High Level Expert Group Research Articles

Стратегічна комунікація ЄС як засіб у боротьбі з дезінформацією.

The article analyzes one of the directions of the European Union strategic communications aimed at debunking fakes and disinformation. Strategic communications belong to the innovative tools of the EU foreign policy, aimed at interaction in the format of both strategic partnership with international actors and regional cooperation with European countries. The East Stratcom Task Force has been created precisely for the East Neighborhood countries to cooperate with the East Europe states and to better inform on the EU in these countries. The Task Force analysts see their mission in explaining and promoting the European Union's policy in the Eastern Neighborhood, as well as correcting disinformation. The Task Force reports and analyzes the trends of disinformation, explains and debunks disinformation messages and raises awareness of disinformation produced by the Russian Federation and Russian-language media.EUvsDisinfo is the publicly available international disinformation database which provides weekly reviews of the Task Force and presents analytical articles on this issue. In particular, analytical materials emphasize that the Kremlin campaign for disinformation uses diversification of channels, messages depending on the target audience. However, all messages have a common goal that is to weaken the West, discrediting the idea of European integration, and to strengthen the Kremlin, promoting the convictions and values of the Russian Federation.Disinformation is used by the Kremlin as a means of acquiring power in both Russian and foreign policy. The Task Force analysts conduct a comprehensive analysis of disinformation messages and demonstrate that disinformation cannot only be a way of intimidating and demonstrating power; it can also be ridiculous, mischievous, when its creators, trying to mislead the audience, are mistaken and exposed.Being aware of the acuteness of the disinformation threats, the European Commission has set up a high-level group of experts whose mission is to provide advice on policy initiatives to counteract false news and disinformation online.

A Critical Take on the Policy Recommendations of the EU High-Level Expert Group on Artificial Intelligence

The European Commission recently published the policy recommendations of its ‘High-Level Expert Group on Artificial Intelligence’: a heavily anticipated document, particularly in the context of the stated ambition of the new Commission President to regulate in that area. This essay argues that these recommendations have significant deficits in a range of areas. It analyses a selection of the Group’s proposals in context of the governance of artificial intelligence more broadly, focusing on issues of framing, representation and expertise, and on the lack of acknowledgement of key issues of power and infrastructure underpinning modern information economies and practices of optimisation.

EDUCATION AND TRAINING IN EUROPE TO SUPPORT LOW-DOSE RADIATION PHYSICS AND RADIOBIOLOGY.

The success of any research programme is dependent on a continuing influx of new expertise, and continuing education to ensure the newest technologies and methods are exploited. In the past decade, a strategic approach has been used to build up the research expertise in the area of radiation protection and risk estimation. The High Level Expert Group (HLEG, www.hleg.de) in their 2009 report on European low-dose research asserted that education and training were key components in the development and maintenance of expertise for research into the risks from low-levels of ionising radiation. Following their recommendations, a Euratom-funded Network of Excellence (DoReMi, www.doremi-noe.net) was setup to develop a platform of European research institutions to coordinate the research programme and develop expertise in the area. We present here the activities initiated by DoReMi and currently continued by CONCERT (www.concert-h2020.eu) in support of education and training in the scientific areas underpinning radiation protection research.

A Behavioral Economics approach to a Sustainable Finance Architecture – Development of a Sustainability Taxonomy for Investor Decision Usefulness

Globalization has led to an unprecedented correlation of massive global systems causing systemic risk to increase exponentially (Centeno et al., 2013). 10 years after the global financial crisis, what are the lessons learned, what was improved and what still needs to be accomplished? The crucial question remains: has the global financial system and with that the world become less susceptible for a reoccurrence of a financial crisis? What are the factors to achieve a sustainable finance architecture with stable economic markets? In the aftermath of the 2008/09 world financial downturn the interest in understanding non-financial factors and interplay to financial markets increased. A system can only be sustainable if inequality, governance and environmental sustainability is surmounted. According to Beyer et al., significant progress was made in the modelling, as the Global Financial Crisis revealed shortcomings in the model strategy (Beyer et al., 2017). The question arises if also progress is made on social responsibility investing in the securities, selected for social environmental ethical and institutional aspects? Based on the EU led High-Level Expert Group on Sustainability (Cullen, 2018) the EU examines how to integrate sustainability consideration into its financial policy framework. The EU plans to develop a classification system (‘taxonomy’) on what can be considered an environmentally sustainable economic activity. To overcome the climate change challenge, a consensus has a pivotal role to enable to invest in climate friendly investments, which do not turn out to be a false labelling. The global architecture of climate finance is important part of a sustainable finance architecture. Additionally, disclosure regulation is planned that institutional investors integrate ESG (environmental, social and governance) factors into their investment-decision making process. In the absence of a globally integrated financial and non-financial framework, this paper tries to put emphasis back on decision-usefulness of the investor and a Sustainability Taxonomy considering the transparency technology Extensible Reporting Mark-up language (XBRL). This working paper tries to bridge early statements about environment and the responsibility for future generations in the financial service sector (Kipper, 2017).

