Policy Brief: Making the Case for Investing in Nutrition

Generation Nutrition calls on the EU to keep nutrition high in the next multi-annual budget

The EU has committed to support partner countries in reducing the number of stunted children by at least 7 million by 2025. Unfortunately, despite all commitments the world is not on track to reach SDG2 and the EU’s own commitments are achievable only if nutrition continues to be priorities and interventions scaled up. Generation Nutrition, a coalition of Brussels-based civil society organisations therefore urges the European Union to make poverty eradication, combating inequality and the achievement of Agenda2030 central to the objectives of the draft EU regulation for its 2020-2027 development and international cooperation policy and keep nutrition at the core of EU external action.

Read the full policy brief here.

Civil society calls on the European Commission to pledge €580 million for the Global Fund to fight AIDS, TB & Malaria

GHA, alongside AIDSfonds and Global Fund Advocates Network, have asked the European Commission to pledge €580m to replenish the Global Fund to Fight AIDS, Tuberculosis and Malaria before the EU elections of May 2019. One of the best performing global initiatives, since 2002, the Global Fund has already saved 27 million lives. The EU played a crucial role in the establishment of the Global Fund and must now act as a leader on the international stage by committing to the replenishment of the fund for the period 2020-2022. In order to end HIV, TB and Malaria and reach the SDGs, civil society estimates that current pledges need to be increased by 22%, bringing the EU’s fair share to €580 million. In the past, Commissioner Mimica has been a strong supporter of the Global Fund, championing the EU’s responsibility to meet their Agenda 2030 obligations.

If you want more information, you can read the full Global Fund Replenishment – Policy Paper:

 

 

 

 

 

 

Civil Society Reaction to the Commission Staff Working Document on HIV/AIDS, Tuberculosis and Viral Hepatitis

October 4, 2018

WEAK SIGNALS OF POLITICAL COMMITMENT

Civil society has long been calling on the European Commission to take a leading role in the response to HIV/AIDS, tuberculosis (TB) and viral hepatitis in the EU by putting in place political strategies to effectively combat the three epidemics within the wider European region. In 2017, the European Parliament, in turn, has given a strong signal to the European Commission by calling it to step up its response to the HIV/AIDS, TB and hepatitis epidemics and develop a comprehensive and integrated policy framework to fight the three diseases with a regional approach, given the cross-border nature of the epidemics.

This summer the European Commission published a Staff Working Document on “combating HIV/AIDS, viral hepatitis B and C and tuberculosis in the EU and neighboring countries”. In the document, the Commission takes stock of EU contributions to tackling the three diseases across several policy areas, and presents the instruments and good practices developed under EU-funded projects. The document shows that the EU has been instrumental in setting policy measures and developing good practices for targeted interventions for tackling HIV/AIDS, TB and viral hepatitis.

By publishing a Staff Working Document, the lowest level policy document on the European Commission’s initiative’s scale, the Commission gives a clear sign that it does not intend to take political commitment and develop further policy for tackling the three diseases in the European region. By limiting itself to a Staff Working Document, which does not have any political power and is only an inventory of actions, the Commission is ignoring the calls for stronger political leadership to address the epidemics.

As members of the EU Civil Society Forum on HIV/AIDS, TB and viral hepatitis, we believe that the EU can and must do more.

EPIDEMICS ON THE RISE

The three diseases continue to take more lives and cripple the health and well-being of EU citizens and citizens of the immediate neighborhood.

Between 2010 and 2016, there was a 60% increase in the number of new HIV infections within the wider European region, the only region in the world where the rate of new HIV infections continues to rise. TB under its resistant forms continues to account for a quarter of all antimicrobial resistance deaths. By 2050, an additional 2.59 million lives could be lost through drug-resistant TB alone in the EU. The WHO estimates that there are 14 million people affected by hepatitis C across WHO European Region with some 6 million living in the Union alone.

DECREASING FUNDING

Despite this, the EU funding dedicated to actions on three diseases has been gradually decreasing: while in the first EU Health Programme (2000-2006) the share for the three diseases was EUR 19 million, in the second Porgramme (2007-2013) it shrank to EUR 15.6 million. In the 3rd Health Programme (2014-2020) it stands at EUR 11.6 million only, mostly for prevention, harm reduction and other activities for vulnerable groups affected by HIV, TB and viral hepatitis.

