IHP news 470: Highlights of the week

By on May 18, 2018

About to start: 71st World Health Assembly  (21-26 May, Geneva) – under the banner of UHC

http://www.who.int/world-health-assembly/seventy-first

Get ready for one of the biggest global health events of the year, also the first one with dr. Tedros as WHO’s DG. With the current Ebola outbreak, all eyes will be even more on him. So far, his leadership gets kudos from all sides.

You find background documents here  (including the preliminary journal.)

Global Health Now – 8 things to watch at this year’s WHA

Start your reading with this (absolute) must-read from our colleagues from Global Health Now8 Things to Watch at This Year’s World Health Assembly—#WHA71   (by Brian Simpson)

If you only read one analysis before the WHA, make sure it’s this one.

Before, we already flagged a similar (gated) piece, on IP-Watch: preview – guide to key issues. We wish you the best of luck trying to find an ungated one. Let’s hope that once the WHA starts, it’ll be open access.

Global Health/ PHM Watch analysis

For the integrated PHM commentary (as of 14 May) on the WHA agenda items, see here.

Stay tuned for their briefs & other analyses as well.  This year, Andrew Harmer is part of the crew. See also Global Health Watch.

For IHP, we have a few colleagues attending the WHA (and preparatory civil society meetings, ahead of the WHA). So do keep an eye on our blog in the coming days & weeks.

  • We also want to flag the interview (in UN Special – by G Aslanyan), with Dr Tedros, just before the WHA – in which he reflects on one year in charge. Interview with Dr Tedros (part of a special issue dedicated to WHO)

 

  • Finally, we think Ilona Kickbush is on to something, cfr her tweets:

In the year of @WHO 70 birthday – could it not get the #Nobelprize for peace – or for medicine to give a signal that health is so much more. What do you think?”

@NobelPrize – on occasion of @WHO 70th birthday would it not be appropriate to consider it for the peace or even the medicine prize! Let’s honour key multilateral institutions in a climate of unilateralism.”

Fran Baum already helpfully suggested a hashtag:   #WHO4Nobel

Finally, in further evidence of the transformation of WHO under Tedros, “@WHO will now provide health insurance for all interns regardless of whether they serve in a country office, a regional office or in HQ.”

Ebola outbreak in the DRC entered a new phase

Clearly, all (global health) eyes are on the Ebola outbreak in the DRC, for many reasons, only one of them being that WHO’s response (in coordination with other actors), under Tedros’ leadership will be carefully watched at the WHA and beyond as a litmus test of the ‘new & transformed’ WHO. Did the organization really learn the lessons from the Ebola outbreak in West-Africa (and is the same true for the many other actors who need to be involved)?  So far, that indeed seems to be the case. WHO’s response was swift, Tedros even went – in a first – to the DRC himself, and coordination with other UN agencies has been exemplary. But it’s early days, so, fingers crossed, as the situation has just worsened with the first confirmed urban case.

Some reads:

Stat News – WHO to weigh declaration of international emergency over Ebola outbreak

https://www.statnews.com/2018/05/17/ebola-who-emergency-committee/

The World Health Organization has convened a special committee of experts to help guide its response to the expanding Ebola outbreak in the Democratic Republic of the Congo. During its first meeting on Friday, the group will be asked if the outbreak should be declared an international health emergency. The announcement that an emergency committee has been convened to assess the latest Ebola outbreak comes a day after the national laboratory in the DRC confirmed a case had been discovered in Mbandaka, a city of 1.2 million people. The case had previously tested positive with a rapid test, but that finding has been confirmed with a second test. The specter of the virus once again transmitting in an urban setting is a chilling one, hearkening to painful memories of the massive West African Ebola outbreak that began at the end of 2013. Then the WHO was slow to recognize the threat. This time, it has warned of the risk of urbanized Ebola from the start and is working hard to forestall it….”

The (updated) story also contains some short input from Tedros why he called for such a meeting of the emergency committee.

The first urban case is clearly a ‘game changer’ (in the words of Peter Salama).  See also WHO WHO concerned as one Ebola case confirmed in urban area of Democratic Republic of the Congo This article also lists the numerous partners of WHO in this outbreak.

Vox – We finally have an Ebola vaccine. We’re about to use it in an outbreak.

https://www.vox.com/science-and-health/2018/5/16/17356464/ebola-virus-vaccine

“In a first, the experimental vaccine is being deployed to try to stop an outbreak from spreading.”

See also ReutersCongo receives first doses of Ebola vaccine amid outbreak

The first batch of 4,000 experimental Ebola vaccines to combat an outbreak suspected of killing 23 people arrived in Congo’s capital Kinshasa on Wednesday.”

Meanwhile, “#EbolaDRC: The estimated cost of containing this outbreak is rising. @WHO now says $26M USD — up from $18M USD a few days ago. So far $8M has been kicked in, from WHO’s contingency fund, the UN, Gavi, Wellcome Trust & the UK….”

