What are our governments doing to protect public health in trade and investment negotiations? (Editorial)
Dear reader,
Sometimes it happens that one is just in the right place at the right time. At the recent World Health Assembly, while we were busy with final preparations and disseminating flyers for the MMI/Wemos side event on non-communicable diseases and public policy space in the context of free trade and market deregulation, the WHO Director-General Margaret Chan hit the nail right on its head saying, in her opening speech: “In my view, something is fundamentally wrong in this world when a corporation can challenge government policies introduced to protect the public from a product that kills”. I couldn’t agree more, and Dr. Chan pointed at more developments that indicate to me something is fundamentally wrong in this world. To name a few: growing inequality and more than 70% of the world’s poor living in middle-income countries, around 7 million people a year dying from exposure to air pollution and an increasing number of people practically eating themselves to death while so many people still go hungry.
The increase in non-communicable diseases (NCDs) is high on the agenda of the WHO and the wider UN system. Not surprisingly, looking at the changing burden of disease and the rising costs for health systems: in some middle income countries diabetes treatment is now absorbing half of the health budget. Obesity is even increasing much faster in low and middle income countries than in high income countries.
What remains strikingly absent from the international agenda though, is how to shape and implement cross-sectoral policies that protect public health. At our side event, we have highlighted the risks for public policy space that stem from trade and investment treaties and from market deregulation. We know that the risks are real, as several governments have already been sued by corporations. They make use of the investor to state dispute settlement (ISDS) mechanisms included in trade and investment treaties – for example because of the lost profits due to new regulation on cigarette packaging. And we know that regulatory measures are urgently needed to counter the massive spread and marketing of junk food, sugar-sweetened beverages and tobacco.
Among some of the lower-income groups in Mexico, the country that now has the highest rates of obesity in the world, children are served soft drinks with breakfast, lunch, dinner and in-between. Many governments are doing something to address the NCD epidemic, but many focus on changing individual behavior and lifestyles. A recent study by the University of Bristol involving 60 primary schools in the UK, examining the effects of programmes aiming at changing food patterns and sedentary behavior, concluded that these programmes have no effect and that “more intensive behavioural interventions with children or upstream interventions at the family and societal level” are needed. This would involve measures to make the healthy option the easiest and the cheaper options, and putting real limits on the marketing of the junk food and drinks that we don’t need.
But what if our own governments are among the main obstacles? From the discussions during our side event it became crystal clear that member states do not provide the WHO with the resources to do proper analysis and to give guidance to countries on how to protect public health in trade negotiations. Governments are under pressure from industries not to take regulatory measures, to have faith in industry self-regulation, not to “demonize” specific food products. At the same time trade negotiations on the Transatlantic Trade and Investment Partnership (TTIP) are taking place behind closed doors, without democratic control. This way it is difficult for the public to actually be involved and improve conditions to make our lives healthier.
One of the messages that came out of our side event, was to call upon ‘the health community’ to get more involved in trade issues. This requires – on the one hand – becoming more knowledgeable about trade. But on the other hand – knowledge does not automatically lead to change. A lot of money is involved in promoting the consumption of things we don’t need. It will take pressure on governments to make them give priority to health over economics and trade.
A high level Commission on Ending Childhood Obesity has been established by the WHO. Let’s hope that this commission learns from the experiences of the Lancet – University of Oslo Commission on Global Governance for Health, in that it makes as sharp an analysis but dares to be bolder in its recommendations and does not shy away from addressing power and politics (see the excellent blog by Dave McCoy).
Mariska Meurs, Wemos Foundation
Senior Global Health Advocate and Programme coordinator
mariska.meurs@wemos.nl
MMI Network: News, events and resources
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MMI Network: conference report
67th World Health Assembly
Geneva, 19-24 May 2014. As an NGO in official relations with WHO, the Medicus Mundi International Network was invited to appoint representatives to the World Health Assembly and to make statements under items concerning technical issues. The MMI Network focused its activities on networking and advocacy related to key MMI projects also represented in the Network’s WHA delegation, mainly:
- WHO watch
- Democratising Global Health Coalition on the WHO reform (DGH)
- Health workers for all and all for health workers (HW4All)
- Health Workforce Advocacy Initiative and its working group on migration
With over 45 members, the MMI crew was one of the biggest NGO delegations at the World Health Assembly. NGO statements including those of the MMI delegation are available for a limited period on the WHO website.
