27 December 2012

Top of 2012 List

Rather than provide a retrospective post that relates to this blog, my work or even aid in development I want to end the year with a lighthearted post. Therefore, I present my top tracks from 2012. I really dug into Frank Ocean's channel ORANGE over the past week or so and I am obsessed to put it mildly.

Grimes has to be what I find to be the most surprising artist, for myself, this year. Her sound is layered upon almost entirely unintelligible lyrics. She is almost the exact opposite of the stripped down track Laura by Bat for Lashes and everything song by The XX. For some reason the experimentation that goes only as far as a pop song can go makes for some captivating songs.

I am taking advantage of the slow pace that characterizes the end of the year to listen to as much 2012 music as possible. It is what allowed me to find Grimes and will ultimately lead me to more tracks that will soon join the initial 30.

If you listen to one song, make it Frank Ocean's performance of Thinkin Bout You from SNL this fall (video at the top). You will thank me later.

Feel free to offer up other suggestions and even criticize my selections.

Happy New Year and back to the regularly scheduled program in 2013

25 December 2012

The Dominance of the Muppet Christmas Carol

The Muppet Christmas Carol is the best of the adaptations of the famous Dickens novel, at least according to Amazon sales and my personal opinion. Can't really pass up a wonkish Christmas-related chart from the Economist.

Merry Christmas to all who celebrate today.

20 December 2012

Clean Cookstoves Continue Stumbling Through Failures

The pursuit of clean cookstoves is a topic that is frequently met with equal measures of promise and skepticism. Smoke inhalation is considered a public health problem since it affects some 3 billion people and is estimated to lead to 2 million deaths each year. People have tried to tackle the problem for decades to little success and a new study published in the American Journal of Tropical Medicine and Hygiene finds that ceramic cookstoves used in rural Kenya did not reduce the incidence of pneumonia among children.

The mothers who used the ceramic "upesi jiko" (quick stove) reported that there was less smoke in the home and noticed a decrease in physical irritation caused by smoke when cooking. However, the researchers found that the pneumonia incidence rate of children under three years old was not significantly lower in households that uses upesi jiko as compared to homes that use the traditional three-stone method.

2010 saw the revival of the cookstove with the announcement of the $60 million Global Alliance for Clean Cookstoves . The initiative, led by the UN Foundation, now has hundreds of partners from governments to donors to the private sector. Secretary of State used her 2010 CGI remarks to focus on cookstoves where she highlighted that the technology was available to tackle the problem. 

"But today, because of technological breakthroughs, new carbon financing tools, and growing private sector engagement, we can finally envision a future in which open fires and dirty stoves are replaced by clean, efficient, and affordable stoves and fuels all over the world – stoves that still cost as little as $25," said Clinton

The initiative set out the ambitious goal to support the adaptation of clean and efficient cookstoves in 100 million households by 2020. Some worried that the idea was too aspirational and missed the  missteps by prior efforts to introduce clean cookstoves. "The major flaw in previous cookstove efforts was focusing too much on good design from a designer’s perspective, and not enough from a user perspective," said Alanna Shaikh in a blog post for Aid Watch.

It appears that the technology is also still a problem. The Kenya study findings show that the cookstove used is still not efficient enough to make an impact. “Despite requiring less fuel, these stoves may not be efficient enough,” Robert Quick, MD, MPH, a researcher in the Division of Waterborne, Foodborne,
and Enteric Diseases at the U.S. Centers for Disease Control and Prevention in the press release. “The belief is that you need much more efficiency, maybe a reduction of 50 percent or more, to really observe the health benefits.”

Quick added that the believes that efficient and clean cookstoves are needed, but the evidence of their efficacy is insufficient. A part of the challenge, as alluded to by Shaikh, is people transitioning from traditional cooking methods to using cookstoves. A five year study in Orissa, India by researchers Rema Hanna, Esther Duflo and Michael Greenstone found that the cookstoves were effective in the short term, but provided little improvement over the long term.

Breakdowns, improper use and poor maintenance all contributed to the failure of the cookstoves, said the researchers. Furthermore, the cookstoves did not reduce fuel use. "While households overwhelmingly claimed that the stoves used less wood, fuel use remained unchanged, and if anything, somewhat increased," wrote Hanna, Duflo and Greenstone in the conclusions. "The lack of obvious benefits may explain why households were not interested in using the stoves optimally."

Behavior change is an important aspect in implementing new technologies and the Hanna study illustrated that challenge. "[S]olving intractable social problems requires fundamental changes in the target population. It also needs a supportive institutional framework to reinforce the right behaviour. Technology can complement this process, but it is no substitute for the human element," argued SC in The Economist citing the Hanna study and the failure of One Laptop Per Child.

End of the Wold Predictions

Tomorrow is the supposed end of the Maya calendar which means the world will end. According to Isaac Newtown there is still time left before the world ends, so all is good. Better yet, there have been many predictions of the end of the world in the past and we keep persevering  The Economist provides a nice chart of some of the more notable failed doomsday predictions.

19 December 2012

How a Simple Blog Post on a UN Announcement Uncovered a Misleading Initiative

Earlier last week, the UN held an announcement regarding new funding towards eradicating cholera in Haiti and the Dominican Republic. I have been keeping tabs on the situation in Haiti because the evidence strongly points towards the UN peacekeepers as the source of the outbreak, but the UN has both neglected shoulder responsibility nor has it fully mobilized a response to the spread of cholera on the island.

I set out to read about the announcement a few days after it happened and write a post based on what was new with some clips of how people reacted. I knew that these announcements are met with strong responses, so it would make for an easy and interesting blog post.

The reports from the AP and Reuters indicated that the UN unveiled a $2.2 billion initiative. I went back to the press release and the statement from Secretary General Ban ki-Moon to get some quotes and further information for the post. Curiously, the UN information that was provided made no mention of $2.2 billion. I searched around and kept coming back to the reports in the news media about the numbers, but saw nothing else.

I used Twitter to ask around and finally pinged former AP reporter Jonathan Katz. He and I spoke awhile back about Haiti and have kept in touch regarding the ongoing response to the outbreak. He began digging around and confirmed my discovery. The UN did not launch a $2.2 billion initiative, it was announcing $23.5 million in new funding and the reallocation of $215 million from bilateral donors.

A bit more digging revealed that the language of the announcement likely misled news outlets and the UN did nothing to correct the error. Katz and I co-wrote an article that published in Foreign Policy yesterday that covers our findings and calls into question how the $2.2 billion initiative that will be announced in January by the UN is going to be funded.