Allopathic Doctors in India

India is a country of 1.32 billion. The World Health Organization recommends, one doctor to serve 1,000 people, across all levels of care. This implies, we need a total of 1.2 million doctors to serve our population. India plans to establish 200 new medical colleges in the next 10 years to meet a projected shortage of 600,000 doctors. However, the information available on allopathic doctors have largely been fragmented and unreliable. A comprehensive search was undertaken to find out the estimates, norms and projections for allopathic doctors provided by the various health committees and experts in India. The Bhore, Sokhey & Mudaliar Committees, Five-year Planning Commission Reports, MCI Vision 2015 document and High-Level Expert Group (HLEG) report on Universal Health Coverage in have yielded estimates, norms and projections for allopathic doctors. The targeted doctor population ratio of 1:1000 could be achieved by 2027 as per HLEG and by 2031 as per MCI Vision 2015. This study emphasizes the estimates and norms of doctors as reported by the Government and allied agencies need strengthening for comprehensiveness and reliability to report information on the allopathic doctors. An important recommendation for the state professional councils is to maintain a live register of health workers.

Outcome of the European initiative for radiation protection research and future perspectives.

In 2009, the European Commission published the report of the high-level expert group that had been mandated to consider the scientific challenges posed by the issues of low dose effects of ionising radiation, and to formulate proposals for research policy evolution in this field at European level. This report formulated a first draft of a strategic research agenda. International scientific cooperation and an integrated approach are essential for the further development and enhancement of the international framework of radiation protection. This paper reflects on the results which have been gained through this integration approach: strategic research agendas have been established, policies and action plans have been developed for infrastructures and training education, several ambitious research projects have been launched, and a first draft of a European 'joint road map' for radiation protection research will be published. Reflecting on the challenges that lie ahead, this paper also presents the initiatives that the five European research platforms (MELODI: low dose research; ALLIANCE: radioecology; EURADOS: dosimetry; NERIS: emergency preparedness; EURAMED: radiation protection in medical applications) have jointly presented to the European Commission and Euratom member states to further enhance radiation protection research.

NEW PROBLEMS, OLD SOLUTIONS? A CRITICAL LOOK ON THE REPORT OF THE HIGH LEVEL EXPERT GROUP ON FAKE NEWS AND ON-LINE DISINFORMATION

This article discusses the actual contemporary problems of the spread of fake news, information wars and disinformation campaigns. The authors analyze recent European initiatives in the field of opposing disinformation on the Internet, among which are the report of the High level expert group of the European Commission on fake news and online disinformation (HLEG) and the “Act to improve law enforcement in social networks” (NetzDG). Based on a wide range of political theories and approaches to the problem of fake news, the authors propose to enhance and amend the key principles of HLEG 5.

Cooperative Learning within Educational Networks: Perspectives for Good Educational Governance in Modern Reading Education

German schools, universities, and libraries haven’t established a teaching and cooperation practice that uses the potential of a convergent and participatory culture (Jenkins 2006, 2009). Schools and libraries have to collaborate more closely using the digital networks and language of the students of today. Although official references, such as the report of the EU High-Level Group of Experts on Literacy (2012), postulate joint efforts with the objective of promoting reading and media education by different educational and non-educational institutions, at least in Germany this is currently still not a collaborative educational practice. One reason for this might be a missing link in local educational governance. Furthermore, the professional self-image of teachers and librarians, as well as the image of the cooperation partner, may limit effective public cooperation. This contribution starts (1) with an outline of the demands in the field of digital literacy and participatory culture, followed by (2) a discussion about the chances and potentials of partnerships between schools and public libraries, their specific interests, and potential. Finally, (3) problems and principles of good educational governance within those networks are identified and developed to excavate the potential, especially for academic teaching and students’ practice. The article is based on empirical data as well as participatory observation of the three-years teacher training and the seven years of on-the-job-training of librarians of public libraries (“Experten für das Lesen”).

