World Cup in Russia
As you know, we tend to think that the World Cup Football is in general good – certainly in the short term – for the health of most men & women, as it brings all kinds of silly joy (as well as a few heart attacks). Even if organized in a country like Russia, not exactly a human rights paradise as you know. No doubt, the workers who helped build the stadiums can tell you a story or two (in North Korean, among others) about that.
The abundant ads for soda, alcohol, chips, football gambling, … you name it, are a different matter altogether, though, in the medium & long term, for the health of spectators. We hope – like Robert Marten on partnerships with the private sector – that global advertising will soon be “SDG-coherent”.
Finally, this, of course, should also be sky high on the agenda: “The Foul Play 2018 report” dwelled on the working conditions of garment workers who make the (Adidas & Nike) shirts of the national teams. We hope the lavishly paid football stars will start a global campaign (along the lines of the campaign ‘Respect’ on racism), to finally try to improve salaries of garment workers.
G7 Summit (or was it the G6 or G0 summit?) in Charlevoix, Canada
You probably all followed the G7 summit disaster in Canada last weekend – with the G7 communiqué eventually not endorsed by the US administration, a first in all these years of G7 summits. It appears the G7 is dead, at least for now. If that is the case, the G7 (which used to be a key actor in global health, certainly till some years ago) might become less relevant as well for global health. Charlevoix was certainly a ‘milestone’ of sorts…
You find all official documents (declarations & statements, supporting documents, …) on the Charlevoix summit here.
G7 communiqué – which, presumably, only 6 countries more or less share then:
The section on health in full:
“To support growth and equal participation that benefits everyone, and ensure our citizens lead healthy and productive lives, we commit to supporting strong, sustainable health systems that promote access to quality and affordable healthcare and to bringing greater attention to mental health. We support efforts to promote and protect women’s and adolescents’ health and well-being through evidence-based healthcare and health information. We recognize the World Health Organization’s vital role in health emergencies, including through the Contingency Fund for Emergencies and the World Bank’s Pandemic Emergency Financing Facility, and emphasize their need for further development and continued and sustainable financing. We recommit to support our 76 partners to strengthen their implementation of the International Health Regulations, including through their development of costed national action plans and the use of diverse sources of financing and multi-stakeholder resources. We will prioritize and coordinate our global efforts to fight against antimicrobial resistance, in a “one health” approach. We will accelerate our efforts to end tuberculosis, and its resistant forms. We reconfirm our resolve to work with partners to eradicate polio and effectively manage the post-polio transition. We affirm our support for a successful replenishment of the Global Fund in 2019….”
Some news & analysis related to the G7 summit
Canadian government press release – Prime Minister concludes successful G7 Summit focused on creating economic growth that benefits everyone
The official picture from the Canadian organizers: “… At the Summit, G7 leaders talked about investing in economic growth that works for everyone and preparing people for the jobs of the future. They reaffirmed their commitment to advance gender equality, defend their democracies against foreign threats, and build a more peaceful and secure world. They also discussed climate change, oceans, and clean energy. Yesterday, Canada, along with the European Union, Germany, Japan, the United Kingdom, and the World Bank, announced an investment of nearly $3.8 billion CAD to support quality education for women and girls living in crisis, conflict-affected and fragile states….”
For more on the latter, see also Canada and partners announce historic investment in education for women and girls in crisis and conflict situations
Project Syndicate – Why the G7 Is a Zero
Overall analysis on the current (dire) state of the G7. Jim O’Neill, among others inventor of the BRICS acronym puts it well: “Since its creation in the 1970s, the Group of Seven has become increasingly irrelevant in a world of new emerging powers. An institution that excludes the BRICs while still including economic basket cases like Italy cannot possibly claim the legitimacy required to exercise global economic leadership.”
“…The recent G7 circus has added to the impression that Western policymakers are incapable of getting a grip on some of the world’s most pressing issues….”
“Looking ahead, it is clear that the G20 offers a better global-governance forum than does the G7 in its current state….”
For another analysis on the current G7 constellation (by the GLI team), see Seven Up, or Seven Down: from G7 to G-Zero?.
Below we focus a bit more on two of the key focal points: gender equality & climate change.
ODI (blog) – How to deliver the G7’s ambitious commitments to gender equality and girls’ education
The gender equality focus is probably what most people will remember from the G7 summit in Canada, together with the diplomatic meltdown caused by Trump. Nicola Jones admits as such, and says “ ODI’s recent research on education, gender and social exclusion suggests seven key actions will be critical to ensuring the effective delivery of the Communique’s goals….”
