Visualizing the massive toll of an abused drug seldom in the headlines | 

Booze
Fotopedia

The legalization of marijuana in Washington and Colorado has been big news around the country and the world.

These laws have spawned concerns that they could encourage more youths to use marijuana and lead to increased frequency of impaired driving. On the other hand, civil rights activists have endorsed marijuana legalization, noting that the law-enforcement approach has largely failed to make a dent in the drug abuse problem and that minorities are imprisoned more often than whites as a result of the prohibition of marijuana.

What about the impact of a drug that causes much greater health loss?

According to the Global Burden of Disease Study, alcohol was the fifth-highest risk factor for early death and disability worldwide in 2010. The screen grab below shows how alcohol ranked higher than high body mass index (an indicator of overweight and obesity), childhood underweight, and sedentary lifestyles (physical inactivity).

AlcoholGBDAlcoholGBD2

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The aid debate continues in the media and on blogs | 

The debate over aid does not want to go away, but it is moving away from general statements about whether it works or not. Regardless of who is right and what we believe, it is promising to see the conversation taking a far more constructive tone. However, the present discussions are not likely to convert people to the pro- or anti-aid camps.

The latest round of disagreement follows on the heels of NYU economist and aid skeptic Bill Easterly’s new book. In it, he argues that technocratic experts have undermined the rights of people around the world. Aid, at times, has been a tool to provide support for leaders that restrict things people can say and do in their countries. In the long term, that undermines advances within a country or region.

Easterly has been making the media rounds to debate whether foreign aid is on the wrong side of human rights. On Wednesday, Easterly joined CARE USA’s CEO Helene Gayle to debate foreign aid on Fareed Zakaria’s television show. Zakaria plays a moderator of sorts who seems a bit of an aid supporter.

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Eight facts about health workers and the brain drain | 

Migration is a much debated subject around the world. We are investigating the impacts that migration on countries, migrants, business and more. Today we hear from Martin Drewry, Director of Health Poverty Action on the issue of brain drain. Read more of the series Migration Matters.

Doctor Kouakoussui gives advice to a patient at PMI hospital. Côte d'Ivoire.
Doctor Kouakoussui gives advice to a patient at PMI hospital. Côte d’Ivoire.
Ami Vitale / World Bank

Migration: a simple concept with incredibly complex ramifications. Is there any other topic that gets people as riled up? Certainly not many.

Recent debates have highlighted some of the sensitivities.  But with the health worker crisis growing, we have a duty to have an honest and nuanced debate, no matter how tricky this may be.

For my part, as director of an international development organisation working on health in 13 countries (in Africa, Asia and Latin America), I can offer information on the connection between migration and health – or, to be more specific, migration and health workers. Here are eight ‘useful things to know,’ some obvious and some less so:

  1. Low income countries are massively short of health workers.

Can you imagine arriving at a hospital with your sick child, only to find no staff there?  Sure, busy and over-worked staff feels (sadly) familiar enough to lots of us, but not no staff. Yet in low-income countries many people genuinely face this. Across the world, extremely poor countries have a shortage of health workers that goes way beyond words like ‘severe’.  It is costing a catastrophic number of lives, and fuelling widespread disease.

A health system can’t work adequately without sufficient health workers. According to the World Health Organization (WHO) 83 countries have less than 23 doctors, nurses and midwives per 10,000 people. They are the world’s poorest countries, and this shortage is described by the WHO as ‘one of the most critical constraints to the achievement of health and development goals‘.

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3.7 million in South Sudan face severe hunger crisis | 

Woman sits with food aid, in the north of South Sudan.
Woman sits with food aid, in the north of South Sudan.
ECHO

Hunger looms over South Sudan. World leaders have spent the past few weeks trying to raise the alarm to garner enough public attention and funding to prevent a hunger crisis.

Some 7 million people are at risk of food insecurity. The UN launched a $230 million appeal in early April to respond to the problem. Then there are the 3.7 million people, nearly one out of every three people in South Sudan, that are at severe risk of hunger.

Fighting in South Sudan since December is responsible for displacing more than 1 million people from their homes. The upcoming rainy season is a vital time for food security because it is when crops are usually planted. It is also the period when food stocks from the previous harvest season begin to run out.

