Lancet Commission - The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa
Irene Agyepong et al;
http://www.thelancet.com/commissions/future-health-Africa
“
The Lancet Commission—The path to longer and healthier lives for all Africans by 2030—was established in 2013 and led African physicians, scientists, and policy makers to chart a vision of the future and roadmap for improved health of sub-Saharan Africans. The Commission has nine key messages ranging from the creation of people-centred health systems to promoting stronger more effective regional cooperation. If the right policies are implemented, and if African leadership is truly empowered to utilise the human resources assets of an ever growing youthful region, unrivalled prosperity and health will be the prize by 2030.”
A Commission by
Irene Agyepong & colleagues, and warmly
welcomed by dr. Tedros himself. The Commission was
launched in Nairobi, on Thursday.
Some
tweets from the launch ( by
Richard Horton) :
“Nairobi: for the launch of our Africa Commission. We can close the health gap for Africa within a generation.”
“
Peter Piot: "Journalists can save more lives than doctors." We must do more to engage the media.”
Do read also the 2
Comments:
Africa and health: a Commission to accelerate success (by R Horton & S Lo)
Longer and healthier lives for all Africans by 2030: perspectives and action of WHO AFRO (by M Moeti (WHO Afro)
Excerpts from Horton & Lo’s Comment:
“
A key message of this Commission is that the opportunities ahead cannot be unlocked with more of the same approaches and by keeping to the current pace. …”
… The final results of a 4-year project to analyse the challenges and opportunities for health in sub-Saharan Africa are now published as a Lancet Commission—The Path to Longer and Healthier Lives for All Africans by 2030—led by African physicians, health scientists, and policy makers. Their conclusion is one of qualified optimism, grounded in a rigorous appraisal of new evidence and past experience. The vision of the Commission is that Africans should expect the same opportunities for health by 2030 as all other peoples. But that hopeful message is based on a further proposition—that more of the same, in terms of policies and programmes, is not enough.
The Commission has nine key messages, together with 43 recommendations, ranging from the creation of people-centred health systems (focused on respect, dignity, and compassion rather than abstract “building blocks”) to promoting stronger and more effective regional cooperation. Commissioners also offer 12 strategic options for health reform, combined with eight areas of action. There is no single blueprint for 49 diverse sub-Saharan African nations to follow. Each country has a unique history and a distinctive future. But the Commission proposes a menu of ways forward that can be adapted to local needs and contexts….
And a warning
: “… But this Commission argues that only if Africans are empowered to lead Africa free from the bondage and neo-colonialism of western nations will these hopes be fully realised.””
WHO Euro meeting (Budapest)
http://www.euro.who.int/en/about-us/governance/regional-committee-for-europe/67th-session/on-the-agenda
You find the agenda here.
Dr Tedros gave another (well-received)
speech.
Our favourite sentence: “…
If you don’t already know that universal health coverage is my top priority for WHO, you do now”.
There’s a lot to say about this WHO Euro meeting, and it was also nice to see some political leaders there (including Orban (
booh!) & Tsipras). Our focus is here on some of Tedros’ key messages (including on WHO governance reform needed (for example, to make the Executive Board more efficient) & new WHO vision) - so we’ll just guide you to
Martin McKee’s (uplifting) take (
BMJ blog) -
Martin McKee: Building bridges in Budapest
McKee was clearly also impressed by the DG (and by the beautiful bridges in Budapest) “
But what was clear was that this was someone with a vision who was committed to making a difference.” (recommended blog on DG’s performance & focus of WHO Euro meeting in general)
Already, Tedros turns out to be somebody good at
building bridges, including at the highest political level. At some point, McKee refers to Brundtland…
New GHI – “Resolve to Save Lives”
https://www.resolvetosavelives.org/
Guardian - Resolve health initiative aims to save 100m lives worldwide
Sarah Boseley;
https://www.theguardian.com/society/2017/sep/12/resolve-health-initiative-aims-to-save-100m-lives-worldwide-tom-frieden
“
A new initiative to save 100 million lives globally through simple interventions such as cutting down on salt and banning trans fats, as well as getting countries prepared for epidemics like Ebola, is being launched with $225m of philanthropic funding. At the helm is Dr Tom Frieden, former director of the Centers for Disease Control (CDC)…” Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill & Melinda Gates Foundation come up with the money for this five-year initiative focused on
preventing cardiovascular disease and epidemics.
