Sharing knowhow and joining forces towards Health for All

MMI Network News, September 2015

Resilience: "Bounce, don't break!"
Resilience: "Bounce, don't break!"

Beyond resilience (editorial)

Dear reader,

Resilience is the next “big thing” in global health and health systems development. It is a reaction to the impact of the Ebola epidemic in West Africa, the financial meltdown in the US and EU, and global climate change. The principle has been firmly anchored in the Sustainable Development Goals: “By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure and vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters” (UN Sustainable Development Goals, target 1.5).

The term now also frequently appears in global health policies. “Resilient health systems” was the theme of this year’s World Health Assembly, but in the first meeting of the WHO Review Committee on the Role of the International Health Regulations in the Ebola Outbreak and Response in August, the concept was not mentioned. It also doesn’t appear in WHO DG Margaret Chan’s opening remarks to the Review Committee. On the other hand, the World Bank favors the resilience approach, and also the Rockefeller Foundation has developed much interest in resilient health systems. This is not surprising as its president Judith Rodin is the writer of the book “The Resilience Dividend”. The theme of next year’s 4th Global Symposium on Health Systems Research will be “resilient and responsive health systems for a changing world”.

I argue that we should distinguish between the resilience discourse as applied in complex adaptive systems, ecology and psychology and its use in normative, political, decision making for health systems. While the first is a useful method to assess the flexibility, responsiveness and shock-absorbing capacity of health systems there is much criticism of the resilience discourse by political scientists. One of those critiques is that the resilience discourse colonizes our political imagination. It hinders us to develop universal and strong systems based on the principles of health equity and to take action on the Social Determinants of Health. As resilience is mainly about anticipating a future crisis, we maintain the status quo. My analysis of the resilience approach to health systems is that it is a modern expression of the decades-old debate of selective versus complementary primary health care, and the political choices behind it. In a recent interesting political sciences article called “Exhausted by resilience the authors even move beyond: The real tragedy for us is the way the doctrine forces us to become active participants in our own de-politicisation... It promotes adaptability so that life may go on living despite experiencing certain destruction. Indeed it even demands a certain exposure to the threat before its occurrence so that we can be better prepared. Resilience as such appears to be a form of immunization. Yes, the doctrine of resilience at the level of policy and power is ubiquitous. And yet in terms of emancipating the political, it is already dead.”

The authors challenge its readers to a new imaginary for rethinking politics, emancipation and the formation of political communities in the twenty-first century. Applied to global health, this would mean a reformulation of what we consider being the necessary conditions for a meaningful, dignified, healthy life. The capability approach developed by Martha Nussbaum and Amartya Sen can guide us. Universal access to essential health services whether people live in high-, low- or middle-income countries would be a core element in this. Such a cosmopolitan approach will move us beyond the iron cage of the nation states we live in and the false security it brings.

Yes, it is a re-imagination of an alternative world order. But we can’t continue with the status quo where we continuously consume beyond Earth’s carrying capacity, global temperature is to rise, global financial markets are casinos beyond control, and refugee patterns are likely to continue. There is no other option than moving beyond the status quo and working on true alternatives for social justice and health. At the minimum, we have to move beyond resilience.  

Remco van de Pas, ITM Antwerp
Member of the MMI Board

(In the meantime, a blog by MMI Executive Secretary Thomas Schwarz on resilient health systems has been published by Medicus Mundi Switzerland in German and French.)

MMI Network: Events and resources

Network event: MMI, i+solutions, Cordaid
MMI Network meeting
The Hague, 7-8 October 2015

The internal MMI events will take place Wednesday 7 October (planning workshop in the afternoon) and Thursday morning (Extraordinary Assembly) at the Cordaid office in The Hague. After this, we are invited to participate in the jubilee symposium “innovation brainstorm” of i+solutions (by invitation only). If you have not received an invitation from i+solutions and are interested to participate in their symposium, please get in touch as soon as possible with the i+solutions secretariat.


