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What’s new in Global Health? July/August 2021

Dear all,

Please discover our monthly press review on global health here :

Echoing the Generation Equality Forum held in Mexico City in March and in Paris from June 30 to July 2, 2021, we offer a summer press review (July-August) dedicated to the consequences of the Covid-19 pandemic from a gender perspective.

As early as spring 2020, it appears that women are paying a higher price than men to the epidemic. Several factors are immediately identified: greater exposure of women to the virus due to their over-representation in the health and service sectors and, compared to men, a greater proportion of women affected by job losses related to the pandemic.

One year later, the observation remains valid. Only in the medical field women happen to be been less affected by Covid-19 than men. In the social and economic sphere, the consequences of the pandemic on women are immense. At the macro level, the World Economic Forum estimates in its annual study published in April 2021 that the health crisis has delayed the time needed to achieve gender equality by more than a generation. A study by the Fondation des femmes details, in the French case, the different temporal sequences and their impacts on women in terms of division of domestic and educational work, professional equality, ability or not to adapt professional activity, job loss and its differentiated consequences according to the existence or not of social protection.

While these studies are growing for high-income countries, they are still relatively scarce for resource-poor countries. Existing studies show that in Latin America and the Caribbean, women have been more vulnerable than men to the labor market changes brought about by the pandemic. Indeed, they occupied – and continue to occupy – a greater proportion of jobs in the informal sector and/or so-called “frontline” jobs, i.e. requiring face-to-face interactions, with less possibility of remote work, such as trade, personal care or tourism. In addition, they have been subjected to an increased domestic workload, with the care of children and dependents falling overwhelmingly to them.

In Africa, the pandemic has resulted in significant disruptions to women-specific services and care, including the closure of many maternal health centers and disruptions to contraceptive supplies, disruptions to HIV prevention services, dramatically reduced school enrollment rates for girls and young women, and increased physical and sexual violence against women. As a study conducted in Morocco in 2021 shows, these difficulties have accumulated, affecting work, increasing domestic work and exposing women to more violence.

The question of the effects of the response and of economic recovery plans on these gender inequalities is therefore strongly raised. In this regard, lessons from past epidemics should be drawn. The Zika and Ebola epidemics have shown that the responses did not take into account structural gender inequalities, and that they ultimately contributed to aggravating them. In this respect, there is much to be done, as shown by the “Covid-19 global gender response tracker“, which proposes to monitor the measures taken by governments in response to the pandemic, highlighting those that take the gender dimension into account.

We should probably go even further. In order to understand the consequences of the pandemic in detail and to design relevant recovery plans, it is necessary to avoid reducing gender to the binarity of men and women, and to adopt an intersectional prism. In other words, to put on glasses that take into account the different social relations – gender, race, class, age, linked to migration, among others – and the specific vulnerabilities that their articulation defines. This is a point that we have already made in a note co-authored with Nathalie Bajos on sexual health and social inequalities through a gender lens. In order to develop and implement policies that counteract the worsening of inequalities, the main challenge is not so much to identify which group is most affected, but to understand how different groups are affected and to decipher the mechanisms at work in the making of these differentiated effects. These are questions that should also find their place in future pandemic preparedness plans, and more generally in public health and global health policies.

We hope that this selection of press articles, scientific articles and reports will give you a clearer view of global health issues. 

Enjoy your reading!

What’s new in Global Health? May 2021

Dear all,

Please discover our monthly press review on global health here :

In this month of World Africa Day (May 25), we offer a round-up of African news related to the Covid-19 pandemic.

Data on Covid-19 is lacking on the continent. We know too little about about how the epidemic is actually affecting Africa. The main reason for this is the very limited means of testing, which are almost non-existent away from the main cities. Difficulties are even more pronounced in terms of sequencing and therefore monitoring of variants, since only a handful of African countries have the required equipment. However, we now know a little more about Covid-19-related mortality south of the Sahara. A recently published study shows that the mortality rate among patients with severe forms of the disease is much higher on the continent (48.2% versus 30% on average on other continents), reflecting the scarcity of intensive care units and related equipment and health products (including oxygen) needed for the management of severe forms.

