#International #Funding for #Global Common #Goods for #Health: An Analysis Using the #Creditor Reporting System and G-FINDER Databases (Health Syst Reform, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Health Syst Reform. 2019 Nov 11:1-16. doi: 10.1080/23288604.2019.1663646. [Epub ahead of print]

International Funding for Global Common Goods for Health: An Analysis Using the Creditor Reporting System and G-FINDER Databases.

Schäferhoff M1, Chodavadia P2, Martinez S1, McDade KK2, Fewer S3, Silva S4, Jamison D3, Yamey G2.

Author information: 1 Open Consultants, Berlin, Germany. 2 Duke Global Health Institute, Duke University, Durham, NC, USA. 3 Institute for Global Health Sciences, University of California, San Francisco, CA, USA. 4 Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.



West Africa’s Ebola epidemic of 2014-2016 exposed, among other problems, the under-funding of transnational global health activities known as global common goods for health (CGH), global functions such as pandemic preparedness and research and development (R&D) for neglected diseases. To mobilize sustainable funding for global CGH, it is critical first to understand existing financing flowing to different types of global CGH. In this study, we estimate trends in international spending for global CGH in 2013, 2015, and 2017, encompassing the era before and after the Ebola epidemic. We use a measure of international funding that combines official development assistance (ODA) for health with additional international spending on R&D for diseases of poverty, a measure called ODA+. We classify ODA+ into funding for three global functions-provision of global public goods, management of cross-border externalities, and fostering of global health leadership and stewardship-and country-specific aid. International funding for global functions increased between 2013 and 2015 by $1.4 billion to a total of $7.3 billion in 2015. It then declined to $7.0 billion in 2017, accounting for 24% of all ODA+ in 2017. These findings provide empirical evidence of the reactive nature of international funders for global CGH. While international funders increased funding for global functions in response to the Ebola outbreak, they failed to sustain that funding. To meet future global health challenges proactively, international funders should allocate more funding for global functions.

KEYWORDS: global common goods for health; global health funding

PMID: 31710516 DOI: 10.1080/23288604.2019.1663646

Keywords: Global Health; International cooperation.


The #human #imperative of stabilizing #global #climatechange at 1.5°C (Science, abstract)

[Source: Science, full page: (LINK). Abstract, edited.]

The human imperative of stabilizing global climate change at 1.5°C

O. Hoegh-Guldberg1,2,*, D. Jacob3, M. Taylor4, T. Guillén Bolaños3, M. Bindi5, S. Brown6,7, I. A. Camilloni8, A. Diedhiou9, R. Djalante10,11, K. Ebi12, F. Engelbrecht13, J. Guiot14, Y. Hijioka15, S. Mehrotra16, C. W. Hope17, A. J. Payne18, H.-O. Pörtner19, S. I. Seneviratne20, A. Thomas21,22, R. Warren23, G. Zhou24

1 Global Change Institute, University of Queensland, St. Lucia, QLD 4072, Australia. 2 School of Biological Sciences, University of Queensland, St. Lucia, QLD 4072, Australia. 3 Climate Service Center Germany (GERICS), Helmholtz-Zentrum Geesthacht, Hamburg, Germany. 4 Department of Physics, University of the West Indies, Kingston, Jamaica. 5 Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, 50144 Firenze, Italy. 6 Faculty of Engineering and Physical Sciences, University of Southampton, Boldrewood Innovation Campus, Southampton SO16 7QF, UK. 7 Department of Life and Environmental Sciences, Faculty of Science and Technology, Bournemouth University, Fern Barrow, Poole, Dorset BH12 5BB, UK. 8 Centro de Investigaciones del Mar y la Atmósfera (UBA-CONICET), UMI-IFAECI/CNRS, and Departamento de Ciencias de la Atmósfera y los Océanos (FCEN), University of Buenos Aires, Buenos Aires, Argentina. 9 Université Grenoble Alpes, French National Research Institute for Sustainable Development (IRD), CNRS, Grenoble INP, IGE, F-38000 Grenoble, France. 10 United Nations University–Institute for the Advanced Study of Sustainability (UNU-IAS), Tokyo, Japan. 11 Halu Oleo University, Kendari, South East Sulawesi, Indonesia. 12 Center for Health and the Global Environment, University of Washington, Seattle, WA, USA. 13 Global Change Institute, University of the Witwatersrand, Johannesburg 2193, South Africa. 14 Aix Marseille University, CNRS, IRD, INRA, Collège de France, CEREGE, Aix-en-Provence, France. 15 Center for Climate Change Adaptation, National Institute for Environmental Studies, Onogawa, Tsukuba, Ibaraki 305-8506, Japan. 16 World Bank, Washington, DC, USA. 17 Cambridge Judge Business School, University of Cambridge, Cambridge, UK. 18 University of Bristol, Bristol, UK. 19 Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany. 20 Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland. 21 Climate Analytics, 10961 Berlin, Germany. 22 Environmental and Life Sciences, University of the Bahamas, Nassau 76905, Bahamas. 23 Tyndall Centre for Climate Change Research and School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK. 24 State Key Laboratory of Severe Weather, Chinese Academy of Meteorological Sciences, Beijing 100081, China.

