The 1000th Ebola survivor of the current outbreak in the Democratic Republic of the Congo (DRC) has just celebrated her return home.

“Today, amid our unrelenting work to end this tenth outbreak of Ebola virus disease in the Democratic Republic of the Congo, we celebrate a bright spot, which is actually 1000 bright spots – each person who has survived an Ebola infection,” said Dr. Matshidiso Moeti, regional director of the World Health Organization’s African Regional Office (WHO AFRO) in a statement.

Dr. Matshidiso Moeti visits the DRC during the Ebola outbreak

As of 1 October, a total of 3197 Ebola cases were reported, including 3083 confirmed and 114 probable cases, of which two thirds have died from the disease. However, of the 1555 cases that were admitted to treatment centers, 1000 have survived.

Ebola survivors have been key community advocates in this response, returning to their communities after being cured to encourage other people to seek care and contacts to get vaccinated.

Despite the optimism, Moeti notes, “..we have more to learn and more to do…We must work harder to build trust and to spread the message: surviving Ebola is possible, and we are here to make that happen.”

The recent decline in Ebola cases over the past three weeks should be interpreted with caution, as operational and security challenges in Mandima and Mambasa health zones, where 55% of the new cases reported in the last week are coming from, continue to cause delays in detecting and responding to new cases.

20 new confirmed cases of Ebola from North Kivu and Ituri provinces were reported from September 25 to October 1, versus 29 from September 17 – 24 and 57 in the week prior according to the latest WHO outbreak news.

In Mambasa, where 162 contacts have been lost to follow-up, delays in involving the community and civil society response have led to community mistrust – now WHO is working with local and civil society partners in the area to engage women’s groups and enhance community-based surveillance.

In Mandima health zone, where 169 contacts have been lost to follow-up, armed conflict and low EVD awareness have led to tension between Ebola response teams and local communities and difficulties investigating community deaths, thus the true number of cases is likely underreported. It has been 17 days since a major security incident in the Lwemba area in Mandima health zone forced Ebola teams to temporarily suspend activities, which greatly limited contact tracing efforts and response activities.

The outbreak hotspots have shifted from high density, urban settings to more rural, less densely populated areas, with fewer new cases coming from Butembo, Katwa, and Beni. The shift in outbreak hotspots to more rural areas may signal changes transmission dynamics, with more community-based transmission and less transmission in healthcare facilities. However, new accessibility and logistical challenges to reach affected villages may come up, especially as the rainy season approaches.

WHO has received US$61 million to fund the response through December 2019, leaving a predicted funding shortfall of approximately US$60-80 million as of October 2nd. Additional funds have been committed or pledged, but WHO continues to appeal to donors to provide generous support.

Image Credits: WHO AFRO.

Bad Hofgastein, Austria – Whether its work or leisure, Europeans are moving more and more between different countries on the continent – but their health records generally lag far behind.

And this can create big barriers to the treatment of chronic health conditions, not to mention effective diagnosis and treatment in emergencies, said members of a panel on digital health Thursday at the European Health Forum (Gastein).

Until just recently, even filling a prescription across borders was challenging, said Clemens Martin Auer, EHFG President and Special Envoy for Health for Austria’s Federal Ministry for Labour, Social Affairs, Health and Consumer Protection.

Marco Marsella

“We need data that can travel from one country to another seamlessly,” said Marco Marsella, head of the European Commission’s Directorate-General for Communications Networks, Content and Technology (DG Connect).

Finland and Estonia took one small step in that direction earlier this year by agreeing to a system of e-prescription exchanges, said Auer, and that model is now being followed by some 21 other countries.

But Auer said it will still take time for real transformation to occur.

On the plus side, the European Commission in 2019 issued a set of clear recommendations for harmonized standards that would ease the flow of e-health data between countries, while also protecting people’s privacy. But countries still need to formally adopt the new EU guidelines to unlock the electronic gates.

And once standards are formally in place, health care providers across the region will need to start updating and adapting their own electronic records systems– a process that would take considerable time considering the large and fragmented health care infrastructure that exists.

Fragmentation a Hallmark of Health Sector Services

“We should stop promising heaven on earth, when it comes to the health sector, there is no other sector that is as fragmented,” declared Auer.

In Austria alone, there are 10,000 outpatient medical clinics, 130 hospitals, and 1200 pharmacies, as well as facilities such as nursing homes, he noted in a follow-up interview. ”They all have totally different digital equipment operating. So this is a barrier; we need to invest in a new generation of digital infrastructure.”

Clemens Martin Auer

Paradoxically, digital transformation could be more expensive for more affluent developed countries, which began investing in electronic patient information systems ten or 20 years ago.

“When these systems were instituted, the purposes were totally different. It was not about sharing data. It was about optimizing internal processes,” Auer observed.  “But we have to speed up.  We don’t want the Googles and Amazons to take over the field of patient data sharing – although I don’t think they would succeed.”

The first wave of data sharing for e-prescriptions took place under the European Framework of CEF – Connecting European Facilities, Auer said.

The first countries were Finland and Estonia, now 21 member states are part of this first wave of cross border sharing of prescriptions and patient summaries, which started only in the spring, although countries are not yet sharing lab results or imaging.

“The next step would be that the European Commission as well as its member states will agree to only fund infrastructures that create an interoperable eco-space. So if a hospital in Stuttgart procures a new hospital information system, it will also be able to communicate with Paris or Lyon.