Here is an excerpt:
In the 25 months since Vibrio cholerae El Torbacteria was confirmed in Haiti for the first time, 7,805 people have died, along more than 400 in the neighboring Dominican Republic. The waterborne pathogen has contaminated nearly every mountain village and barrio stream on the Caribbean island. Yet Ban told reporters at the event that eradicating the disease was a matter of will. "Science," the secretary-general explained, "tells us it can be done." 
This would have been the second surprise. Throughout the epidemic, science has been the last thing the U.N.'s political leaders have wanted to talk about. 
The crisis began in October 2010, when Haitians began dying en masse along the rural Artibonite River. As Haiti had no known history with cholera -- there had never been a confirmed case before -- suspicion quickly focused on the horrendous sanitation at a U.N. base. The installation was home to a detachment of Nepalese soldiers, next to one of the river's main tributaries. U.N. officials in Port-au-Prince actively tried to dismiss the claims as pernicious rumors while mounting a clandestine and amateurish investigation behind the scenes. Within days of the outbreak, stories in the international press already showed not only that the Haitian rumors about the base were true and that the U.N. was dissembling, but that the strain of cholera matched a current outbreak in Nepal. The soldiers had traveled from that outbreak to Haiti just before Haiti's epidemic began.
Read the whole article here

18 December 2012

Twitter and AlertNet #AskValerie About Africa, Syria and More

AlertNet hosted a twitter chat with UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Valerie Amos. Amos answered questions from AlertNet and Twitter users through the #AskValerie hashtag. Here is the transcript of the discussion.

Malaria Fight Losing Momentum, Warns WHO

The leveling of funding for malaria prevention and treatment since 2010 has led to a slowing of promising progress against the deadly impact of the disease finds a new WHO report. The World Malaria Report 2012 finds that 1.1 million lives were saved over the past decade thanks to broad efforts to stem the impact of malaria. More than half of the averted deaths, 58% to be precise, took place in the 10 countries with the greatest malaria burden. However, slowing funding, warns the report, could threaten much of the decade's building momentum.

The WHO estimated that $ 5.1 billion is needed every year until 2020 in order to achieve universal access to malaria interventions. Present funding comes in at only $ 2.3 billion per year, less than half of the estimated need. "There is an urgent need to identify new funding sources in order to further scale up and sustain malaria control efforts, and to protect the investments made in the last decade," says WHO Director-General Helen Chan in her introduction of the report. "We also need to examine new ways to make existing funds stretch further by increasing the value for money of malaria commodities and the efficiency of service delivery."

In 2010, 219 million people were infected by malaria. Of that number, 660,000 died. The greatest burden of malaria deaths falls on children in Africa. However, the good news is that deaths caused by malaria are preventable. Long-lasting insecticidal nets (LLINs) provide protection when people are sleeping and malaria-carrying mosquitoes are active and indoor residual spraying helps to keep more mosquitoes out of households. The development of artemisinin-based combination therapy (ACT) has helped to bring about effective treatment for people who contract malaria, but there are growing concerns regarding the emergence of ACT resistance in southeast Asia.

17 December 2012

Shining a Light on Cancer in the Developing World

The impact of cancer in low- and middle-income countries is rapidly taking hold with fewer children dying and more people living longer. In fact, more people die from cancer each year than of AIDS, TB and malaria combined. Meanwhile, cancer spending by aid donors is a fraction of what is spent when compared to other health challenges.

"I think cancer and other noncommunicable diseases have been under-recognized and they have been neglected, but that’s not a malicious neglect," explained Lancet editor Richard Horton to Public Radio International's The World. "It’s because there’s just been this overwhelming burden of other problems." 

"In many parts of the developing world, particularly in sub-Saharan Africa, the overwhelming burden for many decades has been preventable maternal and child deaths, malaria, tuberculosis, and, over recent decades, HIV/AIDS. And that burden has been so overwhelming to families and to governments that it’s been very hard to see anything else through that very thick fog of death," continued Horton.

14 December 2012

Playing with IHME Data Visuals

I decided to play around with the data visualizations that came out of the IHME release of the burden of disease and what kills people around the world. One of the most striking things is the sudden spike in deaths for children over 10 years old as the result of the earthquake in Haiti. It is no surprise that the burdens shift from high mortality in young people in Asian and sub-Saharan African countries to a greater burden of NCDs in the West as people get older.

Here are some things I did. You can dig deeper into the Guardian's visualization here and check out what the Washington Post did here.

13 December 2012

IHME Report Shows Shifting Causes and Overall Decline in Global Mortality

Good news today from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Their new report, Global Burden of Disease Study 2010 (GBD 2010), looks at the changing mortality trends from 1990 to 2010 and find that fewer people are dying each year, but the fact that more people are staying alive means that long term risks and problems like mental health disorders and obesity are playing an increasing role in global health.

“We’re finding that very few people are walking around with perfect health and that, as people age, they accumulate health conditions,” said Dr. Christopher Murray, Director of IHME and one of the founders of the Global Burden of Disease in a press release. “At an individual level, this means we should recalibrate what life will be like for us in our 70s and 80s. It also has profound implications for health systems as they set priorities."

12 December 2012

Experts Mixed on PEPFAR's Blueprint to End AIDS

The United States government continued its priority of realizing a world without HIV/AIDS. “Now, make no mistake about it: HIV may well be with us into the future. But the disease that it causes need not be,” said Secretary of State Clinton at a press conference marking this month’s World AIDS day. “We can reach a point where virtually no children are born with the virus, and as these children become teenagers and adults, they are at a far lower risk of becoming infected than they are today.”

At the event, Secretary Clinton unveiled the new plan from the President’s Emergency Plan for AIDS Relief (PEPFAR) that establishes a blueprint for creating an AIDS-free generation. It sets out to end new infections of aids by achieving the following five goals: 1) scaling up treatment and prevention; 2) targeting at-risk populations; 3) promoting sustainable, effective and efficient solutions that maximize every dollar spent; 4) supporting country leadership; 5) continuing efforts in science and research.

10 December 2012

K'Naan's Struggle to Reclaim his Voice

Musician K'naan penned a revealing and honest OpEd in the New York Times over the weekend where he argued that he was convinced to believe that he had to censor himself and his views in order to reach a larger audience in the United States.
A war was going on, I was told, and some songs had meanings the government did not want deciphered. Those “anti songs” were different from love songs, or folk songs. You had to take care in dressing the words. In love songs, words could preen in bright colors; in anti songs, they attacked in camouflage. And from that, I got a hint of the power of lyrics — to encapsulate magic, or to spread alarm.
K'naan explains the personal development of his music and lyrics over the development of his first two albums. His third album, released this past September, was the follow up to the worldwide success that he achieved after his track 'Wavin Flag' became the anthem of the 2010 World Cup in South Africa.
On my second album, I had sung about my mother’s having to leave my cousin behind in Somalia’s war — “How bitter when she had to choose who to take with her...” Now I was left, in “Is Anybody Out There?” — a very American song about the evils of drugs — with only “His name was Adam, when his mom had ’im.” 
The first felt to me like a soul with a paintbrush; the other a body with no soul at all. 
So I had not made my Marley or my Dylan, or even my K’naan; I had made an album in which a few genuine songs are all but drowned out by the loud siren of ambition. Fatima had become Mary, and Mohamed, Adam.

07 December 2012

Shameless Audience Bleg - IRP Fellowship

The International Reporting Project (IRP) out of Johns Hopkins University is offering a new media fellowship for 2013. They are looking for journalists and media figures who are using new media and social media to report on health, development and innovation. I think that what I have been doing on A View From the Cave both here and on Twitter fits quite well into with IRP wants for the fellowship.