In the face of initially low mortality figures, the demographics of the continent – half of the population is under 19 years of age – were initially put forward. Recent data show a much more differentiated and strongly evolving situation. While the number of new cases has fallen by 9% continent-wide, there is an increasing number of cases in South Africa and Nigeria. A prevalence survey conducted under the leadership of CDC Africa in seventeen countries of the continent, the results of which are currently only available for five countries, shows that in some areas prevalence is very high (22.9% in the population of Lagos).

These trends should be read in the light of the circulation of several variants south of the Sahara. The “Indian” variant was first detected in Uganda, before being detected in Kenya, South Africa, Botswana, Angola, DRC, Nigeria, Zambia and Zimbabwe. The so-called South African variant, identified in 2020, has since been found in twenty other African countries. In December 2020, another variant was identified in Nigeria, but it is not yet possible to determine its contagiousness. The so-called British variant is also circulating on the continent, where it has been found in twenty countries.

But it is certainly the question of vaccines that is currently dominating the conversations. The United Nations Security Council on May 19 recalled the facts: Africa has received only 2% of all vaccines administered worldwide to date. As a reminder, it is primarily through Covax – one of the three pillars of the Accelerated Access to Vaccines for AIDS-19 (ACT) – that vaccines are made available on the continent. The mechanism favors the AstraZeneca vaccine, which is manufactured in India by the Serum Institute of India. But since February, the continent has faced two new challenges. First, the AstraZeneca vaccine is much less effective against the “South African” variant, as shown by researchers at the KwaZulu-Natal Research Innovation and Sequencing Platform. As soon as these elements were known, the South African government decided to put aside the one million doses of AstraZeneca vaccine already ordered. At the end of March, India announced that it was temporarily suspending its vaccine exports in the midst of an unprecedented wave of Covid-19 outbreaks. The Serum Institute of India, the world’s largest vaccine producer, stopped shipments to Covax. Initially announced for June, the resumption of exports has now been postponed until the end of the year.

The last few weeks have also been marked by announcements of the return of many doses of vaccine, or even their destruction. The DRC has returned 1.3 million AstraZeneca doses to Covax out of the 1.8 million received. To explain these massive returns, most observers point to logistical and infrastructure problems – transport, health system, reaching outlying areas – but also stress the important problem of mistrust of vaccines. This mistrust is heterogeneously distributed on the continent, as shown by a study conducted under the auspices of CDC Africa on the perception of vaccines in 15 countries. Of course, it is important to bear in mind the possible discrepancies between declarations of vaccine hesitancy and behavior, as well as the changing nature of vaccine hesitancy. In some African countries, however, the phenomenon is currently such that expatriate foreigners have easy access to vaccines that health authorities are struggling to sell. This mistrust is also partly fueled by conspiracy rumors that circulate via social networks. In response to this challenge, WHO created Viral Facts Africa in late March 2021, a project that brings together experts in fact-checking and health institutions, with the goal of quickly disproving myths wherever they are spread and in local languages.

However, it would be too simplistic to assume that “correcting” the messages alone will suffice. The question of the source of information, and its legitimacy, is fundamental, and must be adressed. The Ebola epidemics have shown that both authorities and health professionals suffer from a very low level of legitimacy in the eyes of the population. Vaccine hesitancy must be understood as the result of past historical experiences. A research conducted on the rumors of sterilization that accompanied a polio vaccination campaign in Nigeria – and which led to its failure – shows that these rumors are best understood as traces of a collective memory of colonial medical practices. In the present, too, African populations often have good reasons for not giving credit to health care workers. We can mention here the frequent practice of sequestration of patients by health care workers at the end of hospitalization, which can last several weeks and is only lifted when these patients have paid their bills, or an inhospitable culture that is widespread in health services. On the mainland, as elsewhere, a relevant response to the pandemic will therefore require a real consideration of local contexts.

We hope that this selection of press articles, scientific articles and reports will give you a clearer view of global health issues.   

Enjoy your reading!

What’s new in Global Health? April 2021

Dear all,

Please discover our monthly press review on global health here :

While the covid-19 pandemic continues to occupy the days and minds of global health actors, we focus this month on pandemic preparedness and its global governance. We evoke the major historical stages in the structuring of preparedness policies, before turning the gaze to the main issues currently discussed.