The epidemiological situation shows that TB, HIV and viral hepatitis pose the greatest risks for vulnerable and marginalized groups (mostly migrants, sex workers, prisoners, people who inject drugs, LGBTI groups). While across Europe, most vulnerable populations are left behind. They are facing stigma and discrimination and there is limited national political leadership and investments to address their health needs. The social dimension of the diseases is a major factor affecting the ability to tackle them as epidemics and to eliminate them in the EU and in the neighboring countries. Efforts to reach out to vulnerable groups are crucial, and funding for these interventions should be scaled up, not decreased as is currently the case.

LIP SERVICE TO THE SDGs?

In 2016 the EU made a political commitment to support Member States in reaching the Sustainable Development Goals (SDGs) by complementing Member States’ actions on HIV/AIDS, viral hepatitis and TB through legislation and other initiatives.

The Commission Staff Working Document on Combating HIV/AIDS, TB and viral hepatitis in the European Union and neighbouring countries recognizes that significant scale up efforts are needed for the EU to meet the targets for TB, HIV and viral hepatitis set in the SDG. The document shows that several Member States are facing major challenges in meeting internationally agreed targets.

Despite this reality, the EU shows lack of ambition and political leadership in the SDGs implementation. A recent European Parliament briefing on SDGs implementation at EU level concluded that the EU has been focused on technical aspects of implementation (such as indicators) rather than sectoral mainstreaming at political level, with no concrete sectoral goals and actions for achieving SDGs.

We believe that the SDG 3 targets for TB, HIV and hepatitis should be the driving force behind the EU’s policy in these areas with a concrete political road map on how to achieve the targets. The EU should develop a longer term vision and reorient EU budget contributions towards the achievement of SDG 3 for the three diseases, if it’s serious about fulfilling its commitment to achieve the SDGs targets and end TB, AIDS and combat hepatitis by 2030.

HEALTH IN THE EU POST 2020

In the next EU multi-annual budget (2021-2027) the EC has proposed to reduce its health budget to EUR 413 million (8% cut in health funding compared to the 2014-2020 period) and a downgrade of the EU Health Programme into a Health Strand of the enlarged European Social Fund (ESF+).

While merging health with other social areas might be a positive move and create additional synergies between health and social issues, this should not undermine the EU’s leadership on health, and raises a question whether there will be a Health Commissioner in the next legislative cycle, further to Brexit.

 

Contact info: Marine Ejuryan, Global Health Advocates, mejuryan@ghadvocates.org

EU Civil Society Forum on HIV/AIDS, tuberculosis and viral hepatitis is an informal advisory body established by the European Commission DG SANTE to facilitate the participation of HIV/AIDS, viral hepatitis and tuberculosis NGOs and networks in European policy development and programme implementation.

Ensuring Sustainable Societal Impact of EU-Funded Biomedical Research & Innovation

Global Health Advocates very much welcomes the “Matching Health Needs and Pharmaceutical Research” conference organized by the Austrian Presidency today. With Horizon Europe on the negotiating table, the EU should shift towards a needs-driven R&I agenda that focuses on societal impact to deliver better health and wellbeing for citizens. Ensuring the accessibility and affordability of new health technologies is crucial to meeting health needs and delivering societal impact. In coordination with a range of health NGOs, GHA has developed a proposal for “Access Plans” to encourage beneficiaries of EU R&I funding to think upstream about accessibility challenges. GHA commends the willingness of the Austrian Presidency to focus on this highly important issue and urges political leaders to prioritise societal impact via accessibility in EU R&I.

Projet de loi de finances 2019 : hausse de l’aide publique au développement, et en même temps… Recul sur la TTF

Paris, le 24 septembre 2018 – Malgré les récentes annonces du président de la République, le projet de loi de finances pour 2019 engage la France sur une hausse d’à peine 4% de la mission aide publique au développement (APD) en 2019, et recule largement sur la taxe sur les transactions financières (TTF), désormais affectée à 35% au développement contre 50% auparavant.  

