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IHP news #406 (February 17, 2017)

Highlights of the week

Annual letter Bill & Melinda Gates + coverage & political analysis

Annual letter

Gates Notes;

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

Stat news;

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

Tom Murphy;  http://www.humanosphere.org/basics/2017/02/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

B Lomborg;   https://www.project-syndicate.org/commentary/gates-foundation-investment-strategy-by-bjorn-lomborg-2017-02

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:

New Executive Director to be selected at Board Retreat.

News – After initially rejecting a plea for assistance from Venezuelan NGOs out of hand, the Global Fund now says it may be able to help

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 ReportGlobal Gag Order Leaves NGOs Confused, U.S. Agencies Scrambling.

Devex –  Australia responds to the global gag rule

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

Tikki Pang et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30388-4/fulltext

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 EuractivEU 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.

Rosling memories

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 RoslingA 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)


Kent Buse was heavily tweeting from the launch, so do have a look at this tweets on several speakers’ key messages.   See also tweets from  https://twitter.com/UCLGenderHealth

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

Richard Horton; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30399-9/fulltext

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.



Healio – Zika vaccine may not be available until 2020


“… In comments marking the 1-year anniversary of WHO declaring the Zika outbreak in the Americas a Public Health Emergency of International Concern — a declaration that has since been lifted — Chan remarked recently on the nearly 40 candidate vaccines currently in the pipeline but said “a vaccine judged safe enough for use in women of childbearing age may not be fully licensed before 2020.” WHO spokeswoman Monika Gehner told Infectious Disease News that Chan’s comments are in line with WHO’s official estimate of when a safe and effective vaccine may be ready for women of childbearing age — a critical population to protect because of Zika’s causal association with microcephaly and other serious fetal outcomes…. ”  A few years later than suggested by Anthony Fauci, in the past (2018).

Plos NTDs – Environmental and Social Change Drive the Explosive Emergence of Zika Virus in the Americas

Plos NTDs;

Erin Mordecai and colleagues review hypotheses and preliminary evidence for the environmental and social changes that have fueled the ZIKV epidemic. Potential drivers include climate variation, land use change, poverty, and human movement. Beyond the direct impact of microcephaly and GBS, the authors believe the ZIKV epidemic will likely have social ramifications for women’s health and economic consequences for tourism and beyond.”


And a quick link:

CDCPersistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy.


Global Health Events

Coming up – Global Health Lab (London) –  Is global health just a tool of foreign policy?  (21 February)


We have a hunch at least some men will be back from Heidelberg by next Tuesday.  Follow the debate on Twitter: #GHLab

Coming up – 2nd Global Consultation on Migrant Health: Resetting the Agenda @IOM @WHO 21-23 February 2017 Colombo, Sri Lanka


“…In response to the renewed international attention to the topic, IOM, WHO and the Government of the Democratic Socialist Republic of Sri Lanka jointly organize the 2nd Global Consultation on Migrant Health to offer Member States and partners a meaningful platform for multi-sectoral dialogue and political commitment to enhance the health of migrants…. ” Check out the objectives.

We hope to have an editorial related to this event, early March.

Coming up – First meeting of the WHO GCM/NCD Working Group on health education and health literacy for NCDs (27-28 February, Geneva)


Check out the discussion paper, provisional agenda, …

Coming up – Africa Health Agenda International Conference  (March 7-9, Kenya)


Looks interesting. Have my doubts about the venue, though – Radisson Blue Hotel. Certainly keeping in mind the health sector crisis in Kenya (see below).


Global governance of health

Imaxi – Nothing About Us Without Us?


Nothing About Us Without Us’ is a slogan used to express the principle that no policy should be decided without the full and direct participation of members of the group(s) affected by that policy. This principle is called ‘meaningful participation’, a key pillar of the UN’s Human Rights-Based Approach…. ”  “… It’s high time to turn Nothing About Us Without Us into a reality by establishing a new governance ‘norm’ in every global health institution. To do so, we must begin with an evidence-based approach to claiming our right to participate. The IMAXI Cooperative, with a dozen friends and allies, have started ‘All Aboard’, a unique research and development project on the participation of the people most impacted by health policies and their community-based organisations in the decision making processes in global health governance.”

Not just for the WHO, but also for the Global Fund, for example…

FP – Trump’s deafening silence on Africa


Well worth a read. “In the months since he was elected and in the weeks since he has occupied the White House, President Trump has upended diplomatic relationships around the world from Mexico to Australia. Yet he has said practically nothing about Africa. That is a problem. At a time when the continent is poised to take off politically and economically, Trump’s silence on Africa is deafening. It threatens to undermine decades of bipartisan support for American engagement and sideline the United States as China reaps the benefits of increased cooperation with Africa. It also holds dangers for the success of American foreign policy in general….”

An excerpt: “… The implications of this ambiguity in America’s Africa policy are vast and obvious. It may prove difficult, for example, to marshal the political will and material resources to strengthen African health systems to fight the next pandemic disease, as the United States did with its African partners during the Ebola crisis of 2014 and thereafter.”  But the article goes much beyond global health only.

Health Promotion International – new issue


Including must-read  Editorials from  I Kickbusch et al – A watershed for health promotion: The Shanghai Conference 2016; and WHO –  Shanghai declaration on promoting health in the 2030 Agenda for Sustainable Development.

G 20 preparations

First ever G20 Health ministers’ meeting scheduled


You find the global health priorities of the G20 health ministers’ meeting (19-20 May) here.

