Devex CheckUp: The legacy of Dr. Paul Farmer takes shape in Congress

When renowned physician and global health activist Dr. Paul Farmer died unexpectedly this February, Jan Schakowsky, a longtime U.S. representative from Illinois, began to think about how to honor his work and spread his message: that every person in the world has a right to health care.

Months later, the Dr. Paul Farmer Memorial Resolution — a radical plan that Schakowsky introduced in the U.S. Congress last month alongside Rep. Raul Ruiz, a Democrat from Maryland, and Rep. Barbara Lee, a Democrat from California — sets out a three-part strategy for the future of U.S. global health efforts.

• Schakowsky’s efforts stem from the first time she met Dr. Farmer during a visit to Cange, the Haitian village where his organization Partners in Health’s sister hospital Zanmi Lasante provides medical care to anyone who needs it. Her experience of the care that people received — and the empathy with which Dr. Farmer treated patients — stayed with her, she tells our colleague Michael Igoe.

• However, the resolution’s supporters don’t actually expect it to pass, given how radical the plan is. For starters, the resolution’s first proposal is to increase U.S. global health aid to $125 billion a year — roughly 10 times what the U.S. government currently spends.

• But by introducing the resolution, Schakowsky and her colleagues hope to shed light on the fact that the status quo is wholly inadequate to confront the challenges faced by global health.

• Advocates also point out that a substantial increase in U.S. aid spending would be required for the U.S. government to meet an international target to direct 0.7% of its gross national income to aid — in 2021, it spent 0.18% — which donor countries have endorsed in principle but mostly ignored in practice.

• The resolution also calls for reforming U.S. global health aid to “focus on building national health systems and direct funding to local partners, not the development industry.” Adding to that, most ambitiously, the resolution calls for large-scale reforms to “make the global economy more fair, just, and democratic”  — a tall order, but as Joia Mukherjee, Partners in Health’s chief medical officer put it, “Welcome to the world of Paul Farmer.”

Read: The radical plan to honor Paul Farmer — by remaking global health

Related: Paul Farmer's lasting legacy is the quest for equity in global health

The worm has turned

GiveWell, the impact-focused charity evaluator, has dropped four deworming programs — once a poster child of affordable development interventions — from its list of top charities that “save or improve lives the most per dollar,” saying there is too much uncertainty about its actual impact.

Global deworming efforts have weathered controversies in the past, including the “worm wars” — a largely online battle that questioned the research findings used to elevate deworming as a development priority. But will the decision to drop the deworming programs have financial implications and will it resurrect the effectiveness battle? Devex contributor Andrew Green investigates.

Read more: GiveWell drops four deworming programs: Are the worm wars back? (Pro)

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Opportunistic infections

Tedros gave this warning at the launch of a new United Nations appeal for flood relief in Pakistan, where approximately 10% of all health facilities have been damaged by recent record-breaking flooding, leaving millions without access to health care and without stocks of essential medicines and medical supplies that have been washed away. Out of the $816 million U.N. appeal, WHO needs $115 million, according to Tedros.

Usually, the initial impact of natural disasters can be devastating, but response efforts move quickly toward recovery. That’s not the case in Pakistan, where some land is still submerged, giving rise to what WHO Regional Emergency Director Richard Brennan tells Amruta is a “secondary health crisis.” That includes malaria and cholera outbreaks. “The public health needs, the public health risks are persisting longer for this crisis than they do for most natural disasters,” Brennan says.

ICYMI: After the flood, who’s given aid to Pakistan? (Pro)

No trust?

That’s the amount of money a trust fund meant to help curb deaths due to noncommunicable diseases has raised for its work. These deaths account for 74% of all global deaths, Jenny reports.

The Health4Life Fund, a multipartner trust fund dedicated to NCDs and mental health, was established in May 2021 and led by WHO, UNICEF, and the U.N. Development Programme. The fund aims to raise $250 million in five years, and 25 countries have to date expressed interest in accessing the fund.

One of the issues is that there is very little international funding for NCDs. According to a WHO report, just 5% of external aid that goes to health in low- and middle-income countries gets allocated to NCD prevention and control. And there is as yet no The Global Fund to Fight AIDS, Tuberculosis and Malaria-like model for NCDs. “There is, as far as I can see, very little appetite for a similar mechanism,” Dr. Bente Mikkelsen, director of NCDs at WHO, tells Jenny.

Read: NCDs are top global killer but trust fund coffers are empty

Hands to yourself

Uganda now has confirmed 63 cases or probable cases of Ebola, including 10 health workers — four of whom have died — and there are no approved vaccines for the strain of the disease responsible. Now the country is instituting health promotion campaigns to try to contain the spread. Tedros said Wednesday that two vaccines could begin trials in Uganda in the coming weeks, pending regulatory and ethics approval by the government.

What we’re reading

Dozens of child deaths in Gambia from consuming cough syrup have been linked to an Indian manufacturer, WHO says. [CNN]

The Medicines Patent Pool has signed a licensing agreement for a new COVID-19 oral antiviral pill. [Devex]

Sri Lanka — a pioneer in universal health care — is struggling to hold on to progress amid its economic crisis. [The Signal]

Update, Oct. 6, 2022: This edition has been updated to clarify the resolution passed by U.S. Rep. Schakowsky.