PacificSci GLOBAL PERSPECTIVES

MAJOR PROGRESS IN MALARIA CONTROL: THE ROLE OF THE GLOBAL FUND, ITS DETRACTORS AND SUPPORTERS.

2012-02-18T07:34:00.000-08:00

PREAMBLE: Over the past two issues we have taken note of decisions by several European entities (Germany, Ireland, and Sweden and the European Commission itself) to suspend funding to the Global Fund on AIDS, Tuberculosis and Malaria (GFATM). In part, this decision was made ostensibly due to concerns about corruption in recipient countries, even though this was limited to only 4 countries (among over a hundred recipients) and was discovered, investigated and openly reported by the Global Fund itself. This level of corruption, independently analysed, is significantly lower than that of the EURO block.

The truth behind this decision is that Europe has been financially mismanaged, with bank failures in some countries, and problems of corruption and mismanagement. European captains of industry (like their Americans counterparts) walked away with fortunes under their belts in the form of self-awarded bonuses, even as their operations have been bailed out by their taxpayers. Several governments are now at risk of unprecedented financial defaults.

The decisions of these European entities smack of old style colonialism: arrogance from the top down. It damages their hard won (or restored) reputations for being global leaders.

To use developing countries and the Global Fund as a scapegoat for this is unconscionable: at least be honest! Instead, these particular European entities should have had the integrity to own up and say “sorry, we cant afford this now, because we ourselves are in such a mess”.

Thankfully, the Bill and Melinda Gates Foundation, being evidence-based, has stepped in to shore up Global Fund finances due to this donor default. Also, former Japanese prime minister Naoto Kan said his country would contribute $340 million to the fund this year. Two years ago, Japan contributed $200 million, but it gave only $110 million last year because of domestic needs from the earthquake and tsunami. Of course many other countries are honoring their pledges, even as many of them also have financial challenges at this time.

“These are tough economic times, but that is no excuse for cutting aid to the world’s poorest,” Bill Gates said in announcing the $750 million contribution.

We congratulate the Gates Foundation, and the government of Japan, a nation that knows more than most the meaning of hardship and tragedy, and apparently has a high sense of integrity.

We dedicate this issue to the major successes now taking place in malaria control, largely thanks to support from the Global Fund. With this purpose, we have partially extracted verbatim the report below which appeared in the Health and Development Global Update published by the HLSP Institute in June 2011.

Reference: Brown D, Gates Foundation gives $750 million to Global Fund. Washington Post January 27, 2012. http://www.washingtonpost.com/national/health-science/gates-foundation-gives-750-million-to-global-fund/2012/01/26/gIQAHKw5TQ_story.html Accessed February 18, 2012.

MALARIA: A GLOBAL UPDATE
The latest WHO World Malaria Report in April 2011 documents impressive increases in intervention coverage and reductions in malaria morbidity and mortality. WHO estimates that the number of malaria cases has fallen by more than 50% in 43 countries over the past decade. Eleven countries in Africa have shown a reduction of more than 50% in either confirmed malaria cases or malaria admissions and deaths in recent years. In Asia, four countries saw a decrease in the number of malaria cases of more than 50% since 2000.

Africa in particular has seen tremendous progress in increasing access to insecticide-treated nets (ITNs) in past 3 years. However, given an estimated lifespan of three years, nets delivered in 2006 and 2007 are already due for replacement and those delivered between 2008 and 2010 will soon be. The challenge is in ensuring that the high levels of coverage achieved are maintained.

We still have incomplete information on access to treatment in general, and particularly for the significant proportion of patients treated in the private sector. We do know that the number of procured rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs) is increasing globally yet, especially in African countries, most patients are receiving ACTs without confirmatory diagnosis. This continues to represent a significant financial, technical and personal challenge for many patients, health care providers and national malaria control programme managers. One exception is Senegal, which has introduced RDTs on a national scale in public facilities and, with high levels of adherence to diagnostic results, achieved dramatic reductions in ACT consumption . On the other hand, another study in urban Tanzania shows that the introduction of RDTs also had the unintended consequence of increasing inappropriate antibiotic prescription (from 49% to 72%) – a behaviour ascribed to clinicians’ insufficient knowledge and training on other causes of fever. This is why RDTs able to diagnose a range of common illnesses are high on the malaria community’s R&D ‘wish list’.

Coverage with intermittent preventive treatment for pregnant women (IPTp) remains far from target levels – ranging from 2.4% in Angola to 62% in Zambia. No country has yet adopted a national policy of intermittent preventive treatment for infants (IPTi), as recommended by WHO.

In the countries with greatest progress, the decreases are associated with intense malaria control interventions. But this progress is fragile. The resurgence of the disease in 2009 in Rwanda, Sao Tome and Principe, and Zambia shows that control programmes need to be maintained even if numbers of cases have been reduced substantially.

Source: HLSP Institute. Health and Development Global Update. July 2011. http://www.hlsp.org/LinkClick.aspx?fileticket=VxUphqNpW_w%3D&tabid=1575

Envoie: The prevention and control of AIDS, Tuberculosis and Malaria represent moving targets. Only with sustained international support from both public and private sectors, and perseverance by the countries mostly affected, will eventual success be achieved. The results as reported in the above extract are extremely encouraging and should be taken into account by the European entities mentioned in our preamble, when they eventually reconsider their support: which they surely will.

INTERNATIONAL & GLOBAL DEVELOPMENT - YEAR IN REVIEW 2011

2012-01-15T16:41:00.000-08:00

PREAMBLE: This is our 5th annual review of topics we covered over the preceding year. As is also our custom, not restricted to topics covered, we lead off with praise (“flowers”) and criticism (“fertilizer”) within 3 categories: global stewardship, international development, and human rights. A synopsis of monthly blog themes follows.

1. Global Stewardship
For 2011, our flowers for leadership go to The Occupy Movement. While it had no singular leader, it represented collective leadership: like the “Arab Spring”, a democratic awakening around the world. More than a protest, and while controversial for some (especially the mainstream media, much of which is beholden to the status quo), it had the support of millions of people: the so called “99 percent” (a slogan) who see, feel and experience the steadily growing economic and social inequality growing around them, fostered by corrupt collusion between established political and financial interests.

The fertilizer goes emphatically to our own Canada, foot-dragging at the Durban Conference on Climate Change. With once mild mannered reporter Peter Kent, interestingly now Minister of the Environment for the environmentally discredited Harper government, Canada is intent fighting a rearguard action. Harper`s Canada has no coherent climate change policy, but is full of nostalgia over fossil fuel that can be extracted from our precious tar sands and money to be made from it, even as glaciers calve ever more rapidly and their beds recede steadily upstream. Canada is on the wrong side of this issue, and poorly represented.

2. International Development
Continuing the theme of climate change, flowers for this category go to the Alliance of Small Island States (AOSIS), a 42 member coalition drawn from all oceans and world regions, sharing similar development challenges and concerns about vulnerability to climate change. AOSIS is an advocate for global sanity: an impressive five percent of the global population, 350 million people (ten times Canada, equal to the USA) but under existential threat not of their own making.

To receive a deposit of rather smelly fertilizer, we must select the EU entities (Germany, Ireland, Sweden and the European Commission itself) who reneged without honour on their commitment to support the Global Fund for AIDS, TB and Malaria, even as major unprecedented success of this initiative is just emerging. “Without honour”, for the reason they gave: alleging corruption when it was the Fund itself that unearthed this in a small minority of recipient countries. This really is hypocrisy of a high order: corruption on a larger and more complex scale underlies the current economic morass of the EU, the real reason for their backsliding: pot calls kettle black, while sitting in a bully pulpit.

3. Human Rights
We offer flowers (flowering plants in this instance because they come with roots) to Myanmar (also known as Burma) for their movement towards democracy. It seems the five decades old military despotism is receding, and genuine efforts being made by those in power to join the international community: let the flowers bloom!

The fertilizer this year belongs to Iran. Despite the impressive quality of people who emerge from the Iranian diaspora, and relatively advanced aspects of Iran’s education and public health systems (when compared with most other countries in central Asia), these are otherwise dismal days for human rights in that country.

Consider the following quotation from Human Rights Watch:
• Since Iran’s crackdown against anti-government protests following the 2009 presidential election, the human rights crisis in the country has only deepened. Human Rights Watch is particularly concerned about the broad-based targeting of civil society activists, including lawyers, students, women’s rights activists, and journalists, and a sharp increase in the use of the death penalty… Iran continues to refuse access to UN (observers) despite their longstanding and repeated requests for invitations to visit….
Source: Human Rights Watch. Iran`s deepening human rights crisis. Human Rights Issues regarding the Islamic Republic of Iran. 2011. http://www.hrw.org/middle-eastn-africa/iran

2011 AS WE RECORDED IT...
January: THE VIENNA DECLARATION - Evidence-Based Drug Policy and the Need for a Paradigm Shift
This issue focused on Canada’s minority Conservative government`s Bill S-10, the Penalties for Organized Drug Crime Act, including the introduction of mandatory minimum prison sentences. Unfortunately, this legislation is ideological and not evidence-based. Research indicates that Bill S-10 will only serve to create greater health and social harms.

For the purpose of more objective information, the issue drew attention to the Vienna Declaration (www.viennadeclaration.com). The Declaration is a scientific statement seeking to improve community health and safety by calling for the incorporation of evidence based research into the development of illicit drug policies. Since its launch on June 27, 2010, the Vienna Declaration has been endorsed by six Nobel Laureates, thousands of scientific experts, law enforcement leaders, and former heads of state from Brazil, México and Colombia. In Canada, the declaration was signed by five chief provincial medical health officers, the Canadian Public Health Association, the Health Officers Council of British Columbia, and a growing number of municipalities which deal with these issues first hand. PacificSci also has signed.

February: REGULATORY CAPTURE – A CASE STUDY FROM CANADA: Dietary Sodium Regulation
This month`s blog focuses on regulatory capture recently facilitated by Canada’s Conservative government in favour of the food industry in the context of Dietary Sodium Regulation.

The theory of regulatory capture was set out by Richard Posner, an economist and lawyer at the University of Chicago, who argued that "Regulation is not about the public interest at all, but is a process, by which interest groups seek to promote their private interest ... Over time, regulatory agencies come to be dominated by the industries regulated." More descriptively he referred to this as "Gamekeeper turns poacher, or at least helps poacher".

March: COMPARATIVE RISKS OF NUCLEAR ENERGY : Need for Objectivity in light of Japan’s Emergency.
The situation of Japan, following the world’s 5th largest recorded earthquake since 1900 and resulting tsunami, was catastrophic: tens of thousands drowned, swept away with coastal infrastructure. Hundreds of thousands, were displaced, lost family members and livelihoods. The catastrophe also gave rise to a new emergency as a result of damage to several nuclear power plants, and eventual reactor meltdown.

Although there was comprehensive coverage of Japan’s humanitarian disaster, media monitored the nuclear sub-story with an intensity disproportionate to the overall catastrophe. Even some mainstream media (e.g., CTV) appeared to hype this aspect of the disaster, seemingly appealing to populist fear about nuclear power, rather than objectively placing this in the perspective of the far greater human impact of a massive earthquake and tsunami. PBS did a better job.

In light of these observations, we searched for up to date sources of scientific information on nuclear safety, and selected for reference a recent Organization for Economic Cooperation and Development (OECD) report Comparing Nuclear Accident Risks with Those from Other Energy Sources.

In conclusion, risks are associated with every energy source and decisions must be made in every context regarding the viability of available choices. As the OECD report pointed out: There is little value in rejecting one source if that which replaces it presents even greater hazards.

April: WHY IS CANADA FOLLOWING FAILED U.S. PRISON POLICIES? And What It Could Learn from NAACP's "Misplaced Priorities" Report
Canada’s Conservative government is copying failed US prison policies even as its favoured role model, the US Republican Party, repudiates them: policies that lead the US to having the highest incarceration rates in the world. In Canada, a $2-billion prison-building bonanza is about to spawn more than two dozen new prisons.

The motivations behind Prime Minister Harper’s prison obsession once again appear ideologically driven and politically motivated. There is no evidence of increasing crime in Canada (the overall trend is actually down), nor is there good scientific evidence that incarceration is an effective solution to most of the crime that does occur.

These ill-considered legislative measures are creating a level of overcrowding that contravenes international standards on treatment of prisoners. It does nothing for rehabilitation, even as it displaces resources away from measures that could prevent crime in the first place.

