Milestones :: Perspectives

Milestones :: Perspectives

Editor’s Note:
Dr Tedros Adhanom Ghebreyesus assumes the Director General role today [1 July 2017]. WHO posted the vision statement below:

Vision statement by WHO Director-General
I envision a world in which everyone can live healthy, productive lives, regardless of who they are or where they live.

A world in which everyone can live healthy, productive lives
I envision a world in which everyone can live healthy, productive lives, regardless of who they are or where they live. I believe the global commitment to sustainable development – enshrined in the Sustainable Development Goals – offers a unique opportunity to address the social, economic and political determinants of health and improve the health and well-being of people everywhere.
Achieving this vision will require a strong, effective WHO that is able to meet emerging challenges and achieve the health objectives of the Sustainable Development Goals. We need a WHO – fit for the 21st century – that belongs to all, equally. We need a WHO that is efficiently managed, adequately resourced and results driven, with a strong focus on transparency, accountability and value for money.

Putting people first
The right of every individual to basic health services will be my top priority. I will champion mechanisms to meaningfully listen to, learn from and engage people and communities – including migrant, displaced and disabled individuals; people living in rural, urban slum and low-income areas; and other vulnerable populations.
This engagement – and what we learn from it – will be at the centre of our efforts to mobilize resources and hold authorities accountable for the health of all, regardless of age, gender, income, sexual orientation or religion.

Placing health at the centre of the global agenda
When people are healthy, entire communities and nations thrive – indeed, the whole world benefits. I will engage with Heads of State, Ministers across a wide range of portfolios, multilateral institutions, the UN system, civil society and the private sector to make access to health care and protection from infectious disease outbreaks a central component of the world’s security, economic and development agendas.
This will include implementing the International Health Regulations and addressing emerging threats, such as antimicrobial resistance, climate and environmental change and non-communicable diseases. Such engagement will enable WHO and national health authorities to effectively perform their core functions, reaffirm WHO’s leadership in securing a healthier and safer world, and ultimately drive progress towards the Sustainable Development Goals.

Engaging countries and strengthening partnerships
Improving global health requires effective engagement with all Member States and across multiple sectors. Under my leadership an enhanced and independent WHO will take a science-led and innovation-based approach that is results-oriented and responsive, maximises inclusive partnerships, and ensures collective priority setting with all stakeholders. In particular, I will champion country ownership, so that countries are at the table, as full and equal partners, to guide and make the decisions that will affect the health of their populations.
WHO’s work touches hundreds of millions of lives around the world. Every programme, every initiative, every allocation of funding is so much more than a statistic or line in a budget. It is a life protected. It is a child who gets to see adulthood. It is a parent who watches their child survive and thrive. It is a community living disease free or an entire country or region that is better prepared for emergencies or disasters. This is the difference WHO can make, working hand-in-hand with Member States and global partners.
 
WHO Priorities
WHO posted brief overviews describing these priorities, each led by a quotation from Dr. Tedros as below.
:: Health for all
   The right of every individual to basic health services will be my top priority – Dr Tedros
:: Health emergencies
   I will engage with diverse stakeholders to make health care and protection from infectious
   disease outbreaks a central component of the world’s security, economic and social
   development agendas. – Dr Tedros
:: Women, children and adolescents
   I believe healthy, empowered girls and women have the potential to build stronger
   communities, and nations and ultimately transform entire societies – Dr Tedros
:: The health impacts of climate and environmental change
   Developing and nurturing resilient and effective community based structures and multi-
   sectoral approaches is critical to prevent, mitigate and respond to the health impacts of
   environmental risk factors and climate change. – Dr Tedros
:: A transformed WHO
  Thanks to the actions of WHO, more people are living longer, healthier lives than ever before.
   However, we live in a changing world, and WHO must be able to change with it. – Dr Tedros

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World Bank Launches First-Ever Pandemic Bonds to Support $500 Million Pandemic Emergency Financing Facility
[Editor’s text bolding]
Washington, DC, June 28, 2017 – The World Bank (International Bank for Reconstruction and Development) today launched specialized bonds aimed at providing financial support to the Pandemic Emergency Financing Facility (PEF), a facility created by the World Bank to channel surge funding to developing countries facing the risk of a pandemic.

This marks the first time that World Bank bonds are being used to finance efforts against infectious diseases, and the first time that pandemic risk in low-income countries is being transferred to the financial markets.

The PEF will provide more than $500 million to cover developing countries against the risk of pandemic outbreaks over the next five years, through a combination of bonds and derivatives priced today, a cash window, and future commitments from donor countries for additional coverage.

The transaction, that enables PEF to potentially save millions of lives, was oversubscribed by 200% reflecting an overwhelmingly positive reception from investors and a high level of confidence in the new World Bank sponsored instrument. With such strong demand, the World Bank was able to price the transaction well below the original guidance from the market. The total amount of risk transferred to the market through the bonds and derivatives is $425 million.