“
The latest initiative has two distinct aims. One is to cut deaths from heart disease and stroke through three simple measures: reducing sodium intake worldwide, banning trans fats from foods in all countries and getting people with high blood pressure on treatment. The other is to help low and middle income countries prepare to deal better with the inevitable epidemics he says will come along, from flu to Sars….”
Tweet Tedros: “
I am proud that @WHO is an implementing partner of Resolve to Save Lives, a new initiative to combat cardiovascular diseases & epidemics.”
Stat News - Former CDC director Tom Frieden to launch new global health initiative
H Branswell;
https://www.statnews.com/2017/09/12/global-health-tom-frieden-resolve/?utm_content=buffere61d9&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
For some more detail on Resolve.
Excerpt (interview with Frieden):
“Both of the areas you’ve identified, heart disease and stroke, and then disease epidemics are important but they aren’t necessarily often married in the same program. Why do they make a good fit here?
The
commonality between them is that they’re both at tipping points. In the next five years, it will become clear whether the world has continued to make slow or no progress in each of these areas, or if this announcement, along with our partners, represents an inflection point where we can see more rapid progress. And I’m hopeful that we will be able to show rapid progress….”
See also
Devex -
Bloomberg, CZI, Gates join forces in their 'resolve' to save lives
“…
Resolve will be implemented by a team of global health professionals at Vital Strategies, a New York-based organization working to improve public health systems in more than 60 countries, whose major donors include Bloomberg Philanthropies. The initiative will consist of two programs, one that aims to save more than 100 million lives by preventing heart attacks and strokes, and the other to help countries address gaps in epidemic preparedness and response. Resolve will also support and work closely with the CDC, the World Bank, the World Health Organization, the Johns Hopkins Bloomberg School of Public Health and the Campaign for Tobacco-Free Kids, which is also funded by Bloomberg Philanthropies and the Gates Foundation….”
“…This new initiative is part of CZI’s investment of $3 billion over the next decade toward goals that include the curing, prevention and management of all disease by the end of the century. And it builds on whispers that CZI and Gates might do more to collaborate…”
Jeremy Youde (blog) – Resolve to Save Lives has a lot of money: does it have the authority to lead?
http://duckofminerva.com/2017/09/resolve-to-save-lives-has-a-lot-of-money-does-it-have-the-authority-to-lead.html
Euhm, no? (
must-read blog on the global health governance aspects & legitimacy/accountability issue). “….
Resolve to Save Lives brings into stark relief some of the major issues of global health initiatives. Why create a new global health program and run it out of a different non-profit organization when the issues it’s trying to address are precisely the sorts of things that WHO is designed to address?” See also this week’s intro.
Fortunately, Frieden says he doesn’t want to “bypass the WHO”…
Lancet (Viewpoint) - Saving an additional 100 million lives
Tom Frieden & M Bloomberg;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32443-1/fulltext
Here Frieden & Bloomberg explain more in detail what the rationale is of Resolve. Focus on the first arm, though (NCD arm), in this viewpoint.
UNGA72 & coinciding reports/launched campaigns
It’s that time of the year again in New York.
Un News - General Assembly opens 72nd session with focus on the world’s people
http://www.un.org/apps/news/story.asp?NewsID=57504#.WbjmO7JJbIU
“
The UN was created for people,” Miroslav Lajčák said in his first address as President of the General Assembly. “The people who need the UN the most are not sitting in this hall today. They are not involved in the negotiation of resolutions. They do not take the floor at high-level events. It is one of the tasks of the General Assembly to make sure that their voices can still be heard.”
IISD - UNGA 72 President Outlines Priorities for 72nd Session
http://sdg.iisd.org/news/unga-72-president-outlines-priorities-for-72nd-session/
“
In his first address to the UN General Assembly (UNGA) in his new capacity, the President of UNGA’s 72nd session reminded delegates that the session would see the negotiation of the first intergovernmental compact on migration and the signing of the first agreement on the elimination of nuclear weapons. Miroslav Lajčák, a career diplomat from Slovakia, also promised follow-up efforts to maintain the momentum for implementing and financing the SDGs and the Paris Agreement on climate change.”
