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91. 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

92. 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

93. 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

94. 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

95. 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

96. Brain Drain in Africa: The Case of Tackling Capacity Issues in Malawi's Medical Migration

Publication Date:
07-2018
Content Type:
Research Paper
Institution:
The African Capacity Building Foundation (ACBF)
Abstract:
In this strategic paper, the African Capacity Building Foundation shows how African countries can tackle the brain drain by understanding the emigration of medical personnel from Malawi, which in ways mirrors the wider African experience but is also unique. Like much of Sub-Saharan Africa, Malawi has poor health indicators, reflecting its low capacity to deliver quality health care. This situation is due in part to the limited capacity for training physicians and in part to the massive emigration of health workers, especially in the 1990s and early 2000s. The paper's objectives are threefold. First is to understand the state and extent of the brain drain challenge in Africa with an appropriate country case study. Second is to map the strategies, approaches and initiatives countries undertake to address brain drain issues. Third is to identify lessons and good practices in addressing the key capacity needs, specifically defining the roles of state and non-state actors.
Topic:
Health, Migration, Brain Drain, Capacity, and Public Health
Political Geography:
Africa and Malawi

97. The Brazilian model of Investment Agreements and Socio-environmental Safeguards

Author:
Maria Elena Rodriguez and Gabriel de Barros Torres
Publication Date:
03-2018
Content Type:
Policy Brief
Institution:
BRICS Policy Center
Abstract:
With the purpose of contributing to expanding transnational investment flows, Brazil signed, in 2015, a series of Cooperation and Investment Facilitation Agreements (CIFAs) with African and Latin American countries. Among its provisions, the CIFAs feature distinctive characteristics in terms of direct (and indirect) expropriation, corporate social responsibility, dispute settlement mechanisms and national treatment clauses – ultimately, aiming to provide greater legal certainty for investors. However, civil society organizations have warned against the potential impact of this new model of investment agreements on the autonomy of states to establish regulations in the public interest. As such, this Quarterly Brief seeks to analyze similarities and differences between the new Brazilian CIFAs and traditional bilateral investment agreements – as well as to evaluate them in light of alternative frameworks, elaborated by civil society networks, aimed at balancing investment promotion with human and environmental rights protection.
Topic:
Civil Society, Environment, Treaties and Agreements, Regulation, Social Justice, Land Rights, and Public Health
Political Geography:
Brazil and Latin America

98. ACKNOWLEDGING THE FLEXIBILITIES OF THE TRIPS AGREEMENT: ENSURING THE RIGHT TO ACCESS TO MEDICINES OR A STRATEGY OF PASSIVE REVOLUTION?

Author:
Sevgi BALKAN-ŞAHİN
Publication Date:
10-2018
Content Type:
Journal Article
Journal:
Alternative Politics
Institution:
Department of International Relations, Abant Izzet Baysal University, Turkey
Abstract:
The Doha Ministerial Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health adopted in November 2001 clarified the right to use the TRIPS flexibilities to promote public health. Examining the hegemonic struggle of opposing social forces from a neo-Gramscian perspective, the paper attributes this outcome to the strategy of trasformismo used by market-oriented social forces to legitimize the policies of the World Trade Organization (WTO) and prevent resistance against the market-driven TRIPS Agreement. It argues that although non-governmental organizations (NGOs) such as Medecins Sans Frontieres, Third World Network, and Oxfam worked as a counter-hegemonic force to ensure the access of least developed countries to generic versions of patented drugs, flexibilities confirmed by the Doha Declaration can be seen more as a strategy of trasformismo to absorb counter-hegemonic ideas than the counter-hegemonic groups’ successful incorporation of the right to ensure public health into the TRIPS Agreement.
Topic:
Health, World Trade Organization, Hegemony, Health Care Policy, NGOs, and Public Health
Political Geography:
United States, Europe, Asia, and North America

99. New Psychoactive Substances: Challenges for Law Enforcement Agencies and the Law

Author:
Kalliroi Ziavrou
Publication Date:
06-2018
Content Type:
Working Paper
Institution:
George C. Marshall European Center for Security Studies
Abstract:
New psychoactive substances (NPS) present a new global phenomenon in the drug market. This phenomenon is characterized by the emergence of a significant number of new substances every year that are not controlled under international drug control conventions, which means that their trafficking is legal. These substances are designed to mimic traditional illicit drugs and may cause severe adverse health effects.Over the last few years, the unprecedented rate of NPS proliferation has resulted in significant risk to public health; the numbers of people who become sick or addicted as well as the number of fatalities are consistently growing at an alarming pace. With the aid of the internet, new psychoactive substances are spreading at such a rapid rate that law enforcement agencies cannot respond quickly enough when it comes to identifying and regulating these substances. This paper will address the NPS phenomenon, presenting why the issue is generating increased interest worldwide and how it has provoked new challenges for law enforcement agencies (LEA) and policymakers. Beginning with a presentation of the current NPS crisis, this paper will demonstrate how illicit networks have managed to flood the drug market with NPS and examine the emerging issues for the involved communities and countries, legislative and judicial communities, and populations worldwide. Finally, it will discuss current governmental responses and containment measures and offer suggestions on how to counter the challenge using a holistic approach.
Topic:
Law Enforcement, Internet, Drugs, and Public Health
Political Geography:
Global Focus

100. Australia’s Gun Laws Can’t Work in America – For Now

Author:
Philip Alpers
Publication Date:
03-2018
Content Type:
Special Report
Institution:
Georgetown Journal of International Affairs
Abstract:
Thirteen mass shootings in 18 years, 112 victims shot dead. While this may seem to describe contemporary America, it actually describes a late 20th-century period in Australia. The country’s final slaughter occurred in Tasmania in 1996 – the Port Arthur massacre. A lone, “pathetic social misfit” – as described by the judge – killed 35 people. The first 29 bullets from this young man’s AR-15 rifle ended the lives of 20 innocents in just 90 seconds.
Topic:
Government, Weapons, Legislation, Public Health, and Mass Shootings
Political Geography:
Australia, Australia/Pacific, North America, and United States of America