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Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance.
Lancet. 2017; 390:324-332.In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals.
Progress with Scale-Up of HIV Viral Load Monitoring - Seven Sub-Saharan African Countries, January 2015-June 2016.
MMWR. Morbidity and Mortality Weekly Report. 2016 Dec 02; 65(47):1332-1335.The World Health Organization (WHO) recommends viral load testing as the preferred method for monitoring the clinical response of patients with human immunodeficiency virus (HIV) infection to antiretroviral therapy (ART) (1). Viral load monitoring of patients on ART helps ensure early diagnosis and confirmation of ART failure and enables clinicians to take an appropriate course of action for patient management. When viral suppression is achieved and maintained, HIV transmission is substantially decreased, as is HIV-associated morbidity and mortality (2). CDC and other U.S. government agencies and international partners are supporting multiple countries in sub-Saharan Africa to provide viral load testing of persons with HIV who are on ART. This report examines current capacity for viral load testing based on equipment provided by manufacturers and progress with viral load monitoring of patients on ART in seven sub-Saharan countries (Cote d'Ivoire, Kenya, Malawi, Namibia, South Africa, Tanzania, and Uganda) during January 2015-June 2016. By June 2016, based on the target numbers for viral load testing set by each country, adequate equipment capacity existed in all but one country. During 2015, two countries tested >85% of patients on ART (Namibia [91%] and South Africa [87%]); four countries tested <25% of patients on ART. In 2015, viral suppression was >80% among those patients who received a viral load test in all countries except Cote d'Ivoire. Sustained country commitment and a coordinated global effort is needed to reach the goal for viral load monitoring of all persons with HIV on ART.
Systematic review of integration between maternal, neonatal, and child health and nutrition and family planning. Final report.
Washington, D.C., Global Health Technical Assistance Project, 2011 May. 284 p. (Report No. 11-01-303-03; USAID Contract No. GHS-I-00-05-00005-00)This reveiw seeks to focus on the MNCHN and FP components of SRH to examine the evidence for MNCHN-FP integration, review the most up-to-date factors that promote or inhibit program effectiveness, discuss best practices and lessons learned, and identify recommendations for program planners, policymakers, and researchers. The objective was to address these key questions: 1) What are the key integration models that are available in the literature and have been evaluated?; 2) What are the key outcomes of these integration approaches?; 3) Do integrated services increase or improve service coverage, cost, quality, use, effectiveness, and health?; 4) What is the quality of the evaluation study designs and the quality of the data from these evaluations?; 5) What types of integration are effective in what context?; 6) What are the best practices, processes, and tools that lead to effective, integrated services? What are the barriers to effective integration?; 7) What are the evidence/research and program gaps? What more do we need to know?; and 8) How can future policies and programs be strengthened?
New York, New York, United Nations, 2013 Mar.  p.In its second report, "A renewed global partnership for development," the UN System Task Team on the Post-2015 UN Development looks at the possible features for the global partnership for development in the post-2015 era. Building on a review of the current global partnership for development, as crystallized in Millennium Development Goal 8, the report provides recommendations on potential dimensions and contours of a renewed global partnership for development. In addition the report also provides some suggestions for a robust mutual accountability system.
Health in the post-2015 development agenda. Report of the Global Thematic Consultation on Health. Draft for public comment.
[Unpublished] 2013 Feb 1.  p.The purpose of this report is to present a summary of the main themes and messages that have emerged from the consultation and to make recommendations to inform the deliberations of the High-Level Panel of Eminent Persons and the UN Secretary-General’s report to the General Assembly. Annex 1 captures in more detail the depth and breadth of the analyses and proposals in the more than 100 papers and meeting reports that were submitted to the consultation; all the inputs and a digest summarizing the papers are available from www.worldwewant2015.org/health. Chapter 2 describes the consultation process, detailing the processes that were used to reach out to different constituencies. Chapters 3-5 explain why health should be at the centre of the post-2015 development agenda. Chapter 3 summarizes the inputs about the successes and shortcomings of the MDGs, many of which were unintended and only became apparent with the benefit of hindsight. Important lessons can be learned from this assessment. Chapter 4 describes the interdependent linkages between health and development. Chapter 5 considers some of the most significant changes that have happened (and in some cases continue to happen at an accelerated pace) since the MDGs were launched in 2000. Understanding how the world, global health and priority health needs have changed and what changes are likely in the next 15 years is critical to defining the health agenda for the coming years in terms of both what needs to be done (the content) and how (the approach). Chapter 6 presents guiding principles for the post-2015 development agenda and the various options for health goals and indicators that were put forward during the consultation. Chapter 7 focuses on the importance of accountability, inclusive partnerships, innovation, and learning. Chapter 8 includes the report’s main recommendations on how to frame the future agenda for health. The contributors to this consultation are looking in the same general direction: all agree that the new development agenda needs strong and visible health goals supported by measurable indicators. The recommendations in this chapter are those that garnered the most support during the consultation. Chapter 9 concludes by suggesting concrete actions that could be taken between now and 2015 by those advocating for health to feature prominently in the next development agenda. (Excerpt)
Assessing implementation mechanisms for an international agreement on research and development for health products.
