Annual letter Bill & Melinda Gates
Guardian – Bill and Melinda Gates urge Trump to respect people and to not cut foreign aid
Must-read analysis of the Gates’ annual letter of this year. “Donald Trump should treat people – especially women – with more respect and continue investments in poorer countries for the sake of global security, Bill and Melinda Gates said on Tuesday….”
If you want to know in more detail how Bill & Melinda responded to 10 tough questions, see the annual letter. I kind of liked question 8 – “Is it fair that you have so much influence?”
Preparations 40th anniversary Alma Ata
It appears preparations for the 40th anniversary in Almaty are gearing up. A few tweets from an expert meeting this week – the first technical meeting on the renewal of PHC for UHC, or a Global Workshop supporting a Renewed Political Declaration (13-14 Feb) (Geneva)
“The road to a renewed #AlmaAta via reinvigorating primary health care 4 #UHC needs shifts: fr vertical 2 integrated people centered approaches, fr survival 2 #health & #wellbeing, fr disease 2 prevention, need 2 reach all #atAllAges. Insights opening remarks @WHO experts meeting”
Rifat Atun – “Privileged to be part of the International Expert Group planning 40th Anniversary of the Alma-Ata Declaration @WHO :putting ‘new’ PHC at the heart of health systems to achieve #UHC #equity & #healthforall. #SDGs #AA40 “
“Achieving #UHC will require #peoplecentred #primarycare -key message coming out of #AA40 meeting @WHO now, vision of #GPW13 & @DrTedros”
Some of you might want to keep an eye on the hashtag #AA40.
(UK) Oxfam abuse scandal & broader ramifications for aid
MeToo is (going) global now, as Alice Evans pointed out on Twitter, and has now also reached the aid sector. The “Oxfam in Haiti” sexual abuse story was all over the media this week, “starring” a Belgian, of all people. Who, actually, said that a lot had been exaggerated by the media.
By now, that doesn’t matter anymore, though, as the story has gone viral, and kicked off a chain reaction. The broader impact (for DFID, UK aid, … and beyond) will probably depend on how the aid sector reacts to the call for structural reform in this respect.
Some reads from this week:
Guardian – #MeToo strikes aid sector as sexual exploitation allegations proliferate “Senior figures in the humanitarian world have described the allegations of sexual exploitation that have embroiled Oxfam as the tip of the iceberg and the aid sector’s #MeToo moment. In interviews with the Guardian, humanitarian officials with experience working across the globe have told largely similar stories of colleagues’ use of sex workers, suspicions of the exploitation of vulnerable women for sex – including minors – and a unwillingness of their organisations to properly tackle the issue….”
Reuters – Oxfam International boss says Haiti scandal ‘breaks my heart’ (with the reaction of Oxfam International’s executive director, Winnie Byanyima).
“The Oxfam scandal must be a “wake-up call” for the aid sector, the United Kingdom’s aid chief Penny Mordaunt has said, calling on the community to work together to protect beneficiaries and staff from sexual exploitation and ensure the “morally repugnant” actions of a small group of aid workers do not “tarnish” the sector. Mordaunt’s comments, made Wednesday morning during the End Violence Solutions Summit in Stockholm, are part of a strong response by the U.K. Department for International Development to newspaper reports of sexual exploitation among a small group of Oxfam staff in Haiti in 2011….”
“In the wake of news that some of the men involved in the Oxfam sexual misconduct scandal went on to find work elsewhere in the aid sector, humanitarian organizations are being forced to examine the human resources and safeguarding practices that allowed alleged perpetrators of sexual exploitation to move from disaster zone to disaster zone, ignored or undetected….”
“In the aid sector, little to no organizations have this mechanism in place. Oxfam, which has recently come under fire in the press for [reports of sexual abuse], actually does have these mechanisms in place. They are some of the most thorough I have seen. ”She explained that the outraged reactions to the number of reported cases of sexual exploitation were understandable but, in part, misguided, since growing numbers of cases reflect better reporting mechanisms. While the crimes committed are heinous, she said, the fact that the reports are beginning to roll in is a “sign that the system is working.”…
Kevin Watkins (Save the Children) is always worth reading. “Across our programmes at Save the Children, we deal with some of the world’s most vulnerable people. The only antidote to abuse is zero tolerance.”
“Only six out of 10 global aid agencies were willing to disclose the extent of sex abuse by their staff in an exclusive survey, as a major sex scandal involving British charity Oxfam ricochets through the sector….”
“…Several industry experts have warned that the backlash against Oxfam could drive charities to cover up cases of sex abuse for fear of losing support and funding from the public, donors and governments….”
The right approach, is, of course, the one MSF is taking – full transparency.