Position paper on G20 – The G20 and Global Health: A Global Responsibility to implement the Sustainable Development Goals

German Civil society organisations; http://venro.org/uploads/tx_igpublikationen/Venro-MSF_G20_Positionpaper-final.pdf

This position paper by MSF and VENRO (German NGO umbrella organization) builds on the former position paper “The G20 and Global Health”, published in summer 2016 ahead of the G20 summit in China.  “…We continue to call on the G20 to include the following important global health issues in the agendas of the G20 development and health tracks: UHC and Health Systems Strengthening (HSS) as agreed in SDG3; global pandemic preparedness and response; antimicrobial resistance (AMR); research and development (R&D); ending the epidemics of neglected and poverty related diseases (NTDs, PRDs); and finishing the ‘unfinished business’ of the MDGs in the spirit of the SDG principle of ‘Leaving No One Behind’. We furthermore call on the G20 to strengthen the WHO to enable a coherent global health policy that is adequately financed. In this updated position paper, we propose key recommendations to be considered by the stakeholders involved in the G20 process of 2017….”

In other G20 related news, G20 foreign ministers to tackle fight against poverty in Africa (Reuters).  “G20 foreign ministers will discuss ways to fight poverty in Africa, strengthen governmental institutions and better utilise the potential of many African countries, German ministry officials said on the eve of a two-day meeting in Bonn. Germany, keen to improve conditions in Africa and halt a growing stream of economic refugees fleeing to Europe, has made cooperation with Africa a centrepiece of its presidency of the Group of 20 largest industrialised countries….”

HP&P – Allocation of development assistance for health: is the predominance of national income justified?

O Sterck et al; https://academic.oup.com/heapol/article/doi/10.1093/heapol/czw173/2996762/Allocation-of-development-assistance-for-health-is

Gross national income (GNI) per capita is widely regarded as a key determinant of health outcomes. Major donors heavily rely on GNI per capita to allocate development assistance for health (DAH).  This article questions this paradigm by analysing the determinants of health outcomes using cross-sectional data from 99 countries in 2012. … … We consider four primary variables: GNI per capita, institutional capacity, individual poverty and the epidemiological surroundings. … …  We emphasize four findings. First, GNI per capita is not a significant predictor of health outcomes once other factors are controlled for. Second, the poverty gap below the 10.89 health poverty line is a good measure of universal access to healthcare, as it explains 19% of deviation in health outcomes. Third, the epidemiological surroundings in which countries are embedded capture as much as 47% of deviation in health outcomes. Finally, institutional capacity explains 10% of deviation in health outcomes. Our empirical findings suggest that allocation frameworks for DAH should not only take into account national income, which remains an important indicator of countries’ financial capacity, but also individual poverty, governance and epidemiological surroundings to increase impact on health outcomes.

Guardian – UN chief: united Europe essential to keep peace in ‘chaotic’ world


Check out how UN chief Antonio Guterres sees the state of the world now.  Guterres also said that to deal with the challenges in the world we have to boost trust again in multilateral and national governance.

Meanwhile, his wings are already being clipped by the 5 great powers in the Security Council (see Foreign PolicyIn early challenge to Antonio Guterres’ independence, the United States and other veto-wielding powers insist on filling U.N. jobs with their own picks. )

UN News centreUN chief Guterres announces steps towards reforming Organization’s peace and security architecture.    “United Nations Secretary-General António Guterres [today] announced the establishment of an internal review team that will take forward the reforms to the UN Secretariat peace and security strategy, functioning and architecture, which he outlined when he was appointed the Secretary-General last year. According to a statement issued today by the UN chief’s office, the team will be led by Tamrat Samuel, an Eritrean national who held numerous senior UN appointments. The review team has been tasked to submit recommendations to Mr. Guterres by June this year, which will then initiate a process of consultations with UN Member States and other relevant entities….”

Some reads on the post-truth/ populist/far right world & challenges for health policy & global health

IJHPM – The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

Ewen Speed et al; http://www.ijhpm.com/article_3322.html

Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism.”

EJPH – Health policy and Mr. Trump: public health consequences of the Trump presidency

Scott Greer; https://academic.oup.com/eurpub/article/27/1/4/2978093/Heath-policy-and-Mr-Trump-public-health

Read this article together with Martin McKee’s    Health professionals must uphold truth and human rights  and David Stuckler’s The dispossessed: a public health response to the rise of the far-right in Europe and North America

Science (news) – Pasteur president forced to retire


“”Will you still need me, will you still feed me, when I’m 64?” The Beatles once asked. In the case of Christian Bréchot, the 64-year-old president of the Pasteur Institute in Paris, the answer is in: nope. Capping an 8-month crisis at the institute, Pasteur’s board of directors has decided not to change the strict age limit for its top job, denying Bréchot the extension he was hoping for….”

IP-Watch – Geneva Health Campus: New Home For Global Fund, GAVI, UNITAID By 2018


(gated)  “The construction of a new building to host the Global Fund to Fight AIDS, Tuberculosis and Malaria and other key players in the area of global health is well under way in Geneva. The “Campus Santé” (Health Campus) is expected to open its doors at the beginning of 2018. The hosts of the building will be tenants, while the investment costs are borne by Crédit Suisse, a prominent Swiss investment bank.”

KFF (Primer) – The U.S. Congress and Global Health: A Primer


Recommended. For the health policy wonks (and lawyers) among you.

KFF – Key Global Health Positions and Officials in the U.S. Government


Probably updated on a daily basis, given all the turmoil in Trump ranks.

