BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 18 July 2015)

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Research article
Perceptions of Sudanese women of reproductive age toward HIV/AIDS and services for Prevention of Mother-to-Child Transmission of HIV
Ibrahim Elsheikh, Rik Crutzen, H.W. Van den Borne
BMC Public Health 2015, 15:674 (17 July 2015)

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Research article
Pilot to evaluate the feasibility of measuring seasonal influenza vaccine effectiveness using surveillance platforms in Central-America, 2012
Nathalie El Omeiri, Eduardo Azziz-Baumgartner, Wilfrido Clará, Guiselle Guzmán-Saborío, Miguel Elas, Homer Mejía, Ida Molina, Yadira De Molto, Sara Mirza, Marc-Alain Widdowson, Alba Ropero-Álvarez
BMC Public Health 2015, 15:673 (17 July 2015)
Abstract
Background
Since 2004, the uptake of seasonal influenza vaccines in Latin America and the Caribbean has markedly increased. However, vaccine effectiveness (VE) is not routinely measured in the region. We assessed the feasibility of using routine surveillance data collected by sentinel hospitals to estimate influenza VE during 2012 against laboratory-confirmed influenza hospitalizations in Costa-Rica, El Salvador, Honduras and Panama. We explored the completeness of variables needed for VE estimation.
Methods
We conducted the pilot case–control study at 23 severe acute respiratory infections (SARI) surveillance hospitals. Participant inclusion criteria included children 6 months–11 years and adults ≥60 years targeted for vaccination and hospitalized for SARI during January–December 2012. We abstracted information needed to estimate target group specific VE (i.e., date of illness onset and specimen collection, preexisting medical conditions, 2012 and 2011 vaccination status and date, and pneumococcal vaccination status for children and adults) from SARI case-reports and for children ≤9 years, inquired about the number of annual vaccine doses given. A case was defined as an influenza virus positive by RT-PCR in a person with SARI, while controls were RT-PCR negative. We recruited 3 controls per case from the same age group and month of onset of symptoms.
Results
We identified 1,186 SARI case-patients (342 influenza cases; 849 influenza-negative controls), of which 994 (84 %) had all the information on key variables sought. In 893 (75 %) SARI case-patients, the vaccination status field was missing in the SARI case-report forms and had to be completed using national vaccination registers (36 %), vaccination cards (30 %), or other sources (34 %). After applying exclusion criteria for VE analyses, 541 (46 %) SARI case-patients with variables necessary for the group-specific VE analyses were selected (87 cases, 236 controls among children; 64 cases, 154 controls among older adults) and were insufficient to provide precise regional estimates (39 % for children and 25 % for adults of minimum sample size needed).
Conclusions
Sentinel surveillance networks in middle income countries, such as some Latin American and Caribbean countries, could provide a simple and timely platform to estimate regional influenza VE annually provided SARI forms collect all necessary information.

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Research article
Double burden of malnutrition: increasing overweight and obesity and stall underweight trends among Ghanaian women
David Doku, Subas Neupane
BMC Public Health 2015, 15:670 (16 July 2015)

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Research article
Latin American and Caribbean countries’ baseline clinical and policy guidelines for responding to intimate partner violence and sexual violence against women
Donna Stewart, Raquel Aviles, Alessandra Guedes, Ekaterina Riazantseva, Harriet MacMillan BMC Public Health 2015, 15:665 (15 July 2015)

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Research article
Does introducing an immunization package of services for migrant children improve the coverage, service quality and understanding? An evidence from an intervention study among 1548 migrant children in eastern China
Yu Hu, Shuying Luo, Xuewen Tang, Linqiao Lou, Yaping Chen, Jing Guo, Bing Zhang
BMC Public Health 2015, 15:664 (15 July 2015)
Abstract
Background
An EPI (Expanded Program on Immunization) intervention package was implemented from October 2011 to May 2014 among migrant children in Yiwu, east China. This study aimed to evaluate its impacts on vaccination coverage, maternal understanding of EPI and the local immunization service performance.
Methods
A pre- and post-test design was used. The EPI intervention package included: (1) extending the EPI service time and increasing the frequency of vaccination service; (2) training program for vaccinators; (3) developing a screening tool to identify vaccination demands among migrant clinic attendants; (4) Social mobilization for immunization. Data were obtained from random sampling investigations, vaccination service statistics and qualitative interviews with vaccinators and mothers of migrant children. The analysis of quantitative data was based on a “before and after” evaluation and qualitative data were analyzed using content analysis.
Results
The immunization registration (records kept by immunization clinics) rate increased from 87.4 to 91.9 % (P = 0.016) after implementation of the EPI intervention package and the EPI card holding (EPI card kept by caregivers) rate increased from 90.9 to 95.6 % (P = 0.003). The coverage of fully immunized increased from 71.5 to 88.6 % for migrant children aged 1–4 years (P < 0.001) and increased from 42.2 to 80.5 % for migrant children aged 2–4 years (P < 0.001). The correct response rates on valid doses and management of adverse events among vaccinators were over 90 % after training. The correct response rates on immunization among mothers of migrant children were 86.8–99.3 % after interventions.
Conclusion
Our study showed a substantial improvement in vaccination coverage among migrant children in Yiwu after implementation of the EPI intervention package. Further studies are needed to evaluate the cost-effectiveness of the interventions, to identify individual interventions that make the biggest contribution to coverage, and to examine the sustainability of the interventions within the existing vaccination service delivery system in a larger scale settings or in a longer term.

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Research article
Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review
Emma Thomas, Kremlin Wickramasinghe, Shanthi Mendis, Nia Roberts, Charlie Foster
BMC Public Health 2015, 15:650 (14 July 2015)

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 18 July 2015)

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Research article
Level of mother’s knowledge about neonatal danger signs and associated factors in North West of Ethiopia: a community based study
Solomon Nigatu, Abebaw Worku, Abel Dadi BMC Research Notes 2015, 8:309 (19 July 2015)

Conflict and Health
[Accessed 18 July 2015]
http://www.conflictandhealth.com/

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Review
Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review
Spangaro J, Adogu C, Zwi AB, Ranmuthugala G and Davies GP Conflict and Health 2015, 9:19 (13 July 2015)
Abstract
Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to traditional review methods, particularly given the challenges of undertaking research in conflict and crisis settings. This study employed a realist review of the literature on interventions with the aim of identifying the mechanisms at work across the range of types of intervention. The realist approach is an exploratory and theory-driven review method. It is well suited to complex interventions as it takes into account contextual factors to identify mechanisms that contribute to outcomes.