Guardian : Oxfam scandal must force aid sector to finally address its own power Deborah Doane is also always worth reading. “If Oxfam responds by listening to its critics it could restore faith in a sector that was damaged long before the latest allegations.”
The latter war is led by many Tories who are fed up with the 0.7 %. “…The Oxfam scandal has become a fresh front in a culture war: any aid that isn’t a geopolitical or trading instrument is hypocritical do-gooding….”
The Conversation – Oxfam scandal: development work is built on inequality but that’s no reason to cut foreign aid We also enjoyed this piece from a researcher from University of Bath.
Guardian testimony – As a former aid worker, I’m not shocked by the Oxfam revelation
“… It’s not a coincidence that most of Britain’s biggest aid NGOs are dominated by white men and some white women at a senior level. Women have described it as “bro” culture. The culture of silence runs deep – the usual fears that prevent women and whistleblowers from speaking out apply here (for example, the UN whistleblowers in Haiti received anonymous threats). But there is an added stigma in the aid world. There is a fear that if we tell the truth, the reputational damage to the agencies will benefit the sections of the press and politicians who want to reform the sector….”
The Economist’s take – The Saints And Sinners Of Oxfam
To conclude, an interesting thread of tweets by Owen Barder (CGD Europe):
“A short thread with some thoughts about sexual abuse, including in the aid industry. tl;dr there is a widespread problem we need to address; it is not about @oxfamgb and I remain a proud Oxfam supporter. 1/13
There is, disgracefully, sexual harassment and abuse across all industries. Anyone who doubted that will have learned forcefully from the MeToo campaign that the problem is widespread. The good news is that we seem to be beginning to address it. 2/13
The aid and development sector is regrettably no exception. There are both individual cases and systemic problems, as there are in other sectors and industries. 3/13
It can be harder to uncover and tackle abuse in a sector in which many of its supporters and employees feel strong affinity to the mission. People are reluctant to undermine the institutions This has led to cover ups in churches, politics, trade unions, and in NGOs. 4/13
When people say “it is a few bad apples” they dismiss the possibility (indeed likelihood) that there are systemic problems. I understand why people want to protect worthy organisations, but the best protection in the long run is to face up to and address these problems. 5/13
Conversely, there is no reason to think that the aid sector, or any particular organisation within it, is especially problematic. We have seen problems in business, politics, sport, entertainment and many others 6/13
It would be especially paradoxical to single out @oxfamgb which has fought an important fight for women and girls, and for rights, and against sexual abuse around the world. They are a key voice against abuse in the aid sector and in society. 7/13
Nobody said after Harvey Weinstein that we should shut down Hollywood. Nobody says that appalling, systemic abuse in business or politics means those industries should be shut down. But they do need to change. 8/13
British aid is among the most effective in the world (I’m quoted on this in The @TheEconomist today https://www.economist.com/news/britain/21736995-hurricane-harvey-whirls-through-aid-industry-saints-and-sinners-oxfam …). I am proud of what our development aid, partly through our NGOs, achieves. 9/13
Calls to scale back aid (for example by jettisoning the commitment to 0.7%) or to single out @oxfamgb (for example but removing its funding) are absurd. So too are efforts to minimise the problem by asserting that it is a few isolated examples. 10/13
In my view, @PennyMordaunt and @DFID_UK have got this exactly right – demanding systemic reform across the sector as a whole without suggesting that this undermines the case for aid or demonising particular organisations. 11/13
We have to bring about systemic change and end the culture of cover-ups. Singling out particular industries, or particular NGOs, makes it harder to expose and address these problems. 12/13
So let’s all roll up our sleeves and redouble our efforts to address these society-wide problems, including in the sectors in which we work. I’m a proud @oxfamgb supporter and will continue to be. 13/13”
Guardian – UN staff say they were urged to support official accused of sexual misconduct
The latest update on the UNAIDS harassment story. “Employees claim they were implored to sign letter vouching for senior UNAids figure, amid calls for the UK government to establish an independent inquiry into harassment allegations.”
Trump & global health
IP-Watch – Trump Budget Would Slash Funding For Health, International Organisations
(gated) “The Trump administration this week proposed drastic cuts in funding for international activities including foreign policy and global health in 2019, while further building up military and big business activities. Programs related to international activities will have to prove their value to American interests and other countries are demanded to pay more, according to the proposed budget sent yesterday to Congress, which is ultimately expected to set about the task of restoring numerous programs.”
KFF – White House Releases FY 2019 Budget Request
(must-read) brief with an overview. “The White House released its FY 2019 budget request to Congress on February 12, 2018, which includes significant cuts to global health programs compared to FY 2017 enacted levels (the overall levels in the request are similar to the FY 2018 budget request).” It’s a depressing list of budget cuts suggested by the Donald to USAID & State, CDC, Global Fund, PEPFAR, … and many other global health programs. The only exception seems to be global health security, but even there the tiny increase is nowhere near what’s required.