Network event: Medicus Mundi Switzerland
A challenge for Switzerland: Achieving health for all in a changing world
Basel, 28 October 2015

"The UN’s Sustainable Development Goals (SDGs) have changed the frame of reference for development policy worldwide. By applying a new strategy for international cooperation, Switzerland seeks to live up to SDG expectations. Will Switzerland be able to meet its responsibilities in a changing environment? What can it contribute to maximising health across all stages of life? This year’s MMS Symposium will analyse existing challenges and debate comprehensive approaches to strengthening health for all in this new phase.”


Network event: Medicus Mundi Switzerland
Drug resistance: From mechanism to management
Basel, 10-11 December 2015

"Drug resistance is emerging globally as a major public health and economic problem. It is both urgent and highly complex, affecting key aspects of human and animal health as well as agriculture and the environment in many interconnected ways. Whether they target pathogens such as viruses, bacteria, parasites or their vectors, few drugs exist today, for which resistance has not already been documented. Join health professionals, researchers and students in a two-day multidisciplinary symposium bringing together national and international experts from a variety of fields to examine and discuss the central aspects of drug resistance, ranging from the molecular and evolutionary mechanisms of resistance to the clinical, epidemiological and economic implications." Symposium of the Swiss TPH, a member of Medicus Mundi Switzerland.


Network conference documentation: medico international
Fit for Catastrophe?

Frankfurt a.M., 5-6 June 2015. On its 10th anniversary the foundation medico international wanted to have a critical look at the concept of resilience that in the past years emerged as a panacea against all kinds of crisis and problems that societies and individuals are facing nowadays. The symposium was mainly held in German. The remarkable input by Marc Neocleous on "Resisting Resilience." is the only contribution currently available in English.

Network conference documentation: ACHAP
Global Conference on Religion and Sustainable Development affirms role of faith actors

Washington DC, 7-9 July 2015. "A highly significant conference brought together 130 attendees to discuss Religion and Sustainable Development. (...) The conference attracted a unique combination of policy makers, multilateral and bilateral agencies, religious leaders, development professionals from faith-based organisations and academics. The goals of the conference were to connect frontline policy makers to the evidence base and expertise to support more effective partnerships with religious and faith-based groups in the common cause of ending extreme poverty and promoting sustainable development.” MMI Network member ACHAP participated in this conference.


Network reporting:
Annual Reports 2014

Two more MMI Network members have recently published their annual reports.


Global health policy, health cooperation, health systems: MMI updates

Bits and pieces of news on international health policy: each “MMI update” is 140 characters or less - these are the rules of the game on Twitter. Just enough for a headline, eventually an author, a date, the source – and a link to the website where you find the full information. Have a look at some of our “tweets” published during the last month. As usual, it’s a bit much, so take it or leave it.


Universal health coverage
Health systems strengthening
Resilient health systems
Health services, health financing

Evaluating Universal Health Coverage as a Sustainable Development Goal. AR Chapman

Moving towards universal health coverage: lessons from 11 country studies. Michael R Reich et al.

Private sector and UHC: Examining evidence, deconstructing rhetoric. Meeting report

Leaving nobody behind in bad health requires Universal Health Coverage. Rob Yates

Advancing toward Universal Health Coverage through smart choices. Nellie Bristol

UHC from multiple perspectives: Synthesis of conceptual literature and global debates. Abiiro/De Allegri

WHO draft global strategy on people-centred and integrated health services

Faith-based health-care. A Lancet series

Strengthening of partnerships between the public sector and faith-based groups. Jean F Duff and Warren W Buckingham

The roles of faith-based health-care providers in Africa: magnitude, reach, cost, satisfaction. Jill Olivier et al.

