I welcome you to this second annual report from WONCA, our World Organization of Family Doctors. This report has been produced to keep our Member Organizations, our Direct Members, and other interested organisations and individuals, informed about WONCA’s activities over the past year. This report outlines the highlights of the work of your elected executive members, and our CEO and secretariat staff, and our Young Doctor Movements, working parties, special interest groups and individual representatives over the past year. It also includes our 2014 annual financial statement and auditor’s report. This report provides a snapshot of the huge amount of work that is carried out by WONCA and our members around the world. More news and details can be found on our WONCA website – http://www.globalfamilydoctor.com – and you are invited to sign up for our weekly email updates on the activities of our global organization. Your WONCA executive has three main goals for the 2013-2016 triennium…. More

The recent situation of rapid and unplanned migration in Europe has raised my awareness of a situation which many other regions have already experienced. The WONCA Europe conference saw the launch of the ‘Istanbul statement’ on refugee health, and much discussion both within workshops and plenaries about the needs and challenges for family doctors. The very active special interest group (SIG) on migrant care hosted two workshops on refugee and migrant child health, and Prof Jan de Maeseneer in his plenary challenged WONCA to add to these initiatives with policy and evidence on good practice. Another group launched at WONCA Europe was the ‘WONCA SIG on Conflict and Catastrophe medicine’, whose remit also relates to this area….more

WONCA News – October 2015

The latest WONCA News, containing the usual mix of WONCA news, views and events, is available via the WONCA website.

October’s Policy Bite

This month’s policy bite is authored by Dr Luisa Pettigrew.  Luisa is a member of the WONCA Executive and is our Liaison Person with the WHO.  She discusses the challenges of measuring outcomes in relation to the new Sustainable Development Goals and talks about WONCA’s inputs into the process.  

Featured doctors

Two more interesting doctors are featured in WONCA News this month.

Professor Rich Withnall of UK is Convener of the WONCA Special Interest Group on Conflict and Catastrophe Medicine.  Find out more about Rich, and about the activities of the SIG he leads.   

A/Professor Roar Maagaard of Denmark is Chair of the Host Organizing Committee for the 2016 WONCA Europe conference in Copenhagen.  Next month’s WONCA News will have more details of that conference, but for now you can find out more about the man himself. 

Future WONCA Conferences

Whilst Roar will tell us more about Copenhagen 2016 next month, and whilst many of us are heading to Istanbul for this year’s WONCA Europe conference, we’d like to highlight some other WONCA regional conferences scheduled for the first part of 2016.  Of course details of all WONCA conferences can be found by clicking on the “conferences” link above.

WONCA South Asia Region – in Colombo, Sri Lanka, on 13th and 14th February 2016, and pre-conference on 12th February.  The theme of the conference is “Reaching across the shores to strengthen Primary Care” and abstract submission is now open.  For more details of this event go to the WONCA website.

WONCA Eastern Mediterranean Region – in Dubai from 17th to 19th March, with the Al Razi (EMR young doctor movement) pre-conference on 16th March.  More details are available from the WONCA website. The call for abstracts has gone out, and more details can be found from the website.

See here

NEW YORK, 26 September 2015 – Underscoring the urgent need to transform how essential health care is delivered in low- and middle-income countries, the Bill & Melinda Gates Foundation, World Bank Group and World Health Organization today launched a new partnership to support countries in improving the performance of primary health care. Primary health care is the pillar of health systems and is central to preventing epidemics like Ebola; improving women’s and children’s health; controlling major infectious diseases, such as HIV and TB; and managing the rising burden of non-communicable diseases, such as heart disease and cancer…..more

For about a decade now, policy makers and the soda industry have been fighting about the idea of a big soda tax. Proponents say it would fight obesity by reducing consumption of sugary drinks. A leading objection by the industry is that the tax simply would not work…..more

