The Top 10 Global Health Moments in 2013

By Karl Hofmann, President & CEO, PSI

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The end of each year provides the opportunity to reflect on what transpired and what was accomplished. Global health saw plenty of victories and setbacks in 2013. Drug resistant TB, slowing donor funding, new outbreaks of polio and a devastating typhoon showed how easily progress can stall.

Amid these challenges emerged a changing global health landscape. The old way of doing things is now, more than ever, on its way out. In the next five years, the range of actors that are engaging and making a difference in addressing global health issues will continue to broaden and expand, even as the underlying health challenges narrow, and as The Lancet recently described, converge.

The infrastructure that developed over the last 50 years to tackle global development – the United Nations, donor agencies, international NGOs, other intermediaries and host governments – now finds itself working more and more with corporations, impact investors, next generation philanthropists, and socially networked individuals. This burgeoning ecosystem of development actors generates unprecedented attention and potential resources to address global poverty. Getting the roles right for these and other players might have a lot to do with whether we can end extreme poverty during our lifetime.

These are our top 10 moments for global health in 2013. Top 10 lists inevitably leave lots out. What did our global health and development leaders miss? Let us know what you think and share a few of your predictions for 2014.

1. Typhoon Haiyan

We include Haiyan not only for the unimaginable devastation it caused but as a reminder that when the media attention wanes and the world moves on, the health needs of the people affected will still be great.

“We will continue to serve these communities’ immediate needs, as well as long-term needs including child and maternal health; nutrition; water, sanitation and hygiene; and mental health services.” – Nancy A. Aossey, President & CEO of International Medical Corps

2. Malala Yousafzai’s Ripple Effect on Family Planning

The impact of Malala Yousafzai’s efforts on education is obvious, less so is the impact she will have on the reproductive health of girls and women. If Malala has her way, girls will not only be better educated, they will have healthier families, build stronger communities and contribute to more robust economies.

3. Polio Movement Celebrates Successes, Faces Setbacks

The world is watching how the polio community will overcome conflict and violence to eradicate polio by 2018.

4. Global Leaders Show Unprecedented Support for Maternal and Child Health

In September, The World Bank, UNICEF, USAID, Norway committed $1.15 billion over the next three years to advance progress toward Millennium Development Goals 4 and 5, and to get essential services and medicines to women and children who need them most.

5. Women Philanthropists Align for Health and Rights of Girls and Women

Women philanthropists are catalysts for new, innovative ways to deliver life-saving health products that will improve the lives of girls and women throughout the world. They are engaged and here to stay.

6. Gender-based Violence Movement Sees Tipping Point

World leaders acted on their commitments to eliminate gender-based violence, signaling a tipping point in the fight. Momentum is behind the movement. This is an issue to watch in 2014.

7. Under Mark Dybul’s Leadership, the Global Fund Is Back and Better than Ever

An impressive level of financial commitment from existing and new donor governments sends a strong signal.

8. Global USAID-Walmart Partnership Solidifies Long-Developing Trend

Public-private partnerships are not new. It is the magnitude of USAID’s partnership with Walmart that made us stand up and take notice.

9. Drug Resistance Threatens TB Progress, New Drugs Show Promise

By many measures the world is making great progress against TB – the rate of new cases has fallen worldwide and new drugs are in development – yet drug resistance seriously threatens that progress.

10. Women Deliver Conference Secures Bold Commitments for Girls and Women

More than 5,000 people gathered at Women Deliver in Kuala Lumpur, Malaysia, to promote the health of girls and women, adding additional momentum to what economists, government donors, philanthropists conclude: when you invest in the health of girls and women, you lift.

Read the latest edition of PSI’s Impact Magazine here.

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Health Markets: 20 Years of Progress and A Look to the Future

Global health leaders, funders, academics and policy makers met during December to discuss health markets and their future in light of a global push towards universal healthcare coverage. A resolution passed by the UN General Assembly in mid-December called for the provision of universal healthcare. The Washington Post reported that a 2010 WHO report on financing universal health coverage led “60 middle- and low-income countries requested technical assistance and advice to implement universal health coverage.”

Government-led universal healthcare access will require engagement with both the private and public sectors. “Engaging with health markets is going to be critical for governments in the future, especially given the recent UN resolution,” said  Future Health Systems (FHS) CEO Sara Bennett.

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Empowering and Supporting Women Through mHealth

By Deputy Editor Tom Murphy
Washington DC – A marginal part of the recent mHealth Summit, global health took center stage on the final day with keynote addresses and discussions from global health leaders. Dr Nafis Sadik, UN Foundation Board Member and former head of United Nation’s Population Fund used her time in the spotlight to issue a challenge for embedding women and girls into mHealth.
Dr Sadik spoke directly to the mHealth Alliance, a convening group for coordinating mHealth that involves multiple stakeholders from the public, private and NGO sectors. She commended the work done by the Alliance to bring people to the table in order to improve health outcomes through mobile technologies.
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UNICEF: Global Demographic Shift Towards Youth

Today marks the anniversary of the UN General Assembly adopting both the Declaration of the Rights of the Child (1959) and the Convention on the Rights of the Child (1989). The two documents enshrine a global agreement to ensure that the rights of children around the world are protected. They are the result of a long process that began in 1923 with a draft set of rights set forth by  Save the Children founder Eglantyne Jebb.

