Author: Daniele Dionisio

The European Commission's claims of support for development cooperation contrast with budget cuts for aid, raising doubts about the EU'€™s real will and ability to address today'€™s overall challenges and push for inclusive and sustainable development

 Pending Cutback In EU Spending For Development Cooperation

By Daniele Dionisio [1]

The European Commission (EC) released on 29 June 2011 a budget proposal for 2014-2020, where €70 billion is allocated to the heading “€œGlobal Europe,”€ which covers the European Union (EU)’€™s operating plan in the world, including development and humanitarian aid [2]. However, the latest draft proposal laid down by Council President Herman Van Rompuy sharply cuts back [3] development aid and humanitarian assistance by almost €10 billion, to €60.6 billion.

And word is spreading that foreign aid cuts could include a €3.3 billion cut [4] to the European Development Fund (EDF), the largest part of the EU aid budget aimed at African countries.

Moreover, although the EU just adopted a friendly 2013 budget for development cooperation [5], compared with 2012 spending levels, shortfalls are reportedly expected [6] since the budget would fall short as to EC estimates for 2013.

As such, the negotiations for the broader 2014-2020 EU budget continue to be mired in uncertainty [7] by ongoing gridlocks and frictions within governments and institutions. Overall, while affluent EU countries push to either freeze spending or slash budget off the Commission’€™s proposal, other countries, in unison with the Commission and European Parliament, want to increase spending [8].

Meanwhile, development groups claim that proposed cuts to the Global Europe heading are “€œfurther disproportionate [9]”€. They are asking “€œWhy are EU leaders saying they support aid commitments, then not defending them in EU budget talks?”€

These circumstances add room for mistrust about coherence and reliability the EU seemingly laid down in a Joint Africa-EU Strategy [10] as a long-term partnership between EU and the African Union (AU) Commission to finance a series of development goals, including the AU-administered Research Grant Programme [11] to build science and technology development in Africa. Yet, despite EC commitment, a 2014-2020 renewal of funding for this programme is at risk owing to competing EU priorities.

This landscape does not bode well as regards EU steadiness in collaborating with the newly launched AU’€™s Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa [12], which aims at reducing the dependency of African countries on international financing for health, medicines and R&D, and promoted African-owned solutions.

These concerns add to criticism that the EU is becoming more protectionist [13] in agriculture, trade and aid areas, where a number of EU member states seemingly use foreign aid as a “€œbargaining chip”€ for or against priorities such as the Common Agricultural Policy (CAP). [4]

Relevantly, the cutback proposed by Van Rompuy has drawn criticism of disproportionally cracking down on issues including EDF, than for spending on CAP. And substantial reform of EU’€™s agricultural subsidies [13] is being called for.

Criticism is significant now that nongovernmental organizations in EU and ACP (Africa, the Caribbean and the Pacific) countries recently alerted to the risk [14] that the EU development agenda could divert aid funds away from the poorest people and negatively affect the foundation of the Cotonou Agreement [15], the guiding framework of EU-ACP cooperation.

This couples with fear that terms threatening access to medicines by the worst-off people could be approved in forthcoming negotiations for an EU-Thai agreement [16], and in an EU-India trade deal [17] now on track to conclusion [18].

This includes displeasure bound up with the controversial EU involvement in the Anti-Counterfeiting Trade Agreement [19] (or ACTA).

And it comes as no surprise that all of this occurs at a time when the EU global plan for health, development cooperation seemingly falls short of [20] adequate coherence, innovative financing and collaboration with interested parties, while commitment in R&D for poverty-related neglected diseases (NDs) is not spread evenly between member states and only totals 0.0024% of EU’€™s combined GDP [21].

Relevantly, the EU just succeeded in opposing [22] any mention of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) report and recommendations [23] (including a medical R&D treaty, innovative financing sources and the de-linkage of R&D cost from the price of health products) in the lame resolution EB132/R7[24] [pdf] on NDs passed at WHO Executive Board meeting which took place 21-29 January 2013.

The conflicting issues above raise doubts about EU’€™s real will and ability to address today’€™s overall challenges and push for inclusive and sustainable development. Bridging these gaps would be a matter of priority and a way for the EU to gain indisputable leadership. To this aim, the EU should better the coherence of its policies, strategies and practices.

 

Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is reference advisor for “€œMedicines for the Developing Countries”€ for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). 

URLs in this post:

[1] Article previously published on Intellectual Property Watch: http://www.ip-watch.org/2013/01/31/pending-cutback-in-eu-spending-for-development-cooperation/  

[2] aid: http://www.euractiv.com/development-policy/georgieva-pledges-fight-prese…

[3] cuts back: http://static.euractiv.com/sites/all/euractiv/files/MFF%20Van%20Rompuy%2…

[4] €3.3 billion cut: https://www.devex.com/en/news/79771/print

[5] 2013 budget for development cooperation: http://www.europarl.europa.eu/resources/library/media/20121210RES04509/2…

[6] shortfalls are reportedly expected: http://europa.eu/rapid/press-release_MEMO-12-975_en.htm

[7] uncertainty: http://www.publicserviceeurope.com/article/2774/eu-leaders-fail-to-do-bu…

[8] spending: https://www.devex.com/en/news/79814/print

[9] further disproportionate: http://www.concordeurope.org/180-eu-budget-talks-forgetting-development-…

[10] Joint Africa-EU Strategy: http://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/er/9749…

[11] Research Grant Programme: http://hrst.au.int/en/rgp?q=rgp

[12] AU’€™s Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa: http://www.au.int/en/sites/default/files/Shared_Res_Roadmap_Rev_F%5b1%5d.pdf

[13] more protectionist: http://www.odi.org.uk/opinion/6953-european-union-eu-budget-common-agric…