Controversies in faith and health care (in: Lancet series)

Time for Action: Shifting the paradigm towards integrated, people-centred  health systems.  Angeli Rawat

Resilience doctrine: Form of political nihilism forcing us to accept inevitability of liberal politics of catastrophe

Resilience in the SDGs: developing an indicator for Target 1.5 that is fit for purpose. ODI

Resisting resilience. Marc Neocleous at recent medico symposium

Resisting resilience: The revenge of the zombies Remco van de Pas

Increased domestic resource mobilization in Africa: A priority for the post2015 era. Biodun Awosusi et al.

Introducing payment for performance in the health sector of Tanzania - the policy process

  • Twitter: #UHC


Health policy and systems research

Decision-maker led implementation research to improve the performance of immunization programmes

Measuring global health R&D for the post2015 development agenda. COHRED et al.

How to bridge between health systems researchers and practitioners in the field of international health cooperation. MMI hosted session at ECTMIH 2015 congress


Health workers
Human resources for health
Migration of health professionals

Workforce2030. Draft global strategy on HRH

Invest in HRH for sustainable development. Addis Ababa call to action (ministerial meeting)

Strengthening PHC through Community Health Workers: Investment case and financing recommendations. Sirleaf et al.

Health workers: The heroes at the heart of humanitarian action. WHO at WHD2015

Maximizing the impact of community-based practitioners in the quest for universal health coverage

Health sector employment: a tracer indicator for UHC in national Social Protection Floors.

Addressing the HRH crisis: Role of action research to improve workforce performance. Joanna Raven

Using a human resource management approach to support community health workers in five African countries

Accelerate implementation of the WHO Code of Practice: Experiences from the South East Asia Region. Tangcharoensathien/Travis


Access to medicines and vaccination
Medical research and development
Communicable diseases and diseases control

Public Health, Intellectual Property, and TRIPS at 20. Geneva, 28 October 2015

The Trans-Pacific Partnership Agreement TPP and implications for access to essential medicines. Jing Luo et al.

UNAIDS call on trade negotiators: Uphold commitments to public health and access to medicines

SDGs and essential medicines: not an impossible mission, if we’re on target. Maryam Bigdeli

SDGs treatment of TB and  right to health is woefully inadequate. Brian Citro

Fast-tracking to zero. UNAIDS’s draft strategy for 2016–2021

World Hepatitis 2015 Summit, 2-4 September 2015
WHO media release 


Ebola situation and response
Ebola and health systems
Ebola and the state of global health governance

Report of WHO Ebola Interim Assessment Panel, July 2015

Review Committee on the Role of the IHR in the Ebola Outbreak and Response: WHO meeting documentation

Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone

Social and political remedies needed for the Ebola tragedy. David Sanders  David Legge et al.

Health security and political and economic determinants of Ebola. Mahomed S Patel and Christine B Phillips

Ebola’s lessons. How the WHO mishandled the crisis. Laurie Garrett

Are we prepared for the next global epidemic? The public doesn't think so. Jim Kim


Women’s and children’s health
Sexual and reproductive rights and health

Human rights and accountability fundamental to addressing disparities in sexual and reproductive health. Rebecca Brown

WHO recommendations on interventions to improve preterm birth outcomes

Sexual health, human rights, and law - Lancet commentary

Advancing reproductive health on the humanitarian agenda IAWG Global Evaluation 2012-2014

Committing to Child Survival: A Promise Renewed – Progress Report 2015

Child mortality rates plunge by more than half since 1990 but global MDG target missed by wide margin

Updated WHO fact sheet on child mortality

Global, regional, national levels & trends in under-5 mortality between 1990 and 2015, with projections to 2030 (UNIGME)

Child survival in 2015: much accomplished, but more to do. Li Liu, Robert E Black

The slippery target for child survival in the Agenda for Sustainable Development. Elizabeth D. Gibbons

WHO recommendations on interventions to improve preterm birth outcomes.


