Cholera crisis in Yemen
As Katri Bertram said in a tweet: “If we at the end of last year felt that #Aleppo was a test to the world’s humanity and conscience, #Yemen is that next test.” True, but not the only one, I’m afraid…
(Joint) Statement by UNICEF Executive Director, Anthony Lake, WFP Executive Director, David Beasley and WHO Director-General, Dr Tedros Adhanom Ghebreyesus, following their joint visit to Yemen
After a joint visit to Yemen, to see firsthand the situation on the ground, Tedros & fellow UN organization leaders from UNICEF & WFP called on the international community to redouble its support for the people of Yemen, as the situation of famine, malnutrition, cholera, health facilities (including lack of payment for health workers) … remains extremely worrying.
Children are bearing the brunt of the conflict in Yemen, with 80% in desperate need of aid and 2 million suffering from acute malnutrition. And this is now compounded by cholera. See the Guardian. See also BMJ News – Humanitarian leaders call for “redoubling” of aid for crisis engulfing Yemen or UN News – Malnutrition and cholera ‘a vicious combination’ in war-torn Yemen – UN agency chiefs
A few tweets:
“30,000 health workers in #Yemen not been paid for a year, need our support to save lives”
Devi Sridhar – “Biggest scandal in #globalhealth: health workers going unpaid for months & years, esp in crisis situations”
Some other links related to the cholera crisis in Yemen:
“A decision to postpone what would have been the largest ever global delivery of the cholera vaccine to Yemen reveals the extent to which the crisis has already outpaced efforts to contain it, experts say….”
Reuters – Yemen cholera epidemic slowing after infecting 400,000
“Yemen’s cholera outbreak is set to hit 400,000 cases on Tuesday but there are signs the three-month-old epidemic is slowing, according to World Health Organization data analyzed by Reuters. A dramatic fall over the past month in the number of people dying from the disease each day — from about 30 to single figures — suggests the WHO’s strategy of setting up a network of rehydration points to catch patients early is working….”
9th IAS (International Aids Society) conference on HIV science ( 23-26 July, Paris)
This week, the 9th IAS conference on HIV science took place in Paris, against a rather worrying international & funding backdrop.
RFI – Paris AIDS conference opens amid concerns over funding problems
(recommended) Published as the conference started – setting the scene. “Some 6,000 HIV experts gather in Paris from Sunday to report advances in AIDS science as fading hopes of finding a cure push research into new fields.” “…The July 23-26 conference happens amid concerns that funding for HIV research and treatment programmes may be under threat.”
As for the worrying funding environment for HIV:
KFF – Kaiser/UNAIDS Study Finds Donor Government Funding for HIV Declined by 7% in 2016, Falling to Lowest Level Since 2010
Worrying report published late last week. “Donor government funding to support HIV efforts in low- and middle-income countries decreased by US$511 million from US$7.5 billion in 2015 to US$7 billion in 2016, finds a new report from the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS). This marks the second successive year of declines, and is the lowest level since 2010. The decrease stems from actual cuts in funding (accounting for an approximate net 50% of the decline), exchange rate fluctuations (20%), and the timing of U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (30%), due to U.S. law that limits its funding to one-third of total contributions to the Global Fund….”
See also Science Speaks (on a session at IAS) – IAS 2017: With resources already stretched, cuts will hurt, global health advocates say.
FT Health (newsletter last week) – FT Health: Mixed progress on HIV
From the intro from last week’s FT health newsletter: “The good news at the latest International Aids Society (IAS) HIV Science conference, which starts this weekend in Paris, is the excitement over new research. Long-acting, slow-release antiretroviral medicines offer the prospect of improved patient compliance, and progress with immunotherapy for cancer has provided new lines of inquiry. The use of drugs for prevention in high-risk groups and microbicides will boost prevention efforts. In the longer term, work continues on a potential cure as well as on possible vaccines.”
Before we provide some links to some of the HIV science reported in Paris, a few pieces providing a general assessment of the HIV/AIDS situation & prospects:
Thomson Reuters – Tide turns in AIDS fight yet ‘unacceptable’ death toll across sub-Saharan Africa
“The tide may have turned in the global fight against AIDS, but too many people in sub-Saharan Africa are developing and dying of AIDS-related diseases due to limited testing and problems with treatment, Medecins Sans Frontieres (MSF) said on Tuesday.”
