Annual letter Bill & Melinda Gates + coverage & political analysis
Must-read. Check out some of the key stats & figures listed by the Gateses this year. They zero in on 3 investment areas this year: vaccination, contraception, and nutrition.
As Thomas Pogge quipped on Twitter: “Warren Buffet asks Bill & Melinda Gates to reflect on BMGF spending decisions. They respond with an infomercial.” (PS: Buffet put a lot of his fortune into the Gates Foundation in 2006, so ten years later he thought it’d be good to get an overview of the Foundation’s impact – and Bill & Melinda clearly also thought so).
Must-read coverage & analysis of this annual letter
Stat news – Bill and Melinda Gates make the case for vaccines — and US engagement in global health
Helen Branswell provides the (important) political background. “Bill and Melinda Gates’ annual letter about the work of their philanthropic foundation is styled as a report to Warren Buffett, the business tycoon who has donated billions to their endeavor. But reading between the lines of the report, which was released Tuesday, leaves the impression these philanthropists — among the world’s wealthiest people — are making a subtle effort to influence the Trump administration’s thinking on the value of global development and international aid. The letter stresses the importance of vaccines, calling them one of the best deals in global health spending. It also emphasizes how critical it is that women around the world have access to effective contraception, saying family planning lowers child mortality and enables countries to emerge from poverty. Both could be areas of contention with the new administration.”
Important also: “…The general tone of the letter is optimistic, celebrating steady and substantial declines over the last quarter century of the number of children worldwide who die in early childhood and a sizable increase in the number who are receiving basic childhood vaccines….”. And they end by saying that doomsayers will be proven wrong.
Still, it’s a qualified optimism (as also became clear in some of the media interviews by Bill & Melinda this week), given the international political environment (especially in the UK & US).
Humanosphere – Bill and Melinda Gates celebrate humanitarian investments in letter to Warren Buffett
Also a must-read. Focusing on the “difficult waltz” of the Gateses versus the Trump administration.
Among others: “… Perhaps in part because they recognized the official letter may sound a little, well, lacking in context, Bill and Melinda granted interviews with select media to speak out against the Trump Administration’s reinstatement of the so-called ‘global gag rule’ prohibiting recipients of U.S. foreign aid money to promote or provide abortion services. The foundation and other philanthropies are unable to fill the family planning funding gap left by the rule. “We’re concerned that this shift could impact millions of women and girls around the world,” said Melinda Gates, to the Guardian. “It’s likely to have a negative effect on a broad range of health programs that provide lifesaving treatment and prevention options to those most in need. This includes programs that prevent and treat HIV, TB and malaria, and provide healthcare to women and children around the world.”…”
Some quick links related to the Gates annual letter & this week’s media campaign:
Project Syndicate – Learning from Bill Gates
For once, I sort of agree with Lomborg (although there are also many things we shouldn’t learn from Bill).
Guardian (Sarah Boseley) – Trump’s ‘global gag rule’ could endanger millions of women and children, Bill and Melinda Gates warn
Seattle Times – Sell Trump on foreign aid? Melinda Gates vows to try
Global Fund update
NYT – A Contentious List of Finalists for Global Aid Fund Group’s Director
Clearly a must-read. “ Three candidates to become the next director of the Global Fund to Fight AIDS, Tuberculosis and Malaria are likely to draw harsh scrutiny from the fund’s largest donor, the United States. The nominating committee of the fund’s board on Monday produced a report naming the three finalists and its rationale for picking them. A copy of the report was made available to The New York Times. The finalists, selected from a preliminary list of nine, are: Dr. Muhammad Ali Pate, a former health minister of Nigeria; Subhanu Saxena, a drug executive who in August stepped down as chief executive of Cipla, a major Indian pharmaceutical company; and Helen Clark, a former prime minister of New Zealand who ran the United Nations Development Program. …
On the T-question: “… Several people familiar with the fund’s search for a director expressed dismay over the choices, worrying that each might jeopardize support from the United States, but none would speak for attribution. One described himself as distressed; another worried that the candidates had not been adequately vetted. Seth Faison, a spokesman for the fund, argued that no candidate should withdraw. “Lots of people said things about Trump during the campaign that now are working with him,” he said of Dr. Pate.”
