29 June 2012

An Open Reporting Experiement

You may or may not have noticed that I am slowly moving in the direction of providing fresh reporting. I have been doing many interviews, reading and research for articles that end up on this space. It is a deliberate personal and professional move. Blogging is generally reactionary, which is what makes it fun and easy to read. However, there is a lot of space for more humanitarian reporting and to introduce new people, ideas and projects.

I am going to use this space for some small scale experimentation with the process and what is actually published. This blog does not make a dime for me and I have no intention of adding advertisements to this space. With that said, I am making it my aim to make this workable, useful and sustainable. I was hesitant to see blogging as my avenue for participating in aid and development. Avoiding that truth is ultimately fruitless as I enjoy writing immensely, the freedom of being largely independent, and the ability to learn and share information about various parts of the humanitarian endeavor.

Freelance work will be one way to make this work, but I want to prove the value of this space and aid blogging in general. Aaron Ausland acutely pointed out the shortcomings of aid blogging last night with his post and this drawing:

Ausland is absolutely right when he writes:
A few blogs are actually deeply informed by direct experience with aid beneficiaries – those that we often lazily referred to as ‘the poor’. And these are special things (think Owen Scott’s series on PlayPumps). But many blogs are simply opinionated responses to op-eds and articles and other blogs. It seems we write for each other about each other as often as not. It’s not so much navel gazing as it is cliquey aloofness.
I would extend that statement to some aid reporting. Projects are touted as the next great solution without any evidence of their efficacy. My hope is to continue to learn more. Through that process, I hope to find ways to report on and discuss openly aid and development work.

Given the present state of media, a mix reporting and blogging seems to be the trend for written work. It is why the young liberal bloggers like Klein and Yglesias have grown to succeed. Aid is not as popular as the American economy, but there are people who want to stay informed and care to participate in large and small scale discussions.

Improved reporting and discussions can be useful, but are not aid work. The two should not be confused, but the former should not be abandoned entirely for the sake of the later. Nor should writing about aid ever take a place above the work and the very people that it affects. Being good on Twitter or at blogging does not mean that someone is anything more than successful on narrow internet-based social media tools.

There are many limitations, but also opportunities. An article by Spencer Ackerman this morning shows how social media is being used to push forward the discussion in the realm of security policy and terrorism. Aid experiences that to a small extent already, but it can go a bit further. That is why I believe that reporting is a way to balance out the downfalls of social media use.

I am not going to hide behind wanting to take this mainstream. Growing an audience is going to be a goal not for attention, but for changing the way that people understand aid, development, foreign policy, poverty and so on. Right now a lot of this is within the echo chamber. Reporting may be a way to break through. Success might mean this blog moving to become part of a larger brand and I have no illusions of it happening given the state of reporting, but am at the same time I am not deterred from making the case through my work.

The experiment aspect of this will be to do it in an open manner. I am going to share information as I gather it, talk about story ideas and publish notes from recent interviews. It will be a sort of open sourced reporting. My hope is that it will elicit feedback, resources and ideas.

To kick it off, here are a few stories/angles that are in various stages of development. Let me know what you think and feel free to make suggestions about my overall plan and the list below.

  1. Transparency in aid - It is talked about a lot, but few are actually doing it. The idea is to look at how transparency has taken shape in aid, what is being done now, who are the innovators, what are the obstacles and what is to come.
  2. The Sahel - A few angles here, but I am focusing on Chad right now. Am also interested in the now popular term 'resilience.' What does it mean in theory for different actors? How should it be implemented? What is the reality of building resilience? Zooming out a bit further, how are actors responding to disaster on the individual to institutional levels?
  3. MVP - The project has strong opponents and supporters. What is the reality of the project? Is it succeeding? What comes next if it fails/succeeds?
  4. Microfinance - A long overdue review of Roodman's book. Also, why does the evidence from RCTs show little evidence of it working yet organizations still champion successes? What accounts for the gap?
  5. Post 2015 Agenda - What are the lessons learned from the MDGs? Will they be applied to the next set of goals? Does Rio+20 portend what is to come?
  6. Religion and Aid - To what extent does one influence the other? How does faith inform the way individual donors respond to stories and information about aid?
  7. Conflict Minerals - It looks like the present legislation in Dodd-Frank is not going to pan out. If it fails, what should come next. If implemented, how will the legislation impact mining companies, miners, the DRC, individuals in the region and rebel groups?
  8. Global Health - To what extent does the vertical approach to health problems impact global health efforts overall?
  9. Private Sector - What are private sector actors like Merck and Unilever doing to support aid interventions? Why are they doing it? Get a bit into the CSR debate as well.
  10. Aid Comms - To what extent are aid organizations able to connect their programs with marketing? Is there space to add further complexity, including failures, into communications and maintain/grow support? How do aid communications shape expectations for donors and possibly programs?

Reemerging Somalia: The Story Told Through Women

Somalia is rapidly shifting in response to stabilize a nation that has experienced two decades of unrest. Once a place where the only stories that made it to a western audience were of famine and warn, Somalia has quickly evolved from the home of pirates to a place of growth. Though it is still dealing with the problem of al Shabaab, malnutrition in the south and a very fragile government, reporters are telling new stories about the country.

This past April, Jeffrey Gettleman wrote in the New York Times on how some people are returning back to the capital city of Mogadishu.
But people here are sensing the moment and seizing it. More than 300,000 residents have come back to the city in the past six months, local aid groups say, and many are cheerfully carting away chunks of rubble and resurrecting their bullet-riddled homes. The economic boom, fueled by an infusion of tens of millions of dollars, much of it from Somalis flocking home from overseas, is spawning thousands of jobs that are beginning to absorb young militiamen eager to get out of the killing business. 
Given Mogadishu’s importance to the country, it all adds up to a huge opportunity. And though Somalia has self-destructed numerous times before, Augustine Mahiga, the head of the United Nations political office for Somalia, along with so many others here, insisted that this time really is different. Somalia, they contend, is finally turning around.
Tristan McConnell picked up on the same trend earlier this month in the GlobalPost by profiling the town of Hudur. Once a bastion for the Shabaab rebels, life in Hudur is returning to a more normal state.
As soon as the militants left, 19-year-old Hussein Abdi went to the market to buy a pair of jeans, dusted off his soccer ball and started hanging out with his friends again at the tea shops that line the uneven streets of Hudur, the regional capital of Bakool province with about 40,000 people. 
“Life was hard then but now it’s good. We dress how we want, play football, walk with our friends,” said Abdi. He was back at school again, too, and hoped, eventually, to make it to university. 
Abdulkadir Nur, the regional education officer, is responsible for reopening schools and getting pupils back on the standard curriculum after years of learning nothing but Arabic and Quranic studies. 
“We had made something here and Al Shabaab broke it,” he said. “Now we need to build their minds again.”

There is much more to be told, say Eunice Lau and Arthur Nazaryan. Lau, a former Al Jazeera producer, and Nazaryan, a photographer, want to tell the stories of Somali women who are finding ways to thrive despite the many challenges in their lives. Through the Fire will be a documentary and photo series that documents some of these women.

I had the chance to chat with Arthur about the project, what it entails and why he thinks it is a story worth telling.

