COP26 commitments are welcome, but fall short- including on health and equity
Statement from The George Institute for Global Health
As a health and medical research institute committed to improving the health of millions of people worldwide, The George Institute for Global Health welcomes progress made at the 2021 United Nations Climate Change Conference (COP26) towards a zero emissions future. However, with commitments insufficient to prevent devastating impacts on human health and equity, the Institute calls for urgent action to keep the ambition of limiting global warming to 1.5C above pre-industrial levels alive.
COP26 achieved some important commitments towards climate change mitigation thanks in part to strong advocacy from a range of social movements including youth and First Nations and Tribal Peoples. The commitments include pledges by more than 100 countries to end deforestation and reduce methane emissions by 30%. Over 40 countries also committed to transition from coal to renewable energy in the 2030s and 2040s, and fossil fuels were included in the COP agreement for the first time.
However, even if all of the commitments made are implemented in full – which has not been the case with those made at past COPs – projections show temperatures will exceed 2.4C above pre-industrial levels by the end of the century. A rise of that magnitude will threaten food and water security; see rates of non-communicable diseases and injury rise; and undermine decades of hard-won progress on health, sustainable development and human rights, particularly for communities experiencing marginalisation.
“This level of warming is going to be devastating for people everywhere. Climate change is the single biggest health challenge of the 21st century. COP26 was the moment for world leaders to step up and deliver ambitious and just action on climate, but they largely failed to deliver” – Professors Robyn Norton AO and Stephen MacMahon AO, Principal Directors, and Professor Anushka Patel, Vice-Principal Director & Chief Scientist.
Ahead of the conference, The George Institute called for urgent, triple-win actions on climate, health and equity to pull humanity back from the brink, and was encouraged to see progress in some areas. For example, the 2021 Glasgow Climate Pact calls for climate action to promote the right to health; the rights of Indigenous peoples, local communities and others in vulnerable situations; gender equality; and intergenerational equity. Many countries also made important commitments to a lower emissions world.
The lack of greater ambition was disappointing, as was the watering down of the crucial text on fossil fuels at the final hour, and opposition to a requirement for countries to update their national strategies to cut emissions in time for COP27 in 2022. Adaptation is also largely missing from the COP26 text, which urges developed countries to double climate financing to developing countries, but fails to agree to a fund that supports countries experiencing loss and damage as a result of climate change.
“These failures represent a betrayal of future generations. All of us will suffer the health consequences, but those who have contributed least to climate change will be hit the hardest” – Yunyun Zhu, Managing Director China.
“In the face of inevitable increases in global temperatures, it is now a non-negotiable for governments to make greater investments into climate and health research, and health systems resilience. It is essential to prepare for future warming scenarios, with equity at the centre of the climate response” – Professor Vivek Jha, Executive Director India.
With the goal of limiting global warming to 1.5C above pre-industrial levels now recognised to be on life support, The George Institute calls on governments to use the 12 months ahead of COP27 to develop genuinely ambitious, urgently needed Nationally Determined Contributions (NDCs) to address the climate crisis, with increased investments in health and health equity front and centre. These NDCs must be developed with the meaningful involvement of youth leaders, First Nations and Tribal peoples and communities experiencing marginalisation, to ensure equitable climate solutions informed by self-determination principles.
The George Institute is committed to playing its part in the fight against climate change, and we invite all of our public health colleagues to join us.
One in five people around the world are likely to develop cancer during their lifetime, and a third of cancer deaths are linked to common modifiable behavioural risk factors. It is of great importance to implement effective health strategies to prevent cancer and help people live a longer and healthier life. A new study aiming to reduce cancer risks by promoting health programs in workplaces will commence in early 2022.
New global collaboration to accelerate treatments for kidney disease
The International Society of Nephrology (ISN) and The George Institute for Global Health have signed a Memorandum of Understanding (MoU) to develop a network of patients with kidney disease willing to participate in clinical research projects, accessible through a single global chronic kidney disease platform, the Global Kidney Patient Trials Network (GKPTN).