Exactly. The more they dislike Trump’s values (and those of the crew around him), the better. Time for a different Global Fund funding model anyway.
GFO – new issue
A must-read issue this week.
Check out especially:
Analysis (by Charlie Baran) – Global health financing mechanisms: synergy, duplication and distinction “The strategic objectives, recipients and donors of four major multilateral health financing mechanisms have a lot in common. Is it too much?”
Trump & global health
Laurie Garrett on global health – newsletter last week
As already mentioned in the introduction, this is a key read.
“For many years, I have warned that what we call global health—along with humanitarianism, climate change mitigation, development, and food programs—was in grave danger. Having hitched their wagons to globalization, broad humanitarian missions—chiefly financed by the U.S. and UK governments and U.S. private interests—were overly vulnerable to political change in the United States and United Kingdom. After the 2008 financial crisis and the subsequent euro crisis, the volume of my warnings increased, as the pool of major donors to such efforts shrank and dependency on the United States and Bill Gates grew. I sent personal letters in 2008 to several leaders of major multinational health organizations, urging them to prepare for catastrophic losses in donor support and a far-right takeover of the U.S. government. That moment has now come…. ”
“…Here is the bottom line, which I deliver with a knot in my gut: all global public goods will now face dire, even existential, financial and political threats as they become secondary victims to the general assault on globalization and liberalism. …”
Check out also the section at the bottom – “The WHO faces the music’.
JAMA (viewpoint) – Should the Definition of Health Include a Measure of Tolerance?
Robert Brook; http://jamanetwork.com/journals/jama/fullarticle/2601506
I have a hunch this viewpoint was “inspired” by the political turmoil in the West. Provocative (even if a bit nutty) stance. “…I believe it is time to expand the WHO’s definition of health to include acceptance and tolerance. It is time to apply that new definition at the population and individual level. No community or nation should be considered healthy if hatred is pervasive. Nor should any individual be considered healthy if he or she is intolerant….”
Silly idea – but nice ‘out of the box’ thinking!
Inside Philantropy – Gag Reflex: Melinda Gates isn’t the only funder worried about the Mexico City Policy
Overview of who else is (or should be) worried.
The conclusion: “…Some may argue that philanthropic organizations and private donors could step in to fill what will likely be a gaping hole left should the U.S. pull its funding. Surely, the pressure will be on for them to do so and many will do more. But after looking at the numbers, it’s clear the funding gap is way beyond what private donors could fill.” And yes, Bill Gates already confirmed that the Foundation won’t be able to fill the gap left by the Trump administration.
See also US News & World Report – Global Gag Order Leaves NGOs Confused, U.S. Agencies Scrambling.
“Australia [today] announced $9.5 million Australian dollars ($7.3 million) in funding for the International Planned Parenthood Foundation. The move was seen by many as a pointed rebuke to President Donald Trump’s controversial reinstatement of a strengthened “global gag rule,” which bars any foreign NGO that offers or advises on abortion from receiving U.S. funds….”
Guardian – UK to host summit seeking extra funds for family planning
“Britain will lead efforts to secure extra funding for family planning at an international summit in London, ministers have said, amid concern about Donald Trump’s decision to ban US financial support for organisations involved in abortion services overseas. Priti Patel, the international development secretary, said the summit would take place in July, and the UK was aiming for a “step-change on family planning”.” It will be held in cooperation with the UN and the Bill and Melinda Gates Foundation.
WHO – Nine countries commit to halve maternal and newborn deaths in health facilities
“[Today], 9 countries – Bangladesh, Cote d’Ivoire, Ethiopia, Ghana, India, Malawi, Nigeria, Tanzania and Uganda – committed to halving preventable deaths of pregnant women and newborns in their health facilities within the next 5 years. Through a new Network for Improving Quality of Care for Maternal, Newborn and Child Health, supported by WHO, UNICEF and other partners, the countries will work to improve the quality of care mothers and babies receive in their health facilities. This Network aims to strengthen national efforts to end preventable deaths by 2030, as envisioned by the Every Woman Every Child Global Strategy for Women’s, Children’s and Adolescents’ Health.”
