ihp news : world malaria day & world immunization week · ihp news : world malaria day &...
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IHP news : World Malaria Day & World Immunization week
(29 April 2016)
The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium.
Dear Colleagues,
This week we have a very committed voice from the Philippines in the Featured article on breastfeeding and health systems. As Lei Camiling-Alfonso stresses, breastfeeding is one of the most polarizing topics in the world. So surely a good topic for our (very polarized) times. Ask Donald.
Earlier this week I noticed in a Harvard University survey, that a majority of millennials now reject capitalism. In the US! The land of Bill Gates! Also, “people are increasingly identifying themselves as global rather than national citizens, according to another ( BBC World Service ) poll. Not all hope is lost, it seems, even if the latter poll needs some qualification (see the trend in emerging countries versus industrialized countries).
So much for the ‘glass half full’ part of the intro. Now the more realist view: we seem to be heading for a wonderful G 20 line-up of thugs, ‘I can barely hide that I am a thug’ & ‘proud to be among other High-Level thugs’ leaders in the coming years. Putin, Modi, Erdogan, King Salman bin Abdulaziz al-Saud, the next ‘House of cards” style about to be “promoted” Brazilian leader; with a bit of bad luck a few male blonde xenophobic/sexist populist ‘UK/America First’ leaders in former democratic strongholds (Johnson & Trump – I know pundits still say he hasn’t got a chance against Hillary but these are funny times), …
In sum, the post-2015 global governance future looks bright. Already Trump doesn’t rule out nuking IS. The SDG agenda and the fight against climate change will surely also be a piece of cake with these sorts of gentlemen (and a few women), and evidence-based policies will take off like a rocket. (Let’s hope that Ban Ki Moon will soon be replaced by a somewhat rougher UN SG, he must feel like Ba(n)mbi in this sort of company)
Maybe it’s normal that ‘humanity’ (what’s in a name…) goes for ‘strongmen’ or downright thuggish leaders, when we face a perfect storm of political, ecological, social & economic challenges. People become, on average, more rightwing when the going gets tough. And yes, in many cases & countries, voters cannot be blamed for their leaders, as plenty of these gentlemen came to power in not very democratic ways (and even in democratic regimes there are many democratic loopholes or worse). But in better times this economic system already tends to produce far too many people at the top that you don’t exactly want to have a cup of tea with. For every Obama and Bill Clinton (with all their flaws still likeable people), there are tens of Netanyahu’s and Assad’s, it sometimes appears. That cannot be a coincidence. A nasty (economic) system produces the most ‘befitting’ leaders. So brace
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yourself for the age of thuggish & bigot governance, the “harvest” of neoliberal globalization. Well, at least that’s coming to an end now. (I know not everything can be blamed upon neoliberalism. But a lot can.)
On a more cheerful note, let me already announce that from next week on, Radhika Arora will join the IHP editorial team (for three months). Looking forward to the collaboration, the ‘glass half full’ perspective she will bring to the newsletter (sorely needed as you can see!) and the female flavor (even more needed). Let’s face it, I really don’t have a clue about the joys and pains of breastfeeding. For example.
Enjoy your reading.
The editorial team
Featured Article
On health systems & breastfeeding (but also on Hans Rosling & Adele )
Lei Camiling-Alfonso, MD - Alliance for Improving Health Outcomes & Kalusugan ng Mag-Ina (Health of Mother and Child), Philippines; MPH Student, ITM
A weblink related to a recent UHC financing forum in Washington DC (hosted by the World Bank) caught my attention a few weeks ago. The (PR) picture in the article featured health workers handling newborns placed head-to-head in what appears to be a routine setting. All seems peaceful and nice, but from a technical standpoint, the picture actually shouts “nightmare!” to any person working on maternal and child health (MCH). (Common guys, we are trying to undo this!) Among other potential harms, unnecessary separation of newborns from their mothers affects breastfeeding outcomes.
(By now, you have a hunch that I feel strongly about breastfeeding, so in this short piece I will indeed talk about breastfeeding, one of the most polarizing topics on the planet. Don’t leave yet, Hans Rosling and Adele will come later!)
Breastmilk is now likened to personalized medicine. But any breastfeeding is not the same as meeting optimal standards. Delaying breastfeeding initiation, even by an hour, increases the risk of death (seriously!). Mix-feeding newborns with formula inhibits breastmilk’s protective effect against serious illness. WHO recommends mothers to 1) breastfeed within the first hour of birth 2) exclusively breastfeed for 6 months, without giving any water or food and 3) continue breastfeeding up to two years or beyond, with addition of appropriate foods.
This standard is not easy to meet. Ask your mother. Or ask a friend with a kid. Ask health systems.
In low and middle income countries, only 37% of children are exclusively breastfed for the first six months. In the 2013 DHS survey, a region in the Philippines reported 68.3% facility-based deliveries, yet only 26% of their newborns were breastfed within an hour of birth! How can we fail to deliver human milk - a universally prepositioned, no-cost (FREE!) and potent intervention - in a timely manner? There is clearly a need to look into the more complicated aspects of breastfeeding support.
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The situation in developed countries isn’t all that different. In a US study, two-thirds of mothers did not meet their own breastfeeding goal. No wonder people are offended when the issue is discussed. After the recent sugar tax victory in the UK, celebrity chef Jamie Oliver turned his attention to breastfeeding, earning the ire of mothers including pop icon Adele who even mentioned that formula is “just as good” as breastmilk. (Not a smart idea for men to wade into risky female territory, some of you might say, but see below for more on why breastfeeding shouldn’t just be the mother’s responsibility.)
What if mothers do not breastfeed? Mounting evidence links (not) breastfeeding to current global threats: obesity, diabetes and certain cancers (Are we missing out on an early modifiable risk factor?). Globally, breastfeeding averts 823,000 child deaths under the age of five and 20,000 deaths due to breast cancer. In Southeast Asia, it can prevent 50% (as in, five-zero!) of child deaths due to diarrhoea and pneumonia and 10% of deaths due to breast cancer. Not breastfeeding costs society $302 billion annually, which is 0.49% of the world’s gross income.
Does formula really measure up to breastmilk? Breastmilk components are complex and dynamic. For example, breastmilk supplies essential fats to the human brain at a crucial growth phase, reflecting on cognitive outcomes and earning potential in adult life. (Uh-oh, I was also not optimally breastfed... I could have been an ITM PhD student by now!) Formula is modified cow’s milk and will never have specificity for immune protection and human nourishment.
While advocates argue about the relative silence on formula risks, they also challenge the current discourse: human milk is not better, rather formula is suboptimal; breastmilk does not reduce health risks, rather it allows infants to survive and thrive. This perspective shift is needed, BUT must be met with responsive systems that support and protect those who choose to breastfeed. Otherwise we will only terrorize mothers towards failure. Breastfeeding is not exactly a serene experience. If interventions are not appropriately and timely delivered, it requires huge effort and can even be painful, both physically and emotionally. (I know, having been through it, with postpartum depression and all)
The good news is, breastfeeding rates respond to interventions. However, there is underinvestment to deliver protection and support at the health system level. Health systems promote that “breastfeeding is best” but often, mothers are left on their own to figure out how to do so as many countries still struggle to scale up interventions that work.
We place huge pressure on mothers to succeed, but many determinants are beyond the mother’s control. Rising labour force participation among women and poor workplace maternity protection makes optimal breastfeeding inconvenient, if not impossible. (Hey, I am not saying mothers be forced to stay at home to breastfeed. Societies should instead recognize their unique contribution and support them in the workplace!) Unethical marketing facilitates the wrong impression that formula is a suitable, if not an equal alternative. Hence, many perceive breastfeeding as a lifestyle choice, resulting in a tension with health system goals.
