From “the first 1,000 days” to “the first 8,000 days”
Recently the World Bank published the third edition (DCP3) of its Disease Control Priorities in Developing Countries series that systematically assesses the cost- effectiveness of addressing the major sources of the disease burden in low- and middle-income countries. Volume 8 of DCP3 “Child and Adolescent Health and Development” focuses on the critical inter-relationship between learning and the health and nutrition of children, adolescents and teens. It makes a strong case for strengthening education, health and nutrition during middle childhood and adolescence and argues that well-designed health interventions in middle-childhood and adolescence can leverage the already substantial investment in education. Equally it presents evidence that better education design can achieve better health. The volume argues that the potential synergies between health, nutrtion and education are undervalued, and the returns on co-investment are rarely optimized.
The “Child and Adolescent Health and Development” volume sets out evidence to support a broadening investment in human development to include scalable interventions, which it argues, can be achieved cost-effectively with modest financial investment. Two essential packages are set out: the first addresses needs in middle childhood and early adolescence through a school-based approach; the second focuses on older adolescents through a mixed community and media and health systems approach. Both offer high cost-effectiveness and benefit-cost ratios. The full report can be accessed here.
World Malaria Day 2018: Ready to beat malaria
25 April 2018 is World Malaria Day (WMD). This year’s theme “Ready to beat malaria” acknowledges the considerable global success in addressing the disease and at the same highlights serious negative trends identified in the 2017 World Malaria Report:
Without urgent action, the major gains in malaria elimination are under threat and WHO is redoubling efforts in calling for greater investment and expanded coverage of proven tools that prevent, diagnose and treat malaria.
On WMD in 2016, Switzerland reaffirmed its leadership role and commitment to end malaria. This was formalised in the Bern Malaria Declaration that can be read in full here.
The Bern Declaration was made both by the Swiss Parliamentarian Group on Global Health and the Swiss Malaria Group (SMG).
The SMG is a Swiss public, private, research and civil society leadership network for a malaria-free world. Its common goal is to retain and strengthen Swiss commitment in the fight against malaria under the 2030 Agenda for Sustainable Development. Its website sets out Switzerland’s position on malaria and offers a toolbox of reports and articles, working methods, presentations and information for travellers.
Malaria is not only a cause of mortality and morbidity; it also threatens the socio-economic development of 91 countries. The SMG has written an article Malaria and the Sustainable Development Goals for 2030 for WMD that can be accessed here which sets out how a malaria-free world is linked to the achievement of many of the SDGs.
For WMD 2018, the SMG is raising awareness’s with a “High malaria activity in Switzerland” series of events in seven cities, culminating in on 25th April in Geneva. The programme and information on how to register to be involved can be accessed here.
World Tuberculosis (TB) Day 2018: “Wanted: Leaders for a TB-Free World”
Although the TB bacillus was identified 136 years ago, launching research, diagnosis and treatment, it remains one of the top 10 causes of death worldwide. The 2017 WHO Global Tuberculosis Report states that in 2016 some 10.4 million people contracted the disease that caused 1.8 million deaths. TB is also the major opportunistic infection causing the death of people living with HIV and is the main cause of death related to antimicrobial resistance. Indeed, with some 490,000 people having developed drug-resistant TB (DR-TB) this poses a major public health threat.
According to WHO, in 2017, TB prevention and care investments in low- and middle-income countries fell USD 2.3 billion short of the USD 9.2 billion needed and that globally, TB research and development remain severely underfunded with at least an additional USD 1.2 billion per year needed to accelerate development of new, innovative tools to tackle the disease.
To raise awareness of the need for stronger commitment to addressing and funding the response to TB, the theme of this year’s World TB Day is: “Wanted: Leaders for a TB-free world”. The campaign and its resources can be accessed on WHO’s website here.
This year’s campaign follows the new Moscow Declaration to End Tuberculosis, a global commitment made in November last year that came out of the WHO Global Ministerial Conference: Ending tuberculosis in the SDG era: A multisectoral response. A WHO Fact Sheet on the conference can be accessed here. The 2018 campaign focuses on building commitment to end TB, not only at the political level, but also including community leaders, people affected by TB, civil society advocates, health workers, and NGOs among other partners.
WHO together with the Stop TB Partnership has produced an Advocacy and Communication Toolkit for this year’s campaign that can be accessed here. This provides additional World TB Day materials for download that can be used to support awareness-raising on 24th March and throughout the year.
Preventable newborn deaths – where are we now?
In the course of the Millennium Development Goal (MDG) period, considerable progress was made globally towards goals 4 (Reduce child mortality) and 5 (improve maternal health). These improvements in child and maternal health resulted in a decline in the number of deaths among children aged between one month and five years. However, newborn death rates have not declined equally in different settings, and every day, some 7,000 babies take their first and last breath on the day they are born. The recent UNICEF report “Every Child Alive: The urgent need to end newborn deaths”, outlines the risks to newborns between and within countries. It sets out that babies born to the poorest families are more than 1.4 times more likely to die during the neonatal period compared to those born to the richest. Babies of mothers with no education face almost twice the risk of dying compared to those born to mothers with secondary education. The report identifies that the riskiest places to be born are Pakistan, Central African Republic and Afghanistan, and that Japan, Iceland and Singapore are the three safest countries in which to be born. In particular, many Muslim countries in the south Asian, Middle Eastern, and African regions lag behind the global improvement in maternal and child health. In the recently published Lancet article: “Status and drivers of maternal, newborn, child and adolescent health in the Islamic world: a comparative analysis”, Akseer et al explored why some Muslim countries have struggled to improve child and maternal health by analysing publicly available data between 1990 to 2015.The study findings indicate that Muslim majority countries with high child and newborn mortality share contextual determinants including poor governance, conflict, insecurity and population displacement, low female empowerment indicators, and low coverage of essential interventions across the continuum of care for reproductive health. Those with lower under 5 mortality rates have in common: political stability, stronger realisation of political rights, more effective government, higher education levels and greater urbanisation. As expected, in locations where women delivered with a skilled birth attendant and attended four or more antenatal care visits, maternal and neonatal survival were better.Last week, a new global campaign, called “Nursing Now” was launched by the International Council of Nurses in collaboration with WHO, to raise attention on the importance of nurses and midwives. They represent the largest workforce within the health sector and are pivotal in in reducing maternal, newborn and child deaths.To effectively and sustainably address key contextual drivers of the 7,000 preventable newborn deaths each day, inter-sectoral efforts are needed including government, the business sector, development partners, health-care providers, communities, families and parents themselves.The UNICEF Publication Every Child Alive: The urgent need to end newborn deaths was published online in February 2018 and can be accessed here.
