Health Breaking News 315

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 315


‘2018: a Year in Review through PEAH Contributors’ Takes’ by Daniele Dionisio 

Leave no one behind: From development slogan to policy practice 

Neoliberalism has led to a crisis in care – and we urgently need to solve it 

Everyone should be outraged by child poverty in Britain and the US  

UN rights chief welcomes new text to protect rights of peasants and other rural workers 

Smallholders’ global food production underestimated  

Human Rights Reader 468 

The Global Gender Gap Report 2018 

UNPO NEWSLETTER November-December 2018 

WHO launches technical guidance series on the health of refugees and migrants 

The Overwhelming Evidence in Favor of Harm Reduction  

End-of-year news from TDR Director, John Reeder 

WHO Report Shows Global Progress On Influenza Preparedness Response 

The World Needs a Urine Test for TB. But It’s Already Here 

Spatially targeted screening to reduce tuberculosis transmission in high-incidence settings 

Eliminating financial and economic barriers to tuberculosis diagnosis and care 

Opinion: In DRC Ebola crisis, every red line has been crossed 

DRC Ebola: latest numbers as of 18 December 2018 

Donor Transitions From HIV Programs: What Is The Impact On Vulnerable Populations? 

DNDi: 2018 in Review 

3 takeaways from COP24 

Murky climate deal lets down poor countries 

What the COP24 Needs: A New Emerging Mindset 

Climate Change Is The Greatest Threat To Human Health In History 

The impact of climate inaction on food security 

The Doom Effect: In Adapting to Climate Threats, Philanthropy Can Help Reinvent U.S. Politics 

Media Advisory: How much land is degraded globally? 

WHO: 5 tips for a healthy diet this New Year 

Thailand becomes first in Asia to introduce tobacco plain packaging; WHO commends efforts 

Effectiveness of a text-messaging-based smoking cessation intervention (“Happy Quit”) for smoking cessation in China: A randomized controlled trial 

2018: a Year in Review through PEAH Contributors’ Takes

Authoritative insights by 2018 PEAH contributors added steam to debate on how to settle the conflicting issues that still impair equitable access to health by discriminated population settings worldwide

by  Daniele Dionisio*

PEAH – Policies for Equitable Access to Health

2018: a Year in Review through PEAH Contributors’ Takes


As  2018 draws to a close, I wish to thank the top thinkers and academics who enthusiastically contributed articles over the year. Their authoritative insights meant a lot to PEAH scope while adding steam to debate on how to settle the conflicting issues that still impair equitable access to health by discriminated population settings worldwide.

Find out below the relevant links:

Transitioning from Global Fund Grants to Domestic Funds: a New Opportunity for Strengthening Health Products’ Procurement and Supply Chain Systems in Middle Income Countries? by Barbara MilaniIndependent Consultant, Pharmaceuticals and Public Health – Programme & Policy Specialist

‘Lifestyle Drift’, Air Pollution and the World Health Organization by Ted SchreckerProfessor of Global Health Policy, Newcastle University

The UK is Finally Cracking Down on Unreported Clinical Trials. Now Other European Countries Must Take Action Too by Till BrucknerFounder of TranspariMED  

Social Capital Formation in the West African Ebola Pandemic: Tapping Faith-Community Trust Reserves is an Essential Tactical Strategy in Outbreak Control by Richard A. Nisbett, E Julu Swen, M. Scott GilpinUniversity of Liberia-PIRE Center Africa, Discipleship Resources International of the United Methodist Church, Liberia and Wesley College and Foundation, Tanzania 

Equity in Investments – a Need to Map the Research Landscape for Health by Michael HeadClinical Informatics Research Unit and Global Health Research Institute, Faculty of Medicine, University of Southampton, UK

Why Health in All Policies Is a Necessity? by Gisela AbbamDirector, Strategic Partnerships Abt Associates

Discrimination and Stereotype in the Global-North and -South Nation-States: the Major Interlope to Universal Health Coverage for Refugees and Other Vulnerable Immigrant Persons by Michael SsemakulaHealth Rights Researcher & Advocate, Human Rights Research Documentation Center (HURIC) & PHM-Network, Uganda

Private Players in the Growth Paradox of Health Service Provision and Advancement in Uganda by Michael Ssemakula, Health Rights Researcher & Advocate, Human Rights Research Documentation Center (HURIC) & PHM-Network, Uganda

The Global Implications of the Gag Rule and its Manifestations on Reproductive Health Rights in Uganda by Denis Bukenya and Michael SsemakulaHealth Rights Researchers & Advocates, Human Rights Research Documentation Center (HURIC), and PHM-Network, Uganda

