1

IHP news 393 : Trump Trouble ahead

( 11 November 2016)

The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium.

Dear Colleagues,

The last thing I wanted to see on Tuesday night was a glorifying Donald basking in his victory, so I didn’t stay up (unlike a number of EVs & facilitators who had decided to watch the election night together), when the first results gave pretty much everybody here in Vancouver a bad feeling. Anyway, we’ll have to live with the result, I guess, like the rest of the world. But yes, Trump means trouble. Major trouble. As in “Trump Trouble”. As this is meant to be a ‘no thrills no frills’ newsletter (both Radhika & me are at the Vancouver EV F2F event now and involved in EV facilitation), I won’t try to analyze this election shock. I just humbly admit I got it wrong, a few months ago, when I said the guy had no chance whatsoever. Unlike the Brexit, I didn’t see this coming. I just don’t get Americans, I’m afraid. As for the Vancouver symposium, emphasis will now probably shift from “resilient & responsive health systems” to the latter part of the theme, as we clearly need to brace ourselves for “a changing era”.

A few things are already rather obvious, though. Major damage to the brand of democracy worldwide, a brand that was already in trouble. As for global health repercussions, Laurie Garrett’s tweet from Wednesday morning gave a first clue: “Attn global health orgs: If you're dependent on US for'n assist., time 4 new funding models. #PresidentTrump won't be generous. @Gavi @WHO”. More in general, the Trump win sent shockwaves through the development world. Vox also reported “There’s no way around it: Donald Trump is going to be a disaster for the planet”. So the mood at the COP in Marrakech must be rather subdued, now. The fact that so many people in “the greatest democracy on earth” voted for a total nitwit (and a caricature of some of the worst masculine aspects moreover ) bodes ill for the future of the human species on this planet. Yes, like Obama, The Donald had a catchy slogan, “Make America great again”. Unfortunately, as far as I can tell, Trump doesn’t have the faintest idea on how exactly he can pull that feat off (provided it’d be necessary in the first place). Certainly not in an inclusive way.

Suffice to say, in the new Trump era, the Emerging Voices will have to come up with a rather cunning plan to get to transformative change! Maybe we should all become spin doctors instead of real ones.

In this week’s Featured article, Goran Abdulla Sabir Zangana (EV 2016) discusses the underrepresentation of MENA researchers among the EV cohort.

Enjoy your reading.

The editorial team

2

Featured Article

Where are all the people from the Middle East? Participation from MENA in EV4GH

Goran Abdulla Sabir Zangana, EV 2016 & Research fellow, Middle East Research Institute

Mid-afternoon, week-II of the 2016 Emerging Voices for Global Health (EV4GH) program, I look at the participants around me and notice that a policymaker who just arrived and I are the only ones from the Middle East and North African (MENA) region.

The limited participation from the MENA region is intriguing given a large number of researchers, policymakers and health workers from other regions present here. While there were over 200 applications to the EV4GH programme this year, only about five were from the MENA region.

There are several theories about why this might be so. Some of the organisers and the participants of the EV4GH programme feel that the limited participation from the region might be because of visa-related issues. This might be true in the case of those whose visas were rejected (in this instance, applicable to one person). Others feel it may be cause of a lack of interest in health policy and systems research (HPSR) from the MENA region. However, I feel that is not really the case.

There are some universities, institutions and organisations from the MENA region that are interested, working on and leading research on health policy and systems in MENA. Examples include the American University of Beirut (AUB)’s Center for Systematic Reviews on Health Policy and Systems Research (SPARK) which has recently been appointed as the General Secretariat for the Global Evidence Synthesis Initiative (GESI). Other institutions include the Middle East Research Institute (MERI) that is one of the leading think-tanks in the MENA region. MERI is dedicating a significant portion of its work to HPSR. In addition to the examples mentioned above, there are many other researchers and academic institutions which are producing a growing body of literature on health policy and systems in the MENA region. A relatively recent article attempted to compile a list of such literature. Last, but not least, there is a Public Health in the Arab World (PHAW) listserv that is dedicated to announcing, publicising and discussing public health related issues in the region.