“The standards exist. One is the European Commission recommendation for electronic health record exchange formats. The others are guidelines agreed to by European Union member states on infrastructure requirements. Now, we have to politically take up these standards. And then we will see an acceleration of services. This is one of the last missing links.  And once these are adopted, we will see an acceleration of services.”

As for consumer concerns about data protection and data security of health records, Auer said that he is convinced that European data and privacy laws are robust enough to reassure patients that sensitive health information will not accidentally fall into the hands of third parties such as potential employers or creditors.

“There is a huge political consensus among the people who are responsible for the health care system that for the sake of the continuity of care, of processes and outcomes, we have to share data. And we also have sound regulation when it comes to data protection and data security; in general as a European region, on a policy level, we did our homework.”

Digitalization with a ‘Human Touch’  

Another critical aspect of the digital revolution in health is ensuring that new e-health applications are serving patients and health care workers needs, rather than introducing new apps or gadgets that could be difficult for some patients to manage.

“Whenever anyone thinks about digital, they think about an app, but digital is about all sorts of settings that may not be patient care, but support the patient care,” pointed out Indra Joshi, Digital Health & AI Clinical Lead of the National Health Service (NHS) England.

“Digitalization is so driven by technicians sometimes that we lose the main point of why we are doing this in the healthcare sector,” added Auer. “And the healthcare sector needs this to improve the quality of health care.”

The needs are endless. They range from digital solutions that can provide for more seamless continuity of care; to technologies that free doctors and nurses from mundane tasks; as well as methods to facilitate the aggregation of big data for research.

“Digitalization has the potential to increase the outcomes and the quality of processes,” said Auer, “But we need to think more about what does a doctor or nurse really need to get rid of the more routine work, and to free up health care professionals to provide more personalized treatment.”

As Chief Innovation Officer at one of Israel’s largest health funds, Clalit, Ran Balicer spends considerable time thinking about how such innovations can be put into the service of more people-centred health systems.

“There is a fear that digital transformation and Artificial Intelligence (AI) will reduce the human touch,” Balicer said. “This could not be further from the truth. In their daily work, physicians are doing too many repetitive tasks that do not require their unique skills.

“AI will allow doctors and nurses to go back to their real purpose. Digital transformation would offer us an opportunity to move away from the tyranny of reactive medicine and move towards proactive and preventive care,” he stressed.

“Assisted by data and AI, we can locate those patients in need of care before they actually become symptomatic,” he added. “AI will also allow us to move from ‘intuitive’ medicine to more field-safe mechanisms [for diagnosis and treatment]. Today 30% of care is wasted and human error is the third cause of death.”

“Overall, I think that this will allow us to have more of the human touch.”

(left-right) Marco Marsella; Ran Balicer; Clemens Martin Auer; Indra Joshi

Image Credits: NHS England, European Health Forum Gastein, European Health Forum Gastein, European Health Forum Gastein.

Bad Hofgastein, Austria – Promoting an “economy of well-being” can drive European development agendas more sustainably, as well as making health systems more human-centered and responsive to client’s needs, said Finland’s Vice Minister of Social Affairs and Health in a keynote address Thursday at the European Health Forum (Gastein).

The three-day conference, which began Wednesday, has brought together some 600 health policymakers, researchers and practitioners from around Europe to explore challenges, trends and directions for the region’s health systems under the theme “A Healthy Dose of Disruption.”

“The economy of well-being emphasizes the importance of placing individuals at the center of economic measures, and economic growth also improves people’s well-being,” said Eila Makipaa, the Finnish Vice Minister, speaking at a session devoted to the well-being theme. She noted that Finland has made the concept a cornerstone of its European Union presidency term, viewing it as a framework that can advance disparate issues from climate action to democracy.

“The role of well-being is crucial in the context of human rights and security; the economy of well-being is part of the Finnish presidency programme, where we also see how well-being policies can boost productivity, generate economic growth and social stability, and ensure that no one is left behind in our rapidly changing world.”

Social inclusion is not only a positive human value, it is good for the economy, added Josep Figueras, director of the European Observatory on Health Systems and Policies, noting that treatment of patients at advanced disease stages or reintegration of people who are unemployed are all more costly undertakings than preventive measures taken proactively.

“Well-being itself… is a way to bring the diverse sectors of health, social protection, gender, environment together under one umbrella,” he said.

Some countries like New Zealand and France, as well as regions such as Wales in the United Kingdom, are already using well-being measures to evaluate the performance of government in different public policy arenas, he observed. But  most European countries are “still struggling” with effective ways of monitoring and measuring progress in an economy built around ‘well-being.’

“We want to measure things differently, but how do we put that into practice within European policies and strategies?” he asked.

Well-Being In An Ageing World  

Creating an economy of well-being in ageing societies is a key element of the challenge for Europe as well as other developed countries, said Esko Aho. Aho, in 1991 became Finland’s youngest prime minister ever taking office at the age of 36. Today, at age 65, he continues to work as CEO of a private sector firm and he doesn’t envision retiring anytime soon.

”Silver is the next green,” said Aho.

Aho said that economies need to become more inclusive of older people – or else suffer the consequences of having too few active workers to support the health and social welfare benefits of people across the life cycle.

However, health and economic leaders have been slow in coming to grips with the new demographic realities facing Europe as well as other developed economies.

“There is a common view that older citizens are less productive,” observed Aho. “That is why they are kicked out first when you have to reduce your work force.” Recent research in the automobile industry contradicts that perception. It has shown that older employees’ competencies are equivalent to their younger counterparts – because older employees’ experience levels compensate for shortcomings in other areas.