The full article published in The Lancet online on January 30, 2018, by Akseer, Kamali, Bakhache et al. can be accessed here.
The Nursing Now Campaign, launched March 2nd, 2018 can be accessed here.
World Leprosy Day 28 January 2018
World Leprosy Day is commemorated every year on the last Sunday of January. The aim is to increase public awareness that leprosy is curable and if detected at an early stage, disability can be prevented.
Leprosy is a chronic and debilitating bacterial disease, transmitted via droplets from the nose and mouth during close and frequent contact with infected and untreated people. It has a slow incubation period and symptoms appear between one and 20 years after infection. Leprosy mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, as well as the eyes. The disease is curable with multi-drug therapy, but untreated, it can cause progressive and permanent damage to the skin, nerves, limbs, and eyes.
According to the latest WHO factsheet, there were 216,108 new leprosy cases registered globally in 2016.
Officially, leprosy was considered to have been eliminated as public health problem in 2000 globally (as elimination is defined by the World Health Organization as a registered prevalence of less than 1 case per 10,000 population). Control of the disease, however, has relied largely on routine surveillance and clinical diagnosis, based on key signs of leprosy.
Innovative public health initiatives have been developed in line with the detection and prevention guidance of the Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world. One such approach is the retrospective active case findings (RACF) approach developed and implemented in Cambodia to actively prevent transmission at the family and community levels. Household members of patients who were diagnosed and registered between 2001 and 2011, as well as neighbours within a 200m radius, were actively identified and screened by mobile teams throughout the country.
The Cambodian approach and its results are set out in an article published this month by researchers in Cambodia, the UK and three Swiss Institutions including the Swiss Tropical and Public Health Institute. The study determined that 67% of the study's 1,463 cases diagnosed between 2001 and 2010 and registered in the national leprosy database were successfully traced during the period 2012–2015. From these, a total of 17,134 of their contacts were traced– an average: 2.2 household members and 15.2 neighbours) and another 7,469 contacts of the untraced cases were traced and screened. Among them, 264 new leprosy patients were diagnosed.
The article concludes that in spite of loss of patients to tracing as a result of factors such as migration and death, RACF is an effective approach in detecting new leprosy patients among contacts of previously registered patients, where a national leprosy database is well-maintained for successful contact tracing. The new approach is perceived by the research team to be complementary to, rather than replacing the established routine of passive case detection as the two are mutually enhancing, especially in countries with a relatively low number of new leprosy patients but evidence of on-going transmission.
The full article Retrospective active case finding in Cambodia: An innovative approach to leprosy control in a low-endemic country by Fürst et al. 2018 can be accessed here.
Ahead of World Leprosy Day several leading organisations have joined forces to launch a Global Partnership for Zero Leprosy to accelerate progress towards a world without leprosy. Swiss TPH was involved in the creation of the partnership, representing the scientific community. Further details on the partnership launched today can be accessed here.
Spotlight on Environmental HealthThe WEF report identifies the top 10 risks in terms of likelihood which are:1. Extreme weather events2. Natural disasters3. Cyber attacks4. Data fraud or theft5. Failure of climate-change mitigation and adaptation6. Large-scale involuntary migration7. Man-made environmental disasters8. Terrorist attacks9. Illicit trade10. Asset bubbles in a major economy
It also ranks the top 10 risks in terms of impact:1. Extreme weather events2. Natural disasters3. Cyber attacks4. Data fraud or theft5. Failure of climate-change mitigation and adaptation6. Large-scale involuntary migration7. Man-made environmental disasters8. Terrorist attacks9. Illicit tradeBoth sets of risk are further categorized by their nature i.e. economic, geopolitical, societal, environmental and technological, however, all can have a direct or indirect impact on health and well-being as well as livelihoods, security, access to food and resources as well as access to quality health services.
The full Global Risks Report 2018 was published on January 17, 2018. The report and an interactive data platform can be accessed here.
According to the World Health Organization, environmental health risks cause an estimated 12.6 million deaths annually and environmental factors are responsible for more than a quarter of all deaths of children under five of age. To address environmental determinants of morbidity and mortality, this month, UN Environment and the WHO agreed on a new, wide-ranging collaboration to step-up joint actions to reduce air pollution, the impacts of climate change and antimicrobial resistance, as well as to improve coordination on waste and chemicals management, water quality, and food and nutrition over the next 15 years.
The four priority areas of the cooperation include:
Air quality: More effective air quality monitoring including guidance to countries on standard operating procedures; more accurate environment and health assessments, including economic assessment; and advocacy, including the BreatheLife campaign [http://breathelife2030.org/] to promote air pollution reduction for climate and health benefits.
Climate: Tackling vector-borne disease and other climate-related health risks, including through improved assessment of health benefits from climate mitigation and adaptation strategies.
Water quality: Ensuring effective monitoring of data on water quality, including through data sharing and collaborative analysis of pollution risks to health.
