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The Japanese have added their weight — and some funding — to the campaign for universal health coverage at a forum in Tokyo this week. The data in a fresh report is troubling: less than half the world’s 7.3bn population has access to essential health services, while 800m spend more than 10 per cent of their household budget on healthcare. Some 100m are pushed into extreme poverty each year as a result.
The World Bank unveiled plans to hold countries to account from next year by overseeing an annual ranking measuring the outcomes of every nation’s investment in health and education. It will be conducted by Chris Murray from the Institute for Health Metrics and Evaluation, also behind the World Health Organisation’s controversial attempt to rank global health systems in 2000.
Despite the inevitable backlash from countries that ranked poorly, “naming and shaming” provokes two important debates. The first question is how to meaningfully to collect data and measure outcomes, which is difficult enough in health and arguably tougher still in education.
The second debate is about how to bring about improvements. Tedros Adhanom, head of the World Health Organisation, and Jim Yong Kim, president of the World Bank, both argue countries may each have a different approach. Hybrid solutions could involve public, private and non-profit contributions. Yet charities including Oxfam want public-led provision. Whatever the approach, efforts will be needed to ensure better health and education reach the poorest and most excluded.
Jim Yong Kim, president of the World Bank, is stepping up efforts to encourage investment in health and education during his second term in office.
Why do you want to rank countries by human capital?
Human capital is a huge part of the overall wealth of nations. There is overwhelming evidence that health and education outcomes have had a huge impact on economic growth. For first time in history there is such transparency in data across countries that we can compare them. I hope we will see heads of state begin looking actively around the world for ways to improve. The ranking will cause controversy and debate. I’ve talked to credit rating agencies . . . which say they would be open to using [the data] in their assessment of sovereign bonds. If this affects spreads, we will get everyone’s attention.
Should healthcare be funded and provided publicly?
It has to be a hybrid model. We will have a mixture of public and private both in payment and provision. In many countries I don’t see public sectors capable of bringing about change by themselves. A lot will be with non-profits, the private sector and others. Every country will have to figure out the mix on their own. We will be ready with financing and getting more private sector money into infrastructure so governments have money left over to invest in health and education.
What do you consider your most important achievements at the World Bank?
We had to do [internal restructuring] to get expenditures in line. For first time in as along as anyone can remember, IBRD [subsidised loan] income has surpassed our expenditures because we brought discipline to the house. We’re now the largest financers of climate change [amelioration] in the developing world and have worked on pandemic financing. We’ve completely changed our way of thinking about investing in infrastructure.
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Scott Gottlieb, head of the US Food and Drug Administration, told the FT he favoured generics as a remedy for high drug prices. He has tasked officials with speeding up the approval process for cheaper “copycat” drugs and told them to prioritise applications where medicines face little or no competition. (FT)
Tell us which articles from the media and academic journals this year were the most important and we will share a selection next week. Email ideas and links to firstname.lastname@example.org
Less neglected The annual G-Finder report on investment into neglected diseases showed $3.2bn in funding in 2016, the first increase in five years. Rising support from the UK made it the second largest after the US while the EU's contributions fell.
Family planning New, long-acting contraceptives, mobile services and incentives are making family planning programmes more effective. They also help children stay in school longer. (FT's 50 ideas to change the world, The Economist)
Price gouging US drugmaker Avondale raised the prices of its prescription vitamins by more than 800 per cent in a “buy-and-raise” deal — a strategy made famous by Martin Shkreli, the disgraced biotech entrepreneur. (FT)
Help for Huntingdon’s The defect that causes Huntington’s disease has been corrected in patients for the first time, in what experts called the biggest breakthrough in neurodegenerative diseases for 50 years. (BBC)
Medicine and Brexit The UK pharma trade association warned of disruption to patients and problems in coping with public health emergencies after Brexit. Listen to our discussion on Brexit’s effect on drugs research and access to treatment. (FT audio, FT)
NHS squeeze The high-profile chief of London’s King’s College Hospital quit, blaming the “inexorable pressures” of rising costs and the “tightest spending figures in recent times”. The hospital was then put in “special measures” because of a spiralling deficit — a possible canary in the coal mine illustrating the cash problems facing the NHS. Restricting services might become necessary. (FT, BMJ)
Informed policymaking Health programmes need to be guided by evidence that is much broader than pure numbers, involving discussions with policymakers and citizens. (The Conversation)
Stress busting A whole new world of virtual therapy and apps are available to help mental wellbeing in the workplace, but some experts warn of overburdening ourselves with technology and neglecting the importance of real-life social support. (The Guardian)
Best from the Journals
China care Despite recent progress, China’s primary healthcare system still suffers from an inadequately trained workforce, fragmented IT systems, poor data provision, misplaced financial subsidies and inefficient insurance policies. (The Lancet)
Poor disclosure Coca-Cola influenced the research behind 40 scientific studies into childhood obesity far more than public declarations suggested. Academics consulted the company on the studies’ design. (Jnl of Public Health Policy)
Flu’s hidden burden Respiratory deaths linked to seasonal influenza are 291,000-646,000 each year (4·0—8·8 per 100,000 individuals), according to a new model. (The Lancet)
Expanding English wine glasses The link between rising consumption and larger glass sizes. Volume has grown sharply since the 1990s. Can downsizing reduce wine consumption? (The BMJ)
Podcast of the week
Dealing with anorexia Discussing the difficulties of spotting and treating eating disorders in young people. (BMJ, 43m)
In case you missed it
Man flu is real! As the season of goodwill approaches, think twice before condemning all that male whining. Men may not be exaggerating after all — they have weaker immune responses to viruses. As the BMJ puts it: “Perhaps now is the time for male-friendly spaces, equipped with enormous televisions and reclining chairs, to be set up where men can recover from the debilitating effects of man flu in safety and comfort.”
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