We then offered a review of a just released and acclaimed NAACP policy report from the USA.

May: CANADIAN OIL SPILL THREATENS INDIGENOUS PEOPLE
On April 29, 2011, there was a major oil spill from a pipeline in Northern Alberta, Canada. This adversely affected the Lubicon Cree people living in the area, wildlife, forests, streams and lakes.

Global Perspectives drew attention to the estimated $14 billion in revenue generated on Lubicon lands, even as traditional water sources have been contaminated since the onset of resource exploration. Despite this, Lubicon houses lack running water and plumbing. Within 3 years of the first oil wells the number of people dependent on social assistance increased from 10 to 90%. As a matter of human rights, action is required to alleviate these appalling health conditions.

It is now clear also that a competent, independent health team must be provided to the community to address new concerns about the headaches, nausea and other illness experienced since the April 29 spill. In this regard we supported Amnesty’s call for both federal and provincial (majority Conservative) governments to ensure that such an assessment is carried out with results fully available to the community as a whole, and to the general public.

June: EXTREME WEATHER, CLIMATE CHANGE AND HUMAN DISPLACEMENT
In this issue we reported on the Nansen Conference on Climate Change and Displacement in the 21st Century, Oslo Norway, June 6-7, 2011. As summarized by IISD reporting services:

Climate change is the world’s most serious threat to sustainable development, with adverse impacts projected for the environment, human health, food security, economic activity, natural resources and physical infrastructure. While global climate varies naturally, rising concentrations of anthropogenically-produced greenhouse gases in the earth’s atmosphere are leading to changes which, over the short- and long-term, lead to an increase in the severity of droughts, land degradation, desertification, salinization, riverbank and coastal erosion, sea-level rise and the intensity of floods, tropical cyclones and other geophysical events. This in turn will negatively affect crop yields and food production, water supplies, livelihoods and human settlements.

An impact of particular concern is the potential for human displacement and migration: the implications for human welfare and security, and for strategies for adaptation, DRR, humanitarian aid and protection of displaced people, could be far-reaching.

However, a more positive scenario still appears to be largely a matter of choice, even as most of our current political “leaders” remain negligent in not making a serious decision to come to grips with this potentially terminal threat. To quote again from the conference summary:

“Responding to climate change has the potential for millions of green jobs, to transform societies to energy systems that are safe, that are stable and that are based on renewable energy and energy efficiency. Moving away from fossil fuels and towards renewable energy is being embraced now by more and more countries, although funding for alternative systems pales in comparison to subsidies for oil, gas and coal.”

July: DISASTER RISK REDUCTION: REVISITING THE HYOGO FRAMEWORK FOR ACTION (2005-15)
Continuing from last month’s theme, linking extreme weather patterns to longer term climate change and impacts on human displacement, this month we focused more broadly on the phenomenon of disasters. Our primary sources for this material are IDMC, the Internal Displacement Monitoring Council of the Norwegian Refugee Centre, and the 2011 United Nations Global Assessment Report on Disaster Risk Reduction, both referenced.

August: REVITALIZING PHILANTHROPY IN INTERNATIONAL DEVELOPMENT:... The Bellagio Initiative
Our focus this month was on a recently announced initiative, jointly led by the Institute of Development Studies (University of Sussex UK), the Resource Alliance Ltd (London UK) and The Rockefeller Foundation (new York City, USA). The “Bellagio Series on the Future of International Development and the Role of the Philanthropic Sector: Promoting Human Well-being in a Challenging Global Context” is designed to explore future relationships between philanthropy and international development including a convening to be held at the Rockefeller Foundation Bellagio Center (Lake Como, Italy), November 2011.

Our view at PacificSci is that, given the continued lagging of donor countries in meeting their long standing financial commitments to development, particularly the G7 group of nations, the role of private philanthropy has become even more important in filling this gap than ever before.

September: CASE STUDY: The Costs of 9/11 and the Creation of a National Security Establishment in Canada
Earlier this month the world took note of the 10th anniversary of the terrorist attacks on the World Trade Center, New York, that took place on September 11, 2001. While memorial events honored those killed and injured, their loved ones, the rescue teams, and all who were affected, there is no doubt that the event was felt everywhere as one that destabilized the world.

Canada is an interesting case study of some of the unintended consequences of over-reaction: the Rideau Institute has released a new report that tabulates, for the first time, the number of additional dollars spent on national security since the terrorist attacks of September 11, 2001, as well as observations on the opportunities costs that this has entailed. According to the report, the sum already spent in the post–9/11 build-up could have provided significant benefits to Canada. The nearly 100 billion dollars could have rebuilt transit systems in each of Canada’s ten largest cities, it could have provided a national childcare program, or eliminated all payments for prescription medications. Any of these programs could have been fully implemented if the money spent on a national security establishment since 2001 had been used differently.

We agree with the report’s conclusion that “It is time to re-evaluate whether the dramatic post–9/11 spending on national security could be more appropriately spent over the next ten years.”

October: SUPERVISED INJECTION FACILITY WINS LEGAL BATTLE IN CANADA
The purpose of supervised injection facilities is to reduce the harms associated with injection drug use. This said, the way forward is decidedly uphill for any society that pits the perceived interests of “law and order” against public health interests. Insite, a supervised injection facility in British Columbia, Canada’s western most province, illustrates this struggle.

In May 2008, the British Columbia Supreme Court struck down the provisions of the Controlled Drugs and Substances Act that deal with possession and trafficking but suspended the declarations of invalidity for one year to allow Canada`s Parliament to bring the law into compliance with the Constitution, and the Court’s reasons, which ensure Insite a permanent constitutional exemption. The Attorney General of Canada (the Harper government) appealed the decision. On January 15, 2010, the BC Court of Appeal dismissed the appeal by the Attorney General of Canada, allowing Insite to continue operations. The Attorney General filed a further appeal with the Supreme Court of Canada. Early in 2011, it was announced that the Supreme Court of Canada would hear the appeal from Attorney General of Canada.

On September 30, 2011, the Supreme Court of Canada ordered the federal Minister of Health to grant an exemption to Vancouver’s supervised injection facility under the Controlled Drugs and Substances Act. By ruling that addiction-related drug use is a health issue and not simply a criminal justice issue, the Supreme Court decision upheld Canada’s constitutional rights to life, liberty and security of the person and the role of public health interventions of this nature.

Under Canada’s Conservative government, an unremitting effort had been made to close the facility down, despite support from the provincial government. Their objections were based on political ideology. In stark contrast, the decision made by the Supreme Court, was based on a careful reading of Canada’s Charter of Rights, and scientific evidence that the facility was saving lives, and not promoting the drug culture as the federal Conservatives had claimed.

November REVISITING REGULATORY CAPTURE 1) Government- Sponsored Gambling, and 2) Government-Industry Oil Sands Emissions Monitoring
As introduced in our February 2011 blog, “regulatory capture” (RC) is the process by which regulatory agencies eventually come to be dominated by the very industries they were charged with regulating. It happens when a regulatory agency, formed to act in the public's interest, eventually acts in ways that benefit the industry it is supposed to be regulating, rather than the public. As portrayed by The Economist (citing Posner) "Regulation is not about the public interest at all, but is a process, by which interest groups seek to promote their private interest ... Over time, regulatory agencies come to be dominated by the industries regulated."

Recent work by Frederic Boehm throws new light upon this phenomenon: he presents an array of measures to reduce different types of corruption in regulatory processes, preventing capture and ultimately safeguarding the independence, effectiveness and efficiency of regulation.

This blog highlighted two examples: 1) the extraordinary phenomenon of governments in many countries (including several Canadian provinces) both sponsoring yet also charged with regulating the gambling industry, even as it exacts an enormous toll on health (a provincial responsibility in Canada, therefore an obvious conflict of interest); and 2) a government-industry advisory group charged with examining emissions from the Alberta oil sands industry, shown to have been ignoring substantive evidence from reputable independent sources.

December: EUROPEAN COUNTRIES RENEGE ON COMMITMENTS TO THE GLOBAL FUND
Until recently, there was optimism that most would honor their commitments to support the Millennium Development Goals (MDGs). Last year’s UN Special Session on MDG outcomes provided an important reminder: in relation to Goal 8 (Develop a Global Partnership of Development) there was a message for all donor countries, namely that, without more reliable support from developed countries, several Goals are likely to be missed in many developing ones.

However there is now serious concern regarding the 6th Goal, which comes within the remit of a “Global Fund to fight AIDS, Tuberculosis and Malaria”. Tragically, in November 2011, several European entities (Germany, Ireland, Sweden and the European Commission itself), ostensibly in response to fraud in a small number of developing nations (4 out of >120 recipient countries), have frozen or drastically cut back on their funding support to the Global Fund as a whole with the effect that it will not be able to take on any new commitments for a 3 year period.

The documented fraud amounted to $34 million, 0.03% of the Fund’s whole portfolio, and all the evidence of fraud cited in the press was uncovered by the Fund itself after it undertook investigations. And, the Fund had publicly announced these findings as they were uncovered. There was never any duplicity or attempts to cover up the losses. It would be interesting indeed to see how this compares with the extent and impact of fraud in the European Community itself, especially on the heels of various banking collapses, and national defaults. Pot calls kettle black?

The ethics of the European Community need to be called into question. It appears that they have held the Global Fund to a higher standard than they themselves could meet. At least one should expect Europe to be honest about this. Why not lay the blame for reneging on commitments on their own mismanagement, and by extension accept responsibility for any reversals that will result from funding shortfalls in global efforts to combat these diseases over the next 3 years?

ENVOI: PacificSci`s regular blogs will continue next month.

EUROPEAN COUNTRIES RENEGE ON COMMITMENTS TO THE GLOBAL FUND

2011-12-15T17:29:00.000-08:00

PREAMBLE:
The track record of developed countries honoring their aid commitments is not impressive (especially the G8 nations)[1]. However, until recently, there was optimism that most would honor their commitments to support the Millennium Development Goals (MDGs).

To briefly revisit the MDGs for those readers who may not recall what they were about, here is a thumbnail sketch: at a United Nations conference in 2000, governments around the world pronounced the MDGs, to be achieved by 2015. Eight goals were constructed (listed below), reflecting the world's main development challenges and responding to the calls of civil society.[2] Within these goals there are 18 targets, complemented by 48 measurable indicators to measure progress towards the MDGs.

Goal 1: Halve Proportion of People in Extreme Poverty and Hunger
Goal 2: Achieve Universal Primary Education
Goal 3: Promote Gender Equality and Empower Women
Goal 4: Reduce Child Mortality by 2/3
Goal 5: Reduce Maternal Mortality by 3/4
Goal 6: Combat HIV/AIDS, Malaria and other diseases
Goal 7: Ensure Environmental Sustainability
Goal 8: Develop a Global Partnership of Development

Last year’s UN Special Session on MDG outcomes provided an important reminder: in relation to Goal 8 (Develop a Global Partnership of Development) there was a message for all donor countries, namely that, without more reliable support from developed countries, several Goals are likely to be missed in many developing ones.[3]

However there is now serious concern regarding the 6th goal, which comes within the remit of a “Global Fund to fight AIDS, Tuberculosis and Malaria”. Tragically, in November 2011, several European entities (Germany, Ireland, Sweden and the European Commission itself), ostensibly in response to fraud in a small number of developing nations (4 out of >120 recipient countries), have frozen or drastically cut back on their funding support to the Global Fund as a whole with the effect that it will not be able to take on any new commitments for a 3 year period.

Although it is understood around the world that the entire European Union is now under existential threat, and therefore unable to make good on their commitments, in our view it is a “bit rich” (to use the vernacular, no pun intended) that these rich nations, whose own financial mismanagement and fraud in some instances led to their own current morass, feel free to tar recipient countries with the same brush.

The documented fraud amounts to $34 million, which represents 0.03% of the Fund’s whole portfolio, and all of the evidence of fraud that was cited in the press was uncovered by the Fund itself after it undertook investigations. Furthermore, the Fund had publicly announced these findings as they were uncovered. There was never any duplicity or attempts to cover up the losses. It would be interesting indeed to see how this compares with the extent and impact of fraud in the European Community itself, especially on the heels of various banking collapses, and national defaults. Pot calls kettle black?

For this issue of PacificSci Global Perspectives, we extract from an objectively critical situation analysis as presented by Results UK, an NGO registered in England, Wales and Scotland.[4]

NOTE: This is our last issue for 2011. Our Year in Review will appear as the first issue for 2012.