The formula industry presents another important “challenge”. The industry continues to push its agenda despite the International Code of Marketing of Breast-milk Substitutes in place. One sly strategy is to hijack the global nutrition community’s focus on the first 1000 days of life – from pregnancy to a child’s second birthday. In 2012, Nestle quietly succeeded in registering “THE FIRST 1000 DAYS” as their property in the Global Brand Database of Mexico and the Philippines (key in “1000 days” on the weblink). Furthermore, these companies discretely engage in high level health system forums on the global scene and in national settings. (They are in fact so discrete, that I cannot give you a link to prove this. But some of my compatriots surely know what event I’m referring to)
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Let us go back to health systems. In a video, the famous Dr Hans Rosling illustrates financial protection through a Cambodian couple just rising out of poverty. Anticipating twins, the woman delivered in the hospital. Thanks to a financial protection scheme they return home, mother and twins safe, the family spared from the catastrophic costs of hospitalization. But eek… the mother was already formula feeding at the hospital (44:30)!
A single diarrhoea episode is enough to bring these babies back to the hospital. A few more days and the family runs out of money for formula. By that time, normal breastfeeding processes have been sabotaged and it will be a challenge for both mother and babies to return to the breast. The mother will then say that she tried, but she does not have milk. Like so many, many mothers around the world.
An alternative picture is a mother empowered to make an informed decision knowing that with skilled measures and support, her body can ensure adequate breastmilk for the twins. Mothers and babies at high risk for breastfeeding failure often require support beyond routine care. But even routine messages and skills are often unrecognized or not taught properly to health workers. The situation is more depressing for mothers and babies in man-made crises and natural disasters, where resources are scarce and conditions are unhygienic.
Dr Rosling’s video manifests a blind spot we have as a global community. When populations are not covered by optimal breastfeeding interventions, infants succumb to disease or malnutrition, throwing away health system gains. Promoting breastfeeding without responsive systems that protect and support those who choose to breastfeed is unacceptable. Strategies should be embedded in society and health systems to reach mothers in an acceptable, timely and equitable way. As colleagues in nutrition and child health build momentum for breastfeeding, let us all move with them towards the same direction. (I think we can even ask Jamie Oliver to join us, but he will have to read all weblinks in this article first. Alternatively, he could go for a VR breastfeeding experience, that will surely also get him on the same page! )
Highlights of the week
World Malaria Day (25 April) – with this year’s theme: End Malaria For Good
WHO (press release) – On World Malaria Day, a push to eliminate malaria
http://www.who.int/mediacentre/news/releases/2016/world-malaria-day/en/
“A year after the World Health Assembly resolved to eliminate malaria from at least 35 countries by 2030, WHO released a World Malaria Day report that shows this goal, although ambitious, is achievable. The “Global Technical Strategy for Malaria 2016-2030”, approved by the World Health Assembly in 2015, calls for the elimination of local transmission of malaria in at least 10 countries by 2020. WHO estimates that 21 countries are in a position to achieve this goal, including 6 countries in the African Region, where the burden of the disease is heaviest. … “New technologies must go hand in hand with strong political and financial commitment,” Dr Alonso added. … Vigorous leadership by the governments of affected countries is key. Governments must strengthen
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surveillance of cases to identify gaps in coverage and be prepared to take action based on the information received. As countries approach elimination, the ability to detect every infection becomes increasingly important. … Reaching the goals of the “Global Technical Strategy” will require a steep increase in global and domestic funding—from $2.5 billion today to an estimated $8.7 billion annually by 2030…”
For the report, ‘Eliminating Malaria’, see here. Coverage of the report, among others, in AFP.
For a great infographic related to World Malaria Day (‘End Malaria for Good’), see CDC.
FT – Special report: Combating malaria
http://www.ft.com/intl/reports/combating-malaria?ft_site=falcon&desktop=true
With plenty of good stuff in there. “Malaria kills more than 400,000 people a year, most of them children in Africa. New weapons are arriving to aid the fight against it, notably a vaccine that could protect millions from infection. FT correspondents look at latest developments in Africa and Asia, plus updates on funding and the progress made by science in countering a still formidable disease.”
Last week, we already reported on a new paper in the Lancet (by R Feachem et al), which claimed that malaria eradication within a generation is a goal within reach (but only with renewed focus, new tools and sufficient financial support). For the press release, see here.
But for now, the focus is on malaria elimination, country by country.
The Lancet Global Health (Editorial) – Malaria: can we mention the e-word yet?
Zoë Mullan; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30068-7/fulltext
Must-read. Zoë Mullan gives Alonso’s view on malaria eradication. The director of WHO's Global Malaria Programme, that is. Not the F1 driver.
You might also want to have a look at the Bern Malaria declaration, signed earlier this week, “reaffirming Switzerland’s leadership role to end malaria”.
BMJ ( blog) – A more holistic response to malaria is overdue
E Lasry; http://blogs.bmj.com/bmj/2016/04/22/estrella-lasry-a-more-holistic-response-to-malaria-is-
overdue/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bmj%2Fblogs+%
28Latest+BMJ+blogs%29&g=w_blogs_bmj-com
Recommended. By a tropical medicine adviser for MSF. “To significantly and sustainably decrease the burden of malaria in the most affected countries, all relevant actors will need to adopt a more holistic approach—one that integrates interventions and research on health, climate, agriculture (and eventually economics and housing) in tackling the main factors contributing to the disease and its transmission. This will require closer collaboration among different national ministries, UN agencies, research institutions, international organisations, and NGOs to improve health, vector
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control activities, and—in the future—education and housing. The current reactive “silo” approach will unfortunately only bring about temporary dents in malaria’s impact, while requiring much more effort and investment.”
You might also want to read Malaria menace: when insecticide-resistant mosquitoes bite back (Guardian).
World immunization week (24-30 April)
WHO World Immunization Week 2016: Immunization game-changers should be
the norm worldwide
http://who.int/mediacentre/news/releases/2016/world-immunization-week/en/
“During World Immunization Week 2016, held 24-30 April, WHO highlights recent gains in immunization coverage, and outlines further steps countries can take to “Close the Immunization Gap” and meet global vaccination targets by 2020.” See also UN News. Immunization game changers should become the norm, all over the world, Chan said.
WHO (Commentary ) Vaccines: A global health success story that keeps us on our
toes
F Bustreo & MP Kieny; http://www.who.int/mediacentre/commentaries/vaccines/en/
Bustreo & Kieny (both WHO) give the recent picture of fast-tracking vaccine development, preparing for outbreaks, the hopes for malaria & dengue vaccines…
FT - Special report on vaccines
https://next.ft.com/special-reports/NzYwNmIzZWQtYjY0NC00ZDFhLTg3NWMtMjc0ZGZiNzVlOGU0-
U3BlY2lhbFJlcG9ydHM=
“In today’s connected world, where outbreaks of infectious disease can spread faster than ever, scientists and health workers are under pressure to develop vaccines to fight new threats like Ebola and Zika. Innovation and cooperation will be needed to beat the next pandemic…” The special report features seven articles, as well as a video, podcast, and slide show, examining several aspects of vaccine development”.
Very interesting special report. Read, certainly, “Vaccine development needs global alliance: Ebola and Zika are harbingers of an era in which pandemics will occur more frequently”.
Some other (recommended) pieces related to vaccines & vaccine coverage:
Closing the gap on vaccine efficacy in the 'global south' (Devex) “…Vaccines fail for many reasons. Years of effort have failed to deliver a vaccine for HIV. In many cases the best
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solution may simply be to focus resources on alternative therapies, much as antiretroviral drugs have reduced the burden of HIV in the absence of an effective vaccine. What is more immediately concerning is the existence of vaccines that are known to be completely effective in industrialized nations, but that show reduced efficacy when introduced to impoverished communities in the global South. …”
(Guardian) - Why are millions of children still dying from preventable diseases? “An effective immunisation programme, with a focus on universal coverage, can also help to build a functioning health system” – “…Results UK and Save the Children are launching an equity scorecard exploring the critical issues that must be addressed if we are to get back on track to achieve universal immunisation coverage.”
Check out VIEW-hub, a new online, interactive vaccine information tool. VIEW-hub is a publicly accessible, interactive platform that enables users to visualize real-time information on vaccine use, product type, coverage levels, and impact assessments. Developed by the International Vaccine Access center. WHO, UNICEF, Gavi, CDC, and other groups supply the data.
