Challenges and opportunities for eliminating tuberculosis - leveraging political momentum of the UN high-level meeting on tuberculosis.

BACKGROUND: As demonstrated by the United Nations High-Level Meeting on tuberculosis (TB) held in September 2018, the political momentum for TB has been increasing. The aim of this study was to analyze the current challenges and opportunities for global TB control and, with specific focus on policies surrounding TB control, to reveal what kinds of efforts are needed to accelerate global TB control. METHODS: We organized two expert meetings with the purposes of assessing the current situation and analyzing challenges regarding TB control. By applying Shiffman and Smith's framework which contains four categories; Actor, Ideas, Political context, and Issue characteristics, we analyzed the challenges and opportunities for global TB control based on the findings from the two expert meetings. RESULTS: In the Actor Category, we found that although there has already been active engagement by non-governmental organizations (NGOs), civil society organizations (CSOs) and private sectors, there still remained an area with room for improvement. In particular, the complexities behind varying drug regulatory and procurement systems per country hindered the active participation of the private sector in this area. As for the Ideas category, due to an increasing threat of antimicrobial resistance and growing number of global migrations, TB is now widely recognized as a health security issue rather than a purely health issue. This makes TB an easier target for political attention. As for the Political category, having the UN High-Level Meeting itself is not enough; such meetings must be followed up by actual commitments from heads of states. Lastly the issue characteristic indicates that the amount of funding for R&D for new drugs, vaccines and diagnostics for TB is not at an adequate level, and investment in childhood TB and missing cases are particularly in need. CONCLUSIONS: This study provides important insight into the current status of global efforts toward end TB epidemic. The outcomes from the UN high-level meeting on TB need to be closely monitored will be crucial for the progress towards this goal.

How did COVID-19 impact development assistance for health? - The trend for country-specific disbursement between 2015 and 2020.

This study aimed to examine the changes that took place between 2015-2019 and 2020 and reveal how the COVID-19 pandemic affected financial contributions from donors. We used the Creditor Reporting System database of the Organization for Economic Cooperation and Development to investigate donor disbursement. Focusing on the Group of Seven (G7) countries and the Bill and Melinda Gates Foundation (BMGF), we analyzed their development assistance for health (DAH) in 2020 and the change in their disbursement between 2015 and 2020. As a result, total disbursements for all sectors increased by 14% for the G7 and the BMGF. In 2020, there was an increase in DAH for the BMGF and the G7 except for the United States. The total disbursement amount for the "COVID-19" category by G7 countries and the BMGF was approximately USD 3 billion in 2020, which was 3 times larger than for Malaria, 8.5 times larger for Tuberculosis, and 60% smaller for STDs including HIV/AIDS for the same year. In 2020 as well, the United States, the United Kingdom, Japan, Italy, and Canada saw their disbursements decline for more than half of 26 sectors. In conclusion, the impact of COVID-19 was observed in the changes in DAH disbursement for three major infectious diseases and other sectors. To consistently address the health needs of low- and middle-income countries, it is important to perform a follow-up analysis of their COVID-19 disbursements and the influence of other DAH areas.

Ongoing debate on data governance principles for achieving Universal Health Coverage: a proposal to post-G20 Osaka Summit meetings.

The Group of 20 Summit (G20) in Osaka, which Japan chaired for the first time in June 2019 has created a tailwind for achieving universal health coverage (UHC) globally. In response to the rapid digitalization, the G20 leaders commenced negotiations for the Osaka Track framework to formulate international rules on data flow across borders and systematize the concept of 'Data Free Flow with Trust (DFFT).' The strategic harnessing of the power of data to strengthen the healthcare system can allow for rapid and affordable progress toward achieving UHC. However, world leaders have yet to discuss what data governance approaches the Osaka Track will follow, or even on what values it will seek to create and maximize. In this paper, we propose a people-centered, trust-oriented approach as the key principle of data governance toward achieving UHC, using Japan's experience as an example. We believe that this approach is compatible with other prevailing approaches (e.g. the General Data Protection Regulation (GDPR) in the European Union), and can serve as a bridge to their conceptual differences. We hope that our proposed principles will be fully discussed in post-G20 Osaka Summit meetings.