So, I am humbly asking all of you for some help. I want to launch a mini-campaign to help convince IRP that I should be one of their fellows next year. All I ask is for a few kind words directed at the IRP Twitter feed @IRPChirps (#fellowshipforthecave), or a comment on their Facebook Page, or a comment right here on this blog post.

I have been working on this space for free for a few years now and would love to dedicate even more time to covering aid and development. The grant will allow for that effort since it will provide a modest financial injection. If I get the fellowship, my goal will be to provide you with more reporting, information and analysis while focusing in on some large stories. Specifically  I would pursue stories regarding the development of the Post-2015 agenda and investigate the development and innovations within the water sector.

Thanks, as always, for reading and I appreciate your support.

06 December 2012

Embed Women and Girls into mHealth, says Dr Sadik

Washington DC - A marginal part of the recent mHealth Summit, global health took center stage on the final day with keynote addresses and discussions from global health leaders. Dr Nafis Sadik, UN Foundation Board Member and former head of United Nation's Population Fund used her time in the spotlight to issue a challenge for embedding women and girls into mHealth.

Dr Sadik spoke directly to the mHealth Alliance, a convening group for coordinating mHealth that involves multiple stakeholders from the public, private and NGO sectors. She commended the work done by the Alliance to bring people to the table in order to improve health outcomes through mobile technologies.

The promise of rapid technological growth makes Dr Sadik feel optimistic, but she was careful to point out that there are still significant gaps in the technologies and health solutions reaching women. "Whole groups are left out of the hi-tech revolution, notably the poor, and especially poor women," she said. "Women in general are less likely than men to have access to mobile technology – in South Asia, nearly 40% less likely."

Allison Stone of MoTeCh illustrated this very problem at last year's mHealth Summit and the NYC FailFaire. A project in Ghana that used mobile phones to support pre-natal and ante-natal care for women. Both the mothers and the community health workers were meant to use phones in order to enter information and receive SMS reminders. An initial survey found that women had high access to phones.

However, the implementation of the project revealed that access was loosely defined. Some women relied on neighbors to charge a phone or would borrow the phone with the permission of the husband. That meant that messages were not reaching women at the right time or at all. The truth was that cell phone use was much lower than what the survey revealed.

At a summit where major telecoms companies like Verizon presented new technologies for mHealth, Dr Sadik made the argument that access is central to ensuring that women around the world have access to health services. "For the mHealth Alliance to be fully successful, it must reach the women most in need, the less privileged and more excluded: precisely the women least likely to have access to mobile technology," she advised.

Reaching women also includes finding ways to bring men on board and in some cases change their attitudes. When I asked Dr Sadik after her remarks what she wanted to see done about including men in women's health she uncomfortably laughed saying that she had no idea how to do it. Then she switched to a serious tone as she reiterated that men can be a barrier to women's health and must be included in the effort.

To be successful, the mHealth Alliance must not only directly engage with women and girls, but address their needs and tackle the obstacles to better health, Dr Sadik argued. "Whatever opportunity exists we should be giving the maximum opportunity for that person," she said. 

Dr Sadik. stressed that it goes well beyond access to technologies. Women need to be able to access comprehensive services, rather than fractured or specific health interventions. "In the real world, women don’t have separate boxes for family planning and HIV prevention. They don’t know why the HIV clinic supplies condoms but not contraceptive pills, she explained. "They don’t know why they have to go to different places on different days for family planning, pregnancy testing, ante-natal care, cervical cancer screening, and all the other services they need."

Empowerment is at the base of Dr Sadik's argument. "It is not about me taking your power," she said to me. "It is about equal value. I believe everyone has equal value." The end goal is to ensure that women have the ability to make their own decisions in their lives.

At the conclusion of her prepared remarks, Dr Sadik challenged the mHealth alliance to do three things: 1) Involve women directly; 2) support gender equity and women's empowerment; 3) remove the obstacles to participation. "This is both a matter of basic human rights and a contribution to peace, justice and prosperity. Women are half the world. With our help, women will change the world," she concluded.

04 December 2012

Rwanda's Butaro Cancer Center: Realizing Francine's Wish

The following post is written in conjunction with PRI The World's series on cancer and builds on yesterday's post covering Rwanda's efforts to take on cervical cancer.

When Nicole first arrived at the Butaro Cancer Center of Excellence she could no longer stand because she was so sick from leukemia. She received intense treatment for acute lymphoblastic leukemia at the center over a two month period. Over the course of her treatment, Nicole regained her strength and was speaking to health staff in her native Kinyarwandan and English. 

Five weeks ago, Nicole was discharged from the center with oral chemotherapy to return home to her mother and sister. Her family will have to return to the center once a month for the next 30 months to continue the treatment. They will travel the roughly 77 kilometers North towards the border with Uganda to the only center capable of treating Nicole’s cancer in Rwanda. 

Butaro Cancer Center of Excellence, Credit: PIH
One year ago, Nicole never would have accessed the treatment that could save her life. The Butaro Cancer Center of Excellence was inaugurated this past July as the first cancer ward in rural East Africa. The establishment of the hospital represents a step forward towards turning cancer from a death sentence into a treatable illness. 

“Some childhood cancers have cure rates of 80 percent in the US, but in most parts of Africa cancer is a death sentence because treatment simply isn't available. We want to change that paradigm and bring world class cancer care to the world's poorest children, using a replicable and sustainable model,” said Peter Drobac, Rwanda PIH/IMB Country Director, in marking the inauguration of the center. 

Equity in Stone 

“There are tremendous barriers to patients in the rural setting to access specialty care services including for cancer,” explained Dr. Neo Tapela, Partners in Health's (PIH) Director of the NCD Program in Rwanda. Rwanda’s four referral centers exist in urban settings, but 80% of the population lives in rural parts of the country. The center will provide comprehensive cancer services including screening, diagnosis, chemotherapy, surgery, patient follow-up, and palliative care. 

Building the center is a step by the government to reduce the barriers to treatment and ensuring equitable care. Equity is central to the Ministry of health. “Equity is written in stone in our hearts,” said Minister of Health Dr. Agnes Bingawaho with pride. “It is in our constitution.” Achieving equitable health care means taking steps to put skilled doctors in each district and bring cancer services to rural parts of the country. 

Paul Farmer, co-founder of PIH, addressed concerns about investments in cancer by recalling early opposition to funding for AIDS. “Just a few years ago we had no system or financing mechanism to diagnose and treat AIDS in Africa,” said Dr Farmer. “People said it was too expensive or too complicated. But today nearly 7 million people in developing countries are receiving treatment for HIV. We can do the same with cancer.” 

Global Effort 

The establishment of the center in Butaro is the result of a multi-stakeholder partnership between Rwanda’s Ministry of Health, PIH, the Jeff Gordon Children’s Foundation and the Dana-Farber/Brigham and Women's Cancer Center. A $1.5 million donation from the Jeff Gordon Children’s Foundation and comprehensive support from PIH led to the building of the center. The land was provided by the Rwandan army, Dana-Farber/Brigham will provide testing support, and the government will pay the staff. 

