Pioneering policy leadership in a transformative era

With the European Parliament and U.S. elections looming, Europe is facing policy uncertainties on both sides of the Atlantic. Persistent geopolitical turmoil in Ukraine and the Middle East, and threats to democracy — coupled with concerns over slow economic recovery, demographic shifts, climate hazards and the rapid evolution of powerful AI — all add to the complex global political and economic landscape. Europe’s present and future demands leaders who are capable of effectively navigating multifaceted challenges.

At the European University Institute (EUI) in Florence, we are committed to developing a groundbreaking executive program that prepares professionals for multilevel policymaking of the 21st century. Our new EUI Global Executive Master (GEM) aims to transform policy professionals into agents of change and enhance their skills as effective managers and leaders who inspire and drive sustainable change.

Listening and responding to the needs of policy professionals is at the core of our new program.

New leaders wanted

George Papaconstantinou is dean of executive education of the European University Institute, and a former Minister of Finance and Minister of Environment and Energy of Greece. | via European University Institute

Just as public policy has changed in the past 20 years, so has executive education for public policy professionals. Listening and responding to the needs of policy professionals is at the core of our new program. The new GEM takes our commitment to training professionals to respond to today’s cross-border issues to the next level; it stands out from other executive master programs through its dedication to providing a personalized career development journey.

Launching in September 2024, the GEM has a two-year, part-time format, with three week-long study periods in Florence, and two additional visits to global policy hubs. This format, combined with online modules, allows policy professionals to integrate full-time work commitments with professional growth and peer exchange, building their knowledge, skills, and networks in a structured way.

This allows policy professionals to integrate full-time work commitments with professional growth and peer exchange.

During the first year, EUI GEM participants take four core modules that will set the basis for a comprehensive understanding of the complex task of policymaking, and its interaction with government, the economy and global trends. In the second year, they have the possibility to select courses in one or more of four specializations: energy and climate; economy and finance; tech and governance; and geopolitics and security.

These core and elective courses are complemented by intensive professional development modules and workshops aimed at enhancing skills in the critical areas of change management, project management, strategic foresight, leadership, negotiations, policy communications, and media relations.

Through the final capstone project, EUI GEM participants will address real policy challenges faced by organizations, including their own, proposing solutions based on original research under the guidance of both the organizations concerned and EUI faculty.

In addition, the program includes thematic executive study visits for in-depth insights and first-hand practical experience.

In addition, the program includes thematic executive study visits for in-depth insights and first-hand practical experience. Participants attend the EUI State of the Union Conference in Florence, a flagship event that brings together global leaders to reflect on the most pressing issues of the European agenda. They explore the role of strategic foresight in EU institutions’ policy planning through an executive study visit to Brussels, complemented by dedicated training sessions and networking opportunities. A final Global Challenge study visit aims to encourage participants to engage with local policy stakeholders.

Bridging academia and practice

Since its inaugural executive training course in 2004, the EUI has successfully trained over 23,000 professionals of approximately 160 nationalities, in almost 600 courses. The EUI GEM leverages this expertise by merging the academic and practical policy expertise from our Florence School of Transnational Governance and the Robert Schuman Centre, as well as the academic excellence in the EUI departments.

The EUI GEM’s aspiration to bridge the gap between academia and practice is also reflected in the faculty line-up, featuring leading academics, private-sector experts, and policymakers who bring invaluable expertise into a peer-learning environment that fosters both learning and exchange with policy professionals.

Effective, agile and inclusive governance involves interaction and mutual learning between the public sector, the private sector and civil society actors, all acting as change agents. That is why our program is designed to bring innovative perspectives on public policy from all three: the public and the private sector, as well as civil society, and we welcome applications from all three sectors. 

An inspiring environment

EUI GEM participants spend 25 days in residence at the magnificent Palazzo Buontalenti, headquarters of our Florence School of Transnational Governance. The former Medici palace harbors art-historical treasures in the heart of Florence. In September 2024, a dedicated executive education center will be inaugurated at Palazzo Buontalenti, coinciding with the arrival of the participants of the first GEM cohort.

The GEM is poised to redefine the standards for executive education and empower a new generation of policy practitioners. We are ambitious and bold, and trust that our first cohort will be, too. After all, they are the first to embark on this adventure of a new program. We can’t wait to welcome them here in Florence, where the journey to shape the future begins. Will you join us?

Learn more about the EUI Global Executive Master.

The EUI Global Executive Master | via European University Institute



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The right to breathe: how policymakers can tackle severe asthma

Asthma impacts over 330 million people worldwide. While severe asthma makes up only 5-10 percent of cases, it is accountable for over half of asthma-related costs globally.[1] It profoundly affects patients’ lives, undermining their physical, mental and economic well-being, and increasing the risk of preventable deaths. Despite its significance, severe asthma is often overshadowed by other health priorities, leading to inadequate resource allocation and substandard care, further straining already pressured health systems.

Severe asthma outcomes, like many other chronic diseases, are deeply entangled with a wide range of environmental and socio-economic factors. Therefore, addressing it is not merely about medical intervention, but about creating and implementing comprehensive, holistic strategies.

The challenges presented by severe asthma are not beyond our capabilities. Around the globe, there is a wide range of best practices, treatments, and approaches to asthma management. Yet, the path to transformation demands a unified commitment from a broad set of stakeholders, from policymakers to medical professionals, industry, patients and beyond. While the blueprint for a future unburdened by severe asthma exists, it is up to decision-makers to realize it together.

While the blueprint for a future unburdened by severe asthma exists, it is up to decision-makers to realize it together.

And the good news is that progress is already underway. Since autumn 2022, we have collaborated as an international expert group to support the development of the Copenhagen Institute for Futures Studies’ (CIFS) Severe Asthma Index. This tool assesses how 29 OECD countries manage severe asthma across various indicators, such as national strategies, treatment access, hospitalizations, societal costs and air quality, among others.

While the Severe Asthma Index is an important stride in tackling severe asthma, the true test lies in how its insights are applied in practice. Among the many actions needed to be taken to improve severe asthma care, the most pressing concern is policy change.

