Dear Colleagues,

 

In this week’s guest editorial, two short course participants from Ghana, Aku Kwamie and Augustina Koduah, comment on a recent African event on MDG5, held in Kampala, Uganda.

 

Enjoy your reading.

David Hercot, Kristof Decoster, Ildikó Bokros, Josefien Van Olmen, Basile Keugoung & Wim Van Damme

  

Editorial

 

Counting down on MDG 5

Aku Kwamie and Augustina Koduah 

On 27 – 28 March 2012, experts, activists and high-level government officials were invited to Kampala, Uganda, where the Africa Regional Consultation on Achieving MDG 5: Challenges, Opportunities and Lessons Learned, was held. Sponsored by Women Deliver, this meeting was the first in a series of planned regional gatherings in the run-up to 2015.  It was fitting that the first Regional Consultation should be held in Africa, given the region’s global burden of continued maternal mortalities and morbidities. The Africa Region Consultations were followed by the 126th Inter-Parliamentary Union Assembly, from 31 March – 5 April 2012, where for the first time, a resolution on maternal, neonatal and child health, “Access to Health as a Basic Right: The Role of Parliaments in Addressing Key Challenges to Securing the Health of Women and Children”, was debated among 120 countries. These meetings occur in advance of the deadline of 2015 to achieve MDG 5.

Read the rest of the editorial here


World Bank & Kim

Before and after Kim’s appointment at the helm of the World Bank, a wealth of interesting and/or provocative pieces were published. We give a short overview below.

 

Before the appointment

 

1. CFR (expert brief) – Dr. Kim and the World Bank’s Health Role

Laurie Garrett;

http://www.cfr.org/world-bank/dr-kim-world-banks-health-role/p27952

Laurie Garrett examines the Bank’s historical role in advancing worldwide health care and Kim’s high-profile efforts to combat tuberculosis and HIV/AIDS, as they both offer a sense of the challenges that could await him.

Other, perhaps more critical articles (and also must-reads) were written by Easterly (why the rush?) and Pritchett (in the New Republic, taken over on Humanosphere). Pritchett insinuated Kim’s career shows he’s more into ‘humane’ development (which he distinguishes from ‘human’ development, an aspect of development also addressed by the ones promoting national development). A nice read on the philosophical schism in the development community, in other words.

 

After the appointment

Inevitably, lots of pieces were written by experts from different disciplines on the various challenges that Kim await.

 

2. Foreign Policy – 5 Ways Jim Yong Kim can save the World Bank

Vishnu Sridharan;

http://www.foreignpolicy.com/articles/2012/04/17/5_ways_jim_young_kim_can_save_the_world_bank

The World Bank must change if it really wants to reduce poverty – some aspects of this necessary change amount to “slaughtering some of its sacred cows”.

 

A CGD blog post  pointed to the challenge of fragile states, and CGD’s Nancy Birdsall also outlined some challenges. An Oxfam  blogger  also weighed in.

Panels of experts were asked about the challenges for Kim, for example on the Guardian website and the CFR website. Meanwhile, the Bank already announced a focus on social protection.

 

3. Economist – The World Bank: Kim selection

http://www.economist.com/node/21553037

The Economist provides a good overview of the debate around Kim, for example between the ones in the development community favouring ‘Big’ development and the ones in favour of ‘Small’ development. See also a blog entry by Woolcock on this, just before Kim was appointed.

4. Chatham House – Global Health Leader Takes World Bank Helm

Devi Sridhar;

http://www.chathamhouse.org/media/comment/view/182877

For a global health point of view on Kim’s appointment, we recommend this piece by Devi Sridhar. What will Kim’s presidency mean for global health?

 

Global Fund

 

5.  Aidspan – Global Fund Urged to Re-Affirm Commitment to Aid Effectiveness and HSS

http://www.aidspan.org/index.php?issue=181&article=4

There’s a new GFO issue, as well as a brand new Aidspan report, authored by David McCoy, Aidspan’s research director, and three other researchers. The 20-page report says that the Global Fund must do more to re-affirm its commitment to the principles of aid effectiveness and health systems strengthening. You find the full report here.

Aidspan also declared that the GF cannot afford another year like 2011.

6. Sarah Boseley – Can the Global Fund’s new management change its fortunes?

http://www.guardian.co.uk/society/sarah-boseley-global-health/2012/apr/18/can-jaramillo-change-global-fund-fortunes

Meanwhile, the Guardian’s Sarah Bosely seems quite optimistic about the ongoing overhaul at the Global Fund. A related  blog post by Cynthia Schweer (on the Foreign Policy Blogs network) describes the recent restructuring of the Secretariat of the GF.

7. BMJ (news) – Development secretary says UK contribution to Global Fund depends on fund making progress on its reforms

Anne Gulland;

http://www.bmj.com/content/344/bmj.e2854?etoc=

International development secretary Andrew Mitchell has given strong backing to the Global Fund but stopped short of announcing an immediate boost in financial aid.

