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Dear Colleagues,
It’s 6 December today. In my country, typically, then a good old man with a long white beard comes from a country far, far away with some goodies for small children who have behaved more or less well over the past year. In that spirit (though not yet with a white beard, and neither am I sure you all behaved decently in recent weeks 😊), I have another IHP newsletter issue for you, catching up on the past two weeks in global health policies.
As I’m only on Belgian soil again since Wednesday morning, don’t expect some reflections on the state of the world in today’s intro – I’ve been far too busy checking out temples, shrines and Big (belly) Buddhas in Kyoto and Nara over the past ten days, after the HSR symposium in Nagasaki ended. My ensuing few days’ stay in the Ginza area in Tokyo provided the right counterweight to this “Buddhist/Shinto” trail (ahum) enjoyed against a backdrop of lovely autumn colours: whatever hopes I might still have had about a post-growth and sustainable/equitable future in the coming years/decades were firmly put to rest, being bombarded with flashy Dior/Gucci/Hermès/Prada/… ads in the Ginza avenues. (arguably, watching a number of ‘Succession’ episodes on the plane didn’t help)
Nevertheless, maybe against all odds, scholars seem to increasingly use the ‘healing’ metaphor in the current megacrisis era, eg. in this insightful CGD blog, How to Heal Health Financing. Earlier, we already came across ‘planetary healers’ too😊!
But we leave you with the quote of the week, from Oxfam’s Mogha Kamal-Yanni, at the start of yet another (resumed) INB round (2-6 December) re the pandemic agreement: “Do you want an agreement that seriously and practically protects the health and economy of everybody on the planet, or do you want to protect the financial health of companies?”
I’m afraid you are more likely to find the answer to that question in the posh Ginza area than in Kyoto’s zen rock garden.
Enjoy your reading.
Kristof Decoster
Stay tuned for the latest updates via Health Policy Watch and Geneva Health Files. In the meantime, some reads from earlier this week on this (resumed) 12th INB round (still ongoing):
As a reminder: “In December 2021, the World Health Assembly established an Intergovernmental Negotiating Body (INB) to draft and negotiate a convention, agreement or other international instrument under the Constitution of the World Health Organization, to strengthen pandemic prevention, preparedness and response.”
The Twelfth meeting (resumed session and drafting group) of the INB (Intergovernmental Negotiating Body) takes place this week in hybrid format from 2-6 December 2024.
https://healthpolicy-watch.news/pandemic-agreement-get-it-done/
Update from Monday, at the opening of the resumed session. With some key quotes from stakeholders.
“At the opening of the final pandemic agreement negotiations for 2024 on Monday, a group of long-time observers urged countries to “get it done” after three years of negotiations. “The finishing line to the pandemic agreement is in sight, and we urge all member states to keep up the momentum and negotiate a final agreement that is equitable, and that has a clear path to adoption and delivery,” said Dame Barbara Stocking of the Panel for Global Public Health Convention, also speaking for the Pandemic Action Network, the Independent panel for Prevention, Preparedness and Response, the Global Preparedness Monitoring Board and Spark Street Advisors…..”
With various positions from different stakeholders (including dr Tedros, civil society, IFPMA, …) - as this new round was kicking off.
Update from Tuesday morning. “In today’s edition, we bring you the state of play on this week’s deliberations that began yesterday, on December 2. WHO member states continue to dig in their heels in the final month of 2024, potentially carrying forward the impasse to the next year. …. … “The only way to reach consensus, is if no side wins,” a developing country negotiator said describing the dynamics. It is a view that has also been echoed by others. What this risks is a potential agreement that could veer towards the lowest common denominator, far from the lofty ambitions that countries set out to achieve at the beginning of the process…..”
PS: “We (i.e. via contributor Vivek ND) also share research on the size of the pharmaceutical markets, export potential, and mRNA technology production capacities of 16 key countries to illustrate what is at stake in these negotiations…”
“… Countries continue to focus on a few select provisions this week, including on prevention, financing, Pathogen Access and Benefits Sharing, Research & Development, Supply Chain and Procurement matters, apart from provisions on governance…..”
By Nishant Sirohi & Priti Patnaik Geneva Health Files;
From last week. “…. WHO member states remain painfully divided on whether vulnerable populations in humanitarian settings, and in sanctioned countries should have “unhindered” access to medical services and products during health emergencies and pandemics.”
“The draft text of the Pandemic Agreement references the term “unhindered”, which is a continues to be a major flashpoint in the negotiations. While the debate around “unhindered” has long occupied negotiators over the years across policy forums in Geneva and in New York, in the context of a new Pandemic Agreement, this discussion is reaching a crucial juncture, potentially also poised for an eventual trade-off with other competing interests in the negotiations….” “At the heart of the debate lies a critical question: Should sanctions-hit countries be guaranteed access to medical products during public health emergencies? …. “ “ …“Negotiators say, that the impact of sanctions on populations is significant and widespread: more than one in four countries are subject to sanctions by the UN or Western governments…. “ “ …With over 300 million people affected globally by sanctions, it is clear that their reach impacts hundreds of millions, with particularly severe consequences for populations in developing countries and vulnerable groups within those societies. In this story, we first examine the historical context, and then look at the state of play around this discussion in the Pandemic Agreement….”
https://repository.graduateinstitute.ch/record/319779?v=pdf
New paper that explores key steps in the #WHO #PandemicTreaty making process, including the critical phase of moving from negotiation to effective implementation.
“The World Health Organization (WHO) and partners announced 10 projects that will receive almost US$ 2 million in grants to improve capacities in pathogen genomic surveillance.”
“The catalytic grant fund was established by the International Pathogen Surveillance Network (IPSN) to support partners from low- and middle-income countries to build their capacities in pathogen genomic analysis. This technology analyses the genetic code of viruses, bacteria and other disease-causing organisms to understand, in conjunction with other data, how easily they spread, and how sick they can make people. This data allows scientists and public health teams to track and respond to infectious disease threats, supports the development of vaccines and treatments and empowers countries to take faster decisions…. …. The fund is hosted by the United Nations Foundation and supported by the Bill & Melinda Gates Foundation, The Rockefeller Foundation and Wellcome…..”
And a link:
· HPW - DRC Expects Diagnosis of ‘Disease X’ by Weekend
“The Democratic Republic of Congo (DRC) expects to diagnose ‘Disease X’, which has killed at least 79 people in the Panzi district of Kwango Province by the weekend, according to the country’s Director-General of Health, Dr Dieudonné Mwamba. “The disease is characterised by fever, headaches, cough and sometimes difficulty breathing,” Mwamba told a media briefing hosted by Africa’s Centre for Disease Control and Prevention on Thursday. So far, around 376 people have been infected and the disease appears to be airborne, he added. Women are slightly more affected than men, and the majority of cases are over the age of 25…..”
· Related – Euractiv - WHO to investigate unknown disease in Democratic Republic of Congo (gated)
“Much stronger surveillance” of deadly H5N1 and other avian influenza strains in both domestic and wild animals is needed both in The United States as well as globally so as to head off pandemic risks from variants that could mutate to infect humans more directly. … …. A senior World Health Organization official, Dr Maria Van Kerkkove, issued the appeal at a WHO press briefing [last week] on Thursday. She also said that WHO ‘always’ recommends drinking pasteurized, instead of raw, milk – due to the risks of contamination by a number of pathogens, including H5N1 virus.
H Branswell; Stat;
“While grateful, many scientists are perplexed by the H5N1 outbreak’s lack of severity.”
“Since the outbreak of H5N1 bird flu in American dairy cattle began this spring, there have been 55 cases among people in the U.S. That’s an alarming number, but a surprising bright side is that all the infections have been mild so far. Bird flu has a reputation — well-earned, STAT’s Helen Branswell says — as a very dangerous pathogen, with a case fatality rate around 50%. So what’s happening here? Helen spoke to 21 researchers who have studied influenza, and this one in particular, for years. Nobody has definitive answers (“If you find out, please let me know!” one researcher told Helen), but plenty raised theories and questions. Could the way that the virus is being transmitted limit its severity? Do we actually have some protection to it already? With such limited information, the train of thought can even get existential: Has the virus changed? Have we? …”
Helen Branswell with an overview of expert hypotheses.
“Researchers at Scripps, reporting in Science, said their finding is ‘a clear concern’.”
“A study published Thursday contains a sobering piece of news about the H5N1 bird flu viruses circulating in cows in the United States: A single mutation in the hemagglutinin, the main protein on H5N1’s exterior, could turn a virus that is currently not well equipped to infect people into one that is much more capable of doing so…..”
“The jabs are being stockpiled in case avian flu begins to spread between humans.”
· Related: Telegraph - The Liverpool vaccine factory preparing for a H5N1 bird flu pandemic
“Researchers at the vast facility describe the ‘pre-pandemic’ jabs being made there as a ‘first line of defence’”
Mpox emergency response
Update from this week’s Africa CDC media briefing.
“Mpox continues to spread, particularly in Central Africa, with 2,700 new cases in the past week, up from 2,618 new cases the previous week, said Kaseya. The outbreak has affected 20 African countries. After laboratory testing, Zambia and Zimbabwe have confirmed that their outbreaks are Clade 1b.”
“…. The DRC remains the worst affected by mpox, with both clade 1a and 1b circulating. The lion’s share of the week’s new cases – 2,115 – were identified in the DRC and all 36 of the week’s deaths were in the DRC. However, testing remains a challenge in the country, with only 20% of cases confirmed by laboratories…..”
· See also Cidrap News - Mpox continues its Africa spread as clade 1b confirmed in 2 more nations
Re last week’s Africa CDC press briefing.
“The number of mpox cases will continue to rise during the next four weeks before starting to show signs of flattening early next year, the Africa Centres for Disease Control and Prevention said on Thursday. …. "I think with this intensification of the response, we are hoping that after about four weeks... we should see some plateauing of the outbreak as a result of all the current investment, and then towards the end of quarter one, we can then see the bending of the curve," Ngashi Ngongo of Africa CDC told a press briefing. He said outbreak surveillance including contact tracing remained a significant challenge for the response, but that Africa CDC was trying to strengthen it by deploying community health workers, epidemiologists and infection prevention specialists in areas with confirmed cases of mpox, formerly known as monkeypox…..”
“Despite having the second biggest mpox outbreak in Africa, Burundi has no immediate plans to vaccinate those at risk. Donated vaccine doses are available to Burundi for free but “vaccine hesitancy” might be playing a part in the government’s reluctance to vaccinate people, according to Dr Ngashi Ngongo, mpox lead for the Africa Centres for Disease Control and Prevention.
Over the past week, Burundi has registered 273 new mpox cases – an 13.8% increase over the previous week – and its first death. Overall, it has over 2,000 cases…..”
“Adults started getting vaccinations against mpox in Democratic Republic of Congo's capital this week. But there were no shots available for children, the most vulnerable group, after a key dose donation was held back by an old legal hurdle.”
