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Dear Colleagues,
We start with a take from IHP editorial member Cesar Vargas on the ongoing COP16 in his country, Colombia.
As the world turns its attention to Colombia these two weeks (21 Oct-1 Nov) for what has been called “the biggest U.N. biodiversity conference in history“, the ‘16th meeting of the Conference of Parties to the UN Convention on Biological Diversity’ (better known as COP16 ), the summit in Cali aims to address vital issues, with among them: funding for biodiversity conservation, biopiracy, and making sure Afro-descendant communities are included in decision-making (at last). While we focus on biodiversity, however, I can not help but feel that we are still working too much in silos. Pandemic preparedness largely remains separate from the COP discussions on climate and biodiversity, for example. While the upcoming COP29 next month in Azerbaijan, which will focus on carbon reduction and adaptation, has some health related events, pandemic preparedness discussions still seem mainly reserved for other fora. I get confused.
The readers of this newsletter are no doubt well aware of the links between ecosystem balance, zoonotic diseases and global health security. We had plenty of that during the pandemic (or maybe not so much). Besides, I am not an expert on it. Yet, at the risk of sounding anthropocentric, protecting biodiversity is not just about saving species; it is also about protecting human health and preventing future pandemics. To truly prepare for and mitigate future health threats, these discussions cannot remain isolated!
Regardless, the key topics of COP16 must be our focus in the years to come. These include dealing with the colonial legacy in biodiversity agreements, setting clear financial goals for conservation, and making sure historically marginalized voices are being heard. As we gather in these high-level meetings, however, we must also ask ourselves whether big conservation efforts have been captured by private interests, turning biodiversity protection into a tool for profit. We need to carefully consider whether COP16 is a platform for real change, or simply yet another “global (PR) show of progress”. And while we’re at it, the same question can probably be asked about the upcoming COP29 in Azerbaijan…
Cesar Vargas
Over to the rest of the global health policy agenda then, with a look ahead to the coming month and a half.
Lately in global health funding circles the ‘traffic jam’ metaphor has been coined by CGD to refer to the many upcoming replenishment meetings. Beyond global health funding though, it appears that more in general, the period from end of October till early December will feature a real “traffic jam” of events, one way or another related to global/planetary health.
Cesar already referred to two of these above (COP16 & COP29). In this issue, we also pay some attention to the annual IMF/World Bank meetings (Oct 21-Oct26). An IDA related meeting (28-29 October) in the run-up to the “grand IDA replenishment finale” in South Korea (early December) is planned as well. Meanwhile, the HPSR community is (enthusiastically) gearing up for Nagasaki and the HSR symposium (themed ‘Building Just and Sustainable Health Systems Centering People and Protecting the Planet’) (18-22 Nov). INB12 (re the pandemic agreement) is soon kicking off in Geneva (4-15 Nov), and clearly a number of Board meetings from global health organisations are also scheduled in the coming weeks, as usual in this time of the year.
As you might have noticed, Putin also hosted some of his – still many – “friends” at a BRICS+ summit in Kazan this week, and in the coming weeks this newsletter will naturally also pay attention to the G20 Leaders’ summit in Brazil (Nov 18-19), preceded by a G20 health ministers & G20 joint meeting with health and finance ministers on the 31st of October (in Rio). As well as a Pandemic Fund pledging event (31 Oct), also in Rio. And I bet we forget plenty of others. Yes, including * that * election in the US (huh)…
Borrowing a leaf from Kent Buse, we end this intro however with well deserved “kudos” for the Women footballers urging Fifa to end a Saudi oil deal – news from earlier this week. Clearly, female professional footballers are far more courageous and forward-looking than their male counterparts. By the way, now that FIFA leader Infantino is the world’s ‘champ of emissions’ (more than 600.000 km in a Qatar private jet in the past three years!) I reckon it’s time for WHO to also ‘reconsider’ its partnership with FIFA. Or maybe Tedros should have a proper chat with his “good friend” Gianni one of these days? Maybe at the ‘Health Day’ at COP29…?
Enjoy your reading.
Kristof Decoster
A Lal , J Parkhurst, C Wenham; https://academic.oup.com/ia/advance-article/doi/10.1093/ia/iiae238/7824587?login=false
Very neat article. “…This article examines how GHS and UHC have been (re)constructed—from distinct policy sectors to synergistic norm regimes—through repeated contestation and interaction. Utilizing the ‘norm life-cycle’ framework to trace development across three stages (emergence, tipping-point/cascade and internalization), this study discursively analyses key texts from major crises and international agreements spanning several decades to unpack how norms and their underlying discourses and core functions have influenced each other as they evolved. The findings illustrate that GHS and UHC norms would be better understood as dynamic ‘processes’ rather than static concepts. The article concludes that GHS and UHC norms have shaped each other more significantly than previous scholarship suggests, characterizing them as continuously evolving, closely interlinked and increasingly integrated….”
We start this section with some analyses and curtain-raisers ahead of the Annual meetings, and then continue with some news snippets.
https://www.devex.com/news/5-things-to-watch-at-the-world-bank-imf-annual-meetings-108563
“Expect ongoing reforms, IDA replenishment, climate, debt and cooperation (among MDBs, with the private sector, and more.) to be key themes, even as the U.S. election looms over the proceedings.”
· See also Devex Newswire: At the annual meetings, a World Bank on the brink
“As the Bretton Woods institutions turn 80, can they successfully adapt the global financial system to 21st century challenges and keep development and climate goals alive? Plus, how the World Bank is handling U.S. election uncertainty.”
“As thousands gather for the World Bank and International Monetary Fund annual meetings, they find institutions at a crossroads. In one direction, a global financial system revamped for ending poverty in the age of climate change. In the other, a desperate fight for resources and a retreat from multilateral cooperation.”
“The World Bank and its multilateral development bank, or MDB, friends are undergoing their biggest overhaul since the Bretton Woods institutions were founded 80 years ago. It’s nothing short of an existential challenge. … ….. The next year or so “will determine whether MDBs and their shareholders can successfully adapt the MDB model to 21st century challenges or if new institutions must be conceived and created,” write Nancy Lee and Samuel Matthews at the Center for Global Development….”
“The stakes are bigger than these banks though. It’s about whether they can play a part in updating a global financial system that needs to unlock trillions of dollars in grants, low-interest loans, and private investment for lower-income countries in the next five years to keep development and climate goals alive…..”
Another analysis ahead of the annual meetings. “UN Financing for Development CSO Mechanism calls for UN-led independent review of international financial institutions amid ongoing debates around financial architecture reform; World Bank’s Evolution Roadmap reforms sputtering, with civil society expressing serious concerns over revamped Corporate Scorecard and IDA21 processes; IMF’s work on ‘emerging issues’ remains under-funded, as climate vulnerable countries insist IMF must abandon its austerity doctrine.”
Recommended read (from Tuesday). “A status check on the replenishment of the bank’s concessional fund for the lowest-income countries and the financial and policy implications.” Excerpts:
“With less than two months before the pledging conference to raise money for the World Bank’s International Development Association, its most concessional fund for the lowest-income countries, the bank’s annual meetings this week come at a pivotal moment in the negotiations. Today, the bank is hosting an IDA Forum, where it is expected to share proposals for IDA’s 21st replenishment policy priorities — a draft of which Devex obtained. The discussions so far paint a complex picture of ambitious targets, competing visions, and high stakes for the world’s lowest-income nations, which have been buffeted by headwinds from debt distress to conflict and climate change….”
“… IDA is a “lifeline” for the 77 lowest-income countries, World Bank President Ajay Banga said at a recent Reuters event. “We’re critical to their needs” and in many cases the source of half their development money, he added. This IDA21 replenishment could benefit 1.9 billion people over its three-year window, according to the bank, providing funding for everything from primary education to basic health services, clean water, agriculture, infrastructure, and institutional reforms.”
“…. Last year Banga called for the largest replenishment ever, with a target of around $100 billion, although African leaders and development advocates are calling for at least $120 billion. That $120 billion target will require some $30 billion from donors. … ….. but now reality has set in. “IDA replenishment is starting to look really, really, really difficult. That should be kind of terrifying for people,” Clemence Landers (CGD) said, adding that it looks like it will take a “herculean” effort to reach the targets…. …. The path is rocky due to a number of factors, from domestic politics to currency devaluations and more. …. …. There are many dynamics at play this week that will shape what happens at the official IDA replenishment in December — including discussions on both the money and the policies that will guide how it is used — and whether the gathering will be a success, or a let-down….”
https://www.devex.com/news/debt-levels-are-high-but-will-solutions-come-through-108564
(gated) “While various ideas have been proposed to give countries saddled with debt some breathing room, the financial picture is still bleak — and that doesn’t bode well for development.”
“A growing number of countries face unsustainable public debt loads — which are eating into their spending on development priorities — and existing systems have struggled to provide solutions. At the World Bank-International Monetary Fund annual meetings in Washington, D.C., this week, debt will be on the table, but the question is whether there will be any headway…..”
· For a bit more on this, see Devex newswire - The World Bank-IMF annual meetings mull how to solve a debt crisis “Leaders at the meetings are deliberating over how to resolve the debt situation — but must first decide what they actually want to solve…..”
“Before they can solve that problem, the heavy hitters of the international financial system have to decide what problem they actually want to solve, as my colleague Adva Saldinger explains in this look inside the debt debate. Are we looking at a short-term cash crunch, with lower-income countries in need of a financial bridge to help them get back on the road to growth? Or is this a full-blown debt crisis that demands restructuring and relief? And if it’s some combination of both, how should international financial institutions respond?....”
L H Summers & N K Singh; https://www.cgdev.org/blog/g20-independent-expert-group-report-card-strengthening-multilateral-development-banks
“A year ago, an Independent Expert Group, which we co-convened on behalf of the Indian Presidency of the G20, recommended a vision for better, bolder, bigger multilateral development banks (MDBs) as a central tool to respond to the issues facing emerging markets and developing economies (EMDEs). It entailed: (i) revamping vision, mandate and role to respond rapidly and effectively to clients addressing global and national challenges; (ii) bringing engagement with the private sector to the center through a culture of informed risk taking; and (iii) tripling direct financing and quadrupling private finance catalyzed by their efforts.”
“Our recommendations were endorsed by the G20 Finance Ministers and Central Bank Governors. The Brazilian G20 has followed up by developing a Roadmap of MDB reforms. We, nevertheless, believe we have an obligation to monitor the progress and inform public opinion.”
Overall, the assessment is not very positive…. Read why.
“New initiatives aim for swift and impactful solutions to pressing global challenges by uniting public and private resources.”