AVFTC: Somalia is often popular for reporting with stories of famine, war, and pirates. Why make a documentary there?
AN: Well, its difficult to talk about Somalia without mention of the anarchy its been experiencing for over two decades. The problem is that there isn't much reporting about what Somalis themselves have done to strive through all of that, the resilience they've shown. That's the purpose of this documentary: to give some exposure to what people, especially women, are doing to reestablish the stability that Somalia once had.
AVFTC: What role can a documentary play in raising awareness of a given topic?
AN: For a lot of people, it can be an introduction to an issue that they've never heard of before. For others, who may be aware of an issue, it can give them a deeper understanding of the issue's complexity. Most of all, it can put a human face to it, so that (ideally) people can connect to it on a personal level.
AVFTC: What stories do you think are missing from your documentary?
AN: Stories pertaining to the Somalia diaspora. We hear plenty about foreign aid organizations, but the diaspora has also been a major source of funding and expertise for Somalia's redevelopment. A recent report sanctioned by the UNDP estimated that over $130 million dollars are sent back by members of the Somali diaspora, for humanitarian aid and development.

We are working to include that angle in my documentary.
AVFTC: Why focus on women?
AN: Women have been severely marginalized in Somali society, by a combination of tradition and culture. Yet the ongoing war has removed so many men from society, putting a tremendous responsibility on women to step up as bread-winners and leaders in their communities. There are some truly remarkable stories we want to tell: from women who run thriving businesses to Dr. Hawa Abdi, who runs a major IDP camp outside of Mogadishu - and is a Nobel Peace Prize nominee, by the way.

Well, greater exposure can do a lot. There may be many donors and organizations out there with the resources and desire to support these women, but who are not aware of their projects. So, hopefully more exposure will be followed by more support and resources. That is why we've partnered with non-profits like Vital Voices and Common Language Project - to get the word out to as many people as possible.
AVFTC: What makes Somaliland different from other countries in the Horn of Africa?
AN: Somaliland is a fascinating case in general, because it's a positive story out of Africa that does not involve foreign intervention (with the notable exception of Ethiopia) There are NGOs operating there now, but the region was initially stabilized and developed by Somalis themselves.

So I think this case may have a lot of implications and even set precedents, not only for Somalia, but for other countries in Africa: that they can achieve stability on their own. I'll be spending a lot of time investigating Somaliland's story in this documentary.
AVFTC: More issue-based documentaries are tying the film to action for the audience. Will this trend continue? Why is it being done?
AN: I'm sure it will continue, because these kind of documentaries are potent, they move people. Plus YouTube and social media allow them to reach such a large audience.

However, I think a documentary - insofar as it's journalism - needs to be done from a neutral perspective. I mean, not taking sides or promoting any specific point of view. When you start pushing a certain narrative, instead of reporting what you find, it threatens the integrity of the piece. 
Having said that, of course I want a project like this to have a positive affect on the people I document. It's just that it needs to happen after, and separately from, the documentary itself.
AVFTC: Tell me more about your partnerships.
AN: Vital Voices is an organization that works to empower women all over the world, and a major contributor to Dr. Hawa Abdi's foundation. In addition to promoting the project, they're going to host an opening event and photo-exhibition in Washington, DC once it is complete.

The Common Language Project, which is an online news magazine out of Seattle, is our media partner. They give a lot of attention to stories concerning human rights issues and humanitarian affairs, so we thought they would be the perfect outlet to partner with. They were very supportive in planning the documentary and helping us with the Kickstarter campaign.
AVFTC: Why are you using Kickstarter?
AN: Because Kickstarter is not only a way to raise funds for independent documentaries like this, it's also a way to get other people invested in these kinds of issues. I find that when people contribute to a project, they're more likely to follow up on what's going on and where their money went - which is crucial, because it means people will be more connected to the issues we are covering.

Also, Kickstarter is the only way we can possibly get the funding in the very short time we have to get to Somalia - now is an essential time to make this film.
AVFTC: Why is it so important to do this film now?
AN: Well, for the first time in 21 years, Somalia has a real chance to finally become stable. African Union and Somali Transitional Government troops have pushed out Al-Qaeda linked-militants from almost all their strongholds, particularly the capital of Mogadishu. As Somali society is getting back on its feet, women are beginning to take part in education, government, and development.

We think that if there is any time to highlight this change, and support the efforts of these women, it is now.

28 June 2012

New Film Pulls a "Michael Moore" on the UN

A film is making its way into theaters across the US that says it exposes a corrupt and inept UN. Released in 2009, U.N. Me struggled and finally made it to the big screen (you can get it on iTunes and Google Play as well). Filmmaker Ami Horowitz has been making the media rounds for the past two years to promote the film. It seems that it has attracted a strong audience among American conservatives who dislike the UN. Horowitz has been a guest with Beck, Malkin, Varney (seen below) and others.

Overall the film seems to garner some rather mixed reviews.

The discussions and trailer seem to lead towards calling for the abandoment of the UN, but the film website looks towards reform. Namely, the flimmakers advocate for greater transparency. The suggested letter for people to send to their respective member of congress reads:
1) Demand the United Nations post a full and accurate line item budget online.

As taxpayers of the world responsible for the continued funding of the United Nations, we deserve a full and accurate assessment of how our money is being spent. Because the United Nations already has a heavy presence on the Internet, this is a cost-free distribution method that would allow any taxpayer to see how his or her funds are being spent.

2) Enact Article 6

This article declares that any member state that persistently violates the tenets of the UN Charter should have its membership revoked. From North Korea’s continued flaunting of the United Nations to Sudan’s participation in mass atrocities, there are many candidate member states that have persistently violated the principles of the Charter. To demonstrate that the United Nations has a standard when it comes to the make up of its membership would go a long way toward re-establishing its credibility.

The organization too often prefers opacity to transparency, and only continues functioning thanks to the taxpayers of the world. It is through the financing of the UN that we can institute accountability.
It is possible that the filmmakers understand that enacting Article 6 would cause major problems and they hope that further transparency will expose further corruption in the UN. Though it is hard to tell much without having seen the movie or hear from the filmmakers.

I'm going to try to see the film in the next few weeks and try to get a hold of Horowitz to talk further about the documentary. The UN is naturally not too happy with the film. A statement from the UN read during a segment on Morning Joe says the film is full of errors and mis-characterizations.

Has anyone seen or heard of this film? Drop a line in the comments or email me if you have any reactions to the film.

Here is another taste of the film. The clip looks into UNRWA supporting terrorism.

Carter Calls Out US Human Rights Record

Former President Jimmy Carter wrote a pointed OpEd in the New York Times on the waning leadership by the United States in the area of human rights. He writes (emphasis added):
Recent legislation has made legal the president’s right to detain a person indefinitely on suspicion of affiliation with terrorist organizations or “associated forces,” a broad, vague power that can be abused without meaningful oversight from the courts or Congress (the law is currently being blocked by a federal judge). This law violates the right to freedom of expression and to be presumed innocent until proved guilty, two other rights enshrined in the declaration. 
In addition to American citizens’ being targeted for assassination or indefinite detention, recent laws have canceled the restraints in the Foreign Intelligence Surveillance Act of 1978 to allow unprecedented violations of our rights to privacy through warrantless wiretapping and government mining of our electronic communications. Popular state laws permit detaining individuals because of their appearance, where they worship or with whom they associate. 
Despite an arbitrary rule that any man killed by drones is declared an enemy terrorist, the death of nearby innocent women and children is accepted as inevitable. After more than 30 airstrikes on civilian homes this year in Afghanistan, President Hamid Karzai has demanded that such attacks end, but the practice continues in areas of Pakistan, Somalia and Yemen that are not in any war zone. We don’t know how many hundreds of innocent civilians have been killed in these attacks, each one approved by the highest authorities in Washington. This would have been unthinkable in previous times. 
These policies clearly affect American foreign policy. Top intelligence and military officials, as well as rights defenders in targeted areas, affirm that the great escalation in drone attacks has turned aggrieved families toward terrorist organizations, aroused civilian populations against us and permitted repressive governments to cite such actions to justify their own despotic behavior.
He concludes saying (emphasis added):
At a time when popular revolutions are sweeping the globe, the United States should be strengthening, not weakening, basic rules of law and principles of justice enumerated in the Universal Declaration of Human Rights. But instead of making the world safer, America’s violation of international human rights abets our enemies and alienates our friends.
Conor Friedersdorf wonders aloud in The Atlantic why more people are not throwing their support behind the former president.
If there is a more extreme example of a prominent politician breaking with his fellow elites I don't know what it is. But he is saying things most people don't want to hear, so a past president accusing other presidents of violating the law and trampling on human rights is all but ignored. 
The challenge is that 'human rights' can be seen as a politically loaded word. Conservative pundits will lambaste the invocation of the phrase seeing it as an opponent to individual freedoms. Though Carter has gone rogue by taking aim at both sides of the aisle, his rights based argument is seen through a political lens. Because of that, it is not surprising that Carter does not get wide support.

