Tuesday 31 January 2012

Newton Postdoc fellowship in the UK

Full information here: full information here!!

The Newton International Fellowship scheme will select the very best early stage post-doctoral researchers from all over the world, and offer support for two years at UK research institutions.

The long-term aim of the scheme is to build a global pool of research leaders and encourage long-term international collaboration with the UK.

The Newton International Fellowships scheme is run by The British Academy and the Royal Society.

The Fellowships cover the broad range of physical, natural and social sciences and the humanities.

They provide grants of £24,000 per annum to cover subsistence and up to £8,000 per annum to cover research expenses, plus a one-off relocation allowance of up to £2,000.

In addition, Newton Fellows may be eligible for follow-up funding of up to £6,000 per annum for up to 10 years following the completion of the Fellowship.

For more detailed information on the Newton International Fellowships please download the Scheme
Notes.
Newton Fellows round 2008 (PDF 35Kb)
Newton Fellows round 2009 (PDF 28Kb)
Newton Fellows round 2010 (PDF 38Kb)
Newton Fellows round 2011 (PDF 37Kb)

Monday 30 January 2012

Summary of US Pres. Commission for the study of bioethical issues.




From the recent issue of the Lancet.  Volume 379, Issue 9813, 28 January–3 February 2012, Pages e20–e21

Download Report of the Commission here.  Report

Comment

Moral science and the Presidential Commission for the Study of Bioethical Issues

  • Amy GutmannaE-mail the corresponding author
  • James W Wagnera
  • a Presidential Commission for the Study of Bioethical Issues, Washington, DC 20005, USA
“O that moral science were in as fair a way of improvement, that men would cease to be wolves to one another, and that human beings would at length learn what they now improperly call humanity!”
Benjamin Franklin, 17801
Are human volunteers in research sponsored by the US Government treated safely and ethically? President Barack Obama posed this fundamental question to the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) in response to chilling accounts of unethical research undertaken by the US Public Health Service in Guatemala during the 1940s, in which vulnerable populations were deliberately exposed to sexually transmitted diseases without their knowledge or consent. [2][3] and [4]
In a report released on Dec 15, 2011, the Bioethics Commission concluded that the current US system provides “substantial protections for the health, rights, and welfare of research subjects and protects them from harm or unethical treatment”.5 Although confident that the current system affords substantial protections to research volunteers, the Commission identified 14 specific changes to current policies that could further reduce the likelihood of harm or unethical treatment. These recommendations include development of a compensation system for research participants who are injured during research studies; respecting equivalent ethical standards in foreign countries where US-funded research is conducted; and more explicit justifications for site selection to prevent potential exploitation of foreign research volunteers.
As noted by the International Research Panel that advised the Bioethics Commission, the USA—unlike many countries—lacks a comprehensive system to address potential harms connected to research participation.6 Thus some research volunteers are left without any assurance of protection from personal financial and physical risk when they take part in research that benefits society as a whole. Although current US regulations require investigators to inform research participants about any medical care or compensation to be provided in the event of research-related injuries,7 no rule requires free medical care or compensation to be provided. In this regard, the US regulations differ from the research injury compensation systems that exist in most other industrialised nations.8 The Commission recommends that the US Government adopt a carefully designated set of standards for compensation.5
Research supported by the US Government is subject to the same regulatory requirements domestically and internationally. These requirements permit government agencies to recognise foreign procedures if they provide “protections that are at least equivalent” to federal rules.9 For example, procedures for informed consent in the UK might be deemed “equivalent protections” to those required by the US Government. However, US federal agencies have almost never exercised this authority and often insist that all US rules be met even in foreign countries where protections are equal to, or more stringent, than those in the USA.10 The Commission recommends that the federal government develop a process for evaluating requests from foreign governments and other non-US institutions to determine if local laws and procedures can be recognised as providing equivalent protections to research participants.
The increasingly globalised nature of medical research presents ethical challenges when study sites do not offer robust protections for volunteers or if the “research subjects [are]…being systematically selected because of their easy availability, their compromised position, or their manipulability”.11 The Commission recognised the potential for exploitation in low-income communities and countries and recommends that researchers and the proposed research sites demonstrate the capacity—or the ability to achieve the capacity when the research is to be conducted—to protect all human participants.5 In addition, the Commission recommends that the US Government develop criteria for ethical selection of sites, taking into consideration the extent to which sites can benefit the broader community. The Commission found that many of the risks of exploitation can be mitigated, for example, when a study is designed specifically to respond to the health needs of the local community.5
Good science requires good ethics, and vice versa. To do good science, individual investigators, along with the institutions that support and sponsor them, must assume responsibility to protect participants from avoidable harm and unethical treatment and to respect their inherent dignity. Benjamin Franklin1 reminds us of the long-standing ethical principles at the heart of modern laws, rules, and regulations that govern research involving human beings. The challenge of pursuing science in a morally justified way is one that every generation must take up. Without sufficient attention to ethics, we risk losing sight of what is owed to our fellow human beings who deserve special protection by virtue of their willingness to participate in experiments so as to benefit others. The US Government should respond swiftly to the recommendations of the Bioethics Commission's report, or offer compelling reasons for maintaining the status quo.
AG is Chair and JWW Vice Chair of the Presidential Commission for the Study of Bioethical Issues.