For the MSF statement, see MSF concerned by high numbers of AIDS deaths in sub-Saharan Africa “Global attention is needed to prevent and treat AIDS in antiretroviral era, with 50 per cent of hospital admissions in MSF hospitals already on treatment and showing signs of clinical failure.”
Foreign Policy – The Next AIDS Pandemic
Laurie Garrett; http://foreignpolicy.com/2017/07/26/the-next-aids-pandemic/amp/
Garrett is, as usual, even more pessimistic: “Funding cuts to key U.S. programs that support medicine and treatment are coming. And with a booming African population and drug-resistant strains on the rise, the future is grim.” Not everybody thinks the future is that bleak, though.
Science Speaks – IAS 2017: UNAIDS numbers show returns, need for greater investment, international leaders say
With the views of Sidibé (UNAIDS), Marijke Wijnroks (GF), Birx (Pepfar) and others.
“No level of funding can compensate for lack of political commitment,” remarked Marijke Wijnroks, the Interim Executive Director of the Global Fund to Fight AIDS, Tuberculosis & Malaria. In the “countries that made the least progress,” she added, “conflict and lack of political commitment were more important than lack of funding.””
“… Amb. Birx later acknowledged, a new administration would like the U.S. global AIDS response “to do more with less.” … … But “No,” she added, “we are not going to just work in 12 to 13 countries but they will be the model while still continuing our work in 50 plus countries.””
UNAIDS welcomes the launch of the End AIDS Coalition at the 9th International AIDS Conference on HIV Science in Paris
“UNAIDS has welcomed the launch of the End AIDS Coalition (EAC) during the 9th International AIDS Conference on HIV Science taking place in Paris, France. The EAC brings together a strong collaboration of leading AIDS experts, scientists, clinicians, policy-makers, faith leaders, business leaders and activists determined to end the AIDS epidemic as a public health threat by 2030. The EAC aims to amplify efforts to end the AIDS epidemic by strengthening linkages across research, resources and implementation, by encouraging the aggregation and analysis of data from the global AIDS response to identify barriers and encourage efficiencies and by inspiring a movement to mobilize and engage the next generation of young leaders in the response to HIV. The founder of the End AIDS Coalition is the American fashion designer and amfAR chair, Kenneth Cole, who is also a UNAIDS International Goodwill Ambassador.”
They’ll have their work cut out.
IP-Watch – WHO Prequalifies First Generic Hepatitis C Drug And First HIV Self-Test
Announcement from late last week. “In the days before this month’s AIDS conference being held in Paris, the World Health Organization has announced the prequalification of the first generic version of sofosbuvir, a “critical” medicine for treating hepatitis C. Treatment for hepatitis C under patent has been notoriously priced at extreme high levels, putting it out of reach of patients in economies of all sizes. The WHO said the prequalification could open the way to expand treatment access by increasing the number of generic medicines on the market that have met quality assurances. At the same time, the UN health agency announced a new oral self-test for HIV that gives results in as little as 20 minutes, which it hopes will increase diagnosis and treatment.”
See also WHO.
The Paris Statement – HIV Science matters
Ending the epidemic requires the continued contribution of and investment in science. With five key messages.
Some links to (some of the) HIV science reported at IAS
Of course, this is not an extensive overview …
Science – What can science learn from a child who has controlled HIV without drugs for more than 8 years? “An HIV-infected child in South Africa who is controlling the virus without antiretroviral (ARV) drugs has reinvigorated the push to find ways to allow people to control the virus for prolonged periods without treatment….” See also the Guardian – Child treated for HIV at birth is healthy nine years on without further treatment.
Lancet Comment – Long-acting injectable ART: next revolution in HIV?
Comment related to new Lancet research . “A trial assesses the safety and efficacy of two-long acting drugs, given via intramuscular injection every 4 or 8 weeks, and shows comparable maintenance compared with the daily oral drug therapy.
