Improve global health: share your testimony

The Commission values your input - read some of your ideas

I am troubled by the lack of any publications, or insight into issues of global health governance and the role of law (domestic and international) in furthering--or impeding--global health initiatives. As a professor of global health law and policy, I find this particular issue by and large ignored by the global health community. I hope the Commissioners will take efforts to reach out to those of us who have recognized the need to explicitly address the complexities arising from the association between health and human rights, trade, and other branches of international law. I would be eager to contribute my reflections on issues related to women's health and the impact of health-related treaties, which is my particular area of research.

With kindest regards,
Dhrubajyoti (Dru) Bhattacharya, J.D., M.P.H., LL.M.
Assistant Professor, Health Law and Policy Southern Illinois University School of Medicine
Assistant Professor, Medical Jurisprudence Southern Illinois University School of Law

I would like to request that the Commission investigate the current R&D incentives for the development of drugs for conditions affecting the poor (not only for infectious diseases but also for other chronic diseases; drugs that need to be adapted for the use in resource limited settings). There are several innovative ideas circulating (Advanced Market Commitment, the Health Impact Fund, Patent Pools etc). None of these ideas will be successful without the support of the Obama administration. A few might need to be prioritized to give the field clarity and direction. There is also an alternative way to tackle the issue for long term results: provide incentives for the development of sustainable non profit pharmaceutical companies. I am a volunteer at a non profit pharmaceutical organization (www.releef.org) that aims to be sustainable by utilizing co-development and marketing partnerships with for profit business. All members work pro bono and are seasoned pharmaceutical professionals but the system works against getting this type of enterprise off the ground easily. There should be social venture mechanisms that would allow for slow capital investigate is these organizations and eliminate the reliance on foundations and government development agencies for kick start funding. These organizations should be focusing on disease prevention, leadership development and health system strengthening. Thank you.

Best Regards,
Marcia

My name is Chad Swanson, and I am an ER physician, MPH student at Johns Hopkins, and the lead author on a recent publication in the journal Lancet calling for Health Systems Impact Assessments (HSIAs) on all global health activities. I am motivated by the prospect of more effective future global health interventions through the findings of your commission. Experience and evidence suggest that one of the biggest challenges facing global health today is the disconnect between the need and the response. There is wide agreement that effective, efficient, and equitable health systems are needed to improve health in developing countries long-term. However, most of the recent funding has been targeted toward particular diseases. And understandably so: funding is easier to obtain because short-term indicators are easier to measure than the strength of the health system. In the past few months, publications have reviewed the impact that those targeted, disease-specific (so-called "vertical") programs have had on the underlying health system. It has not always been positive. HSIAs would close the gap between the need and the response. Put simply, they would provide an evidence-based framework so that global health planners could consider the impact of their activitieis on the existing, underlying health system prior to implementation. I am currently leading a number of global health professionals around the country and the globe to consider the very question that you are asking: What metrics and indicators should HSIAs use to be most effective, efficient, and equitable tools? For example, while a large portion of the global burden of disease is caused by diseases that can be prevented or treated by simple, cost-effective interventions in the home (diarrhea, pneumonia, etc.), few health systems assessment tools consider the household as an important component of the health system. I hope you'll consider involving our group's findings in your report, and hope for a continued discussion.

Best Regards,
Chad Swanson

Our organisation, Riders for Health, has developed a core competence in the managment of vehicle fleets used in the delivery of health care and critical services in developing countries. We believe that none of the health issues listed above can be effectively addressed unless transportation is appropriate, cost effective and efficient. Our systems mean that vehicles run for the longest possible time at the lowest possible ccost. This conserves capital costs, enables bbudgeting over at least 5 years, makes the money used on vehicles, fuel and other oonsumables absolutely transparent and countable. The system also builds high level, transferable skills and builds appropriate, scalable infrastructures. Riders has 20 years experience and we are the experts in transport for health delivery ifor development. We work with ministries of health and other NGO who can depend on our core competence and integrity. I urge the commission to include transportation and budgeting for transportation as a primary issue on the development agenda. If Riders can offer any helpful advise we will be delighted and honoured to so do. We wish you all great success with the commission.

(Andrea Coleman)