So if it is not the lack of institutions, researchers and interest, what then explains that there has essentially been no participation from the MENA region in the EV4GH programme thus far, with just a few exceptions?

It seems that one of the main reasons has been the lack of publicity for the EV4GH programme in MENA. None of the major institutions, think-tanks and organisations in MENA announced the call for application for the programme. The EV4GH programme was never announced on the PHAW listserv either. Meetings, webinars or seminars which target researchers and policymakers in MENA were never conducted. Those who knew about the programme and applied to attend did so through word of mouth rather than through an organisation.

The lack of participation from the MENA region is a substantial opportunity cost for the region. The EV4GH provides a rich opportunity for researchers in MENA to present their work. Such exposure is

3

crucial particularly within the context of what is going on in the region at the moment. The theme of the fourth Global Symposium on Health Systems and Policy Research is strongly connected to the issues on conflict – an issue that the area continues to grapple with. As a current EV4GH participant from MENA, I make a commitment to spreading the word on this programme among my colleagues from the region. Hopefully more researchers will represent MENA in the next edition of the Emerging Voices for Global Health.

Highlights of the week

Lancet Commission on essential medicines

http://www.thelancet.com/commissions/essential-medicines

“Essential medicines are crucial to satisfy the priority health-care needs of the population, promote health, and achieve sustainable development. Recognition of the importance of essential medicines is not new. The findings of the Lancet’s Commission synthesise lessons learned from the development of essential medicines policies over the past 30 years, and implementation after the landmark Nairobi Conference on the Rational Use of Drugs in 1985. This Commission explores and addresses ongoing questions such as: what progress has been achieved; what challenges remain to be addressed; which lessons have been learned to inform future approaches; and how can essential medicines policies be harnessed to promote universal health coverage and contribute to the global sustainable development agenda? Debates about access to medicines have sometimes mistakenly focused on low-income and middle-income countries only. But the Commission shows that access to medicines is a global concern, irrespective of country income. The Commission’s report makes actionable recommendations to make essential medicines a central pillar of the global health agenda, and to translate policies into meaningful and sustainable health gains for populations worldwide.

The five key areas discussed in this Commission are: Paying for a basket of essential medicines; Making medicines affordable; Ensuring quality of medicines; Promoting quality medicines; Developing new and missing medicines”

“The new report presents the first cost analysis of providing a core set of 201 essential medicines and recommendations for ensuring equal access to safe, quality and affordable medicines.”

You might want to start by reading the accompanying Comment by Das & Horton – Essential medicines for universal health coverage.

Coverage for example in IP-Watch - Lancet Report On Essential Medicines Takes Aim At Access, Affordability (gated). “A much-anticipated report on progress in global access to essential medicines released today has found that change is needed to the system of paying for research and development, including moving beyond sole reliance on patents to cover R&D costs. It calls for a

4

global R&D policy framework, a possible patent pool for essential medicines, addresses financing issues, and claims to have developed a new cost model. …”

American elections – What will the Trump era mean for global health?

In short – no good.

There’ll be plenty of analysis on Trump’s shock victory (and possible implications) in the coming days & weeks. Here I’ll just list a few more public health related reads (in addition to some of the likely consequences already mentioned in the intro):

Marijuana and soda taxes win big, but cigarette taxes fail in several state votes (Stat news)

In a devastating blow to the beverage industry, 4 cities passed soda taxes (Vox)

Trump and the GOP can absolutely repeal Obamacare — and 22 million people would lose health insurance (Vox) Among other pledges, Donald Trump has promised to repeal and replace the Affordable Care Act, and people like Paul Ryan seem very keen on it. See also BMJ news – Republican election sweep is likely to spell end for US health reform law. And if ACA collapses, one can also forget about US global leadership on UHC (as Laurie Garrett & Kent Buse noted, among others).

There’s no way around it: Donald Trump is going to be a disaster for the planet (Vox) (we have a hunch this will become a good template for many articles in the coming weeks: “There’s no way around it: Donald Trump is going to be a disaster for …” ) We basically agree with this view (also on Vox) – Trump’s election marks the end of any serious hope of limiting climate change to 2 degrees.