Health risk preparedness has been the subject of growing interest since the early 2000s. In Foreign Policy, analyst Mark Perry recalls the various concerns from which it stems. First, it is framed in the context of the “war on terror” declared by the Bush administration in the wake of the 2001 World Trade Center attacks. The fear was that large-scale attacks would be carried out using a pathogen. But the concern for spontaneous outbreaks was also growing. More and more scientists warned then of the inevitable occurrence of pandemics similar to the one we are experiencing today: of animal origin, caused by a respiratory pathogen, and which would spread to the four corners of the planet through human circulation. In the United States, preparedness policies were particularly influenced by simulation exercises conducted between 2001 and 2019 to prepare US policy makers for such critical events. The first of these, called Dark Winter, had a profound effect on policymakers and shaped preparedness policies of the following decade.

The desire to respond to health risks on a global scale can be seen as early as 1851. Hélène De Potter, lecturer in public law, evokes the founding moment of this history: the international sanitary conference held in Paris at the initiative of Louis-Napoléon Bonaparte. She shows that the transition to a global scale raised issues that are still very relevant today: scientific uncertainties, the question of national sovereignty, the weight of economic and political issues in decision-making. In 2005, the global governance of health security took an important step forward with the adoption of a treaty called International Health Regulations. Its main tool is the declaration of a public health emergency of international concern (PHEIC), defined as “an extraordinary event that is determined to constitute a risk to public health in other States due to the risk of international spread of disease and that may require coordinated international action. Prior to Covid-19, five such extraordinary events have been reported: in 2009 (H1N1 virus), 2014 (polio and Ebola), 2016 (Zika), 2019 (Ebola).

As journalist Marc Allgöwer points out in an article in Le Temps, policies and preparedness plans oscillate according to the imperatives of the moment. In the wake of the 2008 financial crisis, the Obama administration dismantled some of the preparedness measures put in place by George Bush in 2005, before putting them back in place following the H1N1 epidemic in 2009. More recently, Ebola outbreaks of the mid-2010s have sparked renewed interest. The ability to maintain preparedness over the long term is thus a major issue. This is shown by Andrew Lakoff, a sociologist, in a reference book on the subject, published in 2017 and entitled Unprepared, Global Health in a Time of Emergency. In the French context, the non-renewal of mask stocks illustrates this point. Arnaud Mercier, professor of information-communication, offers a genealogy of the mask shortage, dating back to 2005 and shedding light on the situation observed in spring 2020.

Recent conversations point to the need for significantly increased funding for preparedness policies on a global scale. In her recent address to the United Nations, Kamala Harris calls for the creation of a global funding mechanism for pandemic response. There is indeed much to be done. A recent study by the Institute for Health Metrics and Evaluation points out that of the $41 billion (dollars) spent on global health in 2019, only $374 million were spent on pandemic preparedness. Far too little according to the International Working Group on Financing Preparedness, which estimates that in low- and middle-income countries, the need is $5 billion to $10 billion per year for the next two to three years, and that this level should be maintained for at least ten years.

The existing framework is also questioned. Many call for WHO’s role to be consolidated and strengthened. This is one of the main recommendations issued in one of the latest report of the Independent Panel on Pandemic Preparedness & Response. But many believe that the instruments also must evolve. On March 30, 2021, twenty-five Heads of State, the President of the European Council and the Director of the World Health Organization called, in an article published in Le Monde, for a new international treaty on pandemic preparedness and response. Backed by the International Health Regulations, it would allow “the consolidation of pandemic preparedness at the highest political level”. Another option, which emerged during Ebola and was reiterated in the context of Covid-19, would be to replace the binary system for declaring a public health emergency of international concern with a tiered declaration that would include several levels of alert. However, this is considered inadequate by many experts, who point out that the difficulties lie primarily in the reluctance of states to implement measures recommended by experts from international organizations. For Clare Wenham, professor of global health policy at the London School of Economics, one of the main limitations of the existing system is that it is too focused on the detection and prevention of pandemics, and not enough on the response as such. Detection is certainly essential to guide the response, as two bioengineers, Tim R. Mercer and Marc Salit, remind us in an article on the scaling up of tests during the current pandemic.

