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The 500th IHP issue: Staying the course in disruptive global and planetary health times

By Kristof Decoster
on December 7, 2018

The International Health Policies (IHP) newsletter started in 2009-2010, back then as an initiative of the health policy unit at ITM, with David Hercot and Wim Van Damme as the key initiators. The Belgian Development Cooperation (DGD) has supported us from the start, and we’re very grateful for that. Very early on, a  weekly newsletter focusing on health policies became the aim – hence the name. It targeted readers both in the South and the North, and initially focused on global health policy and governance related reads in the Lancet which is published online at midnight on Thursdays. The weekly deadline on Friday was thus an obvious choice. Over time IHP evolved, and unfortunately, we lost David as a member of the health policy unit and editorial team along the way. One of the reasons why he left our unit was a planetary health dilemma of sorts, even if the term ‘planetary health’ didn’t exist yet back then. He had come to the realization that he couldn’t combine the flying needed for global health expertise with his ethics.  It was an early sign of the new times.

So yes, IHP has evolved with the times, more or less in sync with the global health policy agenda. While IHP – in spite of the first part of its name – pretty much covered international and global health policies  from the start,  we’re now increasingly moving to the planetary health era (which adds an additional layer of complexity and political trade-offs to global health challenges in the 21st century).  Not every global health actor is already on the same page, but the writing is very much on the wall. IHP interprets  ‘planetary health’ here the way Richard Horton conceived it, or along the lines of Kate Raworth’s work, – one of the successors of Hans Rosling in our opinion – who emphasizes that “we’re all developing countries now”. We also transitioned from the MDG health era to the SDG health era a few years ago. That’s not really going according to plan. Instead, our time is turning into an age of global health disruptors, not least because of the decreasing belief in multilateralism and global cooperation, even though the need for these has perhaps has never been greater.

Over the years, IHP has tried to reflect some of these changes, in its selection of items and via Featured articles and intros. Below we will elaborate a bit more on each of these three aspects.

When it comes to selected items, as part of its core knowledge management function, IHP has always tried to focus on the global health policy agenda, global health governance (as well as some global governance for health trends), health policy and systems research (especially those with broader relevance i.e. beyond particular settings), relevant global health reports, etc., based on the belief that many of these will eventually trickle down to the field. We hope this happens vice versa as well, although this has arguably been less of a focus area for IHP. The knowledge management function remains core, and has evolved in line with the policy trends and discourses of the past years (see above). The compilation has also become more systematic over time. Indeed, compared to the early days, global health literature, newsletters (from many stakeholders and on many global health issues), relevant blogs, global health niche journals, etc. have multiplied. In response, IHP has become a comprehensive weekly digest/compilation of all this information – for example, we often refer to key material in newsletters & knowledge management tools from some of our colleagues who tend to focus more for instance, on particular issues, or specific global health actors.

“Switching the poles” was another key aim from the start, as the IHP logo tells you, and very early on, we opted to use IHP as a key forum for Emerging Voices and other young voices from the South, via Featured articles. Over time, IHP interns, residents and correspondents have further contributed to this aim. As you can imagine, from time to time, we have wrestled with a challenge that might be familiar to those of you who work in global health financing: how to ensure that we have stable (structural) contributions, rather than unpredictable contributions (in terms of timing). This has been a bit of a balancing act at times, certainly when it comes to the timeliness of contributions which as you might expect for a newsletter, is important. This is usually less of an issue, before and after HSR symposia, however. Anyhow, we would sincerely like to use this occasion to thank the Emerging Voices and everyone who has contributed so far to IHP in one way or another. We are also very grateful for the good relationship we have with the Medicus Mundi International (MMI) network, via our colleague Remco van de Pas.

In the rest of this article, I’ll switch a bit more to the ‘I’ perspective, and zoom in on the weekly intros, for which I’ve largely been responsible over the years. I’ve tried to do my best with ‘switching some of the poles in the North’ (not an official aim of IHP), especially in the intros, and by and large, these intros have been well received over the years (and I’ve certainly enjoyed writing them!). Yet, it is perhaps good to dwell here a bit more on how they came into being and some of the sensitivities around a few of them.

There’s no denying that I’m male, white, based in the North and now middle aged – and these all come with a certain luggage.  Also, like most people, I have my “lens” (some would say, pet peeves) on the world, comprising among others: a planetary health focus (which also requires structural changes in the North, as no one except that fellow in the White House would deny), political and commercial determinants of health, football, tax justice, not being too fond of PPPs and the corporate sector in general, etc. With my background in political science, I guess some of these biases are just unavoidable. If I were an economist, I would probably see ‘markets’ everywhere, but no …😊

I will also readily admit that, again like most people, I only have ‘‘bandwidth’ for one or two big fights and in my case, that’s probably  inequality & climate justice. As a white man, I don’t “feel” gender (injustice) the same way as many women, or the LGBTI community, even if I find it extremely important, or the need for decolonialization of global health (another key issue of our times). And yes, in terms of inclination, I’m probably a bit more ‘Mouffe’ (conflict is needed) than ‘Tedros’ (partnership) or ‘Gates’ (innovation). Well, at least behind my laptop 😊.

When I look back on these years, I admit a few of these intros have been sensitive, a bit to my surprise. I always thought it was fairly obvious that they were a bit ‘over the top’, with some teasing here and there (especially of ‘power’ in global health). All in all, the intros were not meant to be taken too seriously – I figure the world’s situation is serious enough. Maybe, as a colleague of mine said, the problem was that they were a mixture of satire, and facts/opinion. It appears one needs to distinguish clearly between these categories in our current times. It might also have been, as another friend (from East-Asia) mentioned, that there was a cultural element involved. And of course, in this era of social media, things sometimes get a slightly different dynamic there.  Anyway, I’ve learnt from some of the (relatively few) hiccups along the IHP journey.

Perhaps a few concluding remarks.

I’m no fan of neoliberalism, but I’ve apparently “internalized” enough neoliberalism to sometimes ask myself the question, “is it time to move on and explore new frontiers”? Only time will tell, but for now, I still feel passionate about global health policy (and there’re still a few poles that need shifting 😊).

Sometimes, I also wonder whether global health should just do its thing, and leave the rest (cfr.  climate change, …)  to others (who can probably do it better). However, that feeling usually doesn’t stay with me for long, because everything is connected in this world, and the SDG health era is meant to be a universal agenda. And so global health has no other choice but to make links with climate change, migration, the decoloniality debate, populism, … to mention just a few more recent examples. The  21st century is full of “wicked” problems.

In any case, on behalf of IHP I certainly hope you will continue to read (or at least scan) the newsletter in our current disruptive international, global & planetary health (policy) times!

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