International AIDS Conference 2014

Posted on in Blog Posts, HIV/AIDS

This is a guest post written by Jason Wright, U.S. Director of the International HIV/AIDS Alliance, a GHC Board Member, and a Global Fund Developed Country NGO Board delegation member. The International HIV/AIDS Alliance is an alliance of 40 nationally based, independent civil society organisations (Linking Organisations), six Technical Support Hubs, and an international Secretariat that are dedicated to ending AIDS through community action.

"20th International AIDS Conference (AIDS 2014), Melbourne, Australia."

20th International AIDS Conference (AIDS 2014). Photo credit: International AIDS Society/Steve Forrest

The week of the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia started off on a somber note. As many conference participants arrived on July 18 (Friday), we discovered that Malaysian Airlines Flight 17 had crashed in Ukraine. The passengers on the flight included six of our HIV/AIDS colleagues:

The loss of Martine and Pim was especially difficult for my International HIV/AIDS Alliance. We have a global partnership — the Stop AIDS Alliance — with the Dutch HIV/AIDS NGO consortium STOP AIDS NOW!, and work closely with Aids Fonds. We worked closely with Martine on key populations programming under the Bridging the Gaps program and Pim on parliamentary advocacy.

In the opening session of the conference, there was a fitting tribute to our six colleagues. Conference Co-Chairs Françoise Barré-Sinnoussi and Sharon Lewin called to the stage representatives of our six colleagues’ organizations for a minute of silence. Also in the opening session, Management Sciences for Health (MSH) President and Chief Executive Officer (CEO) and Global Health Council (GHC) Board Chair Jonathan (Jono) Quick introduced the Jonathan Mann Memorial Lecture co-sponsored by GHC.

The death of Joep, another giant in the field of HIV/AIDS, tragically parallels that of Jonathan in the crash of Swiss Air Flight 111 off the coast of Newfoundland in 1998. Jono quoted Jonathan’s daughter Lydia, “[My father] would be so happy and proud of what, in the 15 years since his death, this community has achieved by working together.  He would also share his disappointment at how much more is left to be done.” Jono stated, “Jonathan Mann fought vigorously for the voiceless, the vulnerable, and the stigmatized.  By making AIDS — and with it health — a human rights issue, Jonathan Mann inspired a generation of activists… but his mission is not finished.”

Retired Australian High Court Justice Michael Kirby delivered the lecture.

Jono stated that through Justice Kirby’s roles on international commissions on HIV/AIDS, the law, and human rights including the Global Commission on HIV and the Law, Justice Kirby “has lived the principles that Jonathan Mann stood for:  human rights, dignity for all, and the courage to speak out and take action to defend these principles.”

Justice Kirby imparted six vital lessons, many around the AIDS paradox taught by Jonathan Mann. He stated, “Paradoxically, and almost counter-intuitively, the best way in current circumstances to get people to testing and to reduce the toll of death and suffering is not by punishing and isolating those infected with HIV.  It is actually by protecting them.”

Also in the opening session, UNAIDS Executive Director Michel Sidibé called for the end of AIDS by 2030. He laid out the ambitious target of 90-90-90:

  • 90% of people tested
  • 90% of people living with HIV on treatment
  • 90% of people on treatment with suppressed viral loads

Michel described the target as “a moral and economic imperative … [which] will keep people living with HIV alive and healthy, protect future generations from infection, provide economic value over the long term and drive the AIDS epidemic into history.” He stressed that the target must be achieved across all countries and all populations. Michel concluded, “Our challenge boils down to one painful truth:  too many are being left behind today.  If the world wants stability, peace and sustainable development, we cannot run away from the needs of lesbian, gay, bisexual, transgender and intersex people, sex workers, people who inject drugs, prisoners, migrants, women and girls, and people with disabilities.” To meet the needs of all populations including these key populations, we will have to increase our human rights focus and finish the mission of Jonathan Mann — and Joep Lange.

Participants come out of this conference saddened by our collective loss but together rededicated to ending AIDS.