References:
1. White F. Development assistance for health – donor commitment as a critical success factor. Can J Public Health (2011)102,6:421-3
2. United Nations Development Programme. About the MDGs: Basics - What are the Millennium Development Goals? http://www.undp.org/mdg/basics.shtml Accessed December 15, 2011.
3. UN General Assembly. 65th Session Agenda Items 115. Special Session on the MDGs. Outcome Document: New York. September, 2010.
4. Supporting the Global Fund – making the case for immediate intervention. Background Sheet 1: RESULTS – the power to end poverty. December 11, 2011. http://results.org.uk/sites/default/files/December%202011%20Background%20Sheet%201%20Supporting%20the%20Global%20Fund.pdf Accessed December 15, 2011.

THE GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA (GF)
Note: This report is extracted verbatim from the work of Results-UK (citation #4 above). While we fully endorse what they have stated, the originality of this analysis belongs entirely to them. We recognize that it was written for a primarily UK audience, but we feel that it deserves global recognition and readership.

The GF is a multilateral agency founded in 2002 and is the world’s largest financer of anti-AIDS, TB and Malaria programs. It operates as a partnership between governments, civil society, the private sector and affected communities. It draws its funding from donor governments, trusts and foundations and distributes that money to implementing agencies. To ensure that GF money goes to where it is needed most, it prioritises countries with low incomes and high disease burdens. Importantly the GF is guided by the principles of accountability and transparency. It focuses explicitly on results and has an outstanding track record for delivering real impacts on the ground.

At the end of 2010 the GF has approved funding of $22 billion for more than 600 programs in 150 countries. Because it has such clear monitoring mechanisms the Fund states that it has distributed 190 million insecticide treated nets to treat malaria, provided TB treatment for 8.2 million people and provided antiretroviral drugs and holistic care for some 3.2 million people, saving 7.7 million lives.

How funding works: the replenishment process
The fund is predominantly bankrolled by contributions from the governments of developed nations. Since it was created in 2002, 95% of pledges have been from these governments (totalling $28.3bn), with the other 5% coming from private sector and philanthropic givers like the Gates Foundation. From 2001-2010 by far the largest contributor to the fund has been the USA, followed by France, Japan, Germany and the UK. In terms of giving as per cent of GNI, Sweden gives the largest proportion, followed by France, Norway, Holland and Spain.

After the initial funding it received for 2002-2004 the GF has gone through a replenishment cycle every three years, with the last of these events taking place in 2010 in New York. The GF went into the New York conference seeking $20 billion to fully fund the fight against the three diseases. Whilst this represented a doubling of contributions from the 2007 replenishment, it was considered as absolutely vital to avoid losing ground to the diseases. Unfortunately, pledges and projections at the conference only ended up totalling $11.68 billion. The result was that the GF needed to seek new funding, could not fund certain high cost programs and had to slow the pace of scale up.

The UK contribution
The UK government has been a strong historic supporter of the Fund. In 2001 the Labour government made a pledge to give £1.36 billion between 2001-2015 and has delivered £1.06bn thus far. After coming to power the new coalition undertook a review of all UK giving to multilaterals and the Fund came out very well, rated in the highest category as providing ‘Very Good’ value for money, which was only given to 9 organisations. In giving the Global Fund a top score, the Multilateral Aid Review (MAR) found its “quality and depth of reporting” were very high, and reported that “standards for financial management and audit” were very high as well. Overall it found the Global Fund to be critically important in the delivery of the MDGs.

As such, the new government has committed to continued giving to the fund at the same levels as the previous administration. The UK has not made a new pledge recently, however, our historically strong stance puts us ahead of many European countries. Civil society organisations across the UK and Europe have been calling on the UK to make a contribution of £840 million between 2011-2013, a figure that would represent a ‘fair share’ of the $20 billion that the GF requested to fill financing needs of partner countries.

What went wrong?
There have been several competing factors that have led to countries withdrawing or withholding their payments to the Global Fund.

1. The financial crisis: The global economic downturn of 2008 has severely hit the GF. With aid budgets being squeezed more tightly than ever before, many countries have chosen to hold back or renege on their commitments to the Fund, citing a variety of causes. As the crisis has continued the ratio of pledges to money actually delivered has steadily worsened, with countries including Spain, Holland, Denmark, Italy, Belgium and the US seriously behind on their commitments. Countries are finding the crisis a convenient excuse not to meet their commitments.

2. Global Fund Corruption: In January this year, corruption in GF programmes was inaccurately and sensationally reported by the Associated Press. Citing losses of $34 million dollars across several countries, the media created a situation in which Germany, Ireland, the European Commission and Sweden all announced that they were withholding funding until investigations into the causes of the losses and how they occurred were carried out.

3. A victim of its own success: Ironically, the Fund’s success up until 2010 has partly led to these problems. The Fund introduced new paradigms in the global health and international development arenas. It established a mechanism which channels resources to fund demand through the submission of evidence based, technically sound TB/Malaria/HIV proposals, and as a result has regularly met and exceeded its targets. As such, scale up in demand has been steep, leaving the Fund needing increasingly more and more funding. When global economics were good, this was a curve that could continue. Now this is clearly no longer the case.

The issue of corruption
Stories began to circulate in January 2011 about money going missing from GF supported programs in nine different countries. The total sums that were misappropriated or unaccounted for totalled around $34 million dollars. As a reaction, Germany, Ireland, Sweden and the E.C all stated that they were withholding money to support pledges. They all cited slightly different reasons – and had slightly different motivations – but all called for the Fund to conduct an investigation into its activities.

The media reports of corruption have been very damaging to the Fund, but it’s important to look at this in detail and put the figures into perspective. All of the evidence of fraud that was cited in the press was uncovered by the Fund itself after it undertook investigations. Corruption was found in 9 out of 33 investigated programs (of 145 the fund administers). In Mali, the country with the greatest losses, the Fund has reclaimed a large amount of that money and secured the convictions of nine civil servants involved in its theft. The Office of the Inspectorate General (OIG) is a completely independent body within the Fund that carries out these investigations. What’s more, the Fund had publicly announced these findings as they were uncovered. There was never any duplicity or attempts to cover up the losses. Joe Liden, a spokesman for the Fund stated that they felt they had been “treated very badly by the media.”

Within the whole of the Fund’s portfolio, the $34 million represents 0.03% of the Fund’s whole portfolio (although only 33 countries were investigated). However, these 9 programs were investigated for the very reason that they were some of the riskiest grants the Global Fund provided. Looking at the most recent set of reviews from the OIG, which analysed over $1b of grants, indicates that across the whole portfolio, no more than 1% of funds have been lost to fraud. This is substantially less than is lost by the UK’s DWP every year.2 However, the sensationalist language used by the media has stuck and the Fund’s reputation as been damaged. The Fund has been through a process of self-evaluation and produced a High Level panel report discussing the problems it faced around fiscal accountability, auditing and investigation practices and has addressed many of the criticisms made by concerned donors.

OUR COMMENT: The ethics of the European Community need to be called into question. It appears that they have held the Global Fund to a higher standard than they themselves could meet, especially given the evidence of everything from bank fraud to gross mismanagement of national finances in several of their own members (Ireland is one of the countries that have reneged on their GF commitments, but isnt this also one of the so-called “PIGS” that have exhibited financial mismanagement?), leading to the current crisis in the Euro. At least one should expect Europe to be honest about this and not play “bully in the pulpit”. Why not lay the blame for reneging on commitments on their own mismanagement, and by extension accept responsibility for any reversals that will result from funding shortfalls in global efforts to combat these diseases over the next 3 years?

We wish all readers the very best for the Holiday Season, and a Happy New Year.

REVISITING REGULATORY CAPTURE 1) Government- Sponsored Gambling, and 2) Government-Industry Oil Sands Emissions Monitoring

2011-11-16T16:48:00.001-08:00

PREAMBLE
In our February 14, 2011 blog, we visited the pervasive issue of “regulatory capture” (RC), examining as a case study, sodium regulation in foods. The theory of regulatory capture goes back at least four decades, attributed to Richard Posner and the earlier work of George Stigler (a Nobel laureate), both economists associated with the University of Chicago.

RC is the process by which regulatory agencies eventually come to be dominated by the very industries they were charged with regulating. It happens when a regulatory agency, formed to act in the public's interest, eventually acts in ways that benefit the industry it is supposed to be regulating, rather than the public. As portrayed by The Economist (citing Posner) "Regulation is not about the public interest at all, but is a process, by which interest groups seek to promote their private interest ... Over time, regulatory agencies come to be dominated by the industries regulated." [1]

Recent work by Frederic Boehm throws new light upon this phenomenon: reviewing regulatory capture from the perspective of what can be done to limit it based on a risk analysis (after first analysing the various levels of corruption that can occur), he presents an array of measures to reduce different types of corruption in regulatory processes, preventing capture and ultimately safeguarding the independence, effectiveness and efficiency of regulation.[2] However, it appears all too often, that there is no explicit anti-corruption agenda in regulation. Regulation is widely considered as the key issue in reforms of public service sectors. But it has been pointed early to the problem that regulatory capture in itself could undermine the stated aims of the reforms.[3]

The ethical principle here has long roots and important ramifications across many areas of activity. For example, in the public health field, it is well recognized that "People who work on not only tobacco control, but on chronic disease control, should be critical about receiving money from revenue generated through tobacco sales."[4] Beyond the tobacco industry, there are numerous examples where the credibility of policy makers, regulators, researchers and practitioners may be undermined on the basis of their association with industry e.g., the energy industry, mining interests, agricultural chemical companies, pharmaceutical firms, beverage industries, arms manufacturers, the gambling industry… and so on. This is why government needs to remain at arms-length from such industries, and not be involved simultaneously in regulating and operating such industries. Regulation needs to be based on the best scientific objective evidence; while industrial interests are relevant, those interests should follow, not lead.

Our blog for this month takes note of two additional examples: 1) the extraordinary phenomenon of governments in many countries (including several Canadian provinces) both sponsoring yet also charged with regulating the gambling industry, even as it exacts an enormous toll on health (a provincial responsibility in Canada, therefore an obvious conflict of interest); and 2) the advisory group charged with examining emissions from the Alberta oil sands industry.

CASE STUDY # 1: GOVERNMENT COMPLICITY IN PROBLEM GAMBLING
CONSIDER a British Columbia Government NEWS RELEASE November 30, 2010: In this release, the province’s Solicitor General, whose Ministry both regulates and operates the province’s gambling industry, “commends BCLC for Responsible Gaming” on the basis of its having been awarded “the World Lottery Association’s highest honour recognizing outstanding achievements in the area of responsible gaming.”
[Note: the term “gaming” is a euphemism for gambling, conveying the idea of “fun” rather than psychological addiction which it becomes for many people, from which government (just like the industry as a whole) obviously wants to distance itself].

Discussion
It is notable that the World Lottery Association[5] is itself a classic example of “regulatory capture” as illustrated by its Mission “a member-based organization to advance the interests of State-authorized lotteries” and Vision “for the WLA to be recognized as the global authority on the lottery business, to uphold the highest ethical principles, and to support our members in achieving their vision for their own communities.” Because this is an industry association, such a laudatory News Release from a Solicitor-General is questionable: no such statement would ever come from any United Nations agency with a mandate for health or crime prevention.

Rather than continuing the lead in discussing this particular case further, it is sufficient to draw from statements issued earlier this year by the Institute of Marriage and Family Canada (IMFC):

The Impact of Government Sponsored Gambling on Families and Society
With Nova Scotia and British Columbia (apparently to be followed by Ontario and Quebec) having expanded into online gambling, the Institute of Marriage and Family Canada (IMFC)[6] have called for provincial governments to remove themselves from the gambling business, and for a halt on gambling expansion. The IMFC recently issued a report expressing the essence of the public health view that “provincial governments must get out of the gambling business because insatiable appetites for revenues are creating more addictions and skyrocketing social and economic costs”.[7]

According to IMFC, over $32 per capita is spent annually in Canada to help gambling addicts. The number of problem gamblers has been estimated at 3.2 percent of the population. This estimate would place the annual direct cost of gambling addictions in Canada at around $1 billion. However, the IMFC report argues that an additional 5 to 10 people (spouses, family, co-workers) are affected for each individual with an addiction, making the true impact closer to 12-25 percent of the population. These human impacts will have financial costs to the nation.