Stat News – As Ebola flares once again, a rapid global response invites cautious hope

https://www.statnews.com/2018/05/15/ebola-who-response/

Must-read analysis, with the views of a number of experts on the response so far. Views from Tom Inglesby, Ron Klain, Ashish Jha, David Fidler, Lawrence Gostin…

Lancet (Editorial) – False economy and global health security

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31076-6/fulltext

The Lancet’s take on the current global health security situation (with an eye on the outbreak, but more importantly, on the Trump administration’s disappointing commitment to global health security).

The editorial concludes: “ …The World Health Assembly is scheduled for next week, and Director-General Tedros Adhanom Ghebreyesus was sworn in last year on a platform of strengthening global health security. While we are still early in Tedros’s 5 year term, it unfortunately cannot be said that the world is safer from global health security threats than it was a year ago. The need for robust responses to global health security dangers will not go away. We cannot afford to turn away from proven and effective responses in the name of false economy and blinkered nationalism.”

CGD (blog ) – Ebola Again: Preparedness Is Still Underfinanced, but New Opportunities Are in Play

A Glassman et al; https://www.cgdev.org/blog/ebola-again-preparedness-still-underfinanced-new-opportunities-are-play

“… While new tools are in place, it’s past time to recognize the need to adequately finance preparedness at home and abroad, and to act on existing opportunities to deploy funding and link tightly to progress on preparedness metrics….”

And some other links:

Devex First pledges announced to combat Ebola in DRC  (from late last week – 11 May)

And the WB just announced it is making US$3 million immediately available to support the Government of the Democratic Republic of the Congo (DRC)’s Ebola Virus Disease Response Plan (EVDRP) to fight the current Ebola outbreak in the country. .

Ebola Outbreak – WHO Puts 10 Countries On ‘High Alert’

Next global HSR symposium will take place in Dubai

HSG – Eastern Mediterranean region to host the sixth global symposium on HSR in 2020

http://www.healthsystemsglobal.org/blog/285/Eastern-Mediterranean-Region-to-host-the-Sixth-Global-Symposium-on-Health-Systems-Research-in-2020.html

The HSR community has to go to Dubai in 2020. Interesting choice.

The Sixth Global Symposium on Health Systems Research (HSR2020) will take place in the Eastern Mediterranean Region in Dubai and will welcome around 2,000 delegates over five days from 8th to the 12th November 2020. The winning bid was put forward by the Mohammed bin Rashid School of Government, Dubai, in partnership with the United Arab Emirates, and in coordination and close collaboration with the American University of Beirut (AUB), through its Knowledge to Policy (K2P) Center at the Faculty of Health Sciences, Lebanon.”

Global Fund update

France to Host Global Fund Replenishment Conference   (in 2019 )

https://www.theglobalfund.org/en/news/2018-05-16-france-to-host-global-fund-replenishment-conference/

A new occasion for “Jupiter” to shine on the global scene. (As for Peter Sands, I heard they (still) have pretty good (and expensive!) wine in France.  Could spark some interesting partnerships)

“…France is Global Fund’s second-largest donor, committing more than US$4.2 billion to the Global Fund since 2002. France has played a pioneering role in scientific research, promoting human rights and serving people affected by AIDS, TB and malaria. … The Sixth Replenishment Conference of the Global Fund is expected to raise funds for the period 2020 through 2022. It is the first time that France will host a Global Fund replenishment conference. … … France said in its announcement that President Macron’s decision to host the conference signaled France’s strong engagement in international development, repositioning health as a priority of French development policy. “

A few tweets perhaps:

How will the upcoming replenishments relate to one another, to the #SDGs, to @WHO budget – will member states and replenishment hosts take broader #globalhealth coherence into account ? @theGFF @GlobalFund @gavi

Replenishments feel like an MDG mechanism, not really fit 4 the SDG era. Certainly not 4 current rogue nationalist/populist era. Global health should reach out much more 2 the global fair taxation community, and link GPGs (incl global health) with tax. Cfr national level (UHC).”

Global Fund Board meeting: more analysis

Check out the latest GFO issue here.

PS: The decision on potentially providing aid to epidemics in Venezuela (and other non-eligiblee countries in crisis) is encouraging, but there are still hurdles to overcome   (where will the money come from, a limit apparently of 20 million dollar (which doesn’t go very far), …

As already mentioned, there was absolutely nothing on the Heineken partnership (suspension).

Which begs the question: did the Board members “walk the talk” during the break (and thus serve no Heineken)?

You might also want to read 6  Key Takeaways: The Global Fund’s 39th Board Meeting (by Friends of the Global Fight).

