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IHP news #525 (June 7, 2019)

Highlights of the week

Women Deliver (Vancouver, 3-6 June)

https://wd2019.org/

We already set the scene for this major conference, the world’s largest conference on gender equality and the health, rights, and wellbeing of girls and women, in this week’s intro. The theme this year was, as already mentioned, ‘Power’.

This article on HPW also set the scene:

HPW – Women Deliver Conference On Gender Equality Grabs Global Attention

https://www.healthpolicy-watch.org/women-deliver-conference-on-gender-equality-grabs-global-attention/

This week’s Women Deliver 2019 Conference on gender equality and the health, rights, and well-being of girls and women, has captured the world’s attention, drawing three African heads of state as well as Canadian Prime Minister Justin Trudeau; international NGOs; and directors of UN Agencies, including a host of high-level WHO officials, as among the key speakers. The star-studded speakers list is reflective of the growing importance global policy leaders are ascribing to the gender equality issues covered at the mega-event, taking place in Vancouver, Canada, from 3-6 June, under the theme “power, and how it can drive – or hinder – progress and change.”

 

Without being exhaustive, then, a brief overview of what was said, done and announced in Vancouver, in steno style:

Opening plenary

You can re-watch the high-profile opening plenary, ‘The Power of Us’, here.

Canadian prime minister Justin Trudeau has condemned politicians who give into growing pressure and “shamelessly campaign” to reverse women’s rights around the world, in a thinly veiled swipe on the policies of his neighbour Donald Trump.  Speaking at the Women Deliver conference in Vancouver … … the Canadian Prime Minister criticised the global “pushback” against women’s rights. “Progress can backslide, we’re seeing it happen,” he said. “Gender equality is under attack.”…”

Excerpts:

Women Deliver got underway today amid a sobering backdrop: The release of the findings of the Canadian government’s 3-year inquiry into the country’s missing and murdered indigenous women. … .  …”

Executive Direct of UN Women Phumzile Mlambo-Ngcuka summed up the collective mood at a Women Deliver press conference ahead of the plenary. “We are here to push back against the pushback. When women are united and determined we definitely are unstoppable,” she said, adding that this moment is particularly important, just ahead of next year’s 25th anniversary of the Beijing Platform for Action. Women Deliver, she noted, is really galvanizing that process. Fittingly, this year Women Deliver’s conference theme is Power, Progress, and Change. It’s time, President and CEO Katja Iversen said, to “unapologetically own our individual power and use it to lift others up”—and recognize that with power comes responsibility. …”

  • Melinda Gates (quote via GHN): “The first Women Deliver conference was about women delivering babies … now we deliver so much more,” Melinda Gates said yesterday at #WD2019, adding, “I think what we’re really delivering is change.”
  • Quote dr Tedros (see WHO )

Gender equality must be at the core of ‘health for all” – Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Until all women and girls have access to quality and affordable health care; can freely access services for sexual and reproductive health; and are treated and respected as equals, we have not achieved #HealthForAll. http://bit.ly/2IkvYn0  #WD2019

Financial and other announcements & initiatives

 

Canada will increase its global spending on women’s and girls’ health as other countries “are stepping back”, Prime Minister Justin Trudeau said on Tuesday, citing threats to abortion access and violence against women.  … … Canada will [gradually] increase its spending to C$1.4 billion ($1 billion) by 2023 from C$1.1 billion currently   [i.e. annually ], he announced at the world’s largest conference on gender equality, We Deliver, positioning his country as a leading donor internationally. … … Half the money – C$700 million – will go to sexual and reproductive health under Canada’s commitment.”

“… Almost $9 billion in U.S. foreign aid is at stake under the global gag rule imposed by U.S. President Donald Trump that requires non-governmental organizations working abroad to choose between accepting the abortion-related ban or losing funding….”

See also CTV.

At the Women Deliver Conference in Vancouver, the U.S. government announced [today] that it will invest nearly $2 billion this year to advance gender equality by supporting millions of women and girls through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)….”

Not very clear whether this is ‘new’ money or not. Our guess is probably the same as yours : )

Just before Women Deliver began, “the Canadian-led Equality Fund stepped forward to accelerate outcomes for women by breaking down historic barriers to investment and supporting gender equality globally. The ground-breaking collaboration combines international feminist grant-making, multi-sector philanthropy and a new innovative investment arm, the impact of which will transform and sustain funding for women’s organizations and movements well beyond 2030. The Equality Fund has mobilized initial investments of $100 million to partner with the $300 million multi-year funding award from the Government of Canada announced today.”  The fund brings together 11 partners and it’s hope that eventually, the fund will reach 1 billion in the next 15 years.

  • Via Devex – “ProMujer announced a $35 million gender lens investment fund for Latin America, of which $25 million has already been committed.”

Some other initiatives and announcements:

 

  • A new knowledge hub on safe abortion and post-abortion care programming was launched

 

 

 

  • Via Devex : Youth engagement was enormous in Vancouver. And “ Women Deliver, Girl Effect, and the Canadian government announced a new initiative to engage youth as researchers and advocates for youth sexual and reproductive health and rights efforts…”

 

  • Devex also reported that women health workers & safe abortion were key issues in Vancouver.

New reports, indices & series

Guardian – Not one single country set to achieve gender equality by 2030

https://www.theguardian.com/global-development/2019/jun/03/not-one-single-country-set-to-achieve-gender-equality-by-2030?CMP=twt_a-global-development_b-gdndevelopment

No country in the world is on track to achieve gender equality by 2030, according to the first index to measure progress against a set of internationally agreed targets. Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, said the index, launched on Monday, “should serve as a wake-up call to the world”. … … The inaugural  SDG Gender index, developed by the Equal Measures 2030 partnership, found that 2.8 billion women and girls currently live in countries that are not doing enough to improve women’s lives….”

See also Devex New report says urgent action is needed for gender equality

Launch of Lancet series on  Gender Equality, Norms and Health

Lancet series: Gender Equality, Norms, and Health

(as already flagged in last week’s IHP issue)

Guardian – Trump’s anti-abortion global gag rule threatening women’s lives, [new] report says

https://www.theguardian.com/global-development/2019/jun/05/trump-global-gag-rule-anti-abortion-harms-women-africa-asia-report

The Trump administration’s anti-abortion restrictions on US global health aid funding have significantly damaged healthcare for women in Africa and south Asia, according to a new report.  Restrictions on funding also include limiting access to funds for sex education, and shifting funds to anti-LGBTQ and pro-abstinence groups such as Focus on the Family, researchers say. The “Crisis in Care” report from the International Women’s Health Coalition outlines the two-year impact of the Trump administration’s “global gag rule which prohibits funding to international NGOs that do not sign a pledge saying they will not provide or promote abortions as a method of family planning. The rule applies to an organization’s non-US funded activities too, regardless of the local laws regarding abortion. …”  The new report is built on 118 interviews with community health organizations in Nigeria, Kenya, South Africa and Nepal.

People are dying’ in Africa and south Asia as a result of policy that bans aid to foreign groups who support abortions, says author of report…”

Moreover, “The report also warned that the US’s aggressive stance against abortion counseling and services was emboldening “regressive actors” – rightwing or anti-reproductive health groups – in Kenya, Nigeria and South Africa.  The amount of money from the US to other countries isn’t decreasing, it’s just going more and more to regressive groups,” said Jedidah Maina, executive director, in Kenya, of Trust for Indigenous Culture and Health, at a panel previewing the report….”

See also DevexTwo years in, report finds ‘global gag rule’ cuts access to health care

“…The report also revealed an unexpected impact on governments — even those with liberal abortion laws. While governments themselves are exempt from the policy, they now cannot contract out work to some civil society organizations that previously provided a bulk of the country’s health services, because they signed on to the MCP. “It affects the work of governments pretty significantly. That was something we did not expect to see, to that extent,” Girard said….”

Time Magazine (on a new Plan International report) – ‘The Arc of History Is Bending Back.’ New Study Shows How Girls Around the World View Female Leaders

https://time.com/5599754/women-leadership-discrimination-plan-study/

new report published Tuesday reveals that 9 out of 10 girls around the world believe that female leaders suffer widespread discrimination and sexual harassment. Produced by child rights organization Plan International in partnership with the Geena Davis Institute on Gender in Media, the report found that while a majority of girls and women worldwide want to take leadership positions in the workplace, politics and wider society, an overwhelming majority of those surveyed believe that women leaders face unfair treatment. … … The report found that while nearly 60% girls and young women want to be a leader in the work place and over 75% aspire to be a leader in their country, community or career, overall they perceive a lack of respect for, and harsher criticism of, female leaders. “Inequality, intolerance and isolationism are on the rise,” Albrectsen told TIME. “The arc of history is bending back, away from justice. To turn things around, we must unlock the full power of girls’ leadership.”

Devex – To close gap in unpaid care work, a new call to action asks men to do more

https://www.devex.com/news/to-close-gap-in-unpaid-care-work-a-new-call-to-action-asks-men-to-do-more-95048

Against a backdrop of lagging progress on equalizing unpaid care work, Brazilian-based NGO Promundo is asking men to do more — 50 minutes more, to be exact. Men would need to contribute an additional 50 minutes every day to caring for children and households — and women 50 minutes less — to make a leap toward achieving gender equality in unpaid care, reveals the third edition of the “State of the World’s Fathers” report , released Wednesday by Promundo….”

OECD (report) – Enabling Women’s Economic Empowerment: New Approaches to Unpaid Care Work in Developing Countries

https://www.oecd.org/dac/enabling-women-s-economic-empowerment-ec90d1b1-en.htm

“How can governments and development partners meet the needs of families and communities, while ensuring that all citizens benefit from economic opportunities and fair remuneration? As part of the OECD Policy Dialogue on Women’s Economic Empowerment, this report focuses on identifying what works to address unpaid care work and sheds light on how governments, donors in the private sector and civil society actors – among others – can design policies to support both those who need care and those who provide care. The report brings together existing knowledge of policy options for unpaid care work across regions, in four policy areas: infrastructure, social protection, public services and the promotion of shared responsibility within the household.”

Intrahealth/Nursing Now/ J&J – Investing in the power of nurse leadership: what will it take?

https://www.intrahealth.org/sites/ihweb/files/attachment-files/investing-nurse-leadershipreport.pdf

“Women make up 70% of the total health and social care workforce and an even larger share of the nursing and midwifery profession, yet women only comprise 25% of health system leadership roles. This report draws from a review of existing literature, a survey of 2,537 nurses and nurse-midwives from 117 countries, and eight key informant interviews of nurse leaders to provide an in-depth analysis of the gender-related barriers to and facilitators of nurse leadership. The report derives from that analysis a set of recommendations for policymakers and implementers at the global, national, and institutional levels to accelerate strengthening nursing leadership and gender equality in the global nursing workforce.”

For coverage of this report, see DevexQ&A: Nurse leadership and tackling health workforce shortages

Affirmative action policies don’t help women advance toward leadership in nursing, according to a cross section of nurses who participated in a survey conducted by Johnson & Johnson in partnership with IntraHealth International and the Nursing Now campaign….”

Profiles & Analyses

 

Lancet (Perspective) – Katja Iversen: driving force in women’s health and gender equity

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31296-6/fulltext

Katja Iversen is the President & CEO of Women Deliver (in case you didn’t know). Among others.

Lancet Perspective – Sarah Hawkes: shining a gender lens on global health

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31190-0/fulltext

This Perspective on Sarah Hawkes was part of last week’s Lancet Series on Gender Equality, Norms and Health.

