ODI: Global mental health from a policy perspective: a context analysis

ODI: Global mental health from a policy perspective: a context analysis
Characterising mental health and recommending engagement strategies for the Mental Health Innovation Network
Overseas Development Institute; Jessica Mackenzie, author
November 2014 :: 44 pages
Report pdf: http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/9285.pdf

Mental health is a critically important issue in global health today and yet does not receive due policy attention. This report characterises mental health as a policy issue, and draws upon the experience of different social movements across global health to provide lessons for this field. It presents an array of engagement strategies to specifically inform how the Mental Health Innovation Network (MHIN) can best help to improve policy influence across aspects of the global mental health community.

Executive Summary [excerpt]
Mental health is a critically important issue in global health today, and yet does not receive due policy attention. Mental illness will likely affect one in four people within their lifetime and neuropsychiatric conditions now account for 13% of the global burden of disease – with 70% of that burden in low- and middle-income countries (WHO, 2001; Lopez et al., 2006). Despite this, mental health has not yet achieved the policy influence that would be proportionate to its burden, nor ‘commensurate visibility, policy attention, or funding’ that is warranted (Tomlinson and Lund, 2012).

This report applies several theoretical approaches to analyse mental health as a policy issue and the particular challenges it faces. This report applies the Overseas Development Institute (ODI)’s ‘Knowledge, Policy and Power’ (KPP) framework to assess the characteristics of mental health as a policy issue. It also applies other supporting analytical approaches regarding the tractability of a policy issue and for assessing the effectiveness of global health networks. The report focusses on mental health at a global level, but highlights the need for more detailed analysis at a more local level, given that policy traction is highly dependent on local context, actors and systems of decision-making.

By characterising the different aspects of mental health as a policy issue, it becomes easier to understand why it has faced problems achieving policy influence to date and what opportunities there are to harness change. Characteristics such as stigmatisation, heterogeneity, a recently emergent user movement, the individualistic nature of treatment, the role of the informal sector, low financial investment and lack of data, all act as barriers to achieving policy traction (as well as appropriate access to care, prevention and treatment). These features mean that the salience of the issue is diminished, its actual severity and prevalence is concealed and its ‘solvability’ negatively influenced.

However some positive entry points are also identified in the characteristics of mental health as a policy issue. Public interest in mental health, particularly in high income countries, is growing. Over the past 20 years the interest in promoting mental health and providing solutions has grown dramatically (Friedli, 2009; Secker, 1998; WHO, 2001; WHO, 2013). As public interest increases there will be corresponding demand for information and advice, which leaves the global mental health community (and networks like the Mental Health Innovation Network) well placed to be heard and have influence. While more detailed and rigorous political economy analysis is required, the changing international policy environment suggests that there could be a tipping point approaching in coming years for mental health. Increased international commitments and reporting against set targets will help to mitigate many of the current barriers, and the role of donors like Grand Challenges Canada (with funding from the Government of Canada) will be crucial in future. If the network can engage in the most effective way, and harness this potential upcoming opportunity, there could be a vast improvement in the way that mental health is treated as a policy issue…

UNCTAD: Least Developed Countries Report 2014

UNCTAD: Least Developed Countries Report 2014
Growth with structural transformation: A post-2015 development agenda
eISBN 978-92-1-056923-1 :: 198 pages

[Excerpt from press release]
The report argues that that the international community must learn from the failure of most of the poorest countries to meet the Millennium Development Goals (MDGs) despite registering strong economic growth – a phenomenon the Report dubs the “LDC paradox”. The LDC paradox arises from the failure of LDC economies to achieve structural changes despite having grown vigorously as a result of strong export prices and rising aid flows. Some other developing countries – not categorized as “least developed” – especially those that mostly depend on commodities for production, employment and exports, have also faced a similar paradox.

The report notes that LDCs “are the battleground on which the post-2015 development agenda will be won or lost. Its success will depend on action by the international community and the LDCs to structurally transform their economies and break the vicious circle of human and economic development that has trapped these countries in poverty.”
Under the MDGs, global poverty was halved by rapid progress in the more advanced developing countries, the Report says. But a central goal of the post-2015 development agenda is expected to be the eradication of poverty by 2030. This means reducing it to zero everywhere – and it is in the LDCs that this will be most challenging. Their performance will largely determine the success or failure of the whole post-2015 development agenda.