Global Leadership Initiative – blogs & policy briefs on the G 7 summit
We want to draw your attention in particular to:
Policy brief – G7 2018: Making Gender Inequality History? “Feminists have long argued that gender relations need to be taken seriously as an integral element of the analysis of every social problem, rather than being ‘added on’. In Charlevoix, gender relations were genuinely at the heart of the G7 summit agenda: Prime Minister Trudeau of Canada emphasized their centrality to all five main summit themes, one of which was fully focused on ‘Advancing Gender Equality and Women’s Empowerment’. This is undeniably welcome, but as this policy brief argues, achieving true equality is about far more than simply providing better market opportunities or closing gender pay gaps. Women’s inequality is only partly about economics; rather, it reflects much deeper and often-hidden structures of power that govern society.”
Policy brief – Gender on the Agenda: A Methodological Shift in the G7 “ Gender typically occupies a peripheral role in multilateral policy discussions such as those that take place at the G7. This policy brief considers the place of gender in the G7, and in particular, the conscious move to mainstream it at the 2018 Canadian presidency of the G7. This was undertaken through the adoption of gender as an approach undercutting all other themes and negotiations.”
IISD – Six Countries and EU Reaffirm Strong Commitment to Paris Agreement, Carbon Neutrality at G7 Summit
“In the G7 Leaders’ Summit communiqué, the G7 countries affirm their collective commitment to achieve a clean environment, clean air, clean water and healthy soil, and underscore global efforts the G7 countries are pursuing towards a sustainable and resilient future that creates jobs. Canada, France, Germany, Italy, Japan, the UK and the EU reaffirm their strong commitment to ambitious action to implement the Paris Agreement on climate change and achieving a global carbon-neutral economy over the course of the second half of the century, noting the importance of carbon pricing, a just transition and increasing efforts to mobilize climate finance, among others. The US notes its belief that sustainable economic growth and development depend on universal access to affordable and reliable energy resources, among others, although President Trump indicated on twitter that the US had removed its support for the Summit Communique.”
Shanghai Cooperation Organization summit (in Qingdao, China)
Meanwhile, in Qingdao, at the Shanghai Cooperation Organization (SCO) summit, host Xi Jinping projected an image of ‘adults getting together’, as compared to the bickering kids in Canada.
The SCO has recently been expanded with India & Pakistan. Some info on the organization via Xinhua:
“Chinese President Xi Jinping Sunday called on member states of the Shanghai Cooperation Organization (SCO) to forge closer ties through people-to-people and cultural exchanges. The SCO, after 17 years, has grown into the world’s most populous comprehensive regional organization. Its full members are China, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Uzbekistan, India and Pakistan. The SCO now accounts for over 60 percent of the Eurasian landmass, nearly half of the world’s population and over 20 percent of global GDP. … … Meanwhile, the China-proposed cooperation framework of the Belt and Road Initiative (BRI), which features many flagship projects on infrastructure, finance and people-to-people exchanges, heralds greater opportunities for development. “The SCO and BRI offer mutual support and opportunities to each other, and the BRI concept has already been embedded into the SCO and are making positive progress,” said Li Jianmin, a researcher with the Chinese Academy of Social Sciences….”
As has been noted before, UN key leaders seem to take a quite positive stance towards these high-profile Chinese led organisations & initiatives. See for example this speech: Deputy Secretary-General’s remarks to the Plenary Session of the 18th Meeting of the Council of Heads of State of Member States of the Shanghai Cooperation Organization.
Cfr a tweet: “The world needs a recommitment to multilateralism. The @UN is committed to working with the #SCO towards our shared goal of creating an inclusive, resilient, peaceful & sustainable future for everyone, everywhere- ensuring no one in left behind.”
Ebola outbreak in DRC: cautious optimism
Reuters – We are still at war’ with Ebola: WHO chief
“The head of the World Health Organization (WHO) on Tuesday cautioned against declaring victory too early in Congo’s Ebola epidemic, despite encouraging signs that it may be brought under control. “The outbreak is stabilizing, but still the outbreak is not over,” WHO chief Tedros Adhanom Ghebreyesus told journalists on a visit to Democratic Republic of Congo’s capital Kinshasa. “We are still at war, and we need to continue to strengthen our surveillance and … be very vigilant.” WHO officials on Friday expressed cautious optimism that the epidemic of the deadly virus was stabilizing, partly owing to the swift deployment of vaccines.”
And from late last week (WHO) – At one-month mark in Ebola outbreak, the focus shifts to remote areas “One month into the response to an Ebola outbreak in the Democratic Republic of the Congo, the focus has moved from urban areas to some of the most remote places on earth. The shift comes after a series of unprecedented actions that have led to cautious optimism about the effectiveness of the response….”