WHO – First-ever WHO list of essential diagnostic tests to improve diagnosis and treatment outcomes

http://www.who.int/news-room/detail/15-05-2018-first-ever-who-list-of-essential-diagnostic-tests-to-improve-diagnosis-and-treatment-outcomes

WHO published its first Essential Diagnostics List, a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.

For excellent (& must-read) analysis & background, read M Pai on the Conversation – Health care is an essential human right – and so is a proper diagnosis

“… In a path-breaking development, 40 years after publishing the first Essential Medicines List, the World Health Organization (WHO) this week published the first Essential Diagnostics List. This new list will greatly enhance the impact of the Essential Medicines List (EML). After all, essential medicines require essential diagnostics. While everyone accepts the importance of essential medicines and vaccines, there is little acknowledgement of the central importance of diagnosis — the first, critical step in the management of all diseases….

“…The first EDL, compiled by a WHO expert advisory group on in-vitro diagnostics, contains 113 tests. Of these, 58 are basic tests (e.g. hemoglobin, blood glucose, complete blood count, urine dipstick) intended for detection and diagnosis of a wide range of common communicable and non-communicable conditions. These basic lab tests form the basis for an essential package of tests at the level of primary care and higher. The remaining 55 tests are designed for the detection, diagnosis and monitoring of “priority” infections — namely HIV, TB, malaria, hepatitis B and C, human papillomavirus (HPV) and syphilis….”

Early analysis of WHO High-Level commission on NCDs draft report

For the draft, see WHO  (15 p).

Plos (blog) – Gender and NCDs: Benign neglect in the face of a gaping window of opportunity

http://blogs.plos.org/globalhealth/2018/05/gender-and-ncds-benign-neglect-in-the-face-of-a-gaping-window-of-opportunity/

by Kent Buse & Sarah Hawkes.

NCDs are finally having their moment. … … Yet against this backdrop of cautious optimism, one issue must give cause for concern – the deafening silence on the issue of gender in the discussion. Despite its importance, gender is absent or treated superficially in the NCDs community…. “

They call on the Commission and the negotiators of the Political declaration to bring gender centrally into approaches to address the NCD epidemic.

General analysis of the draft – 11-point thread Kent Buse on Twitter

 

1/11 @WHO High-level Commission on #NCDs released its draft report. Kudos to @DrTedros for this critical initiative in run up to #HLM3 & to commissioners, chairs & Secretariat for working to tight timeframe. My reflections on draft in this 11-point thread https://bit.ly/2jTwqMT 

2/11 Much to like in @WHO High-level Commission #NCDs draft report, including: NCDs in human development index; convention on marketing health harming products; socially responsible investing forum; full cost accounting for externalities of health harming products, etc

3/11 Areas that need more attention / specificity in @WHO High-level Commission on #NCDs report include the ‘how’ as well as #gender, #rights, multisector coordination mechanisms, support to civil society, #STAX #NCDHLCReport18 @VeronicaMagar @MartenRobert

4/11 Gender. #NCDHLCReport18 Report fails to mention #NCDs affect women & men differently. Also fails to recognize gendered drivers, behaviours, service delivery & outcomes or gendered nature of (unpaid) care. @GlobalHlth5050 can draft operative para @VeronicaMagar @womeninGH

5/11 Rights are only mentioned once (as principle) in NCDHLCReport18 – there is a need to spell out various elements of a rights-based approach for #NCDs prevention & control. Take a look at #AIDS political declaration for some inspiration.

6/11 Health-in-all-policies and multisector coordination. Both mentioned in #NCDHLCReport18 draft; but given inherent challenges, what concrete recommendations can the Commission make based on good practice to make them more widespread and tractionable? @Unni_Gopinathan

7/11 Civil society – draft #NCDHLCReport18 thanks NGOs for inputs, but makes no recommendations to support critical role of civil society as service providers, advocates and watch dogs. Such support, including financing, is arguably critical to progress on SDG 3.4 @NCDFREE

8/11 Sugar. Great to see increased taxes proposed for tobacco & alcohol in #NCDHLCReport18, but report doesn’t refer to #sugar – needs addressing – particular window of opportunity now with focus on #SSB tax & #STAX. Similarly, good to consider ultraprocessed foods strategies

9/11 Financing. Mixed feelings about new catalytic fund proposed in #NCDHLCReport18. Could give impetus to get all stakeholders around country proposals. But could add to complexity of health architecture. And will WB be as good as #GlobalFund at bringing civil society to table?

