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Recent Releases In Global Health

Lancet Editorial Argues Global Health Community ‘Too Complacent’ On Development Of An Effective, Affordable Malaria Vaccine  

“What is still needed [to fight malaria] is the only tool that has ever truly conquered any infectious disease: an effective and affordable vaccine. And here, the global malaria community has been too complacent,” a Lancet editorial asserts in an article highlighting achievements and drawbacks in attempting to provide universal access to malaria prevention and treatment. The editorial examines factors that have slowed vaccine development, the prospects of GlaxoSmithKline’s RTS,S plus adjuvant AS01 malaria vaccine, and the recent pledge by GSK that such a vaccine would be sold “at just 5% above cost and [the company would] invest profits back into research for diseases in developing countries.”

“Although a welcome gesture, this commitment simply does not begin to go far enough. And here the global malaria community has remained dismayingly silent. What is urgently needed is serious investment into a broad research and development strategy towards a malaria vaccine. … WHO, the Global Fund, UNICEF, and others must speak loudly and demand true public-private partnerships on a far larger scale” (4/24).

Lancet Comment Examines Health Financing Strategy For WHO’s Asia-Pacific Region

A Lancet comment examines the WHO’s “new health-financing strategy for 2010-15 for the Asia-Pacific region, which was endorsed by Member States in September, 2009,” outlining several target indicators included in the strategy. “Appropriate health-financing policies ensure people have adequate financial protection against the costs of illness, help advocate for additional needed resources for health, and mean that scarce resources are more efficiently and equitably spent,” the authors of the comment write. “WHO’s health-financing strategy, through target indicators and associated strategy areas, focuses attention on key health-financing concerns. In doing so, the hope is that the strategy can help policy makers make further progress towards universal coverage of health services” (James, Bayarsaikhan and Bekedam, 4/24).

Blog: Congressional Hearings Needed To Examine U.S. Global Health Policy Shift

The “Science Speaks” blog outlines several concerns about the Obama administration’s Global Health Initiative with a focus on its impact on PEPFAR. After noting issues and raising questions about the GHI, the blog concludes: “The uncertainty now building around both PEPFAR and GHI is not healthy, and it can only be resolved through Congressional hearings that promote a greater understanding of the issues surrounding this significant shift in policy. Without a strong bipartisan political commitment to this initiative (as there was to the reauthorization of PEPFAR), there is serious potential for failure of not just GHI, but PEPFAR as well. The GHI’s success is dependent on an increase in funding, which at this point may or may not happen. Without that guarantee, we may do more harm than good in embarking down this new road” (Smith, 4/21). 

PLoS Medicine Policy Forum Reflects On Foreign Policy, Health Diplomacy

A PLoS Medicine policy forum reflects on the interplay between foreign policy and global health, in a paper that “reviews recent research in the field of global health diplomacy, discussing why only select global health issues rise in political priority, examining health diplomacy initiatives driven primarily by foreign policy interests, and seeking to illuminate the constellation of interests involved in health diplomacy.” The take-home message of their paper, the authors write, “is that, despite recent commentary to the contrary, foreign policy interests are of primary and enduring importance to understanding the potential and limits of health diplomacy” (Feldbaum/Michaud, 4/20).

Blog: Uganda Doctor Discusses PEPFAR Funding 

The “Science Speaks” blog talks with Lydia Mungherera, an HIV-positive medical doctor from Uganda, about “what’s at stake in the unfolding crisis over global AIDS funding.” The blog notes that Mungherera is “growing increasingly concerned about the ramifications of flat-funding for the President’s Emergency Plan for AIDS Relief, a cornerstone of the international response to HIV/AIDS,” as the implementation of President Obama’s Global Health Initiative “seems to ensure that some funding will have to taken from PEPFAR to make the other pieces of the program work.” The blog addresses how lack of access to treatment hampers HIV testing efforts and features a video of Mungherera discussing the link between HIV and maternal and child health (4/20).

PLoS Medicine Study Estimates Cost, Health Outcomes Of Strategies To Reduce Maternal Mortality In India

“Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India, which has the highest burden of maternal mortality for any single country,” according to a PLoS Medicine study that uses a computer-based model to estimate the effect of several strategies on health outcomes and cost. The authors report, “In just 5 y[ears], more than 150,000 maternal deaths would be averted through increasing contraception rates to meet women’s needs for spacing and limiting births; nearly US$1.5 billion would be saved by coupling safe abortion to aggressive family planning efforts; and with stepwise investments to improve access to pregnancy-related health services and to high-quality facility-based intrapartum care, more than 75% of maternal deaths could be prevented. If accomplished over the next decade, the lives of more than one million women would be saved” (Goldie et al., 4/20).

BMJ Editorial Reflects On Praise, Criticism Of GAVI

A British Medical Journal editorial reflects on the GAVI Alliance’s  triumphs and challenges, since its creation in 2000: “Over the past decade, GAVI has immunised 256 million children and, in doing so, has averted five million deaths … Yet the alliance has not been immune to criticism.” Critics have claimed GAVI allows “too little meaningful participation in priority setting by recipient governments,” which in turn has “led to familiar accusations of donor driven agendas and even the foisting of vaccines on recipient countries.” The editorial concludes, “The world is a better place for millions of children because of the increased rates of immunisation that GAVI has achieved over the past 10 years. The challenge is to ensure that these children go on to live their lives meaningfully and with dignity. This will require equitable access to the full range of basic needs, and to this end, the world still has a long way to go” (4/20).

Blog: Shah’s Remarks Shed Light On U.S. Policy In Pakistan

The “Rethinking U.S. Foreign Assistance Blog” examines USAID Administrator Rajiv Shah’s recent briefings about his trip to Pakistan. The blog notes that Shah’s testimony reveals a “major shift in focus of U.S. aid to signature, ‘transformative,’ large-scale investments in Pakistan’s energy, agriculture and water sectors.” It also outlines some “revealing, new glimpses” for U.S. policy in Pakistan based on Shah’s remarks, which include monitoring development outcomes. “He spoke about monitoring key measures of improved wellbeing in the agriculture, education, and health sectors: learning and educational attainment, for instance, and immunization rates and skilled birth attendance,” the blog writes (Kinder, 4/20).

Blog: The Growing Danger Of Counterfeit Drugs In Developing Countries

The New York Times’ “Consults” blog examines the health dangers of a growing number of counterfeit medications in developing countries: “The World Health Organization estimates that, on average, 10 percent of all pharmaceuticals on the global market are counterfeit. In parts of Africa, Asia and Latin America, more than 30 percent of the medicines on sale by retailers are counterfeit. In some regions, the numbers can be as high as 70 percent,” the blog writes. “In 2006, a coordinated worldwide effort to tackle this public health challenge was started through the World Health Organization’s International Medical Products Anti-Counterfeiting Taskforce. Efforts to strengthen regulatory oversight, craft legislation and enhance custom controls are underway” (Zuker, 4/19).

Blog: Questions About GHI Implementation Remain

In light of the Kaiser Family Foundation’s recent forum on the Global Health Initiative (GHI), the “Global Health Policy” blog raises questions about implementation of the GHI and provides recommendations based on three years of research in Mozambique, Uganda and Zambia. Topics addressed include health aid architecture, country ownership and goals, outcome metrics and health system strengthening (Wendt, 4/15).