Remember, there are Americans who see Iraq as necessary and liberating, would gladly support racial profiling and think extraordinary rendition is acceptable. That is the extreme side of a general view that human rights can stand in the way of liberty and justice. Supporters of a rights-based approach, like Carter, need to connect human rights back to individual freedoms as the two are so closely tied together.

27 June 2012

British MP Voices Hatred for Aid Jargon

Tory Minister Alan Duncan is not a fan of jargon used by DfID. Like any good aid organization (or in my case, aid blogger) there are some important aidspeak terms that are necessary to any public communication or report.

In a pretty funny letter, Duncan lists some of these tried and true terms as examples of what he no longer wants to hear. They include:
  1. leverage
  2. mainstream
  3. grow economies
  4. going forward
  5. access
  6. catalyse
  7. showcase
  8. impact
  9. the humanitarian space
  10. resilience
He also goes into some grammar pet peeves such as, "He finds it annoying when conjunctions such as 'which' or 'that' are inexplicably dropped in a way which ruins the flow and logic of a sentence." It's worth reading Duncan's letter in its entirety. The phrasing is brilliant.

Bill Easterly collected an AidSpeak dictionary last fall through crowdsourced twitter entries. Highlights include:
“participation” : the right to agree with preconceived projects or programs -@edwardrcarr

“partnering with other institutions” : we’re raising barriers to entry – @JustinWolfers

“political will” : I have no comprehension of the incentives faced by the people who I wish would do stuff I want @m_clem
What are some other favorites that are missing from Duncan's letter and Easterly's list. I have to admit that I am guilty of using 'humanitarian space' or some form of that phrase all too often. It's also good to see the word du jour, resilience, make the list.

Add your favorites in the comments section.

Branding and Aid: DfID's New Logo

DfID unveiled the new logo for UK aid yesterday. Now people receiving aid from the UK will have the pleasure of seeing the Union Flag with some important information that it is from the British people. The point is to take credit "for the results that UK aid delivers." Secretary Mitchell drives the point home saying, "I believe it is important that aid funded by the British people should be easily and clearly identified as coming from the UK. It is right that people in villages, towns and cities around the world can see by whom aid is provided."

The logo looks awfully familiar...

Ah, yes. USAID brands its aid with nice and big lettering and the all too important "from the American people."

A few months ago, I was at event (I frankly do not remember what it was for) where a US congresswomen spoke of visiting aid projects a couple years ago. She was dismayed that the project, a newly built school, had no evidence of it being a US-funded project. She proudly told how she demanded that a plaque be placed on the school so that everyone can know it was "from the American people."

The announcement by DfID and the USAID story bring forward the question as to when and how to take credit. Certainly donors want recipients to know who gave them the aid in order to take the credit that is due. The problem is when the credit becomes more important than the act and drives the action.

An argument could be made that it does not really matter as long as the programs work and the aid is distributed. The other side of the coin is that visibility may trump good programming that is not so sexy and easily seen on an everyday basis. Branding is very much a part of aid programs. NGOs do it just as frequently as donors through uniforms, trucks and distributed goods.

What balance should exist? The reality is that branding is not going away any time soon, so how can policies ensure that brand visibility does not stand in front of good aid and effective development?

26 June 2012

UN Panel Finds Strong Evidence of Rwanda Backing Congolese M23 Mutiny

The controversial annex to a report by a UN Group of Experts on the M23 mutiny in the Democratic Republic of the Congo was leaked to Foreign Policy's Colum Lynch and published earlier this evening. Originally blocked, the annex outlines the ways that the Rwandan government has supported the M23 and the destabilization of the eastern DRC.

Notable sections:
Since the outset of its current mandate, the Group [of Experts] has gathered evidence of arms embargo and sanctions regime violations committed by the Rwandan Government. These violations consist of the provision of material and financial support to armed groups operation in the eastern DRC, including the recently established M23, in contravention of paragraph 1 of Security Council resolution 1807. The arms embargo and sanctions regimes violations include the following:
*Direct assistance in the creation of M23 through the transport of weapons and soldiers through Rwandan territory;

*Recruitment of Rwandan youth and demobilized ex-combatants as well as Congolese refugees for M23;

*Provision of weapons and ammunition to M23;

*Mobilization and lobbying of Congolese political and financial leaders for the benefit of M23;

*Direct Rwandan Defense Forces (RDF) interventions into Congolese territory to reinforce M23;

*Support to several other armed groups as well as FARDC mutinies in the eastern Congo;

*Violation of the assets freeze and travel ban through supporting sanctioned individuals.
In turn, M23 continues to solidify alliance with many other armed groups and mutineer movements, including those previously benefiting from RDF support. This has created enormous security challenges, extending from Ituri district in the north to Fizi territory in the south, for the already overstretched Congolese Army(FARDC). Through such arms embargo violations, Rwandan officials have also been in contravention of the sanctions regime's travel ban and assets freeze measures, by including three designated individuals amongst their direct allies.

In an attempt to solve the crisis which this Rwandan support to armed groups had exacerbated, the governments of the DRC and Rwanda have held a series of high-level bilateral meetings since early April 2012. During these discussions, Rwandan officials have insisted on impunity for their armed group and mutineer allies, including ex-CNDP General Bosco Ntaganda, and the deployment of additional RDF units to the Kivus to conduct large-scale operations against the FDLR. The latter request has been repeatedly made despite the fact that: a) the RDF halted its unilateral initiatives to weaken the FDLR in late February; b) RDF Special Forces have already been deployed officially in Rutshuru territory for over a year; c) RDF operational units are periodically reinforcing the M23 on the battlefield against the Congolese army; d) M23 is directly and indirectly allied with several FDLR splinter groups; and e) the RDF is remobilizing previously repatriated FDLR to boost the ranks of M23.
Also noteworthy is the section on standards of evidence. It seems that the group did a rather thorough job in its analysis work for the section and even elevated its usual standards for evidence.
In light of the serious nature of these findings, the group has adopted elevated methodological standards. Since early April 2012, the Group has interviewed over 80 deserters of FARDC mutinies and Congolese armed groups, including from M23. Amongst the latter, the Group has interviewed 31 Rwandan nationals. Furthermore, the group has also photographed weapons and military equipment found in arms caches and on the battlefield, as well as obtained official documents and intercepts of radio communication. The Group has also consulted dozens of senior Congolese military commanders and intelligence officials as well as political and community leaders with intricate knowledge of development between DRC and Rwanda. Moreover, the Group has communicated regularly with several active participants of the ex-CNDP mutiny, the M23 rebellion, and other armed groups. Finally, while the Group's standard methodology requires a minimum of three sources, assessed to be credible and independent of one another, it has raised this to five sources when naming specific individuals involved in these case of arms embargo and sanctions violations.
You can read the full excepts in the original article for FP. Much smarter and well informed people than I will certainly weigh in over the next few days. What this does is raise further questions about the US support for Rwanda. Can we fully stand behind a regime that is acting to support armed rebellion in another country? What are the implications of these findings on diplomatic discussions with neighbors like Sudan? What actions will be taken in response by the international community to these findings?