Falsified and Substandard Medicines: Threat to the SDGs – but Who’s Watching, Caring or Acting? by David PattersonPrincipal Consultant, Health, Law and Development Consultants (HLDC), The Hague, Netherlands

Caning of LGBT Persons – Implications for Public Health and the Economy by Fifa RahmanPostgraduate Researcher (PhD) at University of Leeds, UK

The Untold Story About Counterfeit Medicines And Its Effects On The Right To Health In Uganda by Denis Bukenya and Michael SsemakulaHealth Rights Researchers & Advocates, Human Rights Research Documentation Center (HURIC), and PHM-Network, Uganda

The NHS Postcode Lottery: How the Decision-Making Power of Clinical Commissioning Groups is Preventing Standardised, Equal Access to the Abbott Freestyle Libre in England by Rebecca Barlow-NooneStudent of Medical Sciences at the School of Biological Sciences, University of Leeds (UK)

Accessibility to Medicines in Uganda by Denis Bukenya and Michael SsemakulaHealth Rights Researchers & Advocates, Human Rights Research Documentation Center (HURIC), and PHM-Network, Uganda

Public Finance and Public Health by Ted SchreckerProfessor of Global Health Policy, Newcastle University

Promoting Some Literacy on the Health Systems of Countries of Origin of Migrants in Europe by Yves CharpakMD, PhD, Consultant, Vice-president of the French Public-Health Association

Health and Climate Change: a Third World War with No Guns by Juan E Garay, David Chiriboga, Nefer Kelley, Adam GarayEquity Movement

New Hope for Conquering MDR-TB with Rapid Diagnostic Test and Short, Affordable Treatment Regimens by Subhash Hira, University of Washington-Seattle, USA-Brook Besor University, Lusaka, Zambia,  et al.

HIV and AIDS in Eastern Europe and Central Asia: Pragmatism and Human Rights Versus Taboos by Hans Houweling and Anke (J.J.) van Dam, AFEW International

Challenges and Solutions for the Latinx Population to Effectively Participate in Clinical Trials by Karen Mancera CuevasAssociate Director, Research Projects at Northwestern University, Feinberg School of Medicine, Chicago USA

International HPV Awareness Day by Corie LeiferGive Love Not HPV Campaign Coordinator, International Papillomavirus Society

Governments’ Failure to Curb Rampant Waste in Medical Research Threatens SDG Health Targets by Till BrucknerFounder of TranspariMED

Fair Research Partnerships in European Commission Funded Research by Carel IJsselmuiden and Kirsty KlippCouncil on Health Research for Development – COHRED

Who is Taking Responsibility for the Quality-Assurance of Medicines Supplied in Humanitarian and Development Programs? A Proposal from Belgium by Raffaella RavinettoPublic Health Department, Institute of Tropical Medicine Antwerp, Belgium

Policy Implications for Community-based Interventions to Strengthen Healthcare Delivery, Based Upon a Formative Study of Community Capacity in Urban Monrovia, Liberia Corresponding Author: Richard A. NisbettUniversity of Liberia-Pacific Institute of Research and Evaluation, Africa Center (UL-PIRE), WVS Tubman University, Harper Liberia                    

Corrupt Medical Practices in Germany by Christiane FisherMedical Director, No Free Lunch, Germany MEZISMember of the German Ethics Council

Bridging the Gaps in Clinical Guideline to Care in Pregnancy for Women Using Psychoactive Substances by Grana ZiiaAFEW-Kyrgyzstan

Opium and its Association with Cardio-Vascular Disease by Junior BazileProgram Director at New York Harm Reduction EducatorsResearch Consultant and Online Community Moderator at Global Health Delivery Project, Harvard University

Finally in the (Global Health) Spotlight, Nurses Now! by Clara Affun AdegbuluIntern and Researcher, Health Policy Unit, Institute of Tropical Medicine in Antwerp, Belgium; Masters (MPH) student, University of Vienna, Austria 

Global Health and Occupied Palestine by Angelo StefaniniCentre for International Health, University of Bologna (Italy)

Overcoming Public Health’s Perception Challenges by Lawrence C. LohAdjunct Professor, Dalla Lana School of Public Health, University of Toronto, and Director of Programs at The 53rd Week Ltd

The Strategic Functions of Nutrients in Preventing Tropical Diseases by Adrian BoruchProject Manager, ALVO Medical, Poland

What Public Health Policy Can Learn from the Murders of Nicole Brown Simpson and Ron Goldman by Ted SchreckerProfessor of Global Health Policy, Newcastle University