“Japan pledged in September to donate three million doses from its national stockpile of LC16m8 vaccines, first developed by local firm KM Biologics for smallpox. It is the only vaccine effective against mpox that is approved for use in children, and the pledge was the biggest single donation yet to fight the disease anywhere. But the two countries took time to negotiate over a common issue in global health: who pays if there are unexpected side effects caused by the vaccine.
Congo said the issue has now been resolved. But the delay once again showed the need for a better system, global health experts said, to stop the seemingly technical point holding up life-saving responses….”
And a link:
· WHO – Second meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024 (28 Nov)
“The full report of the second meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024, held on 22 November 2024, has been published here. “
As you know by now, “…Notwithstanding some progress towards controlling the spread of mpox resulting from national and international response efforts, the Committee noted the rising number and continuing geographic spread of mpox, especially those due to clade Ib monkeypox virus (MPXV) infection; the operational challenges in the field in need of stronger national commitment; as well as the need to mount and sustain a cohesive response across countries and partners. The Committee advised that the event continues to meet the criteria for a public health emergency of international concern (PHEIC) and provided its views regarding the proposed temporary recommendations.”
(26 Nov) “Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) and the Clinton Health Access Initiative (CHAI) announced today that they are teaming up to explore interventions to slow the spread of gonorrhea in low- and middle-income countries (LMIC).
The 2-year partnership between CARB-X and CHAI will evaluate the clinical need and address market barriers for diagnostic, therapeutic, and preventive interventions for gonorrhea, which is the second most prevalent sexually transmitted infection in the world. An estimated 82 million gonorrhea infections are reported annually, with the highest prevalence in Africa. ….”
“Urgent action underway to bolster treatments and prevent dangerous microbes from spilling across borders.”
Brand new section : ) (I’m afraid it’ll be a hefty one, week after week)
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02664-3/fulltext
“On Jan 20, 2025, the Trump administration will take charge at a crucial time for health in the USA. To address the seriousness of the task ahead, The Lancet today publishes what can serve as a presidential briefing book, bringing together the best evidence on the state of health in the USA and some solutions for improving it.”
“The five research papers published in this issue paint a bleak picture of health in the USA, with geographical, racial, ethnic, gender, and socioeconomic disparities at the heart of the country's situation. …”
The Editorial then argues that the choice to improve or go further down the abyss is up to the Trump 2.0 administration.
(My best guess: Trump’s newly appointed “all stars” (public) health team will (at most) have a quick look at this Lancet issue and then do exactly the opposite. )
· In this issue, do read also the following Comments:
How the US National Institutes of Health is confronting health threats in a changing world (by J Marazzo et al)
PEPFAR's mission (by J Nkengasong et al)
Addressing the unmet need: US leadership on climate and health (by V Kerry et al)
US health at home and abroad (by T Bollyky et al)
“ Often framed as a product of hard security interests, soft power humanitarian concern, and geopolitical calculation, US global health engagement can seem divorced from health concerns within the nation's borders. Yet health in the USA profoundly shapes the ways in which the country pursues health globally…..”
Concluding: “….[This] recent relative inattention to health in US domestic politics may have international implications. US global health aid flatlined during the Obama and Trump presidencies from 2011 to 2020 and has been declining after the COVID-19 pandemic. The latest Biden administration budget request included a $400 million cut in PEPFAR funding, which would set the programme back to its lowest level of funding since 2018. Over the next 6 months, a crowded field of international health and development institutions, from GAVI, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria to the World Bank and WHO, are seeking to raise collectively almost $50 billion, and their hopes for US fundraising are likely to fall short, irrespective of the US election outcome. Many sub-Saharan African governments face mounting debt obligations and exchange rate pressures after the COVID-19 pandemic, limiting their capacity to self-finance health programmes previously funded through development assistance. Yet the question of to what degree those aid budgets shrink and what gets prioritised within US global health engagement very much corresponds with the US President's domestic health priorities. If past is prologue, health at home will matter profoundly for the quest for better health abroad.”
· And a Lancet Letter (by J Dieleman, C Murray et al) - The USA's role in global development assistance for health, 2000–30
“…. In this Correspondence, we first highlight the effect that the USA's commitment to global heath has had historically, and second explore the destabilising effect that reduced US commitment might have going forward….”
PS: “….Our scenario analyses highlight specific health focus areas that might see changes as consequences of financial pullback from the USA….” “Notably, support for HIV/AIDS could decrease by $8·1 billion (57·5%), and that for reproductive and maternal health could decrease by $1·0 billion….”
· Lancet Viewpoint (Health Policy)- Strategic imperatives for health in the USA: a roadmap for the incoming presidential administration (by V Dzau et al)
“….We present five priority areas to guide US federal strategy in 2025 and beyond: improve public health and address health and social inequities; catalyse transformation towards a more effective, equitable health system; address crucial health issues such as climate change; advance artificial intelligence for health and health care; and strengthen responsible science and innovation. To achieve these goals, we suggest policy action items for federal stakeholders and emphasise the importance of social determinants of health, cross-sector collaboration, population health perspectives, and transformative partnerships…..”
· Lancet Viewpoint – Reversing the decline of health in the USA: a call to action
( by Ali C Mokdad & C Murray) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02372-9/abstract
“In this collection of new papers, part of a special issue on public health in the USA timed for publication during the transition to the 47th President of the United States, we focus in detail on population health trends in the USA, extending global analyses, recently completed in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The evidence presented in these five papers starkly describes the current health state of the nation: growing disparity across socioeconomic, racial, and ethnic groupings that manifests in diverging health outcomes both within the country and relative to all other high-income and middle-income countries. Below we highlight some key observations from these papers on health, its drivers, and future trajectories. We also go beyond the papers here and call for concerted action to address some key challenges.”
https://www.devex.com/news/devex-checkup-what-s-at-stake-for-global-health-under-rfk-jr-108870
Excerpt: “….Lawrence Gostin, O’Neill Institute chair in global health law at Georgetown University, and an established expert on U.S. and global health law and policies, tells me that it’s likely that there will be “wholesale pullback and restructuring of America’s global health presence around the world.” … Such a withdrawal would be deeply felt in terms of funding and influence. One case in point: The U.S. Centers for Disease Control and Prevention, one of the many divisions of HHS, has over 60 offices globally and helps implement global health initiatives such as the U.S. President’s Emergency Plan for AIDS Relief and the Global Polio Eradication Initiative. It also aids countries in outbreak investigations.”
“RFK Jr.'s slogan has been “Make America Healthy Again,” which to him includes both limiting food dyes and additives as well as removing fluoride from water despite its benefits for dental health. But he’s been vocally against the amendments to the International Health Regulations and the pandemic agreement still being negotiated in Geneva. He has also accused the World Health Organization of being “taken over by global elites and foreign powers that don’t share America’s best interests.” Trump said on the campaign trail that if reelected, he would withdraw from WHO again…..”
“If the U.S. withdraws from the global health body, as Trump attempted to do in his first term, the WHO could lose its top government donor.”
With coverage of a Global Fund media briefing on Monday.
“As a political appointee, Ambassador John Nkengasong, head of the US President’s Emergency Plan for AIDS Relief (PEPFAR), said that he will be obliged to resign when President-elect Donald Trump is inaugurated on 20 January. “The rules that govern a transition are that all the political appointees have to resign on the 20th and then their resignation is either accepted or they are asked to stay,” Nkengasong told a Global Fund media briefing on Monday.” “ However, he stressed that PEPFAR has been a bipartisan programme since its inception in 2003 when it was launched by Republican President George W Bush. “It has since enjoyed the support of all administrations,” said Nkengasong, the US Global AIDS Coordinator in the Bureau of Health Security and Diplomacy.”
A few more key quotes from the GF media briefing:
“…. money is drying up. About 60% of the HIV response is paid by domestic finances, and this fell for the fourth consecutive year, with a 6% drop in 2023. Meanwhile, donor resources for HIV dropped by 5%, UNAIDS Deputy Director Christine Stegling told the briefing…..”
“Global Fund executive director Peter Sands said that global overseas development assistance is under pressure, and health has lost its “prime spot” to both climate change and conflict.”
“… Debt relief, future financing at affordable rates and better tax revenue collection are the solutions UNAIDS is focusing on. …. ….”
“… Stegling says donors are likely to move into “gaps”, such as human rights protections for particular marginalized groups that might not immediately find support from their governments.”“Meanwhile, Nkengasong stressed that progress should not be confused with success. “The progress that we have made is very fragile,” Nkengasong stressed. …. PEPFAR did an analysis of 10 to 12 high-burden countries that it supports and found that, to maintain their programmes if PEPFAR was unable to fund them would result in debt risk increasing by 400 percentage point….”
C Pagel, Kent Buse, M McKee et al; https://www.bmj.com/content/387/bmj.q2654 “Trump’s presumptive cabinet raises fears for population health given its anti-science bias. Christina Pagel and colleagues argue that the UK scientific establishment should practice solidarity and resistance with their American counterparts.”
Krutika Kuppalli; https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00767-9/abstract
“The re-election of Donald Trump as the 47th president of the USA has raised concerns among health-care professionals and public health experts about the future of global health and pandemic preparedness…..”
https://healthpolicy-watch.news/sexual-and-reproductive-health-and-lgbtq-rights-under-attack/
“The global rise of right-wing governments is threatening sexual and reproductive health (SRH) and LGBTQ rights – but human rights defenders and progressive donors are rallying to mitigate this…..”
“…. Days after Trump’s victory, ILGA, the international lesbian, gay, bisexual, trans and intersex association, held its biggest-ever international meeting in Cape Town, South Africa, vowing to act “in global solidarity against the ongoing anti-rights pushback”. Shortly before the ILGA meeting, the first-ever Global LGBTI Funding Summit secured $100 million in new donor pledges for global LGBTI rights. But only three governments – Denmark, Germany, and Norway – have pledged so far…..” “ “The Global Philanthropy Project (GPP) mobilized this campaign in response to seeing big risks to global LGBTI funding on the horizon,” GPP deputy director Ezra Nepon told Health Policy Watch…..”
(26 Nov) “The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) held its 52nd meeting last week in Lilongwe, Malawi. The country was selected to host the event in recognition of its remarkable progress against HIV, tuberculosis (TB) and malaria over recent decades, which contributed to the improvement of life expectancy in the country from 44.7 years in 2000 to 62.5 years in 2021…..”
Check out the key decisions taken.
“Gavi’s Board approved a series of measures aimed at strengthening countries’ abilities to sustain their own immunisation programmes and improve access to vaccines in fragile countries and settings. Meeting took place amid unprecedented demand for vaccines in Gavi Implementing countries.”
Official press release after the GAVI board meeting and a must-read.
Check out the detail on support for sustainability, addressing fragility, strengthening health systems, and a framework for demand.
