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IHP news #466 (April 20, 2018)

Highlights of the week

Lancet – Sexual harassment and assault claims at UNAIDS

Arguably, not really a ‘highlight’…

A  Special Report  details allegations of sexual harassment and assault at UNAIDS, and a culture of silence, intimidation, and fear. The Editorial highlights the “unduly weak and unacceptable” response and calls for an independent investigation so that justice is delivered.”

(5 p) Special report (must-read): “Sexual harassment and assault investigation at UNAIDS draws attention to an endemic problem. Critics say the UN’s internal system is flawed and call for external oversight. John Zarocostas reports.”  “…it’s not just UNAIDS: Sexual misconduct and harassment are endemic across UN agencies…”

As for the Editorial’s key message (on UNAIDS): ‘…Zero tolerance should mean zero tolerance’.

Cfr a tweet from Pam Das (Lancet editor): “Working on this for over a month. As a passionate global health advocate, I’ve only felt fury, frustration, & disappointment. Painful, v. painful….”

And another tweet from her: “Today, the UNAIDS Programme Coordinating Board chaired by the UK Government @DFID_UK meet to discuss the terms of reference and aims of a new independent panel. They must take whatever action is necessary.”  (at the time of writing, no more info on this yet)

Earlier in the week, the Guardian already reported UN agency chief under pressure to quit over handling of sexual assault inquiry.

Planetary health

Guardian – More than 95% of world’s population breathe dangerous air, major study finds

Guardian;

More than 95% of the world’s population breathe unsafe air and the burden is falling hardest on the poorest communities, with the gap between the most polluted and least polluted countries rising rapidly, a comprehensive study of global air pollution has found. Cities are home to an increasing majority of the world’s people, exposing billions to unsafe air, particularly in developing countries, but in rural areas the risk of indoor air pollution is often caused by burning solid fuels. One in three people worldwide faces the double whammy of unsafe air both indoors and out. The report by the Health Effects Institute used new findings such as satellite data and better monitoring to estimate the numbers of people exposed to air polluted above the levels deemed safe by the World Health Organisation. …”

Zooming in on China, for example, China cuts smog but health damage already done: study.

Commonwealth heads of state summit in London

We will pay attention to the Malaria summit (part of the Commonwealth gathering) below.

Here we just refer to a few other Commonwealth summit-related articles:

DevexCommonwealth Summit launches in London amid concerns over LGBTQ rights, jobs  (overall analysis, published ahead of the summit).

Leaders from the 53 countries that make up the British Commonwealth arrived in London Monday for the biennial Commonwealth Heads of Government Meeting, where they convened 5,000 participants from a range of sectors, including government officials, members of civil society, and private corporations for a three-day summit to discuss the issues facing Commonwealth countries. The summit will proceed along four tracks: Women, youth, people, and business, and commenced with the launch of a number of new partnerships and initiatives. … …  The first day of meetings was overshadowed by revelations over the weekend by the Guardian newspaper that U.K. officials had indefinitely postponed a guide slated to publish on the opening day of CHOGM to promote gay rights at the meetings. The guide advises on international best practices on sexual orientation and gender identity. Critics accused the U.K. of caving to pressure from some of the 37 Commonwealth member states that outlaw homosexuality; LGBTQ rights remain a contentious issue on the biennial agenda. “This sends a very negative signal to the more than 100 million LGBT+ people who suffer criminalization, discrimination, and violence in 70 percent of Commonwealth countries,” said Peter Tatchell, a British human rights activist….”

GuardianTheresa May urged to apologise for Britain’s anti-gay colonial past

Theresa May has been urged to apologise for Britain’s historical legacy of anti-gay laws across the Commonwealth as leaders of the 53 member states gather for a summit in London on Monday. Gay rights campaigner Peter Tatchell argued that the government should help address colonial-era legislation that treats more than 100 million lesbian, gay, bisexual and trans people across the Commonwealth as criminals….”

Maybe May was too busy apologizing on other fronts this week …

Malaria Summit (London)

Some must-reads:

Guardian – Invest in mosquito surveillance to combat malaria, says Bill Gates

https://www.theguardian.com/global-development/2018/apr/18/commonwealth-nations-malaria-summit-london?CMP=twt_a-global-development_b-gdndevelopment

Overview of some of the main messages at the summit, funding, new innovations, …

Devex – Leaders challenge Commonwealth countries to halve malaria cases by 2023

https://www.devex.com/news/leaders-challenge-commonwealth-countries-to-halve-malaria-cases-by-2023-92561

Also a must-read.

On Wednesday leaders of the 53 Commonwealth nations, the private sector, and NGOs [will] announce their commitment to halve the number of malaria cases worldwide in the next five years. If achieved, this would prevent 350 million cases of malaria and save 650,000 lives, according to estimates by the World Health Organization. The Commonwealth and its citizens account for one-third of the world’s population, but more than half of all malaria cases and deaths globally. The announcement comes during the Malaria Summit London 2018, in the midst of the Commonwealth Heads of State Meeting 2018, also in London. Commitments will include a range of new interventions across three categories: funding, innovation, and better data, with strong support from malaria-endemic countries and a special focus on refugees and internally displaced people….”

Check out what the Gates Foundation promised, big pharmaceutical companies, the UK government, and most importantly – malaria endemic countries (Nigeria, Uganda, …) themselves.

See also BloombergGlaxo, Novartis Join $4 Billion Gates-Led Push to Fight Malaria.

BBC News – Malaria experts fear disease’s resurgence

http://www.bbc.com/news/health-43786343?ocid=socialflow_twitter

This, of course, was the backdrop of the summit.  “For the first time in 10 years, global malaria cases are no longer falling, sparking concerns about a resurgence of the too often deadly disease.”

Not everybody is convinced that the new commitment & movement (to halve malaria by 2023) will be enough, cfr this tweet:

World is at risk of making the same mistakes on malaria that it made in 1960s. The amount of $ needed to keep on track for global malaria control goals is orders of magnitude higher than what’s been pledged. Barring some miraculous tech change, recent success could be reversed.”

The Lancet Commission on Malaria Eradication

I Chen et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30911-5/fulltext

More info on the Lancet Commission on Malaria Eradication (see also last week’s IHP news). The article also sketches the backdrop of the Commission:

“…While the task of malaria eradication will be formidable, 20 years of progress have brought us more than halfway there. This month is an important time for the malaria community. MIM reconvenes in Dakar, Senegal, after 21 years at the 7th MIM Pan African Malaria Conference on April 15–20, 2018, where researchers will share the latest research findings and agree on new strategies to advance elimination and eradication. Today the pace of scientific advance and innovation continues to accelerate with pilot studies to evaluate the first malaria vaccine underway.  At the same time, leaders gather in London, UK, on April 16–20 at the Commonwealth Heads of Government Meeting where malaria is firmly on the agenda. The 53 Commonwealth countries are home to 60% of all malaria cases and 52% of all malaria deaths. A bold commitment by the Commonwealth could greatly increase the prospect of malaria eradication within a generation.”

In other news related to the London Summit, the Telegraph also reported that the UK is stepping up efforts to help eliminate trachoma.  “…  the U.K.’s international development secretary, Penny Mordaunt, has pledged an extra £20million to provide sight-saving antibiotics and surgery to people in 10 Commonwealth countries. … The money comes on top of a £360m pledge the U.K. government made last April to wipe out the world’s forgotten tropical diseases, such as trachoma, sleeping sickness, and leprosy...”

FT Health – special report on malaria

https://www.ft.com/reports/ft-health-combating-malaria

This was a fabulous report. We recommend most of the articles.

The extraordinary biological complexity of malaria may be a scientific challenge but it presents medical researchers with many potential opportunities to stop the disease in its tracks. But will they do so in time?”

Devex – Opinion: African experts warn big changes needed to eliminate malaria

https://www.devex.com/news/sponsored/opinion-african-experts-warn-big-changes-needed-to-eliminate-malaria-92454

“… African malaria experts fear that the World Health Organization’s 2030 malaria targets may not be achieved unless big changes occur in funding and delivery. The three of us have worked in very different roles with malaria experts all over Africa. Much of what we have heard informally in recent years is now confirmed in a major  new studyMalaria Futures for Africa, or MalaFa. Launched on April 17 in London, it reveals what malaria experts in Africa actually think about progress and challenges toward malaria elimination. They believe that malaria can be beaten, but it will require significant political will as well as continued research on scientific breakthroughs and an emphasis on using both old and new tools….”

Multilateral Initiative on Malaria’s (MIM) pan-African conference (Senegal, April 15-20)

As already mentioned, the 7th Multilateral Initiative on Malaria’s (MIM) pan-African conference took place this week in Dakar.

Cfr. Thomson Reuters –  Malaria in conflict zones threatens global progress against the disease

Global gains in the fight against malaria could be reversed unless countries control the disease in conflict zones, where deaths and infections are rising, experts said on Tuesday….”

See also CIDRAP for a lot more info on the Senegal conferenceMalaria meetings garner support, shed new light on spread   (2nd part of the article).

IMF/WB Spring meetings  (16-22 April, Washington)

Below we pay more attention to the 3rd UHC Financing Forum, here just some general info related to the IMF/WB Spring meetings (which still continue over the weekend).

Among others, Jim Yong Kim is going to elaborate on the Human Capital Project but the Spring meetings are so rich – in all meanings, I’m afraid – that below we can just give some idea.

Devex – What to expect at the World Bank Spring Meetings

https://www.devex.com/news/what-to-expect-at-the-world-bank-spring-meetings-92547

Must-read analysis ahead of the Spring Meetings!!

The World Bank Spring Meetings [begin today]  in Washington, D.C., under a threatening cloud of international conflict that raises the stakes for an institution dedicated to marshalling a global commitment to ending poverty. World Bank President Jim Yong Kim, entering the second year of his second term, will showcase the institution’s public face in a week of sessions highlighting the bank’s contribution to tackling global challenges of conflict and fragility, climate change, and health. Behind the scenes, Kim and other bank leaders will seek to marshal support from 188 member country shareholders who have the power to grant the institution more capital to undertake more projects — and the power to demand institutional reforms….”

Among others, Devex was going to focus on: President Kim’s capital push; Fragile states, refugees, and reconstruction; Women top the agenda; Facebook fallout could spell a smaller focus on ‘Big Data’.

See also  Devex :

“…With 60 percent of people living in extreme poverty expected to be located in fragile states by 2030, the bank is showcasing its major pivot toward working in places that have typically been the domain of United Nations and humanitarian agencies. The most recent International Development Association replenishment doubled the amount of funding dedicated to fragile states, and the bank has a target of putting 150 staff members on the ground in FCV (fragility, conflict, violence) countries. One of Kim’s biggest priorities is convincing countries to invest more in “human capital,” by putting more of their domestic resources into chronically underfunded health, education, and social sectors. At the annual meetings in Bali in October, the bank will formally unveil its new “Human Capital Index,” which will rank countries according to those investments and their impact….”

FT – US poised to support $13bn capital increase for World Bank

https://www.ft.com/content/bedf52ca-3f57-11e8-b7e0-52972418fec4

The Trump administration is poised to back a $13bn capital increase for the World Bank in a package that would see significant lending reforms and an increase in China’s shareholding….”  Seemed to be fairly good news for Jim Kim (and his relation with the US) – ahead of the Spring Meetings.