CGD Notes – After 2020: What’s Next for Global Access to Family Planning

F Apter, A Glassman et al; https://www.cgdev.org/publication/after-2020-whats-next-global-access-family-planning#.XPF6-d2qxBs.twitter

This note was published just ahead of the Women Deliver conference.

The authors reckon the conference “…is an opportunity for the family planning (FP) community—including the FP2020 Core Partners (the Bill & Melinda Gates Foundation, DFID, UNFPA, and USAID) and Reference Group—to review lessons from the past eight years and look forward beyond 2020, the landmark that has long dominated FP discussions. The key question: In a rapidly changing context, how can the FP community sustain gains and realize the benefits of high-quality FP access in low- and middle-income countries, including lower maternal mortality, better newborn and child health, and increased women’s empowerment? This note highlights three issues for the global FP movement post-2020, building on CGD’s engagement in this space, including our working group on alignment in family planning. We review the underlying critical assumptions in FP2020’s initial design along with their strengths and weaknesses, and place future approaches squarely within the context of today’s evolving landscape—one that looks very different than the year 2012, when FP2020 was launched.”

Must-read. They explore 3 assumptions (from back then), and offer 3 take away recommendations for FP2020 in the years to come.

Lancet (Perspective) – Gender equality: engaging men in change

Michael Flood; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31295-4/fulltext

Flood sees both encouraging and worrying trends in this respect.

Official G20 Engagement Groups urge G20 to take action on gender equality

https://civil-20.org/official-g20-engagement-groups-urge-g20-to-take-action-on-gender-equality/

Not (directly) related to Women Deliver, but at least indirectly:  “On 5 June 2019, official engagement groups of the Group of 20, Civil20Labour20Think20Women20 and Youth20 issued two statements urging G20 to take action on gender equality.  The statements ask G20 to “put their words into action” on addressing violence and harassment in the world of work and eliminating gaps in labour market participation. …”

The G20 Leaders’ Summit will take place in Osaka on 28 and 29 June.

World Environment Day

HPW – World Environment Day Puts Focus On Air Pollution & Health

https://www.healthpolicy-watch.org/world-environment-day-puts-focus-on-air-pollution-health/

A sizeable cast of global leaders including Pope Francis, United Nations Secretary-General António Guterres and national heads of state marked World Environment Day today with a round of stark warnings over social media about the risks to people and to health of environmental degradation, air pollution and climate change – topics that will demand more than words at September’s upcoming UN Climate Summit in New York….”

“… If in years past, the focus of World Environment Day was on wildlife, plants and ecosystems, this year’s #BeatAirPollution theme, reflects a growing recognition by environmental groups that people-centred messages focusing on health and well-being may be key to tackling pollution sources such as waste burning and poor waste management, energy inefficiencies and fossil fuel combustion, which are simultaneously driving rapid climate change and biodiversity loss….”

See also UN NewsTake action on air pollution to save lives, and the planet, urges UN chief

In a message to mark World Environment Day, celebrated on Wednesday, UN Secretary-General António Guterres has emphasized the link between worsening levels of air pollution and the climate crisis.”

“… Every World Environment Day has a different host country: this year’s host is China, with the official celebration taking place in the eastern city of Hangzhou …”

UN News – With a premature death every five seconds, air pollution is violation of human rights, says UN expert

https://news.un.org/en/story/2019/06/1039661

An independent UN expert said on Monday that the failure of governments across the world to ensure clear air, constitutes a “violation of the rights to life, health and well-being, as well as the right to live in a healthy environment.” Ahead of the 2019 World Environment Day on Wednesday, which has air pollution as its theme, David Boyd, the UN’s Special Rapporteur on human rights and the environment, called on states to take urgent action to improve air quality in order to fulfill their human rights obligations….”

Other Planetary health news & publications

Lancet Editorial – Planetary health in the Anthropocene

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31323-6/fulltext

In May, 29 of 34 members of the Anthropocene Working Group voted to recognise the Anthropocene as the geological epoch entered in the 20th century, characterised by human activity rapidly shaping our planet….  Our 2015 Rockefeller Foundation–Lancet Commission on planetary health recommended an urgent expansion of the interdisciplinary scope of research and capacity. Departments of planetary health and academic initiatives and alliances are now taking shape in universities around the world, notably in Sydney and other Australian universities, Oxford and Edinburgh, the UK, the USA, China, and Hong Kong. Last week, the London School of Hygiene & Tropical Medicine joined this list, celebrating the launch of a new Centre on Climate Change and Planetary Health …”

However, “…There remain gaps in securing political will to address the multiple human-caused challenges that threaten all life on Earth. …”

And so, “The new wave of academia could set its next sights on that goal.”

Guardian – Latest data shows steep rises in CO2 for seventh year

https://www.theguardian.com/environment/2019/jun/04/latest-data-shows-steep-rises-in-co2-for-seventh-year

The stat of the week.  “The concentration of carbon dioxide in the atmosphere has increased by the second highest annual rise in the past six decades, according to new data. Atmospheric concentrations of the greenhouse gas were 414.8 parts per million in May, which was 3.5ppm higher than the same time last year, according to readings from the Mauna Loa observatory in Hawaii, where carbon dioxide has been monitored continuously since 1958. Scientists have warned for more than a decade that concentrations of more than 450ppm risk triggering extreme weather events and temperature rises as high as 2C, beyond which the effects of global heating are likely to become catastrophic and irreversible….”

Independent – India heatwave kills ‘dozens’ of people as temperatures hit 50C

https://www.independent.co.uk/news/world/asia/india-heatwave-death-toll-weather-channel-sunstroke-delhi-a8942056.html

The crazy Indian heatwave is yet another ominous sign of climate crisis carnage to come this century. And already “arrived” in many places.

Guardian – Climate crisis seriously damaging human health, report finds

https://www.theguardian.com/environment/2019/jun/03/climate-crisis-seriously-damaging-human-health-report-finds

Focus on Europe here.

“A report by experts from 27 national science academies [including Andy Haines, co-chair of this report ] has set out the widespread damage global heating is already causing to people’s health and the increasingly serious impacts expected in future.” “… “We think reframing climate change as a health issue can help to engage the public because most people are not just concerned about their own health, but about the health of their nearest and dearest and their descendants. “We think this is a way of mobilising the public and raising concern in a constructive way and increasing the momentum for change.”…”

Journal of Cleaner Production – Academic air travel has a limited influence on professional success

S Wynes et al; https://www.sciencedirect.com/science/article/pii/S0959652619311862

Nicely summarized on Twitter:

Study on academic air travel shows 1) flying & polluting is related to increased salary, not to increased productivity 2) senior scholars fly & pollute significantly more than junior scholars 3) male scholars fly & pollute significantly more than female scholars.”

Guardian – Deforestation of Brazilian Amazon surges to record high

https://www.theguardian.com/world/2019/jun/04/deforestation-of-brazilian-amazon-surges-to-record-high-bolsonaro

Deforestation of the Brazilian Amazon surged last month to the highest May level since the current monitoring method began, prompting concerns that president Jair Bolsonaro is giving a free pass to illegal logging, farming and mining….” “ … Environmentalists fear 2019 will be one of worst years for deforestation in recent memory…”

Maternal, newborn, child and adolescent health

Guardian – Nearly half of all child deaths in Africa stem from hunger, study shows

https://www.theguardian.com/global-development/2019/jun/05/nearly-half-of-all-child-deaths-in-africa-stem-from-hunger-study-shows

One in three African children are stunted and hunger accounts for almost half of all child deaths across the continent, an Addis Ababa-based thinktank has warned. In an urgent  call for action, a study by the African Child Policy Forum said that nearly 60 million children in Africa do not have enough food despite the continent’s economic growth in recent years. A child dies every three seconds globally due to food deprivation – 10,000 children every day – but although figures show an improvement in child hunger at a global level, it is getting worse in some parts of Africa, where the problem is largely a question of political will….”

Via UN News – New UNICEF report – ‘Catastrophic’ healthcare costs put mothers and newborns at risk

https://news.un.org/en/story/2019/06/1039671

See also the UNICEF press release  –   “World not delivering quality maternal health care to poorest mothers”.

More than 5 million families across Africa, Asia, and Latin America and the Caribbean spend over 40 per cent of their non-food household expenses on maternal health services every year, UNICEF said today in a new analysis on maternal health. … … Nearly two-thirds of these households, or around 3 million, are in Asia while approximately 1.9 million are in Africa. According to the analysis, the costs of antenatal care and delivery services can deter pregnant women from seeking medical attention, endangering the lives of mothers and their babies…”

New WHO resource: Maternal, Newborn, child & adolescent health data portal

https://www.who.int/data/maternal-newborn-child-adolescent

Welcome to the Maternal, Newborn, Child and Adolescent Health data portal. In this portal you will find the most up to date global health data, including regional and country data organized separately in the areas of maternal, newborn, child, and adolescent health. These data can be visualized on charts and maps which you can download. You are also able to export data files. Finally, you will find links to other departments within WHO and other UN agencies where additional data and information in specific areas of interest can be found.”

UN News – Around 23 million boys have married before reaching 15; ‘we can end this violation’ says UNICEF chief

https://news.un.org/en/story/2019/06/1039971

An estimated 115 million boys and men around the world were married as children, 23 million of them before the age of 15, according to the first-ever analysis on child grooms, launched on Friday by the UN Children’s Fund (UNICEF). Using data from 82 countries, the in-depth study brings the overall number estimated child marriages to 765 million, UNICEF revealed….”

STIs

WHO – More than 1 million new curable sexually transmitted infections every day

https://www.who.int/news-room/detail/06-06-2019-more-than-1-million-new-curable-sexually-transmitted-infections-every-day

Every day, there are more than 1 million new cases of curable sexually transmitted infections (STIs) among people aged 15-49 years, according to data released today by the World Health Organization. This amounts to more than 376 million new cases annually of four infections – chlamydia, gonorrhoea, trichomoniasis, and syphilis. “We’re seeing a concerning lack of progress in stopping the spread of sexually transmitted infections worldwide,” said Dr Peter Salama, Executive Director for Universal Health Coverage and the Life-Course at WHO. “This is a wake-up call for a concerted effort to ensure everyone, everywhere can access the services they need to prevent and treat these debilitating diseases.”…”

Coverage by Sarah Boseley (Guardian)STIs spreading at rate of more than 1m a day, says WHO

“Experts call for more honest discussion of sexually transmitted infections and more data”.

And DevexWHO calls for point-of-care diagnostics for STIs   (by J L Ravelo)

The World Health Organization is calling for more attention and investment in the development of point-of-care diagnostics for sexually transmitted infections as new data reveals there was no “substantial decline” since 2012….”

Global health security

Cidrap – Pandemic preparedness renewal sent to Trump’s desk

http://www.cidrap.umn.edu/news-perspective/2019/06/pandemic-preparedness-renewal-sent-trumps-desk

The US House of Representatives yesterday passed bipartisan legislation reauthorizing the Pandemic and All-Hazards Preparedness and Advancing Innovations Act (PAHPA), paving the way for the bill to be signed into law by President Donald Trump. …”

See also Healio – Congress takes step to support BARDA’s mission of pandemic preparedness

Congress recently passed the Pandemics and All-Hazards Preparedness and Advancing Innovation Act, or PAHPAI, which will allow the Biomedical Advanced Research and Development Authority, or BARDA, to strengthen the country’s preparedness against a variety of global disease threats.”

See also a tweet: “The fact that Congress passed this bill is acknowledgement that health security is national security.””

