Africa’s Progress Against Maternal and Infant Mortality Has ‘Flatlined’ 01/12/2022 Kerry Cullinan Millions of African women don’t have access to skilled birth attendants. In the past decade, Africa’s progress against maternal and infant mortality has flatlined, and it will need to reduce maternal deaths by a massive 86%, and more than halve the deaths of babies to reach global targets by 2030. This is according to the Atlas of African Health Statistics 2022 released by the World Health Organization’s (WHO) Africa region on Thursday. The atlas assessed the nine targets related to the Sustainable Development Goal (SDG) on health, and estimates that 390 women will die in childbirth for every 100 000 live births by 2030 in sub-Saharan Africa, based on the current rate of progress. This is over five times higher than the 2030 SDG target of fewer than 70 maternal deaths per 100 000 live births, and exponentially higher than the average of 13 deaths per 100 000 live births witnessed in Europe in 2017. The region’s infant mortality rate is 72 per 1000 live births, with a slow annual decline of 3.1%. At this rate, there will be 54 deaths per 1000 live births by 2030, more than double the target of fewer than 25 per 1000. WHO Africa official Dr Humphrey Karamagi described the slowdown in progress as “drastic”, with the likelihood of Africa reaching global targets being unlikely. A slowdown in the progress made during the past decade against maternal & infant mortality is projected in the #African 🌍 Region, a new WHO report released today finds ➡️ https://t.co/6W7eTEaANk pic.twitter.com/nOomg9jhRP — WHO African Region (@WHOAFRO) December 1, 2022 Incomplete abortions The main cause of maternal death is haemorrhaging, followed by sepsis, said Dr Benjamin Tsofa, Principal Research Officer at Kenya Medical Research Institute (KEMRI), who also addressed the briefing. Some of this bleeding was caused by “incomplete abortions” – abortion is illegal in most African countries – but Karamagi said that it was impossible to calculate what percentage this was. “There are different policies in different countries around safe abortion, and the pattern will differ really on a country-by-country basis,” said Karamagi. “What we do know is that the major cause of maternal deaths at present is bleeding, particularly during labour, [whether] it’s due to unsafe abortion or it’s due to lack of appropriate care and so on. I think it’s important that we unpack what is driving that in the different countries and address it.” Karamagi added that millions of women in the region did not have access to antenatal care – access ranged from 30-90% across countries – despite the evidence that it plays a major role in reducing maternal and neonatal mortality. Pandemic’s effect However, between 2000 and 2010, Africa made progress on a number of health issues: under-5 mortality fell by 35%, neonatal death rates dropped by 21%, and maternal mortality declined by 28%. Since then, however, “advances in all three targets have flatlined” – and more recently, the COVID-19 pandemic has undermined progress. “Crucial health services such as postnatal care for women and newborns, neonatal intensive care units, and antenatal care services, immunisation services were disrupted during the pandemic,” notes the report. “Since 2021, Africa has also faced a resurgence in vaccine-preventable disease outbreaks. Measles cases rose by 400% between January and March 2022 compared with the same period the year before.” Dr Matshidiso Moeti, WHO Regional Director for Africa., warned: “It is crucial that governments make a radical course correction, surmount the challenges and speed up the pace towards the health goals. These goals aren’t mere milestones, but the very foundations of healthier life and well-being for millions of people.” Image Credits: Elizabeth Poll/MMV. Air Pollution Linked to Nearly Half of all Stillbirths 01/12/2022 Stefan Anderson The new study is the latest addition to an ever-growing mountain of evidence documenting the negative effects of air pollutants on human health. In 2020, UNICEF estimated that “a stillbirth occurs every 16 seconds somewhere in the world.” A new study has linked air pollution to nearly half of them. The study of 137 countries is the first global analysis to assess the number of fetal deaths, putting into numbers the already documented link between fine particulate matter (PM2.5) concentrations and stillbirths. PM2.5 is primarily produced through the burning of fossil fuels. The United Nations estimates around two million stillbirths occur every year, and describes the global burden of stillbirths as a ‘neglected tragedy’. Some 98% of stillbirths are estimated to occur in low- and middle-income countries across Asia, Africa, and Latin America. Progress in combatting the crisis has stalled, and stillbirths continue to receive little attention on the global health agenda. Despite their impacts on millions around the world, stillbirths are not included in the Millennium Development Goals targets. “Current efforts to prevent stillbirth focus on medical service improvements but compared to clinical risk factors, environmental ones are usually unseen.” Dr Tao Xue, the first author of the study, told the Guardian. “Clean air policies, which have been enacted in some countries, such as China, can prevent stillbirths. In addition, personal protections against air pollution, i.e. wearing masks, installing air purifiers, and avoiding going outside when air pollution occurs could also protect vulnerable pregnant women.” A neglected tragedy The United Nations estimates 98% of all stillbirths occur in low-and middle-income countries. The study estimates cutting air pollution to the World Health Organization’s recommended limits could prevent 710,000 stillbirths a year, but the exact mechanisms behind how air pollution causes stillbirths are still unclear. The researchers found PM2.5 particles could be passing from the mother to the foetus through the placenta, which may not only harm the placenta but also potentially cause “irreversible embryonic damage.” A 2018 study found toxic pollutant particles in the lungs, livers and brains of foetuses. Further, PM2.5 exposure during pregnancy could also reduce oxygen transfer to the foetus or cause placental abnormalities – all possible causes of stillbirths. The study also stressed that the impacts of stillbirths stretch far beyond the strictly medical. Stillbirths have well-documented links to psychological conditions like anxiety, grief, and post-traumatic stress disorders, and the economic burdens resulting from healthcare costs and the inability to work affect individuals and their families – often driving sex inequalities as a consequence. Air pollution is a global epidemic Mounting scientific evidence on the adverse health effects of air pollution shows cutting PM2.5 concentrations would save the lives of millions. This latest study adds to a mounting pile of evidence on the harms of air pollution. It kills nearly seven million people every year, penetrates the brain and lungs of fetuses, is correlated with adverse birth outcomes like miscarriages, pre-mature birth and low birthweight, and is linked to adverse brain development in young children. In 2021, the World Health Organization slashed its limit on air pollution concentration in half, urging nations to tackle polluted air to save millions of lives. WHO estimates 99% of the global population now breathes air beyond its recommended limit. Earlier this year, the Lancet found air pollution is the world’s largest environmental risk factor for