We have identified three actions, derived from the work we have conducted to date, for policymakers to kickstart strengthening health systems’ approaches to and management of severe asthma:

  1. Development and implementation of national asthma plans and strategies

The Severe Asthma Index has found that less than half of the countries analyzed have a national strategy for asthma, prevention, and management. There is, therefore, a need to formulate and actively implement dedicated national asthma programs, tailored to the unique challenges of individual health systems. These programs should not only emphasize prevention, early detection and diagnosis but also adapt best practices to specific national and local contexts.

Importantly, plans should be situated in the context of long-term strategies for improving population health outcomes.

“In England, work around respiratory illness is gaining traction,” notes Sir David Behan, chair of Health Education England, NHS, and expert group member. “Part of the initiative being developed [is] to ease pressure on the emergency care pathways and hospitals.”  

All approaches should promote awareness on respiratory diseases, support personalized care plans, empower patients and improve training and opportunities for training health care professionals working in respiratory care.

2. Coordination and harmonization of policies and care guidelines

There is a patchwork of country approaches to severe asthma, illustrated by the observation that more than two-thirds of the country guidelines assessed in the Severe Asthma Index do not fully align with the Global Initiative for Asthma’s (GINA) guide for Difficult-to-treat and Severe Asthma in Adolescence And Adult Patients. Policymakers must strive to coordinate their approaches to severe asthma by harmonizing policies and guidelines for asthma care to the greatest possible extent, with the aim of reducing outcome disparities, bolstering equity and promoting health system sustainability.

In doing so, there should be an emphasis on identifying and scaling best practices, promoting cross-border collaboration, and championing holistic solutions informed by the widely-acclaimed Health in All Policies approach.

The Australian National Asthma Council’s Australian Asthma Handbook is a strong example of a best practice in this area that policymakers could draw inspiration from in acting on this point.

3. Supporting improved data collection and the development of a more robust evidence base for severe asthma

Policymakers should incentivize and ultimately mandate improved production, recording and utilization of asthma- and severe asthma-specific data, as well as identifier data such as prescription data, adherence to treatment regimes, lung function analysis and demographic and socioeconomic indicators, following a set of common standards.

Currently, despite the existence of clinical codes for severe asthma, the condition remains significantly underreported in clinical settings due in large part to inconsistent coding practices, leading to an increased probability of patients receiving inadequate care and suboptimal allocation of health system resources. The dearth of severe asthma data and barriers to accessing the few datasets that do exist render it difficult to develop a comprehensive and consistent understanding of the full impact of severe asthma.

National policymakers need to prioritize financial and logistical support for country-level asthma research. Research activities should aim to produce a solid evidence base that will offer a nuanced understanding of each country’s needs, challenges and opportunities regarding asthma care. Support for research activities granted over the long term will enable longitudinal studies so that national trends and progress can be accurately tracked.

Only 3 percent of the European Union’s budget for health [is] spent on lung health, although 13 percent of Europeans have lung disease.

“Only 3 percent of the European Union’s budget for health [is] spent on lung health, although 13 percent of Europeans have lung disease,” says Susanna Palkonen, director of the European Federation of Allergy & Airways Diseases Patients’ Associations (EFA) and expert group member.

The International Severe Asthma Registry (ISAR) initiative provides a strong basis for continued work in this area.

The path ahead requires that these actions evolve in tandem with the latest advancements in respiratory care and approaches to the management and prevention of noncommunicable diseases. This is not simply about updating and developing new policies — it’s about crafting robust and well-rounded solutions that proactively address a health challenge that is both global and local and supporting a much-needed vision for improved respiratory health outcomes.

As we look forward, we cannot just treat asthma. We must transform our approach to ensure that every patient’s right to breathe becomes a global reality.


Author(s):
Patrick Henry Gallen, senior advisor and futurist at Copenhagen Institute for Futures Studies

Bogi Eliasen, director of health at Copenhagen Institute for Futures Studies

Professor Dr. Vibeke Backer, MD, DMSci, chief respiratory physician at Department of ENT and Centre for Physical Activity Research (CFAS), Rigshospitalet, Copenhagen, Denmark

Sir David Behan, chair Health Education England, National Health System (NHS), U.K.​

Dr. Mark Levy, board member, Global Initiative for Asthma (GINA), U.K.​

Mikaela Odemyr, chair European Lung Foundation (ELF) Patient Advisory Committee; chair Swedish Asthma and Allergy Association, Sweden

Susanna Palkonen, director, European Federation of Allergy and Airways Diseases Patients’ Associations (EFA)  

Professor Dr. Arzu Yorgancıoğlu, chair European Respiratory Society (ERS) Advocacy Council; member of Global Initiative on Asthma (GINA) Board; chair of GINA Dissemination and Implementation Committee; chair of the WHO GARD Executive Committee Turkey 


References:
[1] Al Efraij K, FitzGerald JM. Current and emerging treatments for severe asthma. J Thorac Dis 2015;7(11):E522-E525



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Speed is everything for patients: together we can bring medicines faster

Working in our industry brings huge responsibility. We deal with people’s lives, and our  medicines give people an opportunity to improve their health, often at the most overwhelming time for them. I had a strong reminder of that recently.

Last month, I met with a colleague, Heiko, who lives in Germany. His young daughter has central nervous system (CNS) neuroblastoma — a type of cancer that tends to affect children under the age of five.

Heiko and his family have been navigating the health system for months, including an overload of information in the form of complex ‘oncological-speak’, treatment guidelines and health insurance claims. They have also been dealing with constant travel to specialist centers — all while juggling the emotional burden of caring for a sick child and the daily challenges of home and work life.

He shared something that stuck in my mind the night I spoke with him, which serves as an important reminder for all of us working in health care.

“Trust must be bigger than fear.”

When their health is at stake, friends, families and colleagues put their trust in their local health care system — every part of it, including industry — in the hope of protecting the future for them and their loved ones.

As Heiko put it to me, “Speed is everything. If you gain enough speed, you gain enough time. And if you have time, you have the hope of more options that can help you.”

Faster, more equitable access to new, life-saving medicines for people living in Europe is a goal that I believe we all share. There are challenges in achieving this, but we at Roche are committed to addressing these, together with everyone involved.

It is the inequality in access to medicines that is untenable.