Devex – Trump budget proposes more US aid cuts, but backs new DFI
“President Donald Trump’s 2019 budget request included all of the expected proposals to cut United States global development spending, but it also endorsed one of the most significant aid reform ideas to gain serious traction in years: Creating a new development finance institution….”
“…If lawmakers do move a new U.S. development finance institution from proposal to reality, it will stand as a major aid reform accomplishment at a time when many development programs are facing White House pressure to cut back. The new institution would also mark the arrival of development finance in a more central role in U.S. global development policy, having overcome political battles that hindered efforts to strengthen these institutions in the past. … … Enhancing U.S. development finance could fit neatly into an agenda that has emerged as one of USAID Administrator Mark Green’s biggest early priorities — finding ways to “transition” countries from development assistance to a new form of partnership with the U.S. government. … … “Development finance is the future of development policy. We want to shift away from foreign assistance to foreign investment, and countries want to shift away from being aid recipients. They want private investment, and development finance is the public policy tool to catalyze capital flows into productive sectors,” Todd Moss (CGD) said.”
Lancet World Report – CDC faces leadership changes, potential spending cuts
Must-read analysis. “The CDC has indicated it will reduce its foreign presence, and proposed budget cuts make some fear its core functions are threatened. Susan Jaffe, The Lancet’s Washington correspondent, reports.” Includes also an assessment of the new budget request, and global health implications (including global health security).
And a few other pieces, not directly linked to Trump’s budget request:
“America’s $42bn foreign assistance programme is facing “unprecedented” disruption a year into Donald Trump’s presidency, according to former top officials who have described the White House’s approach as deeply counterproductive and putting lives at risk. Scott Morris, a former senior US Treasury official now with the Center for Global Development in Washington, told the Observer: “One of the negative things to watch for is how seriously this administration seeks to operationalise a policy of ‘aid to friends’ across the board….”
Devex – NGOs push back on positive US review of ‘global gag rule’
Follow-up on last week’s news on the US review. “Global health organizations called the United States State Department’s new findings that the vast majority of foreign NGOS are complying smoothly with its reinstated Mexico City Policy “skewed” and “premature and inadequate.””
Winter Olympics in South Korea & health
From what we read, the North Korean cheerleading team has boosted the mental health of many viewers around the world, and of course there’s the mysterious norovirus, but here we just want to flag:
“…The advertising of tobacco products at the Olympic games has been outlawed since 1988. But to bar tobacco from advertising at the Olympics, yet to allow companies like Coca-Cola and McDonalds, is nonsensical, given that the major risk factor that drives the most death and disability combined around the world is diet. The International Olympic Committee (IOC), given historical criticism of the Olympics’ association with junk food, must be aware of this fact. Yet through neglect or design, it has done nothing to stop Olympic athletes from being courted by brands like Coca-Cola. It should know better….”
Global Fund partnerships
That brings us seamlessly to the Global Fund’s dodgy partnerships – see also this week’s intro.
Lancet – Stop the toasts: the Global Fund’s disturbing new partnership
Robert Marten & Ben Hawkins ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30253-8/fulltext
This was without any doubt the read of the weekend (even if we’re not allowed to work at the weekend). “…The partnership with Heineken is antithetical to the Global Fund’s core interests. It is clearly an attempt by the alcohol industry to market partnerships with key global health actors to reframe themselves as part of the solution instead of the problem. This partnership shapes and distorts policy makers’ perceptions of the industry and deflects public attention away from regulation to protect public health and save lives. By cooperating with, supporting, and legitimising the alcohol industry, the Global Fund is endangering its own credibility and risks losing public trust….”
Or as Andrew Harmer put it last week in a blog, ‘The Global Fund’s Mugabe moment’, “”…The fact of the matter is that these corporations, ie Heineken, are exercising their power over the @GlobalFund, not the other way around.”
This inspired also watchers to ask if the GF has a Framework of Engagement with Non-State Actors (like WHO has with FENSA).
Some tweets then:
Ilona Kickbusch – “This is an interesting example how private donors//partners can become less acceptable as the #globalhealth debate shifts and the seriousness of the #NCDs pandemic sinks in – global health org need to have common policy @who to lead”
Robert Marten – “Agreed! If #globalhealth wants to be serious about the Sustainable Development Goals, we need to shift and reframe our thinking, governance and policies from the MDGs to the SDGs.”
“The @GlobalFund was best practice when it was created in 2002. It’s now 2018. The Fund’s leadership should use this moment as an opportunity to exert leadership and create a new vision for the Sustainable Development Goal/SDG era.”