NPR Goats & Soda – From AIDS To Zika: Trump On Global Health And Humanitarian Aid – a nice overview of possible positions from Donald on global health & humanitarian aid.

Guardian Global Development – Africa leads outcry over setback for feminism after Trump victory “… “Trump’s victory is a clear message to women around the world that we don’t count, that our safety and demands for justice for sexual violence are not important,” said Mona Eltahawy, a Cairo-based writer and feminist. “When a sexual predator can become president of any country – most of all the most important country in the world – it’s a green light that women’s bodies are fair game….”

A tweet by James Love: “Silver lining, at least IMO, TPP, TTIP seem dead for now. Not sure about

TISA.”

Quartz – Under Donald Trump’s foreign policy, Africa will fall off the map Trump’s victory is bad news for Africa.

5

Laurie Garrett & global health

You certainly will want to read Laurie Garrett’s monthly newsletter, published on Wednesday – which has both huge sections on the Trump victory & implications for global health and on the WHO DG election. http://www.cfr.org/about/newsletters/onthefly.php?id=4140 (recommended)

As for implications for global development in general, see this analysis on Devex - Opinion: Seeing past the shock of the Trump victory “…The global development community is grappling — like much of the world — with a seismic political shock. … … One thing is clear: There will likely be significant challenges for the global development agenda as a result of this election. That said, there are good reasons to think that cataclysmic change (some in the community musing on social media that U.S. Agency for International Development might be abolished for example) is highly unlikely and would only unfold slowly over time if at all. Foreign aid won't fall off a cliff on Jan. 20, 2017. And, there may even be specific issues and initiatives that receive increased support. …” An overview of what might be in store.

CFR (blog) - Goodbye to All That? World Order in the Wake of Trump

Stewart Patrick; http://blogs.cfr.org/patrick/2016/11/09/goodbye-to-all-that-world-order-in-the-wake-of-trump/

Finally, an analysis by Patrick “The Internationalist” Stewart on the implications for the liberal world order. Well worth a read.

Lancet (Editorial) – The unfinished agenda of preterm births

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32170-5/fulltext

Lancet editorial linked to World Prematurity Day (17 November).

Lancet (Viewpoint) – Political origins of health inequities: trade and investment agreements

Desmond McNeill, Anand Grover, Ted Schrecker, David Stuckler et al;

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31013-3/fulltext

It’s worth to give their conclusion in full, even if it was written before the Trump victory (which will most probably change the global picture on trade & investment agreements): “Our argument, in summary, is that TIAs, driven by corporate interests, are rewriting the rules governing trade and investments. They threaten to exacerbate the underlying political and economic drivers of health inequities in years to come. Not only do the processes of TIA negotiation routinely undermine democratic principles, their outcomes conflict with government obligations to fulfill the right to health under human rights treaties and contradict the commitments made to implement the UN Agenda 2030, which clearly spells out health—for all—as a global priority. To counter these trends requires a broad resistance from the health community that underlines the multiple effects on

6

public health priorities and actively promotes alternatives. Specific agreements that regulate the global marketplace in the interests of public health can play a part but we argue that what is required is not only opposition to one agreement at a time, but also—and more importantly—a fundamentally new agenda for how TIAs are negotiated and what they should contain. In particular they need to incorporate: (1) protection of policy space for governments to treat public health as a priority, not to be compromised by trade and investment objectives; (2) transparency and accountability in the TIA negotiation process in which the health sector would have voice; and (3) rejection of new ISDS commitments and renegotiation of those in place so that they are less intrusive on national health priorities.”

Guardian – African nations attempt to suspend UN's LGBT rights monitor

https://www.theguardian.com/global-development/2016/nov/07/african-nations-attempt-suspend-

un-united-nations-lgbt-rights-monitor-vitit-muntarbhorn

On Tuesday the UN were going to vote on a resolution by African states to halt the work of Vitit Muntarbhorn, reflecting deep international divisions on gay rights.

