Global Health Weekly News Round-up

Politics and Policies

Programs

Research

Diseases and Disasters

These headlines were compiled by Vani Nanda, MPH Candidate at West Chester University PA.

The Business of Benevolence

by Dr. Sosena Kebede

The Global Fund (an international financing organization that pools resources to fight against the top three leading infectious diseases in the world: AIDS, TB and Malaria, to date has committed $22.4 billion) just announced that, due to the current financial crisis, it is canceling round 11 of grant renewals for recipient countries. Most of the recipient countries are in the sub-Saharan Africa and the United States has been the single largest donor (traditionally about 33% of all donations through the GF come from the US) since the organization’s inception in 2002.

My initial reaction on hearing this news mirrors that of most of my colleagues in global health – let’s do something, anything; this can be catastrophic and may mean winding the clock back to when hundreds with HIV were perishing because they didn’t have access to drugs. Other thoughts that flash through my head include: What does this mean to governments of poor nations, NGOs, other donor agencies, pharmaceutical companies, health care workers in poor nations, business people, rich people with the disease, or poor people with the disease?  Will this mean drug rationing? Will this give rise to drug resistance if some treatments are stopped due to lack of funding? Will this mean a lucrative business for someone out there who will stand to gain big when resources shrink, and the rich will find a way to get access?  Speculations, speculations.

Some, all or none of the feared may come to pass. However, the more I think about it, the more I am bothered by the commentary this issue makes rather than the potential outcome, however grim it may (or may not) end up being.

It is deeply saddening to face the fact that the very livelihood of millions of poor people can often depend on the benevolence of the rich. Our world is changing fast; emerging economies are flexing their muscles and contending with Western powers for influence in poor countries. Yet, millions of the world’s poor will have no say on how this phenomenon called globalization will affect their lives. Poor nations have also been below the radar detection when debates rage all over the world about the global mess that years of fiscal irresponsibility and corporate greed has brought. For millions of the world’s poor, our new world order and the concept of globalization, the shift in power/wealth etc., whether good or bad, might as well be happening in another planet for all they have any part in it. Unfortunately, their lack of participation in the process does not shield them from the consequences – they stand to lose the most having no means or power for self-determination.

Poverty, health and human rights are inextricably intertwined. We can’t truly advocate for global health equity when the world continues to have millions of voiceless people and people will not have a voice unless they are economically empowered. The business of benevolence, however generous and much needed it may be, is only a temporary measure for the poor that merely affirms to us our implicit sense of moral superiority.

Sosena Kebede, MD, MPH is an assistant professor of medicine in the department of medicine at Johns Hopkins University in Baltimore, MD. She is also an associate faculty at the Johns Hopkins Bloomberg School of Medicine in the department of International Health. Her work in global health focuses on health systems strengthening works such as directing a hospital management training program in Ethiopia for Yale University as well as doing consultancy work for the World Bank. Her professional memberships include being a section counsilor for APHA’s international health advocacy and policy committee, as well as member of the advisory board for the international Association in Technology, Education and Development.

Admitting Failure: Trendy, but (at least for NGOs) not Prudent

This blog post is in response to the Second Aid Blog Forum: Admitting Failure, a topic forum proposed by anonymous blogger J at Tales From the Hood.

Admitting failure is apparently trendy these days.  As nonprofits and NGOs spend countless hours polishing their annual reports and filling them with rosy success stories to placate donors and stakeholders, a growing chorus of bloggers and development pundits are calling on aid organizations to be up-front and honest about their failures so that others can learn from them.  The idea took off when Engineers Without Borders Canada built a website where development groups could share failures and exchange lessons.  A “Fail Faire” was even held in DC last week to “celebrate” failure. 

While all of this openness and honesty is heartwarming, would I, if I were running an NGO, admit to (that is, publicize) a failed project or program?  To me, that answer is simple: Hell no.

Is there value to sharing failures that could be lessons for your own organization or others?  Absolutely.  But how much good does it do the average layperson to hear about a failed project?  And, once they get a hold of the story, what are the chances that it will come back to bite your organization in the ass?

