Waiting for Handouts

by Ibrahim Kargbo E-mail LinkedIn Twitter

On a recent trip to Haiti to conduct program monitoring and evaluation, I was taken aback by the statement of a woman who was forced to relocate due to the 2010 earthquake. When asked why she continues to attend HIV/AIDS education programs, her response was “…because I was promised a house and money”. Upon further interaction with the woman, I learned that she was told by a responding aid organization that she would be given a house and money to help her recover. Hearing her comment, I was left to question whether or not the responsibility of post-disaster recovery is made clear and rightly shared.

I very much support the massive global response to environmental disasters such as the 2004 Indian Ocean tsunami, the 2010 Haiti earthquake, and the recent 2011 Japan earthquake and tsunami. As a global community, we share the tremendous responsibility of assisting each other with disaster recovery efforts. Regardless of the disaster, we donate money, time, technical assistance, and other resources to countries in need, either because we are expected to do so or because we are emotionally impelled to assist; whichever is the case, we manage to step up to the plate to provide recovery assistance.

But at what point should disaster recovery become more of the effected country’s responsibility than that of assisting countries? As we overwhelmingly respond to disasters, we forget to remind countries that emergency assistance they receive is only temporary and as citizens, it is they and their governments who are ultimately responsible for recovery efforts and long-term reconstruction. Donors and disaster response agencies should refrain from promising and or providing long-term resources for disaster recovery, doing so may potentially create an environment which citizens and country governments do not take initiative and responsibility for long-term recovery efforts, further handicapping the people’s ability to recover from future disasters.

In a perfect world, country citizens and their governments do not wait for handouts from donors and other countries, but instead, respond to disasters with pride for their country and support of one another. We all should work towards a perfect world.

Ibrahim Kargbo is a Master of Public Health student at George Mason University.

Global Health News Last Week

POLICY

  • Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) introduced the Water for the World Act of 2011, a bill in the Senate which will make providing safe and clean drinking water around the world a priority for US foreign aid.
  • More than 60 world nutrition experts met at WHO headquarters last week to revise guidelines and to identify solutions to tackle the growing problems of both malnutrition and obesity around the world.
  • Ministers of health and other high-level health officials from throughout the Americas called for a series of actions to reduce the toll of chronic noncommunicable diseases, in a declaration issued last week in Mexico City.
  • The Global Fund announced that former President of Botswana Festus Mogae and former U.S. Health and Human Services Secretary Michael O. Leavitt have agreed to lead a high-level panel of experts that will conduct an independent and thorough review of the Global Fund’s financial safeguards.
  • UN agencies are concerned that reduced donor funding due to the recession, combined with free trade agreements, will reduce the availability of low-cost HIV medications in developing countries.
  • The United Nations General Assembly will convene a high-level meeting in September this year to discuss the financial burden caused by non-communicable diseases (NCD) on countries.

RESEARCH

  • A study done is Malawi by the World Bank attracted attention (and criticism) from Businessweek. Young women were given to stay in school and deter them from accepting money and gifts from “sugar daddies” in exchange for sex. The study found that HIV infection rates were 60% among schoolgirls who received cash compared to those who received nothing.
  • A recent review of malaria treatment clinical trial results, published in the Chochrane Library, shows that artesunate was more effective that quinine at treating severe malaria.
  • A personalized text messaging reminder service significantly boosted antiretroviral (ARV) adherence over a six-week period compared with a standard beeper reminder system, according to a study published in the March issue of AIDS Patient Care and STDs.
  • About 600 people gathered at the Global Health Metrics and Evaluation conference in Seattle to discuss issues surrounding the evaluation of effectiveness of health programs.

PROGRAMS

  • Global health blogger Alanna Shaikh discusses how micro-credit and the Green Revolution, two of international development’s biggest successes, are being re-evaluated.
  • The Nepalese government is planning launch a large vaccination campaign against elephantiasis in 40 high-risk districts.
  • Dubai’s Ministry of Health introduced Pneumococcal Conjugate Vaccine PCV13, a vaccine that protects young children from the worst effects of illnesses including pneumonia, blood infections and meningitis.
  • The National Influenza Center of the Chinese Center for Disease Control and Prevention has been designated as a World Health Organization Collaborating Centre for Reference and Research on Influenza, making China the first developing country to house such an institution.