Check out also
The Sustainable Development Goals: A Universal Push to transform our world - An end of term report from the president of the 71st session of the GA (coverage IISD -
here ). Includes
10 assessments by the president.
Lancet – Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016
GBD 2016 SDG collaborators;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32336-X/fulltext
“
A new Global Burden of Disease 2016 Study takes a country-level look at progress towards achieving 37 of the 50 health-related Sustainable Development Goals in 188 countries.” (
IHME )
You know you have to read this.
Some of the implications of the new study: “…
Country-level performance for the health-related SDG index varied greatly in 2016, emphasising health inequalities by location and levels of sociodemographic development. Our improved measure of UHC showed a divide across the sociodemographic spectrum, which might be associated with major differences in access to high-quality health services focused on non-communicable diseases and complex conditions in higher-income countries. Nonetheless, considerable progress occurred for many countries on the UHC index between 2000 and 2016, especially in Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China. Based on projections of past trends, meeting a subset of established SDG targets by 2030 might be possible for some areas of the world, with more than 60% of countries projected to meet targets on under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria. At the same time, on the basis of past trends, much of western and central sub-Saharan Africa was projected to attain very few—if any—defined targets in 2030. Furthermore, at current rates of progress, fewer than 5% of countries were projected to reach 2030 targets for 11 indicators, including childhood overweight, tuberculosis, and road injury mortality. Translation of the global SDG framework into investments and policy remains in its infancy, offering decision makers the opportunity to address both long-standing and emerging health challenges in the SDG era.”
“ Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. “
Top of the list are countries like Singapore, Norway, … “…And the
bottom of the SDG league table: all in sub-Saharan Africa, plus Afghanistan.”
New Campaign Bill & Melinda Gates – Goalkeepers: the stories behind the data
Guardian – Bill Gates: Don't expect charities to pick up the bill for Trump's sweeping aid cuts
https://www.theguardian.com/global-development/2017/sep/13/bill-gates-foundation-dont-expect-pick-up-the-bill-for-sweeping-aid-cuts-trump
“
Bill Gates has warned that organisations like his are “absolutely not” prepared to plug the yawning gaps in development aid that will result from funding cuts, including those proposed by President Trump. Speaking to the Guardian ahead of the UN general assembly meeting, which opens for general debate next week, the billionaire philanthropist said simply: “There’s no way to balance a cut in [a] rich country’s generosity.”…”
“…
Gates indicated that rather than focusing on Trump, he has instead approached Congress, as well as individual members of the US government’s executive branch, to stress to key players just how vital foreign aid spending is to global health and stability….”
“
New research from the Gates Foundation and the Institute for Health Metrics and Evaluation, published on Wednesday, has found that
remarkable progress has been made in reducing extreme poverty and child deaths by half within the last few decades. Yet the report also warned that such advances will only continue if governments maintain aid programmes, and shows how progress will decrease if aid tapers out….” “…
The report – which the foundation plans to publish every year until 2030 – tracks 18 indicators from the UN sustainable development goals, including child and maternal deaths, stunting, access to contraceptives, HIV, malaria, polio and extreme poverty….”
Devex – Bill Gates says progress on the SDGs is possible but not inevitable
https://www.devex.com/news/bill-gates-says-progress-on-the-sdgs-is-possible-but-not-inevitable-90988
Some more info on this new campaign. “Leadership will determine how much progress the world makes on poverty and disease, which are the clearest examples of solvable human misery, philanthropists Bill and Melinda Gates write in a report released Wednesday. “
Goalkeepers: The Stories Behind the Data,” was produced in partnership between the Bill & Melinda Gates Foundation and the Institute for Health Metrics and Evaluation at the University of Washington, which received $279 million from the Gates Foundation earlier this year, building on the $105 million grant that stood up the effort a decade ago.
The report, co-authored and edited by Bill and Melinda, features projections exploring three potential 2030 scenarios for 18 data points from the United Nations Sustainable Development Goals, featuring Gates Foundation priorities ranging from malaria eradication to vaccines to sanitation.
These visualizations show what could happen if efforts continue without significant changes to approaches or spending; what could happen with strong leadership, innovation and investment; and what could happen if attention and funding decreased. They demonstrate that progress is possible but not inevitable.”