Teresa Graham, CEO, Roche Pharmaceuticals, and chair EFPIA’s Patient Access Committee | via EFPIA

The average time that patients in the EU wait to get access to a new medicine is around 517 days. Uptake of new technologies can be low and slow, but it is the inequality in access to medicines that is untenable. If you have cancer in Germany, you may need to wait, on average, 128 days to access a new medicine, but if you are a patient in Romania it will take you 918 days to receive the same treatment.

I am concerned that Europe’s policymakers believe this can be fixed with legislation alone. And, even if it could, families like Heiko’s do not have the luxury of waiting four to five years for the ongoing revision to the EU pharmaceutical legislation to attempt to resolve these issues.

Improving access to medicines requires solutions that are developed in partnership with everyone who has a stake in their delivery: industry, member states, health regulators, payers, patients and health care providers. With the right ambition and desire for collaboration, we can act now.

The crucial first step is for governments and policymakers to treat spending on health care and innovation as an investment in economic growth and societal advancement. Improving health care and expanding access to innovation are vital for reducing pressure on health care systems, maintaining a healthy and productive society, and driving future economic growth.

Governments and policymakers have a pivotal role in enabling and encouraging this cycle of improved health and economic benefit. We must take a strategic view of investing in innovation, acknowledging the wider societal value it provides, and find sustainable ways to manage immediate fiscal challenges that do not limit or delay access to new medicines and technologies.

The industry is also driving changes. One concrete commitment pharmaceutical companies have made is to file new medicines for pricing and reimbursement in all member states within two years of EU approval of a new medicine. This will improve timely access to the latest innovations.

The industry has also established a portal for tracking access delays and ensuring companies are held accountable in meeting the two-year filing commitment.

With the right ambition and desire for collaboration, we can act now.

With multiple ongoing legislative changes currently taking place in Europe — from the revision of the EU’s Pharmaceutical Legislation, to the EU’s reform of Health Technology Assessment (HTA) and the introduction of the European Health Data Space (EHDS) — we have a unique opportunity to build a stronger and better European environment for life sciences and health care that serves patients’ best interests. One major opportunity for collaboration is the implementation of the EU’s HTA regulation. This aims to address access delays by streamlining and accelerating highly fragmented HTA processes across Europe. There is only one year to go before this either becomes a meaningful contributor to faster access decisions for patients or — if not adequately in focus during 2024 — risks becoming an additional hurdle for patient access to essential treatments. In order to avoid this scenario, industry involvement in the implementation of EU HTA is crucial to leverage expertise, co-design relevant processes, and ultimately ensure a workable system.

Such actions can reduce some of the delays in accessing new medicines, but they will not solve everything. The majority of delays come from the variation and delays in individual countries’ reimbursement and health care systems. That is why it is critical that member states, payers and health systems collaborate with industry to develop tailored access solutions. 

However, there are also proposals on the table today that are concerning and at face value will not lead to improved access for patients. For instance, the EU Commission is proposing to reduce a company’s intellectual property rights — specifically regulatory data protection (RDP) — if a medicine is not available in all member states within two years of receiving marketing authorisation. This would only hinder innovation, without delivering faster, more equitable access to new medicines.

If this were to go ahead as proposed, Europe would become a less attractive place for research. A recently-published study on the impact of the European Commission’s proposal estimated that it would reduce Europe’s share of global R&D investment by one-third by 2040.

I firmly believe this proposal must be reconsidered and focused on policy solutions that ensure patients in Europe continue to benefit from innovation.

As Heiko says, speed, time and hope are all people have. Often, patients are waiting for the next innovation, during which time, their disease progresses or their condition deteriorates. This makes the next clinical trial, the next regulatory approval, the next standard of care, the next reimbursement decision absolutely vital for those who simply cannot wait.

Across industry, there are more than 8,000 new medicines in the global pipeline today. This is the hope Heiko needs, and families like his are trusting us all to deliver.

Speaking with Heiko reminded me that the most effective treatment is the one that makes it to the patient when they need it. It is now our collective responsibility to find the path to making this happen for patients everywhere in Europe.



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Making water the engine for climate action

Much progress has been made on water security over recent decades, yet for the first time in human history, our collective actions have pushed the global water cycle out of balance. Water is life: it is essential for health, food, energy, socioeconomic development, nature and livable cities. It is hardly surprising that the climate and biodiversity crises are also a water crisis, where one reinforces the other. Already, a staggering four billion people suffer from water scarcity  for at least one month a year and two billion people lack access to safely-managed drinking water. By 2030, global water demand will exceed availability by 40 percent. By 2050, climate-driven water scarcity could impact the economic growth of some regions by up to 6 percent of their Gross Domestic Product per year.

Meike van Ginneken, Water Envoy of the Kingdom of the Netherlands

Right now, the world’s first Global Stocktake is assessing the progress being made toward the goals of the Paris Agreement and global leaders are convening at COP28 in Dubai to agree on a way forward. We have a critical opportunity to catalyze global ambition and recognize that water is how climate change manifests itself. While wealthier, more resilient nations may be able to manage the devastating impacts of climate change, these same challenges are disastrous for lesser developed, more vulnerable communities.

Rainfall, the source of all freshwater, is becoming more erratic. Changes in precipitation, evaporation and soil moisture are creating severe food insecurity. Droughts trap farmers in poverty, as the majority of cultivated land is rain-fed. Extreme drought reduces growth in developing countries by about 0.85 percentage points. Melting glaciers, sea-level rise and saltwater intrusion jeopardize freshwater supplies. Floods destroy infrastructure, damage homes and disrupt livelihoods. The 2022 Pakistan floods affected 33 million people and more than 1,730 lost their lives, while 2023 saw devastating floods in Libya among other places.  

Now more than ever, it is urgent that we work together to make water the engine of climate action. Already, many countries are investing in technology and climate-resilient water infrastructure. Yet, we need more than technology and engineering to adapt to a changing climate. To advance global water action, we must radically change the way we understand, value and manage water with an emphasis on two necessary measures.

First, we need to make water availability central to our economic planning and decision-making. We need to rethink where and how we grow our food, where we build our cities, and where we plan our industries. We cannot continue to grow thirsty crops in drylands or drain wetlands and cut down forests to raise our cattle. In a changing climate, water availability needs to guide where we undertake economic activity.

In a changing climate, water availability needs to guide where we undertake economic activity.  