Waste and chemicals: Promotion of more sustainable waste and chemicals management, particularly in the area of pesticides, fertilizers, use of antimicrobials. The collaboration aims to advance the goal of sound lifecycle chemicals management by 2020, a target set out at the 2012 United Nations Conference on Sustainable Development.
The agreement signed by the heads of WHO and UN Environment commits to jointly developing a work programme and high level meetings to foster a systematic framework for joint research, to support the development of tools and guidance, to strengthen global and regional partnerships and environment fora.
The news release on the UN Environment and World Health Organization`s collaboration was published on January 10, 2018 and can be accessed here.
“The solutions to prevent pollution already exist, but the scale of the problem is underestimated.”
Interview with Richard Fuller for the FDFA blog.
What are the findings of this Lancet Commission?
For the first time, our team analyzed all aspects of pollution to see what impact it has on health. To do so, we break down pollution into the four pathways through which toxins affect people: This is through the air, the water and the soil and also through the work place. We found that the overall pollution results yearly in the premature death of 9 million people. This is three times as much as HIV/AIDS, tuberculosis and malaria combined. That makes it the largest cause of death on the planet.
This number is striking. Why do people not care more about preventing pollution?
Because most people are not aware of how big the problem is. This has three reasons:On the one hand, the effects of pollution aren’t immediate. People can develop disease and die long after their exposure to pollution. And the economic costs of pollution are completely underestimated.On the other hand in many governments the topic gets lost between different ministries. What we see is a health problem, but the health ministry says it is an environmental issue, while the environmental ministry claims the opposite. In fact it is in the responsibility of everyone.Finally the prevention of pollution is something that businesses try to avoid because it is costly in the short term. However, overall, the national economy would be better off, if pollution is avoided. The government should be setting regulatory standards and enforce them, so that businesses don’t have comparative advantages through pollution anymore.
In Switzerland air pollution is quite limited and also everyone enjoys access to clean water. Why should Swiss people care anyhow?
The high consumption that we have here in the western world has driven an enormous growth in polluting industries in other countries. So we are to a certain extent responsible for what is going on in these countries. This fast and often unregulated growth in industries – especially in mining where raw materials for our phones are dug for example – is causing much pollution.
Who is most at risk of dying a premature death caused by pollution? Who is most at risk for the different types of pollution?
The people with low income are the hardest hit. Everyone is affected by air quality. But soil and chemical as well as polluted water are the real crux. Imagine a family who lives next to an industrial plant in country with a growing textile industry. The water which is used to produce jeans contains a lot of toxins but flows unfiltered into the river. That is what the family has to drink. Additionally, the air of the nearby power plants is flowing through the walls of the family’s hut and gives everyone a cough. But the most concerning part is that children are disproportionately exposed to any kind of pollution – because the concentration of toxin is much higher per kilogram of body than for a fully grown adult.
Health is a fundamental human right. 70 years after the Universal Declaration of Human Rights
On December 10, 1948 the Universal Declaration of Human Rights was adopted by the United Nations General Assembly. The Constitution of the World Health Organization (WHO) outlines the “…highest attainable standard of health as a fundamental right of every human being.” The emphasis upon human rights was taken up in the recently adopted agendas for Sustainable Development and Universal Health Coverage, which echo the principle that a rights-based approach to health requires that health policies and programmes prioritize the needs of those left behind to achieve greater equity.
In the last few years, there has been a rising a number of global and national initiatives, which explicitly incorporate human rights into public health practice. Yet measurement of outcomes has been challenging. In a recently published article, Gruskin et al., together with an expert advisory group composed of representatives from WHO, international organizations, ministries of health, non-governmental organizations, academic institutions and lawyers developed an analytical framework for human rights principles using family planning indicators as an illustrative example. They analysed public health indicators used in the monitoring and evaluation of contraceptive programmes and their sensitivity to human rights. The set of indicators they identified comprised a mix of quantitative, qualitative and policy-level indicators. The authors conclude however, that standardized methods to effectively measure human rights in public health require greater breadth and depth in order to ensure that no one is left behind.
The full article published in PLoS One online on December 8, 2017, A novel methodology for strengthening human rights based monitoring in public health: Family planning indicators as an illustrative example, by Sofia Gruskin, Laura Ferguson, Shubha Kumar et al. and can be accessed here.Additional sources on the human rights and health are provided in the WHO Factsheet, updated in December 2017 that can be accessed here.
World Malaria Report: Global response to malaria at crossroads
After unprecedented global success in malaria control, progress has stalled, according to the World malaria report 2017. There were an estimated 5 million more malaria cases in 2016 than in 2015. Malaria deaths stood at around445 000, a similar number to the previous year. “In recent years, we have made major gains in the fight against malaria,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “We are now at a turning point. Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”The WHO Global Technical Strategy for Malaria calls for reductions of at least 40% in malaria case incidence and mortality rates by the year 2020. According to WHO’s latest malaria report, the world is not on track to reach these critical milestones.A major problem is insufficient funding at both domestic and international levels, resulting in major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools. Funding shortage An estimated US$ 2.7 billion was invested in malaria control and elimination efforts globally in 2016. That is well below the US $6.5 billion annual investment required by 2020 to meet the 2030 targets of the WHO global malaria strategy. In 2016, governments of endemic countries provided US$ 800 million, representing 31% of total funding. The United States of America was the largest international funder of malaria control programmes in 2016, providing US$1 billion (38% of all malaria funding), followed by other major donors, including the United Kingdom of Great Britain and Northern Ireland, France, Germany and Japan. The global figuresThe report shows that, in 2016, there were an estimated 216 million cases of malaria in 91 countries, up from 211 million cases in 2015. The estimated global tally of malaria deaths reached 445 000 in 2016 compared to 446 000 the previous year.While the rate of new cases of malaria had fallen overall, since 2014 the trend has levelled off and even reversed in some regions. Malaria mortality rates followed a similar pattern.The African Region continues to bear an estimated 90% of all malaria cases and deaths worldwide. Fifteen countries – all but one in sub-Saharan Africa – carry 80% of the global malaria burden.“Clearly, if we are to get the global malaria response back on track, supporting the most heavily affected countries in the African Region must be the primary focus,” said Dr Tedros. Click here for the full article.
