health and medical professions can plead for strong tobacco and alcohol legislation, more exercise, and healthier diets. We can treat the diseases and issue the bills, but we cannot re-engineer social environments to promote healthy lifestyles.” “…Therefore, it should be clear to all of us working in the health sector that an effective, government-led, multisectoral effort needs to be advocated, launched, supported, strengthened and operationalized to deal with NCDs (and road traffic injuries) as we move through the second decade of the 21st century.”
World Bank – Investing in health (blog) - Sugar-Sweetened Beverages and Snack Taxes: All Eyes on Mexico (and Hungary)
Maria Bonilla Chacin;
http://blogs.worldbank.org/health/sugar-sweetened-beverages-and-snack-taxes-all-eyes-mexico-and-hungary
Nice blog, on the frontrunner role played by Mexico & Hungary.
back to topNTDs
back to topHuman Resources for Health
WHO - World Humanitarian Day: WHO calls for protection of health workers in conflicts, disasters
http://www.who.int/mediacentre/news/releases/2014/world-humanitarian-day/en/
As major emergencies around the globe increase in scale, complexity and frequency, WHO is calling for an end to the targeting of health workers in conflicts and other humanitarian crises, which represent a breach of the fundamental right to health. On World Humanitarian Day, celebrated every 19 August, WHO drew attention to the continued trend of attacks on health-care workers, hospitals, clinics and ambulances in Syria, Gaza, Central African Republic, Iraq, South Sudan and other areas.
back to topReproductive, maternal, neonatal & child health
Global public health - The politics of unsafe abortion in Burkina Faso: The interface of local norms and global public health practice
Katerini T. Storeng et al.;
http://www.tandfonline.com/doi/abs/10.1080/17441692.2014.937828#.U_HlC_l_uuI
In Burkina Faso, abortion is legally restricted and socially stigmatised, but also frequent. Unsafe abortions represent a significant public health challenge, contributing to the country's very high maternal mortality ratio. Inspired by an internationally disseminated public health framing of unsafe abortion, the country's main policy response has been to provide post-abortion care (PAC) to avert deaths from abortion complications. Drawing on ethnographic research, this article describes how Burkina Faso's PAC policy emerged at the interface of political and moral negotiations between public health professionals, national bureaucrats and international agencies and NGOs.
Lancet Global Health (blog) - The truth about unsafe abortion
Faustina Fynn-Nyame ;
http://globalhealth.thelancet.com/2014/08/19/truth-about-unsafe-abortion
A must-read blog! (by the country director of Marie Stopes Kenya)
Maternal and Health child journal – Using the Principles of Complex Systems Thinking and Implementation Science to Enhance Maternal and Child Health Program Planning and Delivery
Charlan Kroelinger et al.;
http://link.springer.com/article/10.1007%2Fs10995-014-1586-9
Traditionally, epidemiologic methodologies have focused on measurement of exposures, outcomes, and program impact through reductionistic, yet complex statistical modeling. Although not new to the field of epidemiology, two frameworks that provide epidemiologists with a foundation for understanding the complex contexts in which programs and policies are implemented were presented to maternal and child health (MCH) professionals at the 2012 co-hosted 18th Annual MCH Epidemiology Conference and 22nd City
Mat
CH Urban Leadership Conference. The complex systems approach & implementation science. Both approaches offer MCH epidemiologists conceptual frameworks with which to re-envision how programs are implemented, monitored, evaluated, and reported to the larger public health audience. By using these approaches, researchers can begin to understand and measure the broader public health context, account for the dynamic interplay of the social environment, and ultimately, develop more effective MCH programs and policies.
Lancet (seminar) – Maternal and neonatal tetanus
Louise Thwaites et al.;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60236-1/abstract
Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure.
Archive Global - High Fives project
http://archiveglobal.org/
This week, Archive's
High Fives project was launched, a project on replacing the dirt floors of 500 homes in Bangladesh by 2015. For more info, see the project's
video.