Bulletin of the World Health Organization. 2012; 90:854-863.The Member States of the World Health Organization (WHO) are currently debating the substance and form of an international agreement to improve the financing and coordination of research and development (R&D) for health products that meet the needs of developing countries. In addition to considering the content of any possible legal or political agreement, Member States may find it helpful to reflect on the full range of implementation mechanisms available to bring any agreement into effect. These include mechanisms for states to make commitments, administer activities, manage financial contributions, make subsequent decisions, monitor each other’s performance and promote compliance. States can make binding or non-binding commitments through conventions, contracts, declarations or institutional reforms. States can administer activities to implement their agreements through international organizations, sub-agencies, joint ventures or self-organizing processes. Finances can be managed through specialized multilateral funds, financial institutions, membership organizations or coordinated self-management. Decisions can be made through unanimity, consensus, equal voting, modified voting or delegation. Oversight can be provided by peer review, expert review, self-reports or civil society. Together, states should select their preferred options across categories of implementation mechanisms, each of which has advantages and disadvantages. The challenge lies in choosing the most effective combinations of mechanisms for supporting an international agreement (or set of agreements) that achieves collective aspirations in a way and at a cost that are both sustainable and acceptable to those involved. In making these decisions, WHO’s Member States can benefit from years of experience with these different mechanisms in health and its related sectors.
Rio Political Declaration on Social Determinants of Health, Rio de Janeiro, Brazil, 21 October 2011.
Rio de Janeiro, Brazil, World Conference on Social Determinants of Health, 2011.  p.The Rio Political Declaration on Social Determinants of Health expresses global political commitment for the implementation of a social determinants of health approach to reduce health inequities and to achieve other global priorities. It will help to build momentum within WHO Member States for the development of dedicated national action plans and strategies. On 15 August 2011, the text was circulated to Geneva-based Permanent Missions of Member States. The first meeting of Member States, convened by the Government of Brazil, was held at WHO headquarters on 7 September, 2011. This was followed by a series of informal consultations attended by representatives of Permanent Missions. The text of the declaration was finalized during the conference in Rio de Janeiro on 19-21 October, 2011.
Closing the gap: Policy into practice on social determinants of health. Discussion paper to inform proceedings at the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October, 2011.
Geneva, Switzerland, World Health Organization [WHO}, 2011.  p.This discussion paper aims to inform proceedings at the World Conference on Social Determinants of Health about how countries can implement action on social determinants of health, including the recommendations of the Commission on Social Determinants of Health. Evidence from countries that have made progress in addressing social determinants and reducing health inequities shows that action is required across all of five key building blocks, which have been selected as the five World conference themes: 1. Governance to tackle the root causes of health inequities: implementing action on social determinants of health; 2. Promoting participation: community leadership for action on social determinants; 3. The role of the health sector, including public health programmes, in reducing health inequities; 4. Global action on social determinants: aligning priorities and stakeholders; 5. Monitoring progress: measurement and analysis to inform policies and build accountability on social determinants. (Excerpt)
Country-led monitoring and evaluation systems. Better evidence, better policies, better development results.
Geneva, Switzerland, UNICEF, Regional Office for CEE/CIS, 2009.  p.This collection of articles by UNICEF discusses how to improve evidence-based decision making in developing countries through the use of monitoring and evaluation systems. While information on programmatic best practices is available, knowledge bases in developing countries still have significant gaps. This book forges the link between learning about evidence-based policymaking and the contributions that country-led monitoring and evaluation systems can make in supporting good decision making.