See also Devex:
“The international community is making “significant” progress in responding to the Ebola outbreak in the Democratic Republic of the Congo, but not so much when it comes to addressing the needs of neighboring Central African Republic, WHO DG Tedros Adhanom Ghebreyesus said Tuesday.”
Some other reads, analysis & news related to the Ebola outbreak:
Erap 2 – New epidemic online platform calls for local response to Ebola
“Launched [today] in partnership between the Institute of Development Studies (IDS) and the London School of Hygiene & Tropical Medicine (LSHTM) is a new online platform, the Epidemic Response Anthropology Platform (ERAP2), building on the success of the award-winning work of the original Ebola platform (ERAP)….”
Nature (news) – Advanced Ebola tests confront Africa’s latest outbreak
Health workers battling Ebola in the Democratic Republic of the Congo can now diagnose the virus in hours, instead of days. Read why.
Stat News – With short outbreaks and complex permissions, testing critical Ebola treatments is a challenge
“The Ebola outbreak in the Democratic Republic of the Congo may end without the available experimental drugs having been tested, given the way transmission appears to have slowed. And some experts who have watched with frustration the snail’s pace progress of the efforts to study Ebola drugs during outbreaks are beginning to wonder if, with the advent of Ebola vaccines, the window for doing this kind of research may be closing for good….”
Real-time analysis of the 2018 Ebola outbreak in the Democratic Republic of Congo
For the modellers among you. As of 14 June.
Stat News – China may compete with the West for limited opportunities to test Ebola vaccine
News from late last week. “China is making a bid to use its Ebola vaccine in the Democratic Republic of the Congo. It’s a move that could further complicate efforts to test a crowded field of vaccines and therapies in the context of a waning outbreak. The head of the Chinese Center for Disease Control and Prevention (CDC), Gao Fu, is reported to have said that a team of experts will travel to the DRC on Friday, bringing with them an unspecified number of doses of vaccine. “We will seek to use the Chinese developed vaccine there to help with control and prevention of the disease, but for the present the vaccines will likely only cover Chinese living in Congo,” Gao is reported as saying in China Daily….”
Richard Horton’s take on the report of the WHO Independent High-Level Commission on Non-Communicable Diseases
Horton reckons it’s anything but a failure. And has a strong case. Read why, in his “Offline – NCDs, WHO, and the neoliberal utopia”.
Lancet Global Health (July issue) – 5th anniversary
The (recommended) Editorial of the July issue dwells on the highlights of the past 5 years and ambitions for the future of the journal.
“…In this issue, we publish Comments from five of our International Advisory Board members, who reflect on the field’s evolution over the past 5 years, and from their own personal vantage points, confirm the relevance of our focus….”
Read also in the July issue, among others:
- New opportunities for China in global health (by Lincoln Chen & Minhui Yang)
“In the 5 years since the launch of The Lancet Global Health, China has emerged as a major player in global health. In April, 2018, a new International Development Cooperation Agency (IDCA) was launched in China…”
- Global disability: an emerging issue
- Sick countries and sick individuals: reassessing the inferential targets in global health research (by S Subramanian et al)
- Antibiotic consumption in low-income and middle-income countries (Letter by R Hamers et al)
The study reports that vaccines helped decrease child mortality in developing countries from pneumococcus and Hib between 2000-2015. “…The widespread use of Hib vaccine and the recent introduction of PCV in countries with high child mortality is associated with reductions in Hib and pneumococcal cases and deaths….” (for the exact figures, see the study). Good news for GAVI as well, in other words, but a lot still remains to be done.
HP&P – Cuba’s health system: hardly an example to follow
As HP&P advertised on Twitter: “We have a brand new set of #Cuban #healthsystem related papers available… Commentaries & Replies, a very interested read! Topics include #repression #longevity #infantmortality #politics #health”
#Dynamite. Guess the last word has not been said yet on this.
“…Building on the commentary on infant mortality and longevity in Cuba published in this issue of HealthPolicy andPlanning, I would like to discuss three statements: (1) Enthusiasm around the Cuban health system often stems from an exclusive attention to one indicator, infant mortality rate (IMR), the value of which has been manipulated by a state seeking political legitimacy. (2) The overall performance of the Cuban health system, measured by progress in health conditions, has been overrated. (3) Some of the health achievements in Cuba have been attained at the expense of basic rights.”
But check out also the other reads, for example: Cuban infant mortality and longevity: health care or repression?
“Move Humanity is a new global initiative aiming to establish SDG-focused philanthropy as a global norm. It highlights the power and potential that the world’s wealthiest individuals can have by donating just 1% of their wealth each year to addressing this century’s most pressing challenges. The initiative aims to help close the SDG financing gap in the lowest income countries by mobilizing greater private funding for basic health and education, critical infrastructure, and environmental conservation priorities. The initiative is a partnership between the UN Sustainable Development Solutions Network (SDSN) and Human Act, a Copenhagen-based NGO….”
