High-level Commission Research Articles

How India can reach net zero: a strategy for 2025–35

Abstract This paper assesses the feasibility of India achieving its stated objective of getting to net zero carbon emissions by 2070 and outlines a possible strategy for the next 10 years consistent with this goal. It recommends a combination of price-based measures and several sector-specific interventions. The ideal price-based measure would be a carbon tax. This may not be feasible for various reasons, but in its absence a well-designed emissions trading system, as described in the paper, could make a major contribution in reducing emissions. On sectoral interventions, the critical areas over the next 10 years would be (i) accelerated expansion of various forms of renewable energy capacity, which will require several policy changes, (ii) electrification of transport, and (iii) a shift from private to public transport in urban areas and from road to rail for freight. Action will also be necessary in other sectors such as industry, agriculture, and buildings, but a detailed strategy for these may take more time to put in place. Since responsibility for action in all these areas is spread across different ministries in the central government and, in many cases, state governments, evolving an internally consistent and cost-effective strategy will present a major challenge. There is a case for setting up a high-level commission chaired by the Prime Minister to approve a national strategy. The paper estimates that the additional investment needed to make this transition will be about 2 per cent of India’s GDP by 2030, much of which will have to come from additional public and private savings. In this context, some form of carbon pricing would help generate additional revenue.

Levelized Cost of Heat of the CSPth Hybrid Central Tower Technology

Process heating represents about two-thirds of the energy that the industry sector consumes worldwide; this energy comes primarily from burning fossil fuels. There is a wide variety of processes for which solar technologies can supply energy. Within these technologies, the CSPth Central Tower produces heat at temperatures about 600 °C, making it suitable for high-temperature processes. A CSPth Central Tower can be combined with a fuel-based system to form a CSPth Hybrid Central Tower system, which results in a high-reliable energy source with low rates of CO2 emissions. In this work, the levelized cost of heat (LCOH) of the CSPth Hybrid Central Tower technology was calculated. SolarPILOT was used to design and evaluate the CSPth Central Tower; fuel consumption was calculated using a steady-state energy balance. The LCOH was evaluated considering the CO2 prices recommended by the High-Level Commission on Carbon Pricing. The analysis shows that this technology can be highly competitive and, in certain cases, shows lower LCOH than fuel-based systems. However, these cases depend on reasonable CO2 prices, low costs of capital (≈5%), and efforts to reduce the capital expenditure, which can nowadays be possible for CSPth Hybrid Central Tower systems designed with large solar multiples.

COMMISSIONS OF INQUIRY AS A RESPONSE TO CRISIS: THE ROLE OF THE JALI COMMISSION IN CREATING PUBLIC AWARENESS OF CORRUPTION (PART 2)

When the government of a liberal constitutional democracy is confronted by some or other existential crisis that threatens a major institution of state or the very foundations of the democracy itself, it will often appoint a high-level judicial commission of inquiry as part of its response to the crisis. South Africa is no exception to this tendency, as is evidenced in recent years by the appointment of no fewer than four such commissions in response to a series of crises related to ongoing corruption within state institutions – commonly referred to by ordinary South Africans as “state capture”. This has raised questions as to the alleged benefits of such commissions when viewed in relation to their considerable costs. This article seeks to contribute to this general debate by focusing on one of the purported benefits of such commissions that may be somewhat under appreciated. This is the creation of public awareness, during the life of the commission itself, about the nature and extent of the particular grave threat that confronts the society in question. It is contended that, mediated by a free and vibrant press, the public narrative that emerges during the operation of a commission of inquiry may serve to make a liberal democratic society more resilient in the face of threats to that society’s continued existence. This article seeks to support this contention by focusing on an important precursor to the more recent commissions of inquiry on corruption in South Africa – that is, the Jali Commission of Inquiry into corruption within the South African penal system, which sat in the early years of the new millennium. By analysing the many articles and reports that appeared in a range of South African newspapers during the initial hearings of the Jali Commission, this article documents the emergence of an important public narrative on corruption within South Africa’s prisons, and reflects upon the ultimate significance. This article is divided into two parts: the first part deals with the initial hearings of the Jali Commission in KwaZulu-Natal, and the second part with subsequent hearings in the Free State.

