international health policies newsletter 191 - Tuberculosis and other ...

Dear Colleagues,

While Romney ?scrambled to clarify? abortion policies over the weekend and extreme skydiver Felix Baumgartner jumped from a whopping altitude (probably wondering if he was going to have a close encounter of some kind with debris floating around after the Space Shuttle retired to planet earth), half of our team already left the building for the fabled city of Beijing ? whence they will surely report in no time if and when they will succeed in circumventing the great firewall.

But enough said, this week EU health commissioner John Dalli resigned over tobacco related fraud inquiry while Romney was confronted with more feisty opposition in the second live debate than during his days with Bain (which also made for quicker buck). A new tuberculosis report indicates lots of work ahead in spite of major progress over the last decade and the heated debate about what the world should look like after 2015 goes unabated, while trade remains at odds with public health as the editorial from our man in the Philippines (or China at this stage) clearly shows. Have a great one as usual and

Enjoy your reading,

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

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Editorial

The EU: an obstacle to Philippine aspirations for Universal Health Care

?Raoul A. Bermejo III, MD, MPH

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Global burden of disease

1.??? WHO ? Global Tuberculosis Report 2012

who.int/pdf

This week saw the launch of the new WHO Global Tuberculosis Report 2012, presenting the latest data and analysis about the TB epidemic and the progress made in prevention, care, and control of the disease. As Mario Raviglione, director of the WHO Stop TB Department, said in a statement: ?In the space of 17 years, 51million people have been successfully treated and cared for? Without that treatment, tweny million people would have died?. The report also highlights some country successes, including Cambodia where TB prevalence has dropped with 45% over the last decade ? which adds nicely to the successful TB/HIV collaboration story reported elsewhere.

On the negative side, the report confirms that TB is still a major killer disease and that multi-drug resistant TB is an escalating public health emergency ? of which the global response remains abysmal according to a statement made by MSF. Major work still lies ahead and critical gaps in funding remain, although the program to eradicate TB is on track to reach its goal of halving the number of deaths compared with the 1990 rate (considering the fact that registration has also improved over time). In addition, some new TB drugs and vaccines are in the pipeline, of which one is already at an advanced stage of testing, which reflects increased interest and funding from donors such as the Gates Foundation after decades of neglect. There is also praise for the worldwide roll-out of the new rapid diagnostic TB test (GeneXpert), which has seen a major price cut through innovative global funding mechanisms and is already available in 67 LMICs.

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2.??? Lancet (online) ? Global burden of cancer: opportunities for prevention

thelancet.com/

About 169 million years of healthy life were lost to cancer worldwide in 2008, based on a summary measure (disability-adjusted life-years-lost) that combines years lived with disability and years of life lost due to premature death. Economic development seems to be the main culprit for the rising incidence, as this study published recently indicates (annual health checks will not help us out, as they don?t reduce mortality).

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3.??? Lancet (article) ? Effect of maternal obesity on neonatal death

thelancet.com/

Using data from the Demographic and Health Surveys from 27 countries, Cresswell et al. were able to demonstrate that maternal obesity in sub-Saharan Africa is associated with an increased risk of early neonatal death. Policy implications include the need to prevent and reduce maternal obesity as well as to increase the number of deliveries in facilities that can provide emergency obstetric and neonatal care.

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4.??? IPS (news) ? Developing world has 80 percent of tobacco related deaths

ipsnews.net/

Tobacco use led to almost six million deaths in 2011, of which nearly 80 percent were in low- and middle-income countries, according to research released on Monday, Inter Press Service reports. ?Such trends, fuelled by tobacco industry tactics, have a devastating impact on global economy?, health and development workers warned at the Washington launch of a new report tracking tobacco use worldwide. Nascent research into links between development, economic growth and tobacco use indicate that in Russia, ?GDP would have grown by 1.0 to 1.5 percent faster over the past three decades if it weren?t for tobacco-related costs?.

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The?Wall Street Journal on the other hand, reports about new legislation in Russia ?that would establish nationwide smoking restrictions similar to those seen in the West ? such as limits on advertisements and smoking in restaurants?. Russia also accuses tobacco makers of hooking women and children on smoking (which couldn?t have come at a better time ? given the legacy of Romney?s past at Bain). Meantime, big tobacco companies continue to resist admissions of any wrongdoing (which is of course business as usual ? and how should this be different from profit driven healthcare).

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Post-2015 and universal health coverage

5.??? WHO (Discussion Paper) ? Positioning Health in the Post-2015 Development Agenda

who.int/pdf

In the global thematic consultation on health in the post-2015 development agenda led by WHO and UNICEF, a discussion paper has been posted which focuses on content that need to be addressed in framing future health goals and which discusses ways in which UHC may be used as an inclusive framework for programmatic interests.