Lancet Global Health (Comment) – The Global Maternal and Neonatal Sepsis Initiative: a call for collaboration and action by 2030
By the Global Maternal and Neonatal Sepsis Initiative working group; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30020-7/fulltext
“…Considering the importance of effective prevention, identification, and management of maternal and neonatal sepsis in reducing maternal and newborn deaths, WHO and Jhpiego have launched the Global Maternal and Neonatal Sepsis Initiative. This initiative consists of a broad programme of work that will be delivered through a collaborative and innovative approach combining research, innovation, service delivery programming, and advocacy. Working at the global, national, and health-care facility levels, the Initiative will identify strategic opportunities to increase and strengthen the response to maternal and newborn sepsis….” Check out the Initiative’s vision, goals, priority areas of work, and objectives.
UNAIDS – Plan to increase CHWs endorsed
“Economic experts and representatives of national AIDS programmes, health ministries and health professional organizations endorsed the creation of a global coalition of community health workers in UNAIDS-convened consultations in New York, United States of America, on 9 and 10 February. Community health workers bring cost-effective services to communities and increase service access for marginalized people, who often struggle to access essential health services. More than 6 million community health workers are already in place across the world. However, many are unpaid and are typically not fully integrated into health systems. The participants called for an urgent initiative to recruit, train and deploy at least 2 million community health workers over the next two years to drive progress towards the 90–90–90 targets—whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads—and to lay the foundation for sustainable health for all….”
Lancet Global Health – March issue
Great issue this month. Worth to check it out thoroughly. Some must-reads, out of the articles which didn’t yet appear early online:
Editorial – Surprise us, Mr Trump. (he will – for the worse)
Socioeconomic status and risk factors for non-communicable diseases in low-income and lower-middle-income countries (Comment by S Stringini, related to new research)
Leaving no one behind: can the Family Planning Estimation Tool help?
Evolving migrant crisis in Europe: implications for health systems (by Manuel Carballo et al)
The Ebola suspect’s dilemma.
Science (news) – Science journals permit open-access publishing for Gates Foundation scholars
“If research funders demand open-access publishing, will subscription journals acquiesce? An announcement today by the publisher of Science suggests they will — as long as that funder is as influential as the Bill & Melinda Gates Foundation. The global health charity, based in Seattle, Washington, has partnered with the American Association for the Advancement of Science (AAAS) in a year-long agreement to “expand access to high-quality scientific publishing”. This means that Gates-funded research can be published on open-access (OA) terms in Science and four other AAAS journals….” “The provisional agreement may set a precedent for other funders and journal publishers.”
WHO DG election
Lancet (Correspondence) – Next WHO Director-General: hear the angels while fighting the wolves
Lovely title & ditto article. Pang forgot about the hyenas and the sharks, though. “Much has been written about the technical, political, and managerial skills the new Director-General of WHO needs and which issues should be prioritised. After serving under three WHO Director-Generals, I believe that the next Director-General should also have personal qualities of courage, independence, decisiveness, integrity, and vision.”
Where does the quote come from? “The next Director-General needs to recognise and uphold the strengths of WHO and effectively use the power of his or her office to full advantage. In a tribute to Lee Jong-wook, World Bank President Jim Yong Kim described Lee Jong-wook as someone who can “hear the angels while fighting the wolves. He could run with the wolves: the tough, self-serving ruthless bureaucrats and politicians who often crossed his path. He knew how they thought, often before they knew themselves, and he could run circles around them. But he also heard the angels who never let him forget the pain and suffering of the poor””
Coming up – Political Leadership for Global Health: a moderated discussion with the WHO DG candidates (6 March, Graduate institute)
The event will be live webcast. You can submit questions on Twitter using #WHODGquestion. But only from 00:00 on 23 February 2017 to 23:59 on 1 March 2017.
There was also some Twitter discussion this week on the human rights track record of the three candidates. You might want to check out the –rather blunt/too provocative? – tweets of “The Right to Health”. Even grades were handed out. They all failed. Still, in a world that fails big time as well on human rights (just ask the likes of Trump and even Obama & Merkel et al how they’re/were doing), it’s probably no coincidence. So you wonder to what extent candidates can thus be fully blamed if they’re not as outspoken on human rights as one would like sometimes.