DISEASES AND DISASTERS

  • Europe is concerned by the growing incidence of drug-resistant TB, particularly in children.
  • The world continues to follow the aftermath of the earthquake and tsunami in Japan, including the unfolding situation at the Fukushima Dai-ichi nuclear power plant. The WHO has assured that there is no danger to individuals being exposed to radiation in nearby nations (e.g. China).
  • As if Haiti needed any more bad news, a study published in the Lancet says that the UN estimate of 400,000 cholera cases in Haiti this year is nearly half of what the real projection should be for the recovering nation. Meanwhile, health officials in Lagos have called on residents to observe high standards of personal and environmental hygiene and have designated emergency numbers to call in case of suspected cases; the Ghana Health Service has set up cholera centers in Accra to deal with the outbreak there; and the interim federal government of Somalia on Tuesday denied reports of an outbreak of cholera in the country, responding to an Associated Press story over the weekend that Somali doctors had reported that more than 20 people had died from the disease.
  • In the February 2011 issue of PLoS Neglected Tropical Disease Journal, contributing editor Serap Aksoy discussed the triumphs behind the control of human African trypanosomiasis, or African Sleeping Sickness.
  • Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. The finding was announced at a meeting on TB and women in New Delhi, India.
  • While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade due to public complacency and lower awareness.

Global Health News Last Week (plus interest in a new working group!)

Attention IH Section Members: Dr. Kaja Abbas, MPH student at the University of Rochester, is gauging interest in forming a working group focused on using system science to improve global health, similar to the intitiaves being promoted by NIH. Her interests are in conducting system science research on global health policy by modeling population and disease dynamics and economic evaluation of public health interventions and systems, with a focus on HIV and TB. Dr. Malcolm Bryant, our section chair, has encouraged the expansion of our section’s activities in areas of technical expertise, and Dr. Abbas is enthusiastic about a working group within the section that promotes system science methodologies for global health solutions. She welcomes your thoughts and suggestions at kaja [dot] abbas [at] gmail [dot] com.

Global Health Delivery online’s HIV prevention community is hosting a “virtual expert panel” March 7-11 to continue the dialogue around PrEP as a novel approach to prevention. Panelists from Uganda, South Africa and the United States will lead the online discussion, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered. Panelists include (1) Douglas Krakower, MD, a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School, (2)Andrew Mujugira, MBChB, MSc, the East Africa regional medical director for the Partners PrEP study, and (3) Vivek Naranbhai, PhD, who was involved in CAPRISA microbicide gel study. All GHDonline members can participate in this online discussion. You can sign up here if you are not currently a member.

POLICY

  • Paramount Chief Mpezeni of the Ngoni people in the Eastern Province of Zambia has urged his subjects to get circumcised in order to reduce the chances of spreading HIV/AIDS and other communicable diseases in his land.
  • Britain is threatening to pull out of the Food and Agriculture Organization due to “patchy” performance.
  • Due to uncertainty in past estimates, the Indian government has formed a 16-member expert group to determine the annual death rate caused by malaria in the country each year.
  • The breakdown of the air conditioning in the plenary hall of the Philippines’ House of Representatives stalled the heated debate of a controversial reproductive health bill. The bill is vehemently opposed by the Catholic Church and pro-life groups and has caused a stir in the largely Catholic country.
  • A massive demonstration rally was held in New Delhi to protest a free trade agreement between India and Europe, which many fear may threaten the production of low-cost generic drugs, particularly HIV medicines.

RESEARCH

PROGRAMS

DISEASES

Global Health News Last Week

POLICY

RESEARCH

  • A paper published in Science by a research group at the University of Maryland demonstrates that a fungus, Metarhizium anisopliae, can be used to combat the malarial parasite inside the mosquito. Another promising study suggests that a compound produced by a seaweed in Fiji could be used to combat malaria.
  • A new study has shown that that Internet kiosks providing information on prenatal and postnatal care have helped reduce infant, child, and maternal mortality rates in rural India.
  • A study published by the Harvard School of Public Health last year found that the poorest third of the world’s population account for only 4% of surgeries worldwide, and that over two million people in low-income countries have no access to life-saving surgery.
  • The first phase trials of the HIV vaccine developed in India were completed with no side effects reported. Meanwhile, a three-year research trial on a vaginal anti-HIV gel has been launched in Rwanda.
  • The Trachoma Atlas, an open-access resource on the geographical distribution of trachoma, was launched by a team of collaborators from the London School of Hygiene & Tropical Medicine, the International Trachoma Initiative at The Task Force for Global Health, and the Carter Center. It is funded by a generous donation from (you guessed it!) the Bill & Melinda Gates Foundation.
  • The European Solutions Enterprise for Neglected Diseases (euSEND), a new initiative, based in the Netherlands, was launched to aid in the fight against neglected tropical diseases. The organization’s goal is to “take the role of matchmaker” to facilitate partnerships in research for NTD treatments and vaccines.

PROGRAMS

  • Swaziland has a large-scale circumcision drive in an attempt to lower HIV rates.
  • Cash-transfer programs as a means of assisting the poor are beginning to gain attention and popularity from development and economic professionals. Mexico’s and Brazil’s have captured particular attention and are credited with poverty reduction and GDP growth.
  • The first methadone maintenance program in sub-Saharan Africa recently opened in a hospital in Dar es Salaam, Tanzania. Heroin use is a growing problem in port cities, where the drug passes through en route from Afghanistan to Europe.

DISEASES