Le projet de budget ne s’engage en effet que sur une hausse timide de 4% de la mission APD, soit 130 millions d’euros en crédits de paiement – c’est-à-dire disponibles dès 2019 pour réaliser des projets dans les pays et pour les populations qui en ont le plus besoin. Un montant à ne pas confondre avec les autorisations d’engagements, qui autorisent la puissance publique à engager des sommes à moyen terme, mais ne représentent en aucun cas de l’argent immédiatement disponible pour les projets. Si nous saluons cette augmentation, elle reste bien insuffisante pour les pays et les populations qui en ont le plus besoin.

Le projet gouvernemental entérine en outre une diminution de la part de la taxe sur les transactions financières (TTF) allouée au développement, qui passe de 50% à 35% seulement des recettes totales dégagées par la taxe en 2019. Rappelons que cette taxe affectée, innovation française pour financer la lutte contre la pauvreté, garantissait des ressources prévisibles et pérennes pour les bénéficiaires de l’aide française, permettant de sanctuariser une partie conséquente des dépenses pour la solidarité internationale et la santé mondiale à l’abri des ciseaux de Bercy.

Ce nouvel arbitrage souligne donc une fois encore le manque de moyens associés à l’engagement présidentiel. Dans la dernière version de son étude publiée avec l’IDDRI[1], Action Santé Mondiale estime qu’une augmentation d’au moins 500 millions d’euros de la mission APD et une affectation de 100% de la TTF au développement sont nécessaires dès 2019 pour placer la France sur une trajectoire crédible pour atteindre les 0,55% du RNB alloués à l’aide. Un manque d’ambition également pointé du doigt par l’OCDE à l’occasion de la dernière revue par les pairs de la France[2], qui appelait la France à entreprendre « des actions immédiates » pour atteindre son engagement d’ici 2022.

Notes aux rédactions :

Taxe sur les transactions financières : on estime à 1,5 milliard le montant total des recettes de la TTF chaque année. 798 millions étaient auparavant affectées à l’APD à travers deux canaux : à hauteur de 528 millions par le Fonds de solidarité pour le développement (FSD) et de 270 millions par l’AFD.  Le projet de loi de finance 2019 prévoit la suppression de cette dernière affectation, ainsi compensée par une augmentation des crédits de paiements de la mission APD.

Mission aide publique au développement : le document de présentation du projet de loi de finances 2019 dévoile donc une augmentation trompeuse de 400 millions de la mission aide publique au développement, qui cache en réalité une réallocation des 270 millions de recettes de la TTF aux crédits budgétaires de la solidarité internationale. Ainsi, l’aide française n’augmente en réalité que de 130 millions d’euros, conformément à la loi de programmation des finances publiques 2018-2022.

Contact presse :

Claire Baudot, Responsable plaidoyer, Action Santé Mondiale : 07 81 31 03 66

[1] Vaillé, J., Rivalan, B., Baudot, C., Millot, S. (2017). La France peut-elle tenir son engage- ment de consacrer 0,7 % de la richesse nationale à l’aide au développement ?, Studies N°10/17, Iddri, Paris, France, 20 p.

[2] OCDE (2018), Examens de l’OCDE sur la coopération pour le développement : France 2018, Éditions OCDE, Paris.

Ending malnutrition: what role for the private sector? From prevention to treatment

 

Full report –  Executive Summary

 

 

After over a decade of decline, the number of people suffering from hunger is on the rise again – reaching 815 million in 2016. Still, the world produces enough food to feed its current population. This is a sign that the current food system is not fit to respond to the global challenge of hunger and malnutrition.

World leaders have committed to ending hunger and malnutrition as part of the universally agreed Agenda 2030. Acknowledging that development aid resources alone were never going to be enough to finance the Sustainable Development Goals, innovative financing tools are emerging out of the political discussion as alternate ways to finance sustainable development. Leveraging private sector investments is often identified by donor countries as one of the most promising tool – often referred to as a “silver bullet”. The European Union for instance, with the launch of its External Investment Plan, will be mobilising the private sector with the goal of boosting investments in sustainable development and agriculture.

However, the role of private sector in financing development is raising key questions: what impact do private investments have on improving the livelihoods of people living in poverty? Can private sector investments show a clear development added value? Which private actors are best placed to ensure positive contributions to sustainable development?

Global Health Advocates, with its new report Ending malnutrition: what role for the private sector, provides some food for thoughts around these questions, analysing specifically the role of the private sector and its impact on the causes of malnutrition, acknowledging that the impact of different private sector actors should surely be differentiated and measured.