disease and premature death. While the exact number of stillbirths that could be prevented through meaningful reductions in air pollution is unknown, the study is the latest of a long series of scientific footnotes showing that slashing PM2.5 concentrations would improve the health of millions around the world – and the most vulnerable populations most of all. Alzheimer’s Drug is Hailed Amid Safety Concerns 01/12/2022 Kerry Cullinan Alzheimer’s disease is the most common type of dementia found in elderly people. A candidate drug for people with early Alzheimer’s disease slowed cognitive decline by about 27% over 18 months, according to a report on a phase 3 trial published in the New England Journal of Medicine on Tuesday. Lecanemab is a monoclonal antibody that is given as an intravenous infusion every two weeks, and targets a sticky protein, beta-amyloid, that clogs up the neural passageways of the brains of people with Alzheimer’s. A total of 1795 participants were enrolled in the phase 3 trial, with 898 receiving lecanemab and 897 receiving a placebo. “Lecanemab reduced markers of amyloid in early Alzheimer’s disease and resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events,” according to the report. “Longer trials are warranted to determine the efficacy and safety of lecanemab in early Alzheimer’s disease.” The adverse events reported are “infusion-related reactions in 26.4% of the participants” as well as “amyloid-related imaging abnormalities with edema or effusions in 12.6%”. However, there were also some potentially serious side effects, with Science reporting that there have been two deaths possibly associated with the trial. A 65-year-old woman who was part of the trial died after a brain haemorrhage. She had amyloid deposits surrounding many of her brain’s blood vessels, this “likely contributed to her brain hemorrhage after biweekly infusions of lecanemab inflamed and weakened the blood vessels”, according to Science. Her death follows a report that an 80-year-old man who was part of the trial died from bleeding on the brain. Last year, the US Food and Drug Administration approved another Alzheimer’s drug also based on monoclonal antibodies called Aduhelm, although it has significant safety risks. Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people worldwide, according to the World. Some 60% of dementia cases are caused by Alzheimer’s disease. In May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017-2025. Image Credits: Photo by Steven HWG on Unsplash. South Korea Becomes First Country to Achieve Highest Level in WHO’s Medicine And Vaccine Regulatory Assessment 01/12/2022 Megha Kaveri South Korea becomes an ML4-designated country for medicines and vaccines regulations. South Korea became the first country in the world to achieve the highest level, “maturity level 4” (ML4), in regulating medicines and vaccines. The Ministry of Food and Drug Safety (MFDS) in the Republic of Korea is the only national regulatory authority to be recognised by the World Health Organization (WHO) to have advanced oversight on locally produced and imported medicines and vaccines. The WHO had assessed 33 countries in total, of which only South Korea earned the highest accolade. WHO’s benchmarking on regulatory authorities offer a reference point on drug and vaccine regulation to countries that do not have the internal capacity to do so. Currently, only around 30% of the regulatory authorities across the world have the capacity to ensure that the medical products (drugs and vaccines) they produce meet the required standards, work as intended and do not cause harm in patients, the WHO said. Congratulations to Ministry of Food and Drug Safety @TheMFDS, Republic of Korea🇰🇷, to have achieved maturity level 4, the highest level in WHO’s classification of regulatory authorities for medical products https://t.co/DZojajQ04K pic.twitter.com/GSOphz770Q — World Health Organization (WHO) (@WHO) November 29, 2022 “We highly appreciate the support already provided by the Republic of Korea to several other countries in strengthening their oversight of vaccines and medicines. Its role during the COVID-19 pandemic in supplying countries with quality assured vaccines and in vitro diagnostics has been well recognized,” Dr Zsuzsanna Jakab, WHO’s Deputy Director-General and Officer-in-Charge of the Western Pacific Regional Office said. The Republic of Korea’s regulatory authority was assessed by the WHO in 2022 and the MFDS worked closely with the agency in implementing the recommendations made by an international body of experts. The WHO’s assessment is based on the “global benchmarking tool”, a unified evaluation tool launched in 2019, which examines regulatory systems on their framework and functions. It designates the level of regulatory oversight in countries on a scale of one to four. Level 1 indicates the presence of some regulatory elements whereas level 4 indicates that the regulatory system is operating at an advanced level, with continuous improvements. Global Benchmarking Tool – WHO Apart from South Korea, Singapore is also designated at ML4 level for regulation of medicines. Ten other countries are at the ML3 level on WHO’s list. Countries at ML3 and ML4 levels are eligible to become a WHO listed authority, by which they can be considered a reference point by other countries’ regulators to decide on approving medical products. Image Credits: Photo by Muhammad Syafi Al – adam on Unsplash, World Health Organization. Samuel Kumwanje, Advocating for NCD Patients in Malawi 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Samuel Kumwanje When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived. “This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance. NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty. NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs. Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause. “A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.” As a result, Samuel’s symptoms worsened. “Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.” For years, the man continued to be misdiagnosed and prescribed the wrong treatments. “Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.” Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue. At that point Samuel and other patients decided to take action. “We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.” While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people. “It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.” Read Samuel Kumwanje full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Air Pollution Linked to Nearly Half of all Stillbirths 01/12/2022 Stefan Anderson The new study is the latest addition to an ever-growing mountain of evidence documenting the negative effects of air pollutants on human health. In 2020, UNICEF estimated that “a stillbirth occurs every 16 seconds somewhere in the world.” A new study has linked air pollution to nearly half of them. The study of 137 countries is the first global analysis to assess the number of fetal deaths, putting into numbers the already documented link between fine particulate matter (PM2.5) concentrations and stillbirths. PM2.5 is primarily produced through the burning of fossil fuels. The United Nations estimates around two million stillbirths occur every year, and describes the global burden of stillbirths as a ‘neglected tragedy’. Some 98% of stillbirths are estimated to occur in low- and middle-income countries across Asia, Africa, and Latin America. Progress in combatting the crisis has stalled, and stillbirths continue to receive little