Congratulations to #Sweden for its leadership! It seems #Sweden feels like #Norway about the @GlobalFund’s Disturbing Partnership with Heineken. (Together they represent GF contributions of close to $200M a year.)
We also want to flag here Anthony Costello (WHO)’s series of tweets on another dodgy partnership of the GF, with Lombard Odier:
“Not only Heineken. Ten questions for the Board of the Global Fund for AIDs, TB and Malaria about their director’s Davos deal with a Swiss private bank, Lombard Odier.
1.Theft from governments and flight capital is a major problem for low and middle income country health systems. Lombard Odier has been implicated in failing to monitor flight capital and money laundering. First, in the Brazil Petrobas scandal.
- Then failing to spot money laundering from Argentina.
- They were fined $99.8 million by the US government for failing to prevent tax avoidance from US high net worth individuals https://www.justice.gov/opa/pr/justice-department-announces-two-banks-reach-resolutions-under-swiss-bank-program-4 …
- From Uzbekistan. Lombard Odier currently faces litigation (US Justice Case No. 1:16-cv-01257) over alleged failure to track illicit payments of $797 million made by the daughter of Islam Karimov, the former President of Uzbekistan.
- Swiss prosecutors froze $797 million of payments into Lombard Odier. The case document shows 347 million dollars went through Standard Chartered Bank when the GF director was CEO. Was he or Patrick Odier, CEO of Lombard, aware of these transactions at the time?
- Were the Uzbekistan payments, allegedly laundered through Standard Chartered to Lombard Odier, covered by the 2012 and 2014 fines totalling $667 million paid by Standard Chartered Bank to US regulators for breaching anti-money laundering rules when the GF Director was CEO?
- The GF plans to work with Lombard on new private funding deals, eg. social bonds, to provide both social benefit + returns to private companies. Did the GF Director have any commercial relationship with Lombard when he was CEO of Standard Chartered? Were these links declared?
- What will be the commercial benefit and/or fees paid to Lombard Odier in future planned deals? Was the contract tendered for other Banks to apply?
- Conflicts of interest are taken seriously by international agencies eg.WHO adheres strictly to the Framework for Engagement with Non-State Actors. Is there a similar charter to guide commercial relationships at the GF? Do deals with Heineken + Lombard Odier abide by GF rules?
- Over 99% of GF funds come from donor governments and Foundations. Does the Board think deals with Heineken and Lombard Odier expose the Global Fund to reputational and financial risk?”
“Safer Roads for All Through the Power of Partnerships” – AB Inbev-UNITAR partnership
Carlos Brito (AB Inbev CEO) https://www.linkedin.com/pulse/safer-roads-all-through-power-partnerships-carlos-brito/
The Global Fund’s dodgy example is clearly contagious, certainly in the new SDG ‘let’s engage with the private sector’ era, leaving really no one behind.
News from Valentine Day, the day of new partnerships: “United Nations Institute for Training and Research (UNITAR) and Anheuser-Busch InBev (AB InBev) are partnering on a global public awareness and a capacity-building initiative called “Strengthening Road Safety in Cities.” This initiative will bring together leaders across sectors to share best practices and to implement holistic programming to – ultimately – save lives…. … The UNITAR-AB InBev partnership builds on “Together for Safer Roads (TSR),” a coalition of private companies tackling road safety issues by sharing knowledge, data, technology, and global networks to catalyze impactful solutions. “
Reaction Robert Marten: “Dear @drtedros, I fear we are facing an epidemic of partnerships with the alcohol industry. Might you and @WHO be able to provide evidence to help inform and shape broader @UN policies on this? Thank you for your consideration!”
International Condom day (13 Feb)
“International Condom Day (ICD) is an informal holiday usually observed on February 13 in conjunction with Valentine’s Day. ICD promotes safer sex awareness in a fun and creative way while encouraging people to use condoms. International Condom Day seeks to promote the use of condoms as a means of preventing unwanted pregnancies and sexually transmitted infections (STIs).”
Don’t know how you celebrate International Condom Day. (Or rather, I don’t wanna know : ) )
Lancet Infectious Diseases – Early safety and efficacy of the combination of bedaquiline and delamanid for the treatment of patients with drug-resistant tuberculosis in Armenia, India, and South Africa: a retrospective cohort study
“A study done by MSF describes the safety and efficacy of using bedaquiline and delaminid in combination to describe multidrug-resistant TB. “
See also coverage by Science Speaks – Findings indicate two newest TB drugs, bedaquiline and delamanid in combination safe, promising for patients with few options.