Z-Inspection®: A Process to Assess Trustworthy AI

The ethical and societal implications of artificial intelligence systems raise concerns. In this article, we outline a novel process based on applied ethics, namely, Z-Inspection <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> , to assess if an AI system is trustworthy. We use the definition of trustworthy AI given by the high-level European Commission's expert group on AI. Z-Inspection <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> is a general inspection process that can be applied to a variety of domains where AI systems are used, such as business, healthcare, and public sector, among many others. To the best of our knowledge, Z-Inspection <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> is the first process to assess trustworthy AI in practice.

Editorial introductions

Editorial introductions

Commissions of Inquiry as a Response to Crisis: The Role of the Jali Commission in Creating Public Awareness of Corruption (Part 1)

When the government of a liberal constitutional democracy is confronted by some or other existential crisis that threatens a major institution of state or the very foundations of the democracy itself, it will often appoint a high-level judicial commission of inquiry as part of its response to the crisis. South Africa is no exception to this tendency, as is evidenced in recent years by the appointment of no fewer than four such commissions in response to a series of crises related to ongoing corruption within state institutions – commonly referred to by ordinary South Africans as “state capture”. This has raised questions as to the alleged benefits of such commissions when viewed in relation to their considerable costs. This article seeks to contribute to this general debate by focusing on one of the purported benefits of such commissions that may be somewhat under-appreciated. This is the creation of public awareness, during the life of the commission itself, about the nature and extent of the particular grave threat that confronts the society in question. It is contended that, mediated by a free and vibrant press, the public narrative that emerges during the operation of a commission of inquiry may serve to make a liberal democratic society more resilient in the face of threats to that society’s continued existence. This article seeks to support this contention by focusing on an important precursor to the more recent commissions of inquiry on corruption in South Africa – that is, the Jali Commission of Inquiry into corruption within the South African penal system, which sat in the early years of the new millennium. By analysing the many articles and reports that appeared in a range of South African newspapers during the initial hearings of the Jali Commission, this article documents the emergence of an important public narrative on corruption within South Africa’s prisons, and reflects upon the ultimate significance of this narrative. This article is divided into two parts: the first part deals with the initial hearings of the Jali Commission in KwaZulu-Natal, and the second part with subsequent hearings in the Free State.

Attitudes towards Local Anaesthetic Simulator Kit as a Novel Teaching Aid

Introduction Local anaesthesia is an essential part of dental treatment, and it is formally taught worldwide in the dental curriculum. The inferior alveolar nerve block (IANB) is one of the most common regional anaesthesia techniques used in dental procedures. However, this technique is reported to have the highest failure rate among dental undergraduates, interns and even, dental professionals. Purpose This study primarily aims to present a preliminary assessment of the influence of diffusion of innovation attributes on dental undergraduates’ attitudes towards a Novel Local Anaesthesia Simulator Kit (LASK) in performing Inferior Alveolar Nerve Block (IANB). Methodology A cross-sectional survey was conducted using a questionnaire, and it was distributed to selected dental undergraduates. The questionnaire used in this study consisted of items that were adapted from previous studies. A total of 83 completed questionnaires were obtained and considered valid for data analysis. Results All 83 respondents were dental undergraduates from Year 1, involving 69.9% females and 30.1% males between the ages of 18 - 20. The study’s findings reported that relative advantage (r=.716, p<0.05), complexity (r=.651, p<0.05), compatibility (r=.775, p<0.05), observability (r=.721, p<0.05) and trialability (r=.631, p<0.05) were significantly correlated with the attitudes of the dental undergraduates toward the new LASK in performing IANB. Conclusion The findings from this study will help in conducting an actual study in future. Furthermore, these empirical studies will contribute to specific educational significance, especially in the assessment of clinical competence of dental undergraduates at a more microscopic level. Hence, taking the enhancement of dental undergraduates’ clinical skills into consideration, we are providing pre-clinical training that improves patients’ safety, which is in line with the World Health Organisation’s (WHO) Final Report of the Expert Group to the High-Level Commission on Health Employment and Economic Growth.

Global lung cancer mortality trends and lifestyle modifications: preliminary analysis

Background:According to the Independent High-level Commission on Non-communicable Diseases (NCD) of the World Health Organization (WHO), global reduction in lung cancer mortality has been achieved since the year 2000, although this effect is not sufficient to reach the 30% reduction of mortality from NCDs by the year 2030, as stipulated by the United Nations Sustainable Development Goal 3.4. The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer.Methods:WHO statistics, based on the unified mortality and causes-of-death reports of Member-State countries, were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based, country-wide interventions.Results:The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years. Comprehensive tobacco control remained the major and most successful lifestyle modification measure. In countries with declining lung cancer mortality, 91% of countries had decreasing tobacco prevalence in males and 82% in females. Country- wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality (t = 1.79, P > 0.05). Other WHO “best-buy” lifestyle modification campaigns (diet and alcohol) had been carried out for shorter periods, and their associations with lung cancer were less strong than tobacco. There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use (t = 0.92, P > 0.05) and unhealthy diet reduction measures (t = 0.84, P > 0.05).Conclusion:Following WHO “best-buys” should facilitate to move countries towards the NCD including lung cancer mortality reduction targets. Governments and communities must embrace these targets with coordinated effective action for better health.