Can the AYUSH system be instrumental in achieving universal health coverage in India?

Universal health coverage (UHC) in the Indian context is understood as easily accessible and affordable health services for all citizens. The Planning Commission of India constituted a High Level Expert Group (HLEG) in October 2010 for the purpose of drafting the guidelines of UHC. While the primary focus of UHC is to provide financial protection to all citizens, its delivery requires an adequate health infrastructure, skilled health human resources, and access to affordable drugs and technologies so that all people receive the level and quality of care they are entitled to. This paper attempts to link the ayurveda, yoga and naturopathy, unani, siddha and homoeopathy (AYUSH) systems of medicine with UHC. Here, the AYUSH system refers to the AYUSH workforce, therapeutics and principles, and their individual role in delivering UHC to the citizens of India. In outlining the role of AYUSH, the paper lays stress on the 10 guiding principles of UHC, as proposed by the HLEG. However, as the AYUSH system is not the principal health service provider in India, the dominant system being that of allopathic medicine, a few components of UHC may not fit neatly into the AYUSH system. This paper has adopted the definition of UHC quoted by the HLEG.

Rashtriya Swasthya Bima Yojana (RSBY) for Universal Health Coverage

On 10 June 2012, Anil Swarup, Additional Secretary, Ministry of Labour & Employment, Government of India (GOI), reviewed the report submitted to the Planning Commission of India by High Level Expert Group (HLEG) on universal health coverage (UHC) for India;1 he had mixed feelings about this report. It (HLEG) reported that the main impeding factor to UHC in India is the heavy out-of-pocket (OOP) expenditure on health, that is, 61.7 per cent of the total health expenditure by Indians as compared to the global average of 20.5 per cent. Looking for a solution for this problem, the report appreciated his brainchild, the Rashtriya Swasthya Bima Yojana (RSBY), a social health insurance scheme rolled out in 2008 to reduce OOP expenditures for healthcare. The scheme also aimed to cut down a substantial financial burden on the poor by the GOI. The RSBY scheme was lauded for its innovative approach in financing mechanism,2 public private partnership (PPP) model for enrolment process, use of information and communication technology for delivery of healthcare services. However, the report questioned the potential of RSBY to achieve UHC due to issues in its sustainability. The scheme faced challenges of low coverage ratio, unfair practices in enrolment and hospitalization processes in many parts of the country, inconsistent usage patterns of services, and backing out by insurance companies as result of high claims ratio.3 Swarup was in a dilemma of how to address these issues and make RSBY a platform to implement universal health coverage (prime area of concern for GOI) in India.

India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public health expenditures. These new results strengthen the proposed UHC policy by accounting for age structure transition effect and justifying its sustainability within the framework of India's current fiscal policies. The age structure transition effect is important to incorporate the age-specific cost and benefit of the proposed UHC policy, especially as India moves toward an ageing society. Fiscal sustainability is essential to ensure that the proposed UHC is implementable on a long-term basis and within the framework of current fiscal policies.