Derek Miedema (IMFC’s lead researcher) has noted that problem gamblers often forego basics, such as paying for food, hydro, car payments or mortgages to feed their addictions, with the poor being the most vulnerable. Families with incomes below $20,000 spend more than twice as much on gambling as high-income earners (over $80,000) as a percentage of income, lending "credence that government-run gambling is a tax on the poor," Miedema said. "They've interviewed children where it was clear the mom who is a problem gambler loves slot machines more than her kids. You can't imagine what impact that has on kids - to see Mom spending money on slots when they don't have food to eat," he said. "Or you have one spouse working long hours to bring money in to support the family, and the other spouse spending long hours and money gambling, and it creates conflict. It can lead to family breakdown and crisis."

To quote Miedema further: "It's a conflict of interest… Responsible gambling drops revenues, so it cannot coexist under the same tent..." (as responsibility for health and social welfare and regulation of the gambling industry). Governments should privatize gambling, tax the winnings and use those revenues to fund responsible-gambling initiatives, he said. "If governments are bearing the responsibility of (helping problem gamblers), they have to get out from being the provider of the service." We agree.

CASE STUDY # 2: INADEQUATE STANDARDS OF WATER SAMPLING AND ANALYSIS USED BY RAMP, A GOVERNMENT-INDUSTRY GROUP CHARGED WITH MONITORING THE IMPACT OF OIL SANDS EFFLUENTS SINCE 1997.
The following is an excerpt from a recent report by Andrew Miall, Professor of Geology, University of Toronto, who served as a member of both the Federal Oil Sands Advisory Panel and the Alberta Environmental Monitoring Panel.[8] It speaks for itself in terms of the conflict of interest experienced by a monitoring group representing the industrial and governmental beneficiaries of oil sands development, once contradicted by an independent researcher.

“Just about a year ago, politicians and the general public in the United States were making critical remarks about ‘Canada's dirty oil'. David Schindler, the respected environmental scientist at the University of Alberta published a paper with his colleague Erin Kelley showing that government sponsored environmental monitoring data were inadequate, and James Cameron the Canadian film director (Titanic, Avatar), visited the oil sands to show his concern, and was received respectfully by the Alberta Government. There was widespread alarm at these perceived threats to Canada's reputation and possibly to its export market.

This heightened attention raised public concern to a new level, and both the federal government and the Alberta government realized that action needed to be taken. Several major initiatives were started last Fall, and these are now reaching completion, with whole new sets of analyses and recommendations emerging from government-appointed study groups. A federal Oil Sands Advisory Panel was formed in October, and reported to the then interim Environment Minister John Baird in December. Baird admitted that governments needed to "up their game" with respect to environmental management of the oil sands. He initiated an intensive examination of air and water quality environmental science by his officials at Environment Canada.
The Alberta government appointed a task force in October to examine Schindler's data and to explore the reasons why his results were so different from those resulting from the work of the Regional Aquatic Monitoring Program (RAMP) -- the government-sponsored, industry-funded organization charged with the responsibility for water quality studies since 1997.

The final report of this group of scientists, submitted in March 2011, described the inadequate standards of water sampling and analysis used by RAMP. For example, they had not realized, as had Schindler, that one of the worst sources of air-borne pollution in the surface waters is the winter snowpack. Pollutants from industrial emissions accumulate there all winter long, and are released into the river system rapidly during the spring thaw, at the time when fish are spawning.”

Discussion:
As noted in our February blog, the oil sands industry is perhaps the most visible example of regulatory capture in Canada, where adverse environmental impact is daily more evident. The industry was given disproportionate representation over independent scientists on advisory groups examining the contamination of fresh water sources. The conservative political mentality of federal and provincial governments in this instance, having nothing to do with “conservation”, is an ideology that places commerce above science or public health as a basis for public policy. Given that the RAMP regime held sway since 1997, regulatory capture appears part of their modus operandi.

HOWEVER, it also appears from this encouraging case study that regulatory capture may be reversed in some situations, if a high level of advocacy can be mustered to confront it. In this instance, the advocacy involved independent scientists (willing to put their reputations on the line, against scurrilous lobbying e.g., media outlets aligned with industrial interests), a leading film producer, and the true public media (i.e., media not complicit in the government-industrial conspiracy to subvert what should always have been an independent review, monitoring and evaluation process). Confronted with this force of informed opinion, government and industry clearly backed down.

Whether this will ultimately lead to better practices by government and the oil industry, remains to be seen, keeping in mind that neither the government of Alberta nor that of Canada has yet put in place a comprehensive framework to address oil sands emissions.

REFERENCES:1. Posner R. The Economist - Business School: Research Tools. http://www.economist.com/research/economics/alphabetic.cfm?letter=R)
2. Boehm F. (2010) Regulatory capture revisited – Is there an anticorruption agenda in regulation? Lessons from Colombia and Zambia. IRC Symposium 2010. [Note: This is a shorter and slightly modified version of a chapter prepared for the forthcoming book “International Handbook on the Economics of Corruption. Vol. II”, edited by S. Rose-Ackerman and T. Søreide, Edward Elgar Publishing.]
3. Boehm F. (2007) Boehm F. Regulatory Capture Revisited – Lessons from Economics of Corruption. Working Paper. Anti-Corruption Training & Consulting (ACTC), and Research Center in Political Economy (CIEP, Universidad Externado de Colombia). July 2007.
4. White F. Pacific Health & Development Sciences Inc. Uneasy money: Tobacco philanthropy and conflict of interest in global health. ProCor Global Dialogue. Dec 13, 2010. http://www.procor.org/globaldialogue/globaldialogue_show.htm?doc_id=1435171
5. World Lottery Association http://www.world-lotteries.org/cms/index.php?option=com_content&task=blogcategory&id=13&Itemid=75 Accessed Jan 17, 2011.
6. Institute of Marriage and Family Canada http://www.imfcanada.org/default.aspx?cat=3 Acesessed January 18, 2011.
7. Battagello D. Get out of gambling business, provinces told. Vancouver Sun, Nov 1, 2010 p B03
8. Miall A. Alberta's Oil Sands: A New Regime of Environmental Management? Huffington Post. Politics Canada. November 16, 2011. Posted: 7/26/11 09:40 AM ET http://www.huffingtonpost.ca/andrew-d-miall/alberta-oil-sands_b_906070.html Accessed November 16, 2011.

Envoi: PacificSci will continue to monitor and report on both these situations.

SUPERVISED INJECTION FACILITY WINS LEGAL BATTLE IN CANADA

2011-10-11T09:47:00.000-07:00

PREAMBLE: Harm Reduction for People Addicted to Injection Drug Use
The purpose of supervised injection facilities is to reduce the harms associated with injection drug use. This said, the way forward is decidedly uphill for any society that pits the perceived interests of “law and order” against public health interests. Insite, a supervised injection facility in British Columbia, Canada’s western most province, illustrates this struggle.

When opened in September 2003, Insite was awarded a three-year exemption from Section 56 of the Controlled Drugs and Substances Act, for scientific and research purposes. In September 2006, the Federal Health Minister announced an extension to the facility’s exemption that allowed Insite to operate for another 15 months. In October 2007 the exemption was extended until June 30, 2008. In August 2007, the PHS Community Services Society, the two Insite clients and Vancouver Area Network of Drug Users (VANDU) filed a statement of claim in BC Supreme Court seeking to have the court declare Insite the exclusive jurisdiction of the province and for the federal government not to play any role in its future. In May 2008, the BC Supreme Court struck down the provisions of the Controlled Drugs and Substances Act that deal with possession and trafficking but suspended the declarations of invalidity for one year to allow Parliament to bring the law into compliance with the Constitution, and the Court’s reasons, which ensure Insite a permanent constitutional exemption. The Attorney General of Canada appealed the decision. On January 15, 2010, the BC Court of Appeal dismissed the appeal by the Attorney General of Canada, allowing Insite to continue operations. The Attorney General filed a further appeal with the Supreme Court of Canada. Early in 2011, it was announced that the Supreme Court of Canada would hear the appeal from Attorney General of Canada.

Note: The position of Attorney General is a Cabinet post awarded to an elected member of the governing party; its central role is to advocate and act on the policies and views of the government of the day.

The Outcome: On September 30, 2011, the Supreme Court of Canada ordered the federal Minister of Health to grant an exemption to Vancouver’s supervised injection facility under the Controlled Drugs and Substances Act.

By ruling that addiction-related drug use is a health issue and not simply a criminal justice issue, the Supreme Court decision upheld Canada’s constitutional rights to life, liberty and security of the person and the role of public health interventions of this nature.

Under Canada’s Conservative government, an unremitting effort had been made to close the facility down, despite support from the provincial government of British Columbia. Their objections were based on reasons of political ideology. In stark contrast, the decision made by the Supreme Court, was based on a careful reading of Canada’s Charter of Rights, and scientific evidence that the facility was saving lives, and not promoting the drug culture as the federal Conservatives had claimed. It is relevant to note also that several European countries have similar established facilities in major urban centers, as does Australia.

BACKGROUND: ROLE OF HARM REDUCTION
Supervised Injection as a Public Health Approach to Drug Addiction - the Evidence

Instead of responding to drug addiction primarily as a matter for law enforcement as many nations do, a public health approach to this condition can offer positive alternatives. That superior health and social outcomes can be achieved is illustrated by Insite. Operating under an exemption from provisions under federal legislation, Insite is North America’s first legal supervised site for injection drug use (IDU). Located in a disadvantaged area of Vancouver, Canada, about half of the people who use Insite are marginalized: homeless or living in shelters or have significant mental health issues. Many are older and have been using drugs for many years. Their long-term drug use and chaotic lives have seriously compromised their health. Through Insite, clients develop trusting relationships with health and social workers, making them more likely to pursue withdrawal management (detox) and other addiction services.

Since 2003, Insite has offered a safe place where people may inject drugs and connect with diagnosis and treatment of infection and disease, addiction counselling and treatment, access to housing and community support. The provincial Ministry of Health provides funding, while Vancouver’s public health agency operates the facility in collaboration with community organizations. Insite represents a “harm-reduction” model: it strives to decrease the adverse health, social and economic consequences of drug use without requiring abstinence from drug use. This embodies prevention: reducing the incidence of primary infections through safe injection itself, and reducing HIV and TB transmission by expanding highly active antiretroviral therapy (HAART) coverage among HIV infected persons.

Insite’s front line team includes nurses, counsellors, mental health workers and peer support personnel. The operation has 12 injection booths where clients inject pre-obtained illicit drugs under supervision. It supplies clean injection equipment such as syringes, cookers, filters, water and tourniquets. If an overdose occurs, the team, led by a nurse, is available to intervene immediately. Nurses also provide other health services, like wound care and immunizations. Although there have been 1,418 overdoses at InSite between 2004 and 2010, staff were able to successfully intervene each time. There has never been a fatality at InSite since opening.

Not designed to be a stand-alone facility, Insite is part of a continuum of care for people with addiction, mental illness and HIV/AIDS. It was designed to be accessible to injection drug users who are not well connected to health care services. For people with chronic drug addiction, this is the first step towards possible recovery. When clients are ready to access withdrawal management, they can be immediately accommodated at Onsite, a partner program where people have access to 12 rooms with private bathrooms where they can detox. Mental health workers, counsellors, nurses and doctors work together to help people stabilize and plan their next steps. People can then move up to transitional recovery housing for further stabilization and connection to community support, treatment programs and housing.

Insite is supported by The Urban Health Research Initiative (UHRI), established in 2007 as a program of the British Columbia Centre for Excellence in HIV/AIDS at St Paul’s Hospital in Vancouver, affiliated with the University of British Columbia. The UHRI comprises a network of studies developed to help identify and understand the many factors that affect the health of urban populations, focusing on substance use, infectious diseases, the urban environment and homelessness. For example, UHRI research has produced evidence of reduction of overdose mortality after the opening of Insite: this retrospective population-based study found that fatal overdoses within 500 metres of Insite decreased by 35% after the facility opened compared to a decrease of 9% in the rest of Vancouver.[1] Details of this and other studies are available online.[2]

An initial evaluation focused on the first three years of Insite (2003-6).[3] This revealed that the facility attracted IDUs who were hard to reach through conventional public health programs. Its opening coincided with a significant reduction of public injection drug use and publicly discarded syringes, suggesting that the facility has also contributed to an increase in public order. Among its clientele, Insite significantly reduced the rate of syringe sharing, a practice that is identified as a primary mode of HIV transmission. Individuals who used Insite were also significantly more likely to enter into addiction treatment services. Finally, the opening of Insite was not associated with an increase in levels of drug- dealing or other drug related crime in the area in which the facility is located. The paper concluded that Insite was associated with an array of community and public health benefits and, despite rigorous evaluation, no identified adverse impacts. These findings should be useful to other cities considering opening supervised injecting facilities, and to governments considering regulating their use.