Jebb’s five points were expanded in 1959 to 10 principles that form the Declaration of the Rights of the Child. The rights were more formally enshrined 30 years later with the Convention on the Rights of Child, a document that was ratified by the majority of the countries in the world. Because of the importance of November 20, the UN marks the day as Universal Children’s Day.

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Celebrating UN Day

Today marks the anniversary of the ratification of the UN Charter. On October 24, 1945 the five permanent members and the majority of the 46 member countries established the UN. The first meeting took place in January of 1946 in London before the UN took up residence in Lake Success, New York until 1952. When the UN headquarters were completed on the east side of Manhattan, the UN moved to its current home.

The UN Charter, signed in June of 1945, sets forth the principles for the United Nations. It reflects the lessons learned from the two great wars and the human rights atrocities committed during World War II.

We the peoples of the United Nations determined to save succeeding generations from the scourge of war, which twice in our lifetime has brought untold sorrow to mankind, and to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women and of nations large and small, and to establish conditions under which justice and respect for the obligations arising from treaties and other sources of international law can be maintained, and to promote social progress and better standards of life in larger freedom…

The agencies created by the UN, like the WHO, WFP, UNICEF and UNHCR, play a role in supporting the development of nations and the safety of people around the world. The following infographic provides a sampling of the many things that the UN does today.

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Gates to the UN: "The Future will be Better than the Past"

Bill Gates was given the opportunity to address the UN General Assembly on the issue of the Millennium Development Goals. He praised the goals for raising awareness on specific issues and leading the world to focus on the many needs, even when some countries are falling short.

“Attention alone won’t change the future. We also need greater innovation. both in the tools we discover and the way we deliver them,” said Gates. He used the eradication of small pox as an example of innovation and distribution leading to the end of the disease. There have been many failures in the collective effort, he says, but optimism should stand above the challenges.

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Maintaining Focus and Effort on NCDs

World leaders will descend upon the UN next week for its annual meeting. One year ago, noncommunicable diseases were  a top agenda item for the meeting. The occasion of the anniversary is being marked by various outlets to recognize what has been accomplished and what needs to be done to address the problem of NCDs.

“The past year has been a testament to progress on NCDs at the global level, particularly with our victory of the adoption of the target to reduce premature mortality by 25% by 2025 at the World Health Assembly (WHA). Still, this is only the beginning of a long journey toward a healthy future. We must ensure that the mandates of the Political Declaration are fully developed and successfully implemented at all levels, and among all stakeholders,” said the NCD Alliance in marking the occasion.

An equity and justice argument in regards to NCDs is made by Felicia Marie Knaul, associate professor at Harvard Medical School and Benn Grover, Policy Manager for the National Forum for Heart Disease and Stroke Prevention in the Huffington Post:

The majority, though not all, of the most exposed and vulnerable populations live in LMICs and lack the opportunity and the ability to make healthy lifestyle choices. For the majority of people worldwide who suffer and die from diseases like cardiovascular disease, cancer and diabetes, the freedom to choose a healthier life was never part of the equation. To begin with, inadequate knowledge of exposure to risk eliminates any possibility of making informed choices or undertaking healthy behavior. Furthermore, much exposure to risk is beyond the control of individuals, especially where health policies and laws to protect them are inadequate or lacking. Nor can these individuals readily access proven early detection interventions.

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Celebrating World Humanitarian Day

This past Sunday, the UN and the world marked the annual World Humanitarian Day. The aim was to recognize the people who put their lives in danger in order to help others. August 19 is also the anniversary of the 2003 bombing of the United Nations headquarters in Baghdad, Iraq, which killed 22 UN staff.

“This year’s World Humanitarian Day presents an historic opportunity to bring together one billion people from around the world to advance a powerful and proactive idea: People Helping People. That is the best way to honour the many fallen aid workers we mourn today, and to celebrate the efforts of others who carry on their noble mission by rushing assistance to those who are suffering,” said Secretary General Ban ki-Moon.

The theme for this year’s day is “I Was Here.” Singer Beyonce is leading the way to raise her voice in support of humanitarians. People around the world participated in a  social media thunderclap to will celebrate the work of humanitarians around the world.

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What is the Latest on Haiti's Cholera Outbreak?

Deputy Editor Tom Murphy interviewed AP journalist Jonathan Katz on the topic of Haiti’s cholera outbreak for Humanosphere. Katz was the reporter for the AP in Haiti at the time of the 2010 earthquake and remained in country through the recovery and the cholera outbreak that followed in October of 2010.

Some excerpts from the conversation:

TM: What is the current state of the cholera outbreak in Haiti?