The GKPTN aims to accelerate the development of new treatments for the benefit of millions of people globally who suffer from kidney disease and associated chronic conditions such as cardiovascular disease, diabetes, and high blood pressure.
Professor Hiddo Lambers Heerspink, Co-Director of the Better Treatments Program at The George Institute for Global Health, says the GKTPN will help address current roadblocks to clinical research essential for driving improvements in treatments and care for kidney disease.
“New structures that facilitate patient access to trials are urgently needed to speed up the discovery of novel therapies and to reduce the burden of kidney disease on patients and health systems,” said Professor Lambers Heerspink. “Although some progress has been made in the discovery of new treatments for kidney disease in recent years the risk of kidney failure and cardiovascular disease remains high and more clinical trials to proof efficacy and safety of novel therapies are critical.”
“Through the GKTPN, The George Institute looks forward to working with the ISN and the global research community to bring patients and trials closer together, address evidence gaps, and facilitate more rapid translation of new kidney disease interventions into clinical practice,” he said
Finding participants who are suitable for and willing to participate in clinical studies is time-consuming. The GKPTN collaboration will help establish a global network of willing patients who can be contacted quickly when an appropriate study becomes available. By enhancing clinical research into kidney disease, the platform will also help build capacity, train the next generation of clinical researchers and connect the global kidney disease community.
Dr David Wheeler, Chair of the International Society of Nephrology Advancing Clinical Trials (ISN-ACT) Committee said: “This project is aligned to the aims of the ISN-ACT Committee. ISN-ACT is delighted to be able to work with The George Institute on this project, which should enhance participation of kidney patients in future clinical research studies.”
To achieve the key objectives of this collaboration, a global umbrella network of established patient trials networks and registries, The ISN Patient Trials Network, will also be created. By collaborating with other established ventures worldwide, the GKPTN will be the initial member of the ISN Patient Trials Network.
As low- and middle-income countries are disproportionately impacted by the growing burden of kidney disease, addressing inequities in access to healthcare underpins the focus of the GKPTN and The ISN Patient Trial Network.
Dr Sradha Kowal, nephrologist at Prince of Wales Hospital in Sydney Australia and Program Head of the Renal and Metabolic Division at The George Institute said: “The GKPTN concept has arisen from widespread discussions with clinicians and members of kidney disease organisations and is intended to belong to and serve the interests of the global kidney disease community.”
Gender balance in stroke research goes from strength to strength with new funding
Dr Cheryl Carcel, Research Fellow at The George Institute and a clinician with over ten years of experience in neurology, has secured two new grants to support her pioneering work in achieving better representation for women in stroke trials.
There is increasing recognition of sex and gender differences in stroke. While women and men have a similar (one in four) lifetime risk of stroke, women are more disabled, have worse quality of life, and require more supportive care.
Dr Carcel’s recent paper published in Neurology®, the medical journal of the American Academy of Neurology, found that more than three quarters of international stroke trials enrolled less women than the expected proportion that experience stroke in the community.
This makes it harder to interpret what the findings really mean for them and has implications for how women with stroke may be treated in the future.
The World Stroke Organization will provide US$20,000 to support a pilot project using screening information from large stroke trials and a survey and focus group discussion with stroke survivors to design strategies that will boost the recruitment of women.
Dr Carcel has also received A$10,000 from the Mary Jane Foundation - a philanthropic organisation offering small grants to not-for-profit groups and organisations working to advance the health and wellbeing of Australian women and girls. This additional funding will also go towards the pilot project.
It is hoped that the pilot study will lead to a larger and more ambitious study that will ultimately increase the participation of women in stroke trials, improving the reliability and validity of the evidence for stroke treatments in both men and women.
