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31. The Looming Global Obesity Threat

Author:
Roger Thurow
Publication Date:
10-2019
Content Type:
Special Report
Institution:
Chicago Council on Global Affairs
Abstract:
This paper seeks to raise awareness of the growing global obesity epidemic and the need to address the economic, security, and humanitarian threats it poses for the United States and the world. While the development community—including global agriculture, health, and security practitioners—has been focused on combatting undernutrition, the number of people who are obese or overweight has been on the rise and is now on par with the 2 billion who are food insecure. In western countries where the epidemic started, obesity is not just an enormous health and economic burden, but a national security threat. Seventy percent of 17-to 24-year-olds in America are reported to be unfit to serve in the military, with being overweight and obese as the leading disqualifier. An increasingly sedentary lifestyle and growing reliance on unhealthy processed food has spread to low and middle-income countries around the world. Many of these countries are experiencing a “double burden” of malnutrition, in which people who are overweight or have obesity coexist with those experiencing undernutrition, threatening the growth and vitality of their societies. So far, policy responses from national governments have been slow and inadequate. The costs of the epidemic have not yet been viewed as urgent enough to generate the public demand or political will to act. The view of obesity as a global “syndemic,” along with undernutrition and climate change, has the potential to help rally attention to the challenge. The paper calls for local, national, and global efforts to recognize obesity as the economic, moral, and security crisis that it is and to summon the political will to end the epidemic.
Topic:
Security, Health, Economy, and Non-Traditional Threats
Political Geography:
Global Focus

32. Understanding the Opportunity Cost, Seizing the Opportunity: Report of the Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines

Author:
The Working Group on Incorporating Economics and Modeling in Global Health Goals and Guidelines
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Internationally set goals and guidelines directly influ­ence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The influence of global priority setting, such as through the formu­lation of overarching goals or normative guidelines for specific disease areas, is particularly significant in low- and middle-income countries that rely heavily on overseas development assistance. Because no sys­tematic approach exists for dealing with resource con­straints, however, which vary across countries, goals and guidance are often inappropriate for some country contexts; their implementation can, therefore, reduce the efficiency and equity of health care spending. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines, co-convened by the Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium, has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice. The Working Group deliberated on the roles and purposes of goals and guidelines and consid­ered how economic evidence might be formally incor­porated into policy recommendations and health care decision making. The target audiences for this report are international health institutions, large stakehold­ers in disease programs across the world, and national governments.
Topic:
Development, Health, Health Care Policy, and Public Health
Political Geography:
Global Focus

33. Imagining the Alternative Worlds of 2030: Policy Implications for the Future of Global Health Procurement

Author:
Janeen Madam Keller and William Savedoff
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The availability and affordability of health products—medicines, diagnostics, devices, and equipment—are critical to achieving universal health coverage and improving health outcomes. Yet low- and middle-income countries face multiple challenges in procuring health products related to institutional inefficiencies, market failure, and fragmented demand. At the same time, the world is evolving rapidly in ways that will affect health procurement, from changes in countries’ eligibility for foreign assistance to advances in information technologies. Looking forward, efforts to improve global health procurement must proactively address the sweeping changes on the horizon. Drawing on a range of political, economic, and social trends, this paper envisions how the global landscape might change between now and 2030, with a focus on the implications for global health, particularly the procurement of health products. The paper develops three possible but distinct futures—worlds characterized as atomistic, privately led, or multilateral.It concludes by describing the policy options and locus of action to improve global health procurement in light of these scenarios, emphasizing three areas of work: financing and modes of collaboration, procurement procedures and tools, and procurement capacity.
Topic:
Health, Health Care Policy, Public Health, and Health Crisis
Political Geography:
Global Focus

34. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Amanda Glassman, Kalipso Chalkidou, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive.
Topic:
Health, Public Health, Pandemic, Procurement, and Medicine
Political Geography:
Global Focus

35. Vaccine Introduction and Coverage in Gavi-Supported Countries 2015-2018: Implications for Gavi 5.0

Author:
Roxanne Oroxom and Amanda Glassman
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles.[1] The strategy also called for broadening protection through improved routine coverage and the introduction of new vaccines.[2]
Topic:
Health, Children, Public Health, and Vaccine
Political Geography:
Global Focus

36. Global Immunization and Gavi: Five Priorities for the Next Five Years

Author:
Amanda Glassman, Cordelia Kenney, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Child vaccination remains among the most cost-effective uses of public and aid monies.[1] In a highly contested funding environment where priorities must be set for the allocation of scarce concessional resources, investment in expanding the availability and coverage of cost-effective vaccination must come at the top of the list. Gavi’s mission—saving children’s lives and protecting people’s health by increasing equitable use of vaccines—remains highly relevant. Gavi and its partners have made enormous progress towards increasing equity in the introduction of vaccines; children living in the lowest-income countries now have access to the same set of vaccines as those living in high-income countries. Gavi and partners have also contributed to increased coverage; immunization rates are higher in Burundi and Rwanda, for example, than in many places in the United States and Europe. Yet the effects of under-immunization anywhere can have global implications everywhere, as recent outbreaks illustrate. New or dormant threats are also a new reality—newly vaccine-preventable diseases like Ebola or virulent flu strains can spread swiftly and lethally in an interconnected world.
Topic:
Health, Public Health, Vaccine, and Immunization
Political Geography:
Global Focus

37. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Janeen Madan Keller, Amanda Glassman, and Kalipso Chalkidou
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive. Access to medicines, diagnostics, devices, and equipment is driven in large part by the efficiency of their procurement. Procurement is, therefore, central to the efforts of low- and middle-income countries to improve health, meet the Sustainable Development Goals, and achieve universal health coverage. Health product purchasing in low- and lower-middle-income countries already makes up a sizeable share of overall health spending; in fact, in just a subset of these countries, spending on health products totals an estimated $50 billion per year.[1] Procurement is not only essential to the missions of global health entities like the Global Fund, Gavi, UNICEF, UNFPA, and PEPFAR, but it also represents big money. In the case of the Global Fund, health product procurement accounts for $2 billion per year,[2] or almost half of its 2017 disbursements.[3] Yet despite its importance, procurement is an underappreciated health system function. Today’s procurement systems are hobbled by inefficiencies that leave some of the poorest countries paying some of the highest drug prices in the world.
Topic:
Health, Public Health, Transition, and Procurement
Political Geography:
Global Focus

38. Classification of Psychoactive Substances: When Science Was Left Behind

Author:
Global Commission On Drug Policy
Publication Date:
01-2019
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
In Classification of Drugs: when science was left behind, the Global Commission on Drug Policy explains how the biased historical classification of psychoactive substances has contributed to the "world drug problem". It is the first-ever comprehensive report providing a political reading of the current evaluation and classification, or "scheduling" of drugs according to their harms. Psychoactive substances should be classified with regard to their potential for dependence and other harms. This is not the case today, where some substances are legally available because they are considered beneficial (medicines) or culturally important (alcohol), while others are seen as destructive, and are strictly prohibited. The classification of drugs is at the core of the international drug control system. As such, governments must ensure that such a classification is pragmatic and based on science and evidence, makes clear the benefits and harms of drugs, and allows for responsible legal regulatory models to control drugs.
Topic:
Health, War on Drugs, Drugs, Alcohol, Public Health, and Medicine
Political Geography:
Global Focus

39. Safeguarding Medical Care and Humanitarian Action in the UN Counterterrorism Framework

Author:
Alice Debarre
Publication Date:
09-2018
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
In the past decade, counterterrorism measures have had an increasingly adverse impact on the provision of medical care and the conduct of principled humanitarian action in armed conflict settings. Whether inadvertently or not, they have impeded, and at times prevented, the provision of essential and lifesaving aid, often in violation of international humanitarian law (IHL). This paper aims to assist the Security Council, relevant UN organs, UN member states, and other stakeholders in upholding their obligations under IHL. It maps the UN counterterrorism framework and looks into the extent to which it guides states in complying with these obligations. In doing so, it offers several recommendations for the way forward: All UN resolutions and other UN and national policies that pertain to counterterrorism should contain an exemption for humanitarian activities. Every relevant UN counterterrorism measure should continue to reiterate that counterterrorism efforts need to comply with international law. Humanitarian actors should engage with UN counterterrorism structures more actively, strategically, and systematically. UN bodies that engage in counterterrorism should systematically include humanitarian actors in relevant conversations. The UN Counter-Terrorism Committee’s Executive Directorate and Office of Counter-Terrorism should better integrate IHL considerations into their work. Member states, UN entities, humanitarian actors, counterterrorism and sanctions experts, and other stakeholders should step up efforts to start a wide political discussion on tensions between counterterrorism and humanitarian action.
Topic:
Health, Humanitarian Aid, United Nations, Violent Extremism, and Counter-terrorism
Political Geography:
Global Focus

40. Hard to Reach: Providing Healthcare in Armed Conflict

Author:
Alice Debarre
Publication Date:
12-2018
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
Armed conflict is a global health issue. Long-lasting and protracted conflicts in particular have consequences not only for the war-wounded but also for the health of entire communities. Over the years, global health actors and humanitarian health actors have developed health policies, guidelines, frameworks, and structures to improve delivery of health services in emergencies or humanitarian crises. Despite these advancements, however, the international health response in conflict-affected settings still faces gaps and challenges. Some policies and frameworks need to be rethought or redesigned, while others need to be better implemented. This paper explores challenges to healthcare provision in conflict-affected settings. These challenges are broadly broken down into three categories: constraints related to the health system and damaged health infrastructure, difficulty for health workers to access populations in need, and restrictions to healthcare provision intentionally or accidentally placed by donors or states engaged on humanitarian and health issues (e.g., through the securitization of healthcare). Tackling these challenges will have a direct impact on the lives of people in conflict-affected settings. However, doing so requires a radical shift in mindsets and the incentives that guide the actions of international health actors. Even so, more incremental changes can also be beneficial. To that end, this report puts forth the following recommendations: Improve coordination between and among humanitarian, development, and global health actors; Respond to context-specific needs; Hold health actors accountable to affected populations for their performance, and; Make responses sustainable. This work is based on a combination of desk research, interviews with more than seventy key informants, and an expert meeting bringing together key stakeholders and experts on global and humanitarian health.
Topic:
Health, Humanitarian Aid, and Conflict
Political Geography:
Global Focus