Global Health Governance – special issue: Ebola: implications for global health governance
http://blogs.shu.edu/ghg/2016/04/25/ebola-implications-for-global-health-governance-toc/
Check out the Introduction (by J Bush, K Grepin & J Youde), as a start. (absolute must-read, includesg an overview of the special issue): “Ebola: implications for global health governance “
And then read the whole special issue. Some fabulous articles in there!
HP&P - “Lives in the balance”: The politics of integration in the Partnership for Maternal, Newborn and Child Health
K Storeng;
http://heapol.oxfordjournals.org/content/early/2016/04/21/heapol.czw023.full?keytype=ref&ijkey=
z1nI8YFbBhFL0ZC
Vintage Storeng. “A decade ago, the Partnership for Maternal, Newborn and Child Health (PMNCH) was established to combat the growing fragmentation of global health action into uncoordinated, issue-specific efforts. Inspired by dominant global public-private partnerships for health, the PMNCH brought together previously competing advocacy coalitions for safe motherhood and child survival and attracted support from major donors, foundations and professional bodies. Today, its founders highlight its achievements in generating priority for ‘MNCH’, encouraging integrated health systems thinking and demonstrating the value of collaboration in global health endeavours. Against this dominant discourse on the success of the PMNCH, this article shows that rhetoric in support of partnership and integration often masks continued structural drivers and political dynamics that bias the global health field towards vertical goals. Drawing on ethnographic research, this article
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examines the Safe Motherhood Initiative’s evolution into the PMNCH as a response to the competitive forces shaping the current global health field. ….”
Disaster risk reduction
Guardian – World heading for catastrophe over natural disasters, risk expert
warns
http://www.theguardian.com/global-development/2016/apr/24/world-heading-for-catastrophe-
over-natural-disasters-risk-expert-warns
“The world’s failure to prepare for natural disasters will have “inconceivably bad” consequences as climate change fuels a huge increase in catastrophic droughts and floods and the humanitarian crises that follow, the UN’s head of disaster planning has warned. Last year, earthquakes, floods, heatwaves and landslides left 22,773 people dead, affected 98.6 million others and caused $66.5bn (£47bn) of economic damage. Yet the international community spends less than half of one per cent of the global aid budget on mitigating the risks posed by such hazards. Robert Glasser, the special representative of the secretary general for disaster risk reduction, said that with the world already “falling short” in its response to humanitarian emergencies, things would only get worse as climate change adds to the pressure. … …. “Glasser, speaking ahead of next month’s inaugural world humanitarian summit in Istanbul, said international disaster risk reduction (DRR) efforts remain woefully underfunded. …According to UN figures, in 2014 just 0.4% of the global aid budget of $135.2bn – roughly $540m – was spent on DRR. Glasser said the UN wanted that proportion to rise to at least 1% and would push for an increase at the Istanbul meeting….”
You might also want to read The world's humanitarian burden is too big. How can we lessen it? (by R Glasser & S O’Brien) – in the Guardian.
Plos – The Chernobyl Disaster and Beyond: Implications of the Sendai Framework
for Disaster Risk Reduction 2015–2030
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002017
On the 30th anniversary of the Chernobyl disaster, Amina Aitsi-Selmi and Virginia Murray reflect on the importance of disaster preparedness.
UN News - ‘Worst case scenarios’ could become reality without more funding for
El Niño response – UN relief chief
http://www.un.org/apps/news/story.asp?NewsID=53790#.VyDbsfl97IX
“With 60 million people across the world affected by droughts, floods and other extreme weather events triggered by El Niño, the top United Nations relief official today called on the international community to act now to address urgent humanitarian needs and support building communities’ resilience to future shocks. “I am here to sound the alarm. Again. We must act today to help people whose entire way of life and survival is threatened,” Stephen O’Brien, the UN Under-Secretary-
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General for Humanitarian Affairs and Emergency Relief Coordinator, said in Geneva during a conference on responding to El Niño.”
BMJ (Editorial) – Delivering on the promise of universal health coverage
A Jha et al; http://www.bmj.com/content/353/bmj.i2216
« …the Harvard Global Health Institute and The BMJ are partnering to launch a new initiative on effective universal coverage. « A new initiative on improving health care delivery systems.
Next WHO DG
Lancet (Editorial) –The next Director-General of WHO
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30358-0/fulltext
The Lancet lists three high-profile candidates - Philippe Douste-Blazy; Tedros Adhanom Ghebreyesus; Sania Nishtar. Others will no doubt be nominated. The deadline for member states to nominate candidates is Sept 22.
As for Margaret Chan: “Is it now time for Margaret Chan to turn her attention to life after Geneva? No, it is not. In her final 12 months, Dr Chan should embrace her unprecedented freedom to speak without scruple and act without fear. Now is her best moment to make WHO the supremely radical voice for health equity and social justice it should be.”
Stat news - For the first time in a decade, the world’s leading global health
organization is searching for a new leader
https://www.statnews.com/2016/04/25/who-new-director-general/
Some more info for the ones among you looking for a new job: check out some of your rivals for the WHO DG job in the coming years. (PS: The GHG introduction to the special issue on Ebola & GHG mentions some others). (But do spare us Sidibé!)
See also WHO, Process to elect next Director-General of WHO begins.
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ECOSOC Financing for Development (FfD) Forum (18-20 April)
UN financing forum: A bitter awakening after 2015’s party of multilateralism
A Caliari; https://www.coc.org/rbw/un-financing-forum-bitter-awakening-after-2015%E2%80%99s-
party-multilateralism
The FfD forum was held 18-20 April in NY to address follow-up and review of the Financing for Development outcomes and means of implementing the 2030 Agenda for Sustainable Development. “RBW Project Director Aldo Caliari reports on the outcomes of the first ECOSOC Financing for Development Forum, centerpiece of the reinvigorated follow up created by the Third Financing for Development Conference held last year.”
So apparently, it’s “party” like it’s 2016” in New York….
See also IISD write-ups on 18 April & 19 April.
IPS - How the Definition of Development Aid is Being Eroded
IPS
Must-read from late last week. “The traditional definition of aid is being eroded at the same time that governments have committed to achieving the SDGs), Jeffrey Sachs special adviser to the UN Secretary-General on development told IPS Thursday. “A lot of governments have a kind of magical thinking which is, we’re all for the Sustainable Development Goals but don’t come to us if you want to achieve them, go borrow from the private markets,” said Sachs. Aldo Caliari who represents civil society in UN Financing for Development (FfD) negotiations told journalists here Monday that there has been a “significant shift in the language” in these negotiations towards “a larger presence of the private sector”. “We are concerned about states withdrawing their responsibility and saying the private sector should do it,” said Caliari … . …” …While private sector financing will provide part of the funds needed to achieve the sustainable development goals, there are definitely some areas where public funds remain essential. “If you want to achieve UHC in poor countries, which is SDG 3, that is a public sector function and the poor countries do not have enough domestic revenues to achieve that on their own,” said Sachs. “For the poorest countries the Official Development Assistance should be overwhelmingly in the form of grants because putting absolutely impoverished countries into debt makes no sense,” he said. Sachs said that there are examples right now where donor governments are reducing funding to development programs in favour of domestic refugee costs, peacekeeping budgets and climate financing. “I know cases where contributions to The Global Fund (to Fight AIDS, Tuberculosis and Malaria) and GAVI (The Vaccine Alliance) were cancelled in favour of climate financing because the government wanted to check the
box on climate financing,” said Sachs.”
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UNGASS analysis
For some good reports on the (disappointing) UNGASS outcome from last week, see for example:
UN Special Session on “the world drug problem” just says no . . . (Science Speaks blog – Antigone Barton (recommended))
(The Influence) Global Commission Slams UNGASS 2016 Outcome That Strains the Credibility of International Law
(HRW) A Missed Opportunity to End the War on Drugs
HP&P – How to do (or not to do)… gender analysis in health systems research
R Morgan et al;
http://heapol.oxfordjournals.org/content/early/2016/04/26/heapol.czw037.short?rss=1
“Gender—the socially constructed roles, behaviours, activities and attributes that a given society considers appropriate for males, females and other genders—affects how people live, work and relate to each other at all levels, including in relation to the health system. Health systems research (HSR) aims to inform more strategic, effective and equitable health systems interventions, programs and policies; and the inclusion of gender analysis into HSR is a core part of that endeavour. We outline what gender analysis is and how gender analysis can be incorporated into HSR content, process and outcomes. ….”
