Blog: Chan, Shah Stress Importance Of Country Ownership

Ministerial Leadership Initiative’s “Leading Global Health” blog has an ongoing series: “In the Driver’s Seat: A Series on Country Ownership of Health Programs.” The first post in the series is an interview with WHO Director-General Margaret Chan, who said “If countries don’t own their health programs, I personally believe there is no responsibility and no accountability. If donors go in and do their own projects, and make sure they get visibility, put up their national flag, and keep referring to their initiative, without recognizing the country, that does not lead to a sustainable program. Countries are not happy. In some cases, they are angry” (Donnelly, 9/14).  The second interview is with USAID Administrator Rajiv Shah, who discusses the agency’s participation in pool funding arrangements and the necessity for innovation to reach the Millennium Development Goals (MDGs) (Donnelly, 9/15). A third post features an interview with Ethiopian Health Minister Tedros Adhanom Ghebreysus (Donnelly, 9/16).

NEJM Perspective Calls For Global Unity On Noncommunicable Diseases

“[T]he relentless worldwide spread of noncommunicable diseases offers an opportunity for low-, middle-, and high-income countries to join forces in addressing a major global challenge that threatens health and economies alike,” write the authors of a New England Journal of Medicine Perspective. The article examines how noncommunicable diseases impact national economies and increase the risk of poverty and infectious disease. Noting that risk factors, including hypertension and obesity, are on the rise in developing countries, the authors conclude, “we must also increase the sense of urgency regarding noncommunicable diseases that are ‘communicated’ by means of the global promotion of products and lifestyles, lest they insidiously undermine the health and wealth of nations” (Narayan et al., 9/15).

Kaiser Family Foundation Report Examines U.S. Participation In International Treaties Related To Health

The Kaiser Family Foundation published a report that takes a “comprehensive look at U.S. participation in 50 significant international treaties and agreements that directly or indirectly touch on health issues.” The report’s introduction notes that international agreements have received “new attention” as one core principle of the Obama administration’s Global Health Initiative. The report finds that the U.S. is “most likely to be party” to agreements that address: specific diseases, such as HIV and TB, intellectual property issues or specific populations such as women, children or refugees. The findings break down the 50 treaties by various categories including legally binding, and the international and U.S. status of each. In conclusion, the authors call on the U.S. government to develop a system to catalog and review agreements, find opportunities to strengthen engagement, and reconsider health-related treaties the U.S. is not party to (Kates/Katz, September 2010).

Several Blogs, Publications Examine U.N. Millennium Development Goals (MDGs) Ahead Of U.N. Summit: 

• BMJ Editorial Examines MDG Progress, Forecasts Upcoming Priorities: An editorial in the British Medical Journal asks, “Are the millennium development goals [MDG] on target?” It examines the “mixture of success and shortfalls” reported regarding the targets. The editorial praises recent progress on MDG4, which calls for a reduction in child mortality, for which “19 countries are now on track and 47 have accelerated progress since 2000.” The author also calls for “high and equitable coverage of basic interventions,” including bed net distribution and immunizations. Major priorities in the next five years, according the editorial, should focus on data-driven interventions, innovations to assist in the better delivery of health care, target the poor and strengthen donor and host country accountability (Lawn, 9/14). 
• Global Health Magazine Expert Blog Series On MDGs: Global Health Magazine’s blog has a series of posts on the (MDGs), in advance of the upcoming summit. The post examining MDG 4 recommends ways to “[m]ake vaccination a reality for all children (Fields/Steinglass, 9/16). A post on MDG 5 explores how mobile phone technology can improve maternal and infant health (Aylward, 9/14). A post on MDG 6 looks at new research on malaria, a disease which the blog notes receives “40 percent of African health budgets” (Akpogheneta, 9/14). 
• Science Policy Forum Argues Family Planning Key To Alleviating Poverty, Achieving MDGs: A Science Policy Forum, which examines family planning in relation to the MDGs, writes, “[t]o alleviate global poverty, investments and partnerships in family planning are needed.” The authors discuss how family planning would help to achieve each of the MDGs, for example: “[g]iven control over their fertility, girls are more likely to stay in school and women to be employed.” It also would help to achieve MDG 2, education and MDG 3, empowerment for women and girls. In conclusion, the authors call on global leaders and U.N. MDG advocates to “ensure better access to reproductive health for all” (Cates et al., 9/16). 
• Lancet Examines MDG Progress, Challenges Related To Public Health: A Lancet Perspectives piece looks at the state of the MDGs, as they relate to public health. The author cites progress in “creating primary health systems, deploying new technologies, introducing human-resource strategies, and mobilising new domestic and donor financing.” Looking forward to the MDG deadline in 2015, he adds, “[t]he most pressing challenge is to close the remaining financing gap to enable universal access to a primary-health system in every low-income country” and many poor countries are “ready to lead domestically” with the support of external aid from high-income donor countries (Sachs, 9/18). 
• TB Control ‘Crucial’ To Achieving MDGs: “Tuberculosis [TB] control is crucial to achieve the MDGs” and will require “increased and sustained efforts,” according to a Lancet Comment. Though 43 million TB patients were treated between 1995-2008, the global incidence of TB “peaked in 2004” and absolute numbers have not declined since then. “Beyond the core efforts of national programmes described in WHO’s Stop TB Strategy,” the authors write, “bold health policies are necessary to increase access to care and prevention, starting with universal health coverage” and including better transparency and efforts to fight corruption. The authors call on governments to “recognise the challenge” of controlling TB, with the financial support of U.N. and international agencies (Atun et al, 9/18). 
• Sanitation Issues A ‘Blind Spot’ To Governments, Donors: Ten years after the MDGs were set, “many goals remain way off track, and none more so than sanitation…,” writes the author of a British Medical Journal Feature. “Why has it been so hard to reach the countless communities where people are daily exposed to their own and others’ faeces? In part, it’s the failure to make the link between improved sanitation and better health—and attract the resultant aid dollars—but also because governments’ and the aid communities seem to have a blind spot on this issue.” The article discusses the embarrassment of talking about sanitation, the health threat of unclean water, and evidence-based solutions to improving toilet use (Coombes, 9/15). 
• Shah, Lane Discuss U.S. Commitment To MDG Progress In State Department Discussion: The U.S. State Department hosted a conversation on the MDGs between USAID Administrator Rajiv Shah and David Lane, president of One. More than for “moral purposes,” Shah said, “tackling the MDGs is fundamentally part of a strategic vision of bringing the world together, and thereby enabling our own peace and prosperity over a longer period of time.” Shah also spoke about the Obama administration’s “commitment” to providing resources and technical capabilities to meet the MDGs. Shah and Lane also discussed the challenge of integrating U.S. efforts with other countries and agencies, the role of investment and trade, and the importance of communicating outcomes and transparency. A video of the conversation is available on the State Department’s website (9/16).