 

In other recent news (perhaps better described as GF “pep talk”), the GF hailed a “call by G8 Foreign Ministers for new donors to support the organization’s lifesaving work as a ringing endorsement of major reforms that are underway to strengthen the Global Fund’s management and financial oversight. The G8 Foreign Ministers meeting in Washington on April 12 also called on existing donors to meet their pledges of support and appealed to implementing countries to show leadership in taking on health challenges.”

 

Health Policy & Financing

 

8. Science Speaks – Breaking: WHO issues new guidance for discordant couples

Meredith Mazzotta;

http://sciencespeaksblog.org/2012/04/18/breaking-who-issues-new-guidance-for-discordant-couples/#axzz1sUb3RBJu

The WHO released its new “Guidance on couples HIV testing and counselling, including antiretroviral therapy (ART) for treatment and prevention in serodiscordant couples: Recommendations for a public health approach” on Wednesday. Sarah Boseley already commented.

9. Global Post – A Q&A with US global AIDS coordinator Eric Goosby – Goosby discusses the revelation that the US has accumulated nearly $1.5 billion in unspent funds intended to go to HIV/AIDS programs around the world.

John Donnelly;

http://www.globalpost.com/dispatches/globalpost-blogs/global-pulse/qa-us-global-aids-coordinator-eric-goosby

Eric Goosby discusses the revelation that the US has accumulated nearly $1.5 billion in unspent funds intended to go to HIV/AIDS programs around the world. This could explain why the Obama administration cut funding for PEPFAR in its budget proposal for 2013.

10.   Huffington Post – Summit of the Americas — Flashback and Fast Forward

Sarah Stephens;

http://www.huffingtonpost.com/sarah-stephens/cuba-doctors_b_1424736.html

Last week, the Summit of the Americas took place in Cartagena, Colombia (no doubt you heard about the commotion around Obama’s bodyguards).

Although health was not a prominent topic at the summit, at some point Obama referred to Cuban ‘medical internationalism’, an important aspect of the solidarity of Cuban people with the region and other countries of the world.  This was a somewhat weird remark, to say the least, given Obama’s overall stance on Cuba. In this Huffington Post piece, Stephens dwells on the US poaching policy of Cuban doctors.

 

11.   KFF – Gates Foundation, Brazilian Health Ministry Form Alliance To Expand Grand Challenges In Global Health Initiative

http://globalhealth.kff.org/Daily-Reports/2012/April/17/GH-041712-Gates-Foundation-Brazil-Alliance.aspx

The Gates Foundation and the Government of Brazil are developing plans and activities in the field of global health and related issues such as aid to farmers. A Latin American (ITM) short course participant argues that in this way, the Gates Foundation has increasingly an advantage over other stakeholders in developed countries because the foundation is building strong alliances with a BRICs country  (as well as a role model/benchmark for the entire Latin American region).

 

12.   Right to Health foundation – For universal health insurance

http://saludporderecho.org/wp-content/uploads/2011/02/For-universal-social-health-insurance.pdf

The Right to health foundation advocates  universal social health insurance for low and middle income countries, starting from a model of global responsibility.

 

13.   Guardian – UK aid helps to fund forced sterilisation of India’s poor

Gethin Chamberlain;

http://www.guardian.co.uk/world/2012/apr/15/uk-aid-forced-sterilisation-india

Last week, Melinda Gates held a TEDx on family planning. She will not have been pleased to learn about this news – forced sterilization still happens in India, and perhaps even worse, DFID seems to provide some of the money.

 

14.   CSIS – The End of the Golden Era of Global Health?

J. Stephen Morrison;

http://csis.org/publication/end-golden-era-global-health

Looking ahead to 2013 and beyond, Morrison predicts that, barring an unlikely quick turn to robust economic growth among advanced industrial economies, the global health agenda will remain in very difficult straits into the future. Yet, things could get much more dire if there is a collapse of bipartisanship in Washington or if the economies of major emerging powers falter.

 

15.   A Council on Foreign relations – CGD report – Incentives for Life: Cash-on-Delivery Aid for Tobacco Control in Developing Countries

Thomas J. Bollyky & Amanda Glassman;

http://www.cfr.org/global-health/incentives-life-cash–delivery-aid-tobacco-control-developing-countries/p27898

In this joint report, the authors propose applying Cash-on-Delivery Aid as a new incentive mechanism for tobacco control in low- and middle-income countries.

Check out also this article on Bloomberg Philantropies and the Bloomberg initiative to reduce tobacco use. There’s a lot of emphasis on funding support for litigation (against Big Tobacco villains).