“The World Bank Group (WBG) has unveiled a set of Global Challenge Programs (GCPs) designed to help countries tackle pressing development issues with speed, scale, and impact. These GCPs are a central feature of the Better Bank initiative, representing a significant shift in how the WBG approaches global challenges. By integrating efforts across national, regional, and global levels, the GCPs aim to crowd in public and private solutions to effectively respond to difficult global issues.”
With one of them: “Enhanced Health Emergency Prevention, Preparedness, and Response: Strengthening health systems to better prepare for and respond to health emergencies on various levels.”
Kevin Gallagher et al ; https://theconversation.com/imf-isnt-doing-enough-to-support-africa-billions-could-be-made-available-through-special-drawing-rights-241428
“…. African leaders are approaching a critical year-long opportunity: in November, the first Group of 20 (G20) summit will convene (with the African Union in attendance as a member for the first time). Then in December South Africa assumes the G20 presidency. As African leaders advocate for reforms to the international financial architecture, maximising the potential of special drawing rights should be a central component of their agenda….”
By Anthony Kamande;
https://www.equals.ink/p/governments-across-the-globe-are?r=jd4sf&utm_campaign=post&utm_medium=web
“New Oxfam analysis reveals that global Commitment to Reducing Inequality (CRI) has just hit a new low. Anthony Kamande shares insights from Oxfam’s biannual CRI report that ranks 164 countries’ policies – and offers three big policy changes that should be firmly on the agenda at this week’s World Bank/IMF annual meetings.”
“… Development Finance International and Oxfam’s Commitment to Reducing Inequality (CRI) Index , which assesses 164 governments’ commitment to tackling inequality in three critical areas:
“The 2024 index shows the worst results ever since our analysis started in 2017. About nine in ten countries are implementing policies that are likely to widen the gap between the rich and poor.”
Finally, some more annual meeting snippets: via Devex newswire:
· “ the “superrich” avoid $220 billion a year in taxes, and there’s new momentum behind efforts to close those loopholes. An annual meetings side event Tuesday was standing room only — with observers spilling into the corridor and following on video screens.
A wealth tax has been moving up the agenda lately thanks to radical proposals from French economist Gabriel Zucman and has gathered support in many powerful economies, including Brazil, Germany, South Africa, and Spain. The African Union, among others, looks poised to push this agenda forward at the United Nations and at next month’s G20 summit.
· Via Devex: World Bank doubles agribusiness investment to $9B in strategy shift
“World Bank president Ajay Banga said the “strategic pivot” is a chance to advance climate-smart agriculture while boosting jobs in lower-income countries.”
“in Washington, the World Bank has pledged to double its annual agriculture and agribusiness financing to $9 billion by 2030. The bank’s president, Ajay Banga, is set to announce the pledge at the institution’s annual meetings today. This move comes as the bank faces growing pressure to tackle emissions from agrifood systems. ….”
· Link: World Bank makes progress on gender parity, but future remains unclear
“Just 20% of the bank's board are women. A working group is trying to change that.”
· Link - New paper: European civil society urges UN-negotiated way out of debt crises (via Eurodad)
“Call comes as IMF and G20 fail to take action despite worst ever debt crisis in the global south; New paper published today calls on world leaders to focus on discussing reforms at UN Financing for Development process.”
· And via the Pandemic Action’s network newsletter :
“ The G20 Taskforce on a Global Mobilization Against Climate Change, co-chaired by Vera Songwe and Maria Mazzucato released its final report A Green and Just Planet, calling for urgent action to chart a new path for economic development that reconciles growth with ambitious climate action. “
· And a few stats via ONE’s Aftershocks newsletter:
“40% of the world’s population lives in countries that spend more on debt service than health or education. That’s true for 34 of Africa’s 54 countries. At 18.5% of budget revenues, African countries are spending four times more on external debt payments this year than in 2010. That’s the highest of any region.”
“94 out of 100 countries with World Bank and IMF loans have cut spending on public education, health, and social protection over the past two years. That includes 40 out of 42 countries benefiting from the World Bank's International Development Association, the world’s largest social fund for development.”
WHO - Twelfth meeting of the Intergovernmental Negotiating Body (INB) for a WHO instrument on pandemic prevention, preparedness and response (4-15 Nov, Geneva)
GHF;
Update as of Thursday. “ “…. There is now a renewed push to see whether countries can conclude the Pandemic Treaty Talks in under eight weeks from now. In this edition, we bring you the various factors at play that are weighing down, and shaping these discussions. So while many countries, and other stakeholders are sceptical about an unrealistic December deadline, nevertheless efforts are now on to see if this will be possible at all.”
“Key actors in the negotiations on a new Pandemic Agreement are making vigorous and renewed efforts to see if countries can reach consensus and conclude these discussions in December 2024. Some of these actors reportedly include the Bureau of the Intergovernmental Negotiating Body set up in 2021 to establish this agreement, the World Health Organization led by Director General Tedros Adhanom Ghebreyesus, diplomatic sources in Geneva say. In addition, WHO member states including the Africa Group, among others, have been keen on concluding these negotiations this year. The Africa Group is reportedly discussing options this week at a retreat in Johannesburg, South Africa….”
“Sources indicated that contingency plans are being made to prepare for a special session of the World Health Assembly for a two-day meeting potentially during December 18th-20th in order to adopt the Pandemic Agreement if consensus is reached. (These dates will first need to be determined by the Executive Board of the WHO.) “
PS: “But the push to conclude the discussions by December is being triggered not only by political motivations to clinch a deal on these negotiations at the earliest, but also by the American Presidential elections scheduled for November 5, 2024, sources told Geneva Health Files…”
“Despite these and other pressures, the fundamental question will be if countries will indeed to be able to converge on their positions on key provisions in a matter of days. After all, these discussions have gone on for three years now.”
What’s pending? Quite a lot…..
And Patnaik concludes: “ One of the biggest impediments on the way to consensus remains the distrust between countries. The next few weeks will show whether delegations can overcome their positions and strike compromises. ….. In two weeks time, it will become clear whether countries are able to, and if they are keen on conclude these negotiations in 2024. The race towards the lowest common denominator in a bid to wrap up these crucial negotiations has never been greater.”
M Meurs & K Scholten; Geneva Health Files;
“… In today’s edition, we bring you a guest essay from activists at Wemos, who present the gaps in the policy response to health financing in the PPPR context. They argue that the pandemic agreement is “a chance to move towards tackling some of the wrongs in international finance, including tax loopholes and unsustainable debt piles, and to pave the way for fair and sustainable financing for global common goods for health.”
Note by Priti Patnaik: “ In the Pandemic Agreement, the perception is that developed countries have no appetite to agree to concrete obligations on financing such as a new fund. Already, most of the financing related text is now green. The only way this could be opened up, will be if some developing countries want to trade stronger obligations on prevention, in lieu for more resources, diplomatic sources indicate. The financing discussion is expected to come up in the upcoming meeting of the Intergovernmental Negotiating Body in November.”
Meurs & Scholten focus on three issues: Debt relief; Releasing resources through an effective global tax system; and the current reliance on voluntary and charity-based funding.
And conclude: “…. the pandemic agreement offers a rare opportunity to improve how the world responds to future health crises by ensuring sustainable fair financing of pandemic PPR. Tackling the crushing debt burdens faced by many low- and middle-income countries, raising new funds by reforming the global financial system to curb tax evasion, avoidance, and illicit financial flows, and commitments towards public financing of healthcare, are essential measures for equitable pandemic PPR. “
By Marine Buissonniere (Resolve to Save Lives); Guhermei Faviero (AIDS Global Public Health Foundation at the University of Miami); Christine McNab (The Independent Panel Secretariat), Samantha Rick (AVAC), Nina Schwalbe (Spark Street Advisors).
Another analysis of the current draft.
“Concluding its second funding round, the Pandemic Fund’s Governing Board approved on October 17 US$418 million in new grants designed to bolster pandemic prevention, preparedness, and response (PPR) capacities in 40 countries across six geographical regions. These grants will provide much-needed investments to strengthen disease surveillance and early warning systems, upgrading laboratories, and building health workforce. This latest allocation is in addition to the US$128.89 million approved on September 19 for five fast-tracked projects to support 10 countries impacted by the mpox Public Health Emergency of International Concern (PHEIC), bringing the total funding awarded under the second round to US$547 million, which will mobilize an additional US$4 billion for investments in PPR in benefiting countries. “
“Over 50 percent of the funds awarded under the second round are for countries in sub-Saharan Africa – the region with the highest demand for Pandemic Fund grants. Over 74 percent of the funded projects will benefit low- and lower-middle income countries.”
PS: “The Pandemic Fund’s two rounds of funding to date amount to US$885 million, mobilizing an additional US$6 billion in support of 75 countries, half of which are low- and middle-income countries. These funds will fill capacity gaps to prevent, prepare for, and respond to pandemics. …”
Ann Danaiya Usher; https://www.development-today.com/archive/2024/dt-8--2024/soul-searching-at-the-world-bank-about-how-to-finance-response-to-the-next-pandemic
(gated) “ During the covid pandemic, the World Bank, bound by its country-based model, was unable to put its considerable financial weight behind pooled procurement of vaccines for lower-income countries. Now, the bank is doing some soul searching about how it could make “day zero” financing available at the start of the next pandemic.”
R Glennerster, L H Summers et al; https://www.cgdev.org/blog/five-steps-multilateral-development-banks-can-take-now-enable-at-risk-financing-pandemics
“….much of the delay in COVID-19 vaccine deliveries to low- and middle-income countries (LMICs) resulted from their signing purchase agreements later than high-income countries (HICs). These lags in part reflect the restrictive lending criteria the multilateral development banks (MDBs) adopted for vaccine financing, which precluded countries from using MDB funds to purchase vaccines before they were approved by national regulators or by the World Health Organization (WHO) for emergency use.”
“….This blog outlines five steps that MDBs, using their standard country-based model, can take to make it possible for countries to use their loan envelopes to purchase vaccines and other medical countermeasures at-risk in the way HICs did. Crucially, these steps do not require immediate additional financing from donors or international health agencies. …”
A Strobeyko, M Kamal-Yanni, K Storeng, S Moon et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02258-X/abstract
“…. Pending the outcome of intergovernmental negotiations, WHO created the interim Medical Countermeasures Network (i-MCM-Net) as a temporary measure to coordinate the rapid development of and equitable access to pandemic products. As the global health community debates what longer-term mechanism should follow i-MCM-Net, substantial disagreement remains on governance, particularly the role of WHO. We argue that governments are primarily and collectively responsible for ensuring equitable access to essential health products and should mandate WHO with a more robust role in relation to states and non-state actors…..”