Second, we must restore and protect natural freshwater stocks, our buffers against extreme climate events. Natural freshwater storage is how we save water for dry periods and freshwater storage capacity is how we store rainwater to mitigate floods. 99 percent of freshwater storage is in nature. We need to halt the decline of groundwater, wetlands and floodplains. But our challenge is not only about surface and groundwater bodies, or blue water. We also need to preserve and restore our green water stocks, or the water that remains in the soil after rainfall. To reduce the decline of blue water and preserve green water, we need to implement water-friendly crop-management practices and incorporate key stakeholders, such as farmers, into the decision-making process.

Addressing the urgency of the global water crisis goes beyond the water sector. It requires transformative changes at every level of society. National climate plans such as Nationally Determined Contributions (NDCs) and National Adaptation Plans are key instruments to make water an organizing principle to spatial, economic and investment planning. Much like the Netherlands did earlier this year when the Dutch parliament adopted a policy that makes water and soil guiding principles in all our spatial planning decisions. Right now, about 90 percent of all countries’ NDCs prioritize action on water for adaptation. NDCs and National Adaptation Plans are drivers of integrated planning and have the potential to unlock vast investments, yet including targets for water is only a first step.

To drive global action, the Netherlands and the Republic of Tajikistan co-hosted the United Nations 2023 Water Conference, bringing the world together for a bold Water Action Agenda to accelerate change across sectors and deliver on the water actions in the 2030 Agenda for Sustainable Development and the Paris Agreement. To elevate the agenda’s emphasis on accelerating implementation and improved impact, the Netherlands is contributing an additional €5 million to the NDC Partnership to support countries to mitigate the impacts of climate change, reduce water-related climate vulnerability and increase public and private investments targeting water-nexus opportunities. As a global coalition of over 200 countries and international institutions, the NDC Partnership is uniquely positioned to support countries to enhance the integration of water in formulating, updating, financing and implementing countries’ NDCs.

One example showcasing the importance of incorporating water management into national planning comes from former NDC Partnership co-chair and climate leader, Jamaica. Jamaica’s National Water Commission (NWC), one of the largest electricity consumers in the country, mobilized technical assistance to develop an integrated energy efficiency and renewables program to reduce its energy intensity, building up the resilience of the network, while helping reduce the country’s greenhouse gas emissions. With additional support from the Netherlands, the International Renewable Energy Agency (IRENA) and the United Nations Development Programme (UNDP), together with Global Water Partnership (GWP)-Caribbean, the government of Jamaica will ensure the National Water Commission is well equipped for the future. Implementation of climate commitments and the requisite financing to do so are key to ensuring targets like these are met.

Water has the power to connect. The Netherlands is reaching out to the world.

Water has the power to connect. The Netherlands is reaching out to the world. We are committed to providing political leadership and deploying our know-how for a more water-secure world. As we look towards the outcomes of the Global Stocktake and COP28, it is essential that we make water the engine of climate action. 



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Kamala Harris at climate summit: World must ‘fight’ those stalling action

DUBAI — The vast, global efforts to arrest rising temperatures are imperiled and must accelerate, U.S. Vice President Kamala Harris told the world climate summit on Saturday. 

“We must do more,” she implored an audience of world leaders at the COP28 climate talks in Dubai. And the headwinds are only growing, she warned.

“Continued progress will not be possible without a fight,” she told the gathering, which has drawn more than 100,000 people to this Gulf oil metropolis. “Around the world, there are those who seek to slow or stop our progress. Leaders who deny climate science, delay climate action and spread misinformation. Corporations that greenwash their climate inaction and lobby for billions of dollars in fossil fuel subsidies.” 

Her remarks — less than a year before an election that could return Donald Trump to the White House — challenged leaders to cooperate and spend more to keep the goal of containing global warming to 1.5 degrees Celsius within reach. So far, the planet has warmed about 1.3 degrees since preindustrial times.

“Our action collectively, or worse, our inaction will impact billions of people for decades to come,” Harris said.

The vice president, who frequently warns about climate change threats in speeches and interviews, is the highest-ranking face of the Biden White House at the Dubai negotiations.

She used her conference platform to push that image, announcing several new U.S. climate initiatives, including a record-setting $3 billion pledge for the so-called Green Climate Fund, which aims to help countries adapt to climate change and reduce emissions. The commitment echoes an identical pledge Barack Obama made in 2014 — of which only $1 billion was delivered. The U.S. Treasury Department later specified that the updated commitment was “subject to the availability of funds.”

Meanwhile, back in D.C., the Biden administration strategically timed the release of new rules to crack down on planet-warming methane emissions from the oil and gas sector — a significant milestone in its plan to prevent climate catastrophe.

The trip allows Harris to bolster her credentials on a policy issue critical to the young voters key to President Joe Biden’s re-election campaign — and potentially to a future Harris White House run. 

“Given her knowledge base with the issue, her passion for the issue, it strikes me as a smart move for her to broaden that message out to the international audience,” said Roger Salazar, a California political strategist and former aide to then-Vice President Al Gore, a lifetime climate campaigner. 

Yet sending Harris also presents political peril. 

Biden has taken flak from critics for not attending the talks himself after representing the United States at the last two U.N. climate summits since taking office. And climate advocates have questioned the Biden administration’s embrace of the summit’s leader, Sultan al-Jaber, given he also runs the United Arab Emirates’ state-owned oil giant. John Kerry, Biden’s climate envoy, has argued the partnership can help bring fossil fuel megaliths to the table.

Harris has been on a climate policy roadshow in recent months, discussing the issue during a series of interviews at universities and other venues packed with young people and environmental advocates. The administration said it views Harris — a former California senator and attorney general — as an effective spokesperson on climate. 

“The vice president’s leadership on climate goes back to when she was the district attorney of San Francisco, as she established one of the first environmental justice units in the nation,” a senior administration official told reporters on a call previewing her trip. 

Joining Harris in Dubai are Kerry, White House climate adviser Ali Zaidi and John Podesta, who’s leading the White House effort to implement Biden’s signature climate law. 

Biden officials are leaning on that climate law — dubbed the Inflation Reduction Act — to prove the U.S. is doing its part to slash global emissions. Yet climate activists remain skeptical, chiding Biden for separately approving a series of fossil fuel projects, including an oil drilling initiative in Alaska and an Appalachian natural gas pipeline.