IMF – Upswing in global growth won’t last forever; IMF says world must prepare now for leaner times ahead

https://news.un.org/en/story/2018/04/1007502

While the world economy continues to show broad-based momentum, a new report released Tuesday by the International Monetary Fund (IMF) is warning that there may be choppy seas ahead, caused by increasing protectionism or tit-for-tat trade wars.”  That report is, of course, the IMF’s World Economic Outlook.

IISD – Sustainable Development Financing Report Pulls Alarm on Short-Termism

http://sdg.iisd.org/news/sustainable-development-financing-report-pulls-alarm-on-short-termism/

The annual IATF [Inter-Agency Taskforce on Financing for development ] report sets the tone for the spring meetings of the World Bank Group and the International Monetary Fund (IMF), followed by the annual FfD Forum. On the occasion of the launch of the 2018 report, Liu Zhenmin, Under-Secretary-General for DESA, pointed out that without investing in infrastructure projects like bridges, roads and sewage systems, and if the poorest and women are cut off from access to credit and other financial services, there is little chance of achieving the SDGs.

See also the press release –  Short-termism impedes progress of hundreds of millions of people

“… the vast majority of investment is still short-term oriented and commitments by the international community to create sustainable economies are not being met. There is an increasing interest in socially responsible investing, but that is no substitute for a broader transformation in the financial system. The report states that the current system rewards investors, financiers and project managers that prioritize short-term profits. Similarly, policy makers are excessively focused on short-term considerations. But there is a price to pay. Infrastructure projects are shelved in favour of short term priorities. Small businesses and women remain excluded from the financial system….”

You find the report here.   Financing for Development: Progress and Prospects 2018

Social Watch – CSO’s Open letter to WB executive directors on the Bank’s approach to PPPs

http://www.socialwatch.org/node/18037

“… The implementation of the World Bank Group’s Maximising Finance for Development (MFD) approach implies a problematic ‘private finance first’ attitude to development finance, which raises red flags about the underlying assumptions that will guide the work of the Bank in developing countries. These include whether and how fiscal, environmental and human rights considerations will be taken into account when comparing public versus private finance options….”

As mentioned in this new Devex Op-Ed, so far the WB doesn’t seem to listen much, including at this Spring Meeting…  – Public-private partnerships don’t work. It’s time for the World Bank to take action.   (recommended read)

CGD (blog) – Another Debt Crisis for Poor Countries?

M Ahmed; https://www.cgdev.org/blog/another-debt-crisis-poor-countries

A big worry at the moment.

DevexQ&A: The World Bank’s pivot to fragile states

New report International Growth CentreNew approach needed for countries caught in ‘fragility trap’, says Commission chaired by former UK Prime Minister

Greater attention should be paid to delivering basic security and jobs in states affected by conflict and instability, according to a new report from the LSE-Oxford Commission on State Fragility, Growth and Development, chaired by former UK Prime Minister David Cameron and co-chaired by Dr Donald Kaberuka, former President of the African Development Bank, and Dr Adnan Khan, Research and Policy Director of the International Growth Centre (IGC).”   For the report, see Escaping the Fragility Trap.

Blended Finance Taskforce – Programme of action: “mobilizing private capital for the SDGs at scale”

https://static1.squarespace.com/static/5acdc066c258b4bd2d15050b/t/5ad61db52b6a2806771c1a81/1523981771405/BFT_Action_Programme+FINAL+April+2018+—.pdf

The Taskforce released its programme of action this week to accelerate blended finance (particularly with a view on infrastructure), with 8 key initiatives.

Some new global health financing papers & a viewpoint

2 new Global Burden of Disease papers in the Lancet

http://www.thelancet.com/gbd

Two Global Burden of Disease papers estimate future health spending and performance on a measure of universal health coverage and provide, for the first time, estimated HIV/AIDS spending on prevention and treatment.”

By C Murray’s (IHME) team. Both are must-reads, but we especially recommend the one on UHCTrends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016–40.

See also IHME press releaseFirst Long-Term Study Finds Half Trillion Dollars Spent on HIV/AIDS.  That is spending on HIV/AIDS globally between 2000 and 2015.

And the IHME press release of the second paperNew Study Finds People Covered by Universal Health Coverage Will Fall Far Below UN Sustainable Development Goal.

An estimated 5.4 billion people globally are expected to be covered under some form of universal health care (UHC) by 2030, up from 4.3 billion in 2015, but far below the related target in SDG 3, according to a new scientific study. The study finds that, while health spending is expected to rise over the coming decades, it is likely to continue constraining efforts to achieve universal health coverage…”

Some tweets & coverage:

Robert Marten: “ Is financing #globalhealth in 2017 only about universal health coverage #UHC and HIV/AIDS? Note the implicit agenda-setting and priority-setting for #globalhealth

Robert Marten: “The new & always fascinating #globalhealth financing report from @IHME_UW shows how little the @GlobalGoalsUN have yet changed DAH spending priorities. #NCDs & particularly #injury still the very poor relations…”

‘Health in Myanmar’ – “Good point. Is #UHC the new #HIV?”

Pam Das – “Ah, this was a problem for us too when the papers came to us. But it seems that from this year onward, they will focus on one disease each year, HIV, malaria, TB etc. Agree, that not sure how useful this is…”

Lancet (Viewpoint) – Monitoring country progress and achievements by making global predictions: is the tail wagging the dog?

Ties Boerma et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30586-5/fulltext

Must-read.

“… Globally, considerable investments are being made in advanced statistical modelling, computation of uncertainty ranges, and the production of compelling visualisations of results. However, these advances could give the impression of abundant evidence that is actually based on very sparse empirical data. Unfortunately, global public health experts and academics are often oblivious to the limitations of these estimates and regularly overinterpret the numbers, especially if the estimates support their arguments….”

“…We call for a repositioning of the production of global estimates, and the transition from MDGs to SDGs provides an opportunity to do so. Neither country policy makers nor the global development community are best served by a global flood of health estimates derived from complex models as investments in country data collection, analytical capacity, and use are lagging….  “  They list 5 points that need to be done with a view on this.

Third Annual UHC Financing Forum: Greater Equity for Better Health and Financial Protection  ( April 19-20, 2018, Washington DC)

http://www.worldbank.org/en/events/2017/10/20/third-annual-universal-health-coverage-financing-forum

“The World Bank Group and USAID [will] host the Third Annual Universal Health Coverage (UHC) Financing Forum from April 19-20, 2018, in advance of the World Bank Group’s Spring Meetings. The Forum will take place at the Washington Hilton Hotel in Washington DC. … The Forum will focus on mobilizing and shaping health financing to achieve equity and access to health services.”

In other words, the focus this time was on how decision makers can improve equity in health financing, among others by avoiding “12 no-go’s”.

For the (5 p & must-read) Concept Note, see here.

For a few nice blogs on the WB’s ‘Investing in health’ blog also setting the scene, see Why do finance ministries matter to achieving universal health coverage?

This blog provides sort of the mainstream view now of the ‘powers that be’, and certainly the WB: “… In the SDGs era, the imperative to finance the development agenda from domestic resources has been amplified. Irrespective of a government’s best intentions to achieve UHC, without adequate financing from its national budget, minimal progress will be made. This is in stark contrast to the MDGs era (from 2000- 2015) where emphasis was on effective development cooperation (EDC).  And when it comes to achieving UHC, financing is actually only part of the role ministries of finance can play. … …. Although a legacy of the MDGs, DAH is still needed in the SDGs era but needs to evolve to a catalytic role. … …  However, in the SDGs era, instead of being the primary funding source for health, DAH should rather leverage a bigger pie of domestic resources for UHC, and support the strengthening of country systems for health service delivery to ensure sustainability of results as many countries transition from aid to using financing the UHC agenda from domestic resources. The International Partnership for Universal Health Coverage 2030 (UHC2030), the successor of the International Health Partnership (IHP+) can play a leading role in shaping this shift globally….”

And “Equity Is a Must on the Road to Universal Health Coverage”  (blog by C Ly & Kent Ranson).

Forum paper – Equity on the Path to UHC Deliberate Decisions for Fair Financing Background Report (Conference Version)

http://pubdocs.worldbank.org/en/588321524060370166/BGP-v-8-20180418-0930-FINAL.pdf

(must-read)  “This is a forum paper (conference version) to the “Third Annual UHC Financing Forum: Greater Equity for Better Health and Financial Protection”. This paper sets the stage for the presentations and discussions at the Forum and was prepared under the guidance of the Forum Technical Working Group. The information provided in this document does not necessarily represent the views or position of the organizations represented on the Technical Working Group. ”

 

A few tweets:  check out the hashtag #UHCfinance for more.

 

From Agnes Soucat:

 

When watching an all-male panel: “Apparently there are no women working on health financing in the entire world.. #UHCfinance @allmalepanels

 

 

And: “According to @IHME_UW close to US$15 billion of ODA for health is not accounted for at country level. Where do the funds go? What do donors do about it? @IHME_UW #UHCfinance @TheLancet

 

 

Je
Meer

From Jesse Bump – “My analysis of @UHC2030 Monitoring Report shows that countries are doing well, but donors are not serious about their own accountability.”

Jesse Bump @UHC2030 donors need to move away from the paradigm of aid if still to be relevant in the #SDGs era #UHC”

GFF

 

Also a lot happening on the Global Financial Facility (GFF), check out for example this Save the Children blog –  the GFF: budding with potential, yet to bloom. (recommended)

 

“ …It’s a big year for the GFF, with its first replenishment and an ambitious target of $2 billon. Today, with the replenishment year in full swing, Save the Children has launched a briefing outlining what we think is good about the GFF and what can be improved to turn it into the pioneering develop financing model it has the potential to be.”

 

For a list of GFF country focal points, see GFF country focal points.

Report on global multimorbidity

BMJ News – Treatment for those with multiple serious illnesses is “ineffective,” warns major review

https://www.bmj.com/content/361/bmj.k1736

Medicine is poorly equipped to treat people that develop multiple chronic diseases concurrently, and must commit more resources to improving their treatment, a major global report  has said. The report, produced by the UK’s Academy of Medical Sciences, warns that multimorbidity is increasing “on a massive scale.” But it admits that nobody knows how massive, for lack of an agreed definition. The report, which claims to be the first to look at global multimorbidity, attempts to give a definition, as well as suggest new research initiatives to understand it better and work out how best to organise services to treat it….”   For the report, see  here.

More coverage in the FTSharp rise in patients suffering from several long-term diseases.

Ebola vaccine

Stat News – In encouraging sign, Ebola vaccine appears to provide long-lasting protection

Stat News;

An international consortium of researchers has reported that an Ebola vaccine appears to provide volunteers protection against the virus two years after they were injected —  encouraging findings both for the public health community and the vaccine’s manufacturer. … … The  new study, published in Lancet Infectious Diseases, shows that two years after getting the vaccine, volunteers had high and stable levels of antibodies to the Ebola Zaire virus…”

And a tweet from Mark Chataway: “Only a few months ago, we were told that Ebola vaccines were stalled because they wouldn’t be profitable enough for pharma companies. Now @Merck plans to apply for an FDA licence this year. No doubt @MSF will be congratulating them soon <G>”

National health equity strategies

Devex – Opinion: Countries need to build National Health Equity Strategies. Here’s how.