“Unitaid’s Executive Board concluded this week in Johannesburg where members reflected on a transformative year of achievements and set the stage for future investments in global health. … Building on Unitaid’s commitment to innovation, the Board approved a new Area for Intervention to support and accelerate the transition toward climate-smart health products, recognizing that the health sector, while striving to improve health outcomes, accounts for approximately 4.6% of global carbon emissions. Under this new area of work, Unitaid aims to help communities adapt to climate-related health threats, reduce the environmental footprint of key health products and ensure their resilience to climate-related shocks, and drive sustainable innovation in global health systems.”
“This focus on innovation was further demonstrated through discussions on lenacapavir, a groundbreaking long-acting pre-exposure prophylaxis (PrEP) product. Recognizing lenacapavir as a game-changer in HIV prevention, Unitaid has already committed US$22 million to support its early roll-out in South Africa and Brazil. This investment focuses on reaching at-risk populations – including adolescent girls and young women, men who have sex with men, and transgender and non-binary individuals – while preparing health systems for broader adoption of lenacapavir through partnerships with governments, civil society, and private sector actors….”
“The European Union and the Gates Foundation will co-host a high-level pledging meeting in support of Gavi’s replenishment for its next five-year strategic period from 2026 – 2030. The event, convening leaders from government, partner organisations, vaccine manufacturers, civil society and the private sector, will be held in Brussels in the first quarter or early in the second quarter of 2025.”
“Gavi, which has transformed global immunisation since 2000, protecting over 1.1 billion children, saving 18.8 million lives and generating over US$250 billion in economic benefits for lower-income economies, is seeking to raise at least US$9 billion for its next strategic period. This period, called “Gavi 6.0”, is anchored on three key pillars: protecting the world against pandemics and disease outbreaks; protecting people by vaccinating more children against more diseases than ever before; and protecting communities by reducing the number of ‘zero-dose’ children and strengthening health systems. During the Gavi 6.0 strategic period, Gavi implementing countries will contribute a record 46% towards the total cost of vaccines, up from just 10% a decade ago….”
https://www.cgdev.org/publication/development-cooperation-contested-world
“On December 5, 2024, CGD President Emeritus Masood Ahmed delivered a keynote address at the Australasian AID Conference at the Crawford School of Public Policy, Australian National University, Canberra, Australia. “ I don’t agree with everything he says (or “overlooks”), but well worth a read.
Sad news from last week. “The global health community is shocked by the untimely passing of Dr. Faustine Engelbert Ndugulile who was slated to become the next regional director for WHO's Africa office.”
“…. Dr. Faustine Engelbert Ndugulile, the incoming regional director of the World Health Organization’s Africa office, unexpectedly died [last week] on Wednesday, just months after he was tapped for the position. Ndugulile had been receiving medical treatment in India. A cause of death has not been specified. …. …. It’s unclear who will take over the position, which Ndugulile was set to inherit in February from Dr. Matshidiso Moeti……”
“The February 2024 Decision of the African Union Assembly on the report of the President of the Republic of South Africa, H.E. Matamela Cyril Ramaphosa, the African Union Champion for Pandemic Prevention, Preparedness and Response (PPPR), to “support the establishment of an accountability mechanism within the AU architecture to ensure the effective implementation of the Lusaka Agenda in Africa” is a timely and welcome development.”
“…. H.E. Ramaphosa has been instrumental in advancing the Lusaka Agenda Accountability Framework. Through the PPPR Commission, he championed the establishment of an accountability mechanism for the Lusaka Agenda, which leverages platforms such as the Africa Leadership Meeting (ALM). …”
“… The Lusaka Agenda Secretariat hosted at Africa CDC aligns with the February 2024 Assembly Decision of the African Union Heads of State and Government (Dec.880(XXXVII) and further solidifies Africa CDC and AU Commission leadership in steering the successful implementation of the Lusaka Agenda on the African continent. The establishment of the Secretariat is a pivotal initiative to oversee and coordinate the monitoring and accountability mechanisms essential for advancing Africa’s health transformation…..”
https://www.devex.com/news/devex-newswire-africa-s-bid-to-take-the-wheel-on-hiv-strategy-108858
“A new African-led HIV control group wants the continent to spearhead the fight against the disease. “
““We want to see more Africans on the forefront,” explains Dr. Magda Robalo, president and co-founder of the Institute for Global Health and Development of Guinea-Bissau, in conversation with Sara Jerving, Devex’s senior global health reporter. Robalo adds that the response must be “driven by the continent.” A new African-led HIV Control Working Group, co-chaired by Robalo, is mulling over domestic financing options and new strategies that look at people holistically.”
“Africa’s “precarious position” in the fight against HIV was underlined by the U.S. Congress’ decision this year to extend the $120 billion U.S. President’s Emergency Plan for AIDS Relief to next March only, rather than the standard five-year reauthorization, leaving what happens next up in the air. About half of PEPFAR-supported countries are in Africa…..”
· For more detail, see Devex – ‘The time has come’: Crafting a sustainable, African-led HIV response
“…. a group of experts from across Africa are working to craft a road map for a new kind of HIV response — drawing on the diversity of the continent and its resources, including human capital. The two co-chairs of the African-led HIV Control Working Group gave Devex a preview of the shape it’s taking. This includes Dr. Magda Robalo, president and co-founder of the Institute for Global Health and Development of Guinea-Bissau, and Dr. Izukanji Sikazwe, chief executive officer of the Centre for Infectious Disease Research in Zambia……” “... The working group was established in May 2023 to create a framework for an African-led and financed response to the HIV epidemic, cognizant of the epidemic’s nuances across the continent, Sikazwe said. This included bringing together experts with diverse areas of expertise. They established thematic groups including on prevention, control, governance, sustainability, and community response….”
“Other members of the working group include Dr. Michel Sidibé, African Union special envoy for the African Medicines Agency; Yvette Raphael, executive director of Advocacy for Prevention of HIV in Africa; and Dr. Yogan Pillay, director of HIV & TB delivery program at the Gates Foundation — which is funding this work…… They’re currently engaging with stakeholders such as governments and communities of people living with HIV to craft position papers on what a genuinely African response to HIV should look like in the lead-up to 2030, Sikazwe said. This is the year the world’s committed to ending the epidemic.”
· Related: Y Pillay & M Robalo in The Conversation - Africa’s making progress against HIV, but donor funds are drying up – what must change
“…We write here under the auspices of the Africa HIV Control Working Group, an institution that seeks sustainable ways of eliminating HIV as a public health concern in Africa. We look at what has been achieved so far and ways to make sure the fight against HIV does not lose momentum….”
“…. Africa’s fight against HIV, long reliant on external funding that often tends to focus on donor priorities rather than country contexts, must be reimagined as the global landscape shifts. We suggest the solutions lie in innovative public-private-philanthropic funding models that incorporate strategic taxes, diaspora bonds, co-financing, grants, loans and restructured debt. In addition, African countries should move more rapidly to local and regional production of commodities. They should pool resources to procure commodities and share risks…..”
https://genevasolutions.news/global-news/wto-chief-okonjo-iweala-reappointed-for-second-term
(29 Nov) “Member states unanimously approved the Nigerian economist's leadership for another four-year term.”
“World Trade Organization (WTO) director general Ngozi Okonjo-Iweala was formally reappointed on Friday for a second term, against a backdrop of splintering global trade and a looming Trump presidency likely to fly in the face of trade rules….”
https://www.newstatesman.com/science-tech/2024/11/bill-gates-the-optimists-dilemma
Interesting interview. “…. as the Foundation prepares for its 25th anniversary in 2025, Gates and his team believe the world is at a “crossroads” – or has reached “a tipping or inflection point”. …the “footnotes” to his optimism were bioterrorism, nuclear weapons and the disruptive potential of AI, for good and ill…. “
PS: “ Anupreeta Das, author of Billionaire, Nerd, Savior, King: Bill Gates and His Quest to Shape Our World, wrote that the launch of the Bill and Melinda Gates Foundation “completely refurbished the image of Gates, the jagged edges of the monopolist softened by the halo of the philanthropist”. But one wonders now if Gates feels his influence waning as the new national populism hardens against him and his philanthropic and liberal globalist ethos. He complains about the collapse in state capacity in the West but doesn’t draw a connection with the rise of the billionaire class and the hollowing out of the state and a sense of mass disaffection…..”
Vivek N.D.; https://www.globalhealthunfiltered.com/blog/8kps13nmcubu88twrmfe6acst0wwl3
« Philanthrocapitalism combines philanthropy with business principles, leveraging financial resources and entrepreneurial strategies to address social issues innovatively and sustainably. Prominent examples include the BMGF and Wellcome Trust. While advocates praise its potential for systemic change, critics warn against the undue influence of wealthy donors on social priorities.”
With focus here on BMGF’s work in India & South-Africa.
James Pfeiffer; The Collective;
“ Given the enormous resources that PEPFAR, USAID, and other major Western donors bring to Africa in the name of global health, rechanneling the lion’s share to long term investment in public institutions would not only be transformational, but honor the principles of decolonization through support for local governance of health and the ultimate goal of the SDG’s Universal Health Coverage.”
Among others, focusing on Mozambique in this blog.
https://www.devex.com/news/devex-invested-your-primer-for-the-biggest-ida-replenishment-ever-108867
One of the must-reads of the week. “Everything you need to know ahead of the World Bank’s IDA pledging conference in Seoul. …” Excerpts:
“The target: The goal is to raise around $100 billion for IDA this replenishment, though some have called for $120 billion. Due to IDA’s structure and ability to borrow, reaching the lower target will require between $27 billion and $28 billion from donors.”
“Cautious optimism: This IDA replenishment has been a bit unusual in that a lot of pledges have already come in. “Donors and the IDA team did a great job building a sense of momentum,” Clemence Landers, a senior policy fellow at the Center for Global Development, tells me. The target is “quite realistic” and even if donor contributions fall short, the bank may be able to use additional internal measures to hit the $100 billion target, she adds. … “ (ps: the US already pledged, but you know what might happen to that with the incoming Trump administration)
PS: “Speaking of debt, a new World Bank report out today finds that low- and middle-income countries paid a record $1.4 trillion toward debt in 2023. The lowest-income countries, those eligible to borrow from IDA, have seen their interest payments on external debt quadrupled in the past decade, hitting an all-time high of $34.6 billion in 2023. Ethiopia, Ghana, Pakistan, Sri Lanka, Zambia, and Laos are hit the hardest, with some already defaulting on their debt or seeking restructuring. South Asia and sub-Saharan Africa had the steepest increases in interest payments — far faster than the growth of their gross national incomes. … …. To add insult to injury, the debt distress is causing private creditors to withdraw…..”
· Related: Devex - Devex Newswire: Seoul’s crisis can’t stop a World Bank replenishment
“ The 21st replenishment of the International Development Association carries on in South Korea despite charged domestic politics.”