Many countries have identified primary health care (PHC) as an urgent priority, but they lack comprehensive data to pinpoint specific weaknesses, understand their causes, and strategically direct resources to address them. Health system managers typically have data on inputs such as total number of health workers, medicines, and supplies available. They also measure outputs like the percent of children vaccinated and the percent of pregnant women who deliver in facilities. These are crucial to measure, but they are not sufficient…..more

All about PHCPI and Indicators

The Gauteng Association for Infant Mental Health (GAIMH) in collaboration with the University of the Witwatersrand, Johannesburg and the Centre of Excellence is hosting a conference titled “The bodies and minds of babies in relationship: Dialogues in a multidisciplinary context”. The aim of the conference is to establish greater awareness around infant mental health and to highlight the multidisciplinary nature of the field.

• GAIMH conference pitch October 2015
• GAIMH-Shabir-WONCA
• GAIMH-SA Conference programme printable

Health plans, employers, and state governments increasingly expect Americans to use information about pricing when making health care decisions. After all, the more consumers know about pricing, the better they can budget for out-of-pocket expenses and for routine costs related to chronic conditions, the more intelligently they can choose among providers, and the more easily they can bring pricing information directly into conversations with those providers. Those conversations can lead to more sensible decision making about care, avoiding costly tests and procedures that are unlikely to improve health outcomes. Consumers who are especially knowledgeable and motivated can even negotiate what they will pay for services at their preferred health care facilities,as some anecdotal evidence has shown….more

This 46-page document aims to guide the implementation of health promotion programmes in South Africa….more

The country should move to promote self HIV testing, according to South African National AIDS Council HCT Advisor Rev Zwoitwaho Nevhutalu who spoke at a recent meeting of the Mpumalanga Provincial AIDS Council. “More people on treatment with suppressed viral loads and this means lesser infections,” said Nevhutalu, describing how adhering to HIV treatment can lower the amount of a HI virus in a person’s blood. This, in turn, makes them less infectious, according to recent studies. “The country needs to start thinking about the model of testing and treating in dealing with HIV. ….more

I was so happy when Trevor Noah admitted on his debut The Daily Show in the US this week that growing up in Soweto, one dream he shared with many of his neighbours was that of an indoor toilet….more

THE Department of Health is weighing up the practical and financial implications of expanding HIV treatment to more people, following the release of new guidelines from the World Health Organisation (WHO) this week. The guidelines recommend that patients start treatment as soon as they are diagnosed with HIV, rather than waiting until their immune systems weaken, and say high-risk groups should have access to preventative drug therapy….more

At a time when the scale of investments has raised justifiable concerns about the ability of ongoing research to fulfill expectations [1], the long-run sustainability of research programs will depend on demonstration of value for money. Yet, there has been remarkably little recognition of the need to formally assess research value for money in funding allocation by national governments, funding agencies, and research institutions.

Currently, research priorities are mostly decided using subjective approaches based on consensus among experts, decision makers, and other stakeholders, which tend to lack transparency and may be unduly influenced by special interest groups. More objective measures have been developed based either on the burden of disease or on variations in clinical practice [2]. Prioritization of diseases with the highest burden (morbidity, mortality, or aggregate societal costs) is useful in selecting general areas of neglect [3], but does not help identify what research should be undertaken within these areas. Prioritizing research in areas of disagreement in clinical practice can help practitioners decide between different clinical strategies and, by clarifying what is best practice, reduce variations. In the “clinical variations” method, priorities are defined based on welfare losses due to disagreement [4], with a cost-effectiveness element added in the “payback from research” method (“payback” referring to future savings as a result of the research investment) [5,6]. Setting research priorities based on variations in clinical practice, however, may not be ideal. Scientific uncertainty is not the only cause of clinical variations, which can also be due to poor implementation of research findings. Arguably, only the first should be addressed through additional research, and the second should be dealt with using more efficient means to promote good practice [7].

A decision-theoretic tool, known as “Value of Information” (VOI) [8,9], has been proposed to tackle the complexities of research prioritization in a more comprehensive way. Despite having been promoted and used for over a decade by the National Institute for Health and Care Excellence (NICE) in the United Kingdom [7], VOI is still relatively unknown to the medical scientific community.