Global Fund Board meeting (Abidjan, Ivory Coast)
Global Fund – Global Fund Board Approves Strategy 2017-2022
http://www.theglobalfund.org/en/news/2016-04-
27_Global_Fund_Board_Approves_Strategy_2017-2022/
Check it out. “The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria today approved a Strategy 2017-2022 to maximize impact, strengthen systems for health, promote and protect human rights and gender equality, and mobilize additional resources. The Strategy was approved at a two-day meeting graciously hosted by the Government of Côte d'Ivoire, the first time a Global Fund Board meeting was held in Francophone West Africa….”
More detailed info on the Board Meeting also in GFO’s new issue. Certainly read Main decisions made at the board & Board adopts new Strategy for 2017-2022: “Investing to End Epidemics”.
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…The Global Fund Board has approved a strategy to guide the organization for the next six years. “The Global Fund Strategy 2017-2022: Investing to End Epidemics” – is built around four strategic objectives, as follows: maximize impact against HIV, TB and malaria; build resilient and sustainable systems for health; promote and protect human rights and gender equality; and mobilize increased resources. …”
Guardian – Workers face 'epidemic of heat-related injuries' due to climate change
http://www.theguardian.com/environment/2016/apr/28/workers-epidemic-heat-related-injuries-climate-change-un-report
“Workers in fields and factories face an epidemic of heat-related injuries that will devastate their health, income and productivity as climate change takes hold, a major UN report has warned. Productivity losses alone could rise above $2tn by 2030, as outdoor employees in many regions slow their pace, take longer breaks and shift their work to cooler dusk and dawn hours. The effects of heat stress brought on by a warming world are already evident among the 4 billion people who live in the tropics and subtropics, says the report, Climate Change and Labour, which was jointly produced by the ILO, UNDP & WHO. …”
Lancet – Offline: The King and his courtiers
R Horton ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30309-9/fulltext
Horton on Rwanda - “Why are you telling us to report on hospitals and disease rates when the real problems in this country are political…You are keeping us away from the issues that matter in our lives by making us write these insignificant reports.” This young journalist was pleading with Anjan Sundaram, the author of Bad News (Doubleday, 2016), an urgent account of repression, violence, and torture in a country the global health community has come to celebrate as an extraordinary example of African success. But behind the facade, the mirage, another story apparently lies untold. That story is about Rwanda's last free journalists. The spine of this testimony is Sundaram's attempt to secure a training programme for aspiring reporters….”
For once Horton remains fairly diplomatic – and takes essentially, no position on the two stories on Rwanda: “…But what one can say is that these contradictory accounts invite independent scrutiny. And perhaps an awareness that Rwanda is a country in the midst of a struggle for truth.”
Lancet (World Report) – The age of drones: what might it mean for health?
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30361-0/fulltext
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“Drones can destroy lives in conflict settings where they are used for surveillance and bombings. But can they save them too? Dinsa Sachan reports on the use of drones in the health sector.” (good overview)
Health Policy & Planning – Opening the ‘black box’ of performance-based financing in low- and lower middle-income countries: a review of the literature
D Renmans et al; http://heapol.oxfordjournals.org/content/early/2016/04/28/heapol.czw045.short?rss=1
“Although performance-based financing (PBF) receives increasing attention in the literature, a lot remains unknown about the exact mechanisms triggered by PBF arrangements. This article aims to summarize current knowledge on how PBF works, set out what still needs to be investigated and formulate recommendations for researchers and policymakers from donor and recipient countries alike. Drawing on an extensive systematic literature review of peer-reviewed journals, we analysed 35 relevant articles. To guide us through this variety of studies, point out relevant issues and structure findings, we use a comprehensive analytical framework based on eight dimensions. The review inter alia indicates that PBF is generally welcomed by the main actors (patients, health workers and health managers), yet what PBF actually entails is less straightforward. More research is needed on the exact mechanisms through which not only incentives but also ancillary components operate. This knowledge is essential if we really want to appreciate the effectiveness, desirability and appropriate format of PBF as one of the possible answers to the challenges in the health sector of low-and lower middle-income countries. A clear definition of the research constructs is a primordial starting point for such research.”
Zika
CIDRAP is one of the many great resources to get a quick overview of the key Zika related news & headlines of the week. Check it out.
As for WHO’s latest Zika situation report (as of 28 April), see here.
AFP – WHO warns of potential for 'marked increase' in Zika cases
https://www.yahoo.com/news/warns-potential-marked-increase-zika-cases-083521147.html
“The World Health Organization warned Monday of the potential for a "marked increase" in the number of Zika infections in the coming months, and its spread to new parts of the world. With mosquito season arriving in Europe, "the possibility of local transmission combined with the
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likelihood of onward sexual transmission could see a marked increase in the number of people with Zika and related complications," WHO assistant director general Marie-Paule Kieny told a scientific Zika conference in Paris….”
The two-day Zika expert meeting was hosted by the Institut Pasteur, with backing from the Bill and Melinda Gates Foundation, the Wellcome Trust, the European Commission and the WHO.
WSJ – Brain Damage in Zika Babies Is Far Worse Than Doctors Expected
http://www.wsj.com/articles/brain-damage-in-zika-babies-is-far-worse-than-doctors-expected-
1461859591
Researchers say the Zika virus attacks lobes of the fetal brain that control thought, vision, movement. Worse than ‘normal’ microcephaly, in other words…
Health Systems & Reform – Zika Virus and Health Systems in Brazil: From Unknown to a Menace
M Castro; http://www.tandfonline.com/doi/full/10.1080/23288604.2016.1179085
“The unfolding story of Zika virus in the Americas is much more than a mosquito-borne disease that may affect fetal development. It is the story of a disease that exposed problems and raised challenges that the affected health systems and governments cannot ignore. Next, based largely on lessons provided by Brazil’s Zika epidemic, we discuss five critical problems and challenges and reflect on opportunities to remedy them. …”
Lancet (World Report) – US responds to increase in Zika cases
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30360-9/fulltext
“Health officials pursue Zika research and prepare to combat a formidable foe—the mosquito—despite uncertain funding. Susan Jaffe, The Lancet's Washington correspondent, reports.”
Some other Zika stuff:
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Zika Fight Starts to Bite Republicans Ahead of Mosquito Season (Bloomberg) (on the political battle in US Congress) ; see also AP, Obama wants $1.9B to fight Zika: Where does it stand?. And as one senator said – “The mosquitoes are coming”. Zika is about to get real in the US. Or in GOP language – “time to freak out about Zika” (as Marco Rubio warns his party).
Zika Was Present In Americas Earlier Than Thought: Study (see also Plos Neglected Tropical Diseases )
Lab findings hint that dengue antibodies intensify Zika infection (CIDRAP)
Lab study shows severe, early Zika damage to fetal brain cells (CIDRAP)
Save the Mosquitoes - We should fight Zika with better public health, not genetically modified
mosquitoes (The Jacobin – A Dawson)
Last but not least, we also want to draw your attention to an ongoing webinar series on Zika virus, organized by the HHA CoP in collaboration with WHO Geneva and ITM.
The series will consist of three main webinars on the topics:
1. Zika and biomedical aspects (27th of April) with Erika Garcia; that one already took place this week, clearly.
2. Zika and health systems response. Taking place on the 12th of May from 1-2pm GMT (3-4pm Geneva time) with Mensah Abrampah & Claire-Lise Chaignat;
3. Zika and communication aspects/community engagement, taking place on May 18th from 11:30am-1:00pm GMT (1:30-3pm Geneva time) with Gaya Gamhewage and Asiya Odugleh-Kolev.
Some practical info on these webinars: These webinars shall be conducted on the WebEx platform and each webinar shall be followed by a 30 minutes question/answering session. For those who may have questions or would like to register for these webinars, kindly send an email to
[email protected] and [email protected] with the subject line: Zika webinar.