Similarly, the Biden administration’s opening COP28 pledge of $17.5 million for a new international climate aid fund frustrated advocates for developing nations combating climate threats. The figure lagged well behind other allies, several of whom committed $100 million or more.

Nonetheless, Harris called for aggressive action in her speech, which was followed by a session with other officials on renewable energy. The vice president committed the U.S. to doubling its energy efficiency and tripling its renewable energy capacity by 2030, joining a growing list of countries. The U.S. also said Saturday it was joining a global alliance dedicated to divorcing the world from coal-based energy. 

Like other world leaders, Harris also used her trip to conduct a whirlwind of diplomacy over the war between Israel and Hamas, which has flared back up after a brief truce.

U.S. National Security Council spokesperson John Kirby said Harris would be meeting with “regional leaders” to discuss “our desire to see this pause restored, our desire to see aid getting back in, our desire to see hostages get out.”

The war has intruded into the proceedings at the climate summit, with Israeli President Isaac Herzog and Palestinian Authority leader Mahmoud Abbas both skipping their scheduled speaking slots on Friday. Iran’s delegation also walked out of the summit, objecting to Israel’s presence.

Kirby said Harris will convey “that we believe the Palestinian people need a vote and a voice in their future, and then they need governance in Gaza that will look after their aspirations and their needs.”

Although Biden won’t be going to Dubai, the administration said these climate talks are “especially” vital, given countries will decide how to respond to a U.N. assessment that found the world’s climate efforts are falling short. 

“This is why the president has made climate a keystone of his administration’s foreign policy agenda,” the senior administration official said.

Robin Bravender reported from Washington, D.C. Zia Weise and Charlie Cooper reported from Dubai. 

Sara Schonhardt contributed reporting from Washington, D.C.



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How to get tech right in Europe?

As our societies navigate challenging times and undergo widespread digital transformation, fostering growth in our homegrown tech businesses has never been more critical to achieving the wider goals of the European project.

Via EUTA. Kristin Skogen Lund, president, European Tech Alliance; CEO, Schibsted

The European Tech Alliance (EUTA) represents leading tech companies born and bred in Europe. We believe that with the right conditions, EU tech companies can enhance Europe’s resilience, boost our technological autonomy, protect and empower consumers, and promote European values such as transparency, the rule of law and innovation to the rest of the world.

The European Commission’s ambitious targets for 2030 in the Digital Decade program represent a vision for a sustainable and more prosperous digital future. However, more is needed if we are to achieve our goals.

Europe must boost its tech competitiveness over the next five years. To unlock European tech leadership both at home and beyond, we need to have an ambitious EU tech strategy to overcome growth obstacles, to make a political commitment to clear, targeted and risk-based rules, and to pursue consistent enforcement to match the globalized market we are in.

An EU strategy for European tech

We need a strategy for European tech that empowers digital companies to grow and use new innovation tools to deliver the best services and products, including personalized experiences, to their users. European tech companies are valuable assets for Europe. They deserve to be nurtured and supported.

Europe must boost its tech competitiveness over the next five years.

In practice, this could take on several forms. For instance, we need to unlock the power of data as a key lever for innovation while respecting consumer privacy. Privacy-enhancing technologies and pseudonymization should be further promoted by lawmakers and regulators to empower European companies to use data, grow and remain competitive.

A European strategy for talent to enhance European companies’ attractiveness could also be pursued. Developers should be pushing the limits of innovation, using their imaginations to improve the services and products from European companies, rather than focusing their unique talents on compliance tasks.

Lastly, EU tech companies should have a seat at the table when proposed rules affect their ability to invest in Europe and to provide good services, products and experiences. Bringing in expertise from the ground up would facilitate the growth of European champions at global, national and regional level.

Smart rules for a stronger Europe

The digital world is a fully-regulated sector with a wide range of new and updated rules. It is essential to give these rules time to play out before assessing their efficiency and impact on EU tech companies.

For instance, the EU’s consumer protection framework was recently updated with the ‘Omnibus Directive’. These new rules started applying from May 2022 onward only, yet they were up for another partial revision less than a year later. Businesses need time to put rules into practice, and lawmakers need time to analyze their effects in the real world, before amending the rulebook once again.

European, national and regional measures should complement each other, not clash or duplicate efforts. The ink of the Digital Services Act (DSA) was not even dry when some EU countries added extra layers of regulation at national level, such as the French law for online influencers and the proposed bill to secure and regulate the digital space. There must be a strong focus on avoiding national fragmentation where EU laws exist. Otherwise we are moving further away from a truly single market that is the cornerstone of European competitiveness.      

Where EU rules are needed, lawmakers should focus on concrete problems and be mindful of different tech business models, for example, retailers vs. marketplaces; new vs. second-hand goods, streaming vs. social media. Rules should address problems with specific business models instead of a one-size-fits-all approach or dictating specific product designs. Any proposed solution should also be proportionate to the problem identified.

Better enforcement for fairer competition

One of the big problems we face in Europe is ensuring a level playing field for all businesses, to achieve fair competition. The EU has enshrined these values in the Digital Markets Act (DMA). We must not lose sight of this ambition as we turn to the all-important task of enforcement of the DMA.

European, national and regional measures should complement each other, not clash or duplicate efforts.

Better cooperation should be encouraged between regulatory authorities at national level (for example, consumer, competition and data protection) but also among European countries and with the EU to ensure coherent application.

Now that the European Commission takes on the new role of rule enforcer, it’s of paramount importance to place a strong focus on independence, separate from political interests. This will ensure a robust and impartial enforcement mechanism that upholds the integrity of the regulatory framework.

What’s next?

European tech companies in the EUTA believe the EU can take two crucial steps for our competitiveness, so we can continue to invest in Europe’s technological innovation and European consumers.

First, the EU digital single market is incomplete, we need to avoid 27 different interpretations of the same EU rules. A strong harmonization push is needed for EU companies to grow faster across the Continent.

Second, we look toward the EU, national governments and authorities to bring economic competitiveness and innovation to the core of regulation, and then to enforce these rules fairly and equally.

EUTA members are companies born and bred in Europe. The EU is a crucial market and we are deeply committed to European citizens and European values. With our EUTA manifesto, we propose a vision so Europe can succeed, and our own European champions can grow and become global leaders.