A study of user perspectives revealed that, Of 1,082 Insite users surveyed, 809 (75%) said that they injected more safely as a result of visiting Insite.[4] Of individuals reporting safer injecting, 80% reported rushing less during injecting, 71% reported less outdoor injecting, and 56% reported less unsafe syringe disposal. When asked to list any obstacles or barriers to using Insite, study participants most commonly reported travel time to Insite, the facility’s limited operating hours, and the waiting time to use the facility. When asked in what ways Insite might be improved, the three most common suggestions were longer hours of operation, the addition of a washroom, and reduced wait times. Clearly there is wide demand for Insite’s services.

Insite as a refuge for women who inject drugs has also been studied.[5] Violence is common within open drug scenes, especially for women who spend time in such environments. There is often a sense of danger on the streets, and women who inject illegal drugs live with the constant threat of arrest, robbery, physical abuse, sexual assault, partner violence and even murder. Struggling to avoid these dangers, women are less able to exercise choice in protecting themselves against other threats such as HIV and hepatitis C. In-depth interviews with women have revealed that Insite has provided temporary refuge from the dangers of the street-based drug scene. Women also have learned the correct way to perform an injection. In many cases, the first time a woman uses an injection drug, someone else—usually an older male drug user—injects the drug for her. By learning how to inject themselves, women rely less on men and gain more control over the circumstances of their own drug use. They are then more likely to practise safer habits when injecting, such as using clean needles. This, in turn, reduces their risk of becoming infected with HIV or hepatitis C.

References: 1. Marshall BDL, Milloy MJ, Wood E, Montaner JSG, Kerr T. Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: A retrospective population-based study. Lancet. Published online April 18, 2011. DOI: 10.1016/S0140-6736(10)62353-7.
2. BC Centre for Excellence in HIV/AIDS. http://www.cfenet.ubc.ca/ Accessed September 2, 2011.
3. Wood E, Tyndall MW, Montaner JS, Kerr T. Summary of findings from the evaluation of a pilot medically supervised safer injecting facility. Canadian Medical Association Journal, 2006; 175(11): 1399‑1404.
4. Petrar S, Kerr T, Tyndall MW, Zhang R, Montaner JS, Wood E. Injection drug users’ perceptions regarding use of a medically supervised safer injecting facility. Addictive Behaviors, 2006; 32(5): 1088-1093.
5. Fairbairn N, Small W, Shannon K, Wood E, Kerr T. Seeking refuge from violence in street-based drug
scenes: Women’s experiences in North America’s first supervised injection facility. Social Science & Medicine, 2008; 67(5): 817-823.

Envoi: We at Pacific Health & Development Sciences Inc. congratulate Insite for winning this landmark legal battle. It is to be hoped, now that the Supreme Court of Canada has held sway, that Insite will move forward without the constant threat of political harassment, and thereby more able to focus on its mission of harm reduction, one of the main pillars of a coherent prevention and control strategy for drug abuse. The others pillars are primary prevention, treatment and enforcement.

CASE STUDY: The Costs of 9/11 and the Creation of a National Security Establishment in Canada

2011-09-15T10:55:00.000-07:00

PREAMBLE: Earlier this month the world took note of the 10th anniversary of the terrorist attacks on the World Trade Center, New York, that took place on September 11, 2001. While memorial events honored those killed and injured, their loved ones, the rescue teams, and all who were affected, there is no doubt that the event was felt everywhere as one that destabilized the world. Its impact was felt not only in terms of immediate mass casualties but on the global security environment and psychosocial health of countless millions in virtually all countries. It set in motion geopolitical forces whose overreaching objectives even now are overwhelmingly negative, taking into account the waves of violence that continue to occur in various forms from military interventions, “justified” in relation to 9-11, to stigmatization of peoples through state sanctioned racial, linguistic and religious profiling, and associated injustices.[1]

Canada is an interesting case study of some of the unintended consequences of over-reaction: the Rideau Institute has released a new report that tabulates, for the first time, the number of additional dollars spent on national security since the terrorist attacks of September 11, 2001, as well as observations on the opportunities costs that this has entailed. The Rideau Institute is a non-partisan, non-profit, public-interest research, advocacy and consulting group based in Ottawa.

According to the report, the sum already spent in the post–9/11 build-up could have provided significant benefits to Canada. The nearly 100 billion dollars could have rebuilt transit systems in each of Canada’s ten largest cities, it could have provided a national childcare program, or eliminated all payments for prescription medications. Any of these programs could have been fully implemented if the money spent on a national security establishment since 2001 had been used differently.

We agree with the report’s conclusion that “It is time to re-evaluate whether the dramatic post–9/11 spending on national security could be more appropriately spent over the next ten years.”

Further we are obliged to note that the current global economic crisis includes among its roots vast over-expenditure on military budgets. This too contributes to current social and economic crises in many countries, not least the United States, and the extent to which this impacts all countries is literally unquantifiable.

As the 10th Anniversary of 9-11 will arise only once, and the opportunity so impotant, this issue of PacificSci Global Perspectives presents verbatim, key content from the Rideau report (Note: italics and bolding - our emphasis).

Reference:
1. White F. The case for an epidemiology of terrorism. Int J Epidemiology (2002) 31, 6: 1273-1274. http://ije.oxfordjournals.org/content/31/6/1273.full

The RIDEAU REPORT:
The report, called "The Cost of 9/11: Tracking the Creation of a National Security Establishment", was written by economist David Macdonald, and examines how much federal government spending on Department of National Defence, Foreign Affairs, Public Safety and related agencies has increased over pre–9/11 levels.
“A decade after the attacks of 9/11 it’s time to re-evaluate whether we should continue the high level of national security spending,” says Steven Staples, President of the Rideau Institute. “The government has created a national security establishment in Canada.”

The report’s main findings include the following:
• Since 2000-01, the year before the September 11, 2001 terrorist attacks on the United States, Canada has devoted an additional $92 billion ($69 billion inflation-adjusted) to national security spending over and above the amount it would have spent had budgets remained in line with pre–9/11 levels.
• In this fiscal year, 2011-12, Canada will spend $34 billion on its national security, which is an additional $17 billion ($13 billion inflation-adjusted) more than the amount it would have spent had budgets remained in line with pre–9/11 levels. This is an increase of 105% (60% inflation-adjusted).
• Military expenditures have nearly doubled (+90%) since 9/11 (48% inflation-adjusted), and the Department of National Defence is by far the largest consumer of national security expenditures, at more than $21 billion this fiscal year.
• Security and Public Safety programs have nearly tripled in spending, from $3 billion to almost $9 billion annually ($3.9 billion to $8.7 billion inflation-adjusted), or 186% since 9/11 (123% inflation-adjusted).

Author David Macdonald hopes the report will launch a discussion about future spending. “At a time when the global economy seems to be a greater threat to Canadians’ security than global terrorism, should we spend another $92 billion or more over the coming decade on a national security establishment?” said MacDonald.

Source: Media Release, Rideau Institute, Sept 7, 2011

Conclusion
The following statement appears in the report:

“While other countries have been much harder hit by terrorism, Canada has nonetheless committed significant resources since 9/11 to national security. While some may feel that the $92 billion spent since 2001 has been worth it, others might argue that the money could have been better spent. The real question today is whether or not we should continue this level of expenditure. Should Canada spend another $100 billion or more over the coming decade on a national security establishment? Certainly the political situation today is much different than it was in 2001, and the global economy seems to be a greater threat to Canadians’ security than global terrorism. At the same time, pressures are mounting here in Canada, with high unemployment and large deficits at the federal level. The sum that has been already spent in the post–9/11 build-up could have provided significant benefits here in Canada. Those nearly 100 billion dollars could have easily rebuilt the transit systems in each of Canada’s ten largest cities, it could have provided a national $10-a-day childcare program, or eliminated all payments for prescription medications. Any one of these programs could have been fully implemented if the money spent on a national security establishment since 2001 had been used differently. It is time to re-evaluate whether the dramatic post–9/11 spending on national security could be more appropriately spent over the next ten years.”

Reference: Macdonald D, The Cost of 9/11- Tracking the Creation of a National Security Establishment in Canada. Rideau Institute. Ottawa, September 2011.

REVITALIZING PHILANTHROPY IN INTERNATIONAL DEVELOPMENT:... The Bellagio Initiative

2011-08-22T12:59:00.000-07:00

PREAMBLE: Our focus this month is on a recently announced initiative, jointly led by the Institute of Development Studies (University of Sussex UK), the Resource Alliance Ltd (London UK) and The Rockefeller Foundation (new York City, USA). The “Bellagio Series on the Future of International Development and the Role of the Philanthropic Sector: Promoting Human Well-being in a Challenging Global Context” is designed to explore future relationships between philanthropy and international development including a convening to be held at the Rockefeller Foundation Bellagio Center (Lake Como, Italy), November 2011.

Our view at Pacific Health & Development Sciences Inc. (PacificSci) is that, given the continued lagging of donor countries in meeting their long standing financial commitments to development, particularly the G7 group of nations, the role of private philanthropy has become even more important in filling this gap than ever before.

The following report is abstracted from a press release from the Rockefeller Foundation.

THE BELLAGIO INITATIVE
Bellagio, Italy—As millions of people, multilateral organisations, and philanthropic foundations around the world dedicate time and resources for short and long-term solutions to the urgent food crisis in the Horn of Africa, a global dialogue is launched to foster innovative partnerships focused on the improvement of human well-being.

The Bellagio Initiative plans to bring together “the world’s most respected and innovative thinkers in the fields of philanthropy and international development”. Over the coming months they will consider the key issues likely to shape the future wellbeing of humanity and identify new opportunities for joint action by philanthropic and development organisations.

The initiative comes as philanthropic giving becomes ever-more important in the fight to eradicate poverty. It has more than doubled in size over the past decade, according to OECD figures, standing at over US$22bn in 2009.

Throughout the second half of 2011, the Bellagio Initiative will engage a diverse group of practitioners, opinion leaders, beneficiaries, social entrepreneurs and donors to consider innovative solutions to some of the major challenges affecting poor people today. The Initiative will convene global consultations on topics such as climate change, emerging markets, sustainability, migration and rights which, together with specially commissioned papers and commentary, will feed into debate at a high-level summit being held at the Rockefeller Foundation Bellagio Centre, Italy, in November.

This summit will explore joint solutions to poverty, drawing from the expertise of the invited participants and others from around the globe participating online.

In addition, the Bellagio Initiative will produce:
• A Timeline of Philanthropy, providing insights into the phenomenal growth of private giving.
• A Mapping of the Philanthropic Sector, revealing who the big private donors are today, what they spend their money on and which countries benefit most from their giving.
• A Framework for Action, focusing on building partnerships, across regions and sectors, for the promotion of human wellbeing.

All those interested in the future of development and the role of philanthropy can contribute to the discussion at the following newly launched WEBSITE which contains an interactive BLOG at http://www.bellagioinitiative.org/

Allister McGregor, a research fellow at the Institute of Development Studies (IDS) and Director of the Bellagio Initiative, states: “The process will involve creative thinking, and it will culminate in a concrete action plan that we hope will make a real difference to people’s lives.”

Neelam Makhijani, chief executive of the Resource Alliance (RA), said: "This represents a unique opportunity for those working at the grassroots level, improving wellbeing in their communities, to engage in cross-sector dialogue on today’s most pertinent issues. We anticipate that the innovative solutions to strengthening strategic and sustainable philanthropy discussed throughout the Bellagio Initiative will lead to constructive action in the years to come.”