Stigma faced by women with diabetes is focus of winning submission in first cycle of the WHO Noncommunicable Disease Lab
The first cycle of the virtual Noncommunicable Disease Lab (NCD Lab) thematic area on Women and Girls has been won by a submission that focuses on tackling the stigma faced by women and girls living with diabetes in the Democratic Republic of Congo.
Dr Belma Malanda’s winning submission, on ‘Empowering women bearing the double burden of diabetes and social discrimination’, aims to prevent and reduce the burden faced by women and girls living with diabetes through access to diabetes care, information, education, and opportunities to live safer, less stigmatised, lives.
The NCD Lab thematic area on Women and Girls is co-chaired by The George Institute for Global Health and the World Health Organization’s GCM/NCD Secretariat, and offers a platform for innovative, game-changing projects. It brings stakeholders together to tackle NCD challenges, address their risk factors and determinants, and facilitate an integrated, multisectoral response.
The second cycle of the NCD Lab is open until 22 November 2021. The thematic area on Women and Girls is inviting submissions on primary healthcare innovations for NCD prevention and care which leverage lessons learned from COVID-19 and other infectious diseases to improve access for women and girls. Find out more and apply here.
Dr Malanda’s initiative, which (subject to funding) he hopes to start implementing in coming months across communities in East Congo (Sud-Kivu), will focus on the development of awareness-raising and anti-stigma campaigns to reduce diabetes-related stigma, with a phased approach. Phase 1 will include a baseline analysis of the burden; Phase 2 will implement diabetes education program activities such as peer-to-peer empowerment, and working with community champions to develop testimonies of status disclosure and experience of living with diabetes; Phase 3 will evaluate findings.
The planned outputs include a database on rights violations and discrimination against women and girls with diabetes to inform a policy brief to be updated annually, and key project messages to incorporate into an advocacy strategy designed to empower women and girls living with the condition.
Dr Belma Malanda said:
“I am extremely honoured to be receiving such an important award, the first of its kind from the NCD Lab stream on Women and Girls. This initiative will help in increasing recognition of the linkages between diabetes and women’s and children's health, support the integration of diabetes into existing health systems and maternal and new-born child health initiatives, and empower girls and women to prevent diabetes in current and future generations.”
“I am truly grateful for the recognition I have received for my work, because I am very sure that every other nominee for this award was as capable – if not more – of winning.”
Two further submissions were shortlisted, with the support of the Women and Girls steering committee. Isaac Felix Edimu proposed KAPELA, a screening, sensitisation and training program to enhance the prevention, management and control of NCDs in communities and families in Uganda through outreach teams and targeted referrals to local health facilities.
Also shortlisted was Salvatory Makweta Mlaga’s proposal of the HELLPER Program in the United Republic of Tanzania. Known as ‘the moving specialized hospital’, the aim of HELPPER(TZ) is to run comprehensive mobile healthcare clinics in rural regions to improve access to basic health services and prioritise the screening and diagnosis of NCDs including breast and cervical cancer.
Dr Guy Fones, Head of the Global Coordination Mechanism on NCDs at the World Health Organization said:
“These projects have the potential to make a significant impact in reducing stigma around diabetes and enhancing equitable access to diabetes treatment and care. The winning submissions could potentially also inspire similar projects in other communities or countries.”
On Thursday 4 November 2021 a webinar reflecting on the launch of the NCD Lab, showcasing all first-cycle winners, and announcing a call for the second Lab Cycle was held. Speakers included WHO’s Dr Peter Singer (Special Advisor to the Director General), Dr Svetlana Akselrod (Director, Global NCD Platform), Dr Bente Mikkelsen (Director, NCD Department) and Ms Louise Agersnap (Director a.i. and Head, WHO Innovation Hub, Department for Digital Health & Innovation.
For updates on the NCD Lab please sign-up to the WHO Knowledge Action Portal newsletter here, and check out The George Institute’s webpage.