In particular, private companies are getting increasingly engaged in interventions to treat malnutrition and can have varying impacts on its immediate causes. In some cases, such as in the production of ready-to-use therapeutic food to treat children suffering from acute cases of malnutrition, companies can play a key role in ensuring the provision of high quality, effective and affordable products. In other cases, private companies are putting children’s lives at risk when illegally marketing baby milk formula, undermining the promotion of exclusive breastfeeding, one of the best natural ways to prevent malnutrition. In addition, private companies are massively investing in interventions to fight micronutrient deficiencies through food fortification and biofortification programmes. We consider these interventions to be “techno fixes” to the complex challenge of malnutrition bringing only short-term benefit if not properly integrated into strategies to shape food systems that can deliver healthy and diversified diets.

However, such initiatives to respond to the immediate causes of malnutrition cannot be the only answer. Even if fully scaled-up, they could reduce chronic malnutrition only by 20.3%. As a consequence, strong efforts are needed not only to treat malnutrition, but also to prevent it, implementing policies that can guarantee universal access to diverse, safe, affordable and nutritious diets, ensuring the universal right to food.

Interventions in agriculture can play a crucial role in ensuring food systems are working effectively for nutrition. However, the widespread industrial model of agriculture is failing to ensure universal access to diversified and nutritious diets. Being based on intensive monocropping, today three crops alone (maize, rice and wheat) are currently supplying more than half of the calories people get from food. In addition, this model of agriculture is also having negative impacts on the environment and on people’s health.

Diversified models of agroecology are increasingly emerging as a promising alternative: they have the potential to deliver positive nutrition outcomes, at the same time empowering small farmers, respecting the environment and building resilience. Small farmers, together with cooperatives and micro, small and medium enterprises (MSMEs), are the most legitimate and relevant private sector actors with a key role to play in shifting towards diversified models of agroecology.

If we are to end hunger and malnutrition by 2030, strong efforts to prevent malnutrition and tackle its root causes are crucial. We need to ensure that investments in agriculture shift away from the industrial model towards a more sustainable diversified agroecological model, targeting and empowering small farmers, as they are the main drivers of change towards delivering sustainable and positive nutrition outcomes.

You can download:

Full report –  Executive Summary

Civil society asks upcoming Austrian EU Presidency to defend access to medicines

Access to meds civil society organisations are in Vienna for their annual meeting. On 27 June, they are organising a small demonstration in front of the Health Ministry to hand out this letter to the Minister of Health.

Banners today read: “Austrian Presidency of the EU: put patients before profits”. “Pharma score goals with high prices” “Pharma 3 – Patients 0”

Leaving development cooperation behind: is the EU turning its back on Agenda 2030?

Brussels – 14 June 2018

While many are rejoicing at the prospects of increased resources for external action in the face of Brexit, this is by no means justified. The proposal for a Neighborhood, Development, International Cooperation Instrument (NDICI) does not constitute an EU pledge to support partner countries’ efforts to “leave no one behind”.

Indeed, the proposal to merge 12 instruments from a wide array of policies – such as development, neighborhood, human rights and peacebuilding – into a single instrument de facto dilutes their distinct original objectives. This new instrument pledges to “uphold and promote the Union’s values and interests worldwide”. Read: member states’ economic and policy interests in partner countries. This means that the most vulnerable regions risk being left out at the expense of countries with strategic geopolitical interest.

This reconfiguration marks a major shift away from the EU’s principled and long-term approach to development cooperation. Agenda 2030 is clearly not the underpinning political framework for the EU’s future external action. And aid effectiveness principles are to be applied “when relevant”. But how and by whom will these judgments on relevance be made?

Clearly, the EU has lost sight of aid’s original purpose: addressing the root causes of poverty through substantial investments in areas like health and education. Rather, development aid is now considered a tool to leverage partner countries’ cooperation on matters linked to EU’s interests, such as security and migration. This – and not putting the EU’s political weight behind the Sustainable Development Goals – explains why the Commission proposes a much larger proportion of funds to be spent via geographical programmes.

Of course, foreign policy and development cooperation objectives do not inevitably clash, but there can be conflicts and the Commission provides no answers as to how they will be solved: who will set priorities, arbitrate between competing interests and ultimately decide? Who will control the resources?

