06 November 2015

Which expert does Hillary Clinton consult about global poverty?

Hint: It's not an expert, government official, or people actually living in poverty.

HT +Africa is a Country 

A cynical view of news?

Photo shared by Independent Liverpool on Facebook reads: "News: Rich people paying rich people to tell middle class people to blame poor people."

Can't say I share the sentiment, but I can see why some people feel this way. There are certainly examples of that happening.

03 November 2015

Map of the day: In which Chinese province will you live longest?

As is the case for nearly everywhere in the world, all parts of a country are not created equal. This map from The Economist shows the varying outcomes in each province.

More info:
The study* shows that a baby born in China in 1990 would live on average to the age of 68. One born in 2013 could expect to reach 76, beyond the age at which Confucius said “one can follow one’s heart’s desires—without crossing the line.” There is a large disparity between provinces, but the gap is narrowing. In Shanghai life expectancy is now 83—as good as Switzerland. People in six areas live longer than Americans. The most impressive progress has taken place in the most benighted regions: a child in Tibet born in 1990 had a life expectancy of 56, akin to one of the poorest African countries. This has risen to 70, roughly the same as Moldova, one of Europe’s poorer countries.
HT The Intrepreter 

Finally, some national attention about the heroin epidemic

"Somehow, if it's heroin or cocaine or alcohol, we say, 'They decided it, they're getting what they deserved.'"
Posted by HuffPost Politics on Friday, October 30, 2015

Getting a little local today, but I was glad to see my hometown get a mention in a New York Times article about the growing problem of heroin in the US. It is the top issue for New Hampshire voters and Hillary Clinton stopped by a few months ago to participate in a forum on drugs here in Laconia. The room was filled with national press.

Reporters from NPR, Boston Globe and even Andrea Mitchell were milling about to interview people. The next day, reports focused on earlier comments Clinton made on the Democratic primary debate. At least one reporter was paying attention to the issue and the event:
New Hampshire is typical of the hardest-hit states. Last year, 325 people here died of opioid overdoses, a 68 percent increase from 2013. Potentially hundreds more deaths were averted by emergency medical workers, who last year administered naloxone, a medication that reverses the effects of opioid overdoses, in more than 1,900 cases.

Adding to the anxiety among parents, the state also ranks second to last, ahead only of Texas, in access to treatment programs; New Hampshire has about 100,000 people in need of treatment, state officials say, but the state’s publicly financed system can serve just 4 percent of them.

Since New Hampshire holds the first-in-the-nation presidential primary, residents have repeatedly raised the issue of heroin with the 2016 candidates.

Mrs. Clinton still recalls her surprise that the first question she was asked in April, at her first open meeting in New Hampshire as a candidate, was not about the economy or health care, but heroin. Last month, she laid out a $10 billion plan to combat and treat drug addiction over the next decade.

She has also led discussions on the topic around the country, including packed forums like the one in Laconia, N.H., where hundreds of politically engaged, mostly white middle-class men and women, stayed for two hours in a sweltering meeting hall to talk and listen. One woman told of the difficulties of getting her son into a good treatment program, and said he eventually took his own life. Another told Mrs. Clinton of the searing pain of losing her beloved son to heroin.
The story is important because it highlights the shift in ways that people are talking about addiction in drugs. When the crack epidemic struck, the policies honed in on jail sentences and the war on drugs. With heroin being a problem that strikes mostly white middle-class Americans, the solutions now focus on treatment for addicts, not jail.
But today, with heroin ravaging largely white communities in the Northeast and Midwest, and with violent crime largely down, the mood is more forgiving.

“Both the image and reality is that this is a white and often middle-class problem,” said Mr. Mauer of the Sentencing Project. “And appropriately so, we’re having a much broader conversation about prevention and treatment, and trying to be constructive in responding to this problem. This is good. I don’t think we should lock up white kids to show we’re being equal.”

So officers like Eric Adams, a white former undercover narcotics detective in Laconia, are finding new ways to respond. He is deployed full time now by the Police Department to reach out to people who have overdosed and help them get treatment.

“The way I look at addiction now is completely different,” Mr. Adams said. “I can’t tell you what changed inside of me, but these are people and they have a purpose in life and we can’t as law enforcement look at them any other way. They are committing crimes to feed their addiction, plain and simple. They need help.”

Often working with the police, rather than against them, parents are driving these kinds of individual conversions.

I was not aware of the gravity of the problem until moving here this summer. But seeing drug busts and young people dying from heroin overdoses in the past few months has brought the issue to the forefront. As the article points out, the candidates are responding. It may still not get a lot of attention, but this is a growing problem that I am willing to bet will get more attention during the presidential primaries and campaign.