Vienna, Austria, United Nations, Office on Drugs and Crime, 2006.  p.The present Toolkit was prepared because there is still much to be learned about what works best to prevent and combat human trafficking under various circumstances. It presents a selection of conceptual, legislative and organizational tools in use in different parts of the world. The Toolkit is based on the premise that the problem of trafficking in persons, whether at the national or local level, can only be addressed effectively on the basis of comprehensive strategies that are based on human rights and that take into account the transnational nature of the problem, the many associated criminal activities, the frequent involvement of organized criminal groups and the profound pain, fear and damage suffered by the victims. Although the Toolkit offers a few examples of comprehensive national strategies, most of the tools that it offers focus on one specific aspect of the comprehensive response required. Individual tools may be used to develop comprehensive strategies, or to augment or strengthen some of the essential components of existing ones. Many of these tools will need to be adapted to national or local circumstances. None of the tools, by itself, is sufficient to provide an effective response to the problem. (excerpt)
Unkept promises: what the numbers say about poverty and gender. An international citizen's progress report on poverty eradication and gender equity. Advance Social Watch report 2005.
Montevideo, Uruguay, Social Watch, 2005. 114 p. (Social Watch Report)Almost five years have passed since the largest gathering ever of heads of State and government made this solemn promise to the peoples of the world: "we will spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty."1 Almost ten years have passed since the leaders of the world solemnly committed themselves in Copenhagen "to the goal of eradicating poverty in the world, through decisive national actions and international cooperation, as an ethical, social, political and economic imperative of humankind."2 This is an ambitious agenda. So much so that it was compared by many leaders to the historic task of slavery abolition in the 19th century. Inspired by the Copenhagen Declaration and the complementary Beijing Platform for Action towards gender equity, 3 citizen groups from all over the world came together to form the Social Watch network. Every year since then, Social Watch has published a comprehensive report monitoring the governments' compliance with their international commitments. The findings of the national Social Watch coalitions in over 60 countries and the analysis of the available indicators coincide: the promises have remained largely unmet. Unless substantial changes are put in place soon, the targets set for the year 2015 will not be achieved. (excerpt)
Geneva, Switzerland, UNAIDS, 2005 Feb. 79 p. (UNAIDS/05.28E)This report summarizes UNAIDS' assistance to countries in 2004 and 2005. Drawn from the reports of UNAIDS' Country Coordinators from over 75 countries, the report is divided into five chapters. Basic information on UNAIDS and how it operates, especially at country-level. How UNAIDS is contributing to implementation of the "Three Ones" principles. The many ways in which UNAIDS has assisted countries in strengthening their responses to AIDS. How UNAIDS is working to enhance the United Nations system's capacity to assist countries in responding to AIDS. How UNAIDS plans to meet key challenges for the future. (excerpt)
Emerging Infectious Diseases. 2006 Jul; 12(7):1058-1065.The new International Health Regulations adopted by the World Health Assembly in May 2005 (IHR 2005) represents a major development in the use of international law for public health purposes. One of the most important aspects of IHR 2005 is the establishment of a global surveillance system for public health emergencies of international concern. This article assesses the surveillance system in IHR 2005 by applying well-established frameworks for evaluating public health surveillance. The assessment shows that IHR 2005 constitutes a major advance in global surveillance from what has prevailed in the past. Effectively implementing the IHR 2005 surveillance objectives requires surmounting technical, resource, governance, legal, and political obstacles. Although IHR 2005 contains some provisions that directly address these obstacles, active support by the World Health Organization and its member states is required to strengthen national and global surveillance capabilities. (author's)
Moscow, Russia, Transatlantic Partners Against AIDS, 2005. 52 p.The purpose of this Handbook is to assist members of the Federation Council and deputies of the State Duma of the Russian Federation, and other Russian officials on the federal and regional levels, in enacting appropriate legislation and legislative reform to address AIDS, whether they be initiatives prohibiting discrimination against PLWHA or members of highly vulnerable groups, laws guaranteeing reliable HIV prevention information for all Russian citizens, or other policy priorities — and ensuring adequate fiscal and other resources to support them. This Handbook provides examples of the best legislative and regulatory practices gathered from around the world. Best practices are given for each of the 12 guidelines contained in the International Guidelines on HIV/AIDS and Human Rights, published in 1998 by the Office of the United Nations High Commissioner for Human Rights (UNHCHR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Handbook also presents detailed information on the Russian AIDS epidemic with regard to the establishment and implementation of these Guidelines. Most importantly, the Handbook outlines concrete recommendations on measures that legislators can take to protect human rights and promote public health in responding to the epidemic. (author's)
Tracking progress towards the Millennium Development Goals: reaching consensus on child mortality levels and trends.
