IHP News 190: Health Systems Global roundtable discussion ...

Dear Colleagues,

The Beijing symposium is fast approaching now. As the Emerging Voices training programme already kicks off next Monday, some members of the IHP editorial team? fly to the Chinese capital this weekend. We are all looking forward to the three weeks in Beijing. No doubt all Emerging Voices and other symposium participants will hear many times ?Beijing huanying ni!.

Normally we favour guest editorials from the Global South, but this week we made an exception and asked Tobias Gerber to introduce the upcoming World Health Summit in Berlin. Angela Merkel and Fran?ois Hollande, patrons of the high profile event, will no doubt be pleased that the EU just received the Nobel Peace Prize. Well deserved, but nobody can deny that the timing could have been better. Just ask the Greeks. It will be interesting to see how keynote speakers in Berlin as diverse as Josef Ackermann and Sir Michael Marmot interpret the health impact of austerity policies in the euro zone? and we hope global health firebrand Martin McKee, if present, will also have a word with Ackermann and co.

Enjoy your reading.

Kristof Decoster, David Hercot, Ildik? Bokros, Peter Delobelle, Basile Keugoung & Wim Van Damme

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Editorial

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World HealthSummit? Research for Health and Sustainable Development

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by Tobias Gerber, Media and Communication Manager, World Health Summit

Unhealthy lifestyles are a main cause of new epidemics like non-communicable diseases (NCDs), conditions of global concern like obesity, diabetes, and mental illness. Greater awareness of the global economic risks and human suffering related to the?epidemiological?transition, as well as sustainable solutions for healthcare systems to meet the challenge of non-communicable diseases and conditions are urgently needed.

Read the editorial here

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Health Systems Global

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1.??? HP&P ? Health Systems Global, the new international society for health systems research

Dan Kraushaar et al.;

http://heapol.oxfordjournals.org

HP&P features a Roundtable discussion on the new international society for Health Systems Research that will be launched inBeijing. Check out the various viewpoints on Health Systems Global and what the society?s programme should involve, including one by four Emerging Voices 2010.

To kick off the election campaign, the IHP editorial team also wrote a (slightly teasing) blog post on the issue offering some suggestions for a ?harmonious? election process (warning: do not take it too seriously?).

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US & domestic & global health policy

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US & domestic health care

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It will come as no surprise that journals like JAMA and NEJM pay plenty of attention to the role of health care policy in theUSpresidential elections these weeks. We just flag here the various articles on domestic health care policy in both journals.

NEJM has a perspective on the shortfalls of ?Obamacare?, part of the NEJM special report on health care in the presidential election. It is argued that health care plays a bigger role than usual in the electoral clash (not exactly rocket science). In another piece, authors ponder what health care policy would look like under President Romney. JAMA also has an article on the ?Health Policy election?.

A Lancet Health Policy article explores what the health care reforms in the US and the UK could learn from each other. The UCLA center for health policy research drafted a policy note ( by S. Lavarreda et al.) on health care proposals in the 2012 presidential campaign. How do Romney and Obama differ on major components ofUS health policy, like the private insurance market, Medicare, and Medicaid.

You have the real Slim Shady, and you also have the real Mitt Romney, somewhere deep hidden. This week, the Huffington Post shed some light on the real Mitt, with an extensive article on Bain?s links with the tobacco industry, both in the US and in post-Soviet Russia. (that probably rules Mitt out for the NCD battle; even Putin makes a better champion of the cause. Unless if Mitt would consider a Clinton style ?I never had anything to do with Philip Morris? apology.)

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US & global health policy

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2.??? JAMA (viewpoint) ? The President?s Global Health Initiative at Midterm: ?Progress in the Balance

Eli Y. Adashi;

http://jama.jamanetwork.com

Given the changed environment, Adashi offers a number of recommendations for a revamped GHI. For example, focusing more on NCDs. (Romney might have a couple of interesting PPP ideas there).

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3.??? Lancet (Editorial) ? The USA?s global health work: winning hearts and minds

http://www.lancet.com

This Lancet editorial comes back on the recent KFF report outlining the US Defense department?s work in global health. The Lancet suggests that the new Office of Global Health Diplomacy also looks into the Defense Department?s global health role. There are no recommendations for a Romney administration (but we know Rumsfeld & co already know how to win hearts and minds).

Check out also a Global Post article exploring how Romney and Obama?s HIV and PEPFAR policies might differ in the future.