Health Policy Watch – CDC Head Redfield: Long-Term Investment In Global Health Security Most Critical
“The recently named director of the US Centers for Disease Control and Prevention (CDC), Robert Redfield, told a gathering of global health experts this week that the most critical investment that can be made is in global health security, with the recent fast response to the Ebola outbreak in the Democratic Republic of the Congo the example. …”
He stressed that the world needs to “keep its eye on the ball” especially on pandemics and AMR.
Science Speaks – House bills reject Trump retreat from U.S. leadership of global infectious disease responses
“Brushing aside White House proposals to cut global HIV and other international disease response funding, members of the House Appropriations Labor, Health and Human Services, Education and Related Agencies Subcommittee released a bill set to be finalized Friday, reflecting steadfast, and in some cases growing support for research, preparedness and response efforts to control the impacts of infections and outbreaks worldwide….” All the detail in this short article.
Bill & Melinda Gates Medical Research Institute
Stat – The Gates Foundation rolls out details of its new biotech, one without a profit motive
See also last week’s IHP news.
BMJ (Editorial) – Global health engagement with North Korea
John Park, Rifat Atun et al; https://www.bmj.com/content/361/bmj.k2547
After Trump’s meeting with Fat Boy Kim, we hope for the best (while expecting the worst : ) ).
The authors of this editorials see a rare chance to improve the health of a hard to reach population.
Global Fund update
Check out the latest issue of the Global Fund Observer:
“The Global Fund has made considerable progress in many areas, the Office of the Inspector General says in its 2017 annual report, and has reached a point where many of the remaining challenges are beyond the ability of the Fund, acting alone, to resolve. Supply chain issues and quality of services top the list of challenges.”
“Now that the respective headquarters of Gavi and the Global Fund will be located together in the Global Health Campus in Geneva, cooperation between the two organizations will intensify. There has already been considerable collaboration between the two organizations. Donors are supportive of joint activities among global health funds….”
CRISPR – A serious new hurdle for CRISPR: Edited cells might cause cancer, two studies find
“Editing cells’ genomes with CRISPR-Cas9 might increase the risk that the altered cells, intended to treat disease, will trigger cancer, two studies published on Monday warn — a potential game-changer for the companies developing CRISPR-based therapies. In the studies, published in Nature Medicine, scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the potential to seed tumors inside a patient. That could make some CRISPR’d cells ticking time bombs, according to researchers from Sweden’s Karolinska Institute and, separately, Novartis….”
Guardian – Paraguay is first country in Americas to eliminate malaria in 45 years
“Paraguay is officially free of malaria, the World Health Organization (WHO) said on Monday, making it the first country in the Americas in 45 years to have wiped out the deadly disease which is back on the rise globally….”
UN News – Everyone has ‘a moral imperative’ to uphold the rights of persons with disabilities, says UN chief
“Cementing and protecting the rights of around 1.5 billion people around the world in accordance with the Convention on the Rights of Persons with Disabilities is a “moral imperative” said United Nations Secretary-General António Guterres on Tuesday. He was addressing a conference of signatories to the Convention at UN Headquarters in New York, describing it as one of the most widely-ratified international human rights treaties, which reaffirms that people with disabilities are entitled to the same treatment as everybody else.”
International Men’s health week (11-17 June)
Excellent timing this year, as the World Cup was about to begin.
Devex World – annual meeting on the future of development
“For an industry better known for furnishing donor-funded projects with expert consultants, producing authoritative reports or advising governments on how to develop, a surprising bulk of the most cutting-edge thinking — and the most transformative products and services — is emerging from organizations willing to admit what they don’t know. For many of the leaders and organizations who brought their visions of the future of development to Devex World, that willingness to challenge orthodoxy — and to relinquish some control of the agenda — begins with letting go of development “beneficiaries” and finding better ways to serve development “consumers.”
… The organizations and companies that are applying this consumer-based approach to development have the potential to transform the choices available to people living in some of the most impoverished parts of the world. For development donors and their implementing partners, a shift from designing and delivering programs for “beneficiaries” to designing products and services for “consumers” begs some hard questions. … … Donor-driven health and development programs still tend to privilege risk-avoidance and control over responsiveness to a broad and diverse base of development “consumers,” said Karl Hoffman, president and CEO of PSI….”
Nature – Sexual harassment is rife in the sciences, finds landmark US study
“Existing policies to address the issue are ineffective, concludes a long-awaited report from the National Academies of Sciences, Engineering, and Medicine.”