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AWS digital sovereignty pledge: A new, independent sovereign cloud in Europe

From day one, Amazon Web Services (AWS) has believed it is essential that customers have control over their data, and choices for how they secure and manage that data in the cloud. Last year, we introduced the AWS Digital Sovereignty Pledge, our commitment to offering AWS customers the most advanced set of sovereignty controls and features available in the cloud.

AWS offers the largest and most comprehensive cloud infrastructure globally. Our approach from the beginning has been to make AWS sovereign-by-design. We built data protection features and controls in the AWS cloud with input from financial services, health care and government customers — who are among the most security- and data privacy-conscious organizations in the world. This has led to innovations like the AWS Nitro System, which powers all our modern Amazon Elastic Compute Cloud (Amazon EC2) instances and provides a strong physical and logical security boundary to enforce access restrictions so that nobody, including AWS employees, can access customer data running in Amazon EC2. The security design of the Nitro System has also been independently validated by the NCC Group in a public report.

With AWS, customers have always had control over the location of their data. In Europe, customers who need to comply with European data residency requirements have the choice to deploy their data to any of our eight existing AWS Regions (Ireland, Frankfurt, London, Paris, Stockholm, Milan, Zurich and Spain) to keep their data securely in Europe. To run their sensitive workloads, European customers can leverage the broadest and deepest portfolio of services, including AI, analytics, compute, database, internet of things, machine learning, mobile services and storage. To further support customers, we’ve innovated to offer more control and choice over their data. For example, we announced further transparency and assurances, and new dedicated infrastructure options with AWS ‘Dedicated Local Zones’.

To deliver enhanced operational resilience within the EU, only EU residents who are located in the EU will have control of the operations and support.

Announcing the AWS European Sovereign Cloud

When we speak to public-sector and regulated-industry customers in Europe, they share how they are facing incredible complexity with an evolving sovereignty landscape. Customers tell us they want to adopt the cloud, but are facing increasing regulatory scrutiny over data location, European operational autonomy and resilience. We’ve learned that these customers are concerned that they will have to choose between the full power of AWS or feature-limited sovereign cloud solutions. We’ve had deep engagements with European regulators, national cybersecurity authorities, and customers to understand how the sovereignty needs of customers can vary based on multiple factors, like location, sensitivity of workloads, and industry. We recently announced our plans to launch the AWS European Sovereign Cloud, a new, independent cloud for Europe, designed to help public sector organizations and customers in highly-regulated industries meet their evolving sovereignty needs. We’re designing the AWS European Sovereign Cloud to be separate and independent from our existing ‘regions’, with infrastructure located wholly within the European Union, with the same security, availability and performance our customers get from existing regions today. To deliver enhanced operational resilience within the EU, only EU residents who are located in the EU will have control of the operations and support for the AWS European Sovereign Cloud. The AWS European Sovereign Cloud will launch its first AWS Region in Germany available to all European customers.

Built on more than a decade of experience operating multiple independent clouds for the most critical and restricted workloads.

The AWS European Sovereign Cloud will be sovereign-by-design, and will be built on more than a decade of experience operating multiple independent clouds for the most critical and restricted workloads. Like existing regions, the AWS European Sovereign Cloud will be built for high availability and resiliency, and powered by the AWS Nitro System, to help ensure the confidentiality and integrity of customer data. Customers will have the control and assurance that AWS will not access or use customer data for any purpose without their agreement. AWS gives customers the strongest sovereignty controls among leading cloud providers. For customers with enhanced data residency needs, the AWS European Sovereign cloud is designed to go further and will allow customers to keep all metadata they create (such as the roles, permissions, resource labels and configurations they use to run AWS) in the EU. The AWS European Sovereign Cloud will also be built with separate, in-region billing and usage metering systems.

Delivering operational autonomy

The AWS European Sovereign Cloud will provide customers with the capability to meet stringent operational autonomy and data residency requirements. To deliver enhanced data residency and operational resilience within the EU, the AWS European Sovereign Cloud infrastructure will be operated independently from existing AWS Regions. To assure independent operation of the AWS European Sovereign Cloud, only personnel who are EU residents, located in the EU, will have control of day-to-day operations, including access to data centers, technical support and customer service.

Control without compromise

Though separate, the AWS European Sovereign Cloud will offer the same industry-leading architecture built for security and availability as other AWS Regions. This will include multiple ‘Availability Zones’, infrastructure that is placed in separate and distinct geographic locations, with enough distance to significantly reduce the risk of a single event impacting customers’ business continuity.

Continued AWS investment in Europe

The AWS European Sovereign Cloud represents continued AWS investment in Europe. AWS is committed to innovating to support European values and Europe’s digital future. We drive economic development through investing in infrastructure, jobs and skills in communities and countries across Europe. We are creating thousands of high-quality jobs and investing billions of euros in European economies. Amazon has created more than 100,000 permanent jobs across the EU. Some of our largest AWS development teams are located in Europe, with key centers in Dublin, Dresden and Berlin. As part of our continued commitment to contribute to the development of digital skills, we will hire and develop additional local personnel to operate and support the AWS European Sovereign Cloud.

Our commitments to our customers

We remain committed to giving our customers control and choices to help meet their evolving digital sovereignty needs. We continue to innovate sovereignty features, controls and assurances globally with AWS, without compromising on the full power of AWS.



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Beyond forgetfulness: Why we must act on Alzheimer’s disease now

In the face of an increasingly aging population, today’s reality reveals a harsh truth: health systems in the EU and beyond are ill-equipped to provide early and timely diagnosis of Alzheimer’s disease and embrace innovative treatments that could help to preserve memory and, with it, independence.  

Recent advances suggest that timely intervention may hold the promise to slow the memory decline in Alzheimer’s disease, making early diagnosis more critical than ever before. Yet without the necessary health care infrastructure in place to diagnose and provide treatment, we risk missing the crucial early window and the opportunity to delay — and hopefully in the near future prevent — distressing symptoms for patients and heartbreaking experiences for families.  

The EU and its member countries have the opportunity to be remembered for leading in this space by increasing funding for research, improving health care infrastructure to support accurate diagnosis and timely intervention, and enhancing support services at a national and regional level. The forthcoming European Parliament elections in June 2024 are the ideal moments to make that pledge. For individuals, families and health care systems, Alzheimer’s disease is a ticking time bomb unless we invest in our future health today.  

