Health Equity: November 2011

Monday, November 28, 2011

[EQ] The WHO Global Code of Practice on the International Recruitment of Health Personnel - The Evolution of Global Health Diplomacy

The WHO Global Code of Practice on the International Recruitment of Health Personnel:
The Evolution of Global Health Diplomacy

Global Health Governance, Vol. V, Issue 1, Fall 2011
Allyn L. Taylor and Ibadat S. Dhillon

Available online at: http://bit.ly/tRznWh

“……..The May 2010 adoption of the World Health Organization Global Code of Practice on the International Recruitment of Health Personnel created a global architecture, including ethical norms and institutional and legal arrangements, to guide international cooperation and serve as a platform for continuing dialogue on the critical problem of health worker migration.

Highlighting the contribution of non-binding instruments to global health governance, this article describes the Code negotiation process from its early stages to the formal adoption of the final text of the Code. Detailed are the vigorous negotiations amongst key stakeholders, including the active role of non-governmental organizations.

The article emphasizes the importance of political leadership, appropriate sequencing, and support for capacity building of developing countries¹ negotiating skills to successful global health negotiations. It also reflects on how the dynamics of the Code negotiation process evidence an evolution in global health negotiations amongst the WHO Secretariat, civil society, and WHO Member States…..”

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[EQ] Conditional Cash Transfer Programmes: The recent experience in Latin America and the Caribbean

Conditional Cash Transfer Programmes: The recent experience in Latin America and the Caribbean

Simone Cecchini, Social Affairs Officer
Social Development Division of the Economic Commission for Latin America and the Caribbean (ECLAC), 2011
Aldo Madariaga, research assistant, in the framework of the component “Social assistance: poverty reduction and income redistribution through conditional

transfer programmes“ of the ECLAC/Swedish International Development Cooperation Agency (Sida) Cooperation Programme 2010-2011 “Social protection and social inclusion in Latin America and the Caribbean”

Available online PDF [214p.] at: http://bit.ly/sUbHUT

“….This document summarizes experience with conditional cash transfer or “co-responsibility” (CCT) programmes in Latin America and the Caribbean, over a period lasting more than 15 years. During this time, CCTs have consolidated and spread through the region’s various countries as a tool of choice for poverty-reduction policy.

According to the ECLAC database of non-contributory social protection programmes in Latin America and the Caribbean, CCTs are currently being implemented in 18 of the region’s countries, benefiting over 25 million families (about 113 million people) or 19% of the regional population, at a cost of around 0.4% of regional gross domestic product (GDP).

The basic structure of CCTs entails the transfer of monetary and nonmonetary resources to families with young children, living in poverty or extreme poverty, on condition that they fulfil specific commitments aimed at improving their human capacities. Despite the, as yet, inconclusive debates on the appropriateness of these programmes and their results in different domains, they have been hailed as representing a major step in connecting poor and indigent families with school-age children to broader and more comprehensive social-protection systems.

This document, which it is hoped will serve as a basis and input for discussion and progress in building social-protection systems premised on inclusion and universal rights, provides detailed information on the different components of CCTs. It also reviews their main characteristics in terms of the definition and registration of programme users, the targeting mechanisms used, the various types of benefits provided, and the conditionalities attached to them. It then analyses the historical trend of the indicators of CCT investment and coverage, and the information available on their effects in different domains. Lastly, it makes an assessment of the experience and the main challenges that these programmes pose in terms of their sustainability, legal framework, accountability, participation, institutionality and inter-sectoral characteristics….”

Content:
Chapter I Introduction

Chapter II General characteristics of conditional cash transfer programmes

A. Target population

B. Targeting mechanisms

C. Instruments for the selection and registration of target populations

D. Exit criteria

Chapter III Benefits and conditionalities

A. Demand-side benefits

1. Monetary transfers

2. Non-monetary transfers

3. Provision of services and access to other programmes

B. Supply-side provisions

C. Conditionalities

1. Types of conditionality

2. Sanctions and the monitoring of conditionalities

3. Evaluation of conditionalities

Chapter IV Investment and coverage

A. Countries’ efforts towards eradicating extreme poverty

Chapter V Impact

A. Human capacity indicators

B. Income inequality and poverty indicators

C. Consumption

D. Income generation and labour market insertion

E. Child labour

F. Women’s empowerment

Chapter VI Institutional framework and sustainability

A. Financial and political sustainability

B. Legal framework and institutional anchoring

C. Accountability and citizen participation

D. Transparency of beneficiary records

E. Cross-sector integration

Chapter VII Final observations

Annex

Bibliography.

