June 2010


IN THIS ISSUE

COMING SOON

ALSO OF INTEREST

IN THIS ISSUE

Ethiopia’s Minister of Health Headlines HIV/AIDS Monitor Event on Country Ownership

This week, the HIV/AIDS Monitor hosted an event entitled “What is Country Ownership Anyway? Rethinking Global Health Partnerships.”The event, held at CGD, featured Minister of Health Tedros Adhanom Ghebreyesus of Ethiopia, the Monitor’s key country-level researchers from Mozambique, Uganda and Zambia, and U.S. government representatives from CDC, USAID, and the Office of the Global AIDS Coordinator. Participants had a lively discussion about the meaning and practice of country ownership – a term that appears to have many definitions and little meaning. To learn more about the discussion, read a summary of the session or view the event here.

Drug Resistance Working Group Report Launched at National Press Club

CGD’s Drug Resistance Working Group released a report, The Race Against Drug Resistance, at a well-attended launch last week at the National Press Club. Representative Jim Matheson (UT), a member of the House Energy and Commerce Subcommittee on Health, made opening remarks on the importance of curbing inappropriate drug use both domestically and abroad. Working Group chair Rachel Nugent provided an overview of the report and pointed to the urgent need for donors and others to collectively and immediately take action against this global health time bomb. The report offers four practical steps to tackle drug resistance: (i) improve surveillance and laboratory capacities; (ii) secure the integrity of the drug supply chain; (iii) strengthen drug regulation through regional networks; and (iv) catalyze research and innovation for resistance-fighting technologies. CGD also released a new film to accompany the report.

To close the event, a high-level panel discussed how to build momentum for addressing drug resistance across multiple diseases, and create partnerships to carry out the report’s recommendations. Those who missed the launch can watch a recording of the event here and listen to Rachel’s podcast.

CGD Contributes Background Paper to 2010 Women Deliver Conference

A star-studded line up of researchers, policymakers, and development leaders met in Washington, D.C. in early June for the third annual Women Deliver Conference. CGD’s Nandini Oomman prepared a background paper in collaboration with Miriam Temin and Ruth Levine entitled Why it’s the Right Time: Moving on Reproductive Health Goals by Focusing on Adolescent Girls. Each of the more than 4,000 conference participants received the CGD paper with their conference materials.

Mead Over Publishes Essays on HIV/AIDS Transition

Mead Over released a series of three essays on the HIV/AIDS transition. The first essay, “The Global AIDS Transition: A Feasible Objective for AIDS Policy” explores the need for large reductions in HIV infection rates in order to improve the sustainability of current treatment scale-up programs. The second essay, “Using Incentives to Sustain Treatment,” analyzes methods of incentivizing prevention, including an application of Cash on Delivery Aid. The third essay, “Sustaining and Leveraging Treatment,” discusses the future of HIV treatment, including novel estimates of the potential fiscal burden of scale-up capacity. The three essays will be published as a book entitled, Achieving an AIDS Transition: Preventing Infections to Sustain Treatment, to be released in the fall of 2010.

Changes to CGD’s Global Health Policy Team

We are delighted to announce that Rena Eichler has joined CGD as a visiting fellow and will be working closely with the Global Health Policy team. Rena has a Ph.D. in economics from Boston University and more than fifteen years of experience working on health financing and health systems strengthening, concentrating specifically on the application of incentives to improve health system performance. Rena served as technical lead for CGD’s Performance Based Incentives Working Group and co-authored with Ruth Levine Performance Incentives for Global Health: Potential and Pitfalls.

The Global Health Policy team bids farewell to David Wendt, who has been with CGD for two years and worked extensively with the HIV/AIDS Monitor team, and Sandy Stonesifer, who has contributed to CGD’s work on global health and adolescent girls. Sandy will be joining the ONE Campaign as Special Assistant to the President.

COMING SOON

HIV/AIDS Monitor Examines how Donors Affect Health Workforces

In early July, a report from the HIV/AIDS Monitor team will review the implications of donor interventions on improving the long-term capacity of health workforce systems to handle health needs beyond HIV/AIDS. The report, entitled Making it Happen: Six Tasks for PEPFAR, the Global Fund and the World Bank MAP to Slow Down the Health Workforce Crisis in Mozambique, Uganda and Zambia, examines key interventions for AIDS donors and country stakeholders to inform policy, programmatic, and financial planning as they shift to a long-term response.

HIV/AIDS Monitor to Present at the XVIII Annual International AIDS Conference in Vienna

The HIV/AIDS Monitor team will present a poster entitled AIDS donors and sexual and reproductive health: Removing barriers to integrated service delivery in Mozambique, Uganda and Zambia at the XVIII Annual International AIDS Conference in Vienna next month. The Monitor recommends that need, rather than donor policies, should drive decisions about how resources are allocated within districts and facilities. It finds that AIDS donors should engage in joint planning and policymaking at the national level with other sexual and reproductive health programs, remove restrictions to integrated services, and coordinate funding through national health plans.