Eric Friedman; https://www.devex.com/news/opinion-countries-need-to-build-national-health-equity-strategies-here-s-how-92496

“…One concrete step that could serve as a foundation for comprehensive action toward health equity would be for countries to develop and implement National Health Equity Strategies, grounded in human rights and nondiscrimination. What might these strategies look like? … … Working closely with the Stop TB Partnership, USAID, and other partners, including people who have had and been affected by tuberculosis, the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center is promoting National Health Equity Strategies, and has drafted an implementation guide that could aid in developing them.

We are holding an online consultation, open to all, beginning on April 9 on the guide and overall concept of National Health Equity Strategies. …”  For more info on what the O’Neill institute has in mind, see here and here.

UK Aid reform

IDS – The mission for global Britain – 7 reflections on where next for 0.7

http://www.ids.ac.uk/opinion/the-mission-for-global-britain-7-reflections-on-where-next-for-0-7

The UK Secretary of State for International Development, Penny Mordaunt has set out her vision for UK Aid and Development at the Wellcome Collection. And indeed, there was much to welcome, as well as to cause pause for thought. Here are seven quick reflections on what she said.”

See last week’s IHP newsletter. This was perhaps also relevant in Penny’s speech:

There was a strong focus on strengthening health systems from the Secretary of State.  It will be good to see more detail on this, perhaps in the form of the long awaited publication of the health systems framework/policy paper from DFID.  With the UK hosting the Global Symposium on Health Systems Research in September and celebrating the 70th anniversary of the NHS and 40th Anniversary of the Alma Ata declaration, the timing has never been better.”

Some key publications of the week

Globalization & Health – Defining the global health system and systematically mapping its network of actors

Steven Hoffman et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0340-2

One of the reads of the week, no doubt. “This study presents a conceptually sound and operational definition of the global health system. Importantly, this definition can be applied in practice to facilitate analysis of the system. The study tested the analytical helpfulness of this definition through a network mapping exercise, whereby the interconnected nature of websites representing actors in the global health system was studied.  Using a systematic methodology and related search functions, 203 global health actors were identified, representing the largest and most transparent list of its kind to date. Identified global health actors were characterized and the structure of their social network revealed intriguing patterns in relationships among actors.  These findings provide a foundation for future inquiries into the global health system’s structure and dynamics that are critical if we are to better coordinate system activities and ensure successful response to our most pressing global health challenges.”

But see also this tweet from Mathias Bonk:

#Globalhealth system & systematically mapping its actors. Well, then a huge number of non-Anglo-American institutions and organizations have “systematically” been ignored in this study…very unfortunate, as we live in a multi-polar, transdisciplinary world in the 21st century…”

Global Policy: A time for Hope? Pursuing a vision of a Fair, Sustainable and Healthy World

Sharon Friel; Global Policy;

The confluence of social and health inequities and global environmental degradation shines a light on fundamental ruptures in society. A systems view of humanity reminds us that this status quo is not static, and that the shifting political and economic sands provide an important window of opportunity to collectively change the system towards the public good, such that communities are able to live with good health, dignity and in an environmentally sustainable way. To enable this, global policy, and in particular global health policy must break out of the policy silos and refocus in a systems way. If the system is to adapt, an ambitious vision for the system is needed that is different to the status quo. No one regulatory model that can improve complex societal problems, rather we must use a plurality of approaches. Reorienting the system to achieve positive outcomes depends on reimagining the purpose of structural regulatory powers, and the releasing the agency of networks of concerned actors. In a hyper‐connected world there are many partners to help create systems of hope. “

NEJM – The Blind Men and the Elephant – Aligning Efforts in Global Health

R Dhillion et al; http://www.nejm.org/doi/full/10.1056/NEJMp1800883?query=TOC

“… A more pragmatic way to align global health action might be to delineate actionable issues that incorporate key priorities from each perspective [i.e. security perspective, development perspective, human rights perspective ] and around which the range of actors can integrate their activities. … “

Global Health Governance Program – PLANET

http://globalhealthgovernance.org/planet/

Global health aid rose by 400% from $5.6 billion in 1990 to $28.1 billion by 2012, …  Remarkably, this increase has not yet prompted the development of tools that would enable donors to co-ordinate, plan, monitor or evaluate the effectiveness of their investments. In fact, it could be argued that this large amount of money, the majority of which comes from public sector donors, is among the least transparently allocated, monitored, audited and evaluated part of governmental budgets – which is worrying, given its sheer size and potential importance of the investments. The new PLANET tool is a response to this problem. Based on crowdsourcing approaches, it draws real-time information from those involved in programme delivery – funders, managers and recipients. Simple enough to run on a smart-phone, PLANET turns complex and opaque analyses on implementation of development programmes into a flexible and user-friendly tool. This allows decision-makers to prioritise, monitor and evaluate large-scale development programs, and more closely assess the effectiveness of investment. The tool was developed by Prof. Devi Sridhar and Prof Igor Rudan of the University of Edinburgh, UK.”

SDGs

IISD –  Draft SDG Index and Dashboard Track African Progress on SDGs

http://sdg.iisd.org/news/draft-sdg-index-and-dashboard-track-african-progress-on-sdgs/

The Sustainable Development Solutions Network and the SDG Center for Africa invited comments on the draft Africa SDG Index and Dashboard, which track individual country progress on each of the 17 SDGs. Eleven African countries ranked green on SDG 13 (climate action). For eleven of the SDGs, no African country received a green score.  (i.e. including SDG 3 – health)  ”

Dengue vaccine

Reuters – WHO recommends testing before use of Sanofi’s dengue vaccine

Reuters;

The World Health Organization (WHO) said on Thursday Sanofi’s vaccine against dengue should only be used after testing on individuals to assess whether they have ever been exposed to the infection. After a two-day meeting in Geneva, Switzerland, experts at the U.N. agency recommended extra safety measures for the medicine, sold as Dengvaxia. “We have now clear information that the vaccine needs to be dealt with in a much safer way by using it exclusively in people already infected with dengue before,” Alejandro Cravioto, Chair of the WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization, told reporters. “It requires for the people to be tested through a system that is not currently available but that we feel will be developed in the next years,” he said….”

See also Stat NewsWHO panel urges caution on dengue vaccine, dealing blow to Sanofi

Lancet – The Tsinghua-Lancet Commission on Healthy Cities in China: unlocking the power of cities for a healthy China

http://www.thelancet.com/commissions/healthy-cities-in-China

Increasingly, people leave the countryside to pursue better opportunities in cities. Nowhere has urbanisation been more rapid and pronounced than in China. This Lancet Commission, led by Tsinghua University in Beijing, examines the particular challenges and opportunities for health in China’s cities, with regard to health risks, health promotion, environmental health, and health-care delivery. For cities to be active participants in China’s aspiration as an ecocivilisation, there needs to be increased participation in health-related activities by stakeholders, with fuller integration of health into all civic policies. From this dialogue should come shared goals that are assessed regularly, and research on interventions to improve health for people who live in cities.”

Lancet series on preconception health

http://www.thelancet.com/series/preconception-health

Health and nutrition of both men and women before conception is important not only for pregnancy outcomes but also for the lifelong health of their children and even the next generation. The preconception period can be seen in three different ways: from a biological standpoint as the days and weeks before embryo development; from the individual perspective as the time of wanting to conceive; and through a population lens as any time a women is of childbearing age. This Series of three papers highlights the importance and summarises the evidence of preconception health for future health and suggests context-specific interventions. It also calls for a social movement to achieve political engagement for health in this particular phase in life.”

Vaccines

Orin Levine on Medium – Let’s Create a New Agenda…One That Eliminates Barriers to Immunization

Orin Levine is Director of Vaccine Delivery at the Bill & Melinda Gates Foundation. “… What would happen if we set targets for elimination of delivery problems just like we do for disease problems? What would be different in the way we work if the elimination target were one of these delivery barriers?…” 

“…I challenged our Vaccine Delivery team at the Gates Foundation for their responses and the list was impressive (and occasionally humorous)….”

Global health security

BMJ Global Health (Commentary) – The Nigeria Centre for Disease Control

AM Njidda et al; http://gh.bmj.com/content/3/2/e000712

Nigeria and several other African countries have been battling with public health challenges for decades. These challenges came to fore during the Ebola virus disease (EVD) crisis that affected many countries in the West African region, including Nigeria. As a result, many African countries have established their National Public Health Institutes as a focal point to prevent, detect and respond to diseases of public health importance, but currently, only 9 of the 15 countries in West Africa have a designated national public health institute. Before the EVD crisis, Nigeria established the Nigeria Centre for Disease Control (NCDC), which played a pivotal role in the control of the EVD outbreak in Nigeria, as well as provided support to other countries that were affected by the crisis. Modelled on the US Centre for Disease Control and Prevention (CDC), the NCDC has institutionalised Nigeria’s capacity to respond to the increasing threats of outbreaks of infectious diseases and other public health emergencies. This is achieved through building collaborations and taking the lead in prevention, preparedness and surveillance, and also coordinating the public health laboratory networks. African public health institutes are currently in early stages of evolution. Building a national public health institute requires strong commitment, clarity of vision. The experience of setting up the public health institute of Nigeria can inform similar efforts in other African countries.”

NYT – Will the next superbug come from Yemen?

https://www.nytimes.com/2018/04/14/opinion/sunday/yemen-antibiotic-resistance-disease.html

From Sam Loewenberg, so you know this is a must-read.

“…The global aid architecture has not caught up with the realities” of multidrug-resistant infections in conflict zones. …  … It’s a recipe for catastrophe: a struggling health system where antibiotics remain widely available with little oversight, combined with an overwhelming number of wounded in hospitals and weak hygiene and infection-control practices. … … This goes to a core problem: a lack of surveillance and infection-control procedures as part of humanitarian response, which are increasingly a necessity with so many prolonged conflicts. “Where we need the most information, we don’t have it,” Ms. Elden said….

Emerging Voices

  • Check out the 2nd issue of the EV newsletter – among others, with an update on the applications for the Liverpool EV venture. It’ll be very competitive, that’s for sure!

 

  • Meanwhile, EV alumni can check out whether they’re already ‘fully emerged’ or not – see this (half-joking) IHP blogWhen are you fully ‘Emerged’?     With plenty of ‘tentative indicators’, and the list is still growing : )

 

AB InBev foundation

https://abinbevfoundation.org/about-us/

A few tweets from Robert Marten perhaps suffice here: “

Shocking when one compares the noise and outrage over Philip Morris’s Foundation for a Smoke Free World compared with the absolute silence about the Anheuser-Busch Bev Foundation. ”

Appears @abinbev Foundation is a credible #globalhealth actor supporting policy processes, co-opting credible individuals and institutions by “partnering under the influence

Foundation plans “to address harmful alcohol use and spread ideas advancing broader health and social issues.”  