Prevention and control of NCDs
Nutrition, Disabilities, Mental Health, Care
Ageing and health

Financing for NCDs. Interim Report of WHO Working Group

Sustainable development needs sustainable financing - tackling NCDs is no exception. Oleg Chestnov

Noncommunicable Diseases: A Globalization of Disparity? Peter Hotez

The communicable/non-communicable disease dichotomy is problematic for public health control strategies. Oni/Unwin

Ultra-processed foods are driving the obesity epidemic in Latin America, says new PAHO/WHO report

WHO consultation on inappropriate marketing of foods for infants & young children

WHO consultation: Global Strategy and Action Plan on Ageing and Health  


Equity and human right to health
Social determinants of health
Poverty and social protection

Monitoring inequality: an emerging priority for health post-2015

Inequalities in health: definitions, concepts, and theories. Arcaya et al.

Dignity matters: Applying Human Rights frameworks to health. Alicia Eli Yamine

  • Twitter: #SDH, #HIAP


Global health, health governance and policy
Political and economic determinants of health

Global governance for health. Documentation of GHRF workshop, 1-2 September 2015

A Progressively Realizable Right to Health and Global Governance. Norman Daniels

Analysing Proposals for Reform of the Global Health Architecture. Schäferhoff et al.

10 years of International Health Regulations: Why they matter

First meeting of WHO IHR Review Committee, 24-25 August: Documentation

New "international, independent, multi-stakeholder" commission on Global Health Risk Framework

Outcome of the Financing for Development Conference: Fishing for crumbs of hope in a sea of lost ambition. Aldo Caliari

A framework on the emergence and effectiveness of global health networks. Jeremy Shiffman et al.


World Health Organization
WHO reform and financing

World Health Organization or World Health Corporation? Resisting Corporate Influence in WHO. A reader

WHO shackled: Donor control of the World Health Organisation. David Legge

WHO reform: opening the floodgates to the private sector? Judith Richter

WHO negotiations to continue on non-state actors. KM Gopakumar

The Normative Authority of the World Health Organization. Gostin et al.

Who needs the WHO? Laurie Garrett.

Fit for whose purpose? Private funding and corporate influence in the UN


Health beyond 2015
MDGs and SDGs

Transforming our world: the 2030 Agenda for Sustainable Development. Draft outcome document of the United Nations summit for the adoption of the post-2015 development agenda

What might the SDGs mean for health and Human Rights? HHR Journal series

"Everywhere but not specifically somewhere." Right toh ealth is not explicit in SDGs negotiations. Gorik Ooms et al.

Monitoring inequality: an emerging priority for health post-2015

With new UN development goals, focus shifts away from infectious disease

Not only is good health for all achievable -- it's affordable. Martin McKee

Investing in the SDGs : Whose Business?

The problem with saving the World without transforming it. Jason Hickel

Five practical steps to give oxygen to the SDGs. Tim France


Development, aid and international institutions

Classification of donor aid for health global and country-specific functions and subfunctions

Development assistance for health visualization: Sources, channels, regions, health focus

Uncovering the Politics of Evidence and Results. Rosalind Eyben 2013

The politics of results and evidence in international development. Book review 

The Politics of Evidence and Results in International Development: Playing the Game to Change the Rules?

Projectisation of donor funding: implications for CSO sustainability. CIVICUS SOCS2015

Why political economy analysis is important for development effectiveness. Unicef

The Louis Berger World: The reality of donors' commitments to local ownership

The gospel according to Aid

Facts and stats about NGOs worldwide.

"If NGOs stay politically correct, we won't have an impact." Interview with Justin Forsyth  

Turn the humanitarian system on its head: Strengthen local capacity, shift leadership to local actors

Why is philanthropy so fixated with social entrepreneurs and so uninterested in social movements?

International NGOs and aid: no longer a case of levelling the partner playing field. Alan Fowler, SOCS2015

MMI thematic guides:


Health of refugees and migrants arriving in Europe

European countries should ensure universal health coverage of refugees and migrants, both documented and undocumented. WHO

Statement by Dr Zsuzsanna Jakab, WHO Regional Director for Europe, on influx of refugees and migrants

UK: Contradictions at heart. Natalie Sharples


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