David Aronson writes, "It's every bit as bad for Rwanda as you might have imagined it could be" in his quick post on the release. More will weigh in as the annex is released. I will try to keep an eye out for responses and collect them at the end of this post.

Feel free to jump in and share your initial thoughts in the comments section.

Jason Stearns weighs in and asks more questions.
[T]here is extensive evidence of systematic Rwandan intervention in the DRC in violation of the UN sanctions regime, not to mention of Congolese sovereignty. Many questions, however, remain open: Why is Rwanda doing this? What is their ultimate goal? When did they decide to back these rebellions? What will the international community, which provides almost half of Rwanda's budget - including military cooperation and support to the demobilization commission - do? And what will the Rwandan reaction be, given that donors have invested billions in successful development projects, and Rwanda provides much-needed troops to the African Union mission in Darfur?

Interview: HIV Prevention Trial for Microbicide Ring Begins

Earlier this month, the International Partnership for Microbicides (IPM) announced the beginning of a clinical trial to determine whether a monthly vaginal ring containing the ARV dapivirine can help prevent HIV infection in women and is safe for long-term use. The trial is being conducted in four sites across South Africa with 1,650 women enrolled. IPM hopes to commence trials in Rwanda and Malawi in the next few months pending the clearance off a few regulatory hurdles.

Recent studies have indicated that ARVs can help prevent the spread of HIV between partners. “Sustained delivery of antiretrovirals in a vaginal ring could be a game-changer for prevention of HIV in women,” said Dr. Sharon Hillier, principal investigator of MTN. “The Microbicide Trials Network's partnership with IPM on effectiveness studies of this new technology will provide the most rapid and efficient pathway to licensure of this HIV prevention product.”

A vaginal ring is a promising advance since it requires only monthly replacement. Furthermore, the burden of HIV in Sub Saharan Africa (SSA) is squarely upon women. Women account for 60% of HIV cases in SSA and young women, ages 18 to 24, are twice as likely to be infected with HIV than young men.

The timing is important because the WHO is currently working on a new set of consolidated guidelines on antiretroviral treatment that is planned for release in July 2013. " It is planned to release recommendations on the use of ART in pre-exposure prophylaxis (PrEP) in serodiscordant couples and men who have sex with men, and guidance on the use of ART for prevention in sex workers, in July 2012," says the WHO. Next month's International AIDS Conference in Washington DC will be an important event in the lead up to the development of the guidelines.

A View From the Cave spoke with Dr. Zeda Rosenberg, CEO of the International Partnership for Microbicides, about the microbicide ring and its upcoming trial .

AVFTC: The studies are all taking place in Africa, but do you see this as a product that will have a global reach? When do you anticipate the ring being available to individuals?
Zeda: The Ring Study is currently taking place at four trial sites in South Africa and is expected to launch in Malawi and Rwanda as well, pending regulatory approvals. To date, IPM has focused its clinical trials in Africa, where the HIV epidemic has hit hardest. Over two-thirds of the global HIV burden falls on sub-Saharan Africa, and women and girls comprise 60 percent of people infected with the virus in Africa.

That said, IPM’s mission is to develop HIV prevention products for women and make them available to women in all developing countries, and we have negotiated agreements that allow us to distribute future products in these countries at the lowest possible cost. For example, IPM acquired dapivirine, the ARV drug used in the ring, through a royalty-free licensing agreement from Janssen Pharmaceuticals that will allow us to distribute the ring at an affordable cost in all developing countries.

Results from The Ring Study – and the broader ring licensure program – are expected in 2015, at which point IPM will seek regulatory approval for the product should the package of studies in IPM’s licensure program support its efficacy and long-term safety. In collaboration with partners, IPM is already laying the groundwork to help expedite roll-out and ensure affordability of the dapivirine ring, pending study results.
AVFTC: What are the advantages of providing ARVs through a vaginal ring? What are the drawbacks?
Z: IPM’s Ring Study builds on a number of recent trials that have demonstrated ARVs can successfully prevent HIV when used consistently. However, studies have shown that adherence can be a major barrier to the effectiveness of ARV-based prevention. The vaginal ring could provide a solution to this challenge. It delivers the ARV drug dapivirine continuously over one month, so women may be more likely to use the product consistently, which could help improve its efficacy.

In addition, because the vaginal ring delivers the ARV drug locally, with low systemic absorption, it could also help minimize side-effects and potentially reduce the risk for resistance. IPM is currently studying the ring’s potential to deliver long-acting combinations of ARVs, which may increase the level of protection, and is also developing a dual-purpose ring that would combine dapivirine with a contraceptive.

Preliminary safety and acceptability studies have shown IPM’s ring to be safe, easy-to-use and highly acceptable to both women and their partners. The Phase III study is designed to determine the long-term safety and efficacy of this product, and will provide additional details on the benefits and considerations of this promising technology.

Ultimately, a microbicide will prevent HIV only if it is used. Some women may prefer a long-acting product like the monthly ring, while others may prefer a daily gel used around the time of sex. We know that the more product options a woman has, the more likely she will be to find one that meets her needs and lifestyle — and to use it to protect herself. So it is essential that women are able to choose from a variety of HIV prevention options.
AVTC: Where will the ring be licensed/approved initially?
Z: IPM’s mission is to make safe and effective microbicides available to women in developing countries, where the need for new HIV prevention strategies is greatest. Should the dapivirine ring prove to be an effective HIV prevention option for women and safe for long-term use, IPM will seek regulatory approval for product licensure and collaborate with key partners to help ensure the ring is made available at low cost to women in developing countries as soon as possible. IPM will work with regulatory agencies in African countries, as well as in the United States and Europe, to accelerate the roll-out of an effective product.
AVFTC: What is the anticipated cost of the ring? How do you imagine it will reach people? Will it be a product sold through private markets, distributed at hospitals, or some sort of combination of private and public partners?
Z: The ultimate cost of the ring to women will depend on the scale of manufacturing and other financing mechanisms, which are being further researched. IPM is already laying the groundwork to help ensure that women would have rapid and affordable access to the dapivirine ring should the package of studies in IPM’s licensure program support its efficacy and long-term safety. IPM, in collaboration with key partners, is engaging in strategic access planning — and will be throughout the ring licensure program — to expedite the product’s roll-out and ensure affordable access to women in developing countries.

As a part of this process, IPM is working to optimize manufacturing processes, explore financing mechanisms and identify strategies for efficient scale-up in order to produce the dapivirine ring at the lowest possible cost. In addition, IPM is working to develop longer-acting options such as a 60- or 90-day ring which could potentially lower the overall cost to women who would need to purchase the product on a less frequent basis.