“A package of low-cost drugs designed to prevent deadly infections among people who are starting HIV treatment late could save 10,000 lives a year across sub-Saharan Africa, scientists believe. About one in five people who start HIV treatment in poorer countries are doing so later than advisable, which means they have a low number of CD4 cells, a key component of the immune system. This leaves them far more vulnerable to developing serious illnesses. Roughly one in 10 such people die within the first few weeks of treatment because their immune systems cannot recover fast enough. HIV prevalence is particularly high in sub-Saharan Africa, with women and children especially vulnerable, but a study led by academics at University College London found that a preventative package of anti-infection drugs significantly reduces the number of deaths from HIV-related illnesses. The researchers estimate that if the drugs were given to every patient in sub-Saharan Africa starting anti-HIV treatment and suffering from a low CD4 count, the drugs could prevent roughly 10,000 deaths each year….”
There was also encouraging news on the HIV situation in Swaziland (based on data from Swazi health officals and the CDC), the nation with the highest HIV rate which has apparently managed to cut new infections drastically.
“A new Aids vaccine will begin large-scale trials in southern Africa at the end of this year, in what is hoped will be a breakthrough in the 30-year scientific battle against the disease. Promising early clinical data on the vaccine, developed by Johnson & Johnson with the US National Institutes of Health (NIH), were released at the International Aids Society conference in Paris on Monday. The experimental “Ad26 mosaic” will be the second vaccine to undergo tests by thousands of African volunteers of its effectiveness at preventing infection with HIV, the virus that causes Aids….”
Stat – Could cows be the vaccine factories of the future? (news from the HIV lab) Part of the larger effort to make the first HIV vaccine. Antibodies of cows could come in handy.
(recommended) “… campaigners know that reaching the next 10 million people with treatment will be harder in some ways. These patients are among the most difficult to reach: People living in conflict areas, stigmatized and criminalized populations — like men who have sex with men and sex workers — and young people, leery at the thought of taking HIV medication every day for the rest of their lives.
“… helped center discussions at this week’s IAS meeting around how to make it easier for patients to access and stay on treatment — key improvements that could help in reaching the most vulnerable. HIV advocates hope that a combination of scientific breakthroughs and experience-informed social outreach can bridge the final gaps in treatment. Researchers and programmers are specifically thinking about strategies to make it easier for patients in some of the most difficult settings to start and maintain ARTs, as well as to reduce the number of times patients must travel to health clinics to pick up antiretroviral, ARV, drugs. Potential scientific breakthroughs in long-lasting, injectable ARVs may also mean HIV patients would no longer be looking at a lifetime of daily pills, often a deterrent or obstacle for care.”
International Business Times – Truvada, Vaginal Rings Can Prevent HIV In Adolescents, Study Says
Lancet – IAS (free content made available)
“To mark the 9th IAS Conference on HIV Science, the Lancet journals have made a selection of content free that reflects some of the breadth and diversity of clinical, epidemiological, and operational HIV research produced by the tireless global HIV community. The content includes research published across the Lancet titles—taken from six of our journals, well established and recently launched. … .”
Stat (op-ed) – To achieve universal health care, we need country leadership and globalism
Tedros & Seth Berkley; https://www.statnews.com/2017/07/21/universal-health-care-global/
This piece went viral last week. Not quite sure why. Probably the timing (together with the HLPF) had to do something with it.
African Business Magazine – Africa’s healthcare challenge will not be met by public finances alone
Interesting piece, with the view of WHO’s regional director, Dr Matshidiso Moeti, on the fact that WHO now has an African DG, and also how she sees the UHC momentum in Africa. She sounds quite optimistic.
“… While some countries have maintained their public spending on healthcare, with commodity exporters hardest hit, Moeti says more needs to be done to drive efficiency gains in the sector. “Countries need to put much more effort into coordinating the funding they need to reduce duplication, waste, and simply get more mileage out of what is being spent. I do think that countries could achieve a lot of efficiency from their investments in health, so that they get more return for the money they are currently putting in.” The context is conducive to such policy making, she argues, pointing to a shift in how funding for healthcare is perceived by governments. Rather than being looked at as a drain on public coffers, while sectors like mining and infrastructure are seen as economically productive, Moeti says the value of investing in health is being better understood….”