The limited data available indicate that there are few deterrents to sexual violence in crises. Four main mechanisms appear to contribute to effective interventions: increasing the risk to offenders of being detected; building community engagement; ensuring community members are aware of available help for and responses to sexual violence; and safe and anonymous systems for reporting and seeking help. These mechanisms appeared to contribute to outcomes in multiple-component interventions, as well as those relating to gathering firewood, codes of conduct for personnel and legal interventions.

Drawing on pre-existing capacity or culture in communities is an additional mechanism which should be explored. Though increasing the risk to offenders of being detected was assumed to be a central mechanism in deterring sexual violence, the evidence suggests that this mechanism operated only in interventions focused on gathering firewood and providing alternative fuels. The other three mechanisms appeared important to the likelihood of an intervention being successful, particularly when operating simultaneously. In a field where robust outcome research remains likely to be limited, realist methods provide opportunities to understand existing evidence. Our analysis identifies the important potential of building in mechanisms involving community engagement, awareness of responses and safe reporting provisions into the range of types of intervention for sexual violence in crises.

Humanitarian Exchange Magazine
Issue 64 June 2015
http://www.odihpn.org/humanitarian-exchange-magazine/issue-64

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The Ebola crisis in West Africa
This edition of Humanitarian Exchange focuses on the humanitarian crisis created in West Africa by the Ebola outbreak, the largest and most complex since the virus was discovered in 1976. More than 11,000 people are believed to have died and over 26,300 cases have been reported. While Liberia was declared Ebola-free on 9 May 2015, Sierra Leone and Guinea are still struggling to contain the disease and assess the social and economic impact of the crisis.

In her lead article, Florika Fink-Hooijer analyses the weaknesses and inefficiencies in global humanitarian health governance revealed by the Ebola crisis.
Aspects of humanitarian–military engagement are discussed by André Heller Pérache in the context of Médecins Sans Frontières (MSF)’s unprecedented call for biohazard containment teams.

Josiah Kaplan and Evan Easton-Calabria highlight how humanitarians are using innovations in military medicine to combat Ebola.
Clea Kahn argues that characterising the outbreak as a public health crisis resulted in a failure to adequately consider the dignity and humanity of affected people.
Chukwu-Emeka Chikezie sheds light on the role of the Sierra Leonean diaspora in the response.
Catherine Meredith and her co-authors report on Oxfam’s bottom-up approach to the response.
Craig Dean and Kelly Hawrylyshyn look at the role of children’s and youth groups.
Liz Hughes and Nick McWilliam explore how GIS mapping has been used in planning and targeting interventions.
Jean-Martin Bauer and his co-authors report on the innovative use of mobile technology for monitoring food security.
Articles by Lisa Reilly and Raquel Vazquez Llorente and Clara Hawkshaw highlight risk management and training approaches to the crisis.
Lisa Guppy reflects on the benefits and challenges of carrying out research during the outbreak.
The edition ends with an article by Nadia Berger and Grace Tang on the importance of translation in the response.

Journal of International Development
Volume 27, Issue 5 Pages 573–715
http://onlinelibrary.wiley.com/doi/10.1002/jid.v27.5/issuetoc

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Special Issue: The Political Economy of Africa’s Emergent Middle Class July 2015
Issue edited by: Danielle Resnick
Introduction
The Political Economy of Africa’s Emergent Middle Class: Retrospect and Prospects (pages 573–587)
Danielle Resnick
Article first published online: 15 JUL 2015 | DOI: 10.1002/jid.3110
Abstract
This special issue introduction provides a historical perspective in order to contextualize the political economy of Africa’s emergent middle class. In doing so, three overarching research questions are discussed to better understand the middle class’ transformative potential. First, who constitute Africa’s middle class and how has this concept changed over time? Second, what dynamics explain the growth of this group? Third, what are the implications of the middle class for good governance and pro-poor policies? The contributions of each of the articles in the special issue to answering these specific questions for Africa’s contemporary middle class are then briefly discussed.
[6 Special Issue Papers]

JAMA
July 14, 2015, Vol 314, No. 2
http://jama.jamanetwork.com/issue.aspx

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The JAMA Forum
Critical Choices for the WHO After the Ebola Epidemic FREE
Lawrence O. Gostin, JD
In the aftermath of an unconscionably inadequate response to the Ebola epidemic in West Africa, this year’s World Health Assembly was seen as critically important to the future of the World Health Organization (WHO). The assembly, the WHO’s decision-making forum, attended by delegations from all WHO member states, offered a historic opportunity for fundamental reform of the organization. A failure to decisively shore up its epidemic response leadership risked the loss of confidence in the WHO for a generation.

When the 68th World Health Assembly convened on May 18, 2015, the WHO was experiencing a crisis of confidence. The assembly took 3 key steps to address the organization’s global health security capacities: it combined the secretariat’s outbreak and emergency response programs, developed a new global health emergency workforce, and created a $100 million emergency contingency fund (http://bit.ly/1SHuWjX). What the assembly did not do was address the deep structural problems that have plagued the WHO, undermining its effectiveness.

Margaret Chan, MD, DSc, director-general of the WHO, announced during the assembly that she plans to combine the existing outbreak and emergency response programs into a single program for health emergencies. This new unit will be designed for speed and flexibility, she said, with program performance benchmarks “showing what must happen within 24, 48, and 72 hours, not months” (http://bit.ly/1Hz64rk). The program will partner with United Nations agencies, states, and nongovernmental organizations (NGOs), such as Médecins Sans Frontières (MSF) (http://bit.ly/1hsReV1).

From an organizational perspective, the new unit will be more rational and designed for rapid response. Yet, there are no new funding sources to support outbreak and emergency response. If Chan diverts significant resources to its epidemic response, she risks further weakening already badly underfunded programs, such as for noncommunicable diseases and mental health.