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In a similar vein, the UN has also posted a call for proposals from civil society organizations to host consultation meetings on health in the post-2015 agenda in accordance with its thematic consultations (Medicus Mundi International (MMI) was selected to provide input with regard to coordinate a post-2015 position paper on health).

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6.??? BMJ (News) ? Health organisations urge World Bank to support universal healthcare coverage

bmj.com/

Health campaigners from around the world have written a letter to the World Bank?s president, Jim Yong Kim, urging him to support developing countries that want to introduce universal healthcare coverage (UHC).

WHO Reform

7.??? MMI Network ? WHO Reform: Updated Thematic Guide

medicusmundi.org/

This updated thematic guide of the Medicus Mundi International (MMI) network provides a collection of resources for the Democratizing Global Health Coalition on WHO Reform, which aims to support civil society in raising its voice in the global health policy scene. WHO ? from its side ? has also embarked on a consultation with regard to its NGO engagement this week.

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Global Fund News

8.??? CGD (Global Health Policy) ? Introducing the Global Fund Forum

http://blogs.cgdev.org/globalhealth/2012/10/introducing-the-global-fund-forum.php

In a new CGD online forum, prominent thinkers and practitioners can post comments about what reforms the Global Fund should prioritize and how it should best fulfil its mandate of improving the way development aid is managed in addition to advancing the fight against the three major diseases.

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Health policy & Financing

9.??? Thematic evaluation of the European Commission support to the health sector (Final Report Volume I)

http://ec.europa.eu/europeaid/how/evaluation/evaluation_reports/2012/1308_docs_en.htm

This thematic evaluation on EC support to the health sector was already published in August, providing an independent assessment by looking at the relevance, efficiency, effectiveness, impact and sustainability of the support provided. It also assesses the coherence of EC health support with other EC/European Union (EU) and donor policies and activities, as well as the specific EC added value within the health sector.

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10. Access to Medicines as a Human Right: Implications for Pharmaceutical Responsibility

http://www.utppublishing.com/Access-to-Medicines-as-a-Human-Right-Implications-for-Pharmaceutical-Industry-Responsibility.html

According to WHO, one-third of the global population lacks access to essential medicines. A major question is hence: should pharmaceutical companies be ethically or legally responsible for providing affordable medicines for these people, even though they live outside of profitable markets? And can the private sector be held accountable for protecting human beings? right to health? This interdisciplinary collection grapples with corporate responsibility, providing some food for thought.

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11. BMJ (blog) ? Gathering the evidence to improve healthcare in developing countries

http://blogs.bmj.com/bmj/2012/10/16/nathan-ford-and-philipp-du-cros-gathering-the-evidence-to-improve-healthcare-in-developing-countries/

In this blog, Nathan Ford and Philipp du Cros from M?decins Sans Fronti?res (MSF) advocate for more research to support evidence-based medical decision-making in LMICs, as shown by the case of efavirenz, a drug used to treat HIV/AIDS, where lack of conclusive evidence led to needless safety concerns until research later indicated that the drug could be used during the first trimester of pregnancy.

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12. PAHO/CGD ? from working group report to political action

http://www.cgdev.org/content/article/detail/1426587/

A recent PAHO resolution signed by the US, Canada and countries in Latin-America and the Caribbean will strengthen efforts to improve the quality of Health Technology Assessment research and application in the allocation of public budgets, based on a CGD working group report which indicated that global health donors and countries can greatly reduce suffering from ill-health and save lives by taking into account the cost-effectiveness of health interventions to better allocate healthcare funds.

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Health policy

13. Hand washing to reduce child mortality ? the WASH Project

http://globalhandwashing.org/ghw-day

This week featured Global hand washing day, an event celebrated by over 200 million people worldwide. Hand washing with soap continues to be the most effective and inexpensive way to prevent diarrheal and acute respiratory infections, killing 3000 children under the age of five from diarrhea alone every day, making it the second most common cause of child mortality worldwide. Teaching children to wash their hands can hence save more lives than any single vaccine, according to the Global Public-Private Partnership for Hand washing.

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14. NPR (Blog) ? Efforts to eradicate polio in Nigeria and Pakistan

http://www.theglobalobservatory.org/analysis/369-poverty-and-insecurity-must-not-prevent-an-end-to-polio.html

NPR?s ?Shots? blog reports on efforts to eradicate polio in (Northern) Nigeria, which is the only place in the world where polio cases are increasing. According to the blog: ?On Sept. 1 2012, 90 polio cases were recorded, or nearly three times as many as in the same period last year.? Although the newfound zeal from religious leaders who first opposed the vaccine has helped overcome resistance to vaccination in the region, the eradication effort faces big challenges, such as organization, a lack of sense of urgency among ordinary people, security issues and poor sanitation.