Kevin Watkins; Project Syndicate;
Some final advocacy pre the IDA replenishment. “With a generous replenishment, the World Bank’s International Development Association could help lift millions out of extreme poverty, extend opportunities for improved health and learning, and support adaptation to climate change. Unfortunately, some key donors are not carrying their weight.”
“….On December 7, governments will announce their funding pledges for the International Development Association, the branch of the World Bank Group that delivers finance to the world’s poorest countries (with annual per capita incomes below $1,315). IDA replenishment happens every three years, which means that commitments made today span the critical investment period for salvaging the SDGs. Unfortunately, it isn’t looking good, with several key donors failing to pull their weight…..” Among others, Watkins mentions France in this category.
(5 Dec) And this was the result. “ …. After months of negotiation, partnership, and unwavering commitment from our donor community, the 21st replenishment of the International Development Association (IDA) has raised $24 billion in donor contributions. Thanks to IDA’s unique leveraging model, this $24 billion will generate a total of $100 billion in affordable financing—the largest replenishment in IDA’s history. ….”
V Fan & S Gupta; https://www.cgdev.org/blog/how-heal-health-financing
“Developing economies do not allocate sufficient domestic resources to health, and a cumbersome donor architecture undermines external financing. A multipronged approach that prioritizes strengthening country health systems and integrates global initiatives into national strategies could have a lasting impact on health outcomes in these countries. “
Authors start from a rather daunting diagnosis, and then lay out their integrated approach.
“…Treating this complex diagnosis requires a shift from single-focus interventions, aimed at controlling a specific disease, toward integrated approaches that consider the complex interplay between health, economic, and social factors. There is no need for a revolutionary approach: the 2023 Lusaka Agenda called for greater alignment of global health initiatives with country health systems and primary health care in Africa, consistent with the 2005 Paris Declaration on aid effectiveness. To advance this agenda, the global health community would do well to recognize the need for reform and commit to an approach that strengthens countries’ health systems and integrates global initiatives with national strategies. After all, no country, regardless of income level, has achieved universal health coverage without major increases in public spending. …”
Joseph Kutzin et al; https://www.tandfonline.com/doi/full/10.1080/23288604.2024.2428415
“This paper emphasizes the importance of orienting health system reforms to address underlying system-level performance problems. Too often in practice, the objective-orientation that is stressed in health system frameworks gets lost in relation to policies or schemes that are promoted without plausible linkages to the actual objectives of the reforms. The objective-orientation can also get subsumed by political agendas that are disconnected, or can even detract from, people’s health needs. There are three core attributes to objective-oriented health system reform: (i) problem-oriented; (ii) consistent (extent to which reforms are connected to the problems they are meant to address and reflect lessons from global and national experience); and (iii) continuously evaluated. Country experiences reviewed in the paper, and presented in this special issue, illustrate how taking an objective-orientation led reformers to alter the details of implementation….”
“Sustainable innovation is crucial for strengthening health systems, particularly in low- and middle-income countries in Africa. But investors have historically been hesitant to engage with Africa's health care sector.”
“For decades, health care in Africa was seen as the responsibility of governments and charities. Now, a new wave of African health tech startups is challenging that narrative — and saving lives along the way. But unlike financial, agriculture, or energy tech, health tech faces a unique skepticism: Is saving lives profitable?....”
Among others on Fields Intelligence.
Ps: “…. The sustainability of Field's model is further reinforced by its innovative financing and partnerships. With thousands of pharmacies as paying subscribers and operating within its network, Field leverages its scale to attract investments from both private and public sectors, including collaborations with the Nigerian government and international organizations like the Gates Foundation. In September, the company secured $11 million from the Gates Foundation as part of a partnership designed to accelerate the availability of key maternal, newborn, and child health products…..”
A Ala et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02614-X/fulltext
“The global health landscape spans high-income, middle-income, and low-income and middle-income countries (LMICs) and has pervasive disparities in health outcomes and access to care, particularly among underserved and marginalised populations, including minoritised ethnic groups. The COVID-19 pandemic underscored these inequities, revealing that underserved communities often have high levels of unmet health needs, which are exacerbated by socioeconomic inequalities, cultural barriers, and low access to health-care services. Faith-based organisations (FBOs) have historically played a crucial role in health-care delivery in LMICs, providing a unique avenue to bridge these inequities. The role of religious beliefs in facilitating health-care access and improving outcomes can be instrumental in expanding public health interventions and government programmes, especially for marginalised populations. During disease outbreaks, religious leaders and FBOs have crucially offered front-line humanitarian assistance, providing spiritual support to the community and sharing important health messages. These efforts help to reduce fear, combat misinformation, and prevent stigma……”
Authors admit incorporating them into health initiatives poses challenges. But they aren’t insurmountable, they argue.
This year’s World AIDS day took place under the theme “Take the rights path: My health, my right!”
Some reads we want to flag:
https://news.un.org/en/story/2024/11/1157486
With coverage and key messages of the latest UNAIDS report - Take the Rights Path to end AIDS.
“Ahead of World AIDS Day on 1 December, a new report by the Joint UN Programme on HIV/AIDS (UNAIDS) highlights the critical role of human rights in ending the AIDS pandemic as a public health threat by 2030. … … Titled “Take the rights path to end AIDS,” the report outlines how stigma, discrimination, and punitive laws hinder progress in the fight against HIV. Despite significant advancements in HIV treatment and prevention, human rights violations continue to block access to essential services…..”
“In 2023, 630,000 people died from AIDS-related illnesses, and 1.3 million people acquired HIV. Marginalised communities, including women, girls, and LGBTQ+ individuals (lesbian, gay, bisexual, transgender, queer and others), remain disproportionately affected. …. Sub-Saharan Africa illustrates this disparity starkly: every day, 570 young women aged 15 to 24 acquire HIV, a rate three times higher than their male peers…..”
“Globally, 9.3 million people living with HIV are not receiving life-saving treatment…..”
“…Punitive laws targeting marginalised communities exacerbate the crisis. In 2023, 63 countries still criminalised same-sex relationships……”
Analysis published ahead of World AIDS day. “As we recognize World AIDS Day, experts have fears about the future of the fight against HIV.”
“…On Sunday, it will be 36 years since the first World AIDS Day. Initially created to raise awareness of the disease and honor those who died because of it, the observance has lately become a rallying point to push toward the goal of ending AIDS as a public health threat by 2030. But this year, the day is more likely to serve as a warning that the goal is about to slip out of reach…..”
W Byanyima, R Horton, M Dybul et al; https://www.telegraph.co.uk/global-health/science-and-disease/world-aids-day-hiv-rates-open-letter-pandemic-response/
With some high-level advocacy from global health leaders, ahead of the World AIDS day.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02613-8/fulltext
Lancet Editorial from last Friday.
“2024 has been a year of highs and lows in the global HIV effort. More people than ever are receiving antiretroviral treatment and have viral suppression. Deaths from AIDS are at their lowest level for two decades. Yet despite this encouraging progress, the Sustainable Development Goal of ending HIV as a public health threat by 2030 is not on track. Worryingly, the pandemic continues to expand in some populations. According to the UNAIDS 2024 World AIDS Day report, nine countries have reached the 95-95-95 targets that need to be met by 2025 to end the AIDS pandemic by 2030, with the targets in reach for a further ten countries. At this pivotal moment, efforts must be intensified to bring HIV under control. A major challenge is the number of new HIV infections every year, with an estimated 1·3 million people newly infected in 2023. Prevention efforts in some regions have lost momentum and renewed focus will be needed to reverse this trajectory. Effective HIV prevention requires a combination of behavioural, biomedical, and structural approaches, including viral suppression with antiretrovirals, condom use, needle-exchange programmes, education, and policy reform…..”
“…. if long-acting preventive treatments are to make a substantial dent in new HIV infections, they must be affordable and accessible to those at greatest risk. …”
The editorial concludes: “… Scientific advances alone are insufficient to end HIV as a public health threat: it is a political and financial choice. An approach grounded in human rights, combined with a biomedical, behavioural, and structural response, is needed to curtail the HIV/AIDS pandemic once and for all.”
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00807-7/abstract
“A HIV programme designed for adolescent girls and young women in sub-Saharan Africa celebrates its tenth anniversary on World AIDS Day this year. Udani Samarasekera reports.”
“ Delegations from over 110 countries [came] together to produce national roadmaps and negotiate a joint declaration on oral health at the first-ever global oral health meeting organized by the World Health Organization (WHO). The declaration [outlines] collective commitments from Member States to accelerate the implementation of the Global strategy and action plan on oral health 2023–2030….”
“… This groundbreaking event, hosted by the Government of the Kingdom of Thailand, is part of the preparatory process for the fourth UN High-Level Meeting on NCDs (4th UN HLM on NCDs) in 2025. It aims to accelerate progress towards UHC, reaffirm political commitments made by Member States, and promote the implementation of the Global strategy and action plan on oral health 2023–2030…..”
https://healthpolicy-watch.news/betrayal-climate-finance-battle-ends-in-defeat-at-cop29/
Neat & comprehensive analysis, including of the ‘agreement’ reached. (Recommended read)
“… As negotiations unfolded, developing nations found “quantum” was darkly fitting: while its original Latin meaning asks “how much?”, wealthy nations’ proposed climate finance matched its scientific definition – the smallest amount possible…..”
“…. The final agreement, struck 24 hours after developing nations fiercely rejected the initial offer, barely moved: $300 billion per year by 2035, with the $1.3 trillion acknowledged only as an aspirational target….”
(26 Nov) Open letter by J Rockström & many others.
“In an open letter to UNFCCC, Johan Rockström & others call for an urgent revision of the New Common Quantified Goal of Climate Finance #NCQG …. A more ambitious NCQG update is needed to align with the goal of limiting global warming to 1.5°C.”
“…. The world has thus reached a point of climate emergency. We face potentially unmanageable risks, already within the next decades. … Global emissions must be reduced by 7.5% per year from now on, to have a chance of holding the 1.5°C limit. This means that the task for the world, and for climate finance, is to take approximately 3 billion tons of CO2 off the global economy in 2025. It is thus necessary to mobilise climate finance now — starting at full scale in 2025 — not “by 2035” (or “by 2030” as the Third Report of the IHLEG on Climate Finance suggests). Waiting until 2030 or 2035 to deliver full scale would be inconsistent with climate science, and very likely be path to climate disaster. We outline below our suggestions for how to urgently align the New Common Quantified Goal of Climate Finance — in its necessary update among (groups of) developing and developed countries in 2024-2025 or at COP30 — with delivery on the 1.5°C Paris Agreement Goal (or staying as very close as possible)….”