The Report highlights three key policy priorities as part of a post-2015 development agenda for LDCs: mobilizing resources for investment in such a way as to maximize their development impact, directing these resources towards economic activities that will contribute decisively to transforming their economies and establishing macroeconomic policies that promote investment and demand growth rather than inhibiting them. Diversifying rural economies must also be a principal element of the transformation if poverty is to be eradicated.

[From introductory pages of report]
What are the least developed countries?
At present, there are 48 countries designated by the United Nations as “least developed countries” (LDCs).
These are: Afghanistan, Angola, Bangladesh, Benin, Bhutan, Burkina Faso, Burundi, Cambodia, Central African Republic, Chad, Comoros, Democratic Republic of the Congo, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, the Gambia, Guinea, Guinea-Bissau, Haiti, Kiribati, Lao People’s Democratic Republic, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Myanmar, Nepal, Niger, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, South Sudan, Sudan, Timor-Leste, Togo, Tuvalu, Uganda, United Republic of Tanzania, Vanuatu, Yemen and Zambia.

The list of LDCs is reviewed every three years by the United Nations Economic and Social Council (ECOSOC), based on recommendations of the Committee for Development Policy (CDP). The following three criteria were used by the CDP in its most recent review of the list in March 2012:

(a) Per capita income, based on a three-year average estimate of the per capita gross national income (GNI), with a threshold of $992 for candidate countries for addition to the list, and a threshold of $1,190 for graduation from LDC status;

(b) Human assets, involving a composite index (the Human Assets Index) based on the following indicators:
(i) nutrition (percentage of the population that is undernourished);
(ii) health (child mortality ratio);
(iii) school enrolment (gross secondary school enrolment ratio); and
(iv) literacy (adult literacy ratio); and

(c) Economic vulnerability, involving a composite index (the Economic Vulnerability Index) based on the following indicators:
(i) natural shocks (index of instability of agricultural production; and the percentage of victims of natural disasters);
(ii) trade-related shocks (index of instability of exports of goods and services);
(iii) physical exposure to shocks (proportion of population living in low-lying areas);
(iv) economic exposure to shocks (share of agriculture, forestry and fisheries in gross domestic product (GDP); index of merchandise export concentration);
(v) smallness (population in logarithm); and
(vi) remoteness (index of remoteness).

In all three criteria, different thresholds are used for identifying countries to be added to the list of LDCs, and those that should graduate from the list. A country will qualify to be added to the list if it meets the thresholds on all three criteria and has a population no greater than 75 million. But a country that meets these criteria will only be added to the LDC list if its Government accepts this status. A country will normally qualify for graduation from LDC status if it has met graduation thresholds under at least two of the three criteria in at least two consecutive triennial reviews of the list. However, if the per capita GNI of an LDC has risen to a level at least double the graduation threshold, the country will be deemed eligible for graduation regardless of its performance under the other two criteria.

Four countries have graduated from LDC status so far: Botswana in December 1994, Cape Verde in December 2007, Maldives in January 2011, and Samoa in January 2014. In March 2009, the CDP recommended the graduation of Equatorial Guinea. This recommendation was accepted by ECOSOC in July 2009, and endorsed by the General Assembly through a resolution adopted in December 2013. The same resolution also stated that the General Assembly endorsed the CDP’s 2012 recommendation to graduate Vanuatu from LDC status.

Equatorial Guinea and Vanuatu are scheduled to be taken out of the list of LDCs in June 2017 and December 2017, respectively. The next official review of the list by relevant United Nations bodies will take place in 2015, with particular attention to the potential graduation of Angola and Kiribati.

After a recommendation to graduate a country from LDC status has been endorsed by ECOSOC and confirmed by the General Assembly, that country is normally granted a three-year grace period before graduation effectively takes place. This grace period, during which the country remains an LDC, is designed to enable the graduating State and its development and trading partners to agree on a “smooth transition” strategy, so that the loss of LDC status at the time of graduation does not disrupt the socio-economic progress of the country. A “smooth transition” measure generally implies extending, for a number of years after graduation, a concession the country was normally entitled to by virtue of its LDC status.