attention on the global health agenda. Despite their impacts on millions around the world, stillbirths are not included in the Millennium Development Goals targets. “Current efforts to prevent stillbirth focus on medical service improvements but compared to clinical risk factors, environmental ones are usually unseen.” Dr Tao Xue, the first author of the study, told the Guardian. “Clean air policies, which have been enacted in some countries, such as China, can prevent stillbirths. In addition, personal protections against air pollution, i.e. wearing masks, installing air purifiers, and avoiding going outside when air pollution occurs could also protect vulnerable pregnant women.” A neglected tragedy The United Nations estimates 98% of all stillbirths occur in low-and middle-income countries. The study estimates cutting air pollution to the World Health Organization’s recommended limits could prevent 710,000 stillbirths a year, but the exact mechanisms behind how air pollution causes stillbirths are still unclear. The researchers found PM2.5 particles could be passing from the mother to the foetus through the placenta, which may not only harm the placenta but also potentially cause “irreversible embryonic damage.” A 2018 study found toxic pollutant particles in the lungs, livers and brains of foetuses. Further, PM2.5 exposure during pregnancy could also reduce oxygen transfer to the foetus or cause placental abnormalities – all possible causes of stillbirths. The study also stressed that the impacts of stillbirths stretch far beyond the strictly medical. Stillbirths have well-documented links to psychological conditions like anxiety, grief, and post-traumatic stress disorders, and the economic burdens resulting from healthcare costs and the inability to work affect individuals and their families – often driving sex inequalities as a consequence. Air pollution is a global epidemic Mounting scientific evidence on the adverse health effects of air pollution shows cutting PM2.5 concentrations would save the lives of millions. This latest study adds to a mounting pile of evidence on the harms of air pollution. It kills nearly seven million people every year, penetrates the brain and lungs of fetuses, is correlated with adverse birth outcomes like miscarriages, pre-mature birth and low birthweight, and is linked to adverse brain development in young children. In 2021, the World Health Organization slashed its limit on air pollution concentration in half, urging nations to tackle polluted air to save millions of lives. WHO estimates 99% of the global population now breathes air beyond its recommended limit. Earlier this year, the Lancet found air pollution is the world’s largest environmental risk factor for disease and premature death. While the exact number of stillbirths that could be prevented through meaningful reductions in air pollution is unknown, the study is the latest of a long series of scientific footnotes showing that slashing PM2.5 concentrations would improve the health of millions around the world – and the most vulnerable populations most of all. Alzheimer’s Drug is Hailed Amid Safety Concerns 01/12/2022 Kerry Cullinan Alzheimer’s disease is the most common type of dementia found in elderly people. A candidate drug for people with early Alzheimer’s disease slowed cognitive decline by about 27% over 18 months, according to a report on a phase 3 trial published in the New England Journal of Medicine on Tuesday. Lecanemab is a monoclonal antibody that is given as an intravenous infusion every two weeks, and targets a sticky protein, beta-amyloid, that clogs up the neural passageways of the brains of people with Alzheimer’s. A total of 1795 participants were enrolled in the phase 3 trial, with 898 receiving lecanemab and 897 receiving a placebo. “Lecanemab reduced markers of amyloid in early Alzheimer’s disease and resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events,” according to the report. “Longer trials are warranted to determine the efficacy and safety of lecanemab in early Alzheimer’s disease.” The adverse events reported are “infusion-related reactions in 26.4% of the participants” as well as “amyloid-related imaging abnormalities with edema or effusions in 12.6%”. However, there were also some potentially serious side effects, with Science reporting that there have been two deaths possibly associated with the trial. A 65-year-old woman who was part of the trial died after a brain haemorrhage. She had amyloid deposits surrounding many of her brain’s blood vessels, this “likely contributed to her brain hemorrhage after biweekly infusions of lecanemab inflamed and weakened the blood vessels”, according to Science. Her death follows a report that an 80-year-old man who was part of the trial died from bleeding on the brain. Last year, the US Food and Drug Administration approved another Alzheimer’s drug also based on monoclonal antibodies called Aduhelm, although it has significant safety risks. Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people worldwide, according to the World. Some 60% of dementia cases are caused by Alzheimer’s disease. In May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017-2025. Image Credits: Photo by Steven HWG on Unsplash. South Korea Becomes First Country to Achieve Highest Level in WHO’s Medicine And Vaccine Regulatory Assessment 01/12/2022 Megha Kaveri South Korea becomes an ML4-designated country for medicines and vaccines regulations. South Korea became the first country in the world to achieve the highest level, “maturity level 4” (ML4), in regulating medicines and vaccines. The Ministry of Food and Drug Safety (MFDS) in the Republic of Korea is the only national regulatory authority to be recognised by the World Health Organization (WHO) to have advanced oversight on locally produced and imported medicines and vaccines. The WHO had assessed 33 countries in total, of which only South Korea earned the highest accolade. WHO’s benchmarking on regulatory authorities offer a reference point on drug and vaccine regulation to countries that do not have the internal capacity to do so. Currently, only around 30% of the regulatory authorities across the world have the capacity to ensure that the medical products (drugs and vaccines) they produce meet the required standards, work as intended and do not cause harm in patients, the WHO said. Congratulations to Ministry of Food and Drug Safety @TheMFDS, Republic of Korea🇰🇷, to have achieved maturity level 4, the highest level in WHO’s classification of regulatory authorities for medical products https://t.co/DZojajQ04K pic.twitter.com/GSOphz770Q — World Health Organization (WHO) (@WHO) November 29, 2022 “We highly appreciate the support already provided by the Republic of Korea to several other countries in strengthening their oversight of vaccines and medicines. Its role during the COVID-19 pandemic in supplying countries with quality assured vaccines and in vitro diagnostics has been well recognized,” Dr Zsuzsanna Jakab, WHO’s Deputy Director-General and Officer-in-Charge of the Western Pacific Regional Office said. The Republic of Korea’s regulatory authority was assessed by the WHO in 2022 and the MFDS worked closely with the agency in implementing the recommendations made by an international body of experts. The WHO’s assessment is based on the “global benchmarking tool”, a unified evaluation tool launched in 2019, which examines regulatory systems on their framework and functions. It designates the level of regulatory oversight in countries on a scale of one to four. Level 1 indicates the presence of some regulatory elements whereas level 4 indicates that the regulatory system is operating at an advanced level, with continuous improvements. Global Benchmarking Tool – WHO Apart from South Korea, Singapore is also designated at ML4 level for regulation of medicines. Ten other countries are at the ML3 level on WHO’s list. Countries at ML3 and ML4 levels are eligible to become a WHO listed authority, by which they can be considered a reference point by other countries’ regulators to decide on approving medical products. Image Credits: Photo by Muhammad Syafi Al – adam on Unsplash, World Health Organization. Samuel Kumwanje, Advocating for NCD Patients in Malawi 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Samuel Kumwanje When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived. “This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance. NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty. NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs. Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause. “A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.” As a result, Samuel’s symptoms worsened. “Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.” For years, the man continued to be misdiagnosed and prescribed the wrong treatments. “Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.” Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue. At that point Samuel and other patients decided to take action. “We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.” While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people. “It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.” Read Samuel Kumwanje full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Alzheimer’s Drug is Hailed Amid Safety Concerns 01/12/2022 Kerry Cullinan Alzheimer’s disease is the most common type of dementia found in elderly people. A candidate drug for people with early Alzheimer’s disease slowed cognitive decline by about 27% over 18 months, according to a report on a phase 3 trial published in the New England Journal of Medicine on Tuesday. Lecanemab is a monoclonal antibody that is given as an intravenous infusion every two weeks, and targets a sticky protein, beta-amyloid, that clogs up the neural passageways of the brains of people with Alzheimer’s. A total of 1795 participants were enrolled in the phase 3 trial, with 898 receiving lecanemab and 897 receiving a placebo. “Lecanemab reduced markers of amyloid in early Alzheimer’s disease and resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events,” according to the report. “Longer trials are warranted to determine the efficacy and safety of lecanemab in early Alzheimer’s disease.” The adverse events reported are “infusion-related reactions in 26.4% of the participants” as well as “amyloid-related imaging abnormalities with edema or effusions in 12.6%”. However, there were also some potentially serious side effects, with Science reporting that there have been two deaths possibly associated with the trial. A 65-year-old woman who was part of the trial died after a brain haemorrhage. She had amyloid deposits surrounding many of her brain’s blood vessels, this “likely contributed to her brain hemorrhage after biweekly infusions of lecanemab inflamed and weakened the blood vessels”, according to Science. Her death follows a report that an 80-year-old man who was part of the trial died from bleeding on the brain. Last year, the US Food and Drug Administration approved another Alzheimer’s drug also based on monoclonal antibodies called Aduhelm, although it has significant safety risks. Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people worldwide, according to the World. Some 60% of dementia cases are caused by Alzheimer’s disease. In May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017-2025. Image Credits: Photo by Steven HWG on Unsplash. South Korea Becomes First Country to Achieve Highest Level in WHO’s Medicine And Vaccine Regulatory Assessment 01/12/2022 Megha Kaveri South Korea becomes an ML4-designated country for medicines and vaccines regulations. South Korea became the first country in the world to achieve the highest level, “maturity level 4” (ML4), in regulating medicines and vaccines. The Ministry of Food and Drug Safety (MFDS) in the Republic of Korea is the only national regulatory authority to be recognised by the World Health Organization (WHO) to have advanced oversight on locally produced and imported medicines and vaccines. The WHO had assessed 33 countries in total, of which only South Korea earned the highest accolade. WHO’s benchmarking on regulatory authorities offer a reference point on drug and vaccine regulation to countries that do not have the internal capacity to do so. Currently, only around 30% of the regulatory authorities across the world have the capacity to ensure that the medical products (drugs and vaccines) they produce meet the required standards, work as intended and do not cause harm in patients, the WHO said. Congratulations to Ministry of Food and Drug Safety @TheMFDS, Republic of Korea🇰🇷, to have achieved maturity level 4, the highest level in WHO’s classification of regulatory authorities for medical products https://t.co/DZojajQ04K pic.twitter.com/GSOphz770Q — World Health Organization (WHO) (@WHO) November 29, 2022 “We highly appreciate the support already provided by the Republic of Korea to several other countries in strengthening their oversight of vaccines and medicines. Its role during the COVID-19 pandemic in supplying countries with quality assured vaccines and in vitro diagnostics has been well recognized,” Dr Zsuzsanna Jakab, WHO’s Deputy Director-General and Officer-in-Charge of the Western Pacific Regional Office said. The Republic of Korea’s regulatory authority was assessed by the WHO in 2022 and the MFDS worked closely with the agency in implementing the recommendations made by an international body of experts. The WHO’s assessment is based on the “global benchmarking tool”, a unified evaluation tool launched in 2019, which examines regulatory systems on their framework and functions. It designates the level of regulatory oversight in countries on a scale of one to four. Level 1 indicates the presence of some regulatory elements whereas level 4 indicates that the regulatory system is operating at an advanced level, with continuous improvements. Global Benchmarking Tool – WHO Apart from South Korea, Singapore is also designated at ML4 level for regulation of medicines. Ten other countries are at the ML3 level on WHO’s list. Countries at ML3 and ML4 levels are eligible to become a WHO listed authority, by which they can be considered a reference point by other countries’ regulators to decide on approving medical products. Image Credits: Photo by Muhammad Syafi Al – adam on Unsplash, World Health Organization. Samuel Kumwanje, Advocating for NCD Patients in Malawi 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Samuel Kumwanje When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived. “This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance. NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty. NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs. Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause. “A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.” As a result, Samuel’s symptoms worsened. “Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.” For years, the man continued to be misdiagnosed and prescribed the wrong treatments. “Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.” Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue. At that point Samuel and other patients decided to take action. “We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.” While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people. “It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.” Read Samuel Kumwanje full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