Nursing now and always: evidence for the implementation of the Nursing Now campaign.

Objective:to identify the guiding axes of the documents that grounded the Nursing Now campaign and relate the recommendations of these documents to the campaign goals.Method:documentary research, based on the analysis of the documents that promoted the Nursing Now campaign. The data were collected between March and April 2020, using a form structured into: background, scope, challenges and potentials of health/nursing professionals and recommendations for the future.Results:the challenges and the need for investments in the health and nursing workforce to achieve the Sustainable Development Goals were evidenced. The report of the High Level Commission on health Employment and Economic Growth presents important recommendations, also introduced in the Triple Impact Report and in the Strategic Directions for Nursing and Midwifery, converging to the goals of the Nursing Now campaign, stimulating a profile of nurses with technical, political and leadership skills, engaged in health policy-making, and the effectiveness of their practice is clear to the entire society.Conclusion:knowledge about the dynamics of the factors that converged to the development of the Nursing Now campaign may be a condition for achieving its goals. This reality reveals evidence that global health will not be ensured without strengthening Nursing first.

Financial impacts of climate change mitigation policies and their macroeconomic implications: a stock-flow consistent approach

ABSTRACTTo what extent can worldwide carbon pricing foster the transition towards a low-carbon economy and mitigate the effects of global warming? We address this question by assessing the financial impacts and macroeconomic implications of carbon pricing and public subsidies. More specifically, we evaluate the extent to which such policies are sustainable by computing the probability of remaining below two thresholds that we argue to be indicative of the stability of our current economy and climate: (1) a temperature anomaly above +2°C (a commonly acknowledged target, including in the 2015 Paris Agreement, to potentially avoid nonlinearities in the climate system) and (2) a large global debt-to-output ratio of 270%.Key policy insightsThe upper-bound of the carbon pricing corridor advocated in the High-Level Commission on Carbon Prices (2017. Report of the high-level commission on carbon prices. Washington, DC: World Bank), when implemented together with additional public subsidies on abatement costs in the private sector, is likely to successfully ensure sustainable economic growth by the end of the century.The probability that these climate policies will allow us to cap the average Earth temperature deviation at below +2.5°C by the end of this century is about 50%.Without a strong public commitment, the impact of climate change on gross output and capital, which captures nonlinear effects such as tipping points, appears to be powerful enough to pull the world economy towards a debt-deflationary field, potentially leading to forced degrowth in the second half of the twenty-first century.

The Case against Carbon Prices

Professor Dr. Anthony Patt is head of the Climate Policy Group in the Department of Environmental Systems Science at ETH Zurich, Switzerland. His research focus is on technological pathways and public policies for climate change mitigation and adaptation. He is a Coordinating Lead Author in Working Group III of the Intergovernmental Panel on Climate Change. He obtained his PhD at Harvard University's Kennedy School of Government. He is the author of “Transforming Energy: Solving Climate Change with Technology Policy” (Cambridge University Press, 2015). Download : Download high-res image (204KB) Download : Download full-size image Professor Dr. Johan Lilliestam is head of the Renewable Energy Policy Group in the Department of Environmental Systems Science at ETH Zurich, Switzerland. His research focus is policies and strategies for a transition to a completely renewable energy system, including the effects of interactions between different energy policies. He obtained his PhD at the Central European University in Budapest, Hungary. Before joining the ETH, he worked at the Potsdam Institute for Climate Impact Research (PIK) in Potsdam, Germany, and the International Institute for Applied Systems Analysis (IIASA) in Laxenburg, Austria. He currently holds a grant from the European Research Council for his work on policy interactions. Download : Download high-res image (202KB) Download : Download full-size image

Implication of International Law in Electronic Commerce and Cyber Crime: An Experience of Nepal