The absence of a robust domestic workforce represented a signal failure of the West African Ebola response. The 3 most-affected countries—Guinea, Liberia, and Sierra Leone—had among the world’s lowest health worker-to-patient ratios, and lost more than 500 doctors, nurses, and other health workers to the epidemic (http://bit.ly/1HjtETl). Although NGOs such as MSF and foreign workers filled some of the gap, the paucity of human resources significantly impeded the response.

Although the WHO is doing very little to build human resource capacities in low- and middle-income countries, Chan announced in a report to the assembly that the agency does plan to launch a global health emergency workforce (http://bit.ly/1SHuWjX) by January 2016, drawn from existing networks including the Global Outbreak Alert and Response Network (GOARN) (http://bit.ly/1eEgbyN) the Global Health Cluster (http://bit.ly/1FkxD1u) foreign medical teams, (http://bit.ly/1Azif59), and NGOs, and coordinated by the new outbreak and emergency response unit. Chan also announced that the WHO is strengthening its own emergency staff, adding logisticians, medical anthropologists, and experts in risk communication. The assembly welcomed both of Director-General Chan’s proposals to establish for a global health workforce and to strengthen the WHO’s emergency response unit (http://bit.ly/1FSsNwi).

The Ebola response vividly demonstrated that effective action requires a range of human resources, including clinicians and community health workers, as well as public health professionals to conduct surveillance, laboratory analysis, and contact tracing. Other experts in communications, culture, and behavior are needed to gain insight into local belief systems. These skills should be ensured through comprehensive training and certification, which will be crucial WHO functions.

Although a global workforce reserve requires intensive training, medical equipment, and logistical acumen, the WHO is implementing the emergency workforce without any new resources. It is hard to conceive how such a vital operation can be conducted without a major injection of sustainable resources.

In 2011, after the influenza A(H1N1) pandemic, the independent WHO International Health Regulations (IHR) Review Committee found that the world is “ill-prepared” for a major epidemic and proposed a $100 million contingency fund (http://bit.ly/1KD9oCD). But the WHO never adopted the committee’s recommendation. Chan’s strategy was to mobilize international funding when an emergency strikes, believing that rich states and philanthropists would react quickly to exigent circumstances (http://bit.ly/1teeXhl).

However, as the WHO should have realized, once a rapidly moving infectious disease emerges, it may be too late to first begin resource mobilization. That turned out to be the case with Ebola, as the WHO’s funding appeals took too long to materialize. During the World Health Assembly, delegates approved the creation of a $100 million contingency fund, financed by flexible voluntary contributions (http://bit.ly/1ITTGAI).

Director-General Chan was heavily criticized for delays in declaring a Public Health Emergency of International Concern (PHEIC) under the IHR. Wisely, release of the contingency fund will not be tied to a PHEIC declaration. After a WHO committee discussed the more flexible approach of using the principles of the Emergency Response Framework grading system (http://bit.ly/1FJ8uQJ) as the trigger for tapping the contingency fund (http://bit.ly/1AzjnWt), the assembly ultimately left the decision to release funds at the director-general’s discretion.

The clear goal of a WHO contingency fund should be to prevent an event from escalating into a PHEIC or an even lesser–grade emergency. Yet at $100 million, the fund’s size is incommensurate with the need when one considers the billions of dollars in humanitarian assistance and the loss of approximately 12% of the GDP in the countries most affected by the epidemic (http://bit.ly/1Gq0mrm). It also requires voluntary contributions from member states or other donors. Adding it to WHO core funding through mandatory assessed dues would have been more viable and sustainable.

None of 5 proposals for structural reform of the WHO that I suggested in a previous JAMA Forum were on the assembly agenda in a meaningful form (http://bit.ly/1ADeoUf). In particular, member states did not significantly increase the assessed dues of WHO member states to give the agency the funding and control it needs to meet its worldwide mandate. The lack of coherence between headquarters and its regional offices remains unaddressed. And although the secretariat is exploring new ways to harness the creativity of civil society and avoid conflicts with vested business interests, there was nothing on the assembly agenda to bring NGOs closer into the WHO’s governance (http://bit.ly/1GKm1t8).

Finally, and most importantly, the WHO has not developed a plan to build the core capacities of low- and middle-income countries for sustainable health systems. The idea of an international health systems fund to accomplish this was not on the agenda (http://bit.ly/1GKmo7h).

The WHO is too important to be sidelined or weakened further, but the organization’s ability to provide meaningful leadership is not assured (http://bit.ly/1PrWhSG). To be sure, the WHO has improved its ability to put out fires in the form of rapidly emerging infectious diseases. Although there is a better fire brigade, the assembly has yet to take action to prevent fires from erupting with increasing frequency in every region of the globe.

The Lancet
Jul 18, 2015 Volume 386 Number 9990 p219-310 e1
http://www.thelancet.com/journals/lancet/issue/current
Comment
Measuring the SDGs: a two-track solution
Austen Davis, Zoe Matthews, Sylvia Szabo, Helga Fogstad
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61081-9
Summary
The Millennium Development Goals (MDGs) expire in 2015 and substantial effort is being put into the negotiation of a new set of Sustainable Development Goals (SDGs). The SDG agenda is broader and goes further than that of the MDGs, and critics claim that it is unmeasurable and unmanageable. On the positive side, the consultation process has been far more inclusive and credible than for the MDGs. The resultant Open Working Group (OWG) proposal provides a global agenda for action that is relevant to all nations.

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Comment
Universal health coverage: progressive taxes are key
Robert Yates
Published Online: 14 May 2015
Open Access
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60868-6

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Articles
Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries
Dr Aaron Reeves, PhD, Yannis Gourtsoyannis, MD, Sanjay Basu, PhD, David McCoy, DrPH, Prof Martin McKee, MD, Prof David Stuckler, PhD
Published Online: 14 May 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60574-8
Open access funded by Wellcome Trust
Summary
Background
How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage.
Methods
We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011.
Findings
Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (<$1000 per capita per year), an additional $100 tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive.
Interpretation
Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax policies within a pro-poor framework might accelerate progress toward achieving major international health goals.
Funding
Commission of the European Communities (FP7–DEMETRIQ), the European Union’s HRES grants, and the Wellcome Trust.