IPM is continuing to work with regulatory agencies, HIV prevention experts, local partners and others to identify appropriate distribution channels as part of our access plan, as well as marketing/public education campaigns for a potential product roll-out.
AVFTC: What type of reactions do the women have to the introduction of the product? What about their partners? What are general attitudes towards using vaginal rings compared to other contraceptives such as IUDs and condoms?
Z: A number of IPM safety and acceptability studies have found the ring to be highly acceptable to women, and their partners also expressed support for the ring. Made of flexible silicone, the ring is easy to insert and remove, and most women don’t notice or feel the product during sex. Nearly every woman in IPM’s studies has expressed that she would use the ring for HIV prevention.

The ring fills a critical gap in existing HIV prevention methods because, unlike other HIV prevention technologies that require male participation, the ring is discreet and female-initiated. Therefore, women can use the product without necessarily having to rely on their partner’s involvement. In particular, the ring expands the toolkit of HIV prevention options available to women who are unable to negotiate with their male partners to use condoms and remain faithful, or for those who are married, want to have children or are at risk of violence.

The monthly ring provides a long-acting alternative to other microbicide formulations being studied that are designed to be taken daily or around the time of sex. Women need more than one HIV prevention option, so they can choose according to their individual needs and preferences.
AVFTC: The FDA pushed back its approval of Truvada to be used in the prevention of HIV. To what extent does the approval of Truvada have an impact on the eventual approval of IPM’s ring?
Z: The FDA’s approval of Truvada as a pre-exposure prophylaxis against HIV could establish an important precedent for the approval of other ARV-based HIV prevention methods, including IPM’s ring.

Ultimately, regardless of whether the FDA approves Truvada, the dapivirine ring is primed for licensure. If the package of trials in the broader ring licensure program finds the ring to be effective and safe for long-term use, IPM will seek regulatory approval for the product, and collaborate with key partners to ensure that it is accessible and affordable to women in developing countries, where the need is greatest, as soon as possible.

25 June 2012

Telling a Story of Africa Through Youth and Innovation: 'My Africa Is'

Stories of change within Africa often include a foreigner doing heroic and good work to address a given problem. New York Times journalist Nick Kristof explained in 2010 that such story models connect better with the audience. He said that when he writes stories without a bridge character the response and readership is much lower. Including that character resonates with readers more and gives them the opportunity to connect with the problem at hand.

At the same time, there is a growing movement to tell positive stories about Africa. Years of telling stories that put people in the light of largely suffering are giving way to stories that tell of possibility, innovation and self-reliance. While the stories are changing, the authors are still largely the same. But that is changing as well.

One such example is the collaborative project My Africa is.

My Africa is is a collaborative effort to follow and share the stories of change-makers in 13 cities across sub-Saharan Africa. The eight part series that is scheduled to broadcast in 2013 will travel to Yoff and Dakar in Senegal; Monrovia, Liberia; Freetown, Sierra Leone; Bubusua and Accra in Ghana; Lagos, Nigeria; Luanda, Angola; Johannesburg, South Africa; Addis Ababa, Ethiopia; Nairobi, Kenya; Dar Es Salaam, Tanzania.

The founders say they want to share a warts-and-all look into what young people are doing across the continent. " We’re not about hiding real issues or over-hyping good news. We’re more than aware of the challenges, but we also know that we are not helpless," writes the group. "We hustle. We find ways to overcome. We survive. Every day, we are changing our communities – it may be a process, and it may be a little bit at a time, but we’re changing it nonetheless."

To make the project happen, the team has taken to Kickstarter in order to raise money that will cover the cost of the travel and make it so that the series can reach a larger audience. I had the chance to ask Nosarieme Garrick Kathleen Bomani a bit about the project. Check out the discussion below.

Tom: The show is called "My Africa Is." So I have to ask, what is your Africa?
Nosarieme and Kathleen: The ironic thing about the title is that it's hard to define our continent in one word. It is multi-faceted, beautiful, resilient, diverse, and a million other things which you will see in the show.
T: There is a drive to rebrand Africa in a positive light. Do you see this project as a part of that movement?
N and K: When you first look at it, that's what it may sound like. We think the idea of rebranding Africa runs the risk of denying that Africa has problems. We think it's about giving it a more complete profile. What we are saying is that there are other stories that need to be told for people to get a better and deeper understanding of what Africa is like. The stereotypes that permeate the rest of the world about Africa are pretty much negative, and we want to change that. We want to show the world that there is more to Africa than these stereotypes, there is struggle, yes, but there are people living, rising, and bringing their communities out of that struggle.
T: It appears the focus will be on youth and innovation. Why do you think it is important to tell the stories of young Africans?
N and K: The past few years have shown us the power that can come from the youth. Obama relied on the youth vote. Iran's Green revolution, and the Arab spring were both youth led. What was apparent within those movements is the influence members of the same peer group have on each other. The Arab spring actually spread to sub-saharan Africa, but those protests were squashed pretty quickly. 40% of Africa's population is under the age of 15, and they can and will have a huge impact on Africa's development. We want to empower the people we cover by sharing their stories with a larger audience, and giving them a platform.

We want to inspire other African youth on the continent as well to think about how they can address similar situations, and create an opportunity for the youth to learn from one another. We think that by showing their resilience, and how they are innovating, we'll get people to start thinking differently about change, and development.
T: Who is your intended audience? What do you want them to get out of watching the series?
N and K: We are targeting a global audience between the ages of 15-35 year olds. We want to educate them on the African experience. We want them to draw inspiration from the stories of these young people. We also want to open the world's mind up to the potential Africa holds for investment, trade, and tourism.
T: Your show in Abuja is features the photography collaborative Photo Wagon. What drew you to their project and what did you learn from the people involved?
N and K: We liked what Photowagon stood for. They were out to document the reality of their Nigeria, so be it the beauty of traditional weddings, or chaos of anti-government protests, they were capturing these moments, and sharing them with their communities. This is how they expressed themselves. Beyond that there was something to be said about how they served as each others teachers. While some of the members actually had real classroom experience, they mostly learned various techniques from one another during meetings. All the members are from various tribal groups, and their images reflect that, which brought to light how ethnically diverse Nigeria is, and their exhibits were a way of celebrating and encouraging this diversity.
T: What other stories are you looking forward to telling through this series?
N and K: We don't want to give away too much but we'll be covering a TV drama changing the HIV conversation in Kenya that has actually gone viral, We are personal fan of the show, so I'm excited to meet the team behind it. As well as the growth of the youth civil society in Nigeria. Nigeria is going through a turbulent time right now, and it's important to recognize that, but also to recognize what is being done to change it.

22 June 2012

How I Tweet: The Method to The Madness

I am asked often how I find enough time to tweet during the day. Others say they can't keep up with even a few hundred followers, meanwhile I am tweeting 20+ times a day with 4,000 followers. My attempts to answer the question are usually long winded and make it seem farm more complex that it really is. So, for the sake of having a point of reference and to share with the few of you who care, I present a rundown of how I tweet.

I am awake every morning at roughly 7, sometimes a bit earlier and sometimes a bit later. I do a skim through my Google Reader where I pull together the aid and development blogs that I read. The posts that look interesting I open up into tabs on my browser for reading. Once done, I revisit the tabbed posts and give each one a quick read. The ones I find interesting are queued up using Timely. The program spreads out up to 9 tweets throughout the day that form the backbone of my tweeting.

In total, this process takes 30 to 45 minutes. It largely depends on reading time. Timely has a neat bookmark button that allows me to set up tweets with a click of a button and a small pop up. It is pretty much the equivalent of "set it and forget it."