HPW – Expand Funding For Pandemic Preparedness: R&D Advocacy Group Says To US Congress

https://www.healthpolicy-watch.org/expand-funding-for-pandemic-preparedness-rd-advocacy-group-says-to-us-congress/

After applauding the United States Congress for passing a bill that aims to strengthen preparedness against global disease threats, an R&D advocacy group is now calling on Congressional leaders to ensure there is actually money allocated to fund an expanded set of activities. A larger investment is needed, “to fully and equitably fund the breadth of disease threats,” and ensure sufficient research and development (R&D) “to generate innovations that could dramatically boost our capacity to neutralize potentially catastrophic outbreaks,” said Jamie Bay Nishi, Director of the Washington, DC-based Global Health Technologies Coalition (GHTC), in a press release issued yesterday. …”

GAVI – Kingdom of Norway contributes NOK 600 million to IFFIm

GAVI

News from last week. “The Kingdom of Norway has agreed to donate NOK 600 million to the International Finance Facility for Immunisation (IFFIm). The donation is intended to support the Coalition for Epidemic Preparedness Innovation (CEPI). In a novel arrangement approved by Gavi, the Vaccine Alliance, IFFIm is planning to issue bonds on international capital markets, backed by the donation from Norway, which hosts CEPI….”

Guardian – ‘No way to stop it’: millions of pigs culled across Asia as swine fever spreads

https://www.theguardian.com/world/2019/jun/06/millions-of-pigs-culled-across-asia-african-swine-fever-spreads-thailand-?CMP=Share_iOSApp_Other

Experts say region is losing the battle to stop the biggest animal disease outbreak the planet has ever faced.”

See also Vox “Pig Ebola” is spreading uncontrollably in China and Vietnam  China may have to kill 200 million pigs in an unprecedented outbreak of ‘Pig Ebola’.

Global Health Financing

Devex – Opinion: The US must continue to support Africa’s advances in health

Mark Dybul, Charles Holmes et al ; https://www.devex.com/news/opinion-the-us-must-continue-to-support-africa-s-advances-in-health-94994

Also from a point of view, if the US doesn’t do it, China & Russia will step in…

« … The [US] House Committee on Appropriations, on May 16, continued Congress’ bipartisan leadership on global health, by approving a 2020 funding bill that provides the first increase in six years for the Global Fund — a strong “first installment” for the Global Fund’s 2020-2022 replenishment cycle — and maintains support for PEPFAR and PMI….” “ Such U.S. investments have helped catalyze domestic resource mobilization for health by governments, communities, and partners throughout the African continent. Powered by substantial economic gains across much of the African continent, and a political recognition by the African Union and governments of the societal benefits of health investments, 29 African countries increased their investments in health since 2000. This commitment to increased domestic financing for health was further advanced to the top of the regional agenda at the “game-changing” African Leadership Meeting, “Investing in Health,” hosted by the African Union as part of its 32nd Summit in February 2019….”

…. As African leaders advance their commitments to fund some of the world’s most pressing health challenges, the United States should meet that ambition with robust commitments of our own. … We are entering an era where African leadership will increasingly define and lead the efforts in global health security, migration, and broader improvements in health that will further stimulate a virtuous cycle of development. This is not the time to back away from US support, as the current administration has suggested. »

“…Africa’s leaders are taking concrete and innovative steps to pay for their own health care over time. It is in our interest to walk with them a while longer on what U.S. Agency for International Development Administrator Mark Green has called the “journey to self-reliance,” so that when that place is reached, it is the U.S., not Russia and China, standing with them.”

Global Health Governance

Lancet Offline – Young people—from listening to leadership

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31328-5/fulltext

The hypocrisy of global health can be suffocating. Writing in their 2016 Lancet Commission on Adolescent Health and Wellbeing, George Patton and colleagues argued for the “establishment of forums for meaningful youth participation”. Such forums should strengthen “mechanisms for the meaningful participation of adolescents in the design, communication, and implementation and monitoring of policies and practices that affect their health and wellbeing. This is particularly important for socially and economically marginalised adolescents”. … …  Although the Commission’s recommendation was widely endorsed, and although young people are increasingly given platforms to express their views ……  the difficult truth is that young people are rarely invited to contribute to shaping the future of their societies. They are rarely invited to shape the future of global health, despite the platitudes of global health leaders….”

After pointing to one positive example of serious engagement with young people, the annual Arab Youth survey, and noting that Arab leaders don’t listen much (just like leaders elsewhere in the world, I’d add), Horton stresses: “Young people must be given not only voice but also power to shape their futures. This power is their fundamental right. Despite advocacy for greater youth engagement, much of what passes for participation is still little more than tokenism and lip service. Power is rarely given to young people. Yet, as George Patton and colleagues showed, “adolescents are emotionally primed to engage”. The denial of engagement will increase the risk of later life mental ill health or, worse, violent extremism, even terrorism. Young people in every nation are entitled to express their views and visions for their futures. It is then up to political leaders to create the means to channel those ideas into a political process for action. The fact that they do not is a monumental betrayal of their people.”

Polio endgame & vaccines

Lancet – Polio endgame options: will we have the vaccines needed?

K Thompson; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31294-2/fulltext

Comment related to new findings from colleagues from Antwerp university  (Pierre van Damme et al) who “….tested novel monovalent oral type-2 poliovirus (OPV2) vaccine candidates that are genetically more stable than existing OPVs, with a lower risk of reversion to neurovirulence. …”    – The safety and immunogenicity of two novel live attenuated monovalent (serotype 2) oral poliovirus vaccines in healthy adults: a double-blind, single-centre phase 1 study

“… These new findings represent an exciting first step toward the creation of a better OPV2 (oral type-2 poliovirus vaccine) option in a world that might need it. … … (but)   The question remains: can the Global Polio Eradication Initiative (GPEI) stop serotype-2 transmission soon, or will the world need more OPV2, and will we have the best possible vaccines available when needed?…”

Cholera response momentum

Project Syndicate – Maintaining the Momentum Against Cholera

Anita Zaidi (BMG Foundation) ; Project Syndicate;

The world still has a great deal of work to do to eliminate cholera from the Global South, as the ongoing outbreak in Yemen shows. But significant progress is being made, and, in 2018, global health organizations set a new record in the delivery of oral cholera vaccines to many of the world’s most vulnerable countries….”

“…in the past 18 months, the world has made significant strides in the fight against cholera. In partnership with the governments of cholera-affected countries, the Global Task Force on Cholera Control (GTFCC), a network of leading global health organizations, is working to consign cholera to history books. … … This achievement would not have been possible without Gavi, the Vaccine Alliance.  … … It is possible that historians will remember 2019 as the beginning of the end of cholera, but much depends on our efforts in the next few years. …”

Other vaccine news

Gavi – Gavi, NEC, and Simprints to deploy world’s first scalable child fingerprint identification solution to boost immunisation in developing countries

GAVI;

In Tokyo, “Gavi, the Vaccine Alliance, NEC Corporation, and Simprints Technology Ltd. have signed a memorandum of understanding on the use of biometrics to improve immunisation coverage in developing countries.”

Global Fund replenishment

GF – Takeda Makes First Private Sector Pledge for Global Fund Replenishment

https://www.theglobalfund.org/en/news/2019-06-03-takeda-makes-first-private-sector-pledge-for-global-fund-replenishment/

Have to say that JP ¥ 1 billion sounds so much better than (approximately) US$9 million – over five years…  😊.

Part of this ridiculous goal of having the private sector contribute 1 billion (for the next GF replenishment) – whereas Sands should, instead, just argue for progressive and fair taxation all around the world, starting with multinational companies & high-net-worth individuals.  Will make financing of GPGs so much easier. I’m sure Elizabeth Warren can give him some advice, if needed.

AMR

Tourists are spreading superbugs across international borders, report warns

https://www.telegraph.co.uk/news/2019/05/30/tourists-spreading-superbugs-across-international-borders-report/?WT.mc_id=tmg_share_tw

Holiday-makers are at risk of picking up and bringing home superbugs, according to a study looking at the spread of antimicrobial resistance (AMR) worldwide. … … The report, published by the Center for Disease Dynamics, Economics & Policy (CDDEP), found that tourists are contributing to the spread of AMR across international borders – with as many as 88 per cent of unwell tourists returning to the UK from India infected with drug resistant bacteria….”

UHC & PHC

WHO Bulletin – The private sector and universal health coverage

David Clarke, Agnes Soucat, Gerard Schmets et al; https://www.who.int/bulletin/volumes/97/6/18-225540/en/

Already flagged in a previous issue, but if you hadn’t noticed yet, an absolute must-read!

“…Ignoring the role of the private sector in national efforts towards UHC is not an option. Here we suggest the following approach to managing, and where appropriate, engaging the private sector as part of efforts to achieve UHC…..”

BMJ (Editorial) – Primary healthcare is cornerstone of universal health coverage

Agnes Binagwaho & dr. Tedros; https://www.bmj.com/content/365/bmj.l2391

A familiar message by now (certainly if you’ve been to the #WHA72, or before, to the Astana conference).  With examples from Rwanda & Ethiopia here, unsurprisingly given the authors. And “Now we must reinvent primary care to make it happen”, they argue.

Project Syndicate – Women and Girls Hold the Key to Universal Health Coverage

F Girard; Project Syndicate;

Sexual and reproductive services are often left out of health-care strategies for the sake of political expediency. This threatens to derail efforts to achieve the Sustainable Development Goal of universal health coverage by 2030.” Interesting read, on the global (UHC & SRHRà picture, but also with contrasting examples from Ghana & Turkey, among others.

IISD – Draft Political Declaration Outlines Leaders’ Commitments on UHC

IISD;

The zero draft of a political declaration on universal health coverage is under consideration by UN Member States. The text highlights health as a right and stresses the importance of health for “all the goals and targets” of the 2030 Agenda. The draft was expected to be presented to governments on 21 May, discussed at informal consultations on 28 May, and considered further through informal consultations in June and early July….”

Good short overview of what’s in the current zero draft.

Ebola DRC – Over 2000 cases and counting…

Some of the reads & links from this week:

Cidrap –  Aid groups weigh in on DRC topping 2,000 Ebola cases

http://www.cidrap.umn.edu/news-perspective/2019/06/aid-groups-weigh-drc-topping-2000-ebola-cases

“… the Democratic Republic of the Congo (DRC) health ministry marked an Ebola outbreak milestone of passing 2,000 cases late on 2 June, and groups working in the region called for pushing the reset button on the response….”

Cidrap – No ‘reset’ with Ebola outbreak, WHO official says

http://www.cidrap.umn.edu/news-perspective/2019/06/no-reset-ebola-outbreak-who-official-says

Today leaders from the World Health Organization (WHO) said the Ebola outbreak in the Democratic Republic of the Congo (DRC) remains contained to a small geographic area, but that does not mean the virus is retreating….”

“…Ryan also said the WHO estimates it is detecting 75% of cases, with as many as 25% missed or being picked up “too late.” He also responded to recent criticism from various non-governmental organizations that the WHO needs to “reset” the outbreak response. “This is not an iPhone. We don’t just hit a reset button,” Ryan said. “We get to adapt… and make the response the best we can make it.”

“…He also reminded the reporters in the room that 80% of vaccinators in the region are Congolese, and most doctors and nurses working the outbreak are Congolese. “It’s Congolese people ending this outbreak,” he said….”

 

NPR Goats & Soda – An Urgent Mystery: Who’s Attacking Ebola Responders In Congo — And Why?

NPR;

Must-read. With some of the hypotheses by David Gressly, the new UN Ebola czar.

Some links:

 

“The director of the Centers for Disease Control and Prevention predicts that responders in the Democratic Republic of the Congo will exhaust the current supply of the Ebola virus vaccine before the pharmaceutical company manufacturing them can produce more….”