“Negotiations to produce a legally binding treaty to curb the global explosion of plastic pollution collapsed Sunday as efforts to limit the production of fossil fuel-based plastics supported by over 100 countries, including the European Union, met fierce opposition from oil-producing nations. A coalition of oil and gas producing countries, led by Saudi Arabia and including Iran, Russia, and other Gulf states under the Arab group, opposed capping plastic production, insisting the treaty should focus solely on plastics waste management. The next round of plastics negotiations has not yet been scheduled or assigned a location…..”
PS: “…. the Busan talks became the third major failure of multilateral environmental negotiations in as many weeks, following disappointing outcomes at COP29 in Baku and a total collapse of talks on new funding and enforcement mechanisms at the UN Convention on Biological Diversity’s COP16 in Cali, Colombia, which aims to protect nature and wildlife…..”
· Related: Guardian – Countries call for binding targets to cut plastic production after talks fail
“Group of 85 countries and blocs press for ambition in plastic waste treaty after no agreement was reached in Busan.”
· Guardian – Plastics lobbyists make up biggest group at vital UN treaty talks
“Fossil fuel and chemical industry representatives outnumber those of the EU or host country South Korea.”
https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(24)00304-8/fulltext
(26 Nov) “ Nearly 100 nations will present their views on climate change and the law to the International Court of Justice in a landmark hearing. The International Court of Justice (ICJ), sitting in The Hague, is hosting two weeks of oral submissions starting on 2 December to inform its advisory opinion on climate change…..”
“Drawing on a wide body of international law, it will consider two fundamental questions: what obligations do states have under international law to protect the climate system and what are the legal consequences for failing to do so?”
“The hearing is the culmination of years of campaigning by a group of Pacific island law students who had the idea to ask the court for an advisory opinion in 2019. The students secured the support of the state of Vanuatu, which spearheaded diplomatic negotiations…….”
· Related – Guardian – Handful of countries responsible for climate crisis, top court told
“Vanuatu envoy makes claim as hearing gets under way at international court of justice in The Hague.”
“A focus on climate ‘tipping points’ — moments of abrupt and irreversible shifts in the Earth system, such as the loss of the Amazon rainforest — isn’t helpful, argues an interdisciplinary group of ten researchers that includes climate scientists, science communicators and environmental sociologists. The issues involved are important to study, but the framing is too abstract and frightening to trigger useful action, and not rigorous enough to inform policy, they argue. They recommend that scientists avoid using the idea as a scholarly tool and instead consider it “a fuzzy, boundary-spanning concept akin to ‘sustainability’”.” (#hmmmmmm)
https://news.un.org/en/story/2024/12/1157791
“The UN sexual and reproductive health agency, UNFPA, appealed on Thursday for $1.4 billion to safeguard the rights and well-being of women, girls and youth in 57 crisis-affected countries in the coming year. The funding will be used to deliver life-saving reproductive health services and vital gender-based violence prevention programmes to more than 45 million people. The appeal comes as an estimated 11 million pregnant women will require urgent support in 2025….”
https://healthpolicy-watch.news/rapists-avoid-punishment-in-many-african-countries/
“Rape is common across Africa yet inadequate laws, weak implementation and cultural barriers mean that many perpetrators go unpunished, according to new research by Equality Now.”
“ “After examining rape laws across Africa, it is clear that to end impunity for perpetrators, governments urgently need to carry out comprehensive legal reform of rape laws, strengthen enforcement mechanisms, and improve access to justice and support for survivors,” said Jean Paul Murunga, a human rights lawyer and the report’s lead author. The report looked at rape laws and their enforcement in 47 African countries with an in-depth analysis of nine of these: Cameroon, Democratic Republic of Congo, Madagascar, Rwanda, Senegal, Sierra Leone, South Africa, South Sudan, and Zambia…..”
https://www.bmj.com/content/387/bmj.q2724
Big news from early this week (which Elon didn’t like much). “Children and young people aged under 16 will be banned from a range of social media platforms in Australia within a year, after the federal parliament passed a law to “deliver greater protections for young Australians during critical stages of their development.” “
https://news.un.org/en/story/2024/11/1157596
From last week.
“More than 60 million women and girls worldwide who are forcibly displaced or stateless face high risks of gender-based violence (GBV), but funding for lifesaving services to support them is woefully lacking, the UN refugee agency UNHCR said [last week] on Friday. “
“UN data reveals that reports of conflict-related sexual violence increased shockingly by 50 per cent last year compared to 2023, and women and girls accounted for 95 per cent of verified cases. These numbers, however, “represent a small fraction of the reality” as many cases go unreported, the agency warned…..”
Maureen Murphya et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02625-4/abstract
Comment related to a forthcoming meta-analysis of prevalence data.
https://news.un.org/en/story/2024/12/1157706
“Multiple unending conflicts, climate change and a glaring disregard for long-established international humanitarian law are set to leave a staggering 305 million people in need of lifesaving assistance next year, the UN’s top aid official warned on Wednesday.”
“ “The world is on fire…We are dealing with a polycrisis right now globally and it is the most vulnerable people in the world who are paying the price. We are dealing with the impact of conflicts - multiple conflicts - and crises of longer duration and of more intense ferocity” said Tom Fletcher, UN Emergency Relief Coordinator and head of the UN aid coordination office, OCHA, in an appeal for $47.4 billion to provide life-saving aid in more than 30 countries and nine refugee-hosting regions. Dire as OCHA’s new humanitarian assessment is on behalf of more than 1,500 humanitarian partners, it is expected that of the 305 million in need, only 190 million will be reached…..”
Re the climate change accelerator: “…While stressing how many lives have been shattered by conflict around the world – not least in Sudan, where the new UN relief chief spent last week visiting and talking to people uprooted by the war – Mr. Fletcher underscored how severe the climate crisis is on already vulnerable people. “The dread I have is that those two huge drivers of need are now combining,” he said. And that's what makes our job so difficult. And they're often combining in areas that have already suffered huge levels of poverty and inequality.”….”
· Related (Recommended) in-depth analysis: New Humanitarian - Key takeaways from the UN’s “ruthless” aid blueprint for 2025
“ …. It’s the second year of slimmed-down, pared-back planning under a mandate of so-called “prioritisation” and “boundary setting”: The cost estimates for 2025 are nearly $10 billion less than what they hit by the end of 2023. …”
“Facing budget shortfalls, aid groups have been urged – or been told – to focus on the most severe needs to lower the overall price tag for donors, who have been kicking in a shrinking percentage of funding over the last decade. Proponents say it’s a realistic understanding of what the international system can do – especially given forecasts for continuing drops in donor government funding, and another Trump presidency on the horizon. Others warn that it leaves out potentially tens of millions of people who need aid from even being counted, while giving short shrift to the sorts of reforms needed to adapt to a world of volatile crises…..”
“…The UN’s new relief chief, Tom Fletcher, acknowledged a “ruthlessness” behind the tough decisions of who to target and what to count. Next year’s response plans estimate some 305 million people are in need of aid, but targets roughly 62% of them…. “It’s a recognition that we have struggled in previous years to raise the money we need,” Fletcher told reporters, a couple of weeks into his job as the UN’s head humanitarian….”
https://www.reuters.com/investigates/special-report/famine-response-overview/
“The IPC ( Integrated Food Security Phase Classification) is meant to head off famine by sounding alarms that direct food aid to brewing crises. But the tiny watchdog and other key players are struggling to operate in areas ridden with conflict – the main driver of hunger today.”
“…Critically, the IPC is struggling to access the data it needs to conduct informed analyses. With most of the world’s food crises being driven by conflict, it has become increasingly difficult to gather the information the IPC requires to classify vulnerable nations on its five-stage acute food-security scale. In Gaza, Israeli bombing and restrictions on movement have impeded efforts to collect statistics on malnutrition, deaths unrelated to trauma, and other essential data. In Sudan, violence, military roadblocks, bureaucratic obstruction and a telecommunications blackout have disrupted efforts to test for malnutrition, count deaths and survey people about their access to food….”
“Another frequently false assumption underpinning the IPC’s work: The world will respond promptly to its warnings. In reality, significant aid sometimes comes after the starving are already dying in droves. Perhaps the system’s greatest weakness – one its creator Haan points to himself – is the premise that governments in hunger-stricken countries will cooperate fully with the IPC, the U.N. and other outside helpers….”
“Human rights group says Israel ‘brazenly, continuously and with total impunity … unleashed hell’ on strip’s 2.3m population.”
“A report from Amnesty International alleges that Israel’s war against Hamas in the Gaza Strip constitutes the crime of genocide under international law, the first such determination by a major human rights organisation in the 14-month-old conflict…..”
Link:
· HPW – WHO Welcomes Israel-Lebanon Ceasefire – But Onset of Winter Increasing Desperation in Gaza
M Barber ; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003940
“Debates over the scope, terms, and governance of technology transfer–the sharing of essential technical information, know-how, and materials needed to manufacture a health product–are prominent and controversial in international health diplomacy. These debates have become focal points in recent contentious negotiations to amend the International Health Regulations (IHR) and draft a global Pandemic Agreement. While some countries advocate for automatic or compulsory mechanisms to facilitate access to health technologies, especially in times of crisis, others oppose legal frameworks that mandate non-voluntary participation by the pharmaceutical industry. Also at stake are questions of institutional mandate: the United States has amplified calls by industry that pandemic technology transfer policy should be the domain of the World Trade Organization (WTO) instead of the World Health Organization (WHO). This essay offers a counternarrative to claims that WHO is overstepping its historic role in global governance. Far from being a contemporary development, technology transfer was at the heart of WHO’s work at its founding. WHO’s early failure to secure antibiotic technology transfer in the face of US opposition led to its first major crisis, prompting the withdrawal of several member states. In response, WHO embarked in the 1950s on a visionary programme to establish a global network of non-profit, state-run drug manufacturers and scientists committed to the free exchange of knowledge. This ambitious initiative has been largely forgotten, excluded even from WHO’s self-published accounts of historical technology transfer work. In the context of ongoing pandemic governance negotiations and the nascent mRNA hub program, remembering the lost vision of global solidarity embodied in WHO’s midcentury technology transfer program offers a glimpse into an alternate path we might still chart, one where access to medicines is not bound by the logic of enforcing scarcity to maximize profit, and the right to health is a global responsibility.”
“The World Health Organization (WHO) has granted prequalification to the molecular diagnostic test for tuberculosis (TB) called Xpert® MTB/RIF Ultra. It is the first test for TB diagnosis and antibiotic susceptibility testing that meets WHO's prequalification standards…..”
Peter Singer; https://www.telegraph.co.uk/global-health/science-and-disease/how-to-save-a-million-lives-a-year-with-obesity-drugs/
“The benefits of GLP-1 inhibitors are so far largely limited to wealthy nations. Expanding global access could bring transformative effects.”
Singer mentions three bottlenecks, though.