Washington Post - Melinda Gates decries ‘loss of U.S. leadership’ in global aid
https://www.washingtonpost.com/news/to-your-health/wp/2017/09/13/melinda-gates-decries-loss-of-u-s-leadership-in-global-aid/?utm_term=.182214a008e0
Also more than worth a read. Excerpts:
“
Melinda Gates is calling on world leaders to step up global aid funding, saying “a loss of U.S. leadership” is resulting in “confusion and chaos” in some of the most vulnerable corners of the planet. The billionaire philanthropist and her husband, Bill, who spoke in separate interviews at the offices of their charitable foundation last week, have deep concerns about the global repercussions of the federal budget debate in Washington. The Gateses are pushing back against the administration's proposed funding cuts with a global effort to raise awareness of what is at risk.
… Although lawmakers have said they would reject some cuts, especially if they raise national security concerns, this “mood of retrenchment” has the potential to undo the world's significant progress over the past few decades in public health and anti-poverty programs, the couple said. HIV rates would rise again. Women’s access to contraceptives could disappear in some areas. And fewer children, they fear, would get a chance to live long enough to reach their full potential….
They will officially launch their campaign next week with an event in New York City that will be attended by U.N. Deputy Secretary General Amina J. Mohammed, Nobel laureate Malala Yousafzai and former president Barack Obama, who championed foreign assistance programs while in office.
The Gates Foundation has long been a pioneer in setting measurable goals for its work. Program directors there talk about “investment cases” for each initiative and carefully track the “returns” (usually lives saved) for every dollar expended. It is taking the same approach in the new campaign, with a focus on data and accountability for progress — or the lack thereof.
The centerpiece of the effort will be a series of charts, based on data being published in the medical journal the Lancet, that tracks the story of world health over time by focusing on 18 key indicators. Those include child mortality, HIV deaths and “stunting,” which is children grow up shorter than they should because of malnutrition. “
Devex - Bloomberg Philanthropies aims to make splash during Global Goals Week
https://www.devex.com/news/bloomberg-philanthropies-aims-to-make-splash-during-global-goals-week-91005
You know we love Michael Bloomberg.
“
Bloomberg Philanthropies is set to arrive at Global Goals Week and refocus an already packed schedule in New York. The philanthropy giant’s launch of a major new event is set to make the week a little more glitzy and aim to shift the focus toward the role of the private sector in driving a transparent, sustainable global economy forward. Bloomberg Philanthropies’ Global Business Forum, an all-day event on Sept. 20 at the Plaza Hotel in midtown Manhattan, may serve as an answer to which platform could replace the star-studded Clinton Global Initiative, which closed its doors last year after more than a decade. The first Global Business Forum appears to have certain shadows of CGI, from its broad, global outlook to its impressive speaker list….” Lots of big leaders, CEOs and members of the 0.01 %. So happy they’ll transform our world for the better.
Financing the UN Development System - Pathways to Reposition for Agenda 2030
http://www.daghammarskjold.se/shorthand/financing-unds-2017/
“
With the basic data around the UN Development System ( UNDS ) financing in mind, what then are the major opportunities and challenges around financing the UN system? What financing reform is needed to help the UNDS meet the challenges of Agenda 2030? These questions are debated and explored in the papers by senior contributors from inside and outside the UN system outlined below. Grouped along five key clusters, they provide fresh perspectives and ideas on pathways to financing reform, which can help the UNDS reposition for Agenda 2030.”
Check out p. 154 for
conclusions.
“…
A few key themes emerge in this report as essential to a successful repositioning of the UNDS to meet the challenges of Agenda 2030. To begin with,
the UN must strengthen its leveraging role. This will require a major push on the part of the UN in developing robust system-wide financial data and strategies, employing professional capabilities and developing the skills needed to partner effectively with a range of financing actors at the local, regional and international levels.
The UNDS must also reinforce the sustaining peace approach and the creation by the Secretary-General of a strategic platform for financing prevention and peacebuilding could go a long way in accomplishing this. … … The
UN should pursue both stronger normative and global public goods agendas as globalisation currently faces a significant backlash. It must ensure it is an effective instrument in facilitating solutions to challenges aggravated by globalisation, those requiring a collective response.