Electronic commerce is one of the human innovations to serve the necessity of the people. It has not only nationalized the business but also universalized or transnationalized of the trading activities from one country to another country. Without application of any means and method of electronic commerce, no contemporary trade is possible. It is associated with business to business, business to consumer, consumer to business, and consumer to consumer relationship. Even government sectors are also one of the targets of these types of transactions in government procurement system. Affiliate marketing, integrated E-commerce, interface E-commerce, subscription, and vanity etc are used for the transaction purposes. There is equal chance to misuse these systems. No human life is possible in the absence of electronic transaction in contemporary time. However, this transaction system can be abused by the offender of this area. It is covered by the cyber crime which can be computer related, perpetrator based, victims based and contents based cyber crimes. In contemporary time, the payment system and payment service providers are the target of the people occurred frequently across the globe. Individual, society, organization, property are targeted by cyber criminal. Internet banking, mobile banking, debit card, credit cards, visa cards, Cash and Cheque Deposit Kiosks, ATM and Point of Sale are also the target of criminals. To make it secured, many stringent policies are recommended and applied. Yet, it is not a complete immune. So, user of these tools should be conscious. Beware buyer and beware seller both principles are applicable in electronic commerce. In intellectual arena, plagiarism from those instruments can also be the subject of cyber crime. Identity thefts, banking frauds, hacking, phishing, pirating, defamation, obscene publications are also the issues of offence under this regime. Nepal Police, Metropolitan Police Crime Division, investigates cyber crime in Nepal. The provisions of Company Act, 2006 (2063), Export-Import (Control) Act, 1957 (2013), Foreign Investment and Technology Transfer Act,1992 (2049), Patent, Design and Trademark Act, 1965 (2022), Copy Rights Act, 2002 (2059), Electronic Transaction Act, 2008 (2063), Telecommunication Act, 1997 (2053), Electronic Transaction Rules, 2007 (2064), Competition Promotion and Market Protection Act, 2007 (2063), Long Term Communication Policies, 2002, Information Technologies Policies, 2000 and Information Technology Tribunal (Procedures) Rules, 2007 (2064) are applicable in the offence of cyber crime in Nepal. Electronic Transaction Act and its Rules are specialized legislation of Nepal applicable on cyber crime. United Nations Convention on the Use of Electronic Communications in International Contracts, 2005, European Convention on Cyber Crime, 2001, World Intellectual Property Rights Organization Copyright Treaty, 1997, Convention on the Recognition and Enforcement of Foreign Arbitral Awards, 1958, United Nations Convention on the Use of Electronic Communications in International Contracts, 1998 , United Nations Convention on Contracts for the International Sale of Goods, 1980, Recommendations to Governments and international organizations concerning the legal value of computer records , 1985 are some of the international instruments developed to check cyber crime in different territory of the globe. High Level Commission for Information Technology, Computer Association of Nepal, National Information Technology Center, Nepal Copyright Registrar Office, Office of the Controller of Certifying Authority, Ministry of Environment, Science and Technology, Nepal Police and Information Communication Technology Tribunal and its Appellate Tribunals are existed in Nepal. Electronic commerce is the business activity which grants accesses to the world community to business. It is not only the subject matter of technology but overall system of business through the use of technology. Despites its benefit, it is necessary to check the abuse of those instruments from criminals by applying stringent measures and international cooperation and coordination.

Primary health care for the 21st century, universal health coverage, and the Sustainable Development Goals