ITU – Measuring the Information Society – MIS Report 2014

ITU – Measuring the Information Society – MIS Report 2014
International Telecommunications Union
November 2014 :: 270 pages w/o Annex
pdf: http://www.itu.int/en/ITU-D/Statistics/Documents/publications/mis2014/MIS2014_without_Annex_4.pdf

The MIS Report, which has been published annually since 2009, features key ICT data and benchmarking tools to measure the information society, including the ICT Development Index (IDI). The IDI captures the level of ICT developments in 166 economies worldwide and compares progress made during the last year. The MIS 2014 highlights the relationship between ICT development (as measured by the IDI) and the MDGs, a contribution to the ongoing discussions on the potential of ICTs as development enablers. The report includes the results of the ICT Price Basket (IPB) and new mobile-broadband price data for over 140 economies. Price data are analysed to provide insights into the relationship between affordability and income inequality, competition and regulation. The report also looks at new ICT data sources for measurement and examines the possible role of ICT big data for monitoring and development.

The 6th edition of the ITU Measuring the Information Society (MIS) Report was launched on November 24th, in Tbilisi, Georgia, at the World Telecommunication/ICT Indicators Symposium (WTIS) 2014.

Press Release [Excerpt]
Geneva, 24 November 2014 – Over three billion people are now online and information and communication technology (ICT) growth remains buoyant in just about every country worldwide, according to ITU’s flagship annual Measuring the Information Society Report.

The report is widely recognized as the repository of the world’s most reliable and impartial global data and analysis on the state of global ICT development, and is extensively relied upon by governments, financial institutions and private sector analysts worldwide.

Latest data show that Internet use continues to grow steadily, at 6.6% globally in 2014 (3.3% in developed countries, 8.7% in the developing world). The number of Internet users in developing countries has doubled in five years (2009-2014), with two thirds of all people online now living in the developing world.

Of the 4.3 billion people not yet using the Internet, 90% live in developing countries. In the world’s 42 Least Connected Countries (LCCs), which are home to 2.5 billion people, access to ICTs remains largely out of reach, particularly for these countries’ large rural populations…

…In the mobile cellular segment, the report estimates that by end 2014 there will be seven billion mobile subscriptions, roughly corresponding to the total global population. But it warns against concluding that everyone is connected; instead, many users have multiple subscriptions, with global growth figures sometimes translating into little real improvement in the level of connectivity of those at the very bottom of the pyramid. An estimated 450 million people worldwide live in places which are still out of reach of mobile cellular service.

Encouragingly, the report notes substantial improvements in access to international bandwidth in poorer countries, with developing nations’ share of total global international bandwidth rising from just 9% in 2004 to over 30% today. But lack of sufficient international Internet bandwidth in many of the LCCs remains an important barrier to ICT uptake in these countries, and often limits the quality of Internet access…
Executive Summary:

INFORM – Index for Risk Management

INFORM – Index for Risk Management
19 November 2014
Web tool developed as a collaboration of the Inter-Agency Standing Committee Task Team for Preparedness and Resilience and the European Commission. The first global, objective and transparent tool for understanding the risk of humanitarian crises. INFORM The InfoRM model is based on risk concepts published in scientific literature and envisages three dimensions of risk: hazards & exposure, vulnerability and lack of coping capacity dimensions.

New, open-source tool to support resilience-building
The Index for Risk Management (InfoRM) sheds new light on what drives crises — and what communities need in order to face them
27 November 2014, Rome – Each year millions of people dependent on agriculture, forestry and fisheries are confronted by droughts, floods, plant pests or animal diseases, and conflict. When that happens, the livelihoods of communities can be left in tatters, while disruptions to food production and distribution undermine the food security of nations and entire regions…
…The index builds up a picture of risk by bringing together some 50 different indicators measuring three dimensions of risk: hazards and exposure of people, vulnerability of communities to those hazards, and their capacity to cope with them. This data is synthesized into a consolidated, simple risk profile for each country, which includes natural and human hazards, vulnerability and lack of coping capacity. Currently, InfoRM covers 191 countries.