“Sexual harassment is pervasive throughout academic science in the United States, driving talented researchers out of the field and harming others’ careers, finds a report from the US National Academies of Sciences, Engineering, and Medicine in Washington DC. The analysis concludes that policies to fight the problem are ineffective because they are set up to protect institutions, not victims — and that universities, funding agencies, scientific societies and other organizations must take stronger action….”
“…The most common type of sexual harassment is gender harassment, the report finds. Such behaviour conveys the impression that women do not belong in the workplace or do not merit respect — “the put-downs as opposed to the come-ons”, Johnson says. These actions might seem minor but can seriously affect the person targeted. She says that they also set the stage for the other types of sexual harassment: unwanted sexual attention and sexual coercion….”
UN News – Prevention is key to ‘breaking the cycle of HIV transmission’, UN chief tells General Assembly
“This year’s United Nations annual debate over how best to battle HIV and AIDS heard that while progress had been made, it remains “uneven and fragile” with many hurdles still to come.”
See also Health Policy Watch – Big Drop In AIDS-Related Deaths But Uneven Progress On Ending Disease, UN Says
See also a Science Editorial – HIV—No time for complacency. And a Science article – Far from over “…. A unique package of graphics looks at HIV/AIDS around the world using five different metrics: How many people are living with HIV? What is the rate of new infection? What percentage of infected people are receiving antiretroviral drugs, which both stave off disease and prevent transmission? How many infected people have progressed to AIDS and how many have died from it? And how many children are infected by their mothers? By these gauges, Nigeria, Russia, and Florida stand out from their neighbors and, in some cases, the entire world.”
Preparations for UN High-Level meeting on TB
Politico Pro- Draft EU Declaration: EU, US push against funding, delinkage pledges
(gated) “The E.U. and U.S. are resisting concrete commitments on new funding for tuberculosis ahead of a high-level U.N. meeting about fighting the world’s top infectious killer. The two regions are also pushing to eliminate language that would urge countries to work to separate the cost of R&D from the price of a drug — so called delinkage — according to a draft of the political declaration to be signed by heads of state at the U.N. General Assembly on September 26…”
Guardian – Yemen port city gripped by panic and fear as Saudi-led forces close in
“On Wednesday, the Saudi-led coalition backing Yemen’s exiled government began an assault on the port (Hodeidah), a vital lifeline for the humanitarian aid that sustains the majority of the population. About 80% of Yemenis are in need of humanitarian assistance and 8.4 million are on the brink of famine. … … The UN children’s agency, Unicef, said the assault could endanger the city’s 300,000 children and “choke off” aid for millions more. Other aid agencies have warned of “catastrophic” consequences for a country in the midst of what the UN has called the world’s worst humanitarian crisis….”
See also the NYT – Humanitarian Crisis Worsens in Yemen After Attack on Port.
Guardian – Argentina congress takes historic step towards legalising abortion
“The lower house of Argentina’s congress has narrowly approved a bill that would legalise abortion in the first 14 weeks of pregnancy in what has been described as a historic move. The bill was narrowly passed by the chamber of deputies by 129 to 123 votes on Thursday and will now go before the senate. Argentina’s president, Mauricio Macri, has said he will sign it if it is approved. The vote in favour means the homeland of Pope Francis could become one of Latin America’s most progressive countries on reproductive rights….”
Earlier this week, a Lancet World Report had looked ahead:
Lancet (World Report) – Argentina votes on bill to legalise abortion up to 14 weeks
“The vote marks a shift in culture in Argentina, powered by grassroot activism spanning South America. Amy Booth reports from Buenos Aires. Argentine deputies are debating a bill that would legalise unrestricted abortion up to 14 weeks. If approved, the law would be a huge step towards reducing maternal deaths and could influence the reproductive rights debate throughout Latin America—but victory is far from assured….”
NPR Goats & Soda – Trump’s Ban On Funding For Overseas Abortions Has Some Little-Known Exceptions
“… the [Trump] administration has actually included several exceptions to the [global gag rule ] policy — essentially a list of conditions under which a group that accepts U.S. aid money can still refer clients to an abortion provider. Now several advocacy groups that oppose the policy are trying to spread the word. Among them is the Washington, D.C.-based group Center for Health and Gender Equity, or CHANGE, which released this month a report that includes an analysis of these exceptions….”