World AIDS Day 2017: My Health, My Right
World AIDS Day 2017: My Health, My RightEvery December 1st World AIDS Day is widely commemorated. It has become one of the most recognized international health days, usually celebrated under one global theme that individual countries can choose to interpret the theme in their own way.
World AIDS Day (WAD) is dedicated to raising awareness of the AIDS pandemic, to show solidarity with people living with HIV, as well as to commemorate those who have died from AIDS-related illness. Word Health Organization and the United Nations General Assembly launched the first WAD in 1988. Since then, it has become one of the most successful memorial days where activists, people living with HIV, global, as well as local institutions and concerned individuals all join together in solidarity.
This year’s WAD campaign, led by UNAIDS, focuses on the right to health. “All people, regardless of their age, gender, where they live or who they love, have the right to health,” said Michel Sidibé, Executive Director of UNAIDS. “No matter what their health needs are, everyone requires health solutions that are available and accessible, free from discrimination and of good quality.”
You can read more on this dedicated UNAIDS website.
Key messages of the campaign are:
Too many people around the world are being denied their right to health, and people living with HIV are particularly affected
Only by placing rights at the centre of global health can quality health care be available and accessible for everyone, leaving no one behind.
Social media have become some of the most popular campaign channels to increase awareness of the need to achieve full realization of the right to health of everyone, everywhere. You can join the campaign on Twitter (#myrighttohealth) and on
Facebook you can join the conversation and post what “My health, my right” means to you and you feel we can ensure that everyone can realize that right.
The campaign by UNAIDS can be accessed here and
campaign materials can be found here.
The persistent gender gap in adolescent sexual and reproductive health and rights
The 2017 World Population Data Sheets highlight that young women aged 15-19 accounted for two-thirds of the newly HIV infected youth globally. Gender-based violence, together with unequal access to secondary school and economic opportunities hinder young women and girls to become independent, which is linked to negotiating safer sexual practices and better access to family planning , as well as prevention and treatment services. The data sheets can be accessed here.
The UNFPA flagship report State of the World Population 2017, which can be accessed here emphasizes how gender inequalities obstruct women from living their lives on an equal footing with men. The report highlights that many women and girls do not have access to sexual and reproductive health services, which means they face difficulties in accessing both family planning as well as maternal services.
In the report A familiar face: violence in the lives of children and adolescents, UNICEF reveals that violence starts early for many children around the world. As girls and boys move through adolescence, they begin to spend increasing amounts of time in expanding social environments beyond their immediate families, interacting with a wider array of people. This widening of the social world, while beneficial in many aspects, also creates situations in which young people may be exposed to violence. The UNICEF report which can be accessed here shows that as children enter the second decade of their lives, the mortality rate from violence more than doubles that of their first 10 years of life.
The first findings from the Global Early Adolescent Study were published in the Special Supplement of the Journal of Adolescent Health in October 2017 and can be accessed here This comprises articles that explore the constellation of factors that shape adolescence and highlights the need for gender and socio-cultural issues to be mainstreamed across all interventions, to achieve better health outcomes for adolescent girls.
Together on the road to universal health coverage: A call to action by WHO
At least 400 million people have no access to basic health services, and 40 % of the world’s population lacks social protection. These factors combined mean that the majority of the very poorest in the world cannot afford adequate health care and those that do, may be pushed further into poverty by the costs of accessing their basic health needs. Dr. Tedros Adhanom Ghebreyesus, the new Director General of WHO, promises that WHO will catalyse engagement and advocacy with global, regional, and national stakeholders. His call to action specifies that:
All countries must make universal health coverage a political priority
Each country should use available evidence and tools to determine its own path towards universal health coverage
Countries should ensure that universal health coverage meets the needs and aspiration of its people, with their participation.
The UHC concept is that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of adequate quality to be effective, while also ensuring that the use of these services does not expose users to financial hardship. UHC is pivotal to achieving better health and well-being for all people at all ages and ensures that poorer individuals, families and communities are not driven into poverty because of the costs of health care.
Dr. Tedros’ call to action: Together on the road to universal health coverage: a call to action. Geneva: World Health Organization; 2017 (WHO/HIS/HGF/17.1) can be accessed here.
Lancet Commission on Pollution and Health
The long-awaited Report of the Lancet Commission on Pollution and Health has been published in October revealing pollution's severe and underreported contribution to the Global Burden of Disease. In fact, pollution is the largest environmental cause of disease and death in the world today, responsible for an estimated 9 million premature deaths. Besides the health burden the Lancet Commission on pollution and health addresses the full health and economic costs of air, water, and soil pollution and uncovers the economic costs of pollution to low-income and middle-income countries particularly.
Some main results:
Pollution causes 16% of deaths globally. Diseases caused by pollution were responsible in 2015 for an estimated 9 million premature deaths - 16% of all deaths worldwide – three times more deaths than AIDS, tuberculosis, and malaria combined; and fifteen times more than all wars and other forms of violence. It kills more people than smoking, hunger and natural disasters. In some countries, it accounts for one in four deaths.
The health impacts from many pollutants are completely unquantified because of insufficient data collection and scientific research.
Pollution disproportionately kills the poor and the vulnerable. Nearly 92% of pollution-related deaths occur in low- and middle-income countries.
Pollution is neglected.
The cost of inaction is high, while solutions can yield economic gains.