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4.??? CSIS report ? Improving maternal mortality and other aspects of women?s health ? the United States? global role

Phillip Nieburg;

https://csis.org

Starting from a recent visit toTanzania(by a small CSIS delegation), this report offers some policy recommendations for long term US policy priorities on women?s health.

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Global Fund

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5.??? Lancet Correspondence ? The future of the Global Fund

Simon Bland;

http://www.lancet.com

The chairman of the GF board emphasizes the fund has re-established strong leadership and is restoring the confidence of its donors. Meanwhile, both the Global Fund (in news flash 10) and the Global Fund Observer have some articles on evolving issues (like the funding model, and the decision on the fate of AMFm) in the run-up to the Board meeting in November.

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Maternal & child health

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6.??? Lancet (editorial) ? ?Child health: reducing inequities

http://www.lancet.com

This Lancet editorial introduces a Series (already published online a few weeks ago) on inequities in child health, and how to deal with it. The Series shows what causes inequities in child health, suggests improvements, and assesses cost-effectiveness. It appears that for the same investment, a focus on the poorest communities could lead to larger reductions in child mortality and stunting than would a mainstream approach?especially in countries of lowest socioeconomic status.

Check out also the Plos collection on Maternal health. The Collection on Maternal Health provides a freely available resource of published research and commentary on maternal health care with the aim of improving access to information and encouraging more progress in reducing maternal morbidity and mortality around the world. This year?s focus is on quality of care. A number of articles have been added recently.

John May and Jean-Pierre Guengant wrote a nice blog post on the CGD blog: ?A wake up call on contraceptive rates inAfrica.? They worry, and rightly so.

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7.??? First International Day of the Girl Child ? 11 October

http://www.un.org/en/events/girlchild/

On 17 November 2011, the UN General Assembly adopted a resolution designating 11 October as the International Day of the Girl Child. The first international day of the Girl Child focused on child marriage, which is a fundamental human rights violation and impacts all aspects of a girl?s life. Over 30% of girls in developing countries are married before 18 years of age; around 14% are married before the age of 15. Early marriage is a risk factor for early pregnancy and poor reproductive health outcomes. Furthermore it perpetuates the cycle of under-education and poverty. Child marriage constitutes an obstacle to the achievement of nearly every MDG and the development of healthy communities.

Sadly, the shooting of a 14-year old Pakistani girl?by the Taliban may have done more than any other humanitarian organization could have hoped to do to draw attention to this first?International Day of the Girl.

Coinciding with the Day, the global advocacy organization Women Deliver launched Catapult, ?the first online funding platform dedicated to advancing the lives of girls and women worldwide.? As girls? and women?s organizations are chronically underfunded, despite their key role in addressing inequality, harnessing the power of social networks, Catapult is intended to be the digital hub driving donations to organizations working to improve the lives of girls and women.?A new example of crowdfunding, Catapult itself is funded in part by the Gates Foundation, and is working with a variety of partners including the Global Fund for Women, UNPF, IPPF, the Akilah Institute for Women and One-Heart World-Wide. Check out their short video on how crowdfunding works.

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UHC & post-2015

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8.??? WHO Bulletin early online ? Anything goes on the path to universal health coverage? No.

Joe Kutzin;

http://www.who.int

WHO Bulletin has a few new ?early online? articles ready on health policy issues, so perhaps good to have a look on the website. In this Perspective, Joe Kutzin argues that the lack of a blueprint for health financing reforms (as advocated in the World Health Report 2010) was not meant to convey the message that ?anything goes? on the path to universal health coverage. Indeed, concerns have been raised that some reforms, often implemented in the name of expanding coverage, may actually compromise equity.

Meanwhile, happy flyer Richard Horton attended the IMF/WB annual meeting inTokyo, and noticed UHC was centre stage there (for the first time?). On Twitter, he posted plenty of interesting questions he intended to ask there, like ?Why is UHC sweeping the world?, what could be the role of the private sector, why should Ministries of Finance support UHC, etc. ?Yet, he also noticed world politics involves a lot more than health.

Earlier this month, in Nairobi (October 4-5), Partners in the Harmonization for Health in Africa (HHA) initiative convened as a follow-up to the recent Tunis Ministerial Conference for African Health and Finance Ministers. Regional Directors, senior representatives and a multidisciplinary group of technical experts from the HHA partner agencies used the opportunity to discuss how to further strengthen their support to countries in providing quality and affordable healthcare to African populations, particularly the under-served.