[14] alerted to the risk: http://www.devex.com/en/news/78315/print

[15] Cotonou Agreement: http://ec.europa.eu/europeaid/where/acp/overview/cotonou-agreement/index…

[16] EU-Thai agreement: http://www.ipsnews.net/2012/12/thai-eu-fta-raises-alarm-for-people-with-…

[17] EU-India trade deal: http://www.ip-watch.org/2012/02/10/eu-india-summit-kicks-off-amidst-warn…

[18] conclusion: http://donttradeourlivesaway.wordpress.com/2013/01/14/india-receives-pos…

[19] Anti-Counterfeiting Trade Agreement: http://www.msfaccess.org/content/acta-and-its-impact-access-medicines

[20] falls short of: http://www.ip-watch.org/?p=24380&utm_source=post&utm_medium=email&utm_ca…

[21] is not spread evenly between member states and only totals 0.0024% of EU’€™s combined GDP: http://www.dsw-online.org/fileadmin/user_upload_en/PDF/GH_R_D_EU/Saving_…

[22] opposing: http://www.ip-watch.org/2013/01/28/who-board-approves-resolution-on-negl…

[23] report and recommendations: http://www.who.int/phi/cewg_report/en/index.html

[24] EB132/R7: http://apps.who.int/gb/ebwha/pdf_files/EB132/B132_R7-en.pdf

 

“True compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring.” 

 

26 Years On: A Need for a Moral Revolution in Maternal Health Care*

by AKU KWAMIE on JANUARY 22, 2013 Â· 

Research Fellow, Ghana Health Service/University of Ghana; Emerging Voice 2012

We gathered at the foot of Mount Meru for three days: 800 researchers, practitioners, advocates, policy-makers and donors, to discuss the state of quality maternal health care. The fact that we were congregated in one of the oldest inhabited regions on Earth, where women and girls had been dying in childbirth – for millennia – was not lost on the delegates.

The conference itself was a typical affair: well organised, with a steady stream of findings. Yet, the question of implementation – how do we actually do it – played on so many lips. There was palpable dissatisfaction that after CEDAW, Nairobi, Cairo, Beijing, we were still here. The maternal health community has been at this for a long time, even longer than the 26 years since the launch of the Safe Motherhood Initiative. When I canvassed my fellow delegates about their optimism – can we make it? – the collective response was overwhelmingly ‘yes’. Why? Because we have more technology, more attention, and more money than ever (attention and money are always nice). Of course progress has been made, yet we still have unanswered questions on an unfinished agenda.

To the clichéd, but true avowal that pregnancy is not a disease, our approaches remain depressingly biomedical. The belief that technology, signed declarations, or more money is the answer, is false. Listening to various presentations, I was reminded of his book The Honour Code, where philosopher Kwame Anthony Appiah discusses the role of honour in moving ‘moral revolutions’ forward. Appiah theorises that transforming societies happens when the integrity of that society’s honour is breached. He shows how this happens, citing examples like foot-binding, duelling, and even the trans-Atlantic slave trade. We change our practices when they come into conflict with honour. When our practices are no longer honourable, we can dismantle them quickly. Radically, this implies that all of our evidence, resources, and political will may well be drops in the ocean, but not the deluge that we require to halt needless maternal deaths once and for all. What we need to improve the quality of maternal care is a moral revolution.

While no one at the conference would disagree that the challenges we face are rooted in power structures, one could not help but notice a few things about the conference itself: that only one-third of the conference steering committee represented countries with the greatest maternal death burden; and less than half of the presentations were from ministries or universities in the ‘south’. With the exception of large delegations from the host country Tanzania, and notably Bangladesh, the low presence of some of the heavy-burden countries was observed. This is not to take away from those present. But it does illustrate that within our own communities, we still have work to do to amplify the voices that need to be heard, and do so without being tokenistic. We cannot lead the charge for moral revolution in the broader world when we maintain the same old structures among ourselves.

The other thing I kept mulling over was the topic of continuity of care that is equitable, accessible, and respectful – was this any different from having strong health systems able to deliver services when and where they are needed? If we centralise the quality of women’s lives, then our health systems should serve them well at all points during those lives. This also includes those women who provide the bulk of services and are ill-served by the systems in which they work. As we wrote last year (and is outlined in a proposed manifesto for maternal health), the brutality of maternal death is that it occurs where the social, economic, and political disempowerment of women intersect, during a vulnerable period in their lives. In such complex systems, the future is not knowable. But this also means the future is not a given, and change, from an unexpected place is possible.

On the conference’s opening day, the excellent Dr Agnes Binagwaho, whose energising comments have been highlighted elsewhere, noted the coincidence of the Reverend Dr Martin Luther King Jr.’s birthday, by quoting: â€œTrue compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring.” Our edifices are our disciplines, our systems and our funding streams. We need to find new ways of building our communities so that we can change our broader societies. This is particularly true on the eve of a new, post-MDG agenda, the topic of which was raised during the conference only by those with an international view, while those managing the daily crises in communities and facilities remained focused on just that.

We need a moral revolution in maternal health care. If ‘Arusha’ becomes another name on the list as we wait for another 26 years, would there be any honour in that?