See also the Conversation - UN fight over LGBT protection threatens to undermine the human rights system (R Freedman).

COP 7 in Delhi, India (7-12 November)

http://www.who.int/fctc/cop/sessions/cop7/en/

Some news from (and reads about) the WHO FCTC meeting in Delhi:

Margaret Chan in the Guardian: Every tobacco death is an avoidable tragedy. The epidemic must

stop here.

Tax Justice Net - Press release: Campaign to expose big tobacco’s lobby front may save millions of lives in lower-income countries In a major victory for campaigners against Big Tobacco, the ‘International Tax and Investment Center’ (ITIC) was forced to withdraw claims of association with World Bank, IMF, tax authorities and major multinationals.

BMJ news - WHO urges restrictions on e-cigarettes

“The World Health Organization has urged countries to restrict the sale, promotion, and use of electronic cigarettes. WHO made the call in a paper [to be] discussed at this week’s meeting of the Framework Convention on Tobacco Control in India….”

7

Not everybody is all that happy about this WHO move – see for example an op-ed (in Stat News) , Could changes to a global tobacco treaty harm health?

UN News - New direct funding available for low- and middle-income countries to regulate tobacco –

UN

“New funding is now available to support tobacco control implementation for low and middle income countries through the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) , currently the strongest global instrument to control tobacco. … …. The new project will be delivered by the WHO FCTC through a collaboration with the United Nations Development Programme (UNDP) and other partners. 179 countries and the European Union are Parties to the Convention. The partnership will provide support to low- and middle-income countries as they move to implement new control strategies and policies. The Convention is expected to greatly reduce tobacco use if implemented properly….”

See also Huffington Post- UNDP is strengthening its partnership with the WHO FCTC Convention Secretariat to advance tobacco control governance in developing countries, including by making the economic case for tobacco taxation.

The Huffington Post – President Obama Cements Global Health Security Agenda As A National Priority

Tom Frieden; http://www.huffingtonpost.com/tom-frieden-md-mph/president-obama-cements-

g_b_12801936.html

“…President Obama signed an executive order which cements the Global Health Security Agenda (GHSA) as a national, presidential-level priority and establishes the United States as a committed, long-term catalyst for achieving the promise and protections that GHSA holds.”

See the White House Executive Order -- Advancing the Global Health Security Agenda to Achieve a World Safe and Secure from Infectious Disease Threats

In other news related to global health security, see this tweet: #AfDB President declares US $100M in private sector #health funds and $14M for disease surveillance in #SierraLeone, #Guinea, #Liberia.

Globalization & Health (Debate) –Political economy challenges in nutrition

Y Balarayan & M Reich; http://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-

016-0204-6

“Historically, implementing nutrition policy has confronted persistent obstacles, with many of these obstacles arising from political economy sources. While there has been increased global policy

8

attention to improving nutrition in recent years, the difficulty of translating this policy momentum into results remains. We present key political economy themes emanating from the political economy of nutrition literature. Together, these interrelated themes create a complex web of obstacles to moving nutrition policy forward. From these themes, we frame six political economy challenges facing the implementation of nutrition policy today. Building awareness of the broader political and economic issues that shape nutrition actions and adopting a more systematic approach to political economy analysis may help to mitigate these challenges. Improving nutrition will require managing the political economy challenges that persist in the nutrition field at global, national and subnational levels. We argue that a “mindshift” is required to build greater awareness of the broader political economy factors shaping the global nutrition landscape; and to embed systematic political economy analysis into the work of stakeholders navigating this field. This mindshift may help to improve the political feasibility of efforts to reform nutrition policy and implementation—and ensure that historical legacies do not continue to shape the future.”

Chatham House/UNICEF (paper) – Accelerating progress towards UHC for women and children in South Asia, East Asia and the Pacific

A Beattie, R Yates et al;

https://www.chathamhouse.org/sites/files/chathamhouse/publications/research/2016-11-07-

global-health-unicef-

paper.pdf?utm_content=buffer8f5b2&utm_medium=social&utm_source=twitter.com&utm_campai

gn=buffer

(recommended) “…All countries can make progress wherever they are on the UHC journey. This paper reviews lessons learned from across Asia and the Pacific using a literature review and interviews with key informants to identify best practices, challenges and opportunities to further advance UHC. The paper culminates in ten lessons learned and ten policy recommendations….”