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MMI Network: conference report
Prevention and control of non-communicable diseases in the face of free trade and market deregulation: How to preserve policy space for public health?
Geneva, 19-24 May 2014. For a report, please also refer to the editorial by Mariska Meurs, above.
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MMI Network: conference report
Working towards Health for All: What’s the count?
And what role for civil society action and networking?
MMI mini-symposium in Geneva, 24 May 2014. As the Medicus Mundi International Network is orienting on its network strategy for the coming 5 years, we made use of having many partners close to us because of the World Health Assembly to invite them to a mini-symposium on key issues for the next years and the potential role of civil society – and the MMI Network – related to health systems, global health governance and determinants of health. It was a great informal talk with some insights into the environment of our work.
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MMI Network: conference report
Annual Assembly
The documentation of the MMI Assembly is available in the internal section of the MMI ePlatform (for Network members only – please get in touch with the Secretariat if you have access problems). The Assembly revisited the MMI Network Policy and statutes and adopted new internal regulations
- MMI Network Policy: www.medicusmundi.org/en/mmi-network/documents/mmi-network-policy
- MMI Statutes: www.medicusmundi.org/en/mmi-network/documents/mmi-statutes
- MMI membership regulations: www.medicusmundi.org/en/mmi-network/community
- Full Assembly documentation via www.bit.ly/mmi-2014
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Network reporting: MMI Annual Report
Universal Health Coverage, complexity, and a birthday…
Contents of the annual report: Message from the President; Plans, progress and perspectives; From Basel to Barcelona and Brussels: Network meetings; Financial facts and figures; “Short stories” by Members of the MMI Network (see below); list of Network members
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Network reports: HealthNet TPO
Afghan women take control of their own lives
“For several years HealthNet has been working in addressing the needs of women and vulnerable people in Afghan communities and provinces. After a 3 year programme, this year we see it is time to harvest results.”
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Network reports: Health Poverty Action
Realising the Right to Health with disaggregated data
“The health of the most poor and marginalised communities around the world will not be improved without better data collection practices. The Millennium Development Goals (MDGs), which run until next year, and the data collection practices behind them hide the truth about the health of ethnic minorities and hinder global development.”
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Network reports: EPN
How to address the shortages of children’s medicines
“A significant proportion of the health care resources at any level is spent on medicines and health supplies. Unfortunately in spite of this, access to medicines remains a global challenge. One of the millennium development goals that are directly impacted by access problems is MDG 4 that seeks to reduce the less than five mortality rate by two thirds. The major killers of this age group are pneumonia (18 %), malaria (16 %), and diarrheal diseases (15 %). All these conditions are largely treatable with low cost medicines which should be available right from the lowest level of care.”
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Network reports: Cordaid
No more teenage pregnancies in Myove, Rwanda
“One determined nurse is making sure no more teenagers in her community will get pregnant against their will. Christina de Vries, reproductive health advisor at Cordaid, was impressed, as she reports from a visit in December 2013, to Myoye, Rwanda.”
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Network reports: Medicus Mundi Italy
We called her Chantal…
“We called her Chantal – her parents had not thought of a name yet, as they weren’t sure she would make it. In fact her twin brother already died a couple of months ago. Chantal probably was about 2 years old, but her bodyweight was only 5,050 g – not much more than a newborn! And too much of this weight was concentrated in her legs: both presented pitting oedema. We found Chantal in a small village in Burkina Faso near Leo on the border to Ghana…”
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Network reports: Emergenza Sorrisi
Happy End for Zine
“Zine is a little boy who came to Italy when he was only 7 months old. He lives in Iraq, born in a poor and humble family, which, as many other in Iraq, suffers the consequences of uncontrollable and negative historical events. When Zine’s mother was pregnant all the family components were very excited and involved in the joyous and happy preparation of the birth of the baby.”
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Network reports: Redemptoris Missio
Working hard for the poorest of the poor
“The Humanitarian Aid Foundation Redemptoris Missio was designed as medical facility for polish missionaries who work in the farest corners of the world for the most needy people. From the beginning we shared the vision of contributing to health for all, but not through policy making and advocacy but direct action. Last year was exceptional because of many successful projects. Our doctors, nurses and midwives worked in Cameroon, Ethiopia, Namibia, Jamaica, Republic of South Africa and India.”