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[EQ] International Profiles of Health Care Systems

International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Italy, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States

S. Thomson, R. Osborn, D. Squires, and S. J. Reed
November 9, 2011 - The Commonwealth Fund

Available online at: http://bit.ly/sHZOGP

“…..This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States.
Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations.

In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views…….”

Content:

Executive Summary

Project Goals and Specific Aims

Background

Methods Overview

Results

Summary of Key Findings

Conclusions

References

Appendix I. Detailed Project Methodology

Appendix II. Measures Identified from Literature Search

Appendix III. Conceptual Frameworks and Draft Measure Concepts

Appendix IV. Care Coordination Advisory Panel

Appendix V. Wave 3 Site Visit Findings: Implication of Data Availability and Access on Measure Implementation

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[EQ] New tool on Social Determinants of Health now available

New tool on Social Determinants of Health now available

ACTION:SDH at: http://bit.ly/rBjlT9 .

This tool is being brought to the public health community by the World Health Organization with the aim of providing public health, and other practitioners on the social determinants of health, with a one-stop portal.

ACTION:SDH houses knowledge on the social determinants according to the five social determinants of health action areas identified in the World Conference on Social Determinants of Health in October 2011.

It also provides a platform for discussion of action on the social determinants of health. We invite all in the social determinants of health community to register on ACTION:SDH. We are also actively seeking partners interested in collaborating in building up the tool, together with its users (contact: actionsdh@who.int).

There are currently three main features to the tool, which we hope to develop jointly with you, and other partners within and beyond WHO:

i. embedded web-pages pages on SDH knowledge relevant to the five action areas for SDH that were identified in the Rio Declaration;

ii. discussion forums that can be used to share tacit knowledge from practice - either by invitation only, or open to all members;

iii. a document repository that initially is housing selected WHO materials on SDH - documents are classified as Examples (case studies), Tools & Resources, and E-library.

Other standard website features also exist, such as an area for advertising upcoming training (Campus) and upcoming meetings (Events).

WHO website: http://bit.ly/u7YMza

Dr Rüdiger Krech Director, Department of Ethics, Equity, Trade and Human Rights
World Health Organization WHO
Geneva Switzerland

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Monday, November 21, 2011

[EQ] English - Spanish version Rio Political Declaration on Social Determinants of Health

Rio Political Declaration on Social Determinants of Health

The Rio Political Declaration on Social Determinants of Health was adopted during the
World Conference on Social Determinants of Health on 21 October 2011

The declaration expresses global political commitment for the implementation of the social determinants of health approach to reduce health inequities and to achieve other global priorities. It will help to build momentum within countries for the development of dedicated national action plans and strategies.

The declaration is currently available in English and Spanish only but it is being translated to all official UN languages.
Translating the text into other languages is welcome and needs WHO approval.

English version http://bit.ly/uflK9J

Spanish version http://bit.ly/tpwET7

Process of development

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.

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Thursday, November 17, 2011

[EQ] A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries

A win-win solution?:
A critical analysis of tiered pricing to improve access to medicines in developing countries

Suerie Moon1*, Elodie Jambert2, Michelle Childs2 and Tido von Schoen-Angerer2

1 Harvard Kennedy School and School of Public Health, Boston, USA

2 Médecins Sans Frontières, Campaign for Access to Essential Medicines, Geneva, Switzerland
Globalization and Health 2011, 7:39 doi:10.1186/1744-8603-7-39

Available online at: http://bit.ly/vOOoAb

“…………Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines.

We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term.