For more information:
James Georgalakis
email: j.georgalakis@ids.ac.uk
tel: +44 (0)1273 915781
or +44 (0)7713 110579

Summary Notes:
1. The Bellagio Initiative: The Future of Philanthropy and Development in the Pursuit of Human Wellbeing high-level summit will be held at the Rockefeller Bellagio Centre, Italy, from 8-22 November 2011.
2. The Rockefeller Foundation’s mission to promote the wellbeing of people throughout the world has remained unchanged since its founding in 1913.
3. The Institute of Development Studies is a leading global charity for research, teaching and information on international development. It is based at the University of Sussex, Brighton UK.
4. The Resource Alliance is an international charity specialising in building the fundraising capacity of not-for-profit organisations

Source: Press Release, Rockefeller Foundation. August 8, 2011. http://www.rockefellerfoundation.org/news/press-releases/rockefeller-foundation-partners-launch

Envoi: We at PacificSci wish the Bellagio Initiative the best possible success, and trust that its action plan will deliver on its central goal of global poverty alleviation over the coming years.

DISASTER RISK REDUCTION: REVISITING THE HYOGO FRAMEWORK FOR ACTION (2005-15)

2011-07-15T15:05:00.000-07:00

PREAMBLE: Continuing from last month’s theme, linking extreme weather patterns to longer term climate change and impacts on human displacement, this month we focus more broadly on the phenomenon of disasters. Our primary sources for this material are IDMC, the Internal Displacement Monitoring Council of the Norwegian Refugee Centre, and the 2011 United Nations Global Assessment Report on Disaster Risk Reduction, both referenced below [1,3]. Our selections of material are captured verbatim, with only minor editorial amendments e.g., subheadings, paragraph breaks and use of italics, to emphasize aspects that we believe to be of interest to our readers. NOTE: This does not mean that we agree with each and every interpretation, but we do believe that the essence of the material is accurate and in the public interest. Readers who find our selection to be of value of course may visit the original documents as cited.

WHAT IS A DISASTER?
The United Nations has defined a disaster as “a serious disruption of the functioning of a society, causing widespread human, material, or environmental losses which exceed the ability of the affected society to cope using its own resources”[2]. By this definition, only those events where the losses exceed a society’s ability to cope and external aid is required constitute a disaster.

Most classifications of disaster identify two main types: natural and human-made. Natural disasters are subcategorized as sudden impact, slow-onset, and epidemic diseases; human-made disasters include two sub-categories— industrial/technological disasters and complex emergencies:

1. Sudden impact disasters include floods, earthquakes, tidal waves, tropical storms, volcanic eruptions, and landslides. Floods are most frequently associated with sudden migration of large populations and food shortages. Earthquakes cause the greatest number of deaths and overwhelming infrastructural damage.

2. Slow-onset disasters include droughts, famine, environmental degradation, deforestation, pest infestation, and desertification. These disasters are usually the result of adverse weather conditions combined with poor land use.

3. Epidemic diseases such as cholera, measles, dysentery, respiratory infections, malaria, and, increasingly, HIV, generally do not trigger large-scale displacement even during a severe outbreak although they often threaten displaced populations, especially those clustered in overcrowded and unsanitary conditions following a major disaster.

4. Industrial/technological disasters result from a society’s industrial and technological activities that lead to pollution, spillage of hazardous materials, explosions, and fires. Earthquakes, floods as well as human factors such as armed conflict may trigger secondary disasters such as fires, industrial explosions and pollution/contamination.

5. Complex emergencies are usually human-made with multiple contributing factors (e.g., war, internal conflict and natural disaster) and are marked by large-scale displacement, food insecurity, human rights violations and elevated mortality.

DISASTER TRENDS
Over the past two decades, the number of natural and technological disasters has climbed. From 1994 to 1999, reported disasters averaged 459 per year; from 2000 to 2004, this average shot up to 728 disaster events each year, with Asia experiencing the most events. Both hydro-meteorological and geophysical disasters are more common, becoming respectively 68 % and 62% more frequent between 1993 and 2003. This reflects longer-term trends:

• between 1960 and 2003, the number of reported hydro-meteorological disasters has risen x7, while geophysical disasters have risen x5
• despite the increased number of disasters, average annual death toll dropped, from over 75,000 per year (1994-1998) to 59,000 per year (1999-2003); the death toll from natural and technological disasters during 2004 soared to around 250,000, mainly due to the Indian Ocean tsunami on 26 December 2004
• numbers of people affected (people requiring immediate assistance for basic needs, injured or homeless) continued to climb; an average 250 million people per year were affected by disasters between 1994 and 2004. Disasters during 2000-2004 affected one-third more people than during 1995-1999. Over this period, the numbers of people affected by disasters in countries of low development doubled, with Africa showing the greatest increase
• that more people are being affected by disasters reflects a range of factors. Overall numbers of reported disasters are increasing, driven partly by a more variable global climate. Meanwhile, a rapid increase of population in poorer parts of the world – combined with rapid, unplanned development (particularly in urban areas) – is putting more people at risk.

Disaster Risk Reduction: The Hyogo Framework for Action 2005-2015 [1]
The World Conference on Disaster Reduction held in Hyogo, Japan, in January 2005, pledged to reduce the risks facing millions of people who are exposed to natural disasters. The 168 delegations adopted a framework for action calling on States to put DRR at the centre of political agendas and national policies. The “Hyogo Framework for Action: 2005 – 2015” aims to strengthen the capacity of disaster-prone countries to address risk and invest heavily in disaster preparedness.

The conference also adopted a declaration recommending, among other things, that a “culture of disaster prevention and resilience” must be fostered at all levels, and recognised the relationship between disaster reduction, sustainable development and poverty reduction. These non-binding documents were to serve as a “blueprint” to guide nations and individuals to build disaster-resilient communities, calling on the international community to pursue an integrated multi-hazard approach for sustainable development to reduce the incidence and severity of disasters.

Progress in implementing the Hyogo Framework for Action [1]
Disaster-related economic losses are increasing across all regions, critically threatening the economies of low-income countries and even outstripping wealth creation across many of the world’s richer nations.

The 2nd edition of the Global Assessment Report on Disaster Risk Reduction (GAR11) shows that damage to infrastructure continues to rise, especially in low- and middle-income countries where governments are still struggling to address the underlying risk drivers [1,3]. And while the risk of being killed by cyclone and floods in East Asian countries is today markedly lower than it was 20 years ago, the risk of economic loss due to floods has increased by over 160% and to tropical cyclones by 262% since 1980 in the high-income countries of the Organization for Economic Co-operation and Development (OECD). During that time, the absolute value of global GDP exposed to risk tripled from US$525.7 billion in the 1970s to US$1.6 trillion in the 2000s.

Drawing from country examples, the report highlights that since 1982 each Mexican government has absorbed disaster losses of over US$10 billion, which is now rising to almost US$20 billion in the new millennium – a clear illustration of the loss governments have to deal with in the absence of investments in disaster risk management. The GAR11 report makes the direct correlation between disaster-related economic losses and the limited investment in risk management particularly at the local level, with resulting skewed actions. On the one hand, there is good progress in early warning, preparedness and response for example, but on the other hand, countries are struggling with addressing the underlying risk drivers such as unplanned urbanization, ecosystem degradation and vulnerable livelihoods as well as critical issues such as public awareness or gender.

This current economic scenario affects all regions, and governments need to decide how they can tip the balance so that the scale of public investment no longer dwarfs current investment in disaster risk management. They must also decide now on how much risk they are willing to retain and how much they can afford to transfer. Drawing on a large volume of new and enhanced data on both risks and risk management taken from UN, governmental, civil society, scientific and academic sources, as well as from almost 100 governments and regional inter-governmental organizations about their progress in implementing the Hyogo Framework for Action, the report gives an important overview of trends and patterns in disaster risk globally and regionally. This includes analysis of new emerging risks, such as technological break-downs in highly interdependent systems, as experienced in Europe recently after the Iceland volcanic eruptions and in Japan after the Great East Japan Earthquake. The report also provides new information on earthquake mortality, which is increasing exponentially in low- and middle-income countries, and points to drought risk as mainly the product of economic decisions and social choices.

As half of humanity is now living in cities - commitment to resilience is urgently needed particularly in vulnerable groups, localities, and regions. Governments, institutions, communities and individuals need to place disaster risk reduction at the forefront of efforts to preserve and protect the balance of nature, and ensure sustainable development and well-being for generations to come. More action is needed to reduce disaster risk including supporting local governments, building on the role of women as agents of change, involving children and youth in decisions that affect their future, and fully engaging the private sector as leaders in the construction of resilient infrastructure and systems for sustainable development. Well-planned and coordinated recovery will achieve better results at lower cost, and support sustainability and disaster-resilience.

Conclusion: The imperative of disaster risk reduction [3]

Each country has its own unique risk profile or signature with different kinds and proportions of extensive, intensive and emerging risks. To reduce their risks, therefore, governments will need to adopt a mix of prospective, corrective and compensatory risk management strategies together with strategies to manage disasters and anticipate emerging risks.

Countries that have invested in strengthening their disaster management capacities have witnessed a steady decline in mortality risk, at least with respect to weather-related hazards. However, much more needs to be done to reduce economic losses fuelled by the rapid growth of asset exposure. If the objective of the Hyogo Framework for Action – the significant reduction of disaster losses – is to be achieved and if progress is to be made towards the UN’s Millenium Development Goals, a new paradigm in disaster risk reduction must emerge.

Reducing disaster risk is primarily an issue of identifying the political and economic incentives and negotiating the different trade-offs. Unfortunately, without systematically accounting for disaster impacts and comprehensively assessing the full range of risks they face, few countries have been able to find these incentives, let alone to identify the costs, benefits and trade-offs that would inform a balanced and effective portfolio of risk management strategies.

The good news is that a new paradigm is indeed emerging. It is driven by innovations in accounting for disaster losses and assessing risk, in the adaptation of development planning and public investment, and in efforts to strengthen risk governance by those governments that have recognized the importance of investing today for a safer tomorrow. An opportunity to reduce disaster risk is now appearing: learning from, building on, and scaling up these innovations; revealing risk; and redefining development.

References:
1. Norwegian Refugee Centre, Internal Displacement Monitoring Council: Training on the Protection of IDPs. http://www.internal-displacement.org/8025708F004BE3B1/(httpInfoFiles)/7CE8640E88EEB381C125711500479885/$file/Protection%20during%20module%20handout%20natural%20disaster.pdf Accessed July 15, 2011.
2. From: Risks and Rights: the Causes, Consequences and Challenges of Development-Induced Displacement, by W. Courtland Robinson, the Brookings Institution-SAIS Project on Internal Displacement, May 2003, as cited by : Norwegian Refugee Centre, Internal Displacement Monitoring Council: Training on the Protection of IDPs.
3. 2011 United Nations Global Assessment Report on Disaster Risk Reduction (GAR11). http://www.preventionweb.net/english/hyogo/gar/2011/en/home/executive.html Accessed July 15, 2011.

EXTREME WEATHER, CLIMATE CHANGE AND HUMAN DISPLACEMENT

2011-06-15T09:19:00.000-07:00

PREAMBLE: In this issue of Global Perspectives, we report on the essence of the Nansen Conference on Climate Change and Displacement in the 21st Century, convened in Oslo Norway, June 6-7, 2011. As summarized by IISD reporting services (1):

Climate change is the world’s most serious threat to sustainable development, with adverse impacts projected for the environment, human health, food security, economic activity, natural resources and physical infrastructure. While global climate varies naturally, rising concentrations of anthropogenically-produced greenhouse gases in the earth’s atmosphere are leading to changes which, over the short- and long-term, lead to an increase in the severity of droughts, land degradation, desertification, salinization, riverbank and coastal erosion, sea-level rise and the intensity of floods, tropical cyclones and other geophysical events. This in turn will negatively affect crop yields and food production, water supplies, livelihoods and human settlements.

An impact of particular concern is the potential for human displacement and migration (1): it is projected that climate change and the increasing frequency of natural disasters will trigger larger and more complex movements of people, including large-scale displacement of people, both within and across borders, and has the potential to render some people stateless. The implications for human welfare and security, and for strategies for adaptation, DRR, humanitarian aid and protection of displaced people, could be far-reaching.

While environmental migration is not officially recognized, according to the International Organization on Migration (IOM), the number of persons forced to move due to climate change and environmental degradation by 2050 is forecast to vary by a factor of 40 (between 25 million and 1 billion) and largely depends on which climate scenario unfolds. The world’s poorest and most crisis-prone countries will be disproportionately affected, with the level of vulnerability, exposure to risk and capacities of people being among the determinants of this migration (1).

