BLOG FROM THE WORLD CONGRESS ON HEALTH ECONOMICS, BEIJING

By JULIA DAY, STEPS Centre member

'Harmonising health and economics' sounds like a tall order, nonetheless it is the title of this year's World Congress on Health Economics being held in Beijing.

Our colleagues from Future Health Systems and POVILL, Samantha Reddin and Adrijana Corluka, are blogging live from the event, and have already covered subjects including the role of the private sector, social franchising, innovation and training, as well as giving a flavour of what's happening behind the scenes in Beijing.

Check out their blog on the Eldis Community site to keep up-to-date with all the goings-on at the International Health Economics Association event.
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AID FOR AIDS: HOW DO COMMUNITY GROUPS NEGOTIATE THE NEW FINANCIAL ARCHITECTURE?

By Kate Hawkins, STEPS Centre member

The past decade has witnessed a change in the public health funding landscape - with the rise of global health initiatives as well as increases in bilateral funding for health sector development. Action on HIV/AIDS has been associated with high profile programmes such as the Global Fund to Fight AIDS, TB and Malaria and the US President’s Emergency Plan for AIDS Relief as well as large philanthropic initiatives such as the Bill and Melinda Gates Foundation.

How to improve the aid architecture for health is a hot topic. Recent weeks have seen publication of a report from the World Health Organization’s Maximizing Positive Synergies Collaborative Group and a widely read editorial in the Lancet about the effect of global health initiatives on efforts to strengthen health systems.

Critics of global health initiatives have claimed they lead to inefficiency, duplication, lack of country ownership and the co-option of national agendas by international agencies and the private sector. Many health actors have called for greater simplification of the way that aid for health delivered often favouring sector wide and general budgetary support. However, others have cautioned that budget support needs good governance, transparency and real ownership by the citizens of countries if it is to deliver the health outcomes that are needed.

In some respects explorations of the aid architecture have tended to represent the view ‘from above’ or to concentrate on tracking the flow of funds. Very little research has been conducted into how community groups experience the new aid for AIDS - how sovereignty and the politics of knowledge at local level are influenced by these global health relationships. Whilst funding directives might provide constraints they may also open up new possibilities in the negotiation of appropriate local responses to the epidemic. These may influence the relationship between citizens and the state.

To address this gap in the knowledge base IDS is working with the Research for Equity and Community Health (REACH) Trust (Malawi), Institute of Economic and Social Research of the University of Zambia and the African Population and Health Center (Kenya) on a three-country research project, ‘Aid for AIDS’, which will highlight community level stories, as well as perspectives of government and international representatives, and will provide lessons for future donor policy.

The long-term vision underpinning this study is of a World where local people have appropriate resources, knowledge and informed access to options for transcending significant health and social challenges.

To find out more about the project contact Hayley MacGregor.

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BEYOND SCALING UP: PATHWAYS TO UNIVERSAL ACCESS

By Kate Hawkins, STEPS Centre member

The STEPS Centre and our affiliate Future Health Systems are launching a series of activities that challenge the thinking behind prevailing concepts of “scaling up” in the health sector.

There is an increasing awareness amongst policy-makers in developing countries that their government's health services do not adequately meet the health-related needs of the poor.

Opinions on how to improve access to services vary. There is a long standing debate on the relative merits of blue-print approaches, which involve the replication of a well-designed intervention in multiple settings, and locally driven approaches, which rely exclusively on local innovation. Both have limitations.

The dominant response of developing country decision makers and donors has been to identify interventions which have been cost-effective in meeting health-related needs, often through pilot projects, and propose that these interventions are “scaled up” through the design of large programmes. Most discussions of scaling up focus explicitly or implicitly on the public sector and on the interventions which increased public resources should fund, whether through integrated or vertical approaches.

But a growing body of evidence indicates that the translation of increased resources into improved access is much more complex than the language of “scaling-up” implies. Health-related needs are diverse; they vary by setting and group. Blue-print approaches are rarely adaptive enough to work in predictable ways in different contexts, and are likely to produce unintended consequences, which can lead to poorly functioning and unsustainable interventions. In the case of locally driven approaches, it is more difficult to move to institutional scale and transmit learning from one site to another, so the impact may be local and modest.

Our work on “Beyond Scaling Up: Pathways to Universal Access” will explore emerging approaches that support local and scaled up innovations and facilitate rapid organisational learning about what works and what does not. It will contribute to discussions of practical approaches for ensuring that substantial increases in health financing lead to significant improvements in access to health services.