Then I browse through the morning updates made by Mark Goldberg for the morning edition of the DAWNS Digest. There I can see if anything new happened over night. I will do a quick pass on Twitter before making breakfast and possibly thumb through my main feed while eating breakfast.

I rely heavily on Tweetdeck to keep track of my various accounts (I maintain 3 Twitter feeds). I have two main lists. One is my Devevelopment Peeps list that is publicly available. I have 283 feeds that I believe provide some of the most interesting information and conversation about aid and development - it is a list that I really need to update, so if you feel that you are unjustly missing feel free to call me out. A second list of about 500 people is kept privately as additional feeds that I want to keep an eye on.

The two lists have slowly built over the past 2 years. There is not actual method to the two, but I have added feeds slowly as I find them. My hope is to create a few more lists to help organize the feed to a greater extent, but that is a tad ambitious at this moment. The main list of all my followers moves at a rapid pace that is impossible to keep track of. I will glance over at it from time to time and do often stumble upon interesting content.

My tweetdeck dashboard.

While working, I keep Tweetdeck running in the background. I will reply to mentions that are conversation related within the pop-up box so as not to waste time scrolling around the feed. I give my reader and twitter a check around lunch time to see if there is any breaking news or interesting stories that I missed.

My phone has both Tweetdeck and Hootsuite apps. The Tweetdeck app is much easier for reading through twitter, while the Hootsuite one is better for setting up and scheduling tweets. When on my phone I will usually look through the main twitter list. The ease of scrolling quickly with my thumb makes it a much better read.

For the most part, I follow people who tweet about development, aid and international affairs. There are a few random feeds in the mix, but it is very development focused. As a general rule, I will not follow accounts without a photo and a short bio. You can tell a lot quickly from the bio as to what kind of tweets will be in a person's feed. Development tweeters tend to be a bit more professional with their bios, so that is a good indicator of a feed that will provide useful information.

By using lists I am able to focus on what are some of the best feeds. However, I am very sensitive to not creating too many filter bubbles. I worry that curating lists can stem from a bias of finding people with whom I largely agree. By following anyone who tweets about aid and development I feel that I can at least bring in some divergent view points. To me, it is important to seek out ideas with which I do not agree. For example, I listen to conservative talk radio whenever I am driving as a way to challenge my held beliefs and understand a point of view that I think is wrong.

By the afternoon I am going through my curated news content to pull together the latest edition of DAWNS. Stories that really stand out will then be scheduled using tweet deck to go out between 2PM and 9PM (roughly). Other stories that I found throughout the day will also make it into that time period.

I usually try to make sure I can get things done so that I can take an earnest break for dinner and some time to relax. Starting at 8PM I begin pulling together the stories that make up the Healthy Dose. Interesting global health stories will get tweeted out or queued up using Timely. That is followed by a short break and then another pass through the news before sending out DAWNS Digest at 11 PM.

Mixed in between will be some random tweets and instagram pictures - it is a fact that I will tweet at least a few times about the Euro Cup match today. This all probably makes it sound like I take tweeting way more seriously than I actually do. In total, I would say I spend an hour a day actually on twitter.

The method to all this madness has been trial and error and a lot of learning. The evolutionary process of two years of tweeting has lead to this current mode of operation, but I am betting it will shift a bit more over time. This is by no means a "How To" guide. It is what works for me.

Feel free to ask questions and make comments. I would love to learn from you as to how you go about using Twitter.

21 June 2012

Is the UN Off the Hook for Haiti's Cholera Outbreak?

The blame game for Haiti's cholera outbreak took an unexpected turn with the release of a new study. University of Maryland researchers say that "two distinct populations of V. cholerae coexisted in Haiti early in the epidemic." The information comes from sampling people with cholera in 8 towns across eight Arrondissements of Haiti shortly after the October 2010 outbreak. A study published last year attributed a single cholera strain to Nepal, meaning that it was likely carried into the country by UN peacekeepers.

The initial connection to the UN led to public outrage and even a lawsuit filed on behalf of 5,000 Haitians against the UN. In the months since the discovery, the U.N. Stabilization Mission in Haiti (MINUSTAH) has continued to deflect blame. The Daily Beast reported in April:
The spokesman for United Nations Secretary-General Ban Ki-moon, Martin Nesirky, reiterated on Monday that “it was not possible to be conclusive about how cholera was introduced into Haiti … and therefore, at this point, I don’t have any further comment.”
The report by Jonathan Katz is a damning case against MINUSTAH, but the comments from Nesirky that were condemned and criticized back in April may now ring some level of truth given the new information. However, dismissing the UN peacekeepers from any sort of blame is the wrong reaction to the new information.

Study leader Rita Colwell told the NPR Shots blog:
"This suggests that it's very likely that local (Haitian) strains are involved," Colwell told Shots. "Because no one has tested for pathogenic cholera strains in that country before, we have no evidence that it wasn't there already." 
I asked Colwell if she thinks one strain was introduced by the Nepalese soldiers and the other was native to Haiti, or at least predated the current epidemic. 
"The introduction (from Nepal) can't be ruled out but it can't be proven either," she replied. "I think the evidence is at best circumstantial, and it is not sufficient to account for the entire epidemic."
The same post also quotes Johns Hopkins public health researcher Dr. David Sack as the voice of doubt that the MINUSTAH forces are to blame.
He thinks the epidemic exploded too soon after the Nepalese reportedly arrived in Haiti. UN officials tell him that was on October 8, and the first cholera case was recorded on October 12 in a town near the UN camp. 
"Cholera's incubation period is at least 24 hours, sometimes two or three days," Sack told Shots. "Just to have a cholera vibrio floating downstream, and considering the dilution factor – well, it raises questions in my mind. Not that it wasn't imported. I think it was imported. I just question when it was imported."
Colwell describes a sort of 'perfect storm' between the imported cholera strain from Nepal and the local strain that lead to the massive outbreak. No doubt this further complicates the issue of blame, which matters only to the extent of preventing the same mistakes. Invariably, disasters like the earthquake will unfortunately occur in the future. Knowing how to minimize a massive outbreak of cholera will be a vital part of the appropriate response.

The unfortunate sequence of events is also providing an opportunity to learn how to address a cholera outbreak. A year and a half on and the most promising development is a vaccine administered by Partners In Health. The Boston-based global health organization has done a fantastic job sharing information about the ongoing vaccine pilot by dedicating web space to provide the latest updates from the effort. An update on Monday says that phase II of the vaccine has reached 90% of the people who took part in the first phase.

In the end, there no doubt that a foreign strain of cholera made its way into Haiti. The evidence points towards MINUSTAH. Whether or not it was the strain that kicked off the outbreak, the fact that it is detected in Haitians means that the strain has done damage. For that alone, the UN should take responsibility. The Maryland study confirms the UN spokesman's assertion that it is complicated, but skirting admission only delays the much needed learning process that will hopefully prevent this from happening again.

20 June 2012

Handwashing with soap can help us achieve the Millennium Development Goals

Myriam Sidibe, Global Social Mission Director, Unilever-Lifebuoy

Being able to live a clean, active and healthy life should be a basic human right. Yet, this is not a privilege that everyone has – a point underscored by two high level reports last week.

UNICEFs latest report [1] reminds us that pneumonia and diarrhoea are the biggest killers of children globally, causing the deaths of approximately two million children under the age of five, every year. Meanwhile the World Health Organisation (WHO) reported that despite significant progress, the world is unlikely to meet the fourth Millennium Development Goal [2] – to reduce child mortality by two thirds from 1990 levels. 