Maternal and Child Health Journal
Volume 19, Issue 8, August 2015
http://link.springer.com/journal/10995/19/8/page/1

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Maternal Education and Immunization Status Among Children in Kenya
Elijah O. Onsomu, Benta A. Abuya, Irene N. Okech, DaKysha Moore, Janice Collins-McNeil
Abstract
Child morbidity and mortality due to infectious diseases continues to be a major threat and public health concern worldwide. Although global vaccination coverage reached 90 % for diphtheria, tetanus and pertussis (DTP3) across 129 countries, Kenya and other sub-Saharan countries continue to experience under-vaccination. The purpose of this study was to examine the association between maternal education and child immunization (12–23 months) in Kenya. This study used retrospective cross-sectional data from the 2008–2009 Kenya Demographic and Health Survey for women aged 15–49, who had children aged 12–23 months, and who answered questions about vaccination in the survey (n = 1,707). The majority of the children had received vaccinations, with 77 % for poliomyelitis, 74 % for measles, 94 % for tuberculosis, and 91 % for diphtheria, whooping cough (pertussis), and tetanus. After adjusting for other covariates, women with primary, secondary, and college/university education were between 2.21 (p < 0.01) and 9.10 (p < 0.001) times more likely to immunize their children than those who had less than a primary education. Maternal education is clearly crucial in ensuring good health outcomes among children, and integrating immunization knowledge with maternal and child health services is imperative. More research is needed to identify factors influencing immunization decisions among less-educated women in Kenya.

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A Review of e-Health Interventions for Maternal and Child Health in Sub-Sahara Africa
Oluwaseun Ireti Obasola, Iyabo Mabawonku, Ikeoluwa Lagunju
Abstract
To review e-health interventions for maternal and child health (MCH) and to explore their influence on MCH practices in sub-Sahara Africa (SSA). Keyword searches were used to retrieve articles from four databases and the websites of organisations involved in e-health projects for MCH in SSA. A total of 18relevant articles were retrieved using inclusion and exclusion criteria. The researchers reveal the prevalence of the application of mobile phones for MCH care and the influence of the use of information and communication technology (ICT) for delivering MCH information and services to target populations. There is a need to move the application of ICT for MCH care from pilot initiatives to interventions involving all stakeholders on a sub-regional scale. These interventions should also adopt an integrated approach that takes care of the information needs at every stage along the continuum of care. It is anticipated that the study would be useful in the evolution and implementation of future ICT-based programmes for MCH in the region.

New England Journal of Medicine
July 16, 2015 Vol. 373 No. 3
http://www.nejm.org/toc/nejm/medical-journal

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Perspective
The Trans-Pacific Partnership — Is It Bad for Your Health?
Amy Kapczynski, J.D.
N Engl J Med 2015; 373:201-203 July 16, 2015 DOI: 10.1056/NEJMp1506158

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International trade deals once focused primarily on tariffs. As a result, they had little direct effect on health, and health experts could reasonably leave their details to trade professionals. Not so today. Modern trade pacts have implications for a wide range of health policy issues, from medicine prices to tobacco regulation, not only in the developing world but also in the United States.

The Trans-Pacific Partnership Agreement (TPP) is a case in point. A massive trade deal now reportedly on the verge of completion, the TPP has nearly 30 chapters. A draft chapter on intellectual property (IP) alone runs 77 single-spaced pages.

The full health implications of the TPP are hard to judge, not only because its provisions are complex but also because the draft text is a closely held secret. Even members of the U.S. Congress can see it only if they agree not to talk publicly about it and if they leave their pens and phones (and, until recently, their expert staffers) at the door. But several key chapters have recently been leaked and reveal that the TPP could have a substantial impact on health.

Groups including Médecins sans Frontières and Oxfam warn, for example, that the agreement could threaten the lives of millions of people in developing countries. Their concerns stem primarily from the leaked IP chapter and the effect that patents have on the prices of medicines. In the context of human immunodeficiency virus, for example, patents increase the annual cost of antiretroviral therapy from around $100 per person to $10,000 per person.

The TPP could impose obligations on developing countries that go far beyond any existing trade agreement. Indeed, some proposals in the leaked IP chapter seem directly targeted against innovative measures that developing countries have used to maximize the use of low-cost generic medicines.

For example, India allows patents on new drugs but not on new uses of old drugs or new forms of known drugs that do not increase therapeutic efficacy. These provisions have paved the way for generic versions of lifesaving drugs such as the cancer treatment imatinib mesylate (Gleevec) in that country.1 But such limits on patent eligibility could be outlawed by the TPP. Reports suggest that there may be some kind of phase-in period for developing-country members, but only for some parts of the agreement. And at best, a phase-in period would merely postpone some of the TPP’s effects for a few years.2

India is not a party to the TPP negotiations, which have been conducted by 12 Pacific Rim countries: Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, the United States, and Vietnam. Why, then, would India’s laws — sometimes word for word — be targeted in the TPP negotiations? For one thing, other developing countries have started to follow India’s lead. For another, the TPP is a platform agreement designed for other countries to join, and it will establish a new baseline for future international negotiations. The risk regarding access to medicines in developing countries is real.

Though it is less widely recognized, the TPP could also have a direct effect on health in developed countries. For example, the leaked IP chapter contemplates major extensions of “data exclusivity” provisions. These laws prevent drug regulatory agencies like the Food and Drug Administration from registering a generic version of a drug for a certain number of years — and as a result can substantially affect the prices of medicines.

In recognition of this fact, President Barack Obama’s fiscal year 2016 budget proposes rolling back the data-exclusivity period for biologic drugs in the United States to 7 years from 12 years, yielding a projected savings of more than $4 billion over the next decade.3 In the TPP negotiations, however, the United States is proposing a 12-year term of exclusivity. Such a requirement would lock the United States into a policy that many observers, including, apparently, the President himself, believe inflates the cost of medicines unjustifiably. Even if the number of years required by the TPP is negotiated downward, the lock-in effect remains a concern, because trade agreements can be extremely difficult to amend.