Finally, many call for a broadening of the framework to include environmental issues. Henrique Lopes, professor and expert in public health at the Catholic University of Lisbon, and John Middleton, president of the Association of Schools of Public Health in the European Region (ASPHER), remind us that it would be futile not to put in place measures to prevent the occurrence of new pandemics by acting on the destruction of ecosystems. In the same line, a group of academics invites to make deep prevention, i.e. the prevention of the passage of pathogens from animals to humans, a major axis of the possible future treaty. These conversations are fueled by the upcoming United Nations conference on biodiversity to be held in Kunming next October, during which civil society organizations would like to see clear objectives set.

All these topics will undoubtedly fuel the discussions at the WHO Global Hub for Pandemic and Epidemic Intelligence, whose creation has been announced these days…

We hope that this selection of press articles, scientific articles and reports will give you a clearer view of global health issues.   

Enjoy your reading!

What’s new in Global Health ? March 2021

Dear all,

Please discover our monthly press review on global health here :

This month the review addresses the notion of health as a global public good. If the notion is widely used, what it exactly means is often not so clear.

We first look back at its theoretical foundations in political economy, and suggest few other articles in which elements of definition, conceptual issues raised by this notion in health policy and development, and challenges triggered by its operationalization in global health governance are addressed.

This concept appears particularly relevant in the midst of the Covid-19 crisis. We point to articles addressing Covid-19 vaccines issues through this lens. Their authors highlight discrepancies between the political and institutional discourses promoting vaccines as global public goods and the observed realities regarding their production and distribution.

Finally, some articles expand this notion to pharmaceutical products as a whole, or mobilize it for the issue of insulin.

We hope that this selection, which combines press articles and scientific articles, will provide you with useful insights into global health issues.

What’s new in Global Health ? February 2021

Dear all,

Like every month, discover our press review on global health, available as usual by clicking on this link:

As you know, we alternate thematic press reviews (the “One health” approach and Europe were, for example, our last two subjects) and general press reviews, such as the one we are proposing for February.

Among the international events that have marked the last few weeks, there is of course the election of Joe Biden at the head of the United States: what impact would this change in the White House have on global health? By removing the “global gag rule” that prevented NGOs funded by the US government from working on abortion-related projects, the new president is making a strong symbolic gesture. We have also selected for you an absolutely edifying interview with Tony Fauci, who recounts his experience as advisor to Donald Trump and several articles on the geopolitical impact of this election and on the conditions for the return of the United States to the WHO.

The WHO has also been the subject of many reflections in recent weeks, about the launch of a “WHO Foundation” in charge for mobilising new funding, about the possible reform of the UN organisation (Olivier Nay proposes some concrete avenues), or about the presentation of the intermediate results of the High Level Panel responsible for evaluating the international response to the Covid.

We are sharing with you a WHO report entitled “Weathering the storm” which summarises the funding dedicated to human resources for health over the period 2000-2018 and points out the risks linked to the COVID crisis.

Finally, we have obviously chosen for you a few articles on the vaccine, which is the subject of obvious geopolitical tensions. While several articles point to the rise of anti-vaccine scepticism in Africa, we have also selected for you a few articles on the issues of accessibility in middle-income countries, on the importance of the names given to the different variants, and on the notion of common public good.

We hope that this selection, which, as every month, brings together press articles and scientific articles, will give you a clearer view of global health issues…

What’s new in Global Health ? January 2021

Dear all,

Like every month, discover our press review on global health, available as usual by clicking on this link:

We have decided to devote it this time to the One Health approach. While this approach promoting an integrated approach to human health, animal health and the environment is not new, the Covid crisis has put it at the centre of attention, and invites us to think about health differently, with a particular emphasis on the interdependence between human and animal well-being and respect for ecosystems.

We have selected for you some theoretical articles on this concept born at the beginning of the 2000s, as well as general articles, such as that of Philippe Myers, presenting the stakes and the main principles of this new, deeply multidisciplinary approach.

Climate change threatens to undermine the achievements of the last 50 years in public health. It reinforces the ever closer proximity between human habitats and animals (which are losing their natural habitats) and we thought it would be interesting to focus in particular on zoonoses, those diseases transmitted from animals to humans. You will be able to read an interview with Didier Sicard and several articles showing the increase in frequency and power of these zoonoses.

We also share with you some reference documents from international organisations involved in these issues (UNEP, OIE, WHO and FAO), the latest IPCC report and some international or French initiatives related to these issues (the Lancet Countdown, the Prezode Initiative, the OSH approach). Things are changing, as evidenced by the opening up of the ANRS mandate to emerging infectious diseases.