South Korea Becomes First Country to Achieve Highest Level in WHO’s Medicine And Vaccine Regulatory Assessment 01/12/2022 Megha Kaveri South Korea becomes an ML4-designated country for medicines and vaccines regulations. South Korea became the first country in the world to achieve the highest level, “maturity level 4” (ML4), in regulating medicines and vaccines. The Ministry of Food and Drug Safety (MFDS) in the Republic of Korea is the only national regulatory authority to be recognised by the World Health Organization (WHO) to have advanced oversight on locally produced and imported medicines and vaccines. The WHO had assessed 33 countries in total, of which only South Korea earned the highest accolade. WHO’s benchmarking on regulatory authorities offer a reference point on drug and vaccine regulation to countries that do not have the internal capacity to do so. Currently, only around 30% of the regulatory authorities across the world have the capacity to ensure that the medical products (drugs and vaccines) they produce meet the required standards, work as intended and do not cause harm in patients, the WHO said. Congratulations to Ministry of Food and Drug Safety @TheMFDS, Republic of Korea🇰🇷, to have achieved maturity level 4, the highest level in WHO’s classification of regulatory authorities for medical products https://t.co/DZojajQ04K pic.twitter.com/GSOphz770Q — World Health Organization (WHO) (@WHO) November 29, 2022 “We highly appreciate the support already provided by the Republic of Korea to several other countries in strengthening their oversight of vaccines and medicines. Its role during the COVID-19 pandemic in supplying countries with quality assured vaccines and in vitro diagnostics has been well recognized,” Dr Zsuzsanna Jakab, WHO’s Deputy Director-General and Officer-in-Charge of the Western Pacific Regional Office said. The Republic of Korea’s regulatory authority was assessed by the WHO in 2022 and the MFDS worked closely with the agency in implementing the recommendations made by an international body of experts. The WHO’s assessment is based on the “global benchmarking tool”, a unified evaluation tool launched in 2019, which examines regulatory systems on their framework and functions. It designates the level of regulatory oversight in countries on a scale of one to four. Level 1 indicates the presence of some regulatory elements whereas level 4 indicates that the regulatory system is operating at an advanced level, with continuous improvements. Global Benchmarking Tool – WHO Apart from South Korea, Singapore is also designated at ML4 level for regulation of medicines. Ten other countries are at the ML3 level on WHO’s list. Countries at ML3 and ML4 levels are eligible to become a WHO listed authority, by which they can be considered a reference point by other countries’ regulators to decide on approving medical products. Image Credits: Photo by Muhammad Syafi Al – adam on Unsplash, World Health Organization. Samuel Kumwanje, Advocating for NCD Patients in Malawi 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Samuel Kumwanje When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived. “This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance. NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty. NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs. Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause. “A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.” As a result, Samuel’s symptoms worsened. “Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.” For years, the man continued to be misdiagnosed and prescribed the wrong treatments. “Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.” Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue. At that point Samuel and other patients decided to take action. “We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.” While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people. “It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.” Read Samuel Kumwanje full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Samuel Kumwanje, Advocating for NCD Patients in Malawi 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Samuel Kumwanje When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived. “This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance. NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty. NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs. Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause. “A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.” As a result, Samuel’s symptoms worsened. “Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.” For years, the man continued to be misdiagnosed and prescribed the wrong treatments. “Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.” Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue. At that point Samuel and other patients decided to take action. “We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.” While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people. “It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.” Read Samuel Kumwanje full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Betsy Rodriguez: Giving a Voice to those Who Live with Chronic Conditions 01/12/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Dr. Hedwig Borges as he goes through his journey with cutaneous T-cell lymphoma. For many years, Betsy Rodriguez was terrified that she could lose her daughter Carmen to hypoglycemia at any moment. As a girl, Carmen was diagnosed as having type 1 diabetes. “I cannot count the hours I’ve spent dealing with insurance companies and third-party vendor pharmacies for my daughter to receive a life-saving continuous glucose monitor and an insulin pump,” Betsy writes in the NCD Diaries project, an initiative launched by the NCD Alliance. “Now that she has these, my fear of losing her to hypoglycemia has settled!” Diabetes is one of the most common forms of NCDs – short for noncommunicable diseases, which are diseases that are not transmissible from person to person. Continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII). NCDs are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability. They also include cancers, cardiovascular disease, stroke, chronic respiratory diseases, mental health and neurological conditions, amongst many others. The NCD Diaries are a participatory, community-based and multimedia storytelling project that illustrates and highlights individual lived experiences and calls for action on NCDs. Because of Carmen’s condition, Betsy had always been aware of the challenges of taking care of a person with a chronic disease. However, this did not prepare her for the moment her husband Hedwig, also known as Papa Bear, was diagnosed with cancer five years ago. “Hearing the word ‘cancer’ in a diagnosis is terrifying enough, but here’s another scary thought: the treatment method is likely to be dictated by your insurance coverage,” she wrote. “It was devastating to see the love of my life and husband of 46 years go through his journey with Cutaneous T-cell lymphoma – a rare cancer.” Hedwig and his whole family were heavily affected by the disease and the treatments he had to undergo. “His appearance, vitality and productivity