PREAMBLE: This is our 3rd annual review of topics that justify an end of year comment. We lead off with praise (“flowers”) and criticism (“fertilizer”) within three categories: global stewardship, international development, and human rights. Then follows a synopsis of each of the monthly blog themes throughout the year.
1. GLOBAL STEWARDSHIP
This issue of Global Perspectives is being constructed during the United Nations Climate Change Conference, Copenhagen, December 2009. Clearly, no national government deserves unqualified recognition for its work to combat climate change; all are conflicted. Instead, we offer “flowers” to the World Wildlife Federation (WWF). WWF is the world’s largest conservation organization, working in 100 countries for half a century. With support from 5 million members, WWF is dedicated to delivering science-based solutions to preserve the diversity and abundance of life on Earth, to stop the degradation of the environment and to combat climate change. For more, visit www.worldwildlife.org. The WWF Climate Savers program was established in 1999 as a voluntary partnership. It has been a trend-setter in demonstrating that reducing corporate carbon emissions makes business sense and should be at the core of business strategy.
By stark contrast, we allocate “fertilizer” to the Conservative Government of Canada. Once host to the conference that led to the 1987 Montreal Protocol on Substances That Deplete the Ozone Layer, and an early advocate of the Kyoto Accords, Canada has emerged as the worst performer among G8 countries. The current Conservative government of Stephen Harper in particular has dragged its feet at every turn, showing no genuine leadership. Only when President Obama announced he would attend at Copenhagen, among other real leaders, did Harper decide to attend; this is not leadership.
2. INTERNATIONAL DEVELOPMENT
To receive our virtual bouquet of “flowers”, we select Mr Lula da Silva, President of Brazil. A former shoe-shine boy and factory worker with a grade 5 education, “Lula”, the popular 2-term president has presided over significant growth in the economy that has solidified the country as the center of gravity in Latin America and an increasingly important player in the world. Mr da Silva has demonstrated sound economic stewardship and political diplomacy. He has fostered Brazil's growth through a centrist combination of respect for financial markets and targeted social programs, which have lifted millions out of poverty and narrowed the yawning income gap between rich and poor. He has demonstrated clearly what third world countries can do for themselves, especially if they can avoid the clutches of the development industry.
References:
1. New York Times, December 8, 2009. http://topics.nytimes.com/topics/reference/timestopics/people/d/luiz_inacio_lula_da_silva/index.html
2. A Comparative Perspective on Poverty Reduction in Brazil, China and India. Martin Ravallion, The World Bank Development Research Group - Director’s Office
Policy Research Working Paper 5080 - October 2009 WPS5080
Available online as PDF file [38p.] at: http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2009/10/15/000158349_20091015114049/Rendered/PDF/WPS5080.pdf
Turning now to the case for “fertilizer”, we readily select the most powerful and wealthy developed countries: the G7. For 2008 (most recent data available), the OECD noted that aid was at its highest level ever in dollar terms, increasing over 10% from 2007 in real terms. However, as high as it was, this was only at 0.3% of GNI, compared to the 0.7% target set 35 years ago, a target that continues to be renewed but never met!). In other words, with aid at almost $120 billion, it is still short by some $260 billion (2007 prices).
Moreover, development assistance is often of dubious quality. In many cases:
• Aid is primarily designed to serve the strategic and economic interests of the donor countries;
• Or [aid is primarily designed] to benefit powerful domestic interest groups;
• Aid systems based on the interests of donors instead of the needs of recipients’ make development assistance inefficient;
• Too little aid reaches countries that most desperately need it; and,
• All too often, aid is wasted on overpriced goods and services from donor countries.
Source: Anup Shah. US and Foreign Aid Assistance. April 13, 2009.
http://www.globalissues.org/article/35/us-and-foreign-aid-assistance
3. HUMAN RIGHTS
By way of “flowers” we offer a bouquet to the Geneva Conventions (see column at right for: Geneva Conventions 101 What we thought we knew, or at least should have known, but perhaps were afraid to ask?). These are the time honored central reference point for human rights, but abused by many countries engaged in current conflicts. There are many recent examples: Israel’s military abuse of civilians in Lebanon and Gaza, to Canada’s willful blindness over detainee transfers to Afghan prisons where they are tortured and even lost to follow-up. Other human rights abuses also concern the wellbeing and future of humanity: Mugabe’s Zimbabwe and its organized rape of opposition women as a political tool, Iran’s violent suppression of civil liberties, Chinese oppression of the Uyghurs, genocide in the Sudan, and the maltreatment of indigenous minorities the world over.
An ample truckload of “fertilizer” is required for the Catholic Church as a perpetrator of child sexual abuse by its own clergy, which it has too often sought to cover up in many countries. While not alone among organized religion in this pattern of abuse, any claim for leadership among the world Christian community is jeopardized by this hypocrisy.
We will give space to these issues in the 2010 series. Now onto the review of 2009!
2009 AS WE RECORDED IT.
January: INTERNATIONAL & GLOBAL DEVELOPMENT – YEAR IN REVIEW 2008
Our 2nd annual review was offered at the beginning of New Year 2009 because we reserved our December 2008 issue to celebrate the 5th anniversary of Pacific Health & Development Sciences (PacificSci), incorporated December 8 2004.
February: CLIMATE CHANGE & THE EXPANDING GLOBAL REACH OF DENGUE FEVER
Since the late 1970s dengue fever reemerged in the Caribbean basin, and is now endemic. Because this involves co-circulation of 3 serotypes, the threat to public health has heightened as primary infection does not immunize against infection from other strains: it sets up a complex immune response that may result in serious disease e.g, dengue hemorrhage fever and dengue shock syndrome. Also, climate change has extended the range of mosquito vectors and the length of the breeding season.
Although warnings about this increasing threat are longstanding, concerns about adverse impacts on tourism have contributed to insufficient public recognition and response by politicians. This is unfortunate as the disease in the meantime is becoming more firmly established. Unfortunately, some governments are more prone to spend money on trappings of power e.g, executive helicopters, than on public health e.g., drainage ditches.
However, despite the risk to visitors, the major risk of dengue is for the people of affected countries living in mosquito infested areas. The adequacy of health care systems in many instances is insufficient to cope with epidemic surges; clearly the appropriate response is to refocus on prevention. Dengue Fever falls within a group of “Neglected tropical diseases” (NTDs) that can result in lifelong disabilities and death, as well as stigma, discrimination and poverty. Affected populations often do not have access to treatment and preventive measures, and research and development has been insufficient. In recent years, there is growing attention to NTDs as both a public health and human rights issue.
For more information: A Human Rights Approach to Neglected Tropical Diseases. http://www.who.int/hhr/activities/NTD%20information%20sheet%20-%20English.pdf
March: LEADERSHIP AND MANAGEMENT OF HEALTH ORGANIZATIONS – 7 QUESTIONS
Given the role of poorly prepared leaders and managers in the global financial crisis, we proposed that that a similar crisis develop in health organizations. As a “backgrounder” we extracted from a Globe and Mail opinion piece, in which Henry Mintzberg, McGill University, took aim at “America’s monumental failure of management”. His focus on the global financial crisis and the contribution of US management teaching, including that of Harvard University, stimulated our interest in reflecting on current approaches to health leadership and management and the potential for similar failures. Among the concerns we expressed, is that the current fashion of promoting leadership studies among health professionals early in their career development may be at the cost of first building their management skills; if so, this will eventually adversely impact the managerial competence of their organizations. To explore the issues, we posed 7 questions, then attempted to answer them. The questions follow, but readers now interested in our answers will have to visit our March issue!
The Seven Questions:
1. Like GM, are some health care organizations now “too big to fail”?
2. Is too much emphasis now being given to “leadership” training for health organizations at the expense of basic management skills?
3. Noting a trend towards recruiting CEOs for large health organizations from outside the health system, based on their success in unrelated fields e.g, food, energy, tourism, are such CEOs adequately prepared for the health context?
4. Do such CEOs give enough philosophical commitment (comparable to that of the health professionals they lead) to health goals and objectives?
5. With such CEOs is there a greater risk of remote leadership with an easy exit out of health in the event of failure?
6. Are “leaders” of health organizations receiving disproportionate compensation, driven more by the size of their operating budgets than consistency with evidence of efficacy and positive outcomes, while extolling teamwork and sustainability?
7. Do teachers of health leadership and management in tertiary education institutions have sufficient health leadership and management experience to relate their teaching to reality?
April 2009: GLOBAL ECONOMIC CRISIS AND THE MILLENNIUM DEVELOPMENT GOALS
For this issue we selected a recent UN News Release that addressed global consequences of the greed and corruption in the financial industry. While almost all people have been affected by the economic crisis, the World Bank states that the crisis is set to drive 53 million more people into poverty in 2009, seriously threatening the prospect of achieving the Millennium Development Goals.
May: INDIGENOUS PEOPLE'S GLOBAL SUMMIT ON CLIMATE CHANGE
Indigenous peoples from 80 nations gathered for The Indigenous Peoples' Global Summit on Climate Change in Anchorage, Alaska, April 20-24, 2009. “Leading the Way,” organized by the Inuit Circumpolar Council (ICC), an international organization representing Arctic Inuit nations, convened some 400 participants to exchange ideas and set strategies for responding to global warming. The Summit was designed to help strengthen communities’ participation in and articulate recommendations to the December UN conference in Copenhagen. The Summit concluded Friday, April 24 with the signing of the Anchorage Declaration and action plan. Highlights were posted.
June: ACTING ON CLIMATE CHANGE TO PROTECT HUMAN HEALTH
Following on from our May issue, for this issue we donated our space to dissemination of another statement on climate change, this time from the UK-based Climate and Health Council whose message is that ‘Climate Change is the biggest global health threat of the 21st century’. This message is part of a campaign to elicit support for action from the global health community, leading up to the United Nations Climate Change Conference (COP15) in Copenhagen, December 7-18, 2009. As the editors of the British Medical Journal and Lancet have stated, as co-chairs of the Climate and Health Council: “Over the coming months it is crucial that all those involved in the negotiations are made aware of this campaign, of the growing body of health professional consensus, and of the importance of the message.” They appeal for a broader-based communication strategy, and Pacific Health & Development Sciences Inc. is pleased to add its voice to this effort.