Speech Margaret Chan – Grand challenges for the next decade in global health policy and programmes


We have a soft spot for Chan. Especially for her speeches (and karaoke skills). We hope the next DG will also have an angel’s voice. This was her keynote address at a celebration of the 10th anniversary of the University of Washington’s Department of Global Health, last week.

Meanwhile, her African counterpart Mrs Moeti (WHO Afro) stressed in an interview with Africa Renewal  that it’s very well possible to improve health systems in Africa. She reflects on the second annual meeting with Africa’s ministers of health recently (among others).

SDG High-Level Political Forum – some info


Knowledge hub on the upcoming HLPF. Includes some info on the regional preparatory meetings.

Health Affairs (blog) – A Fauci –What Three Decades Of Pandemic Threats Can Teach Us About The Future


Fauci reflects on the respective challenges for US presidents in the past thirty years.

HP&P – Civil war, contested sovereignty and the limits of global health partnerships: A case study of the Syrian polio outbreak in 2013

J Kennedy et al; https://academic.oup.com/heapol/article-abstract/doi/10.1093/heapol/czw148/2999097/Civil-war-contested-sovereignty-and-the-limits-of?redirectedFrom=fulltext

States and the World Health Organization (WHO), an international organization that is mandated to respect the sovereignty of its member states, are still the leading actors in global health. This paper explores how this discrepancy inhibits the ability of global health partnerships to implement programmes in conflict-affected areas that are under the de facto control of rebel organizations. We concentrate on a single crucial case, the polio outbreak in Syria in 2013…”

Euractiv – European Parliament Passes CETA After Debate Over Whether It’s A Good Or Bad Deal


Our favourite quote: “… Greens, Left Party Group and S&D had argued they wanted to fight for a better deal instead of rushing into CETA now. And while Trump continuously was mentioned as the bad guy – from both sides – with regard to Trudeau’s government, one Finnish member of Parliament said: “You know, Canada is a nice country and Trudeau is a nice guy. But some of the Canadian mining companies are not and this might even be felt in my country.””

Meanwhile, turns out Ivanka Trump also seems to like the company of Justin Trudeau. (Let’s hope Trudeau is yet another secret Russian agent, bent on wreaking havoc in the Trump family.)

IDS – Mobilising social science for humanitarian action – Launch of online platform


From late last week. “Launched [today] is the Social Science in Humanitarian Action: A Communication for Development Platform. This platform, developed in partnership between the Institute of Development Studies (IDS) and UNICEF with support from Anthrologica, is an online resource which aims to establish networks of social scientists to rapidly provide insight and advice to emergency responses.

Quick links:

DevexONE Campaign announces Gayle Smith as CEO. Smith is the former administrator of USAID.

Xinhua – China, South Sudan strengthen cooperation in health sector.

Oxfam (Briefing paper)Private-finance Blending for Development: Risks and opportunities

Aid donors increasingly seek to inject private-sector resources into development by ‘blending’ official development assistance (ODA) with private finance. There is little evidence of the development impact, and projects often do not align with country ownership, transparency and accountability. It is not always clear whether ODA subsidies are necessary. Blending could support pro-poor projects, such as easing credit constraints for small- and medium-size enterprises. At a minimum, donors must subject blending projects to development effectiveness principles.”




Guardian – Kenya’s health system on the verge of collapse as doctors’ strike grinds on


Kenya’s hospitals have almost ground to a halt, with millions facing a third month in a row without healthcare as doctors strike over low pay and poor working conditions. The public healthcare system has long been overburdened and underfunded, but has now virtually stopped functioning after 5,000 doctors walk out in December after attempts to reach a compromise with the health ministry stalled….”

The Atlantic –  A Political Opening for Universal Health Care?


Rob Yates was, naturally, the first one to spot this article on the US.  “The winner in the fight between keeping Obamacare and rolling it back might be something else entirely.”  We hope so with him (and the author of this article).

NYT – Tom Price is confirmed as health secretary


From late last week. It’s clear that not every reader of this newsletter is looking forward to this new Trump appointment.

Check out also (Vox) – Today in Obamacare: Atul Gawande explains why Obamacare repeal is terrible for science (on the unintended effects of an ACA repeal on disease research).

Financing Health in Africa (blog) – Is your “UHC system” a learning system?

Bruno Meessen et al; http://www.healthfinancingafrica.org/home/is-your-uhc-system-a-learning-system

The Universal Health Coverage (UHC) agenda raises questions in each country. There is only one answer: each country must develop its own systemic learning capacities. Experts from the Communities of Practice measured this capacity in six Francophone African countries. In this blog post, we present the objectives of this multi-country research, the approach followed and some of the main results for the six countries.”

And some bits & pieces:

Resyst What is everyday health system resilience and how might it be nurtured?

A tweet – “Tracking disease-specific expenditure @WHO 3rd consortium: where does the money go ? with 30+ countries Geneva, March 20-24 #UHC

The Lancet (World Report) – New era for health in The Gambia?


Gambia’s new president has stated that maternal and child health will be his first priority and experts are hoping for a new focus on health in the country. Andrew Green reports.”



Planetary health

Guardian – Millions of premature births could be linked to air pollution, study finds


Air pollution could be a contributing factor in millions of premature births around the world each year, a new report has found. Nearly 15 million babies are born annually before reaching 37 weeks gestation. Premature birth is the leading cause of death among children younger than five years old, and can cause lifelong learning disabilities, visual and hearing problems, the World Health Organization (WHO) reports. Researchers for the Stockholm Environment Institute (SEI), the London School of Hygiene and Tropical Medicine and the University of Colorado, have concluded that as many as 3.4 million premature births across 183 countries could be associated with fine particulate matter, a common air pollutant, with sub-Saharan Africa, north Africa and south and east Asia most impacted by the issue….”

