Winning hearts and minds, one aid dollar at a time | 

PEPFAR branding appears on hospital in South Africa.
PEPFAR branding appears on hospital in South Africa.

There is plenty of debate over whether aid can help countries grow economically, but there is new evidence showing that it affects public opinion in a recipient country. Programs that provide targeted, sustained, effective and visible aid can lead to positive views of the donor countries.

While the money that US spends on aid programs in other countries helps people, it also serves a foreign policy goal. On one hand, the US stands to benefit from a safer, healthier and more prosperous world. On the other, it can generate good will towards the US.

“By doing good, a country can do well,” says Yusaku Horiuchi, an associate professor at Dartmouth College.

Benjamin Goldsmith of the University of Sydney, Terence Wood of the Australian National University and Horiuchi published a paper that proves how foreign aid can be a positive force for winning the hearts and minds of individuals. While the impact has been claimed for some time, they say that there was no evidence base, only anecdotes and claims by aid proponents. They undertook a  comparative, cross-national perspective using data from a variety of countries to evaluate how the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by the Bush administration in 2003, has impacted views on the US.

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Future of Aid: Where’s the Impact? | 

This originally appeared in the Brookings Institute blog.

Where's the impact?
Where’s the impact?

A results-oriented aid agenda for Africa has picked up steam in the past few years. Last year closed with excitement about cash transfers. Researchers in Western Kenya found that just giving people money was an effective form of assistance. As the MIT report notes, GiveDirectly recipients increased household asset holdings by 58 percent compared to the mean control group, and did not increase spending on tobacco or alcohol. Thus, the once cast-aside form of aid is making a comeback on the strength of evidence and research. GiveDirectly is only the tipping point for a new way of thinking about aid in Africa and elsewhere.

An era of evidence-based aid is here. GiveDirectly is a new standard because it has proof that evidence-based aid works and what it can actually accomplish. Nongovernmental organizations (NGOs) have often talked about the potential of a given intervention and tell the stories of the people who benefited. Now they will have to talk about evidence. Donors want to know whether a project works and what is actually achieved. The charity evaluator, GiveWell, gives charity recommendations based on cost-effectiveness and whether there is proof that what is being done has an impact. It has analyzed 136 charities and has recommended only four: GiveDirectly, Deworm the World, the Against Malaria Foundation and theSchistosomiasis Control Initiative.

GiveWell is not alone. AidGrade is employing meta-analyses of existing research to learn what different programs actually accomplish.  Users can see how effective interventions are at achieving a given target (i.e., increasing school attendance, eliminating stunting, or creating business profit) and donate to an organization that is effective at creating such impacts. GiveWell’s recommended charities are listed there, as well as the microfinance organization Kiva and the clean energy organization the Global Village Energy Partnership. Continue reading

South African hospital sending patients with drug-resistant TB home | 


Drug resistant tuberculosis is a serious global problem, especially those forms of drug-resistant TB that can fend off multiple types of drugs. Patients with resistant forms of TB are supposed to be treated and monitored to reduce the spread of the disease.

That is not happening in South Africa.

A new study published in the British medical journal The Lancet today shows that South African hospitals are releasing a “ substantial” number of patients with extremely drug resistant forms of TB to their homes.

Given the already poor status of people living with TB in South Africa, the lack of proper care poses a threat to the millions who live in the country. The first case of totally drug resistant TB in South Africa was recorded last year as more and more people with TB are not being cured. It is made worse by the fact that people living with HIV are at a greater risk of catching TB. Continue reading

Global Progress Made Against AIDS, Despite Wavering Support | 

We’re not there yet, but the fight against AIDS is reaching a tipping point.

The number of new cases of HIV are falling while the number of people receiving life-saving treatment is going up. If current trends holds, the two trends will meet by 2015, says a new report.

That is the tipping point for beating AIDS.

The 2.3 million new HIV infections recorded in 2012 is the lowest number since the 1990s, says the Joint United Nations Programme on HIV/AIDS (UNAIDS). The cost of treatment for AIDS is down dramatically from roughly $10,000 per person per year in the 1990s to $140 today.