altered, so I became the caregiver and only source of income,” Brenda says. “Catastrophic conditions like these demand high out-of-pocket payments. Sometimes, I feel like a deflated balloon!” For her, taking part in the NCD Diaries was very important. “I want to give a voice to those that live with chronic conditions that do not have a voice, especially those from marginalized communities living and experiencing health disparities and inequities,” Brenda emphasizes. “I want to help put a face to diabetes and other chronic conditions.” Read Betsy Rodriguez’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Brenda Chitindi: Struggling with Multiple NCDs in Zambia 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Brenda Chitindi When Brenda Chitindi was growing up, one of many children in a family in a rural village of Zambia, she had no idea that her father’s habit of smoking would have a negative effect on her health. “We lived in a three room, grass thatched house with our parents,” she recalls. “Our house had no ventilation, so smoke circulated all around the room. Each time he smoked, we, the children, would enjoy the smell and didn’t feel any signs of health complications.” However, when she was 45, Brenda, who is now 70 years old and a mother of five, was diagnosed with hypertension, rheumatoid arthritis and chest congestion. The woman shared her experience in the NCD Diaries project, an initiative launched by the NCD Alliance. “As I waited for my appointment, my condition worsened,” she explains in her testimony, as she describes how she had to wait for three months before the only specialist at the local hospital could see her. “I continued taking painkillers but experienced stiffness of my hands and fingers, weight loss, knee and feet pains, numbness on my left side, shortness of breath at night, weakness and dizziness.” NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular disease, stroke, chronic respiratory and kidney diseases, diabetes, mental health and neurological conditions – all conditions that are not transmissible from person to person. An estimated 80% of NCDs are preventable. They are driven by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, and air pollution. Brenda says that her hypertension medication – whose cost she had to cover out of pocket with the help of her children – left her with significant side effects, including fatigue. “This led me to develop obesity as I slept more and exercised less,” she writes. “Since developing obesity, my health provider advised me to adopt a special diet which I still follow, and to walk 2-3 km every morning.” Zambia has now introduced its National Health Insurance Management Authority, which covers the costs of Brenda’s treatments. Brenda has also benefited from the establishment of Zambia NCD Alliance. “I’ve acquired knowledge on risk factors of hypertension, obesity, arthritis and other NCDs, which has helped me to spread awareness to women on prevention measures relating to tobacco and alcohol use, and on the importance of physical exercise,” the woman remarks. Yet, there is still significant work to do to support NCD prevention and treatment in the African country. “My NCD care journey highlighted key challenges with health providers in Zambia, including long wait times, limited pain management expertise, and scarcity of resources and services,” Brenda points out in her diary. “There’s a need to improve NCD prevention, care and pain management, and equip people with the skills to self-manage their own treatment.” Read Brenda Chitindi’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Seema Bali: Coping With Disease And Debt While Raising A Family In India 30/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Seema Bali In March 2011, Seema Bali, a mother of two from India, was recovering from a hysterectomy. However, just as she went back to work, her husband Anand’s health suddenly deteriorated. In the following months, this crisis forced her to assume the role of caregiver, in addition to the ones of the family’s sole breadwinner and parent looking after her children. Bali shares her experience in the NCD Diaries project, an initiative launched by the NCD Alliance and people living with NCDs. NCDs (noncommunicable diseases) are the first cause of death and disability worldwide, accounting for 74% of all deaths. Among many others, they include cancers, cardiovascular diseases, stroke, chronic respiratory and kidney diseases, diabetes, and mental health and neurological conditions – all conditions that are not transmissible from person to person. In the case of Seema’s husband Anand, it was not immediately clear what was causing his problems. “He had lost some 17 kgs of weight in two months, he had come down from 87 to 70,” she writes. “He was experiencing loss of appetite and was generally very sleepy, sleeping for 22 hours a day.” When they met with a doctor, the physician thought that Anand was suffering from depression and put him on antidepressants. After two cycles of antidepressants led to no improvement, Seema insisted on a full checkup. The tests revealed that Anand’s kidneys had shrunken and were not functioning correctly. “My legs just turned into jelly, and I just sank into the sofa,” Seema recalls. “For that moment of time there was total blackout.” Because her husband had just relocated to India from Dubai, he did not have any health insurance which meant that they would need to cover the cost of treatment out of pocket. Seema knew there was nothing to do but face the situation. Anand got his fistula fixed and started dialysis as they were exploring options for a transplant. “When Anand had dialysis, I used to accompany him and take a day off from work,” Seema says. “On the days when he did not have dialysis, he used to be at home, and I used to go to work.” NCDs have a disproportionate impact on people living in low-and middle-income countries, and are both a cause and a consequence of poverty. The Bali family was no exception. Every session of dialysis for Anand would cost over 3,000 rupees, which amounted to 48,000 rupees in a month. “My salary was 50,000,” Seema remarks. “There was no help available. I did not know which door to knock on and I had to take all of our savings.” Life, she says, became “a rollercoaster ride for me because it was hospital, home, school, kids, shopping essentials, looking after the education of my kids, visit to the bank, take out money, go to the hospital. So it was like a vicious circle I was into.” As a result of the situation, Seema developed psoriasis and mental health issues herself. “It was devastating and heartbreaking, but I had full faith and trust in God,” she recalls. “And I was waiting to come out of this, thinking that maybe the transplant thing could happen.” Indeed, one day the hospital called the family to inform them that there was an available kidney for Anand. “I called my family and my husband’s family and quickly we got the act together, we deposited the money and he was admitted to the hospital because the doctor said that the procedure had to be done on the same day,” Seema recalls. The operation was successful. After ten days, Anand was discharged from the hospital. “I had converted our room into an intensive care unit,” she explains. “I had to be on my toes 24/7 and there were some hiccups. We tried to deal with it. Postoperative care is really crucial and critical.” However, while Anand was physically recuperating, he was also becoming mentally unstable, worried about his job, his future and the children. Seema struggled but continued to manage. “I feel like a machine that wakes up at a specific time and works by the clock,” she says. I cannot travel, I cannot attend functions. Social life is highly compromised and it affects my mental well-being really hard. Overall efficiency at home and performance at work also get badly affected.” “Nobody signs up for something like this,” she notes. “But when we actually face these kinds of situations, why is there no help?” Read Seema Bali’s full NCD Diary. Read previous post. Image Credits: NCD Alliance, Courtesy of NCD Alliance. EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