Bulletin of the World Health Organization. 2006 Mar; 84(3):225-232.The increased attention to tracking progress towards the Millennium Development Goals (MDG), including Goal 4 of reducing child mortality, has drawn attention to a number of interrelated technical, operational and political challenges and to the underlying weaknesses of country health information systems upon which reliable monitoring depends. Assessments of child mortality published in 2005, for almost all low-income countries, are based on an extrapolation of the trends observed during the 1990s, rather than on the empirical data for more recent years. The validity of the extrapolation depends on the quality and quantity of the data used, and many countries lack suitable data. In the long run, it is hoped that vital registration or sample registration systems will be established to monitor vital events in a sustainable way. However, in the short run, tracking child mortality in high-mortality countries will continue to rely on household surveys and extrapolations of historical trends. This will require more collaborative efforts both to collect data through initiatives to strengthen health information systems at the country level, and to harmonize the estimation process. The latter objective requires the continued activity of a coordinating group of international agencies and academics that aims to produce transparent estimates -- through the consistent application of an agreed-upon methodology -- for monitoring at the international level. (author's)
Summary and recommendations from the UNAIDS Resource Tracking and Priority Setting Meeting, Washington D.C., USA, 20-21 March 2003.
[Geneva, Switzerland], UNAIDS, 2003 Mar. 10 p.The key objectives of the meeting were: 1. To review current and future efforts on resource tracking by the practitioners; 2. To identify gaps; 3. To identify key (short/long term) priorities; 4. To develop a consensus on how to work together in the future with a discussion on the potential value of forming a Consortium. All of the presentations given during the course of the meeting are available on the UNAIDS website (www.unaids.org) and will not be discussed here. This report highlights the discussions on gaps, priorities, and recommends next steps. (excerpt)
“Three Ones” key principles . “Coordination of National Responses to HIV / AIDS”. Guiding principles for national authorities and their partners.
Geneva, Switzerland, UNAIDS, 2004. 4 p.The HIV/AIDS pandemic is a genuine global emergency taking the lives of eight thousand people a day and threatening the lives of tens of millions more as the infection continues to spread around the world. New but still limited resources to respond to the needs of people living with HIV and AIDS and those at risk of infection will be utilized most efficiently if there is maximum coordination within the international community. To leverage resources and have the maximum impact on the global response to AIDS, all parties should strive to target their programmes on the priority needs of affected countries strive, seeking to avoid duplication of effort. (excerpt)
Geneva, Switzerland, UNAIDS, . 2 p.The AIDS epidemic is a complex global crisis, which continues to worsen. At the same time, the world is responding more effectively than ever before. National responses are broader and stronger, and have improved access to financial resources and commodities. We, bilateral and multilateral donor agencies meeting with national leaders combating the spread of AIDS, reaffirm our broad and sustained commitment to supporting national AIDS responses. We endorse the “Three Ones” or key principles for concerted AIDS action at country level, with a view toward achieving the most effective and efficient use of available resources and ensuring rapid action and result-based management. These principles – detailed in the conference papers – are: One agreed HIV/AIDS Action Framework that provides the basis for coordinating the work of all partners. One National AIDS Coordinating Authority, with a broad based multi-sectoral mandate. One agreed country level Monitoring and Evaluation System. (excerpt)
Geneva, Switzerland, UNAIDS, 2004 Jun.  p. (UNAIDS/04.35E)This progress report summarizes the achievements of CRD (Country and Regional Support Department) in 2003 and presents selected highlights in greater detail. The first section outlines the strategic framework for action, Directions for the Future, the status of its implementation, the associated capacity strengthening of UNAIDS at country level, and challenges for 2004 and the next biennium. Text boxes in this section highlight “UNAIDS corporate tools” employed to implement the strategic framework. The second section reviews CRD’s efforts to translate global initiatives into results at country level. UNAIDS is involved in numerous global initiatives, three, which required particular involvement of UNAIDS resources at country level, are highlighted here. The third section reviews regional progress towards implementing the strategic framework for action. The examples cited, whilst not being an exhaustive review of country work, illustrate how UNAIDS has worked as a catalyst for national AIDS response. This report concludes with a collection of two-page country situation and progress summaries from 70 of the 134 countries with the UN Theme Groups on HIV/AIDS. (excerpt)
International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control. Summary report. Geneva, Switzerland, 16-17 January 1997.