1st Amref Health Africa International Conference – Conference Communiqué

1st Amref Health Africa International Conference
Theme: From Evidence to Action – Lasting Health Change in Africa
November 24 – 26, 2014, Nairobi,
Organised in Collaboration with the World Health Organization

Conference Communiqué
We, the organisers, keynote speakers, scientists and researchers, leaders from governments, multilateral agencies, the private sector and civil society, representatives of development partners, delegates, participants and the media, came together in this inaugural Amref Health Africa International Health conference to:
:: Share cutting edge research on health and health systems in Africa
:: Identify and discuss priorities in addressing Africa’s health in the post-2015 agenda
:: Bring together stakeholders to reflect on home-grown solutions to health system challenges in Africa.

In the past three days, we have had rich sharing and discussion around the deep knowledge shared by keynote speakers, the findings of researchers, and the experience and skills of the private sector in innovation to find solutions to improved service delivery in Africa.

We Note That:
:: Africa has made progress in improving the health of her peoples in the MDG era, but that this progress has been inadequate to achieve the MDG targets for health.
:: Serious challenges in health persist in relation to the health of women and children, communicable diseases and infectious diseases that have long been eliminated or mitigated in other continents.
:: Africa additionally faces an emerging health burden from non-communicable diseases (NCDs).
:: More than one-third of African children are stunted due to chronic malnutrition, which seriously reduces their future economic productivity. This is a root cause of Africa’s under-development as malnutrition reduces national GDP by up to 3%.
:: In some countries, up to 40% of healthcare expenditure is out of pocket
:: African governments and the private sector must work together to invest in systems of production of human resources for health, taking maximum advantage of current technologies like e- and m-learning to lower the cost of training.
:: Accountability, efficiency, value for money, and transparent tracking of health expenditure must become standard principles in utilisation of health care resources by both state and non-state health stakeholders.
:: African governments must put in place enabling policies, invest in quality health services, and show greater political will to address the root causes of ill health and galvanise other stakeholders to contribute towards sustainable universal health care coverage.
:: African governments should enact polices that adopt task shifting to address the shortage of human resources for health.
:: African governments must urgently create the policy framework, legislation and investment to rapidly improve the health research output in the continent.
:: Implementers, researchers and policy makers must create the platforms that ensure that research is translated into evidence-based policy-making and action to improve health in Africa.
:: African governments should create policies to facilitate networking of African researchers to generate evidence from research for practice and policy change.
:: Non-governmental organisations must advocate with the key stakeholders to focus attention continuously on translation of evidence to investment decisions for sustainable health systems in Africa.
Conference Bulletin Issue No. 1
Conference Bulletin Issue No. 2
Conference Bulletin Issue No. 3

United Nations – Selected Meetings Coverage and Press Releases [to 29 November 2014]

United Nations – Selected Meetings Coverage and Press Releases [to 29 November 2014]
Secretary General, Security Council, General Assembly

28 November 2014
Marking International Day for Abolition of Slavery, Secretary-General Urges States to Renew Efforts to Eradicate Practice Still Affecting 18 Million Worldwide
UN Secretary General Ban Ki moon’s message on the International Day for the Abolition of Slavery, observed on 2 December.

28 November 2014
Adaptive, Assistive, Inclusive Technology Can Aid Persons with Disabilities in Reaching Their Potential in Communities, Workplace
UN Secretary-General Ban Ki-moon’s message for the International Day of Persons with Disabilities, to be observed on 3 December.

26 November 2014
On World AIDS Day, Secretary-General Calls on World Leaders to Unite in Common Cause to End Epidemic by 2030
UN Secretary-General Ban Ki-moon’s message for World AIDS Day, observed on 1 December.

26 November 2014
Secretary-General Expresses ‘Utmost Gratitude’ to Under-Secretary-General for Humanitarian Affairs Valerie Amos Following Her Decision to Step Down
Statement by United Nations Secretary-General Ban Ki-moon.