The cost of medicines is no small concern in the United States today: spending on prescription drugs in the United States jumped 13% in 2014 alone. The recent experience with new hepatitis C treatments shows that even lifesaving cures may be rationed in the United States — whether implicitly or explicitly — if we fail to contain drug costs and promote more efficient innovation. The TPP, however, could make moves toward more rational drug pricing in the United States difficult and even imperil existing provisions that help to contain costs for government programs.

A 2011 “annex” to the TPP, apparently proposed by the United States, would have mandated that all countries use “competitive market-derived prices” or benchmarks that “appropriately recognize the value” of the drug in question when establishing drug prices. A just-leaked December 2014 draft omits these provisions but still contemplates substantial procedural obligations for governments and makes clear that these rules apply to the Centers for Medicare and Medicaid Services (CMS). The text is difficult to decipher and still in flux. But consumer groups argue that the annex could create opportunities for interference in the decisions of CMS and render health programs in all TPP countries more vulnerable to drug-company influence and more difficult to reform.4

In March 2015, a third bombshell dropped: a draft chapter on “investor-state dispute settlement” (ISDS). It would empower foreign companies to sue member countries for hundreds of millions of dollars in damages in a wide range of cases in which they argue that their expected future profits have been undermined. These challenges would be heard by “arbiters” — typically private lawyers, many of whom cycle in and out of industry — with no prospect of independent review by a national court. Such provisions have been included in trade agreements before. But the scale of the TPP would substantially increase the number of companies that could bring such challenges. Firms have already used provisions like these to challenge an astonishing range of laws, from minimum-wage laws in Egypt, to tobacco regulations in Uruguay and Australia, to core aspects of patent law as they apply to medicines in Canada. The ISDS provisions alone could interfere with domestic health policy for decades to come. Under their auspices, policies covering a wide range of issues, from food and tobacco labeling, to patent law, to drug-pricing rules, to environmental protection could be challenged in participating countries — including, of course, the United States.

The course that the TPP takes is not yet set in stone. Negotiations continue, and the Obama administration could work toward an agreement that excludes provisions such as ISDS and the health care “annex” or that incorporates robust safeguards to protect health. Congress has an important role, too. As of early June, it was in the midst of a fierce legislative battle over whether the TPP and deals like it should be “fast-tracked.” If Congress takes this route, its ability to influence the treaty will be much diminished: fast tracking allows passage of a trade treaty with only a simple majority vote in Congress and also denies Congress any opportunity to make changes to the agreement’s text.

Much hangs in the balance in the coming weeks and months. If the TPP includes robust ISDS provisions and the expansive provisions proposed in the IP chapter and the health care annex, the United States could be signing away its authority to regulate critical aspects of health policy for years to come.

Pharmacoeconomics
Volume 33, Issue 7, July 2015
http://link.springer.com/journal/40273/33/7/page/1

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Issue Theme: Economic Consequences of Obesity
Article
Policy Makers’ Views of Obesity-Related Challenges Around the World
Pierre Cremieux
Policy makers from across the world discuss the measures undertaken by their governments to combat rising obesity levels. They include Patricia Constante Jaime (Coordinator of Food and Nutrition, Ministry of Health of Brazil), Kimberly Elmslie (Acting Assistant Deputy Minister, Health Promotion and Chronic Disease Prevention Branch of the Public Health Agency of Canada), Bin Wang (Deputy Director of the Disease Control Division, National Health and Family Planning Commission of China [MOH]), François Crémieux (Chief Executive Officer, University Hospitals of the North Paris Region, France), and Mark McClellan (Director, Initiatives on Value and Innovation in Health Care, Brookings Institution, and former FDA Commissioner and CMS Administrator, USA).

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 18 July 2015]

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Virtual Disaster Simulation: Lesson Learned from an International Collaboration That Can Be Leveraged for Disaster Education in Iran
July 13, 2015 · Perspective
Abstract
Disaster education needs innovative educational methods to be more effective compared to traditional approaches. This can be done by using virtual simulation method. This article presents an experience about using virtual simulation methods to teach health professional on disaster medicine in Iran.

The workshop on the “Application of New Technologies in Disaster Management Simulation” was held in Tehran in January 2015. It was co-organized by the Disaster and Emergency Health Academy of Tehran University of Medical Sciences and Emergency and the Research Center in Disaster Medicine and Computer Science applied to Medicine (CRIMEDIM), Università del Piemonte Orientale. Different simulators were used by the participants, who were from the health system and other relevant fields, both inside and outside Iran.

As a result of the workshop, all the concerned stakeholders are called on to support this new initiative of incorporating virtual training and exercise simulation in the field of disaster medicine, so that its professionals are endowed with field-based and practical skills in Iran and elsewhere.

Virtual simulation technology is recommended to be used in education of disaster management. This requires capacity building of instructors, and provision of technologies. International collaboration can facilitate this process. Keywords: Virtual simulation, disaster management, education, training, Iran

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 18 July 2015)

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Human Onchocerciasis: Modelling the Potential Long-term Consequences of a Vaccination Programme
Hugo C. Turner, Martin Walker, Sara Lustigman, David W. Taylor, María-Gloria Basáñez Research Article | published 17 Jul 2015 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0003938
Abstract
Background
Currently, the predominant onchocerciasis control strategy in Africa is annual mass drug administration (MDA) with ivermectin. However, there is a consensus among the global health community, supported by mathematical modelling, that onchocerciasis in Africa will not be eliminated within proposed time frameworks in all endemic foci with only annual MDA, and novel and alternative strategies are urgently needed. Furthermore, use of MDA with ivermectin is already compromised in large areas of central Africa co-endemic with Loa loa, and there are areas where suboptimal or atypical responses to ivermectin have been documented. An onchocerciasis vaccine would be highly advantageous in these areas.
Methodology/Principal Findings
We used a previously developed onchocerciasis transmission model (EPIONCHO) to investigate the impact of vaccination in areas where loiasis and onchocerciasis are co-endemic and ivermectin is contraindicated. We also explore the potential influence of a vaccination programme on infection resurgence in areas where local elimination has been successfully achieved. Based on the age range included in the Expanded Programme on Immunization (EPI), the vaccine was assumed to target 1 to 5 year olds. Our modelling results indicate that the deployment of an onchocerciasis vaccine would have a beneficial impact in onchocerciasis–loiasis co-endemic areas, markedly reducing microfilarial load in the young (under 20 yr) age groups.
Conclusions/Significance
An onchocerciasis prophylactic vaccine would reduce the onchocerciasis disease burden in populations where ivermectin cannot be administered safely. Moreover, a vaccine could substantially decrease the chance of re-emergence of Onchocerca volvulus infection in areas where it is deemed that MDA with ivermectin can be stopped. Therefore, a vaccine would protect the substantial investments made by present and past onchocerciasis control programmes, decreasing the chance of disease recrudescence and offering an important additional tool to mitigate the potentially devastating impact of emerging ivermectin resistance.