“….The 2024 World Conference on Traditional Medicine [was] held in Beijing, China and co-sponsored by the World Health Organization (WHO), in collaboration with the National Health Commission of China, the National Administration of Traditional Chinese Medicine (NATCM), and the Beijing Municipal Government. The conference [will be] a pivotal platform to enhance dialogue and collaboration among international experts, policy-makers, health workers, and traditional medicine practitioners. It [will help] advance progress towards the United Nations Sustainable Development Goals (SDGs), particularly Goal 3 on ensuring healthy lives and promoting well-being for all. Discussions [will also] align with the Global Strategy for Traditional Medicine (2025–2034), which WHO will present at the Seventy-eighth World Health Assembly in May 2025….”
Check out the objectives.
Ongoing (from 2-6 December).
“The 2024 Joint Meeting brings together global health agencies, manufacturers, and suppliers to address challenges and opportunities in ensuring equitable access to quality-assured health products. Building on the momentum of the November 2023 discussions, this year’s meeting takes a forward-looking approach to unlocking the power of innovation and local manufacturing to drive equitable access and help to achieve Universal Health Coverage (UHC). With the theme “Ensuring Health Equity: Partnerships for Accessible Quality Products,” the event offers participants a deep dive into sustainable local manufacturing practices and cutting-edge supply chain innovations. ….”
“African researchers are turning to the continent’s rich reservoir of medicinal plants to develop new locally produced drugs as growing pandemic outbreaks and global antimicrobial resistance continue to ail health systems.”
“….The Kenya Medical Research Institute now has a Center for Traditional Medicine and Drug Research that conducts scientific studies on traditional medicines with the aim to integrate them into the country’s health care system. Burundi is extracting essential oils from the catnip plant to develop a mosquito repellent. And at least 15 plant species from southern Africa applied in traditional medicine have been fully or partially commercialized.
“Researchers from the medical research consortium Afrique One have partnered with the West African Traditional Healers Association to study and validate Africa’s traditional remedies, professor Bassirou Bonfor, director of the consortium told Devex…..”
https://healthpolicy-watch.news/report-charts-urgent-course-correction-for-how-the-world-grows-food/
“The world needs to urgently change the way food is grown and land is used in order to avoid irreparable harm to global food production capacity, according to a major new scientific report released Sunday. Currently seven out of nine ‘planetary boundaries’ have been negatively impacted by unsustainable land use, mostly related to unsustainable agriculture, warns the report produced by the German-based Potsdam Institute for Climate Impact Research (PIK) along with the UN Convention to Combat Desertification (UNCCD)…..”
“Approximately 15 million km² of land area, or 10% of the world’s terrestrial space, is already severely degraded, as measured by the extent of deforestation, diminished food production capacity, and the disappearance of freshwater resources. And this degraded land area is expanding each year by about 1 million km², according to the report.”
“We stand at a precipice and must decide whether to step back and take transformative action, or continue on a path of irreversible environmental change,” said Johan Rockström, Director at PIK who is also the lead author of the report…..”
“Shifting food production to “regenerative agriculture” practices as well as land restoration to improve the health of lakes, rivers and underground aquifers are among the immediate solutions needed to make a course correction…..”
“Nearly five years since COVID-19 was first reported, a new global report on infection prevention and control (IPC) by the World Health Organization (WHO) shows there has been slow progress in addressing critical gaps to prevent health care-associated infections (HAIs).”
“A large proportion of HAIs can be prevented with improved IPC practices and basic water, sanitation and hygiene (WASH) services, which are also a highly cost-effective "best buy" to reduce antimicrobial resistance (AMR) in health care settings. This report, launched at a G7 side-event hosted by Italy, provides a baseline assessment for policymakers, IPC professionals, health care workers and stakeholders to guide action…..”
“ The report finds that though 71% of countries now have an active IPC programme, just 6% met all of the WHO IPC minimum requirements in 2023-2024. This is well behind the target of more than 90% by 2030 set in the WHO Global action plan and monitoring framework on IPC. The report also highlights that patients in low- and middle-income countries (LMICs) have up to 20 times higher risk of acquiring infections during health care delivery than in high-income countries (HICs)….”
· Coverage via Cidrap News – WHO report highlights burden, impact of healthcare-associated infections
“A new report from the World Health Organization (WHO) provides an updated analysis of the harm caused to both patients and healthcare workers worldwide by the avoidable infections that result from gaps in infection prevention and control (IPC). …. … most studies show the problem is particularly acute in low- and middle-income countries (LMICs). For example, WHO analysis of published data show an average of 7 out of every 100 patients in acute-care hospitals in high-income countries (HICs) will acquire at least one HAI during their hospital stay. In LMICs, the figure is twice that (15%). Similarly, the incidence of HAIs in intensive care units is 30% overall but 2 to 20 times higher in LMICs than HICs. ….”
“The Global Commission on Drug Policy’s report, Beyond Punishment: From Criminal Justice Responses to Drug Policy Reform, exposes how punitive drug policies have driven mass incarceration and grave human rights violations. ….”
“In 2023 alone, over 3.1 million people were arrested for drug-related offenses, with 20% of the global prison population detained for such crimes - nearly half for simple possession. …. The report underscores the devastating consequences of prohibitionist policies, including over one million overdose deaths in the U.S. in the past two decades and 40,000 in Canada in just eight years. It also highlights systemic inequities, such as Indigenous peoples in Canada being six times more likely to face drug-related arrests than white counterparts. Furthermore, the report illustrates the disproportionate burdens on women and children, deepening cycles of poverty and marginalization…..”
· Related Lancet Global Health Editorial - Harm reduction must replace punitive drug policies
“... The so-called war on drugs has failed. In the last century, countries have increasingly attempted absolute prohibition of drug use, often via penal measures. Despite global action, these policies have not deterred drug use…”
“…On Dec 5, the Global Commission on Drug Policy published a call-to-action report, Stop Punishment: From Criminal Justice Responses to Drug Policy Reform. This report urges immediate humane and evidence-based reframing of the problem and the solution: to lessen the damage of illicit drug use and dependency, we must put harm reduction strategies at the centre of our response and tackle the social determinants of drug use…..”
· And via UN News - ‘War on drugs has failed, completely and utterly’: UN human rights chief
“ The UN human rights chief has called on leaders and international stakeholders to radically rethink global drug policy, stating that the decades-long “War on Drugs” approach has “destroyed countless lives and damaged entire communities”.”
https://news.un.org/en/story/2024/12/1157691
“Marking the International Day of Persons with Disabilities on Tuesday, UN Secretary General António Guterres emphasised the crucial need to increase the leadership of persons with disabilities in addressing global challenges, as essential to shaping technological advances and policy decisions.”
“… The day comes as countries recently adopted the Pact for the Future, committing to addressing long-standing inequalities faced by more than one billion persons with disabilities globally. The theme for 2024 – “Amplifying the leadership of persons with disabilities for an inclusive and sustainable future” – reinforces the disability rights movement’s core principle of “Nothing About Us Without Us”….”
M L O’Ryan, F Baum et al ; https://www.bmj.com/content/387/bmj.q2508
“A BMJ Commission will redefine the role of academia in healthcare.”
“Academic medicine remains under scrutiny. Despite various attempts to tackle its problems, including a global initiative in 2003, The BMJ’s editor in chief recentl yconcluded it is “broken.” At the centre of the “crisis” are historical power imbalances that have led to broken career structures, perverse incentives for academic reward and research funding, and a widening rift within medical institutions between research and education. A crisis in evidence based medicine is also part of the problem. In addition, workforce shortages and growing health service demands are putting strain on health system budgets, leaving little room for governments to direct public funds into research rather than service delivery…..”
“To respond to the growing crisis, TheBMJ has launched a Commission on the Future of Academic Medicine, which aims to revive academic medicine and redefine its role for the rest of the century. The commission seeks to trigger a global conversation to build on what is working, to fix what is not, and to realign the role and function of academic medicine to ensure its relevance for the future…..”
PS: “….As a first step, we as co-chairs have identified misalignments in goals and drivers of scientific agendas, and gaps in academic capacity that need fixing in academic medicine (box 1)…..”
“Elon Musk’s satellite internet offering is now in 15 African nations, bringing reliable connectivity to previously offline remote areas”
“In November 2004, health ministers and delegates from 58 countries gathered in Mexico City to address the urgent need for robust national health systems and equitable health services. Organized with the World Health Organization (WHO), this landmark event culminated in the Mexico Statement on Health Research, which called on governments, funders, and the international research community to strengthen health research systems and advance equity in health. Almost exactly two decades later, at the Eighth Global Symposium on Health Systems Research in Nagasaki, Japan, the Alliance for Health Policy and Systems Research and the Asian Development Bank brought together participants to reflect on the Summit’s enduring legacy and address the pressing challenges facing global health systems today…..”
With the views of Jeanette Vega, J-A Röttingen, J Frenk & R Horton.
“Policy-makers from around the globe gathered in Geneva, Switzerland, from 9-11 October 2024 for the inaugural Alliance Policy-maker Forum. The Forum is part of the Alliance’s commitment to enhance the perspectives of policy-makers in evidence-informed policy-making, promote cross-country learning and dialogue and establish a platform for exchange with global health funders. The diverse group included policy-makers from Brazil, Ghana, India, Indonesia, Ethiopia, Nigeria, South Africa and the West Bank. …….”
This event took place on 21 November 2024 under the theme: Digitalization as a Growing Determinant of Health and Well-being: Getting It Right.
· Related (via LinkedIn) by Tim France: 7 vital lessons on digitalization and health
With seven key take-aways from Prof. @IlonaKickbusch keynote address at the recent 14th Annual Global Forum on Health Promotion.
https://g20.org/news/south-africa-pledges-continuity-on-brazils-g20-priorities/
“Zane Dangor, South Africa’s sherpa, said the country’s G20 presidency, beginning in December, will focus on global solidarity, sustainable development, and reducing inequality.”
K Mathiasen et al; https://www.cgdev.org/blog/lookback-biden-administrations-development-agenda-part-ii-health-food-and-human-capital
Second blog in the CGD series on the Biden administration’s global development agenda over the past 3 ½ years, with analysis on how the next Trump administration could affect its legacy.
“The blogs are based on the administration’s own account of its accomplishments as laid out in the U.S. Strategy on Global Development released by the White House in September 2024, which centers around five key objectives:
For the second piece in this series, we look at the outgoing administration’s record on health, food security and human capital. Because President Biden came into office during the global pandemic, health policy was an urgent priority. An initial focus on vaccine production and distribution evolved into an agenda around pandemic preparedness in addition to the more traditional areas of reproductive health and HIV/AIDS prevention. Of all the issues we consider, the administration’s legacy around health, especially reproductive health, is likely among those at highest risk under the Trump Presidency, along with support for decarbonization, democracy and human rights. The nomination of Robert F. Kennedy Jr., a prominent vaccine skeptic, as the Director of Health and Human Services, is also an ominous sign for global health cooperation…..”
https://www.devex.com/news/what-do-germany-s-snap-elections-mean-for-aid-108859
(gated) “A breakup in Germany’s ruling party coalition has frozen proposed funding cuts to the development budget for next year. But depending on the outcome of the election, bigger changes could be on the horizon.”