Lancet (Comment) – Social lobbying: a call to arms for public health

A Demaio et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30831-6/fulltext

« …In this context, we define social lobbying as advocacy with the intention of influencing decisions made by governments, solely to protect and further the greater social good, including health….”

« Health is inherently political and there is no public health issue that is not impacted in some way by government decision making. Faced with the increasingly pervasive reality of political systems gridlocked by private sector special interests, public health organisations must acknowledge their responsibility to engage with the political process. As a public health community, we have lingered too long outside the public lobby. It is time for social lobbying to protect health for all. »

Lancet (Correspondence) – Healthier lives for all Africans

R Mash, J De Maeseneer et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30502-6/fulltext

In their Commission, Irene Agyepong and colleagues (Dec 23, 2017, p 2803) provide a comprehensive report on the pathway to healthier lives for all Africans by 2030. As highlighted in the Commission, we have been involved in training family physicians in Africa for the past 20 years within the framework of the Primary Care and Family Medicine Education (Primafamed) network, a South–South cooperation that brings together family medicine, primary care, and public health in more than 20 African countries.”

“…In 2018, there is an urgent need for financial donors to fund interventions that strengthen the African primary health-care system as a priority, rather than just investing in vertical disease-orientated programmes, and to continue contributing to networks such as Primafamed.”

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Global Health Events

Stockholm Forum on Gender equality  (April 15-17)

http://genderequalworld.com/

This was the aim of the event: “The Stockholm Forum on Gender Equality will mobilise civil society, governments, private sector and academia from all over the world to intensify efforts for a gender equal world. The forum will be held in a spirit of co-creation and use the strength and momentum of the UN Global Goals. Gender equality cuts through all the Goals and is essential to ensure sustainable development, peace and security. The overall purpose of the conference is to intensify efforts for a gender equal future – the only way we can ensure sustainable peace, security and development….”

We agree, and think that SDG 5, together with SDG 12, are among the key ones to still make something of this world in this century.

Perhaps a tweet that set the scene:

“‘It started with the radical notion that women are human beings too’ – @margotwallstrom gives the background 2 the #Swedish feminist foreign policy. And welcomes 700 #genderequality experts and advocates from 100+ countries to #StockholmGenderForum. Good 2 be here.

Too bad there’s uproar in the Nobel house, just now : )

Regional World Health Summit in Coimbra, Portugal – 19-20 April

https://www.worldhealthsummit.org/m8-alliance/members/coimbra-health.html

This Regional WHS  in Portugal “highlights regional approaches to solving global threats”.

The conference [will] focus on four topics: Managing Infectious Diseases in Low & Middle Income Countries; Governance for Health Equity in Low & Middle Income Countries; Opportunities and Challenges in Translating Innovation into Healthcare; Biomedical Education for a Changing World.”

Coming up: World Immunization Week, 24-30 April 2018

http://www.who.int/campaigns/immunization-week/2018/en/

Hope you all get a shot or two : )

Coming up – WHO – Walk the Talk: The Health for All Challenge  (20 May, Geneva)

WHO;

As part of celebrations of the World Health Organization’s 70th anniversary in 2018, WHO is staging a major health promotion event in Geneva on the eve of the 71st World Health Assembly.

The free walk/run event, titled Walk the Talk: The Health for All Challenge, will be open to people of all ages and abilities and be held over three distances (short 3 kilometres, medium 5 kilometres and long 8 kilometres). These connected routes will build a bridge between “international” and “local” Geneva and Lac Leman by linking key health, international and touristic landmarks found in the city.”

One of the aims is to launch a global movement to promote health and particularly physical activity as part of a healthy sustainable future.

Coming up: 71st WHA  (Geneva, 21-26 May)

http://apps.who.int/gb/e/e_wha71.html

More documents are available now. Among others, a new version of the draft GPW ( as of 5 April )

HSG calendar

http://www.healthsystemsglobal.org/events/

Check out HSG’s calendar of HSR related events, webinars, deadlines, …

PS: as you know, the individual abstract notification for Liverpool has been delayed till 4 May.

 

And a tweet :

First SAGE IVD meeting @WHO! Great initiative by WHO to develop an Essential Diagnostics List & make Diagnostics an integral part of UHC! Well done »

For more info on this Strategic Advisory Group of Experts on In Vitro Diagnostics (SAGE IVD), see WHO.

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Global governance of health

CEPI update – cfr latest newsletter (17 April)

https://mailchi.mp/cepi/update-from-cepi?e=c69e7c5164

“Establishment of Partnership Agreements
We’ve announced our first two partnership agreements with
Themis and Inovio Pharmaceuticals. Both companies will develop vaccine candidates for Lassa Fever and Middle East Respiratory Syndrome.   These partnership agreements are now the leading edge of CEPI’s product development portfolio.  We anticipate the portfolio will ultimately include 4-6 vaccine candidates against each of our priority diseases (Lassa Fever, MERS and Nipah). …”

“Inauguration of CEPI’s Permanent Board
At the beginning of March CEPI held the inaugural meeting of its new permanent Board in Addis Ababa. The transition from CEPI’s interim to permanent Board represents an important moment for us as we move from being a ‘start-up’ to being an established global organisation.
We were also delighted that our Board meeting provided Ethiopian Minister of Health Professor Yifru Berhan Mitke the opportunity to announce his Government’s intention to join CEPI as a contributing member.
Ethiopia thus became the first African nation, and first developing country, to commit to joining CEPI…”

The National Academies of Sciences, Engineering & Medicine – Exploring Partnership Governance in Global Health: Proceedings of a Workshop—in Brief (2018)

https://www.nap.edu/catalog/24997/exploring-partnership-governance-in-global-health-proceedings-of-a-workshop

On October 26, 2017, the National Academies of Sciences, Engineering, and Medicine’s Forum on Public–Private Partnerships for Global Health and Safety convened a workshop on the governance of global health partnerships. Collaboration, a common approach in both 21st-century engineering and global health, brings together the talents, experiences, and resources of multiple sectors, and the diversity of these sectors leads to creative solutions for tackling system challenges. In global health, collaboration frequently occurs through public–private partnerships (PPPs), with public and private parties sharing risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. PPPs include government and industry as well as partners from a range of other sectors. The workshop examined what role governance assumes in global health PPPs through presentations and discussion on transparency and accountability, operational challenges, legal considerations, barriers and strategies for engagement, examples of governance structures and lessons learned, and measurement. This publication briefly summarizes the presentations and discussions from the workshop.”

Chatham House – Jim O’Neill elected new chair of Chatham House

https://www.chathamhouse.org/news/2018-04-19-jim-o-neill-elected-new-chair-chatham-house

You probably know Jim O’Neill, among others from his work related to BRICs & also AMR.

IP-Watch – Charles Gore, Founder Of World Hepatitis Alliance, To Head Medicines Patent Pool

http://www.ip-watch.org/2018/04/19/charles-gore-founder-world-hepatitis-alliance-head-medicines-patent-pool/

The Medicines Patent Pool announced today that it has appointed Charles Gore as new executive director. Gore is founder and former president of the World Hepatitis Alliance.”

IP-Watch – Carlos Correa Named Head Of Intergovernmental South Centre

http://www.ip-watch.org/2018/04/18/carlos-correa-named-head-intergovernmental-south-centre/

Prof. Carlos Correa of Argentina, an influential academic whose analyses of patents and medicines access have informed debates and challenged the status quo for decades, has been named the next executive director of the South Centre. He will take over for Martin Khor, who will be retiring after nine years at the helm. Separately, former South African President Thabo Mbeki was named chair of the Board.”

G20 next year in Japan

Forbes – Thought Leaders Want Alzheimer’s At The Top Of G20 Agenda.

Some of the leading experts on Alzheimer’s and dementia globally are asking the wealthiest countries in the world to put Alzheimer’s disease at the top of the 2019 G20 Osaka Summit Agenda. Thought leaders, researchers and scientists from around the world last week released a Consensus Statement and Research Framework that outlines the urgent need to adopt Aging and Dementia as a theme of the G20 Summit next year, and puts forward recommendations on what exactly they want to see done about the disease that is fast becoming a global crisis….”

IISD – Civil Society, Resolute Resistance and Renewed Purpose

http://sdg.iisd.org/commentary/guest-articles/civil-society-resolute-resistance-and-renewed-purpose/

This year’s ‘State of Civil Society’ report from CIVICUS reaches an important conclusion: even as fundamental freedoms and democratic values are being encroached upon, peaceful acts of resolute resistance by civil society give us reasons for hope. The report encourages active citizens to join or start their own organizations, social movements and social enterprises to further rights based agendas and defend progress on human rights.”

Overall, the report highlights ten key trends impacting civil society.  For the CIVICUS report, see here.

Medium – Development assistance for health workers and equity — is a Global Fund for Health the answer?

https://medium.com/health-for-all/development-assistance-for-health-workers-and-equity-is-a-global-fund-for-health-the-answer-976e1f88f0e0

By Mariska Meurs – Global Health Advocate from the Wemos Foundation.

“…ultimately what we need is long-term, sustainable, funding for health that adopts a comprehensive and cross-sectoral approach. Funding that is equitably raised and equitably spent. Can that be done via traditional ODA? Or via public-private partnerships that are increasingly being promoted by donors? I rather believe the answer lies in a global fund for health, one that pools resources, is based not on charity but rather on solidarity following a sense of global responsibility, which includes (international) taxes, and where allocations are driven by health needs instead of by the — be it well-intended — whims of donors.”

UN News – UN launches global plan to strengthen protection of internally displaced persons

https://news.un.org/en/story/2018/04/1007552

With multiple crises forcing millions of people away from their homes, United Nations agencies, Governments and partners have launched a set of measures to strengthen protection of internally displaced persons as well as find solutions to address their problems.”  “… The framework, formally called the Plan of Action for Advancing Prevention, Protection and Solutions for Internally Displaced People (2018-2020), calls on all relevant actors to step up efforts to prevent, respond to and resolve internal displacement….”

GAVI – United Arab Emirates to host Gavi 2018 mid-term review

https://www.gavi.org/library/news/press-releases/2018/united-arab-emirates-to-host-gavi-2018-mid-term-review/

The high-level event will celebrate 10 million lives saved since Gavi’s inception, launching its next replenishment cycle.”  “… The high-level conference will take place in Abu Dhabi on 10-11 December 2018 and will lay out a vision for the future of the Gavi model, providing an opportunity to take stock of Gavi’s performance halfway through the current strategic period (2016-2020). The conference will outline new ways of working with partners, allowing Gavi to forge new alliances with the private sector and adopt transformative solutions to advance the global immunisation agenda….”

