Earlier this week, Humanosphere reported on the overall trends in funding for global health – fairly steady, mostly flat the last few years, and perhaps in need of a re-focus.
But which countries need help the most on the health front?
That critical question came up at the April 8 launch event for this report from the Institute for Health Metrics and Evaluation’s (IHME), Financing Global Health 2013: Transition in an Age of Austerity at the Center for Strategic and International Studies (CSIS) in Washington, D.C.
The question about which countries deserve the most aid is a complex question. IHME director Chris Murray pointed to key regional funding gaps identified in the study.
- Chris Murray
“If you are thinking ahead, then who do we need to help the most?” asked Murray. “Central and Western Africa and a few other fragile states have the worst health outcomes. We might need to strategically rethink what we’re doing to address problems in countries who are most at risk.”
A related paper was also published the same day in the journal Health Affairs. J. Stephen Morrison, Senior Vice President and Director of the Global Health Policy Center at CSIS, chaired the launch event. The panel featured Murray and USAID Assistant Administrator for Global Health Ariel Pablos-Méndez. Continue reading
The significant progress made against child mortality around the world over the last two decades is frequently cited as one of the biggest success stories of international development.
Much more remains to be done, but it’s worth looking at what we know – and don’t know – about this propitious decline in child deaths.
Between 1990 and 2010, death rates among children under 5 decreased by 43% in sub-Saharan Africa, according to the Global Burden of Disease Study 2010 (GBD 2010). The screen grab below shows how deaths from different diseases and injuries in this age group decreased over time. Three major categories of diseases played key roles in driving this decline: diarrhea, lower respiratory infections, and other infectious diseases; neonatal disorders; and neglected tropical diseases and malaria.
Death rates in children under 5 years, sub-Saharan Africa, 1990-2010
What interventions deserve credit for these declines? GBD researchers have not yet done a formal study to pinpoint all the reasons for the drop in child mortality, but a deep dive into the data can reveal likely causes. Continue reading
The story of mobile money in Africa is as much a one of success as it is one of failure. The rapid rise of M-PESA in Kenya and other competing ways to send money from cell phone to cell phone has been heralded for years. Today, nearly 70% of Kenyans who own a cell phone regularly send or receive money on their phones.
The growth has been staggering considering that M-PESA turned 7 years old this month. Estimates show that one-quarter of Kenya’s gross national product travels through mobile phones. As a result, it has helped to make it easier for people to send money home, pay for goods and services, and gain instant access to a savings account.
Due to the success in Kenya, the belief has been that mobile money can work elsewhere. Advocates are buoyed by the fact that the continent managed to leap past land-line phones for mobile technology. It means more people are connected by phones and as higher speed coverage expands, by the internet.
That is why USAID, the Gates Foundation and other funders have been making the bet to support the growth of mobile money elsewhere in the world. So, how are things faring in Africa?
It’s still early, but the results are not so great. As seen in the infographic of use across the continent, there is a steep decline from leading Kenya to Uganda to South Africa. There is reason for hope that mobile money will catch on elsewhere in the world, but it is evident that copying the success of Kenya is not enough. The trend also seems to be making its way north. T-Mobile is now letting its customers deposit checks in a mobile money account, which they can then access at ATMs.
“Some of the factors behind Kenya’s lead cannot be copied; but many of them can, which means it should eventually be possible for other countries to follow Kenya’s pioneering example,” said The Economist blog last year.
- Ugandan pupils from different schools take part in an event organised by born-again Christians to celebrate the signing of a new anti-gay bill.
- AP Photo/Stephen Wandera
Boston, MA – Returning home to Uganda after two years makes James* feel uneasy. As a gay man from a country that penalizes homosexuality, James cannot even use his real name for fear of outing himself to the wrong people.
“I choose not to think about it,” he said to Humanosphere.
Only some friends and family know that that he James is gay. Being out has not necessarily changed the minds of the people close to him. The Boston-area student said that friends that do not know about his sexuality will freely share anti-homosexual sentiments on social media.
“The ones that know; I will post something on Facebook and they won’t say anything,” he said. “They choose not to engage in that, but they will comment on other things.”
That was before the east African nation’s President Yoweri Museveni signed into law legislation that now imposes harsher penalties on homosexuality. People can now go to jail for life if convicted of “aggravated homosexuality.” Such a punishment would be dealt to those having gay sex with a minor, having sex if infected with HIV and with a vulnerable victim. It adds onto existing laws that carried punishments from 14 years to life in prison.
The law makes for a more tense situation in a country that has witnessed hostility towards gay Ugandans. Activist David Kato was among some 100 Ugandans outed by the tabloid magazine Rolling Stone in 2010. A year later he was brutally attacked in his home. He died on the way to the hospital. A public outcry galvanized the issue of gay rights in Uganda to slow down anti-gay legislation, but the law finally passed.
Such tactics were undertaken only a day after the bill was signed.The headline on today’s Ugandan tabloid magazine Red Pepper, touted exposing “Uganda’s 200 Top Homos.” International leaders reacted strongly to the signing.