Specialty cancer nurses from Dana-Farber Cancer Institute serve as mentors for the nurses in the center to support their work with the patients. PIH will support the government efforts to implement a comprehensive cancer plan that will serve to inform and shape all of the country’s health systems. Not only will rural Rwandan’s have improved access to care, but the proximity to neighboring Burundi and Uganda means that the center will serve as a regional hub that extends beyond borders. PIH will support patients from other countries who do not have health insurance, explained Dr. Tapela. 

Anne Elperin , an oncology nurse from Boston who already participated in the program as a Dana-Farber fellow was struck by how eager the nurses were to learn. "The Rwandan nurses were very engaged and would come to my chemotherapy classes on their days off or after they had worked a full night shift," Elperin told nurse.com. "They took a lot of pride in the fact that they were doing something new for Rwanda." 

One example is the implementation of national cancer trainings for doctors and nurses beginning March 2012. Doing so, “provides baseline knowledge for doctors and nurses at all levels in cancer diagnosis, treatment and care,” said Dr Tapela. The work goes further to include curriculum development and training community health workers in chronic diseases. “We need to create a community of care providers to accelerate science and the transfer of skills,” said Dr Bingawaho. 

Francine’s Wish

The story of Nicole is illustrative of the center’s transformational power. Francine Tuyishime, only fifteen years old, was the first patient to receive chemotherapy in PIH-supported hospital in Rwinkwavu, Rwanda. Like Nicole, Francine arrived at the hospital when her family thought that she would likely die. When traditional healers failed, Francine’s father brought her to the hospital in Rwinkavu for treatment. 

“There was a time when I thought I would never make it, when they started the medications,” said Francine. “I wish others in this part of the world could be cured just like I was cured by the medicines I was given.” Enrollment at both centers in Butaro and Rwinkwavu has grown this year, especially in Butaro following its opening. The establishment of the Butaro Cancer Center of Excellence and the story of Nicole are realizations of Francine’s wish.

03 December 2012

Rwanda's Bold Focus on Cancer Starts with HPV

The following post is written in conjunction with PRI The World's series on cancer. Go here to see the series.

A recent WHO assessment of Rwanda’s capacity to address non-communicable diseases (NCDs) found that country failed on every measure. Except for having a branch in the Ministry of Health that addresses NCDs. In between the lines of the assessment, and captured within the Ministry of Health, is a major push by Rwanda to take on cancer.

The Rwandan Ministry of Health is implementing preventative structures to reduce the incidence of cancer. For women, that means improving access to breast cancer screenings and a national HPV plan. Cancer is responsible for 5% of deaths in Rwanda each year. As a point of comparison, cancer is accounts for 23% of all deaths in the United States.

Major Development Gains

Rwanda has experienced a relatively rapid growth rate over the past few years. It was revealed earlier this year that 16 of 20 surveyed African countries by World Bank researchers are experiencing falling child mortality rates that are equal to or greater that what is set of the Millennium Development Goals. Rwanda’s 8% annual reduction stands at twice the rate of what is needed.

The gains are not limited to health. Roughly one million Rwandans are no longer living in poverty. The gains are a testament to the government, said Paul Collier, director of the Center for the Study of African Economies at Oxford University, at the time. “Basically, [President Paul] Kagame built a culture of performance at the top of the civil service. Ministers were well paid, but set targets. If they missed the targets there were consequences,” said Collier to the LA Times. “Each year, the government holds a whole-of-government retreat where these performances are reviewed: good performance rewarded, and poor performers required to explain themselves.”

All Eyes on NCDs

One of the focal points during the UN’s annual general assembly (UNGA) in September of 2011 was the rising global burden of NCDs. A resolution adopted by the General Assembly recognized the global problem and urged governments to work together, with donors and the WHO to support measures that will prevent and treat NCDs.

“Addressing NCDs is critical for global public health, but it will also be good for the economy; for the environment; for the global public good in the broadest sense,” said UN Secretary General Ban ki-Moon in his remarks to the UNGA in 2011. If we come together to tackle NCDs, we can do more than heal individuals – we can safeguard our very future.”

“According to the World Health Organization, deaths from NCDs will increase by 17% in the next decade. In Africa, that number will jump by 24%,” said Ban. The burden of NCDs will increase in low income countries like Rwanda as development gains eliminate avoidable child and maternal deaths.

Tackling HPV

HPV is almost entirely responsible for cases of cervical cancer. The three shots during adolescence will provide protection against HPV and all but eliminate the chances of developing cervical cancer when they get older.

“We are a government that is evidenced based and result oriented,” asserted Minister of Health Dr. Agnes Bingawaho. That is why Rwanda implemented one of the first widespread HPV vaccination campaigns for young girls in a low-income country.

For Rwanda’s older population, health clinics will undertake systematic screenings of women between the ages of 35 and 45 years old for cervical cancer. The solutions dominated approach has shaped the Rwandan cervical cancer program and the way that it developed. Bingawaho explained, “We always go for a policy first – the science in front of everything. We develop a strategy plan, followed by an implementation plan and then fundraise.”

Rwanda began working with Pharmaceutical giant Merck as far back as 2009 to develop a partnership that led to the signing of a three year memorandum of understanding in December 2010 to provide the vaccine at no cost. A paper authored by Dr Bingawaho covered the rollout of the vaccines for over 90,000 schoolgirls in April 2011. The researcher report over 90% coverage for all three vaccine rounds.

The authors answered questions regarding the allocation of resources towards the campaign by making a rights-based argument for vaccinating against HPV. They write, “High-level leaders are committed to ensuring the long-term integration of a rights-based cervical cancer prevention, care and treatment programme into the basic package of health services.” Prices will continue to fall, argue the authors, as more countries follow the lead of Rwanda and implement HPV vaccination campaigns.

Merck announced in June of 2011 that it would provide the GAVI Alliance, a global organization dedicated to improving access to vaccines, its HPV vaccine at two-thirds its market price of $15. GAVI followed up in November by officially announcing its intention to support that introduction of HPV vaccines in developing countries with the goal of vaccinating as many as 2 million girls in nine countries by 2015. “The HPV vaccine in particular is critical to women and girls in poorer countries because they usually do not have access to screening to detect cervical cancer and treatment available in richer nations,” said GAVI Alliance CEO Dr Seth Berkley in announcing the organization’s goals.

The Ministry of Health relies heavily upon community health workers to reach its citizens. Dr Bingawaho considers them to be the ‘echo’ of the ministry and an integral connection point to communities. There are three community health workers per village and they are selected by the village members. Doing so, explained Dr Bingawaho, engenders greater trust. That in turn leads to better health outcomes. “When people are given the opportunity to have better health, they are very responsive,” she said.

In tomorrow’s post I will talk about the development of Rwanda’s cancer referral center in Butaro.

29 November 2012

An exciting Post-2015 Development Agenda. Is it time for trees?

By Dr. Philip Goodwin, Chief Executive, TREE AID

It appears we are entering a new and exciting phase in development. For over a decade, the Millennium Development Goals have provided a focus for all those working in development. As the first holistic strategy for addressing the world’s development needs, they have also provided an opportunity to evaluate successes and failures. 