Finally, the UNDS must recognise the centrality of transparency and accountability for the effective implementation of Agenda 2030. In 2015, the Addis Ababa Action Agenda and SDG 16 both enshrined the notion of open financial data into their outcomes and the UNDS must make the most of this lowest of the ‘low-hanging fruit’ in SDG financing. …”
PS: You should probably also read Reforming the WHO's financing model (by Dr Gaudenz “silver tongue” Silberschmidt and Dr Guitelle Baghdadi-Sabeti) (p. 52-54)
Lancet - GBD2016: 5 new papers
http://www.thelancet.com/gbd
In addition to the (above mentioned) health SDG GBD analysis, read the
5 other new Global Burden of Disease 2016 papers which provide worldwide data trends, including mortality and risk factors and injuries (covering the period 1990-2016).
For some background and context, as well as some key messages, see this week Lancet
Editorial -
Life, death, and disability in 2016. “…
Overall, the findings show that the world is becoming healthier, but progress is uneven. People are living longer, but with more disease. As SDI (i.e. the socio-demographic index, a metric that measures a country’s development) rises, the gap between healthy life expectancy and life expectancy (ie, the time living with ill health) is less for high SDI countries compared with low SDI countries. So, while there is an expansion of morbidity as life expectancy increases, there is a relative compression of morbidity (less time spent with ill health) as a country becomes richer.”
The
conclusion is worth giving in full –
“One message from these papers is that there are certain health issues that need specific attention in different countries. These challenges will require strengthening of the health system, together with more vertical initiatives—universal health coverage alone will not suffice. There should be a global forum where these results and their policy implications are discussed. We propose that WHO, the World Bank, and other technical and multilateral agencies join together annually to discuss the GBD findings, and how they should influence decision making.
Looking ahead, a key further task for GBD is how to incorporate one of the defining challenges of our times—threats to our planetary health—into their analyses. For example, the likely effects of climate change on the displacement of people will be substantial. Human beings also depend on a variety of ecosystem resources for their health and wellbeing. To recognise these new risks, the GBD will have to consider developing additional health-related metrics that relate to planetary health: such as concerning biodiversity, climate change, and ecosystem services. Therein lies a challenge for the next GBD.”
Do read also the Lancet Viewpoint (by Chris Murray & Alan Lopez) - Measuring global health: motivation and evolution of the Global Burden of Disease Study “… In this viewpoint, we trace the evolution of 10 key dimensions of the GBD study, which in our view as the two founders of the GBD, have had an important role in increasing the utility, relevance and integration of GBD findings in national and global health policy debates, and highlight what we see as some of the principal challenges for the future.”
Global Evidence summit Cape Town (13-16 September)
https://www.globalevidencesummit.org/
Ongoing. Some publications & news already from Cape Town:
Tweet Trishalgh: “
Strong theme of #GESummit17 is evidence geeks need to get out more, build collaborations, address practicalities.”
Cochrane Africa was launched
http://africa.cochrane.org/
Check it out.
WHO (Alliance) – Rapid reviews to strengthen health policy and systems: a practical guide
Edited by
A Tricco, E Langlois et al;
http://apps.who.int/iris/bitstream/10665/258698/1/9789241512763-eng.pdf
“
Policy-makers require valid evidence to support time-sensitive decisions regarding the coverage, quality, efficiency, and equity of health systems. Systematic reviews and other types of evidence syntheses are increasingly employed to inform policy-making and produce guidance for health systems. However, the time and cost to produce a systematic review is often a barrier to its use in decision-making. Rapid reviews are a timely and affordable approach that can provide actionable and relevant evidence to strengthen health policy and systems. This Practical Guide explores different approaches and methods for expedited synthesis of health policy and systems research, and provide guidance on how to plan, conduct, and promote the use of rapid reviews, while highlighting key challenges including their application in low- and middle-income countries. Our proposed solutions will help provide policy-makers and health systems managers with strategic evidence to make crucial decisions about health systems’ response in emergency situations, as well as in routine decision-making.”
Four new Cochrane EPOC overviews of reviews show reliable evidence on the effects of different ways of organising, financing, and governing health systems in low-income countries and identify important evidence gaps.
http://epoc.cochrane.org/news/health-systems-low-income-countries-four-new-overviews?platform=hootsuite
A team of Cochrane researchers from Argentina, Chile, Norway, and South Africa prepared
four overviews of the available evidence from up-to-date systematic reviews about the effects of health system arrangements in low-income countries. Coinciding with the Global Evidence summit.