In any case, we hope to see some of these question pop up at the moderated discussion on the 6th of March.
BBC News – Ebola ‘super-spreaders’ cause most cases
“The majority of cases in the world’s largest outbreak of Ebola were caused by a tiny handful of patients, research suggests. The analysis, published in Proceedings of the National Academy of Sciences, shows nearly two thirds of cases (61%) were caused by 3% of infected people. The young and old were more likely to have been “super-spreaders“.”
Nature (News) – Ebola funding surge hides falling investment in other neglected diseases
“Global funding for research on neglected diseases — which include tuberculosis, HIV/AIDS and malaria — is at its lowest level since 2007, according to the annual G-FINDER investment report by Policy Cures, a health-policy analysis firm in Sydney, Australia. But that total — just over US$3 billion for 2015, the latest year for which figures are available — does not include a rapid burst of funding for research into Ebola, to tackle West Africa’s outbreak. Investments in Ebola and other African viral haemorrhagic fevers shot up to $631 million in 2015 — more than was spent on any other neglected disease except HIV/AIDS. Almost two-thirds of that was spent on developing preventive vaccines, and more than one-third of funding came from industry. That is an unusually high proportion, notes Nick Chapman, director of research at Policy Cures….”
See also Euractiv – EU overtakes UK on medical research for developing world.
Bill Gates was in Brussels to unveil the report.
BMJ (Letter) – Post-Ebola reforms deserve support
Margaret Chan’s reply to Suerie Moon et al’s piece in the BMJ from a view weeks ago. “…As their report concludes, “substantial reforms are under way and deserve support.”” Chan lists these reforms in this short letter.
Munich Security report 2017 – Post-Truth, Post-West, Post-Order?
As already mentioned in the intro, this year’s Munich Security Report has a short global health security chapter. See p. 54-55: focus on the spread of epidemics, and attacks on health care facilities.
AJPH – UHC and Public Health: Ensuring Parity and Complementarity
T Ottersen (Oslo Group on Global Health Policy) http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303590?journalCode=ajph
Must-read. How to position (strategically) public health versus UHC, and a few other vital questions.
Bill Gates on Hans Rosling:
“…In the last year of his life, Hans sent us a very touching letter. He told us that he had cancer, and then he made a request. He wasn’t asking for any personal favors. He simply hoped that we would promise to keep spreading the message he was so passionate about: that the world is making progress, and that policy decisions should be grounded in data. Of course we were happy to make that pledge….”
BMJ (Opinion) – Seeing human lives in spreadsheets: The work of Hans Rosling (1948–2017)
Fantastic – warm as well as insightful – piece by Max Roser (Oxford economist).
PS: New foundation to be started in memory of Hans Rosling “A foundation is to be set up in the memory of Hans Rosling, making it easier for scientists to engage in public education.”
Launch of UCL Centre for Gender and Global Health (16 Feb)
2017 Conference on Retroviruses and Opportunistic Infections in Seattle
Science Speaks has a number of articles on this conference in Seattle – a conference, that is – we humbly admit – a bit “out of our league”, scientifically speaking.
Apart from Science Speaks articles & coverage, check out:
New Scientist – Two new drug therapies might cure every form of tuberculosis
“Tuberculosis, the world’s leading infectious killer, may have finally met its match. Two new drug therapies may be able to cure all forms of tuberculosis – even the ones most difficult to treat. “We will have something to offer every single patient,” says Mel Spigelman, president of the TB Alliance, the organisation coordinating trials of the two treatments. “We are on the brink of turning TB around.” It presently takes six months of drug treatment to cure ordinary TB, and two years to cure people whose infections are resistant to drugs. People may need to take up to 20 tablets a day, plus injections. Together, the new treatments, called BPaMZ and BPaL, could make treating TB much simpler and more effective. BPaMZ involves taking four drugs once a day. Trials carried out in 240 people across 10 countries in Africa suggest that it cures almost all cases of ordinary TB in four months, and most people with drug-resistant TB in about six months. In the majority of cases, the TB bacterium had disappeared from sputum within two months….”