Executive Director Listening Tour: Ten Key Trends that are Shaping Today’s Global Health Outlook

Posted on in Blog Posts, Leadership

By Dr. Christine Sow, Executive Director

Map of listening tour

When I joined the Global Health Council (GHC) as its new executive director last November, I made one of my first priorities to meet and consult with global health stakeholders around the world. I wanted to get a sense of our community’s priorities and needs. So for the past three months, I’ve been on what I call a listening tour. It took me to eight US metropolitan areas—Seattle, Boston, Ann Arbor, Atlanta, the Research Triangle area of North Carolina, San Francisco, New York, and Washington DC—and abroad. Throughout the tour I met with global health stakeholders one-on-one, in large group meetings, and by participating in thought-provoking conferences such as Switchpoint and the Shared Value Leadership Summit.

The listening tour ended last month, fittingly enough, in Geneva at the 67th World Health Assembly. There, GHC’s core staff met with global health stakeholders, advocates, and implementers. It was fascinating to note the many similarities these global health hubs share, as well as the differences that set them apart. We have a tendency to work in silos without linking our issues to the overall strategic umbrella of global health. Here are just a few of the things that stood out to me and will shape the course of GHC’s activities in the coming months:

  • Global health engagement takes many forms. We’ve seen a shift from the classic troika of government, nongovernmental organizations, and big pharma, to a wider variety of actors, including innovative biotech firms, corporations that are making increasingly profound commitments, and academic institutions throughout the US.
  • Global health is everywhere throughout the United States. Once you scratch the surface, you see there are organizations and individuals in most major metropolitan areas who are deeply committed to improving the health of the global population—particularly those living in low-resource settings.
  • There is a strong desire to keep global health at the forefront of US government commitments and to promote understanding throughout the US general public. The game-changing nature of the US government’s commitment over the last decade is clearly acknowledged and appreciated.
  • The global health community is not always well organized. As many of us know, we have a tendency to work in silos without linking our issues to the overall strategic umbrella of global health.
  • We need to make more deliberate connections across the spectrum of engagement in global health, particularly between and among innovation, R&D, programmatic implementation and implementation sciences, measurement, and assessment of impact. We all need to find common purpose and language to better coordinate and collaborate with one another.
  • The future of global health funding is uncertain, at least in terms of large-scale bilateral government investment. The US government’s leadership in global health would be sorely missed if it went away.
  • The future of global health cuts across sectors. Successful engagement requires us to multiply and scale up multi-sector partnerships such as the Pink Ribbon Red Ribbon Alliance and Every Woman Every Child.
  • Different actors commit to making global health impact for different reasons. There are enormous shifts going on in the official development assistance funding environment. Combine that with the explosion of social media, and we have a rapidly expanding, dynamic, and at times chaotic global health landscape. At the end of the day, though, we all need to find common purpose and language to better coordinate and collaborate with one another.
  • We are all interested in and concerned about the position of health within the post-2015 agenda and sustainable development goals. But at the same time, continued commitment to eliminating preventable child and maternal deaths (Millennium Development Goals 4 and 5) is being demonstrated through high level meetings such as the US Agency for International Development’s Acting on the Call and the 5th Birthday and Beyond coalition’s celebration of U.S. government leadership in child survival.
  • Concern around non-communicable diseases (NCDs) is growing worldwide but their position within the global health agenda is still uncertain. The current state of NCD advocacy and commitment resembles the early days of the AIDS crisis: for example, the need for more strategic and targeted messaging, lack of clarity around metrics and impact, and the struggle to find a place for NCD funding within existing envelopes.

As a unique neutral convener in the US global health space, GHC takes to heart these and other observations from the listening tour. We’re using them to refine and improve our action plan for this year and into next. We’ll be working to raise the visibility of global health priorities at the upcoming US-Africa Leaders Summit and the United Nations General Assembly. And at an applied level, we’ll work with policymakers and advocates to strengthen evidence-based decision-making in favor of sound global health policies and increased investment.

This blog was also cross-posted here along with a video of Dr. Christine Sow and Pape Gaye’s conversation around Rethinking Global Health.