July: FAMILY PLANNING & REPRODUCTIVE HEALTH FALL OFF GLOBAL DEVELOPMENT RADAR
During the second half of the 20th century, world population more than doubled to reach 6 billion, an astonishing 3 billion increase in population in just 40 years. Although this rate has slowed to 1.2% a year, an additional 75 million people are being added every year this decade. The world’s population could reach 9 billion by 2050, with the majority likely to live in the world’s poorest countries.
On the eve of the 20th anniversary of World Population Day, the World Bank and the United Nations Population Fund (UNFPA) warned that family planning and other reproductive health programs had fallen off the development radar of many low-income and donor country governments and international aid agencies.
World Bank figures show that while official global development aid for health soared from US $2.9 billion in 1995 to US $14.1 billion in 2007, a 5-fold increase in 12 years, aid for population and reproductive health increased much more modestly during the same period, from $901 million in 1995 to $1.9 billion in 2007. In the 35 highest-fertility countries in Africa, Asia, and the Middle East, aid for family planning and reproductive programs started at $150 million in 1995 and increased to $432 million in 2007, while overall aid for health in these 35 countries went from $915 million in 1995 to $4.9 billion in 2007. Support for population and reproductive health programs has significantly declined as a percentage of overall health aid, from about 30% in 1994 to 12% in 2008.
Said Joy Phumaphi, Vice President for Human Development at the World Bank, ”The global economic downturn has taken a wrecking ball to growth and development in poor countries worldwide, and has become a development emergency …”
August: THE GLOBAL ECONOMIC, HEALTH & SOCIAL IMPACTS OF AGEING POPULATIONS
On June 25, 2009, the Economist published a special report on ageing populations, drawing from recently released estimates from the International Monetary Fund (IMF). We selected this topic because of its importance world-wide, and also because – in our teaching, publishing and advisory roles – we (among others active in population health sciences) have been stressing the relevance and impact of ageing to the health of populations for over two decades. We are therefore pleased that attention is finally being given to these demographic forces and effects by established media sources such as the Economist. Their ability to present the phenomenon in common (non-technical) language, placing it in the perspective of the global financial crisis (that affects everyone), and then highlighting what the future may hold, should be a wake-up call to governments around the world: to come to grips with the policy and fiscal implications. We reflect on some key points, and refer interested readers to the complete article which includes several charts to illustrate the main observations (see issue for details).
September: U.N. RELEASES MILLENNIUM DEVELOPMENT GOALS 2009 REPORTS
In September 2000, the Millennium Declaration set 2015 as the target date for achieving most of the Millennium Development Goals (MDGs), which established quantitative benchmarks to halve extreme poverty in all its forms. More than halfway to this target date, major advances in the fight against poverty and hunger have begun to slow or even reverse as a result of the global economic and food crises. A UN assessment warns that, despite successes, overall progress has been too slow for most of the targets to be met by 2015. Progress towards the goals is now threatened by sluggish or even negative economic growth, diminished resources, fewer trade opportunities for the developing countries, and reductions in aid flows from donor nations.
October: DRAWING ATTENTION TO A GLOBAL PANDEMIC - Diarrhoeal Disease
Diarrhoea remains the 2nd leading cause of death among children under five globally, surpassed only by pneumonia, the most common cause. Nearly 1 in 5 child deaths (about 1.5 million each year) is due to diarrhoea. It kills more young children than AIDS, malaria and measles combined. We draw attention to a recent joint report from UNICEF and WHO that addresses this pandemic. Diarrhoeal disease, no longer a scourge in developed countries, attracts comparatively little attention from the international donor community, when compared with conditions such as HIV/AIDS, TB and malaria. Today, the media spotlight has shifted to H1N1 influenza, with little sense of proportionality in terms of continuing real disease burdens globally.
November DESERTIFICATION, FOOD SECURITY & CLIMATE
In this issue we feature the commentary of Max Ajl in Daily Climate News and Analysis. October 20, 2009 (reference supplied). The topic is critical to survival of our planet, and Ajl’s grasp of the issues is transparent. He cites conclusions from an October 2009 UN conference on desertification, which offers warnings and solutions. For example, dryland populations are already some of the planet’s most vulnerable: about 90% of such populations are in developing countries, and infant mortality rates in dryland areas are among the highest. However, he is optimistic that the process of desertification may be fixable: example - in a northern province of Argentina, a team of soil experts worked with native plant species to restore the micro-region’s bio-diversity and soil quality through a slow, deliberate process of re-vegetation. The plants are still growing and the project is still on-going, and it appears that the process of degradation has been stopped, at least for the time being. Relevant to the global search for carbon capture methods, he notes that dry land soils are nowhere close to carbon saturated and may have enormous potential for carbon sequestration. He concludes by emphasizing the primary need to ensure that cultivation techniques are ecologically appropriate: to prevent desertification it before it starts.
December: INTERNATIONAL & GLOBAL DEVELOPMENT – YEAR IN REVIEW 2008…
This Issue!
AND A HAPPY NEW YEAR!
We extend to readers our best wishes for 2010, with hopes that the global challenges of recent years will be better understood and more humanely managed going forward. For this to happen we need more enlightened world leadership. In the public interest, PacificSci will continue to offer an independent view.
FROM a Great Canadian and World Statesman
Monday, December 14, 2009
Sunday, November 15, 2009
DESERTIFICATION, FOOD SECURITY & CLIMATE
PREAMBLE: For each issue of this blog, we search for topics which deserve wider dissemination and action. In this issue we feature the commentary of Max Ajl in Daily Climate News and Analysis. October 20, 2009 (reference below). The topic is critical to survival of our planet as we know it, and Ajl’s grasp of the issues is transparent. He cites conclusions from an October 2009 UN conference on desertification, which offers both warnings and potential solutions. For example, dryland populations are already some of the planet’s most vulnerable: about 90% of such populations are in developing countries, and infant mortality rates in dryland areas are among the highest. However, he appears optimistic that the process of desertification may be fixable: for example, in a northern province of Argentina, a team of soil experts worked with native plant species to restore the micro-region’s bio-diversity and soil quality through a slow, deliberate process of re-vegetation. The plants are still growing and the project is still on-going, and it appears that the process of degradation has been stopped, at least for the time being. Relevant to the global search for carbon capture methods, he notes that dry land soils are nowhere close to carbon saturated and may have enormous potential for carbon sequestration. He concludes by emphasizing the primary need to ensure that cultivation techniques are ecologically appropriate: to prevent desertification it before it starts.
Read on for more detail on these timely and constructive observations, which we have taken liberty to select and paraphrase, for further dissemination in the public interest:
Desertification Threatens Food Security and ClimateAccording to Max Ajl, one must keep in the mind the distinction between deserts as a specific ecosystem and desertification as a specific process: “deserts are beguiling and wondrous…; (but) desertification is the rapid, human-induced creation of deserts — the sudden, accelerated conversion of arid or semi-arid land, usually by over-grazing, deforestation, over-extraction of groundwater, drought, over-planting, or some nasty combination of the five. Desertification, we can hopefully stop and, if we catch it early, reverse at a reasonable cost — and in the process, do a good bit to stop climate change and global warming.” That, he notes, is the idea behind a recent congress on the United Nations Convention on Desertification, which wrapped up this month (October 2009) in Argentina. The Convention is an off-spring of the 1992 United Nations Conference on Environment and Development (UNCED), better known as the Rio Conference. Its executive secretary, Luc Gnacadja, warned that action is urgent: ‘If we cannot find a solution to this problem ... in 2025, close to 70 percent [of the planet’s soil] could be affected," Gnacadja said. "There will not be global security without food security.’ ”
Ajl summarizes the process of desertification: “When land covered with vegetation loses its vegetation, it heats up more rapidly, worsening climate change. Hotter soil leaks carbon into the atmosphere faster than non-overheated soil, thereby contributing to the world’s CO2 count. Furthermore, as vegetation is eaten up during over-grazing or destroyed, its root structure disappears. Massive amounts of plant-based carbon go directly into the atmosphere from the land, where it had formerly been securely stashed away. Furthermore, the humus that had been stored in the soil also migrates into the atmosphere, contributing to the overload of CO2 already there.” He continues: “Processes of desertification are world-wide and worsening. Even in 2000, nearly 40 percent of the world’s agricultural land was… seriously degraded, according to the World Resources Institute. In Central America, the figure was 70%; in Africa, 20%.... UN officials claim… that if current trends continue, 75% of the continent’s people will rely on some kind of food aid by 2025.”
“Dry-land — which can include forests but primarily means grasslands — is particularly susceptible to desertification. Dry-lands are 40 percent of the earth’s surface and technically refer to lands where the prevailing climate is classified as dry sub-humid, semi-arid, arid or hyper-arid. Although they have a lower per-meter amount of plant biomass, roughly 6 kg/m2, compared to other vegetation-covered ecosystems, which have between 10 and 18 kg/m2 of biomass, they are estimated to contain 27 percent of total global soil carbon. Many of these regions are also degraded, due to rampant over-grazing compounded by drought. As the United Nations Environment Program point out, such soils are not remotely close to being saturated with carbon and may have enormous potential for carbon sequestration. According to the Millennium Ecosystem Assessment (MEA), World Resources Institute, 10 to 20% of drylands are already degraded. Between 1 and 6% of the people living in drylands live in totally desertified areas."
He notes, “dryland populations are already some of the planet’s most vulnerable. About 90% of dryland populations are in developing countries, and infant mortality rates for countries dominated by drylands tower over the others. Likewise, gross national product is far lower for dryland-countries than for those countries with more diverse and moist bio-regions. Another issue is the over-use of intensive agriculture in places ecologically unsuited for it. As the MEA researchers note, ‘Transformation of rangelands and sylvo-pastoral dryland systems to croplands increases the risk of desertification.’ Such risks are worsened by the use of input-intensive and heavily mechanized cultivation practices, especially in lands that are utterly unsuited for such intensive agriculture.”
He continues: “A different source of degradation is the forced shift from grassland to shrub-land, as large-scale unsustainable ranching or pasturing practices increasingly prevail throughout the world (although properly-practiced ranching can increase the amount of carbon stores in soil). As grass-land transitions to shrub-land leads to more naked and exposed soil, accelerating run-off and heightening erosion. In savannas, the carbon flux into the atmosphere may be at least as large as that from deforestation.”
However, he appears optimistic that the process of desertification may be fixable, citing an Argentine example: in a northern province, Santiago del Estero, a team led by Italian soil expert Massimo Candelori reversed desertification in Colonia El Simbolar… the team worked with native plant species to restore the micro-region’s bio-diversity and soil quality through a slow, deliberate process of revegetation. The plants are still growing and the project on-going; it appears that the process of degradation has been stopped, at least for the time being.