“
An overview of delivery arrangements included 50 systematic reviews that included a total of 919 studies. These reviews found that that many delivery arrangements probably have desirable effects, including task shifting or role expansion and strategies for coordinating care.
An overview of financial arrangements included 15 systematic reviews that included a total of 276 studies. The effects of most of the financial arrangements that were reviewed were uncertain. This includes the effects of providing financial incentives and disincentives for health care workers, and the effects of most types of financial incentives and disincentives for people using health services.
An overview of governance arrangements included 21 systematic reviews that included a total of 172 studies. These reviews found that restrictions on medicines reimbursement (pre-authorisation), community mobilisation, and disclosing to the public performance data on health facilities and providers probably have desirable effects. The effects of other governance arrangements that were reviewed were uncertain.
An overview of implementation strategies included 39 systematic reviews that included a total of 1332 studies. These reviews found that many different implementation strategies probably improve professional practice, including educational meetings, educational outreach, practice facilitation, local opinion leaders, audit and feedback, and tailored interventions. Many strategies targeted at healthcare recipients also probably have desirable effects on the use of health care. For example, mass media interventions lead to an increase in immediate uptake of HIV testing and reminders and recall strategies for caregivers probably increase routine childhood vaccination uptake.”
International South-South cooperation day (12 September)
http://www.un.org/en/events/southcooperationday/
By way of example:
Independent - Irma: Cuba sends hundreds of doctors to Caribbean islands devastated by hurricane
http://www.independent.co.uk/news/world/americas/irma-hurrican-cuba-doctors-carribbean-islands-sends-hundreds-castro-a7938171.html?amp
Tweet from
Kent Buse: “Kudos to Cuba: more South-South solidarity & #healthdiplomacy” Cuba has been doing this since the 60s, of course.
Lancet Global Health – August issue
Editorial - Facing forwards along the Health Silk Road
Lancet Global Health;
Must-read editorial. “
Last month, China made a significant move towards the consolidation of its role as a major player in global health policy. At the Belt and Road High-level Meeting for Health Cooperation in Beijing, delegates from between 20 and 30 countries plus WHO, UNAIDS, the GAVI Alliance, and the Global Fund signed a communiqué aimed at increasing collaboration on research, health security, and education among the countries of China's proposed Belt and Road Initiative.”
The Lancet’s take, including on the
Health Silk Road Communiqué.
One major gap: “
Non-communicable diseases, however, were distinctly absent from the High-level Meeting agenda and the Health Silk Road communiqué.”
World Suicide prevention day (10 September)
http://www.who.int/mediacentre/factsheets/fs398/en/
Seventy-eight percent of suicides occurred in low-and middle-income countries in 2015, making it the second leading cause of death among 15–29-year-olds. “
Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions. For national responses to be effective, a comprehensive multisectoral suicide prevention strategy is needed.”
World Sepsis Day 2017
WHO;
This year’s World Sepsis Day shined a spotlight on
maternal and neonatal sepsis. It can be prevented.
Trump & global health
Some reads from last & this week:
Foreign Policy - Senate Committee Votes Against Administration on Anti-Abortion Global Gag Rule
http://foreignpolicy.com/2017/09/07/senate-votes-against-administration-on-anti-abortion-global-gag-rule/amp/
See also
Stat -
Senate panel votes to reverse Mexico City Policy, signaling support for global family-planning assistance. “
In a move likely to prove only symbolic, the Senate Appropriations Committee voted on Thursday to overturn the Mexico City Policy, which President Trump announced in January he would reinstate and which the State Department formalized in May….”
For the breakdown, see
KFF Senate Appropriations Committee approves FY 2018 State & Foreign Operations (SFOPs) and Health & Human Services (HHS) Appropriations Bills.
Reuters – Senate panel rejects Trump's 'doctrine of retreat' on foreign policy
Reuters;
And the bigger picture: “
A powerful Senate committee blasted the Trump administration on [last week’s ] Friday in a report accompanying its spending plan for the State Department, saying its approach to foreign policy weakens U.S. standing in the world. On Thursday, the Senate Appropriations Committee voted 31-0 for legislation allocating more than $51 billion for the State Department and foreign operations, nearly $11 billion more than requested by President Donald Trump’s administration. In the report released on Friday accompanying the legislation, the committee criticized the administration’s request to cut spending on such operations by 30 percent from the year ending on Sept. 30, 2017. “The lessons learned since September 11, 2001, include the reality that defense alone does not provide for American strength and resolve abroad. Battlefield technology and firepower cannot replace diplomacy and development,” it read. “The administration’s apparent doctrine of retreat, which also includes distancing the United States from collective and multilateral dispute resolution frameworks, serves only to weaken America’s standing in the world,” it said.”