Humanosphere – Pressure mounts on India to tackle air pollution that now rivals China’s


India’s ministers may not be able to deny the health impact of air pollution much longer. According to the first annual State of Global Air  report  published Tuesday, the number of premature deaths attributable to India’s air pollution now rivals China’s. Together, they account for more than half of the world’s pollution deaths….”  (The State of Global Air website is a collaboration between the Health Effects Institute and the Institute for Health Metrics and Evaluation, with expert input from the University of British Columbia).

See also ReutersChina, India account for half world’s pollution deaths in 2015: study.


Meanwhile, in “Trumpland” :

Vox – Trump signs his first significant bill — killing a transparency rule for oil companies.

And the Bill to kill the EPA –  H.R.861 – To terminate the Environmental Protection Agency.

But more encouragingly (Vox) – Renewable energy draws increasing Republican support. That could shift climate politics.  “GOP governors are becoming clean energy leaders.”


infectious diseases & NTDs

WHO – Twelfth meeting of the Emergency Committee under the International Health Regulations (2015) regarding the international spread of poliovirus


The Committee unanimously agreed that the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). “  (at a teleconference on 7 February)

NPR – Why Killer Viruses Are On The Rise


NPR Goats & Soda launched a new series on Killer Viruses. This article is a must-read.  (among others “on the  $200 million project called PREDICT, sponsored by the U.S. government and led by University of California, Davis, School of Veterinary Medicine. The goal is to figure out the viruses that are lurking inside animals around the world.”  (and the article features some of these virus hunters))

However, “… Not everyone is a fan of the project. Some infectious disease scientists think creating a long list of viruses isn’t very helpful. They say money could be better spent on diseases we actually have now instead of trying to guess which ones might become a problem someday. And even if scientists could predict when an outbreak is likely to happen, it might not, says Michael Osterholm, who directs the Center for Infectious Disease Research and Policy in Minneapolis. “I don’t think the actual premise for the PREDICT project — that it will make us better prepared for a pandemic — holds water,” Osterholm says. …”

But more importantly, the article explains why killer viruses are on the rise. “…It’s like puncturing a balloon filled with viruses, says Barbara Han, a disease ecologist at the Cary Institute of Ecosystem Studies in New York. “Whatever survives, spills out. Deforestation is closely tied to disease emergence.” … … Wild animals are now refugees. They have no home. So they come live in our backyards. They pee on our crops. Share our parks and playgrounds. Giving their viruses a chance to jump into us and make us sick. … … “So it’s really the human impact on the environment that’s causing these viruses to jump into people.”

See also NPRMAP: Find Out What New Viruses Are Emerging In Your Backyard.

Lancet – Educating religious leaders to promote uptake of male circumcision in Tanzania: a cluster randomised trial

Jennifer A Downs et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32055-4/fulltext

On the use of religious leaders to increase uptake of VMMC. The authors did a study in Tanzania to establish whether educating religious leaders about male circumcision would increase uptake in their village. They conclude: “…Education of religious leaders had a substantial effect on uptake of male circumcision, and should be considered as part of male circumcision programmes in other sub-Saharan African countries. This study was conducted in one region in Tanzania; however, we believe that our intervention is generalisable. We equipped church leaders with knowledge and tools, and ultimately each leader established the most culturally-appropriate way to promote male circumcision. Therefore, we think that the process of working through religious leaders can serve as an innovative model to promote healthy behaviour, leading to HIV prevention and other clinically relevant outcomes, in a variety of settings.”

You find the accompanying comment (by Nelson K Sewankambo et al) here:  Educating religious leaders to create demand for medical male circumcision.

Science Speaks – TB training for just 5 to 9 percent of private pharmacies not enough for public health impact


Based on recent research (by Emily Delmotte et al) Engagement of the private pharmaceutical sector for TB control: rhetoric or reality?.   The authors “found that despite recognition of the importance of partnering with retail drug outlets, and despite their demonstrated willingness and ability to contribute to TB control efforts, widespread engagement of this sector has been slow.”

Delmotte also presents some ways forward in the Science Speaks article.

What are national governments willing to pay for malaria control?

Bill Brieger; http://malariamatters.org/what-are-national-governments-willing-to-pay-for-malaria-control/

A case for mobilizing more in-country governmental, corporate and non-governmental resources.

LSE – Debunking delusions around deworming


Recommended. “Tim Allen and Melissa Parker argue that a biosocial approach is necessary for ‘deworming’ to succeed in improving lives.”


Quick links:

NPR – Scientists May Have Solved The Mystery Of Nodding Syndrome.   (see also The Economist – Blame the worm )

Yellow Fever:  For the first time in a decade, Bolivia has yellow fever. As from the DRC, there’s good news though.   “The Democratic Republic of Congo declared the end of the yellow fever outbreak following a similar announcement in Angola on 23 December 2016, bringing an end to the outbreak in both countries after no new confirmed cases were reported from both countries for the past 6 months.”  (see UN News )




Coming up – Global Dialogue on promoting policy coherence relevant to the NCDs  (18-20 October 2017)


The Global Coordination Mechanism on NCDs (GCM/NCD) is hosting another Global Dialogue on 18-20 October 2017 in the Americas (country to be determined). The theme of the upcoming Global Dialogue is ‘how governments can promote policy coherence between different spheres of policy-making that have a bearing on noncommunicable diseases’. In preparation for the Global Dialogue meeting, a series of pre-Dialogue caucus meetings will be held, offering an opportunity for stakeholders to engage early with the Global Dialogue theme and lend their voice to the discussion. The first pre-Dialogue caucus will be held in Montenegro in March 2017.  See also http://who.int/global-coordination-mechanism/dialogues/2017-dialogue/en/ .