More broadly, he states, “making sure cultivation techniques are ecologically appropriate, is the best weapon against desertification: preventing it before it starts…. Practices that contribute to soil degrading include removing crop residue for cheap fodder, fuel and fencing; removing top soil for making bricks; and using animal waste for household cooking rather than working it into the soil as natural fertilizer. These long-held practices can be changed through education.” He cites Rattan Lal, the world’s leading soil authority: "long-term sustainable management of soil must be given priority over the short-term gains." Ajl concludes: “Desertification is stoppable, if action begins now.”
Source: Max Ajl. Solve Climate. Daily Climate News and Analysis. October 20, 2009. http://solveclimate.com:80/blog/20091020/desertification-threatens-food-security-and-climate
Read on for more detail on these timely and constructive observations, which we have taken liberty to select and paraphrase, for further dissemination in the public interest:
Desertification Threatens Food Security and ClimateAccording to Max Ajl, one must keep in the mind the distinction between deserts as a specific ecosystem and desertification as a specific process: “deserts are beguiling and wondrous…; (but) desertification is the rapid, human-induced creation of deserts — the sudden, accelerated conversion of arid or semi-arid land, usually by over-grazing, deforestation, over-extraction of groundwater, drought, over-planting, or some nasty combination of the five. Desertification, we can hopefully stop and, if we catch it early, reverse at a reasonable cost — and in the process, do a good bit to stop climate change and global warming.” That, he notes, is the idea behind a recent congress on the United Nations Convention on Desertification, which wrapped up this month (October 2009) in Argentina. The Convention is an off-spring of the 1992 United Nations Conference on Environment and Development (UNCED), better known as the Rio Conference. Its executive secretary, Luc Gnacadja, warned that action is urgent: ‘If we cannot find a solution to this problem ... in 2025, close to 70 percent [of the planet’s soil] could be affected," Gnacadja said. "There will not be global security without food security.’ ”
Ajl summarizes the process of desertification: “When land covered with vegetation loses its vegetation, it heats up more rapidly, worsening climate change. Hotter soil leaks carbon into the atmosphere faster than non-overheated soil, thereby contributing to the world’s CO2 count. Furthermore, as vegetation is eaten up during over-grazing or destroyed, its root structure disappears. Massive amounts of plant-based carbon go directly into the atmosphere from the land, where it had formerly been securely stashed away. Furthermore, the humus that had been stored in the soil also migrates into the atmosphere, contributing to the overload of CO2 already there.” He continues: “Processes of desertification are world-wide and worsening. Even in 2000, nearly 40 percent of the world’s agricultural land was… seriously degraded, according to the World Resources Institute. In Central America, the figure was 70%; in Africa, 20%.... UN officials claim… that if current trends continue, 75% of the continent’s people will rely on some kind of food aid by 2025.”
“Dry-land — which can include forests but primarily means grasslands — is particularly susceptible to desertification. Dry-lands are 40 percent of the earth’s surface and technically refer to lands where the prevailing climate is classified as dry sub-humid, semi-arid, arid or hyper-arid. Although they have a lower per-meter amount of plant biomass, roughly 6 kg/m2, compared to other vegetation-covered ecosystems, which have between 10 and 18 kg/m2 of biomass, they are estimated to contain 27 percent of total global soil carbon. Many of these regions are also degraded, due to rampant over-grazing compounded by drought. As the United Nations Environment Program point out, such soils are not remotely close to being saturated with carbon and may have enormous potential for carbon sequestration. According to the Millennium Ecosystem Assessment (MEA), World Resources Institute, 10 to 20% of drylands are already degraded. Between 1 and 6% of the people living in drylands live in totally desertified areas."
He notes, “dryland populations are already some of the planet’s most vulnerable. About 90% of dryland populations are in developing countries, and infant mortality rates for countries dominated by drylands tower over the others. Likewise, gross national product is far lower for dryland-countries than for those countries with more diverse and moist bio-regions. Another issue is the over-use of intensive agriculture in places ecologically unsuited for it. As the MEA researchers note, ‘Transformation of rangelands and sylvo-pastoral dryland systems to croplands increases the risk of desertification.’ Such risks are worsened by the use of input-intensive and heavily mechanized cultivation practices, especially in lands that are utterly unsuited for such intensive agriculture.”
He continues: “A different source of degradation is the forced shift from grassland to shrub-land, as large-scale unsustainable ranching or pasturing practices increasingly prevail throughout the world (although properly-practiced ranching can increase the amount of carbon stores in soil). As grass-land transitions to shrub-land leads to more naked and exposed soil, accelerating run-off and heightening erosion. In savannas, the carbon flux into the atmosphere may be at least as large as that from deforestation.”
However, he appears optimistic that the process of desertification may be fixable, citing an Argentine example: in a northern province, Santiago del Estero, a team led by Italian soil expert Massimo Candelori reversed desertification in Colonia El Simbolar… the team worked with native plant species to restore the micro-region’s bio-diversity and soil quality through a slow, deliberate process of revegetation. The plants are still growing and the project on-going; it appears that the process of degradation has been stopped, at least for the time being.
More broadly, he states, “making sure cultivation techniques are ecologically appropriate, is the best weapon against desertification: preventing it before it starts…. Practices that contribute to soil degrading include removing crop residue for cheap fodder, fuel and fencing; removing top soil for making bricks; and using animal waste for household cooking rather than working it into the soil as natural fertilizer. These long-held practices can be changed through education.” He cites Rattan Lal, the world’s leading soil authority: "long-term sustainable management of soil must be given priority over the short-term gains." Ajl concludes: “Desertification is stoppable, if action begins now.”
Source: Max Ajl. Solve Climate. Daily Climate News and Analysis. October 20, 2009. http://solveclimate.com:80/blog/20091020/desertification-threatens-food-security-and-climate
Thursday, October 15, 2009
DRAWING ATTENTION TO A GLOBAL PANDEMIC - Diarrhoeal Disease
PREAMBLE: Diarrhoea remains the second leading cause of death among children under five globally, surpassed only by pneumonia, the most common cause. Nearly one in five child deaths – about 1.5 million each year – is due to diarrhoea. It kills more young children than AIDS, malaria and measles combined.
PacificSci wishes to draw attention to a recently released joint report from UNICEF and WHO that addresses this perennial global pandemic. Diarrhoeal disease, no longer a scourge in developed countries, attracts comparatively little attention from the international donor community, when compared with conditions such as HIV/AIDS, TB and malaria. And today, the media spotlight has shifted to H1N1 influenza, with little sense of proportionality in terms of continuing real disease burdens globally.
Acknowledgement: The material used in this edition of Global Perspectives is drawn almost verbatim from the Executive Summary of the joint UNICEF/WHO report, as referenced below.
THE REPORT:
In 2006, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) issued a report highlighting the most common cause of death among children (Pneumonia: The Forgotten Killer of Children). The purpose was to raise the profile of that neglected disease. This new report is written with the same intent – to focus attention on the prevention and management of diarrhoeal diseases as central to improving child survival. Together, pneumonia and diarrhoea are responsible for an estimated 40 per cent of all child deaths around the world each year.
There are lessons to be learned from past experience. An international commitment to tackle childhood diarrhoea in the 1970s and 1980s resulted in a major reduction in child deaths. This came about largely through the scaling up of oral rehydration therapy, coupled with programmes to educate caregivers on its appropriate use. But these efforts lost momentum as the world turned its attention to other global emergencies. Today, only 39 per cent of children with diarrhoea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000.
This report examines the latest available information on the burden and distribution of childhood diarrhoea. It also analyses how well countries are doing in making available key interventions proven to reduce its toll. Most importantly, it lays out a new strategy for diarrhoea control, one that is based on interventions drawn from different sectors that have demonstrated potential to save children’s lives. It sets out a 7-point plan that includes a treatment package to reduce childhood diarrhoea deaths, as well as a prevention package to make a lasting reduction in the diarrhoea burden in the medium to long term.
New aspects of this approach include vaccinations for rotavirus, which is estimated to cause about 40 per cent of hospital admissions due to diarrhea among children under five worldwide.3 In terms of community-wide sanitation, new approaches to increase demand to stop open defecation have proven more effective than previous strategies. It has been estimated that 88 per cent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene.
Actions needed to take interventions to scale
In many countries, progress has been made in the delivery or promotion of several of these interventions, particularly vitamin A supplementation and exclusive breastfeeding. However, a substantial reduction in the diarrhoea burden will require greater emphasis on the following actions:
■ Ensure wide availability of low-osmolarity ORS and zinc, which could have a profound impact on child deaths from diarrhoea if scaled up immediately. Possible strategies to increase their uptake and availability could include the development of smaller ORS packets and flavoured formulas, as well as delivering zinc and low-osmolarity ORS together in diarrhoea treatment kits.
■ Include rotavirus vaccine in national immunization programmes worldwide, which was recently recommended by the World Health Organization.
A 7-point plan for comprehensive diarrhoea control is outlined immediately below: two (#1 and #2) elements are contained with a treatment package”, while five (#3 to #7) are contained within a prevention package.
Treatment Package
The treatment package focuses on two main elements, as outlined in a 2004 joint statement from UNICEF and WHO: 1) fluid replacement to prevent dehydration and 2) zinc treatment. Oral rehydration therapy – which has been heralded as one of the most important medical advances of the 20th century – is the cornerstone of fluid replacement.
New aspects of this approach include low-osmolarity oral rehydration salts (ORS), which are more effective at replacing fluids than the original ORS formulation, and zinc treatment, which decreases diarrhea severity and duration. Important additional components of the package are continued feeding, including breastfeeding, during diarrhoea episodes and the use of appropriate fluids available in the home if ORS are not available, along with increased fluids in general.
Prevention Package
The prevention package highlights five main elements that require a concerted approach in their implementation. The package includes: 3) rotavirus and measles vaccinations, 4) promotion of early and exclusive breastfeeding and vitamin A supplementation, 5) promotion of handwashing with soap, 6) improved water supply quantity and quality, including treatment and safe storage of household water, and 7) community-wide sanitation promotion.
Key strategic elements include:■ Develop and implement behaviour change interventions, such as face-to-face counselling, to encourage exclusive breastfeeding.
■ Ensure sustained high levels of vitamin A supplementation, such as by combining its delivery, where effective, with other high-impact health and nutrition interventions.
■ Apply results of existing consumer research on how to motivate people to wash their hands with soap to increase this beneficial and cost-effective health practice. Handwashing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent.