Pollution control will advance the Sustainable Development Goals.
We can fix this. Proven, cost-effective solutions exist and pay high returns on investment.
Launch of the Global Roadmap to 2030 to #endcholera on October 4, 2017
Click here to view the list of participants.
Click here to view the agenda.
Why investing in food security when we work in the health sector?
The Global Nutrition Report 2016 illustrated that nearly 800 million people experience hunger and suffer from calorie deficiency, 2 billion people worldwide suffer from micronutrient malnutrition and 2 billion people are overweight and obese. Nutrition has become more complex over the last decades with the apparition of the double burden of malnutrition: Many countries witness a simultaneous increase of undernutrition and overweight.
Nutrition has become more complex over the last decades with the apparition of the double burden of malnutrition: Many countries witness a simultaneous increase of undernutrition and overweight. In low- and middle-income countries, poor nutrition has led to a fast rise in childhood overweight and obesity while undernutrition still causes nearly half of deaths in children under five years old worldwide. Particularly, the globally changed dietary patterns, with an increasing consumption of meat, sugar, fats and processed food have led to a rapidly increasing proportion of overweight children world-wide. This is alarming since obese children are very likely to remain obese as they grow up and to be at high risk for non-communicable diseases (NCDs) like diabetes or heart diseases.
Malnutrition is a multi-faceted problem with multiple causes across a number of sectors. Single sector approaches do not work for nutrition interventions. The fight against malnutrition requires a multi-sectoral approach, covering aspects of health, water and sanitation, education, agriculture and many more.
How are our projects doing?
SDC's Global Programme Food Security together with the Global Programme Health recently conducted a resource tracking exercise based on a methodology developed by the SUN Donor Network (Scaling Up Nutrition). At an international level, this exercise aims at increasing accountability for international development funding targeted at improving nutrition. At an SDC internal level, the exercise revealed that SDC supports many interventions in the health, water and agriculture domains, which are considered nutrition-sensitive. Interventions are nutrition-sensitive if their primary objective is not nutrition, but if they have the potential to improve the food and nutrition security of beneficiaries or address the underlying causes of malnutrition (e.g., by targeting agriculture and food security, health, care, education, water and sanitation).
Improving hygiene and sanitation has tremendous effects on well-being and increases the body's ability to take up and use nutrients. In our projects, we can acknowledge and increase these benefits by programming in a more nutrition-sensitive manner.
More information about World Food day: FAO
Read our last newsletter article to know more about food and health at SDC: Newsletter article
The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa
sub-Saharan countries face a double burden of persistent infectious diseases,
malnutrition, and child and maternal mortality, as well as emerging challenges
from an increasing prevalence of chronic and non-communicable diseases, mental
health disorders, injuries, and health problems related to climate change and
environmental degradation. Although there has been some progress, life
expectancy and many population health indicators remain behind most low-income
and middle-income countries in other parts of the world. The Lancet Commission
– ‘The path to longer and healthier lives for all Africans by 2030’ - led by
African physicians, scientists, and policy makers has been established to chart
a vision of the future and a roadmap for improved health for sub-Saharan
Africans. The spirit of this Commission is one of evidence-based optimism, but
with caution. The Commission developed key messages ranging from the creation
of people-centred health systems to promoting stronger more effective regional
cooperation. A key message is that if the right policies are implemented, and
if African leadership is truly empowered to utilise the human resources assets
of an ever growing youthful region, closing the health gap in a generation can
article published in the Lancet online on September 13, 2017, by Akua Agyepong
I, Sewankambo N, Binagwaho A et al.can be accessed here.
Are you feeling well at work? World Mental Health Day 2017
been shown that investing in the promotion of mental health and in the support
of employees who have mental disorders was beneficial for companies and
employers doing so. The gains did not only benefit the health of their
employees but also their productivity at work. On the other hand, a negative
working environment, may lead to mental health issues which can have as
consequences to increase employee absenteeism, lower rates of productivity.
mental health disorders like depression or anxiety have an impact on our ability
to work. Globally, more than 300 million people suffer from depression; 260
million are living with anxiety disorders. A recent WHO-led study estimates
that depression and anxiety disorders cost the global economy US$1 trillion per
year in lost productivity!
health is an integral part of health and well-being. Mental, neurological, and
substance use disorders are common in all regions of the world, affecting every
community and age group across all income countries. While 14% of the global
burden of disease is attributed to these disorders, most of the people affected
- 75% in many low-income countries - do not have access to the treatment they
more about Mental Health, WMHD and the Global Action Plan (mhGAP): who.int
Start of the course "Health Care and Management: From Research to Implementation”
Swiss TPH, a world-leading institution in health research, training and
services, would like to announce the 25th “Health Care and
Management: From Research to Implementation” course starting in March 2018.
Since 1994, almost 600 course participants from 70 countries have successfully
completed this course and made an important step forward in their career.
The 14-week, full-time course introduces students to a range of skills
and knowledge needed to work as a public or international health professional
in resource-constrained settings, with a special focus on supporting
Students of the course benefit from the expertise and experience shared
by facilitators, who are active in the field. Topics range from concepts and
research methods to health problems and responses and health systems,
management and communication.
“The Health Care and Management: From Research to Implementation” course
is a mandatory core course for the tropEd accredited MAS in International
Health. The course itself is accredited by the University of Basel as a Diploma
of Advanced Studies (DAS).
Self-paying students are welcome to apply for the next course in 2018,
while a limited number of scholarships is only available for the course in
We have extended the deadline for application to 31 December 2017.
For further Information and other course opportunities please visit
"Take a minute, change a life”
Every year, 800’000 people die due
by suicide or one person every 40 seconds. Yet suicide is preventable.