 

*This post was crossposted from International Health Policies website 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 33

 

–WHO Director-General Chan throws down the gauntlet on the CEWG process: “Let’s fight this out at the Assembly!” http://www.keionline.org/print/1643 

–MSF Intervention on CEWG: Financing & Coordination at 132nd WHO Executive Board http://www.msfaccess.org/content/msf-intervention-cewg-financing-coordination-132nd-who-executive-board 

–Universalising Health Care for All  http://www.phmovement.org/sites/www.phmovement.org/files/JSA%20Convention%20Universal%20Health%20Care%20for%20All%20-%20booklet.pdf

–Global Leaders Take Action to StrengthenFood Security http://www.weforum.org/news/global-leaders-take-action-strengthen-food-security

–Are America’s Nutrition Professionals in the Pocket of Big Food?   http://www.aaci-india.org/Resources/Corporate_Sponsorship_Report.pdf

–Worldwide resilience key to our future  http://www.chicagotribune.com/news/columnists/sns-201301232030–tms–ahuffcoltq–m-a20130123-20130123,0,1660517,print.column 

–Ensuring health in universal health coverage http://www.nature.com/news/ensuring-health-in-universal-health-coverage-1.12263

–India Battles For Right To Use Compulsory Licences To Make Medicines Affordable  http://www.ip-watch.org/?p=25835&utm_source=post&utm_medium=email&utm_campaign=alerts

–UNITAID Seeks Bids For ‘Freedom To Operate’ IPR Analyses For HIV Products  http://www.ip-watch.org/?p=25822&utm_source=post&utm_medium=email&utm_campaign=alerts

–UK International Development Committee concerned about post-2015  https://www.devex.com/en/news/80165/print

–No Woman Should Die Giving Life http://www.ipsnews.net/2013/01/no-woman-should-die-giving-life/

–Economies rebound faster from crisis when responses focus on women’s needs http://www.unwomen.org/2013/01/economies-rebound-faster-from-crisis-when-responses-focus-on-womens-needs/?mkt_tok=3RkMMJWWfF9wsRouv6zPZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YYBRMt0dvycMRAVFZl5nQhdDOWN

–Il ritorno all’Universalismo http://www.saluteinternazionale.info/2013/01/il-ritorno-alluniversalismo/

–Major increase in pharmaceutical research and development (R&D) for neglected diseases  http://www.ifpma.org/fileadmin/content/Publication/2013/IFPMA_R_D_Status_Report_Neglected_Conditions.pdf

–More ethanol could lighten Malawi’s fuel http://www.irinnews.org/Report/97337/More-ethanol-could-lighten-Malawi-s-fuel-bill

–Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates  http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001355

–GERMANY MAKES EUR 1 BILLION CONTRIBUTION TO THE GLOBAL FUND http://www.theglobalfund.org/en/mediacenter/newsreleases/2013-01-24_Germany_Makes_EUR_1_Billion_Contribution_to_the_Global_Fund/

–Antibiotics Not Being Used Properly, Leading To ‘Apocalyptic Scenario’ Of Drug-Resistant Infections, England’s Chief Medical Officer Says http://globalhealth.kff.org/Daily-Reports/2013/January/25/GH-012513-Drug-Resistance-Warning.aspx

–UNITAID URGES EUROPEAN FTT REVENUES TO BE PUT TO POVERTY ERADICATION http://www.unitaid.eu/resources/press-centre/statements/1115-unitaid-urges-european-ftt-revenues-to-be-put-to-poverty-eradication 

 

 

 

 

 

 

 

 

The universal availability of essential quality medicines, at affordable prices and with appropriate quality standards, is a fundamental prerequisite to ensure universal access to health

Access to Medicines and Quality of Medicines: Always Together!

by Raffaella Ravinetto *, Clinical Sciences Department,

 and Christophe Luyckx**, Public Health Department

 Institute Tropical Medicine Antwerp

 

 

The universal availability of essential quality medicines (1), at affordable prices and with appropriate quality standards, is a fundamental prerequisite to ensure universal access to health.

In the field of prices of essential medicines, a lot has been done in the last decade for avoiding that the enforcement of inadequate intellectual property rules in the pharmaceutical field kept new medicines out of the reach of people living in middle- and low-income countries (2). Even if much more must be done to make all the essential medicines available to all those who are in need, India has set -with its Patent Act of 2005 (3)- a valuable model for maintaining the primacy of public health over commercial interests. Importantly, the lessons learned in the field of HIV/AIDS to increase the affordability of quality-assured essential antiretrovirals (4) seem now to start to serve as an example in other therapeutic fields: for instance, legitimate exceptions to patent-monopoly, like compulsory licenses, are now used to increase the access to appropriate anti-cancer medicines for those in need (5).

However,  the gap between high-income countries vs. middle- and low-income countries is still outstanding in what concerns the assurance of appropriate quality standards for all essential medicines (6). The World Health Assembly (WHA) has been discussing for many years the challenge to individual and public health represented by poor-quality medicines, without reaching an agreement on measures to be implemented to fight them. Only in 2012, the 65th WHA approved a resolution to create a new ‘€˜Member State mechanism’€™ (i.e. an intergovernmental mechanism, open to all WHO Member States), proposing international collaboration on ‘€˜substandard, spurious, falsely-labelled, falsified or counterfeit (SSFFC) medical products’€™ (7). Its explicit goal is ‘€˜to promote the prevention and control of SSFFC medical products and associated activities, to protect public health and promote access to affordable, safe, efficacious and quality medical products’€™. Noteworthy, the definition of “€œSSFFC medical products”€ is quite comprehensive: in fact, it encompasses medicines, vaccines, medical devices and in vitro diagnostic tests. Also, this definition does not prioritize counterfeits (products whose identity has deliberately and fraudulently hidden) (8) over substandards (legitimate, authorized products that do not comply with appropriate quality standards) (9). In fact, sub-standards are at least as dangerous as counterfeits, because their effects are often life-threatening or fatal, due to either direct toxicity or lack of efficacy. In addition, substandards are often the result of structural negligence, and structural negligence in pharmaceutical production should never be considered less important than a deliberate or fraudulent action, because the consequences are equally serious for the final user (10). As we already reminded elsewhere (11), the creation of the Member Mechanism offers a precious opportunity to tackle this problem in a comprehensive, patient-centered approach, aimed in first place at protecting individual and public health from the effects of ineffective or contaminated medicinal products, which are mainly prevalent in resource-poor countries. To do so, the Member State mechanism should prioritize activities that:

– Promote preventive measures, aimed at avoiding that poor-quality medical products reach the patients, rather than identifying them a posteriori, when a significant harm may have already been done, as it happened in recent cases in Bangladesh (12), Panama (13), Pakistan (14), and as showed by many retrospective surveys conducted on antimalarials (15, 16);

– Promote measures that may help to eliminate poor-quality medical products as a whole, rather than concentrating on counterfeits only. Even if there may be commercial interests to do so, a counterfeits-focused approach is market-centered rather than patient-centered, and it leaves many neglected patients exposed to the risk of being treated with substandard medicines.