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Network reports: action medeor / EPN
A shelf matters!
“Lokang Peter Dario is Pharmaceutical Assistant at Omeo Dispensary in Eastern Equatoria, South Sudan. When he was entering the small pharmacy of the health facility he had to pick all the medicines for dispensing from different boxes on the floor. Lokang never received formal pharmaceutical training…”
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Network reporting: Network members
Annual Reports
First Annual Reports 2013 of Network members are published on the organizations’ website. Have a look at them – and let us know when further reports are available.
- Health Poverty Action: in English
- HealthNet TPO: in English
- medico international: in German
- Medicus Mundi Switzerland: in German and French
- Wemos: in Dutch
International Health Policy: 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.
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Universal health coverage
Health systems strengthening
Health services, health financing
- Making fair choices on the path to UHC. Final report of the WHO Consultative Group on Equity and UHC
http://www.who.int/choice/documents/making_fair_choices/en/ - Monitoring progress towards UHC at country and global levels. Framework, measures and targets. WHO / World Bank
http://apps.who.int/iris/bitstream/10665/112824/1/WHO_HIS_HIA_14.1_eng.pdf - Let’s be clear: Universal Health Coverage must mean health coverage for all. Ch. Soulary
http://www.globalhealthcheck.org/?p=1618 - Universal health coverage – but mind the equity gaps. Kevin Watkins
http://www.odi.org.uk/opinion/8458-universal-health-coverage-but-mind-equity-gaps - Principle meets pragmatism on Universal Health Coverage. Jonathan Jay
http://www.msh.org/blog/2014/05/28/principle-meets-pragmatism-on-universal-health-coverage - Would an international equalization scheme for #UHC serve the international collective interest? Gorik Ooms et al.
http://www.globalizationandhealth.com/content/10/1/41/abstract - Ten (plus one) things to think about when planning and Implementing Universal Health Coverage. Robert Marten
https://blogs.worldbank.org/health/ten-plus-one-things-think-about-when-planning-and-implementing-universal-health-coverage?cid=EXT_WBBlogSocialShare_D_E - Different roads to UHC in Latin America – Chile vs Costa Rica
http://www.globalhealthcheck.org/?p=1623 - Accountability under Universal Health Coverage: what role should civil society play? A. Kyrillou
http://www.actionforglobalhealth.eu/blog/?p=2286 - Community preferences for improving public sector health services in South Africa. HEU policy brief,
http://uct-heu.s3.amazonaws.com/wp-content/uploads/2012/03/HEU-Policy-Brief-public-preferences-for-health-care3_1.pdf - Is ‘Value for Money’ the best approach for improving weak health systems? Swiss TPH Spring Symposium presentations
http://www.swisstph.ch/news-events/symposia/spring-symposium-2014/presentations.html
See also below:
Health beyond 2015
Twitter: #UHC
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Human resources for health
Migration of health professionals
- A health worker for everyone, everywhere! Call to Action for European decision-makers
https://interact.healthworkers4all.eu/pages/viewpage.action?pageId=4620361 - Migration of health workers: The WHO Code of Practice and the global economic crisis. WHO 2014
http://www.who.int/hrh/migration/14075_MigrationofHealth_Workers.pdf?ua=1 - WHA67 adopts Recife Political Declaration and gives mandate to WHO to develop global HRH strategy
http://www.who.int/workforcealliance/media/news/2014/recife_political_declaration/en/
- Interview with new GHWA Executive Director, Dr. James Campbell
http://youtu.be/c3_sy8YX3c8?a - Hope and despair: community health assistants’ experiences of working in a rural district in Zambia. Zulu et al.
http://www.human-resources-health.com/content/12/1/30/abstract - Should WHO stop recruitment of developing world health workers? Michael Clemens sees no evidence of harm in developing world health outcomes
http://buff.ly/1l7f8qm - Why sub-Saharan African health workers migrate to European countries that do not actively recruit. A. Poppe et al.