10/11 Accountability. Great to see so much space on accountability and its strengthening & streamlining in NCDHLCReport18. Need more specificity on how it will work & how to engage civil society–lessons from the Global #AIDS reporting system https://bit.ly/2jX1OtT  @SofiaGruskin https://twitter.com/kentbuse/status/995922842528165888 …

11/11 Further thought on report of @WHO Commission on #NCDs: front end unnecessarily long–suggest replace first 33 paras 3 paras: 1) ambitious targets agreed at previous HLMs; 2) we know what works (Best Buys); 3) lack of progress; response off track & incommensurate w challenge

REPLACE : a roadmap to make the world trans fat free by 2023

Guardian – Industrial trans fats must be removed from food supply, WHO says

https://www.theguardian.com/science/2018/may/14/industrial-trans-fats-must-be-removed-from-food-supply-who-says?CMP=share_btn_tw

Trans fats used in snack foods, baked foods and fried foods are responsible for half a million deaths worldwide each year and must be eliminated from the global food supply, the World Health Organization says [today].  …  … The WHO is saying that trans fats should be limited to less than 1% of food energy, which it equates to a maximum of 2.2g of trans fats in a diet of 2,000 calories a day. … Recent guidance on saturated fats from the WHO said they should be limited to 10% of food energy per day.

You find all the detail on REPLACE in this piece in the Lancet CommentREPLACE: a roadmap to make the world trans fat free by 2023  (by Dr Tedros & Thomas Frieden)

“…On May 14, 2018, WHO and Resolve to Save Lives announced the REPLACE initiative to make the world trans fat free by 2023. The REPLACE action package provides countries with tools they can implement now to eliminate industrially produced trans fats from their national food supplies. REPLACE is the first global initiative to eliminate a risk factor for cardiovascular disease…. REPLACE aims to accelerate the elimination of industrially produced trans fats by providing governments with six strategic action areas that ensure the prompt, complete, and sustained elimination of this toxic chemical from the food supply …”

see the Guardian – https://www.theguardian.com/science/2018/may/14/industrial-trans-fats-must-be-removed-from-food-supply-who-says?CMP=share_btn_tw

WHO (report) – Investing in noncommunicable disease control generates major financial and health gains

http://www.who.int/news-room/detail/16-05-2018-investing-in-noncommunicable-disease-control-generates-major-financial-and-health-gains

The “investment case” for NCDs. Long awaited (though not by me).

A new WHO report launched today shows that the world’s poorest countries can gain US$350 billion by 2030 by scaling up investments in preventing and treating chronic diseases, like heart disease and cancer, that cost an additional US$1.27 per person annually. Such actions would save more than 8 million lives over the same period. The report, titled Saving lives, spending less: a strategic response to NCDs, reveals, for the first time, the financing needs and returns on investment of WHO’s cost-effective and feasible “best buy” policies to protect people from noncommunicable diseases (NCDs), the world’s leading causes of ill health and death.

… It shows that for every US$1 invested in scaling up actions to address NCDs in low- and lower-middle-income countries (LLMICs), there will be a return to society of at least US$7 in increased employment, productivity and longer life….”

Tobacco control

UNICEF rebuttal to claims made in The Tobacco Industry and Children’s Rights article  (in the Journal ‘Pediatrics’)

http://pediatrics.aappublications.org/content/early/2018/04/26/peds.2017-4106.comments#unicef-rebuttal-to-claims-made-in-the-tobacco-industry-and-childrens-rights-article-

By Stefan Peterson.

The article The Tobacco Industry and Children’s Rights[1], authored by van der Eijk, et al. and published in Pediatrics on 26 February, contains serious inaccuracies and misrepresentations of both UNICEF’s past engagement with the tobacco industry and UNICEF’s current advocacy for tobacco control. We were surprised and disappointed that UNICEF was not given any opportunity to respond to the allegations set out in the article before it was published — which would have been standard practice. This letter therefore identifies and rebuts the most serious of these inaccuracies….”

2018 Global Drug Survey

Independent – Alcohol and tobacco by far the worst drugs for human health, global review finds

https://www.independent.co.uk/news/health/alcohol-drinking-smoking-drugs-addictive-health-worst-bad-cannabis-cocaine-amphetamines-opioids-a8345741.html

Alcohol and tobacco are by far the biggest threat to human health around the world, while illegal drug harms “don’t even come close”, a major report on addictive substances has found. The Global Statistics on Alcohol, Tobacco, and Illicit Drug Use: 2017 Status Report found a quarter of a billion hours of healthy human life are lost each year because of smoking and drinking, ten times more than is lost to illicit drug use….”

The report, published in the journal Addiction,also found that Europe is a world leader in these bad habits.

Lancet (Editorial) – Changing the conversation to make drug use safer

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31075-4/fulltext

“Last week, the 2018 Global Drug Survey (GDS) published its annual findings on recreational drug use (both legal and illegal) among 130 000 people across 44 countries. The anonymised online survey uses a detailed questionnaire to assess trends in drug use and self-reported harms among regular drug users and early adopters of new trends. … …  It is time to accept that for many people the use of drugs plays an important and functional part in their lives. For many, the risk related to their use lies within inherent personal and social vulnerabilities and the way they use the drug. Given current laws, policies to reduce harm from drug use need to be pragmatic and receptive to the evidence. Governments need to promote honest conversations about drug use and harm and avoid selectively listening to evidence that supports pre-existing ideological or political positions. We can make a good start in reducing harm by engaging in conversations with people who use drugs, and who are also very interested in protecting their health and wellbeing while they do so.”