– Strengthen the national and international regulation, with special focus on initiatives that promote collaboration, knowledge-sharing, resource-sharing and networking among national medicines regulatory authorizes, as described in a recent, very interesting concept paper by the WHO Pre-qualification programme (17);

– Reinforce the current WHO Pre-qualification programme (18) and possibly expand it to more therapeutic fields in addition to HIV/AIDS, malaria, tuberculosis and reproductive health.

– Educate and sensitize the main public and private stakeholders to adopt and implement procurement practices for medicines and other medical products based on stringent quality assurance criteria, in order to avoid risks for the patients and to promote the economical sustainability of quality production.

We hope that the Member State mechanism, which met for the first time in Buenos Aires in November 2012, will manage to overcome all the ideological, economical and commercial interests that could hamper its work, and that it will promote effective and patient-centered measures to ensure universal access to medicines of ensured quality. Just as States have a duty to ensure access to essential medicines for all, they should also ensure the same level of quality assurance and protection from ineffective or toxic medical products to everyone, irrespectively of the income level of the individuals, households and countries. Access to medicines and quality of medicines should be universal, and they should always go together, everywhere and for everyone.

Bibliography and websites

1 – http://www.who.int/topics/essential_medicines/en/

2 – http://www.msfaccess.org/

3 – Lancet Special Report. India’s patent laws under pressure. Vol 380 September 15, 2012. http://www.thelancet.com/

4 – MSF Access Campaign. Untangling the web of antiretroviral price reduction. 15th Edition. July 2012. Available at http://utw.msfaccess.org/

5 – Arie S. Bayer challenges India’€™s first compulsory licence for generic version of cancer drug BMJ2012;345:e6015

6 – Caudron J-M, Ford N, Henkens M, Mace C, Kiddle-Monroe R & Pinel J (2008) Substandard medicines in resource-poor settings: a problem that can no longer be ignored. Tropical Medicine and International Health 13, 1062-€“1072

7 – http://apps.who.int/gb/ssffc/

8 – WHO Fact sheet N°275; http://www.who.int/mediacentre/factsheets/fs275/en/

9 – WHO frequently asked questions. What are substandard medicines? Available at http://www.who.int/medicines/services/counterfeit/faqs/06/en/index.html

10 – Dorlo TPC, Ravinetto RM, Beijnen JH, Boelaert M.  Commentary: Substandard medicines are the priority for neglected tropical diseases. BMJ 2012;345:e7518

11 – Ravinetto R, Boelaert M, Jacobs J, Pouget C, Luyckx C. Editorial. Poor-quality medical products: time to address substandards, not only counterfeits. Tropical Medicine and International Health 2012. doi:10.1111/j.1365-3156.2012.03076.x

12 -€“ Dorlo TPC, Eggelte TA, Schoone GJ, de Vries PJ, Beijnen JH (2012) A Poor-Quality Generic Drug for the Treatment of Visceral Leishmaniasis: A Case Report and Appeal. PLoS Negl Trop Dis 6(5): e1544. doi:10.1371/journal.pntd.0001544

13 -€“ E Danielle Rentz et al., Outbreak of acute renal failure in Panama in 2006: a case-control study. Bulletin of the World Health Organization 2008; 86: 749-756. Available at WHO website

14 -€“ Arie S. Contaminated drugs are held responsible for 120 deaths in Pakistan. BMJ 2012;344:e951 doi: 10.1136/bmj.e951

15 – C. Maponga and C. Ondari, The quality of antimalarials. A study in selected African countries. WHO/EDM/PAR/2003.4, May 2003. Available at: http://apps.who.int/medicinedocs/en/d/Js4901e/

16 – Survey of the quality of selected antimalarial medicines circulating in six countries of sub-Saharan Africa. WHO (Quality Assurance and Safety of Medicines, Department of Essential Medicines and Pharmaceutical Policies), January 2011. Available at: www.who.int/medicines/publications/WHO_QAMSA_report.pdf

17 -€“ Regulator prequalification of medicines: a future concept for networking. WHO Drug Information Vol. 26, No. 3, 2012

18 – http://www.who.int/topics/prequalification/en/

 

———————————————————————

*Raffaella Ravinetto holds a Pharmacy Degree from the University of Torino and a Postgraduate Diploma in Tropical Medicine from the Antwerp Institute of Tropical Medicine.

After a seven-year experience as a Clinical Research Scientist in the private pharmaceutical sector, she worked in emergency and development programs in the Balkans and in Africa. In 2002, she joined Médecins Sans Frontières (MSF), where she followed various dossiers on access to essential medicines and quality of medicines, while performing regular field assessments. She currently works at the Antwerp Institute of Tropical Medicine, as head of the Clinical Trials Unit, coordinator of the Switching the Poles Clinical Research Network and promoter of Quamed (a Network promoting evidence-based strategies for universal access to quality medicines). She was president of the Italian branch of MSF (2007-2011). Her main areas of interest include North-South collaborative clinical research, research ethics (particularly in relation to resource-constrained settings) and access to health.

 

**After 8 years experience in the field of pharmaceutical marketing and communication, Christophe Luyckx joined the humanitarian sector where he implemented social marketing programs for various NGOs, donors and consultancy offices, aimed at strengthening the impact of generic medicines in developing countries.