Excerpt:
“New international rules could transform and strengthen the role of WHO. The amended IHR mandate WHO to “facilitate, and work to remove barriers to, timely and equitable access by States Parties to relevant health products”9 in emergencies, putting its politically sensitive work in this area on stronger legal and political footing. With sufficient financial and political support, the amendments could allow WHO to expand initiatives such as the mRNA Technology Transfer hub and Health Technology Access Pool or launch new initiatives. The Pandemic Agreement could expand WHO's mandate further. Governments are negotiating the establishment of a Global Supply Chain and Logistics (GSCL) Network. According to draft text, the GSCL Network “shall be developed, coordinated and convened by WHO in partnership with”10 other actors as the likely successor to i-MCM-Net. Contrary to ACT-A, which was established quickly by a few public and private actors in 2020 without the involvement of LMIC governments, the GSCL Network would operate under the oversight of governments that sign on to the Pandemic Agreement….”
“However, it is also important to recognise the limits of WHO's mandate expansion…”
“Yet even without hierarchical authority over all actors involved with research and development, regulation, production, allocation, and uptake of pandemic products, we argue that WHO can exercise greater power. This situation of ambiguous authority calls for “good enough governance”, a pragmatic, feasible governance strategy that still holds the potential for meaningful change. WHO should use its political legitimacy and considerable convening power to bring actors around a single GSCL table, and establish clear ground rules for who gets a seat…..”
M Pai et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02323-7/fulltext
“Global health continues to be a field where Global North actors see themselves as leaders. Although the decolonising global health movement has exposed the deep inequities inherent within the architecture of global health, this movement, prone to elite capture, faces several institutional barriers that prevent meaningful shifts in power… “
Authors list some of these.
“Despite these challenges, it is possible for Global North institutions to decentre themselves, shift power, and demonstrate allyship. We propose some examples of what is possible for Global North allyship….” “…. We believe the biggest progress will come from leadership by Global South nations, institutions, and people, as they seek to exercise their agency and challenge the saviourism, charity model of global health. LMIC actors need to claim positions they have historically been denied in the places and organisations where decisions are made in global health, and lead an agenda centred on self-determination and self-reliance. We also propose some examples of such Global South leadership….”
They conclude: “To reimagine global health and shift power to people and institutions on the margins and the periphery, everyone in global health must advocate for and activate two forces: leadership by the Global South and allyship by the Global North. It is the synergy of these dual forces that is required to disrupt the status quo and tip the scales in transforming global health into a model rooted in justice, equity, global solidarity, and collective liberation. In an era of polycrisis and widening inequities, global solidarity and global citizenship are not mere buzzwords—they are crucial for our collective survival.”
R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02347-X/fulltext
Horton comes back on the launch of Global Health 2050: the Path to Halving Premature Death by mid-Century, a Lancet Commission launched last week at the World Health Summit in Berlin, Germany.
He sounds, rightly, combative. As we really have not other choice. Even he admits, “This latest Lancet Commission offers an extraordinary opportunity—and, make no mistake, it is an extraordinary opportunity. But one must frame it between two axes: conflict and, of course, climate change….”
Concluding: “….My point is that the political conditions in 2024 are not as propitious as they were in 2013. Except that we have, perhaps, one great advantage. I sense a strengthening resistance among us, a toughening refusal to accept the emerging status quo of human brutalisation, bigotry and prejudice, and planetary destruction. The multiple strands of existing global health activism—from climate to gender, race to peace—must be woven together into a single movement and manifesto for immediate action. Global Health 2050 offers a means and motivation to do so.”
V Sriram, S Bennett et al; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-024-01080-6
Important paper. “….”In this paper, we explore the perspectives of key global health stakeholders, specifically around the nature of evidence sought regarding HSS and its potential impact on prioritization, the challenges in securing such evidence, and the drivers of intra- and inter-organizational divergences.”
(gated) “To secure a record-high budget for the next five years, the vaccine alliance Gavi needs USD 9 billion in fresh funds, and at the same time, it is seeking permission from donors to repurpose billions of dollars that were originally earmarked for COVID-19. “Country by country, negotiations are underway,” says Gavi’s CEO Sania Nishtar.”
“Development Today asked 9 key Gavi donors how they view leftover USD 1.8b in unspent #Covid_19 money. Will donors add this on top of new pledges for #Gavi’s next #replenishment, or will they deduct them? None is asking for reimbursement.”
“Donors’ responses are mixed. @gatesfoundation has “no intention” of deducting unspent funds from future pledges. Sweden, Canada, UK are weighing options. …”
“Gavi replenishment 6.0: To secure a record replenishment for its next funding period, the vaccine alliance wants to include the USD 1.8b in unspent donor funds meant for COVID vaccines via COVAX. In addition, Gavi needs USD 9b in fresh funds.”
“The latest vaccine bonds have raised $1 billion to fund new immunisation efforts in the world's poorest countries after record demand from investors, the International Finance Facility for Immunisation (IFFIm) said.”
“IFFIm, which raises funding for the UN-backed Gavi vaccine alliance, said in a statement it had priced a $1 billion, 3-year fixed-rate bond "to fund critical vaccine research and immunisation programs." The order book for the bond topped $4 billion, IFFIm's largest order book to date, it said, with interest coming from central banks and official institutions, asset managers, insurance and pension funds and from banks.”
https://andrewharmer.org/2024/10/20/whos-investment-round-sustainably-financing-a-sinking-ship/
“According to WHO’s dedicated Investment Round (IR) webpage, the IR (which was launched in May this year) “aims to mobilise predictable and flexible resources from a broader base of donors for WHO’s core work for the period 2025–2028”. It has until the end of this year to secure pledges of approximately $7.1bn from state and non-state donors. Unfortunately, as I describe in this post, it’s having to do so at a time when its donors’ voluntary contributions (VCs) are falling significantly. I’ve evoked the metaphor of a sinking ship. To be clear, WHO is not an actual ship it’s an International Organisation, but for the purposes of artistic licence think of it as a ship that’s taking on water with its Secretariat desperately bailing. Currently, its efforts are keeping the ship afloat. But for how long?”
“The IR was launched and the pledges are rolling in – just a bit slowly. As you can see from the IR webpage, pledges currently total about $1bn (thanks to a boost via the World Health Summit in Berlin last week). So, $6bn more to go by Christmas. It’s anticipated that much of the heavy lifting in terms of pledges will happen at the G20 Leaders’ Summit in Brazil next month, the last event on the pledging calendar for 2024 (so get your wallets ready, world leaders).”
“… One major problem, as you will know if you have read WHO’s Audited Financial Statement 2023 (please tell me that, besides its author, I am not literally the only other person on the planet that has read this document – I am, aren’t I), is that donors are significantly reducing their VCs to WHO now that the pandemic has receded…. At the same time that revenue is falling, WHO’s expenses are increasing and in 2023 were the highest ever at $4111m. Despite the financing gap, WHO was able to fund its activities thanks to unspent revenue from previous years. But that ‘buffer’ money has gone now….”
Harmer concludes: “…. Ok, so where does that leave the IR? Well, it’s here! And after nearly 15 years in gestation. Unfortunately, its birth coincides with deep uncertainty around the political future of its number one donor – the United States – and also a potential financial crisis. It’s not at all clear to me how WHO will manage the evident drop in revenue and continue to do what it wants to do at its current scale. This is why I evoked the metaphor of a sinking ship. WHO’s Secretariat know that WHO’s finances are in a precarious position (not dire but not buoyant either). There are a lot of moving parts and I wouldn’t be surprised if there is a Special Session of the Executive Board in December to discuss this, as well as the IR. But let’s see. We will have a better understanding of the IR after the G20 in November. At the very least, Member States need to reaffirm their commitment to financing WHO’s GPW 14. I’m not expecting the IR to reach its $7bn target by the end of the year but, again, let’s see. For now, the Secretariat just has to keep bailing.”
“The traditional G-7 donors are facing economic headwinds; Saudi Arabia, Qatar and Kuwait are giving more to health funds.”
“At least five major funds, including some that help finance childhood immunizations and research for cures for diseases that kill millions of people each year, are seeking to replenish their coffers with about $100 billion by the end of next year. That’s creating a so-called traffic jam that threatens the future of global health financing and with it, the world’s health security.”
Eg: “Gavi, which helps bring vaccines for diseases such as cholera and measles to children in the world’s poorest countries, is “tapping the donors that have not traditionally supported in a massive way,” Nishtar said. This includes Saudi Arabia, Qatar and the United Arab Emirates. When Gavi formed in 2000, its donors were mostly western nations. Now Saudi Arabia, Qatar, Kuwait, Oman and Bahrain have pledged $267 million, part of a broader trend of Arab Gulf states becoming more prominent in multilateral humanitarian funding.”
“…. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which faces a fresh round of fundraising next year, saw pledges from Saudi Arabia, Qatar, Kuwait and the UAE quadruple in its last funding period.”
“…Across the board, foreign aid budgets are under immense pressure,” said Janeen Madan Keller, deputy director of the Center for Global Development’s global health-policy program. “Many of the major traditional donors are slashing their aid budgets.” One strategy to fill what’s ceded by traditional donors is to lean on new funders, she said. “Collectively, the group of Gulf donors have been a set of rising players that are worth watching,” she said.”
“Despite their growing role, the Arab Gulf states remain small donors for Gavi and the Global Fund and the support of these countries is not enough to top up the potential gaps left by the historically large donors….”
PS: in my opinion, only part of the solution if linked to Zucman’s G20 related taxation of wealth proposals…
https://www.devex.com/news/the-battle-for-limited-global-fund-resources-108537
“Tuberculosis has received the lowest Global Fund disease allocation for years. But now, ahead of a board decision in November, TB advocates want a fairer split. Their petition has so far garnered over 10,000 signatures.” Excerpts:
“The Global Fund provides the lion’s share of international funding for TB at 76%. But for years, advocates say the portion TB is getting as part of the fund’s global disease split — the percentage of funding that goes to each of its three priority diseases — is significantly behind HIV and malaria despite TB having the most deaths among the three diseases. In 2022, 1.3 million people died from TB while 630,000 and 608,000 died from HIV and malaria, respectively. Now TB advocates want a fairer split — 33% for each of the diseases. Their petition has so far garnered over 10,000 signatures.”
PS: “The Global Fund said it considers multiple factors when deciding on the split. While it acknowledged more resources are needed for TB, it cautioned this should not come at the cost of HIV and AIDS, and malaria, which also require increased resources….”