Meanwhile, in case you haven’t done so yet, you might want to check out the final report of the (2016) GCM/NCD Global Dialogue Meeting on the role of Non-State Actors in supporting Member States in their national efforts to tackle NCDs as part of the 2030 SDG agenda  (Meeting in Mauritius, 19-21 October).   “… The final report of the 2016 Global Dialogue meeting, “Working together to tackle noncommunicable diseases” is available. On 19-21 October 2016, representatives from Member States, United Nations organizations, other intergovernmental organizations and non-state actors such as non-governmental organizations (NGOs), philanthropic foundations, business associations, and academic institutions convened at a Global Dialogue Meeting in Balaclava, Mauritius to discuss a critical dimension of accelerating NCD prevention and control: how non-State actors can support governments in meeting their NCD-related commitments to implement the NCD Global Action Plan and the global targets on NCDs as part of realizing the 2030 Agenda for Sustainable Development.”

NCD Alliance webinar – 14 February


Recordings & slides are now available. “Updates from the 140th WHO Executive Board; Progress on Global Physical Activity Policy; 2018 UN High Level Meeting on NCDs; Preparation for CSW and the UN HLPF.”

BMJ Global Health – What is the value of palliative care provision in low-resource settings?

R Eleanor Anderson et al; http://gh.bmj.com/content/2/1/e000139

Palliative care is a human right, yet there are significant disparities in the worldwide provision of palliative care services for individuals with life-limiting illness. Of the 40 million people globally in need of palliative care, just 14% receive it, largely in high-income countries. While proven to be ‘cost-effective’ in high-income settings based on principles of cost avoidance, the costs of illness for incurable disease in low-resource settings is largely unknown. The critical absence of palliative care services in low-resource settings results in significant costs being absorbed by the individual, family and local community. This results in intractable, devastating and perpetuating financial losses that are passed on to future generations and function as a catalyst in the poverty cycle while stunting local economic growth. In considering the direct, indirect and broader societal costs of incurable disease in low-resource countries, palliative care should be considered as a poverty-reduction strategy.”

NYT – Spyware’s Odd Targets: Backers of Mexico’s Soda Tax


It’s a wonderful world we live in... “…The discovery of commercial spyware on the phones of Mexican nutrition policy makers, activists and even government employees, like Dr. Barquera, raises new questions about whether NSO’s tools are being used to advance the soda industry’s commercial interests in Mexico….”  (PS: NSO Group is an Israeli cyberarms dealer that sells its digital spy tools exclusively to governments and that has contracts with multiple agencies inside Mexico…)

For more on this story, see an NCD Alliance blog. (by A Calvillo)

HRW – Did a Child Get Sick Farming the Tobacco in Your Cigarette?


“…Most smokers probably don’t realize that the tobacco in their cigarettes may be tainted by child labor. But as recent Human Rights Watch research shows, this is a particular problem in Indonesia, where kids as young as 8 work in hazardous conditions on small-scale tobacco farms to help support their families. They are exposed to nicotine and toxic pesticides, and many suffer nausea, vomiting, and other symptoms consistent with acute nicotine poisoning, which can happen when people absorb nicotine through their skin. The tobacco farmed by children is bought up by multinationals like Philip Morris International and British American Tobacco, as well as big Indonesian firms, who buy either directly from the farmers or through intermediary traders or suppliers. The tobacco then ends up in cigarettes smoked in Indonesia and all over the world.”

Quick links:

BloombergDementia Joins Ranks of Top Global Killers With No Drug in Sight. “Alzheimer’s and other dementia unseat AIDS on WHO death list”.



SR/Mat/neonatal & child health

Lancet (Letter) – Setting maternal mortality targets for the SDGs

A Boldosscher-Boesch, R Jolivet et al (for the Ending Preventable Maternal Mortality working group);   http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30337-9/fulltext

The Global Burden of Disease (GBD) 2015 Article on maternal mortality by Nicholas Kassebaum and colleagues (Oct 8, p 1775) contains a serious error reflecting a basic misunderstanding of the Sustainable Development Goal (SDG) target for maternal mortality, one that is potentially very dangerous to the lives of childbearing women and to the vital programmes around the world that support them. The report states that “only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1”. This is a dangerous and inaccurate interpretation of the global goal. The SDG target is a global target, not a country target….”

Read also the authors’ reply (by C Murray et al) – http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30339-2/fulltext

“… Development of the Sustainable Development Goals (SDGs) specifically focused on reducing this inequity, based on the notion that sustained and focused investment toward specific targets could facilitate progress toward a grand convergence in health….”  “ … The alternative interpretation suggested by Jolivet and colleagues—that a global maternal mortality ratio target of 70 should be subsequently reframed (with little supporting documentation) as a relative country-level target (of two-thirds reduction)—is dangerously anti-equity and one with which we profoundly disagree. A global relative target could lead to worsening inequity…”

CGD (blog) – New Systematic Review on Cash Transfers and Contraceptive Use—Good Research and Bad Advice?