Children under five infected with Ebola in eastern Democratic Republic of Congo are dying at a higher rate than other patients as their parents shun special treatment centres, the World Health Organization (WHO) said (last week) on Thursday.”

“Many under-fives are not taken to Ebola treatment centres, known as ETCs, where survival rates are markedly higher, but instead visit multiple healthcare facilities that are not as well-equipped to provide treatment or isolation, the WHO said in a weekly update.  … …  Children under five are also less likely than older youth to be included on lists of possible contacts exposed to the disease, who require surveillance or vaccination, it said, calling for improved tracing and monitoring….”

In the words of Duncan Green, on Twitter: “Pretty damning account of the role of the patent system in slowing down the creation of an Ebola vaccine, despite $m of public money being thrown at it.”

 

Trump & (global) health

Guardian – US abortion policy is ‘extremist hate’ and ‘torture’, says UN commissioner

https://www.theguardian.com/global-development/2019/jun/04/us-abortion-policy-extremist-hate-torture-un-commissioner-kate-gilmore

The US policy on abortion is a form of extremist hate that amounts to the torture of women, the UN deputy high commissioner for human rights told the Guardian. The attack on women’s rights was a “crisis”, organised and well-resourced by very extremist groups. “We have not called it out in the same way we have other forms of extremist hate, but this is gender-based violence against women, no question,” Kate Gilmore said….”

Quick links:

Government scientists will no longer conduct research using fetal tissue, the Trump administration said Wednesday, granting the wishes of anti-abortion groups and overruling the concerns of scientists. The Department of Health and Human Services said it has discontinued all internal research that involves fetal tissue, which is obtained through elective abortions….”

The Trump administration plans to launch a new panel to offer “fresh thinking” on international human rights and “natural law,” a move some activists fear is aimed at narrowing protections for women and members of the LGBT community. The new body, to be called the Commission on Unalienable Rights, will advise Secretary of State Mike Pompeo, according to a notice the State Department quietly published Thursday on the Federal Register….”

HIV

UNAIDS (press release)- Galvanizing global ambition to end the AIDS epidemic after a decade of progress

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2019/june/20190603_sg-report

“A new report from the United Nations Secretary-General, Galvanizing global ambition to end the AIDS epidemic after a decade of progress, has been presented to United Nations Member States during the 73rd session of the United Nations General Assembly. The Member States gathered at the United Nations in New York, United States of America, to review progress and share their own progress and challenges….”  This UNAIDS press release gives a good overview of the key messages of the report on progress & challenges, including on a number of recommendations for member states.

Also, “…The report outlines that there is an important opportunity to seize the growing momentum to achieve universal health coverage, a core principle of which is leaving no one behind. …”

Access to Medicines

Lancet World Report – UK, Germany, dissociate from WHO drug pricing resolution

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31329-7/fulltext

The passage of a landmark resolution on improving the transparency of markets for medicines at the latest WHA fails to narrow the political divide. John Zarocostas reports from Geneva.”

The Lancet on ICD-11

Lancet (Editorial) – ICD-11

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31205-X/fulltext

The Lancet assesses the newly revised  International Classification of Diseases (ICD)   (ICD-11 now), and considers it a good update for the 21st century. After giving an overview of the key changes, the Editorial concludes: “Overall, this revision is a huge step forward for health worldwide.”

First UN World Food Safety Day (June 7): Food safety is everyone’s business

WHO – The first UN World Food Safety Day to be marked on Friday 7 June

https://www.who.int/news-room/detail/06-06-2019-food-safety-is-everyones-business

The first ever celebration of the United Nations World Food Safety Day, to be marked globally on 7 June, aims to strengthen efforts to ensure that the food we eat is safe. Every year, nearly one in ten people in the world (an estimated 600 million people) fall ill and 420,000 die after eating food contaminated by bacteria, viruses, parasites or chemical substances. Unsafe food also hinders development in many low- and middle-income economies, which lose around US$ 95 billion in productivity associated with illness, disability, and premature death suffered by workers.

World Food Safety Day 2019’s theme is that food safety is everyone’s business. Food safety contributes to food security, human health, economic prosperity, agriculture, market access, tourism and sustainable development. The UN has designated two of its agencies, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) to lead efforts in promoting food safety around the world….”

See also UN News‘From farm to plate’, first-ever World Food Safety Day demonstrates the need to take unsafe food off the menu

On a different (but still food related) note, we already want to flag the EAT Forum, next week in Stockholm (12-13 June). On Global Food transformation.

Academic publishing & Plan S

Lancet Editorial – Plan S: the final cut

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31322-4/fulltext

A consortium of research funders, Coalition S, has published its revised recommendations for accelerating the transition to open access for scientific publications. The fundamental principles of Plan S remain intact. …”

The Lancet largely welcomes the latest guidance, and sees many positives. However, in one aspect they differ with Plan S: “…Plan S partners argue that they will not pay for “brand value”. But journals such as The Lancet are not neutral publishing platforms. We stand for values and activities beyond publication—campaigning, for example, for the right to health, health equity, and social justice. Publishing in (or subscribing to) a Lancet title brings authors (and readers) inside this community of values. Deeming those values irrelevant is harmful to health and medical science. Coalition S partners must respect and protect those values during the welcome acceleration to a more open access world.”

Giga Science – Over-optimization of academic publishing metrics: observing Goodhart’s Law in action

M Fire et al; https://academic.oup.com/gigascience/article/8/6/giz053/5506490

In this study, we analyzed >120 million papers to examine how the academic publishing world has evolved over the last century, with a deeper look into the specific field of biology. Our study shows that the validity of citation-based measures is being compromised and their usefulness is lessening. In particular, the number of publications has ceased to be a good metric as a result of longer author lists, shorter papers, and surging publication numbers. Citation-based metrics, such citation number and h-index, are likewise affected by the flood of papers, self-citations, and lengthy reference lists. Measures such as a journal’s impact factor have also ceased to be good metrics due to the soaring numbers of papers that are published in top journals, particularly from the same pool of authors. Moreover, by analyzing properties of >2,600 research fields, we observed that citation-based metrics are not beneficial for comparing researchers in different fields, or even in the same department. “ Conclusion: “Academic publishing has changed considerably; now we need to reconsider how we measure success.

American society for microbiology – Blacklists and Whitelists To Tackle Predatory Publishing: a Cross-Sectional Comparison and Thematic Analysis

M Strinzel et al; https://mbio.asm.org/content/mbio/10/3/e00411-19.full.pdf

We aimed to develop an in-depth understanding of quality criteria for scholarly journals by analyzing journals and publishers indexed in blacklists of predatory journals and whitelists of legitimate journals and the lists’ inclusion criteria. … …  We included two blacklists (Beall’s and Cabells Scholarly Analytics’) and two whitelists (the Directory of Open Access Journals’ and Cabells Scholarly Analytics’). The number of journals per list ranged from 1,404 to 12,357, and the number of publishers ranged from 473 to 5,638. Seventy-two journals and 42 publishers were included in both a blacklist and a whitelist. Seven themes were identified in the inclusion criteria: (i) peer review; (ii) editorial services; (iii) policy; (iv) business practices; (v) publishing, archiving, and access; (vi) website; and (vii) indexing and metrics. Business practices accounted for almost half of the blacklists’ criteria, whereas whitelists gave more emphasis to criteria related to policy. Criteria could be allocated to four concepts: (i) transparency, (ii) ethics, (iii) professional standards, and (iv) peer review and other services. Whitelists gave most weight to transparency. Blacklists focused on ethics and professional standards. Whitelist criteria were easier to verify than those used in blacklists. Both types gave little emphasis to quality of peer review. Overall, the results show that there is overlap of journals and publishers between blacklists and whitelists. Lists differ in their criteria for quality and the weight given to different dimensions of quality. Aspects that are central but difficult to verify receive little attention.”

Some papers and reports of the week

BMJ Global Health (Analysis) – The governance of local health systems in the era of Sustainable Development Goals: reflections on collaborative action to address complex health needs in four country contexts

Helen Schneider et al; https://gh.bmj.com/content/4/3/e001645

This analysis reflects on experiences and lessons from four country settings—Zambia, India, Sweden and South Africa—on building collaborations in local health systems in order to respond to complex health needs. These collaborations ranged in scope and formality, from coordinating action in the community health system (Zambia), to a partnership between governmental, non-governmental and academic actors (India), to joint planning and delivery across political and sectoral boundaries (Sweden and South Africa). The four cases are presented and analysed using a common framework of collaborative governance, focusing on the dynamics of the collaboration itself, with respect to principled engagement, shared motivation and joint capacity….”

WHO Bulletin – June issue

https://www.who.int/bulletin/volumes/97/6/en/

From this new WHO Bulletin issue, we want to flag, among others:

Among others, pointing to the work of a research unit on health in situations of fragility at Queen Margaret University, Edinburgh, Scotland.

The definition of gaming disorder is an important first step in developing a public health response to a new problem. Gary Humphreys reports.”

ICRW (Brief) – Defining Feminist foreign policy

L Thompson & R Clement; https://www.icrw.org/publications/defining-feminist-foreign-policy/

What is feminist foreign policy? What definition can capture its complexity, its nuances? And how do we ensure the focus is not just on women but on power relations and gender equality more broadly, using an explicitly rights-based and intersectional understanding of feminism? In this brief, we take a closer look at the world’s few existing “feminist” (Sweden, Canada, France) approaches to foreign policy, and it’s clear that there is room for improvement as we seek to influence the second wave of emerging policies  [i.e FFP 2.0 ]. Two ways to improve: (1) push countries to increase their commitments to gender equality as a principle and funded goal; and (2) adopt a more rigorous and independent practice for monitoring, evaluation, research and learning tied to policies’ intended outcomes….”

ODI (Comment paper) – Transforming fragile states:  Forging a new consensus

Alex Thier ; https://www.odi.org/sites/odi.org.uk/files/resource-documents/12717.pdf

The prospect of accomplishing the Sustainable Development Goals by 2030 (or ever) dims when viewed through the lens of fragile states. …  fragility is on the rise, bringing enormous human, political, economic and environmental costs. Urgent collective action is needed to reverse these trends. Although the world came together in 2015 to set a framework for sustainable development, global commitment to address conflict and fragility is lacking. There are signs of a growing consensus on the need for new tools, approaches and resources. However, it is essential to grapple with the problem at the centre of current failings: fragility is fundamentally a political issue that cannot be resolved by technical approaches alone. • Five key principles – articulated in the Bellagio Consensus – must form the bedrock for a reinvigorated approach: keeping politics at the centre; local ownership; a transition from donor-led, many priorities to country-led, few priorities; inclusion and engagement from idea to implementation; and confidencebuilding along the way. • A movement of actors and institutions must be built, with tools and incentives to make progress in specific contexts based on these principles while also reforming international approaches and practices for the future.”

Background: “… A group of world leaders, including former UN Secretary-General Kofi Annan and former President of Liberia Ellen Johnson Sirleaf, came together with policy experts under the leadership of the Overseas Development Institute (ODI), The Rockefeller Foundation and the United States Institute of Peace (USIP) in June 2018 to draft a set of five principles and ten key approaches in order to build a platform for broader dialogue and action. At their core is a simple but powerful idea: the challenges of fragile states are inherently political, and therefore the starting point must be to keep politics at the centre of approaches to address them. The resulting Bellagio Consensus seeks to create a movement, bringing together the local leaders responsible for change in fragile environments and international institutions charged with supporting them….”

For the Bellagio consensus (4 p), see here.