The ongoing fighting and instability has disrupted the country, meaning that some will miss the planting season due to a lack of resources or other factors. A missed or poor planting season would put people already struggling at greater risk, especially young children.

UNICEF warned that as many as 50,000 children could die if the international response in South Sudan does not gain the necessary support. A total of $1.27 billion is necessary to respond to the totality of the crisis in South Sudan, says the UN. Only 36% of the funding has been raised so far. The pleas to act now to prevent hunger hope to revive funding for the response.

The US, EU and UN rushed to sign a call to action for the country in Washington over the weekend. Representatives from the three groups gathered to pledge $80 million for South Sudan. That is in addition to the $100 million that was pledged in the prior week. The money will be used to reach the nearly 5 million people who need assistance because of the ongoing crisis in South Sudan.

“We know that if we work together we can deal with this challenge,” said UN humanitarian chief Valerie Amos, at the signing. “But we also know that without improved and significant resourcing now, we face a situation next year where South Sudan is in an even worse situation than it is right now.”

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Why did Congolese soldiers kill a surrendered militia leader? | 

Congolese military (FARDC) members.
Congolese military (FARDC) members.
Radio Okapi

The death of a Congolese militia leader who surrendered to the military is raising serious questions.

A brutal militia leader known as Morgan surrendered to the armed forces of the Democratic Republic of the Congo on Saturday. He was joined by somewhere around 40 of his militia members.

He was killed during a firefight while being transported to be taken in by the UN peacekeeping force in the Congo. According to the government, Morgan and some of his men tried to escape from the soldiers providing escort.

“He caused a shootout which resulted in the deaths of two army soldiers and two of his own men. He tried to flee but suffered a serious injury,” said government spokesman Lambert Mende to Reuters on Monday.

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Private health care for diarrhea in Africa kills 20,000 kids annually | 

A nurse gives oral rehydration salts to a two-year-old in Sierra Leone.
A nurse gives oral rehydration salts to a two-year-old in Sierra Leone.
UNICEF

Children in sub-Saharan Africa who suffer from diarrhea are receiving lifesaving treatment at a lower rate when visiting private hospitals as compared to public ones. Closing that gap would save an estimated 20,000 lives each year.

When a child present signs of diarrhea, hospitals are supposed to instruct parents to give the child oral rehydration salts (ORS). The basic mixture of water with a little bit of sugar and salt prevents the child from dying from dehydration. It’s wide use over the past few decades has saved millions of lives. However, it is not always available nor is it recommended in every case.

“Clearly the private sector is not following public health guidelines in the way that the public health sector is doing,” said Zachary Wagner, co-author and doctoral student in public health at the University of California, to Humanosphere.

The findings from his research, with Neeraj Sood, PhD, the study’s senior author and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, were published yesterday in the American Journal of Tropical Medicine and Hygiene.

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Gates Foundation won’t take a stand on universal health coverage | 

A funny thing happened at the World Bank the other day.

World Bank President Jim Yong Kim  gestures while speaking at the forum Endpoverty 2030 during the IMF/World Bank Spring Meetings at IMF headquarters in Washington,  Thursday, April 10, 2014.
World Bank President Jim Yong Kim gestures while speaking at the forum Endpoverty 2030 during the IMF/World Bank Spring Meetings at IMF headquarters in Washington, Thursday, April 10, 2014.
AP

The international financial institution devoted to fighting poverty and advancing economic growth in the poorest parts of the world held an event last week, Toward Universal Health Coverage by 2030.

That wasn’t the funny part. What was funny (or, well, funny-strange maybe) was watching the Bill & Melinda Gates Foundation work so hard to avoid taking a position on this goal of ensuring all people have access to affordable, basic health care.

As Humanosphere has noted, there’s a lot of enthusiasm around the world today for universal health coverage. Even many of the hard-pressed health and finance ministries of poor and middle-income countries are enthusiastic, largely because a number of analyses and expert studies have shown that getting everyone reliable access to basic health services contributes to long-term economic development, social stability and poverty reduction.

“There’s a consensus out there that universal health coverage is a critical development goal,” said Robert Marten, a global health policy expert for the Rockefeller Foundation. Continue reading