Esko Aho addresses the audience.

“There are people who have the capacity to keep working until 80, but technically are retired. We have these standardized solutions, which we are afraid to change, we are afraid to move to more personalized solutions,” he said.

“The 100-year life is totally different than 65 year life when Bismarck created the pension system,” he added, referring to the German chancellor, Otto Von Bismarck, who in 1883 created the first mandatory retirement and pension system in a move to counteract growing Marxist influence.

Older workers also suffer from other forms of powerful but subtle discrimination which cause them to fall behind, added Jonathan Cylus, an economist and the London Hub Coordinator for the European Observatory on Health Systems and Policies. For instance, older people are less likely to be offered training opportunities than their younger counterparts – and that can cause them to fall behind their peers in performance, .

“We need to have a more equitable approach to ensure that older people are able to work, and that they have the same opportunities,” he said, noting that there are 100 million people over the age of 65 in Europe and while incomes often decline after retirement, consumption needs remain about the same, creating economic stress.

At the same time, he said one-size-fits all approaches need to be rejected.  “The knee jerk reaction is to raise pension ages and that can also cause stress among people who didn’t expect this,” he said.  “The economy of well-being is about more personalisation and more flexible policy-making.”

Image Credits: David Rowe, European Health Forum Gastein.

Sweden pledged to increase its support to the Global Fund by 14%, committing some SEK 2.85 billion (US $290 million) over the next three years, one of the latest in a line of donors to step to the call of the Global Fund’s Sixth Replenishment Conference, coming up next week on October 9-10 in Lyon.

The pledge was announced Thursday by Sweden’s Minister for International Development Cooperation, Peter Eriksson.

“In recent years, we have seen a tougher climate and dwindling interest in women’s rights, and particularly sexual and reproductive rights. For this reason, Sweden’s contribution to the Global Fund is particularly important,” said Eriksson in a Global Fund press release. “Through this increased contribution, Sweden will remain a strong donor to global action for health. And with this, we will also have increased expectations and demands that the Global Fund will deliver in Sweden’s priority areas, including preventive efforts, equitable health, human rights and sexual and reproductive health and rights.”

Peter Sands, Executive Director of the Global Fund, commended Sweden’s commitment saying: “Sweden’s investments in global health have contributed immensely in the fight against HIV, TB and malaria and in building strong health systems.”

The Swedish announcement follows recent pledges by Norway’s Prime Minister Erna Solberg to give NOK2.02 billion to the Sixth Replenishment, and Spain’s commitment for EUR100 million Euros. Five private sector partners announced new pledges for the Global Fund’s Sixth Replenishment during the World Economic Forum on Africa on September 4-6 in Cape Town.

Natalie Portman introduces Peter Sands and Erna Solberg at the Global Citizens Festival 2019

Meanwhile activity in the lead up to the conference has intensified with high-powered celebrities such as, Annie Lennox, Diane Kruger, Natalie Portman and Penélope Cruz launching a petition on change.org in an open letter addressed to today’s 7-year-olds, calling on the world to commit to end AIDS, TB and malaria by 2030 – when today’s children become adults. Portman also appeared live on stage calling on the world to step up the fight and support the Global Fund at the annual Global Citizen concert in New York on September 28.

The most recent Global Fund Results Report 2019 credits the partnership with saving 32 million lives from the three leading diseases that it is pledged to combat – HIV/AIDS, tuberculosis and malaria – since its inception in 2002.

The Global Fund’s Sixth Replenishment pledging conference will be hosted by French President Emmanuel Macron in Lyon, France on October 9-10 2019, with the goal to raise US $14 billion for the fund’s next three-year cycle.

At the United Nations General Assembly in New York last week, the Global Fund also joined 11 other major UN and international health agencies to launch a joint action plan, Stronger Collaboration, Better Health: Global Action Plan for Healthy Lives and Well-being for All, to better support countries to accelerate progress towards the health-related Sustainable Development Goals. This followed the landmark commitment by UN member states to scale up efforts to achieve universal health coverage by 2030.

Image Credits: Global Citizen.

As delegates gathered in New York for the UN General Assembly (UNGA) last week, tobacco companies were lurking on the margins to cultivate influence and undermine policies that would accelerate the Sustainable Development Goals. More than 140 health organizations from over 40 countries have joined me in calling on delegates to reject invitations to meet with tobacco companies and their front groups and to denounce tobacco industry partnerships.

This is the only tenable position for governments and UN agencies: few industries are as incompatible with the sustainable development goals as tobacco, which leaves behind a devastating trail of health, social, economic, and environmental harms.

Every year, the industry’s products claim 8 million lives among smokers and non-smokers exposed to second-hand smoke. Among adolescents, smoking and exposure to second-hand smoke leads to learning problems and cognitive impairment. Tobacco-related diseases are costly to treat, hindering progress towards UHC 2030. According to the World Health Organization (WHO), the costs to health and related productivity losses result in economic losses of around $1.4 trillion every year – equivalent to two percent of global GDP- with much of the burden placed on low- and middle- income countries. This $1.4 trillion does not include the social and economic costs of enduring cyclical poverty, widening inequality, poor labour practices, and environmental harms and far outweighs the $269 billion revenues from tobacco taxes.

Premature deaths place a financial burden on families, and cycles of ill health and poverty among vulnerable populations are reinforced when tobacco use diverts money from food, clothing, healthcare and education – widening inequality.

About 1.3 million children aged under 14 years work in tobacco fields.