EU’s New Global Health Strategy Stresses Regional Collaboration, Seeks More Influence for Europe 30/11/2022 Kerry Cullinan European Commissioner Stella Kyriakides Stronger international rules and cooperation mechanisms on health are at the heart of the European Union’s new global health strategy, which was launched on Wednesday. The strategy is based on three priorities: ensuring that people stay well throughout their lives, strengthening health systems particularly by advancing universal health coverage, and applying a ‘One Health’ approach to preventing health threats. “This is a strategy which is rooted in equity. It’s rooted in solidarity, in human rights and in partnership. But what really fuels it is our determination to strengthen good global governance,” said European Commissioner Stella Kyriakides. Stressing that global health threats “know no borders”, Kyriakides called for “stronger international rules and cooperation mechanisms on health, including a legally binding pandemic agreement”. Better detection of threats, more equitable access to vaccines and treatments, and more robust global governance to guarantee results. Today we've adopted a new EU Global Health Strategy to improve global health security and deliver better health for all.#HealthUnion — European Commission (@EU_Commission) November 30, 2022 The strategy – the first in 12 years – also means that the EU is “stepping up its leadership on global health”, said Commissioner Jutta Urpilainen. Urpilainen said that the EU would “ramp up investments in health systems with innovative financial instruments”, including supporting the African Union to achieve its goal of producing 60% of the continent’s vaccines by 2040. “COVID-19 really highlighted the deep challenge in medical manufacturing capacities and other supply chains, bottlenecks. Africa, for example, still imports 99% of its vaccines and 94% of its medicines,” said Urpilainen. The EU wanted to fill any gaps in global health governance and financing through a “strong and responsive multilateral system” with the WHO at the core. More power for EU? However, the EU also indicates that it wants a more prominent seat at the decision-making table, based on its large investment in global health, and some sources have indicated that the EU might seek membership of the WHO itself. “The main message of this strategy is that the EU intends to reassert its responsibility and deepen its leadership in the interest of the highest attainable standards of health,” the strategy states. Pointing out that the EU and its member states contributed €53.7 billion to assist 140 countries during the COVID-19 pandemic, the strategy states that “the EU’s influence in shaping the agenda must match its financing support as a champion of global health”. Sandra Gallina, European Commission Director-General for Health and Food Safety. Sandra Gallina, European Commission Director-General for Health and Food Safety, also stressed the need for “an international rulebook” because, without it, there had been a “cacophony” and “very, very rapid degradation of relations” during COVID-19. “We want to have a pandemic treaty with antimicrobial resistance at the heart of it,” she stressed. UHC contribution A smiling World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, while commending the EU’s strategy for being aligned with that of the WHO, revealed that the EU had just contributed €125 million to the WHO to promote universal health coverage. “Each of these challenges transcends borders, sectors, languages, ethnicities and political divides. No single country or organization can deal with them in isolation. Which is why multilateralism is more important than ever”-@DrTedros pic.twitter.com/Ah7jpy2sFl — World Health Organization (WHO) (@WHO) November 30, 2022 “This new strategy comes at a critical time as our world faces so many threats to health from the continuing COVID 19 pandemic, to the silent pandemics of non-communicable diseases and antimicrobial resistance, conflicts around the world, rising inequality and the existential crisis of climate change,” said Tedros. “Each of these challenges transcends borders, sectors, language, ethnicities, and political divides. No single country or organisation can deal with them in isolation, which is why multilateralism is more important than ever. “ Dr Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance and WHO Special Envoy for the ACT Accelerator. Dr Ayoade Alakija, chair of the African Union (AU) Africa Vaccine Delivery Alliance and the WHO’s Special Envoy for the ACT Accelerator, said that the EU’s strategy was important to address the “geopolitical schism” and reassert a “global” response. Pointing to the fact that “global procurement didn’t work during the pandemic”, Alakija said that the influence of the global vaccine alliance, Gavi, was declining, and being replaced by other organisations like CEPI and FIND with ‘transformative leaders” that are cooperating with regions. EU leaders travelled to Nigeria to consult with the African Union before finalising the strategy, which will now be fine-tuned by member states. Lack of detail on climate change But Alan Dangour, the Wellcome Trust’s director of climate and health, was critical of the lack of “clearly defined deliverables” about how to address climate change. “So there are really, I’m afraid, substantial things that are potentially missing from this strategy, which is a much greater ability to plan for the future for something that we know is coming. This is physics. This is basic physics. And I would love there to be a substantially stronger agenda on climate change and the impact that climate change is having and will continue to have around the world.” The WHO’s head of health emergencies, Dr Mike Ryan, welcomed that the document stated what needed to be done “because we need to move our communities from doom to do”. However, Ryan stressed that “global solutions will not deliver what we need” in a health emergency. “Epidemics, pandemics, begin and end in communities. Global health security emerges when you have strong national and local systems responsive to the needs of their communities, well prepared, agile, mobile, scalable, and able to serve. “There are only two things we do in a public health crisis. We protect communities, and we provide safe, scalable, clinical treatment.” Ryan warned that, in terms of climate change, the world needs to prepare for “multiple intertwined amplifying events” rather than a single event. Meanwhile, Prof Peter Piot, the special advisor to the President of the European Commission, warned that Europe, in seeking to address its health workforce problems “should make sure that we are not making things worse for low and middle-income countries by recruiting staff from there. So we need to make sure that we honour international commitments at that level.” What are the promises? To address people’s well-being, the strategy undertakes to “prioritise addressing the economic, social and environmental root