The article and video at the top of Gov Chris Christie shows just how mush the conversation about addiction is changing.

02 November 2015

This thing is not a silver bullet: cookstoves edition

Because we as people like to over hype technical solutions, fads take off with plenty of fanfare that set up expectations well beyond what is possible. Cookstoves are a good example.

Indoor smoke inhalation is a major killer. Getting people who cook using open fires to change their methods can save a lot of lives and reduce illness. Enter the clean cookstove - an endeavor that dates back more than a half century. The idea is straightforward, come up with a device that does not give off much smoke, replace existing cooking methods with said device, et viola problem solved.

A recent piece by Marc Gunther in the Washington Post describes how the formula for suceess has not panned out as planned. He writes:
Of those 28 million cookstoves, only 8.2 million — the ones that run on electricity or burn liquid fuels including liquefied petroleum gas (LPG), ethanol and biogas — meet the health guidelines for indoor emissions set by the WHO. The vast majority of the stoves burn wood, charcoal, animal dung or agricultural waste — and aren’t, therefore, nearly as healthy as promised. Although these cookstoves produce fewer emissions than open fires, burning biomass fuels in them still releases plenty of toxins. “As yet, no biomass stove in the world is clean enough to be truly health protective in household use,” says Kirk Smith, a professor of global environmental health at the University of California at Berkeley and the leading health researcher on cookstoves. 
That’s not the only problem with the stoves. Some perform well in the lab but not in the field. Others crack or break under constant heat. The best cookstoves burning clean fuels won’t protect poor families from disease if those who use them continue to cook over open fires as well — which many do. “They’re not the big solution, unfortunately, that we thought they were going to be,” says Rema Hanna, a Harvard economist who led “Up in Smoke,”the most extensive field study to date on this subject. Perhaps more research could apprehend what actually works, but for now it makes no sense to “push more stoves into the world that people aren’t going to use.”
To be clear, cookstoves are not bad. Nor is the effort to come up with better ways for people to cook and not endanger their health. Anyone who has spent even a few seconds in an enclosed space while an open fire heats food knows just how overwhelming all the smoke can be.

It is a whole different matter when it comes to getting people to change habits and even pay for a new household item. Challenges include generating enough heat and change in flavor when there is less smoke. Gunther's piece is worth a read as it explains further the history of cookstoves and more of the struggles to get the widespread initiative to have lasting impact.

23 October 2015

MSF continues pressing for accountability in Kunduz attack

Médecins Sans Frontières/Doctors Without Borders (MSF) is continuing to apply pressure on the United States to determine what happened when it bombed an MSF-run hospital in Kunduz, Afghanistan this month. An OpEd from MSF USA executive director Jason Cone in the New York Times makes the case for an independent investigation.
Our call for an independent international investigation is not a political gesture, pursued solely because the United States was so prominently involved in the Kunduz attack. Just as our medical ethics and commitment to international humanitarian law mandate that we treat all wounded persons in a conflict zone — regardless of affiliation, race or religion, and regardless of how or why they were injured — our founding principles compel us to highlight encroachments on the medical facilities through which we deliver care. We have done so recently in Yemen, Syria, the Central African Republic, South Sudan and other places. 
But if international humanitarian law is flouted, if violations on this scale can be dismissed as a “mistake,” “the fog of war” or even just “a terrible tragedy,” then all of our medical staff, projects and patients in conflict zones could be jeopardized. 
In the case of Kunduz, it is not our responsibility to prove that the United States military violated the laws of war or its own rules of engagement. It is the responsibility of the party that destroyed a fully functioning hospital, with some 200 staff members and patients inside, to prove that it did not.
I find it hard not to see the case for an independent investigation made by Cone and MSF as compelling. At the very least, the families of the 22 people killed and MSF deserve to know what happened and for people to be held accountable. But, I am not holding my breath that the U.S. will condone such an investigation. The best bet is that the internal investigation is transparent and honest about its findings.

Does this Gates-commissioned cartoon criticize the foundation?

Bill Gates shared a cartoon yesterday by Randall Munroe, better known as the genius behind XKCD. It marks World Polio Day by describing how close the world is to eradication and the fact that the solutions (aka vaccines) are already known. True to form, Munroe uses conversation between two characters to assail the tendency to overlook the obvious.

But does the character who continues to propose innovative solutions, many using new technologies, also serve as satire for Gates and his foundation? The drive for innovation is a leading criticisms of the Gates approach to global health.

Regardless, Gates is a fan of the comic writing, "anything that combines Randall and polio eradication is great in my book....I got a kick out of it and thought I'd share it with you."

What do you think? Even if it is not about Gates, it does a good job criticizing some of the worst tendencies in global health.