References

    • 1
    • B Franklin, J Sparks
    • The works of Benjamin Franklin, vol VIIIHilliard, Gray, and Company, Boston (1839)
    • 2
    • Presidential Commission for the Study of Bioethical Issues
    • “Ethically impossible” STD research in Guatemala from 1946 to 1948. Sept, 2011Presidential Commission for the Study of Bioethical Issues, Washington, DC (2011)
    • 3
    • US Department of Health and Human Services
    • Information on the 1946–1948 United States Public Health Service STD Inoculation Study
    • http://www.hhs.gov/1946inoculationstudy (accessed Dec 12, 2011).
    • 4
    • S Reverby
    • Normal exposure and inoculation syphilis: a PHS Tuskegee doctor in Guatemala, 1946–1948
    • J Policy History, 23 (2011), pp. 6–27
    • 5
    • Presidential Commission for the Study of Bioethical Issues
    • Moral science: protecting participants in human subjects research. Dec 15, 2011Presidential Commission for the Study of Bioethical Issues, Washington, DC (2011)
    • 6
    • Presidential Commission for the Study of Bioethical Issues
    • Research across borders: proceedings of the International Research Panel of the Presidential Commission for the Study of Bioethical Issues. Sept, 2011, Presidential Commission for the Study of Bioethical Issues, Washington, DC (2011), p. 11
    • 8
    • Institute of Medicine
    • Responsible research: a systems approach to protecting research participantsNational Academies Press, Washington, DC (2003)
    • 11
    • The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research
    • The Belmont report: ethical principles and guidelines for the protection of human subjects of research. Department of Health, Education, and Welfare Publication OS 78-0012, Department of Health, Education, and Welfare, Washington, DC (1978), p. 10

Wednesday 25 January 2012

Head of Global Fund resigns!