Hypertension Day  (May 17)  & May Measurement Month

Lancet Global Health – May Measurement Month 2017: an analysis of blood pressure screening results worldwide

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30259-6/fulltext

Increased blood pressure is the biggest contributor to the global burden of disease and mortality. Data suggest that less than half of the population with hypertension is aware of it. May Measurement Month was initiated to raise awareness of the importance of blood pressure and as a pragmatic interim solution to the shortfall in screening programmes.

“… In 2017, the International Society of Hypertension expanded the annual World Hypertension Day on May 17 to a May Measurement Month (MMM). In this issue of The Lancet Global Health, Thomas Beaney and colleagues present results from this very large global initiative which aimed to increase the awareness and treatment of high blood pressure. 100 countries were approached for this low-cost project, and data from 80 countries were included in the analysis…”

See also NCD AllianceElevating hypertension on the public health agenda

Marking World Hypertension Day on May 17, the World Heart Federation (WHF) is taking stock of its recent initiatives to accelerate progress in the management and prevention of raised blood pressure and to elevate this significant public health issue on the global health agenda. Efforts include translating WHF’s global roadmap on hypertension into national contexts through roundtables, and capitalising on the advocacy opportunities at the 71st World Health Assembly.”

WHO/WB/OECD (report) – Delivering quality health services: a global imperative for universal health coverage

http://apps.who.int/iris/handle/10665/272465

This document – Delivering quality health services: a global imperative for universal health coverage – describes the essential role of quality in the delivery of health care services. As nations commit to achieving universal health coverage by 2030, there is a growing acknowledgement that optimal health care cannot be delivered by simply ensuring coexistence of infrastructure, medical supplies and health care providers. Improvement in health care delivery requires a deliberate focus on quality of health services, which involves providing effective, safe, people-centred care that is timely, equitable, integrated and efficient. Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge…”

High-quality health services involve the right care, at the right time, responding to the service users’ needs and preferences, while minimizing harm and resource waste. Quality health care increases the likelihood of desired health outcomes and is consistent with seven measurable characteristics: effectiveness, safety, peoplecentredness, timeliness, equity, integration of care and efficiency

The five foundational elements critical to delivering quality health care services are health care workers; health care facilities; medicines, devices and other technologies; information systems; and financing.

This document, from the perspective of three global institutions concerned with health – OECD, the World Bank and the World Health Organization – proposes a way forward for health policy-makers seeking to achieve the goal of access to high-quality, people-centred health services for all. High-level actions are called for from each of the key constituencies that need to work together with a sense of urgency to enable the promise of the Sustainable Development Goals for better and safer health care to be realized…”

Global Health security

CGD (blog) – Global Health Security in the Trump Era: Time to Worry?

https://www.cgdev.org/blog/global-health-security-trump-era-time-worry

J Konyndyk lists the three reasons why he’s worried now, unlike much of the past year, on the US commitment to global health security.

JH Center for health security (report) – The characteristics of pandemic pathogens: Improving Pandemic Preparedness by Identifying the Attributes of Microorganisms Most Likely to Cause a Global Catastrophic Biological Event

http://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2018/180510-pandemic-pathogens-report.pdf

Unsurprisingly, respiratory viruses are far more dangerous than the ones that make headlines currently (Ebola, Zika, …), when it comes to causing a global pandemic.

See Live Science for quick & good coverage of this report.

AMR

Lancet (Comment) – Global governance of antimicrobial resistance

C Rochford, D Sridhar, Sally Davies et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31117-6/fulltext

(must-read) “Ensuring future generations have access to antimicrobials is high on the agenda for many heads of state, and almost all Ministers of Health. Following the UN General Assembly’s 2016 High-Level Meeting on antimicrobial resistance (AMR), an ad-hoc Interagency Coordination Group (IACG), co-chaired by the UN Deputy Secretary-General and the Director-General of WHO, was tasked with providing guidance to political leaders on approaches needed to promote sustainable action on AMR. … …  With just over 12 months remaining until the IACG is due to report back to the UN Secretary-General, its recommendations must seek to improve the global governance of AMR for the long term while supporting the development of a “21st-century UN”.

“… To inform the recommendations of the IACG to the UN Secretary-General, a small initial meeting of stakeholders was convened at Leeds Castle in the UK under the leadership of Dame Sally Davies, Chief Medical Officer (CMO) for England, member of the IACG, and Chair of the subgroup on SDG alignment, global governance post 2019, and the UN role and responsibilities….”

They come up in this article a Global Governance for AMR proposal.  Check it out.