HSR symposium in Vancouver (14-18 November)

http://healthsystemsresearch.org/hsr2016/

The Vancouver symposium is very close now – and the 2016 EV4GH F2F programme in full swing.

We already want to notify you that plenary sessions will be livestreamed here. You also find all recent blogs & other social media activity on this site. (live symposium coverage)

You can already find all e-posters here and to get in the mood for the discussions, you might want to read a couple of papers from the HP&P pre-read collection – Pre-HSG conference key reading material.

9

NPR – Haiti Launches Largest-Ever Cholera Vaccination Campaign

NPR;

“Haiti on Tuesday launched the largest emergency cholera vaccination campaign ever attempted. The plan is to try to vaccinate 800,000 people in parts of the country devastated by Hurricane Matthew….”

UNFCCC CoP meeting in Marrakech (7-18 November)

http://unfccc.int/meetings/marrakech_nov_2016/meeting/9567.php

Last week, the Paris Agreement took effect, but this week was a major disaster for the fight against climate change for the reasons you know. We can probably throw all analyses pre-Marrakech in the dustbin now, but for what they’re worth:

Preview: The UN’s COP22 climate talks in Marrakech (Carbonbrief)

Guardian - COP22 host Morocco launches action plan to fight devastating climate change

Devex - 5 questions ahead of Morocco's 'COP of action'

After the Trump victory, BBC reported from Marrakech - Climate change: Nations will push ahead with plans despite Trump. Let’s hope so. But the damage that can be done by the new Trump administration can be irreparable for the planet.

WHO – Pregnant women must be able to access the right care at the right time, says WHO

http://www.who.int/mediacentre/news/releases/2016/antenatal-care-guidelines/en/

“WHO has issued a new series of recommendations to improve quality of antenatal care in order to reduce the risk of stillbirths and pregnancy complications and give women a positive pregnancy experience.”

For coverage, see for example NYT - While Pregnant, Women Should Get Health Care 8 Times, W.H.O. Says.

10

Zika

Cidrap News - Researchers detail features of congenital Zika syndrome

CIDRAP; “Five features rarely seen with other congenital infections are distinct in babies born with Zika-related birth defects, according to a new review of almost three dozen reports in the medical literature….” (from last week already)

Global health events

In Rio, a meeting took place of/on global health policy think tanks.

And WHO published its report on the Financing Dialogue from last week.

IP-Watch – WTO Members Discuss UN High-Level Report On Medicines Access That WHO Declined To Discuss

http://www.ip-watch.org/2016/11/10/wto-members-discuss-un-high-level-report-medicines-access-

declined-discuss/

“The World Trade Organization intellectual property committee this week discussed the report of United Nations Secretary General’s High-Level Panel on access to medicines which offered recommendations regarding the use of intellectual property in international trade. Developing countries taking the floor accentuated the use of flexibilities under trade rules, and the World Health Organization gave an overview of how its activities follow the panel’s recommendations, and its future projects. Civil society meanwhile criticised the WHO’s decision to dismiss a request by some developing countries to include discussions on the UN report at the next Executive Board Meeting. WHO then used this WTO meeting to make a statement about the UN report….”

Global governance of health

Laurie Garret’s monthly newsletter on global health

http://www.cfr.org/about/newsletters/onthefly.php?id=4140

11

In addition to the implications of the Trump victory, this month also has a big section on the WHO DG election race and the WHO financing dialogue (a failure, according to Garrett).

You might also want to check IP-Watch’s account of the WHO (DG election ) meeting in Geneva on 1-2 November - Six Candidates For WHO Director General Lay Out Their Views (gated)

UN News - General Assembly President outlines strategy for stepped-up implementing UN 2030 Agenda

UN News;

“General Assembly President Peter Thomson briefed United Nations Member States [today] on the implementation strategy for implementation of the Sustainable Development Goals (SDGs), the transformative 17-point framework for ensuring peace and prosperity for all on a healthy planet….”