However, Attention and financing for AIDS is wavering as the world nears this crucial moment. UNAIDS estimates that as much as $24 billion will be needed each year by 2015. Continue reading

The next line of protection against HIV: breast milk | 

baby ACAN

New research shows that a protein in breast milk protects against HIV. While it is know that breast milk of untreated mothers with HIV can infect some infants, it was not understood why it was such a low rate. Turns out that a protein,  tenascin-C, in breast milk attaches itself to HIV, thus disabling it.

Genevieve Fouda of Duke University and her fellow researchers say that  tenascin-C naturally protects infants from contracting HIV. Their research was published recently in the Proceedings of the National Academy of Sciences. As The Economist points out, the news is important because it shows one way that HIV can be rendered ineffective.

This was a surprise, because tenascin-C is not an antibody, nor had it been suspected of having any antiviral function. Its known jobs are to help the development of the fetal brain and to assist in wound healing. That it is also the right shape to attach itself to HIV’s envelope protein seems a complete coincidence—which, indeed, it must be because AIDS is such a recent disease that evolution could not have had time to throw up a novel (and also ubiquitous) anti-HIV protein of this sort.

Whether tenascin-C, or something derived from it, can be deployed against HIV by doctors, rather than just by nature, remains to be seen. As far as possible, infected mothers are now given antiretroviral drugs—both for their own health and for the health of their suckling infants—so Dr Fouda’s discovery will probably not affect them directly.

Using the protein will be a big challenge, but knowing what is effective against HIV brings the world closer defeating the virus.

Advocates warn of global health doomsday if Global Fund doesn’t get money | 

DfID Secretary Justine Greening at UNDP last year.
DfID Secretary Justine Greening at UNDP last year.

(New York) – A pledge by the UK to provide the Global Fund to Fight AIDS, TB and Malaria £1 billion ($1.6 billion USD) over three years inches the global health funder closer to its goal of $15 billion for its next funding replenishment. The announcement buoys hopes that the international donor community will continue to keep the Global Fund afloat.

“It is in all our interests to help people to live longer, healthier, more productive lives so we all need to play our part in working towards a world free of HIV/AIDS, malaria and TB,” said UK Department for International Development secretary Justine Greening at a UN meeting on the Millennium Development Goals.

A £1 billion commitment to the Global Fund equates to one life saved every three minutes, said Greening. Providing 10% of the needed Global Fund budget over three years will only happen if other donors step up to reach $15 billion. There are concerns that progress gained by the Global Fund’s work over the past few years could be lost if the funding does not come through. Continue reading

Behind the story: The lingering effects of South Africa’s war on AIDS | 

After years struggling with the AIDS epidemic, South Africa has turned the corner. Fewer people are contracting HIV and treatments are making it so those who do get it can not only live full lives, but not pass it along to their children or partners.

We caught up with the Christian Science Monitor’s Jina Moore to ask her more about a cover story she did examining the lingering effects, and hidden dimensions, of the impact of HIV and AIDS on South Africa.

Readers meet Olga Thimbela, a woman who cares for her her nieces and cousins orphaned by AIDS. South Africa is in many ways a story of success, in terms of foiling a pandemic that once threatened to overwhelm the nation.

It’s difficult to resist the evangelism of South Africa’s good news on AIDS, and not just because there’s finally relief in a country that was the worst-hit in the world for so long. It’s difficult because South Africa represents what can be achieved around the world.

But it’s not an unmitigated success, free from ongoing tragedy and struggle. Thimbela’s challenges show what families must continue to endure. I asked Jina how South Africa found success and what readers should expect next as she reports from Congo, South Sudan and Rwanda in the coming months. Continue reading

Global Health at the Oscars | 

The talk the day after the Academy Awards is about Argo’s win, Jennifer Lawrence’s fall and whether or not host Seth McFarlane was funny. The show ended with a song saluting the losers of the night. Two of those losers were documentary films that covered stories of health.

Open Heart was nominated in the short form category. It tells the story of eight Rwandan children who suffer from rheumatic heart disease. They must travel to Sudan’s Salam Center in order to undergo lifesaving open-heart surgery. It includes the dual story of Rwandan cardiologist Dr. Emmanuel Rusingiza, illustrating the challenges he faces, and Italian surgeon Dr. Gino Strada, the head surgeon at the Salam Center. Continue reading