PSScience also has a special issue on ‘The rise of resistance’, this week. Among others, with Worldwide emergence of resistance to antifungal drugs challenges human health and food security.

International Nurses Day – 12 May

Last week (12 May), International Nurses Day was celebrated.

I wish all readers of this newsletter (and especially health economists, Ministers of Finance and overpaid specialists : ) ) well-paid and not overworked nursing staff when they’ll need them. Sooner or later, that day will come.

Trump & access to medicines

FT Health – Trump blames ‘freeloading’ foreign countries for high drug prices

https://www.ft.com/content/5ec2c642-54b0-11e8-b3ee-41e0209208ec

News from late last week: “Donald Trump hit out at “freeloading” foreign countries that benefit from US pharmaceutical research as he launched an initiative to lower drug costs, but he stopped short of measures that would crimp American companies’ profits. Mr Trump complained that foreign countries were paying “a tiny fraction of what the medicine costs in the USA” as his officials said overseas buyers were not contributing their fair share to research and development costs. “It’s unfair and it’s ridiculous and it’s not going to happen any longer,” Mr Trump said in a speech at the White House on Friday. “It’s time to end the global freeloading once and for all.” Healthcare stocks rallied following the speech on relief among investors that the plan did not contain radical measures likely to hurt profits in the US healthcare industry, although Mr Trump did chastise the industry for its prolific lobbying….”

See also Stat NewsTrump promised to bring pharma to justice. His speech sent drug stocks soaring

& IP-Watch  Trump Declares Intent To Stop Pharma Companies From ‘Gaming’ Patent System. .

Guardian – Warning sounded over China’s ‘debtbook diplomacy’

https://www.theguardian.com/world/2018/may/15/warning-sounded-over-chinas-debtbook-diplomacy

China’s “debtbook diplomacy” uses strategic debts to gain political leverage with economically vulnerable countries across the Asia-Pacific region, the US state department has been warned in an independent report. The academic report, from graduate students of the Harvard Kennedy school of policy analysis, was independently prepared for the state department to view and assessed the impact of China’s strategy on the influence of the US in the region. The paper identifies 16 “targets” of China’s tactic of extending hundreds of billions of dollars in loans to countries that can’t afford to pay them, and then strategically leveraging the debt….”

The academics identified the most concerning countries, naming Pakistan and Sri Lanka as states where the process was “advanced”, with deepening debt and where the government had already ceded a key port or military base, as well places including Papua New Guinea and Thailand, where China had not yet used its amassed debt leverage….”

In other news on the Belt & Road, see Is China’s Belt and Road working? A progress report from eight countries  (Nikkei Asian Review).

FT – Michael Bloomberg launches China-linked rival to Davos gathering

https://www.ft.com/content/6f50198e-5793-11e8-bdb7-f6677d2e1ce8

The “New Economy Forum” focuses on the emerging world order, in a challenge to the WEF.

Michael Bloomberg is launching a rival to the World Economic Forum’s annual gatherings in Davos, aimed at addressing a changed global order in which China’s rise challenges the primacy of the US.  The financial data billionaire has enlisted two long-term China watchers, former US secretary of state Henry Kissinger and ex-US Treasury secretary Hank Paulson, to design the New Economy Forum. They have partnered with the China Center for International Economic Exchange…  … Mr Bloomberg said it would keep the guest list to 400 people, in contrast to the World Economic Forum, whose annual meeting in the Swiss mountains attracts about 3,000 people. … …
Mr Paulson said the organisers were eager to make their forum more than another talking shop. “You need to have real dialogue, not people reading talking points or giving speeches, and then you need to figure out how to advocate for those solutions,” he said, hailing Mr Bloomberg’s focus on data, results and pragmatism
….”

First meeting is scheduled for November, in Beijing.

Planetary Health

Open Democracy – The pitfalls of generational thinking

J White; https://www.opendemocracy.net/transformation/jonathan-white/pitfalls-of-generational-thinking

Recommended. “Taking collective action on climate change requires that we avoid privatising and depoliticising the problems we want to solve.”

The concept of generations has been central to the way scholars, decision-makers and activists portray the implications of climate change. International agreements enshrine ‘future generations’ as stakeholders in the decision-making of the present. Moral philosophers and economists describe ‘intergenerational’ obligations that are designed to preserve a stable environment. And climate-change science has been brought to a mass public by evoking the threats posed to our children and grandchildren. This generational framework has emerged as the pre-eminent way in which human-caused climate change is rendered intelligible in contemporary societies. But the same qualities that lend the framework its appeal are also the source of some serious tensions: its use in public debate tends to privatise and depoliticise how the future is conceived….”