Big tobacco’s thirst for profit has led to decades of poor labor practices. About 1.3 million children aged under 14 years work in tobacco fields, missing school and risking illness from nicotine poisoning related to handling tobacco leaves. Furthermore, the supply chain exploits small farmers in countries across Africa and Asia, leading to financial dependence. Research shows they make little to no profit (or even a loss) from the crop, but many are forced to continue growing tobacco because they are contracted or in debt to tobacco companies.

Beyond the devastating health, educational, and financial impacts, tobacco places a massive burden on our planet. Cigarette butts are the most littered product globally leading to massive air, land, water and sea pollution. Tobacco curing leads to significant deforestation. On top of these environmental harms, tobacco crops leach nutrients from land that could be used for crops to improve food security.

Satellite images show environmental damage from tobacco farming. In many countries, farmers clear forested land that is agriculturally marginal to grow tobacco—often by burning —and/or harvest wood for curing. Typically, the land is quickly abandoned and becomes unusable, often leading to desertification.

The industry tries to mask this reality, and the United Nations risks being complicit. Tobacco companies are using the Sustainable Development Goals as part of their strategy to diminish the focus on their accountability for harms caused and to launder their sordid reputations for the purpose of engaging with governments, the development community and UN organizations:

  • They use SDG logos in their reports, sponsor UN-linked events and launch global initiatives to divert public attention from the harm they cause and detract government attention from holding them accountable and liable for harms.
  • They claim they can use their knowledge of supply chains to improve productivity and economic outcomes for other crops, but tobacco cultivation continues to leave many tobacco farmers in poverty.
  • They claim to be actively engaged in eliminating child labor, using this issue to maintain relationships with the International Labour Organization (ILO) in particular, but decades after their well-publicized, so-called “corporate social responsibility” work in this area, the problem remains.
  • They claim their activities are essential to the economic success of many countries, when analysis consistently finds that tobacco-related costs incurred by their products significantly outweigh the tobacco industry’s contribution to government revenues, and
  • They claim their new products will help countries progress toward targets for reductions in tobacco use, when there isn’t sufficient independent evidence to support smoking cessation claims.

We know that these efforts are planned: tobacco industry documents reveal that access to the UN is part of a deliberate strategy to establish credibility, to gain access to policy makers for the purposes of undermining tobacco control and to open up new markets for its products.

Such infiltration has the potential to risk hard-won progress within the UN system. World Health Organization led efforts to protect policy from tobacco industry interference. Article 5.3 of the Framework Convention on Tobacco Control (WHO FCTC) states that “there is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests.” In its Framework for Engagement with Non State actors, WHO commits to not partner with tobacco industry or those furthering its interests. WHO also developed the Model Policy for UN agencies– a path which led to the exclusion of tobacco companies from the UN Global Compact, and the UN Economic and Social Council passing resolution E/2017/L.21, which calls upon all UN agencies to “implement their own policies on preventing tobacco industry interference.”

But even as UN agencies have worked to withstand industry pressure and close the door to tobacco companies, influential third parties are opening back doors for the industry to threaten the SDGs.

Concordia, the high profile, public private partnership-focused non-profit held its Annual Summit in New York this week to coincide with UNGA, attracting global leaders from UN agencies, business and the media. The organization actively promotes its partnership with the tobacco industry, with Philip Morris International (PMI) being featured in Concordia’s program in a manner that allows it to engage with policymakers and regulators, which could lead to a violation of Article 5.3. PMI’s CEO was invited to speak at Concordia’s Annual Summit in 2018 and 2019, but PMI isn’t the only tobacco company involved; British American Tobacco has used previous Concordia events to align itself with the health and development agenda. Tobacco sponsorship of Concordia events helps tobacco companies side-step bans on tobacco advertising, promotions and sponsorship, including corporate social responsibility activities, which some countries have implemented in accordance with Article 13 of the WHO Framework Convention on Tobacco Control.

In July, a PMI executive managed to directly address policymakers at a precursor event to the UN High Level Political Forum on Sustainable Development, through an invitation from the World Business Council for Sustainable Development (WBCSD).

Details about apparent lobbying efforts were leaked the same month. In a letter to UN Secretary General Antonio Guterres from Michael Møller, the retiring Director-General of the United Nations Office at Geneva advocated in favour of tobacco partnerships in the 2030 Agenda for Sustainable Development.

And on the eve of UNGA, PMI launched a video stating that it will be in New York “to be part of the conversation,” as well as posting a message targeted at delegates, saying they should  “talk with us, leave dogma behind”– a clear and arrogant declaration of intent to subvert settled UN policy.

These actions signal a renewed effort by the tobacco industry to infiltrate the UNGA and steer global policy to its advantage.

It’s vital that health and development advocates mobilize on this issue and hold UNGA delegations to account. STOP (Stopping Tobacco Organizations and Products) led an open letter, co-signed by 142 public health groups and individuals from 42 countries, calling on every member and observer at the UNGA to abide by the model policy and reject any engagement with the tobacco industry- including invitations from tobacco companies or those furthering their interests and proposals that support tobacco industry partnerships, funding and positions. STOP intends to deliver its message to UNGA delegates at the meeting, calling on them to avoid being complicit in the tobacco industry’s plans.

The message is simple: It is impossible to produce, market and sell tobacco products in a way that is compatible with public health or the UN’s 2030 Agenda, so partnerships with the tobacco industry directly contradict the Sustainable Development Goals.

It’s time to close the door on the tobacco industry and its allies.