“…Moeti is enthusiastic about the role business can play in driving better healthcare, saying that stronger partnership with business is a key priority for the WHO in Africa. …”
Reproductive Health (Editorial) – Three recommendations to the new Director-General of the WHO on how to deliver for girls and women
Katja Iversen; Reproductive Health;
More advice for Tedros, this time from Katja Iversen (Women Deliver).
More High-Level Political Forum (HLPF) analysis & news
See also last week’s IHP news.
Civil society reaction on ministerial declaration
Must-read. Hard-hitting, but fair.
IISD – Summary of the 2017 Meeting of the High-Level Political Forum on Sustainable Development
Great summary. Make sure you check out the ‘Brief analysis’’, towards the end.
“…Since the adoption of the 2030 Agenda and its 17 Sustainable Development Goals in September 2015, the High-Level Political Forum on Sustainable Development has become the central intergovernmental platform for follow-up and review of the world’s ambitious and universal new roadmap to end poverty, protect the planet, and ensure that all people enjoy peace and prosperity. The HLPF was established in 2012 to replace the UN Commission on Sustainable Development (CSD), whose systemic shortfalls on the fronts of monitoring sustainable development implementation, integrating the three dimensions of sustainable development, and responding to emerging issues rendered it incapable of effectively addressing the sustainable development challenges of the 21st century. Against the backdrop of high poverty and “astounding inequality,” growing instability, and a dangerously warming world, at HLPF 2017 many wondered if the Forum is up to the task of confronting today’s considerable sustainable development challenges head-on? In the words of the French electronic music duo Daft Punk, is the “HLPF at five” “harder, better, faster, stronger” than its predecessor? This brief analysis contemplates this question across three dimensions, considering the extent to which HLPF 2017 succeeded in: offering robust follow-up and review of the SDGs; catalyzing national implementation; and providing the necessary political leadership and guidance to spur momentum for sustainable development. It concludes by considering whether the Forum is moving in the right direction, or is repeating the mistakes of its predecessor….”
A few more nice analytical blogs:
After listing some of the positive aspects of this year’s HLPF, he notes: “…At the same time, Agenda 2030 has been able to emphasize some critical shifts in how we think about development. One of the most important for me has been the much-needed understanding that development is a universal endeavour, and that all countries are still developing—albeit in different ways and with different priorities. While it is true that richer countries can play an important role in supporting others to develop, this doesn’t mean that it’s only about aid and development cooperation for them. It is also about adapting their own domestic policies, for their own citizens. We heard less about this at the HLPF, although it is encouraging to see movement in some European countries such as Switzerland, Sweden and Germany. Agenda 2030 is also about the myriad policies in richer countries that enhance or reduce the space for poorer countries to develop, such as pollution, over-consumption, trade, migration, and international tax policy. The bundle of issues that we label as relating to ‘policy coherence’. There was still too much silence on this latter set of commitments by richer countries. It is still easier for them to talk about their investments and influence in other places….”
Andrew Griffiths: Four lessons from the Forum: what we learned at this week’s HLPF
Among others: All government ministries (beyond the SDG focal ministry) have to be involved in the VNR process; Where civil society is organised at a national level it can make a big difference; The role of parliaments is being seen as more and more important; …
Family planning & women’s (health) rights
Devex – She Decides fund for family planning takes shape
The latest state of affairs on She Decides. Must-read. “Six months after U.S. President Donald Trump’s reinstatement of an extended “global gag rule,” the She Decides family planning movement launched in its wake is beginning to take shape. A spokesperson told Devex that donations “have risen substantially” since the She Decides conference in March, when approximately $190 million were raised to support organizations affected by U.S. funding cuts and restrictions. And that money is “still coming in.” Details are also emerging of how the funds will be used and about a new U.K.-based management team.” The aim is certainly to be more than just an anti-Trump, pro-choice movement.
Devex – How significant were the pledges at the London Family Planning Summit?