Christophe has also served as CEO of PSF (Pharmaciens sans Frontières) and PAH (Pharmacie et Aide Humanitaire) and was Marketing Director of an important procurement agency for generic medicines where he developed the procurement channels from China and India.

These various assignments and experience in over 20 countries led Christophe to identify the quality of medicines as a major concern for developing countries and encouraged him to join the Institute of Tropical Medicine of Antwerp where he currently coordinates QUAMED – quality medicines for all -.

Christophe holds a master’€™s degree in Social Communications and a University degree in Public Health and Health Promotion.

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

NEWS LINK 32

–Il rilancio della cooperazione internazionale: perché solo insieme si cresce http://www.cooperazioneintegrazione.it/news/2013/01/rilanciocoop.aspx

–PAHO Director’s Corner http://new.paho.org/hq/index.php?option=com_content&view=article&id=6419&Itemid=39346&lang=en

–DONOR FUNDING FOR HEALTH IN LOW- & MIDDLE-INCOME COUNTRIES, 2002–2010 http://www.kff.org/globalhealth/upload/7679-06.pdf 

–Letters To The President Obama http://www.interaction.org/letters-president  

–President Obama, Set a Goal to End Hunger http://www.huffingtonpost.com/david-beckmann/obama-hunger_b_2442728.html

–EU’s next step to fight global child hunger  https://www.devex.com/en/news/80143/print  

–On Day One: Ensuring Food Security  http://www.diplomaticourier.com/news/topics/environment/1314-on-day-one-ensuring-food-security?mkt_tok=3RkMMJWWfF9wsRouuaXMZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YcIRMB0dvycMRAVFZl5nQhdDOWN

–Global health education in U.S. Medical schools  http://www.biomedcentral.com/1472-6920/13/3

–US FTC Finds Sharp Rise In ‘Pay-For-Delay’ Deals Blocking Generics  http://www.ip-watch.org/?p=25732&utm_source=post&utm_medium=email&utm_campaign=alerts

–Free Drugs Are “Crucial Part” Of Neglected Topical Disease Fight  http://www.ip-watch.org/?p=25624&utm_source=post&utm_medium=email&utm_campaign=alerts

–Could a new business model be the next wonder drug?  https://www.devex.com/en/news/79455/print

–Developing countries’ private debt is on the rise, and the international institutions are ill-prepared  http://eurodad.org/1544376/?mkt_tok=3RkMMJWWfF9wsRouuK%2FPZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YYBT8B0dvycMRAVFZl5nQhdDOWN

–Official Offers Reflections On WHO Reform, Private Sector Role  http://www.ip-watch.org/?p=25704&utm_source=post&utm_medium=email&utm_campaign=alerts

–Business’ Privileged Access To EU-India Trade Documents http://www.ip-watch.org/?p=25617&utm_source=post&utm_medium=email&utm_campaign=alerts

–World Trade Organisation’s new boss will face an in-tray filled with problems  http://www.guardian.co.uk/world/2013/jan/13/world-trade-organisation-new-director-general?mkt_tok=3RkMMJWWfF9wsRouua7PZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YcJRcB0dvycMRAVFZl5nQhdDOWN

–Responsibility in the Time of Cholera: What the UN and Others Should Do in Haiti  http://blogs.cgdev.org/globalhealth/2013/01/responsibility-in-the-time-of-cholera-what-the-un-and-others-should-do-in-haiti.php 

–China, UK unveil joint global health program  http://usa.chinadaily.com.cn/china/2013-01/17/content_16133956.htm

–Family planning stands pat http://usa.chinadaily.com.cn/china/2013-01/16/content_16122760.htm

–Looking Ahead at Global Health in 2013  http://www.chathamhouse.org/media/comment/view/188419 

 

 

 

 

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 31

–Dear President Obama: Africa is calling  https://www.devex.com/en/news/80092/print 

–2013 EU humanitarian aid budget: Who gets what?  https://www.devex.com/en/news/80093/print 

–Widespread Use Of New TB Drug Faces Challenges, Science Reports  http://globalhealth.kff.org/Daily-Reports/2013/January/11/GH-011113-TB-Drug-Approval.aspx 

–The Financial Transaction Tax: Globalization’s Payback Time for the World’s Poor  http://www.huffingtonpost.com/philippe-dousteblazy/financial-transaction…  

–Q&A: Middle Eastern web technology for social change, with Esra’a Al Shafei  http://www.scidev.net/en/new-technologies/icts/features/q-a-middle-eastern-web-technology-for-social-change-with-esra-a-al-shafei-1.html

–India rejects claims it exported fake medicine to Africa  http://www.guardian.co.uk/world/2013/jan/02/india-rejects-fake-medicine-africa 

–‘Two Indias exist everywhere, especially in healthcare’ – video http://www.guardian.co.uk/global-development/video/2013/jan/07/india-hea…

–Can India Defeat Poverty? http://www.foreignpolicy.com/articles/2013/01/08/can_india_defeat_povert…

–Innovation to fund global health http://thehill.com/blogs/congress-blog/healthcare/275677-innovation-to-f…

–A  New  Agenda  for  the  G20:  Addressing  Fragile  States  http://blogs.cfr.org/patrick/2012/12/12/a-new-agenda-for-the-g20-addressing-fragile-states/?cid=nlc-public-the_world_this_week-link26-20130104&mkt_tok=3RkMMJWWfF9wsRouuq%2FBZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YcGS8Z0dvycMRAVFZl5nQhdDOWN

–Disease Eradication  http://www.nejm.org/doi/full/10.1056/NEJMra1200391

–Video of the Week: Cash and Carry with the World Food Programme in Zimbabwe http://blog.usaid.gov/2013/01/video-of-the-weekcash-and-carry-with-the-world-food-programme-in-zimbabwe/