 

16.   WHO Bulletin – Cash transfer schemes and the health sector: making the case for greater involvement

Ian Forde et al.;

http://www.who.int/bulletin/online_first/11-097733.pdf

Cash transfer schemes can be important contributors to human development and social protection. Although they have significant health benefits, they have rarely been considered an integral part of the health policy portfolio. The authors believe that a case can be made for greater health sector involvement in the design, implementation and evaluation of such schemes.

 

17.   Lancet (Correspondence) – Medicine and surgery: the yin and yang of health systems

Adam L. Kushner et al.;

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(12)60631-X/fulltext

Unfortunately, surgery remains the “neglected stepchild of global health”, in the words of Paul Farmer.

For some recent evidence on this, see the following articlein the new issue of HP&P: “Access to emergency and surgical care in sub-Saharan Africa: the infrastructure gap”

 

18.   Global Heart – Priority-Setting Institutions in Health: Recommendations from a Center for Global Development Working Group

Amanda Glassman & Kate McQueston;

http://blogs.cgdev.org/globalhealth/2012/04/making-priority-setting-a-priority-for-global-health.php

When facing a limited budget (as is the case in most LMICs) how can countries best sort multiple priorities into effective, sustainable policies? The Center for Global Development’s working group on Priority Setting Institutions for Health has been evaluating this question, particularly on how allocation decisions can be made in an informed, transparent, and fair way within the health systems of low- and middle-income countries. You find the (abstract of the)  report here.

Finally, we also want to draw your attention to the first global health ambassador (in Sweden), and to a Perspective in BMJ on  ‘The new scramble for Africa – how rich world donors are damaging health care’, in which the term ‘health colonialism’ is quite prominent.

 

Workshops & Conferences

 

  • This week, 50 experts from 13 African countries gathered in Bujumbura, Burundi for an in depth-discussion around financial access and health care financing schemes, with a specific focus on performance-based financing and selective free health care. The event was organized by the Communities of practice “Financial Access” and “Performance-Based Financing” and the University of Montreal. The workshop featured a mix of methods, sharing of experiences, a study tour (of the fascinating case of Burundi) and analysis of challenges to integrate different schemes into a holistic universal coverage strategy. A working group on “Performance-Based Financing and equity” was officially launched. For more info on this new working group, see the following blog post. We look forward to their future activities.
  • Geneva Health forum 2012: the Forum (this year’s theme was chronic diseases) ends today. For an update, check out their website. All plenary sessions were webcasted live; you can also watch them again, in case you missed them. Among others, our colleague Grace Marie Ku made a keynote speech at the opening session about the vital role of a family physician for patients with chronic conditions.

Research

 

19.   Health Systems 20/20 – Performance-based Incentives in Africa: Experiences, Challenges, Lessons

Lindsay Morgan and Rena Eichler;

http://www.healthsystems2020.org/content/resource/detail/85806/

This USAID ‘Health systems 20/20’ report traces the evolution of PBI programs in sub-Saharan Africa and shares evidence on its impact on health and health systems as well as the gaps in knowledge and practice.

20.   HP&P – Provider payment in community-based health insurance schemes in developing countries: a systematic review

P.J. Robyn et al.;

http://heapol.oxfordjournals.org/content/early/2012/04/18/heapol.czs034.short?rss=1

CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research.

Emerging voices

 

21.   Pakistan Journal of Public Health – Reforms of 2001 in Pakistan: opportunities lost in strengthening health service delivery

Asmat Malik et al.;

http://www.pakmedinet.com/18704

Another article from one of our most prolific Emerging voices, Asmat Malik from Pakistan. He explores the devolution in Pakistan from 2001, and more in particular the health delivery implications. Some opportunities were missed.

 

Development & Aid

 

You already got the main D&A news in the section on Kim’s appointment.

Some other stuff you should probably read a bit more about:

  • As mentioned last week, David Cameron was asked to chair a new UN committee tasked with establishing a new set of MDGs. Cameron (or somebody in his administration) leaked the news himself, but more importantly, the New Statesman thinks Cameron’s values (i.e. his conservatism) will impede UN progress.
  • Global Dashboard also has a number of interesting posts on the post-2015 panel (possible members, what sort of high level panel, which post-2015 goals, …)
  • A joint reportby ODI, Save the Children and UNICEF, analysed the improvement in children’s lives during the past two decades in five sectors, including health.
  • A CGD working paper explores how the Gates foundation can increase other people’s donations to fund public goods. Large, public gifts to a charity from well-known donors increase the number and size of smaller individual gifts. In this working paper, Dean Karlan and John A. List posit that the effect has to do with overcoming the asymmetry of knowledge about the quality of the charity.
  • A piece in Foreign Policy, aptly titled ‘Dirty laundry’, claims that if the West really wants to prevent developing countries from laundering money, it can start by cleaning up its own act. So far enthusiasm is underwhelming (with the exception of Norway).
  • Finally, the influence of Big Business on the G20 seems to be increasing.

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