causes of health and disease – including poverty and discrimination, age, nutrition and healthy diets, social protection, education, care, water, sanitation and hygiene, occupational health – and other areas such as healthy ecosystems pollution or contact with chemicals and waste and threats to security of energy supply.” It also aims to put the needs of women, girls and young people at the forefront of responses, and te EU will “engage with partner countries to expand access to a basic package of health services covering prevention and care with particular focus on poor and marginalised populations through bilateral and regional programmes”. The EU also plans to make digital health a pillar of its approach, undertaking to “leverage the potential of health data worldwide in line with the principles of the planned European Health Data Space and foster the use of new technologies including artificial intelligence to boost their potential to improve diagnosis and treatments worldwide”. Way forward At this stage, the strategy is a draft that is not binding on member states. Radic Policar, the Czech deputy health minister, said that it will be presented to member states’ development ministers for further discussion. However, Sweden assumes the presidency of the EU from the Czech Republic in 2023 and it will need to champion the strategy with members, a challenge that Anders Nordstrom, Sweden’s Ambassador for Global Health seems ready to do. “During the Swedish EU Council presidency , starting on 1 January, member states will have the opportunity to address the strategy through council conclusions and we will do our utmost to support that process. And what will be important that is of course to see how we as, member states, together with EU institutions actually can support the implementation of this and also ensure that there is an effective monitoring and accountability,” said Nordstrom. WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
WHO’s Director General Announces Five New Appointments to WHO Senior Team 30/11/2022 Elaine Ruth Fletcher Dr Tedros Adhanom Ghebreyesus at an earlier event. WHO’s Director General Dr Tedros Adhanom Ghebreyesus has announced the “interim” appointment of five new senior leaders to replace outgoing members of his senior team, whose departure was announced internally just last week, Health Policy Watch has learned. The new appointments were also revealed in a second internal email sent by Tedros to WHO staff on Wednesday, and seen by Health Policy Watch. Strikingly all of the new appointees have been drawn from within WHO’s internal ranks – a significant departure from Tedros’ previous pattern of making high-profile appointments of professionals drawn largely from outside WHO’s direct ranks, when he first took office in 2017, and during the last major shakeup in 2019. In contrast, the five new appointees are longstanding WHO directors and known quantities. Notably, however, all of the appointees have been named as “interim” heads of WHO’s major divisions – leaving questions over whether Tedros still intends to eventually replace them with other, outside, candidates, or to merely test the performance of the acting leaders, more thoroughly, prior to deciding whether to make the appointments permanent. Additionally, no replacements were announced at all for three outgoing staff members. That may be a signal that Tedros was finally bending to pressures from donor states, including the United States, to cut unnecessary frills at WHO’s top echelons where the salary and pension benefits of one senior staff can effectively pay for two mid-level professionals. Critics had accused the DG of making excessive appointments of senior advisors and aids with vague and poorly defined jobs – outside of the organization’s key disease theme and activity areas. No public announcements by Tedros So far, however, Tedros has not made any public announcements about the staff changes – only communicated through internal staff emails. Outside speculation was that he might wait until January’s WHO’s Executive Board meeting to communicate his long term intentions more fully. “At the end of November, several senior leadership team members will depart the Organization, and once again, I reiterate my thanks for their contribution to WHO.” “I have asked several colleagues to serve, in ad interim, as heads of divisions while keeping their portfolios. I have also requested Dr Zsuzsanna Jakab to delay her retirement date and continue as DDG [deputy director general] and OIC WPRO for some more time,” Tedros said in the mail. Jakab, born in 1951, is now 71 years old. The key new appointments include: The key new appointments confirm reports earlier this week of pending staff changes. They include: Dr John Reeder, Director of TDR, the Special Programme for Research and Training in Tropical Diseases, will be the acting head of the WHO Science Division, replacing the outgoing Soumya Swaminathan. Dr John Reeder Dr Hanan H. Balkhy, currently Assistant Director-General, Antimicrobial Resistance, will also lead the Division of Access to Medicines and Health Products, replacing Mariangela Simão, a Brazilian national. Dr Hanan H. Balkhy Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, will lead the Division of Universal Health Coverage/Communicable and Noncommunicable Diseases, replacing the outgoing Ren Mingui, a Chinese national. In addition, Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, was appointed as acting head of the Division of Universal Health Coverage/Healthier Populations, replacing the outgoing Naoko Yamamoto, a Japanese national. Dr Maria Neira And Dr Anshu Banerjee, Director, Department of Maternal, Newborn, Child and Adolescent and Aging, was appointed as acting head of the Division of Universal Health Coverage/Life Course – a role which until now had been held by Jakab as DDG. Dr Anshu Banerjee Doubling up on other appointments In several other cases, meanwhile, the DG has asked other senior staff to take on tasks held by outgoing leaders – effectively saving their salaries for the moment at least. Among those appointments: Dr Bruce Aylward, Senior Adviser for Organizational Change and coordinator of the Access to COVID-19 Tools (ACT) Accelerator, was appointed, as acting leader of the Division of External Relations and Governance, a position held by the outgoing Jane Ellison, a former UK health minister. Dr Bruce Aylward In the Health Emergencies, Preparedness and Response (WHE) team, no new appointment was made to replace the outgoing Dr Jaouard Mahjour, Assistant Director General for Emergency Preparedness. Instead, “the directors in the Division of Emergency Preparedness will report to Dr Mike Ryan, Executive Director, WHE, upon the incumbent’s retirement. The directors in the Division of Emergency Response will also report to Dr Mike Ryan,” Tedros’ message to staff stated. Dr Mike Ryan Similarly, Tedros said that work on cervical cancer, “will become part of the Department of Noncommunicable Diseases reporting to Dr Bente Mikkelsen.” Dr Bente Mikkelsen Cervical cancer was one of the key tasks in the portfolio of South Africa’s outgoing DGO Special Advisor, Dr Princess Nothemba Simelela, along with gender, equity, health rights and youth (GER/DEI). The gender equity and health rights work, Tedros stated, “will remain in DGO,” without specifying a replacement. Image Credits: Science of Eradication, UNFCCC, Photo © Dominic Chavez/World Bank Group, By Salesforce.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=114278728, World Economic Forum. Posts navigation Older postsNewer posts