PS: “According to Dr. Lucica Ditiu, executive director of the Stop TB Partnership who sits on the Global Fund board as a nonvoting member, the secretariat has proposed four options for the board’s consideration. The first retains the current split where TB gets 18% for resources up to $12 billion, with incremental increases as more resources become available — an option that Stop TB said “must be totally rejected.” Under the second, third, and fourth options, TB will receive a 25% share if the available resources for country allocation reach $15 billion, $17 billion, and $18 billion, respectively, according to Stop TB.”
“Ditiu is concerned the options are pegged on high replenishment targets, which are “unrealistic” amid a challenging fundraising environment. For a country allocation of $18 billion, the Global Fund will need to raise at least $20 billion in its replenishment, she said. This is because a small portion of the money received during a replenishment is set aside for the organization’s operating expenses and other investments. The Global Fund’s Strategy Committee is suggesting the third option to the board, she added.”
“In its last replenishment, the Global Fund asked donors for $18 billion but only secured pledges of $15.7 billion. Experts say the fund could lose 1.2 billion more, as the U.S. by law cannot provide more than a third of all pledges to the fund. “A $12 billion replenishment is more of a realistic one, to be very honest with you,” Ditiu told Devex. “A low scenario will be $11 billion, in which case, indeed, everybody will be in … deep shit.”
· And via Devex Newswire re the annual IMF/WB meetings:
“One issue we are hoping van Trotsenburg (World Bank) elaborates more on this week is the critique he made earlier this year of the $45 billion received by vertical funds such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria. “The question I would have is, is this effective?” he said at the European Bank for Reconstruction and Development’s annual meeting in Armenia in May, arguing that MDBs like his own could have leveraged that into $100 billion. The Center for Global Development has also been asking whether global health funds are falling behind on financial innovation…..”
https://www.devex.com/news/new-the-union-head-says-eliminating-tb-doable-but-expensive-108538
(gated) “Dr. Cassandra Kelly-Cirino (the new head of The International Union Against Tuberculosis and Lung Disease ) says a lot of countries will continue to need international funding to tackle tuberculosis — but given the global health funding crunch, domestic commitments could become even more important.”
“…There’s movement behind a pitch for global governance reform. Denmark is supporting a push to create a so-called solidarity levy – a global tax that could be used to fund public goods (and perhaps even humanitarian action, some hope). Barbados, France, and Kenya are leading a task force that plans to design, propose, and commit to a new levy by next year’s COP30 climate summit. Some form of levy is a core plank of the new version of the Bridgetown Initiative, the Barbadian proposal for global financial reforms – Prime Minister Mia Mottley was selling the levy hard at September’s UN General Assembly high-level week. The task force now consists of 10 countries, including Denmark, which came on board 30 September….”
P Baker et al; https://www.cgdev.org/blog/2025-crucial-year-scaling-health-taxes
Coming back on the high-level Task Force on Fiscal Policy for Health, co-chaired by Mike Bloomberg, Mia Amor Mottley, and Larry Summers (of which CGD is secretariat). “The Task Force found that health taxes could raise $3.7 trillion over the next five years, while saving 50 million lives over the next 50 years, but this will require intelligent use of political strategies by national leaders, supported by multilateral agencies. This blog summarises the key findings of the report. “
And: “… In autumn of 2025, the United Nations will convene a High-Level Meeting to galvanise global action on NCDs. Turning the tide on the lack of progress on health taxes must be top of the agenda. This makes the next 12 months critical in raising the profile of the issue. A global coalition of strong country leaders, backed by civil society, academia, and multilateral agencies, is needed to take forward the Task Force recommendations, resist industrial pressure, and implement high and sustained health taxes to save lives and raise revenue for social progress…..”
Updated WHO dashboard: https://worldhealthorg.shinyapps.io/mpx_global/#3_Situation_in_focus_-_Democratic_Republic_of_the_Congo (as of 24 Oct)
https://healthpolicy-watch.news/another-rwandan-health-worker-gets-marburg/
From Africa CDC’s media briefing on Thursday. “…. cases of children coinfected with both mpox and measles are rising in the Democratic Republic of Congo (DRC)….”
“Some 2,729 new mpox cases were reported in the past week – over 90% of which in DRC and Burundi, although Liberia, Kenya and Uganda reported new cases, according to Dr Ngashi Ngongo, Africa CDC’s lead on mpox.”
“There has been an increase in mpox patients under the age of 15 being co-infected with measles in the DRC, particularly in Nord Kivu and Sud Kivu – but it is unclear whether one disease made children susceptible to the other. ….”
“… The DRC’s vaccination campaign underway in six provinces, was generally going well with over 39,000 people vaccinated. Nigeria plans to launch its vaccination campaign on 29 October…. … “We have 5.6 million doses of mpox vaccines that have been confirmed, of which 2.5 million are MVA-BN and three million of the LC16 from Japan,” said Ngongo. Close to 900,000 doses of MVA-BN are available this month October, with another 700,000 potentially available in November, which he described as being “enough, at least, for the moment, to cover the plans that we have received”. However, getting vaccines for children remains a challenge although World Health Organization (WHO) has said that the MVA-BN can be used “off label” for children at risk.”
“After weeks of struggling to increase testing, there had been a 37% increase in tests in the past week – and a big jump in test positivity from 36.5% to 63%.....”
Update from last week. “Congo needs to do more to raise awareness about mpox and the availability of vaccines, an official with the response team said [last week] on Thursday, warning the campaign to distribute the shots would take longer than anticipated… Cris Kacita, the head of Congo's mpox response team, said more needed to be done to boost vaccine uptake, adding that the ongoing vaccination campaign would last longer than the planned 10 days. "The awareness campaign has been carried out, but only timidly. These are gaps that need to be filled," he told Reuters….”
· And via Devex ( last week on Friday ) :
“Jean Kaseya …. criticized the slow pace at which financial pledges are translating into funding that first responders can use — pointing specifically to the Pandemic Fund pledge and the U.S. government's pledge of $500 million. He called on donors to release these funds “very quickly.”…”
And a link:
· TGH - Youth Initiatives Rise to Combat Nigeria's Mpox Outbreak
https://healthpolicy-watch.news/another-rwandan-health-worker-gets-marburg/
Coverage of the Africa CDC media briefing on Thursday.
“Rwanda has recorded its 63rd Marburg case …. according to officials at the Africa Centres for Disease Control and Prevention’s (CDC) weekly media briefing on Thursday. After 10 days of no new cases, a health worker who has been caring for Marburg patients tested positive for the virus on Wednesday night, Rwandan Health Minister Dr Sabin Nsanzimana told the briefing. But the health worker was vaccinated a few days ago and is “doing well” with disease presentation that was “not usual”, Nsanzimana added….”
PS: as this newsletter was about to published, we learnt yet another Marburg case had popped up…
https://healthpolicy-watch.news/rwandas-high-level-critical-care-ensures-low-marburg-fatality-rate/
From earlier this week. “After a full week of no new Marburg cases, Rwanda appears to have contained one of the biggest recorded of the deadly virus outbreaks – and with a low case fatality rate of 24%.”
“World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus, who visited the country over the weekend, praised the level of Rwanda’s critical care for patients as well as how the country deployed high-level leadership to address the viral haemorrhagic fever, which often kills over 80% of those infected. “Two of the patients we met had experienced all of the symptoms of Marburg, including multiple organ failure, but they were put on life support, they were successfully intubated and extubated, and are now recovering,” Tedros told a media briefing in Rwanda on Sunday. “We believe this is the first time patients with Marburg virus have been extubated in Africa. These patients would have died in previous outbreaks.” Tedros added that Rwanda had worked for many years to “strengthen its health system, to develop capacities for critical care and life support that can be deployed both in regular hospital care and in emergencies”….”
PS: “ …The outbreak will only be declared over once no new cases have been recorded for 21 days, potentially on 5 November. “
PS: “… the Rwandan minister of Health and Tedros also visited the site of the BioNTech vaccine manufacturing facility, announced two years ago to facilitate local production of vaccines. “
· See also Cidrap News – WHO lauds Rwanda's Marburg response as country shares initial genetic findings
“… Responding to questions from journalists, Nsanzimana said the index patient is a 27-year-old man who had been exposed to bats in a cave and that the bats in the region had been sequenced before. “
“Analysis points to single jump to humans, no red flags: Yvan Butera, MD, PhD, a researcher who is with the health ministry, said on X yesterday that all sequences share a single zoonotic origin, suggesting a single jump from animals to humans. Phylogenetic analysis shows that all sequences from patients are closely related, including four that are identical, a sign of rapid spread in a short time, he said. "While we found some mutations, none suggest the virus is spreading more easily or becoming more severe." The outbreak strain shares a common ancestor with a 2014 Marburg virus, which Butera said shows a limited mutation rate, which is a good sign. He said scientists continue to analyze the clinical data alongside genetic findings to learn more about transmission dynamics.”
· Related link: Nature News - Animal-to-human viral leap sparked deadly Marburg outbreak
As a reminder (via TWN ) : “The 16th Meeting of the Conference of Parties (COP16) to the Convention on Biological Diversity (CBD), will be held along with the 11th Meeting of Parties to the Cartagena Protocol on Biosafety (CP-MOP11) and 5th Meeting of Parties to the Nagoya Protocol on Access and Benefit Sharing (NP-MOP5). These will take place in Cali, Colombia, from 21st October to 1st November 2024 under the title “United Nations Biodiversity Conference 2024””
“Experts say UN event will be critical for world’s declining wildlife population as host nation pushes for inclusivity.”
PS: “… Gustavo Petro’s government is pushing for Indigenous people to have more of a role in protecting Colombia’s ecosystems and has said they will be at the centre of Cop16.”
“… Cop16 is the first time countries will meet to discuss global biodiversity since the Kunming-Montreal agreement in 2022 when world leaders made a series of unprecedented pledges to protect the natural world…..”
“Delegates from 196 countries are discussing progress in preserving biodiversity. So what are the sticking points?”
Is the this decade’s big deal for nature agreement still alive? … Where is the money? …. Can countries agree on biopiracy? … Will Indigenous groups play a role in decisions? … Can Colombia leverage the meeting for peace with its rebels? … How do we measure progress?
“The majority of developed countries are paying less than 50% of their “fair share” towards biodiversity finance, according to new analysis.”