_________________________________________

Atty. Deborah Sy is a Partner in STOP (Stopping Tobacco Organizations and Products), a tobacco industry watchdog, and Head of Global Public Policy and Strategy at the Global Center for Good Governance in Tobacco Control. Debby is a Johns Hopkins University IGTCI Awardee for Excellence in Advocacy (2012) for instituting tobacco industry monitoring activities, which won the Bloomberg Award (M) for HealthJustice- a think tank aimed at bridging the gap between health and law, where she is the founding trustee and senior advisor. She collaborated with the Harrison Institute of Public Policy at Georgetown University on the recognition of tobacco control issues in trade and investment negotiations. She provides legal assistance on universal health care, health promotion, good governance, food and drug regulation, intellectual property, taxation, trade as well as women and children’s rights.

Image Credits: Vital Strategies/WHO SEARO, tobaccoatlas.org/ Environmental Degradation photos from Landsat 8.

[The Medicines Patent Pool]

Geneva (2 October 2019) — The Medicines Patent Pool today announced the first of a two-step update of its database MedsPaL to include additional patented small molecule medicines following the publication of the World Health Organization (WHO)’s updated Model List of Essential Medicines (EML) in July.

Launched in 2016, MedsPaL is a free resource on the intellectual property status of patented medicines included in the WHO EML for low- and middle-income countries (LMICs). Initially covering selected HIV, hepatitis C and tuberculosis medicines in LMICs, MedsPaL expanded to all patented treatments on the EML in 2017.

“We are passionate in our belief that public health stakeholders must have simplified access to accurate patent information on essential medicines in order to make informed decisions when the time comes to procure and supply those important drugs to the people who need them,” said Charles Gore, Executive Director of the Medicines Patent Pool. “MedsPaL now provides patent and licensing data covering 96 priority medicines in more than 130 low- and middle-income countries and includes over 8,000 national patents and patent applications.”

This update includes data on patents for medicines to treat lung cancer, multiple myeloma, prostate cancer, atrial fibrillation, chronic obstructive pulmonary disease, nausea, post-partum haemorrhage, hypertension and for three antibiotics, namely abiraterone, afatinib, apixaban, aprepitant, bortezomib, carbetocin (heat-stable formulation), ceftazidime+avibactam, dabigatran, edoxaban, erlotinib, gefitinib, lenalinomide, meropenem+vaborbactam, plazomicin, rivaroxaban, telmisartan+amlodipine, telmisartan+hydrochlorothiazide and tiotropium. For some of these medicines, key patents have expired, but a number of relevant secondary patents remain in force in some LMICs.

Information on patented biologics will be made available in a second update before the end of the year.

“It is fundamental that countries willing to provide greater access to essential medicines can refer to a reliable up-to-date database like MedsPaL to check the patent status of the medicines they want to procure,” said Nicola Magrini, Secretary of the WHO Essential Medicines List. “Access to medicines is certainly an important pillar of Universal Health Coverage and MedsPaL supports its efficient implementation at country level.”

The MPP regularly updates the patent and licensing status data included in MedsPaL, including through data collected from national and regional patent offices from around the world. The MPP has signed collaborative agreements with the African Regional Intellectual Property Organization (ARIPO), the Eurasian Patent Office (EAPO), the European Patent Office (EPO), Argentina’s National Institute of Industrial Property (INPI), Brazil’s National Institute of Industrial Property (INPI), Chile’s National Institute of Industrial Property (INAPI), Dominican Republic’s National Office of Industrial Property (ONAPI), Ecuador’s National Service of Intellectual Rights (SENADI), the Egyptian Patent Office (EGPO), El Salvador’s National Registry Center (CNR), Peru’s National Institute for the Defense of Free Competition and the Protection of Intellectual Property (INDECOPI), South Africa’s Companies and Intellectual Property Commission (CIPC), and Uruguay’s National Directorate of Industrial Property (DNPI).

About the Medicines Patent Pool

The Medicines Patent Pool is a United Nations-backed public health organisation working to increase access to, and facilitate the development of, life-saving medicines for low- and middle-income countries. Through its innovative business model, the MPP partners with civil society, governments, international organisations, industry, patient groups and other stakeholders, to prioritise and licence needed medicines and pool intellectual property to encourage generic manufacture and the development of new formulations. To date, the MPP has signed agreements with nine patent holders for thirteen HIV antiretrovirals, one HIV technology platform, three hepatitis C direct-acting antivirals and a tuberculosis treatment. The MPP was founded by Unitaid, which serves as sole funder for the MPP’s activities in HIV, hepatitis C and tuberculosis. Funding provided by the Swiss Agency for Development and Cooperation (SDC) for MPP’s feasibility study on the potential expansion of its licensing activities into patented essential medicines made the upgrade of MedsPaL to include other EML treatments possible.

More information about the Medicines Patent Pool, its public health mission and impact: https://medicinespatentpool.org/

For more detailed information on a given patent or its interpretation, MedsPaL users are encouraged to contact national patent offices or consult legal counsel.

www.medspal.org

Image Credits: The Medicines Patent Pool.

On the eve of the September UN Climate Action Summit, young women and men around the world mobilized by the millions and told global leaders: “You are failing us”.

They are right.

Global emissions are increasing.  Temperatures are rising.  The consequences for oceans, forests, weather patterns, biodiversity, food production, water, jobs and, ultimately, lives, are already dire — and set to get much worse.

Secretary General Antonio Guterres speaks at the opening ceremony of the 2019 Climate Action Summit.