According to the International Association for Suicide Prevention (IASP) a word
of support and listening with no judgement someone in difficulties can make all
the difference in this person’s life. People are usually reluctant to talk to
somebody because they do not want to worsen the situation. Well, according to
individuals who went through this deter and now advocate for suicide prevention,
they mostly argue that they were not looking for any specific advice but simply
for compassion and empathy.
Suicide is recognized as a public
health priority by the World Health Organization. It published a first World
Suicide Report “Preventing suicide: a global imperative” in 2014. This report
aimed to raise the public awareness on health implications and the importance
of suicide and suicide attempts. It put suicide prevention as a high priority in
the global public health agenda. WHO also encourages and supports countries to
develop or strengthen comprehensive suicide prevention strategies in a
multisectoral public health approach.
Suicide also figures as a priority
condition in the WHO Mental Health Gap Action Programme (mhGAP). In the WHO
Mental Health Action Plan 2013-2020, WHO Member States committed themselves to
working towards the global target: reducing the suicide rate in countries by
10% by 2020.
More recently, the Sustainable
Development Goals integrate the suicide mortality rate as an indicator of the
target 3.4: reduce by one third premature mortality
from non-communicable diseases through prevention and treatment, and promote
mental health and well-being.
Read more about it:
WHO on Suicide: http://www.who.int/mental_health/suicide-prevention/en/
World Suicide Prevention Day: https://iasp.info/wspd2017/
High Level Political Forum on Sustainable Development and Health
The "2017 HLPF Thematic review of SDG3: Ensure healthy lives and promote well-being for all at all ages", provide the progresses of each target. The 2017 publication of the World Health Statistics which include 31 health and health-related indicators reveal that despite the improvements achieved during the MDG era, challenges remain in the field of reducing maternal, newborn and child mortality, improving nutrition, ensuring universal access to sexual and reproductive health and rights, and making further progress in the battle against communicable diseases such as HIV/AIDS and other sexually transmitted infections, tuberculosis, malaria, neglected tropical diseases and hepatitis is necessary.
In terms of reproductive, maternal, newborn and child health, the maternal mortality ratio stood at 216 per 100 000 live births globally in 2015. To achieve the 3.1 goal a huge acceleration in the annual rate of reduction of at least 7.3% is require, which represents more than the triple that attained between 1990 and 2015.
The neonatal mortality rate declined from 31 deaths per 1000 live births in 2000 to 19 deaths per 1000 live births in 2015. Nevertheless, if neonatal mortality is decreasing, its proportion of the global under-give mortality is increasing.
The HIV incidence rate among children declines by 59% to 0.31 new infections per 1000 children in five years between 2010 and 2015. AIDS still remains the leading cause of death among women aged between 15 and 49 years.
When it comes to non-communicable diseases, the risk of dying from the four main NCDs between ages 30 and 70 decreased from 23% in 2000 to 19% in 2015.
The access to sexual and reproductive health-care services increased slightly globally when measuring the proportion of women of reproductive age who were married or in-union who had access to modern family planning methods, from 74.5% in 2000 to 76.7% in 2017.
The document also gives recommendations in which it stresses the needs to invest in multi-stakeholder partnerships "in order to remove barriers to equitable health serves which are responsive to increasingly diverse population health profiles and needs, and to reach those most further behind first". Furthermore, it insists on the improvement of "multi-sectoral action, strengthen health systems, realize equity and fulfil protect and promote human rights, promote gender equality and the empowerment of all women and girls, and to secure adequate and sustained financing and investment in scientific research and innovation". Furthermore, the report highlights the connection between SDG 3 and the other goals.
Lastly the report addresses the growing challenges that are not part of the 2030 Agenda but will need to be tackled to achieve them like the threats of Anti-Microbial Resistance, which will have consequences beyond health. It will have repercussions on the SDGs related to "the environment, food and agriculture, water, sanitation, research and development, and economic growth". Mental health is the second challenge addressed here. Investment of human and financial resources in the area is lacking and more effort should be put into it as the linkages with many SDGs are at stakes. Mental health "in accordance with human rights norms and standards are crucial for the achievement of SDG3 and the 2030 agenda as a whole".
Linkages between the different SDGs are crucial for the realization of the 2030 agenda, which is why Switzerland joined the cross-regional statement on the linkages between SDG3 and 5 on sexual and reproductive health.
This High Level Political Forum was also the opportunity for Switzerland to underline the importance of a multistakeholders approach to realize SDG3. It fostered its support to this approach in the R&D field for neglected diseases by showing its support to DNDi, which took part to the panel.
Background note: 2017 HLFP Thematic Review of SDG 3: Ensure healthy lives and promote well-being for all at all ages
Visit the Sustainable Development: Knowledge Platform
Toward Access 2030: a better access to medicines for all!
Access to affordable and quality
medicines is a key target of the SDG 3. With this in mind, WHO calls for new
research and development (R&D) models in this field among other steps to
achieve universal health coverage and access for all. The new WHO Medicines and
Health Products Programme Strategic Framework 2016-2030: “Towards Access 2030”,
sets the stage for WHO’s vision on the topic: “a world where every child, man
and woman has access to the quality essential medicines, vaccines and other
health products they need to lead a healthy and productive life”.
The document presents the
challenges to achieve the 3.8 target by underlining the costs of medicines and
health products and the financial burden it represents in low- and
middle-income countries where households pay medical products out-of-pocket.
The financing gap in R&D and
market toward many public health needs remains a great challenge in developing
countries and WHO calls for new research and development (R&D) models, as
well as the delinkage of the costs of these R&D from the final price of
products and fair pricing.
The framework cites existing
initiatives aiming to foster R&D: the Global Strategy and Plan of Action on
Public Health, Innovation, and Intellectual Property (GSPOA), the report of the
Consultative Expert Working Group on Research and Development (CEWG).