This evaluation, three years from the deadline is sparking new debate and action across the globe. There has been success. Parity in primary education between girls and boys is happening. The target of halving the proportion of people without access to improved sources of water has been met. So too, has the goal of halving extreme poverty and hunger.

But what does that actually mean? 

According to FAO General Director Jose Graziana Da Silva the overall number of hungry people may be decreasing slowly in the world, but not in Africa. Here the number of hungry has gone up in the last 20 years - from 175 million in 1990 to 239 million, figures included in this year's The State of Food Insecurity in the World (SOFI) report.

It is this issue that has seen an increased and timely focus on the role trees play beyond that of carbon catchers and nurturers of the environment. Joining the post-2015 debate means that the role trees can play in ending poverty and hunger can now be explored.

In Africa, it is no coincidence that incidences of drought and famine are taking place in areas where efforts to slow rates of deforestation have failed – or that such events are increasing in frequency. Loss of trees clearly leads to increased vulnerability to climate change and erratic weather patterns for those living there. It also leads to the loss of vital sources of food and income, and therefore opportunities to break free from poverty.

Malava, Kenya
'Conventional' crops are often not indigenous, and can require expensive inputs, significant irrigation and land preparation in order to produce a successful harvest. Trees on the other hand often survive when other crops fail. Commonly seen by smallholder farmers as 'famine foods', tree foods form a significant part of daily diets across rural Africa, providing fruits, nuts, seeds, leaves, flowers, sepals and even sap, which can all be used as high nutrient food.

The Thiombiana family, from Burkina Faso recently told me how they “escaped starvation”during this year’s food shortages in the country as a result of eating baobab leaves and fruit, and because of the income they were generating through the sale of tree foods when the in families granary was empty.

This existing, localised ‘emergency relief’, is what the international community must seek to strengthen. To do so, it must listen to the men and women on the ground, to the community groups to which they belong – and to the local government representatives that provide the bridge between them and the rest of the country.

Such an approach has seen Ghana and Burkina Faso receive endorsement of their far-reaching plans for sustainably managing their forest sectors as part of their goals for climate-resilient economic development earlier this month. Pitched as a “catalytic investment in an all-important sector for both sustainable development and climate change,” this is forestry that considers the interests of local communities’.

Crucially the research is there to back it up – research that the new Director General of the Centre for International Forestry Research (CIFOR), Peter Holmgren, recently wrote about in an article for the Guardian. “Scaling up sustainability: time for forestry to come out of the forest” discusses how food security is an area where, previously, conservation and human development agendas have been framed as opponents.

Yet, results released from a six-year study by the CIFOR, show that forest income, on average, constitutes more than one-fifth of total household income for people living in or near forests. This includes income from wood for fuel and construction, bushmeat, edible and medicinal plants. Forest products also contribute significantly to global business and trade; wood and non-wood forest products constitute 4% of global trade in commodities. 

The role trees play protecting the environment, increasing biodiversity, improving crop production and diversifying food supplies, combined with their ability to provide a viable case for economic development, sees many of the boxes needed for ending poverty and hunger ticked. 

The UN Secretary-General Ban Ki-moon has recently announced his plans for a "Zero Hunger Challenge" that links the achievement of food security to the elimination of hunger and poverty through sustainable production and increased small-scale productivity.

Trees, as an integral part of agricultural systems, need to be part of the solution.

A new World Bank report,“Forest Trees and Woodlands in Africa” agrees, citing that Africa’s forests have often been narrowly viewed as a source of export revenues from industrial timber and a global public good. When in reality, forests play much broader roles, as diverse sources of jobs and livelihoods and as providers of valuable ecosystem services that are vital for increasing economic and social resilience – including combating climate change.

In the words of Jamal Saghir, World Bank Director for Sustainable Development in the Africa Region, “The objective of sustainable management of forests, trees and woodlands in Africa can best be met by taking a fresh approach that recognizes the diverse roles that forests play, both in nurturing peoples’ lives and nature.”

The UN has recently named Prime Minister, David Cameron, as co-chair of a panel set to for advise the global development agenda beyond 2015. TREE AID wants trees to be firmly on that agenda. www.treeaid.org.uk

28 November 2012

AIDS Progress is Off Track, says ONE Campaign Report

Progress over the past two years against AIDS leads advocates to speak optimistically about the end of the devastating pandemic. In the same period of time there have been five million people newly infected with HIV, a number that represents a slowing of progress according to a new ONE Campaign report.

"The world is off-track for achieving the beginning of the end of AIDS by 2015," says the report which shows that the number of new infections are continuing a slow decline while the number of people newly put on ARVs has flat-lined since 2010. To alter the trajectories of prevention and treatment efforts will bring the world to what the ONE campaign calls "the beginning of the end of AIDS."

Projections based on current trends show that the point where the number of new people who receive ARVs will not exceed the number of new infections until 2022. ONE proposes an alternative projection where 140,000 people are added to ARV treatment each year and a doubling of prevention efforts will accelerate the transition point to be met by 2015.

To do so will require a global effort, not one that only involves traditional donor nations. "I call for a shift from the perception that aid is charity to an understanding that it is our shared responsibility and a smart investment that reaps dividends for all. Together, we must foster a more sustainable response to the HIV epidemic for the sake of our common future," says UN Secretary General Ban ki-Moon in the report.

More specifically, the level of financing must fill the gap of $6 billion estimated by UNAIDS. Seven countries and the European Commission are singled out in regards to their AIDS donations. ONE commends the United States, UK and France while adding pressure on Canada Germany and Japan. The per capita spending by the United States ($14.54), which is also the largest net donor, is roughly three times greater than Germany ($3.82) and more than twenty times greater than Japan ($0.66).

ONE's head Michael Elliott made sure to tell Reuters that he understands that many countries are under financial stress since 2008 and the earthquake in Japan was out of the country's control. "You have to be an unfeeling idiot, which we're not, to fail to recognize that the last few years have been tough economic times for people in many places all over the world," he said. "(And) Italy may have fiscal problems. But it's not going to solve its fiscal problems on the back of development assistance."

African countries also have a role to play in filling the spending gap. The members of the African Union  signed a commitment to allocate at least 15% of their budgets on health as a part of the Abuja Declaration. Only four countries (Togo, Zambia, Botswana and Rwanda) have met the target as of 2010. Three years remain to meet the goal and the majority of African nations are above the 10% threshold. However, there are thirteen countries that will need to make drastic changes by at least doubling their health budgets in order to meet the goal.

The report recommends using 2013 as a year to step up efforts. "Here's a moment to put your pedal to the metal and go for it," says Elliott. A replenishment meeting for the Global Fund in September and the ongoing discussions about the post-2015 agenda are instances, says ONE, where donors, organizations, governments and individuals can show their commitment to ending AIDS.

"Without scaled-up financing, more targeted programming and expanded displays of political will, this will remain a distant ambition, and millions of lives will hang in the balance. But with renewed urgency and concerted action, the world can transform the beginning of the end of AIDS from a vision to a reality and chart a course towards ending this pandemic," conclude the authors.