Global Report on Internal Displacement 2018

Global Report;

Some of the main findings:

In 2017, there were 30.6 million new (internal) displacements associated with conflict and disasters across 143 countries and territories. “

“The ten worst-affected countries – China, the Philippines, Syria, the Democratic Republic of the Congo (DRC), Cuba, the United States, India, Iraq, Somalia and Ethiopia – accounted for more than a million new displacements each.”

 “The number of new displacements associated with conflict and violence almost doubled, from 6.9 million in 2016 to 11.8 million in 2017. Syria, DRC and Iraq together accounted for more than half of the global figure.”

“The global distribution of internal displacement mirrors the patterns of previous years. Most conflict displacement took place in Sub-Saharan Africa and the Middle East. Disaster displacement was prevalent in East Asia and the Pacific, South Asia and the Americas, regions with high disaster risk because of high levels of exposure and vulnerability.”

For coverage of this report, see Reliefweb

Irin (Analysis) – Emergency aid funding fell in 2017, even as Syria/Yemen wars drove needs higher

http://www.irinnews.org/analysis/2018/05/15/emergency-aid-funding-fell-2017-even-syriayemen-wars-drove-needs-higher

“2017 was another costly year for humanitarian aid donors, but despite huge needs in Yemen, Syria, South Sudan, and elsewhere, funding levels have stagnated. In 2017, preliminary UN figures show a drop in relief funding of $1.56 billion, or seven percent, against 2016, despite rising needs. Funding levels continue to be heavily reliant on the United States and the European Union, while an inner circle of 13 aid agencies commands two thirds of spending. Confirmed 2017 funding reported to the UN’s Financial Tracking Service (FTS) was $21.3 billion, down from $22.9 billion in 2016. … …  However, the decline shown in 2017 is in the context of a 19 percent increase in needs, according to the total price tag for the UN-managed response plans – reflecting increasing levels of need that donors didn’t keep pace with.”

IISD – GPEDC Monitoring Dashboard Visualizes Development Cooperation Data

http://sdg.iisd.org/news/gpedc-monitoring-dashboard-visualizes-development-cooperation-data/

The Global Partnership for Effective Development Co-operation’s online Monitoring Dashboard visualizes data on ten indicators that track progress on internationally agreed development cooperation principles. The tool enables users to view country-specific results, compare data across countries and regions, and examine progress and trends in different areas of development cooperation over time.

Quite a tool!

Family planning: a human right since 50 years

UNFPA – Fifty years ago, it became official: Family planning is a human right

https://www.unfpa.org/news/fifty-years-ago-it-became-official-family-planning-human-right

“… at the 1968 International Conference on Human Rights, family planning became a human rights obligation of every country, government and policymaker. The conference’s outcome document, known as the Teheran Proclamation, stated unequivocally: “Parents have a basic human right to determine freely and responsibly the number and spacing of their children.”…”

“…Until family planning is a universally available choice, this human right will not be fully realized. UNFPA and the World Health Organization have recognized nine standards that must be met in every community, for every individual….” Check them out.  Non-discrimination, available, … etc

Read also (Devex – by N Kanem (UNPF)) – Half a century on, let’s make family planning a reality for all.

“…The United Nations Population Fund is committed to ending the unmet need for family planning by 2030 and is already the world’s largest public provider of contraceptives for developing countries. …”

International Day against Homophobia, Transphobia and Biphobia  (17 May)

UNAIDS calls for strengthened partnerships to leave no one behind

http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2018/may/idahot

On the International Day against Homophobia, Transphobia and Biphobia (IDAHOT), UNAIDS is calling for strengthened partnerships to support lesbian, gay, bisexual, transgender and intersex (LGBTI) people and their families living with or affected by HIV or facing discrimination….”

UNAIDS & #MeToo

Lancet – Offline: Sexual and reproductive rights—health and hypocrisy

R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31089-4/fulltext

Coming back on the launch of the Guttmacher–Lancet Commission on Sexual and Reproductive Health and Rights for All, in South-Africa, and a question raised by Mark Heywood on Sidibé & the current crisis engulfing UNAIDS, Horton advocates for this: “…the growing schism over his leadership only shows how divided the AIDS community has become through statements and decisions that many view as ambivalent and ambiguous. There are calls for Sidibé to resign or to be fired. Neither outcome should happen. The UNAIDS Programme Coordinating Board last week issued its terms of reference for an Independent Expert Panel on sexual harassment, bullying, and abuse at the UNAIDS secretariat. The panel will deliver its report by December. UN Secretary-General António Guterres must then decide Sidibé’s fate. In the meantime, the right response should surely be that Sidibé voluntarily suspends himself during the period of this inquiry. Voluntary suspension would enable an acting Executive Director (possibly Gunilla Carlsson, who only joined UNAIDS in February) to defuse a disablingly acrimonious dispute and restore confidence in UNAIDS. Defending sexual and reproductive health and rights leaves no room for hypocrisy.”