Switzerland, through the Global Programme Health actively supports the CEWG
initiative. The framework recognizes that although these efforts stressed “the
need to change the way R&D is financed”, a “global agreement on how to
ensure new products are developed that meet priority health needs” is still
The purpose of the Programme will be to “coordinate
across the three organizational levels to promote and prioritize the following approaches:
responsiveness to Member States’ health needs; recognition of country
ownership; adherence to the highest professional and ethical standards in
technical work and stakeholder relations; outstanding leadership and service
through information and knowledge sharing advocacy; commitment to
partnerships; and accountability and focus on results by
defining clear objectives, and organizing work and resources to achieve them.”
Towards Access 2030: WHO Medicines and Health Products Programme Strategic Framework 2016-2030
Health at the G20‘s Table
The “G20 Leaders’ Declaration:
shaping an interconnected world” that concludes the meeting in Hamburg did not
take major steps towards the health challenges. However two specific paragraphs
were concerned with health matters.
The first one on “safeguarding
against health crises and strengthening health systems” call on the UN “to keep
global health high on the political agenda” and value the importance of
cross-sectoral cooperation. They also recognize the importance of the
International Health Regulations (IHR 2005) in prevention, preparedness and
response efforts. They also stressed the importance of fostering R&D
preparedness through globally coordinated models such as the Coalition for
Epidemic Preparedness Innovations (CEPI).
On “Combatting Antimicrobial
Resistance (AMR)”, the G20 members agreed to “have implementation of our
National Action Plans, based on a One-Health approach”. The Declaration also
states that they will promote a prudent use of antibiotics in all sectors,
strengthen public awareness, infection prevention and control, and improve the
understanding of antimicrobials in the environment. They promise access to “and
quality antimicrobials, vaccines and diagnostics, including through efforts to
preserve existing therapeutic options”. The declaration stressed the importance
of strengthening R&D and “call for a new international R&D
Collaboration Hub to maximize the impact of existing and new anti-microbial
basic and clinical research initiatives as well as product development”.
Find more details in the official statement, here>>
World NoTobacco Day
between tobacco and health is pretty clear, but how is tobacco linked to sustainable
development and economic well-being? Well, on this World No Tobacco Day, the
response will be unveiled. Hence, this year’s campaign by WHO and its partners
aims to demonstrate the threats that the tobacco industry poses to the
sustainable development of all countries.
control contributes directly to achieving the Sustainable Development Goal 3.4:
to reduce premature deaths from noncommunicable diseases, including cardiovascular
disease, cancers and chronic obstructed pulmonary disease. But more than this,
tobacco control contains the adverse environmental impact of tobacco growing,
manufacturing, trade and consumption. Indeed, according to WHO, “tobacco
control can break the cycle of poverty, contribute to ending hunger, promote
sustainable agriculture and economic growth and combat climate change”.
are not the only ones this year’s campaign is directed to. At an individual
level people can contribute to a sustainable, tobacco-free world by committing
to never start using tobacco products, quit the habit or seek help for doing
Find more information here>>
G20 Health Ministers Meeting
It was a first, 20 health ministers met in Berlin on 19 and 20 May, for the first meeting of G20 Health Ministers. The meeting focused on global health and was held under the motto: “Together Today for a Healthy tomorrow – Joint Commitment for Shaping Global Health”. The G20 countries covered topics like health security and Antimicrobial Resistance. The G20 countries committed for example to combat Antimicrobial Resistance by developing and implementing national action plans based on a One-Health approach. The meeting looked at ways to improve global health systems and explored ways to combat antimicrobial resistance. Also in order to rehearse their preparedness, the ministers went through an exercise of a fictitious cross-border outbreak together with representative of the WHO and World Bank. This meeting was also the occasion for the G20 Health Ministers to adopt the Berlin Declaration of the G20 Health Ministers. The declaration states the importance that products emerging from such R&D efforts become accessible to all people in need. Moreover the declaration commits to broaden the voluntary financial support for ongoing initiatives, such as the Global Antibiotic Research and Development Partnership (GARDP), the Drugs for Neglected Diseases initiative (DNDi), UNITAID, the Joint Programming Initiative on AMR (JPIAMR), Combating Antibiotic Resistance Bacteria Biopharmaceutical Accelerator (CARB-X), Innovative Medicines Initiative (IMI), and the TB Alliance for new anti-tuberculosis medicines. The health ministers also called on other countries, philanthropic organizations, academia, and the private sector to support those initiatives.
Link to the declaration >>
Find more information here >>
BMG/Inga Kjer (photothek)
70th World Health Assembly - 22-31 May 2017
The World Health Organization’s 70th annual World Health Assembly will take place from 22 to 31 May 2017 at the Palais des Nations in Geneva, Switzerland. It will be attended by nearly 4000 delegates from WHO’s 194 Member States and partner organizations. The Assembly is WHO’s highest decision-making body, setting out the Organization’s policy and approving its budget.
This year’s meeting will be webcast live, including the plenary sessions and the deliberations in Committees A and B. WHO will issue daily press releases, detailing decisions taken at the Assembly.
On Tuesday, 23 May, the Assembly will elect a new Director-General, who will take office for a term of five years on 1 July 2017. Full details of how the election will proceed can be found here>>
Technical issues to be discussed at this WHA include:
The provisional agenda can be found here>>
An updated WHA Daily Journal will be posted on the web every morning from 22 May.