BMC Reproductive Health (Supplement) – Effective integration of sexual reproductive health and HIV prevention, treatment, and care services across sub-Saharan Africa: where is the evidence for program implementation?

D M Kangudie et al; BMC reproductive health;

The title of this supplement says it all : )

International Journal for Equity in Health – Conceptual framework of equity-focused implementation research for health programs (EquIR)

J Eslava-Schmalbach, N Tran, E Langlois et al ;   https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-019-0984-4

« Implementation research is increasingly used to identify common implementation problems and key barriers and facilitators influencing efficient access to health interventions. » This article develops and proposes anequity-based framework for Implementation Research (EquIR) of health programs, policies and systems.

Global Public Health – Implementing health system strengthening projects at USAID: Findings from five cases using an integrated framework

Adam Koon et al; https://www.tandfonline.com/doi/full/10.1080/17441692.2019.1622758

Evidence on the implementation of health systems strengthening (HSS) interventions is scarce. Donors need this information to prioritise investments and lobby for continued financial support. To develop a deeper understanding of the implementation dynamics of robust HSS interventions, we retrospectively compared five USAID-supported projects in the Dominican Republic, Ethiopia, Kazakhstan, Rwanda, and Zambia. … … The framework was organised by four phases of implementation. For the pre-condition phase, data-driven HSS interventions were nested in a range of political contexts and with differing levels of financial support. In pre-implementation, cases relied on diverse teams that created a data-informed, inclusive, and transparent project ethos for implementation. Implementation was located at multiple tiers of the health system, used interventions as catalysts for government initiatives, supported governance/accountability initiatives, and responded nimbly to contextual changes in the implementation climate. There was less evidence of maintenance and evolution but all cases were designed with an eye towards sustainability. This research yields important insights about the dynamics of HSS, identifying ways donors can better support countries to achieve universal health coverage.”

HP&P – Towards inclusive priority-setting for global health research projects: recommendations for sharing power with communities

B Pratt; https://academic.oup.com/heapol/advance-article-abstract/doi/10.1093/heapol/czz041/5511582?redirectedFrom=fulltext

Global health research priority-setting is dominated by funders and researchers, often from high-income countries. Engaging communities that are considered disadvantaged and marginalized in priority-setting is essential to making their voices and concerns visible in global health research projects’ topics and questions. However, without attention to power dynamics, their engagement can often lead to presence without voice and voice without influence. Global health research priority-setting must be designed to share power with such communities to ensure that research projects’ topics and questions reflect the health care and system inequities they face. To better understand what sharing ‘power over’ priority-setting requires, 29 in-depth, semi-structured interviews and one focus group were undertaken with researchers, ethicists, community engagement practitioners and community-based organization staff….”

International Journal for Equity in Health – Is the judicialization of health care bad for equity? A scoping review

T S Andia et al ; https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-019-0961-y

« The term “judicialization of health care” describes the use of rights-based litigation to demand access to pharmaceuticals and medical treatments. The judicialization of health care in Latin America has two defining features. Firstly, it has been conducted in an individualized fashion. Secondly, it is highly pharmaceuticalized, since most public expenditure related to health rights litigation is invested in paying for costly medications. Recent studies also suggest that the judicialization of health care is bad for equity since it skews limited health resources away from the poorest citizens and in favor of the more affluent. We used a scoping methodology to analyze the study-design and the quality of the data employed by the literature that explicitly assesses the impact of the judicialization of health care on equity in Latin American countries….”

Conclusion: “…Is the judicialization of health care bad for equity? According to this review we are far from reaching a consensus on this issue. Half of the studies analyzed here find that judicialization has a negative impact on equity, but the other half finds that evidence is inconclusive or that the judicialization of health care has a positive effect on equity….”

Plos Med (Policy forum) – The missed potential of CD4 and viral load testing to improve clinical outcomes for people living with HIV in lower-resource settings

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002820

“In a Policy Forum, Peter Ehrenkranz and colleagues discuss the contribution of CD4 and viral load testing to outcomes for people with HIV in low- and middle-income countries.”

International Political Sociology – How Do Professions Globalize? Lessons from the Global South in US Medical Education

Tine Hanrieder;  https://academic.oup.com/ips/advance-article/doi/10.1093/ips/olz010/5498829

This article explores the professional construction of the space of Global Health. I argue that the growth of Global Health as a field of practice does not merely indicate an intensification of North-South intervention. It is also a professional project of reimporting lessons from the South to countries in the North. I focus on the emerging didactic regime for Global Health in US medical education and the deterritorialized “global” lessons that students are taught in poor countries. By rescaling these lessons to precarious settings at home, the space of Global Health is reterritorialized as a Global Medical South stretching into the United States, reinforcing the perception that health is not a right but a privilege. The analysis is based on a content analysis of university websites and didactic handbooks and a sample of sixty-four articles evaluating the education effects of study abroad experiences. It reveals an emerging canon of Global Health virtues and the construction of domestic scales for Global Health practices, which are based on ethnic and socioeconomic categories. This analysis of professional projects as spatial projects sheds new light on the geography of Global Health and of professional globalization more generally.”

WB policy paper – How Much Does Reducing Inequality Matter for Global Poverty?

C Lakner et al; http://documents.worldbank.org/curated/en/328651559243659214/pdf/How-Much-Does-Reducing-Inequality-Matter-for-Global-Poverty.pdf

“…Using data from 164 countries comprising 97 percent of the world’s population, this paper simulates a set of scenarios for global poverty from 2018 to 2030 under different assumptions about growth and inequality. This allows for quantifying the interdependence of the poverty and inequality goals….” “… Reducing each country’s Gini index by 1 percent per year has a larger impact on global poverty than increasing each country’s annual growth 1 percentage point above the forecasts, suggesting an important role for inequality on the path to eliminating extreme poverty.”

Blogs & mainstream articles of the week

Nick Dearden (essay) – Trumpism goes global

https://www.redpepper.org.uk/trumpism-goes-global/

Trumpism is capitalism’s Plan B, writes Nick Dearden.”

Interesting read, even if not fully convincing. Focusing among others on the commonalities in countries like  Brazil, India, the Philippines and Turkey. And the US, of course.

Economist – Can think-tanks survive a post-fact world?

https://amp.economist.com/open-future/2019/05/29/can-think-tanks-survive-a-post-fact-world?__twitter_impression=true

“The brainy, technocratic, urbane elites need to rejuvenate their mission or accept their demise.”

Brookings institute (blog) – The future of aid: How the global development business is evolving

G Ingram; https://www.brookings.edu/blog/future-development/2019/05/30/the-future-of-aid-how-the-global-development-business-is-evolving/

The Chief Economist of the World Bank, Pinelopi Goldberg, recently called out the need for a “new vision in development.” We may not yet have a clear new vision, but thanks to three recent publications, we know some of the components. Raj Kumar’s “The Business of Changing the World” contrasts “new aid” with “old aid” and is built on examples of new modes of finance and innovative implementation. Last month, Kristin Lord and I released “Global Development Disrupted,” which provides highlights from a survey of 94 development leaders on how they see the development landscape changing and presents a range of perspectives from the global political environment to how development activities are funded and implemented. Late in 2018, Ann Mei Chang published “Lean Impact,” which draws from interviews with over 200 organizations as well as her careers in the tech industry, government, and civil society to drill down into how both funders and NGOs (domestic and international) can be more impactful—it is a how-to guide.  Each publication takes a different tack, but they all present how the approach to development is, or should be, advancing. Viewed together, they create insights into where the field may be headed….”

Matthew Spencer (Oxfam) (blog) – How should INGOs respond to growing nationalism in the UK?

https://oxfamblogs.org/fp2p/how-should-ingos-respond-to-growing-nationalism-in-the-uk/

Excerpt (related to a recent brainstorm & discussion day on this question ):

The morning got off to a bracing start with a talk from journalist and commentator Paul Mason, who described a Manichean world, where forces of evil (fascism 2.0) were exploiting the legitimate grievances of citizens around the world to destroy multilateralism and create an ultra-libertarian, rule-less world. In this dog-eat-dog future, the mandate of development and human rights NGO’s would evaporate. In this scenario, Mason said our job was to join with the forces of good and uphold the defences of international human rights law. The counterpoint was presented by Alex Evans, now leading the Collective Psychology Project at New York University. He confessed that when he wrote his book The Myth Gap he wanted to help social justice and environmental organisations like us get better at telling stories, so that we could win. He now thinks that because the dangers of extreme polarisation are so great, ‘winning’ is less important than ‘healing’. The weaponization of our deepest anxieties by social media means that public debate is now dominated by ‘them’ versus ‘us’. The development of mutually exclusive narratives will make resolving issues like inequality and climate change impossible. Evans’ plea to INGO’s was to build ‘a larger us’ by bridging differences within and between communities, and above all to do no harm by avoiding reinforcing tribalism….”…”

I agree we can’t afford a Manichean world. Certainly not now.

Top

Global governance of health

Lancet Letter – Inequality, world health, and global governance

Sascha Meijer; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30350-2/fulltext

Richard Horton correctly states that good health depends on political, economic, and social forces that shape conditions of living. To address health care on a global scale, immediate and comprehensive efforts both on an international and national level have to be realised….”

“…Important results have materialised from global collaboration on this issue (eg, the Paris climate agreement). However, to achieve sustainable solutions, the concept of global governance—ie, Weltinnenpolitik, a term first coined by Carl Friedrich von Weizsäcker—will have to be implemented….”    “… political internationalism (built on close cooperation of nations worldwide) … … has the potential to provide sustainable solutions to the most important and relevant health issues…”

Nature (Editorial) – The World Health Organization’s decision about traditional Chinese medicine could backfire

https://www.nature.com/articles/d41586-019-01726-1

Traditional therapies have been included in a global diagnostic compendium. That comes with risks.”   Interesting read, also given the increasing link of TCM with the Belt & Road Initiative.

See also Apolitical Healthcare access: Why the WHO is recognising traditional medicine 

Traditional medicine’s position at the confluence of Chinese foreign policy interests, the startling gaps in universal health coverage, and a range of conditions that medicine can’t yet fix suggest that its reach is only likely to grow….”

UN News – World Bank downgrades global growth forecasts, poorest countries hardest hit

https://news.un.org/en/story/2019/06/1039861

The World Bank has lowered its expectations of global economic growth for this year in a new report. It says that, although the picture for poorer countries is expected to stabilize in 2020, economic momentum remains weak.”

UN ‘financial crisis,’ years in the making, Guterres tells budget body, proposes solutions

https://news.un.org/en/story/2019/06/1039851

The UN’s financial crisis has been years in the making and is undermining the organization’s mandates and reform efforts, Secretary-General António Guterres told the Fifth Committee,  the body responsible for the United Nations budget,  on Tuesday. Mr. Guterres said that the inability to meet payroll and pay supplies would be “catastrophic” for the UN’s reputation and ability to conduct business. “The solution lies not only in ensuring that all Member States pay in full and on time, but also in putting certain tools in place,” he said. Mr. Guterres urged Member States to put aside political differences and longstanding objections to certain proposals, recommit to paying their financial obligations on time and in full, and help to find a solution to structural problems that are compounding the Organization’s liquidity problems….”