Take, for example, the field day that the AP had with the results of an audit of grants at the Global Fund.  The Fund, which maintains a policy of “full transparency and zero tolerance of corruption,” published the results of an ongoing audit last year that discovered that several million dollars of grants (representing a very small portion of total funds disbursed) had been lost to fraud and corruption in four countries.  It then began to pursue legal action to recover the funds and prosecute the individuals responsible.  Sounds great, right?  Did the press or anyone else respond with gratitude or acknowledge the up-front and open nature of the Fund in publishing its findings?  If only.  It became a runaway news “scandal,” with the AP painting the “celebrity-backed” Fund as being “plagued by fraud.”  The result: Sweden, Germany, Denmark, and the European Commission froze their disbursements

While it is true that the Global Fund is a uniquely high-profile organization that deals in numbers with many zeros, I think the general tendency of people to react poorly to failure holds true across the board.  Particularly in the current atmosphere of fiscal austerity, the last thing people want to see is their tax dollars or donations being “wasted” on failed projects that were not originally designed to help them in the first place.  While most Americans support foreign aid, I imagine that a lot of them would change their tune if they thought that it did not work.  People have (reasonable, IMHO) objections to their tax dollars being used for “trial and error” projects.

There is, however, true value to learning from failed projects – this is part of the reason that researchers publish (albeit reluctantly) the results of unsuccessful experiments in professional journals and share them at conferences.  But that is precisely the point – the failures are shared with an audience that can appreciate them and the lessons they bring.  The aid community would benefit from creating supportive forums through which they can exchange lessons about failure, whether that be conferences like “Fail Faires” or practice-based journals in which such stories can be published.

Many organizations could stand to make their annual reports, particularly the finance portion, more transparent in order to give donors a better idea of their operations.  Saundra Schimmelpfennig has a great summary of resources that describe good standards and best practices.  But NGOs shy away from laying bare individual project failures, and for good reason.  Unless an individual has background knowledge on how aid and development works, it is difficult to put these stories into context.  It is a whole lot easier to simply decide to hold your donation (or call your Congressman) than it is to have faith in a charity’s ability to learn from its mistakes, especially when stories of ill-conceived projects abound.

Global Health News Last Week

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe. Interested parties should register here. Please note that registration will close on October 14th. Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


POLITICS AND POLICY

PROGRAMS

  • Sanitation and hygiene are sensitive and unpopular subjects, but funding them is essential to fighting disease, ensuring basic rights and meeting millennium development goals.
  • The Gates Foundation’s European director Joe Cerrell comes to the defense of the beleaguered Global Fund to Fight AIDS, TB and Malaria, arguing to improve on its “impressive record and ensure that millions more lives are saved and the progress against global disease is secured for generations to come.”
  • Almost four months into the Horn of Africa crisis, aid agencies are involved in much soul-searching as to whether they could have responded more quickly to the drought and famine.

RESEARCH AND INNOVATION

  • A Japanese company, the Sumitomo Chemical Company, unveiled a new kind of insecticide treated bed net at a product launch in Kenya.
  • Pregnant women who load up on fruits, veggies and whole grains have a reduced risk of having babies with neural tube defects, such as spina bifida or cleft lip, according to one of the first studies to look at the connection between diet and birth defects.
  • A study by Stanford researchers has determined that infant health can be improved when a mother has a low-fat high fiber diet up to a year prior to getting pregnant.
  • A study published in the British Medical Journal says that if current smoking trends continue until 2050, TB related deaths will jump by 40 million.
  • Though young, there is a lot of potential in what mHealth can offer in developing countries. Amanda Glassman shares some ways that it can be improved.
  • Researchers at the University of Washington have reported some highly problematic findings regarding a common method of birth control in eastern and southern Africa. They are problematic in that they indicate a popular injectable hormone, Depo-Provera, used by perhaps 140 million women worldwide (and often in poor settings) signficantly raises a woman’s risk of HIV infection.
  • Test subjects in a Spanish HIV vaccine trial have shown a 90 percent immune response.

DISEASES AND DISASTERS

  • A cohort of American and British researchers say that by investing in AIDS treatments, money can be saved in the long term.
  • What should be the top priorities in global health? Infectious diseases? Neglected tropical diseases (NTDs)? Non-communicable diseases (NCDs)? A research scientist wonders at the confusion amid this sea of bad acronyms.
  • Former US President Carter is leading the fight against guinea worm making a request that WHO members provide $93 million in funding to wipe out the disease.  DfID has committed to support the push against guinea worm by announcing it will allocating £20 million to the effort.
  • The business news channel CNBC has published an extensive report on the lucrative and growing Dangerous World of Counterfeit Prescription Drugs.

Global Health News, Week of September 26-30

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe. Interested parties should register here. Please note that registration will close on October 14th. Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


The University of Washington has launched the first full year of its Global Health Minor program!