“… Mr. Thomson announced that in order to motivate actors at global, regional, national, and community levels, he had appointed an SDG implementation team, to be led by Special Adviser Ambassador Dessima Williams along with experts from the UN Secretariat and secondees from the UN Development Programme (UNDP), World Bank Group, the UN Population Fund (UNFPA), the UN Children’s Fund (UNICEF), and Member States. Ambassador Macharia Kamau will serve as the Special Envoy on SDP Implementation and Climate Change. The team will focus on three key tracks: Raising the global public’s awareness of the importance of SDG implementation; Strengthening momentum in the implementation of each of the 17 SDGs; and Supporting the UN and related agencies in making their maximum contribution to SDG implementation at all levels….”

Devex – The future of health financing: Investing in data

A Haakenstad & J Dieleman (IHME) ; Devex ;

“The future of health financing requires investments in health financing data.” “Now, more than ever, a health financing data revolution is sorely needed”. Read what they have in mind.

Lancet (Letter) – Health metrics priorities: a perspective from young researchers

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32134-1/fulltext

More than worth a read. By a number of young researchers at the Institute for Health Metrics and Evaluation (IHME). “With the SDGs' emphasis on the complex relationship between health and development, we, as young researchers at IHME, see an opportunity for the health metrics field to examine its priorities through collaboration and outreach within and outside of the health metrics field….”

12

Chatham House (Comment) - The WHO's New Electoral Format Could Be a Model for Other UN Agencies

Charles Clift; Chatham House;

“Even with its limited reforms, the UN health agency's new and more transparent process for choosing its director-general should improve the quality of elections and leadership. “

Not everybody agrees about the merits of this new WHO transparency. See for example, on Imaxi - WHO DG Forum: Outside Looking In The authors wasn’t impressed much by the livestreaming of the event on 1-2 November. Far more is needed to have real civil society participation.

Global Policy - What is Next? …for World Order and Global Governance

Chin & Freeman;

http://www.globalpolicyjournal.com/sites/default/files/Chin%20and%20Freeman%20-

%20What%20is%20Next%20%E2%80%A6for%20World%20Order%20and%20Global%20Governance.

pdf

You tell me… .

Devex - Opinion: 3 key insights for RBF success

https://www.devex.com/news/opinion-3-key-insights-for-rbf-success-89067

By Frank Van de Looiy (Cordaid).

Guardian - NGOs aren't just mute. They're being gagged

D Doane https://www.theguardian.com/global-development-professionals-

network/2016/nov/04/ngos-arent-just-mute-theyre-being-gagged?CMP=share_btn_tw

D Doane on the situation in the UK for NGOs. “A number of changes in contracts and conditions mean that it is increasingly hard for NGOs to criticise the government.”

13

FCGH state of affairs

Do read a number of articles on Imaxi on the state of affairs with respect to the Framework Convention on Global Health (FCGH). Most importantly, a FCGH NGO will be set up.

Boarding the FCGH Express.

All Aboard The FCGH Express!

FCGH: Year of Progress and Promise (by Eric Friedman)

CSIS (report) - Imperiling Progress: How Ethiopia's Response to Political Unrest Could Undermine Its Health Gains

J Fleishman et al; CSIS;

“ With each passing week, the political unrest and repression in Ethiopia is attracting new levels of global attention: from Feyisa Lilesa’s protest sign at the Rio Olympics in August, to recent clashes in Oromia where hundreds of protesters were killed by security forces and hundreds more jailed, and now the government’s declaration of a sweeping state of emergency for the next six months. There is little doubt that the inherent contradictions of Ethiopian rule—tight restrictions on human rights and governance while pursuing pro-poor policies—now threaten to derail its notable but fragile progress in women’s and children’s health. The current crisis also exposes the shortcomings of U.S. policy in Ethiopia; while providing substantial funding for health and development and maintaining close security ties, U.S. reluctance to hold its longtime ally accountable for its repressive tactics could put these investments at risk.”