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Global health events
WHO – Fiscal space, public financial management, and health financing: sustaining progress towards universal health coverage (26-28 April, Montreux)
http://www.who.int/health_financing/topics/public-financial-management/montreux-meeting-
2016/en/
WHO’s Department of Health Systems Governance and Financing convened representatives from national health and finance ministries and other relevant government bodies, partner agencies, foundations, initiatives and civil society organizations, to discuss priorities and opportunities for enhancing productive engagement between finance and health authorities to enable countries to sustain progress towards UHC. The meeting showcased ongoing work as part of the jointly agreed upon collaborative agenda on fiscal space, public financial management and health financing. The event was live web streamed. As somebody put it on Twitter, “#healthfinancing #UHC @WHO 100+ global experts in public finance and health policy gathered to learn and talk the same language for UHC”. The dialect of the MoF, that is.
You find all info (including the program, key messages, purpose & scope, daily summaries (at least already of day 1 last time I checked), …) on the WHO site.
“Day One: Alignment between public financial management and health financing systems from finance and health perspectives, as well as instruments to facilitate dialog and implement output-oriented reforms. Day Two: Mechanisms to inform progress on sustainability and transition planning, both related to declines in external assistance and to the mobilization, allocation, use and management of domestic resources. Day Three: Explore experience with the use of fiscal space for health analysis to inform health financing policy dialog. To ensure that the discussions and follow-on work will reflect country needs, several representatives of national health and finance ministries are expected to participate.”
For a good overview of some of the debate & presentations, see @P4HNetwork ; @larabrearley ; @asoucat …
Open-Ended Intergovernmental Meeting on the draft framework of engagement with non-State actors (25-27 April 2016)
Episode 4588 (or is it 4589?)…. in the FENSA saga. As you know, FENSA is part of WHO’s governance reform agenda launched in 2011. And not exactly the easiest bit.
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IP-Watch – WHO Debates Changes To Safeguards Against Undue Influence By
Outside Actors
http://www.ip-watch.org/2016/04/26/who-debates-changes-to-safeguards-against-undue-
influence-by-outside-actors/
This (overview) article set the scene well, ahead of the meeting. “This week a group of delegates at the UN World Health Organization is seeking to finalise agreement on a draft framework defining the organisation’s relationships with external actors, such as philanthropy, the private sector, academia, and civil society. Today, Norway put forward a potential compromise. Meanwhile, dozens of civil society organisations called on member states to stand up to pressure to compromise the intergovernmental body’s independence from private sector influence. The WHO Executive Board (EB) in January extended work of the Open Ended Inter-Governmental Meeting working on the draft Framework of Engagement with Non-State Actors (FENSA) for one last session before the World Health Assembly next month (IPW, WHO, 2 February 2016). Member states are holding a closed-door meeting on FENSA from 25-27 April. WHO declined to speak to the press about the meeting, citing the sensitivity of the talks at this stage. …” (See also TWN, WHO: Final FENSA negotiations to focus on private sector engagement. )
The aim was “to finalize the draft Framework of engagement with non-State actors, in order to submit a consensus text and a draft resolution to the Sixty-ninth World Health Assembly through the Programme, Budget and Administration Committee.”
Read also the Civil Society FENSA statement (25 April), “Save the World Health Organization from the undue influence of corporations and corporate linked entities”.
For background documentation related to FENSA, see WHO - Draft framework of engagement with non-State actors.
For the ones who want to delve deeper in some of the action at the meeting this week, read also:
(The News Minute) Is the WHO at risk of giving in to undue private sector influence?
WHO: Member States agree to prohibit private sector secondments (TWN – 26 April: K M
Gopakumar)
WHO: Norway re-opens paragraph on due diligence and risk assessment of NSA (TWN – 27 April )
WHO: Switzerland refuses to join consensus on FENSA emergency exception (TWN – 27 April)
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Coming up: fifth meeting of the High-level Group for Partnership, Coordination and Capacity-Building for statistics for the 2030 Agenda for Sustainable Development (HLG)
Will take place in Budapest (25-26 May). “The main objectives of the fifth meeting of the HLG are to review and discuss the Global Action Plan for Data and incorporate key points from issue partners, and further define the next steps in the organization of the UN World Data Forum, including an update by the host country.”
Coming up: Women Deliver's fourth global conference on the health, rights, and wellbeing of girls and women will take place from 16 - 19 May in Copenhagen, Denmark.
http://wd2016.org/
Check it out.
Global governance of health
6 th IHP+ Steering Committee Meeting – Note for the record
http://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/About_IHP_/mg
t_arrangemts___docs/Steering_Committee_as_of_2014/SC_VI/Note_for_the_record_IHP__Sixth_St
eering_Committee_Meeting_April_2016.pdf
As you know, this (rather important) meeting took place a few weeks ago. “The IHP+ Steering Committee (SC) met for the 6th time on 8th of April 2016 (in Geneva) for an extraordinary meeting called to discuss and decide whether to evolve and update the scope for IHP+ to become a UHC partnership or alliance (name not yet decided) and the way forward.” Here is a short overview of decisions, recommendations and agreed actions.
Project Syndicate – Overcoming Market Obstacles to New Antibiotics
Jim O’Neill; https://www.project-syndicate.org/commentary/market-obstacles-to-new-antibiotics-by-jim-o-neill-2016-04?referrer=/rdzZ3rNf80
We can’t view antibiotics simply as a commodity. And “$2.5 billion per year is needed to restock the antibiotics pipeline, Jim O’Neill argues.” (how about asking Apple?)
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CSIS (report) – Transitioning from Gavi Support in Lower-Middle-Income Countries: Options for US engagement in Central America
http://csis.org/publication/transitioning-gavi-support-lower-middle-income-countries
By K Bliss et al. The authors examine ways in which the U.S. can engage in Central America to ensure the smooth transition of LMICs from Gavi support.
Devex – Measles — the canary in the coalmine
Seth Berkley; https://www.devex.com/news/measles-the-canary-in-the-coalmine-88044
“Measles outbreaks are [also] the closest thing we have to an early warning system against threats to global health security.” Call it a stress test for health systems, if you want.
Action Aid (report) – The price of privilege: Extreme wealth, unaccountable power and the fight for equality
http://www.actionaid.org/publications/price-privilege
New damning report from Action Aid.
They recommend that countries and the global community in general consider how best to implement the following set of policies: “Institute a wealth tax; recognise, redistribute and reduce women’s unpaid care burden; increase corporate democracy — implement structural shifts towards employee control of companies; institute a maximum wage that is proportional to the wage paid to the most junior workers in a company; limit private finance for political parties and political campaigns.”
All common sense. And all incredibly hard to implement, for some reason (see this week’s intro). But all incredibly necessary to tackle rising inequality.
Guardian – Forget the Camerons, the African giveaway is the real Panama Papers story
Kevin Watkins (ODI); http://www.theguardian.com/news/2016/apr/26/forget-the-camerons-the-
african-giveaway-is-the-real-panama-papers-story
“Offshore accounts have helped people get rich off the continent’s natural resources – just not ordinary citizens.”
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Speri (blog) – The time has come for a progressive TTIP
Ferdi de Ville; http://speri.dept.shef.ac.uk/2016/04/25/the-time-has-come-for-a-progressive-ttip/
While I applaud Ferdi’s view, I wish him good luck in the current political environment. “With mounting concern on both sides of the Atlantic that trade politics only serves the interests of the elite, the time has come to use the Transatlantic Trade and Investment Partnership to refashion the global trading regime.”
As you know, Obama was on a TTIP PR tour in Germany this week. Don’t think he was very successful.
Washington Post – A healthy agreement
Washington Post; On TPP & access to affordable medicines. Referring to (CFR’s) Thomas Bollyky’s stats from a few weeks ago.