Understanding the Systems that Influence Distribution Channels for Drugs in Uganda by Denis Bukenya JosephHealth Rights Researcher & Advocate, Human Rights Research Documentation Center (HURIC) & PHM-Network, Uganda

On Health Inequalities, Davos, and the Deadly Neoliberalism by Ted SchreckerProfessor of Global Health Policy, Newcastle University

Challenges in Universal Health Coverage in Pakistan by Nighat KhanAffiliate at Global eHealth Academy University of Edinburgh

The contributions highlighted above add to PEAH internal articles published throughout the year. Find the links below:

The Contradictory Case of EU SPC Mechanism and Waiver by Daniele Dionisio

Will Ever WHO’s Roadmap for Medicines Move into Action? The Threat of Neoliberal Polices, Corporate Interests Collusion by Daniele Dionisio

Uganda: the Big Challenge of Maternal and Child Health by Pietro Dionisio

Interview to Saliou Diallo by Daniele Dionisio

La Salute Sostenibile (Pensiero Scientifico Ed. 2018) review by Daniele Dionisio

The Uncertain Status of UHC and the Latent Balance of the Social-Justice Approach to Health by Pietro Dionisio

Moreover, as part of PEAH scope and aims, a new column titled ‘Focus on: Uganda’s Health Issues‘ has been set up. A space open to contribution articles from everywhere, this column aims to serve as an observatory of challenging health issues in Uganda from a comprehensive view encompassing the policies, strategies and practices of all involved actors. 

In the meantime, our weekly page Health Breaking News Links has been serving as a one year-long point of reference for PEAH contents, while turning the spotlight on the latest challenges by trade and governments rules to the equitable access to health in resource-limited settings.


*Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is an advisor for “Medicines for the Developing Countries” for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). Dionisio is Head of the research project  PEAH – Policies for Equitable Access to Health. He may be reached at

Health Breaking News 314

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 314


Why the Universal Declaration of Human Rights is still relevant, 70 years on 

How can the UN become a Thought Leader again? 

‘Transitioning from Global Fund Grants to Domestic Funds: a New Opportunity for Strengthening Health Products’ Procurement and Supply Chain Systems in Middle Income Countries?’ by Barbara Milani 

Tanzania is first African country to reach an important milestone in the regulation of medicines 

Could The Latest In Medical Treatment Be… A Roof? Medicaid Says Maybe 

Moving Work On Social Determinants Of Health From Health Funders To Health Funder Partnerships 

Journal of Public Health Volume 40, Issue suppl_2, December 2018 

Experts Call For Global Accountability Mechanism For Access To Essential Medicines 

A global accountability mechanism for access to essential medicines 

Pharma and medical device lobbies stonewall on transparency as doctors and patients call for fines on companies hiding clinical trial results 

OECD Report Presents Policies To Balance Innovation With Access To Medicines 

Latest numbers of DRC Ebola as of 12 December 2018 

Country-owned strategies to fight malaria 

So Close, Yet So Far: Why is HIV/AIDS Funding Decreasing? 

It is not our fault”: the plight of HIV positive adolescents in Cameroon – What difference can compassionate care make to HIV care for adolescents in LMICs? 

Vaccines in the fight against AMR and access by vulnerable groups 

Fostering synergies and strengthening joint efforts to fight AMR 

The role of specialist nurses in the fight against AMR 

Hospital pharmacists in the frontline against AMR 

EMSA’s View on Antimicrobial Resistance 

Medical students taking action on AMR 

How the new CAP can support the reduction in use of farm antibiotics 

Human rights in 2018 – ten issues that made headlines 

Rethinking global poverty reduction in 2019 

Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies 

Nearly 30 million sick and premature newborns in dire need of treatment every year 

The Global Compact on Migration: Dead on arrival? 

163 states just approved the Global Compact for Migration. Now what? 

Indigenous IP And Climate Change Subject Of New Book 

No One Solution: A Climate Prize Hopes to Plant Many Seeds 

The most important country for the global climate no one is talking about 

Scientists decry lack of data on ocean pollution 

Two of 196 signatory countries to Paris Agreement have raised their climate ambitions

Transitioning from Global Fund Grants to Domestic Funds in Middle Income Countries

Preparing the transition of Middle Income Countries from Global Fund to domestic funds may provide new opportunities to strengthen procurement and supply chain management areas.  Reforming health products’ procurement procedures, price policies, domestic financial flows and national quality assurance procedures are likely to represent needed steps to capitalize on Global Fund supported health procurement. This will require renovated country ownership and a central role for WHO to implement efficiently collaborative regulatory projects

By Barbara Milani

Independent Consultant, Pharmaceuticals and Public Health – Programme & Policy Specialist

Transitioning from Global Fund Grants to Domestic Funds

A New Opportunity for Strengthening Health Products’ Procurement and Supply Chain Systems in Middle Income Countries?