Health Affairs (blog) - Countries Transitioning From Donor Health Aid: We Need A Common Research Agenda And Mechanisms For Action

R Hecht & Sara Bennet; http://healthaffairs.org/blog/2016/11/04/countries-transitioning-from-

donor-health-aid-we-need-a-common-research-agenda-and-mechanisms-for-action/

In this blog post, the authors describe “global health transitions and explain the reasons why they are happening now; point to the risks inherent in the transition process; highlight emerging best practices as well as weak and neglected areas; outline what we see as an emerging analytical agenda; and propose next steps to make such an agenda and more coordinated action across countries and donor agencies a reality.”

14

IJHPM – Labonté Identifies Key Issues for Health Promoters in the New World Order

D Raphael; http://www.ijhpm.com/article_3291_8a9b9f08f23f1a1540e903ecc5a0ba5e.pdf

The ‘New World Order’ has just been shaken massively (it probably won’t be the last time), but still worth a read, this Comment.

The Lancet - US CDC celebrates 70 years

Lancet;

From last week’s Lancet issue.

CFR - Health and U.S. Foreign Policy in the Age of Miracles

Thomas Bollyky & Eric Goosby; http://www.cfr.org/health/health-us-foreign-policy-age-

miracles/p38459?cid=soc-twitter-Health+and+U.S.+Foreign+Policy+in+the+Age+of+Miracles-110316

Written just before the Trump victory, clearly. “Can this age of [global health] miracles endure? Yes, but only with continued U.S. leadership and investment amid some challenging headwinds. The next president should build on the recent efforts to harness the positive synergies between global health and U.S. foreign policy.”

Guardian – Canada broadens aid horizons as focus falls on women and girls in Mozambique

https://www.theguardian.com/global-development/2016/nov/04/canada-aid-women-girls-

mozambique-marie-claude-bibeau-interview

“A project to tackle child, early and forced marriage in Mozambique is indicative of a new direction for Canadian aid, says the country’s development minister.” “… … “The previous government really targeted all its support to safe delivery,” says Bibeau. “We want to open this to look at the full range of sexual and reproductive health services and rights. It means family planning, contraception, obviously safe delivery too, but safe abortion too when it is legal. So we really have a much larger approach to supporting women’s rights.””

15

UHC

Do sign the joint letter on the need to change UHC indicator 3.8.2 – ahead of the meeting in Geneva next week

https://www.surveymonkey.co.uk/r/TDDDQ8S

Health Financing in Africa (blog) – E-learning course on health financing policy for UHC: an interview with Matthew Jowett

http://www.healthfinancingafrica.org/home/e-learning-course-on-health-financing-policy-for-

universal-health-coverage-uhc-an-interview-with-matthew-jowett

“Following successful trainings on health financing policy in Tunis and then Barcelona, the World Health Organization recently launched a new web-based e-learning course, Health Financing Policy for Universal Health Coverage. HFA spoke to Matthew Jowett, Senior Health Financing Specialist at WHO Geneva and organizer of this course, to learn more about the latest offering and WHO’s new blended learning approach.”

Lancet (Comment) - The post-Ebola baby boom: time to strengthen health systems

R McBain et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31895-5/fulltext

Comment related to the short-term baby boom in Liberia, or temporary spike in the country's facility-based childbirth rate, after the country was declared Ebola-free in May 2015.

Planetary health

Humanosphere - United Nations: Time is running out to limit global warming

Tom Murphy; http://www.humanosphere.org/environment/2016/11/united-nationstime-is-

running-out-to-limit-global-warming/

16

“…The world has three years to get its act together and reduce carbon emissions.” Now you tell me how this will fit with a Trump presidency.

Infectious diseases & NTDs

Critical public health – Comparison of social resistance to Ebola response in Sierra Leone and Guinea suggests explanations lie in political configurations not culture

Annie Wilkinson et al; http://www.tandfonline.com/doi/full/10.1080/09581596.2016.1252034

“Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. In Sierra Leone, defiant resistance was rarer. Instead of looking to ‘culture’ to explain patterns of social resistance (as was common in the media and in the discourse of responding public health authorities) a comparison between Sierra Leone and Guinea suggests that explanations lie in divergent political practice and lived experiences of the state. In particular the structures of state authority through which the national epidemic response were organised integrated very differently with trusted institutions in each country. Predicting and addressing social responses to epidemic control measures should assess such political-trust configurations when planning interventions.”