Unfortunately, not much chance this will ever become a law.
JAMA Forum - “America’s Health First”: A Misnomer
Larry Gostin;
http://jamanetwork.com/journals/jama/fullarticle/2653724
Larry nails it once again. Second part of this short forum focuses on global health assistance.
DFID’s 20th anniversary
Some key reads:
Devex - DFID turns 20: The 7 politicians who shaped UK aid
https://www.devex.com/news/dfid-turns-20-the-7-politicians-who-shaped-uk-aid-90995
ODI – The politics of the results agenda in DFID: 1997-2017
C Valter et al;
https://www.odi.org/publications/10902-politics-results-agenda-dfid-1997-2017
Recommended!!! “
The United Kingdom's Department for International Development (DFID) was created 20 years ago. In this time, its budget has grown dramatically and its management has shifted. One of the most dominant shifts is towards the ‘results agenda’ – a political agenda for foreign aid, associated with fixed target-setting, which has changed the way DFID operates around the world. In this report we analyse how and why the results agenda emerged. Our primary focus is on the politics of the story, how it has intersected with DFID's management, and the response to these changes. We ask whether DFID's results management is fit for purpose; that is, does it reflect the UK's development ambitions? To answer these questions, we interviewed more than 60 people, including former Secretaries of State, senior civil servants and international development experts.”
And for the ones with little time, read this (very nice)
accompanying blog -
DFID is 20 years old: has its results agenda gone too far? (by Craig Valters et al)
FT Health – Philip Morris pledges $1bn to stub out smoking around the world
https://www.ft.com/content/d9acceae-97d5-11e7-a652-cde3f882dd7b
Strange The Donald didn’t label this as ‘Fake news’ on Twitter.
“
Philip Morris International has pledged up to $1bn over the next 12 years to an arm’s-length foundation that will fund scientific research designed to eliminate the use of smoked tobacco around the globe. The Swiss-based group, one of the world’s largest producers of cigarettes, last week registered the Foundation for a Smoke-Free World as a US charitable organisation, with the stated aim of making grants on “how to best achieve a smoke-free world and advance the field of tobacco harm reduction”. It has appointed as head of the foundation Derek Yach, a former senior executive at the World Health Organisation (WHO) who led the development of its Framework Convention on Tobacco Control, an agreement between governments that helped impose advertising restrictions, tougher anti-smoking laws and higher taxes on cigarettes. …”
See also
Bloomberg – “Philip Morris International Inc. said it will spend about $1 billion setting up a foundation to reduce the prevalence of smoking as the maker of Marlboro cigarettes aims to convert smokers into consumers of devices that don’t burn tobacco.”
Some tweets:
Horton – “
Derek Yach to lead Philip Morris funded Foundation for a Smoke-Free World. How should the health community respond? “
Kickbusch – “
Note my tweet from a few days ago - what I predicted! The money lies with ecigs in future #ncds”
For an in-depth take, see this blog by
Richard Smith -
How public health moralists are promoting harm from tobacco and helping the tobacco industry.
NYT- What Does It Cost to Create a Cancer Drug? Less Than You’d Think
https://www.nytimes.com/2017/09/11/health/cancer-drug-costs.html?smid=tw-nythealth&smtyp=cur
What does it really take to develop a new (cancer) drug? “…For years, the standard figure has been supplied by researchers at the Tufts Center for the Study of Drug Development: $2.7 billion each, in 2017 dollars. …“ “…
a new study looking at 10 cancer medications, among the most expensive of new drugs, has arrived at a much lower figure:
a median cost of $757 million per drug. (Half cost less, and half more.)
Following approval, the 10 drugs together brought in $67 billion, the researchers also concluded — a
more than sevenfold return on investment. Nine out of 10 companies made money, but revenues varied enormously. One drug had not yet earned back its development costs. The
study, published Monday in JAMA Internal Medicine, relied on company filings with the Securities and Exchange Commission to determine research and development costs….”
Well, well.