GHC: Analysis of Global Health Provisions in House and Senate Full Committee Mark-ups

Posted on in Blog Posts, Global Health Budget

The House Appropriations Committee and the Senate Appropriations Committee both marked-up their respective Fiscal Year 2015 State, Foreign Operations Appropriations in late June.  Unlike in previous years, both the House and Senate started with very similar allocations for State, Foreign Operations — $48.3 billion.  This amount is about 1.5% below the allocations approved last year and 0.3% below the President’s request level for FY2015, necessitating belt tightening. The House allocated a total of $8.3 billion for global health accounts and the Senate allocated a total of $8.14 billion – a difference of approximately 2%.  Global health funding last year totaled $8.44 billion, so these levels, if enacted, represent a decline of between 1.7 – 3 % in global health funding over FY14.
  • The House and Senate took different approaches on funding for PEPFAR and the Global Fund.  Both the House and Senate reduced the amount available for a contribution to the global fund by $300 million – allocating a total of $1.35 billion.  The House, however, shifted the additional $300 million to the PEPFAR budget, allocating it $4.32 billion.  The Senate removed the funds from the Global Fund allocation, but did not reallocate them to PEPFAR.  These allocations fall well short of the request level of $5.038 billion made by GHC members.
  • The House and Senate differed widely on their allocations for international family planning and reproductive health assistance.  The House allocated $461 million and included language that would reinstate the Mexico City policy and defund the United Nations Population Fund (UNFPA).  The Senate allocated $644 million, matching the President’s FY2015 request level, and did not include similar restrictions.  Funding for family planning in the Senate bill totaled $610 million last year.   GHC members requested that $1 billion be allocated for family planning in Fiscal Year 2015.
Additional details from the Senate Committee-approved bill include:
  • Accounts funded above the President’s request: maternal and child health, nutrition, tuberculosis, polio, pandemic influenza, and neglected tropical diseases
  • Account funded below the President’s request: Malaria ($669.5 million compared to a request of $674 million, a difference of 0.7%)
Additional details from the House Committee-approved bill include:
  • Accounts funded above the President’s request: malaria, tuberculosis, maternal and child health, nutrition, vulnerable children and polio
  • Consistent with recent years, the house bill did not specify amounts for neglected tropical diseases and pandemic influenza
  For more details on specific funding levels, please see the Kaiser Family Foundation’s analysis of the Senate Bill here and of the House Bill here.    

GHC: Proud to Support 5BB and Acting on the Call

Posted on in Blog Posts, Child health, Maternal & Child Health

By Dr. Christine Sow, Executive Director 

Amazing progress has been made in dramatically cutting child deaths across the globe over the past 25 years. Just a few years ago we celebrated the fact that the number of annual deaths of children under five had fallen from 12.5 million deaths a year to below 10 million; by 2012 the number had fallen to 6.6 million annual deaths.  Two major events took place in Washington D.C. on June 25th to celebrate progress made and assess existing challenges in ending preventable child and maternal deaths: Acting on the Call, a high level meeting organized by USAID in collaboration with UNICEF and the Bill & Melinda Gates Foundation and the 5th Birthday and Beyond celebration of the U.S. government’s leadership in child survival and maternal health. And next week the analysis and discussions will continue at a multi-sectoral global summit of the Partnership for Maternal, Newborn and Child Health being held in Johannesburg South Africa.

GHC-2014_AOC_1

The progress being considered at these meetings has been the result of many different actions and partnerships, not the least of which is the untraditional and one could say, unexpected emergence of the multi-sectoral partnership model in support of child survival and maternal health. With the emergence of HIV and AIDS in the 1980s and 90s and the realization of the toll HIV-related morbidity and mortality was taking on economic growth, corporations and large employers began to engage in workplace health schemes that went beyond traditional approaches. However they could not do this alone – UN and bilateral development agencies played a critical role in catalyzing support around these kinds of initiatives and NGOs contributed technical know-how and community development approaches. In this context we saw large scale engagement by employers in prevention and care efforts for employees, but also increasingly for their families and communities. Corporate engagement began to rapidly go beyond small scale corporate social responsibility initiatives; at the same time bilateral government agencies such as USAID started to develop mechanisms to encourage private sector involvement in favor of public health in the global south.

What has been so important to child survival and maternal health since this initial period of engagement is the expansion of these types of partnerships to encompass a much wider spectrum of public health engagement. This has included initiatives for many health priorities including malaria prevention and control, vaccination and now women’s cancers. Corporations, governments and civil society have very quickly understood that multi-sectoral partnerships, as complicated as they can be, offer a unique way to bring much-needed skill sets and resources to confront complex public health challenges.  Formal partnerships have taken shape, catalyzed to work together by the knowledge that gain can be made both for social good as well as for individual partner priorities.