Both reports come at a critical point in time: the world has less than three years to scale-up efforts to achieve the Millennium Development Goals. At Unilever we want to scale-up our own efforts on this front. 

UNICEF’s report points to areas where business can help achieve the fourth Millennium Development Goal. Not only can diarrhoea and pneumonia be prevented through basic best practices, including frequent handwashing with soap at key occasions, but also more awareness raising campaigns could reduce deaths caused by pneumonia by 30 per cent and diarrhoea by 60 per cent – potentially saving more than two million children by 2015. This would be a significant progress in the aim to achieve the fourth Millennium Development Goal and reduce infant mortality.

Although we’re seeing a steady increase in awareness raising campaigns that demonstrate the link between health and good hygiene – from the WHO’s Clean Care is Safe Care [3] programme through to the Global Public Private Partnership for Handwashing with Soap [4] – more needs to be done to ensure that governments prioritise hygiene education programmes.

Just as we know that prevention is better than cure, we also know that business has an important role to play. For this reason, Unilever is committed to the biggest handwashing with soap campaign the world has ever seen.

By 2020, Lifebuoy, the world’s leading soap brand aims to change the handwashing behaviour of over one billion consumers. To help achieve this ambitious target we started running behaviour change programmes with partners including PSI, which is dedicated to improving the health of people in the developing world, and UNICEF across the world. So far, we have programmes in 16 countries and have changed the behaviour of 48 million people. The next step for us now is to look at ways to further scale up our programmes and reach even more people.

Where we can, we work with governments on public health because we know we can make an even greater impact. For example, in Indonesia, we work with the Ministry of Education – and next year we are due to teach an estimated 4.5 million schoolchildren about the benefits of handwashing with soap at crucial times during the day. [5]

For Unilever, the moral case is clear – we know we can improve and save lives through our products and by changing behaviour. Moreover, the business incentive is clear – our Sustainable Living Plan commits us to doubling the size of our business while improving our impact on society.

The UNICEF and WHO reports remind us that our end goal is in sight. However we achieve the Millennium Development Goals - business, governments and civil society must continue to collaborate both in policy and programme making.

Together we can work to make a difference and save the lives of over two million children.


[1]UNICEF Report, Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children, June 2012, http://www.unicef.org/media/files/UNICEF_P_D_complete_0604.pdf

[2] For more information on the Millennium Development Goals see: http://www.guardian.co.uk/global-development/datablog/interactive/2012/jun/14/millennium-development-goal-progress-check

[3] http://www.who.int/gpsc/en/

[4] http://www.globalhandwashing.org/

[5] http://www.unilever.co.uk/sustainable-living/healthandhygiene/

A Kony 2012 Satire Succeeds in Getting Attention, Falls Short on Engagement

Invisible Children (IC) are upset with the parody of their Kony 2012 by a bunch of NYU students on the website called 'Kickstriker.' Spencer Ackerman covers the story in Wired's Danger Room and includes excerpts of the cease-and-desist letter that makes it clear the advocacy group is not OK with the satirical website.
“It has come to our attention that you are causing public confusion through your use of Invisible Children’s copyrighted and trademarked property on www.kickstriker.com. This impermissible use is a blatant and egregious infringement of Invisible Children’s valuable copyright and trademark rights,” reads a letter Invisible Children sent last week and acquired by Danger Room. “[F]ailure to cease and desist your unlawful use of Invisible Children’s intellectual property will result in legal action.”
The founders of Kickstriker, a blatant tip of the hat to Kickstarter, are not willing to back down. They cite fair use for being able to reproduce the IC images and information. A quick look at the page (seen below) can fool the unknowing user. However, when the pledge opportunities increase and a would-be supporter can receive Kony's teeth or even his skull for a cool million, it becomes apparent that this is a hoax.

If that doesn't work, clicking on the "Back this Project" button will launch a page that tells the users:
Kickstriker is a hoax 
Kickstriker is a satirical website. If you were horrified by the content on this site, we hope you will consider making a contribution to one of the following charities: 
Reprieve: Reprieve uses the law to enforce the human rights of prisoners, from death row to Guantánamo Bay. Reprieve is one of the leading organizations working to draw attention to drone strikes.
African Youth Initiative Network (AYIN): The AYIN works to physically and psychologically rehabilitate youth affected by war in Uganda.
The Tibet Fund: The Tibet Fund is dedicated to helping Tibetans improve their lives and preserve their distinct cultural, religious and national identity.
The American Civil Liberties Union (ACLU): The ACLU's National Security Project advocates for national security policies that are consistent with the Constitution, the rule of law, and fundamental human rights. The Project litigates cases relating to detention, torture, discrimination, surveillance, censorship, and secrecy.
All in all, it is a rather clever way to point out the consequences of advocating and cheering on a military solution to the problem of the LRA. Some may be upset that it carries it too far, but the point of satire is to push the boundaries while remaining within the constraints of a given subject area.

What is most interesting is this final section from Ackerman's article:

Even though Kickstriker plans to contest any actual legal action Invisible Children may bring, as a parody, it’s kind of tapped out. “It was designed to be a one-off, self-contained sort of thing,” Jayasuriya says. Although it got media attention, “we had all hoped that the site would kick off a conversation about the ethics of crowdsourcing, privatized warfare and clicktivism and that still has yet to happen.”

Hmm, kind of like Kony 2012, you might say.
The comment from Mehan Jaysuriya, one of the NYU students responsible for Kickstriker, is worth highlighting. Specifically, because Ackerman is right to point out that the lack of meaningful conversation coming out of Kickstriker is exactly the same criticism leveled at Kony 2012.

I argued, with some push-back, that Kony 2012 failed because it did not maintain the same level of audience from the first video to the second. The lack of support for the public campaign only seems to have confirmed my declaration of failure. But this has little to do with IC or even Kickstriker.

The fact that IC is worried about the Kickstriker site confusing supporters seemingly indicates that the group is aware that its audience has a very low understanding of the issue at hand. IC would never advocate for what is depicted on Kickstriker. Yet, it is concerned enough that people will not realize that a website that celebrates the killing of Joseph Kony is not connected with IC.

Such a problem illustrates the challenge of engagement to the point that people understand the issue at hand. The well produced and told video was seen by 100 million people, but how many left with any understanding beyond the fact that Kony is a bad man and he must be stopped? How many of those people know more about Kony, the LRA, and Uganda in the three months since the video's release?

The question if online-based campaigns can lean to a long term engagement is brought up yet again. Thus far, the theory seems to outweigh the evidence. I actually think there is good reason to be excited by the potential for connecting with and reaching more people. However my concerns are if the point of entry is too shallow that a campaign manages to miss the pool entirely.

Maybe that is not the point. The sheer buzz around Kony 2012 can be credited to some extent for moving the needle on the issue of the LRA. Little policy has changed, but getting politicians to not only remark on it but work on legislation in response to the problem is quite the accomplishment. But the same can be said for the Darfur movement which by many accounts fell well short of its intended goals.

19 June 2012

Will a New Private-Public Partnership Ease the Burden of Maternal Mortality?

A version of this originally appears in the PSI Healthy Lives Blog.

Millennium Development Goal 5 outlines a three-quarters reduction in maternal deaths by 2015. The world is behind on the mark and will require rapid changes in order to meet the target. Among the many events, panels and announcements that took place at last week's Child Survival Call to Action, one of the biggest came from pharmaceutical giant, Merck.