“…. the snap elections that are likely to be called for Feb. 23, 2025, could remake the government and have the potential to shift the country’s approach to development…..”
A Kulenova, R Lencucha et al ; https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-024-01086-0
« …. Our research examines the process of problem and solution representation, priority setting, and factors that shape the policymaking process concerning women and girls within the UN system in relation to the SDGs….”.
B Clements et al; https://www.cgdev.org/blog/securing-climate-and-sdg-financing-only-half-battle
« …. In this blog post, we argue that while mobilizing additional financing is challenging, effectively absorbing and utilizing these additional resources presents an equivalent challenge for recipient countries. Our analysis reveals that for many low-income countries (LICs) and low-middle-income countries (LMICs), the volume of incoming funds would vastly exceed current levels of revenue, expenditure, and external financing. This underscores the urgent need to focus on enhancing institutional and operational capacities in recipient countries to ensure resources are utilized effectively and achieve their intended impact. »
https://www.bmj.com/content/387/bmj.q2675
« Consistent and fair remuneration is essential to empower African patient partners to contribute to health decisions and policies that affect them, writes Kwanele Asante. »
« Global calls for patient partners to be paid fairly for their contributions to the health sector are growing. Most patient partners in Africa work within health facilities as chaperones or “champions” or as ad hoc public partners in health policy making and biomedical research. »
« The fair pay movement is particularly strong in Canada and Europe, but it’s yet to take hold in a meaningful way in Africa, where it’s most needed. African member states and global health organisations are leaving health users in Africa behind by not prioritising their health and human right to participate in policy making and decisions that affect their healthcare. Consistent and fair remuneration will enable and empower African patient partners to meaningfully participate in key national and global health deliberations. »
(gated) “Brieuc Pont, charged with putting on the Nutrition for Growth summit in March, is spreading the “gospel of nutrition” as he drums up financial and political pledges.”
“…. Brieuc Pont is a French diplomat with a global mission: He’s rallying governments, businesses, philanthropy, civil society, and development banks to end malnutrition together. …. Last December he became France’s special envoy on nutrition and secretary-general of the Nutrition for Growth Summit, a major pledging conference. With four months until the big event in Paris on March 27-28, he’s been traveling worldwide trying to get anyone and everyone involved to prepare their commitments — both financial pledges and, for governments, nutrition policy plans.”
“…. The Paris summit is set for March 27-28, 2025. It follows a 2021 event in Tokyo that raised more than $27 billion in financing. Of course, that was before the global downturn in donor activity and the conflicts in Ukraine and Gaza. But Pont, a diplomat who was previously France’s ambassador to Nicaragua, is doing his best to convince stakeholders that it’s worthwhile to invest. …. …“When you plant $100 million in nutrition-specific or -sensitive development policies, you get $2.3 billion in returns — that is wealth that can be redistributed or reinvested,” he tells Devex Senior Editor Tania Karas in a wide-ranging interview. Yet only 1% of official development aid is nutrition-specific. “So there is the challenge to get back to that issue, to make governments and donors aware that it works.” Pont is especially hopeful that the cost-effectiveness pitch will appeal to development banks. …. …. He’s also open to talking to corporations, despite some hesitance in the nutrition sector to engage big food companies. Pont says there are obvious red lines: N4G won’t be looking for contributions from companies producing weapons, alcohol or cigarettes, or those that aggressively market breastmilk substitutes….”
“Over the last decade, more than a dozen countries have laid claim to feminist foreign policies (FFPs), marking a notable shift in rhetoric and attitudes towards gender, feminism and foreign policy objectives in international forums. Many such policies are focused on international assistance over other realms of foreign policy, and of these, Canada and Germany are amongst the most prominent humanitarian donors. “
“This study forms part of a two-year research project examining the role of narratives – that is, prescriptive stories like FFP that motivate spending and decision-making – in humanitarian policy and practice.”
Check out key messages.
T Oluwaseun Sokunbi, Elijah Orimisan Akinbi; https://www.sciencedirect.com/science/article/pii/S2590229624000170?via%3Dihub#s0020
“… This study aims to provide an overview of health financing in Africa and to examine the impact of the re-emergence of mpox on health financing in the region.”
“The research paper “The cost of the re-emergence of monkeypox: An overview of health financing in Africa,” authored by Taiwo Oluwaseun Sokunbi and Elijah Orimisan Akinbi, examines the financial burden of the recent monkeypox (mpox) outbreaks on Africa’s healthcare systems….”
Josephine Borghi et al; https://academic.oup.com/heapol/article/39/Supplement_2/i4/7901680?login=false
In case you missed this (from a new HP&P Supplement).
I Mitchell et al; https://www.cgdev.org/blog/depolluting-oda-five-trends-finance-international-development
“This week, international organizations will meet in New York to prepare for next June’s UN Conference on Financing for International Development. …. One item on the agenda, is Official Development Assistance’ (ODA); and the conference next year could eventually lead to reforms. …“
“….We have already created an alternative measure—Finance for International Development (FID)—which is a better guide to the funding that matters to development. In this blog, we highlight five insights from that measure; and use it to highlight where ODA is expanding unhelpfully with items barely relevant to developing countries.”
Authors conclude: “…Time to reform ODA: “We have argued before that ODA needs reform. The title of the UN’s financing for development process has the thing we care most about in its title. We should measure that, rather than the valuable but much-less relevant elements of ODA.”
With some new studies in the Political Economy Analysis of Primary Health Care–oriented Reforms Country Case Study Series. Country Case Studies from Kazakhstan, Kenya, New Zealand, Thailand, & Uruguay on Political Economy of PHC-oriented reforms.
E Luyten et al; https://www.sciencedirect.com/science/article/abs/pii/S0168851024002288
“The design of health financing impacts income redistribution within the population. Health financing with progressive taxation can reduce post-taxes income inequality. Tax-based systems are more redistributive than social and private health systems. Recent studies on the redistribution of health financing sources are limited.”
V Nafade, M Pai et al ; https://www.sciencedirect.com/science/article/pii/S2589537024004784
« … there is comparatively little research and advocacy about the value of medical imaging in low- and middle-income countries (LMICs), particularly at the primary care (PC) level. Discussions around diagnostics in global health often focus on laboratory tests: for example, the WHO Essential Diagnostics List (EDL) is exclusively focused on in vitro diagnostics (IVDs). There may be a missed opportunity to advocate for and invest in medical imaging, to meet the Sustainable Development Goal objective of universal health care (UHC), which includes primary health care as a core. Available data suggest that imaging is highly limited at the PC level…..”
By Y Lee, L Gostin et al.
“As conventional methods to control mosquito populations become less effective, a controversial experiment yields promising results .”
“The weekly shop in Brazil is a little different these days, and may soon change in other parts of the world plagued by dengue fever. In addition to the usual staples – bread, fruit, meat and vegetables – Brazilians can now add dried mosquito eggs to their shopping trolley. … Why would anyone do this? Aren’t mosquitoes the problem to begin with? …. The answer lies with Oxitec, a UK biotech company that has genetically modified the insects in question. Brazilians who buy the eggs are releasing a relatively small number of mutant mosquitoes in order to prevent the production of many millions more.”
https://www.science.org/doi/10.1126/science.adt9594
“Recently, I sat in a room in Cape Town with African climate scientists, watching them present results from sophisticated models examining how solar geoengineering interventions might affect local weather patterns across the continent. These researchers, primarily climate impact modelers who have expanded their work to include solar geoengineering scenarios, were doing exactly what critics claim the Global South lacks capacity for: producing rigorous, locally relevant climate science…..”
Liz Willetts, R van de Pas et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02557-1/abstract
“For the first time in the history of global biodiversity governance and global health governance, countries negotiated and adopted a Global Action Plan on Biodiversity and Health at the 16th Conference of the Parties to the Convention on Biological Diversity (CBD COP16) in 2024. The 6-year process to develop and agree to this Plan culminates decades of progress to advance the broad interconnections between biodiversity and health into international decision making. By adopting the Global Action Plan on Biodiversity and Health, parties acknowledged that biodiversity and health interlinkages encompass physical and mental health, communicable and non-communicable disease, health emergencies, social determinants, and food and water security. In the Plan, parties agreed to strengthen and enable health and environmental coordination across national ministries, disciplines, and sectors. The Plan contains 91 intersectoral health actions to incorporate into National Biodiversity Strategies and Action Plans (NBSAPs) in alignment with the CBD Global Biodiversity Framework….”
https://www.who.int/publications/i/item/B09119
“The aim of this overview is to provide thorough yet succinct information about safe, climate-resilient and environmentally sustainable health care facilities along with actionable strategies for implementing them.”
Including:
· How our team at Our World in Data became a global data source on COVID-19
· 17 key charts to understand the COVID-19 pandemic
“The pandemic has resulted in over twenty million deaths. In this article, we review the key insights from global data on COVID-19.”
PS: the global vaccination effort saved an estimated 20 million lives – in just its first year.
https://www.nature.com/articles/d41586-024-03968-0
“A preliminary analysis takes a closer look at genomic data collected at the market.”
“The quest to understand where the COVID-19 pandemic started has revealed fresh clues. Researchers have re-analysed data collected from a market in Wuhan, China, during the early days of the pandemic and found that animals there were infected with a virus – although they could not confirm what exactly caused the infection…..”
https://www.science.org/content/article/house-panel-concludes-covid-19-pandemic-came-lab-leak
In the category ‘that zombie just won’t die’: “Two-year probe led by Republicans faults agencies for pandemic response, as Democrats on panel challenge final report’s findings on SARS-CoV-2’s origin.”
“African countries, under the leadership of the Africa Centers for Disease Control and Prevention (Africa CDC), have endorsed a new continental strategic plan as a blueprint to tackle endemic and neglected tropical diseases across Africa. The new strategic plan was endorsed by Africa Union (AU) members during a high-level gathering convened by the Africa CDC from Nov. 27 to 29 in Addis Ababa, the Ethiopian capital. Delegates from all AU members came together to review and approve the continental blueprint for 2024-2027 aimed at combating endemic and neglected tropical diseases, according to a statement issued by the Africa CDC late Thursday.”
“With an emphasis on integrated health systems, the new strategic plan prioritizes preventing and controlling major health threats such as HIV/AIDS, malaria, tuberculosis, hepatitis, and neglected tropical diseases…..”
“Globalization, urbanization, and climate change have significantly raised the risk of "explosive, unpredictable" outbreaks of the mosquito-borne disease chikungunya, which disabled millions and likely amassed close to $50 billion in healthcare and disability-related costs in 110 countries from 2011 to 2020, researchers report in BMJ Global Health….”