Health insurance, assurance, and empowerment in India

In this issue of The Lancet, Vikram Patel and colleagues 1 Patel V Parikh R Nandraj S et al. Assuring health coverage for all in India. Lancet. 2015; 386: 2422-2435 Summary Full Text Full Text PDF PubMed Scopus (131) Google Scholar present a balance sheet of universal health coverage (UHC) policy in India. They describe progress and the failures, identify seven challenges, and call for a “restructuring of India's health-care system” to implement UHC. Their analysis is evidence-based and the prescription reiterates the 2011 recommendations of the High Level Expert Group appointed by the Government of India. 2 Planning Commission of IndiaHigh Level Expert Group Report on Universal Health Coverage for India. Government of India, New Delhi2011 Google Scholar But UHC in India faces four questions. The road to universal health coverage in IndiaIn this issue Vikram Patel and colleagues1 report on the need for health coverage for all in India. The Government of India had set up a High Level Expert Group to suggest a road map for achieving universal health coverage (UHC) in India. The blueprint outlined an entitlement-based national health system, with an emphasis on substantial strengthening of the public health system and a radical approach to health financing.2,3 Full-Text PDF India's health: more practical solutions neededVikram Patel and colleagues1 are to be congratulated for their comprehensive review of India's health conditions, programmes, and policies. Despite many shortcomings, there has been substantial progress. India's high infant, child, and maternal mortality rates show sustained decline and life expectancy is increasing.1 Some credit is due to increased national support since 2005, under the umbrella of the National Rural Health Mission (NRHM)/National Health Mission (NHM). States have accelerated efforts to generate demand for and strengthen supply of health services. Full-Text PDF Assuring health coverage for all in IndiaSuccessive Governments of India have promised to transform India's unsatisfactory health-care system, culminating in the present government's promise to expand health assurance for all. Despite substantial improvements in some health indicators in the past decade, India contributes disproportionately to the global burden of disease, with health indicators that compare unfavourably with other middle-income countries and India's regional neighbours. Large health disparities between states, between rural and urban populations, and across social classes persist. Full-Text PDF

Commentary on Metrebian et al (2015): What is addiction treatment research about? Some comments on the secondary outcomes of the Randomized Injectable Opioid Treatment Trial.

Keywords: Addiction treatment policy; addiction treatment research; heroin assisted treatment; randomized controlled studies; risk factors; cost-effectiveness; treatment objectives

Taxation of the Digital Economy - An EU Perspective

The EU High Level Expert Group on Taxation of the Digital Economy, one of the experts of which was the author, gave its Report on 28 May 2014. This article comments on the characteristics of the digital economy and the Report’s conclusions in respect of value added taxes and corporate income taxes.

Out of pocket expenditure among the households of a rural area in Puducherry, South India

Background:As a measure to reduce the out of pocket health spending in our country, the high level expert group on Universal Health Coverage recommends a National Health Package free of cost to all. Whether availability of services free of cost, will reduce out of pocket expenditure?Aim:To assess this, we studied the out of pocket health spending among the households of a Ramanathpuram, a village in Puducherry, where surplus health services are available free of cost.Settings and Design:An exploratory study was conducted in by 200 purposively selected households of Ramanathpuram, during the months of March-April 2012.Materials and Methods:Information was sought on socio-demographic details (age, gender, and income), expenditure incurred during OPD visits, follow up for chronic diseases, and hospitalization using a pretested questionnaire. Recall periods of 1 and 3 months were considered for OPD visits and hospitalizations, respectively.Results:Of the total 935 individuals from the 200 households included, 51.3% (480) were men and 455 (48.7%) were women. A total of 231 visits to health care facilities were recorded from 143 (71.5%) households, of which 153 (66.2%) were for acute illness and 68 (29.4%) for follow up of chronic diseases and 10 (4.3%) for hospitalization. The mean per visit expenditure for acute illness, chronic diseases, and hospitalization were INR72.7 ± 143.6, 135.7 ± 196.2, and 1340 ± 1192.9, respectively. Government facilities were availed for 175 (75.7%) visits. Majority of those who incurred health expenditure for acute illness (80.4%) and utilized the private sector for acute illness (78.4%) were from higher socioeconomic class (P = 0.001).Conclusion:Majority (58.1%) of the households did not incur health care expenditure. Public health care facilities were preferred (75.5%) for seeking care. Availability of services free of cost reduces out of pocket expenditure among non-hospitalized cases.

Health systems performance assessment in low-income countries: learning from international experiences.