Analysis. “… Advocates have welcomed the news that an estimated $5 billion was pledged to improve and expand reproductive health services in developing countries at the London Family Planning Summit earlier this month — double the figure cited in initial reports — but say it still falls far short of the sums needed, and that better monitoring systems are required to ensure the commitments materialize…. experts pointed out that the $5 billion pledged is nowhere near the $8 billion that the London-based think tank the Overseas Development Institute estimates will be needed annually to meet the challenge. … Some have also questioned whether all of the commitments will materialize, and say it is difficult to tell if it all represents new and additional funding. … … The bulk of southern commitments came from just three countries (India, Indonesia, Bangladesh) … However, the fact that the commitments of these three countries represent the lion’s share of the $4 billion pledged by developing countries at the London summit tempers the narrative about developing countries starting to champion family planning, she (i.e. R Silverman) said.”
Do check out also – in the Guardian – Families, fertility and feminism: landmarks in women’s rights “Women have fought long and hard to secure access to family planning and abortion, and reduce maternal mortality. A modern timeline of that struggle tells a story full of highs and lows.”
Guardian – How Trump signed a global death warrant for women
Sarah Boseley; Guardian
(recommended) “With one devastating flourish of the presidential pen, worldwide progress on family planning, population growth and reproductive rights was swept away. Now some of the world’s poorest women must count the cost.” An in-depth overview of the many dire (global & national) implications so far.
Global humanitarian crisis (& lack of/or downright criminal policy response)
This is one of the most dire sections in the newsletter every week, unfortunately. Just a couple of headlines & reports (although there are many more):
Guardian – European and African ministers discuss plan to tackle flow of refugees
“European and African ministers met in Tunis on Monday to discuss a plan to try to regularise the flow of refugees from Africa to Europe to about 20,000, coupled with a much tougher strategy to deport illegal migrants from Italy and break up smuggling rings. The plan to regularise the migrant flow is being pushed by the UNHCR, the UN refugee agency…”
Washington Post – How McKinsey quietly shaped Europe’s response to the refugee crisis
Among others, in Germany. Interesting piece. To quote a notorious leader, #SAD !
UNICEF – Majority of children fleeing to Europe just want to get away, UNICEF reports
“Facing violence and trauma in Libya and other countries, thousands of children decided to flee by themselves, seeking to get away but not necessarily aiming for Europe, UNICEF [today] reported. A new study of push-pull factors on child marriage showed that 75 per cent of children on the move decided to leave unaccompanied and that initially, they had no intention to come to Europe, UNICEF spokesperson Sarah Crowe told journalists in Geneva….”
Guardian – Foreign governments must ‘pressure South Sudan to end epidemic of rape’
“Donor countries should be pressuring the government of South Sudan to end the sexual violence being carried out on a mass scale and with impunity in the country, say campaigners. Karen Naimer, a director at advocacy group Physicians for Human Rights, said countries that give aid must hold the recipient government’s “feet to the fire”by speaking publicly about atrocities and insisting they do the same. A report published on Monday by Amnesty International found sexual violence in the world’s newest country was rampant, and catalogued a litany of rape, sexual slavery, torture and castration perpetrated by South Sudan’s government and the opposition.”
STAT – Human trafficking must be officially recognized as a medical diagnosis
“…The International Classification of Disease (ICD) codes aim to describe diseases and causes of death and disease. These codes, which are used for everything from hospital billing to research, establish legitimacy for the conditions that harm and kill people every day. As the World Health Organization works toward the 11th iteration of these codes, we urge that “victim of human trafficking” be recognized as an official diagnosis.” The authors have a strong case.
And “… The importance of including human trafficking as a billable medical condition by including it in the ICD code system is part of a larger movement to frame trafficking as a significant public health issue that affects millions of vulnerable people around the world. The harms of trafficking to human health are multifold, spanning multiple disciplines of medicine, including emergency medicine, internal medicine, obstetrics/gynecology, infectious disease, pediatrics, and psychiatry….”
1st newsletter HS Governance collaborative
Read about this Collaborative (formally launched on 12 December 2016), what its aims are as well as the double focus this year. The newsletter will be sent out every three months.
Make sure you also check out the short Youtube video featuring Maryam Bigdeli, Kabir Sheikh et al. https://www.youtube.com/watch?v=p5BEJ7qMeMs&feature=youtu.be
Stay tuned for more in next week’s IHP newsletter!