Lancet (Letter) – Dengue vaccination: a more balanced approach is needed
Tikki Pang et al (on behalf of the Asia Dengue Vaccine Advocacy Group) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30245-9/fulltext
“Media reports have cast doubt on the safety of dengue vaccination, resulting in the suspension of school-based immunisation programmes in the Philippines. The main concern about the vaccine is the risk of severe disease in children naive to dengue virus. Although these concerns are justified, it is important to consider this risk in the context of the wider population and to consider the public health value of dengue vaccination for the prevention of a disease that affects 400 million people annually, mostly in developing countries….” The authors suggest 2 approaches to dengue vaccination.
China & global health
BMJ (Feature)– Rise of a new superpower: health and China’s global trade ambitions
Good update on the Silk & Belt Road. “Massive foreign infrastructure projects are designed to increase China’s economic and political influence—for example, opening up new markets to Chinese drugs and tobacco. The “belt and road initiative,” writes Flynn Murphy, the country’s enigmatic policy backed by huge investment, could have profound implications for local and global health. ”
In other China & global health related news, the AU reported China will help establish an African Union office in Beijing.
“… China welcomed the planned establishment of an African Union Office in Beijing to ensure effective and timely follow-up of the China-Africa partnership, and committed to support the setting up of this Office. This representation will also support the work of the African Group of Ambassadors in Beijing, to ensure alignment with African Union positions. It should be noted that China had established a Permanent Mission to the African Union, since 2015. The two sides also discussed China’s support to the African Union Centres for Disease Control and Prevention (Africa CDC). China agreed to expedite the construction and equipping of the Africa CDC, within the framework of the five-year strategic plan developed by the Africa CDC in collaboration with international partners, including China. China committed to earmark RMB 500 million to that end and in support of other projects. …”
And Bill Gates noted, in an interview with Xinhua, China’s growing innovation capacity to play bigger role in global health.
Lancet (Correspondence) – Germany’s contribution to global health
While applauding Germany’s increasing leadership in global health, the authors say Germany still has a long way to go: “…The fundamental problem is conceptual: the persistent misinterpretation of global health as just an extension of national public health or international health, with a strong focus on strengthening health systems and bringing medical supplies to low-income countries. Most German stakeholders interpret global health as being part of the development agenda and even the government’s Marshall Plan with Africa is highlighting this post-colonial approach. We argue that global health requires a multidisciplinary, transnational approach that considers and cross-links the social, environmental, political, commercial, and other determinants of health….”
You might also want to read some of the other Letters in the Lancet related to Germany’s expanding role in global health, including the Authors’ reply – Germany’s expanding role in global health – Authors’ reply.
Global Health Security
Some reads from this week:
- An Op-Ed by Gavin Yamey from last week, after the news on CDC’s imposed global health security cuts – Penny-wise, pandemic-foolish
- Speech Tedros at a UAE conference (World Government Summit, Dubai) earlier this week, “Can we create a pandemic-free world?”
In his speech, he laid out what WHO is doing (and planning) in this respect. See also “A deadly epidemic could start at any time – and we’re not ready, says the head of the WHO”.
“The next large-scale infectious disease outbreak would not just be a public health crisis but also an economic crisis for the United States, in the shape of jobs lost and a draining of the export economy—even if it were to happen halfway around the world—according to two studies from the Centers for Disease Control and Prevention (CDC) published in Health Security….”
End Violence Summit (Stockholm, 14-15 Feb)
The #EndviolenceSWE Summit in Stockholm, 14-15 Feb, gathered world leaders in the common goal to end violence against children. Tedros participated.
WHO – Global summit highlights solutions to end violence against children, calls for accelerated action
“Globally, up to 1 billion children aged 2-17 years – or one in two children – have suffered physical, sexual or emotional violence or neglect in the past year. WHO [will be] joining global efforts next week aimed at promoting solutions, and reinforcing global commitments, to end all forms of violence against children. … … Dr Etienne Krug, from WHO, says experiencing violence in childhood has lifelong impacts on the health and well-being of children, their families and communities. “We must not tolerate that half of the world’s children suffer violence each year,” explains Dr Krug, Director of the WHO Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention. “The sad fact is that we know what needs to be done, yet we do not do it. Violence is not inevitable. Its causes are understood and it can be prevented; only the will is needed.” “Evidence-based measures include those reflected in the WHO-led INSPIRE: Seven strategies for ending violence against children, …”
“… The World Health Organization is proud to be among the founding members of the Global Partnership to End Violence Against Children, and I am excited to be here with you today to celebrate our successes and plan how to scale up….