JK: It’s still terrible. In less than two years an estimated 584,000 people have been sickened and, officially, 7,497 people have died — all from a strain of bacteria that had never been seen in Haiti before. Infections appear to be at a low point, but while the rate ebbs and flows, the epidemic isn’t going away. A pilot project to vaccinate about 1% of the population appears to have been a success in terms of distribution, and there’s talk about scaling it up. The great tragedy is that people in Haiti who already had so much to deal with now have to contend with this new threat. They’ll know how successful mitigation efforts have been after the next big set of floods.

TM: What does the University of Maryland study revealing two strains of cholera in Haiti tell us?

JK: As to whether the U.N. introduced a previously unknown, deadly strain of cholera to Haiti, it has nothing apparent to say at all. It may ultimately point to a more complicated hypothesis about exactly how that imported strain proved to be so deadly, though it’s a bit too early to say.

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Preventing 1.1 Million Premature Deaths

By Deputy Editor Tom Murphy

Over 60% of global premature births take place in Africa and South Asia. The majority of deaths in newborns, defined as babies under 4 weeks old, is attributable to prematurity. The number is so great that prematurity is the second leading cause of death for children under 5 years old. The good news is that the majority of the deaths caused by prematurity are avoidable.

An estimated 15 million babies are born early around the world every year. Of those babies, 1.1 million die. Three quarters of those deaths can be avoided, says a new report, Born Too Soon: The Global Action Report on Preterm Birth, by The March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health, Save the Children and The World Health Organization.

“These facts should be a call to action. Fortunately, solutions exist,” says UN Secretary General Ban Ki-Moon in the report’s introduction. “Ensuring the survival of preterm babies and their mothers requires sustained and significant financial and practical support.”

Preterm births are on the rise. Of the 65 countries with reliable birth data, only three are not experiencing an increase in preterm birth rates. The difference between high and low income countries for preterm survival is stark. “Over 90% of extremely preterm babies of extremely preterm babies (<28 weeks) born in low-income countries die within the first few days of life; yet less than 10% of babies of this gestation die in high-income settings,” says the report.

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Aid Groups Come Together to Eradicate Measles

A group of researchers have attempted to track the progress towards the goal of 90% reduction in measles mortality by 2010 over 2000 levels. In their paper published in the Lancet, the researcher find, “global measles mortality decreased 74% from 535,300 deaths (95% CI 347 200–976 400) in 2000 to 139,300 (71,200–447,800) in 2010. Measles mortality was reduced by more than three-quarters in all WHO regions except the WHO southeast Asia region. India accounted for 47% of estimated measles mortality in 2010, and the WHO African region accounted for 36%.”

WHO Director-General Dr Maragret Chan welcomed the findings saying, “A three-quarters drop in measles deaths worldwide shows just how effective well-run vaccination programmes can be. Now we need to take the next logical step and vaccinate children against rubella, too.”

The reasons for the shortfalls in each region is varied, but vaccinations are the common thread. Southern Africa continued to reduce mortality until 2007 where it then leveled off. India, on the other hand, decreased its measles mortality rate by a comparatively lower 26%.

In the commentary that follows the study, Walter A Orenstein and Alan R Hinman examine the methods of the authors in determining the estimates. They raise some questions and conclude pointing to the importance of getting the data right. They write, “Simons and colleagues’ report highlights crucial gaps in available data to guide prevention programmes—surveillance and vital record registrations are inadequate in much of the world. What is most needed is not more advanced ways to estimate mortality, but the direct measurement of mortality. As measles is considered for eradication, it will be crucial to improve surveillance to the point that deaths and cases will actually be measured, not estimated.”

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Scaling Up Nutrition Movement Convenes 27 Global Leaders

UN Secretary-General Ban Ki-moon appointed a group of 27 global leaders that will carry forward the mission of the Scaling Up Nutrition (SUN) Movement. “Never before have so many leaders, from so many countries and fields, agreed to work together to improve nutrition,” said Secretary-General Ban Ki-moon. “The Scaling Up Nutrition Movement gives all of us, including the UN, an opportunity to support countries in their efforts to end hunger and malnutrition.”

 

The SUN movement aims to address the burden of under-nutrition and support the effort of the MDG to halve poverty and hunger by 2012. The group created a framework in 2010 on how to acheive the goal. The advised, “The worldwide pursuit of vital strategies to improve nutrition will need backing through a strong public information programme which focuses on the importance of (a) making the economic impact of under-nutrition visible (b) engaging decision makers as activists for attention to under-nutrition in the context of food security, health and social protection in order to tackle this negative economic impact, (c) encouraging public participation in a social movement that empowers households and communities for better nutrition.”

The appointment of SUN leaders helps to further the goal of encouraging international participation in the framework. “It is time to recognize nutritional status not only as a marker of progress in development, but also as a maker of progress – and a key to more sustainable development. We must invest now in programmes to prevent stunting or risk diminishing the impact of other investments in education, health and child protection,” said Anthony Lake, Executive Director of UNICEF, who has been appointed by Secretary-General Ban to chair the Lead Group.

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