Eurodad (blog) – 2017 development aid figures: A half empty mixed bag

http://www.eurodad.org/2017-development-aid-figures

By Jeroen Kwakkenbos.  “Last week the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD) released their preliminary figures on the amount of Official Development Assistance (ODA), or development aid, raised in 2017. The week before I wrote a blog outlining Eurodad’s expectations for these figures – and the results are a mixed bag.”   “… While certain negative trends seem to be on the mend, overall the amount of aid raised every year has stagnated in volume and although there was positive economic growth across donor countries ODA dropped to 0.31% of Gross National Income (GNI). The continued inclusion of costs not directly linked to development and poverty eradication inflate the figures and undermines the credibility of the reporting exercise of a scarce resource that is of paramount importance to the poorest people in the world…”

IISD – It Is About Time to Promote Policy and Institutional Coherence for the SDGs

Louis Meuleman; http://sdg.iisd.org/commentary/guest-articles/it-is-about-time-to-promote-policy-and-institutional-coherence-for-the-sdgs/

The SDGs are designed as “indivisible” and this means that each Goal needs the involvement of several or many sectors at several levels. In a paper I wrote as member of the UN Committee of Experts on Public Administration (CEPA), I suggest combining nine different approaches to promote coherence for implementation of the SDGs, and I outline ten recommendations.”

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UHC

Japan’s Shinzo Abe tipped to resign in June as cronyism scandals take toll

https://www.theguardian.com/world/2018/apr/16/japan-shinzo-abe-tipped-to-resign-june-cronyism-scandal

Guess this could have some UHC implications, as Abe is something like a global advocate.  Not that we like him much.

BMJ Global Health – Bias in patient satisfaction surveys: a threat to measuring healthcare quality

F Dunsch et al; http://gh.bmj.com/content/3/2/e000694

Patient satisfaction surveys are an increasingly common element of efforts to evaluate the quality of healthcare. Many patient satisfaction surveys in low/middle-income countries frame statements positively and invite patients to agree or disagree, so that positive responses may reflect either true satisfaction or bias induced by the positive framing. In an experiment with more than 2200 patients in Nigeria, we distinguish between actual satisfaction and survey biases. Patients randomly assigned to receive negatively framed statements expressed significantly lower levels of satisfaction (87%) than patients receiving the standard positively framed statements (95%—p<0.001). Depending on the question, the effect is as high as a 19 percentage point drop (p<0.001). Thus, high reported patient satisfaction likely overstates the quality of health services. Providers and policymakers wishing to gauge the quality of care will need to avoid framing that induces bias and to complement patient satisfaction measures with more objective measures of quality.”

Ghana News – Universal Health Coverage within reach in Africa -WHO

https://www.ghanabusinessnews.com/2018/04/15/universal-health-coverage-within-reach-in-africa-who/

Matsidiso Rebecca Moeti, WHO Afro regional director has observed that accelerating Universal Health Coverage (UHC) was within reach in Africa. She said what was required was political leadership, clear strategic vision, innovation and intra and inter-sectoral collaboration to break barriers to Universal Health Coverage (UHC) on the continent. Dr Moeti made the observation at the third University of Health and Allied Sciences (UHAS) Leadership Lecture Series in memory of Professor John Evans Atta Mills in Ho….”

Still quite a lot needed, then, I’d say…

Joint Learning Network – Compassion: An Integral Component of Health Care Systems

http://www.jointlearningnetwork.org/news/compassion-an-integral-component-of-health-care-systems

In February 2013, the publication of the Mid Staffordshire NHS Foundation Trust Public Inquiry catalyzed the emergence of a new paradigm for health professionals and health systems: healing requires more than treatment of a disease – it requires person-centered, compassionate care. Since then, the concept of “compassion” has ricocheted throughout the global health sphere, often with varied meanings in different contexts and languages and is now recognized as an essential component to achieving quality in universal health coverage (UHC)….”

“… The Global Learning Lab for Quality UHC (GLL) recently elevated the discussion on compassion by establishing a learning pod that specifically grapples with how compassion places people at the center of care: both those receiving care and those delivering care….”

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Planetary health

IISD – UNFCCC, UNDP Highlight Long-Term Strategies to Meet Climate Goals

http://sdg.iisd.org/news/unfccc-undp-highlight-long-term-strategies-to-meet-climate-goals/

In a series of articles, UNFCCC Executive Secretary Patricia Espinosa explains that LTSs and NDCs are mutually reinforcing, in that LTSs provide a framework and direction for subsequent NDCs, while “increasingly ambitious” NDCs are a means to achieve LTSs.”

Guardian – Warming climate to nearly double demand for cooling appliances

https://www.theguardian.com/environment/2018/apr/17/demand-for-cooling-predicted-to-outstrip-heating-as-earth-warms

A burgeoning middle class and a warming world will result in energy demand for cooling overtaking that for heating by the middle of the century, researchers have predicted. Energy use for air conditioning, refrigeration and other cooling appliances will jump 90% on 2017 levels, experts estimated, posing a challenge for energy grids and efforts to curb climate change. The University of Birmingham said the rise would come even with conservative estimates of how much demand for cooling was likely to increase in China, India and hotter countries….”

The [Birmingham Energy ] institute [will] host the first ever conference on “clean cold” on Wednesday, exploring how to tackle the problem and boost the 0.2% of energy R&D budgets spent on cooling….”

ODI (Briefing paper) – Meeting the global challenge of adaptation by addressing transboundary climate risk

https://www.odi.org/publications/11096-meeting-global-challenge-adaptation-addressing-transboundary-climate-risk

Under the current UNFCCC frameworks and Paris Agreement, adaptation is mainly seen as a national level issue. However, the effects of climate change – and adaptation actions themselves – will be felt globally and so must be addressed on the regional and global levels as well. Failing to meet the challenges of adaptation will produce risks from which no country is able to fully isolate itself. International supply chains, migration patterns, financial systems and shared ecosystems will be destabilised to everyone’s disadvantage, leading to a situation of “climate change contagion” in the global economy. It is therefore critical to examine the role of adaptation in reducing – rather than redistributing – vulnerability globally. This brief, co-authored by researchers at IDDRI, SEI and ODI, reviews recent progress in international climate change negotiations before discussing how progress in meeting the global challenge of adaptation might be achieved.”

The Anthropocene review – In a broken world: Towards an ethics of repair in the Anthropocene

D P McLaren; http://journals.sagepub.com/doi/full/10.1177/2053019618767211

With the power to break Earth Systems comes responsibility to care for them, and arguably to repair them. Climate geoengineering is one possible approach. But repair is under-researched and underspecified in this context. In a first attempt to establish basic principles for the obligations of repair in the Anthropocene, five disciplines of repair are briefly reviewed: reconstruction of historic buildings; remediation of human bodies; restoration of ecosystems; reconfiguration of cultural materials and artifacts; and reconciliation of broken relationships. In each case ethical practices and debates are described to help identify key themes and challenges in understanding repair. Three interlinked pragmatic ethics or virtues of repair in the Anthropocene are suggested: care, integrity, and legibility. Implications for climate geoengineering, climate politics, and the possibilities of climate justice are explored. Climate repair is defended against objections that it would exacerbate a moral hazard effect, or frame climate responses as politically conservative.”

Yale News – Children’s health is disproportionately affected by climate change

https://www.yaleclimateconnections.org/2018/04/how-climate-change-hurts-childrens-health/

They’re more vulnerable than adults.  “… Frederica Perera is director of the Columbia Center for Children’s Environmental Health. She says children are vulnerable because their immune systems are not mature. And, their rapidly growing bodies are more sensitive to damage from disease and environmental contaminants. In particular, children are more likely than adults to die from diarrheal disease, which is expected to become more common in some areas as the climate warms. And some children are at more risk than others. Perera: “It is the children living in low income countries and communities who are most affected.”…

Devex – Cooperation at heart of Africa Climate Week talks

https://www.devex.com/news/cooperation-at-heart-of-africa-climate-week-talks-92546

Cooperation between countries and the private sector will be key to the successful implementation of the Paris Agreement on climate change in African nations, panelists at Africa Climate Week held at the United Nations Office at Nairobi said….”

UN News – Protect indigenous people’s land rights and the whole world will benefit, UN forum declares

https://news.un.org/en/story/2018/04/1007432

Protecting the land and resource rights of indigenous peoples will not only provide security for historically exploited groups but also help the global fights against climate change and biodiversity loss, said speakers on Monday at the annual United Nations Permanent Forum on Indigenous Issues.

That’s probably why humanity is so enthusiastically destroying their rights at this very moment.

Guardian – Deep-sea mining possibly as damaging as land mining, lawyers say

https://www.theguardian.com/environment/2018/apr/18/deep-sea-mining-possibly-as-damaging-as-land-mining-lawyers-say

As a case in point: “The “new global gold rush” over deep-sea mining holds the same potential pitfalls as previous resource scrambles, with environmental and social impacts ignored and the rights of Indigenous people marginalised, a paper in the Harvard Law Review has warned.”

Guardian – Scientists accidentally create mutant enzyme that eats plastic bottles

https://www.theguardian.com/environment/2018/apr/16/scientists-accidentally-create-mutant-enzyme-that-eats-plastic-bottles

Exciting news in the global fight against plastic.

UN body adopts climate change strategy for shipping

http://www.imo.org/en/MediaCentre/PressBriefings/Pages/06GHGinitialstrategy.aspx

More encouraging news from last week:

Nations meeting at the United Nations International Maritime Organization (IMO) in London have adopted an initial strategy on the reduction of greenhouse gas emissions from ships, setting out a vision to reduce GHG emissions from international shipping and phase them out, as soon as possible in this century.  The vision confirms IMO’s commitment to reducing GHG emissions from international shipping and, as a matter of urgency, to phasing them out as soon as possible. … … More specifically, under the identified “levels of ambition”, the initial strategy envisages for the first time a reduction in total GHG emissions from international shipping which, it says, should peak as soon as possible and to reduce the total annual GHG emissions by at least 50% by 2050 compared to 2008, while, at the same time, pursuing efforts towards phasing them out entirely….”

Project Syndicate – China’s Bold Energy Vision

Jeffrey Sachs; https://www.project-syndicate.org/commentary/china-global-renewable-energy-grid-by-jeffrey-d-sachs-2018-04

Jeffrey is once again in shock & awe for China: “China’s proposed Global Energy Interconnection – based on renewables, ultra-high-voltage transmission, and an AI-powered smart grid – represents the boldest global initiative by any government to achieve the goals of the Paris climate agreement. It is a strategy fit for the scale of the most important challenge the world faces today.”

Nature News – Air-pollution trackers seek to fill Africa’s data gap

https://www.nature.com/articles/d41586-018-04330-x

Low-income sub-Saharan countries bear a high burden of air pollution, but are nearly unrepresented in the research on its health impacts.”

“…The Eastern Africa GEOHealth hub aims to begin filling the sub-Saharan Africa data gap. The project is one of seven GEOHealth programmes centred in low-income countries across the world, and is funded in part by the US National Institutes of Health and Canada’s International Development Research Centre….”

And some quick links:

DeSmog blogWorld May Hit 2 Degrees of Warming in 10-15 Years Thanks to Fracking, Says Cornell Scientist

Bad news.

Nature – US environmental group wins millions to develop methane-monitoring satellite

“…The Environmental Defense Fund is working with researchers at Harvard University on the probe….”     “A US environmental group has been awarded tens of millions of dollars to develop a new satellite to help track — and ultimately, reduce — emissions of the greenhouse gas methane from oil and gas facilities around the world. If the Environmental Defense Fund (EDF) succeeds at launching its probe, it could be the first environmental group to send its own satellite into space. The group’s efforts are being funded through the Audacious Project, a joint effort of the non-profit group TED and philanthropic organizations such as the Bill & Melinda Gates Foundation….”