The EU is not prepared for Alzheimer’s disease  

In Europe, approximately 7 million people are affected by Alzheimer’s disease, a number set to double to 14 million by 2050.1 On top of the physical and emotional distress this will cause, there are direct financial and social implications on families and communities, with Alzheimer’s costs expected to reach a staggering €250 billion by 20302 — bigger than the GDP of Portugal3 — placing an additional and substantial weight on global health care systems that are already struggling under cost and capacity burdens.4 

Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients.

That’s why MEP Deirdre Clune is leading the call for a European Parliament hearing to discuss a focused EU strategy on dementia and Alzheimer’s disease. “Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients,” argues Clune. “Therefore, the EU must create a strategic framework which lays out clear recommendations for national governments and recognises the toll of dementia and Alzheimer’s disease on societies across Europe, encourage innovation and take on board best practices to develop effective and efficient approaches. Together, with a unified approach and firm commitment, the EU can pave the way for better Alzheimer’s care.”

In the next EU political mandate, policymakers must answer the call by developing a comprehensive EU Beating Dementia Plan that specifically addresses the unique challenges posed by Alzheimer’s disease and building on established coordinated action plans for other significant health burdens, such as the EU Beating Cancer Plan. The European Brain Council and EFPIA’s, RETHINKING Alzheimer’s disease White Paper is a useful resource, calling for policymakers to rethink Alzheimer’s and offering policy recommendations to make tangible changes to improve the lives of people living with the disease.  

EU member countries must commit to investing in diagnostic infrastructure, technology and integrated care that can help to detect Alzheimer’s disease at an early stage and ensure timely intervention resulting in the preservation of memory and, thereof, independent living and normal social functioning.  

Laying the foundations at national level  

While action is certainly needed at the EU level, huge opportunity lies at the national and regional levels. Each member country has the chance to apply well-funded national dementia plans that tailor their strategies and responses to address the distinct needs of their populations, making a real and meaningful impact on the people and health systems in their country.  

Inspiration stems from Italy, which recently launched its Parliamentary Intergroup for Neuroscience and Alzheimer’s, dedicating its efforts to raising awareness, fostering discussions among national and regional institutions, promoting clinician and patient involvement, supporting novel research, implementing new diagnostic models, and strengthening patient access to care. 

Italian MP Annarita Patriarca, co-host of the Parliamentary Intergroup, affirms: “Primary responsibility of a member state is to ensure to all citizens the greatest standards of diagnosis and access to treatment and care. Thus, it is necessary to put in place a strong collaboration between the public and private sector to strengthen investments in neurological diseases. Improving patients’ diagnostic and care pathways, especially in a disease area like AD with such a high unmet medical need and societal impact will be the core focus of the intergroup.” 

Additionally, during the Alzheimer’s and Neuroscience Conference: a priority for the country in July, members of the Italian Parliament importantly put forward legislative and regulatory solutions to ensure an early and accurate diagnosis. 

Leading the conversation on the international stage   

Amid the growing burden of Alzheimer’s disease globally, this is a moment for policymakers to hold each other accountable. Member countries are uniquely placed to do this within the EU but also across the wider health care ecosystem, calling on countries and leaders to honor prior commitments that prioritized investment in relieving major health burdens, including Alzheimer’s.  

Encouragingly, the May G7 Hiroshima Leaders’ Communiqué specifically recognized and supported dementia as a freestanding issue, breaking away from the typical categorization with NCDs. Moreover, the G7 health ministers published a joint Communiqué spotlighting the priority to “enhance early detection, diagnosis and interventions, including developing care pathways and capability and capacity building of health and primary care providers by strengthening primary health care (PHC)”.  

These promising steps mean that Alzheimer’s disease is beginning to gain the recognition it deserves but also acts as a line in the sand to ensure complacency doesn’t creep in. Collectively, EU countries must assume a leading voice within the international fora, ensuring that Alzheimer’s disease remains a global health care priority and receives the investment it warrants. 

Time to commit to action in Alzheimer’s disease  

September marks World Alzheimer’s Month, and its theme Never Too Early, Never Too Late, reiterates the importance of early diagnosis. It presents a valuable foundation to initiate discussions on country- and regional-level strategies to drive and strengthen diagnostic infrastructure and services for the prevention, diagnosis, case management, monitoring and treatment of Alzheimer’s disease. 

Unless we act now, a generation of people will be forgotten as they begin to lose their memories.

“Unless we act now, a generation of people will be forgotten as they begin to lose their memories,” shares Frédéric Destrebecq, executive director of The European Brain Council. “By recognizing the urgency of the situation and making concerted investments, we can forge a path toward a more compassionate, empowered future for individuals, families and communities impacted by Alzheimer’s, and remember all those who’ve been lost to this devastating disease.”

It is never too early, never too late, to be remembered for taking action against this debilitating disease.  

References:  

1 – Jones RW, Mackell J, Berthet K, Knox S. Assessing attitudes and behaviours surrounding Alzheimer’s disease in Europe: key findings of the Important Perspectives on Alzheimer’s Care and Treatment (IMPACT) survey. The journal of nutrition, health & aging. 2010 Aug;14:525-30.  

2 – Cimler R, Maresova P, Kuhnova J, Kuca K. Predictions of Alzheimer’s disease treatment and care costs in European countries. PLoS One. 2019;14(1):e0210958. Published 2019 Jan 25. doi:10.1371/journal.pone.0210958 

3 – Published by Statista Research Department, 20 J. GDP of European countries 2022. Statista. June 20, 2023. Accessed August 1, 2023. https://www.statista.com/statistics/685925/gdp-of-european-countries/. 

4 – The Economist. Why health-care services are in chaos everywhere. Available at:  https://www.economist.com/finance-and-economics/2023/01/15/why-health-care-services-are-in-chaos-everywhere. Accessed: July 2023.  