Resignation letter original link here  Also Laurie Garrett's  response below


A MESSAGE TO STAFF, PARTNERS AND FRIENDS FROM THE EXECUTIVE DIRECTOR

Date : 24 January 2012
Dear Friends and Colleagues,
This has been a difficult letter to write.  Its purpose is to inform you of my decision to step down from my position as Executive Director of the Global Fund by March 16, 2012.
For the last ten years, the Global Fund has been my passion and my most important undertaking.  As a member of the Transitional Working Group in 2001 that laid down the basic structure and principles of the Fund, as the first Chair of the Technical Review Panel from 2002 to 2005, as the Vice-Chair of the Board in 2005 and 2006, and in my five years as Executive Director, I have been deeply committed to helping the Global Fund achieve its vision of a world free of AIDS, tuberculosis and malaria.
No institution is perfect, and the Global Fund is no exception.  Yet, I am immensely proud of what the Global Fund has achieved in these ten years, and I am tremendously grateful that I have been able to play a central part in its evolution and success.  As a physician, I am particularly proud of the role that the Fund has played in reducing human suffering and saving lives.  Through its strong focus on human rights, the Global Fund is also helping to protect vulnerable groups in many countries who suffer discrimination, persecution and indignity.  And with its principle of country ownership and its unique power-sharing and multi-stakeholder governance structure of governments, civil society and the private sector, the Global Fund has helped to spearhead an entirely new framework of international development partnership.   Although we still have a long way to go to make this new approach work in every country, I believe that the Global Fund has permanently changed the development landscape for the better. 
In this year of the Fund’s tenth anniversary, there is much to celebrate.  The Global Fund has been a force for good and has helped to make the world a better place. 
Today, the Global Fund stands at a cross-road.  The High-Level Panel which delivered its report last September clearly stated that the Fund must adapt to the different realities of its second decade.  The prevailing economic climate poses new and formidable challenges to all international development efforts.  In the international political economy, power-balances are shifting and new alignments of countries and decision-making institutions are emerging or will have to be developed to achieve global goals.  Within the area of global health, the emergency approaches of the past decade are giving way to concerns about how to ensure long-term sustainability, while at the same time, efficiency is becoming a dominant measure of success.
My belief that the Global Fund has an indispensable role to play in the coming decade is unwavering and I am confident that the rationale, targets and objectives of the new strategy adopted by the Board last November provide a strong institutional framework for the next five years.
In November, the Board decided to appoint a General Manager to oversee implementation of the Consolidated Transformation Plan who will report directly to the Board.  I respect this decision and trust that it was made in the best interests of the Global Fund.  I have reflected long and hard on the implications of this decision for me and for the organization.  While I remain fully committed to the Global Fund and its mission, I have concluded that I should not continue as Executive Director in these circumstances. 
I am committed to an orderly transition and I will do all that I can to ensure that the Global Fund emerges from it as a stronger organization.
I sincerely thank all members of the Global Fund staff for their commitment to the Global Fund.   Each and every person working in the Secretariat is making a direct and invaluable contribution to saving lives.   It has been a true privilege to work with such a committed, diverse and talented group of people.  There will be an informal event in March for us to say goodbye and for me to thank staff members personally for their efforts.
I thank everyone in the Fund’s major partner organizations for their support.  Without WHO, UNAIDS, UNDP, UNICEF, Stop TB, Roll Back Malaria, the Bill and Melinda Gates Foundation, Unitaid and the many civil society organizations that I have seen in action, Global Fund financing could not make such impact. 
I thank all the Friends organizations, particularly those in Europe, Japan, the US, Africa and the Pacific, whose advocacy and constant support for the Global Fund are so essential to its visibility and success.   I thank all the governments that are donors to the Global Fund.   And I thank our many other donors, including everyone associated with Product RED, as well as Bono, for their remarkable support.
Finally, I thank all the countries that are implementing AIDS, TB and malaria programs for their courage and commitment to fighting disease and improving the health of their people.  The opportunities that I have had to travel to many countries in the last five years and to see firsthand the difference that the Global Fund is making have been a tremendous source of personal inspiration.
As the Global Fund faces a challenging year of transition, it is more important than ever that staff, partners, donors, implementers, friends and supporters of the Fund pull together to maintain the remarkable hope that the Fund has generated around the world, and to keep up the fight.
With warm regards
Michel Kazatchkine


Letter from Laurie Garrett -- missing graphs.  Find original on her website.Laurie Garrett's website