–USTR holds NGO briefing on TPP negotiations http://www.keionline.org/node/1635

–Top tech breakthroughs of 2012 http://www.scidev.net/en/health/news/top-tech-breakthroughs-of-2012.html

–Twelve countries sign UN treaty to combat illegal tobacco trade http://www.un.org/apps/news/story.asp?NewsID=43899&Cr=tobacco&Cr1=%23.UO…

–Information is key to effective malaria control http://www.guardian.co.uk/global-development-professionals-network/2013/jan/10/malaria-awareness-raising-africa 

–FAO Food Price Index down 7 percent in 2012 http://www.fao.org/news/story/en/item/168067/icode/ 

 

 

 

 

 

 

 

 

 

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

News Link 30

–Aids, un nemico sempre in agguato: intervista con Mario Figoni   http://www.pianetaqueer.it/news/focus-h-i-v/265-aids-un-nemico-sempre-in-agguato.html

–SANITÀ, INVECCHIAMENTO E NUOVE TECNOLOGIE  http://www.nelmerito.com/index.php?option=com_content&task=view&id=1852&Itemid=1

–Il nuovo Global Burden of Disease study: cosa c’è di nuovo?  http://www.saluteinternazionale.info/2012/12/il-nuovo-global-burden-of-disease-study-cosa-ce-di-nuovo/

–Emerging economies drive frugal innovation  http://www.who.int/bulletin/volumes/91/1/13-020113/en/index.html

–Effect of vitamin A supplementation on cause-specific mortality in women of reproductive age in Ghana: a secondary analysis from the ObaapaVitA trial http://www.who.int/bulletin/volumes/91/1/11-100412-ab/en/index.html

–First new tuberculosis drug for 50 years – works on drug-resistant forms of the disease  http://www.msfaccess.org/about-us/media-room/press-releases/first-new-tuberculosis-drug-50-years-%E2%80%93-works-drug-resistant-forms

–At Europe’s Doorstep, Fierce War Against TB  http://online.wsj.com/article/SB10001424127887324660404578201593636497964.html

–Editorial, Opinion Pieces Address Effects Of Health Worker Murders In Pakistan On Polio Eradication  http://globalhealth.kff.org/Daily-Reports/2013/January/04/GH-010413-Opinion-Polio-In-Pakistan.aspx

–Taking Calls on Abortion, and Risks, in Chile  http://www.nytimes.com/2013/01/04/world/americas/in-chile-abortion-hot-line-is-in-legal-gray-area.html?_r=0

–Thai-EU FTA Raises Alarm for People With AIDS   http://www.ipsnews.net/2012/12/thai-eu-fta-raises-alarm-for-people-with-aids/  

–In China, Grass-Roots Groups Take On H.I.V./AIDS Outreach Work  http://www.nytimes.com/2013/01/03/world/asia/chinese-groups-slowly-carve-out-space-in-work-against-hiv-aids.html?pagewanted=1&_r=0 

–Global development podcast transcript: hopes and fears for 2013  http://www.guardian.co.uk/global-development/2012/dec/28/global-development-podcast-2013-transcript 

–Renowned US doctor appointed to support UN efforts to eliminate cholera in Haiti http://www.un.org/apps/news/story.asp?NewsID=43853&Cr=haiti&Cr1=cholera#.UOhUC2_8Lie

–Q&A with Eric Goosby, US Global AIDS Coordinator  http://www.globalpost.com/dispatches/globalpost-blogs/global-pulse/qa-eric-goosby-us-global-aids-coordinator

–Transforming Health with Mobile Technology   http://www.impatientoptimists.org/en/Posts/2012/12/Transforming-Health-with-Mobile-Technology

–Efforts To Eliminate FGM ‘Breaking New Ground’ With Approval Of U.N. General Assembly Resolution http://globalhealth.kff.org/Daily-Reports/2012/December/21/GH-122112- Opinion-FGM-Resolution.aspx 

–Myanmar eyes microfinance, private sector development   https://www.devex.com/en/news/80050/print 

–Collaborative Capacity Building In Intellectual Property: Leveraging On African Diaspora Exchange  http://www.ip-watch.org/?p=25523&utm_source=post&utm_medium=email&utm_campaign=alerts

–US aid policy under John Kerry: Expect few changes   https://www.devex.com/en/news/80027/print 

–Most-Read IP-Watch Stories Of 2012: India Pharma, Europe, ACTA, WIPO Technical Assistance, Gene Patents  http://www.ip-watch.org/?p=25510&utm_source=post&utm_medium=email&utm_campaign=alerts

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 29

–TOP 10 GLOBAL HEALTH MILESTONES OF 2012  http://psiimpact.com/top-10-global-health-milestones-of-2012/

–Ricerca scientifica: non è sufficiente dire Bad Pharma  http://www.saluteinternazionale.info/2012/12/ricerca-scientifica-non-e-sufficiente-dire-bad-pharma/

–Ambassador Goosby Named Head Of State Department’s New Office of Global Health Diplomacy  http://globalhealth.kff.org/Daily-Reports/2012/December/17/GH-121712-Goosby-Diplomacy-Office.aspx 

–The Office of Global Health Diplomacy: A Christmas Miracle or Lump of Coal?  http://blogs.cgdev.org/globalhealth/2012/12/the-office-of-global-health-diplomacy-a-christmas-miracle-or-lump-of-coal.php 

–Susan Rice withdraws for secretary of state  https://www.devex.com/en/news/79958/print

–The U.S. Role in Global Polio Eradication http://csis.org/publication/us-role-global-polio-eradication

–Science put at heart of US global AIDS strategy  http://www.scidev.net/en/health/hiv-aids/news/science-put-at-heart-of-us-global-aids-strategy.html