BackgroundThe study aimed at developing a set of attributes for a ‘good’ health system performance assessment (HSPA) framework from literature and experiences in different contexts and using the attributes for a structured approach to lesson learning for low-income countries (LICs).MethodsLiterature review to identify relevant attributes for a HSPA framework; attribute validation for LICs in general, and for Uganda in particular, via a high-level Ugandan expert group; and, finally, review of a selection of existing HSPA frameworks using these attributes.ResultsLiterature review yielded six key attributes for a HSPA framework: an inclusive development process; its embedding in the health system’s conceptual model; its relation to the prevailing policy and organizational set-up and societal context; the presence of a concrete purpose, constitutive dimensions and indicators; an adequate institutional set-up; and, its capacity to provide mechanisms for eliciting change in the health system. The expert group contextualized these attributes and added one on the adaptability of the framework.Lessons learnt from the review of a selection of HSPA frameworks using the attributes include: it is possible and beneficial to involve a range of stakeholders during the process of development of a framework; it is important to make HSPA frameworks explicit; policy context can be effectively reflected in the framework; there are marked differences between the structure and content of frameworks in high-income countries, and low- and middle-income countries; champions can contribute to put HSPA high on the agenda; and mechanisms for eliciting change in the health system should be developed alongside the framework.ConclusionIt is possible for LICs to learn from literature and the experience of HSPA in other contexts, including HICs. In this study a structured approach to lesson learning included the development of a list of attributes for a ‘good’ HSPA framework. The attributes thus derived can be utilized by LICs like Uganda seeking to develop/adjust their HSPA frameworks as guidelines or a check list, while taking due consideration of the specific context. The review of frameworks from varied contexts, highlighted varied experiences which provide lessons for LICs.

Role of Family Medicine Education in India's Step Toward Universal Health Coverage.

India's commitment to universal health coverage has grown stronger with the submission of High Level Expert Group report by the Planning Commission in 2012. With this report comes the commitment to increase the primary health-care workforce to meet the population needs. However, the focus should not be just to increase the number of health workers, but to produce better health workers. Doctors, nurses and community health workers trained in primary and secondary health-care facilities can make a significant contribution in responding to the needs of the local community. The role of family medicine education is worth exploring in this context to equip the primary care health workers with the competencies of providing person-centered, comprehensive and continuous care.

Promotion of Reading and Early Literacy Skills in Schools: a comparison of three European countries

This article gives a short overview based on the EU High Level Group of Experts on Literacy (HLWG) report to address issues and challenges in Europe on improving literacy competencies in schools. Furthermore, an analysis is conducted focusing on the promotion of reading and early literacy skills in schools taking into account psychological and institutional learning conditions in three countries (Denmark, Germany, and France) with different outcomes in PIRLS 2011 (Progress in International Reading Literacy Study). Country comparison is conducted using multiple groups – multilevel structural equation modelling (MG‐MSEM). An important finding is that policy action taken in order to evaluate and improve school effectiveness in each country must address particular needs of its educational system. Suggestions for improving reading achievement in schools are derived from the analysis.

The Prerequisites for Successful Teaching and Learning of Literacy

The report of the European Union High Level Group of Experts on Literacy presents a clear statement of their vision for the future of literacy in our continent. The first part of the statement is: ‘All citizens of Europe shall be literate, so as to achieve their aspirations as individuals, family members, workers and citizens.’ How is this vision to be achieved? This article analyses 16 preconditions necessary for achieving the vision, classifying them as physiological, social, linguistic, educational, governmental and motivational. In each category these prerequisites are related to the Group's findings and recommendations, especially where current policy and provision may be lacking. For example, for most people, normal or corrected‐to‐normal vision and hearing are essential for literacy development. Arguably, this implies mass screening of young children at the appropriate ages so that problems can be identified and treated — but this is not in fact routine everywhere. The article concludes by analysing the Council of Ministers' conclusions of November 2012 against the framework provided by the prerequisites, in order to judge the likelihood of ambitious targets for 2020 being achieved in this ‘age of austerity’.

India's “tryst” with universal health coverage: Reflections on ethnography in Indian health policymaking

In 2011, India stood at the crossroads of potentially major health reform. A High Level Expert Group (HLEG) on universal health coverage (UHC), convened by the Indian Planning Commission, proposed major changes in the structure and functioning of the country's health system. This paper presents reflections on the role of ethnography in policy-based social change for health in India, drawing from year-long participation in the aforementioned policy development process. It theorizes that international discourses have been (re)appropriated in the Indian case by recourse to both experience and evidence, resulting in a plurality of concepts that could be prioritized for Indian health reform. This articulation involved HLEG members exerting para-ethnographic labour and paying close attention to context, suggesting that ethnographic sensibilities can reside within the interactive and knowledge production practices among experts oriented toward policy change.