The science is undeniable.  But in many places, people don’t need a chart or graph to understand the climate crisis.  They can simply look out the window.

Climate chaos is playing out in real time from California to the Caribbean, and from Africa to the Arctic and beyond.  Those who contributed least to the problem are suffering the most.

I have seen it with my own eyes from cyclone-battered Mozambique to the hurricane-devastated Bahamas to the rising seas of the South Pacific.

I called the Climate Action Summit to serve as a springboard to set us on the right path ahead of crucial 2020 deadlines established by the Paris Agreement on climate change.  And many leaders — from many countries and sectors — stepped up.

A broad coalition — not just governments and youth, but businesses, cities, investors and civil society — came together to move in the direction our world so desperately needs to avert climate catastrophe.

More than seventy countries committed to net zero carbon emissions by 2050, even if major emitters have not yet done so.  More than 100 cities did the same, including several of the world’s largest.

At least seventy countries announced their intention to boost their national plans under the Paris agreement by 2020.

Small Island States together committed to achieve carbon neutrality and to move to 100 per cent renewable energy by 2030.

Countries from Pakistan to Guatemala, Colombia to Nigeria, New Zealand to Barbados vowed to plant more than 11 billion trees.

More than 100 leaders in the private sector committed to accelerating their move into the green economy.

A group of the world’s largest asset-owners — responsible for directing more than $2 trillion — pledged to move to carbon-neutral investment portfolios by 2050.

This is in addition to a recent call by asset managers representing nearly half the world’s invested capital – some $34 trillion – for global leaders to put a meaningful price on carbon and phase out fossil fuel subsidies and thermal coal power worldwide.

The International Development Finance Club pledged to mobilize $1 trillion in clean energy funding by 2025 in 20 least developed countries.

One-third of the global banking sector signed up to align their businesses with the Paris agreement objectives and Sustainable Development Goals.

The Summit also showcased ways in which cities and global industries like shipping can achieve major reductions in emissions.  Initiatives to protect forests and safeguard water supplies were also highlighted.

These steps are all important — but they are not sufficient.

From the beginning, the Summit was designed to jolt the world and accelerate action on a wider scale.  It also served as a global stage for hard truths and to shine a light on those who are leading and those who are not.  Deniers or major emitters have nowhere to hide.

I will continue to encourage them to do much more at home and drive green economic solutions around the world.

Our planet needs action on a truly planetary scale.  That cannot be achieved overnight, and it cannot happen without the full engagement of those contributing most to the crisis.

If our world is to avoid the climate cliff, far more is needed to heed the call of science and cut greenhouse emissions by 45 percent by 2030; reach carbon neutrality by 2050; and limit temperature rise to 1.5 degrees by the end of the century.  That’s how we can secure the future of our world.

Too many countries still seem to be addicted to coal – even though cheaper, greener options are available already.  We need much more progress on carbon pricing, ensuring no new coal plants by 2020, and ending trillions of dollars in giveaways of hard-earned taxpayers’ money to a dying fossil fuel industry to boost hurricanes, spread tropical diseases, and heighten conflict.

At the same time, developed countries must fulfill their commitment to provide $100 billion a year from public and private sources by 2020 for mitigation and adaptation in developing countries.

And I will make sure that the commitments that countries, the private sector and local authorities have made are accounted for — starting in December at the UN Climate conference in Santiago, Chile. The UN is united in support of realizing these initiatives.

Climate change is the defining issue of our time.

Science tells us that on our current path, we face at least 3 degrees Celsius of global heating by the end of the century.  I will not be there, but my granddaughters will.

I refuse to be an accomplice in the destruction of their one and only home.

Young people, the UN – and a growing number of leaders from business, finance, government, and civil society – in short, many of us – are mobilizing and acting.

But we need many others to take climate action if we are to succeed.

We have a long way to go. But the movement has begun.

_________________________________________

António Guterres is Secretary-General of the United Nations.

 

This article appears as part of the Health Policy Watch partnership with Covering Climate Now, a global collaboration of more than 300 news outlets to strengthen coverage of the climate story.  

 

Image Credits: UN Photo/Ariana Lindquist.

Bad Hofgastein, Austria – Malta is working with Italy and 8 other European countries to lay the groundwork for a formal European Union framework in which members could voluntarily share information about medicines prices, in order to advance more coherent pricing policies in regional markets, Malta’s Deputy Prime Minister and Health Minister said on Wednesday.

The 10 countries of the so-called “Valletta Group” are among the first worldwide to band together on practical steps to implement the aims of the landmark World Health Assembly resolution approved in May, calling for greater price transparency in medicines markets.

Christopher Fearne, Malta’s Deputy Prime Minister and Health Minister, said he expects Croatia, another member of the Valletta Group, to put the issue on the agenda of the European Employment, Social Policy, Health and Consumer Affairs Council [EPSCO] sometime next year, after it assumes the EU presidency.

Fearne spoke to Health Policy Watch following Wednesday’s opening session of the 2019 European Health Forum – Gastein, where he delivered a keynote address at this year’s opening session. Under the banner “a healthy dose of disruption” the Forum is focusing on new policies, digital technologies, research and advocacy, which have the potential to positively transform health systems.

“What we would like to do is to bring this on the agenda of the European Health Council [EPSCO] next year,” Fearne said.

Christopher Fearne, Malta’s Deputy Prime Minister and Health Minister

The Valletta Group process is being followed closely both by countries outside of Europe as well as by civil society advocates, to see if the group can formulate a model for practical implementation of the ambitious WHA resolution that others could follow.