World Hepatitis Day (28 July) – Fight is gaining momentum
WHO – Eliminate hepatitis
“New WHO data from 28 countries – representing approximately 70% of the global hepatitis burden – indicate that efforts to eliminate hepatitis are gaining momentum. Published to coincide with World Hepatitis Day, the data reveal that nearly all 28 countries have established high-level national hepatitis elimination committees (with plans and targets in place) and more than half have allocated dedicated funding for hepatitis responses. On World Hepatitis Day, WHO is calling on countries to continue to translate their commitments into increased services to eliminate hepatitis. This week, WHO has also added a new generic treatment to its list of WHO-prequalified hepatitis C medicines to increase access to therapy, and is promoting prevention through injection safety: a key factor in reducing hepatitis B and C transmission….”
“World Hepatitis Day 2017 is being commemorated under the theme “Eliminate Hepatitis” to mobilize intensified action towards the health targets in the 2030 Sustainable Development Goals.”
PS: “World Hepatitis Summit 2017, 1–3 November in São Paulo, Brazil, promises to be the largest global event to advance the viral hepatitis agenda, bringing together key players to accelerate the global response. Organised jointly by WHO, the World Hepatitis Alliance (WHA) and the Government of Brazil, the theme of the Summit is “Implementing the Global health sector strategy on viral hepatitis: towards the elimination of hepatitis as a public health threat“.”
Reuters – Hepatitis drugs more affordable but disease still deadly: WHO
“Prices of drugs to cure hepatitis C and to treat hepatitis B are dropping dramatically, offering affordability and hope to 325 million people living with the viral liver disease that can be fatal, the World Health Organisation (WHO) said on Thursday. A generic antiviral drug for hepatitis C, which can be cured in three months, was placed this week on WHO’s list of pre-qualified medicines. That means it can be used safely by aid agencies and countries for bulk purchasing. “Indeed, the first drug sofosbuvir has now been pre-qualified, that means it is quality-assured through the WHO prequalified mechanism, which is very good news,” Dr. Gottfried Hirnschall, director of the WHO department of HIV and global hepatitis program, told a Geneva news briefing….”
Guardian – Rule that patients must finish antibiotics course is wrong, study says
Was big news all around the world yesterday. Based on this BMJ Analysis piece – The antibiotic course has had its day.
“With little evidence that failing to complete a prescribed antibiotic course contributes to antibiotic resistance, it’s time for policy makers, educators, and doctors to drop this message, argue Martin Llewelyn and colleagues. ”
Plos Med (essay) –Multidrug-resistant gonorrhea: A research and development roadmap to discover new medicines
AMR is terrifying, and when it concerns gonorrhea, for some reason, it even feels more terrifying. So this comes timely:
“… In 2016, the Global Antibiotic Research and Development Partnership (GARDP) was launched by the World Health Organization (WHO) and Drugs for Neglected Disease initiative, which hosts and provides governance for GARDP. GARDP has worked together with experts from different regions to draft “ideal” and “acceptable” Target Product Profiles for the treatment of gonorrhea, reflecting medical need. Amongst other activities to combat antimicrobial resistance, GARDP has developed a plan to meet the urgent need for new drugs to treat gonorrhea. Over the next 7 years, this research and development proposal includes the following: exploring the introduction of a new clinical entity against gonorrhea; the identification of existing, suitable partner drugs; the recovery of previously abandoned, out-of-favor, and withdrawn antibiotics; and the development of simplified treatment guidelines for the empiric management of sexually transmitted infections.”
CARB-X announces new funding for scientists
“Scientists developing promising new antibiotics in India, Ireland, France, Switzerland, the US and UK are to share up to US$17.6m to speed treatments for the world’s deadliest superbugs. A year since launching, the international partnership CARB-X today announced its second round of antibiotic research and development funding – alongside a call for greater global support….” With info on 7 supported projects.
BMJ – Trade is central to achieving the sustainable development goals: a case study of antimicrobial resistance
(recommended) “Johanna Hanefeld and colleagues highlight the links between trade and health and argue for greater consideration of trade agreements in actions to meet the sustainable development goals.” Applied on AMR here.