Visualizing the Sharp Rise of Aid to Least Developed Countries

The global financial crisis caused a slow-down in foreign direct investments in least developed countries, but aid is still rising quickly. Remittances are on the up and up, but The Economist notes that it is in some part due to an increase in migration. However, remittances play an important economic role accounting "for 4.4% of the LDCs' GDP, are equivalent to 15% of their exports, and are their second-largest source of foreign financing"

27 November 2012

Where is the best place to be born in 2013?

According to the latest index from The Economist the answer is Switzerland followed by Australia, Norway, Sweden and Denmark. For those of you looking for the United States (16) and Britain (27) in the top ten, look down a bit further Only 80 countries are evaluated in the index making it no surprise that emerging economies of Kenya, Nigeria and Bangladesh occupy the spots on the bottom of the list.

The big loser in the list, other than the US and UK, is the Euro Zone. The top ten is littered with small European nations that are all not a part of the Euro Zone. The Netherlands acts as the sole outlier of the group.

Scoring is determined by looking a life satisfaction surveys taken by Gallup and a series of measured well-being indicators such as life expectancy, GDP per head, divorce rates, rate of corruption and gender equality. The data showed that, "GDP per head alone explains some two thirds of the inter-country variation in life satisfaction."

As with any index, there are places to raised questions. Quality of family life is measured by divorce rates which is unable to capture unstable living situations where the parents remain together. Gender equality is determined by the number of parliamentary seats held by women, which can be skewed by countries that have mandatory limits. Such measures are rather hard to adequately quantify, so the Economist Intelligence Unit does deserve some slack in trying to create the index.

The short article from The Economist that introduces the list also includes a picture of the the 1988 article and index. The United States sat high at the top alongside other European countries like France and Italy.

The Economist calls itself out on the differences between the two lists by pointing out how the index indicators can impact the overall scores. It makes a cased for the less dynamic economies that site at the top of the list writing, "In the film “The Third Man”, Orson Welles’s character, the rogue Harry Lime, famously says that Italy for 30 years had war, terror and murder under the Borgias but in that time produced Michelangelo, Leonardo da Vinci and the Renaissance; Switzerland had 500 years of peace and democracy—and produced the cuckoo clock. However, there is surely a lot to be said for boring stability in today’s (and no doubt tomorrow’s) uncertain times."

Libertarian think tank the Cato Institute released its annual Economic Freedom of the World report which includes an index of countries ranked by economic freedom. It should come as no surprise that the index does not look favorably upon the United Sates who comes in ranked 18th in the world. There are some interesting points of similarity and divergence between the two indices 

Cato's 5 most economically free countries (Hong Kong, Singapore, New Zealand, Switzerland and Austria) are all in the top ten of the Economist's index. However, Mauritus and Bahrain, two nations considered to have high economic freedoms, do not make the list for The Econmist. Also, Norway (3) and Sweden (4), are ranked 25 and 30 by the Cato Institute.

There appears to be some level of correlation between economic freedom and the best place to live, but it is not perfectly aligned based on a quick comparison of each index. Developing economies are largely not included in The Economist's index, so it becomes a bit harder to make a comparison from the angle of development.

Kenya is just ahead of Nigeria on the Economist Index for the last spot, but is well ahead in the Cato index coming in at 78th as compared to Nigeria at 120. That variance may be due in some part to the fact that more countries are evaluated by Cato's index. A lack of data makes it hard to then draw any conclusions in regards to development policies.

26 November 2012

Since Busan, A Changing Aid Landscape

Rwanda went to the 4th High Level Fourm on Aid Effectiveness in Busan last year with the agenda of increasing transparency and ending untied aid. Paul Kagame challenged the attendees asking, "While donors may not be entirely to blame for bypassing these systems where they are weak, or non-functional, why not use aid to build up and strengthen such critical systems?" Rwandan Minister of Finance John Rwangombwa echoed the same sentiments in an interview to the Rwandan newspaper The New Times.

The implementation and measurement of aid accountability have changed since the agreement that came to be known as the Paris Declaration. South-South aid cooperation, the rise of the BRICS, and the graduation of countries like India to middle-income status have all contributed to a changing accountability landscape. 

Rwanda, the very country that advocated for untied aid only a year ago, is now serving as the sparkplug for a wider discussion on how aid can be used by donors to achieve political goals. The application of aid as a political tool is not new, but the case of Rwanda is one that offers a glimpse into the evolving relationships between donor and recipient countries. 

World leaders like Bill Clinton, Tony Blair and Bill Gates have found it easy to say nice things about Rwanda’s President Paul Kagame and the progress made by Rwanda. Clinton ended his annual Clinton Global Initiative meeting in New York this past September by inviting a group of leaders from Rwanda to commend them on their efforts to implement a universal healthcare system.

However aid accountability became a political issue for Rwanda when a leaked U.N. High Level Panel report disclosed findings that linked the Rwandan government and the M23 rebels in eastern DRC. The U.K. decided to withhold £16 million in funding it was set to disburse, following a visit to the region by then international development secretary Andrew Mitchell. Countries such as the Netherlands also suspended aid to Rwanda and human rights groups voiced support for suspending aid from the Kagame government.

Mitchell surprised many when he then reinstated aid to Rwanda, a move that was supported by the Cameron government, before assuming the role of government chief whip in September. He argued in a letter dated August 31, that pulling aid from Rwanda would only hurt the country’s most vulnerable. 

“Taking away budget support would have no effect on the elite in Kigali, but it would, bluntly, take girls out of school elsewhere in that country,” wrote Mitchell. “It might make us feel better to remove budget support and avoid taking these difficult decisions, but it would not affect who makes decisions in Kigali and it would have the effect of damaging the poverty programme." 

A public investigation followed as pressure from human rights groups mounted. Hearings were held earlier this month and Mitchell defended the decision. While awaiting the outcome of the hearing from Mitchell’s replacement Justine Greening, the M23 rebels continued forward to seize control of the city of Goma, eastern DRC’s main hub and home to numerous NGOs. 

A U.N. source told the Guardian the suspension of aid, the decision reversal and a very public debate has caused another kind of harm. 

"The mixed message from the U.K. obviously emboldened the Rwandans. They probably thought they could get away with it. They were delivering equipment and new uniforms in the run-up to this offensive, so it is no surprise,” said the source.

The same Guardian report says that the capture of Goma is building further pressure for the U.K. to seriously reconsider the suspension of aid to Rwanda. There are concerns about the message sent when providing aid to a country that is funding a rebel group seeking to overthrow the Congolese government.

Goals leading up to and following HLF-4 focused on accountability through a lens of reporting and data collection. Stakeholders talked about publishing data according to the International Aid Transparency Initiative (IATI) standards and ensuring that countries have the capacity to measure results.

The reaction to Rwanda’s support for M23 illustrates a different form of accountability that can lead countries to withhold aid. Other examples include India, where public and political pressure over the past few months led to the recent announcement by the Greening administration that DfID would move to ending aid to India and increase its focus on expanding and supporting trade.