–US Chamber Holds Annual IP Attaché Roundtable, Announces New “IP Index”  http://www.ip-watch.org/?p=25409&utm_source=post&utm_medium=email&utm_campaign=alerts

–KEI notes on the 15th round of Trans-Pacific Partnership Agreement (TPPA) negotiations in Auckland, New Zealand  http://www.keionline.org/node/1617

–The MDGs: Where Does Nutrition Fit? http://www.developmenthorizons.com/2012/12/the-mdgs-where-does-nutrition-fit.html

–Future of Agriculture: Online Discussion blog  http://blogs.oxfam.org/en/future-of-agriculture 

–FAO: Poor Countries Must Invest in Farming to Tackle Hunger http://ictsd.org/i/news/bridgesweekly/151477/

–Analysis: Five reasons malnutrition still kills in Nepal http://www.irinnews.org/Report/97046/Analysis-Five-reasons-malnutrition-still-kills-in-Nepal 

–Waiting For Customs And Trademark Reforms, EU Rights Owners Get “Proactive” Against Fakes  http://www.ip-watch.org/?p=25321&utm_source=post&utm_medium=email&utm_campaign=alerts

–Howard Berman Unveils Landmark Foreign Assistance Reform Legislation  http://www.democrats.foreignaffairs.house.gov/press_display.asp?id=1010

–Finally, a 2013 EU budget https://www.devex.com/en/news/79950/print

–EU to join efforts with the World Bank to develop water and energy in Central Asia  http://europa.eu/rapid/press-release_IP-12-1402_en.htm?locale=en

–European Unitary Patent And Court Becomes Reality  http://www.ip-watch.org/?p=25258&utm_source=post&utm_medium=email&utm_campaign=alerts

–Dispatch From Sweden: Development Talks, Gender Equality, and the Nobels http://blogs.worldbank.org/voices/dispatch-from-sweden-development-talks-gender-equality-and-the-nobels

–SHIFTS IN AIDS RELIEF AND BEYOND  http://www.usglc.org/2012/12/13/shifts-in-aids-relief-and-beyond/

–GENERAL ASSEMBLY ENCOURAGES MEMBER STATES TO PLAN, PURSUE TRANSITION OF NATIONAL HEALTH CARE SYSTEMS  TOWARDS UNIVERSAL COVERAGE  http://pnhp.org/blog/2012/12/13/united-nations-passes-resolution-supporting-universal-coverage/  

–The Ongoing Fight for Safety, Equality, and Health  http://www.intrahealth.org/page/the-ongoing-fight-for-safety-equality-and-health

–OP-ED: Women Out Loud  http://www.ipsnews.net/2012/12/op-ed-women-out-loud/

–80 Programs to Improve the Health and Lives of Women in the Developing World http://www.impatientoptimists.org/en/Posts/2012/12/An-Explosion-of-Private-Sector-Innovation-Improving-Maternal-Newborn-and-Child-Health-in-Developing-World

–How Big Pharma Prevents The Poor From Accessing Life-Saving Medicines  http://thinkprogress.org/health/2012/12/15/1336081/how-big-pharma-prevents-the-poor-from-accessing-life-saving-medicines/?mobile=nc 

–Will innovative financing replace ODA?   https://www.devex.com/en/news/79995/print 

–The year of cataclysm for the NHS http://www.nhscampaign.org/NHS-reforms/nhs-2012-review.html  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 La Ricerca e Sviluppo (R&S) di nuovi strumenti diagnostici e terapeutici per le malattie neglette legate alla povertà (PRMN) è in sofferenza per la sensibile tendenza al ribasso dei finanziamenti

 

Fondi in calo per le malattie neglette: un panorama frammentato da riordinare

Daniele Dionisio

 

Come appena riferito da Policy Cures  “…Con 3 miliardi di dollari destinati nel 2011, i fondi per la ricerca globale nel settore superano oggi di circa 440 milioni di dollari gli stanziamenti del 2007, ma sono inferiori ai fondi del 2009, e simili a quelli del 2010…”€  [1, 2]

Questa stagnazione è preoccupante se si pensa che le PRMN (fra cui, ma non solo, AIDS, morbillo, polio, dengue, polmoniti, malaria, tubercolosi, malattia del sonno, leishmaniosi, diarree) insieme causano 5 milioni di morti all’€™anno nei paesi a basso reddito, dove 3 miliardi di persone sopravvivono con meno di 2 dollari al giorno  e le medicine salvavita protette dai brevetti sono fuori portata, mentre regole del commercio e governi stanno stravolgendo i diritti di proprietà intellettuale a favore di politiche allineate a interessi di monopolio [3-5]

Tutto questo in un momento in cui la assenza di una agenda operativa condivisa su scala mondiale rende ragione di un quadro generale decisamente frammentato, con sovrapposizione e duplicazione di iniziative.

In questo contesto, l’€™impegno dell’€™Unione Europea (UE) in R&S per PRMN  non è distribuito uniformemente fra gli Stati Membri, rappresenta solo lo 0.0024% del PIL combinato UE, e manca di adeguata condivisione con tutti i partners [6].

La UE dovrebbe coordinarsi e collaborare strettamente con le iniziative dei partners, non ultima la Roadmap appena lanciata dall’ Unione Africana sulla Responsabilità  Condivisa e Solidarietà  Globale per la Risposta ad AIDS, Tubercolosi e Malaria in Africa [7]

Ed è auspicabile una collaborazione più stretta della UE con il Fondo Globale per la Lotta ad AIDS, Tubercolosi e Malaria per compattare le forze in questi tempi di recessione economica globale [8].