The Global Fund: Can it be saved?
By Laurie Garrett, Senior Fellow for Global Health
January 24, 2012
Today Dr. Michel Kazatchkine tendered his resignation as Executive Director of The Global Fund to Fight AIDS, Tuberculosis, and Malaria (The Fund). Regardless of whether you’ve ever heard of the French AIDS scientist, or even of The Fund, you should keep reading. This is a critical, dangerous moment for all of Global Health.
In his letter delivered today to the Board of The Fund, Kazatchkine made clear the parameters of the political struggle that forced his resignation. “The Global Fund has helped to spearhead an entirely new framework of international development partnership. Although we still have a long way to go to make this new approach work in every country, I believe that the Global Fund has permanently changed the development landscape for the better,” Kazatchkine wrote.
But under stress during the world economic crisis, with radically declining support from donors, a battle has ensued, Kazatchkine wrote. “Today, the Global Fund stands at a cross-road. The prevailing economic climate poses new and formidable challenges to all international development efforts. In the international political economy, power-balances are shifting and new alignments of countries and decision-making institutions are emerging or will have to be developed to achieve global goals. Within the area of global health, the emergency approaches of the past decade are giving way to concerns about how to ensure long-term sustainability, while at the same time, efficiency is becoming a dominant measure of success.”
It is almost possible to hear Kazatchkine spitting out the words “efficiency” and “sustainability.” Indeed, a battle has been brewing since the financial crisis of November 2008 filtered pain down a year later on all types of foreign aid recipients, for everything from humanitarian crisis responses to malaria bed net distribution. Put in broad strokes, it is a fight between
Source Kaiser Family Foundation/ Jen Kates
those that believe the AIDS pandemic and allied diseases constitute global “emergencies” that must be tackled with full force, mistakes be damned; versus those that feel AIDS is now a chronic disease, managed with medication, requiring a permanent infrastructure of care and treatment that can eventually be operated and funded by the countries, themselves. It is a classic battle of titans, pitting urgency against long term sustainability.
The Fund was established ten years ago as a unique mechanism for moving billions of dollars from rich countries to poorer ones, to combat and treat three infectious diseases. Inspired by AIDS activists’ and physicians’ demands for access to life-sparing medicines, The Fund launched in 2002 in radical form. It is para-United Nations, meaning it is technically outside of the UN system, but all of the major health-related UN agencies and the World Bank sit on its Board. The Fund acts like a granting agency, accepting disease control and treatment application from governments and health organizations. The applications are reviewed by technical experts, often returned for redesign, and eventually deemed worthy of support. At the closure of a given grant cycle The Fund convenes a replenishment meeting, telling donors – mostly the governments of the U.S., U.K., France, and Germany – how much money is needed to support the accumulated grants.
This grant/replenishment mechanism is novel, unlike any other funding that directs resources for health or development from the North to the South, or from traditionally wealthy nations to the poorer ones. As designed, the mechanism puts recipients in the driver’s seat, stipulating how much money they want, and how they plan to spend it. Donors were assured that mechanisms were in place to monitor the cash flows, minimizing corruption, and maximizing the numbers of lives saved.
And The Fund worked. Just six years after its conception The Fund dispersed $2.3 billion in 2008. By 2010, The Fund was disbursing $3.5 billion annually. It was responsible for underwriting about 40 percent of all HIV treatment in poor countries and much of the care in middle-income nations such as China and India. More than two thirds of all malaria prevention and treatment in the world is now dependent on The Fund; three-quarters of all tuberculosis efforts. The Fund’s most marked impact has been on malaria, which has plummeted with infusion of cash for bed nets, insecticides, medicines and public health personnel. At the close of 2011 the World Health Organization (WHO) estimated that the number of malaria deaths fell 25 percent
between 2000 and 2010 – by a third in sub-Saharan Africa. In 2010, WHO reckons, 216 million people contracted malaria, which killed 655,000 of them.
A key point underscored repeatedly in a recently released WHO malaria report is that these successes reflect growing dependency on The Fund. The same is true for TB control. And while the United States government is by far the biggest supporter of HIV prevention and treatment programs, The Fund ranks second, and its collapse would leave more than a million HIV+ people without treatment, condemning them to swift death.
The prolonged recession and economic realignments are now hitting aid-dependent organizations hard, and will continue to exact budgetary pain for at least two more years. (If the Chinese financial wizards are right the world may be at the front end of a 25 year recession.) The initial reactions from global leaders like Kazatchkine was to scramble from donor to donor, hoping to garner guarantees of not only continued current-level financial support, but even expansion of funding to allow larger numbers of people to benefit from their services in poorer countries. Time was bought, and most of the major donors fulfilled their commitments in 2009 and 2010.
But with no end in sight to the economic downturn in the U.S., the tsunami-earthquake-Fukushima catastrophes in Japan and deepening crisis in the EuroZone, 2011 brought financial angst crashing down on Global Health. In October 2010 The Fund convened a replenishment meeting, asking donors for $20 billion for five years’ worth of disbursements. The donors were indignant: they committed just over half that amount. The Fund was flabbergasted.
After taking stock of its donor situation The Fund announced that it was cancelling the next grant round, and will not accept new grants until late 2013, disbursing those funds in 2014. Medecins Sans Frontiers and other health advocacy groups cried in protest, issuing estimates of numbers of people that would die for lack of new grants rounds.
The International Health Metrics and Evaluation Institute (IHME) in Seattle estimates that overall Global Health funding stagnated, and can only be expected to grow by 1-2 percent annually (if at all) over the next few years. Many programs are already feeling the budget blade in their backs. Humanitarian crises such as the famine in the Horn of Africa are groveling for handouts.