■ Adopt household water treatment and safe storage systems, such as chlorination and
filtration, in both development and emergency situations to support reductions in the number of diarrhoea cases.
■ Implement approaches that increase demand to stop community-wide open defecation. As with handwashing, the new approach employs behavioural triggers, such as pride, shame and disgust, to motivate action, and leads to greater ownership and sustainability of programmes.
The report states: “We know what works to immediately reduce deaths from childhood diarrhoea. We also know what actions will make a lasting contribution to reducing the toll of diarrhoeal diseases for years to come. But strengthened efforts on both fronts must begin right away.”
The following actions are needed to take the 7-point plan to scale:
■ Mobilize and allocate resources for diarrhea control.
■ Reinstate diarrhoea prevention and treatment as a cornerstone of community-based primary health care.
■ Ensure that low-osmolarity ORS and zinc are adopted as policy in all countries.
■ Reach every child with effective interventions.
■ Accelerate the provision of basic water and sanitation services.
■ Use innovative strategies to increase the adoption of proven measures against diarrhoea.
■ Change behaviours through community involvement, education and health-promotion activities.
■ Make health systems work to control diarrhoea.
■ Monitor progress at all levels, and make the results count.
■ Make the prevention and treatment of diarrhea everybody’s business.
The Executive Summary to the report concludes with the statement that "There is no better time than now. Political momentum is building to address the leading causes of child deaths, including pneumonia and diarrhoea, to achieve measurable gains in child survival. The year 2008 marked the 30th anniversary of the Alma- Ata Declaration, with reinvigorated calls to focus on primary health care. Lessening the burden of childhood diarrhoea fits squarely with this emphasis, and is essential for achieving Millennium Development Goal 4: reduce child mortality, whose target date is now only six years away."
SOURCE: Executive Summary. Diarrhoea :Why children are still dying and what can be done. The United Nations Children’s Fund (UNICEF)/World Health Organization (WHO), 2009. http://whqlibdoc.who.int/publications/2009/9789241598415_eng.pdf
PacificSci wishes to draw attention to a recently released joint report from UNICEF and WHO that addresses this perennial global pandemic. Diarrhoeal disease, no longer a scourge in developed countries, attracts comparatively little attention from the international donor community, when compared with conditions such as HIV/AIDS, TB and malaria. And today, the media spotlight has shifted to H1N1 influenza, with little sense of proportionality in terms of continuing real disease burdens globally.
Acknowledgement: The material used in this edition of Global Perspectives is drawn almost verbatim from the Executive Summary of the joint UNICEF/WHO report, as referenced below.
THE REPORT:
In 2006, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) issued a report highlighting the most common cause of death among children (Pneumonia: The Forgotten Killer of Children). The purpose was to raise the profile of that neglected disease. This new report is written with the same intent – to focus attention on the prevention and management of diarrhoeal diseases as central to improving child survival. Together, pneumonia and diarrhoea are responsible for an estimated 40 per cent of all child deaths around the world each year.
There are lessons to be learned from past experience. An international commitment to tackle childhood diarrhoea in the 1970s and 1980s resulted in a major reduction in child deaths. This came about largely through the scaling up of oral rehydration therapy, coupled with programmes to educate caregivers on its appropriate use. But these efforts lost momentum as the world turned its attention to other global emergencies. Today, only 39 per cent of children with diarrhoea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000.
This report examines the latest available information on the burden and distribution of childhood diarrhoea. It also analyses how well countries are doing in making available key interventions proven to reduce its toll. Most importantly, it lays out a new strategy for diarrhoea control, one that is based on interventions drawn from different sectors that have demonstrated potential to save children’s lives. It sets out a 7-point plan that includes a treatment package to reduce childhood diarrhoea deaths, as well as a prevention package to make a lasting reduction in the diarrhoea burden in the medium to long term.
New aspects of this approach include vaccinations for rotavirus, which is estimated to cause about 40 per cent of hospital admissions due to diarrhea among children under five worldwide.3 In terms of community-wide sanitation, new approaches to increase demand to stop open defecation have proven more effective than previous strategies. It has been estimated that 88 per cent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene.
Actions needed to take interventions to scale
In many countries, progress has been made in the delivery or promotion of several of these interventions, particularly vitamin A supplementation and exclusive breastfeeding. However, a substantial reduction in the diarrhoea burden will require greater emphasis on the following actions:
■ Ensure wide availability of low-osmolarity ORS and zinc, which could have a profound impact on child deaths from diarrhoea if scaled up immediately. Possible strategies to increase their uptake and availability could include the development of smaller ORS packets and flavoured formulas, as well as delivering zinc and low-osmolarity ORS together in diarrhoea treatment kits.
■ Include rotavirus vaccine in national immunization programmes worldwide, which was recently recommended by the World Health Organization.
A 7-point plan for comprehensive diarrhoea control is outlined immediately below: two (#1 and #2) elements are contained with a treatment package”, while five (#3 to #7) are contained within a prevention package.
Treatment Package
The treatment package focuses on two main elements, as outlined in a 2004 joint statement from UNICEF and WHO: 1) fluid replacement to prevent dehydration and 2) zinc treatment. Oral rehydration therapy – which has been heralded as one of the most important medical advances of the 20th century – is the cornerstone of fluid replacement.
New aspects of this approach include low-osmolarity oral rehydration salts (ORS), which are more effective at replacing fluids than the original ORS formulation, and zinc treatment, which decreases diarrhea severity and duration. Important additional components of the package are continued feeding, including breastfeeding, during diarrhoea episodes and the use of appropriate fluids available in the home if ORS are not available, along with increased fluids in general.
Prevention Package
The prevention package highlights five main elements that require a concerted approach in their implementation. The package includes: 3) rotavirus and measles vaccinations, 4) promotion of early and exclusive breastfeeding and vitamin A supplementation, 5) promotion of handwashing with soap, 6) improved water supply quantity and quality, including treatment and safe storage of household water, and 7) community-wide sanitation promotion.
Key strategic elements include:■ Develop and implement behaviour change interventions, such as face-to-face counselling, to encourage exclusive breastfeeding.
■ Ensure sustained high levels of vitamin A supplementation, such as by combining its delivery, where effective, with other high-impact health and nutrition interventions.
■ Apply results of existing consumer research on how to motivate people to wash their hands with soap to increase this beneficial and cost-effective health practice. Handwashing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent.
■ Adopt household water treatment and safe storage systems, such as chlorination and
filtration, in both development and emergency situations to support reductions in the number of diarrhoea cases.
■ Implement approaches that increase demand to stop community-wide open defecation. As with handwashing, the new approach employs behavioural triggers, such as pride, shame and disgust, to motivate action, and leads to greater ownership and sustainability of programmes.
The report states: “We know what works to immediately reduce deaths from childhood diarrhoea. We also know what actions will make a lasting contribution to reducing the toll of diarrhoeal diseases for years to come. But strengthened efforts on both fronts must begin right away.”
The following actions are needed to take the 7-point plan to scale:
■ Mobilize and allocate resources for diarrhea control.
■ Reinstate diarrhoea prevention and treatment as a cornerstone of community-based primary health care.
■ Ensure that low-osmolarity ORS and zinc are adopted as policy in all countries.
■ Reach every child with effective interventions.
■ Accelerate the provision of basic water and sanitation services.
■ Use innovative strategies to increase the adoption of proven measures against diarrhoea.
■ Change behaviours through community involvement, education and health-promotion activities.
■ Make health systems work to control diarrhoea.
■ Monitor progress at all levels, and make the results count.
■ Make the prevention and treatment of diarrhea everybody’s business.
The Executive Summary to the report concludes with the statement that "There is no better time than now. Political momentum is building to address the leading causes of child deaths, including pneumonia and diarrhoea, to achieve measurable gains in child survival. The year 2008 marked the 30th anniversary of the Alma- Ata Declaration, with reinvigorated calls to focus on primary health care. Lessening the burden of childhood diarrhoea fits squarely with this emphasis, and is essential for achieving Millennium Development Goal 4: reduce child mortality, whose target date is now only six years away."
SOURCE: Executive Summary. Diarrhoea :Why children are still dying and what can be done. The United Nations Children’s Fund (UNICEF)/World Health Organization (WHO), 2009. http://whqlibdoc.who.int/publications/2009/9789241598415_eng.pdf
Tuesday, September 15, 2009
U.N. RELEASES MILLENNIUM DEVELOPMENT GOALS 2009 Reports
PREAMBLE: In September 2000, the Millennium Declaration set 2015 as the target date for achieving most of the Millennium Development Goals (MDGs), which established quantitative benchmarks to halve extreme poverty in all its forms. More than halfway to this target date, major advances in the fight against poverty and hunger have begun to slow or even reverse as a result of the global economic and food crises, a UN progress report has found. The assessment, launched by UN Secretary-General Ban Ki-moon, warns that, despite successes, overall progress has been too slow for most of the targets to be met by 2015. Progress towards the goals is now threatened by sluggish or even negative economic growth, diminished resources, fewer trade opportunities for the developing countries, and reductions in aid flows from donor nations.
Background: In September 2000, leaders of 189 countries met at the United Nations (UN) in New York and endorsed the Millennium Declaration, a commitment to work together to build a safer, more prosperous and equitable world. The Declaration was translated into a roadmap setting out eight time-bound and measurable goals to be reached by 2015, known as the Millennium Development Goals (MDGs):
1. Eradicate extreme poverty and hunger
Reduce by half the proportion of people whose income is less than $1 a day
Achieve full and productive employment and decent work for all, including women and young people
Reduce by half the proportion of people who suffer from hunger
2. Achieve universal primary education
Ensure that all boys and girls complete a full course of primary schooling »»
3. Promote gender equality and empower women
Eliminate gender disparity in primary and secondary education preferably by 2005, and in all levels of education no later than 2015
4. Reduce child mortality
Reduce by two thirds the mortality of children under five »»
5. Improve maternal health Reduce maternal mortality by three quarters
Achieve universal access to reproductive health
6. Combat HIV/AIDS, malaria and other diseases
Halt and reverse the spread of HIV/AIDS
Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
Halt and reverse the incidence of malaria and other major diseases
7. Ensure environmental sustainability
Integrate principles of sustainable development into country policies and programmes; reverse the loss of environmental resources
Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss
Halve the proportion of people without access to safe drinking water and basic sanitation
Improve the lives of at least 100 million slum dwellers by 2020
8. Develop a global partnership for development
Develop further an open, rule-based, predictable, non-discriminatory trading and financial system
Address special needs of the least developed countries, landlocked countries and small island developing States
Deal comprehensively with developing countries’ debt
In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
In cooperation with the private sector, make available the benefits of new technologies, especially information and communications technologies
OVERVIEW – Extracts Paraphrased from the Report
The grim repercussions of the economic crisis
Although data are not yet available to reveal the full impact of the recent economic downturn, they point to areas where progress towards the 8 goals has slowed or reversed. Major advances in the fight against extreme poverty from 1990 to 2005, for example, are likely to have stalled. During that period, the number of people living on less than $1.25 a day decreased from 1.8 billion to 1.4 billion. In 2009, an estimated 55 million to 90 million more people will be living in extreme poverty than anticipated before the crisis.