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infectious diseases & NTDs

NYT – We’re out of Options: Doctors battle drug-resistant typhoid outbreak

https://www.nytimes.com/2018/04/13/health/drug-resistant-typhoid-epidemic.html

The first known epidemic of extensively drug-resistant typhoid is spreading through Pakistan, infecting at least 850 people in 14 districts since 2016, according to the National The typhoid strain, resistant to five types of antibiotics, is expected to disseminate globally, replacing weaker strains where they are endemic. Experts have identified only one remaining oral antibiotic — azithromycin — to combat it; one more genetic mutation could make typhoid untreatable in some areas. Researchers consider the epidemic an international clarion call for comprehensive prevention efforts. If vaccination campaigns and modern sanitation systems don’t outpace the pathogen, they anticipate a return to the pre-antibiotic era when mortality rates soared. “This isn’t just about typhoid,” said Dr. Rumina Hasan, a pathology professor at the Aga Khan University in Pakistan. “Antibiotic resistance is a threat to all of modern medicine — and the scary part is, we’re out of options.”…”

AP – Nigeria’s Boko Haram extremists hamper polio eradication

AP;

… The World Health Organization had declared Nigeria polio free in September 2015 after it went a year without any new cases. But in 2016 — after two years with no cases — fresh polio cases broke out in three locations in Borno state. No new cases were reported in Nigeria in 2017 or so far this year. Now the WHO says it will be spending $127 million toward eradicating polio in Nigeria between 2018 and 2019. Rotary’s program is helping that effort by targeting some 2.1 million children in 24 accessible local governments. But there are still three areas in Borno state that are not included because of ongoing instability: Kala-Balge, Marte and Abadam. For those unreachable areas, the vaccinators train Nigerian soldiers in how to administer the vaccines….”

Diagnosing Ebola before Symptoms Arrive

http://www.bu.edu/research/articles/diagnosing-ebola/

”Currently, doctors diagnose Ebola when symptoms like fever emerge; Diagnosing infected people earlier could save lives; Primates’ antiviral response kicks in up to four days before symptoms appear, suggesting a path to early diagnosis.” 

For the paper (published end of March), see A conserved transcriptional response to intranasal Ebola virus exposure in nonhuman primates prior to onset of fever

The Conversation – Emerging infectious diseases in India: the scourge that could boost urban development

O Telle; https://theconversation.com/emerging-infectious-diseases-in-india-the-scourge-that-could-boost-urban-development-95076

“…These epidemics are a scourge, but also an opportunity: in a context where these infectious diseases do not recognise administrative frontiers, much less social ones, they may finally have a positive impact on urban development and encourage the development of more inclusive cities.”

CIDRAP –  ‘Mad camel’ disease? New prion infection causes alarm

CIDRAP

“Italian and Algerian researchers released new evidence of prion disease in three dromedary camels found in an Algerian slaughterhouse, according to a new study in Emerging Infectious Diseases. The discovery, now being called camel prion disease (CPD), has raised more questions than answers about this deadly illness characterized by misfolded brain proteins….”

AP – Brazil yellow fever vaccination campaign far short of goal

https://www.apnews.com/adcbd325226e4723a0f47e0be22a2a7b/Brazil-yellow-fever-vaccination-campaign-far-short-of-goal

From last week: “Brazil’s yellow fever vaccination efforts have fallen significantly short of their goal, the Health Ministry acknowledged this week, and an official said Friday that more than 16 million people in the targeted population still need to be immunized.”

Reuters – Miami among cities at risk from yellow fever spread : study

Reuters

Miami is at risk of a deadly yellow fever outbreak because the disease could thrive there but the city has no checks on travelers arriving from endemic zones, a study to be published by the World Health Organization showed. … … But the study, “International travel and the urban spread of yellow fever”, showed that almost 2.8 million people flew to the United States from endemic yellow fever areas in 2016. Unlike some countries, the United States does not require travelers from such places to show proof of yellow fever vaccination….”

US News & World Report – In South Africa, Charity Begins at Home: Uncertain over U.S. funding, many of the country’s aid organizations are scrambling for new sources of money

US news;

On the situation for South African charities. Now that PEPFAR funding is threatened, some charities are looking towards China, as government funding won’t suffice either.

“… South Africa plans to spend $6.74 billion through 2020 on programs dedicated to treating people with HIV/AIDS, tuberculosis and sexually transmitted infections. But government funding alone will inevitably fall short of meeting needs, forcing charities and nongovernmental organizations to find alternatives. One alternative may come from China looking to ground its strategy of aid as diplomacy in Africa. It’s a move that represents a challenge to the United States’ own soft power ambitions….”

Global Public Health – Factors contributing to and strategies to combat emerging arboviruses

D M Callender et al ; https://www.tandfonline.com/doi/full/10.1080/17441692.2018.1464588

Less than half a century ago infectious diseases appeared to be destined to be extinguished via as a culmination of medical triumphs. As focus turned towards combating non-communicable diseases, emerging and re-emerging diseases (EIDs) have bloomed from those ashes. Five epidemic mosquito-borne arboviruses (Yellow Fever virus (YFV), Dengue virus, West Nile virus, Chikungunya virus, and Zika virus) have emerged in the recent past. Arboviruses are of the utmost importance with respect to EIDs due to intensive growth of globalisation, arthropod urban fitness/adaption, and environmental changes. We focus on recent outbreaks of the arthropod borne viruses (arboviruses) Zika virus and YFV. Factors contributing to the blossoming of EIDs (environmental, globalisation, and urbanisation) and combating strategies (surveillance, containment, and prevention) will be discussed. Specifically, Zika virus and YFV will be used in the context of these factors and strategies. YFV is discussed in detail as it pertains to these factors and strategies in the United States (US), 2017 Brazil Outbreak, 2016 Africa Outbreak, and global risk. Vigilance is needed to focus on, prevent, and control the current and next arbovirus EIDs.”

And some quick links:

NYTTrillions upon trillions of viruses fall from the sky each day

ScienceMalaria infection creates a ‘human perfume’ that makes us more attractive to mosquitoes

“The parasite that causes malaria can change the way you smell, making you more attractive to mosquitoes, according to a new study. The work may help explain why the disease is able to spread so effectively.”

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AMR

South Bulletin – latest issue focuses on AMR in the South

https://www.southcentre.int/south-bulletin-101-18-april-2018/

Antibiotic resistance—and the broader antimicrobial resistance (AMR) – is a silent but major killer. In fact it is emerging as the most serious threat to global health, with experts warning of a “post-antibiotics apocalypse”. This special issue of South Bulletin focuses on the AMR crisis, especially on how it affects developing countries—and the great challenges on fighting this threat.”

Cidrap – New UK-Canada initiative focuses on AMR in livestock, aquaculture

http://www.cidrap.umn.edu/news-perspective/2018/04/new-uk-canada-initiative-focuses-amr-livestock-aquaculture

“Health officials in Canada and the United Kingdom have announced a new initiative aimed at combating antimicrobial resistance (AMR) in livestock and aquaculture production in low- and middle-income countries (LMICs). Innovet-AMR, a partnership between the UK government’s Global AMR Innovation Fund and Canada’s International Development Research Centre (IDRC), will fund and support research to develop new animal vaccines and other innovative veterinary solutions to reduce the use of antimicrobials in livestock and aquaculture in LMICs, and will build partnerships to ensure that those solutions can be delivered in a sustainable way. The four-year initiative is being backed by $27.9 million Canadian dollars ($22.1 million USD)….”

 

Check out also a new Lancet Global Health studyAntimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey.

“The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients….”

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NCDs

UN Interagency taskforce on NCDs – Integrating NCDs into United Nations Development Assistance Frameworks (UNDAFs): 2017 Survey

http://apps.who.int/iris/bitstream/handle/10665/259857/WHO-NMH-NMA-18.98-eng.pdf;jsessionid=28FAE7734D9ADB767EA555A9C0C2AF41?sequence=1

The purpose of this memo is to update members of the United Nations Interagency Task Force on the Prevention and Control of NCDs, on WHO and UNDP global baseline for the number of countries that have integrated work on NCDs into their UNDAFs, and the global target for 2022 from a baseline of 1 January 2018.”

“… Following a review of 59 countries that rolled out UNDAF in 2016-2017, 45 countries (76%) integrated NCDs into their UNDAF (Annex 2). Results also showed that 27 out of the 43 countries had included NCDs in their UNDAFs for the first time…”

Reuters – Novo Nordisk, Red Cross team up to tackle chronic diseases in conflict zones

https://www.reuters.com/article/us-novo-nordisk-aid/novo-nordisk-red-cross-team-up-to-tackle-chronic-diseases-in-conflict-zones-idUSKBN1HP0UR

Danish drugmaker Novo Nordisk and aid agency Red Cross have teamed up to try to improve the treatment of chronic diseases among the millions affected by conflicts and humanitarian crises in countries such as Syria and Yemen.” Among others, “…The partnership will also work to ensure supply of low-cost human insulin to the Red Cross’ global operations and start 2-3 projects to “provide care to people with hypertension and diabetes in humanitarian crises to be conducted within three years.””

UN – Traffic Deaths, Injuries Major Health, Development Concern, Delegates Stress, as General Assembly Adopts Resolution on Improving Global Road Safety

https://www.un.org/press/en/2018/ga12008.doc.htm

Last week the UN Assembly adopted a draft resolution titled “Improving global road safety”.

See also a tweet: “Great day for @who health at the @UN w adoption of 2 imp. resolutions in GA: #RoadSafety facilitated by @RussiaUN , & #NCDs modalities led by PRs of @ItalyUN_NY #UruguayUNMission -great progress towards #UNGA High Level Meeting on NCDs. Thx to the missions for their hard work!”

NCD Alliance Campaign Priorities The 2018 United Nations High-Level Meeting on NCDs

https://ncdalliance.org/sites/default/files/resource_files/2018HLM_NCDA_CampaignPriorities_22Jan_0.pdf

This (10 p.) briefing paper aims to inform civil society and partners about the crucial opportunity of the 2018 UN High-Level Meeting on NCDs (UN HLM) to mobilise political leadership and new resources and action to improve the lives of people affected by NCDs worldwide, and to guide advocacy at global, regional and national level for strong commitments at the UN HLM.”

Lancet – Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext

Was big news, end of last week. “A study analyses patient data from 19 high-income countries and suggests that current guidelines on low-level limits for alcohol should be reduced.”

For some coverage, see for example Sarah Boseley in the Guardian – Extra glass of wine a day ‘will shorten your life by 30 minutes’.

Drinking will shorten your life, according to a study that suggests every glass of wine or pint of beer over the daily recommended limit will cut half an hour from the expected lifespan of a 40-year-old. Those who think a glass of red wine every evening will help keep the heart healthy will be dismayed. The paper, published in the Lancet medical journal, says five standard 175ml glasses of wine or five pints a week is the upper safe limit – about 100g of alcohol, or 12.5 units in total. More than that raises the risk of stroke, fatal aneurysm (a ruptured artery in the chest), heart failure and death.”