Tia Palermo & Amanda Glassman ; https://www.cgdev.org/blog/new-systematic-review-cash-transfers-and-contraceptive-use-good-research-bad-advice

Can cash transfers increase women’s modern contraceptive use? This was the question that researchers recently set out to answer through a systematic review of existing studies on conditional and unconditional cash transfers published in Studies in Family Planning….”  Palermo & Glassman’s assessment.

Global Health Now – Estimating infertility: conceiving of a new approach

C B Polis et al; Global Health Now;

Infertility in low-income countries is a neglected reproductive health issue, despite its staggering impact. It’s also under-measured, especially in low-income settings—but a new approach to measuring the extent of the problem could be a catalyst for change….” Commentary linked to new research.  (on the application of the “current duration” measurement approach in LICs)

Guttmacher institute – The Growing Challenge of Meeting the Reproductive Health Needs of Women in Humanitarian Situations


About one in four of the 129 million people around the world in need of humanitarian assistance are women and adolescent girls of reproductive age. Women and girls are at particular risk when a region or country’s social, health and other support systems collapse, exposing them to sexual violence, unwanted pregnancy, unsafe abortion, STIs (including HIV), and maternal illness and death. And yet, sexual and reproductive health services in humanitarian settings continue to lag far behind the enormous need, argues a new analysis in the Guttmacher Policy Review….”

Sneha Barot, lead author, also “…notes that these long-standing and structural challenges are now compounded by rising nationalism in the United States and many European donor countries. This trend could result in fewer resources being allocated in the future for aid and relief efforts in general and for sexual and reproductive health services in particular.”

Lancet (Letter) – Health professional associations and industry funding

Anthony Costello (& 4 other WHO employees); http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30277-5/fulltext?rss=yes

The UK Royal College of Paediatrics and Child Health (RCPCH) announced in October, 2016, its decision to continue to accept funding from manufacturers of breast milk substitutes (BMS). This decision raises serious concerns about the college’s impartiality and sets a harmful precedent for other health professional organisations. In order to protect the credibility and the authority of professional organisations that contribute to the formulation of public policy, they need to adopt codes of conduct and practices that protect their independence from vested interests….”

HP&P – Reaching the global target to reduce stunting: an investment framework

M Shekar et al; https://academic.oup.com/heapol/article-abstract/doi/10.1093/heapol/czw184/2996542/Reaching-the-global-target-to-reduce-stunting-an?redirectedFrom=fulltext

Childhood stunting, being short for one’s age, has life-long consequences for health, human capital and economic growth. Being stunted in early childhood is associated with slower cognitive development, reduced schooling attainment and adult incomes decreased by 5–53%. The World Health Assembly has endorsed global nutrition targets including one to reduce the number of stunted children under five by 40% by 2025. The target has been included in the Sustainable Development Goals (SDG target 2.2). This paper estimates the cost of achieving this target and develops scenarios for generating the necessary financing. We focus on a key intervention package for stunting (KIPS) with strong evidence of effectiveness….”


And some quick links:

HumanosphereHow eight countries will replace abortion funding lost due to U.S. restoring ‘Global Gag Rule’

Mostly news you already know: “…The Belgian government said Thursday that it will host the “She Decides” conference on March 2, which the Netherlands, Sweden, Denmark, Luxembourg, Finland, Canada and Cape Verde have agreed to attend. So far, the AP reported that Belgium, the Netherlands and Denmark have committed a combined $32 million to finance access to birth control, abortion and sex education for women in developing countries.

This we had overlooked, though (on another Trump executive order perhaps in the pipeline): “…draft of another executive order, which has yet to undergo federal review, would expand the current policy even further by freezing funding to United Nations organizations that endorse abortion or sterilization.”

HumanosphereWant to reduce teen pregnancy? Talk about HIV.  “In developing countries, teenage girls have the best chance of succeeding later in life if they avoid unwanted pregnancy and sexually transmitted infections. Both directly impact the health of girls and force them out of school. A new working paper from Cameroon shows evidence that simply talking about HIV can reduce teen pregnancy….

New Security BeatThe Urban Disadvantage: Rethinking Maternal and Newborn Health Priorities.


Access to medicines

IP-Watch – WHO, Netherlands To Hold Fair Drug Pricing Forum In May


The World Health Organization and The Netherlands government will co-host a meeting in the spring that brings experts together to look at high drug prices and government purchasing of medicines. The forum is planned for the first half of May in The Hague, according to Daniela Bagozzi of the WHO Department of Essential Medicines and Health Products, which is handling the initiative at the WHO. Details are still being worked out, but it will convene “all of the main stakeholders” involved in negotiations for what medicines governments will purchase, such as governments, industry and others, she told Intellectual Property Watch….”

IP-Watch – Special Report: WHO Board Sets Review Of 10-Year Effort To Boost Medicines Access, Affordability


Once considered a breakthrough in negotiations to address problems of making cutting-edge medical products and research available to poor countries, the decade-old World Health Organization Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPOA) is now undergoing review, with the WHO Executive Board calling for a report on the initiative and plans for its future next year….”

HHR (blog) – How We Fix This: The Case for a Publicly Financed Medicines Research System

Fran Quigley; https://www.hhrjournal.org/2017/02/how-we-fix-this-the-case-for-a-publicly-financed-medicines-research-system/?platform=hootsuite

(recommended) Quigley zooms in on Dean Baker’s new book, and its relevance in the access to medicines debate: “…In Dean Baker’s new book, Rigged: How Globalization and the Rules of the Modern Economy Were Structured to Make the Rich Richer.  Baker is an economist and co-director of the Washington DC-based Center for Economic and Policy Research, and widely admired and cited for his books and his blog posts about intellectual property, employment policies, and globalization. In Rigged, Baker returns to the challenge he and others have engaged before: explaining what a medicines system would look like if it was based on the principles of the human right to health and medicines access as a moral imperative, not a tool for record-breaking profits. Baker’s explanation, which takes up most of a chapter in Rigged, is the most accessible and compelling one yet offered….”