We are in the midst of a number of simultaneous transitions in demography, epidemiology, medical technology, information and communications technologies and economic and governance arrangements. We need to identify strategies for working with the uncertainties that these changes bring in addressing major health-related needs. We need to recognise that socio-technical systems and social institutions move along pathways that are profoundly influenced by their historical development. This both produces path dependency and opens opportunities for different models to emerge, and for alternative pathways to be built and promoted. Read more

BLOG FROM THE SCIENCE FORUM 2009

By JULIA DAY, STEPS Centre member

Former STEPS member Dominic Glover was blogging earlier this week for The Broker from the Science Forum 2009, in Wageningen, the Netherlands. Dominic, now a Postdoctoral fellow in technology and agrarian development at Wageningen University, provided a blogger’s perspective on the sessions, conversations and general atmosphere at the forum.

The Science Forum is organized by the Consultative Group on International Agricultural Research (CGIAR) Science Council, in partnership with the CGIAR Secretariat, the Alliance of the CGIAR Centers, the Global Forum on Agricultural Research (GFAR) and Wageningen University and Research Centre (Wageningen UR). Read more

By JULIA DAY, STEPS Centre member

Like many, I have been following recent events in Iran with interest. The use of social media (Twitter, YouTube, Facebook etc) via mobile and the net to organise and reveal ordinary Iranians’ perspectives has been fascinating and ground-breaking.

Timothy Garton Ash says in today's Guardian: “Probably the single most important thing the US state department has done for Iran recently was to contact Twitter over the weekend, to urge it to delay a planned upgrade that could have taken down service to Iranians for some crucial hours of people power ­protest. Welcome to the new politics of the 21st century.”

Sky News reports: “2.25 million blog posts were written about Iran in the last 24 hours, a significant sign of the way the political crisis in Tehran has captured the attention of a global web audience. But in a single hour on Wednesday, more than 220,000 messages on that topic were sent via Twitter.” Although it is getting harder to find tweets from inside Iran, says the report.

If you want to have a look at some of the activity, here are some links, but please do note that there are some graphic violent images flying around, particularly on the Flickr site:

YouTube: Iran videos

Twitter feeds:
#IranElection
#Iranvote

Flickr: Iran feed


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KILLER DUST: NEW ASBESTOS REPORT

By JULIA DAY, STEPS Centre member

STEPS member Linda Waldman has co-aurthored a new academic report commissioned by construction union UCATT. Linda and Heather Williams have uncovered huge deficiencies in the rules covering the management of asbestos in people’s homes. Potentially exposing both residents and maintenance workers to asbestos exposure.

Householders undertaking standard DIY functions are at particular risk of unknowingly exposing themselves to asbestos. This was due to a combination of ignorance and a lack of readily accessible information and advice.

The report As Safe as Houses? by Dr Linda Waldman and Heather Williams, will be formally launched at a meeting in Parliament today (June 2). It primarily examines how asbestos is managed and removed in social housing but also uncovers major flaws in legislation concerning properties containing asbestos in the private sector.

Alan Ritchie, General Secretary of UCATT, said: “Everyone has a right to feel safe in their own homes. This excellent new report details how thousands of householders’ health is being put at risk because they do not know that asbestos is present in their home.”

A copy of the report, As Safe as Houses?, can be viewed here . Media coverage of the report includes pieces by The Mirror and Local Government Chronicle.
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MANIFESTO SEMINAR: DR. PADMASHREE GEHL SAMPATH ON IP

By JULIA DAY, STEPS Centre member

See photos from this event (Flickr link)

We're delighted to have Dr Padmashree Gehl Sampath of the United Nations University with us today to talk about 'Promoting Knowledge Generation through Intellectual property in Late Development', as part of the Innovation, Sustainability, Development: A New Manifesto project.

While the centrality of knowledge, technology and innovation to the process of economic development is broadly agreed upon, the precise mechanics of overcoming economic development challenges in different contexts vary. Dr Gehl Sampath's paper presents important findings on the role of intellectual property in latecomer development both from a theoretical and empirical point of view.

Her paper seeks to position IPRs and their role within a framework on innovation and knowledge for latecomer development. This is followed by evidence gathered by the author through empirical surveys on the impact of IPRs (as opposed to a range of other factors) at firm and organizational level innovation in some latecomer countries across Asia and Africa.

We'll have video, audio, photos and Dr Gehl Sampath's presentation on the STEPS website soon. The links will be here on The Crossing. Read more