Euractiv – EU to hike migration spending in development aid overhaul
“The European Commission [will] set out its plans to dramatically increase spending on migration control on Thursday (14 June), as part of its overhaul of EU development spending between 2021 and 2027. The Commission [will] unveil its Neighbourhood and the World Instrument, merging the bloc’s external spending into a single instrument. EURACTIV understands that the proposal is set to assign around €9 billion to migration-related spending, with the money to be drawn from across different budget lines. That has prompted concerns from NGOs that this figure could be subject to political horse-trading among governments. The Commission insists that the next seven-year budget will significantly increase the amount that the bloc spends on development, proposing to allocate a total of €123 billion. That will include the €30 billion European Development Fund, which had previously been an instrument controlled by member states outside the EU budget. However, civil society groups fear that the MFF will see the EU downgrade its development priorities in pursuit of any measures that will reduce the number of people from Africa and the Middle East seeking to reach Europe. The EU executive insists that migration control can be justifiably considered as a tool in development….”
See also Euractiv – EU unveils increased foreign aid budget for 2021-27. “The European Commission has defended its plans to overhaul its foreign spending budget, promising that it would deliver a large increase in aid spending and ‘eliminate bureaucratic barriers’.”
“…The Commission’s focus on migration has prompted a number of development NGOs and MEPs to complain that the EU wants to downgrade its development priorities in favour of migration control….”
“…the increased flexibility has also prompted concerns among civil society groups. “Clear rules for transparency, governance and predictability are needed to counterbalance the proposed flexibility for aid spending. As it stands, the EU will be able to divert money to its own interests more easily,” said Oxfam’s EU Policy Advisor, Hanna Saarinen….”
IISD – UN Releases Zero Draft on Modalities for Universal Health Coverage Meeting
“The co-facilitators of negotiations towards a High-Level Meeting on universal health coverage have released the zero draft of a UN resolution outlining proposed modalities of the meeting, which is to take place in 2019. The zero draft indicates that the High-Level Meeting is planned as a one-day event, with plenary segments and multi-stakeholder panels on the overall theme of ‘Universal Health Coverage: Together for a Healthier World’.”
For more, see UN.
Global Health Science & Practice (Editorial) – At Last! Universal Health Coverage That Prioritizes Health Impact: The Latest Edition of Disease Control Priorities (DCP3)
James D Shelton; http://www.ghspjournal.org/content/early/2018/06/11/GHSP-D-18-00193
“Sadly, we face a vast sea of health problems in global health. Universal health coverage programming should prioritize interventions with the most health impact, but instead largely succumbs to emphasizing less impactful clinical curative services. In contrast, DCP3 provides an evidence-based template that prioritizes impact. Yet even the most basic and realistic DCP3 package comes at a formidable price.”
Must-read. Interview with Kickbusch on how she sees her role for UHC 2030 & how UHC 2030 should evolve in the years to come.
Lancet (Editorial) – Untangling the complications of diabetes
This week’s Lancet issue has a focus on diabetes. “The Global Burden of Disease 2016 study reported diabetes to be the twelfth leading cause of disability globally and attributed nearly 1·5 million deaths to diabetes worldwide. Other studies estimate that the number of people living with diabetes today ranges from 415 million to 425 million, with a projection of as many as 700 million people living with the disease by 2025. Ageing populations, increasing urbanisation, and widening social inequalities are all contributing factors to the rapid rise in diabetes prevalence seen over the past 40 years. In the era of the UN Sustainable Development Goals, reducing premature mortality from non-communicable diseases, including diabetes, has become a global priority.”
“…People with diabetes are leading longer lives. As mortality from cardiovascular complications continues to decline, attention must be turned to identifying, preventing, and treating other diabetes complications. There is no scope for complacency in diabetes care. Understanding and managing complications associated with the disease must become a clinical and public health priority.”
Key publications & papers
Oxfam briefing note – Doubling down on DRM
“Education, health, sanitation, infrastructure and other critical public services are severely underfunded in many countries each year. A major reason for this shortfall is weak collection of tax and non-tax revenues – also known as Domestic Revenue Mobilization (DRM). In 2015, developing country governments and international donors made three political commitments to strengthen DRM, as part of the Addis Tax Initiative (ATI). This report assesses the donor “track record” since ATI commitments were made in 2015. … … Below are some of the key findings: 1. Donors are not on track to meet their commitment to double support for DRM. Support increased from 2015 to 2016, but only by $7.1 million (a 5 % increase) 2. A commitment to equity is absent or unclear in most DRM projects. … … 3. Gender equity is largely neglected. …. 4. Country Ownership is far too weak; trending in wrong direction. … … 5. Support for broader accountable public finances has decreased. Aid for complementary sectors (such as public financial management and anti-corruption) in Sub-Saharan Africa, the largest recipient of DRM aid, declined by $203 million in 2016. 6. The role of multilateral institutions is increasing. … 7. There is too little qualitative information on DRM strategies and interventions, including for multilateral institutions and Southern providers (e.g. China).”