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Imagine a laptop or smartphone that uses almost no power to perform computations. It’s still decades away, but it’s the logical conclusion of a technique that’s already under development using the spin of electrons in graphene….more

I plan to present one more VAPP course this year. If you are interested in venomous animals and poisonous plants come and join us on Friday the 20^th of November. Please make your booking with Thobile Tshela. All contact details and payment instructions are in the attached brochure. Please forward to anyone who may be interested.

Kind regards,

Prof Andreas Engelbrecht

Adjunct Professor

Head: Divsion of Emergency Medicine, Dept. of  Family Medicine

University of Pretoria / Steve Biko Academic Hospital

Tel: +2712 354 2147 / Cell: +2784 789 7364

VAPP Course information 2015

http://www.hifa2015.org/sponsored-discussions/achieving-the-new-global-health-targets

On 25th September 2015, governments launched the 2030 Sustainable Development (SDG) Agenda, committing all to work together for 17 SDGs encompassing poverty eradication, health, education, food security and nutrition, as well as a broad range of economic, social and environmental objectives, and the promise of more peaceful and inclusive societies.

SDG 3 is specifically on health: “Ensure healthy lives and promote well-being for all at all ages”  (see list of health targets below). Health is also recognised as a key input to other SDGs.

On 5 October 2015, HIFA will launch a major thematic discussion to explore what is needed to achieve SDG 3 and its constituent health targets, and to examine in particular the role of university-based global health programs.

The discussion is supported by the Canadian Society for International Health, the Global Health Research – Capacity Strengthening (GHR-CAPS) Program and The Lancet, and will lead into the 22nd Canadian Conference on Global Health, Montreal, 5-7 November 2015 (see below).  The key points will be synthesise and made available at the upcoming Canadian Global Health Conference, with a view to bring in the perspectives of stakeholders who may not be able to attend the conference in person, and thereby help inform future efforts by global health programmes and others towards the achievement of the new global health targets. It will run for 5 weeks, addressing the 5 questions below.

QUESTIONS FOR DISCUSSION

1. Agenda 2030 has defined a number of targets for global health (below). This will be the main global health agenda for the next 15 years. What is needed to ensure that we make rapid progress towards these targets collectively? What is needed for rapid progress towards individual targets?

2. What skills and competencies are needed among policymakers, researchers, health professionals and others to drive progress on Agenda 2030 targets? In particular, what is the role of University-based Global Health Programs (UGHs)?

3. What is needed to promote global health research that matters? What is the role of UGHs?

4. What is needed to promote uptake of research into policy and practice? What is the role of UGHs?

5. What is needed to promote global partnerships, collaboration and communication? What is the role of UGHs?

SDG 3: “ENSURE HEALTHY LIVES AND PROMOTE WELL-BEING FOR ALL AT ALL AGES”

3.1. By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

3.2. By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and

under-5 mortality to at least as low as 25 per 1,000 live births

3.3. By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

3.4. By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.5. Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

3.6. By 2020, halve the number of global deaths and injuries from road traffic accidents

3.7. By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes 3.8. Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all 3.9. By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

3.9a. Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.9b. Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

3.9c. Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States 3.9d. Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

22ND CANADIAN CONFERENCE ON GLOBAL HEALTH, 5-7 NOVEMBER 2015 This year, the 22nd Canadian Conference on Global Health will be held in Montreal, from November 5th to November 7th, 2015, a partnership between the Canadian Society for International Health

(CSIH) and the Global Health Research-Capacity strengthening Program. The conference theme for

2015 is Capacity Building for Global Health: Research & Practice.

This conference will provide a forum for practitioners, researchers, educators, students, policy makers and community mobilizers interested in primary health care to share knowledge, experience and promote innovation and collaborative action.