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Author Summary
Novel and alternative strategies are required to meet the demanding control and elimination (of infection) goals for human onchocerciasis (river blindness) in Africa. Due to the overlapping distribution of onchocerciasis and loiasis (African eye worm) in forested areas of central Africa, millions of people living in such areas are not well served by current interventions because they cannot safely receive the antiparasitic drug ivermectin that is distributed en masse to treat onchocerciasis elsewhere in Africa. The Onchocerciasis Vaccine for Africa—TOVA—Initiative has been established to develop and trial an onchocerciasis vaccine. We model the potential impact of a hypothetical childhood vaccination programme rolled out in areas where co-endemicity of onchocerciasis and African eye worm makes mass distribution of ivermectin difficult and potentially unsafe for treating, controlling and eliminating river blindness. We find that, 15 years into the programme, a vaccine would substantially reduce infection levels in children and young adults, protecting them from the morbidity and mortality associated with onchocerciasis. Most benefit would be reaped from a long-lived vaccine, even if only partially protective. We also discuss how a vaccine could substantially reduce the risk of re-emergence of onchocerciasis in areas freed from infection after years of successful intervention.

PLoS One
http://www.plosone.org/
[Accessed 18 July 2015]

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Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis
Egidia G. Miftode, Olivia S. Dorneanu, Daniela A. Leca, Gabriela Juganariu, Andra Teodor, Mihnea Hurmuzache, Eduard V. Nastase, Dana T. Anton-Paduraru
Research Article | published 17 Jul 2015 | PLOS ONE 10.1371/journal.pone.0133477

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Acceptability and Feasibility of Delivering Pentavalent Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and Senegal
Elise Guillermet, Hamadou M. Dicko, Le Thi Phuong Mai, Mamadou N’Diaye, Fatoumata Hane, Seydina Ousmane Ba, Khadidjatou Gomis, Nguyen Thi Thi Tho, Nguyen Thi Phuong Lien, Phan Dang Than, Tran Van Dinh, Philippe Jaillard, Bradford D. Gessner, Anais Colombini
Research Article | published 17 Jul 2015 | PLOS ONE 10.1371/journal.pone.0132292

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The French Connection: The First Large Population-Based Contact Survey in France Relevant for the Spread of Infectious Diseases
Guillaume Béraud, Sabine Kazmercziak, Philippe Beutels, Daniel Levy-Bruhl, Xavier Lenne, Nathalie Mielcarek, Yazdan Yazdanpanah, Pierre-Yves Boëlle, Niel Hens, Benoit Dervaux
Research Article | published 15 Jul 2015 | PLOS ONE 10.1371/journal.pone.0133203

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Do Maternal Living Arrangements Influence the Vaccination Status of Children Age 12–23 Months? A Data Analysis of Demographic Health Surveys 2010–11 from Zimbabwe
Rodolfo Rossi
Research Article | published 13 Jul 2015 | PLOS ONE 10.1371/journal.pone.0132357

Risk Analysis
June 2015 Volume 35, Issue 6 Pages 961–1186
http://onlinelibrary.wiley.com/doi/10.1111/risa.2015.35.issue-5/issuetoc

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Special Issue: Special Series on Research Synthesis Methods: A Cross-Disciplinary Approach
Introduction to the Special Series on Research Synthesis: A Cross-Disciplinary Approach (pages 963–970)
Lisa A. Robinson and James K. Hammitt
Article first published online: 17 JUN 2015 | DOI: 10.1111/risa.12437
Abstract
To estimate the effects of a policy change, analysts must often rely on available data as time and resource constraints limit their ability to commission new primary research. Research synthesis methods—including systematic review, meta-analysis, and expert elicitation—play an important role in ensuring that this evidence is appropriately weighed and considered. We present the conclusions of a multidisciplinary Harvard Center for Risk Analysis project that evaluated and applied these methods, and introduce the resulting series of articles. The first step in any analysis is to clearly define the problem to be addressed; the second is a systematic review of the literature. Whether additional analysis is needed depends on the quality and relevance of the available data to the policy question, and the likely effect of uncertainty on the policy decision. Meta-analysis promotes understanding the variation between studies and may be used to combine the estimates to develop values for application in policy analysis. Formal, structured expert elicitation promotes careful consideration of the evidence when data are limited or inconsistent, and aids in extrapolating to the policy context. Regardless of the methods used, clear communication of the approach, assumptions, and uncertainty is essential.

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Macroeconomics of Natural Disasters: Strengths and Weaknesses of Meta-Analysis Versus Review of Literature (pages 1050–1072)
Peter A. G. van Bergeijk and Sara Lazzaroni
Article first published online: 6 APR 2015 | DOI: 10.1111/risa.12372

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Research Synthesis and the Value per Statistical Life (pages 1086–1100)
Lisa A. Robinson and James K. Hammitt
Article first published online: 7 APR 2015 | DOI: 10.1111/risa.12366

Science
17 July 2015 vol 349, issue 6245, pages 209-340
http://www.sciencemag.org/current.dtl

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Policy Forum
Global Nutrition
Metrics for land-scarce agriculture
Ruth DeFries1,*, Jessica Fanzo2, Roseline Remans3,4, Cheryl Palm3, Stephen Wood1,3,
Tal L. Anderman5
Author Affiliations
1Department of Ecology, Evolution, and Environmental Biology, Columbia University, New York, NY, USA.
2Institute of Human Nutrition, Columbia University, New York, NY, USA.
3Agriculture and Food Security Center, The Earth Institute, Columbia University, New York, NY, USA.
4Bioversity International, Addis Ababa, Ethiopia.
5Environmental Defense Fund, San Francisco, CA, USA.
Summary
Over the past half-century, the paradigm for agricultural development has been to maximize yields through intensifying production, particularly for cereal crops (1). Increasing production of high-yielding cereals—wheat, rice, and maize—has replaced more nutrient-rich cereals, which has eroded the content of essential dietary nutrients in the world’s cereal supply. New approaches are needed to produce healthy foods, rich in essential nutrients, with efficient use of land. Standard yield metrics that measure the quantity of production are inadequate to assess progress toward this goal; thus, we propose alternative metrics of nutritional yields.