BMJ (news) – Roche asks WHO to remove Avastin from essential medicines list


The Swiss drug company Roche has applied to have its drug bevacizumab (marketed as Avastin) taken off the World Health Organization’s list of essential medicines as an ophthalmic treatment.”  That is a first…

Lancet (World Report) – India plans to expand access to new tuberculosis drug


The Government of India is planning to increase access to a new drug for drug-resistant tuberculosis after a landmark court ruling. Dinesh C Sharma reports from New Delhi.”


Human Resources for Health

HRH – Health workforce metrics pre- and post-2015: a stimulus to public policy and planning

F Pozo-Martin et al ; https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0190-7

Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the ‘Countdown to 2015’ initiative as accounting for more than 95% of the world’s maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015…. ”



Lancet (Editorial) – Yemen’s silent killers


Nearly 2 years of war have devastated Yemen. 14·8 million people currently lack access to basic health care, 7 million people are facing food insecurity, and 2·1 million children are acutely malnourished. On Feb 8, WHO and its health partners released their emergency response plan for Yemen’s health sector in 2017, including its funding requirement: US$321·6 million….”    And  “…The 2017 emergency response plan is realistic and targeted, focusing on priority accessible districts and interventions for delivery. It deserves to be fully supported.”

Thomson Reuters Foundation – Interview-Four famines mean 20 million may starve in the next six months


More than 20 million people – greater than the population of Romania or Florida – risk dying from starvation within six months in four separate famines, U.N. World Food Programme chief economist Arif Husain says….”  Drought & increasing violence play a key role.

Foreign Policy – Democracy is dying as technocrats watch

Bill Easterly; http://foreignpolicy.com/2016/12/23/democracy-is-dying-as-technocrats-watch/

From just before Christmas, actually. “Assaults on democracy are working because our current political elites have no idea how to defend it.”   “…I have no sympathy for Trump’s repulsive disregard for facts, truth, and legitimate expertise. Yet he was canny in identifying how both parties’ technocratic mindset — their approaching every problem with a five-point plan designed to produce evidence-based deliverables had left democracy vulnerable. Trump knew that if he waged a war on democratic values, the technocrats who now monopolize the country’s political elite would be incapable of fighting back….”

ODI (blog) – Two landmark publications from the World Bank and DFID bring ‘good fit’ governance into the mainstream

David Booth; https://www.odi.org/comment/10488-two-landmark-publications-world-bank-and-dfid-bring-good-fit-governance-mainstream

Recommended.   “It finally happened. After decades of evidence-based argument and critical reflection, at last the big development agencies seem to be embracing a fundamental truth: that they can’t solve the challenges facing the world today with blanket promotion of ‘best practice’ institutions and norms of good governance. They need a more targeted and context-sensitive approach. On some level, we know what governance institutions must provide to enable a country to succeed in economic and social development. But these needs can be met in different ways. What matters is the way institutions function, not the particular form they take. So the priority is to find the governance arrangements that work to solve development problems at hand. This means paying attention to what’s feasible and having the courage to embrace second-best, ‘good fit’ solutions when appropriate. While these ideas have gained prominence among researchers and practitioners, in official donor literature they have remained marginal. That is, until now. Two remarkable publications launched in late January signal, in different ways, the mainstreaming of these ideas: the World Bank’s 2017 World Development Report (WDR), Governance and the Law, and the UK Department for International Development’s (DFID) Economic Development Strategy….”

Senegal’s Health Minister named as ‘best minister’ at Dubai Summit


Senegal’s Health Minister and Social Action was named as the ‘Best Minister in the World’ at the World Government Summit on Sunday. Coll Seck was awarded for her work in stopping Malaria and limiting Ebola from spreading locally and internationally.”

CGD (blog) – New Leadership at the IFC Aims to Get Us from Billions to Trillions

Scott Morris; https://www.cgdev.org/blog/new-leadership-ifc-aims-get-us-billions-trillions

CGD had a discussion with Philippe Le Houérou, the CEO of IFC, the private sector arm of the World Bank.  Key takeaways from Scott Morris.

BMJ (Opinion) – Why an academic boycott of Trump’s America is misguided

Nick Hopkinson; http://blogs.bmj.com/bmj/2017/02/14/why-an-academic-boycott-of-trumps-america-is-misguided/

Worth reading.

Meanwhile, in the US : (Bloomberg) – Harvard, Yale and Stanford Among 17 Colleges Joining Fight Against Trump’s Travel Ban.

Devex – Q&A: Emmy Simmons, author of ‘Recurring Storms’ report, on food insecurity and political instability

Devex ;

In a new report, “Recurring Storms: Food Insecurity, Political Instability, and Conflict,” Emmy Simmons, senior adviser on global food security project at Center for Strategic and International Studies highlighted recent trends in food insecurity and its connection to political instability. She recommended the establishment of an annual high-level summit to review progress on the global food crisis and called for more collaboration between stakeholders. In this way the international development community can take actions to reduce the political, social and economic shocks caused by events associated with food insecurity….”