A multi-partner effort, Saving Mothers, Giving Life will support the aggressive reduction of maternal mortality in countries with the highest mortality rates. The partners are putting some serious money behind the effort to the tune of $200 million over five years. The founding partners include the US Global Health Initiative (GHI), Merck for Mothers, American College of Obstetricians and Gynecologists (The College), Every Mother Counts (EMC), and The Government of Norway.

Of the estimated 3 million women that die from complications due to pregnancy and childbirth, the majority take place in the developing world. Of that total, 90% of maternal deaths are believed to be avoidable. Hundreds of thousands of lives can be saved by focusing on the countries with the highest burden of maternal mortality. "A mother's death is a tragedy because it destroys one of the most fundamental human connections – the bond between a mother and her child. Compounding this tragedy is the way this death unravels families and communities. The effects of a mother's loss can echo for generations. Merck is supporting Saving Mothers, Giving Life through our Merck for Mothers initiative because we need to make a change," said Kenneth C. Frazier, Merck's chairman and CEO.

By ensuring that mothers are healthy, children are provided with a greater opportunity to survive and thrive. The program says it will focus on accomplishing the following three objectives:
  1. Develop models of quality maternal health services through district health network strengthening to achieve maximum, sustainable impact
  2. Galvanize the American public to create a domestic constituency to support saving mothers’ lives around the world
  3. Engage new public and private partners around the world to co-invest in saving mothers
Uganda and Zambia will serve as the start point for the program. In Uganda, the program will hone in on the districts of Kabarole, Kibaale, Kamwenge, and Kyenjojo. In Zambia, the partners will a focus on the districts of Lundazi, Nyimba, Kalomo, and Mansa. If the objectives are achieved, Saving Mothers, Giving Life expects to reduce maternal mortality by 50% in the nations' targeted districts.

Secretary of State Clinton voiced her support for the partnership earlier in the month when speaking in Oslo, Norway. "I am very pleased that the United States will be a part of the Saving Mothers, Giving Life partnership, along with Merck for Mothers, Every Mother Counts, and the American College of Obstetricians and Gynecologists. We’re not focusing on a single intervention, but on strengthening health systems."

The focus on a systems approach was echoed by Geralyn Ritter, Merck's Senior Vice President for Global Public Policy & Corporate Responsibility. "We're really trying to leverage the infrastructures in place by multilateral partners and the governments themselves," she explained. Such a push could signal a shift away from the vertical approach that has come to dominate global health programming.

For Merck, the partnership is both practical and an extension of its commitment to health. "The humanitarian drive is really central to this. It is a part of the corporate culture and why people come to and stay with Merck. It is an important driver," explained Ritter. "It is also in our long term business interests. This helps the organization learn how to deliver care to populations around the world."

According to the WHO maternal mortality worldwide dropped by almost 50% between 1990 and 2010. Such remarkable gains have been celebrated, but the 3.1% rate of decline still falls short of MDG 5 which requires a 5.5% rate. 99% of the burden is in felt in developing countries. For the wealthier nations, maternal mortality is a story of the past. It means that the known solutions do in fact work and the goals set forth by the MDGs and the Saving Mothers, Giving Life partnership are attainable.

"Saving Mothers, Giving Life builds on the U.S. government's longstanding commitment to global health, including PEPFAR and USAID's host of maternal and child health programs," remarked Rajiv Shah, administrator of the U.S. Agency for International Development (USAID). "We look forward to working with the partners to leverage these and other platforms to make an accelerated impact on the health of women and newborns in need."

With actual money behind it, this stands out among the other announcements, pledges and partnerships that came out of the Call to Action. The need for relatively strong governance and infrastructure to carry out the program lead to the decision to start in countries that have high maternal mortality rates, but pale in comparison to countries like Sudan and the Central African Republic.

A targeted reduction of 50% in targeted districts is an ambitious goal by the partnership. With a series of partners and significant financial backing, this will be an intervention that is worth tracking

A Funny Thing Happened on the Way to Twitter

Foreign Policy released their annual Twitteratti 2012 list. Somehow I managed to sneak on it in the 'wonk' category with some people who are quite brilliant inside and outside of the twittersphere.

The kind inclusion lead to a bunch of new followers and likely visitors to this space. So, while I have some small amount of attention related to foreign policy and twitter, I want to share some others who did not make the list, but are worth your follow.

I present you with the unofficial 2012 Caveratti (in no particular order and subject to change):

Laura Seay - @texasinafrica - Morehouse Prof and Lakes Region Expert
Lee Crawfurd - @rovingbandit - Randomista and South Sudan expert
Alex Thurston - @sahelblog - PhD candidate with stellar analysis of the greater Sahel/West African region
TMS Ruge - @tmsruge - Villiages in Action Founder and African activist
Todd Moss - @toddjmoss - He says it best himself,"working on oil, US-Africa policy, IDA, Sahel, Nigeria, Zimbabwe, and criticizing USG hole-of-govt"
Linda Raftree - @meowtree - ICT4D
J. - @talesfromthhood - Anon aid worker, A must follow
Eliza Anyangwe - @ElizaTalks - Africa Gathering and ICT4D
Jason Stearns - @jasonkstearns - Central Africa analyst and Congo Expert
Josh Ruxin - @joshruxin - Rwanda Works founder
Scott Gilmore - @scott_gilmore - Building Markets founder
Katherine Maher - @krmaher - Tech for development and human rights activist and evangelist
Ken Banks - @kiwanja - ICT4D expert and FronelineSMS Founder
Tate Watkins - @tatewatkins - Reporter in Haiti
Calestous Juma - @calestous - African Ag Expert and Harvard Prof. He tweets A LOT, but is full of good information and links.
Alanna Shaikh - @alanna_shaikh - global health expert and TED fellow
Elmira Bayrasli - @endeavoringe - Turkey expert and with a pulse on entrepreneurship
Richard Horton - @richardhorton1 - Lancet Editor who is not afraid to share his vision for the Global Fund and WHO
Rosebel Kagumire - @RosebellK - Ugandan journlist
Ory Okolloh - @KenyanPundit - Google Africa and co-founder of Ushahidi
Solome Lemma - @InnovateAfrica - Social entrepreneurship and African diaspora
Semhar Araia - @semhar - Founder of @DAWNInc
Idilay Bilan - @IdiAuslander - Blogger, feminist, and pot-stirrer
Ian Thorpe - @ithorpe - UN knowledge management specialist
Ed Carr - @edwardrcarr - At the crossroads of environment and development
Marc Bellemare - @mfbellemare - Food Security expert
Kate Cronin-Furman and Amanda Taub - @WrongingRights - A pair which can easily mix snark with hard hitting analysis on issues ranging from Kony 2012 to the ICC.
Chris Blattman - @cblatts - Political Scientists focusing on recovery from conflict in African states such as Uganda and Liberia
Amanda Glassman - @glassmanamanda - CGD global health expert
Lauren Jenkins - @laurenist - Conflict kid with a dash of celebrity snark
Penelope Chester - @penelopeinparis - UN Dispatch contributor and solid Western Africa source
Carol Gallo - @carol_gallo - DRC focused PhD student
Dan Solomon - @danatgu - Georgetown student, International security maven, future foreign policy star
Sean Langberg - @seanlangberg - UNC student and DRC advocate
Bec Hamilton - @bechamilton - Sudan and ICC expert, Author of the fantastic Fighting for Darfur

I will add more to this list. For some gender balance and more great people to follow, check out this crowd sourced FP Womeratti list.