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Labs: the (overlooked) building block of Universal Health Coverage

Hepatitis C (HCV) — a potentially life-threatening virus that infects 1.5 million new people around the world every year — is highly treatable if diagnosed early.[1]

Unfortunately,  access to quality screening is far from universal. Countries like Egypt — one of the countries with the highest prevalence of HCV in the world — demonstrate the impact screening can have. In 2015, HCV was prevalent in an estimated 7 percent of the country’s population and accounted for 7.6 percent of the country’s mortality, presenting a significant health care and societal burden.[2]

But since then, Egypt has turned a corner. In 2018, the Egyptian Ministry of Health and Population launched a massive nationwide HCV screening and treatment campaign as part of its 2014-2018 HCV action plan.[3] The campaign’s results were inspiring: by July 2020, Egypt had screened more than 60 million people[3] and treated 4 million residents.[2] Today, Egypt is set to be the world’s first country to eliminate HCV within its borders.[2]

The results of Egypt’s HCV screening program speak to diagnostics’ power in contributing to improved health outcomes around the world. Among the essential components of any health system is the capacity for prevention, which includes timely screening and detection. But a preventive approach based on timely diagnosis won’t work without the right infrastructure in place.

Strong laboratories as a cornerstone of building better health care

Matt Sause, CEO Roche Diagnostics | via Roche

The World Health Organization (WHO) highlights the critical role well-functioning laboratory services play in health systems with good reason.[4] Around the world, clinicians increasingly rely on  laboratory tests for diagnostic and treatment decisions. These tests help them make more informed decisions that result in better care and potentially improved outcomes for patients.

The challenges facing labs today — and tomorrow

Two key challenges facing laboratory systems today are underfunding and insufficient resources. Despite their central importance, laboratories struggle to garner the political and financial support they need to be as effective as possible. For example, it’s estimated that while lab results drive approximately 70 percent of clinical decision making, laboratories make up only 5 percent of hospital costs.[5]

After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

What’s needed is a political commitment to provide everyone with access to accurate and timely diagnosis that paves the way to effective treatment and health. And putting this commitment into practice can only be achieved and sustained through coordinated multistakeholder efforts and public—private partnerships. This is not just a worthwhile investment for patients, but also the wider health care system in the long run. After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

Another challenge is the health care workforce. Effective use of diagnostics requires qualified people to drive it, with expertise in pathology and laboratory medicine. Yet the world currently faces a laboratory staffing shortage. For diagnostics in particular, baccalaureate degree programs in laboratory science have previously been on the ‘endangered list’ of allied health professions.[6] In the end, inadequately trained staff, frequent turnover and scheduling problems all make quality lab results more difficult to guarantee.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems.

And that’s not all: inadequate infrastructure and staffing shortages are more present in low-income, rural communities, which exacerbate the broader diagnostics gap troubling global health care today. Many low-income countries lack an integrated laboratory network that can fully provide high-quality, accessible and efficient laboratory testing services for the entire population. In fact, a commission convened by The Lancet concluded that 81 percent of these populations have little or no access to diagnostics.[7]

The path to Universal Health Coverage

Put simply, innovative diagnostics are only meaningful if they reach people where and when they’re needed. Advancing this equity is at the heart of the WHO’s vision for Universal Health Coverage (UHC) by 2030. The goal? To guarantee all people have access to high-quality services for their health and the health of their families and communities, without facing financial hardship.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems. To do this, UHC should explicitly include diagnostics services. Financially, it’s savings from screening, early diagnosis and targeted treatment that make UHC feasible. Health care systems will have to undergo a systemic shift from focusing on treatment to focusing on prevention. And that’s just not possible when clinicians don’t have access to fast, accurate and cost-efficient lab results to inform their clinical decision-making. Policies and regulations that safeguard UHC goals of access and health equity are essential to make progress toward UHC.[8] The Saving Access to Laboratory Services Act (SALSA), in the United States, is an example of how national policies can help to ensure sustainable laboratory networks and contribute to equitable access to essential healthcare.

Stronger labs can not only help health care systems make savings in the routine management of population health; investing in them also helps to reduce costs and prepare in advance for any future public health crises.

This year has already seen encouraging progress toward achieving UHC through enhanced diagnostics capacity. The adoption of the resolution on strengthening diagnostics capacity at the World Health Assembly in May was an important signal of growing international political support for diagnostics. It was also a call to action. The next step for this month’s United Nations General Assembly and Sustainable Development Goals (SDG) Summit is channeling political support for diagnostics into the development of an action-oriented declaration.

To put us closer to UHC, this declaration should commit to ensuring that national health plans include access to timely detection and prevention. That starts with supporting laboratory systems and establishing National Essential Diagnostics Lists that identify the most critical diagnostic tests to help diagnose patients quickly and accurately so that they can receive needed treatment. At Roche, we’re advocating that governments, industry, civil society and other policy stakeholders will come together around concrete plans and shared resources that strengthen diagnostics and the lab infrastructure that makes them effective. In line with our commitment to increase patient access to important diagnostic solutions by 2030, we plan to do our part.


[1] Hepatitis C. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c (Accessed 22.08.2023)

[2] Egypt’s Ambitious Strategy to Eliminate Hepatitis C Virus: A Case Study. Hassanin, A. et al. Available at:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087425/ (Accessed 22.08.2023)

[3] Hepatitis C in Egypt – Past, Present, and Future. Roche Diagnostics. Available at: https://diagnostics.roche.com/global/en/article-listing/egypt-s-road-to-eliminating-hepatitis-c-virus-infection—a-stor.html (Accessed 22.08.2023)

[4] Monitoring the Building Blocks of Health Systems. World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/258734/9789241564052-eng.pdf (Accessed 14.07.2023)

[5] The Cost-effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing. Bogavac-Stanojevic N. & Jelic-Ivanovic Z. J Med Biochem. Volume 36, Issue 3, 238 – 242. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287218/

[6] Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century: Workshop Summary. National Academy of Sciences. Available at: https://www.ncbi.nlm.nih.gov/books/NBK215247/ (Accessed 14.07.2023)

[7] Essential diagnostics: mind the gap. The Lancet Global Health. Available at: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00467-8/fulltext (Accessed 14.07.2023)

[8] Private Sector Commitments To Universal Health Coverage. UHC Private Sector Constituency 2023 Statement. https://www.uhc2030.org/fileadmin/uploads/UHC2030_Private_Sector_Commitments_Statement_April2023.pdf (Accessed 29.08.2023)



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