Report Save the Children: One in six children ‘affected by conflict’
New report released ahead of the influential Munich Security Conference, which begins on Friday and which the charity says is an opportunity for global leaders to agree on measures to protect children. “One in every six children are now living in a global conflict zone, a new report by Save the Children claims. Children are at more risk from armed conflict now than at any other time in the last 20 years, the charity says. Its new analysis found more than 357 million children were living in a conflict zone – an increase of 75% from the 200 million of 1995. Syria, Afghanistan and Somalia were ranked as the most dangerous places for children. In general, children in the Middle East were most likely to live in a conflict zone, where two in every five lived within 50km of the site of a battle or other fatal attack. Africa was ranked second, at one in five….”
In a somewhat related report, “Gaps in data covering refugees, asylum seekers, migrants and internally displaced populations are endangering the lives and wellbeing of millions of children on the move, warned five UN and partner agencies [this week]. In ‘A call to action: Protecting children on the move starts with better data’, UNICEF, UNHCR, IOM, Eurostat and OECD together show how crucial data are to understanding the patterns of global migration and developing policies to support vulnerable groups like children. “
BMJ Global Health – Towards a more balanced rethinking of performance-based financing
The latest addition in this debate, and a nice one. By Maarten Oranje (Cordaid).
Project Syndicate – The World Bank Needs to Return to Its Mission
Must-read from Jeff Sachs. “With a clear plan, the World Bank would be able to find partners to help it support progress toward achieving the Sustainable Development Goals, which has been disappointing so far. Instead, the Bank is adopting an approach that would leave poor countries mired in debt, by relying on Wall Street to finance their basic needs.”
Lancet Global Health (March issue)
Plenty of good stuff in this new Lancet Global Health issue. Check out, among others:
- The editorial – Local research in Africa: a glimpse at possibilities in Niger
- Exploring the broader consequences of diarrhoeal diseases on child health (Comment)
- Limited access to CVD medicines in low-income and middle-income countries: poverty is at the heart of the matter
“It is well established that Africa is undergoing rapid transitions resulting in a triple burden of malnutrition, infectious diseases, and non-communicable diseases (NCDs). That health systems are unlikely to be able to cope with this burden is also widely noted. What is less often discussed outside academic circles is the degree to which infectious diseases and malnutrition in Africa are exacerbating the burden of NCDs, and the implications of this exacerbation for individuals and populations….”
- And for our purposes certainly also this Comment (by J Sundewall, A Nordström et al) Swedish development assistance for health: critical questions to ask going forward
“The world has agreed on an ambitious pathway for global health in the 2030 Agenda for Sustainable Development By this deadline, countries should have achieved universal health coverage, providing people with protection from financial hardship as a result of ill health. This challenge is particularly daunting at a time when global development assistance for health (DAH) is plateauing. In view of the bleak outlook for future DAH growth, together with the need for domestic finance for health to increase, Sweden and other donors need to revisit their role going forward and consider what can be done to truly strengthen national health systems in low-income and lower-middle-income countries. In this Comment, we summarise the development of Swedish DAH and propose some key questions that should be answered going forward….”
Lancet Planetary Health (February issue)
Some articles we want to flag in this issue: the editorial The world’s biggest threats are environmental risks; a Comment on a new study – Ambient air pollution and diabetes in China and certainly Operationalising planetary health as a game-changing paradigm: health impact assessments are key. “….Now more than ever, the question arises of how planetary health can most pragmatically get real world traction and catalyse a proactive, science-based way forward. In short, how can the concept be applied to maximum effect, as a go-to tool in the global problem-solving toolbox in support of the UN 2030 Agenda for Sustainable Development? We propose that a key response to these questions would be the formal adoption of the Health Impact Assessment (HIA) concept at a wide range of scales…”
Foreign aid & migration
Guardian – Foreign aid ‘less effective than expected’ at curbing migration, study says
Maybe not really news, but still worth noting: “Europe’s policy of using overseas aid to persuade people to stay in their own countries has been challenged by research suggesting the strategy may instead encourage migration. A new paper by the development economist Michael Clemens and his colleague Hannah Postel for the Center for Global Development suggests that, far from discouraging migration from the poorest countries to the developed world, foreign aid programmes may actually accelerate it. The paper – entitled Can Development Assistance Deter Migration? – turns on its head the key assumption of much EU assistance policy, arguing that “economic development in low-income countries typically raises migration”. The new research by Clemens and Postel suggests that, while “greater youth employment may deter migration in the short term for countries that remain poor”, that effect is both temporary and negligible in its effects on migration. Instead, they argue, “sustained overall development” shapes “income, education, aspirations, and demographic structure” in ways that actually encourage emigration. In contrast to the short-term effect delivered by decreasing youth unemployment in the poorest countries, say Clemens and Postel, the longer-term impact that encourages migration can last for generations, with the pressures contributing to migration only beginning to drop as countries develop beyond middle-income status. The paper calls for a complete rethink of strategies based on deterring migration and argues instead for new policies that shape how migration takes place….”