The encouraging trend in the eradication of hunger since the early 1990s was reversed in 2008, largely due to higher food prices. The prevalence of hunger in the developing regions is now rising, from 16% in 2006 to 17% in 2008. A decrease in international food prices in the second half of 2008 failed to translate into more affordable food for most people around the world. Not surprisingly, children bear the brunt of the burden. More than a quarter of children in developing regions are underweight for age, stunting their prospects for survival, growth and long term development. Meagre progress on child nutrition from 1990 to 2007 is insufficient to meet the 2015 target, and will likely be eroded by higher food prices and economic turmoil.
These ongoing crises may also hold back progress towards gender equality, by creating new hurdles to women’s employment. The International Labour Organization estimates that global unemployment in 2009 could reach 6.1 to 7.0% for men and 6.5 to 7.4% for women, many of whom remain trapped in insecure — often unpaid — jobs.
Other fallout from the global financial situation may be compromised funding for programmes to improve maternal health, the goal towards which there has been least progress so far. Since the mid-1990s, most developing countries have experienced a major reduction in donor funding for family planning on a per woman basis, despite the undeniable contribution of such programmes to maternal and child health.
The ability of countries to mobilize domestic resources for development is in jeopardy. Export revenues of developing countries fell in the last quarter of 2008, with the collapse of commodity prices and exports more generally. Debt service to exports ratios of developing countries are likely to deteriorate further, especially for those countries that enjoyed increased export revenues for the last several years. Economic necessity will continue to exert pressure on a fragile global environment, where deforestation and the species extinction proceed at alarming rates, and a global water crisis looms.
At the Gleneagles summit of the Group of Eight in 2005, and at the UN World Summit later that year, donors committed to increasing their aid. With most OECD economies in recession, even fulfillment of those commitments, which were expressed as a percentage of donors’ national income, would imply a diminished amount of aid. For many developing countries, lower levels of aid would not only impede further progress, but could reverse some of the gains already made.
Successes so far
The report also portrays the remarkable advances that many countries and regions had made before the economic landscape changed so radically in 2008:
• Those living in extreme poverty in the developing regions accounted for slightly more than a quarter of the developing world’s population in 2005, compared to almost half in 1990.
• Major accomplishments were also made in education. In the developing world as a whole, enrolment in primary education reached 88% in 2007, up from 83% in 2000. And most of the progress was in regions lagging the furthest behind. In sub-Saharan Africa and South Asia, enrolment increased by 15% and 11% respectively from 2000 to 2007.
• Deaths of children under five declined steadily worldwide — to around 9 million in 2007, down from 12.6 million in 1990, despite population growth. Although child mortality rates remain highest in sub-Saharan Africa, recent survey data show remarkable improvements in key interventions that could yield major breakthroughs for children in that region in the years ahead. Among these interventions are the distribution of insecticide-treated bed nets to reduce the toll of malaria; as a result of immunization, dramatic progress is also being made in the fight against measles.
• At the global level, the world came together to achieve a 97% reduction in the consumption of substances that deplete the Earth’s protective ozone layer, setting a new
precedent for international cooperation.
Where accelerated progress is needed
• Efforts to provide productive and decent employment for all, including women and young people, must be revitalized. The share of women in paid employment outside the agricultural sector has increased only marginally over the years. And in South Asia, North Africa and West Asia, employment opportunities for women remain extremely low.
• The war against hunger must be embraced with renewed vigour, especially in the interests of our youngest citizens. In the countries hardest hit by the recent rise in food prices, we must implement measures to increase the availability of food, and strengthen social policies that address the negative impact on the poor.
• Work must be intensified to get all children into school, especially those living in rural communities, and eliminate inequalities in education based on gender and ethnicity, and among linguistic and religious minorities. The target of eliminating gender disparities in primary and secondary education by 2005 has already been missed.
• Greater political will must be mustered to reduce maternal mortality, especially in sub-Saharan Africa and South Asia, where negligible progress has been made so far.
• Rapid acceleration of progress is needed to bring improved sanitation to the 1.4 billion people who were doing without in 2006, with all its attendant consequences for the health of communities and the local environment. At the present rate of progress, the 2015 sanitation target will be missed.
• Efforts to improve the living conditions of the urban poor must pick up speed and extend even further. Although every region except one has made progress in this area,
slum improvements are barely keeping pace with the rapid growth of developing country cities.
• Last, but by no means least, greater priority must be given to preserving our natural resource base… We have not acted forcefully enough — or in a unified way — to combat climate change; our fisheries are imperiled; our forests, especially old-growth forests, are receding; and water scarcity has become a reality in a number of arid regions.
Learning from past experience, and looking ahead
Advances are most evident where targeted interventions have had an immediate effect, and where increased funding has translated into an expansion of programmes to deliver services and tools directly to those in need. In contrast, progress has been more modest when it requires structural changes and strong political commitment to guarantee sufficient and sustained funding over a longer period of time. This is likely the reason behind the poor performance of most countries in reducing maternal mortality and increasing access of the rural poor to improved sanitation facilities.
Achieving the MDGs will require that the development agenda be fully integrated into efforts to jumpstart growth and rebuild the global economy. At the top of the agenda is the climate change problem, which will have to be regarded as an opportunity to develop more efficient ‘green’ technologies and make the structural changes needed that will contribute to sustainable growth. Achieving the MDGs will also require targeting areas and population groups that have clearly been left behind — rural communities, the poorest households and ethnic minorities, all of whom will have a hand in shaping our common future.
Note: This overview is attributed to Sha Zukang, UN Under-Secretary-General for Economic and Social Affairs. The selection of extracts and paraphrasing from this overview for the purposes of this blog is by PacificSci, in the global public interest.
Source: The Millennium Development Goals Report 2009. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202009%20ENG.pdf
Background: In September 2000, leaders of 189 countries met at the United Nations (UN) in New York and endorsed the Millennium Declaration, a commitment to work together to build a safer, more prosperous and equitable world. The Declaration was translated into a roadmap setting out eight time-bound and measurable goals to be reached by 2015, known as the Millennium Development Goals (MDGs):
1. Eradicate extreme poverty and hunger
Reduce by half the proportion of people whose income is less than $1 a day
Achieve full and productive employment and decent work for all, including women and young people
Reduce by half the proportion of people who suffer from hunger
2. Achieve universal primary education
Ensure that all boys and girls complete a full course of primary schooling »»
3. Promote gender equality and empower women
Eliminate gender disparity in primary and secondary education preferably by 2005, and in all levels of education no later than 2015
4. Reduce child mortality
Reduce by two thirds the mortality of children under five »»
5. Improve maternal health Reduce maternal mortality by three quarters
Achieve universal access to reproductive health
6. Combat HIV/AIDS, malaria and other diseases
Halt and reverse the spread of HIV/AIDS
Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
Halt and reverse the incidence of malaria and other major diseases
7. Ensure environmental sustainability
Integrate principles of sustainable development into country policies and programmes; reverse the loss of environmental resources
Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss
Halve the proportion of people without access to safe drinking water and basic sanitation
Improve the lives of at least 100 million slum dwellers by 2020
8. Develop a global partnership for development
Develop further an open, rule-based, predictable, non-discriminatory trading and financial system
Address special needs of the least developed countries, landlocked countries and small island developing States
Deal comprehensively with developing countries’ debt
In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
In cooperation with the private sector, make available the benefits of new technologies, especially information and communications technologies
OVERVIEW – Extracts Paraphrased from the Report
The grim repercussions of the economic crisis
Although data are not yet available to reveal the full impact of the recent economic downturn, they point to areas where progress towards the 8 goals has slowed or reversed. Major advances in the fight against extreme poverty from 1990 to 2005, for example, are likely to have stalled. During that period, the number of people living on less than $1.25 a day decreased from 1.8 billion to 1.4 billion. In 2009, an estimated 55 million to 90 million more people will be living in extreme poverty than anticipated before the crisis.
The encouraging trend in the eradication of hunger since the early 1990s was reversed in 2008, largely due to higher food prices. The prevalence of hunger in the developing regions is now rising, from 16% in 2006 to 17% in 2008. A decrease in international food prices in the second half of 2008 failed to translate into more affordable food for most people around the world. Not surprisingly, children bear the brunt of the burden. More than a quarter of children in developing regions are underweight for age, stunting their prospects for survival, growth and long term development. Meagre progress on child nutrition from 1990 to 2007 is insufficient to meet the 2015 target, and will likely be eroded by higher food prices and economic turmoil.
These ongoing crises may also hold back progress towards gender equality, by creating new hurdles to women’s employment. The International Labour Organization estimates that global unemployment in 2009 could reach 6.1 to 7.0% for men and 6.5 to 7.4% for women, many of whom remain trapped in insecure — often unpaid — jobs.
Other fallout from the global financial situation may be compromised funding for programmes to improve maternal health, the goal towards which there has been least progress so far. Since the mid-1990s, most developing countries have experienced a major reduction in donor funding for family planning on a per woman basis, despite the undeniable contribution of such programmes to maternal and child health.
The ability of countries to mobilize domestic resources for development is in jeopardy. Export revenues of developing countries fell in the last quarter of 2008, with the collapse of commodity prices and exports more generally. Debt service to exports ratios of developing countries are likely to deteriorate further, especially for those countries that enjoyed increased export revenues for the last several years. Economic necessity will continue to exert pressure on a fragile global environment, where deforestation and the species extinction proceed at alarming rates, and a global water crisis looms.
At the Gleneagles summit of the Group of Eight in 2005, and at the UN World Summit later that year, donors committed to increasing their aid. With most OECD economies in recession, even fulfillment of those commitments, which were expressed as a percentage of donors’ national income, would imply a diminished amount of aid. For many developing countries, lower levels of aid would not only impede further progress, but could reverse some of the gains already made.