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9.??? Post- 2015 ? Health in the Post-2015 Development Agenda ? Call for?Papers

As we already mentioned in last week?s newsletter, WHO and Unicef are co-leading the facilitation of the global thematic consultation on health in the post-2015 development agenda. They are inviting interested individuals and groups to submit ?think pieces? on the positioning and role of health in the post-2015 agenda.

Download the call for papers?here. Manuscripts will be accepted from 5 October 2012. The final date for submissions is 15 December 2012.

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Health Policy & Financing

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10. Lancet (Comment) ? Measuring progress on NCDs: one goal and five targets

Robert Beaglehole et al.;

http://www.lancet.com

Beaglehole and the Lancet NCD Action Group propose to limit the number of priority targets to meet the global NCD mortality goal of 25% reduction by 2025 (?25 by 25?) to: tobacco control, salt reduction, treating people at high risk of CVD, reduce alcohol consumption and increase physical activity. They also urge WHO to use a population-based strategy instead of arbitrary cut-off points for hypertension and cholesterol, and call for sustained commitment and leadership to meet the predefined objectives.

WHO, on the other hand, has just published an updated draft of its Global Action Plan for Prevention and Control of NCD 2013-2020 including six objectives and multilevel actions for Member States, the WHO Secretariat, and international partners to support implementation at country level, in line with the Political Declaration of the UN High-Level Meeting of September 2011 that called upon WHO to develop a comprehensive global monitoring framework for assessing progress in the implementation of national strategies for the four main NCDs (CVD, diabetes, cancer, and chronic lung diseases):

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11. Global Public Health ? ?A question of balance?: Addressing the public health impacts of multinational enterprises in the OECD Guidelines for Multinational Enterprises

Joshua S. Yang et al.;

http://www.tandfonline.com

The global community is beginning to address NCDs, but how to increase the accountability of multinational enterprises (MNEs) for the health impacts of their products and practices remains unclear. The authors examine the Organization for Economic Cooperation and Development?s (OECD) efforts to do so through voluntary MNE guidelines. They developed a historical case study of how the OECD Guidelines for Multinational Enterprises were developed and revised from 1973 to 2000 through an analysis of publicly available archived OECD and tobacco industry documents.

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12. Sarah Boseley ? Indonesia in bold move to obtain cheap drugs for HIV

http://www.guardian.co.uk

The Indonesian government has quietly made an order that overrides Big Pharma?s patents on seven important drugs for HIV and hepatitis B, allowing local drug companies to make cheap and affordable versions for its citizens. This could turn out to be a very influential decision, at least if it?s implemented.

In other encouraging news, Sarah Boseley reported on GSK?s decision to open up the detailed data from its clinical trials to the scrutiny of scientists in a bid to help the discovery of new medicines and end the suspicions of critics that it has secrets to hide.

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13. Global Public Health ? Access to medicines, market failure and market intervention: A tale of two regimes

Owain D. Williams;

http://www.tandfonline.com

This study explores how an ?Intellectual Property Rights (IPR)/trade regime? has generated a particular set of problems regarding access to medicines despite patents on drugs being presented as economically necessary for reward and future drug innovation. These problems have also inspired and informed activities by so-called new actors in global health. This study argues that a parallel ?pro-access regime? has developed in order to correct some of the most high-profile issues associated with a dysfunctional global pharmaceutical market, especially problems regarding price and innovation that have been exacerbated by stringent global patent rights on new drugs. Therefore, the IPR/trade regime?s basic role in global-health governance diverges from how it has been framed and understood, not least of all by its constituent agents and donors. The pro-access regime encompasses new actors in health such as Global Health Partnerships, major philanthropic foundations and new access initiatives.
Check out also the book ?Access to Medicines as a human right: implications for pharmaceutical industry responsibility?.

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14. BMJ (news) ? Global operation tackles internet trade in fake drugs

Jacqui Wise;

http://www.bmj.com

An international operation to crack down on the internet trade in counterfeit and unlicensed drugs has resulted in the seizure of ?6.5m ($10.5m) worth of pharmaceuticals worldwide and the closure of 18?000 illegal online pharmacy websites. The FT (Andrew Jack) also reported on the operation.