See also CGD.
CGD – Cultivating a New Bargain on Migration: Three Recommendations for the Global Compact
“The Global Compact on Migration is a non-binding agreement expected to be signed by most countries on earth near the end of 2018. They are negotiating the text now. This Compact is a once-in-a-generation chance for the world to strike a new bargain on migration. There will not be another chance soon to get this bargain right. As it stands, the Zero Draft of the Global Compact is mostly not a bargain. It is mostly a detailed and inspirational list of general ways that countries can coordinate to advance their shared interests: … … But the final draft of the Global Compact needs something else. It must be a bargain. In a bargain, people don’t pretend their interests are aligned. They admit conflicting interests. And they partially concede, in order to come out better than they could by going it alone….”
Brookings ‘Future Development’ blog – In defense of traditional aid
A Pipa; Brookings;
Interesting blog on highlights from a recent roundtable on the role of the OECD’s Development Assistance Committee (DAC), how it has to adjust to a new era, and is actually well positioned to shepherd the shift from development aid to development finance.
Devex – Aid groups targeted by fake news, report says
“Development organizations are “struggling to cope” with the impact of “fake news,” according to a new report. The report, published Tuesday by the International Broadcasting Trust, a nonprofit working on media coverage of developing countries, highlights the experience of international NGOs including Save the Children and ActionAid, which have been targeted by false stories designed to disrupt their work and smear the reputations of senior staff. IBT says that NGOs need to monitor fake news about them, and be better prepared to challenge misleading information. It also warns that development organizations face greater media scrutiny than ever before, and should take steps to avoid disseminating misleading stories and statistics themselves, even unintentionally. “Conflicts and natural disasters are increasingly accompanied by rumours and misinformation on social media making humanitarian operations in these areas even more difficult. People need fact-based information about key global issues such as climate change and migration,” the report states.”
See also the Guardian – Charities colluding with traffickers? Fake news, says report
“Aid agencies and charities are increasingly the target of fake news aimed at undermining their credibility, according to by the International Broadcasting Trust. In a week in which in the aid sector hit the headlines, the new report – Faking It – examined the reputational impact of fake news, typically on social media, amid already declining public trust in NGOs…. ”
First global conference on Tax and the SDGs (New York, 14-16 Feb) – Platform for Collaboration on Tax (PCT)
“The Platform for Collaboration on Tax (PCT), [holds] the first global conference of the PCT at the UN Headquarters in New York, USA, during 14-16 February 2018. The PCT is a collaborative initiative of the IMF, the OECD, the UN and the WB group designed to intensify our cooperation on tax issues, as well as to support capacity-building efforts in developing countries and the joint delivery of guidance on a range of tax issues. The theme of this first global conference is “Taxation and the Sustainable Development Goals”. “
See the press release – Countries Must Strengthen Tax Systems to Meet SDGs “ Major international organizations -including the IMF, OECD, UN and World Bank Group- today called on governments from around the world to strengthen and increase the effectiveness of their tax systems to generate the domestic resources needed to meet the Sustainable Development Goals (SDGs) and promote inclusive economic growth….”
“…At the end of the event, PCT partners will issue a conference statement, which will inform a future agenda on tax policy and administration.”
By the way, we hope Richard Branson and Michael O’Leary are invited. And then catapulted by Elon Musk into space, in a fancy Tesla, all the way to Mars.
WHO – Individualized, supportive care key to positive childbirth experience, says WHO
“WHO has issued new recommendations to establish global care standards for healthy pregnant women and reduce unnecessary medical interventions…. Worldwide, an estimated 140 million births take place every year. Most of these occur without complications for women and their babies. Yet, over the past 20 years, practitioners have increased the use of interventions that were previously only used to avoid risks or treat complications, such as oxytocin infusion to speed up labour or caesarean sections. …
“… The new WHO guideline includes 56 evidence-based recommendations on what care is needed throughout labour and immediately after for the woman and her baby. These include having a companion of choice during labour and childbirth; ensuring respectful care and good communication between women and health providers; maintaining privacy and confidentiality; and allowing women to make decisions about their pain management, labour and birth positions and natural urge to push, among others….”
Coverage in Reuters – “Women in labor should be given more time to give birth and have fewer medical interventions, while participating more in decision-making, the World Health Organization (WHO) said on Thursday. …”
UN News – Without firm action on gender equality, women’s empowerment, world may miss development targets
UN Women launched its first monitoring report on gender equality and the SDGs. “Without speedy progress on gender equality and real action to end pervasive discrimination against women and girls, the global community will not be able to keep the promise to ‘leave no one behind’ on the road to ending poverty, protecting the planet and advancing prosperity by 2030, according to a new United Nations report launched on Wednesday. “This is an urgent signal for action, and the report recommends the directions to follow,” Phumzile Mlambo-Ngcuka, the Executive Director of UN Women, said on the launch of the new report, Turning promises into action: Gender Equality in the 2030 Agenda for Sustainable Development…..”