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 18 July 2015]

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Research Article
The Security Gap in Syria: Individual and Collective Security in ‘Rebel-held’ Territories
Ali Ali
Abstract
This paper examines security in Syria through the conceptual lens of the security gap, understood as the gap between security practices and objectives which have implications for individual and collective security. Practices of security can be the state apparatus, the military, and militias. The objective – safety – can refer to the safety or security of a range of collectives including the state, political parties, and ethnic groups, while individual security refers to the general safety of inhabitants and the protection of human rights. This paper compares the security situation in so-called ‘rebel-held’ areas of Syria where alternative governance structures have emerged, examining the security approaches of Local Administrative Councils and Rebel Councils in Deir Azzor, Manbij, Dera, and areas dominated by the Kurdish Democratic Union Party (PYD). It argues that security and safety are strongly influenced by authority formation and the nature of deals and relationships involved in the formation of these nascent authorities. It also argues that security in these areas is strongly influenced by the Syrian government, which disrupts collectives that threaten its own collective security while giving limited support to those which serve its agenda of retaining power. It also demonstrates the limited utility of the ‘regime’ vs. ‘rebel-held’ dichotomy, as rebel groups at times must accommodate the Syrian state in limited ways for instrumental purposes. The article is based on fieldwork conducted in Turkey in 2013–2014, interviews conducted in 2015, and secondary sources based on field research.
DOI: http://doi.org/10.5334/sta.gd

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Research Article
Does Security Imply Safety? On the (Lack of) Correlation Between Different Aspects of Security
Anouk Rigterink
Abstract
This paper investigates to what extent different aspects of security correlate. It distinguishes four concepts covered by the term ‘security’: technical safety, perceived safety, technical security and perceived security. It is shown that these concepts need not correlate conceptually. Furthermore, the paper shows empirically that these concepts correlate weakly in two cases. This has implications for policy and research. First, it leaves open the possibility that interventions targeting one aspect of security do not affect, or even adversely affect, another aspect of security: an expression of a security gap. Second, research is commonly motivated by individual-level arguments relating to safety, whilst relying on aggregate indicators more likely capturing security.
DOI: http://doi.org/10.5334/sta.fw

Vulnerable Children and Youth Studies
An International Interdisciplinary Journal for Research, Policy and Care
Volume 10, Issue 3, 2015
http://www.tandfonline.com/toc/rvch20/current#.Uzg2bFcWNdc

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Original Articles
Migration as a risk factor for school dropout amongst children made vulnerable by HIV/AIDS: a prospective study in eastern Zimbabwe
Erica L. Pufall, Constance Nyamukapa, Laura Robertson, Paradzai George Mushore, Albert Takaruza & Simon Gregson
pages 179-191
Open access
DOI:10.1080/17450128.2015.1034799

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Perceived social support of HIV/AIDS orphans: a review
Shikha Verma & Swaran Lata
pages 243-256
DOI:10.1080/17450128.2015.1054455

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 11 July 2015

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 11 July 2015

blog edition: comprised of the 35+ entries to be posted below on 12 July 2015

earlier pdf editions archived here

American Psychological Association (APA) – US Defense Department Interrogation Techniques/Torture

Press Release and Recommended Actions: Independent Review Cites Collusion Among APA Individuals and Defense Department Officials in Policy on Interrogation Techniques
APA Apologizes for “Deeply Disturbing” Findings and Organizational Failures; Announces Initial Policy and Procedural Actions to Correct Shortcomings

July 10, 2015 WASHINGTON — The American Psychological Association (APA) today announced an initial series of policy and procedural steps in response to findings of individual collusion and organizational failures in the group’s activities related to the Bush Administration’s war on terror.

The actions come as the APA released a 542-page report produced by attorney David Hoffman, of the Sidley Austin law firm, detailing the relationship between various activities of the APA and Bush Administration policies on interrogation techniques. Mr. Hoffman was retained by the APA Board of Directors last November to conduct a thorough and independent review, and the APA cooperated fully during the eight-month process.

“The Hoffman report contains deeply disturbing findings that reveal previously unknown and troubling instances of collusion,” said Dr. Susan McDaniel, a member of the Independent Review’s Special Committee. “The process by which the Presidential Task Force on Psychological Ethics and National Security (PENS) was created, the composition of the membership, the content of the PENS report and the subsequent activities related to the report were influenced by collusion between a small group of APA representatives and government officials.”

The Hoffman report states that the intent of the individuals who participated in the collusion was to “curry favor” with the Defense Department, and that may have enabled the government’s use of abusive interrogation techniques. As a result, the 2005 PENS report became a document based at least as much on the desires of the DoD as on the needs of the psychology profession and the APA’s commitment to human rights.

“Our internal checks and balances failed to detect the collusion, or properly acknowledge a significant conflict of interest, nor did they provide meaningful field guidance for psychologists,” said Dr. Nadine Kaslow, chair of the Independent Review’s Special Committee. “The organization’s intent was not to enable abusive interrogation techniques or contribute to violations of human rights, but that may have been the result.

“The actions, policies and the lack of independence from government influence described in the Hoffman report represented a failure to live up to our core values. We profoundly regret, and apologize for, the behavior and the consequences that ensued. Our members, our profession and our organization expected, and deserved, better.”