Successes so far
The report also portrays the remarkable advances that many countries and regions had made before the economic landscape changed so radically in 2008:
• Those living in extreme poverty in the developing regions accounted for slightly more than a quarter of the developing world’s population in 2005, compared to almost half in 1990.
• Major accomplishments were also made in education. In the developing world as a whole, enrolment in primary education reached 88% in 2007, up from 83% in 2000. And most of the progress was in regions lagging the furthest behind. In sub-Saharan Africa and South Asia, enrolment increased by 15% and 11% respectively from 2000 to 2007.
• Deaths of children under five declined steadily worldwide — to around 9 million in 2007, down from 12.6 million in 1990, despite population growth. Although child mortality rates remain highest in sub-Saharan Africa, recent survey data show remarkable improvements in key interventions that could yield major breakthroughs for children in that region in the years ahead. Among these interventions are the distribution of insecticide-treated bed nets to reduce the toll of malaria; as a result of immunization, dramatic progress is also being made in the fight against measles.
• At the global level, the world came together to achieve a 97% reduction in the consumption of substances that deplete the Earth’s protective ozone layer, setting a new
precedent for international cooperation.
Where accelerated progress is needed
• Efforts to provide productive and decent employment for all, including women and young people, must be revitalized. The share of women in paid employment outside the agricultural sector has increased only marginally over the years. And in South Asia, North Africa and West Asia, employment opportunities for women remain extremely low.
• The war against hunger must be embraced with renewed vigour, especially in the interests of our youngest citizens. In the countries hardest hit by the recent rise in food prices, we must implement measures to increase the availability of food, and strengthen social policies that address the negative impact on the poor.
• Work must be intensified to get all children into school, especially those living in rural communities, and eliminate inequalities in education based on gender and ethnicity, and among linguistic and religious minorities. The target of eliminating gender disparities in primary and secondary education by 2005 has already been missed.
• Greater political will must be mustered to reduce maternal mortality, especially in sub-Saharan Africa and South Asia, where negligible progress has been made so far.
• Rapid acceleration of progress is needed to bring improved sanitation to the 1.4 billion people who were doing without in 2006, with all its attendant consequences for the health of communities and the local environment. At the present rate of progress, the 2015 sanitation target will be missed.
• Efforts to improve the living conditions of the urban poor must pick up speed and extend even further. Although every region except one has made progress in this area,
slum improvements are barely keeping pace with the rapid growth of developing country cities.
• Last, but by no means least, greater priority must be given to preserving our natural resource base… We have not acted forcefully enough — or in a unified way — to combat climate change; our fisheries are imperiled; our forests, especially old-growth forests, are receding; and water scarcity has become a reality in a number of arid regions.
Learning from past experience, and looking ahead
Advances are most evident where targeted interventions have had an immediate effect, and where increased funding has translated into an expansion of programmes to deliver services and tools directly to those in need. In contrast, progress has been more modest when it requires structural changes and strong political commitment to guarantee sufficient and sustained funding over a longer period of time. This is likely the reason behind the poor performance of most countries in reducing maternal mortality and increasing access of the rural poor to improved sanitation facilities.
Achieving the MDGs will require that the development agenda be fully integrated into efforts to jumpstart growth and rebuild the global economy. At the top of the agenda is the climate change problem, which will have to be regarded as an opportunity to develop more efficient ‘green’ technologies and make the structural changes needed that will contribute to sustainable growth. Achieving the MDGs will also require targeting areas and population groups that have clearly been left behind — rural communities, the poorest households and ethnic minorities, all of whom will have a hand in shaping our common future.
Note: This overview is attributed to Sha Zukang, UN Under-Secretary-General for Economic and Social Affairs. The selection of extracts and paraphrasing from this overview for the purposes of this blog is by PacificSci, in the global public interest.
Source: The Millennium Development Goals Report 2009. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202009%20ENG.pdf
Monday, August 17, 2009
THE GLOBAL ECONOMIC, HEALTH & SOCIAL IMPACTS OF AGEING POPULATIONS
PREAMBLE: On June 25, 2009, the Economist published "A slow-burning fuse: A special report on ageing populations”, drawing significantly from recently released estimates from the International Monetary Fund (IMF). The Economist report is available online at http://www.economist.com/specialreports. It begins with a focus on rapid aging trends in rich countries, and affirms that low-income countries are only a few decades behind. For a direct link to the report, go to http://tinyurl.com/kw7bvh
We selected this topic for the August issue of Global Perspectives not only because of its importance world-wide, but also because – in our teaching, publishing and advisory roles – we (among others active in the population health sciences) have been stressing the relevance and impact of ageing to the health of populations for over two decades. By way of historical interest, the following references to two early publications are listed:
White F, The Environment of Medicine in the 21st Century: implications for Preventive and Community Approaches. Canadian Medical Association Journal 1987, 136: 571 75.
White F, Prevention of Disease and Promotion of Health An Overview of Medical Education in Canada, Association of Canadian Medical Colleges. ACMC Forum, 1987, XX, 2:1 3,6.
We are pleased to note that appropriate attention is finally being given to these demographic forces and effects by widely established media sources such as the Economist. Their ability to present the phenomenon in common (non-technical) language, placing it in the perspective of the global financial crisis (that affects everyone), and then highlighting what the future may hold, should be a wake-up call to governments around the world: to come to grips with the policy and fiscal implications.
What we reflect below is a précis of some key points; interested readers should consult the complete article which includes several charts to illustrate the main observations.
REVIEW OF “A slow-burning fuse”
The special report places the current deep recession, trillion-dollar rescue packages and burgeoning job losses within an even more sobering perspective. It contemplates the longer term consequences of demographically ageing populations: the prospects of slow growth, lower productivity, rising public spending and labour shortages.
In June 2009 the IMF released its estimates of the impact of the current financial crisis. The costs will be huge: the fiscal balances of the G20 countries will likely deteriorate by 8 % of GDP in 2008-09. However, they also noted that in the longer term these costs will be dwarfed by age-related spending. Between now and 2050, it predicted that “for advanced countries, the fiscal burden of… ageing-related costs” will be about 10 times greater than this, mostly due new spending on pensions, health and long-term care.
The report notes that the rich world’s population is ageing fast, and that the poor world is only a few decades behind. According to the UN’s latest biennial population forecast, the median age for all countries is due to rise from 29 years now to 38 years by 2050. At present just under 11% of the world’s 6.9 billion people are over 60. Taking the UN’s central forecast, by 2050 that share will have risen to 22% (of a population of over 9 billion), and in the developed countries to 33% (see the Economist’s chart 2). Put another way, in the rich world 1 person in 3 will be a pensioner; nearly 1 in 10 will be over 80. This is a relentless development that in time will have vast economic, social and political consequences. By about 2020, barring huge natural or man-made disasters, demographic changes are much more certain than other long-term predictions (even climate change).
So what is making the world so much older?
There are two long-term major causes, plus a “temporary blip”.
The first major cause is that people everywhere are living far longer than they used to: in 1900 average life expectancy at birth for the world as a whole was only around 30 years, and in rich countries under 50. The figures now are 67 and 78 respectively, and still rising. We agree with the Economist that this is something to be grateful for - especially since older people these days also seem to remain healthy, fit and active for much longer.
A second, and much larger, cause of the ageing of societies is that people everywhere are having far fewer children (declining fertility rates), so that younger age groups are too small to counterbalance the growing number of older people. This trend emerged first in developed countries and is taking place now in poor countries too. In the early 1970s women across the world were still, on average, having 4.3 children each. The current global average is 2.6, and in rich countries only 1.6. In many less developed countries the rates are still in the range of 3-6, but steadily falling. The UN predicts that by 2050 the global figure will have dropped to just 2 (2.1 is often taken as the level for zero population growth, independent of migration), so by mid-century the world’s population will begin to level out. The numbers in some developed countries have already started shrinking. As the report argues, this will certainly turn the world into a different place.
The temporary blip that has magnified the effects of lower fertility and greater longevity is the baby-boom that arrived in most rich countries after World War II. The timing varied slightly from place to place, but in North America it covered roughly the 20 years from 1945. The first “baby boomers” are now approaching retirement. For the next 20 they will swell the ranks of pensioners, and lead to a decline in the working population.
In richer parts of Asia e.g, Japan, South Korea, Taiwan, populations are already old and will become even older. Europe is split: Germany, Italy and Spain now have tiny families and are therefore ageing fast, whereas France, Britain and most Nordic countries have more children which keeps them younger. In eastern Europe, and particularly in Russia, birth rates are low and life expectancy has also taken a knock. North America, due to a resilient birth rate and high immigration, will remain fairly youthful by mid-century.
In most developing countries, although birth rates are dropping, populations will remain relatively young for decades yet. But in the longer term demographic dynamics will cause poorer countries to age too. Before then, the absolute numbers of older people will swell substantially, simply because these countries are so populous. The current total of 490m over-60s, will more than triple by 2050. Since most poor countries have little or nothing in the way of a state-funded welfare net, those numbers will be hard to manage.
Alone among developing countries, China is already ageing fast. For the past 30 years it has been keeping a tight lid on population growth: not quite the “one-child policy”, as it is often called (the average number of children per woman was closer to 2), the population will peak at about 1.46 billion in 2030 and then decline. Although China has seen stupendous economic growth in recent years, it will be challenged by the cost of absorbing the cost of this rapidly ageing population.
The report also addresses the macroeconomic impacts: “as more people retire, and fewer younger ones take their place, the labour force will shrink, so output growth will drop unless productivity increases faster. Since the remaining workers will be older, they may actually be less productive.” The implications for financial markets also receive comment in the report, along with speculations regarding the potential for declining standards of living related to such issues as reduced savings rates, and asset depletion. The OECD estimates that over the next three decades the age-related decline in the labour force could cut growth in its member countries by a third compared with the previous three decades.
Envoi:The following two paragraphs are quoted verbatim, as they seem to sum up the implications not only for health but also for social policy:
“For the public finances, an ageing population is a huge headache. In countries where public pensions make up the bulk of retirement income, these will either swallow up a much larger share of the budget or they will have to become a lot less generous, which will meet political resistance (and remember that older people are much more inclined to vote than younger ones). Spending on health, which in most rich countries has been going up relentlessly anyway, is likely to grow even faster as patients get older. And because of a huge increase in the number of over-80s, a lot more money, and careful thought, will be needed to provide long-term care for them as they become frailer.