Devex – USAID, OPIC team up on women’s finance in ‘preview’ of new DFI era

https://www.devex.com/news/usaid-opic-team-up-on-women-s-finance-in-preview-of-new-dfi-era-95050

The U.S. Agency for International Development and the Overseas Private Investment Corporation announced contributions to a fund for women’s economic empowerment Tuesday, describing the collaboration as a sign of things to come when the new U.S. development finance institution launches in October. USAID will give $500,000 in funding and $100,000 in technical assistance to a Women’s World Banking Asset Management, or WAM, blended finance fund, which aims to raise $100 million to support financial inclusion for low-income women in Africa, the Middle East, and the Indo-Pacific. OPIC announced its intent to provide $25 million in financing. “… …  Speaking at a press conference in The Hague, USAID Deputy Administrator Bonnie Glick said the commitment was a first of its kind for two reasons. “It’s something that is a preview to how USAID will be working with OPIC when the two combine forces on October 1 to launch the U.S. International Development Finance Corporation,” she said. …”

Stat News – Ex-CDC chief Frieden settles sexual harassment charges

https://www.statnews.com/2019/06/04/ex-cdc-chief-frieden-settles-sexual-harassment-charges/

Thomas Frieden, the former head of the Centers for Disease Control and Prevention, settled charges of sexual harassment Tuesday with a guilty plea to a lesser violation. Frieden, who led the CDC from 2009 to 2017, pleaded guilty to disorderly conduct, striking a deal that will leave him with no criminal record if he stays out of trouble for a year, according to press reports….”

WHO Western Pacific Region Partners’ Forum

https://www.who.int/westernpacific/partners-forum

Interesting. Now also a “WHO Partners Forum”  (planned) at regional level…   Online though.

For the first time, WHO’s Western Pacific Region will host an online Partners’ Forum 1-3 July 2019 to collaborate on ideas for delivering better health in the Region.  … … Effective partnerships, both within and beyond the health sector, will be pivotal in achieving the Regions’ goals for the next five years.  Based on consultation with Prime Ministers, Health Ministers, partners, health workers, and WHO staff, the new Regional Director of WHO’s Western Pacific Region, Dr. Takeshi Kasai, has developed a White Paper that sets out a vision for the Region for the next five years. It includes thematic priorities (the what) and operational shifts (the how).  … “   “The White Paper is intended to stimulate discussion with Member States, partners and other stakeholders  in the lead-up to this year’s seventieth meeting of the Regional Committee for the Western Pacific (to be held in Manila, Philippines from 7 to 11 October 2019).”

The Forum is open to all individuals and organizations who wish to collaborate with WHO on public health in the Western Pacific….”

Oxfam Discussion paper – Fighting Inequality to Beat Poverty: The role of UK international development

M Chiara et al; https://policy-practice.oxfam.org.uk/publications/fighting-inequality-to-beat-poverty-the-role-of-uk-international-development-620763

See also this week’s intro. “UK international development actors – from government to private sector and NGOs – can play a key role in fighting extreme economic inequality to beat poverty in developing countries. This paper shares key principles, policies and programmes that have emerged from Oxfam’s work with partners around the world in recent years, so as to encourage a sector-wide response to the inequality crisis. There will be no end to poverty unless we can close the gaps between rich and poor and between men and women, and adopt a development agenda based on feminist principles and a human economy.”

Guardian – Amnesty International to make almost 100 staff redundant

https://www.theguardian.com/global-development/2019/jun/06/amnesty-international-to-make-almost-100-staff-redundant?CMP=twt_a-global-development_b-gdndevelopment

« Amnesty International is to cut almost 100 jobs as part of urgent restructuring to tackle a “serious budget deficit”, the human rights organisation has confirmed. … … Overspending by organisation’s senior leadership team’ blamed for £17m budget deficit…”

Excerpt: « Kumi Naidoo, Amnesty’s recently appointed secretary general and a former head of Greenpeace International, will make the climate crisis and economic rights a central focus of the organisation’s work. One insider told the Guardian of concerns that vital areas of Amnesty’s work such as research, law and policy may be disproportionately affected by the cuts. “Amnesty is known for its good and credible and focused research,” the source said. “The focus on campaigning rather than research and law and policy, to make sure the research is sound, is worrisome.”…”

Devex – Chemonics lands in London

https://www.devex.com/news/chemonics-lands-in-london-95010

(gated) “The United States’ biggest development contractor, Chemonics, has landed in London, United Kingdom, in the hopes of winning more contracts from the Department for International Development and Foreign & Commonwealth Office. The American development giant, which employs 5,000 staff across 100 countries, looks set to shake things up for British aid contractors, a number of which have been left reeling after DFID introduced tough reforms to crack down on “profiteering,” cronyism, and unethical behavior….”

Eurodad – Delivering human rights and the SDGs: Does IMF Conditionality pass muster?

https://eurodad.org/Entries/view/1547070/2019/05/29/Delivering-human-rights-and-the-SDGs-Does-IMF-Conditionality-pass-muster

Last week the International Monetary Fund (IMF) published its Review of Program Design and Conditionality 2018, which provides an overview of the IMF’s lending programmes between 2011 and 2017. While the review includes some positive elements, such as the acknowledgement to improve debt sustainability analysis (DSA), it falls short of fully accounting for the impact of conditionality on: inequality; public service provision; labour rights; gender equality.  It is, therefore, a missed opportunity to evaluate IMF-lending practices against international agreements, in particular the SDGs and international human rights and labour standards.  …”

IISD – World Health Assembly Adopts Resolutions on Universal Health Coverage

IISD;

Good (concise) summary of everything done & decided at the 72nd WHA.

Public Administration & Development – BRICS, the southern model, and the evolving landscape of development assistance: Toward a new taxonomy

V Lauria et al; https://onlinelibrary.wiley.com/doi/10.1002/pad.1851

« In recent years, there has been an explosion of categories and labels to account for the expansion of forms of cooperation beyond the membership of the Development Assistance Committee. Such hype has led to the construction of the so‐called southern model as the archetype of development cooperation coming from non‐Development Assistance Committee countries that are somehow committed to the principles of the South–South cooperation. The present article challenges the idea of a southern model by providing an analysis of drivers, tools, and modality of development assistance. »

IISD – African Countries Stress Need for Data, Financing in VNR Main Messages

IISD;

“The 17 African countries scheduled to present voluntary national reviews (VNR) of SDG implementation in July 2019 have released the main messages of their forthcoming reports….” This article gives an overview of their priorities (and challenges), one by one.

IISD – UNGA President Announces Plans for SDG Summit

IISD;

The UNGA President issued the modalities for the SDG Summit taking place on 24-25 September 2019, based on consultations that have taken place with UN Member States and stakeholders since February 2019. The Summit’s programme will feature six Leaders Dialogues on specific themes, and it will highlight SDG “acceleration actions” announced in the course of the Summit. Consultations on the draft political declaration to be adopted during the SDG Summit will resume on 7 June 2019.”

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UHC

FT – Could the NHS be part of a US-UK trade deal?

https://www.ft.com/content/7795cb64-877d-11e9-97ea-05ac2431f453

(gated) “Donald Trump sparked concern about the NHS’s future, but the reality is more complex.”

The Print – Modi govt plans to bring 75% of all Indians under Ayushman Bharat

https://theprint.in/india/governance/modi-govt-plans-to-bring-75-of-all-indians-under-ayushman-bharat/244718/

The PM-JAY or Ayushman Bharat health insurance scheme currently covers the poorest 40%, but the Modi govt plans to merge all state & central schemes under it….”

Meanwhile, K. Srinath Reddy published his take on  A health agenda for development in Modi’s 2nd term  (Livemint).  Well worth a read.

Lancet World Report –AMLO’s Mexico leads to drastic cuts to health system

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31331-5/fulltext

The anti-corruption president has set some stringent targets for the health system—critics worry that these are brash and could be damaging to the system. David Agren reports.”

Quick link:

Duterte looks to fund universal health care with tobacco tax

The Philippine Senate on Monday night voted to raise taxes on tobacco products to fund President Rodrigo Duterte’s cash-strapped universal health care program….”

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Planetary health

Science – Rising methane: A new climate challenge

https://science.sciencemag.org/content/364/6444/932

“The amount of the greenhouse gas methane in Earth’s atmosphere is rising rapidly.”

Guardian – Climate crisis and antibiotic use could ‘sink’ fish farming industry – report

https://www.theguardian.com/environment/2019/jun/05/climate-crisis-and-antibiotic-use-could-sink-fish-farming-industry-report

The climate crisis, drug use and feeding farmed fish with wild stocks risks “sinking” the $230bn (£180bn) aquaculture industry, according to an ethical investment network. Fish farms now surpass wild fisheries as the main provider of seafood on our plates, but combined risks from global heating, excessive use of antibiotics, a dependence on wild stocks for feed, and poor governance threatens the lucrative and fast-growing sector, warned Farm Animal Investment Risk and Return (Fairr), a $12trn-backed network….

Guardian – Eight reasons Trump’s ‘clean climate’ claims fail to stack up

https://www.theguardian.com/environment/2019/jun/05/eight-reasons-why-trumps-clean-climate-claims-fail-to-stack-up

You might recall the times when Trump boasted of ‘clean coal’. Now he also told Prince Charles the US has ‘among the cleanest climates there are’.  Total rubbish, as this piece shows.

Guardian – The climate crisis is our third world war. It needs a bold response

J Stiglitz; https://www.theguardian.com/commentisfree/2019/jun/04/climate-change-world-war-iii-green-new-deal

Critics of the Green New Deal ask if we can afford it. But we can’t afford not to: our civilisation is at stake.”

World Pedal power makes ‘positive impact on climate’, urges UN on World Bicycle Day

https://news.un.org/en/story/2019/06/1039721

The simple, affordable, and environmentally friendly bicycle is not just a means of transportation, but also “a tool for development”, the United Nations said in a message on Monday commemorating World Bicycle Day.”

To celebrate the day in style, I decided to ‘reactivate’ my own bicycle, after a long winter.

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infectious diseases & NTDs

Stat – Measles outbreaks put U.S. at risk of losing prized ‘elimination’ status

H Branswell; Stat news;

With two large and still growing outbreaks in New York pushing the country’s measles count to a quarter-century high, public health officials are starting to grapple with an unpleasant prospect. The Rockland County and Brooklyn outbreaks have dragged on for eight months. If transmission from either of those outbreaks continues until late September, the United States will likely lose a hard-fought and prized status — that of a country deemed to have “eliminated” measles. And if that happens — Venezuela and Brazil are the only other countries in the Americas where measles is considered endemic, or constantly circulating — the implications could be profound, experts say….”

See also NEJM –  Measles in 2019 — Going Backward.  Perspective authored by A Fauci et al.

“Recent increases in measles cases in the US mirror patterns in other countries that had previously eliminated the virus. This resurgence is all the more frustrating as the disease is entirely preventable through vaccination. “

Lancet Infectious Diseases (Personal view) – More medicines alone cannot ensure the treatment of neglected tropical diseases

G F Chami et al ; https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30160-4/fulltext

« Neglected tropical diseases afflict more than 1 billion of the world’s poorest people. Pharmaceutical donations of preventive chemotherapy for neglected tropical diseases enable the largest en masse treatment campaigns globally with respect to the number of people targeted for treatment. However, the blanket distribution of medicines at no cost to individuals in need of treatment does not guarantee that those individuals are treated. In this Personal View, we aim to examine the next steps that need to be taken towards ensuring equitable treatment access, including health system integration and the role of endemic countries in ensuring medicines are delivered to patients. We argue that the expansion of medicine donation programmes and the development of new medicines are not the primary solutions to sustaining and expanding the growth of neglected tropical disease programmes. Treatment is often not verified by a medical professional, independent surveyor, or national programme officer. Additionally, access to medicines might not be equitable across at-risk populations, and treatment targets for disease control remain largely unmet within many endemic countries. To enable equitable access and efficient use of existing medicines, research is needed now on how best to integrate the treatment of neglected tropical diseases into local health systems. A comprehensive approach should be used, which combines mass drug administration with on-demand access to treatment. Increased commitment by endemic countries, when possible, around the ownership of treatment campaigns is essential to improve access to medicines for neglected tropical diseases. »

IDS – Lessons from the Zika epidemic: Institutional links for research on care, disability and public policies

https://www.ids.ac.uk/opinions/lessons-from-the-zika-epidemic-institutional-links-for-research-on-care-disability-and-public-policies/

For the last few years, IDS has been gathering evidence on the social, economic and political dimensions of epidemics in different contexts worldwide, seeking to improve the way social science is used to improve response planning and preparedness. IDS researchers have recently been collaborating with the Centre for Cultures of Reproduction, Technology and Health (CORTH) and Brazilian institutions explore how the Zika virus in Brazil feeds into the broader dynamics that shape the emergence of an epidemic and the policy responses to health crises. The project, supported by a Newton Fund Institutional Links grant, aimed to understand the social and emotional impact on families affected by the Zika virus, as well as the reorganisation of public services to meet their needs.”