Good health and wellbeing are fundamental to the prosperity of societies. By many measures, modern humanity enjoys better health than earlier generations. 1 WHOWorld health statistics 2018: monitoring health for the Sustainable Development Goals. World Health Organization, Geneva2018 Google Scholar But the benefits of modern health care are not accessible to all. Even as the incidence of infectious diseases such as HIV, tuberculosis, and malaria are reduced, many countries struggle to cope with the growing burden of non-communicable diseases, and the complex and growing health needs of ageing populations. 2 WHOTime to deliver: report of the WHO Independent High-level Commission on Noncommunicable Diseases. World Health Organization, Geneva2018 Google Scholar , 3 WHOWorld report on ageing and health. World Health Organization, Geneva2015 Google Scholar The Astana Declaration: the future of primary health care?Primary health care is in crisis. It is underdeveloped in many countries, underfunded in others, and facing a severe workforce recruitment and retention challenge. Half the world's population has no access to the most essential health services. Yet 80–90% of people's health needs across their lifetime can be provided within a primary health-care framework—from maternity care and disease prevention through vaccination, to management of chronic conditions and palliative care. As populations age, and multimorbidity becomes the norm, the role of primary health-care workers becomes ever more important. Full-Text PDF Alma-Ata at 40 years: reflections from the Lancet Commission on Investing in HealthIn 2013, the Lancet Commission on Investing in Health published its report, “Global health 2035: a world converging within a generation” (GH2035). The report concluded that a grand convergence in health—a reduction in infectious, child, and maternal mortality to rates seen in the best-performing middle-income countries—is technically and financially feasible for all but the poorest countries by 2035. Mortality from non-communicable diseases could be reduced through inexpensive population-based and clinical interventions, especially fiscal policies such as heavy tobacco taxation. Full-Text PDF Effectiveness and sustainability of a diagonal investment approach to strengthen the primary health-care system in EthiopiaWeakness of primary health-care (PHC) systems has represented a challenge to the achievement of the targets of disease control programmes (DCPs) despite the availability of substantial development assistance for health, in resource-poor settings. Since 2005, Ethiopia has embraced a diagonal investment approach to strengthen its PHC systems and concurrently scale up DCPs. This approach has led to a substantial improvement in PHC-system capacity that has contributed to increased coverage of DCPs and improved health status, although gaps in equity and quality in health services remain to be addressed. Full-Text PDF Yelzhan Birtanov: leading Kazakhstan to universal health coverageAlthough only a child at the time, Yelzhan Birtanov, Minister of Healthcare of Kazakhstan, remembers the landmark 1978 Alma-Ata conference. His physician parents were attendees. “I recall doing drawings with the pens that they brought back from the meeting, and looking at a lot of photos of the conference; even as a young child, it was clear that something major was taking place in my country”, he says. Full-Text PDF

Commentaries on health services research

Commentaries on health services research

Time to Deliver in 2018: WHO Independent High Level Commission on Noncommunicable Diseases (NCDs)

Time to Deliver in 2018: WHO Independent High Level Commission on Noncommunicable Diseases (NCDs)

Moving from advocacy to activism? The fourth WHO global forum on human resources for health and implications for dentistry

As we debate shaping the future oral health workforce within the UK, to meet the needs of current and future populations, it is helpful to take an international perspective on this very important issue. Globally, there is a strong recognition that human resources for health (HRH) are fundamentally important to deliver effective care, accessible to all people. This paper reviews the outcome of the fourth global forum held by the World Health Organisation (WHO) in Dublin which highlighted the urgency for action. The main objectives of the forum were to advance the implementation of (i) the WHO Global Strategy on HRH 2030 and (ii) the United Nations High-Level Commission's Health Employment and Economic Growth recommendations. From an oral health perspective, the global burden of oral disease remains huge with untreated dental caries, periodontal disease and tooth loss ranking among the most prevalent conditions worldwide. Major considerations are how dental education, practice delivery and/or oral health systems as a whole could and should innovate to accommodate the growing needs of the population. As dental professionals, it also becomes necessary for us to engage and play a proactive role in this change process. Due to growing differences between population needs and available services, it is necessary for oral health personnel to work more closely with the broader health workforce so as to identify solutions that are in the best interests of the patients and populations at large.