5BB EdittedIn some cases these partnerships have been multilateral in nature, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and its supporting regional organizations, the Friends of the Global Fight, that work to leverage public and private sector investment in support of the Global Fund’s goals. The Global Alliance for Vaccines and Immunization (GAVI) is another example of a major global partner that was created and has been sustained through multi-sectoral efforts and partnerships, bringing together pharmaceutical companies, major donors, civil society and governments and resulting in more than 4 million averted child deaths.

At the same time other models have been successful in mobilizing the private sector without the formation of stand-alone agencies; examples of this type of approach include the Voices for a Malaria Free Future, funded by the Gates Foundation and implemented by Johns Hopkins Center for Communications Programs and its partners, that has successfully mobilized major corporate support for malaria prevention and control across Africa. The Pink Ribbon Red Ribbon partnership has rolled out successful approaches to identifying and treating cervical and breast cancer in women in low and middle income countries.

The take-home message of the last 25 years of multi-sectoral partnerships is that they have helped propel us into impactful intervention models that are suitably multi-faceted to tackle complex public health challenges. This “big tent” approach is necessary in today’s world where new technologies and networks allow for an increasing number of contributors to public health challenges. Strategic partnership platforms and coordination will be increasingly important in ensuring that these alliances remain aligned and productive, and working toward a common social good, all while acknowledging individual partner priorities and added value.

The 67th World Health Assembly: Reflections from Dr. Christine Sow

Posted on in Blog Posts, Leadership

Dr. Sow and Professor Francis Omaswa, of the African Center for Global Health and Transformation at Wednesday's Governance event

Dr. Sow and the Minister of Health for Uganda at Wednesday’s Governance event

By Dr. Christine Sow, Executive Director

Last week, GHC led a delegation of more than 70 members to the World Health Assembly (WHA) meetings in Geneva, Switzerland. As an official non-state actor affiliated with the World Health Organization, GHC once again made the most of the opportunity to provide its members with access to this critical venue. Our delegation profile was unique for a number of reasons: it included members from across multiple sectors of global health involvement (non-profit NGOs, R&D organizations, private international development partners, corporate representatives, and others engaged in global health); our delegation members represented a wide array of issues and interests that were being discussed during the WHA; and it provided a robust platform for civil society (CS) participation particularly from the US.

Our role as a civil society (CS) leader was quickly identified and optimized during the week – GHC was represented as the CS voice on many of the panels where we participated, even if our remit is much wider than that of CS representative. This was also an indication of how little CS is represented at the WHA; several of the many interesting conversations I had during the week focused on the involvement of civil society at WHA, its desirability vis a vis the other sectors represented, and the best way to ensure our complete and constructive participation. The importance of GHC’s active linking with other CS networks, alliances and coalitions was made clear throughout the week and is something that we will be actively pursuing over the coming months.

It was also interesting to be at WHA as the leader of a diverse issue-driven constituency, given that our mandate was to keep the vast notion of global health firmly on the agenda. This necessarily meant identifying and promoting cross-cutting themes to which GHC can contribute such as innovation and research, UHC, and global health financing. And in these particular cases, GHC’s contribution equated with better defining and highlighting the role of CS in shaping these agendas as they move forward.

Christine WHA Floor

Dr. Christine Sow reading a statement on nutrition interventions with child health programs on the floor of the Assembly.

At the same time it was heartening to be in the position to support individual delegates and their issues within the formal assembly. Specifically, GHC submitted and read for the record a statement on the importance of integrating nutrition interventions with child health programs, as well as a statement emphasizing the critical role played by maternal health within the newly adopted Every Newborn Action Plan. Finally, our multi-sectoral approach to membership meant that representatives from across the global health partner spectrum were able to attend the Assembly and fully contribute their perspectives and questions. The diversity of our delegation provided a conceptual snapshot of how the global health landscape is shifting – business as usual is no longer relevant; it is necessarily multi-sectoral, thematically cross cutting, and more complex given the growing numbers and types of players involved.

GHC and its membership are collectively tasked with moving the needle in the direction we see for the future of global health. This means supporting evidence-based policy change and the operational elements that will mean its success. The World Health Assembly is a unique venue providing a platform for multi-sectoral, multi-issue engagement; the strength and profile of GHC’s membership means that our role can only increase over time. Going forward, we will be sure to optimize the collective impact of our actions and voices. 

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