*Corresponding author. Email: oveh@uq.edu.au

Science  20 Sep 2019: Vol. 365, Issue 6459, eaaw6974 / DOI: 10.1126/science.aaw6974


The need to stabilize global climate

Climate change will be the greatest threat to humanity and global ecosystems in the coming years, and there is a pressing need to understand and communicate the impacts of warming, across the perspectives of the natural and social sciences. Hoegh-Guldberg et al. review the climate change–impact literature, expanding on the recent report of the Intergovernmental Panel on Climate Change. They provide evidence of the impacts of warming at 1°, 1.5°, and 2°C—and higher—for the physical system, ecosystems, agriculture, and human livelihoods. The benefits of limiting climate change to no more than 1.5°C above preindustrial levels would outweigh the costs.

Science, this issue p. eaaw6974


Structured Abstract


The United Nations Framework Convention on Climate Change (UNFCCC) was established in 1992 to pursue the “stabilization of greenhouse gas concentrations at a level that would prevent dangerous anthropogenic interferences with the climate system.” Since 1992, five major climate change assessment cycles have been completed by the UN Intergovernmental Panel on Climate Change (IPCC). These reports identified rapidly growing climate-related impacts and risks, including more intense storms, collapsing ecosystems, and record heatwaves, among many others. Once thought to be tolerable, increases in global mean surface temperature (GMST) of 2.0°C or higher than the pre-industrial period look increasingly unmanageable and hence dangerous to natural and human systems.

The Paris Climate Agreement is the most recent attempt to establish international cooperation over climate change. This agreement, ratified or acceded to by 185 countries, was designed to bring nations together voluntarily to take ambitious action on mitigating climate change, while also developing adaptation options and strategies as well as guaranteeing the means of implementation (e.g., climate finance). The Agreement is aimed at “holding the increase in the global average temperature to well below 2.0°C above pre-industrial levels and pursuing efforts to limit the temperature increase to 1.5°C above pre-industrial levels, recognizing that this would significantly reduce the risks and impacts of climate change.” Many unanswered questions regarding a 1.5°C target surround the feasibility, costs, and inherent risks to natural and human systems. Consequently, countries invited the IPCC to prepare a Special Report on “the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty.” The Special Report was completed and approved by the 48th Session of the IPCC in October 2018.


Multiple lines of evidence indicate that the next 0.5°C above today (which will take GMST from 1.0°C to 1.5°C above the pre-industrial period) will involve greater risks per unit temperature than those seen in the last 0.5°C increase. This principle of “accelerating risk” is also likely to drive proportionally and possibly exponentially higher risk levels in the transition from 1.5°C to 2.0°C above the pre-industrial period. We argue that this is a consequence of impacts accelerating as a function of distance from the optimal temperature for an organism or an ecosystem process. Coral reefs, for example, often appear healthy right up until the onset of mass coral bleaching and mortality, which can then destroy a reef within a few months. This also explains the observation of “tipping points” where the condition of a group of organisms or an ecosystem can appear “healthy” right up to the point of collapse, suggesting caution in extrapolating from measures of ecosystem condition to predict the future. Information of this nature needs to be combined with an appreciation of organisms’ distance from their optimal temperature.

Finally, we explore elements of the costs and benefits associated with acting in response to climate change, and come to the preliminary conclusion that restraining average global temperature to 1.5°C above the pre-industrial period would be much less costly than the damage due to inaction on global climate change.


As an IPCC expert group, we were asked to assess the impact of recent climate change (1.0°C, 2017) and the likely impact over the next 0.5° to 1.0°C of additional global warming. At the beginning of this exercise, many of us were concerned that the task would be hindered by a lack of expert literature available for 1.5°C and 2.0°C warmer worlds. Although this was the case at the time of the Paris Agreement, it has not been our experience 4 years later. With an accelerating amount of peer-reviewed scientific literature since the IPCC Special Report Global Warming of 1.5°C, it is very clear that there is an even more compelling case for deepening commitment and actions for stabilizing GMST at 1.5°C above the pre-industrial period.



Increased concentrations of atmospheric greenhouse gases have led to a global mean surface temperature 1.0°C higher than during the pre-industrial period. We expand on the recent IPCC Special Report on global warming of 1.5°C and review the additional risks associated with higher levels of warming, each having major implications for multiple geographies, climates, and ecosystems. Limiting warming to 1.5°C rather than 2.0°C would be required to maintain substantial proportions of ecosystems and would have clear benefits for human health and economies. These conclusions are relevant for people everywhere, particularly in low- and middle-income countries, where the escalation of climate-related risks may prevent the achievement of the United Nations Sustainable Development Goals.

Keywords: Climate Change; Global Warming; International cooperation.