“
By 2050, the UN Habitat estimates that 3 billion people will live in slums if urbanization continues at its current pace. According to the WHO, children who live in these conditions - absolute poverty, substandard homes, with little sanitation, and lack of drinkable water - are five times more likely to die before turning five. In fact, 3 million children die each year from parasitic infections associated with diarrhea, malnutrition, and micro-nutrient deficiencies. …Globally, diarrhea related illnesses are responsible for 2.2 million deaths annually. There is a dual and interconnected burden of poor housing and poor health, a burden that must be targeted simultaneously. The High Fives project focuses on implementing simple design modifications to homes so we can help combat and prevent common and deadly diseases.”
back to topSocial Determinants of Health & Health Equity
back to topHealth Policy & Financing
IOM – Evaluation Design for Complex Global Initiatives – Workshop Summary
http://www.iom.edu/Reports/2014/Evaluation-Design-for-Complex-Global-Initiatives.aspx
“
Every year, billions of dollars are spent on large-scale, multi-national global health initiatives. These initiatives encompass multiple types of interventions, programs, and systems-strengthening efforts. They are implemented in varied settings within partner countries through a large number of diverse, multisectoral governmental and non-governmental partners. Evaluations that examine the links between program activities and desired outcomes are used to assess whether these initiatives are achieving their objectives. These evaluations, like the initiatives being evaluated, require complex designs to be successful. On January 7–8, 2014, the Institute of Medicine (IOM) held a workshop to explore examples of recent evaluation experiences that have drawn on an array of available methodologies applied in different ways to evaluate health and development initiatives. The workshop was an opportunity to reflect on the relative benefits and limitations of different evaluation design options that can be used within the context of a large-scale, complex initiative to reach credible conclusions and recommendations and to improve the implementation and performance of the evaluated initiative. This document summarizes the workshop.”
Lancet (World Report) –Health services overwhelmed in northern Iraq
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61380-5/fulltext
Iraq's health services are struggling to meet the needs of millions of Syrian refugees and internally displaced Iraqis in the north of the country. Sharmila Devi reports.
Lancet (World Report) - Upcoming election could rekindle health debate in Brazil
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61381-7/fulltext
Last year's mass protests in Brazil drew attention to health-care spending—an issue that could be in the spotlight again ahead of October's national election. Michael Kepp reports from Rio de Janeiro.
KEI – TDR and the Pooled Fund for R&D: WHO demonstration projects and CEWG follow-up
http://keionline.org/node/2076
In May 2014, the 67th World Health Assembly passed decision WHA67(15) setting the stage for the
creation of a new pooled funding mechanism for R&D. This decision should be viewed in the context of WHO's demonstration projects, a process created by the WHA, to address R&D funding gaps "related to discovery, development and/or delivery" predicated upon open collaborative development models and de-linkage”.In particular, the decision instructed the WHO to explore the option for UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) to host this pooled fund for R&D. In June 2014, TDR's governing board, the Joint Coordination Board (JCB), deliberated over WHA67(15).
CIGI (policy brief) – Responding to Health Challenges: The Role of Domestic Resource Mobilization
Alan Whiteside et al.;
http://www.cigionline.org/publications/responding-health-challenges-role-of-domestic-resource-mobilization
At least US$87 billion is needed to support the prevention, care and treatment of HIV/AIDS, tuberculosis (TB) and malaria in low- and middle-income African countries between 2014 and 2016. Much of the financing for these diseases previously came from international sources; however, implementing countries are progressively graduating from international support as their economies grow. The authors of the brief, Alan Whiteside and Samantha Bradshaw, explain that in order to reach the US$87 billion target, national governments need to mobilize more domestic resources and increase spending on health. They recommend that health ministers in Africa work with international donors, development partners and their own respective national governments to mobilize domestic resources and advocate health spending in the context of shared responsibility and individualized needs.
CFR – Protecting the Global Supply of Medicines
Patrick Stewart;
http://blogs.cfr.org/patrick/2014/08/20/protecting-the-global-supply-of-medicines/
IIGG (International Institutions and Global Governance) released a new policy innovation memorandum entitled “
Designing a Global Coalition of Medicines Regulators.” This
policy memo assesses the regulatory landscape of the global supply chain for medicines and proposes that a multilateral coalition of regulatory authorities would substantively improve the ability of public regulators to keep pace with a dynamic global marketplace.