See also Devex – Progress on gender equality ‘unacceptably slow:’ UN Women and a blog on Duncan Green’s blog – New Report from UN Women argues that Universal Childcare can unlock progress across multiple SDGs (and costs it) (by Silke Staab et al)
Key publications of the week
BMJ Global Health – What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition
P Baker, C Hawkes, A Demaio, J Parkhurst et al; http://gh.bmj.com/content/3/1/e000485?cpetoc
“Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016–2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic ‘commitment-building’ actions….”
BMJ (Analysis) – How many lives are at stake? Assessing 2030 sustainable development goal trajectories for maternal and child health
“John W McArthur, Krista Rasmussen, and Gavin Yamey examine how far countries have to go to meet the targets for maternal and child mortality and what needs to be done to help them.”
Some of their key messages: “42 countries are not on track to achieve the sustainable development goal targets for both maternal and child mortality; Another 37 countries will miss at least one of these thresholds; The lives of 1.6 million mothers and 10.2 million children will be saved if all countries meet the thresholds; The rates of decline required in countries with the biggest gaps are very high; Scaling up integrated packages of evidence based interventions, both inside and outside the health sector, will be essential to accelerate progress.”
And they conclude: “Universal achievement of the SDG targets for maternal and child health requires accelerated progress across 79 countries. Overall, roughly 11.8 million lives can be saved if the targets are reached, including 1.6 million mothers and 10.2 million children. Close to seven million (57%) of the lives are at stake in only three countries: Nigeria, Pakistan, and DR Congo. To reach the SDG benchmarks for both maternal and child mortality, Nigeria will need to achieve faster average annual rates of decline than those of any countries recorded over the most recent decade. Considerable evidence exists regarding the interventions needed to achieve these standards. But success will not arise through business-as-usual approaches”
Guardian – Many young African women with HIV unaware they are infected
“Less than half of young women with HIV in seven southern and east African countries are aware they are infected, according to a wide-ranging study. The incidence of HIV infection among 15- to 24-year-old women in Lesotho, Malawi, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe is currently around 3.6% – some 1.5 million young and adolescent women – with an infection rate almost double that of their male counterparts. Only 46.3% of those infected were aware that they had the disease, and only 45% of those with the infection were receiving treatment and virally suppressed. …” Based on a two-year survey, published by the US Center for Disease Control’s Morbidity and Mortality Weekly.
Globalization & Health – Corporate practices and health: a framework and mechanisms
“The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities. We use Steven Lukes’ three-dimensional view of power to guide the study of the practices deployed by commercial interests to foster the consumption of these commodities. Additionally, we propose a framework to systematically study corporations and other commercial interests as a distal, structural, societal factor that causes disease and injury. Our framework offers a systematic approach to mapping corporate activity, allowing us to anticipate and prevent actions that may have a deleterious effect on population health….”
Lancet (Editorial) – Examining humanitarian principles in changing warfare
“…From October, 2016, to July, 2017, a US-led coalition supported the Iraqi and Kurdish forces in a battle to retake the city of Mosul from the Islamic State of Iraq and the Levant (ISIL). What became known as the Battle of Mosul was one of the largest urban sieges since World War 2. Over 940 000 civilians fled—facing bullets, mortar shells, and air strikes. Providing timely and efficient trauma care to these civilians was paramount but fraught with difficulty. How the humanitarian community responded to this situation provides an insight into the evolving debate over the provision of trauma care in war….”
“…in modern warfare, access to the injured may increasingly be one sided when fighting against warring factions that see health workers and civilians as acceptable targets of war. Governments should be prepared to face this eventuality. To be able to continue providing the best standards of care and saving lives, a high-level meeting must urgently be organised to examine and answer this question: are the humanitarian principles as they are defined today still relevant for this changing warfare?”
Lancet (Offline) – Apostasy against the public health elites
“…Last week, The Health Foundation convened an assembly of heretics to make the case for a deeper appreciation of different forms of evidence for public health….”
In the end, “…what mattered was the common view that public health science needed to pay more attention to the lived experiences of people in societies. Public health needed to recognise the importance of identity, reasoning, and voice. Public health today is crudely reductionist, often ignoring or denying the lives of those it purports to defend. Public health has evolved into an elitist endeavour, more concerned with its own power, reputation, and survival. It’s time for some apostasy.”