“We will continue to urge the Ugandan government to repeal this abhorrent law and to advocate for the protection of the universal human rights of LGBT persons in Uganda and around the world,” said White House spokesman Jay Carney. Continue reading
Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.
- A child in Burkina Faso receives a vaccination against meningitis.
- WHO, PATH
One of the biggest obstacles to expanding immunization to the remotest regions on the planet has been that vaccines must be kept refrigerated at low temperatures.
Keeping vaccines cool during their entire trek – from the manufacturer to a ship or airplane to a refrigerated truck down to the guy riding a bicycle with a cooler – is known as the ‘cold chain.’
A new vaccine created by Seattle-based PATH, with help from the World Health Organization and other partners, now indicates it may be possible to break free from these chains.
The vaccine, known as MenAfriVac, was designed specifically for the ‘meningitis belt’ of central Africa – a region that had seen tens of thousands of annual deaths from this disease, not to mention the survivors left brain damaged, deaf or otherwise disabled.
Since the new vaccine campaign began, more than 150 million people have been vaccinated and disease rates have fallen significantly. Africa’s so-called ‘meningitis belt’ may soon disappear.
In addition, a new study of the vaccine’s use in the field is being hailed by some as evidence the cold chain may also soon go the way of horse-and-buggy. Continue reading
Doctors Without Borders tried to once again call attention to the ongoing violence in the Central African Republic. The organization has treated tens of thousands of people for injuries from grenades, machetes and more, since December. It said that the world was not doing enough to address a problem that has continued to deteriorate since the overthrow of the government last March.
This week, I speak with Muriel Tschopp, International Rescue Committees’ Emergency Field Programme Coordinator. She is on the ground in Bangui, the capital of the Central African Republic, where much of the international response to the crisis is focused. Bottom line is that this crisis can likely be averted, before it gets worse with the rainy season, simply by beefing up the peacekeeping presence. Says Tschopp:
“The majority of the people are trapped in the middle” between Muslim and Christian extremist militias, explains Tschopp. Much of the fighting may be drawn across religious lines, but current tensions are not deep rooted. There’s a long history of the two sides getting along just fine, with lots of intermarriage and little bloodshed.
The opportunity to change the course of violence and restore order to the Central African Republic is there, but security is sorely needed. Tschopp’s sentiments reflect that of many humanitarian organizations working in response to the crisis, including the UN.
In the headlines portion, Tom Murphy and I discuss an interesting new study on savings and loans groups in Uganda. After the NGOs left, people started forming their own group, to the surprise of the researchers. We also heard from Tom about his new series, Migration Matters. He explains why he is interested in the issue of immigration and brain drain.
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- A survivor of a suspected Anti-Balaka grenade attack waits to go to hospital with the help of MISCA.
- Laurence Geai/NurPhoto/Sipa USA
Extreme violence persists on a daily basis across the Central African Republic.
The inability to protect civilians affected by targeted violence is evidence that the international community is failing the Central African Republic, said humanitarian aid organization Doctors Without Borders/Médecins Sans Frontières (MSF) today.
MSF says it has treated more than 3,600 people for injuries caused by gunshot, grenade, machete and more, since December 5.What little that is being done falls well below acceptable humanitarian standards.
When regular violence returned the country that has been in crisis for nearly a year, in December, people had few options for humanitarian assistance. Medical aid was the only form of assistance many people received for roughly four weeks, claimed Hurum. She described the situation in the Central African Republic as the “roughest mission” in her eight years with MSF.
“There is an exceptional situation going on. I’ve never seen such a high level of violence, in the last few years,” agreed Dr Joanne Liu, President for MSF International.
The Chinese are gaining ground in Africa while Western powers, and corporations, struggle to catch up. Last week, China’s official news service reported on the success of a joint effort of the Chinese and Congolese governments: A new $8.7 million, 40-mile long electricity line linking two towns in the Democratic Republic of Congo.
The line will also supply power to a new hydroelectric dam. But an even larger dam – the largest in the world, in fact – to be built by Chinese contractors could also be in the works. And the United States is considering whether to contribute its own humanitarian funds to the project.
- Workers in a mine near Goma, eastern DR Congo. 2012
In today’s podcast, Nairobi-based reporter Jacob Kushner puts that news in context and explains why America should be open to collaborating with Chinese investments in the Congo. After reporting on Western mining operations in Haiti, Kushner visited similar Chinese mining operations in the Congo, but noticed that many Congolese respect and appreciate the presence of Chinese companies even as they extract the country’s resources without any “do-gooder” pretensions.
He published an e-book last fall called “China’s Congo Plan: What the Economic Superpower Sees in the World’s Poorest Nation.” Kushner joins us to explain what China’s influence in the Congo looks like on the ground, why many Congolese respect Chinese profit motives over Western humanitarian ones, and how China’s massive investments in Central Africa might hold up over the long term.
And I ask him an obvious but little-asked question: what should Western humanitarians learn from Chinese contractors? The answer might surprise you.
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