Critical Public Health – Policy coherence, health and the sustainable development goals: a health impact assessment of the Trans-Pacific Partnership
A Ruckert, A Schram, R Labonté et al;
http://www.tandfonline.com/eprint/3mrNebgFss3BHCdKs4Pw/full
(Some of these authors are as productive as the very best neoliberal employees, churning out papers as if it’s “just another day at the office”). “The international community, comprised of national governments, multilateral agencies and civil society organisations, has recently negotiated a set of 17 SDGs and 169 targets to replace the MDGs, which expired in 2015. For progress in implementing the SDGs, ensuring policy coherence for sustainable development will be essential. We conducted a health impact assessment to identify potential incoherences between contemporary regional trade agreements (RTAs) and nutrition and health-related SDGs. Our findings suggest that obligations in RTAs may conflict with several of the SDGs. Areas of policy incoherence include the spread of unhealthy commodities, threats to equitable access to essential health services, medicines and vaccines, and reduced government regulatory flexibility. Scenarios for future incoherence are identified, with recommendations for how these can be avoided or mitigated. While recognising that governments have multiple policy objectives that may not always be coherent, we contend that states implementing the SDGs must give greater attention to ensure that binding trade agreements do not undermine the achievement of SDG targets.”
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Guardian – Does payment by results dehumanise aid work or encourage success?
http://www.theguardian.com/global-development-professionals-network/2016/apr/25/payment-
by-results-dehumanise-aid-work-encourage-success?CMP=share_btn_tw
“Oxfam, Swift Consortium and Opportunity International share their experiences of running PbR programmes.”
UHC
Lancet (Correspondence) – No universal health coverage without primary health care
F Stigler et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30315-4/fulltext
“…We believe that the time to move the universal health coverage debate towards primary health care is now.”
The Nation - Health insurance being pushed by NRC
http://www.nationmultimedia.com/webmobile/national/Health-insurance-being-pushed-by-NRC-
30265351.html
Very worrying UHC related news from Thailand.
The Huffington Post – Mobilizing Resources to Finance Global Health Priorities
A Pabloz Mendez; http://www.huffingtonpost.com/ariel-pablosmendez-md-mph/mobilizing-
resources-to-f_b_9778548.html
On the first annual forum on Resource Mobilization for UHC of a few weeks ago. Good overview of some of the key messages by various people, including Chris Elias, Agnes Soucat, …
And also: “…Participants agreed that bringing together finance and health officials is critical for making the case that investing in health makes economic sense. Isaac Folorunso Adewole, Minister of Health for Nigeria, was adamant when he said, “We must speak the dialect of finance ministers when advocating for health, use credible data and strive for efficiency.” His words were echoed by
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Ngozi Okonjo-Iweala, former finance minister for Nigeria and now chair of the GAVI Vaccine Alliance Board, who added that the health and education communities must combine forces in their quest for more resources.”
Which begs the obvious question – does the Pentagon (and similar ministries of Defense all over the world) also need to speak the ‘dialect of finance ministers’ to get heard?
Planetary health
Coming up: WHO and the Government of France will jointly host a Second Global Conference on Health and Climate
http://www.who.int/phe/news/april2016/en/
“The Paris Agreement, adopted at the 21st Conference of the Parties (COP21) to the United Nations Framework Convention on Climate Change (and signed last week, as you know) stipulates that “the right to health” will be central to the actions taken in the global response to climate change. To build on this historic opportunity, WHO and the Government of France will jointly host a Second Global Conference on Health and Climate: “Building Healthier Societies through implementation of the Paris Agreement. The Conference will demonstrate how the public health community will support implementation of the Paris Agreement, in order to build healthier and more sustainable societies. The Conference will be held on 7–8 July 2016 in Paris, France. “
Guardian – Want to beat climate change and achieve sustainability? Try paying your taxes
TM Ryding et al; http://www.theguardian.com/global-development/2016/apr/22/paris-climate-
change-agreement-sustainability-try-paying-taxes-panama-papers
The Paris climate agreement has been signed amid much fanfare but, as the Panama Papers show, the need for global tax cooperation is greater than ever.
Project Syndicate - New Politics for Clean Energy
Jeff Sachs; https://www.project-syndicate.org/commentary/clean-energy-implementation-politics-
by-jeffrey-d-sachs-2016-04
Jeffrey has some good (as well as some dangerous post-democratic) suggestions. An example of the latter: “One key step, I believe, is to remove these issues from short-term electoral politics. Countries should consider establishing politically independent energy agencies with high technical expertise. Of course, key energy decisions (such as whether to deploy nuclear energy or to build a new
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transmission grid) will require deep public participation, but planning and implementation should be free of excessive partisan politics and lobbying. Just as governments have successfully given their central banks some political independence, they should give their energy agencies enough leeway to enable them think and act for the long term. …”
Independent – Denmark ethics council calls for tax on red meat to fight 'ethical problem' of climate change
http://www.independent.co.uk/news/world/europe/denmark-ethics-council-calls-for-tax-on-red-meat-to-fight-ethical-problem-of-climate-change-a7003061.html
Could be interesting. “Denmark is considering proposals to introduce a tax on red meat, after a government think tank came to the conclusion that “climate change is an ethical problem”. The Danish Council of Ethics recommended an initial tax on beef, with a view to extending the regulation to all red meats in future. It said that in the long term, the tax should apply to all foods at varying levels depending on climate impact.”
You might also want to read:
The political hurdles facing a carbon tax — and how to overcome them (Vox)
Poor countries must find $4tn by 2030 to avert catastrophe, says climate study (Guardian)
Infectious diseases & NTDs
Guardian – With $1bn, blinding trachoma can be eliminated in four years – experts
http://www.theguardian.com/global-development/2016/apr/26/with-1bn-blinding-trachoma-can-
be-eliminated-in-four-years-experts?CMP=twt_a-global-development_b-gdndevelopment
“Eliminating blinding trachoma worldwide within four years is “highly doable” but it would cost US$1bn, the world’s leading eye health experts estimate. The ambitious goal is backed up by the findings of a global mapping project, presented at the WHO’s alliance for the global elimination of trachoma by 2020 (GET2020) in Sydney on Tuesday.”
BMJ - What does it mean to put new hepatitis C drugs on a list of essential medicines?
http://www.bmj.com/content/353/bmj.i2035?etoc=
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“Expensive treatments for common conditions are unaffordable for most health system, even if they are cost effective. Julian Urrutia and colleagues examine how countries could respond to WHO making direct acting antivirals essential medicines.”
NCDs
WHO - WHO Global Coordination Mechanism on the Prevention and Control of Noncommunicable Diseases Engaging with the private sector for the prevention and control of NCDs
http://who.int/global-coordination-mechanism/working-
groups/final_3_1report_with_annexes_apr16_fin.pdf?ua=1
“This report is the outcome of the Working Group convened by the WHO Global Coordination Mechanism on the Prevention and Control of Noncommunicable Diseases (GCM/NCD), based on objective 3, action 3.1 of the 2014–2015 GCM/NCD work plan, to “recommend ways and means of encouraging Member States and non-State actors to realize the commitment included in paragraph 44 of the Political Declaration of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases”. The Working Group was tasked with providing recommendations to the WHO Director-General on ways and means of encouraging countries to realize their commitments to call on the private sector to strengthen its contribution to the prevention and control of NCDs in five specific areas.”
The other final report is also online now: “Financing national NCD responses in the post-2015 era”.
So the Final reports from the Working Group on engagement with the private sector (Working Group 3.1) and Working Group on financing for NCDs (Working Group 5.1) have both produced their final report now.
BMJ (Analysis) – Nicotine without smoke—putting electronic cigarettes in context
http://www.bmj.com/content/353/bmj.i1745?etoc=
“John Britton and colleagues set out why a new Royal College of Physicians report supports the role of electronic cigarettes as part of a comprehensive tobacco control strategy.”
See also Reuters, UK doctors urge wide promotion of e-cigs to help smokers quit. (Martin McKee will have to stop his anti-Brexit campaign for a couple of hours to write a reply)
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But see also this week’s Lancet editorial on, among others, electronic nicotine delivery systems: “…A new report Nicotine without smoke: tobacco harm reduction by the Tobacco Advisory Group of the UK's Royal College of Physicians, released on April 28, re-emphasises the stance taken by Public Health England last year that e-cigarettes are likely to be beneficial to UK public health since they are claimed to be much safer than smoking. But while it is understandable that the emphasis on a “safer than smoking” message to current smokers serves the harm reduction agenda, some statements seem premature at best. The press release in particular contains highly contentious messages, such as “e-cigarettes are not a potential gateway to smoking; e-cigarettes do not result in normalisation of smoking; the possibility of some harm from long-term e-cigarette use…is likely to be very small”. In each case, it is simply too soon to be so certain. Interestingly, the discussions on e-cigarettes in the USA are at the opposite end of the spectrum and are almost exclusively about
potential harms and uptake by adolescents and non-smokers….”