These questions of accountability are all the more important as there is much more margin for interpretation planned under the new proposal: flexibilities for emerging challenges are being increased to 10% of the budget, and the Commission intends to allocate another 10% to migration, without detailing which specific areas will be prioritized. One should not overlook that EU elections are coming, that new Commissioners will be put in place and that polls for the progressive camp are all but promising. Therefore, too much flexibility risks pulling the EU further away from its principles and international commitments.

At the institutional level, things are even more unclear: how will responsibilities be shared between the EU External Action Service and DG Development? The same question goes for the European Parliament and the Foreign Affairs and Development Committees.

Many of our concerns align with the European Parliament’s recurrent positions. We therefore count on the Parliament to use all its power to drastically amend the single instrument and turn it into a Sustainable Development mechanism, and to clarify its governance, including priority setting. We also urge Member States to support an alternative proposal that is aligned with the Lisbon Treaty and conducive to the realization of the Paris agreement and Agenda 2030. The clock is ticking, and there won’t be a plan B.

Check the full statement here.

Ensuring EU funded medical R&I delivers for EU citizens and beyond: Civil society reaction to the European Commission’s proposal on Horizon Europe

Full reaction here

Brussels, 7 June 

We, the undersigned twenty one civil society organisations, raise our strong concern about the European Commission proposal on the next research framework programme Horizon Europe which fails to make a serious commitment to ensure public interest-driven biomedical R&I.

Though the challenge of access to medicines has long been a concern for low- and middle-income countries, high prices and the lack of added therapeutic value now also threaten equitable access to treatment in the world’s wealthiest countries, including in Europe. Despite numerous political statements and recommendations of the European Parliament[1] and the Council[2] to find alternative and sustainable R&I models that would guarantee better health outcomes for everyone, the Commission proposal on Horizon Europe fails to include concrete safeguards that would help to maximise public return on investments for publicly funded R&I and address public health needs. The new framework also rolls back EU commitments on the fight against poverty-related and neglected diseases which suffer from a lack of private sector interest to invest in R&I.

We believe that the need to deliver suitable, safe, effective and affordable innovative health technologies should be prioritised in all six health areas of intervention identified in the Horizon Europe framework.

Furthermore, a new requirement should be introduced according to which all beneficiaries of EU public funding for biomedical R&I for treatment, prevention or diagnosis of seriously debilitating or life-threatening diseases shall commit to access, effectiveness, affordability and availability principles. Details on how the project results and potential health products will be made accessible, effective, affordable and available shall be outlined jointly by all applicants in the appropriate section of their application. Depending on the stage of R&I, some elements will be developed to a greater or lesser extent.

The next EU research programme is an important vehicle to implement increasingly prominent political recommendations of the European Parliament and the Council and to increase the societal impact of biomedical R&I. This will be key to reinforce EU citizens’ confidence and show that investments into health R&I result in high-quality, accessible and affordable products and more effective health systems.

 

List of signatories

  1. Access to Medicines Ireland
  2. AIDES (France)
  3. BUKO Pharma-Kampagne (Germany)
  4. Commons Network
  5. Consumer Association the Quality of Life – EKPIZO (Greece)
  6. Deutsche Stiftung Weltbevoelkerung – DSW
  7. Drugs for Neglected Diseases Initiative – DNDi
  8. European Public Health Alliance – EPHA
  9. France Assos Santé (France)
  10. Global Health Advocates – GHA
  11. Global Justice Now (UK)
  12. Grupo de Ativistas em Tratamentos – GAT (Portugal)
  13. Health Action International – HAI
  14. Health Projects for Latvia
  15. Just Treatment (UK)
  16. Médicins sans Frontières Access Campaign – MSF
  17. Salud por Derecho (Spain)
  18. StopAids UK
  19. The All-Ukrainian Network PLHIV (Ukraine)
  20. The Romanian Association Against AIDS (Romania)
  21. Universities Allied for Essential Medicines – UAEM 

Contacts:

Marine Ejuryan, Global Health Advocates, mejuryan@ghadvocates.org

Viviana Galli, European Alliance for Responsible R&D and Affordable Medicines,

viviana@medicinesalliance.eu