Aidsmap – Most new HIV infections occur in lower prevalence countries not prioritised by PEPFAR

Aidsmap;

The burden of the global HIV epidemic is disproportionately falling on lower-prevalence countries, according to an analysis published in the Journal of Virus Eradication. The majority of new HIV infections, cases of mother to child HIV transmission and AIDS-related deaths now occur in countries with HIV prevalence below 4.5%. Lower-prevalence countries also had lower rates of antiretroviral therapy (ART) coverage and early infant diagnosis. The authors note that international donor organisations such as PEPFAR (President’s Emergency Plan for AIDS Relief) and the Global Fund target their resources at countries with the highest HIV prevalence. Currently, PEPFAR has 13 priority countries. Can targets for the control of HIV be met if countries with lower prevalence are being neglected? …”

BMJ Analysis – Increasing male engagement in the prevention of vertical transmission of HIV: what works in sub-Saharan Africa?

https://www.bmj.com/content/365/bmj.l1965

Muktar Aliyu and colleagues discuss barriers, enablers, and research gaps in engaging male partners in prevention of vertical HIV transmission in sub-Saharan Africa.”

Quick links:

CidrapIndian government confirms Nipah virus in Kerala man

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AMR

Two out of Three Healthy Indians Resistant to Antibiotics: Study

https://fit.thequint.com/health-news/two-out-of-three-healthy-indians-resistant-to-antibiotics-study

A study by the Indian Council of Medical Research has revealed that two out of three healthy individuals are now resistant to common antibiotics. The findings are alarming, making the treatment of common infectious diseases difficult and complex….”

“Notably, the resistance was maximum against the two most commonly used antibiotics: cephalosphorins and fluoroquinolones….”

NEJM (Correspondence) – Bedaquiline Microheteroresistance after Cessation of Tuberculosis Treatment

https://www.nejm.org/doi/full/10.1056/NEJMc1815121?query=featured_home

Based on a South-African case.

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NCDs

Globalization & Health – Are industry-funded charities promoting “advocacy-led studies” or “evidence-based science”?: a case study of the International Life Sciences Institute

S Steele, M McKee, D Stuckler et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-019-0478-6

“…MNCs often fund charities, both national and international, which then support research and promote industry-favourable policy positions to leaders….”

The authors explored “… whether one industry funded charity, the International Life Sciences Institute (‘ILSI’), is the scientifically objective, non-lobby, internationally-credible body that it suggests it is, so as to aid the international health and scientific communities to judge ILSI’s outputs….”

For coverage, see the Guardian –  Science institute that advised EU and UN ‘actually industry lobby group’

An institute whose experts have occupied key positions on EU and UN regulatory panels is, in reality, an industry lobby group that masquerades as a scientific health charity, according to a peer-reviewed study. The Washington-based International Life Sciences Institute (ILSI) describes its mission as “pursuing objectivity, clarity and reproducibility” to “benefit the public good”. But researchers from the University of Cambridge, Bocconi University in Milan, and the US Right to Know campaign assessed over 17,000 pages of documents under US freedom of information laws to present evidence of influence-peddling….”

Lancet Gastroenterology & Hepatology (Editorial) – Global alcohol targets unlikely to be met

https://www.thelancet.com/journals/langas/article/PIIS2468-1253(19)30149-9/fulltext

Global targets for the reduction of harmful use of alcohol are unlikely to be met, according to a modelling study published (some weeks ago)  in The Lancet. … …  Projections to 2030 forecast further growth to a global per-head consumption of 7·6 L, driven by changes in alcohol use in the WHO southeast Asia and western Pacific regions, where large increases in heavy episodic drinking and decreases in lifetime abstinence are predicted. … … This predicted growth in alcohol use suggests that the burden of alcohol-related liver disease is likely to increase in lower-middle-income countries in the near future….”

CGD (blog) – Health Taxes to Save Lives: Colombia Version

Intro by Amanda Glassman; https://www.cgdev.org/blog/health-taxes-save-lives-colombia-version?utm_source=190604&utm_medium=cgd_email&utm_campaign=cgd_weekly

Very nice blog, using a football metaphor: “ In April, CGD hosted a discussion on the findings of the Task Force on Fiscal Policy for Health led by Larry Summers and Michael Bloomberg: Health Taxes to Save Lives. At the event, we focused on the evidence—how smart fiscal policies to tax tobacco, alcohol, and sugar-sweetened beverages could save lives and help economies. … …  Now, Pamela Gongora-Salazar, a former ministry of health official in Colombia, shares her account of how health taxes happen (or don’t) in the real world. Pamela describes the sequence of events in Colombia as a soccer game in which policy change requires a whole team of people across institutions and sectors to move proposals forward, and where there is a clear opposing team—industries with influence in every part of politics and society….”

In December 2016, Colombia played that game and the match ended in a tie: tobacco taxes increased but it was not possible to introduce a tax on sugar-sweetened beverages. …”

Question for Pamela: football teams usually have a star player (or a few of them). Who would they be, on both sides?

Guardian (briefing) – Mental illness: is there really a global epidemic?

https://www.theguardian.com/society/2019/jun/03/mental-illness-is-there-really-a-global-epidemic

As the Guardian launches a series looking into the extent of the global mental health challenge, we examine the issue, how it is treated and the myths surrounding it.”

One of the myths (at least according to this article): “…there is no global epidemic. It is not growing exponentially. It is not a disease of western capitalism.”  Now that’s a disappointment 😊.

FT – Obamacare helps fight against cancer, studies show

https://www.ft.com/content/d0830568-853c-11e9-a028-86cea8523dc2

Cancer patients have received more timely treatment since the implementation of Obamacare in the US due to earlier detection.  See also France24 –  Obamacare led to better cancer outcomes: studies.

A pair of studies have found that Obamacare led to an increase in early-stage ovarian cancer detections and helped nearly erase racial differences in the timely treatment of a range of cancers….”

IJHPM – Addressing NCDs: Protecting Health From Trade and Investment Law; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”

K Cowling et al; http://www.ijhpm.com/article_3628.html

Building on Tangcharoensathien and colleagues’ description of four tactics used by the tobacco, alcohol, processed food, and breast milk substitute industries to interfere with the development and implementation of health policies, we present a fifth tactic: trade and investment disputes. We describe recent examples of trade and investment claims filed by the tobacco industry to challenge plain packaging legislation, which may serve as a model for future claims by this and other industries. Next, we clarify specific areas of potential conflict between non-communicable disease (NCD) control policies and trade and investment agreement (TIA) commitments, identifying possible vulnerabilities that may be exploited by industry to challenge the legality of these policies. We conclude with ideas to strengthen the position of health policies vis à-vis commitments in TIAs.”

HPW – As World Celebrates “No Tobacco Day,” Big Tobacco Seeks Rebrand To “No Smoking Day”

https://www.healthpolicy-watch.org/as-world-celebrates-no-tobacco-day-big-tobacco-seeks-rebrand-to-no-smoking-day/

Amid calls by the World Health Organization to reduce tobacco use and improve lung health on this year’s “World No Tobacco Day,” tobacco industry giant Philip Morris has pushed back, calling on its longtime adversaries in the public health community to group instead around a “World No Smoking Day.”…”

Good luck to that.

Lancet Respiratory Medicine (Viewpoint) – Early-life exposure to electronic cigarettes: cause for concern

A Larcombe; https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)30189-4/fulltext

Electronic nicotine delivery systems, or ENDS, are devices that heat and aerosolise a solution of propylene glycol, glycerine, nicotine, and flavourings. They have only achieved widespread use in the past 5 years or so, and therefore evidence around their potential to effect health is scarce. Importantly, they are often viewed as safer than tobacco cigarettes, meaning that at-risk populations, including pregnant women, might be more inclined to use them. No human studies, however, have assessed the potential for maternal ENDS use to effect the health of a developing baby. Experimental research suggests that nicotine alone is likely to adversely affect the fetus. Further, there is a misconception that ENDS do not produce second-hand aerosols. This misconception might put infants and young children at risk because their parents are more likely to use ENDS around them than they are to use tobacco cigarettes. Emerging evidence also proposes that nicotine and other substances produced by ENDS can deposit onto surfaces, and subsequently be exposed to infants and children; a process known as third-hand exposure. Finally, ENDS are often refillable, and instances of accidental poisonings of children who drink nicotine-containing refills have occurred. Thus, there are a multitude of ways that, with respect to early-life exposures and health, ENDS are a cause for concern.

WB (paper) – Distributional effects of tobacco taxation: a comparative analysis

A Fuchs et al ; http://documents.worldbank.org/curated/en/358341554831537700/pdf/Distributional-Effects-of-Tobacco-Taxation-A-Comparative-Analysis.pdf

« … This study compares the simulated distributional effects of tobacco tax increases in 8 LMICs…” “…. The comparative results do not support the claim that tobacco taxes are necessarily regressive…”

BMJ analysis – International trade and investment: still the foundation for tackling nutrition related non-communicable diseases in the era of Trump?

H Walls, J Hanefeld, R Smith et al; https://www.bmj.com/content/365/bmj.l2217

Trade and investment policy strongly influence diet, nutrition, and risk of non-communicable disease—but what does this mean in the context of recent global political developments?”

Key messages: “The 2030 Agenda for Sustainable Development identified international trade as a structural driver of sustainable development, including identification of the risk posed by international trade to the prevalence of non-communicable disease (NCD). Poor diet and nutrition are risk factors for NCDs, accounting for 40% of annual deaths from NCDs. Trade and investment policy impact diet and nutrition through the food system and by affecting domestic policy and regulatory space relating to nutrition. We outline key pathways of this trade-nutrition impact on nutrition related NCD risk and consider their implications in the context of an evolving global trade regime. “

The Journal of Nutrition – Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries

Sarah Frank et al; https://academic.oup.com/jn/advance-article-abstract/doi/10.1093/jn/nxz040/5510069?redirectedFrom=fulltext

The WHO recommends 400 g/d of fruits and vegetables (the equivalent of 5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). … … The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation….”

Over 80% of individuals aged ≥15 y living in these 28 LMICs consumed lower amounts of fruits and vegetables than recommended by the WHO. Policies to promote fruit and vegetable consumption in LMICs are urgently needed to address the observed inequities in intake and prevent NCDs.”

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SR/Mat/neonatal & child health

JAMA (viewpoint) – State Abortion Restrictions and the New Supreme Court;  Women’s Access to Reproductive Health Services

R Reingold & L Gostin; https://jamanetwork.com/journals/jama/fullarticle/2735678

This Viewpoint reviews the number and types of US state-initiated restrictions on abortion in 2019, their likely effects on compromising women’s access to reproductive health services, and prospects for the overturn of Roe v Wade by the US Supreme Court.”