Fearne said that the first step for the Valletta group would likely be an agreement to confidentially share information on the prices that they pay for medicines and other health products, so as to begin building trust towards collective negotiations on regional prices for bulk purchases.

Malta hosted a ministerial meeting of the Valletta Group in July, which mandated a group of technical experts to come back to the ministers with a firm proposal for moving ahead on a collaborative framework for price information-sharing, which could also be advanced before the European Health Council.

The group is named after a 2017 Valletta Declaration, in which the countries first agreed to work together to leverage reduced drug prices from industry.  Representing some 160 million citizens, the group of ten countries also includes Ireland, Portugal, Spain, Cyprus, Greece, Slovenia, and Romania, along with Malta, Croatia and Italy.

Italy, the lead sponsor of the WHA resolution, recently enacted its own national legislation stipulating that prices must be disclosed for any new bulk purchases of medicine made.

But Fearne stressed that a European legal framework is needed to empower countries to buck the non-disclosure agreements that are the standard of practice now, and which critics say have led to large disparities in prices paid for the same drug in neighbouring European countries.

“One country is paying 15 000 Euros and another country can’t pay 100 000 Euros. Why can’t we all buy it at 15 000?  The company is still making money,” he said, adding that he was referring to a specific drug that Malta procures, but he could not cite the name due to the NDAs that are currently in place.

“The pharmaceutical companies, when they enter into agreements for procuring medicine, specifically state that you are not at liberty to publicize the price,” he added.

“They usually release the medicines first in countries where there is a high GDP, and so when they [publicly] reference the price, they are referencing the high end of the European market.”

The Valletta Group ministers are due to meet soon again in Rome, to consider the proposals of the technical group, and see if they can form a unified position to submit to the Health Council [EPSCO].

Fearne said that in his opinion, “the next step is to agree between us to share prices between us confidentially, not publicly.  That will enable us to start trusting each other, when we come together to negotiate jointly. So in our case, instead of having a market of half a million, the Valletta Group is made up of 163 million; if we negotiate collectively then we have a stronger bargaining power.

”But because we have always been told that we get the best prices, amongst us there are people who don’t believe that negotiating jointly is going to be beneficial. The only way to break this is to make prices known, and then we will realize the inevitable truth that most of us are paying very high prices.  Breaking this secrecy will allow member states to build trust and then will be able to negotiate jointly.”

Tobacco Control Research Group Receives European Health Leadership Award

In other events at the Gastein Forum, the Tobacco Control Research Group (TCRG) of the University of Bath, United Kingdom, was awarded a first-ever €10,000 European Health Leadership Award (EHLA).

This was the first year for the prize, sponsored by the Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection. A press release said the award was launched to “shine the spotlight on disruptive thinkers who are leading efforts to improve health outcomes across the EU.

TCRG, founded in 2007, was awarded the prize due to its global leadership in tobacco control research that leads to policy action, the Gastein Forum’s organizers said in a press release. The group’s Tobacco Tactics data base has exposed controversial tactics of the tobacco industry, including industry-supported tobacco smuggling to avoid taxes levied on the health-harmful product. The smuggling practices were the focus of two studies published in the BMJ journal, Tobacco Control, over the past year.

Bloomberg Philanthropies has made the Tobacco Control Research Group one of the leaders of an all-new $20 million global tobacco industry watchdog which aims to counter the negative influences of the tobacco industry on public health. The global partnership aims in particular to highlight tobacco industry activity across low- and middle-income countries.

(left-right) TCRG Director Anna Gilmore and Christopher Fearne

“Tobacco use is one of the most severe risk factors for non-communicable diseases – one of the biggest global health problems to date. The TCRG has made it their mandate to disrupt one of the most lucrative global industries by monitoring and investigating the industry’s influence on health behaviour and critically examining their public intention of reducing harm from tobacco,” said Anna Gilmore, TCRG director in a press release, “We are thrilled to be the proud recipients of the EHFG´s first European Health Leadership Award”.

The TCRG was chosen from six shortlisted candidates all of which were said to have  demonstrated unique and innovative ideas to challenge the status-quo of health in Europe.

Image Credits: European Health Forum Gastein, European Health Forum Gastein, European Health Forum Gastein.

Some 70% of all health needs can be addressed through primary health care systems based in local communities, and yet the bulk of the US $7.5 trillion spent on health each year goes towards funding care in secondary and tertiary hospital care, which people reach only after they are already very ill, leading to higher costs for governments and households.

This was a key message of World Health Organization Deputy Director General Zsuzsanna Jakab in an address Tuesday evening at the Graduate Institute of Geneva, where she spoke about the challenges facing health policymakers in making last week’s landmark UN Declaration on Universal Health Coverage (UHC) a reality.

“To many countries spend large parts of their health budget on managing diseases in hospitals -where the costs are higher and the outcomes can be worse – instead of preventing them at the primary health care level,” Jakab said.

More than half of the world’s population cannot access quality, affordable healthcare, through primary health care systems, and this is particularly true for preventive services, she said.

But by the time people reach a hospital, they require more expensive and intensive care, she pointed out. Catastrophic health expenses have pushed over 100 million people into extreme poverty, keeping both individuals and whole economies from thriving.

Last week’s landmark UHC declaration called on countries to increase primary health care spending by 1% of their GDP.

This additional investment is “not just a moral imperative, it’s an economic imperative,” Jakab said, “We must make a crucial shift – from a focus on treating the sick to a focus on protecting the healthy.“

She was sounding a battle cry that is sure to be echoed repeatedly over the coming months and years, as WHO seeks to convince member states as well as donors to finance the billions of dollars in spending annually that health economists say would be needed to attain the ambitious UHC goals.