Guardian – Mental health laws would diminish stigma and improve the lives of millions
L Davidson; http://www.theguardian.com/global-development-professionals-
network/2016/apr/26/mental-health-law-diminish-stigma-improve-lives
“Nearly two thirds of the world either has no mental health legislation or has a law more than ten-years-old, and the 2030 agenda does not require the implementation of mental health legislation to enforce obligations, such as the right to access appropriate treatment.” That needs to change.
“…If nations comply with the CRPD (Convention on the rights of persons with disability) and other international human rights treaties, we’ll be able to see evidence that SDG3 and SDG16 are being met. Meanwhile, mental health lobbyists should press for additional indicators on SDG3 to measure mental health improvements – in particular an indicator requiring the introduction or updating of mental health legislation.”
Global Organizations Urge Coke, Pepsi to Acknowledge Soda's Link to Obesity & Curb Marketing to Kids
http://cspinet.org/new/201604201.html
From last week already. “The World Public Health Nutrition Association, World Obesity Federation, Consumers International, and health groups from around the globe are calling on Coca-Cola and PepsiCo to adopt and enforce a policy of not marketing sugar drinks to children aged 16 and under. Organized by the nonprofit Center for Science in the Public Interest in Washington, DC, the groups wrote to Coca-Cola CEO Muhtar Kent and PepsiCo CEO Indra Nooyi. The letter was also sent to the companies’ major institutional investors for their consideration at Coca-Cola’s annual meeting on April 27 and PepsiCo’s meeting on May 4.”
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Sexual & Reproductive / maternal, neonatal & child health
Save the Children (report) – Every last child
https://www.reddbarna.no/Media/dokumenter/EveryLastChild-report.pdf
A new and hard-hitting report related to ‘Save the Children’s’ new global campaign, Every Last Child.
Every Last Child shows that recent progress in fighting extreme poverty has often not reached those children who need it most – because of geography, gender, ethnicity or disability, or because they are victims of conflict. In many countries, the situation is even getting worse. So this report argues that, to overcome the financial, discriminatory and accountability barriers to inclusion, leaders across the world should make ‘Three Guarantees to All Children’: fair finance (sustainable financing of and free access to essential services), equal treatment (end discriminatory policies, norms and behaviours) & accountability of decision makers to children, their families & communities.
Plos –The Vast and Varied Global Burden of Norovirus: Prospects for Prevention and Control
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001999
“Benjamin Lopman and colleagues outline key findings from the PLOS Norovirus Collection. The global burden falls hardest on children, and efforts to develop vaccines focus primarily on this vulnerable group.”
Inside Philantropy - Two Mega-Funders Take Aim at Adolescent Sexual and Reproductive Health in Africa
http://www.insidephilanthropy.com/home/2016/4/25/two-mega-funders-take-aim-at-adolescent-
sexual-and-reproduct.html
“The funding field for global sexual and reproductive health (SRH) is pretty well populated, with some new funders entering this space in recent years. The same can't be said when comes to adolescent sexual and reproductive health (ASRH), which is considerably less crowded. On the other hand, several mega-funders are keenly interested in this area. Recently, two of these leaders came together to launch a contraception outreach program that aims to “change the way we reach teenagers with contraception, at scale.” …”
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Guardian - Founder of Bangladesh's first and only LGBT magazine killed
http://www.theguardian.com/world/2016/apr/25/editor-bangladesh-first-lgbt-magazine-killed-
reports-say-roopbaan
Very sad news.
KFF – U.S. Government Funding for Women and Family Health
http://kff.org/global-health-policy/issue-brief/u-s-government-funding-for-women-and-family-
health/
The Kaiser Family Foundation released a series of issue briefs on US government funding for women & family health. “While many U.S. programs address women and family health generally, several are focused on them directly, including: maternal and child health (MCH), which includes immunization activities; family planning and reproductive health (FP/RH); and nutrition. The accompanying papers examine U.S funding for each of these sectors. They look at funding trends over time, the top country recipients of aid, the share of funding provided to the sector within the larger U.S. global health funding portfolio, and the role of the U.S. as a donor in the context of overall donor support….” Check out the key findings.
Lancet (Letter) – Suicide in adolescent girls – Authors' reply
S Petroni, V Patel et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00693-0/fulltext
“Thomas Verberne correctly notes that suicide has become the top ranked cause of death among 15–19–year–old girls, because of very welcome declines in maternal mortality in this age group. But we disagree that by shining a light on what have long been neglected issues, such as adolescent mental health, harmful gender norms, and adolescent mortality, we are somehow being misleading…” (in a reply to a Letter from T Verberne).
Lancet (Letter) – The urgency of a sociocultural approach to adolescent men's health risk behaviours
M Bernales et al ; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30318-X/fulltext
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The authors advocate for the urgent need to include a sociocultural approach to adolescent men's health (and go beyond just individual approaches).
Access to medicines
Guardian – Shareholders urged to push for cheaper pneumonia drugs
http://www.theguardian.com/business/2016/apr/27/shareholders-cheaper-pneumonia-drugs-
shareaction-gsk-pfizer
“Shareholders are being urged to use the annual general meetings of Pfizer and GlaxoSmithKline to put pressure on the companies to lower the price of their life-saving pneumonia vaccines. ShareAction, the responsible investment charity, issued the call ahead of Pfizer’s AGM in New York on Thursday, and GSK’s annual meeting in London next week. MSF has just delivered petitions to both companies asking them to lower their vaccine prices to $5 for each child in developing countries, and plans to raise the issue at both AGMs.”
IP-Watch – Innovative R&D Financing Discussed At Geneva Health Forum
http://www.ip-watch.org/2016/04/26/innovative-rd-financing-discussed-at-geneva-health-forum/
“The recent Geneva Health Forum captured the fevered pitch in the larger ongoing conversation around innovative financing for research and development for public health. A new report on a voluntary pooled fund for neglected diseases was discussed at the forum.”
Human resources for health
Human Resources for Health - Follow-up on commitments at the Third Global Forum on Human Resources for Health: Indonesia, Sudan, Tanzania - “A commitment is a promise, a promise is a debt”
G Dussault et al; http://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-
0112-0
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“This study sought to assess actions which Indonesia, Sudan, and Tanzania took to implement the health workforce commitments they made at the Third Global Forum on Human Resources for Health (HRH) in November 2013. …“
Miscellaneous
BBC – Identity 2016: 'Global citizenship' rising, poll suggests
http://www.bbc.com/news/world-36139904
But the trend for emerging countries seems more positive than for industrialized countries (with Germany as a case in point).
The Atlantic - Harvard Has a New Center for Happiness
http://www.theatlantic.com/health/archive/2016/04/harvard-center-for-happiness/479784/
Hurray! “At a launch ceremony on Friday, the Harvard School of Public Health announced a $21 million initial investment in the happiness center. Its goal is to promote the role of what’s broadly referred to as “positive psychological wellbeing” in bodily health.” Amongst others, the center will focus on ‘primordial prevention ( which looks at ‘the risks of the risks’).
Let’s ask the Donald to fund the center.
Guardian – The global land rights struggle is intensifying
http://www.theguardian.com/global-development-professionals-network/2016/apr/27/the-global-
land-rights-struggle-is-intensifying
“A new report, written by the environmental journalist Fred Pearce, estimates that roughly 50% of our earth’s land is subject to claims from customary land users including indigenous people. But only around 10% of this land is officially recognised as belonging to these communities. This renders a huge number of people around the world – perhaps up to 2.5 billion in total – highly vulnerable to having their lands and resources taken by outside, and often more powerful, interests….”