http://www.globalhealthaction.net/index.php/gha/article/view/24071/html
- Health workfoce: South Africa’s protracted struggle for equal distribution and equitable access. HCJ van Rensburg
http://www.human-resources-health.com/content/12/1/26/abstract - Time to address gender discrimination and inequality in the health workforce. Constance Newman
http://www.human-resources-health.com/content/12/1/25/abstract
Twitter: #HRH, #healthworkers, #Call2Action
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Access to medicines and vaccination
Medical research and development
Communicable diseases and diseases control
- PHM urges WHO to encourage using compulsory licensing for inclusion of new drugs in essential list of medicines
http://www.phmovement.org/en/node/9414 - Global coalition warns World Health Assembly of antibiotic resistance, urges leadership and action
http://klou.tt/1ckw0ob8csurc - Antibiotic resistance – are we driving our own extinction? Constance Georgina Khaendi Walyar
http://equinetafrica.org/newsletter/index.php?issue=160#1 - What’s the global action plan antimicrobial resistance developed at WHA67?
http://ow.ly/xiLyR - AIDS 2014: 20th International AIDS Conference in Melbourne, Australia, July 20-25
http://www.aids2014.org - AIDS 2014: Melbourne Declaration: Nobody Left Behind.
http://goo.gl/xnf2wO
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Women’s and children’s health
Sexual and reproductive rights and health
- Success factors for reducing maternal and child mortality. Shyama Kuruvilla et al. (WHO Bulletin online first, PDF) http://www.who.int/bulletin/online_first/BLT.14.138131.pdf?ua=1
- Global causes of maternal death: a WHO systematic analysis. Lale Say et al.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X%2814%2970227-X/fulltext - Trends in Maternal Mortality, 1990-2013. Estimates by WHO, UNICEF UNFPA, Worldbank, UN Population Division http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2013/en/
- Responding to sexual violence in armed conflict. Ted Alcorn
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960970-3/fulltext - A Universal Pathway. A Woman’s Right to Health. The State of the World’s Midwifery 2014.
http://unfpa.org/public/home/publications/pid/17601 - May 28: International Day of Action for Women’s Health: Reducing severe morbidity for healthy pregnancies
http://www.paho.org/clap/index.php?option=com_content&view=article&id=214%3Adia-internacional-de-accion-para-la-salud-de-las-mujeres-2014&catid=797%3Acampanas&lang=en
- Every Newborn. Lancet series
http://www.thelancet.com/series/everynewborn - Action plan on newborn health adopted by WHA67
http://apps.who.int/gb/e/e_wha67.html
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Prevention and control of NCDs
Disabilities, Mental Health, Care
- Zero draft of proposal for a global convention to promote and protect healthy diets
http://www.worldobesity.org/site_media/uploads/convention_supporting.pdf - NCDs as global policy concern: WHO approves Work Plan to tackle scourge
http://bit.ly/1jnnQMv - Unhealthy diets greater threat to health than tobacco; UN expert calls for global regulation
http://www.srfood.org/en/unhealthy-diets-greater-threat-to-health-than-tobacco-un-expert-calls-for-global-regulation - Nearly one-third of the world’s population is obese or overweight. IHME UW report.
http://www.healthdata.org/news-release/nearly-one-third-world%E2%80%99s-population-obese-or-overweight-new-data-show
- Social determinants of mental health report
http://www.who.int/mental_health/publications/gulbenkian_paper_social_determinants_of_mental_health/en/ - On World No Tobacco Day, EPHA releases its ‘Briefing on on-line marketing of tobacco products’:
http://bit.ly/1oU5W9x
See also below:
Political determinants of health
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Global health governance and policy
Political and commercial determinants of health
- Health justice in global governance – the quest continues. Renzo R. Guinto
http://www.internationalhealthpolicies.org/health-justice-in-global-governance-the-quest-continues/ - Shared Responsibilities: A Coherent Global Framework for Health Financing.