1% Increase In Primary Health Care Financing, 60 Million Lives Saved

A 1% GDP increase in spending would infuse approximately US $200 billion a year into primary health services, which WHO estimates would contribute to saving over 60 million lives and addressing the shortfall of 18 million additional health workers needed to achieve UHC by 2030.

WHO Deputy-Director General, Zsuzsanna Jakab, said health financing for primary care is crucial to the long-term sustainability of health systems, so as to prevent non-communicable diseases (NCDs) such as cancer, cardiovascular and respiratory disease, and mental health disorders from occurring in the first place. These NCDs have become the leading causes of death around the world.

“With ageing populations and the rising tide of diseases that need long-term care, no country can afford simply to treat the people who turn up in its hospitals and clinics,” Jakab pointed out.

Countries that strengthen health spending on preventative and health promotions services, delivered through a primary health care platform, will “not only save lives, they will save money.” The same platform can also be used for integrating “siloed” global health funding from disease-focused programs, “making that money work harder.”

Investing in Innovative Global Health Solutions

Jakab’s reflections on Universal Health Coverage were made at the awards ceremony of the 2019 “Advancing Development Goals” Geneva Challenge, where five teams of young global health practitioners from five continents were awarded cash prizes ranging from CHF 2500 – 10000 for innovative health projects on research, policy and practice.

ReMedic – an integrative solution turning medicines’ excess into access – the brainchild of Asia’s team, won the first place prize of CHF 10000. The projects, selected and ranked by a panel of judges, all targeted key issues raised in the discussions around UHC, including: care for aging populations, access to essential medicines and safe water, and addressing the burden of non-communicable mental health disorders. The runner-ups were:

  • North America/Oceania: PEACE – Program for Elderly Adults with Cohabitation and Enrichment
  • Europe: RapidCare – strengthening health systems in an urbanizing world
  • Africa: Rural Water Filtration Kit – improving global health through safe drinking water
  • South America: Project Wanöpo – Improving mental health

An additional special prize, co-sponsored by the United Nations’ Sustainable Development Solutions Network, was granted to the project “Renewable Energy as the Game Changer in Rural Health Crisis: Bringing Advancement in Community-Based Healthcare Facilities in Remote Rural Areas of Indonesia”.

The contest was hosted by the Global Health Centre at the Graduate Institute in Geneva. Established and sponsored by the late Kofi Annan and Ambassador Jenö Staehelin, the contest aims to identify innovative and pragmatic graduate student projects that address key international issues. This year’s theme was identifying solutions to address issues in global health tied to social and economic development.

 

Image Credits: Ilona Kickbusch/Twitter.

Life expectancy increased to a historic peak of 68 years for men and 78 years for women in the Russian Federation in 2018 thanks in part to stringent alcohol regulations. A new study published by the World Health Organization’s European Regional Office found that alcohol regulations in the country reduced consumption by more than 40% and could be linked to declines seen in deaths from alcohol-related disorders, homicides, and transport accidents between 2003 to 2018.

“These results show that measures such as the introduction of monitoring systems, price increases and limited alcohol availability, work to save lives and health system costs”, said Carina Ferreira-Borges, from the Alcohol and Illicit Drugs programme at WHO Europe said in a press release.

During “Russia’s mortality crisis” of the 1990s and early 2000s, one out of every two young men died prematurely due to alcohol. The Russian Federation made key moves to regulate alcohol production and consumption between the early 1990s to 2011. The most effective reforms began in 2005/06, after reforms attempting to reduce the proportion of unrecorded or “illegal” alcohol were introduced. Individual behavior was targeted beginning in 2009, when Russia began implementing its first national strategy focused on reducing the harmful use of alcohol and alcohol dependence, which included strategies such as raising taxes on alcohol, introducing alcohol-free public spaces, and real-time tracking of alcohol production and sales.

As a result, alcohol poisoning mortality has dropped by 73% in men and 78% in women, morbidity from alcohol related psychosis has dropped by 64%, and mortality from alcohol-related liver diseases has decreased by 22% in men and 24% in women between 2003 to 2018. However, the report was unable to clearly measure the effect of alcohol regulations on the incidence of alcohol-related cancers, as cancer takes decades to develop and gains will only be seen years down the line if regulation continues.

Deaths attributable to alcohol-linked causes such as heart disease, traffic accidents, suicides and homicides also dropped between 2003 and 2017, with mortality due to heart disease and transport accidents slashed in half, and suicide and homicide deaths dropping by around 60% and 80% respectively.

While the report notes that other factors such as abrupt economic changes, malnutrition, smoking, and a deterioration of social services may have helped lead to the sharp decline in life expectancy observed in the early 1990s, alcohol regulation, or the lack thereof, has played a key role in the dramatic health changes in the Russian population.

Notably, the authors found that growth in life-expectancy flattened in 2015, when major alcohol regulations were temporarily discarded. Since 2016, Russian policy-makers have attempted to mainstream alcohol control into many health and development policies, recognizing its role as a key risk factor for a variety of poor health and socioeconomic outcomes.

Still, the analysis shows that alcohol consumption has stagnated at about 11-12 litres of pure ethanol per person per year, which remains one of the highest consumption levels worldwide. Tackling individual drinking behaviors remains a key challenge in the future.

Image Credits: Alcohol Policy Impact Case Study/WHO EURO.