In response to the Hoffman report, the Board initiated several actions and made additional recommendations to the APA’s governing Council of Representatives…
Summary of actions outlined in full release here

Report of the Independent Reviewer and Related Materials
The APA Board of Directors engaged attorney David Hoffman of the law firm Sidley Austin in November 2014 to conduct an independent review of whether there was any factual support for the assertion that APA engaged in activity that would constitute collusion with the Bush administration to promote, support or facilitate the use of “enhanced” interrogation techniques by the United States in the war on terror. Following is a link to the complete, unedited independent review.
Report of the independent reviewer (PDF, 2.62MB :: 566 pages0

SDGs / Sustainable Development Goals

Editor’s Note:
Key milestones were reached in the SDG process last week. The first is the release of the “final draft” of the SDG agenda for adoption in September by the United Nations which specifies 17 Sustainable Development Goals and 169 targets and recent amendments to some targets. The other is the convening of the High-level Political Forum [HLPF] on Sustainable Development which will provide political oversight to the SDG process overall over its 15-year term. Running in parallel was a high-level ministerial meeting also considering SDG themes and issues.

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Transforming our World: The 2030 Agenda for Global Action (Final draft of the outcome document for the UN Summit to adopt the Post-2015 Development Agenda)
8 July 2015 :: 33 pages
Preamble
This Agenda is a plan of action for people, planet and prosperity that also seeks to strengthen universal peace in larger freedom. All countries acting in collaborative partnership will implement the plan. We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet for present and future generations. We are determined to take the bold and transformative steps needed to shift the world on to a sustainable path. As we embark on this collective journey, we pledge that no one will be left behind.

The 17 Sustainable Development Goals and 169 targets which we are announcing demonstrate the scale and ambition of the new Agenda. They will stimulate action over the next fifteen years in the following areas of critical importance for humanity and the planet:

People
We want to ensure that all human beings can fulfil their potential. We want to end poverty in all its forms; end hunger and malnutrition; promote human dignity; combat inequalities in and between countries; achieve gender equality and empower all women and girls; ensure quality education, water and sanitation and a healthy life for all; and secure the participation of all people and groups, including children, in the realization of the new Goals and targets.

Planet
We must respect and safeguard our common home. We want to protect the planet so that it can support the needs of present and future generations. We will conserve and sustainably use our oceans and seas; fight climate change; protect and restore ecosystems; combat desertification, land degradation and biodiversity loss; promote safe and inclusive cities and human settlements; and promote disaster risk reduction.

Prosperity
We want all human beings to enjoy the fruits of economic, social and technological progress and live productive and fulfilling lives. We want to ensure sustained, inclusive and sustainable economic growth; promote decent work and employment for all; foster shared prosperity and sustainable lifestyles worldwide; promote sustainable industrialization, agriculture and infrastructure; and ensure access to affordable modern energy services.

Peace
All people yearn to live in peaceful and harmonious societies, free from fear and violence. We want to foster peaceful, safe and inclusive societies; to strengthen governance and institutions at all levels; to ensure equal access to justice; and to protect the human rights of all men, women, boys and girls.

Partnership
We want to create an effective Global Partnership for Sustainable Development which will embrace all countries and stakeholders. The Global Partnership will mobilize the means required for implementation of the Agenda, acting in a spirit of strengthened global solidarity and supporting, in particular, the needs of the poorest and most vulnerable.

If we realize our ambitions in these areas and across the full extent of the new Agenda, the lives of millions of human beings will be profoundly altered and our world will be transformed for the better….

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At Closing of Economic and Social Council High-level Segment, Secretary-General Urges Stakeholders to End Poverty, Build Sustainable World for All
10 July 2015
ECOSOC/6714
The 2015 high-level segment of the Economic and Social Council concluded today with interactive national voluntary presentations and a thematic discussion on ways of strengthening and building institutions for policy integration in the post-2015 sustainable development agenda, capping week-long deliberations that Secretary-General Ban Ki-moon said had helped to outline how the forum could organize its work, keep track of progress and bolster implementation.

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Concluding Session High-level Political Forum on Sustainable Development Adopts Declaration of Commitment to Ambitious People-centred Post-2015 Agenda
8 Jul 2015 – The High-level Political Forum for Sustainable Development closed its eight-day annual session today with the adoption of a declaration that committed ministers from around the world to establishing a “strong, universal, ambitious, inclusive and people-centred” post-2015 development agenda that completed the unfinished business of the Millennium Development Goals and responded to new challenges.

Through the text, Forum ministers welcomed what had been achieved through the Millennium Goals, which had set out a common vision and contributed to “significant and substantial advances” in several areas. They requested the President of the Economic and Social Council to issue summaries of discussions in the Forum and in the Council’s high-level segment, which runs until 10 July, to the Third International Conference on Financing for Development, which convenes from 13 to 16 July in Addis Ababa.

“Our meeting was convened under a heightened mindfulness of the forthcoming post-2015 development agenda,” said Council Vice-President Mohamed Khaled Khiari (Tunisia) in closing remarks, the most ambitious one yet at the United Nations. Delegates had covered much ground, with substantive and practical deliberations on how to make the Forum fit for supporting implementation of the new agenda.

Throughout the session, he said, debates had shown that the Forum could be what Heads of State and Government attending the 2012 Rio+20 Conference had envisioned: one that provided leadership and political guidance, brought enhanced coherence to the institutional framework for sustainable development, served as the apex of follow-up and review of the new agenda, and offered a strengthened science-policy interface. “We will need to continue these discussions so we can hit the ground running,” he said, noting that several participants had suggested elaborating a road map to prepare the Forum for delivering on its role as soon as the agenda was adopted.

The declaration capped a day that featured the Forum’s adoption of its 2015 report, as well as two panel discussions. In the first — on “Reviewing and monitoring progress: What have we learned and how can it advance implementation?” — delegates weighed how national reviews to be conducted by the Forum starting in 2016 could best advance implementation of the sustainable development goals, with many advocating that existing review mechanisms be used to maximize impact. The second, on “Realizing the sustainable development goals: Matching ambitions with commensurate means of implementation — resources, technology and capacities”, focused on financing, trade, debt sustainability and capacity-building as ways to advance the new agenda…

[Editor’s Note: The text of declaration referenced above is not evident on website]