The Associated Press examines the debate over the future of the Affordable Medicines Facility-malaria (AMFm), after the recent release of two papers evaluating the program’s effectiveness. AMFm was established in 2010 as “a pilot project to subsidize artemesinin combination drugs, the most effective malaria treatment,” the AP writes, noting the $460 million program is managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. “Last week, a report by Oxfam, an international charity, labeled the program a failure and said there was no proof it had saved lives because officials didn’t track who received the drugs,” the news service writes, adding, “But in another paper published Wednesday in the journal Lancet, experts insisted the program was ‘an effective mechanism’ to lower the price of preferred malaria drugs and make them widely available.” The Global Fund is scheduled to discuss the future of the program at a meeting next month, according to the AP (Cheng, 10/31).
Programs, Funding & Financing
“The implementation of an ambitious bill that guarantees cheap food grains for India’s poor could be pushed back to the next fiscal year, a top government adviser said,” the Wall Street Journal reports. “[I]mplementing the bill in the fiscal year starting April 2013 would make financial and political sense for the government, which is facing a yawning budget gap and federal elections before May 2014,” according to the newspaper, which adds the bill is “likely to be introduced in the budget session, which is due late February, C. Rangarajan, chairman of the Prime Minister’s Economic Advisory Council, said in an interview.” After a general debate, parliament would have to approve the bill, which “aims to provide subsidized grains to more than 60 percent of India’s 1.2 billion people, with special provisions for pregnant women, destitute children and others,” for it to become law, the newspaper writes, adding, “A government spokesman declined to comment on the matter Friday” (Sahu/Guha, 10/27).
While there is “much to be proud of” in the progress in the fight against polio, “there’s still more work to be done,” former Canadian Prime Minister Paul Martin writes in a GlobalPost opinion piece. Martin, a polio survivor, notes that in 1988, when the Global Polio Eradication Initiative was launched, 350,000 cases in more than 125 countries were recorded annually, but “[s]o far this year, we’ve seen just 171 cases, and only Pakistan, Afghanistan and Nigeria have never stopped transmission.” He continues, “Canada has been a leader in this fight,” but “[t]he credit for this progress, of course, goes far beyond Canada” to “the work of global partners like the World Health Organization, UNICEF, Rotary International and the Bill & Melinda Gates Foundation; the frontline workers whose tireless efforts make all of this possible; and the countries that are making the political and financial commitments necessary to see the end of this disease.”
Noting “[w]e are just three years away from the target date for achieving the U.N. Millennium Development Goals (MDGs) agreed by all … U.N. member states back in 2000 to eradicate global poverty,” Peter Piot, director of the London School of Hygiene and Tropical Medicine, in this Independent opinion piece reflects “on the critical role of health in and beyond the Millennium Development Goals” ahead of the second meeting of the U.N. Secretary General’s High-Level Panel on the future strategy to fight global poverty, set to take place in London on Wednesday. Piot writes that the MDGs have “given local and global focus to efforts to tackle the big issues,” while inspiring action, innovation, and new financing models, but he notes “there is still so much more we need to do.”
“The world is on the verge of a great success story: the eradication of polio,” John Hewko, CEO and general secretary of Rotary International, and Jeffrey Sachs, director of the Earth Institute at Columbia University and special adviser to U.N. Secretary-General Ban Ki-Moon, write in the Huffington Post’s “Global Motherhood” blog. But “[t]here is still ground to cover,” they continue. “Even though the current cases of polio transmission number less than 200 so far this year, the case for finishing the job — getting to zero — is more crucial than ever,” they write, adding, “If polio is fully eradicated, it can’t ever return. On the other hand, if even a few cases persist, and the world lets its guard down, those few cases could become the start of a new epidemic.”
Researchers from Imperial College London, the Harvard Global Equity Initiative, and Harvard School of Public Health “have identified three global organizations that new funding initiatives should emulate in order to meet health priorities in poorer countries, in research published [Thursday] in the journal the Lancet,” Imperial College London reports in an article on its webpage. The study, “a comprehensive review of new funding methods that raised money for health in developing countries between 1990 and 2010 … found that the GAVI Alliance, … the Global Fund [to Fight AIDS, Tuberculosis and Malaria], and UNITAID, … were the sole organizations whose innovative financing methods had raised and distributed funds on a global scale,” the article notes, adding, “The authors concluded that innovative financing is essential to reduce dependence on contributions from donor governments. These innovative instruments provide a different way of raising money from new sources and making it available to address global health problems” (10/25).
Negative Effects Of Global Health Initiatives On Developing Countries' Health Systems Exaggerated, Review Shows
“An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated,” according to a press release from the Royal Society of Medicine. The systematic review, published on Wednesday in JRSM Short Reports, “found that much of the research literature did not fulfill the requirements of rigorous scientific evidence,” according to the press release. “The systematic review identified 24 studies published in peer-reviewed scientific journals between 2002 and 2009 that have commented on adverse effects on health systems arising from investments by the Global Fund,” the press release states, adding, “All the studies evaluated contained only seemingly anecdotal evidence or authors’ perceptions or interpretations of circumstances” (10/24).
“Though the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has been touted as one of our nation’s most successful initiatives in global health (and certainly one of President George W. Bush’s most positive legacies) it continues to miss the mark” when it comes to family planning, global gender specialist and freelance writer Jessica Mack writes in KPLU 88.5’s “Humanosphere” blog. “The essential role of contraception, especially barrier methods, in preventing the spread of HIV/AIDS is intuitive, obvious, and also well documented,” she writes. “While earlier PEPFAR rules did not specifically dictate whether or not funding could be used for contraceptive supplies, the language over the last few years has become increasingly restrictive on this point,” she continues, noting that PEPFAR’s recently released 2013 country operational plan (COP) forbids the use of PEPFAR funds to purchase family planning commodities. Mack concludes, “PEPFAR is simply flying directly in the face of the Global Health Initiative’s vision and the stated objectives of the Obama Administration” (10/25).
Contradictions Among Member State, Donor Priorities Must Be Resolved For Current WHO Reform To Be Successful
In a BMJ analysis examining the future of the WHO, David Legge, scholar emeritus at Australia’s La Trobe University, notes “[a] substantial shortfall in the funds available for basic administrative functions led WHO’s director general, Margaret Chan, to initiate another reform of the WHO in 2010,” and “outlines the problems and what the reforms are trying to achieve.” He writes, “Success of the current reform program depends on resolving the contradiction between member state priorities and donor control and requires the freeze on assessed contributions to be lifted,” adding, “To achieve this, member states must be persuaded to prioritize global health over parochial interests.”
Differing Opinions About AMFm 'Unlikely To Be Resolved' After Global Fund Decision On Program's Future
In her “Global Health Blog,” Guardian health editor Sarah Boseley examines the Affordable Medicines Facility-malaria (AMFm), “which aims to enable countries to increase the provision of affordable artemisinin combination therapies (ACTs) through not only the public sector but also the private sector and [non-governmental organizations (NGOs)].” Following pilot projects in seven African countries and an independent evaluation by the London School of Hygiene and Tropical Medicine, the Global Fund to Fight AIDS, Tuberculosis and Malaria, which hosts AMFm, is set to decide the future of the scheme at a board meeting in November. She notes Oxfam recently released a report criticizing the mechanism, saying the evaluation was flawed because it looked at the number of ACTs sold and not lives saved.