Lancet World Report – HIV/AIDS community divided over allegations about UNAIDS

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31074-2/fulltext

(must-read) “Although terms of reference were agreed for an Independent Expert Panel on harassment, the controversy continues to divide the HIV/AIDS community. John Zarocostas reports.”

Lancet Global Health – June issue

https://www.thelancet.com/journals/langlo/issue/current

In the new Lancet Global Health issue, we want to flag among others:

Most would agree that “parasitic” research … … has no future in global health. But what about secondary data analysis?”   Based on a survey of the International Advisory Board.  Led to quite a range of answers.  The editorial concludes: “…we strongly encourage those embarking on secondary analyses to recruit, and involve at all stages of the research and publication process, suitably qualified local researchers….”

For coverage of the latter (shocking) study, see The GuardianDiscrimination kills 230,000 girls under five in India each year, study shows

Hundreds of thousands of young girls in India die every year because of “invisible discrimination”, according to research published in the Lancet Global Health. Researchers from the International Institute for Applied Systems Analysis estimate an average of 239,000 girls under five in India die each year, or 2.4 million in a decade, because of their gender….”

Key publications of the week

IJHPM – Framing the Health Workforce Agenda Beyond Economic Growth

Remco van de Pas et al; http://www.ijhpm.com/article_3500_0.html?utm_source=dlvr.it&utm_medium=twitter

New paper from my somewhat dystopian colleague. “The fourth Global Forum on Human Resources (HRH) for Health was held in Ireland November 2017. Its Dublin declaration mentions that strategic investments in the health workforce could contribute to sustainable and inclusive growth and are an imperative to shared prosperity. What is remarkable about the investment frame for health workforce development is that there is little debate about the type of economic development to be pursued. This article provides three cautionary considerations and argues that, in the longer term, a perspective beyond the dominant economic frame is required to further equitable development of the global health workforce. The first argument includes the notion that the growth that is triggered may not be as inclusive as proponents say it is. Secondly, there are considerable questions on the possibility of expanding fiscal space in low-income countries for public goods such as health services and the sustainability of the resulting economic growth. Thirdly, there is a growing consideration that economic growth solely expressed as increasing gross domestic product (GDP) might have intrinsic problems in advancing sustainable development outcomes. Economic development goals are a useful approach to guiding health workforce policies and health employment but this depends very much on the context. Alternative development models and policy options, such as a Job Guarantee scheme, need to be assessed, deliberated and tested. This would meet considerable political challenges but a narrow single story and frame of economic development is to be rejected.”

Globalization & Health (Editorial) – Reprising the globalization dimensions of international health

Ronald Labonté; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0368-3

Globalization is a fairly recent addition to the panoply of concepts describing the internationalization of health concerns. What distinguishes it from ‘international health’ or its newer morphing into ‘global health’ is a specific analytical concern with how globalization processes, past or present, but particularly since the start of our neoliberal era post-1980, is affecting health outcomes. Globalization processes influence health through multiple social pathways: from health systems and financing reforms to migration flows and internal displacement; via trade and investment treaties, labour market ‘flexibilization’, and the spread of unhealthy commodities; or through deploying human rights and environment protection treaties, and strengthening health diplomacy efforts, to create more equitable and sustainable global health outcomes. Globalization and Health was a pioneer in its focus on these critical facets of our health, well-being, and, indeed, planetary survival. In this editorial, the journal announces a re-focusing on this primary aim, announcing a number of new topic Sections and an expanded editorial capacity to ensure that submissions are ‘on target’ and processed rapidly, and that the journal continues to be on the leading edge of some of the most contentious and difficult health challenges confronting us.”

Globalization & Health – What did the Go4Health policy research project contribute to the policy discourse on the sustainable development goals? A reflexive review

V Te, Sameera Hussain, Peter Hill et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0367-4

In 2012, the European Commission funded Go4Health—Goals and Governance for Global Health, a consortium of 13 academic research and human rights institutions from both Global North and South—to track the evolution of the Sustainable Development Goals (SDGs), and provide ongoing policy advice. This paper reviews the research outputs published between 2012 and 2016, analyzing the thematic content of the publications, and the influence on global health and development discourse through citation metrics….”

Analysis of the 54 published papers showed 6 dominant themes related to the SDGs: the formulation process for the SDG health goal; the right to health; Universal Health Coverage; voices of marginalized peoples; global health governance; and the integration of health across the other SDGs. The papers combined advocacy—particularly for the right to health and its potential embodiment in Universal Health Coverage—with qualitative research and analysis of policy and stakeholders….”

The analysis offers clear evidence for the contribution of funded programmatic research—such as the Go4Health project—to the global health discourse.”

On a more negative note, the “Orban line” has become mainstream in the EU, over the same time period. And in the whole world, this doesn’t really feel like the ‘SDG era’ anymore… We live on a far more brutal planet now than just a few years ago.

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