This article addresses recent calls for the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) to develop a Code of Practice on the Marketing of Unhealthy Food and Beverages to Children. The author argues that such suggestions ignore the development of WHO’s Set of Recommendations on the Marketing of Food and Non-Alcoholic Beverages to Children and misrepresent its scope. The recommendations, adopted by the World Health Assembly in 2010, aim ‘to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.’ In light of the current WHO reform process and financial constraints, the fact that WHO member states explicitly chose to develop a Set of Recommendations instead of a Code, the author questions the feasibility and value of re-opening the issue. Instead he recommends that the Secretariat be supported in their mandate to provide assistance to member states in implementing the existing WHO Set of Recommendations.
Public-Private Mix
This paper argues that the Affordable Medicine Facility–malaria, a global subsidy for malaria could skew investment away from more effective solutions to the disease. The AMFm advocates selling artemisinin-based combination therapy (ACT) medicines through the private sector, such as small shops. But selling ACT drugs, even at a small cost, is argued to exclude poor people who cannot afford to pay for a full course of treatment. Furthermore, the informal private sector does not have the ability or incentive to provide correct diagnosis and treatment, which may contribute to worsening drug resistance. The authors raise that getting malaria medicines from informal private providers is not a sound public health approach and not a substitute for investment in public service provision.
In this article, the author argues that there is a conflict of interest regarding public and nonprofit leaders who sit on the corporate boards of major commercial softdrink companies and their role on non profit foundations. The author reports in the paper that 7% of the Gates Foundation’s corporate stock endowment (more than 15 million shares) is in the form of shares of Coca-Cola, and questions whether Gates should be invested so heavily in sweetened soft-drinks given its health focus.
In September 2009, the Constitutional Court of South Africa heard the final appeal in a case brought by five Soweto residents challenging prepaid water meters and insufficient free basic water. The Bill of Rights of the South African Constitution guarantees right of access to sufficient water. However, poor communities in Johannesburg's townships do not have sufficient water and do not receive the same water service as the richer suburbs. Amanzi Ngawethu (The Water is Ours) is a short documentary representing the six-year legal battle against water privatisation. It brings together protest songs, photos and video from people and organisations involved in the struggle and working in solidarity.
Product development partnerships, non-profit research institutes and private sector groups have come together over the past years to conduct research and development (R&D) in the areas of the development of drugs, vaccines and diagnostics for neglected diseases, including tropical diseases and other major infectious diseases like HIV and AIDS, tuberculosis and malaria. However, arguments have been put forward that their efforts are disjointed and that funding flows inefficiently to individual research projects resulting in insufficient resources, funding volatility, poor resource allocation, and duplicated and unnecessary efforts. In response, several pooled funding mechanisms have been proposed to address what proponents see as the key problem(s) in the current system: the Industry R&D Facilitation Fund (IRFF) originally proposed by the George Institute; the Fund for Research in Neglected Diseases (FRIND) proposed by Novartis; and the Product Development Partnership Financing Facility (PDP-FF) proposed by the International AIDS Vaccine Initiative (IAVI). The goal of this paper is to provide insight into the extent to which these three proposed mechanisms would have a positive effect on accelerating R&D for neglected diseases. It considers how these proposals are likely to perform against two criteria: their capacity to raise additional money for neglected disease R&D and their capacity to improve the efficient allocation of those funds. The authors of the paper use a literature review, interviews with key stakeholders and illustrative modelling to assess the proposals against these two criteria. Most interviewees expressed doubts that common ground could be found with regard to the metrics on resource allocation if the fund were covering a large and diverse part of the R&D space. However, stakeholders overwhelmingly agreed that a pooled fund focused on late stage work only would be a more feasible and useful proposition.
The World Health Organisation (WHO) includes regulatory system functions as one of the six core building blocks of health systems: access to medical products, vaccines, and technologies of assured quality, safety, and efficacy. However, little attention has been focused on regulatory systems in low- and middle-income countries. They have not featured prominently in global health and development assistance programmes, according to this paper, and few strategic documents of major global health initiatives, including the United States Global Health Initiative, reference regulatory systems. The global activities that do involve regulatory systems typically involve high-income countries, such as the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH), which harmonises regulatory standards and processes for the pharmaceutical industry. ICH includes regulatory authorities from the European Union, Japan and the United States. The authors argue that lack of attention to medical product regulatory systems in low- and middle-income countries is a significant gap that needs to be bridged. They thus propose that strengthening regulatory systems in low- and middle-income countries must become a global health priority.
ECDPM organised an informal multi-stakeholder meeting in Brussels in December 2012 to highlight and share the different views of the opportunities and challenges, as well as potential ways forward, in measuring the impact of the private sector on development. Participants included European Union (EU) officials, research institutes, development agencies, African, Caribbean and Pacific (ACP) and EU ambassadors, civil society organisations and private sector actors and confederations. Despite the private sector’s often-cited move beyond corporate social responsibility, delegates agreed that the focus for some still seems to be predominantly placed within the (often marginal) add-on projects on the side of the core business. By choosing to not address this, private sector actors are avoiding the fact that their main business activities most likely are their main development impact. The author recommends that partnerships between public-private and/or civil society actors should be balanced and in the interest of all partners, and that assessment of these partnerships should not only capture corporate social responsibility-type activities, but also core business impacts.
Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to artemisinin-based combination therapy (ACT) for malaria in the private sector could be improved through the provision of a high level supply chain subsidy. Four intervention districts were purposefully selected to receive branded subsidised medicines, while the fifth district acted as the control. Researchers analysed the intervention's impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, it accounted for 69 % of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8 % at baseline to 26.2 % at evaluation in the intervention districts. These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda.
This policy brief aims to understand whether or how session work in hospitals could be expanded to help achieve universal health coverage. About 14% of private sector specialists work part-time in public hospitals, through what is known as ‘session work’. Private specialists undertake session work for a number of mainly non-financial reasons, such as to ‘give back’ to the public sector and to teach in academic hospitals. There are a number of private specialists who seem interested in working in the public sector in future, but the pay is very low for session work. The author argues that higher session wages may induce specialists to leave full-time public work to undertake private and session work. Thus it may be important to only give new session worker posts to those who have already left the public sector.
This report explores the shift from privatisation to corporatisation of urban water services in developing countries. The author calls for the water justice movement to adjust its strategy to take this into account. Corporatisation reform implies the implementation of commercial neoliberal management approaches within public sector water utilities. The author argues that the strategy of the water justice movement has largely focused on privatisation and that it needs to direct more attention towards resisting corporatisation.