So, if you drink a few more Heinekens every day to help the Global Fund, you’ll not just help people with HIV or TB, but also end up in heaven faster yourself.  A win-win.

Globalization & Health – The effect of sugar and processed food imports on the prevalence of overweight and obesity in 172 countries

T Kuo Lin et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0344-y

Studies find that economic, political, and social globalization – as well as trade liberalization specifically – influence the prevalence of overweight and obesity in countries through increasing the availability and affordability of unhealthful food. However, what are the mechanisms that connect globalization, trade liberalization, and rising average body mass index (BMI)? We suggest that the various sub-components of globalization interact, leading individuals in countries that experience higher levels of globalization to prefer, import, and consume more imported sugar and processed food products than individuals in countries that experience lower levels of globalization….”

We find that sugar and processed food imports are part of the explanation to increasing average BMI in countries; after controlling for globalization and general imports and exports, sugar and processed food imports have a statistically and substantively significant effect in increasing average BMI. In the case of Fiji, the increased prevalence of obesity is associated with trade agreements and increased imports of sugar and processed food….”

Some quick links:

NYTYou share everything with your Bestie. Even brain waves

Interesting article – check out just how much you have in common with your best friends.

Big ThinkMultivitamins are not only ineffective, but dangerous

So far, there’s not much attention (from global health) for this multi-billion dollar industry, though.

 

And a tweet:

Ilona Kickbusch isn’t a fan of the term ‘sin tax’: “Health Promotion levies or #STAX – let’s drop the term #sin tax”

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SR/Mat/neonatal & child health

Devex – With improvements in child marriage fight, some fear a funding drop

https://www.devex.com/news/with-improvements-in-child-marriage-fight-some-fear-a-funding-drop-92465

Last month, UNICEF released new data showing that the prevalence of child marriage is globally decreasing. Out of all regions, South Asia has witnessed the largest decline. In the past decade, the percentage of girls marrying before their 18th birthday in the region has dropped from nearly 50 percent to 30 percent. While this decline of more than one-third has drawn praise, it also doesn’t fully represent the realties on the ground, according to groups that focus on child marriage. And some fear the rare positive news could lead to a drop in funding — and a backsliding in progress. “It’s crucial that donors, governments, nongovernment organizations, and others don’t walk away from the news about the new data with the idea that their work is finished. If we don’t accelerate progress, 150 million girls will marry between now and 2030,” said Lakshmi Sundaram, executive director of Girls Not Brides, a United Kingdom-based umbrella organization of 900 local NGOs combating child marriage.  …”

Buzzfeed – In Closed-Door UN Meetings, Trump Administration Officials Pushed Abstinence For International Women’s Health Programs

Buzzfeed;

“… Members of HHS, USAID, and the US Mission to the UN asked for references to contraception, abortion, and comprehensive sex education to be struck from a document on international gender equality, calling the US a “pro-life nation.” In closed-door meetings at the United Nations in March, Trump administration officials pushed socially conservative views on women’s rights issues — including abstinence-based policies over information about contraception — that were further to the right than those expressed by most other countries present, including Russia and the representative for the Arab states, UN officials who attended the meetings told BuzzFeed News. The Trump officials’ approach at the UN meeting makes it clear that the administration intends to extend its views on abortion, contraception, and sexual education beyond US borders to an extent that is unusual even for Republican administrations….”   The comments came during the annual UN Commission on the Status of Women.

Project Syndicate – Demystifying Menstruation

C Dolan et al; https://www.project-syndicate.org/commentary/female-empowerment-managing-menstrual-sanitation-by-catherine-dolan-et-al-2018-04

In many societies, a woman’s period is a topic shrouded in euphemism and secrecy, owing to communal beliefs that can leave girls and women feeling embarrassed, isolated, and insecure. When this is combined with lack of access to sanitary products, or to safe, private places to use them, the results can be socially and emotionally devastating.”  The authors list three tasks that require urgent attention.

Guardian – Amnesty reports that women suspected of Isis links face sexual violence in IDP camps, amid claims they are being denied aid

https://www.theguardian.com/global-development/2018/apr/17/iraqi-women-targeted-amnesty-report

Sad & revolting news from earlier this week.

Health and Human Rights Journal – Political Priority for Abortion Law Reform in Malawi: Transnational and National Influences

Judith Daire (EV 2012), K Storeng et al; https://www.hhrjournal.org/2018/03/political-priority-for-abortion-law-reform-in-malawi-transnational-and-national-influences/

In July 2015, Malawi’s Special Law Commission on the Review of the Law on Abortion released a draft Termination of Pregnancy bill. If approved by Parliament, it will liberalize Malawi’s strict abortion law, expanding the grounds for safe abortion and representing an important step toward safer abortion in Malawi. Drawing on prospective policy analysis (2013–2017), we identify factors that helped generate political will to address unsafe abortion. Notably, we show that transnational influences and domestic advocacy converged to make unsafe abortion a political issue in Malawi and to make abortion law reform a possibility. Since the 1980s, international actors have promoted global norms and provided financial and technical resources to advance ideas about women’s reproductive health and rights and to support research on unsafe abortion. Meanwhile, domestic coalitions of actors and policy champions have mobilized new national evidence on the magnitude, costs, and public health impacts of unsafe abortion, framing action on unsafe abortion as part of a broader imperative to address Malawi’s high level of maternal mortality. Although these efforts have generated substantial support for abortion law reform, an ongoing backlash from the international anti-choice movement has gained momentum by appealing to religious and nationalist values. Passage of the bill also antagonizes the United States’ development work in Malawi due to US policies prohibiting the funding of safe abortion. This threatens existing political will and renders the outcome of the legal review uncertain.”

BMJ Global Health – Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries

L Benova et al; http://gh.bmj.com/content/3/2/e000779

Antenatal care (ANC) provides a critical opportunity for women and babies to benefit from good-quality maternal care. Using 10 countries as an illustrative analysis, we described ANC coverage (number of visits and timing of first visit) and operationalised indicators for content of care as available in population surveys, and examined how these two approaches are related….”

BMJ Global Health – From the battlefield to the bedroom: a multilevel analysis of the links between political conflict and intimate partner violence in Liberia

Jocelyn Kelly et al; http://gh.bmj.com/content/3/2/e000668

This article assesses the link between levels of armed conflict and postconflict intimate partner violence (IPV) experienced by women in Liberia.

Conclusion: “Residing in a conflict-affected district even 5 years after conflict was associated with postconflict IPV”. Policy implications:”Recognising and preventing postconflict IPV violence is important to support long-term recovery in postconflict settings.”

 

Quick links:

NYTLegal abortion in Argentina? A long shot is suddenly within reach.

 

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Access to medicines

IP-Watch – Dozens Of NGOs Oppose Proposed EU Watch List On IP Rights

http://www.ip-watch.org/2018/04/16/dozens-ngos-oppose-proposed-eu-watch-list-ip-rights/

A wide-ranging list of international nongovernmental organisations [today] issued a letter to European Trade Commissioner Cecilia Malmström opposing a proposal to establish a “watch list” of countries deemed failing to protect European intellectual property. The groups raised concern that the list would violate World Trade Organization rules on intellectual property, have a chilling effect on developing countries’ public health initiatives, and lead to expanded and untenable levels of IP enforcement….”

Journal of Pharmaceutical Policy & Practice – The Belgian commitment to pharmaceutical quality: a model policy to improve quality assurance of medicines available through humanitarian and development programs

R Ravinetto et al; https://joppp.biomedcentral.com/articles/10.1186/s40545-018-0136-z

Today, a combination of globalization of pharmaceutical production, lack of regulatory harmonization, and weakness of Medicines Regulatory Authorities, creates the “perfect conditions” for poor-quality medicine to circulate in the global market and to penetrate the less-regulated countries. Medicines regulation is the responsibility of the national regulatory authorities in the recipient country, but in the poorer countries, in practice, the responsibility of supply of quality-assured medicines is often taken by Non-Governmental Organizations and other implementers. But with some notable exceptions, many donors lack a pharmaceutical procurement policy with adequate quality requirements; and many implementers lack the skills and expertise needed to orient themselves in the complex web of global pharmaceutical supply. Thus, patients served by humanitarian or development programs may remain exposed to the risk of poor-quality medicines. When public money is used to purchase medicines for medical programs to be carried out overseas, adequate policies should be in place to assure that the same quality requirements are set that would be required for medicines marketed in the “donor” country. We will describe here a policy recently adopted in Belgium, i.e. the “Commitment to Quality Assurance for Pharmaceutical Products”, signed in October 2017 by the Vice Prime Minister and Minister for Development Cooperation and 19 Belgian implementing agencies. By signing the new policy, the counterparts committed to ensure quality of medicines in the programs funded by Belgium’s Official Development Assistance, and to build quality-assurance capacity in the recipient countries. Implementers are requested to integrate in their financing applications a section for pharmaceutical quality assurance, with a justified budget. They are also invited to consider how costs could be rationalized and mutualized by aligning the strengths of the various implementers. This model policy has the potential to be considered for adoption by other donors, to help to reduce the current multiple standards in pharmaceutical quality, and to contribute to protect vulnerable communities from the plague of poor-quality medicines. »

BMJ – Slashed cost of hepatitis C drugs spurs drive to eliminate the disease

https://www.bmj.com/content/361/bmj.k1679

Unimaginable just a few years ago, new drugs for hepatitis C are becoming affordable for all, reports Richard Hurley.” “Access to hepatitis C virus testing and treatment should be expanded now that effective, curative drugs are so affordable, the World Health Organization said on 13 April. The advice comes two years after the agency made a global commitment to eliminate all types of viral hepatitis by 2030…”

The Conversation – Why manufacturing a key vaccine in South Africa is so important

D R Walwyn; https://theconversation.com/why-manufacturing-a-key-vaccine-in-south-africa-is-so-important-94380

South Africa has been granted a licence to manufacture one of the world’s most important vaccines. It’s the first time the country will be able to do so since the mid 1990s, and is news that will result in many positive spin-offs for the country….”

 

Some quick links:

STAT –  More GOP lawmakers urge U.S. trade officials to lean on Colombia over drug approvals

Still more Republican lawmakers are urging the U.S. trade representative to require Colombia to change its laws governing drug approvals before supporting the country’s membership in the Organization for Economic Cooperation and Development….” “… In a letter late last week, U.S. Reps. Tom Rice (R-S.C.) and Patrick Meehan (R-Pa.) argued that the Colombian government must alter a national development plan, because it differs from World Health Organization standards by tying marketing approval for approving drugs to pricing criteria, which they argue is not used by other OECD countries. …”

FT – Drug sellers get a shot in the arm from Amazon report

“Shares of drug stores and related companies got a booster on Monday from a report that Amazon may not be making a foray into pharmaceutical sales after all.”

Scientific AmericanExpanding Global Access to Essential Heart Medications

On the need to modernize WHO’s official list of essential medicine, in this respect.