For more info on CSIH and the conference:

http://www.ccgh-csih.ca/ccgh2015/index/&lang=en

With thanks,

HIFA profile: Sarah Brown is Conference Manager for the Canadian Society for International Health. www.csih.org  sbrown AT csih.org

Several alternatives have been put across for Africa’s development agenda: industrialization, infrastructure, agriculture, universal primary education, universal secondary education, aid, trade and Millennium Development Goals (MDGs) among others. The debate continues, especially after the expiry of the MD Gs. The immediate context of this discussion is the UN Summit scheduled in September 2015 on the Sustainable Development Goals (SDGs). I want to suggest a bold idea of promoting e-learning or distance learning at tertiary level based on the concept of ICT for innovation. By this I want to reduce the SDGs to one: quality and affordable education for job creation for all. We are living in an age of cyberspace where computer and mobile applications are spurring innovation in health, education, agriculture, commerce, banking and technological innovation. But for this ICT for innovation to succeed there is need for a paradigm shift in how tertiary education is conducted in Africa. The called for paradigm shift includes development of online or distance learning courses of high quality that are affordable, since there is less dependence on physical infrastructure, transport costs and hard copy learning materials…..more

In 2003, Turkey embarked on ambitious health system reform to overcome major inequities in health outcomes and to protect all citizens against financial risk. Within 10 years, it had achieved universal health coverage and notable improvements in outcomes and equity….more

Dear reader,

In 2010 the Executive Committee of CIOMS decided to revise the CIOMS Ethical Guidelines for Biomedical Research. The document was last revised in 2002. Since then, several developments have taken place, both in the field of biomedical research itself and in the field of research ethics. Among the latter developments is the recent revision of the Declaration of Helsinki in 2013.
The research and research ethics community, as well as the wider public, are now cordially invited to provide the Working Group of CIOMS with comments until 1 March 2016. The Working Group will then process the comments and suggestions, and submit the final document to the Executive Committee of CIOMS. This Committee will approve the document.

The Working Group
The Working Group consists of 10 members, one chair (President of CIOMS), four advisers (from WHO, UNESCO, COHRED and WMA) and one scientific secretary. The composition of the Working Group ensures that different cultural perspectives are present, members vary in age and expertise, and a gender balance is reached. One of the members represents the patient perspective. The group has met three times each year from September 2012 until September 2015.

Status of the current draft
The current version of the CIOMS guidelines is a draft. Although guidelines address specific issues, such as choice of the control, individual informed consent, and research with children, the CIOMS guidelines should be read and understood as a whole.
In the final version the Working Group will add introductory texts and appendices.

Literature and guidance documents
The draft guidelines have been based on the results of literature searches and ethical reflection within the Working Group. Certain papers and guidelines have been particularly valuable for the current draft guidelines, such as the Declaration of Helsinki of the WMA, the Ethical considerations in biomedical HIV prevention trials of UNAIDS and Standards and operational guidance for ethics review of health-related research with human participants of the WHO. All sources used will be acknowledged in the final document.

Major changes
Most guidelines have been substantially revised. Guidelines have also been merged where possible. At the same time, new guidelines have been added to address new, pressing issues that require ethical guidance (such as disaster research or implementation research). The Working Group has also decided to merge the “Green Book” (the CIOMS Guidelines for Biomedical Research, 2002) with the “Blue Book” (the CIOMS Guidelines for Epidemiological Research, 2009) since the two guidelines substantially overlap each other. The scope of the guidelines has been broadened from biomedical research to health-related research with humans.

Providing feedback
The proposal of the Working Group is now open for comments. Below each guideline there are two boxes: one for general comments and one for specific comments. Please provide us as much as possible with concrete, specific comments and text proposals. Since we expect to receive a great number of suggestions, we would like to caution that we will not be able to respond individually to each commentator.

We are grateful for your support of this important project and hope the revised CIOMS Guidelines will help to foster ethical research worldwide.
Yours sincerely,

Dr. J.J.M. van Delden
President of CIOMS

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