“With this new facility, we have taken a momentous step that has the potential to save millions of lives and entire economies from one of the greatest systemic threats we face,” World Bank Group President Jim Yong Kim said. “We are moving away from the cycle of panic and neglect that has characterized so much of our approach to pandemics. We are leveraging our capital market expertise, our deep understanding of the health sector, our experience overcoming development challenges, and our strong relationships with donors and the insurance industry to serve the world’s poorest people. This creates an entirely new market for pandemic risk insurance. Drawing on lessons from the Ebola Outbreak in West Africa, the Facility will help improve health security for everyone. I especially want to thank the World Health Organization and the governments of Japan and Germany for their support in launching this new mechanism.”

The World Bank announced the creation of the PEF in May 2016 at the G7 Finance Ministers and Central Governors meeting in Sendai, Japan. The PEF will quickly channel funding to countries facing a major disease outbreak with pandemic potential. Its unique financing structure combines funding from the bonds issued today with over-the-counter derivatives that transfer pandemic outbreak risk to derivative counterparties. The structure was designed to attract a wider, more diverse set of investors.

The PEF has two windows. The first is an ‘insurance’ window with premiums funded by Japan and Germany, consisting of bonds and swaps including those executed today. The second is a ‘cash’ window, for which Germany provided initial funding of Euro 50 million. The cash window will be available from 2018 for the containment of diseases that may not be eligible for funding under the insurance window…

The bonds will be issued under IBRD’s “capital at risk” program because investors bear the risk of losing part or all of their investment in the bond if an epidemic event triggers pay-outs to eligible countries covered under the PEF.

The PEF covers six viruses that are most likely to cause a pandemic. These include new Orthomyxoviruses (new influenza pandemic virus A), Coronaviridae (SARS, MERS), Filoviridae (Ebola, Marburg) and other zoonotic diseases (Crimean Congo, Rift Valley, Lassa fever).
 
PEF financing to eligible countries will be triggered when an outbreak reaches predetermined levels of contagion, including number of deaths; the speed of the spread of the disease; and whether the disease crosses international borders. The determinations for the trigger are made based on publicly available data as reported by the World Health Organization (WHO).
Countries eligible for financing under the PEF’s insurance window are members of the International Development Association (IDA), the institution of the World Bank Group that provides concessional finance for the world’s poorest countries. The PEF will be governed by a Steering Body, whose voting members include Japan and Germany. WHO and the World Bank serve as non-voting members…

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Featured Journal Content
 
Pediatrics
July 2017, VOLUME 140 / ISSUE 1
http://pediatrics.aappublications.org/content/139/6?current-issue=y
Articles
Childhood Illness and the Gender Gap in Adolescent Education in Low- and Middle-Income Countries
Marcella Alsan, Anlu Xing, Paul Wise, Gary L. Darmstadt, Eran Bendavid
Pediatrics Jul 2017, 140 (1) e20163175; DOI: 10.1542/peds.2016-3175
Abstract
BACKGROUND: Achieving gender equality in education is an important development goal. We tested the hypothesis that the gender gap in adolescent education is accentuated by illnesses among young children in the household.
METHODS: Using Demographic and Health Surveys on 41,821 households in 38 low- and middle-income countries, we used linear regression to estimate the difference in the probability adolescent girls and boys were in school, and how this gap responded to illness episodes among children <5 years old. To test the hypothesis that investments in child health are related to the gender gap in education, we assessed the relationship between the gender gap and national immunization coverage.
RESULTS: In our sample of 120,708 adolescent boys and girls residing in 38 countries, girls were 5.08% less likely to attend school than boys in the absence of a recent illness among young children within the same household (95% confidence interval [CI], 5.50%–4.65%). This gap increased to 7.77% (95% CI, 8.24%–7.30%) and 8.53% (95% CI, 9.32%–7.74%) if the household reported 1 and 2 or more illness episodes, respectively. The gender gap in schooling in response to illness was larger in households with a working mother. Increases in child vaccination rates were associated with a closing of the gender gap in schooling (correlation coefficient=0.34, P=.02).
CONCLUSIONS: Illnesses among children strongly predict a widening of the gender gap in education. Investments in early childhood health may have important effects on schooling attainment for adolescent girls.

Excerpt
…In our analysis of vaccination rates relative to the education gap, we found a statistically significant and strong negative correlation between the vaccination rates of children <5 years old and the gender gap in education (eg, the higher the vaccination rate, the smaller the gender gap in education; correlation coefficient=0.34, P=.02; Fig 4). The adolescent gender gap in education approaches zero with coverage rates exceeding ∼70% for all 8 vaccines. We performed several specification checks to ensure that our results are robust. These include varying the age of the included older children, using alternative educational outcomes, and splitting the sample by rural and urban location. We describe these supplementary changes in detail. In Supplemental Fig 5, we varied the age thresholds for older children in the following different ways: 10 to 16, 10 to 17, 10 to 18, 11 to 16, 12 to 16, 12 to 17, and 12 to 18. Our results are not sensitive to varying the thresholds….
 
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