Learning from the #Epidemiological #Response to the 2014/15 #Ebola Virus Disease #Outbreak (J Epidemiol Globa Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Epidemiol Glob Health. 2019 Sep;9(3):169-175. doi: 10.2991/jegh.k.190808.002.

Learning from the Epidemiological Response to the 2014/15 Ebola Virus Disease Outbreak.

Holding M1,2,3, Ihekweazu C4,5, Stuart JM1,6, Oliver I1,2.

Author information: 1 NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, Bristol, UK. 2 Field Service, National Infection Service, Public Health England, Bristol, UK. 3 NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK. 4 Nigeria Centre for Disease Control, Abuja, Nigeria. 5 ECOWAS Regional Centre for Surveillance and Disease Control, Abuja, Nigeria. 6 School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.



A large international response was needed to bring the 2014/15 West African Ebola virus disease outbreak under control. This study sought to learn lessons from this epidemic to strengthen the response to future outbreaks of international significance by identifying priorities for future epidemiology training and response. Epidemiologists who were deployed to West Africa were recruited through a snowball sampling method and surveyed using an online anonymous questionnaire. Associations between demographics, training, qualifications, and role while in-country were explored alongside respondents’ experience during deployment. Of 128 responses, 105 met the inclusion criteria. Respondents originated from 25 countries worldwide, for many (62%), this was their first deployment abroad. The most common tasks carried out while deployed were surveillance, training, contact tracing, and cluster investigation. Epidemiologists would value more detailed predeployment briefings including organizational aspects of the response. Gaps in technical skills reported were mostly about geographical information systems; however, epidemiologists identified the need for those deployed in future to have greater knowledge about roles and responsibilities of organizations involved in the response, better cultural awareness, and leadership and management skills. Respondents felt that the public health community must improve the timeliness of the response in future outbreaks and strengthen collaboration and coordination between organizations.

© 2019 Atlantis Press International B.V.

KEYWORDS: Ebola virus; West Africa; FETP; epidemiologist; international deployment; outbreak response

PMID: 31529934 DOI: 10.2991/jegh.k.190808.002

Keywords: Ebola; West Africa; Public Health.


#Pandemic #bonds: designed to #fail in #Ebola (Nature, summary)

[Source: Nature, full page: (LINK). Summary, edited.]

Pandemic bonds: designed to fail in Ebola

Olga Jonas


The final toll of the Ebola outbreak in West Africa in 2014–16 was more than 11,000 lives, plus an estimated US$53 billion from economic disruption and collapse of health systems. In the outbreak’s wake, the global health community scrambled to deliver initiatives for increased health security. One flagship programme was the World Bank’s Pandemic Emergency Financing Facility (PEF). Under the scheme, investors who buy pandemic bonds receive generous ‘coupons’, which annually pay about 13% interest. This compensates investors for the risk that the bonds will make ‘insurance’ payouts to fight pandemics under certain conditions. Otherwise, cash returns to the investors when the bonds mature in July 2020.


Nature 572, 285 (2019) / doi: 10.1038/d41586-019-02415-9

Keywords: International cooperation; Pandemic preparedness; Ebola; DRC.


The #truth about #PHEICs (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

The truth about PHEICs

Johan Giesecke, on behalf of STAG-IH †

Published: July 05, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)31566-1


The recent decision by the WHO Director-General that the Ebola virus outbreak in DR Congo does not constitute a Public Health Emergency of International Concern (PHEIC)1
has generated controversy, as articulated by the Editors2 of The Lancet. Members of the WHO Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH) have discussed this Editorial and would like to clarify the role of the International Health Regulations (IHR) and the designation of a PHEIC.



I declare no competing interests.

Keywords: Ebola; IHR(2005); PHEIC; Global Health.


The #politics of #PHEIC (Lancet, summary)

[Source: Lancet, full page: (LINK). Summary, edited.]

The politics of PHEIC

The Lancet

Published: June 18, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)31406-0


An emergency committee decided on June 14 that the current Ebola virus disease outbreak in the Democratic Republic of the Congo did not warrant a Public Health Emergency of International Concern (PHEIC). It was the third time the committee has decided against a PHEIC declaration since this Ebola outbreak began in August, 2018, which has now affected over 2100 people. WHO Director-General Tedros Adhanom Ghebreyesus agreed with the committee’s advice but asserted the outbreak remains an emergency.



© 2019 Elsevier Ltd. All rights reserved.

Keywords: Ebola; DRC; Uganda; WHO; PHEIC.


The #legal #determinants of #health: harnessing the power of law for #globalhealth and sustainable #development (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

The legal determinants of health: harnessing the power of law for global health and sustainable development

Prof Lawrence O Gostin, JD, John T Monahan, JD, Jenny Kaldor, LLB, Mary DeBartolo, JD, Eric A Friedman, JD, Katie Gottschalk, LLM et al.

Published: April 30, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30233-8



Health risks in the 21st century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains substantially underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public’s health and safety.

Keywords: Global Health; International cooperation.