BACKGROUND: This issue of Global Perspectives was stimulated mostly by media reports from the conference, particularly that which appeared on June 8th, 2011 in the Guardian newspaper (2). In “A perfect storm of stupid” Amy Goodman notes that “the news is full of extreme weather headlines – floods, wildfires, droughts, tornadoes – but the US still doesn't get climate change”. We feel obliged to add that nor do a lot of other countries that also should know better. For examples, neither Canada and Australia, both of whom have recently endured unprecedented flooding while the prospect of historically hotter and drier weather now confronts them, have in place serious policies to combat global warming. All three countries mentioned are heavily dependent on fossil fuels, as are many other countries around the world.

Goodman quotes Bill McKibben, founder of the grassroots climate action organisation 350.org, who has been advocating to stop climate change for more than two decades:
"We're making the Earth a more dynamic and violent place … We're trapping more of the sun's energy in this narrow envelope of atmosphere, and that's now expressing itself in many ways. We don't know for sure that any particular tornado comes from climate change. There have always been tornadoes. We do know that we're seeing epic levels of thunderstorm activity, of flooding, of drought, of all the things that climatologists have been warning us about."

Drawing attention to the plight of climate refugees, at the Nansen Conference, the United Nations High Commissioner for Refugees, Antonio Guterres warned of two threats: slow onset disasters like drought and desertification that lead to "a tipping point at which people's lives and livelihoods come under such serious threat that they have no choice but to leave their homes", and "natural disasters [that] uproot large numbers of people in a matter of hours" (2). He noted that most climate refugees will be internally displaced within their home countries. However, Naomi Klein (author of The Shock Doctrine – the Rise of Disaster Capitalism) goes further in a recent warning, "This crisis will be exploited to militarise our societies, to create fortress continents”. (2)

According to Linda Ngyen of PostMedia News (3), Lester Brown, for the Earth Policy Institute, Washington, D.C. stated:

“We know the best way to manage disasters is to prevent them in the first place.” “We should’ve done something about climate change years ago, which makes it all the more urgent now to begin to get serious about cutting carbon emissions,… we don’t know the point of no return… nature sets these… thresholds…”
Brown will deliver this message in Toronto to more than 1,500 participants from around the world at the upcoming 21st World Conference on Disaster Management, June 19-22.

According to Brown, the world is ill-prepared and may not survive an impending colossal natural disaster such as flooding, hurricanes, tornadoes, droughts or record-breaking heat waves that are triggered by climate change. “At some point, these disasters will be unmanageable at the societal level,” said Brown. Furthermore, a number of recent weather-related incidents should act as a warning for the world to take action. He notes that one of the most troubling impending disasters is the current “irreversible” rapid melting of the Greenland ice sheet. If temperatures continue to rise, it is feared the ice sheet will melt completely and raise sea levels by a projected seven metres, which will disrupt rice production in the river deltas in Asia, where 60% of the world’s population lives. (3)

Envoi: It is sadly obvious that it is the poor and the dispossessed who are so far bearing the burden of climate change, not the overpaid CEOs in the fossil fuel and financial industries, nor for that matter the politicians and media sycophants who support them. However, a more positive scenario than the one painted still appears to be largely a matter of choice, even as most of our current political “leaders” remain negligent in not making a serious decision to come to grips with this potentially terminal threat. To quote again from the conference summary (1):

“Responding to climate change has the potential for millions of green jobs, to transform societies to energy systems that are safe, that are stable and that are based on renewable energy and energy efficiency. Moving away from fossil fuels and towards renewable energy is being embraced now by more and more countries, although funding for alternative systems pales in comparison to subsidies for oil, gas and coal.”

References:
1) Summary of the Nansen Conference on Climate Change and Displacement in the 21st Century. 6-7 June 2011. Linkages. IISD Reporting Services. http://www.iisd.ca/ymb/climate/nansen/html/ymbvol189num1e.html
2) Goodman A. A Perfect Storm of Stupid. The Guardian June 8, 2001. http://www.guardian.co.uk/commentisfree/cifamerica/2011/jun/08/climate-change-extreme-weather
3) Nguyen L, World needs to manage weather disasters by preventing climate change: environmentalist. Postmedia News June 12, 2011. http://www.canada.com/news/World+needs+manage+weather+disasters+preventing+climate+change+environmentalist/4933889/story.html#ixzz1PITTzgJ7

CANADIAN OIL SPILL THREATENS INDIGENOUS PEOPLE

2011-05-16T10:10:00.000-07:00

PREAMBLE: On April 29, 2011, there was a major oil spill from a pipeline in Northern Alberta, Canada. This adversely affects the Lubicon Cree people living in the area, as well as wildlife, forests, streams and lakes.

By way of background, in November 2009, citing a report by Amnesty International, Global Perspectives drew attention to the estimated $14 billion in revenue generated on Lubicon lands, even as traditional water sources have been contaminated since the onset of resource exploration. Despite this, Lubicon houses lack running water and plumbing. Within 3 years of the first oil wells the number of people dependent on social assistance increased from 10 to 90%. As a matter of human rights, action is required to alleviate these appalling health conditions. In addition, it is now clear also that a competent and independent health team must be provided to the community to address new concerns about the headaches, nausea and other illness experienced since the April 29 spill.

The main aim of this edition of Global Perspectives is to support Amnesty’s call that both federal and provincial (majority Conservative) governments have a responsibility to ensure that such an assessment is carried out with the results fully available to the community as a whole, and to the general public.

Apparently also, access to the spill site is controlled. We therefore also support Amnesty’s call to ensure that the Lubicon people have full access to the spill site so as to document the spill for themselves.

The main focus of this issue is to capture the content of two current information sources: A. A post by Melina Laboucan-Massimo on the Greenpeace site, dated May 4, 2011; and B. A new Amnesty Factsheet which outlines the situation in more technical detail. Both items are reproduced verbatim below:

A. RESIDENTS, INCLUDING CHILDREN, SICK AFTER LARGE OIL SPILL IN ALBERTA’S PEACE REGION
by Melina Laboucan-Massimo - May 4, 2011 at 13:43 on Greenpeace site (cited below)
Little Buffalo community members, including school children, continue to experience nausea, burning eyes and headaches after one of the largest pipeline spills in Alberta history last Friday by Plains All American leaked nearly 30,000 barrels of oil into Lubicon traditional territory in the Peace Region of Northern Alberta.

Instead of attending an in-person community meeting, the Alberta Energy Resources Conservation Board (ERCB) faxed a one-page fact sheet to Little Buffalo School. The fact sheet indicates that 28,000 barrels of crude oil, or 4,500 cubic metres, has spread into nearby stands of “stagnant water.” The spill, April 29 at 7:30 a.m., occurred only 300 metres from local waterways. The ERCB said the spill has been contained, but community members report that the oil is still leaking into the surrounding forest and bog. The ERCB also said to the community that there is “no threat to public safety as a result of the leak.” Yet people are still getting sick, the local school has been shut down and children ordered to stay at home. An investigation into the incident is underway.

“It has been four days since classes were suspended due to the noxious odours in the air. The children and staff at the school were disorientated, getting headaches and feeling sick to their stomachs,” said Brian Alexander, the principle of Little Buffalo School. “We tried to send the children outside to get fresh air as it seemed worse in the school but when we sent them out they were getting sick as well.

“The company and the ERCB have given us little information in the past five days. What we do know is that the health of our community is at stake,” said Chief Steve Nosky. “Our children cannot attend school until there is a resolution, The ERCB is not being accountable to our community; they did not even show up to our community meeting to inform us of the unsettling situation we are dealing with. The company is failing to provide sufficient information to us so we can ensure that the health and safety of our community is protected.”

The ERCB fact sheet states that air monitors are in place on site and have “detected no hydrocarbon levels above Alberta Ambient Air Quality guidelines.” But this is little consolation for a community that is scared to breathe the air. Veronica Okemow has six children, the youngest one attending the school, and she is very worried. “We are deeply concerned about the health effects on the community,” Okemow said. “It is a scary thing when your children are feeling sick from the air. People are scared to breathe in the fumes.”

Melina Laboucan-Massimo, a member of the Lubicon Cree First Nation and also a Greenpeace climate and energy campaigner said: “The Plains All American spill marks the second pipeline spill in Alberta in just a week, with Kinder Morgan spilling just days before. This is an alarm bell for Alberta residents. If this 45-year-old pipeline were to break elsewhere along its route there would be more safety and health hazards. Communities across Alberta and B.C. are demanding an end to this type of risky development; yet the government refuses to listen. Instead it continues on as business as usual without plans for the cleaner, healthier, sustainable future that is possible.”

Source: Greenpeace Canada. Blogpost by Melina Laboucan-Massimo May 4, 2011. http://www.greenpeace.org/canada/en/Blog/residents-including-children-sick-after-large/blog/34569

B. FACTSHEET - BACKGROUND TO THE PIPELINE SPILL ON TRADITIONAL LUBICON LANDS

1. Pipelines and Lubicon lands
There are more than 2300 kms of oil and gas pipe¬lines through the traditional lands of the Lubicon.

According to an Alberta government study, from 1983 to 1997, there were between one and eight leaks or ruptures per year for every 1000 km of pipeline in the province, depending on the kind of pipeline.

In 2008, when the Province of Alberta approved the last major pipeline across Lubicon land (TransCanada Pipeline’s North Central Corridor project) the Alberta Utility Commission denied the Lubicon the opportu¬nity to present their concerns. The Commission ruled that the Lubicon had not established that the project was harmful to their rights. The pipeline was then built over the community’s objections.

2. Indigenous rights denied
The Lubicon Cree have never entered into a treaty with the Government of Canada. They have not given up their rights to their lands and resources through any other legal agreement. Resolution of the dispute requires a negotiated settlement but there have been no negotiations since 2003.

Large-scale development began on Lubicon territory in 1979. Since then, more than 2600 oil and gas wells have been drilled, along with some in situ oil sands extraction.

The scale of development led to the rapid collapse of the Lubicon hunting and trapping economy. At the same time, the community has been denied basic services that most other communities in Canada take for granted, such as running water and sanitation.

Since the early 1980s, the Lubicon have reported pervasive health problems associated with poverty, environmental degradation and cultural erosion. These problems include high rates of infectious dis¬ease such as tuberculosis; disproportionate numbers of miscarriages, stillbirth and other maternal health concerns; and high youth suicide.

The Alberta government has leased approximately 70 percent of Lubicon territory for future oil, gas and minerals development.

3. Repeatedly condemned by the United Nations
In 1990, the United Human Rights Committee ruled that Canada was violating the International Covenant on Civil and Political Rights by failing to properly protect Lubicon land rights from the impact of re¬source extraction activities.

Since then, the treatment of the Lubicon Cree has been condemned by the UN Human Rights Committee again in 2006 and 2007, the UN Committee on Economic, Social and Cultural Rights in 2006, and by the UN Special Rapporteur on the Right to Ad¬equate Housing in 2008. The UN Committee on the Elimination of Racial Discrimination raised concerns about pipeline development in 2008.

In 2010 the UN Special Rapporteur on the Rights of Indigenous Peoples submitted a detailed report to the UN Human Rights Council in which he said there should be no further development on Lubicon land unless the Lubicon people give their consent.

Source: Amnesty International (Canada). Fact Sheet: Background to the pipeline spill on traditional Lubicon lands http://www.amnesty.ca/files/factsheet_context_of_pipeline_spill.pdf

EPILOGUE: On May 15, 2011, efforts at clean up and to contain the impact were suspended due to numerous uncontained forest fires in the region.

WHY IS CANADA FOLLOWING FAILED U.S. PRISON POLICIES? And What It Could Learn from NAACP's "Misplaced Priorities" Report

2011-04-14T09:09:00.000-07:00

PREAMBLE: Canada’s Conservative government is copying failed US prison policies even as its favoured role model, the US Republican Party, repudiates them: policies that lead the US to having the highest incarceration rates in the world.

In Canada, a $2-billion prison-building bonanza is about to spawn more than two dozen new prisons as Conservative candidates make pre-election announcements on 8 prisons in Alberta, Saskatchewan, Ontario and Quebec, while in Ontario 3 minimum-security prisons will each get 50 new cells, and Quebec’s medium-security Cowansville Institution a 96 cell addition, in addition to new cells at another Quebec prison.[1]

The motivations behind Prime Minister Harper’s prison obsession appear ideologically driven and politically motivated. There is no evidence of increasing crime in Canada (the overall trend is actually down), nor is there good scientific evidence that incarceration is an effective solution to most of the crime that does occur. Nonetheless, Canada is now scrambling to expand the penitentiary system to house a surging inmate population due to legislative changes that were not properly costed in the first instance. According to the Parliamentary Budget Officer, abolition of the 2-for-1 pre-trial custody credit will add 4,000 more inmates over the next 5 years, and other proposals including tightened parole rules and more mandatory minimum sentences will have similar effects. These ill considered legislative measures are creating a level of overcrowding that contravenes international standards on treatment of prisoners. It does nothing for rehabilitation, even as it displaces resources away from measures that could prevent crime in the first place.