Future health systems – Time for a new approach to health systems in developing countries, parliamentary meeting told
http://www.futurehealthsystems.org/blog/2014/7/21/time-for-new-approach-to-health-systems-in-developing-countries-parliamentary-meeting-told
Gerry Bloom and others on the UK stage. The All Party Parliamentary Group (APPG) for
Trade Out of Poverty, the APPG for Debt, Aid and Trade and IDS co-hosted a meeting in the UK parliament examining how governments, businesses, practitioners and academics can collaborate more effectively to ensure that health markets in developing countries work better for the world’s poorest communities.
Defense US - Military Health System Protects Global Health, Official Says
http://www.defense.gov/news/newsarticle.aspx?id=122916&utm_campaign=KFF%3A+Global+Health+Report&utm_source=hs_email&utm_medium=email&utm_content=13802461&_hsenc=p2ANqtz--HWAmPXQ37sjehC9laaqnwVcNe9wrZEe1jbvV0i4eIAul1QUHh-GyC-Hkdm99Okyc8qy9spBCowH-ncxdx-hhALgkmYg&_hsmi=13802461
Meanwile, the Pentagon says it has never seen anything like IS before. Don’t know whether that statement is related to the one in this article.
BMJ (Editorial) - Drug legalisation
Michael Farrel;
http://www.bmj.com/content/349/bmj.g5233
International drug control treaties need to allow for policy experiments.
Our Global Voices – Indonesia takes a leadership position in the Global Health Security Agenda
http://blogs.cdc.gov/global/2014/08/20/indonesia-takes-a-leadership-position-in-the-global-health-security-agenda/
In the words of William Hawley, country director for CDC-Indonesia: “…
As one of the early countries to take a leadership role in the Global Health Security (GHS) Agenda, the Government of Indonesia will welcome senior health and agricultural leaders from 36 countries and 12 international organizations for the next commitment meeting August 20-21. The meeting, ‘Building Global Commitment to Multisectoral Approaches to Manage Emerging Zoonotic Diseases in Support of the Global Health Security Agenda within the Framework of Public Health,’ demonstrates the progress and growing momentum of the GHS Agenda.” For some of the presentations in Jakarta, see
here.
Trust – Insight - Extreme medicine: The search for new antibiotics
http://www.trust.org/item/20140817075214-2l746/?source=jt&utm_campaign=KFF%3A+Global+Health+Report&utm_source=hs_email&utm_medium=email&utm_content=13856853&_hsenc=p2ANqtz-_iB8T4OYjHCj1k_u-WHormWFQh5jOu0fwGuKpt8X1ijxc47yGVoyvkw7KMHSZRPxuwqGPElmgkUWmffkrd5dziGLUhkIOae4w5vfGO7kqVxMwFzTU&_hsmi=13856853
Fascinating stuff.
CGD – Data Revolution from the Bottom-Up
Amanda Glassman;
http://www.cgdev.org/blog/data-revolution-bottom
“
Data revolutionaries around the world (myself included) are using every forum possible to call for more and better data that is disaggregated, produced more frequently, more open, and more useable. Recently, my colleague Alex Ezeh at the African Population and Health Research Centre wrote me: “We cannot address data system challenges in Tanzania or Nigeria by holding high level meetings in New York or London.” He’s right: The path to more, better, timely, and open data starts with strengthening country governments’ core data collection, analysis, and use, whether it’s routine economic statistics or sustainable development goals. Country action should drive the revolution, bottom-up not top-down.”
Health & Human rights journal (blog) - The Health of Low-Income Migrant Workers in Gulf Cooperation Council Countries
Maria Kristiansen et al.
http://www.hhrjournal.org/2014/07/22/the-health-of-low-income-migrant-workers-in-gulf-cooperation-council-countries/
As Gulf Cooperation Council (GCC) countries increase global engagement and aspire to host high-profile international events such as the 2022 FIFA World Cup in Qatar and the 2020 World Expo in the United Arab Emirates (UAE), the plight of migrant workers in the region is receiving intensified media attention. The authors of this blog post describe the long-standing health-related problems these migrants face; reflect on recent positive developments; and suggest ways to improve the health and well-being of migrant workers in this region, as it increases in financial and geopolitical importance.