FT – Africa’s life expectancy jumps dramatically
https://next.ft.com/content/38c2ad3e-0874-11e6-b6d3-746f8e9cdd33
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Good news, and quite welcome now that the ‘Africa rising’ narrative has come under some pressure recently. “Life expectancy in a swath of African countries since 2000 surged by between 20 and 42 per cent, providing an upbeat counterpoint to the gloom increasingly enveloping the continent….”
Rockefeller (blog) - Effective Public Health Communication in an Interconnected World
C Meyers; https://www.rockefellerfoundation.org/blog/effective-public-health-communication-in-
an-interconnected-world/
Blog related to a new Rockefeller Foundation report, Effective Public Health Communication in an Interconnected World: Enhancing Resilience to Health Crises. “KYNE and News Deeply, supported by The Rockefeller Foundation, convened a meeting on Effective Public Health Communication in an Interconnected World: Enhancing Resilience to Health Crises, held at the Bellagio Center in Bellagio, Italy, in October 2015. At the convening, 18 experts in communication, public health, and emergency response came together to detail areas of alignment and gaps. This report seeks to distill those lessons learned and contribute to the research base on public health communication in times of crisis, by detailing key takeaways from the convening. News Deeply also conducted interviews with participants, as well as external reviews with community organizations and leaders, to inform the body of the report. In addition, we have synthesized case studies from three participants across different regional contexts: the 2013–15 Ebola crisis in West Africa, the SARS epidemic of 2003 in Singapore, and the 2015 Legionnaires’ disease outbreak in New York City.”
KFF Poll: Public ranks global health lesser priority behind terrorism, human rights and climate change
Beckers hospital review;
The times are changing, and the golden era of global health (at least narrowly defined) might indeed be over. “A majority of Americans want the U.S. to either lead or take a major role in trying to solve international problems, including improving health for people in developing countries, according to a new Kaiser Family Foundation survey of the public's views on America's role in global health. However, for the ways in which the U.S. might engage in world affairs, improving the health for people in developing countries is not the public's top priority.” Some of the findings of the survey:
1. When it comes to world affairs, a majority of Americans listed fighting terrorism (64 percent), protecting human rights (60 percent), and protecting the environment and fighting climate change (51 percent) as top priorities for the president and Congress.
2. Global health, however, ranked somewhat lower on the public's priority list, with 35 percent of Americans saying it is one of the top priorities for U.S. engagement in world affairs, and 51 percent listing it as an important priority.
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3. Although improving health for people in developing countries is not among the public's list of top priorities for world affairs, two issues related to health — hunger and clean water — are named by the largest shares of Americans as the most urgent problems facing developing countries, according to the survey. …”
The Conversation - How and why China became Africa’s biggest aid donor
K Amusa et al; https://theconversation.com/how-and-why-china-became-africas-biggest-aid-donor-
57992
Recommended. Extract from a working paper titled “The political and economic dynamics of foreign aid: A case study of United States and Chinese aid to Sub-Sahara Africa”.
Foreign Policy (Feature) - Is Jim Kim Destroying the World Bank — or Saving it From Itself?
http://foreignpolicy.com/2016/04/27/is-jim-yong-kim-destroying-the-world-bank-development-
finance/
You know you have to read this …
MSF – MSF resumes Search and Rescue activities in the central Mediterranean
http://www.msf.org/article/msf-resumes-search-and-rescue-activities-central-mediterranean
“MSF has resumed search, rescue and medical aid operations in the central Mediterranean Sea, between Africa and Europe, and conducted its first operation of 2016. Due to the lack of safe and legal alternatives for people to flee and seek protection, the deadly stretch of water between Libya and Italy, which in 2015 claimed the lives of 2,892 men, women and children, is now almost the only way for thousands to reach European shores and it is already as busy as ever. “This time last year, as MSF launched our first search and rescue operation, we called the Mediterranean Sea a mass grave – and little has changed since then,” said Joanne Liu, International President of Médecins Sans Frontières. ”As crises and conflicts across the world continue to cause people to flee in their millions, the absence of a global solution to the current refugee crisis, and the European states’ policies of deterrence, as well their refusal to provide alternatives to the deadly sea crossing, continue to kill thousands. As humanitarians, we again refuse to look on from the shore….”
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Research
European Journal of Political Research – Theoretically refining the multiple streams framework: An introduction
http://onlinelibrary.wiley.com/doi/10.1111/1475-6765.12102/abstract
From the Forum Section - Theoretically Refining the Multiple Streams Framework. Guest Editors: Reimut Zohlnhöfer and Friedbert Rüb.
Warmly recommended series of 4 articles. “This introduction to the forum section on the Multiple Streams Framework (MSF) developed by John W. Kingdon argues that the conditions under which policy making takes place today increasingly resemble the assumptions upon which Kingdon built his lens. At the same time, while the framework is extremely successful with regard to citations and has been applied in various contexts that often differ remarkably from those for which the framework was originally developed, a systematic theoretical debate about the Multiple Streams Framework is still lacking. It is the intention to spark such a debate with this forum section.”
Check out also Streams and stages: Reconciling Kingdon and policy process theory (by M Howlett et al) & other articles in the Forum Series.
HP& P – 10 Best resources on… intersectionality with an emphasis on low- and middle-income countries
E Larson et al; http://heapol.oxfordjournals.org/content/early/2016/04/27/heapol.czw020.abstract
« Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. ‘race’/ ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification in isolation from one another or in an additive manner. Despite its potential use and long history in other disciplines, intersectionality is uncommonly used in health systems research in low- and middle-income countries (LMICs). To orient readers to intersectionality theory and research, we first define intersectionality and describe its role in public health, and then we review resources on intersectionality. … »
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Global Public Health – Introduction: Participatory visual methodologies in global public health
C M Mitchell et al; http://www.tandfonline.com/doi/full/10.1080/17441692.2016.1170184
“This Introduction serves to map out a range of participatory visual approaches, as well as critical issues related to the use of participatory visual methodologies in global health. In so doing, it offers both an overview of these innovative practices in global health and a consideration of some of the key questions that researchers might ask themselves in design and implementation.”
From a special issue in GPH, with also an article by EV 2014 David Musoke, Supporting youth and community capacity through photovoice: Reflections on participatory research on maternal health in Wakiso district, Uganda.
Global Public Health – Monitoring the Decade of Action for Global Road Safety 2011–2020: An update
Adnan Hyder et al; http://www.tandfonline.com/doi/full/10.1080/17441692.2016.1169306
“The United Nations Road Safety Collaboration (UNRSC) was set up in 2004 in response to the recognised need for the United Nations (UN) system to encourage efforts to address the global road safety crisis. In 2010, the UN General Assembly Resolution 64/255 declared 2011–2020 the Decade of Action for Road Safety with the overarching goal of stabilising and reducing the forecasted number of road traffic deaths by increasing activities at national, regional and global levels. In 2011, a Plan of Action for the Decade of Action, a tool to support the development of national and local plans of action, was launched. Countries are encouraged to implement activities according to the five pillars set out by the Plan of Action. The UNRSC, tasked to evaluate the overall impact of the Decade, developed and populated indicators for each pillar. Currently, 36 of 38 proposed indicators are populated by baseline data for 2010 from the second Global status report for road safety. However, gaps exist in data quality and availability on a global level. Therefore, there is an urgent need for improving data quality and availability to measure the progress of the Decade of Action.”
For a related article, see a recent systematic review in WHO Bulletin - The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis (by D Adeloye et al)
Health Systems & Reform – The Effect of Demand and Supply Side Health Financing on Infant, Child, and Maternal Mortality in Low and Middle Income Countries
D Bowser et al; http://www.tandfonline.com/doi/full/10.1080/23288604.2016.1166306
“Demand and supply side health financing programs that improve maternal and child health are being implemented more frequently, however there is limited evidence estimating their impact on
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maternal, infant and child mortality at the macro level.” The authors determined “the impact of four specific types of demand and supply side health financing programs on infant, child, and maternal mortality at the global level and by county income categories.” They conclude: “Health insurance schemes with a broad population reach, such as community based health insurance, can have a large impact on infant and under-5 mortality. Demand and supply side health financing programs, such as pay for performance and voucher programs, have a varying impact on infant, under five and maternal mortality depending on the income level of the country.”