|
September , 2011
Dear Colleague:
September has been busy. Contagion—a movie about a fragmented response to a global outbreak of a novel virus—scared its viewing public, even while the Administration and Congress proposed funding cuts to the CDC. The UN concluded its high-level meeting on noncommunicable disease (NCD), amid a flurry of events, media and a mandate to the chronically underfunded WHO to lead a global response. A new foundation—the George W. Bush Institute—joined the NCD response with a $20 million contribution for cervical cancer screening and treatment through PEPFAR, while the U.S. Government matched the contribution with $10 million. The Global Fund's High Level Independent Review Panel released its report, recommending a renewed focus on its "core business" of managing grants. Finally, the 2012 World Development Report was released, taking fresh look at gender issues as they relate to health, finding that globally over a third of women die during their reproductive years and that two-fifths of girls are never born due to son preferences.
At CGD, we looked at low-cost solutions the U.S. Government could support to reduce NCD, planned for the October 31 launch of the Clinical Trials Working Group report, responded to the Global Fund report, and studied the cost-effectiveness of HIV treatment. Next month, we'll take a closer look at the priority-setting dilemmas implicit in the "triple" burden of disease facing low- and middle-income countries. In case you're wondering, the triple threat is (1) communicable disease and reproductive health, (2) non-communicable disease and injuries and (3) novel viruses—the health system has to respond to it all while trying not to bankrupt the government.
Sincerely,
Amanda Glassman
Director of Global Health Policy
NCD Shines in the Spotlight
|
|
The United Nations met this month to address the global burden of NCD and its disproportionate impact on low- and middle-income countries. CGD welcomed a panel including representatives from the Department of State, Health and Human Services, Center for Disease Control and Prevention, and the National Institutes of Health with an accompanying brief suggesting five low-cost ways the US could reduce NCD worldwide. Despite disappointment that the high-level meeting hasn’t generated significant new funding for NCD (as was suggested at the CGD’s panel discussion), I point out here that policy changes can often have a more substantial impact. More worrying, the main outcome of the UN meeting—more work for the WHO—remains unfunded, particularly by emerging economies (see my blog here). In the follow up to the NCD meeting, we'll be watching the emerging economies and their contributions to WHO, as well as multilateral development banks and their policy lending, hoping to see more on tobacco control, as I discuss here.
|
|
|
Celebrating the Clinical Trials Report Launch
|
|
On October 31, CGD will launch the Clinical Trials Working Group report with a key note from FDA Commissioner Dr. Margaret Hamburg. The working group—led by Tom Bollyky—offers practical and scalable policy recommendations to expedite the clinical trials process in developing countries. An estimated one billion people suffer from one or more neglected diseases, including tuberculosis, malaria, dengue and others. Medicines, therapies and treatments have been discovered, but regulatory barriers in the late-stage clinical trials of developing countries have prevented these drugs from helping those in need. The working group suggests a two pronged solution (1) the development of regional pathways for the review of clinical trials in disease-endemic settings, and also (2) better, faster, and cheaper clinical trials by focusing on key parameters and objectives of trials, evidence-driven approaches, and early engagement among trial sponsors.
|
|
|
The Global Fund in Review
|
|
Last week the Global Fund’s independent review panel issued a report offering recommendations on the quality of the Fund's fiduciary controls, following a tumultuous year of reported corruption (see here and here). William (Bill) Savedoff has blogged on the report’s recommendations, questioning if more stringent financial controls will do more harm than good, especially if they decrease country ownership and increase bureaucratic limitations. Bill suggests that a system of better performance measurement would take the burden of tracking funds and change the focus to achieving better performance. While the Fund still needs to address the concerns of its donors, Bill suggests that rigorously demonstrating progress in health improvement would be a better path to improved accountability.
|
|
|
Copenhagen Consensus: a Focus on HIV
|
|
In 2004, an expert panel of leading economists commissioned by the Copenhagen Consensus Center responded to the question, “If we had an extra $50 billion to spend to improve the world, what should we do first?” They ranked spending on the control and treatment of HIV/AIDS as the top priority, ahead of other urgent problems like hunger, free trade, and malaria. This year, CGD Senior Fellow Mead Over and Geoff Garnett of the Bill & Melinda Gates Foundation are submitting a cost-benefit analysis of spending that budget on HIV treatment, while other assessment papers will estimate the cost and benefits of spending on HIV/AIDS research, on health system strengthening or on HIV prevention. Mead blogs here about the upcoming paper which will presented to a panel this week at Georgetown University. Watch this space for links to the papers and for Mead’s take on the process and the outcome.
Mead’s new book, Achieving an AIDS Transition: Preventing Infections to Sustain Treatment (available for pre-order here) will be launched by CGD in November, check back soon for more details.
|
|
|
|