http://www.chathamhouse.org/publications/papers/view/199542 - Large gains in life expectancy. World Health Statistics 2014
http://www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/en/ - Stepping out of the silos: integrating global health into trade negotiations. Kristine Onarheim
- http://globalhealth.thelancet.com/2014/06/06/stepping-out-silos-integrating-global-health-trade-negotiations
- TTIP contradicts post-2015 development goals, experts say
http://www.euractiv.com/sections/development-policy/ttip-contradicts-post-2015-development-goals-experts-say-302704 - Proposed plans for US-EU trade TTIP deal would weaken health, consumer, worker and environmental protections
http://corporateeurope.org/pressreleases/2014/05/proposed-plans-us-eu-trade-deal-would-weaken-health-consumer-worker-and - The case against global health – “an increasingly toxic network of sinister alliances” Richard Horton
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960797-2/fulltext
- Medicalization of global health. Article series by Jocalyn Clark
http://www.globalhealthaction.net/index.php/gha/issue/view/1602#Medicalization%20of%20Global%20Health - BRICS and global health. Bulletin of the World Health Organization, special theme
http://www.who.int/bulletin/volumes/92/6/en/ - Visualizing what’s not there in global health data. Katie Leach-Kemon
http://www.humanosphere.org/science/2014/05/visualizing-whats-global-health-data/ - Glossary for the implementation of Health in All Policies (HIAP). Alix Freiler et al.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841750/ - UN Special – Special issue on global health diplomacy
http://www.unspecial.org/2014/05/where-health-and-diplomacy-come-together/
- So, what do you do?
Me? I … I’m in global health.
What’s that?
http://ow.ly/xHNmI
Twitter: #globalhealth #healthgovernance
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World Health Organization
World Health Assembly
WHO reform and financing
- World Health Assembly: documentation
http://apps.who.int/gb/e/e_wha67.html - World Health Assembly: NGO statements
https://apps.who.int/ngostatements/content/sixty-seventh-world-health-assembly-a671-0 - The record breaking 67th WHA – reflections from one of the survivors. Remco van de Pas
http://shar.es/VE50A - WHO Members note reform progress, ask for speedy implementation
http://bit.ly/1jKsnOG - What’s the World Health Organization for?
http://www.chathamhouse.org/publications/papers/view/199537 - Draft decision resulting from a drafting group on the framework of WHO engagement with non-State actors
http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_ACONF5Rev1-en.pdf - WHO’s engagement with non-State actors and the politics of stakeholder-governance: Time to turn the tide. J Richter
http://www.bmj.com/content/343/bmj.d5012/rr/697686
Twitter: #WHA67
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Health beyond 2015
MDGs and SDGs
- Health in the post-2015 development agenda. WHA resolution
http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R14-en.pdf - Health goals post-2015 must address root causes of crisis. David G. Legge
http://www.ghwatch.org/sites/www.ghwatch.org/files/Legge(2014)HealthPost2015(TWResurgence283-284).pdf - WHO offers a new future for sustainable development. Richard Horton
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60889-8/fulltext - Aidspan interview with C. Benn: Global health will remain top priority for development funding in post-MDG world
http://www.aidspan.org/gfo_article/global-health-will-remain-top-priority-development-funding-post-mdg-world-benn - Indicators linking health and sustainability in the post2015 development agenda. Carlos Dora et al.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60605-X/fulltext - Progress toward the health MDGs: Are the poor being left behind? Adam Wagstaff et al
http://www-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2014/05/28/000158349_20140528155646/Rendered/PDF/WPS6894.pdf - Call for clearer road map as 17 proposed SDGs released. Yojana Sharma
http://www.scidev.net/global/mdgs/news/road-map-proposed-sdg-.html - Available documentation for OWG12 may be found here:
http://sustainabledevelopment.un.org/owg12.html
Twitter: #health2015 #post2015 #globalhealth
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Development, aid and international institutions
- Aid must change in order to tackle inequality: the OECD responds to Angus Deaton
http://oxfamblogs.org/fp2p/how-aid-must-change-in-order-to-tackle-inequality-guest-post-from-the-oecd
- Cooperation, not instrumentalisation: How to support civil society organisations in developing countries
http://ow.ly/xSsN8 - The crisis in Official Development Assistance (ODA) statistics.
http://www.cgdev.org/blog/crisis-official-development-assistance-oda-statistics-needed-revamp-would-lift-japan-lower - Cold water splashes on the face of public-private partnerships in development. Tom Murphy
http://www.humanosphere.org/2014/05/cold-water-splashes-face-private-public-partnerships-development/
Follow the MMI Updates on Twitter:
https://twitter.com/mmi_updates