“These nations contributed less than $11bn in total in 2022, the year that a landmark global nature deal, known as the Kunming-Montreal Global Biodiversity Framework (GBF), was agreed at COP15. Taking into account the historical responsibility for biodiversity loss over the past 60 years, the London-based development thinktank ODI has calculated a “fair share” for each country towards a minimum collective target agreed in 2022 aimed at raising $20bn annually by 2025 for biodiversity conservation. In 2022 – the most recent year for which data is available – only Norway, Sweden and Germany contributed their “fair share”, the analysis shows. The UK, Italy and Canada – host of the COP15 biodiversity summit, where the deal was struck – each contributed less than 40% of their share…..”
https://www.twn.my/title2/health.info/2024/hi241004.htm
“Examination of the draft decision “Digital sequence information (DSI) on genetic resources” (CBD/COP/16/2) that will be considered at the upcoming governing body meetings of the Convention on Biological Diversity and its Nagoya Protocol, uncovers a draft text unfit for delivering fair and equitable benefit-sharing from the use of DSI. “ Read why.
“Just designating key areas will not meet 30x30 target on nature loss, study says, pointing to oil drilling in parks.”
Hailemariam Desalegn (former Ethiopian prime minister) ; Project Syndicate
“The rapid decline of the planet’s biodiversity is not just an environmental issue; it threatens the economy, public health, national security, and global stability. World leaders must urgently recognize this, and start dedicating far more attention, effort, and financing to the response.”
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02350-X/fulltext
This week’s Lancet Editorial. The Lancet also reckons “…biodiversity loss is a vitally important health issue.” Read why.
https://news.un.org/en/story/2024/10/1155911
“Secretary-General António Guterres urged delegations from some 190 countries to “make peace with nature” and shore up a plan to stop habitat loss, save endangered species, and preserve our planet’s precious ecosystems as the latest UN biodiversity summit got under way in Cali, Colombia on Sunday night.”
“Discussions on mobilizing financing and getting countries to adopt plans to address biodiversity loss and protection dominate this week's U.N. Biodiversity Conference.”
“Some biodiverse developing nations want to replace it with a new fund that would give them a bigger say in how it’s run and easier access to its resources.”
“….A group of developing countries – concerned about their access to the existing fund – is pushing a proposal to establish a new fund for biodiversity under the COP. The plan is for it to replace the one created in Montreal, which is managed by the Global Environment Facility (GEF), and offer biodiversity-rich developing countries a bigger say in how it is run….”
“Global efforts to reduce greenhouse gas emissions remain catastrophically off track, with current policies putting the world on course for a 3.1C temperature rise by century’s end, the UN Environment Programme warned Thursday in its annual “Emissions Gap” report. To keep the 1.5C target alive, nations must slash emissions by 42% by 2030 – yet emissions continue to climb….”
“The G20, particularly the members that dominate emissions, need to do the heavy lifting”
· See also UN News - ‘Climate crunch time is here,’ new UN report warns
https://en.vedur.is/media/ads_in_header/AMOC-letter_Final.pdf
(October 2024) Worrying letter, among others signed by J Rockström.
“We, the undersigned, are scientists working in the field of climate research and feel it is urgent to draw the attention of the Nordic Council of Ministers to the serious risk of a major ocean circulation change in the Atlantic. A string of scientific studies in the past few years suggests that this risk has so far been greatly underestimated. Such an ocean circulation change would have devastating and irreversible impacts especially for Nordic countries, but also for other parts of the world….”
“Science increasingly confirms that the Arctic region is a "ground zero" for tipping point risks and climate regulation across the planet. In this region, the Greenland Ice Sheet, the Barents sea ice, the boreal permafrost systems, the subpolar gyre deep-water formation and the Atlantic Meridional Overturning Circulation (AMOC) are all vulnerable to major, interconnected nonlinear changes. The AMOC, the dominant mechanism of northward heat transport in the North Atlantic, determines life conditions for all people in the Arctic region and beyond and is increasingly at risk of passing a tipping point…. …. … Given the increasing evidence for a higher risk of an AMOC collapse, we believe it is of critical importance that Arctic tipping point risks, in particular the AMOC risk, are taken seriously in governance and policy. Even with a medium likelihood of occurrence, given that the outcome would be catastrophic and impacting the entire world for centuries to come, we believe more needs to be done to minimize this risk.”
E Mulcahy & R Smith; https://www.bmj.com/content/387/bmj.q2244
“Real progress is needed on fossil fuels and supporting vulnerable countries.”
“Two issues will dominate and test COP29: hastening the transition from fossil fuels to renewable energy and high income countries increasing financial support to vulnerable countries. Lower income nations, which are most exposed but have contributed the least to climate change, are proposing four priorities: ambitious new climate finance goals, more ambitious climate action plans, accelerated adaptation efforts and finance, and a sufficient response package for the loss and damage they have experienced…”
And re health, authors conclude: “ The biggest benefits to health will flow from drastic cuts in fossil fuels, rapid transition to renewable energy, and wealthy countries providing much greater support to vulnerable countries. “
“Exclusive: Those with ‘interest in keeping world hooked on fossil fuels’ should not oversee climate talks, say report authors.”
“…. The new report, produced by Urgewald and CEE Bankwatch, found Azerbaijan was set to increase its gas production by a third in the next decade, with fossil fuel companies forecast to spend $41.4bn (£31.9bn) on the country’s gas fields….”
S Srikhande et al; https://ehjournal.biomedcentral.com/articles/10.1186/s12940-024-01105-y
“To facilitate the use of the mounting evidence on how human health is inextricably linked to the health of the planet and the urgent need for measures against the escalating triple planetary crisis, the WHO has developed a repository of systematic reviews on interventions in the area of environment, climate change and health (ECH). This commentary introduces the repository, describes its rationale and development, and points to potential future evolutions. The repository aims to provide a user-friendly tool for quickly finding systematic reviews and meta-analyses on specific ECH topics….”
Coverage of a related WHO media briefing on Wednesday. “The United Nations (UN) climate change meeting, COP29, will feature a Health Day on 18 November as part of the negotiations in Baku, Azerbaijan.”
“The World Health Organization’s (WHO) Maria Neira said that the global body wants to ensure that health is “very prominent” in all the member states’ climate negotiations, which run from 11-22 November. “We have two objectives. One is making sure that everybody understands that the climate crisis is a health crisis, and that climate change is negatively affecting our health, and we need to respond to that,” Neira told a media briefing on Wednesday. “The second objective is to convince all the negotiators, participants, and member states that whatever they do to mitigate the process of climate change will have enormous potential health benefits,” said Neira, who directs the WHO’s Department of Public Health, Environment and Social Determinants of Health.”
“The Health Day will kick off with a high-level meeting on the Baku Initiative on Human Development for Climate Resilience, which aims to strengthen human development to address climate change, particularly in education, health, social protection, and green jobs and skills….”
Check out the rest of the health related events at COP29.
PS: “The WHO, in collaboration with the Wellcome Trust, is also hosting a Health Pavilion at the COP29 which aims to “ensure health and equity are placed at the centre of climate negotiations”, according to WHO. “
In-depth analysis re some of the related World Health Summit discussions.
“Those challenges were a cross-cutting theme at last week’s World Health Summit in Berlin, which devoted almost an entire day of its two-day event to health-related aspects of the climate question – from strategy sessions on how to amplify health and climate research and investments to the panels on the health damage done by fossil fuel investments. Here’s a snapshot of what was discussed. “
A few excerpts:
“…One thing is increasingly clear, however, the old research models need to be re-invented, given the urgency of the moment, said Alan Dangour, the lead on climate change at the UK-based Wellcome Trust, one of the world’s oldest health research philanthropies, which has made climate and health a key part of its new strategic portfolio, including a $25 million grant to the World Health Organization, announced at the Berlin conference. The priority, said Dangour at WHS, needs to be “delivering research that is a pathway to impact rather than purely academic research- which is what academia is classically trained to do.”
Re funding: “…. In line with the increased interest in health, donor funding at the climate and health nexus has also ballooned from less than $1 billion in 2018 7.5 – 9 billion in 2022- with further commitments since COP28, according to a landscape review of commitments by OECD donors, presented at another, more intimate WHS session, co-sponsored by Rockefeller Foundation. The Foundation has also made climate and health a key part of its strategic portfolio. ….”
“But those investments still pale in comparison to the estimated $7 trillion in direct and indirect subsidies (2022), which the fossil fuel industry is receiving from governments, including nearly $1.7 trillion in direct subsides such as corporate tax breaks, multilateral bank and other public investments, consumer price controls and other incentives. In terms of the other $5+ trillion in indirect, or ‘implicit’ subsidies, air pollution impacts on health and climate damage are among the largest uncounted costs, accounting for about 30% each, according to the International Monetary Fund. … ….Against that landscape, health actors – from UN agencies to government ministries and foundations and philanthropies – are asking themselves what kinds of catalytic investments should be at the top of the list of their ‘asks’ or conversely, at the top of donor priorities – so as to amplify the climate and health synergies. “ “At two intimae sessions on Monday and Tuesday, several dozen key players in the philanthropic world huddled together with a select group of thinkers from governments in Africa and Europe, and WHO officials to ponder the optimal entry points….”. Read what they came up with.
PS: “… to really leverage action, governments need to close the tap on fossil fuels subsidies and investments, powering most of the planet’s unhealthy development, to achieve long-term, meaningful health benefits, panelists said at another WHS closing day session, on the fossil fuel subsidy reform as “indispensable” to a healthy energy transition. “
· Finally, via LinkedIn: (Arthur Wyns)
“The Green Climate Fund has just approved it's 2nd-ever health project! After approving it's first health project in Lao in the lead-up to COP28 last year, GCF has now approved a second project, this time in Malawi. This is a sea-change from the complete lack of GCF funding going to climate and health projects. Several other health projects are in the application stage, including one for Senegal and Indonesia……”
https://news.un.org/en/story/2024/10/1156041
“Countries facing conflict, natural disasters and humanitarian crises are struggling to provide routine childhood immunisations leaving many children vulnerable to the resurgence of polio, the UN Children’s Fund (UNICEF) warned in new report. “
“On World Polio Day, UNICEF has issued a stark warning: polio cases in fragile and conflict-affected countries have more than doubled over the past five years, with 85 per cent of the children affected by the disease in 2023 living in these regions. “In conflict, children face more than bombs and bullets; they are at risk of deadly diseases that should no longer exist,” said UNICEF Executive Director Catherine Russell. A new analysis from the agency highlights that vaccination coverage has dropped from 75 to 70 per cent, far below the 95 percent needed to achieve community immunity. …”
· And a tweet from L Gostin:
“How ironic & tragic that @WHO & partners were forced to postpone its vaccination campaign in Northern Gaza on World Polio Day. Conflicts must never prevent public health & humanitarian work. That’s required under international law & basic ethics.”