Visiting Fellow Tom Bollyky Scrutinizes Challenges Posed by Clinical Trials

A working paper by Tom Bollyky entitled Bridging the Gap: Improving Clinical Development and Regulatory Pathways for Health Products for Neglected Diseases will suggest potential strategies for reducing trial duration, cost, and risks to clinical trial subjects. These challenges are the topic of a CGD workshop next week that will develop practical proposals for improving and streamlining clinical trials and regulatory pathways for products for neglected diseases. The paper will be available after the workshop on the CGD website.

CGD Seminar will Present Evidence on Use of Malaria Diagnostic Tests

On Tuesday, June 29, Jessica Cohen (Harvard School of Public Health and Brookings Institution) will present the results of a recent field experiment evaluating the impact of increased access to malaria diagnosis in Western Kenya. Cohen will discuss whether subsidies for treatment and rapid diagnostic tests for malaria in African pharmacies create an incentive for the effective use of anti-malarials, and whether social marketing of anti-malarials can improve adherence to treatment guidelines and curb resistance. Register here for the event.

ALSO OF INTEREST

In the Media

  • Reuters, NPR, Agence France Presse, and Nature were among a wide range of news sources that quoted Rachel Nugent on CGD’s Drug Resistance Working Group’s final report.
  • In The Guardian’s Global Health Policy Blog, Sarah Boseley cites the CGD Working Group report and quotes Nancy Birdsall on the importance of drug resistance.
  • The Huffington Post features two of Nandini Oomman’s recent blog posts on women’s health. The first offers suggestions for Canada’s pledge to commit $1 billion towards maternal and child health. The second post gives Oomman’s reflections on the promises made at the 2010 Women Deliver conference.
  • The Lancet quotes Visiting Fellow April Harding on physician and peace activist Flavia Bustreo’s maternal health leadership.
  • Science Magazine publishes Mead Over's article on global AIDS policy in transition.
Recent Events

Visiting Fellow Tom Bollyky Testifies Before Senate Appropriations Subcommittee

On June 23, Tom Bollyky testified before the Senate Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration (FDA), and Related Agencies on the FDA’s review process for products to treat neglected tropical diseases. Tom joined other experts and U.S. government witnesses to discuss current government efforts and to offer recommendations for speeding the development and distribution of drugs, vaccines, and diagnostics for rare and neglected diseases. Read Tom’s testimony here.

Global Health Council Hosts Panel on Drug Resistance

On June 16, CGD hosted a panel at the annual conference of the Global Health Council to present major findings from the CGD Drug Resistance Working Group report. The session, entitled “Global Leadership: Who is Fighting Drug Resistance and How?” highlighted the need for improved leadership to coordinate a multifaceted approach to respond to resistance, with both public and private sector involvement. Presenters included Rachel Nugent, Walter Straus from Merck, David Heymann from the UK’s Health Protection Agency, and Ramanan Laxminarayan from Resources for the Future. Gail Cassell from Eli Lilly & Company moderated the session.

Making HIV Prevention Work: Couples Counseling and Testing

CGD hosted a seminar on June 8 entitled “Making HIV Prevention Work (Really): An Incentive-based approach, with a specific focus on couples' voluntary counseling and testing.” Moderated by Nandini Oomman, the event featured Mead Over, who presented key ideas from his new essays (see above), and Susan Allen and Gordon Street of Emory University, who discussed their new research findings on the effectiveness and cost-effectiveness of such testing in Africa. Personnel from the Centers for Disease Control in Atlanta called into the event, a first for CGD.

Commitments Made at Drug Resistance Stakeholder Meeting

Rachel Nugent hosted a global drug resistance stakeholder meeting in Annecy, France last month, with the objective to spur key partners to action against drug resistance via the recommendations set forth in CGD’s Working Group’s report, The Race Against Drug Resistance. The meeting resulted in commitments from multilateral organizations, pharmaceutical companies, governments, and technical agencies to respond to the growing crisis of drug resistance. Details of these commitments will be shared through CGD’s Global Health Policy blog.

Tom Bollyky on Trade, Nutrition, and Food Security at the Global Health Council

On Wednesday, May 26, Tom Bollyky spoke at the Global Health Council on the topic of “Trade, Nutrition and Food Security.” His remarks focused on trade-related barriers to food security and adequate nutrition for the world’s poor. Tom highlighted promising, practical proposals for improving the status quo, including existing CGD proposals for improving World Food Program purchases and reforming trade preferences, as well as new proposals for eliminating export restrictions and reducing non-tariff barriers to trade. In a related blog, Steve Rosenzweig assessed the U.S. government’s newly released Feed the Future initiative.