What can be done? As the IMF puts it, 'the fiscal impact of the [financial] crisis reinforces the urgency of entitlement reform.' People in rich countries will have to be weaned off the expectation that pensions will become ever more generous and health care ever more all-encompassing. Since they now live so much longer, and mostly in good health, they will have to accept that they must also work for longer and that their pensions will be smaller.”
Source: A Special Report on Ageing Populations - A slow-burning fuse. Jun 25th 2009 Economist.com. http://www.economist.com/specialreports/displayStory.cfm?story_id=13888045
We selected this topic for the August issue of Global Perspectives not only because of its importance world-wide, but also because – in our teaching, publishing and advisory roles – we (among others active in the population health sciences) have been stressing the relevance and impact of ageing to the health of populations for over two decades. By way of historical interest, the following references to two early publications are listed:
White F, The Environment of Medicine in the 21st Century: implications for Preventive and Community Approaches. Canadian Medical Association Journal 1987, 136: 571 75.
White F, Prevention of Disease and Promotion of Health An Overview of Medical Education in Canada, Association of Canadian Medical Colleges. ACMC Forum, 1987, XX, 2:1 3,6.
We are pleased to note that appropriate attention is finally being given to these demographic forces and effects by widely established media sources such as the Economist. Their ability to present the phenomenon in common (non-technical) language, placing it in the perspective of the global financial crisis (that affects everyone), and then highlighting what the future may hold, should be a wake-up call to governments around the world: to come to grips with the policy and fiscal implications.
What we reflect below is a précis of some key points; interested readers should consult the complete article which includes several charts to illustrate the main observations.
REVIEW OF “A slow-burning fuse”
The special report places the current deep recession, trillion-dollar rescue packages and burgeoning job losses within an even more sobering perspective. It contemplates the longer term consequences of demographically ageing populations: the prospects of slow growth, lower productivity, rising public spending and labour shortages.
In June 2009 the IMF released its estimates of the impact of the current financial crisis. The costs will be huge: the fiscal balances of the G20 countries will likely deteriorate by 8 % of GDP in 2008-09. However, they also noted that in the longer term these costs will be dwarfed by age-related spending. Between now and 2050, it predicted that “for advanced countries, the fiscal burden of… ageing-related costs” will be about 10 times greater than this, mostly due new spending on pensions, health and long-term care.
The report notes that the rich world’s population is ageing fast, and that the poor world is only a few decades behind. According to the UN’s latest biennial population forecast, the median age for all countries is due to rise from 29 years now to 38 years by 2050. At present just under 11% of the world’s 6.9 billion people are over 60. Taking the UN’s central forecast, by 2050 that share will have risen to 22% (of a population of over 9 billion), and in the developed countries to 33% (see the Economist’s chart 2). Put another way, in the rich world 1 person in 3 will be a pensioner; nearly 1 in 10 will be over 80. This is a relentless development that in time will have vast economic, social and political consequences. By about 2020, barring huge natural or man-made disasters, demographic changes are much more certain than other long-term predictions (even climate change).
So what is making the world so much older?
There are two long-term major causes, plus a “temporary blip”.
The first major cause is that people everywhere are living far longer than they used to: in 1900 average life expectancy at birth for the world as a whole was only around 30 years, and in rich countries under 50. The figures now are 67 and 78 respectively, and still rising. We agree with the Economist that this is something to be grateful for - especially since older people these days also seem to remain healthy, fit and active for much longer.
A second, and much larger, cause of the ageing of societies is that people everywhere are having far fewer children (declining fertility rates), so that younger age groups are too small to counterbalance the growing number of older people. This trend emerged first in developed countries and is taking place now in poor countries too. In the early 1970s women across the world were still, on average, having 4.3 children each. The current global average is 2.6, and in rich countries only 1.6. In many less developed countries the rates are still in the range of 3-6, but steadily falling. The UN predicts that by 2050 the global figure will have dropped to just 2 (2.1 is often taken as the level for zero population growth, independent of migration), so by mid-century the world’s population will begin to level out. The numbers in some developed countries have already started shrinking. As the report argues, this will certainly turn the world into a different place.
The temporary blip that has magnified the effects of lower fertility and greater longevity is the baby-boom that arrived in most rich countries after World War II. The timing varied slightly from place to place, but in North America it covered roughly the 20 years from 1945. The first “baby boomers” are now approaching retirement. For the next 20 they will swell the ranks of pensioners, and lead to a decline in the working population.
In richer parts of Asia e.g, Japan, South Korea, Taiwan, populations are already old and will become even older. Europe is split: Germany, Italy and Spain now have tiny families and are therefore ageing fast, whereas France, Britain and most Nordic countries have more children which keeps them younger. In eastern Europe, and particularly in Russia, birth rates are low and life expectancy has also taken a knock. North America, due to a resilient birth rate and high immigration, will remain fairly youthful by mid-century.
In most developing countries, although birth rates are dropping, populations will remain relatively young for decades yet. But in the longer term demographic dynamics will cause poorer countries to age too. Before then, the absolute numbers of older people will swell substantially, simply because these countries are so populous. The current total of 490m over-60s, will more than triple by 2050. Since most poor countries have little or nothing in the way of a state-funded welfare net, those numbers will be hard to manage.
Alone among developing countries, China is already ageing fast. For the past 30 years it has been keeping a tight lid on population growth: not quite the “one-child policy”, as it is often called (the average number of children per woman was closer to 2), the population will peak at about 1.46 billion in 2030 and then decline. Although China has seen stupendous economic growth in recent years, it will be challenged by the cost of absorbing the cost of this rapidly ageing population.
The report also addresses the macroeconomic impacts: “as more people retire, and fewer younger ones take their place, the labour force will shrink, so output growth will drop unless productivity increases faster. Since the remaining workers will be older, they may actually be less productive.” The implications for financial markets also receive comment in the report, along with speculations regarding the potential for declining standards of living related to such issues as reduced savings rates, and asset depletion. The OECD estimates that over the next three decades the age-related decline in the labour force could cut growth in its member countries by a third compared with the previous three decades.
Envoi:The following two paragraphs are quoted verbatim, as they seem to sum up the implications not only for health but also for social policy:
“For the public finances, an ageing population is a huge headache. In countries where public pensions make up the bulk of retirement income, these will either swallow up a much larger share of the budget or they will have to become a lot less generous, which will meet political resistance (and remember that older people are much more inclined to vote than younger ones). Spending on health, which in most rich countries has been going up relentlessly anyway, is likely to grow even faster as patients get older. And because of a huge increase in the number of over-80s, a lot more money, and careful thought, will be needed to provide long-term care for them as they become frailer.
What can be done? As the IMF puts it, 'the fiscal impact of the [financial] crisis reinforces the urgency of entitlement reform.' People in rich countries will have to be weaned off the expectation that pensions will become ever more generous and health care ever more all-encompassing. Since they now live so much longer, and mostly in good health, they will have to accept that they must also work for longer and that their pensions will be smaller.”
Source: A Special Report on Ageing Populations - A slow-burning fuse. Jun 25th 2009 Economist.com. http://www.economist.com/specialreports/displayStory.cfm?story_id=13888045
Tuesday, July 14, 2009
FAMILY PLANNING & REPRODUCTIVE HEALTH FALL OFF GLOBAL DEVELOPMENT RADAR
WASHINGTON, June 30, 2009. On the eve of the 20th anniversary of World Population Day, the World Bank and the United Nations Population Fund (UNFPA) warned that family planning and other reproductive health programs vital to poor women had fallen off the development radar of many low-income and donor country governments and international aid agencies.
These programs, they said, were vital to boost women’s economic and social well-being, especially during the current global economic crisis, and to reduce endemic poverty and high numbers of maternal and infant deaths.
”The global economic downturn has taken a wrecking ball to growth and development in poor countries worldwide, and has become a development emergency for women because invariably they’re the first to suffer when economic crises strike”, said Joy Phumaphi, Vice President for Human Development at the World Bank, and a former Health Minister for Botswana. “Even before this crisis began, family planning and reproductive health had fallen off the radar of low-income countries, aid donors, and development agencies with the result that we’ve lost precious time in helping women get access to these vital health services, and helping countries get on a faster track to reducing poverty.”
Delivering a keynote address at the World Bank to mark the 20th anniversary of World Population Day, UNFPA Executive Director Thoraya Obaid said that investing in women was a smart choice during a time of global economic crisis and cutbacks in health budgets worldwide.
“The sad and shocking truth is that maternal mortality represents the largest health inequity in the world, and of all the Millennium Development Goals, MDG 5 to improve maternal health is lagging the farthest behind. And with the financial crisis and the reduction in budgets for health, this goal will be even harder to realize. It is not a lack of knowledge that is hindering progress; it is a lack of political will to protect the health and rights of women.”
New preliminary World Bank figures show that while official global developmentaid for health soared from US $2.9 billion in 1995 to US $14.1 billion in 2007,roughly a five-fold increase in 12 years, aid for population and reproductive health had increased much more modestly during the same period, from $901 million in 1995 to $1.9 billion in 2007. In the 35 highest-fertility countries in Africa, Asia, and the Middle East, aid for women's family planning and reproductive programs started at $150 million in 1995 and increased to $432 million in 2007, while overall aid for health in these 35 countries went from $915 million in 1995 to $4.9 billion in 2007. Support for population and reproductive health programs has significantly declined as a percentage of overall health aid, from about 30 percent in 1994 to 12 percent in 2008.
According to UNFPA, more than 500,000 women die each year during pregnancy and childbirth from mostly preventable and treatable medical problems. For every woman who dies, another 20 women suffer injuries and disabilities that can last a lifetime and rob them of livelihoods and physical well-being. Of all regions, Africa has the world’s highest rates of maternal mortality, at least 100 times those in developed countries.
Also speaking at the World Bank on behalf of the Obama Administration, Margaret Pollack, Acting Deputy Assistant Secretary, Bureau of Population, Refugees, and Migration, U.S. Department of State, said that falling birth rates cannot be achieved through better health programs alone and that better education for girls, equal economic opportunities for women, and fewer households living below the poverty line are also vital.
"We have seen time and time again that investing in women is an investment in families, communities, and societies. It is, in other words, an investment in our future. The United States is engaged and committed, and we look forward to working in partnership to ensure a world in which women are healthy, respected, and their rights are protected."