Public–private partnerships in practice: collaborating to improve health finance policy in Ghana and Kenya
L Suchman, D Montagu et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czy053/5037236
“Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public–private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why. Drawing on semi-structured interviews conducted with National Health Insurance (NHI) officials in Kenya and Ghana, as well as with staff from several international NGOs (INGOs) representing social franchise networks that are partnering to increase private provider accreditation into the NHIs, this article examines one example of public–private collaboration in practice…”
Health & Place – How extractive industries affect health: Political economy underpinnings and pathways
Ted Schrecker et al; https://www.sciencedirect.com/science/article/pii/S1353829217311966
Highlights: “We present an innovative approach to the health effects of extractive industries, adopting a broader than usual definition of these industries. Drawing on four case examples, two of them region-specific and two considered in global context. We posit five generic pathways to health outcomes. Situate those pathways in the context of the global political economy of extraction, in order to. Identify key issues and priorities for future research in a neglected field.”
Medicine Anthropology Theory – Drone philanthropy? Global health crowdfunding and the anxious futures of partnership
Nora Kenworthy; http://medanthrotheory.org/read/10614/drone-philanthropy
“This piece explores some of the dynamics of global health crowdfunding by examining the work of Watsi, a highly successful crowdfunding platform that raises funds to cover the costs of medical care for patients in countries throughout the global South. While Watsi relies on a somewhat traditional formula for fundraising that uses individual patient stories to attract donations, its origins, aims. and values reflect an imagined (and perhaps, probable) future of global health partnerships. What relationships and connections are enabled in this future space? What subjectivities, anxieties, and values are brought to the fore by Watsi’s modes of work? And what forms of intimacy and estrangement are enabled by such connections and relations? Watsi represents, I argue, a new kind of ‘drone philanthropy’ that both disrupts and evokes older forms of partnership, affiliation, and connection among donors, organizations, and individual recipients of aid.”
BMJ Global Health – Pharmaceutical quality assurance of local private distributors: a secondary analysis in 13 low-income and middle income countries
K Van Assche, Ariadne Nebot Giralt, B Meessen, Rafaella Ravinetto et al; http://gh.bmj.com/content/bmjgh/3/3/e000771.full.pdf
“The rapid globalisation of the pharmaceutical production and distribution has not been supported by harmonisation of regulatory systems worldwide. Thus, the supply systems in low-income and middle-income countries (LMICs) remain exposed to the risk of poor-quality medicines. To contribute to estimating this risk in the private sector in LMICs, we assessed the quality assurance system of a convenient sample of local private pharmaceutical distributors…” Findings from a QUAMED database.
Plos Med (Policy Forum) – The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties
“In a Policy Forum, Peter Hotez and colleagues discuss vaccination exemptions in United States states and possible consequences for infectious disease outbreaks.”
WB Working Paper – Going Universal in Africa : How 46 African Countries Reformed User Fees and Implemented Health Care Priorities
“This paper describes the health financing policies used today by African countries to expand health coverage. It identifies key health financing policies used by African countries and measures the existence of regional patterns in the use of these policies. The paper does not attempt to identify best practices, nor does it try to measure the effective coverage of the policies or their impact. Rather, it aims to add value to the existing literature by providing a systematic portrayal of the health financing policies that are in place across the region. The study concludes with a discussion about the implications of its findings for planning next steps to advance universal health. The rest of the paper is organized as follows. Section 2 describes the conceptual framework and methodology used in the study. Section 3 describes the different paths chosen by African countries to expand health coverage. Sections 4 and 5 describe the two key instruments used in that journey: the universal basic package of health services and the subpopulation health coverage programs. Section 6 reviews in detail some of the technical instruments required for the successful implementation of these policies. Section 7 uses the findings of the paper to discuss the cost estimations of implementing a broader benefit package to advance universal health coverage. The paper concludes with a summary of the findings and their implications.”
Report – SDGs, health and the G20: a vision for public policy
S Neupane, I Kickbusch et al; http://www.economics-ejournal.org/economics/journalarticles/2018-35
“Ensuring ‘health for all’ remains a persistent and entrenched global challenge. G20 governments are in a position to elevate the priority accorded to health, and acknowledge the centrality of health to attaining the SDGs. The authors call on G20 leaders to build nations that are more inclusive and less divided, by: adopting a Health- in-All-Policies approach, prioritizing the most vulnerable, engaging citizens in policy processes, and filling health data gaps.”
BMJ Editorial – Food for thought
The BMJ launches a series of articles examining the science and politics behind our understanding of nutrition and health.