S Gilmour & S Rahman; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02291-8/fulltext
Excerpt: “…The Lancet is the flagship journal on global health and has a long history of engaging with debates on infant and child health, yet its editorial board remains notably silent on the mass murder of children in Gaza. Its continued silence on this issue raises two questions, which we believe the editorial board need to address if they wish to retain any credibility with their global health readership. How are we to trust the Commission on Health, Conflict, and Forced Displacement that The Lancet announced on March 30, 2024, if you are unwilling to comment on or even report the mass murder of children in Gaza? And does The Lancet's refusal to comment on or even to report these atrocities arise from editorial priorities or other, more political concerns?”
(24 Oct).
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02349-3/fulltext
“Israeli military operations in Gaza have decimated child health, resulting in a “lost generation”. Sharmila Devi reports.”
“Due to the escalating violence, intense bombardment, mass displacement orders, and lack of assured humanitarian pauses across most of northern Gaza, the Polio Technical Committee for Gaza, including the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners have been compelled to postpone the third phase of the polio vaccination campaign, which was set to begin today. This final phase of the ongoing campaign aimed to vaccinate 119 279 children across northern Gaza…..”
· Related (from earlier this week): Telegraph - Fighting in Gaza limits vaccine access in ‘dangerous’ polio red zones
“Health workers will not send vaccine teams into outbreak hotspots unless their safety can be guaranteed.”
“Health workers in Gaza are concerned polio vaccines won’t reach the north of the enclave because of ongoing fighting. The United Nations and World Health Organization (WHO) launched the second round of a polio vaccination campaign in Gaza on Monday, targeting 590,000 children under the age of 10. “We are concerned about the north because of the repeated evacuation orders, including for the hospitals and populations around that,” said Rik Peeperkorn, the WHO’s representative in the Palestinian territories. “We cannot afford to falter in the second round. We need to stop this transmission of the poliovirus.” Mahmoud Shalabi, Deputy Director of Programmes at Medical Aid for Palestinian’s (MAP), said that he is “still unsure” if the polio campaign will be able to go ahead in northern Gaza, adding that he will “not send [his] colleagues to red zones, as it is too dangerous”. “We need a ceasefire and assurances that humanitarian workers will not be targeted,” he told The Telegraph. “
https://www.theguardian.com/world/2024/oct/22/ruined-gaza-economy-un-report-israel?CMP=share_btn_url
“Report says ‘intense military operations in Gaza have left unprecedented humanitarian, environmental and social catastrophe’.”
https://news.un.org/en/story/2024/10/1155971
“The head of UN Palestine refugee agency UNRWA appealed on Tuesday for an immediate truce in northern Gaza in a social media post describing how “three weeks of non-stop bombardments” by Israeli forces have impacted the region.”
“UN Women says figure doubled in 2023 amid ‘blatant disregard’ of laws that left women and children unprotected.”
“The proportion of women killed in conflicts around the world doubled last year, with women now accounting for 40% of all those killed in war zones, according to a new report by the United Nations. The report from UN Women, which looks at the security situation for women and girls affected by war, says UN-verified cases of conflict-related sexual violence also rose by 50% in 2023 compared with 2022….”
https://www.thelancet.com/commissions/gambling?dgcid=tlcom_carousel4_lanpubgambling24
“The global gambling industry is rapidly expanding, with net losses by consumers projected to reach nearly US$700 billion by 2028….”
Via the press release:
“Gambling harms are far more substantial than previously understood, exacerbated by rapid global expansion and digital transformation of the gambling industry. Harms from gambling include physical and mental health problems, relationship breakdown, heightened risk of suicide and domestic violence, increased crime, loss of employment and financial losses. An estimated 80 million adults globally experience gambling disorder or problematic gambling. The harms of gambling are not evenly distributed; adolescents, children and those from disadvantaged socio-economic groups are more at risk. Lower- and middle-income countries are less equipped to regulate the industry and deal with the harms it generates. Effective and well-resourced regulatory controls and international leadership are urgently needed to reduce the impact of commercial gambling on public health and protect progress on UN Sustainable Development Goals.”
Related Editorial - Time for a public health response to gambling
· Coverage via the Guardian - Gambling poses huge global threat to public health, experts warn
https://www.srpoverty.org/2024/10/01/the-burnout-economy-poverty-and-mental-health/
By Olivier de Schutter (UN Special Rapporteur on extreme poverty and human rights)
See also a Two-pager summary.
“Rapid urbanisation thought to be damaging adolescent health, as researchers say need for medication and diagnostic tests is urgent.”
“Millions of teenagers in Africa are suffering from asthma with no formal diagnosis as the continent undergoes rapid urbanisation, researchers have found. The study, published in the Lancet Child and Adolescent Health, involved 27,000 pupils from urban areas in Malawi, South Africa, Zimbabwe, Uganda, Ghana and Nigeria. It found more than 3,000 reported asthma symptoms, but only about 600 had a formal diagnosis. … …. The Achieving Control of Asthma in Children and Adolescents in Africa (Acacia) study recruited pupils aged between 12 and 14. Screening revealed that while 12% reported asthma symptoms, only 20% of that group had received a formal diagnosis of asthma….”
https://healthpolicy-watch.news/new-initiative-to-boost-east-africas-medical-oxygen-supply/
“A sod-turning ceremony in Mombasa, Kenya, on Tuesday marked the launch of the East African Programme on Oxygen Access (EAPOA), which aims to massively boost access to medical oxygen in the region.”
“Unitaid is investing $22 million in support for Kenyan manufacturers Hewatele and Synergy, and Tanzania Oxygen Limited to set up Africa’s first liquid oxygen regional manufacturing initiative.
…The initiative is projected to save 154,000 lives in the two countries alone over the next decade, with the three manufacturers expanding the production capacity threefold by over 60 tons per day, enabling treatment of thousands of additional patients each month….”
“….“This is Africa’s first regional manufacturing approach to increasing access to medical oxygen,” according to Unitaid, which is working with governments in both countries and other partners. “The program aims to expand medical oxygen production by 300% in East Africa and reduce oxygen prices by up to 27%, making it more affordable for health care systems across the region, and enabling treatment of thousands of additional patients each month,” added Unitaid in a media release.”
PS: “The Clinton Health Access Initiative (CHAI) will lead on market strategy, while PATH will focus on community and civil society engagement. “
“Blended financing: “Using an innovative blended financing approach that combines grants awarded to Unitaid by Canada and Japan, concessional loans, and support from MedAccess through volume guarantees, this program will strengthen the capacity of Kenyan and Tanzanian oxygen suppliers, fostering competition in the market and ensuring a sustainable, affordable oxygen supply across East and Southern Africa,” according to Unitaid. … The EAPOA aims to develop a regional network of liquid oxygen production facilities, known as air separation units, to ensure medical oxygen reaches underserved communities.
PS: “ … The program is part of a broader Unitaid strategy to increase regional and local production of essential health products in Africa, in line with continental initiatives to enhance health security, such as Africa CDC’s Partnership for the Harmonization of African Health Products Manufacturing.”
· See also Devex - Blended finance expands medical oxygen production in East Africa (gated) & Devex check-up - Devex CheckUp: A breath of fresh air for Africa’s medical oxygen supply
“Updated analysis from Africa CDC, CHAI, and PATH can help inform pathways forward.”
https://medicalxpress.com/news/2024-10-world-cholera-vaccine-stockpile.html#google_vignette
“There are no more oral cholera vaccines left in the global stockpile, the World Health Organization said [last week on ] Friday, with the shortage jeopardizing work to stop the disease's spread. … …. Global vaccine production is operating at full capacity, but demand is outpacing supply, the UN health agency said in its monthly situation report.”
PS: “In April, the Gavi vaccine alliance and the UN children's agency UNICEF said South Korean firm EuBiologics was currently the only oral cholera vaccine supplier to the global stockpile, although other manufacturers were expected to have products available in the coming years……”
· See also Stat - In 2024, fewer cholera cases than last year but a spike in deaths
“From the beginning of this year to the end of September, there were 439,724 cases of cholera worldwide and 3,432 deaths, WHO announced Friday. The number of cases is 16% lower than last year, but there’s been a 126% spike in deaths. … …. The increase in deaths may have to do with where the outbreaks have occurred this year, according to the organization — areas affected by conflict and compromised access to health care, hit with massive flooding, or with inadequate medical facilities. Countries particularly struck by the disease include Afghanistan, Sudan, the Democratic Republic of the Congo, and Nigeria.”· And via Cidrap News - Global cholera deaths are surging, WHO says
‘Moral threshold coming down,’ warns Mo Ibrahim, as his index of governance reveals widespread decline in 10 years.”
“The global rise of populism and “strongmen” has led to an increase in authoritarianism in Africa that is holding back progress in governance, the businessman and philanthropist Mo Ibrahim has said. According to the latest edition of the Ibrahim index of African governance, 78% of Africa’s citizens live in a country where security and democracy deteriorated between 2014 and 2023….”
“… The report said the result had been a stalling of progress in governance across Africa, with effects on health and education, though the results were not uniform across the continent, with half the countries experiencing deteriorating overall governance and the other half seeing progress.”
PS: “Despite signs of progress in many countries, the public perception of how well governments are performing has dropped, especially in relation to economic opportunities, security and poverty. Ibrahim said this could be due to heightened expectations and also greater access to information from other parts of the world….”
White paper building on a previous June 2023 paper.
· Related introduction to the White Paper by CEO Mark Suzman - How strategic financing can drive progress on development and climate “Discover how strategic financing can drive real progress on development and climate goals. Our latest white paper, introduced by Mark Suzman, outlines key principles that can help us shape a more sustainable future. “
“The World Health Organization (WHO) and the Kingdom of Saudi Arabia announced a new milestone digital health collaboration today to expand the Hajj health card initiative to support the roughly 3 million pilgrims who undertake the holy pilgrimage every year. The Hajj health card, built on the WHO Global Digital Health Certification Network’s public key infrastructure, summarizes critical health information, such as medication needs, allergies, immunization status and pre-existing conditions. The card gives individuals agency over their own health information when they travel to Saudi Arabia so that they can provide authorized health providers access to accurate, up-to-date patient summary information and obtain personalized quality care…..”
https://twn.my/title2/unsd/2024/unsd241001.htm
“More than 100 States, civil society organizations (CSOs), statelessness-led entities, academics and other stakeholders have formed a new Global Alliance to End Statelessness, aimed at addressing the grave inequity faced by millions of people around the world denied a nationality, according to UNHCR, the UN Refugee Agency. UNHCR said the Global Alliance, which builds on the decade-long #IBelong campaign, was officially launched by UN High Commissioner for Refugees, Mr Filippo Grandi, during the annual Executive Committee meeting of UNHCR, which began on 14 October….”
Thomas Bollyky ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02268-2/fulltext
A few excerpts – re Fauci’s memoir.