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In Pakistan, another part of the world where polio still lingers, government declared a national emergency last year and embarked on an aggressive vaccination campaign with the support of international institutions. Although the number of new cases is around a third of last year?s total of 198, the campaign suffers from one critical problem: gaining access to the volatile and dangerous lawless tribal regions along the border with Afghanistan, which is still controlled by the Taliban, al-Qaida and other Islamist groups.

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Research

15.? Globalization and Health ? Global health and national borders: the ethics of foreign aid in a time of financial crisis

Mira Johri et al.

http://www.globalizationandhealth.com/content/8/1/19

This paper aims to foster debate on donor responsibilities for global health through a critical review of contemporary accounts of justice. The examined frameworks concur that there are important ethical responsibilities to support current initiatives to promote global health, but offer different rationales for intervention and suggest different implicit limits on responsibilities.

16. Health Research Policy &Systems ? The multi-step process of building TB/HIV collaboration in Cambodia

Mao Tan Eang et al.

http://www.health-policy-systems.com/content/10/1/34/abstract

This article reviews the process by which TB/HIV collaboration was established in Cambodia, illustrating the influence of research on policy and demonstrating that clear policy guidance, the pursuit of incremental advances and different approaches towards generating evidence can overcome structural barriers.

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17.? Health Policy & Planning ? Repackaging exemptions under National Health Insurance in Ghana: how can access to care for the poor be improved?

Emmanuel Kanchebe Derbile and Sjaak van der Geest

http://heapol.oxfordjournals.org/content/early/2012/10/12/heapol.czs098.abstract

Informed by past experiences that undermined the equity goal of exemptions, three policy recommendations are put forward for improving exemptions for the poor under the NHIS.

18.? Health Policy & Planning ? Combining user fees exemption with training and supervision helps to maintain the quality of drug prescriptions in Burkina Faso

Nicole Atchessi, Val?ry Ridde, and Slim Haddad

http://heapol.oxfordjournals.org/content/early/2012/10/16/heapol.czs100.abstract

This paper examines how the combination of user fees exemption with staff training and supervision affected the quality of drug prescriptions in health centres in Burkina Faso.

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Development and aid

19. VOX (Blog) ? Why political short-sightedness and randomized control trials can be a deadly mix for aid effectiveness

http://www.voxeu.org/article/deadly-mix-aid-effectiveness

In a blog post for the policy portal set up by the Centre for Economic Policy Research, Anders Olofsgard argues that political short-sightedness and randomised control trials can be a deadly mix for aid effectiveness.

20. WB (blog) ? How can the Knowledge Bank make development more effective?

http://blogs.worldbank.org/developmenttalk/how-can-the-knowledge-bank-make-development-more-effective

Enhancing ?development effectiveness? emerged as a key concern in a recent review of the World Bank?s governance structure ? and what is new is the energy surrounding current efforts to put development effectiveness at the center of Bank operations.

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21. CSIS (blog) ? Where did all the poor people go?

http://www.smartglobalhealth.org/blog/entry/where-did-all-the-poor-people-go/

The emergence of new MIC countries has resulted in a growing discrepancy between where international development assistance is focused and where it is needed, which has implications for GHI eligibility and prioritization policies. Todd Summers of the Global Health Policy Center reports.

Miscellaneous

• The 2012 CGD Commitment to Development Index (CDI) ? which ranks 27 of the world?s richest countries on their dedication to policies that benefit the 5.5 billion who live in poorer nations ? indicates that Scandinavian countries rank first (which comes as no surprise) and that the US fares considerably less well

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• A newly launched movement led by prominent doctors is challenging the basic assumption in US healthcare that more is better. Jeanne Lenzer reports.

• Using her family?s philanthropic panacea Chelsea Clinton steps up the fight against diarrheal deaths in Nigeria in a sweeping effort to prevent the deaths of one million mothers and children

• Humanosphere?s Tom Paulson in his blog continues to unravel the Novartis vs. India patent dispute

• In its lead-up to the 8^th Global Conference on Health Promotion WHO has run a web-based consultation on the draft Health-in-All Policies Definition

• A WHO sustainable-development initiative in Serbia called SWIFT(Sustainable Waste management Initiative For a healthier Tomorrow) won the first prize in the ?greening? category at the UN21 Awards, presented by UN Secretary-General Ban Ki-Moon

• A recent study has found that Europeans still favor aid for poor countries, including in countries which are hard hit by the economic crisis, such as Spain and Greece

• The 31^st Annual World Food Day focused on agricultural cooperatives which were nicely advocated in state and donor blogs; food security, however, is not among the top global policy priorities according to this World Bank blog ?? although food instability threatens further progress on the MDG on hunger.

Source: http://e.itg.be/ihp/archives/ihp-news-191-tuberculosis-grand-challenges/

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