Global Policy – Chinese Development Finance: A Convergence of Passions and Interests

Kevin Gallagher; http://www.globalpolicyjournal.com/blog/03/02/2017/chinese-development-finance-convergence-passions-and-interests

Kevin P. Gallagher’s commentary for the Emerging Global Governance (EGG) series explores China’s growing passion for green finance, south-south development cooperation, and global leadership.”

Social Watch – OECD proposal risks transforming aid into backdoor subsidy for western corporations?


On March 9, the OECD’s  Development Assistance Committee will decide on how to include what are known as ‘private sector instruments’ (PSI), in aid. This could mean a dramatic increase in the use of aid to invest in or give loans to private companies, or to agree to bail out failed private sector projects, through guarantees. However, without strong safeguards and transparency standards there is a real risk that aid could be used as a backdoor subsidy for corporations with powerful lobbies in donor countries. Read the CSO background paper on the proposal  here.  “

ILO – New report highlights opportunities and challenges of expanding telework


New ILO-Eurofound report shows that the use of modern communication technologies facilitates a better overall work-life balance but, at the same time, also blurs the boundaries between work and personal life.

ODI (conference paper) – Gulf country donorship: opportunities and challenges for international cooperation

S El-Taraboulsy McCarthy; https://www.odi.org/publications/10718-gulf-country-donorship-opportunities-and-challenges-international-cooperation

This conference paper summarises discussions at a roundtable organised by the Overseas Development Institute and the Center for Conflict and Humanitarian Studies at the Doha Institute for Graduate Studies in Doha, Qatar, on 12 December 2016. The discussion was chaired by Professor Sultan Barakat, Director of the Center for Conflict and Humanitarian Studies at the Doha Institute for Graduate Studies, and Dr Sara Pantuliano, Managing Director at the Overseas Development Institute. The discussion, convened under the Chatham House Rule, explored the institutional and policy shifts in the development and humanitarian donor landscape in the Gulf, the Gulf countries’ role in responding to major crises in the region, and, finally, opportunities and challenges for Gulf donors in global international cooperation. …”

ODI (briefing) – How does social protection build resilience?

R Slater et al; https://www.odi.org/publications/10712-how-does-social-protection-build-resilience

The below three briefings assess evidence from Kenya, Uganda and Ethiopia on how large-scale national social protection programmes contribute to resilience. A fourth briefing synthesises the findings from across these three countries, and presents some key policy messages. …”


Emerging Voices

Health Systems & Reform – Why Performance-Based Financing in Chad Failed to Emerge on the National Policy Agenda

Joël A Kiendrébéogo (EV 2016) http://www.tandfonline.com/doi/full/10.1080/23288604.2017.1280115

Supported by the World Bank (WB), Chad implemented a performance-based financing (PBF) scheme as a pilot, from October 2011 to May 2013. But despite promising results and the government’s stated commitment to ensure its continuation after the World Bank’s departure, PBF failed to come on to the national policy agenda. This article aims to explain why this was the case, an especially interesting question given that several factors were favorable for project continuation. Data for this case study were collected through literature review and key informant interviews. We applied Kingdon’s agenda setting theory to explain this failure. We found that while the potential of PBF to address challenges facing the Chadian health system was confirmed by internal and external evaluations of the pilot, it failed to move from the “governmental agenda” to the “decision agenda”. The main reason was a lack of dedicated policy entrepreneurs resulting in a weak actual ownership of the policy by national authorities and key stakeholders. We tried to understand why such policy entrepreneurs failed to emerge.”

IHP – When Cost-Effectiveness Turns into Crime – The Death of Vulnerable Populations (94+ Psychiatric Patients) in South Africa

Shakira Choonara (EV 2014); http://www.internationalhealthpolicies.org/when-cost-effectiveness-turns-into-crime-the-death-of-vulnerable-populations-94-psychiatric-patients-in-south-africa/

Shakira reflects on the inhumane deaths of – by now more than 100 – mentally ill patients in Gauteng province, South-Africa. A horrific crime.

Shakira also just published a BMJ Global Health viewpointSignificance of informal (on-the-job) learning and leadership development in health systems: lessons from a district finance team in South Africa.



Book – Researching Corporations and Global Health Governance: An Interdisciplinary Guide

Edited by Kelley Lee et al; http://www.rowmaninternational.com/books/researching-corporations-and-global-health-governance

A practical guide on how to conduct research on the impact of corporations on global health and global health governance, which draws on the theoretical and methodological insights of a range of scholarly disciplines.

Good to know perhaps for the Twitterandi among you. Kelley Lee is now also on Twitter.

Global Public Health – The impact of debt relief on under five mortality rate in Sub-Saharan Africa

J B Oryema et al; http://www.tandfonline.com/doi/full/10.1080/17441692.2017.1287211

This paper examines the impact of the Highly Indebted Poor Countries (HIPC) Initiative on under five mortality rate (U5MR) in Sub-Saharan Africa. The HIPC Initiative involves debt forgiveness and the redirection of funds that were meant to service external debt towards the provision of social services and poverty reduction in eligible countries. The Initiative is akin to a natural experiment since some countries benefited while some did not, and the timing of debt forgiveness varied across countries. We exploit these variations to identify the impact of HIPC Initiative on child mortality using a dynamic panel data estimator. We find that participation in HIPC Initiative is associated with statistically significant decreases in U5MR. On the other hand, the impact of actual debt cancelled is statistically insignificant.”

BMJ Global Health Supplement : abstracts of the 8th EDCTP Forum, 6-9 November 2016


All abstracts you ever dreamed of (and then some more).