IP-Watch – Patents On Delivery Devices Can Extend Drug Patent Protection For Years, Study Finds

The number of patents for drug delivery devices has shot up in recent years, and has had the effect of significantly extending the protection enjoyed by patented pharmaceuticals, delaying cheaper versions of the drugs and leading to higher prices, a recent paper found. … … The study looked at patents on drug delivery services, such as inhalers or injector pens (like EpiPen), and found that such patents have tripled since 2000. This contributes a media of 5 years of additional market exclusivity to such products, it said. The paper, entitled, “Tertiary patenting on drug–device combination products in the United States,” was published in the February edition of Nature Biotechnology…

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Human Resources for Health

Guardian – Zimbabwe sacks thousands of nurses on strike for better pay

https://www.theguardian.com/world/2018/apr/18/zimbabwe-sacks-thousands-of-nurses-on-strike-for-better-pay

Zimbabwe has fired thousands of nurses who went on strike to demand higher salaries, in a hardline response by the country’s leadership to growing labour unrest. The vice-president, Constantino Chiwenga, sacked the nurses in a terse statement issued on Tuesday evening, in which he claimed their industrial action was politically motivated.”

BMJ Global Health – Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya

M B Adam et al; http://gh.bmj.com/content/3/2/e000665

Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-for-profit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike. The volume of patients increased and exceeded the hospital’s ability to respond to needs. There were substantial increases in sick newborn admissions during this time frame and an additional ward was opened to respond to this need. Increased need occurred across all services but staffing and space limited ability to respond to increased demand. There were increases in deaths during the strike period across the paediatric medical, newborn, paediatric surgical and obstetric units … …. Increased mortality across paediatric and obstetrical services at AIC-Kijabe Hospital correlated with the crippling of healthcare delivery in the public sector during the national physicians’ strike in Kenya.”

WHO Education hub – Developing a Global Competency Framework for Universal Health Coverage

http://www.who.int/hrh/news/2018/developing-global-competency-framework-universal-health-coverage/en/

“…a key priority of the WHO Education Hub is to support the scale up of health worker numbers through developing a Global Competency Framework for UHC to better align education with population health needs. The Global Competency Framework for UHC will describe the competencies (knowledge, skills, attitudes and behaviours) for the health workforce to deliver on the goals of UHC….”  Check out what this entails.

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Miscellaneous

Guardian – Where’s the diversity among charity trustees, asks critical report

https://www.theguardian.com/global-development/2018/apr/19/alarming-lack-diversity-charity-trustees-england-wales

The largest charities in England and Wales have less diverse boards than FTSE 100 firms,  has found.

 

An analysis of board members across the biggest charities in terms of income in the two countries, including Oxfam and Save the Children, showed that only 6.3% were from black, Asian or minority ethnic backgrounds, compared with 8.2% among FTSE 100 companies. Women of colour were the least likely group to be on a board or a senior leadership team…”

World Development Report 2019: the changing nature of work – concept note

http://pubdocs.worldbank.org/en/816281518818814423/2019-WDR-Concept-Note.pdf

For the ones among you who want to have a (thorough) sneak preview at the WDR 2019.  Or you can just stick to the first 3 pages (overview).

Nature (News) – African scientists call for more control of their continent’s genomic data

https://www.nature.com/articles/d41586-018-04685-1?utm_source=briefing-dy&utm_medium=email&utm_campaign=briefing&utm_content=20180418

As the genomics revolution finally turns its attention to Africa and northern researchers flock there to collect data, scientists from the continent are demanding a larger role in projects. On 18 April, a group of Africa-based researchers issued guidelines for the ethical handling of samples for genomic studies. The voluntary rules are an effort to combat ‘helicopter’ research, in which foreign scientists take samples and data from communities and then return to their home institutions. The guidelines also aim to ensure that African citizens see health benefits from research….”

“…The rules were issued by the ethics working group of the Human Heredity and Health in Africa (H3Africa) Initiative, a health-genomics consortium that supports research in African institutions. It is funded by the US National Institutes of Health and the biomedical research charity the Wellcome Trust….”

UN News – Donors pledge over $500 million to tackle growing needs in DR Congo; UN warns humanitarian crisis cannot be ignored

https://news.un.org/en/story/2018/04/1007251

News from late last week. “The first-ever international conference to help the Democratic Republic of the Congo (DRC) opened at the United Nations Office at Geneva on Friday amid dire warnings of a growing humanitarian crisis in the vast African country.

LSE Impact blog – Research assessments based on journal rankings systematically marginalise knowledge from certain regions and subjects

http://blogs.lse.ac.uk/impactofsocialsciences/2017/10/30/research-assessments-based-on-journal-rankings-systematically-marginalise-knowledge-from-certain-regions-and-subjects/

Many research evaluation systems continue to take a narrow view of excellence, judging the value of work based on the journal in which it is published. Recent research by Diego Chavarro, Ismael Ràfols and colleagues shows how such systems underestimate and prove detrimental to the production of research relevant to important social, economic, and environmental issues. These systems also reflect the biases of journal citation databases which focus heavily on English-language research from the USA and north and western Europe. Moreover, topics covered by these databases often relate to the interests of industrial stakeholders rather than those of local communities. More inclusive research assessments are needed to overcome the ongoing marginalisation of some peoples, languages, and disciplines and promote engagement rather than elitism.”

Guardian – Obama Foundation’s fellows include South African activist and Afghan refugee

https://www.theguardian.com/us-news/2018/apr/16/obama-foundations-fellows-include-south-african-activist-and-afghan-refugee

Former US president has said he wants to create ‘a million young Barack Obama or Michelle Obamas’.

Far better than a million young “Macrons”, I think.

“… The Obama Foundation describes the fellowship as a two-year non-residential programme that will bring together leaders who are “creating transformational change on many of the world’s most pressing problems”. The fellows are engaged in areas including healthcare, community organising, technology and the arts. Their work includes empowering parents and teachers to improve schools, ensuring deaf children have equal access to literacy tools and engaging with the healthcare system to treat addiction….”

BMJ (Editorial) – The rise of ambiguous competing interest declarations

https://www.bmj.com/content/361/bmj.k1464

“Terms such as “unpaid consultancy” should be consigned to the dustbin.”

A recent analysis in the Journal of General Internal Medicine reports on a new trend: many more authors of medical journal articles are disclosing that they are “unpaid consultants” to pharmaceutical, biotech, or medical device companies. Before 2000, there were one or two such disclosures a year; this increased to over 150 a year from 2012 to 2014. This form of disclosure may reflect greater openness, or it may disguise industry sponsorship of medical research with new terminology. Menkes et al suggest that declarations of “unpaid” consultancies “may do more to conceal than illuminate.”…”

Devex – USAID, State, and DOD to release first-ever Stabilization Assistance Review

https://www.devex.com/news/usaid-state-and-dod-to-release-first-ever-stabilization-assistance-review-92535

The Trump administration is releasing the first of its kind interagency review of United States overseas involvement that creates a framework for how the State Department,  U.S. Agency for International Development, and Department of Defense can coordinate efforts to streamline diplomacy, aid, and military operations around the world and maximize resources and results. The Stabilization Assistance Review, or SAR, is based on lessons from Syria and Iraq, as well as other areas of the world in which the U.S. government is engaged, and is intended to be a guide for operations in conflict zones and fragile states. “This helps USAID because it establishes a clear division of labor and responsibilities in the joint efforts of USAID, State, and DOD in stabilization,” USAID Administrator Mark Green said. “It also helps us because it delineates mission parameters as quantifiable objectives as opposed to really open ended good intentions.”…”

Medium – De-constructing credibility: Factors that affect a think tank’s credibility

A B Helguero; https://medium.com/@info_92670/de-constructing-credibility-722ade1f731b

This paper explores the concept of credibility and its importance for think tanks. Credibility is paramount to a think tank as having it qualifies think tanks to be consulted on and invited to participate in policy processes. It makes them attractive to funders; promotes engagement with the media as experts in their field; and facilitates access to reputable networks. Without it, none of this can occur. The paper explores the concept of credibility, and explains (based on a literature review) that credibility is constructed through the interaction of characteristics and actions of an organisation, and the assessment of others in the context within which communication takes place. Stakeholders give (or take away) credibility based on their assessments of the information they have and the influence of the current context. The credibility of a think tank goes beyond the quality of its research. Quality research is desirable, needed and even the foundation on which credibility rests, but it is not sufficient. The paper argues that beyond it there are a common set of factors from which individuals draw from and focus on (in various degrees) to assess the credibility of a think tank. These are: Networks; Past Impact; Intellectual independence; Transparency; Credentials and expertise; Communications and visibility; Research quality; Ideology and values; and Current context.”

Global Policy – Measuring the Diffusion of the Millennium Development Goals across Major Print Media and Academic Outlets

John McArthur et al; https://onlinelibrary.wiley.com/doi/full/10.1111/1758-5899.12553

To what extent did the MDGs succeed in becoming a reference point for public debates, academic inquiry, and policy‐focused research? We explore this by considering three empirical questions. First, were there discernible trends in the extent of media references to the MDGs – by year, publication, and geography over the relevant period? Second, were there discernible trends in MDG references across a sample of relevant academic journals and disciplines? Third, how does the pattern of MDG media references compare to the emerging early pattern of Sustainable Development Goal (SDG) media references? In our sample, we find that newspapers in the UK, India and Nigeria had much more frequent MDG references than those published in Australia, Canada or the United States. We also find that The Lancet had a notably high frequency of MDG‐referencing articles, potentially helping to explain the distinctive patterns of acceleration on health MDGs. We further find that UN summits were a key driver of MDG coverage, with 2005 as the year of peak MDG attention. News coverage for the SDGs in 2016 was similar to latter year coverage of the MDGs, although considerably higher than related coverage in 2001 and 2002.”

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Emerging Voices

Integrated HIV-Care Into Primary Health Care Clinics and the Influence on Diabetes and Hypertension Care: An Interrupted Time Series Analysis in Free State, South Africa Over 4 Years

https://journals.lww.com/jaids/Abstract/2018/04150/Integrated_HIV_Care_Into_Primary_Health_Care.6.aspx

By Angeli Rawat (EV 2014) et al.

Cfr a tweet by Angeli herself: “Can integrated #HIV care in #PHC clinics potentially compromise #hypertension & #diabetes care in #SouthAfrica? We found decreases in new hypertensives on treatment.”

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Research

Global Health Action – The odd couple: using biomedical and intersectional approaches to address health inequities

O Hankivsky et al; https://www.tandfonline.com/doi/abs/10.1080/16549716.2017.1326686

“…In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements. … … We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease.” Conclusion: “We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.”

BMJ Global Health – Supporting capacity for research on malaria in Africa

B Greenwood et al; http://gh.bmj.com/content/3/2/e000723

Substantial progress has been made in the control of malaria in Africa but much remains to be done before malaria elimination on the continent can be achieved. Further progress can be made by enhancing uptake of existing control tools but, in high transmission areas, additional tools will be needed. Development and evaluation of these new tools will require a substantial cadre of African scientists well trained in many different disciplines. This paper describes the activities undertaken by the Malaria Capacity Development Consortium (MCDC) to support the careers of PhD students and postdoctoral fellows undertaking research on malaria at five African universities….”

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