“What changed between AIDS and COVID-19? Fauci's memoir offers an insider's view of rise and fall of an era in #globalhealth: one that was focused on infectious diseases, driven by technology, broadly supported & largely American-led” “
“The need for timely science and the role of the USA in global health is not disappearing. But, like COVID-19, the world's next most pressing health problems—climate change, future emerging pathogens, and the fast-rising global burden of chronic diseases—will not be solved by vaccines and donated medical interventions alone. Navigating these threats will require governments, people, and industries to adopt large-scale changes, often not because of the risk to themselves but because of the outsized risk to others. The success of that effort depends on more empowered local governments and regional authorities, sustained investment in domestic public health, and mobilising the cooperation of communities, even those with historical reasons to mistrust.”
By L Husain et al.
H S Sajadi et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02248-7/fulltext
“….The 71st committee meeting of WHO's Regional Office for the Eastern Mediterranean (EMRO), scheduled for Oct 16, 2024, in Qatar, under the slogan “Health beyond borders: action, access, and equity” is a significant and much-needed initiative. The main expected outcomes of the technical event are to develop standardised methods for assessing the health effects of economic sanctions and establish advocacy channels for addressing these issues. Of the 22 countries and territories in the WHO Eastern Mediterranean region, 11 are currently under economic sanctions, other restrictive sanctions, or both,4 making this initiative a crucial step forward. Although some countries have endured economic sanctions for decades, this effort marks progress. Our 2022 study outlined additional measures that should be taken to mitigate the effects of economic sanctions…”
E Banin et al; https://www.cgdev.org/blog/without-action-ida21-will-become-missed-opportunity-women-and-child-crisis-affected-areas
“…Unfortunately, the proposed IDA21 policy package reflects further backtracking on gender equality and childcare, and it misses opportunities for ensuring resources go to FCS countries. It is critical that action is taken in the upcoming replenishment meeting scheduled for October 28-29, 2024…..”
https://impact-investor.com/new-blended-finance-health-fund-seeks-high-impact-in-africa/
See also previous IHP newsletter issues. “ The Transform Health Fund aims to provide a template for blended finance in Africa’s healthcare sector. Following the fund’s close, we talk about progress so far with Martin Edlund of the Health Finance Coalition, one of the fund’s founding organisations.”
“…. Thus far, the fund has already committed $20m in financing to three companies. Africa Healthcare Network is the largest dialysis chain across sub-Saharan Africa. Lapaire Glasses provides a network of shops, providing affordable eye care products and services in six West and East African countries. Finally, Insta Products produces ready-to-use therapeutic food for millions of malnourished children and mothers across sub-Saharan Africa, which are bought and distributed by international NGOs….” “Edlund said these companies were chosen for their high impact on the poorest communities. “
“…. IDinsight, in partnership with the Gates Foundation, mapped Kenya’s health system's financial and non-financial information flows and explored the pathways to accountability in the data flow process. This report presents the findings of that exercise, undertaken between September 2023 and June 2024. ….”
"Overall, the integration of financial and non-financial health data is limited; when it happens, it is ad hoc. As a result, it is difficult to ascertain if the allocations within the health sector budget (determined mainly by planning ceilings) and made on a line-item basis are effectively allocated to priority health programs."
https://gh.bmj.com/content/9/10/e014610
By Aloysius Odii et al.
H K Bosa, J Kaseya et al ; https://africacdc.org/download/how-to-prepare-for-the-next-inevitable-ebola-outbreak-lessons-from-west-africa/
“Many lessons have been learned 10 years after the Ebola virus disease outbreak in West Africa, but urgent work is now needed to prevent another outbreak.”
https://www.tandfonline.com/doi/full/10.1080/17441692.2024.2415499#abstract
By J Rietveld et al.
“A look at the key sticking points behind setting new climate finance targets.”
A Banga, F Haddad et al; https://www.project-syndicate.org/commentary/tropical-forest-forever-facility-how-it-will-work-by-ajay-banga-et-al-2024-10
“While forest carbon markets have created new revenue streams, they usually reward only those countries, communities, or project developers who are focused on reducing their emissions from deforestation. Something more is needed to tie financial rewards to forests that aren’t under immediate threat.”
“…. The World Bank Group is also working to turn the vast potential of carbon markets into an income stream for developing countries that are committed to reducing emissions and conserving their forests. Already, 15 countries are benefiting from a pipeline that could produce more than 24 million carbon credits by the end of 2024 – a win for both the climate and development…. But those engaged in these efforts have long been dogged by the question of how to support the conservation of standing forests over the long term. While forest carbon markets have created new revenue streams, they usually reward only those countries, communities, or project developers that are focused on reducing their emissions from deforestation. Thus, forests that are not under immediate threat offer no financial reward. One solution is the proposed Tropical Forest Forever Facility, a large-scale, performance-based mechanism that would use blended finance to generate financial returns and reward countries for protecting their standing forests. Instead of carbon credits, the TFFF would provide predictable long-term financial support linked to a country’s hectares of standing forests, thus aligning economic incentives with environmental outcomes.
Led by the Brazilian Ministry of Finance and Ministry of Environment and Climate Change, and in partnership with other tropical-forest countries, developed economies, and non-traditional sponsors, the TFFF aims to leverage sovereign and philanthropic funding to mobilize more private capital, thus expanding forest finance beyond purely public-sector tools. Crucially, it would allow private investors to support a global public good by quantifying and verifying the underlying asset on terms aligned with their business models…..”
PS: We didn’t include this new Facility in the Highlights section, you might have noticed : )
https://www.chathamhouse.org/2024/10/azerbaijans-climate-leadership-challenge
“What’s at stake at COP29 and beyond.”
“….This paper assesses Azerbaijan’s prospects for brokering a meaningful summit outcome, and for contributing to a wider schedule of climate and environmental responsibilities over the next two years, including as a member of the COP ‘Troika’ (with the UAE and Brazil) and as host of World Environment Day in 2026. “
“Two evolutionary biologists speak to Science about the disparities in how some geographic areas are represented in biodiversity research.”
“Even though tropical regions in the Global South—broadly countries in Latin America, Africa, and Asia—are home to many more animal species and have richer biodiversity, species from the Global North are more often cataloged in a genomic database scientists use for research and decisions to guide conservation efforts. That’s the major finding of a new study published this week in Molecular Evolution….”
V Diamond & S Gupta; https://www.cgdev.org/publication/how-enhance-appeal-imfs-climate-transition-facility
“The IMF’s Resilience and Sustainability Facility (RSF) is now two years old. Since its inception, 20 countries have accessed the RSF, with Costa Rica and Jamaica recently becoming the first to complete their programs. The RSF has substantial funding available, with $47.2 billion pledged by donor countries as of June 2024, of which only $9.5 billion has been committed so far (taking 1 special drawing right to be worth $1.33). Yet demand for new RSF programs appears to be declining despite the significant climate finance needs in many lower- and middle-income countries…..”
“To enhance the RSF’s appeal, we propose three recalibrations to program design: first, for countries with repeat RSF programs, a concurrent IMF upper credit tranche (UCT) program should not be required for at least one additional RSF arrangement; secondly, access limits should be raised for strong performers; and thirdly in the case of small developing states (SDS) which are particularly vulnerable to climate shocks, the IMF should pilot waving the UCT program requirement and increase SDS access limits, as current arrangements provide minimal funding due these country’s small size. To ensure that other countries are treated equally, we suggest the RSF pilot these changes for SDS first…”
“Cities that fail to take meaningful climate action face a future of severe degradation with infrastructure collapse and environmental deterioration, warned climate and health experts at the yearly Academy of Medical Sciences & The Lancet International Health Lecture in London. “
“…. Mark Nieuwenhuijsen (keynote speaker) presented European cities as falling into one of four groups: compact high-density cities, open low-rise medium-density cities, open lowrise low-density cities, and green low-density cities….”
“The more compact a city, the more efficient. Yet compact cities have potential drawbacks, including higher mortality rates, traffic density, air and noise pollution, and excess heat.
“… greener and less densely populated cities have lower mortality rates, lower air pollution levels, and a lower urban heat island effect, but higher carbon footprints per person.”…”
“… This dichotomy – where current urban configurations are either high emitters with better health quality, or lower emitters with worse health – means that cities must implement policies that better health and reduce emissions. Nieuwenhuijsen believes that both are possible. Policies that lower air pollution levels and reliance on cars, and increase green space, cycling lanes, and physical activity would “substantially reduce the mortality rate,” he argued. Several cities have begun implementing innovative urban models that bridge the goals of lower emissions and healthier environments, especially in how they use public land…..”
“Global heating particularly increasing risk of death from smoke inhalation in Australia, South America, Europe and parts of Asia.”
· Related – Carbon brief - Climate change almost wipes out decline in global area burned by wildfires
https://www.nature.com/articles/d41586-024-03431-0
“Support for a moderate environmental group rose after a motorway closure, substantiating the ‘radical flank effect’.”
A Lambrechts et al. https://www.climatechangenews.com/2024/10/21/its-time-to-pull-down-the-uns-artificial-divide-between-biodiversity-and-climate/
“The biodiversity and climate crises are interlinked – and failing to coordinate our response leaves critical ecosystems like forests and peatlands at risk .”
“Rising global temperatures have warped the earth’s natural cycles, causing once easily predictable events to become increasingly erratic.”
Grazia Pacillo et al; https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000280
“…. This paper introduces the Integrated Climate Security Framework (ICSF), a comprehensive mixed-methods approach designed to unravel the complexities of climate-human security-conflict sconnections across various scales.” With Kenya as a case study.
“Idea would cost trillions, but could avoid issues with other “geoengineering” schemes.”
“A mere 5 million tonnes of diamond dust sprinkled in the skies each year could cool the climate by 1.6 ℃, finds an eye-popping comparison of different geoengineering ideas. The plan would avoid some of the downsides of other materials being mooted for ‘stratospheric aerosol injection’. For example, sulfur dioxide — which has a natural cooling effect when spewed by volcanic eruptions — risks acid rain and damage to the ozone layer. But synthetic diamond would cost something like US$175 trillion if deployed from 2035 to 2100, whereas sulfur is widely available and very cheap.”
M Gulati et al ; https://odi.org/en/insights/climate-change-conflict-fragility-recipe-for-disasters/
“In 2022, fragile and conflict-affected countries received only one quarter of the climate finance they need. In the coming months, we must see a meaningful shift towards closing this gap.”