Summary

To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior to tiered pricing for reliably achieving the lowest sustainable prices……………”

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[EQ] Public health in Austria - An analysis of the status of public health

Public health in Austria - An analysis of the status of public health

Edited by

Joy Ladurner, Marlene Gerger, Walter W. Holland, Elias Mossialos, Sherry Merkur, Susie Stewart, Rachel Irwin and Jürgen Soffried

World Health Organization 2011 - European Observatory on Health Systems and Policies

Available online PDF [370p.] at: http://bit.ly/w1tdvv

“………Current demographic, medical and economic developments challenge our health care system in a hitherto unknown way, to be relevant not only today but also for decades to come. We are confronted with the difficult task of providing accessible, needs-orientated, high-quality and cost-effective health care services to everyone.

Great efforts need to be made to promote sustainable health for the entire population, especially in view of the fact that disadvantaged population groups currently tend to have less favourable health opportunities and outcomes and that health system processes can intensify this situation. Health service provision must strive to be independent of income, level of education or professional status.

Orientating health policy solely towards the health care sector is too limited. Modern health policy, which is characterized by a public health orientation, combines scientific, organizational and political efforts in order to promote the health of populations or defined population groups and creates health care systems which show a stronger focus on people’s needs and efficiency.

Quality, effectiveness, efficiency, free access, equitable and needs-oriented health services are the basis for an optimal level of health care services for the population in the long term…..”

Content:

Methodology

1. Introduction

1.1 History

1.2 The German experience

1.3 The history of public health in developed countries

Late 19th century

Before the First World War

Between the wars

After the wars

Recent and current issues in public health

1.4 Scope, functions and responsibilities of public health

Addressing determinants of health

Scope and responsibilities

1.5 Structure of public health

National and local structures

Supranational and international structures

Other actors and sectors

Multidisciplinary public health

1.6 Education, training and research

1.7. Examples of public health in practice – selected issues

Coronary heart disease

Abortion and fertility

Violence

Reference to country examples

1.8 Conclusions

2. Analysis of the Austrian public health system

2.1 Introduction and definitions

Core functions of public health – a brief overview

Notions of public health in Austria

Experts’ opinions on the definition and understanding of public health

2.2 Legislation

2.3 Funding

Legislation

Research and literature

Funding of public health-related services – overview

Funding of selected public health services and activities

2.4 Organization, structures and stakeholders

2.5 Public health disciplines, training and research – key functions

Public health disciplines

Public health training and research structure

Functions of public health in Austria

2.6 Challenges and priority areas for public health in Austria

Health and disease in Austria 80

Challenges and priority areas for public health based on expert opinion

2.7 Conclusions

3. Information management and health reporting

3.1 Introduction

3.2 Legislation

3.3 Stakeholders

3.4 Health information systems

3.5 Data protection

3.6 Data surveillance and data analysis

3.7 Health reporting

Definitions and targets of health reporting

Development of health reporting in Austria

Infrastructure

Producers of health reports

Time spans between reporting

Contents of reports

Influence of international reporting activities

Follow-up measures, evaluation and sustainability

Success factors for health reporting

Ideal health reporting versus current practice in Austria

Trends

The role of social insurance in health reporting

3.8 Infectious diseases

Legislation on infectious diseases

Mandatory reporting of notifiable infectious diseases

Surveillance of infectious diseases

Early-warning systems

Outbreak control

Reporting and control of infectious diseases in practice

3.9 Registries

3.10 Conclusions

4. Health targets

5. Addressing disadvantaged and special needs groups

5.1 Introduction

5.2 Identification of disadvantaged groups

Dimensions and scope of the disadvantaged population

Impact of disadvantage on health status

5.3 Equity of access to curative and public health services

Promoting access to care and healthy lifestyles of disadvantaged groups

Equity of access to curative services

Equity of access to public health services

Selected health services for disadvantaged groups

5.4 Potential role of social insurance

5.5 Conclusions

6. Health professionals and public health

6.1 Public health professionals in Austria

Physicians and public health

Nurses

Midwives

Other public health professionals

6.2 Capacity-building in public health

The concept of capacity-building

Leadership and commitment

Resources

Structures and organizational development

Networking and partnerships

Workforce development

Trends

Capacity-building in social insurance

6.3 Public health research

Public health research topics in Austria

6.4 Conclusions

7. Recommendations

7.1 Immediate recommendations

Definition

Overall framework and strategy

7.2 General recommendations

7.3 Specific recommendations

8. Annexes

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