Reuters – Study finds gene markers for drug-resistant malaria in Cambodia

Reuters;

Based on new research in the Lancet Infectious Diseases.

Lancet Global Health (Comment) – World Pneumonia Day 2016: pulse oximetry and oxygen

A S Ginsburg et al; http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30296-

0/fulltext

“There is an urgent need to increase access to oxygen and pulse oximetry in low-resource settings.”

17

NCDs

Plos – Three Steps to Improve Management of Noncommunicable Diseases in Humanitarian Crises

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002180

“Kiran Jobanputra and colleagues argue that better evidence, guidance, and tools are needed to improve the effectiveness and feasibility of noncommunicable disease care in humanitarian settings.”

WHO Euro (report) – Tackling food marketing to children in a digital world: trans-disciplinary perspectives

http://www.euro.who.int/__data/assets/pdf_file/0017/322226/Tackling-food-marketing-children-digital-world-trans-disciplinary-perspectives-en.pdf?ua=1

Long overdue, but better late than never. WHO wants to tackle the marketing of unhealthy food to kids. (from last week)

Sexual & Reproductive / maternal, neonatal & child health

Lancet – Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

Li Liu et al; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31593-8/fulltext

This article outlines updated annual estimates of child mortality during 2000-2015, and considers the implications for meeting the 2030 SDG target for child survival.

In short: global progress on reducing child deaths is largely due to fewer cases of pneumonia, diarrhoea, death during birth, malaria and measles. “Estimates for 2015 suggest that 5.9 million children worldwide died before reaching the age of five, including 2.7 million newborns. Globally, four million (4.02 million) fewer child deaths occurred in 2015 than in 2000, mainly thanks to reductions in deaths from pneumonia, diarrhoea, death during birth, malaria and measles. However, progress on reducing newborn deaths (in the first 28 days) has been slower meaning that as a whole the world failed to reach the Millennium Development Goal (MDG) target of reducing child deaths by two-thirds between 1990 and 2015. …”

18

For the related comment by Peter Byass, see Child mortality is (estimated to be) falling.

CGD (publication) - Aligning to 2020: How the FP2020 Core Partners Can Work Better, Together

R Silverman & A Glassman; http://www.cgdev.org/publication/aligning-2020

From last week. The partnership Family Planning 2020 (FP2020) is halfway. CGD fellows Silverman & Glassman take stock.

WB ‘Investing in health’ blog - Global Financing Facility invests in sexual and reproductive health by prioritizing family planning and other high-impact interventions that pave the way for healthier families and stronger economies

M Vledder; http://blogs.worldbank.org/health/global-financing-facility-invests-sexual-and-

reproductive-health-prioritizing-family-planning-and

The GFF completes its first year since the launch at the July 2015 Financing for Development conference – Vledder assesses where we are now.

Access to medicines

Global health check – The High-Level Panel report: to gather dust or create real change on access to live saving medicines?

M Kamal-Yanni; http://www.globalhealthcheck.org/?p=1923

Kamal-Yanni concludes: “…Concerted efforts are now needed for the UN system and member states to adopt and implement the HLP recommendations. Otherwise the report will simply end up gathering dust on some shelves in a UN office. It is now in the hands of the UN Secretary General to move this process forward. His action would be a valuable parting gift to the world as he leaves office at the end of this year, a critical step toward ensuring access to medicines for all so no one is left behind.”

In other access to medicines news, you might also want to read Buyers clubs for cheaper drugs help

fight hepatitis and HIV (Reuters).

19

Miscellaneous

Afrobarometer - Afrobarometer: China wins favorable reviews in new Africa survey

http://www.chinaafricarealstory.com/2016/10/afrobarometer-china-wins-favorable.html

That will probably not change after the last US elections…