The Global Fund financing model started off with unprecedented central ownership placed at national level for procuring quality assured health products at competitive prices. At the same time, by establishing clear procurement and supply chain management  (PSM) policies it has created a global market for quality assured medicines prequalified by WHO and/or registered by Stringent Regulatory Authorities. (1) Among the several requirements that the Global Fund placed on country systems, quality control of medicines has motivated several countries to strengthen national Quality Control laboratories to obtain WHO accreditation.

The Global Fund procurement policies embraced a much larger field of opportunities to strengthen health product management systems at the national level; either strategically building through disease specific grants or using Health System Strengthening dedicated grants. Many countries were supported to meet the most urgent needs such as central storage facilities and distribution systems meeting WHO Good Storage and Distribution Practices. Much of the potential to strengthen PSM remained underused due to weak proposal conceptualization. A 2017 Global Fund systematic analysis using a sample of 15 countries clearly recognized that supply chain management remains a major challenge. (2) Technical assistance is still required in several countries for quantification and procurement planning.  As reported by several organizations, risks of stock-outs and actual stock-outs are not unusual and technical assistance is often called in on an emergency level to solve or mitigate these risks.  (3) (4)

In the wider context of all Global Fund supported countries, the challenges raised for an unplanned transition are understandable. (3) (4) The positive element is that the Global Fund has set policy and guidance for co-financing and transition learning from the first experiences on transition. (5) (6) The policy reassures on the fact that the transition process has to be prepared and evaluated before enacting the actual transition.

There are countries for which the Global Fund contribution constitutes only a minimal fraction of the national programme operating budget (20% or less). However, this contribution can be vital for several reasons. In many cases the Global Fund contribution covers key activities that the national health system is currently unable to absorb. These activities range from community approaches addressing the epidemics in the most vulnerable and difficult to reach populations to the procurement of specific categories of health products.

De facto, the Global Fund systems have allowed countries to procure quality assured medicines even in small quantities through international procurement mechanisms bypassing price-related or government procedural limitations. In other instances, the Global Fund has mandated procurement of specific health products through certain channels. According to Global Fund policies, second line anti-tuberculosis medicines shall be procured through the Global Drug Facility, a United Nations-based  procurement agency which is pooling demand and consolidating a market for quality assured medicines for less than half a million patients per year globally.

In preparing the transition of Middle Income Countries, there are opportunities to strengthen PSM areas, which have been neglected during the rollout of grants. There is also an unprecedented possibility to prepare the transition in ways that support countries to reform their laws, regulations and procedures to procure and supply health products using modalities that meet WHO standards and obtain the “best value for money”. More specifically, domestic procurement of quality assured health products at competitive or internationally negotiated prices requires that government procurement procedures be reformed and adapted. These, among other aspects, shall enable timely procurement of health products, which are single/limited source or required in small quantities or for which internationally negotiated prices are available. These categories of products require distinct procurement methods beyond national tendering processes.  Assessing the current status of government procurement procedures for health products seems a starting point for preparing a step-wise transition. Reforming national procurement procedures for health products requires conceptualization and time.  Such processes are indeed framed within the legislative system of the country. (6)

Price policies should also be evaluated and reviewed. Especially in Middle Income Countries, price policies shall favour all measures to access quality assured health products at the most affordable price. These include among various interventions, mechanisms for procurement of health products at internationally negotiated prices as discussed above, but also training to enhance knowledge, reform and use of TRIPS flexibilities included in national laws. (6)

Another crucial aspect is the quality assurance of medicines and other health products. This requires major involvement and a renovated role of the World Health Organization to make use, expand and evaluate the WHO collaborative projects aimed at facilitating registration of quality assured medicines at the national level. (7) While the Global Fund has mandated quality standards for health products procured with its funds, the transition may result in procurement of locally registered medicines without recognition of the nearly two decades of work to expand access to generic affordable medicines through the WHO prequalification programme. (1) (3) (4) National disease programmes, through the implementation of Global Fund procurement procedures, have generally acquired the concept of quality assured medicines and its link with treatment’s efficacy and prevention of drug resistance. This may not be the case for unstructured and understaffed National Regulatory Agencies. Hence the need for WHO to offer, engage and measure participation in the WHO collaborative registration project seems the only way to interface with governments. Until now, the collaborative procedures for accelerated registration for medicines prequalified by WHO and registered by Stringent Regulatory Agencies (SRA) have been largely underused by the participating countries. Effective collaborative procedures to facilitate registration of quality assured medicines are very much needed. Countries preparing for a transition from Global Fund grant shall engage in such collaborative procedures.