Ma è altresì necessaria più aperta collaborazione UE con l’€™OMS circa i modelli e le fonti che l’€™OMS ha indicato e  sta esaminando per l’€™ottimale finanziamento di R&S per le malattie della povertà  [9]. Nel merito ben si presterebbero parte dei proventi (almeno il 10%) da  una Tassa sulle Transazioni Finanziarie oggi prossima all’€™attuazione in UE [10]  .

Nel frattempo gli Stati Uniti continuano a detenere un ruolo leader nella R&S per PRMN, anche attraverso le alleanze politico-strategiche che l’€™amministrazione Obama sta moltipicando negli scacchieri di Asia-Pacifico e Africa [11-14]

E questo mentre la spesa estera in R&S per PRMN da parte dei BRICS (Brasile, Russia, India, Cina, Sud Africa), soprattutto in termini di cooperazione Sud-Sud, è in lievitante ascesa, e gli Stati del Golfo, Turchia, Indonesia, Argentina, Messico e Corea del Sud sono protesi allo sviluppo di tecnologie per la salute in grado di coniugare innovazione, qualità  e basso costo [15, 16].

Riordinare questo panorama altamente frammentato è obiettivo prioritario se la R&S per PRMN deve fare di più e meglio. Allo scopo, sostegno generalizzato a OMS  e una agenda di lavoro comune per la condivisione delle priorità , senza dispersioni e ridondanze, sono assolutamente necessari.

 

RIFERIMENTI

1. http://www.policycures.org/downloads/GF2012_Report.pdf

2.  http://www.scidev.net/en/health/news/r-d-funding-for-neglected-diseases-failing-.html

3. http://www.action.org/documents/CALL_TO_EU_LEADERSHIP_ON_GLOBAL_HEALTH_RD.pdf

4. http://apps.who.int/gb/ebwha/pdf_files/A61/A61_R21-en.pdf 

5. http://www.msfaccess.org/content/acta-and-its-impact-access-medicines 

6. http://www.dsw-online.org/fileadmin/user_upload_en/PDF/GH_R_D_EU/Saving_Lives_and_Creating_Impact_DSW-PC_Report.pdf 

7. http://www.au.int/en/sites/default/files/Shared_Res_Roadmap_Rev_F%5b1%5d.pdf 

8. http://www.action.org/documents/ACTION-TBEC_Briding_the_Gap_Sept2012_EMBARGOED.pdf

9. http://www.ip-watch.org/2011/12/14/who-expert-group-to-recommend-binding-rd-treaty-negotiation/ 

10. http://www.euinside.eu/en/news/after-all-the-ftt-will-be-introduced-though-not-across-the-eu 

11. http://www.policycures.org/downloads/GF2012_Report.pdf 

12. http://www.pepfar.gov/ 

13. http://globalhealth.kff.org/Daily-Reports/2010/November/09/GH-110910-Obama-In-India.aspx

14. http://www.devex.com/en/news/76981/print

15. www.g20civil.com/documents/199/472/

16. http://pib.nic.in/newsite/erelease.aspx?relid=080683

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 28

–Changing the World: A Bold Endorsement of the Power of Vaccines and Immunization  http://www.impatientoptimists.org/en/Posts/2012/12/Changing-the-World-A-Bold-Endorsement-of-the-Power-of-Vaccines-and-Immunization

–Asia: Hopes rise in fight against HIV/AIDS   http://www.globalpost.com/dispatch/news/regions/asia-pacific/121129/HIV-AIDS-epidemic-china-cambodia-myanmar-thailand-vietnam-indonesia 

–Cancer’s New Battleground — the Developing World   http://www.theworld.org/cancer-new-battleground/

–Building Resilience to Recurrent Crisis. USAID POLICY AND PROGRAM GUIDANCE  http://transition.usaid.gov/resilience/USAIDResiliencePolicyGuidanceDocument.pdf

–Novartis vs. India: Supreme Court hearing ends   http://www.msfaccess.org/content/novartis-vs-india-supreme-court-hearing-ends

–CHINA AND GLOBAL FUND SIGNAL STRONG PARTNERSHIP  http://www.theglobalfund.org/en/mediacenter/newsreleases/2012-11-30_China_and_Global_Fund_Signal_Strong_Partnership/

–Chinese-Style Decentralization and Health System Reform  http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001337

–A beginner’s guide to land grabs   http://www.oxfam.org/en/grow/video/2012/beginners-guide-land-grabs 

–FEB 21, 2013 LOCAL PHARMACEUTICAL PRODUCTION AND ACCESS TO MEDICINES  http://www.medicusmundi.org/en/contributions/events/2012/local-pharmaceutical-production-and-access-to-medicines

–A FRAMEWORK CONVENTION ON GLOBAL HEALTH: A CATALYST FOR JUSTICE  http://www.who.int/bulletin/volumes/90/12/12-114371.pdf

–PUBLIC HEALTH ROUND-UP  http://www.who.int/bulletin/volumes/90/12/12-011212.pdf 

–Single European Patent Dominates IP Summit As European Parliament Vote Nears http://www.ip-watch.org/?p=25226&utm_source=post&utm_medium=email&utm_campaign=alerts

–GFINDER 2012 report http://www.policycures.org/g-finder2012.html

–African scientists seek more commitment against tropical diseases  http://big5.xinhuanet.com/gate/big5/news.xinhuanet.com/english/world/2012-12/11/c_132034319.htm 

–Making bad drugs? Three strikes and you’re out   http://thehill.com/blogs/congress-blog/healthcare/271721-making-bad-drugs-three-strikes-and-youre-out 

–UNITAID NEW GRANTS TOTAL US$ 120 MILLION   http://www.unitaid.eu/resources/press-centre/releases/1053-eb17-project-release

–DfID oversight of EU aid spending in poor countries gets ‘amber-red’ rating https://www.devex.com/en/news/79933/print 

–How corrupt is your government?  https://www.devex.com/en/news/79900/print