“The first documented outbreak of the viral illness occurred in Tanzania in 1952. But over the past 20 years, climate change has allowed its vectors, Aedes aegypti and Aedes albopticus mosquitoes, to thrive in expanded geographic areas, posing threats to both developed and developing countries, the study authors noted. ….”
“Dengue and other arborviruses including Zika can be spread through donor blood which is not screened with fatal results.”
“Blood donors should be screened for dengue during large outbreaks, health workers have warned, amid concerns Brazil is facing a “hidden epidemic” of transfusion-transmitted infections.”
“In a letter published in the Lancet journal, experts from two paediatric intensive care units in São Paulo said that, at the peak of the country’s worst epidemic in history, they treated six children who contracted the virus via blood transfusions, rather than mosquito bites. “These cases raise considerable concerns about transfusion safety during dengue outbreaks,” the health workers wrote, adding that many more people have likely been affected. “Failure to address this risk could result in a hidden epidemic of [transfusion-transmitted cases] during dengue outbreaks in patients receiving blood products, particularly those who are more susceptible to severe disease,” they said. ….”
https://www.nature.com/articles/d44148-024-00330-4
“Discovery spurs call for kidney disease screening in West Africa, where APOL1 variant drives rising CKD Risk.”
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00802-8/abstract
Review of a book.
“…. A WHO public health approach to ending AIDS in the global South: lessons for NCD control and universal health coverage, written by Charles Gilks and Yibeltal Assefa Alemu, argues for the implementation of WHO's public health approach towards AIDS for non-communicable diseases (NCDs). Offering a comprehensive guide to policy makers and healthcare workers, this book provides a step-by-step guide to implementing an effective strategy to prevent and control NCDs…..”
https://www.thelancet.com/series/cancer-care-in-saarc-countries
“This Series on Cancer Care in the South Asian Association for Regional Cooperation (SAARC) countries comprises four papers and a Reportage in The Lancet Oncology. The first two papers focus on cancer care and outreach in the SAARC countries. Saiful Huq and colleagues explore the disparity of the region's health-care systems, and the challenges that exist. In the third paper, the authors discuss the necessity of implementing an effective education and training system for the oncology health-care workforce. The final paper focuses on the current status of cancer research across the region…..”
“A mystery is finally being solved.”
https://www.ft.com/content/cf5a2dbe-84b1-4479-b772-f2951d7cb28d
“Research intensifies debate over health risks of mass-produced goods made more palatable for consumers.”
“People whose diets are heavy in highly processed foods increased thigh muscle fattiness even if they did not eat excessive calories, scientists have found, in another sign the products’ health risks could stretch beyond overconsumption. The study, to be presented on Wednesday at the annual meeting of the Radiological Society of North America in Chicago, will intensify debate over the risks of so-called ultra-processed foods. While attention has focused on how the industrial addition of appealing ingredients such as flavourings, sugars, fats and salt can lead to overconsumption and obesity, new research on other possible health problems caused by UPFs is still emerging. “Muscle fattiness seemed to happen regardless of calorie intake,” said Zehra Akkaya, part of the team of Turkey- and US-based researchers. “We hypothesise that muscle fatty infiltration is related to the type of food — ultra-processed foods in the diet….”
“The Food Culture Alliance aims to mobilize culture as a means of countering the private sector’s push toward poor consumer habits.”
“What people eat, the way they eat, where, and with whom are all influenced to some degree by the culture around them; yet that link between food and culture is underexamined and underutilized amid a global food crisis, say experts. The Food Culture Alliance, which launched late last year, could change that. …. The consortium, launched in November of 2023, centers around using food culture in ways that haven’t been explored before to transform food systems. As it stands, the world has enough food to feed 10 billion people healthily and sustainably, but not if the current model stays in place…..”
“Exclusive: Campaigners say company’s apparent abandoning of 2030 pledge is a ‘masterclass in greenwashing’.”
“Coca-Cola has been accused of quietly abandoning a pledge to achieve a 25% reusable packaging target by 2030 in what campaigners call a “masterclass in greenwashing”. … In 2022, the company made a promise to have 25% of its drinks sold in refillable or returnable glass or plastic bottles, or in refillable containers that could be filled up at fountains or “Coca-Cola freestyle dispensers”. But shortly before this year’s global plastics summit, the company deleted the page on its website outlining this promise, and it no longer has a target for reusable packaging….”
BMJ;
“Researchers probing the effects of tobacco, alcohol, and ultraprocessed food are often the targets of intimidation and tactics designed to deter them from continuing their work or to discredit them, a study has found. …” “The intimidation most often takes the form of companies in these sectors seeking to discredit researchers but has also included surveillance, threats of violence, burglary, bribery, and cyberattacks…. … A team of researchers from the University of Bath collaborated with others at the George Washington University Milken Institute School of Public Health, Washington, DC, and Inserm, France’s national institute of health and medical research…..”
https://academic.oup.com/heapro/article/39/6/daae174/7907285?login=false#google_vignette
By Hannah Pitt et al.
H Lambie-Mumford et al ; https://www.sciencedirect.com/science/article/abs/pii/S027795362401044X
« CDoH provides important theoretical and empirical tools for food charity research; CDoH analysis enhances our understanding of corporate power over food insecurity ; Corporations employ a range of practices in their relationships with food charities; CDoH enables the exploration of disparities between this power and practice. »
M A Pianesi; https://www.thinkglobalhealth.org/article/argentinas-abortion-law-three-years-later
“The country's abortion law has reduced fertility rates and preventable deaths among girls ages 10 to 14.”
https://www.ghspjournal.org/content/early/2024/11/25/GHSP-D-24-00210
“We draw lessons from immunization research by assessing the applicability of the 5C framework of vaccine hesitancy to contraceptive acceptability in sub-Saharan Africa.”
https://www.bmj.com/content/387/bmj.q2710
“Consumption of commercial baby foods has been normalised in infancy and early childhood, but mounting evidence of their problems should prompt tighter regulation, says Vicky Sibson.”
K M Gopakumar et al ; https://www.twn.my/title2/health.info/2024/hi241104.htm
“The Africa Group and Brazil raised concerns about political pressure against the use of patent flexibilities during the 36th Session of the Standing Committee on Patent Laws (SCP) of the World Intellectual Property Organization (WIPO). This took place in a hybrid mode from 14 to 18 October at the WIPO Headquarters in Geneva.”
“The Africa Group and Brazil cited political pressure against the use of flexibilities in the Trade-related Aspects of Intellectual Property Rights Agreement (TRIPS), especially compulsory licenses, during the discussion of the WIPO Secretariat’s report titled “Constraints Faced by Developing Countries and Least Developed Countries (LDCs) in Making Full Use of Patent Flexibilities and Their Impacts on Access to Affordable, Especially Essential Medicines for Public Health Purposes in Those Countries”…..”
“More countries are looking to legalize versions of a right to die that are not only assisted, but accepted.” Journaist J Johnson charts the global rise of assisted death, comparing how countries integrate medical aid in dying into palliative care.
A Kirpalani et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003656
« This study examines the relationship between democracy and corruption and key healthcare workforce metrics….”
Among the findings: « … Higher levels of democracy and lower levels of corruption are associated with a greater density of medical doctors, independent of healthcare spending. “
By Minmin Wang, Minghui Ren et al.
https://www.who.int/publications/i/item/B09157
Evidence brief (7 Nov)
BMJ;
“The humanitarian charity Médecins Sans Frontières (MSF, Doctors Without Borders) has called on the Mexican government to guarantee the safe passage of migrants making their way to the US and provide more healthcare services en route….. ”
“Sierra Leone becomes the first country, among those most severely affected ten years ago by the West Africa Ebola outbreak, to launch nationwide preventive Ebola vaccination, targeting 20,000 frontline workers who will receive a single dose of Ebola vaccine. The campaign comes one decade after the 2014 Ebola PHEIC – the deadliest Ebola outbreak in history – during which Sierra Leone was the country hardest-hit, including the loss of 7% of its health care workforce. With the virus presenting an ongoing threat in endemic regions, preventive Ebola vaccination will protect frontline workers, communities and health systems in advance, helping mitigate the impact of future outbreaks.”
https://www.devex.com/news/how-us-aid-spending-changed-over-time-from-obama-to-trump-to-biden-108857
(gated) “The data shows that USAID's disbursements steadily increased between 2014 and 2022 — from $18.6 billion to $33.2 billion.”
“This month’s theme issue on sexual health is introduced in an editorial by Manjulaa Narasimhan and Pascale Allotey. In related editorials, Sagri Singh et al. advocate for improved sexual health and well-being and Nicaise Ndembi et al. explain how mpox poses a new threat. Etienne V Langlois et al. present a critical pathway for the reduction of maternal newborn and child mortality…..”
Welington Serra Lazarini ; https://journals.sagepub.com/doi/abs/10.1177/27551938241291715
“The anti-poverty agenda has been at the heart of the World Bank's discourse in recent decades. Social policies started to be identified as strategic for combating poverty and promoting development in poor countries. We analyzed the health policy recommendations made by the World Bank to Brazil in the Lula da Silva and Rousseff administrations from 2003 to 2014….”
Sophie Witter et al; https://onlinelibrary.wiley.com/doi/10.1002/lrh2.10475
“Learning sites have supported intervention development and testing in health care, but studies reflecting on lessons relating to their deployment for health policy and system research (HPSR) in low- and middle-income settings are limited. This experience report draws from learning over three continents and five research and community engagement programs—the oldest starting in 2010—to reflect on the challenges and benefits of doing embedded HPSR in learning sites, and how those have been managed. Its objective is to generate better understanding of their potential and constraints….”
M Tanzer et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003941
“Epistemic trust ‐ defined as readiness to regard knowledge, communicated by another agent, as significant, relevant to the self, and generalizable to other contexts–has recently been applied to the field of developmental psychopathology as a potential risk factor for psychopathology. The work described here sought to investigate how the vulnerability engendered by disruptions in epistemic trust may not only impact psychological resilience and interpersonal processes but also aspects of more general social functioning. We undertook two studies to examine the role of epistemic trust in determining capacity to recognise fake/real news, and susceptibility to conspiracy thinking–both in general and in relation to COVID-19…..”
https://bmcglobalpublichealth.biomedcentral.com/articles/10.1186/s44263-024-00106-w
By M Amri, J Bump et al.
“My new favorite definition of global health, inspired by John Green: Global health aims to make the world “suck less”.”
“The Terms of Reference for a new #UNTaxConvention have been ADOPTED by the UN General Assembly! Negotiations are set to start in February 2025.”
“In December, I feel not just a bit international-dayed-out. No, the international health day in April where everyone advocates and campaigns half-heartedly in a fragmented way is not the solution. Can we advocates and campaigners not unite?”
“Imagine how powerful a campaign we could have if global health advocates, campaigners and funders would unite forces in December instead of fragment around: World AIDS day (1 Dec) Human Rights Day (10 Dec) UHC Day (12 Dec).”