Offline: NCDs, WHO, and the neoliberal utopia

The WHO Independent High-Level Commission on Non-Communicable Diseases presented an important opportunity. Yet, by common consensus, it failed to deliver. The Guardian newspaper reported that, “An independent panel advising the World Health Organisation has stopped short of recommending taxing sugary drinks to reduce obesity after failing to reach a consensus.” WHO scrambled to reassure critics that the agency “still supported taxing” sugar-sweetened beverages. The Commission was left unhappily advocating a set of recommendations substantially weaker than those already existing. Dr Tedros, WHO's Director-General, rejected the Commission's conclusions. “WHO's position cannot change because of this report”, he commented. Critics called the Commission's findings “scandalous”, “startling”, “vague”, “absurd”, “limp”, “lacklustre”, “disappointing”, “unfortunate”, and “sugar-shy”. Overall, the Commission left global health advocates underwhelmed. As one Commissioner wrote to me, “You win some…”. His implication? We lost this one. Although the Commission was certainly disappointing in several ways—and the Commission co-chairs pointed these deficiencies out themselves—such negative interpretations are unfair and mistaken. The Commission was direct in the scale of the challenge it sees ahead. Despite myriad well-intentioned declarations, conventions, commitments, roadmaps, goals, and targets, commissioners underlined a “lack of adequate global progress”, concluding without equivocation that SDG 3.4 (to reduce premature mortality from NCDs by one third) “will not be met”. As a result, their recommendations were not only directed at the usual suspects—ministers of health and the broad global health community. Instead, they appealed to Heads of State. It was they who needed “to accept primary responsibility for taking action”. The Commission went beyond the traditional 4x4 NCD agenda (four main diseases, four main risk factors). It widened its circumference of concern to include mental health, dementia, and air pollution, emphasising the importance of taking a life-course and gendered approach. The Commission pulled no punches about the obstacles to progress: lack of political action, damaging commercial and market forces, no money, and zero accountability for promises easily made and later broken. Now turn to the recommendations. Heads of State need to take responsibility and set priorities. Achieving universal health coverage will be critical. Effective regulation is essential. Although no sugar-sweetened beverage tax was proposed specifically, the Commission did recommend that “fiscal [ie, tax] incentives and disincentives should be considered to encourage healthy lifestyles by promoting the consumption of healthy products and by decreasing the marketing, availability, and consumption of unhealthy products”. Commissioners called for “evidence-based fiscal measures” to reduce the use of unhealthy foods and beverages. The Commission demanded a huge scale-up in financing, proposing new NCD-specific financial instruments, such as a multidonor trust fund. And finally, the Commission called for the creation of an independent accountability mechanism—a Countdown 2030 for NCDs—to monitor and review progress, and to call out those who failed to act on their prior commitments. When you look at the totality of the Commission's proposals, it is far too harsh to call it a failure. On the contrary, it has set a high bar to judge progress in countries and has provided an ambitious manifesto for the UN High-Level Meeting on NCDs, to be held later this year. There are two further important reasons why the Commission should be judged a success. First, it flushed out the chief opponent of political progress—the US Government. As Jamey Keaten and Maria Cheng reported for the Associated Press, it was the US representative on the Commission, Eric Hargan, who “torpedoed” efforts to add a recommendation on taxing sugar-sweetened beverages. Now we have a target: the US administration, which has adopted an anti-science position on fiscal interventions and whose raison d'être is to defend health-harming industries. Second, the controversy over the Commission's report highlights the context of the debate about NCDs—namely, the pervasive and escalating dangers of neoliberalism. We should thank the Commission for so expertly clarifying the terms on which the struggle against NCDs must now be fought.

Nursing Now - why nurses and midwives will be even more important and influential in the future.

Nursing Now - why nurses and midwives will be even more important and influential in the future.

Forecasting imbalances in the global health labor market and devising policy responses

BackgroundThe High-Level Commission on Health Employment and Economic Growth released its report to the United Nations Secretary-General in September 2016. It makes important recommendations that are based on estimates of over 40 million new health sector jobs by 2030 in mostly high- and middle-income countries and a needs-based shortage of 18 million, mostly in low- and middle-income countries. This paper shows how these key findings were developed, the global policy dilemmas they raise, and relevant policy solutions.MethodsRegression analysis is used to produce estimates of health worker need, demand, and supply. Projections of health worker need, demand, and supply in 2030 are made under the assumption that historical trends continue into the future.ResultsTo deliver essential health services required for the universal health coverage target of the Sustainable Development Goal 3, there will be a need for almost 45 million health workers in 2013 which is projected to reach almost 53 million in 2030 (across 165 countries). This results in a needs-based shortage of almost 17 million in 2013. The demand-based results suggest a projected demand of 80 million health workers by 2030.ConclusionsDemand-based analysis shows that high- and middle-income countries will have the economic capacity to employ tens of millions additional health workers, but they could face shortages due to supply not keeping up with demand. By contrast, low-income countries will face both low demand for and supply of health workers. This means that even if countries are able to produce additional workers to meet the need threshold, they may not be able to employ and retain these workers without considerably higher economic growth, especially in the health sector.

Civil society challenged: towards an enabling policy environment

Abstract The roles of non-governmental or civil society organizations have become more complex, especially in the context of changing relationships with nation states and the international community. In many instances, state-civil society relations have worsened, leading experts to speak of a “shrinking space” for civil society nationally as well as internationally. The author proposes to initiate a process for the establishment of an independent high-level commission of eminent persons (i) to examine the changing policy environment for civil society organizations in many countries as well as internationally, (ii) to review the reasons behind the shrinking space civil society encounters in some parts of the world and its steady development in others, and (iii) to make concrete proposals for how the state and the international system on the one hand and civil society on the other hand can relate in productive ways in national and multilateral contexts.