Science (News) – Simpler, safer treatment hailed as ‘breakthrough’ against drug-resistant TB
(On Nix-B) – “A new treatment strategy has had astonishing success against extensively drug-resistant tuberculosis (XDR TB), which kills more than 70% of patients. XDR and other drug-resistant forms of TB are burgeoning among people with HIV, and current treatments are so prolonged and toxic that many patients fail to adhere to them. But a small study now shows that a simpler, safer regimen can cure the disease. ..”
See also Bhekisisa Two drugs could be the key to quicker TB cures.
Thomson Reuters- New Africa disease agency aims to prevent fresh Ebola crisis
This month’s Lancet Global Health issue also had a few articles on the African CDC. Here’s some more info. “”What the Africa CDC can truly contribute is to bring (international disease) response closer to the countries,” said incoming director John Nkengasong, a virologist and senior official at the U.S. CDC. The agency will focus on strengthening national health systems through its regional networks, Nkengasong said, making countries less reliant on overseas medical aid, staff and equipment during outbreaks….”
Yet, experts “…… said Africa CDC’s effectiveness could hinge on funding. “The AU initiative is evidence that countries have taken stock of the Ebola crisis,” said Mads Oyen, West and Central Africa emergency adviser for the U.N. children’s agency, UNICEF. “However, in order for Africa CDC to be a strong organisation, it will require long-term political will and financial commitment by national governments, as well as strong support from donor institutions,” he added. The AU Commission has allocated about 0.5 percent of its operating budget to Africa CDC, and other funding will come from member states, partner countries and the private sector. The United States and China are among those supporting the initiative…. ”
Guardian – Major report prepares ground for genetic modification of human embryos
“Powerful gene editing procedures could one day be allowed to prevent people from passing on serious medical conditions to their children, according to a major report from senior US researchers. The cautious endorsement from two of the most prestigious US science institutions means that human embryos, sperm and eggs could all be genetically manipulated to mend faulty genes which are known to cause serious disease or disability, once research has shown it is safe to do so…. ” See also Vox – Scientists can now genetically engineer humans. A big new report asks whether we should.
And a Lancet Editorial – “Safeguarding the future of human gene editing” – also reflects on this new report. “…Culminating in a report released on Feb 14, 2017, Human Genome Editing: Science, Ethics, and Governance is a broad framework by which developments in this rapidly evolving and advancing field can be assessed…” It comes at a crucial time, the Lancet says.
WHO – Landmark working group on the health and human rights of women, children and adolescents meets in Geneva
“A group of champions and experts met in Geneva last week to reaffirm the urgency of putting human rights at the heart of global efforts to improve the health of women, children and adolescents – including the poorest, and those living in conflict zones and as refugees. … … The High Level Working Group on the Health and Human Rights of Women, Children and Adolescents was announced last year by the World Health Organization (WHO) and the Office of the High Commissioner for Human Rights (OHCHR). The group responds to the demand of the SDGs and the Global Strategy for Women’s, Children’s and Adolescents’ Health to leave no one behind by rallying political support for a human rights based approach to health. It comes at a critical juncture time when many rights, especially sexual and reproductive rights, are being challenged….”
Lancet – Offline: Turning fear into resistance
Horton’s take on the first meeting of the High-Level Working Group on the Health and Human Rights of Women, Children, and Adolescents. (must-read)
“…The human rights community faces a stark choice. Should it fight as ruthlessly as its opponents and be uncompromising in its advocacy? Or should it recognise that the coming years are going to be arid times and modify its language to accommodate a new reality?…” Both cases were made at the meeting.
But “The conclusion of the meeting seemed to be that now was a moment when human rights activists had to take risks to defend their values, or else those values were little short of meaningless. President Halonen put it succinctly—“Why are some issues dangerous?”, she asked. “Because they are important.” The war has begun.”
WHO Health Financing Technical Network
“Following the launch of the WHO Health Financing technical network during the recent UHC Day event, WHO has launched its online community focused on health financing policy for UHC. This global network, previously based around sub-communities of those attending courses, or workshops, is now open to all interested in and working on health financing policy.”
You can join the group here.