The Preliminary Journal is available here>>
International Nurses Day 2017
Today we celebrate Florence Nightingale birth (the founder of modern nursing), or the International Nurses Day. An occasion to highlight the key role played by nurses and every healthcare worker around the world. This year, the theme of this special day is Nursing: A voice to lead – Achieving the Sustainable Development Goals. At this occasion, the International Council of Nurses released a Resource and Evidence guidance pack as well as a website and video to emphasis the role of nurses in achieving the sustainable development goals. Nurses play a key role in caring for and educating/ training/ empowering patients, and always take into account the situation as a whole, included the social determinants of health. All around the world, they strive to deliver the best and most adapted care to their patients and communities by thinking outside the box and overcoming external challenges. According to the ICN President, “Investing in the nursing profession is essential for economic growth and the achievement of universal health care.”Find out more about the Nurse’s role in achieving the SDGs here>>Source: International Council of Nurses – The global voice of nursing Press Information
Image Credit: UN Photo/x Arab Refugee Girls Study Nursing in England
Impact of health insurance on use of maternal health services
premiums, factors influencing enrolment in health insurance were found to
include perceivjuan Wang et aled need for health insurance, knowledge about its
benefits and cultural factors, as well as individuals’ health conditions.
Additionally, women in poorer households did not always know about their health
insurance status when coverage is household-based, which affected service uptake.
In all three
countries, health insurance coverage contributed to a 5–11% increase in use of
facility-based delivery care. In Indonesia and Rwanda insurance coverage has a
significant positive impact on women’s access to at least one antenatal care visit.
In Ghana and Indonesia, insurance coverage shows a positive impact on women
making at least four antenatal visits, as recommended by the World Health
Organization. The variation in results relates in part to different insurance
conditions relating to comprehensive free care or the requirement for
overall suggests that free health insurance enrolment for the poor and
income-sensitive premiums, as well as the provision of antenatal care with no
or low co-payments, can encourage higher rates of maternal care utilization.
These results support the case for broadening access to health insurance
offering comprehensive coverage of maternal healthcare services.
article can be accessed accessedcan be accessed online, here>>
and Lindsay Mallick (2017). The impact of health insurance on
maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.
Health Policy and Planning 32 (3): 366-375.
World Malaria Day
Today, Malaria is still highly prevalent
worldwide. In 2015, almost 212 million cases were recorded and an estimated of
429 000 malaria deaths. The African Region is predominantly affected by the
disease by “hosting” 90% of the malaria cases and 92% of malaria deaths. More
than a simple disease, Malaria reinforces poverty and causes the deaths of
almost half a million people per year – mainly among young children, babies,
and pregnant women. Malaria is accountable for the death of one child every 2
minutes (World Malaria Report 2016).
Malaria is preventable and
curable. The incidence of the disease fell by 21% in the last five years so did
the malaria mortality rates among population at risk within the same period. Investment
in malaria is considered to be one of the “best buys” in global health and
development. Since 2000, more than 6 million lives have been saved (UNICEF and WHO 2015. Achieving the malaria MDG Target. Reversing the
incidence of malaria 2000-2015). Yet, these recent gains are increasingly threatened by resistance
against medicines and insecticides, combined with insufficient investments
against the disease.
Good news in terms of
vaccination were announced yesterday by the WHO. The first malaria vaccine,
RTS,S will be administrated from 2018 in Ghana, Kenya and Malawi. This is an
important step toward a global rollout. The aim of this pilots in these three
countries is to evaluate the feasibility of delivering the required four doses
of RTS,S in real-life settings as well as its potential role in reducing
childhood deaths and the safety of the vaccine in the context of routine use.
Together Gavi, the Vaccine
Alliance, The Global Fund to Fight AIDS, Tuberculosis and Malaria, and UNITAID
invested $49.2 million for the first phase of the pilot program. The
implementation will be done by the Ministries of Health in coordination with
WHO.Sources articles: WHO, Swiss Malaria Group, the
Global Fund Partnership Supports Launch
of Malaria Vaccine Pilots in Three African Countries
Picture copyright: David ODwyer/ Swiss Malaria Group
Take the online quiz from BioMed Central here>>
Find related information here:
Systematic review of performance-based financing for improving HIV and AIDS service delivery
As funds to
address HIV and AIDS are under pressure, innovative ways are needed to make
services more effective and efficient. A systematic review has recently been
published on whether providing incentives for the health system such as
performance-based financing (PBF) may support countries to achieve more with
Amitabh B.Suthar, Jason M. Nagata, Sabin Nsanzimana, Till Bärnighausen, Eyerusalem K.Negussie and Meg C. Doherty (2017). Performance-based financing for improvingHIV/AIDS service delivery: a systematic review. BMC Health Services Research 2017. 17:6
Results of the
analysis of effects of PBF on HIV and AIDS service delivery revealed that
although PBF did not improve individual testing coverage, it significantly
improved testing coverage of couples and pregnant women. Furthermore, PBF
improved antiretroviral coverage of both pregnant women and other adults. It
was also significantly associated with reduced treatment drop-outs and failure.
The full article on the systematic review findings can be accessed here>>
Partnerships model for mental healthcare in low-resource settings
Tackling the growing burden of mental health poses great challenges in low- and middle-income countries (LMICs) were often specialist professions are weak and need to be strengthened. Health partnerships are often cited as the way forward, yet these often exist informally between healthcare delivery or training institutions in high-income countries, and their low- or middle-income counterparts. Such peer-to-peer collaborations can build the capacity and expertise of the health workforce within a particular institution and can also broaden into more integrated support for health systems, such as national and institutional health strategies, standards and protocols.
A 2017 commentary by Acharya et al shares a model developed in Nepal where there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. The model integrates mental healthcare services within a rural public hospital and includes the training and supervision of generalist health workers by off-site psychiatrists. This was made possible by complementing the strengths and weaknesses of a variety of groups involved that included public sector services, a non-profit organization that provided general healthcare services and one that specialized in mental health, a community advisory board, academic centres in high- and low-income countries, and bicultural professionals from the Nepal diaspora community.
The commentary can be accessed online: Acharya, B. et al (2017). Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and Health. 13:2.
The journal Globalization and Health has a 2017 series on a broad range of health partnerships that can be accessed here>>