BMJ – Role for academic institutions and think tanks in speeding progress on SDGs
I Kickbusch & J Hanefeld ; http://www.bmj.com/content/358/bmj.j3519
(must-read) “Academic institutions and think tanks are uniquely placed to broker links between different sectors and assist with cross cutting approaches to achieving the health related sustainable development goals, say Ilona Kickbusch and Johanna Hanefeld. “
Key messages: “Achieving the sustainable development goals will require a new transformative governance for health which focuses on intersectionality and partnership. Think tanks and academic institutions have a crucial role to play in realising and accelerating action for sustainable development. Six core areas will contribute to the achievement of the SDGs—developing elements of governance, increasing political accountability for sustainable development, engaging national and global stakeholders, identifying new solutions to systemic challenges in intersectoral working, enabling joint learning, and knowledge sharing. We invite think tanks and academic institutions to join this effort in the form of a Global Health Policy Think Tank Network.”
PS: The network just came together in Chile. Stay tuned for the Santiago declaration on accelerating political support for SDG implementation.
Read also (BMJ blog by Peter Taylor) – Health, SDGs, and public policy—the role of policy research institutions which provides a bit more background on this network and what the aims are, including on a series of articles that is being started.
… The “first 1000 days” of implementation have been identified as critical to the SDGs’ success. To avoid the dangerous perception that there is still plenty of time to act before 2030 draws near, the International Development Research Centre (IDRC) and the Think Tank Initiative (TTI), collaborating closely with the Graduate Institute, Geneva and other partners, have convened a series of global and regional consultations in Geneva, Berlin, Kampala, Rio de Janeiro, Vancouver, Islamabad, London, Montreal, and most recently in a meeting of West African representatives in Dakar, Senegal. These consultations have conveyed a real sense of urgency: it is clear that policy making processes can no longer remain business as usual. There is a pressing need to put in place now the thinking and collaboration required to catalyse progress towards the SDGs…. “
… To help respond to these challenges, IDRC and the Graduate Institute have helped support the emergence of a new global collective “Think_SDGs” (Think Tanks, Health policy Institutions, Networks, and Knowledge), which aims to collaborate in generating and sharing knowledge, and to combine the efforts of those working at global, regional, national, and local levels. As a key part of its response, IDRC understands that public engagement is crucial; and so is very pleased to collaborate with The BMJ and Think_SDGs in supporting a collection of articles that will include a guiding framework for policy researchers seeking to catalyse progress towards the health related SDGs; … .” The first articles in the series were already published this week.
Indian Express – Willing to quit in foundation’s interest: PHFI chief
PHFI’s Srinath “Reddy now says that he is willing to step down in the foundation’s interest if his stature in the global public health arena or perceived closeness to the UPA are a problem.”
Must-read – update on the dire situation of PHFI in India, the tobacco scheming by powerful tobacco lobbies & much more. A freely speaking Srinath Reddy on the situation, even if he remains diplomatic, for understandable reasons.
Global Justice Now (report) – After a year of aid scandals, new report lays out a progressive strategy for the UK’s 0.7% spending
“A new report lays out the case for why a new, progressive vision for UK aid is urgently needed, arguing that it must be re-focused on principles of social justice and the need to redistribute economic and political power in the world. ‘Re-imagining UK aid: What a progressive strategy could look like’ argues that “aid spending has been driven by notions of charity, national self-interest, and an ideological belief that free markets and multinational business can solve the world’s problems,” and lays out eight areas where aid money could be used to achieve long-term, structural, progressive change.” Recommended reading also for the current Belgian minister, Alexander De Croo.
See also a piece by Nick Dearden (Global Justice Now) – We need to talk (honestly) about aid
“The trickle-down dogma of the aid industry is false. It is time to start distributing aid to create public goods.”
Lancet (Editorial) – What can evolutionary theory do for public health?
“Today The Lancet publishes a three-part Series on evolutionary public health. It aims to widen appreciation of the value of evolutionary theory for designing public health interventions and for understanding why they often fail. As Jonathan Wells, the Series lead, and colleagues lay out in the first paper, evolutionary theory offers a holistic framework for public health that takes account of individuals’ physiological and behavioural decisions in the context of their life-course trajectories and responses to environmental exposures. The two other papers consider the evolutionary perspective of human reproduction, and how human behaviour and microbes interact to shape our physiology and metabolism….”