During the second half of the 20th century, world population more than doubled to reach 6 billion, an astonishing 3 billion increase in population in just 40 years. Although this rate has now slowed to 1.2 percent a year, an additional 75 million people are being added every year this decade. The world’s population could reach up to 9 billion by 2050, with the majority likely to live in the world’s poorest countries.
A recent World Bank report, Population Issues in the 21st Century: The Role of the World Bank, notes that family size can also greatly affect women’s jobs in the workplace. One cross-national survey suggests that the percentage of women in the labor force is directly related to national birth rates. For example, in Bolivia, there were strong links between women using contraception and having jobs outside of the home. In the Philippines, the average income growth for women with 1-3 pregnancies was twice that of women who had been pregnant more than seven times. The globe’s highest birth rates are found in Sub-Saharan Africa, where average fertility remains above five children per woman.
”The low status of women often poses a barrier because in many societies, women lack the power to make their own decisions about using contraceptives or using other reproductive healthcare”, says Joy Phumaphi of the World Bank. “Educating girls, improving economic opportunities for women, while giving them control over the design, management, and oversight of reproductive health programs, are very important ways to encourage better access to these essential health programs.”
Source: Press Release No: 2009/450/HD Washington, June 30, 2009.
For further information: World Bank Contact in Washington: Phil Hay (202) 473-1796 Cell (202) 409 2909 phay@worldbank.org UNFPA Contact in New York: Omar Gharzeddine (212) 297-5028 gharzeddine@unfpa.org
These programs, they said, were vital to boost women’s economic and social well-being, especially during the current global economic crisis, and to reduce endemic poverty and high numbers of maternal and infant deaths.
”The global economic downturn has taken a wrecking ball to growth and development in poor countries worldwide, and has become a development emergency for women because invariably they’re the first to suffer when economic crises strike”, said Joy Phumaphi, Vice President for Human Development at the World Bank, and a former Health Minister for Botswana. “Even before this crisis began, family planning and reproductive health had fallen off the radar of low-income countries, aid donors, and development agencies with the result that we’ve lost precious time in helping women get access to these vital health services, and helping countries get on a faster track to reducing poverty.”
Delivering a keynote address at the World Bank to mark the 20th anniversary of World Population Day, UNFPA Executive Director Thoraya Obaid said that investing in women was a smart choice during a time of global economic crisis and cutbacks in health budgets worldwide.
“The sad and shocking truth is that maternal mortality represents the largest health inequity in the world, and of all the Millennium Development Goals, MDG 5 to improve maternal health is lagging the farthest behind. And with the financial crisis and the reduction in budgets for health, this goal will be even harder to realize. It is not a lack of knowledge that is hindering progress; it is a lack of political will to protect the health and rights of women.”
New preliminary World Bank figures show that while official global developmentaid for health soared from US $2.9 billion in 1995 to US $14.1 billion in 2007,roughly a five-fold increase in 12 years, aid for population and reproductive health had increased much more modestly during the same period, from $901 million in 1995 to $1.9 billion in 2007. In the 35 highest-fertility countries in Africa, Asia, and the Middle East, aid for women's family planning and reproductive programs started at $150 million in 1995 and increased to $432 million in 2007, while overall aid for health in these 35 countries went from $915 million in 1995 to $4.9 billion in 2007. Support for population and reproductive health programs has significantly declined as a percentage of overall health aid, from about 30 percent in 1994 to 12 percent in 2008.
According to UNFPA, more than 500,000 women die each year during pregnancy and childbirth from mostly preventable and treatable medical problems. For every woman who dies, another 20 women suffer injuries and disabilities that can last a lifetime and rob them of livelihoods and physical well-being. Of all regions, Africa has the world’s highest rates of maternal mortality, at least 100 times those in developed countries.
Also speaking at the World Bank on behalf of the Obama Administration, Margaret Pollack, Acting Deputy Assistant Secretary, Bureau of Population, Refugees, and Migration, U.S. Department of State, said that falling birth rates cannot be achieved through better health programs alone and that better education for girls, equal economic opportunities for women, and fewer households living below the poverty line are also vital.
"We have seen time and time again that investing in women is an investment in families, communities, and societies. It is, in other words, an investment in our future. The United States is engaged and committed, and we look forward to working in partnership to ensure a world in which women are healthy, respected, and their rights are protected."
During the second half of the 20th century, world population more than doubled to reach 6 billion, an astonishing 3 billion increase in population in just 40 years. Although this rate has now slowed to 1.2 percent a year, an additional 75 million people are being added every year this decade. The world’s population could reach up to 9 billion by 2050, with the majority likely to live in the world’s poorest countries.
A recent World Bank report, Population Issues in the 21st Century: The Role of the World Bank, notes that family size can also greatly affect women’s jobs in the workplace. One cross-national survey suggests that the percentage of women in the labor force is directly related to national birth rates. For example, in Bolivia, there were strong links between women using contraception and having jobs outside of the home. In the Philippines, the average income growth for women with 1-3 pregnancies was twice that of women who had been pregnant more than seven times. The globe’s highest birth rates are found in Sub-Saharan Africa, where average fertility remains above five children per woman.
”The low status of women often poses a barrier because in many societies, women lack the power to make their own decisions about using contraceptives or using other reproductive healthcare”, says Joy Phumaphi of the World Bank. “Educating girls, improving economic opportunities for women, while giving them control over the design, management, and oversight of reproductive health programs, are very important ways to encourage better access to these essential health programs.”
Source: Press Release No: 2009/450/HD Washington, June 30, 2009.
For further information: World Bank Contact in Washington: Phil Hay (202) 473-1796 Cell (202) 409 2909 phay@worldbank.org UNFPA Contact in New York: Omar Gharzeddine (212) 297-5028 gharzeddine@unfpa.org
Saturday, June 13, 2009
ACTING ON CLIMATE CHANGE TO PROTECT HUMAN HEALTH
PREAMBLE: Following on from our May issue (scan down, directly below), which devoted its space to the predicament of indigenous peoples in the face of climate change, for this June issue we decided to donate our space to dissemination of another statement on climate change, this time from the UK-based Climate and Health Council whose message is that ‘Climate Change is the biggest global health threat of the 21st century’.
This message is part of a campaign to elict support for action from the global health community, leading up to the United Nations Climate Change Conference (COP15) in Copenhagen, December 7-18, 2009 (for more information: http://www.en.cop15.dk/ ).
As the editors of the British Medical Journal and Lancet have stated, as co-chairs of the Climate and Health Council:
“Over the coming months it is crucial that all those involved in the negotiations are made aware of this campaign, of the growing body of health professional consensus, and of the importance of the message.”
They appeal for a broader-based communication strategy, and Pacific Health & Development Sciences Inc. is pleased to add its voice to this effort.
TACKLING CLIMATE CHANGE, PROTECTING HEALTH
The essence of the Climate and Health Council position is this.
1. For all those involved in negotiations to control climate change, it is important to understand that mitigating climate change can have the immediate and beneficial effect of improving public health and reducing health inequalities. These health arguments have a particular, and so far unrealised, force. They should be set alongside the powerful arguments that “climate change is the single biggest global health threat of the 21st century” (Lancet May 16th)
2. In particular, the policies that are needed to reduce greenhouse gas emissions will also bring about immediate reductions in heart disease, cancer, obesity, diabetes, mental illness, road deaths and injuries, and air pollution through promoting substantially increased physical activity (e.g. walking and cycling) and much improved diets (less meat, fat and sugar, more fruit and vegetables). Not only will overall health be improved but there is good evidence that such action will contribute to minimising the gap in health between rich and poor, promoting more biodiversity and a more sustainable food system – both important additional determinants of a just and sustainable society.
3. The evidence for this being true, important, and possible comes from health professionals, a sector of society in which the public places trust, who are firmly calling for substantial action on behalf of their families, their patients and the public, and which is showing itself foursquare behind the need for action. Health professionals are amongst those who are at the front line in enabling the enormous behavioural and social changes which will be necessary if we are to achieve a transition to a low carbon economy and lifestyle.
4. These arguments are rooted in notions of equity and social justice and must occupy a much more dominant position in the minds of the negotiators in the run up to, and at, Copenhagen than they have at previous UN Climate Change conferences.
Reference: Climate and Health Council is part of a registered charity Knowledge into Action. www.climateandhealth.org
This message is part of a campaign to elict support for action from the global health community, leading up to the United Nations Climate Change Conference (COP15) in Copenhagen, December 7-18, 2009 (for more information: http://www.en.cop15.dk/ ).
As the editors of the British Medical Journal and Lancet have stated, as co-chairs of the Climate and Health Council:
“Over the coming months it is crucial that all those involved in the negotiations are made aware of this campaign, of the growing body of health professional consensus, and of the importance of the message.”
They appeal for a broader-based communication strategy, and Pacific Health & Development Sciences Inc. is pleased to add its voice to this effort.
TACKLING CLIMATE CHANGE, PROTECTING HEALTH
The essence of the Climate and Health Council position is this.
1. For all those involved in negotiations to control climate change, it is important to understand that mitigating climate change can have the immediate and beneficial effect of improving public health and reducing health inequalities. These health arguments have a particular, and so far unrealised, force. They should be set alongside the powerful arguments that “climate change is the single biggest global health threat of the 21st century” (Lancet May 16th)
2. In particular, the policies that are needed to reduce greenhouse gas emissions will also bring about immediate reductions in heart disease, cancer, obesity, diabetes, mental illness, road deaths and injuries, and air pollution through promoting substantially increased physical activity (e.g. walking and cycling) and much improved diets (less meat, fat and sugar, more fruit and vegetables). Not only will overall health be improved but there is good evidence that such action will contribute to minimising the gap in health between rich and poor, promoting more biodiversity and a more sustainable food system – both important additional determinants of a just and sustainable society.
3. The evidence for this being true, important, and possible comes from health professionals, a sector of society in which the public places trust, who are firmly calling for substantial action on behalf of their families, their patients and the public, and which is showing itself foursquare behind the need for action. Health professionals are amongst those who are at the front line in enabling the enormous behavioural and social changes which will be necessary if we are to achieve a transition to a low carbon economy and lifestyle.
4. These arguments are rooted in notions of equity and social justice and must occupy a much more dominant position in the minds of the negotiators in the run up to, and at, Copenhagen than they have at previous UN Climate Change conferences.
Reference: Climate and Health Council is part of a registered charity Knowledge into Action. www.climateandhealth.org
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INSPIRATIONAL WELCOME ............................... from T.S.Eliot's "Little Gidding"