Global Health Science and Practice – new issue
http://www.ghspjournal.org/content/current
Check out the new issue, with for example the editorial ‘
Evidence-based public health: not only whether it works, but how it can be made to work practicably at scale’.
WSJ – Big Investors ask Drug Maker Boards not to Denigrate Biosimilars
http://blogs.wsj.com/pharmalot/2014/08/11/big-investors-ask-drug-maker-boards-not-to-denigrate-biosimilars/
A group of 19 institutional investors is asking the boards of more than two dozen drug makers and biotechs to agree to various
business principles in hopes of supporting use of biosimilar medicines.
DNDi annual report – A decade of R&D for neglected patients
http://www.dndi.org/images/stories/annual_report/2013/DNDi_AR_2013.pdf
This report marks the 10th anniversary of the Drugs for Neglected Diseases initiative.
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Health Research Policy and systems - Health systems research in the time of health system reform in India: a review
Krishna D Rao, Radhika Arora and Abdul Ghaffar;
http://www.health-policy-systems.com/content/12/1/37
EV 2012 Radhika Arora co-authored this paper. “
Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period.”
Please share and promote in your networks.
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Social Science & Medicine – Enrolment of older people in social health protection programs in West Africa – Does social exclusion play a part?
http://www.sciencedirect.com/science/article/pii/S0277953614005280
My colleague Fahdi Dkhimi co-authored this paper, an output of the Health Inc project. The authors explore whether social exclusion determines enrolment of older people in Senegal's Plan Sesame and Ghana's NHIS. Social exclusion affects older people's uptake of social health protection (SHP) programs in both Senegal and Ghana. Reducing financial barriers is not enough to achieve universal coverage. Efforts to cover older people at risk of social exclusion should be increased. Sociocultural, political and economic dimensions should be considered while designing SHP schemes.
Health Research policy & systems – The accountability for reasonableness approach to guide priority setting in health systems within limited resources - findings from action research at district level in Kenya, Tanzania, and Zambia
Jens Byskov et al.;
http://www.health-policy-systems.com/content/12/1/49/abstract
Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT).
Health Research & Policy – National health policy-makers' views on the clarity and utility of Countdown to 2015 country profiles and reports: findings from two exploratory qualitative studies
Benjamin M Hunter et al.;
http://www.health-policy-systems.com/content/12/1/40/abstract
The use of sets of indicators to assess progress has become commonplace in the global health arena. Exploratory research has suggested that indicators used for global monitoring purposes can play a role in national policy-making, however, the mechanisms through which this occurs are poorly understood. This article reports findings from two qualitative studies that aimed to explore national policy-makers’ interpretation and use of indicators from country profiles and reports developed by Countdown to 2015.
Health Policy & Planning - The effectiveness of community-based loan funds for transport during obstetric emergencies in developing countries: a systematic review
http://heapol.oxfordjournals.org/content/early/2014/08/19/heapol.czu084.short?rss=1
Scarcity and costs of transport have been implicated as key barriers to accessing care when obstetric emergencies occur in community settings. Community-based loans have been used to increase utilization of health facilities and potentially reduce maternal mortality by providing funding at community level to provide emergency transport. This review aimed to provide evidence of the effect of community-based loan funds on utilization of health facilities and reduction of maternal mortality in developing countries.
HP&P – African stakeholders’ views of research options to improve nutritional status in sub-Saharan Africa
http://heapol.oxfordjournals.org/content/early/2014/08/14/heapol.czu087.short?rss=1
Some colleagues of mine were involved in this paper. Check it out. “Setting research priorities for improving nutrition in Africa is currently
ad hoc and there is a need to shift the status quo in the light of slow progress in reducing malnutrition. This study explored African stakeholders’ views on research priorities in the context of environmental and socio-demographic changes that will impact on nutritional status in Africa in the coming years.”
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