Geneva, Switzerland, World Health Organization [WHO], Division of Emerging and Other Communicable Diseases Surveillance and Control, 1997. 19 p. (WHO/EMC/ DIS/ICG/97.9)This was the first meeting of the International Coordinating Group (ICG) proposed at the 2-3 December, 1996 meeting of the Ad Hoc Working Group on WHO Strategy for Provision of Meningitis Vaccine for Epidemic Prevention and Control. The meeting was chaired by Dr d'Almeida, DPM, AFRO, and the agenda and list of participants are provided as annexes. The objectives of the meeting were to define terms of reference, agree on the membership of the International Coordinating Group (ICG) and its Executive Sub-Group, to establish the criteria for determining priority distribution of vaccine for epidemic control in the 1997 season, for which only 14 million doses of vaccine would be available, and to consider a strategy for ensuring adequate vaccine supplies in future years. The expected outcome of the meeting was to obtain agreement on the responsibilities of the ICG and its Executive Sub-Group, on the criteria for vaccine distribution in 1997, on a funding mechanism for an emergency stock of vaccines and auto-destruct syringes, and on a strategy to address adequate vaccine and syringe supplies for future years. The meeting met these goals. (excerpt)
Geneva, Switzerland, WHO, 2003.  p. (WHO/HIV/2003.11)The main strategy foreseen in order to implement a global M&E is to simplify and standardize tools for tracking the performance of antiretroviral therapy programmes, including surveillance of drug resistance, with the following steps: develop simple, standard, easy-to-use monitoring and evaluation indicators for ART programmes, promote the universal adoption and use of the core indicators for ART programmes, develop guidelines and networks for surveillance of antiretroviral drug resistance, develop guidelines and networks for monitoring risk behaviour, establishment of a Strategic Information Centre to collect data analyse and present the information on progresses made towards 3 by 5 for all to use. (excerpt)
Geneva, Switzerland, WHO, 2003.  p. (WHO/HIV/2003.17)Country support is central to global efforts to reach the 3 by 5 target of providing antiretroviral therapy (ART) to 3 million people in resource-limited countries by the end of 2005. Achieving the 3 by 5 target will require the concerted efforts of all concerned parties in countries and at the global level. However, countries must take the lead. International partners will need to assist in meeting the resource gap and also in helping to build the necessary capacity to deliver ART. The World Health Organization (WHO), as the UNAIDS Cosponsor responsible for care and treatment, together with UNAIDS and the other Cosponsors and partners, is taking the lead in catalyzing action to reach 3 by 5 by building on existing national and global efforts. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 24-46.The solemn commitment that was made in Cairo in 1994 to make reproductive health care universally available was a culmination of efforts made by the United Nations Population Fund (UNFPA) and all those concerned about a people-centred and human rights approach to population issues. The commitment posed important challenges to national governments and the international community, to policy makers, programme planners and service providers, and to the civil society at large. The role of UNFPA in building up the consensus for the reproductive health approach before Cairo had to continue after Cairo if the goals of the International Conference on Population and Development (ICPD) were to be achieved. UNFPA continues to be needed to strengthen the commitment, maintain the momentum, mobilize the required resources, and help national governments and the international community move from word to action, and from rhetoric to reality. Reproductive health, including family planning and sexual health, is now one of three major programme areas for UNFPA. During 1997, reproductive health accounted for over 60 per cent of total programme allocations by the Fund. (excerpt)
Essentials. 2003 Jan; (10): p..While the outcomes of monitoring poverty are not always self-evident and may become apparent only with time, it is important to draw key lessons from the experience. These outcomes have major implications for fostering innovations in poverty reduction strategies as well as programming for human development, political participation and social integration. The lessons learned from monitoring poverty presented in this ESSENTIALS are drawn from a diverse pool of resources from UNDP’s experience and those of key partner organizations. (excerpt)
Civil-Military Alliance Newsletter. 1997 Jul; 3(3):6-7.This article reviews the complementary initiatives between the Civil-Military Alliance to Combat HIV & AIDS and the Division of Emerging and other Communicable Diseases Surveillance and Control of the World Health Organization in Geneva. (excerpt)