You find the first paper in the series here – Evolutionary public health: introducing the concept. (by J Wells et al)
“The emerging discipline of evolutionary medicine is breaking new ground in understanding why people become ill. However, the value of evolutionary analyses of human physiology and behaviour is only beginning to be recognised in the field of public health. Core principles come from life history theory, which analyses the allocation of finite amounts of energy between four competing functions—maintenance, growth, reproduction, and defence. A central tenet of evolutionary theory is that organisms are selected to allocate energy and time to maximise reproductive success, rather than health or longevity. Ecological interactions that influence mortality risk, nutrient availability, and pathogen burden shape energy allocation strategies throughout the life course, thereby affecting diverse health outcomes. Public health interventions could improve their own effectiveness by incorporating an evolutionary perspective. In particular, evolutionary approaches offer new opportunities to address the complex challenges of global health, in which populations are differentially exposed to the metabolic consequences of poverty, high fertility, infectious diseases, and rapid changes in nutrition and lifestyle….”
Do read also the other papers, ‘Human reproduction & health: an evolutionary perspective’, … if you’re not on holidays (or ensuring your own reproduction this weekend).
Lancet (Comment) – Avoiding globalisation of the prescription opioid epidemic
“In May, 2017, 12 members of the US Congress wrote to the then WHO Director-General Margaret Chan to warn of an expanding international drug epidemic fuelled by what they called a “reckless”, “greedy”, and “dangerous” organisation. The subject of their letter was the US-based opioid manufacturer Purdue Pharma and its global counterpart Mundipharma International. … … their warning demands urgent attention across the world.”
Lancet – Defending academic and medical independence in Turkey
PHM took the lead in drafting this letter. “We write on behalf of 207 health professionals, academics, and researchers, and 25 health and human rights organisations from many countries. We wish to bring to the attention of The Lancet’s readers alarming events taking place in Turkey, where the state has been waging a campaign of terror and punishment against thousands of health professionals and academics….”
Key reads of the week
IJHPM – State Support: A Prerequisite for Global Health Network Effectiveness; Comment on “Four Challenges that Global Health Networks Face”
Robert Marten & Richard Smith; http://www.ijhpm.com/article_3394.html
“Shiffman recently summarized lessons for network effectiveness from an impressive collection of case-studies. However, in common with most global health governance analysis in recent years, Shiffman underplays the important role of states in these global networks. As the body which decides and signs international agreements, often provides the resourcing, and is responsible for implementing initiatives all contributing to the prioritization of certain issues over others, state recognition and support is a prerequisite to enabling and determining global health networks’ success. The role of states deserves greater attention, analysis and consideration. We reflect upon the underappreciated role of the state within the current discourse on global health. We present the tobacco case study to illustrate the decisive role of states in determining progress for global health networks, and highlight how states use a legitimacy loop to gain legitimacy from and provide legitimacy to global health networks. Moving forward in assessing global health networks’ effectiveness, further investigating state support as a determinant of success will be critical. Understanding how global health networks and states interact and evolve to shape and support their respective interests should be a focus for future research.” Recommended.
BMJ Global Health – Health sector governance: should we be investing more?
R Fryatt, S Bennett, A Soucat; http://gh.bmj.com/content/bmjgh/2/2/e000343.full.pdf
“Governance is central to improving health sector performance and achieving UHC. However, the growing body of research on governance and health has not yet led to a global consensus on the need for more investment in governance interventions to improve health. This paper aims to summarise the latest evidence on the influence of governance on health, examines how we can assess governance interventions and considers what might constitute good investments in health sector governance in resource constrained settings. The paper concludes that agendas for improving governance need to be realistic and build on promising in-country innovation and the growing evidence base of what works in different settings. For UHC to be achieved, governance will require new partnerships and opportunities for dialogue, between state and non-state actors. Countries will require stronger platforms for effective intersectoral actions and more capacity for applied policy research and evaluation. Improved governance will also come from collective action across countries in research, norms and standards, and communicable disease control.”
JAMA – Challenges in international comparison of health care systems
I Papanicolas, A Jha; http://jamanetwork.com/journals/jama/fullarticle/2646461
“This Viewpoint discusses the challenges in cross-national comparisons of health care system performance, including defining the responsibilities of the health system, managing limitations of data, and accounting for different values in different nations.”