With this dire situation has come the search for more efficient ways to spend stagnating or shrinking resources: eliminate redundancies, better anticipate crippling foreign exchange rates amid monetary speculation, improve volume purchasing and supply chain management, and root out all semblances of corruption. Donor scrutiny increased. And under the bright lights of forensic financial investigation The Fund could not account for some $34 to $39 million. Moreover, specific “missing money” corruption cases opened in Mali, Mauritania, Djibouti, and Zambia, spawning loud protests from donors. Sweden, Germany and Ireland froze their monies for The Fund in escrowed accounts.
A High-Level Independent Review Panel convened in early 2011 to audit The Fund’s books, and investigate how the money was being spent at the country levels. In November the Panel released a condemning report, citing a litany of problems so lengthy that they cannot be summarized here: among them were fraud, theft, inconsistent decision-making by grant reviewers, nearly complete failure to develop metrics for reliably measuring the outcomes of The Fund’s spending, and sluggish disbursement from the organization’s Geneva headquarters.
The Board convened in Accra, Ghana on November 21, and by multiple accounts was stunned by the Panel report, and by internal audit findings. From a number of sources that attended the Accra meeting and subsequent Board gatherings I have gleaned a nightmarish picture. Some African leaders described riots and demonstrations protesting stock-outs of vital medicines, especially for HIV. Malaria experts said that even a momentary set-back in funding could swiftly push mosquito populations back to high levels, bringing the deadly parasites back to African and Asian villages.
The Board demanded Kazatchkine’s resignation. He refused.
The Board’s audit showed that The Fund has committed assets of $10 billion for 2011-13. But only about $4 billion was in its bank accounts. Auditors presented a “risk adjusted forecast for resources,” which demonstrated few avenues for fulfilling its commitments, much less taking on new ones.
The Board called for a Transitional Funding Mechanism, aimed at finding ways to stretch available resources, eliminate inefficiencies and get better bang for the HIV/malaria/TB buck. Key to that Mechanism would be appointment of a General Manager to oversee all spending, pushing Kazatchkine aside to a sort of figurehead status.
Kazatchkine refused. He was under tremendous pressure from the Sarkozy government – reportedly taking calls during the Accra meeting and following gatherings from the French Ministry of Foreign Affairs. It is an election year in France, and President Nicholas Sarkozy is battling a very cold image, seen by many of his voting population as an uncaring conservative that is putting Paris financial market concerns above the needs of the poor and middle class. He needs a softer asset – and The Fund has always been a darling of French foreign aid. February marks the 10th anniversary of The Fund, and Sarkozy plans a grand celebration in Paris, which must be chaired by the French head of The Fund.
The French situation was complicated further in 2011 when Kazatchkine was attacked in Paris newspapers for allegedly diverting Fund HIV money to a small foundation run by French First Lady Carla Bruni. A furious round of accusations and counter-accusations flew in the French media, but official investigations cleared Kazatchkine of all wrong-doing. He is not a member of Sarkozy’s party, nor a supporter of the President’s reelection. But Kazatchkine is French, and the prospect of a grand Parisian celebration of his institution’s 10th birthday was important.
Kazatchkine would not (could not) step down. And the Board’s selection for General Manager declined to step into the position so long as Kazatchkine remained.
Over the Christmas and New Years’ holidays, U.S. Secretary of State Hillary Clinton pressured the French, according to several sources that asked not to be identified, arguing that the very credibility of The Fund was on the line – Kazatchkine had to step down. She also gave a speech telling other donors to step up to the plate and support The Fund, noting that “to sit on the sidelines now would be devastating.”
Apparently a deal was finally struck, allowing Kazatchkine to stay in his position until March 16 (after the Paris celebration).
In his resignation letter today he writes, “As the Global Fund faces a challenging year of transition, it is more important than ever that staff, partners, donors, implementers, friends and supporters of the Fund pull together to maintain the remarkable hope that the Fund has generated around the world, and to keep up the fight.”
Stepping into the newly created position of General Manager of The Fund is Gabriel Jaramillo, who served on the High-Level Panel that audited The Fund in 2011. Columbia-born Jaramillio was CEO of Banco Santander Banespa Brasil, and previously was an executive for Citibank. Jaramillo served as Special Advisor to Malaria No More. At the World Economic Forum in Davos later this week Bill Gates will throw his support behind Jaramillo, pledging a 5-year funding commitment to The Fund that will significantly increase his foundation’s support above the current $100 million/year level. The government of Saudi Arabia announced this week that it will provide The Fund with $25 million in 2013. Similar proclamations are expected over coming days, following Kazatchkine's resignation letter, but it is unlikely the total in this flurry will top $500 million for 2013.
This tragic series of events has unfolded at The Fund amid a tremendous shake-up throughout Global Health. A similar set of events unfolded in 2010 at GAVI – the umbrella alliance for vaccines – nearly sinking the institution. But following a major overhaul of the institution, dismissal of its executive and intervention from Bill Gates, GAVI went into a funding meeting with donors in London in June. It came out with more than a billion dollars than it requested, thanks largely to U.K. Prime Minister David Cameron, and has a popular new leader, Dr. Seth Berkley (founder of the International AIDS Vaccine Initiative).
WHO is also in the middle of a major shake-up that has in recent months featured lay-offs of 300 employees and a $1 billion budget cut. Director-General Margaret Chan is executing a top-to-bottom reform of the agency that is both painful and necessary.
We can hope that this awful moment in The Fund’s history will leave the institution stronger, tougher, and better supported in 2013.
From Kaiser Family Foundation/ Jen Kates