See also O’Neill institute (press release) – Casey Ruling, Not Roe v. Wade, Likely to Be Key in U.S. Supreme Court Cases Impacting Women’s Access to Abortion

The U.S. Supreme Court is unlikely to overturn Roe v. Wade, but could uphold multiple abortion restrictions in newly passed state laws, say two prominent health law experts. They explain why such action would exacerbate health, social, and economic inequities for already disadvantaged and underserved women.   In 1973, Roe v. Wade established a privacy right to choose abortion. Planned Parenthood of Southeastern Pennsylvania v. Casey in 1992 reaffirmed the Supreme Court’s ruling. However, Casey leaves open options for a conservative Supreme Court to redefine abortion access, explains Lawrence Gostin, professor and faculty director of Georgetown University’s O’Neill Institute for National and Global Health Law…. “

NPR – It Looked As Though Millions Of Babies Would Miss Out On A Lifesaving Vaccine

NPR Goats & Soda;

Fortunately, other drug manufacturers have stepped in to fill the gap in rotavirus vaccine supply for West Africa after Merck ended its long-term agreement with four countries there (and started selling the vaccine, RotaTeq, in China, for X times the price).

Among others, GSK & two Indian pharmaceutical companies have stepped in.

Openly – Opinion: What Kenya’s continued gay sex ban means for Africa’s LGBT+ movements

Openly;

LGBT+ people across the continent should take heart from the fact that Kenya’s high court actually heard the petition against the gay sex ban.”

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Access to medicines

FT – Pharma groups combine to promote drug discovery with AI

https://www.ft.com/content/ef7be832-86d0-11e9-a028-86cea8523dc2

(gated) “ Blockchain system allows companies to share data without revealing commercial secrets”.

Guardian – Fight the fakes: how to beat the $200bn medicine counterfeiters

https://www.theguardian.com/global-development/2019/jun/05/fake-medicine-makers-blockchain-artificial-intelligence?CMP=twt_a-global-development_b-gdndevelopment

Armed with blockchain and AI, health workers and campaigners are battling the bogus business that kills thousands, says Helen Lock.”

Some quick links:

News from the UK: “Parents of children with cystic fibrosis who are desperate to use a drug that the NHS cannot afford are forming a buyers club to obtain a cut-price version made in Argentina where the patent does not apply….

A team of researchers inside Pfizer made a startling find in 2015: The company’s blockbuster rheumatoid arthritis therapy Enbrel, a powerful anti-inflammatory drug, appeared to reduce the risk of Alzheimer’s disease by 64 percent. The results were from an analysis of hundreds of thousands of insurance claims. Verifying that the drug would actually have that effect in people would require a costly clinical trial — and after several years of internal discussion, Pfizer opted against further investigation and chose not to make the data public, the company confirmed….”

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Social determinants of health

New (US) (Harvard) website: Drivers of Health

http://driversofhealth.org/

Social determinants of health site – focus on the US.

The Drivers of Health project was created in May 2019 to make progress on the question of what affects health. Over the course of a year, we will analyze published, scientific evidence and consult with experts to assess what is known about the social determinants of health. We will also identify areas where knowledge is lacking and propose new studies to fill in the gaps….”

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Human Resources for Health

If you want to check out the latest WHO Health Workforce (May) newsletter (with plenty of health workforce related info, announcements & reports from the 72nd World Health Assembly), see here.

BMJ global Health – What do community health workers want? Findings of a discrete choice experiment among Accredited Social Health Activists (ASHAs) in India

M Abdel-All, Seye Abimbola et al; https://gh.bmj.com/content/4/3/e001509

“A number of factors contribute to the performance and motivation of India’s Accredited Social Health Activists (ASHAs). This study aims to identify the key motivational factors (and their relative importance) that may help retain ASHAs in service.”

Conclusions:  “ASHAs are motivated by both non-financial and financial factors and there is significant heterogeneity between workers. Policy decisions aimed at overcoming workforce attrition should target those areas that are most valued by ASHAs to maximise the value of investments into these workers.

Gendered effects of pay for performance among family physicians for chronic disease care: an economic evaluation in a context of universal health coverage

N Gupta et al; https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-019-0378-0

Despite increasing popularity among health organizations of pay for performance (P4P) for the provision of comprehensive care for chronic non-communicable diseases, evidence of its effectiveness in improving health system outcomes is weak. An important void in the evidence base is whether there are gendered differences in P4P uptake and in related outcomes amenable to healthcare improvement. This study assesses the gender-specific effects of P4P among family physicians on diabetes healthcare costs in a context of universal health coverage.”   In New Brunswick, Canada. “

Among the results: “…We observed greater male physician uptake of incentive payments, seemingly exacerbating gender gaps in professional remuneration….”

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Miscellaneous

F2P blog – #PowerShifts Resources: Wellbeing and Development

F Faciolince; https://oxfamblogs.org/fp2p/powershifts-resources-wellbeing-and-development/

Nice blog on the politics of wellbeing, with as starting point New-Zealand’s wellbeing budget & WHO’s recognisation of burn-out in ICD-11 (or rather re-definition) .  “…how do we incorporate wellbeing into our conversations, but ensure its radical potential as an idea is not diluted? How can we account for and value plurality in the politics of wellbeing? …”

Complement with (on Global Policy)  New Zealand has Unveiled its First ‘Well-Being’ Budget

The government’s plan to move away from traditional methods of measuring growth and development are in keeping with a global push for a more purposeful capitalism….”

The piece also contains a paragraph on the UAE:The UAE has a Minister of State for Happiness and a National Programme for Happiness and Positivity. Its agenda is based on three pillars: inclusion of happiness in the policies, programmes and services of all government bodies and at work, promotion of positivity and happiness as a lifestyle, and development of benchmarks and tools to measure happiness.”

ODI – Risk-informed development: from crisis to resilience

S Opitz-Stapleton et al ; https://www.odi.org/publications/11314-risk-informed-development-crisis-resilience

Over the past decade, important progress has been made on poverty reduction, disease control and access to healthcare, education and services. However, these gains are fragile, and are undermined by new and emerging threats… …  These threats are interconnected, they cross national borders and they are occurring simultaneously.  Growing awareness of these challenges is leading to calls by governments, the international development community and donors for an approach to development that takes account of these complex risks: that is risk-informed. Risk-informed development is a risk-based decision process that enables development to become more sustainable and resilient. It pushes development decision-makers to understand and acknowledge that all development choices involve the creation of uncertain risks, as well as opportunities.  This report highlights the need for: a move away from single hazard risk analysis to an explicit acknowledgement of the interactions between multiple threats, including economic and financial instability, geopolitical volatility, natural hazards and climate change; systematic assessments of complex threats and risks, opportunities, uncertainties, risk tolerances, perceptions and options to ensure that development is sustainable and  resilient; identifying who has responsibility to act upon risk management, with what resources, by when and how those actions are to be monitored; analysis of the potential trade-offs of development policies and investment actions, including social and environmental impacts, feasibility and cultural and ethical outcomes; the provision to policy-makers of a robust evidence base around the role that unsustainable development plays in creating risk; understanding and acknowledging that all development and investment choices involve trade-offs.”

Guardian – Bernie Sanders’ plan to empower workers could revolutionise Britain’s economy

https://www.theguardian.com/commentisfree/2019/jun/03/bernie-sanders-workers-economy-employees-inequality-corporate-power

Giving employees a stake in firms would reshape power: this could be the start of a transatlantic challenge to neoliberalism.”   Will be an essential part of a fairer global economic system indeed.

Brookings institute – Is inequality really on the rise?

A Revanga et al; https://www.brookings.edu/blog/future-development/2019/05/28/is-inequality-really-on-the-rise/

Based on a recent book, authored by the first author.  Nuanced blog, and thus well worth a read.

Nature (News) – Gene edits to ‘CRISPR babies’ might have shortened their life expectancy

https://www.nature.com/articles/d41586-019-01739-w

Study of almost half a million people links mutation that protects against HIV infection to an earlier death.”

Stat – China is leapfrogging the U.S. in using AI in medicine. These five companies are leading the way

Stat plus;

In the race to deploy artificial intelligence in medicine, China has surged ahead of the U.S. and other countries, spawning technology companies that are using algorithms and novel software tools to help treat millions of patients and relieve pressure on the country’s overwhelmed hospital system….” (gated)

“….With the Chinese government also backing the work, AI — with a special health care focus — is poised to become a $150 billion industry there in the next 10 years….”

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Emerging Voices

Health Research Policy & Systems – Decision-making in district health planning in Uganda: does use of district-specific evidence matter?

Dorcus K Henriksson (EV chair) et al; https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-019-0458-6

In a decentralised health system, district health managers are tasked with planning for health service delivery, which should be evidence based. However, planning in low-income countries such as Uganda has been described as ad hoc. A systematic approach to the planning process using district-specific evidence was introduced to district health managers in Uganda. However, little is known about how the use of district-specific evidence informs the planning process. In this study, we investigate how the use of this evidence affects decision-making in the planning process and how stakeholders in the planning process perceived the use of evidence….”

BMJ Global Health – “He is suitable for her, of course he is our relative”: a qualitative exploration of the drivers and implications of child marriage in Gezira State, Sudan

Laura Dean (EV 2014) et al ; https://gh.bmj.com/content/4/3/e001264

Child marriage is a fundamental development challenge for women and girls, with significant negative health and social outcomes. Sudan has a high rate of child marriage, with 34% of women aged 20–24 married before their 18th birthday. Since limited preventive interventions exist, we aimed to inform the evidence base to strengthen strategic action, using mixed qualitative methods to enhance study credibility. This study is the first to conduct a rigorous qualitative examination of the drivers of child marriage from the perspective of key stakeholders involved in marriage decision making within Sudan, and makes a significant contribution towards global knowledge by developing an evidence-based conceptual framework….”

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Research

Global Health Action – Towards a framework for multisector and multilevel collaboration: case of HIV and AIDS governance in South Africa

P Mahlangu et al; https://www.tandfonline.com/doi/full/10.1080/16549716.2019.1617393

“While multisectoral action (MSA) is advocated as one of the strategies to address complex health and development challenges, there is limited clarity about the process of multisector collaboration in practice. Informed by the findings of the research on implementation of the multisectoral response to HIV in South Africa, and drawing from the existing literature; we propose a framework for multisector and multilevel collaboration. The framework describes key components of the process of multisector collaboration, and aims to inform policy and practice…..”

Public Administration & Development – Policy entrepreneurship in developing countries: A systematic review of the literature

N F Aviram et al ; https://onlinelibrary.wiley.com/doi/10.1002/pad.1852

What can be learned from two decades of studies on policy entrepreneurship in developing countries? Policy entrepreneurship is a rapidly evolving analytical concept. A growing number of studies exploring public policy in developing countries use policy entrepreneurship as an explanatory theoretical concept. However, a substantial part of this research relies on qualitative case study analysis, lacking a comprehensive overview of the concept of policy entrepreneurship. This paper conducts a systematic review of the literature on policy entrepreneurship in developing countries. … … . The purpose and contribution of this paper are to offer a clearer picture of policy entrepreneurship in the developing world by concentrating on two aspects. First, we describe the characteristics of the studies on policy entrepreneurship in the developing world. Second, we analyse such studies, identifying the lessons that can be drawn on the phenomenon of policy entrepreneurship in the developing world. We conclude with an agenda for future studies, examining new theoretical, methodological, and empirical opportunities to advance the understanding of policy entrepreneurship in developing countries.”

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