Secondly, the Global Fund financing is often used to overcome limitations in procurement due to unreliable flow of domestic funds. In preparing for a transition, the domestic financial procedures need to be reviewed to enable reliable national procurement planning. Financial engagement and disbursement for health products shall be framed to allow the regular launch of national procurement processes and suppliers contracting.  Irregular availability of funds is detrimental to procurement planning, may discourage suppliers to apply for national tenders also for health products required in considerable quantities. Irregular financial flow makes any health products quantification and procurement planning exercise ineffective.

While several elements come into play to ensure an uninterrupted supply of essential health products to patients, it is important to highlight key elements that are likely to come up for any Middle Income Country transition.  Addressing the suitability of national health product procedures, price policies, quality assurance systems and domestic financial procedures shall be at the core of discussion. Moving in this direction requires renovated country ownership to make the best use of this opportunity to improve efficiency throughout the whole health system as well as a renovated role of WHO to address shortfalls in the functioning of National Regulatory Agencies.



1 -Guide to Global Fund Policies on Procurement and Supply Management of Health Products, July 2017 Geneva,  Switzerland

2 -Audit Report :The Global Fund’s In-country Supply Chain Processes, GF-OIG-17-008, 28 April 2017, Geneva, Switzerland

3 -Article: Transitioning in the context of universal health coverage: Reflections from STOPAIDS and partners event at World Health Assembly 71, Jenny Vaughan, 11th June 2018

4 -MSF calls on Global Fund Board to make urgent changes to prevent drug stock-outs and quality issues, Geneva, 13 November 2018 and co-

5 -The Global Fund Sustainability, Transition and Co-financing Policy, 35th Board Meeting, GF/B35/04 – Revision 1 Board Decision

6 -Guidance Note: Sustainability, Transition and Co-financing of programs supported by the Global Fund, 13 January 2017

7 -Website : Prequalification of medicines: Collaborative Procedure for Accelerated Registration






Health Breaking News 313

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 313


Unhealthy conditions: IMF loan conditionality and its impact on health financing 

The problem with Public-Private Partnerships and the role of the EU 

CGD UPCOMING SEMINAR: Disrupting Health Product Distribution: The Emergence of Digital Innovators in Africa THURSDAY, DECEMBER 13, 2018 – 12:00PM TO 1:30PM 

International symposium on understanding the double burden of malnutrition for effective interventions 10 – 13 December 2018 IAEA Headquarters, Vienna, Austria 

WHO says spread of polio remains international health emergency 

The President’s Malaria Initiative and Other U.S. Government Global Malaria Efforts 

Congo Ebola outbreak is 2nd largest, 2nd deadliest 

DRC Ebola: Latest numbers as of 4 December 2018 

Are we on the cusp of a breakthrough in Ebola treatment? 

Measles cases spike globally due to gaps in vaccination coverage 

On World AIDS Day, a Moment for Celebration and Self-Reflection 

MPP: Accelerating access to treatment for children with HIV must be a public health priority 

The right to deworming: The case for girls and women of reproductive age 

‘Antimicrobial Resistance Knows No Boundaries’ 

First-ever UN report on disability and development, illustrates inclusion gaps 

The crisis of multilateralism and the future of humanitarian action 

Over 40 million people still victims of slavery 

Human Rights Reader 467 

Amit Sengupta (1958 to 2018) was a powerful voice for health equity 

UNPO Khmer-Krom Newsletter #2, November-December 2018 

No decline in discrimination against people of African descent in EU 

Ten harmful beliefs that perpetuate violence against women and girls 

Medicines Law & Policy: The TRIPS Flexibilities Database 

Putting People’s Health First: Improving Access to Medicines in Europe 

Amgen Cuts Repatha’s Price By 60 Percent. Will Value-Based Pricing Support Value-based Patient Access? 

Study Finds Arthritis Drug Enbrel Overpatented, Overpriced in US 

French health groups challenge public funders INSERM and CNRS over unreported clinical trials 

Research into medical devices needs to be made transparent – statement by TranspariMED  

In Yemen, Lavish Meals for Few, Starvation for Many and a Dilemma for Reporters 

The future of the sweetened beverages tax in Portugal 

World is woefully short of 2 degree goal for climate change, according to UN report 

World Bank Group to Raise $200 Billion to Fight Climate Change 

Pollution by the numbers 

Legal tweak could wreck Amazon forest