We also felt the importance to delve deeper into the operational aspects of this approach, which for the moment remains very conceptual for most of us. We have therefore selected a few articles or documents proposing concrete avenues for implementation, such as a Veterinarians Without Borders guide, a World Bank operational framework, or even a few articles on how hospitals, for example, can become “green”.

Finally, at the end of this chapter, we will discuss other issues: antimicrobial resistance, measures to adapt to or mitigate the risks of climate change, food-related issues, the results of the Paris Agreements, the forthcoming establishment of a high-level council of experts “One health” in France and the latest human development report which now includes environment-related indicators.

We hope that this selection, which, as every month, brings together press and scientific articles, will give you a clearer view of global health issues….

The entire team of Santé mondiale 2030 wishes you a very happy new year 2021.

Download the list of articles selected for the newsletter of January 2021.

Agenda Global Health 2021

Discover the agenda of the main events in global health that will take place in the coming year, in France and abroad! (we will make regular updates)

Download the PDF version : Agenda Global Health 2021

What’s new in Global Heath ? December 2020

Dear all,

Like every month, discover our press review on global health, available as usual by clicking on this link:

On the occasion of the publication of our latest policy note on the French-German axis of global health (which you can read here), we have decided to make Europe the central theme of this press review. As you know, health is traditionally the responsibility of the Member States, but the Covid crisis could change this state of affairs. What are the challenges at European level and what would be the new prerogatives for the European Union in the field of health? The articles and links that we have selected for you at this end of the year should give you a clearer and more global vision of these issues, which are sometimes very technical.

First, you will find in this selection several links on European health issues. In particular, you will be able to discover the latest OECD study on the health of Europeans or a reflection on the European challenges of access to medicines with an analysis of Europe’s place in the world pharmaceutical market.

On the subject of the famous “Europe of health”, which is much talked about at the moment, several articles look back at the common mechanisms or initiatives already existing in the field of health at European level, and the recent proposals of the European Commission. We have selected for you several reflections related to these issues, from French, but also Dutch, English or German researchers, with for example a note by Ilona Kickbusch and Christian Franz calling for the development of a real European strategy for global health. Several articles also return to the issues at stake during the German presidency of the Council of the European Union (which will end in a few days, at the end of December), and in the continuity of which the upcoming French presidency of the EU, in the first half of 2022, is expected to follow.

We propose a specific focus on Germany, a European country particularly involved in the field of global health. This press review is both an opportunity to (re)review the Treaty of Aachen, signed in January 2019 to strengthen cooperation between France and Germany, but also to look back on the latest edition of the World Health Summit, the annual French-German health conference, or to discover the brand new German global health strategy.

We also looked at the issue of health aid from European countries, whether it was to take stock of the achievement of the commitment of 0.7% of GNI devoted to development aid by European countries (“Aidwatch 2020” study by the European platform CONCORD) or to understand the priorities and funding circuits of the top ten European countries contributing to development aid (Graduate Institute).

Finally, we offer a selection of articles and links both on the dynamics of the Covid epidemic in Europe (with the interactive maps of the WHO and the ECDC) and on the response of the Member States, with the “Health System response monitor” which centralises information on how the different European countries have responded to the crisis. Particularly attentive to health democracy issues, the launch of a European Citizens’ Initiative (“Right to cure”) on access to health products for European citizens also caught our attention this month.

We hope that this selection, which, as every month, brings together press and scientific articles, will give you a clearer view of global health issues…

Download the list of articles selected for the newsletter of December 2020.

Save the date !

The 10th AFRAVIH conference, scheduled for 8-11 November, will finally be 100% virtual.

Discover the full programme by clicking on this link.

An AFRAVIH symposium on “Covid-19 and Global Health” will take place on Monday 9 November, from 12:15 to 2:15 pm (French time) with Gilles Brucker, Jean-François Delfraissy, Dr. Cheikh Tidiane Ndour, Fatou Bintou SARR, Daniel Low-Beer, Dr. Louis Pizarro and Stéphanie Tchiombiano.

Registration for the entire conference is free of charge for all participants outside Europe and America. It is 100 euros for all European and American participants.

Click here to register

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