POLITICS AND POLICY

  • Tobacco companies knew that cigarettes contained a radioactive substance called polonium-210, but hid that knowledge from the public for over four decades, a new study of historical documents revealed.
  • Latin American leaders have agreed to accelerate their efforts to address maternal health at the 51st Directing Council of the Pan American Health Organization/World Health Organization.
  • Journalist Georgianne Nienaber looks at the impact of PEPFAR and how it may be impacted by budget battles in Congress.
  • Earlier this week, the World Health Organization released a report analyzing air pollution levels in nearly 1100 cities in 91 countries. The analysis was based on air particulate levels between 2003 and 2010.
  • When it came out a while ago that the CIA had used a fake vaccination scheme to try to find out where Osama bin Laden might be in Pakistan, many said it would undermine real health and humanitarian efforts. Here’s one group’s story.
  • Foreign aid has acquired a bad reputation in recent years, as something usually wasteful and useless. Yet all this sound and fury has overshadowed the evidence that aid often can work.
  • A report by the Partnership for Maternal, Newborn & Child Health finds that over 100 countries have increased financing for maternal and child health initiatives.
  • The humanitarian impact of the world economic crisis became clearer this week, as the UN warned of huge job losses, a rise in the number of people afflicted by chronic undernourishment, and the “extraordinary price” being paid by children as “austerity programs” constrict the developing world.
  • There is enough water in the world’s rivers to meet the demands of the expanding global population, but the rivers have to be better managed, according to a series of studies released today at the 14th World Water Congress in Porto de Galinhas, Brazil.
  • UNICEF has called on the IMF and World Bank to ensure that children are not negatively impacted by austerity measures carried out by various countries.

PROGRAMS

  • The New York Times shows how male circumcision is one of the most effective and simple solutions in HIV reduction, but has so far been hard to implement.  Meanwhile, a group of economists, including Bjorn Lomborg, are casting doubt on the cost-effectiveness of voluntary male circumcision campaigns as an HIV prevention measure.
  • The New York Times features an article about the simple innovation of using vinegar to detect if a woman has cervical cancer by applying it with a brush to the cervix.
  • The Global Fund, the world’s largest funder of global health, is set to radically shake up the way it disburses and manages donor money, in a move to boost efficiency that could reallocate a third of its financing in order to save more lives.
  • On Tuesday, the Global Alliance for Vaccines and Immunization announced that it will be expanding its target vaccine areas to directly address diarrhea and pneumonia.
  • UNFPA has announced that it is now collaborating with UNICEF to combat Female Genital Mutilation.

RESEARCH AND INNOVATION

DISEASES AND DISASTERS

  • Roads may accelerate spread of antibiotic resistance: Samples from villages by major roads in Ecuador compared to more rural villages shows antibiotic resistant E. coli is spreading along roads.
  • The recent heavy flooding caused by the monsoon in Pakistan, most devastating in Sindh, has affected the lives of over five million people. The Health and Nutrition Cluster is appealing for US$45.9 million. WHO requires US$14.8 for response for Health, Nutrition and Water and Sanitation intervention.
  • New enterovirus causes respiratory disease: Promed reports on 6 clusters of respiratory illness associated with human enterovirus 68 in Asia, Europe, and the United States during 2008–2010.
  • More than 20 percent of the population of Latin America and the Caribbean lacks basic sanitation and 15 percent has no access to drinking water because of poor management, said experts at a meeting that ended Thursday in Brazil.
  • The likelihood of water-borne disease outbreaks is high in areas in Philippines recently devastated by Typhoon Nesat.
  • Aid groups are criticizing the U.S.government delay on deciding whether to resume large-scale food donations to North Korea. The charities warn that many vulnerable people in the impoverished communist state could die from starvation.
  • In a new report on rabies, the WHO finds that 45% of cases in the world take place in Southeast Asia.
  • A decade-long study of 135,000 men found that those who did not have children had a higher risk of dying from heart disease than those who did, raising new questions over the links between fertility and overall health,U.S. researchers said on Monday.
  • More money is needed to save lives in famine-ravaged East Africa, with the UN saying it’s something like $700 million through year’s end. The World Bank announced from Washington it would boost its aid to area countries to nearly $1.9 billion.  As if famine weren’t enough, Nick Kristoff tells us that as Somalis stream across the border into Kenya, at a rate of about 1,000 a day, they are frequently prey to armed bandits who rob men and rape women in the 50-mile stretch before they reach Dadaab, now the world’s largest refugee camp.
  • An explosion of new technologies and treatments for cancer coupled with a rapid rise in cases of the disease worldwide mean cancer care is rapidly becoming unaffordable in many developed countries, oncology experts said on Monday.

TOTALLY UNRELATED TO ANYTHING – Twitter knows what you’re feeling!