“….Our new analysis, drawn from OECD climate-related development finance data, shows that in 2022, 24 of the world’s most fragile and conflict-affected countries received only $8.4 billion dollars in climate funding. By comparison, these same countries’ costed climate adaptation needs – expressed in their Nationally Determined Contributions, National Adaptation Plans or other submissions to the UNFCCC – added up to $35 billion per year. In short, fragile and conflict-affected countries are receiving only one quarter of the climate finance they require….”
Links:
· Globalization & Health - A toxic relationship: ultra-processed foods & plastics (by Joe Yates et al)
· Plos GPH - Heatwave interventions must reduce invisible gendered challenges in the Global South
Ekaterina Pazukhina et al; https://gh.bmj.com/content/9/10/e015245
“ A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).”
Findings: “… Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. …”
https://medicalxpress.com/news/2024-10-mpox-strain-poses-bigger-young.html
“Girls and young women may be more susceptible to an infectious subvariant of the virus that causes mpox that has spread from the Democratic Republic of Congo to neighboring countries, a study showed. Of 154 cases that tested positive for mpox in Burundi, which borders eastern Congo, from July 3 to Sept. 9 the median age was 9.5 years, researchers said in a study released Oct. 17 in the scientific journal Eurosurveillance. The average age of girls who were infected was six years old, while boys were 17.5 years old, the data showed…..”
““We vaccinated for smallpox and eradicated it. But look, something came out of that: monkeypox,” said Uganda’s health minister, Jane Ruth Aceng, in August. Smallpox and mpox are closely related diseases — having immunity to one boosts immunity to the other. Once smallpox was eradicated, and the vaccination campaigns halted, population immunity to both diseases waned. Researchers were aware of this risk, but at the time, mpox wasn’t seen as a big enough threat. Now, African nations are scrambling to rebuild the medical expertise to diagnose and treat mpox outbreaks; skills that disappeared along with the vaccines.”
· Link: Nature Medicine - Global genomic surveillance of monkeypox virus (23 Oct)
https://www.who.int/news/item/20-10-2024-egypt-is-certified-malaria-free-by-who
“The World Health Organization (WHO) has certified Egypt as malaria-free, marking a significant public health milestone for a country with more than 100 million inhabitants…..”
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004355
by A Lépine et al. « …We investigated if health insurance protects against economic shocks, reducing the need for vulnerable women to engage in risky sexual behaviours and reducing HIV and sexually transmitted infection (STI) incidence.”
· Related Plos Med Perspective - Leveraging behavioral economics strategies to close gaps in biomedical HIV prevention (by J Heitner et al)
“ Adolescent girls and young women (AGYW) in southern Africa face triple the HIV incidence of their male peers due to multiple factors, including economic deprivation and age-disparate relationships. A new study by Aurélia Lépine and colleagues has demonstrated that addressing healthcare costs among AGYW has the potential to reduce HIV incidence.”
https://www.bmj.com/collections/chronic-diseases-in-china
“In China, the burden of chronic diseases, including cardiovascular diseases, cancers, respiratory diseases, and diabetes, has greatly increased in recent decades, driven mostly by population ageing and poor control of risk factors such as tobacco use, physical inactivity, alcohol consumption, unhealthy diets, and air pollution. Non-communicable diseases account for 91% of deaths in China and present an increasing burden on national healthcare expenditure. China urgently needs innovative and decisive strategies to tackle these chronic diseases.”
“In this BMJ Collection, experts from China shed light on the current state and challenges of non-communicable chronic disease prevention and control and discuss future strategies for tackling the problem.”
Stat;
“The idea is gaining support as scientists learn more about how shingles harms the brain.”
N Freudenberg; https://www.ijhpm.com/article_4662.html
“Systematic public monitoring of the practices of corporations that harm health is a necessary but not sufficient measure to reduce the adverse impact of these practices. By supporting social movements and health activist campaigns that seek to modify the corporate structures, systems and practices that harm health, public health professionals and researchers can bring powerful new voices into this crucial public health task. Partnerships between the public health organizations and social movements and activists who seek to make human and planetary well-being more important objectives than higher corporate profits can help to achieve this aim. Public health professionals can play an important role in supporting such partnerships.” With some recent examples.
Miriam van den Berg, S Friel, F Baum et al; https://gh.bmj.com/content/9/Suppl_1/e015694
“….Using case study methodology, this article identifies five countries (Ethiopia, Jordan, Spain, Sri Lanka and Vietnam) that made progress on health equity during 2011–2021 and three countries (Afghanistan, Nigeria and the USA) that had not made the same gains. The case studies revealed social, cultural and political conditions that appeared to be prerequisites for enhancing health equity. ….”
They list four key factors that help advance health equity.
“In global mental health, there is a huge, barren wasteland between need and demand and the funding and services available. The World Health Organization claims that lost productivity associated with anxiety and depression costs the global economy about $1 trillion a year. Private philanthropy is leading the way, as outlined in the Power of Giving Report, which has published the top 10 funders focused on global mental health.”
Olivier De Schutter and Philippe van Parijs; https://www.socialeurope.eu/can-universal-basic-income-really-improve-mental-health-the-surprising-results-are-in
“Recent UBI trials reveal that guaranteed income provides immediate mental health relief, but sustaining long-term benefits may depend on lasting economic security.”
https://gh.bmj.com/content/9/10/e015165
By André Janse van Rensburg et al.
R Kamba et al ; https://gh.bmj.com/content/9/10/e015675
“…Despite signing the Global Vaccine Action Plan and Addis Declaration, the Democratic Republic of the Congo (DRC) was unable to fully disburse its portion of allocated funds to cover vaccines without support from Gavi, the Vaccine Alliance and the World Bank between 2017 and 2019. Additionally, during the same time, vaccine coverage outcomes indicated negative trends, with over 750 000 children considered ‘zero-dose’ in 2018. In 2019, a primary focus of the then newly elected President’s agenda was universal healthcare. In collaboration with development partners and stakeholders, the first Presidential Forum was held as a public commitment to increasing childhood immunisation and ensuring the country remains polio-free. This article seeks to highlight the key outcomes of the Forum such as the signing of the Kinshasa Declaration, which formally set targets and specified national, provincial and community-level commitments to vaccination and polio eradication. As of 2023, three Forums have been conducted to reiterate political commitment to routine immunisation in the DRC. This type of high-level commitment could serve as a template for other countries struggling to have high engagement as targets for polio eradication and strengthened routine immunisation are set for 2025–2030.”
https://jogh.org/2024/jogh-14-03042
By B Gaye et al.
By guest contributors Luchuo Engelbert Bain, Ojong Samuel Akombeng, and Daniel Krugman.
https://www.cell.com/cell/abstract/S0092-8674(24)00230-7
By W. Marcus Lambert et al.
““Helicopter research” refers to a practice where researchers from wealthier countries conduct studies in lower-income countries with little involvement of local researchers or community members. This practice also occurs domestically. In this Commentary, we outline strategies to curb domestic helicopter research and to foster equity-centered collaborations.”
M Lee et al; https://www.cgdev.org/publication/mdb-ships-are-turning-not-yet-course-results-cgds-updated-mdb-reform-tracker
Background: “…The comprehensive reform agendas for the multilateral development banks (MDBs) constitute the most ambitious effort to overhaul these institutions since their launch at Bretton Woods 80 years ago. The ambition is driven by the urgency and scale of development and climate challenges and by the recognition that MDBs, while currently underperforming in terms of the scale of finance, are uniquely placed to address those challenges. But ambitious agendas can and often do languish, especially at a time of global fragmentation, ongoing shocks, high debt, and tight fiscal constraints. The period ahead will determine whether MDBs and their shareholders can adapt to 21st century challenges or if new institutions must be conceived and created…..”
“For these reasons, CGD built an MDB reform tracker as an independent, objective tool for assessing reform progress. We have updated the tracker as the reform agenda has taken shape and expanded. This third version of the tracker identifies 39 separate reform agenda items, grouped under six headings: (1) efficient use of capital, (2) adding new forms of capital, (3) expanding mandates and associated shareholder capital expansion, (4) reporting on impact (new in this version), (5) transforming country engagement, and (6) achieving a major expansion in private finance mobilization… …. “
PS: This external tool complements internal efforts in the institutions themselves and in the G20 to chart and report progress, such as the forthcoming G20 MDB Roadmap developed under Brazil’s G20 presidency……”
Check out some of the findings so far.
https://www.tandfonline.com/toc/khsr20/10/2?nav=tocList
New special issue.
· Start with the Editorial by M R Reich – Introduction to the Special Issue on Digital Health: Opportunities and Challenges for Global Health
“This Special Issue on Digital Health celebrates the 40th Anniversary of the Takemi Program in International Health at Harvard University. During the past four decades, 323 mid-career global health professionals from 61 countries have participated in the program as Takemi Fellows. …. ….Earlier versions of the articles in this Special Issue were first presented at the program’s 40th Anniversary Takemi Symposium held in Boston in October 2023, organized around the theme of “Digital Health: Opportunities and Challenges for Global Health.” A follow-up 40th Anniversary Symposium was held in Tokyo in November, with a focus on digital technologies for community health, organized by the Japan Medical Association and the Takemi Program….”
“Digital health” encompasses a broad range of current and potential interventions in health systems that make use of digital technology and innovations, including smartphones and apps, data systems, and artificial intelligence …. ….. …. The articles in this Special Issue explore the opportunities and challenges presented by the influx of digital technologies into health systems around the world, and in both public and private sectors. “
https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czae097/7831181?searchresult=1
By Ferdinand C Mukumbang et al.
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-024-02292-3
By K Than, S Witter et al.
https://eurohealthobservatory.who.int/publications/i/trust-the-foundation-of-health-systems-study
By M McKee et al.
A Ardalan & C Affun-Adegbulu; https://healthsystemsglobal.org/news/building-back-better-10-key-messages-on-health-systems-recovery-2/
“Given the importance of the topic, particularly in the region, the World Health Organization's Eastern Mediterranean Region Office (WHO EMRO) has been working on building understanding and capacity for health systems recovery. In December 2023, WHO EMRO held a meeting in Cairo, Egypt with a diverse group of health system recovery experts, including academics, practitioners, donors, UN agencies, NGOs and national organizations. The goal was to share knowledge and experiences, discuss effective, innovative approaches and identify key principles and lessons learned to tackle complex recovery challenges in settings affected by conflicts and crises in the Eastern Mediterranean region and beyond. In this blog hosted by the TWG FCAS, Ali Ardalan and Clara Affun-Adegbulu highlight ten strategic messages for health systems recovery emerging from the meeting.”
PS: “…. The Health Systems Resilience Unit, situated within the Department of Universal Health Coverage/Health Systems (UHC/HS) at WHO EMRO, plays a vital role in bridging health systems strengthening initiatives with emergency preparedness and response activities…..”