Taking Prevention to Scale: Lessons from India's Mukta Project

Darshana Vyas, director of the Mukta Project—a prevention initiative in Maharashtra state in India—spoke at CGD on May 25 about taking HIV/AIDS prevention to scale. During the event, she discussed how to transition program implementation and management to national governments and communities, where empowerment is especially crucial to program sustainability. Mead Over served as a discussant and Nandini Oomman moderated the discussion. More information on the event can be found here.

Every Dollar Counts: How Global AIDS Donors Can Better Link Funding Decisions to Performance

The HIV/AIDS Monitor hosted a panel discussion on May 10 to launch a report that examines how three AIDS donors—PEPFAR, the Global Fund, and the World Bank MAP—have used evidence of recipient performance as a key criterion in their funding decisions. Nandini Oomman kicked off the discussion by sharing key findings and recommendations. The report finds that the Global Fund effectively uses performance criteria in spite of persistent weaknesses in its monitoring systems, while PEPFAR and the World Bank MAP have not systematically applied standards of performance throughout their funding decisions. Officials from PEPFAR, the Global Fund, and the World Bank responded with potential changes to the role recipient performance plays in their funding decisions. Highlights and video clips from the discussion can be found here. A policy brief with key recommendations is here.

Rachel Nugent on Drug Resistance at Resources for the Future Seminar

Rachel Nugent participated in a luncheon seminar on May 5 at Resources for the Future on the need to develop new drugs and better policies in response to global drug resistance. Rachel spoke about the current lack of global coherence and the need for stakeholders to better coordinate their responses to drug resistance. Also on the panel were CGD Drug Resistance Working Group member Kevin Outterson from Boston University School of Law, and Resources for the Future Senior Fellow Ramanan Laxminarayan. A podcast of the event is available here.

Closing the Evaluation Gap: 3ie One Year On (Are Conditional Cash Transfer Programs Improving Human Capital?)

On May 4, CGD and the International Initiative for Impact Evaluation (3ie) co-hosted a workshop entitled “Closing the Evaluation Gap: 3ie One Year On” to explore existing research on Conditional Cash Transfers (CCTs) for health and education, and to recommend ways for the development community to improve impact evaluations. The workshop highlighted the importance of continued improvements in monitoring and evaluation for determining the efficacy of social interventions. In particular, the day-long agenda looked at the effect of CCT programs on outcomes such as birth weight and access to family planning methods. Marie Gaarder, deputy director of 3ie, called for researchers to evaluate the overall causal chain for CCTs and health outcomes and introduced a special issue of the newly-launched Journal of Development Effectiveness that explores the implications of CCT programs. You can read more about the workshop on CGD’s blog Views from the Center.

Rachel Nugent Urges High-Level Attention to Non-Communicable Diseases

On April 13 in New York, Rachel Nugent presented the case for greater global attention to health and economic impacts of non-communicable diseases (NCDs) in developing countries at a side event of the United Nations Commission on Population and Development. Nugent was part of an expert panel assembled by the World Health Organization. Following the panel presentations, the UN Commission on Population and Development voted for a resolution to hold a high-level meeting on NCDs. A UN General Assembly Special Session on NCDs is planned for September 2011.

Global Health Policy Blog

Country Ownership and Rethinking Global Health Partnerships: From Dependence to Symbiosis, Nandini Oomman

Could Local Public Disclosure Improve Country Ownership? Mead Over

Antiretroviral Drugs Will Retain Their Power Longer if Donors and Governments Assure Good Adherence, Mead Over

Yet Another Inconvenient Truth: AIDS Treatment Is a Costly Way to Save Lives, Bill Savedoff

A New Report Slams the World Bank’s Support of Health Systems for Insufficient Focus on Results, Mead Over

Congress Faces Resistance of a Different Sort, Rachel Nugent

Can Couples Testing Contribute to Achieving the AIDS Transition?, Mead Over

Women Deliver 2010: A Second Chance for the World to Deliver for Women, Nandini Oomman

Canada Reported Ready to Spend $1 Billion to Cut Maternal Mortality—How To Use the Money Well, Nandini Oomman

Global AIDS Donors Share Challenges and Opportunities for Performance Based Funding, David Wendt

The AIDS War may not be falling apart, but it IS falling behind, Mead Over

Drug Resistance Gets a Hearing on Capitol Hill, Rachel Nugent

Slender on Gender: Global Fund Round 8 and 9 Proposals, Christina Droggitis

Making Sense of New Maternal Mortality Numbers: Four Take-Aways for Policy and Research Action, Nandini Oomman

Squishy Findings on Aid Fungibility, David Roodman

Global Health Initiative Could Lead the Way for Broader Foreign Assistance Reform, but Questions Remain, David Wendt

Do PEPFAR, the Global Fund, and the World Bank MAP Make Funding Decisions Against Performance? And Why This Matters NOW!, Nandini Oomman

Making the Case for Healthier Hearts in the Developing World, Rachel Nugent

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