Furthermore, questions emerge following recent examples of organizations and countries admitting to the misuse of funds. Findings by the Global Fund’s Inspector General of waste and fraud in some programs led donors to withhold money and ignite a series of reforms that ranged from the resignation of the Executive Director to the implementation of a new funding scheme.

An audit into Uganda’s aid spending found that money was transferred from Prime Minister Amama Mbabazi's office into private accounts. The European countries, including the U.K., announced the suspension of aid to Uganda this month following the news. The Ugandan government is attempting to regain the trust of donors as the effects of suspended aid are being felt. Money meant to support over 6,000 new community health workers in Uganda was not released this month as a result of the reduction in aid.

As aid actors work towards meeting the accountability measures set forth in the HLF-4 outcome document, the events of the past year are evidence of the political complications and pressures on accountability. Wielding aid disbursements as a political tool can lead to new partnerships (India), reform (Global Fund) and possibly lead to negative outcomes (Rwanda). Going forward, the process of accountability will have to continue to adapt to the changing politics of aid.

Thanks to Jennifer Lentfer for some editorial help.

21 November 2012

Thanksgiving Eve Twitter Debate: Sachs vs Everyone

Daron Acemoglu and James Robinson finally responded to Jeff Sach's review of their book Why Nations Fail. It in turn led to a spirited Twitter debate. Here is the debate, warts and all. I will attempt to put it into separate conversations to make it easier to read.

Meet the New (Global Fund) Boss...

A series of big announcements were made regarding the Global Fund following the November 15th board meeting. Among other changes, the board unveiled the appointment of the next Executive Director, Dr. Mark Dybul. As the  United States Global AIDS Coordinator during the Bush Administration, Dr Dybul helped to lead the PEPFAR program. Deborah Derrick, president, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, expressed her support for the decision earlier in the week by writing in The Hill blog.

"As Dr. Dybul and the Global Fund move toward implementation of this new funding model, resources will flow more efficiently to support lifesaving programs," wrote Derrick. "With these changes under its belt, the Global Fund is prepared to save many more lives in the years ahead, and Dr. Dybul is well positioned to capitalize on the work of the past year and build on the Global Fund’s legacy."

Further glowing praise came from leaders in the press release announcing the appointment. “Mark Dybul is a true leader, who can take the Global Fund to the next level,” said Simon Bland, Board Chair of the Global Fund. “He has a really impressive vision of how to achieve global health goals. He is passionate, energetic and focused.”

20 November 2012

Quick Post: M23 Rebels take Goma

The M23 rebels in the eastern Democratic Republic of the Congo took control of the provincial capital, trade port and NGO hub of Goma this morning. According to the Associated Press, "Explosions and machine-gun fire rocked the lakeside city as the M23 rebels pushed forward on two fronts: toward the city center and along the road that leads to Bukavu, another provincial capital which lies to the south. Civilians ran down sidewalks looking for cover and children shouted in alarm. A man clutched a thermos as he ran."

Reports indicate that the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) have provided little support during the advances by the M23 rebels. "MONUSCO is keeping its defensive positions. They do not have the mandate to fight the M23. Unfortunately, the M23 did not obey the MONUSCO warnings and went past their positions (at the airport). We ask that the MONUSCO do more," said UN Congolese military spokesman Olivier Hamuli to the AP.

M23 made it into the city today and took the city airport after noon. Andrew Gatehouse, a correspondent from the BBC, reported this morning that no fire was exchanged as the rebels entered the city and they took what he described as a 'victory lap' around the city of Goma before a good portion exited the city. However, some rebels to remain in Goma and appear to be taking position in a director towards the city of Bakavu having taken control of a part of the road that connects the two cities.

M23 soldier near Goma, Congo

An M23 soldier in Rubare, north of Goma. The Congolese army has denied reports its troops were refusing to fight and were fleeing. Photograph: Jerome Delay/AP

Rwanda makes a few appearances in reports due to regional allegations and recent findings by a UN panel that the government is providing support for M23. "On Tuesday, a colonel in the Congolese army who was in Goma fighting the rebels said by telephone that the soldiers he is fighting are Rwandan. He requested anonymity because he is not authorized to speak to the press," reports the AP.

19 November 2012

A Comprehensive Approach to Bringing Improved Sanitation to 2 Billion People

Toilets may not be a topic that get as much attention as others, but over 1 billion people around the world must defecate out in the open and over 2 billion people do not have access to clean and private toilets. That means that billions are at risk of diseases that are spread through fecal matter such as diarrhea and cholera.

Today's World Toilet Day is meant to make some noise about the issue by raising awareness. The stakes are high and the issue is serious. According to the WHO, the areas with the lowest access to proper sanitation are sub-Saharan Africa (31%), southern Asia (36%) and Oceania (53%). "World Toilet Day has a serious purpose: it aims to stimulate dialogue about sanitation and break the taboo that still surrounds this issue," says the World Toilet Day website. "In addition, it supports advocacy that highlights the profound impact of the sanitation crisis in a rigorous manner, and seeks to bring to the forefront the health and emotional consequences, as well as the economic impact of inadequate sanitation."

Satire: Africa Aids Freezing Norwegians

What happens when you take the formula used by Band Aid in 1984 and flip the script? You get Radi-Aid. Some nice satire to kick off your week. Enjoy.
HT Tom Paulson

16 November 2012

DAWNS Goes Mobile! Join the Experiment.

We have a new mobile app. We think this app can lay the groundwork for a sustainable and revolutionary new model for supporting global humanitarian journalism.

Here’s why.

We started DAWNS Digest on a hunch that a community of global news consumers could be nurtured, inspired and empowered to support compelling global humanitarian journalism. Our idea was pretty simple: We sell subscriptions to a global humanitarian news aggregation service to people who value easy access to that kind of news, then use our revenue to support nuanced international reporting and storytelling that this community craves.

We are one year into this experiment and we think we are onto something. So far, major international NGOs and government agencies, students, and the general news consuming public have signed up for an email version of our aggregation service. Through a competitive voting process, these subscribers helped chose three very interesting international reporting projects to support over the past year.

With the launch of our new mobile app, we think we can take this model to the next level. You can learn about all the great features of our mobile here, but the reasoning behind it is what I want to emphasize. We think 1) There are a few thousand people out there who would pay a couple dollars a month to receive timely updates on parts of the world the mainstream media tends to ignore. 2) This community has a rooting interest to help journalists, photographers, and online media tell local stories of global significance.

Over the past year, we have found that this process helps develop a community, ensures that audiences can access stories of interest to them, and provides journalists with the chance to pursue stories that might otherwise not be told.

We have not yet reached our few thousand subscriber threshold, but with or new app we think we can. If we succeed, we would be pioneering a sustainable financial model to support global development and international human rights reporting.

That’s our gamble. And that’s why we are launching DAWNS Digest mobile. Join us.

15 November 2012

Emerging Economies to Take Off, What Does that Mean for Aid?

The global economic map in 2060 will be radically different from the one today, predicts the Organization for Economic Co-operation of Economic Development (OECD). A report released by the organization shows that developing economies, led by China and India, will eclipse the major powers in the next fifty years.