25 November 2014
Secretary-General, on International Day, Calls Violence against Women, Girls ‘Most Extreme Example’ of Oppression Worldwide, Urging All to Help End Global Disgrace
UN Secretary General Ban Ki moon’s remarks, as prepared for delivery, on the International Day for the Elimination of Violence against Women, in New York.

25 November 2014
While Approving 14 Draft Resolutions without Vote, Third Committee Tackles Four Texts on Human Rights, Peace, International Democracy, Mercenaries
As the Third Committee (Social, Humanitarian and Cultural) approved 18 draft resolutions, with 14 without a vote, delegations voiced concerns regarding four texts including one on the report of the Human Rights Council, debating whether that body had been politicized, thus undermining its legitimacy and credibility.

25 November 2014
General Assembly, Concluding Annual Debate on Question of Palestine, Situation in Middle East, Adopts Six Resolutions by Recorded Vote
Offering a range of solutions for moving the Middle East peace process forward, while regretting the steps backward due to escalation of violence in recent months, the General Assembly adopted six draft resolutions today by recorded vote on the question of Palestine and the situation in the Middle East overall.

WHO & Regionals [to 29 November 2014]

WHO & Regionals [to 29 November 2014]
:: GIN November 2014 pdf, 1.38Mb 28 November 2014

:: World AIDS Day 2014: Closing the gap in HIV prevention and treatment 1 December 2014

:: Closing the gap in HIV prevention and treatment
27 November 2014 — In 2013, a record 13 million people were able to access life-saving antiretrovirals (ARVs). But many people still lack comprehensive HIV treatment and prevention services. This feature story describes how a centre in South Africa offers emergency HIV prevention medication, as well as support and advice to rape victims. On World AIDS Day 2014, WHO will release new guidelines on providing ARVs as emergency prevention following HIV exposure, and on the use of the antibiotic co-trimoxazole to prevent HIV-related infections.
Read the feature story on emergency HIV prevention service in South Africa
World AIDS Day 2014

WHO Regional Offices
WHO African Region AFRO
:: When Ebola came calling: how communities in Sierra Leone faced the challenge – 24 November 2014

WHO Region of the Americas PAHO
:: PAHO/WHO to provide training in clinical management of Ebola for doctors and nurses in Latin America and the Caribbean (11/28/2014)
:: Antiretroviral treatment for people with HIV is increasing in Latin America and the Caribbean (11/26/2014)

WHO South-East Asia Region SEARO
World AIDS Day – Close the gap
On this World AIDS Day with the theme “Close the gap”, the World Health Organization, Regional Offices for South-East Asia and Western Pacific are calling on Member States to recognize that in order to close the significant gaps that remain for millions of people to access to HIV prevention, treatment and care, key populations most vulnerable to HIV must be equal partners with governments and health authorities.
Joint press release – Closing the gap

WHO European Region EURO
:: High cancer burden due to overweight and obesity in most European countries 28-11-2014
:: Europe’s HIV response falls short in curbing the epidemic: 80% more new HIV cases compared to 2004 27-11-2014
:: WHO project to combat noncommunicable diseases with major grant from Russian Federation 26-11-2014

WHO Eastern Mediterranean Region EMRO
:: Yemen vaccinates more than 11 million children in measles/rubella campaign
23 November 2014 – Yemen conducted a national measles/rubella vaccination campaign from 9 to 20 November 2014, in which more than 11 million children from 9 months to 15 years were vaccinated. In spite of political unrest and insecurity, vaccination teams achieved a coverage rate of 98%, which included children from high-risk groups, such as refugees and internally displaced persons. Effective partnership was crucial to successful implementation of the campaign with the GAVI Alliance supporting 80% of operational costs and the cost of the vaccine and many other partners on the ground providing support to the campaign.
Read more

WHO Western Pacific Region WPRO
:: Asia-Pacific countries need to improve affordable access to healthcare
27 November 2014 – Most countries in the Asia-Pacific region need to step up their efforts to give more people access to affordable, quality health care. Too many people, especially women, cannot get the medical treatment they need due to high costs, difficulties in getting permission to see a doctor or a lack of health care providers in rural areas, according to Health at a Glance: Asia/Pacific 2014, a joint publication by the World Health Organization and the Organisation for Economic Co-operation and Development.