Check out for example:
Tobacco control -Tobacco industry’s elaborate attempts to control a global track and trace system and fundamentally undermine the Illicit Trade Protocol
“The Illicit Trade Protocol (ITP) requires a global track and trace (T&T) system to reduce tobacco smuggling. Given the tobacco industry’s (TI) historical involvement in tobacco smuggling, it stipulates that T&T ‘shall not be performed by or delegated to the tobacco industry’. This paper explores the rationale for & nature of the TI’s effors to influence the ITP & its T&T system….”
“Growing & diverse sources of evidence indicate that the TI remains involved in tobacco smuggling and that TI cigarettes account for around two-thirds of the illicit cigarette market. The TI therefore has a vested interest in controlling the global T&T system aimed to curtail this behaviour….”
For coverage, see The Guardian – Tobacco industry seeking to control anti-smuggling measures, say critics. “ The tobacco industry is working to secure control of a system to track the movement of cigarettes around the world, allegedly because it is complicit in the smuggling of its own products, according to a new research paper. A detailed study from the Tobacco Control Research Group at the University of Bath, using a range of sources including internal documents and whistleblower testimony, claims the industry is now going to elaborate lengths to control the global “track and trace” system that the United Nations has said must be put in place to counter smuggling.”
Some key articles, op-eds & blogs
Stat News – Nurses play vital roles in health care. Why are they invisible in the media?
C Myers; Stat News;
Good question. Because Tim Evans can’t shut up, of course : )
The op-ed is based on updated research. “… These findings are consistent with the results of other studies, which together show that most conversations in the public sphere are echo chambers with the same narrow range of white male voices dominating. It is hard to ignore the relative absence of nurses and the fact that 90 percent of nurses are female….”
“… Nurses are not viewed as experts or as key leaders, and so are not good sources. The lack of nursing representation in the media is part of deep-rooted gender disparities in the media. In the other direction, contacts at health care organizations, academic institutions, and nursing associations do not promote nurses as subjects for stories on health and health care or sources for them….”
Andrew Harmer (blog) – Governing the global health system: a critical review
In this blog, Harmer (critically) reviews “Governance Challenges in Global Health” (2013, NEJM), by Julio Frenk & Suerie Moon. A must-read.
Teaser: “…Alarmingly, a June 2018 study in Advances in Atmospheric Sciences found that most computer models predict that 4 degrees of warming is inevitable, they just disagree about when it will happen. Crucially, the median year is 2084! I don’t want to downplay the seriousness of the smorgasbord of health threats Frenk and Moon identify but if we are going to start thinking about global health systems, then we should probably focus on the one challenge that’s about to plunge us into the abyss….” Climate change, yes.
Philanthropy Must Connect the Planet’s Health and Human Health
G Fitzgerald et al; Philantropy;
“…The majority of philanthropic funding still sits within such traditional silos as health, environment, or development. Only limited funding has been made available for activities that intentionally and efficiently deliver benefits in both areas. Our organizations have just issued a report that examines the grant-making landscape and identifies foundations that have invested across health and the environment to date….”
Plos (blog) – What does progress look like in global health?
S Venkatapuram; Plos blog;
“…The resurgence of Ebola and potential repeat of the horrors that occurred during 2014-16 juxtaposed with the visible excitement of national delegates at #WHA17 and the sheer number of advocates of diverse health issues raises the question, what does progress look like in global health? Is the transformation of the WHA from what used to be a relatively boring annual meeting of health ministers into an industry jamboree like event progress? … … My own preferred approach is to focus on the metric of social justice; is all this activity in global health realizing more or less social justice?... “
More in particular, on issues like UHC, “…For many years, we have left such important value decisions and, indeed, important national and global policy levers of social justice in the hands of people who saw themselves as health technocrats. Perhaps, one sign of progress in global health is that we have come to see that health is not just a technical issue, and indeed, that much of it is a result of social choice….”
Coming up – Conference: Sustainable AIDS Response Results in the Era of Shrinking Donor Funding (July 20-21, Amsterdam)
“The International AIDS Economics Network (IAEN) provides a mechanism to debate and inform the vital economic and policy steps necessary to address HIV and AIDS globally. … The aim of this joint initiative from IAEN, UNAIDS, Avenir Health, Bill & Melinda Gates Foundation, and the World Bank, in collaboration with other partners is to focus on “Sustainable AIDS Response Results in the Era of Shrinking Donor Funding,” including a range of topics related to HIV programs and economics, the broader interface with Health Financing and development frameworks. The IAEN pre-conference is one of the only dedicated global events that convenes economists and health and AIDS response policy makers to focus on accelerating progress in countries towards sustainable financing of the HIV response. …”
The preliminary program looks very exciting.