INJURY PREVENTION SESSIONS GRSP Botnar Child Road Safety Challenge and the Decade of Action
The fifth session in the ‘Injury Prevention Sessions', co-hosted by UNSW School of Population Health, Sydney and the WHO Collaborating Centre on Injury Prevention and Trauma Care at The George Institute for Global Health, focused on how child road safety projects are contributing to the 2nd Decade of Action for Road Safety (2021-2030) global plan.
The session opens with an introduction from Dr Nhan Tran, Unit Head of Safety and Mobility at the World Health Organization on the global plan. Three grantees of the Global Road Safety Partnership managed and Fondation Botnar funded Botnar Child Road Safety Challenge then present their projects, highlighting how they address various aspects of the plan:
Gendered approaches in Vietnam (Dao Thi Bao Thu)
Road infrastructure and mobility in India (Vaibhav Kush)
Safe and Healthy Journeys to School for Children and Adolescents in Tanga, Tanzania (Simon Kalolo)
The recording is available here:
The 'Injury Prevention Sessions' are action-focused conversations about how we learn from local solutions to address the global problem of injury. From practitioners to researchers to students, this informal forum brings together like-minded individuals to explore innovative injury prevention research methodologies and opportunities to work together to save lives globally. This webinar series is co-hosted by UNSW School of Population Health and the WHO Collaborating Centre on Injury Prevention and Trauma Care at The George Institute for Global Health.
Speakers
Dr Nhan Tran
Dr Nhan Tran holds a graduate degree in International Public Health and a PhD in Health Systems Research with an emphasis on road traffic injuries from the Johns Hopkins University School of Public Health. He started his career as an educator and then as a science advisor within the U.S. Department of Health & Human Services. Later, as a researcher at Johns Hopkins University, he co-founded the International Injury Research Unit (IIRU). Dr Tran joined WHO in 2011 and was previously the Manager of the Alliance for Health Policy and Systems Research. In October 2017 he assumed his current role as the Head of Safety and Mobility.
Dao Thi Bao Thu
Dao Thi Bao Thu is a project coordinator at Plan International Vietnam. She has been working on the Safer Cities for Girls programme in Hanoi since its beginning in 2014. Thu has 17 years of experience working at Plan International on various projects related to child protection and gender-based violence.
Vaibhav Kush
Vaibhav Kush is Senior Project Associate in the Sustainable Cities and Transport team at WRI India, where he works on projects related to road safety and child-friendly cities. He also assists the team in conceptualizing new areas of intervention and policy making in the field of road safety. Prior to joining WRI India, Vaibhav was associated with a Delhi-based architectural firm, where he worked on developing detailed architectural drawings for green office complexes. He has also worked with renowned Architect Raj Rewal on several university projects. Vaibhav holds a bachelor’s in architecture, wherein as part of his thesis he designed an Energy Efficient Senior Secondary School in Delhi. He holds a master’s in planning with specialization in Urban Planning from School of Planning & Architecture, New Delhi. His thesis was on the Impact of Urban Development on Climate: Case of Delhi & Environs.
Simon Kalolo
Simon Kalolo is the country manager for Amend Tanzania. He joined in 2012 and is currently based in Dar es Salaam. Simon has a background in project planning and management. He is a trained road safety advocate with experience in facilitating workshops at global road safety events. Simon has managed Total Foundation’s VIA program and motorcycle taxi riders training in Togo and Guinea. His other work has included implementation of safe infrastructure around schools in Botswana, Côte d’Ivoire, Ghana, Malawi, Mozambique, Namibia, Senegal, Tanzania, and Zambia. He led a traffic conflict analysis study around schools in Ghana and delivered road safety training to NGOs and local government authorities in Jamaica and Morocco.
Xuejun Yin is a PhD candidate at The George Institute China, working in the Food Policy team. She has been involved in multiple research projects including the recent ground-breaking study on salt substitutes that shows how a simple salt swap can save millions of lives worldwide.