Such gains indicate a rebounding global economy and giant strides in the global South. "The shifting balance of long-term global output will lead to corresponding improvements in living standards, with income per capita expected to more than quadruple in the poorest countries by 2060," said OECD Secretary-General Angel GurrĂ­a. "The increase could even be seven-fold in China and India. With these gains, the gap that currently exists in living standards between emerging-markets and advanced economies will have narrowed by 2060"

14 November 2012

Boston NGOs Keep Up Family Planning Summit Momentum

Family planning became a high profile topic over the past year thanks to controversial remarks from American politicians and a renewed effort by the Gates Foundation. Melinda Gates said that family planning is not a controversial issue in a TED talk that served as a precursor for the London Summit on Family Planning.

World leaders, organizations and advocates gathered in London in July to make financial commitments towards ensuring that the 250 million women around the world who lack access to family planning services will see their need filled. Prime Minister David Cameron delivered remarks at the event where he advocated for further partnering with countries.

"Studies show that limited education and employment opportunities for women in Africa mean annual per capita growth is almost a whole percentage point lower than it should be. Had this growth been achieved, Africa’s economies would have doubled in size over the last thirty years. Providing girls with just one extra year of schooling can increase their wages by as much as 20 per cent," said Cameron in July.

12 November 2012

Calling Attention to the Leading Killer of Children

An estimated 1.3 million children under the age of five die from pneumonia each year. Children can be treated with antibiotics, but as many as 30% of children with pneumonia are unable to access the antibiotics that can save their lives. Prevention of pneumonia starts at birth and includes ensuring that children are not malnourished and are immunized against pneumonia and other diseases that put them at risk. The UN Commission on Life-Saving Commodities issued a recent report estimated that the lives of over 1.5 million children can be saved over the next five years if amoxicillin is made available in a dissolvable tablet.

The number one killer of children under five oftentimes flies under the radar. “Pneumonia can be prevented and cured. Yet, for too long it has been the leading cause of global deaths among children. We know what to do, and we have made great progress – but we must do more. We must scale-up proven solutions and ensure they reach every child in need,” said United Nations Secretary-General Ban Ki-moon marking today's World Pneumonia Day.

What it Takes to be an Africa Expert

It is becoming just as popular to write satirical pieces about Africa as it is to be what the pieces of satire are criticizing. Duncan Clarke writes in the Guardian Africa network about how to be an expert on Africa and includes a few zingers. He does a pretty good job of including just about everyone who says anything about Africa in his piece.
Remember, Africans are "entrepreneurial" (you saw that in three places on your 10-day tour de l'Afrique). They would be more so but for colonialism, imperialism, francafrique (add Eurafrique), "unequal exchange", foreigners (except Chinese), apartheid, prejudice against the "global south", or other harbingers of disadvantage and victimology like anthropogenic climate change (admittedly difficult to predict, just like Africa or the weather).
"Africans" should always be seen to prefer "African solutions" (and you too) even where no one knows what these might be. Speak "of them and to them" so they know they "exist", alike vague socio-anthropological entities, notwithstanding a couple of thousand languages, 55 "nation states" in balkanising evolution, hundreds of fragile borders, multiple power-brokers, and an unfathomable mix of ethno-linguistic societies and competitive entities seeking survival under Africa's sun.
Read the whole thing here to get the proper context.

09 November 2012

Nigeria's Ignored Floods and Western Media's Role

Flooding across Nigeria since July has displaced over 2 million people. Some are calling it the worst flooding the country has seen in half a century. It is a story that is only now beginning to get some press attention following the new estimates regarding the number of people displaced and the 363 deaths attributed to the floods.

Before the data became available, John Campbell lamented the lack of media coverage in the Council for Foreign Relations blog. "It baffles me that the Western media is paying so little attention to the flooding in Nigeria. There are dramatic aerial photographs of the flooding in the Delta, and affected areas spread as far afield as Kano and Kogi states in northern and central Nigeria," begins Campbell.

He proceeds to call out Oxfam and the Red Cross and Red Crescent for not making enough noise about the problem. IRIN reported in early October that Oxfam was seeking $850,000 to respond to the floods. Though it appears that singling out Oxfam may miss the mark. 

“Never before has there been a disaster of this scale or magnitude,” said Oxfam’s deputy regional humanitarian coordinator in Nigeria, Dierdre McArdle to IRIN today. “Finding partners who have the capacity to deal with it is challenging.”

McArdle proceeds to say that problems include the scale of the flooding, a lack of information and a lack of technical knowledge to respond. Earlier estimates of the people displaced by the flooding were under 1 million. The jump to 2.1 million reflects the time it took to properly assess the situation and come up with a reasonable estimate regarding the number of people affected by the floods.

A coordinated appeal from Oxfam, Nigeria's National Emergency Management Authority (NEMA) and the UN requires $38 million to relief and recovery services in 14 states. According to a UNICEF official, NEMA had established plans to respond to disasters that displace 500,000 people, only a quarter of the number of people displaced by the current floods.

The emerging information regarding the challenges to respond helps to explain the lack of noise from NGOs. The problem was easily apparent, but it is possible that organizations were reluctant to react too quickly without the proper information. Campbell criticized the media, but it should come as no surprise that the story did not pick up any steam until the 2 million number was determined.

Part of the problem for media in the story is connected to the response by the NGOs. A severe lack of data and information makes it hard for the NGOs to communicate the scale of the problem to media outlets and garner interest on the story. That is only compounded by a small amount of space that is given to international reporting and a lack of staff reporters in sub-Saharan Africa.

The issue is not Nigeria itself or really the story as much as it is a pattern of a lack of Western media reporting on the continent. Little was reported in regards to the Sahel crisis. It took a famine declaration to get any attention to the Horn of Africa this year and northern Mali is all but off the map save a few mentions from Mitt Romney when talking about al Qaeda.

Campbell is on to a bit problem, but it is much bigger than the flooding in Nigeria. I spoke about this problem on Wednesay night with Jaclyn Schiff and Mark Goldberg. Blaming the media misses the totality of the problem. When it comes to reporting on developing countries, the information provided is like one of those puzzle games where pieces are removed to show a picture that is never completed.

A few pieces are taken away to reveal a partial picture. NGOs issue reports and make calls to action that tell what is happening relative to their own work. Local media will tell a bit more, but the stories rarely reach an international audience. When it comes time for Western media to step in the reports are informed by the NGOs on the ground and are restricted due to resources and time/page space allotted to such issues.

All these factors contribute to the incomplete picture. What is often forgotten is the audience. There needs to be a demand for more and better reporting regarding developing countries. News consumers can voice this demand by frequenting the sources that do provide better reporting or urge their favorite outlets to cover more stories.

There are some excellent reporters who are telling important stories.The talent and desire is there from the side of the storytellers, it is a challenge of getting to the right audience. NPR is trying to reach the audience through its Shots blog, PRI is ramping up The World, the Guardien has its Development section, DAWNS is chugging along to pull together news and there are many more attempting to find ways to remove the pieces from the incomplete puzzle. Yes, Campbell is right that it needs to be better, but there are efforts underway to address that problem and ensure that issues like Nigeria's flood are not ignored.