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Offline: Missed opportunities?
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Offline: Missed opportunities?
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What was the main message of last week’s paper on malaria mortality from Chris Murray and colleagues at the Institute of Health Metrics and Evaluation (IHME) in Seattle? On the surface it was the extraordinary figure of 1·24 million malaria deaths in 2010 (as compared with the previous official estimate of 655 000 deaths). But the more important political message was that donor investments into the Global Fund over the past decade have produced astonishing results. Hundreds of thousands of lives have been saved thanks to the distribution of insecticide-treated bednets and antimalarial drugs. How, then, should the media have responded to these new IHME data? Positively, looking towards the larger story for rich donors? Or negatively, reacting to perceived criticism of WHO’s malaria mortality statistics? *
The University of Queensland
Getty Images
Katherine Rolfe
Here are four headlines that appeared after official WHO reaction was sought: “WHO, Lancet in malaria war”; “WHO rejects bigger malaria death toll reported by Seattle researchers”; “WHO stands by its numbers on malaria deaths”; and “Malaria death toll disputed”. The agency’s new Malaria Policy Advisory Committee (MPAC) said these latest data fuelled “a sterile argument over whose numbers are best”. What a missed opportunity. We have had battles before between WHO and scientists at IHME. Surely we should have learned the lessons of these episodes, on both sides. I thought we had. On the agency’s request, I forwarded a final version of the IHME paper so that it could be circulated to MPAC members before publication. The goal was to enable MPAC to prepare a constructive response. But instead of using the paper to say the agency welcomed these new findings, would work with the IHME team to understand better their new estimates, and would embark on a broad consultation to examine the implications of these latest data, WHO seemed to initiate its own “sterile argument” about numbers. Rather than identify an opportunity for collaboration (to support investment in the Global Fund, for instance), WHO preferred to offer journalists a story, which was eagerly accepted (as the headlines above show), about a territorial dispute over who controls estimates of malaria deaths. In a world where many scientific groups will produce results at 504
variance with WHO’s opinions, the agency needs to show that it can adapt to a more plural scientific environment. WHO has some way to go to prove that it can do so. * Anonymous letters sometimes get submitted to editors. Here is one, a single page, neatly typed and addressed personally, but with no signature. I don’t know whether the critical statements made about the centre under scrutiny are true. But the questions being asked are interesting and worthy of answers. Here is a short sample of its contents. “Two years ago a new global health center was created at the [US] Centers for Disease Control and Prevention (CDC) with a lot of hope and promises. This new center was going to anchor the CDC commitment to global health. Unfortunately as 2012 begins it is unclear whether this new center will have the intended effect on global health, and it increasingly looks like a major missed opportunity...it is not too late to change the direction of this new and important global health center. An objective evaluation is urgently required to establish where to go from here with a clear strategic direction and key strategic priorities.” We would like to hear from the CDC about its Center for Global Health Leadership. What are its achievements? What is its strategy? What are its immediate priorities? * A final reflection on malaria. Last month, one of the authors of the IHME paper, Alan Lopez (from the University of Queensland, Australia), was elected Chairman of the Board of the Health Metrics Network, an independent partnership hosted by WHO, which is dedicated to improving health information systems in low and middle income settings. Here is a further lesson from the residual uncertainties about malaria mortality. Unless we work with countries to put more reliable health information not only at the top of their health agendas, but also as cross-governmental priorities, debates such as those we have seen this past week will continue to cause confusion and misunderstanding. Here is an issue I believe all of us could unite behind. Richard Horton [email protected]
www.thelancet.com Vol 379 February 11, 2012
Offline: Missed opportunities?
Science Photo Library
What was the main message of last week’s paper on malaria mortality from Chris Murray and colleagues at the Institute of Health Metrics and Evaluation (IHME) in Seattle? On the surface it was the extraordinary figure of 1·24 million malaria deaths in 2010 (as compared with the previous official estimate of 655 000 deaths). But the more important political message was that donor investments into the Global Fund over the past decade have produced astonishing results. Hundreds of thousands of lives have been saved thanks to the distribution of insecticide-treated bednets and antimalarial drugs. How, then, should the media have responded to these new IHME data? Positively, looking towards the larger story for rich donors? Or negatively, reacting to perceived criticism of WHO’s malaria mortality statistics? *
The University of Queensland
Getty Images
Katherine Rolfe
Here are four headlines that appeared after official WHO reaction was sought: “WHO, Lancet in malaria war”; “WHO rejects bigger malaria death toll reported by Seattle researchers”; “WHO stands by its numbers on malaria deaths”; and “Malaria death toll disputed”. The agency’s new Malaria Policy Advisory Committee (MPAC) said these latest data fuelled “a sterile argument over whose numbers are best”. What a missed opportunity. We have had battles before between WHO and scientists at IHME. Surely we should have learned the lessons of these episodes, on both sides. I thought we had. On the agency’s request, I forwarded a final version of the IHME paper so that it could be circulated to MPAC members before publication. The goal was to enable MPAC to prepare a constructive response. But instead of using the paper to say the agency welcomed these new findings, would work with the IHME team to understand better their new estimates, and would embark on a broad consultation to examine the implications of these latest data, WHO seemed to initiate its own “sterile argument” about numbers. Rather than identify an opportunity for collaboration (to support investment in the Global Fund, for instance), WHO preferred to offer journalists a story, which was eagerly accepted (as the headlines above show), about a territorial dispute over who controls estimates of malaria deaths. In a world where many scientific groups will produce results at 504
variance with WHO’s opinions, the agency needs to show that it can adapt to a more plural scientific environment. WHO has some way to go to prove that it can do so. * Anonymous letters sometimes get submitted to editors. Here is one, a single page, neatly typed and addressed personally, but with no signature. I don’t know whether the critical statements made about the centre under scrutiny are true. But the questions being asked are interesting and worthy of answers. Here is a short sample of its contents. “Two years ago a new global health center was created at the [US] Centers for Disease Control and Prevention (CDC) with a lot of hope and promises. This new center was going to anchor the CDC commitment to global health. Unfortunately as 2012 begins it is unclear whether this new center will have the intended effect on global health, and it increasingly looks like a major missed opportunity...it is not too late to change the direction of this new and important global health center. An objective evaluation is urgently required to establish where to go from here with a clear strategic direction and key strategic priorities.” We would like to hear from the CDC about its Center for Global Health Leadership. What are its achievements? What is its strategy? What are its immediate priorities? * A final reflection on malaria. Last month, one of the authors of the IHME paper, Alan Lopez (from the University of Queensland, Australia), was elected Chairman of the Board of the Health Metrics Network, an independent partnership hosted by WHO, which is dedicated to improving health information systems in low and middle income settings. Here is a further lesson from the residual uncertainties about malaria mortality. Unless we work with countries to put more reliable health information not only at the top of their health agendas, but also as cross-governmental priorities, debates such as those we have seen this past week will continue to cause confusion and misunderstanding. Here is an issue I believe all of us could unite behind. Richard Horton [email protected]
www.thelancet.com Vol 379 February 11, 2012