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15. Global Public Health ? New life in old frames: HIV, development and the ?AIDS plus MDGs? approach

Marie Woodling et al.;

http://www.tandfonline.com

This article is the first critical academic analysis of the Aids plus MDGs approach. Capitalizing on this case, the authors also show the importance of framing in global health.

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16. World Mental Health day

Wednesday (October 10th) was ?World Mental Health day. The World Health Organization used the occasion to call for an end to stigma against those who suffer from depression and other mental disorders. More than three-quarters of people living with mental health disorders reside in developing countries. Eight in every 10 of those living in developing nations receive no treatment at all.

A BMJ news article had some encouraging news on mental health care in LICs this week: mental health experts hailed an investment of more than $19m for projects aimed at improving mental health in developing countries. Grand Challenges Canada, a donor body funded by the Canadian government, invited proposals for projects that would increase access, improve treatment, and reduce stigma among people with mental health disorders in developing countries. The organisation has announced that 15 projects in 14 countries will share the money.

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17. Gender action (report) ? Banking on Health: World Bank and African Development Bank Spending on Reproductive Health and HIV/AIDS in Sub-SaharanAfrica

http://www.genderaction.org

Gender Action recently released a new?report, titled ?Banking on Health: World Bank and African Development Bank Spending on Reproductive Health and HIV/AIDS in Sub-Saharan Africa?. The report, based on fieldwork in Cameroon and Uganda, reviews World Bank and AfDB projects to highlight how good quality matters as much as high quantity in reproductive and sexual health and HIV/AIDS spending.

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Global Health bits & pieces

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• The Gates foundation signed a deal with the Islamic development bank for a program to fight contagious diseases and provide food security in several countries. Check out also another article on Gates? trip in the Middle East (on the Devex website), reporting on another new partnership of the foundation (with Al Ansari Exchange) to tackle polio and neglected tropical diseases. The foundation and Al Ansari Exchange, a major foreign exchange and remittance company in the UAE, have committed $10 million over the next five years to tackle these two health challenges.

• Speaking of neglected tropical diseases, the Financial Times had a special report? on NTDs. And the ?End the Neglect? blog reported that more than 30 African governments are taking steps towards NTD control.

• Finally, IRIN featured a nice article on a five-day workshop on how to find the best available evidence for priority health issues in Afria.? Researchers called for the establishment of an Africa-based regional information hub to distribute scientific research on the continent?s top killer diseases, including HIV, malaria and tuberculosis.

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Research

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18. Health Planning & Management ? Thinking through health capacity development for Fragile States

Annabelle Mark et al.;

http://onlinelibrary.wiley.com

The purpose of this paper is to consider capacity development for healthcare in fragile states and its roles, for example, in securing civil and political stability, as well as improved health, within the various contexts prevailing in fragile settings across the world.

Yesterday, a Medicus Mundi International Network expert meeting took place in Amsterdam, hosted by Cordaid at the Royal Tropical Institute (KIT), on ?HSS and conflict transformation in fragile countries?. You find many of the presentations on the MMI website. The objective of this expert meeting was to facilitate learning and information sharing on health sector initiatives that aim to improve health outcomes, contribute to longer term, sustainable health system strengthening and conflict transformation, in order to inform programming, policy, advocacy and further research.

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Miscellaneous

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• The IMF World Economic Outlook was a remarkable document this year, the FT notes. The IMF sees threats from ?fiscal consolidation?, which marks an important stage in an ongoing intellectual shift. But as Krugman notes in today?s NYT, it?s not likely the Republicans will pay much attention; the same goes for their counterparts in theUK and EU. A Nobel prize will not change that.
• This week, the Guardian reported on a UN proposal for a social safety ?Global Fund?. Epi-analysis also had a post on this and similar proposals for global social protection schemes.
• Easterly and Sachs were both speakers at aStockholmevent ? afterwards, Easterly tweeted it had been a very peaceful encounter?
• In an article linked to the FTT debate (where there was some encouraging news this week in the EU), the FT ?reported on Douste-Blazy?s ideas for microdonations for development programs.
• Rwanda?seeks diaspora investment to cut its reliance on development aid.
• Bill Gates said he will never run for office.
• The Economist has a special report on the world economy, zooming in on the increasing within-country inequality. The magazine also offers some ?truly progressive? recommendations to do something about this inequality. A recent UNCTAD report on inclusive and balanced growth also highlighted the growing inequality, you find an overview of the key findings here.

Source: http://e.itg.be/ihp/archives/ihp-190-health-systems-global-roundtable-discussion/

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