It is difficult to imagine that any political party now so far into the throes of an election campaign could reverse its own “tough on crime” platform. However, we live in hope, and for this reason offer the following review of the just released and already much acclaimed NAACP policy report from the USA.

We have taken the liberty of minor paraphrasing, so as to focus on what is most relevant to Canada. However, the full report should be required reading by federal politicians of all stripes. Let us learn from this report which documents how Harperian “tough on crime” policies have already been shown to fail south of the border. QUESTION FOR THE ELECTION: Why copy failure?

References
1. Robb Tripp. Harper Government to announce more prison expansion. iPolitics.ca Postmedia News. January 10, 2010. http://ipolitics.ca/2011/01/10/harper-government-to-announce-more-prison-expansions/
2. NAACP. Misplaced Priorities: Over Incarcerate, Under Educate. April, 2011. http://naacp.3cdn.net/01d6f368edbe135234_bq0m68x5h.pdf Accessed April 13, 2011.

MISPLACED PRIORITIES – The Report
Misplaced Priorities, released by the National Association for the Advancement of Colored People (NAACP), America’s leading Civil Rights group, focuses on the over-funding of prisons and under-funding of education in the USA (reference 2 above). The Report reveals how that nation is wasting financial resources on over-incarceration while depriving schools of resources that would help children in distressed communities - who, without adequate education, are at greatest risk of becoming the next generation of prisoners.

Misplaced Priorities examines research and analysis from leading experts on crime, public safety, and education policy, and analyzes new information gathered at neighborhood level to provide a unique local perspective on the national incarceration crisis in the USA. It was released in the context of a Smart and Safe policy framework that ensures public safety as a civil and human right for all communities, especially for the many communities in crisis. Instead of calling for “lock ‘em' up" practices to solve social problems, Smart and Safe was developed to meet public safety goals by meeting community needs and more effectively addressing violent crimes.

Misplaced Priorities: Over Incarcerate, Under Educate
The report’s key conclusion is that excessive spending on incarceration undermines educational opportunity and public safety in communities. States are thereby urged to lock away fewer prisoners for drug offenses, and to redirect some of the massive amount of money that goes to jails to schools.

The report has been endorsed by some politically unexpected allies: former GOP Speaker of the House Newt Gingrich and Grover Norquist, conservative founder of Americans for Tax Reform. "You have Tea Party activists and NAACP activists pushing the same bills," NAACP president Ben Jealous said during a PBS NewsHour report, referencing the prison reform movement in Texas.

Executive Summary – Selected Extracts
In Misplaced Priorities: Over Incarcerate, Under Educate, NAACP researchers assembled data from leading research organizations and profiled 6 cities to show how escalating investments in incarceration over the past 30 years have undermined educational opportunities. Misplaced Priorities is a call to action for public officials, policymakers, and local NAACP units and members by providing a framework to implement a policy agenda that will financially prioritize investments in education over incarceration, provide equal protection under the law, eliminate sentencing policies responsible for over incarceration, and advance public safety strategies that effectively increase healthy community development.

Misplaced Priorities echoes existing research on the impact excessive prison spending has on education budgets. Over the last two decades, as the criminal justice system came to assume a larger proportion of state discretionary dollars nationwide, state spending on prisons grew at six times the rate of state spending on higher education. In 2009, as the nation plummeted into the deepest recession in 30 years, funding for K–12 and higher education declined; however, in that same year, 33 states spent a larger proportion of their discretionary dollars on prisons than they had the year before.

Other Important Findings from Misplaced Priorities:
1. Over incarceration impacts vulnerable populations and destabilizes communities.
• The majority of the 2.3 million people incarcerated in U.S. prisons and jails are people of color, people with mental health issues and drug addiction, people with low levels of educational attainment, and people with a history of unemployment or underemployment.
[Ed: In Canada, the situation is similar: for example, under current legal frameworks and practices, aboriginals are 7 times more likely to be incarcerated than non-aboriginals. Nothing in the Conservative “tough on crime” platform addresses these inequities.]
• The (USA) nation’s reliance on incarceration to respond to social and behavioral health issues is evidenced by the large numbers of people who are incarcerated for drug offenses. Among people in federal prisons, people in local jails, and young people held in the nation’s detention centers and local secure facilities, more than 500,000 people—nearly a quarter of all those incarcerated—are incarcerated as the result of a drug conviction.
• During the last two decades, as the criminal justice system came to assume a larger proportion of state discretionary dollars, state spending on prisons grew at six times the rate of state spending on higher education.

2. In the six cities profiled in the report, the NAACP research team found stark disparities. Approximately each year:
• In Texas, taxpayers will spend more than $175 million to imprison residents sentenced in 2008 from just 10 of Houston’s 75 neighborhoods (by zip code). These neighborhoods are home to only about 10 percent of the city’s population but account for more than one-third of the state’s $500 million in prison spending.
• In Pennsylvania, taxpayers will spend nearly $290 million to imprison residents sentenced in 2008 from just 11 of Philadelphia’s neighborhoods (by zip code). These neighborhoods are home to just over a quarter of the city’s population but account for more than half of the state’s roughly $500 million in prison spending.
• In New York, taxpayers will spend more than half a billion dollars ($539million) to imprison residents sentenced in 2008 from 24 of New York City’s approximately 200 neighborhoods (by zip code). These areas are home to only about 16 percent of the city’s population but account for nearly half of the state’s $1.1 billion in prison spending.

3. Incarceration impacts educational performance at the local level.
• For three cities—Los Angeles, Philadelphia, and Houston—the research team examined the spatial relationship between “high-incarceration communities” and “low-performing schools” (as measured by mathematics proficiency). By grouping five different ranges of incarceration from the two lowest to the two highest, the authors have shown where high- and low-performing schools tend to be clustered:
◦◦In Los Angeles, 69 of the 90 low-performing schools (67 percent) are in neighborhoods with the highest incarceration rates;
◦◦In Philadelphia, 23 of the 35 low-performing schools (66 percent) are clustered in or very near neighborhoods with the highest rates of incarceration; and
◦◦In Houston, 5 of the 6 low-performing schools (83 percent) are in neighborhoods with the highest rates of incarceration.

Call to Action & Recommendations
Among a growing number of states that are finding better ways to manage their corrections systems, four states—Kansas, Michigan, New Jersey, and New York—have seen significant declines in their prison population as a result of policy changes that seek to re¬verse the trend of overspending on incarceration. However, the relative successes in these states have yet to spread across the nation or result in increased investments in education.

It is critical that all states prioritize education over incarceration. The NAACP calls for the downsizing of prisons and the shifting of financial resources from secure corrections budgets to education budgets. This can be accomplished if states accept the following recommendations:

1. Study the problem: Support federal, state, and local efforts to create a blue-ribbon commission that will conduct a thorough evaluation of the criminal justice system and offer recommendations for reform in a range of areas, including: sentencing policy, rates of incarceration, law enforcement, crime prevention, substance abuse and mental health treatment, corrections, and reentry.
2. Create reinvestment commissions: Support commissions charged with identifying legislative and policy avenues to downsize prison populations and shift savings from prison closures to education budgets.
3. Eliminate disparities in drug laws: Support efforts to eliminate disparities in sentencing between crack and powder cocaine at the state and federal level.
4. Increase earned time: Support reforms that would allow prisoners to earn an earlier release by participating in educational and vocational programming as well as drug and mental health treatment.
5. Support youth violence reduction programs: Support programs and policies to develop a comprehensive plan for implementing evidence-based prevention and intervention strategies for at-risk youth to prevent gang activity and criminal justice involvement.
6. Reform sentencing and drug policies: Eliminate mandatory minimum sentencing for drug offenses that help fuel drug imprisonment.
7. Use diversion for drug-involved individuals: Reform prosecutorial guidelines to divert people to treatment who would otherwise serve a mandatory prison term.
8. Shorten prison terms: Send young offenders who would otherwise receive mandatory sentences to structured programs to help them earn their GED and shave time off their prison sentences.
9. Increase parole release rates: Improve parole boards’ ability to use evidence-based strategies when making decisions to parole prisoners, thus improving parolees’ chances for success and increasing parole approval rates.
10. Reduce revocations of people under community supervision: Develop alternative-to-incarceration programs that will reduce the number of people sent to prison for technical violations.
11. Support reentry and the sealing of records: Support legislation that will close criminal records of certain offenders after they have not committed another crime within a certain number of years.

Reference: NAACP. Misplaced Priorities: Over Incarcerate, Under Educate. April, 2011. http://naacp.3cdn.net/01d6f368edbe135234_bq0m68x5h.pdf Accessed April 13, 2011.

OUR COMMENT
Given this backdrop of serious reexamination of failed US prison policies, and the sane response to the ensuing recommendations not only by Democrats but also Republicans, surely it is time that our own Conservative Party of Canada did some serious homework, and cleaned up its own misguided policies on crime? The current divergence between Canadian and US conservative thinking is odd indeed, especially given their otherwise close ideological bonds and operational ties. If a US Republican Party Epiphany was possible, then all is not lost here in Canada: how about a Conservative Epiphany? Alternatively why not throw the blighters out, or at least consider this as yet one more reason to continue to deny them a majority in parliament?

COMPARATIVE RISKS OF NUCLEAR ENERGY

2011-03-14T22:54:00.000-07:00

PREAMBLE: Need for Objectivity in light of Japan’s Emergency.

The situation of Japan, following the world’s fifth largest recorded earthquake since 1900 and resulting tsunami, is catastrophic. It is possible that tens of thousands may have drowned, swept away with their coastal infrastructure. Hundreds of thousands of people, perhaps millions, have been displaced and lost family members and their livelihoods.

The catastrophe has given rise to a new emergency as a result of damage to several nuclear power plants. There is a risk of reactor meltdown. Containment efforts now underway are in a dynamic phase, with changes in status reported on a continuous basis.

Although there appears to have been comprehensive coverage of Japan’s humanitarian disaster, the global media is also monitoring this sub-story with an intensity that may turn out to be disproportionate to the overall catastrophe, or perhaps not, giving time to both nuclear power proponents and adversaries to vent their opportunistic viewpoints.

Even some mainstream media in Canada (e.g., CTV 10 pm News, March 14 Pacific DST) appeared to hype this aspect of the disaster, seemingly appealing to populist fear about nuclear power, rather than objectively placing this in the perspective of the far greater human impact of a massive earthquake and tsunami. American PBS Newshour at 6pm was more balanced.

In light of these observations, we searched for up to date sources of scientific information on nuclear safety, and selected as a primary reference for this issue a recent Organization for Economic Cooperation and Development (OECD) report Comparing Nuclear Accident Risks with Those from Other Energy Sources [1]. We refer readers to it (reference below) for a policy-relevant technical document, written for intelligent lay readers.

A RATIONAL APPROACH TO ENERGY CHOICES
Some Observations (our italics added for selective emphasis)

As the 2010 OECD report notes, many countries are reconsidering the role of nuclear energy in their energy mix, as a means to alleviate the concerns over climate change, security of energy supply and the price and price volatility of fossil fuels. However, nuclear energy remains a contentious technology in some political circles and in the minds of many members of the public.

One of the common themes of concern is the safety of nuclear power plants. However a rational choice of energy sources should involve an even handed comparison of risks across the various energy chains available.

There is little value in rejecting one source if that which replaces it presents even greater hazards. The purpose of the OECD document therefore, is said to provide energy policy makers with quality data and information that will enable understanding of how accident risks are managed in nuclear plants and also to provide a rational analysis of the relative risks presented by the various major energy chains used for the production of electricity.

The OECD report presented data compiled by the Paul Scherrer Institute (Switzerland) on accidents causing five or more prompt deaths in the energy industry between 1969 and 2000, during which there were 1870 such severe accidents globally resulting in 81,258 deaths. The only severe accident at a nuclear power plant (Chernobyl) killed 31 plant and emergency workers.

Regarding long range health impacts in areas affected by Chernobyl, one set of OECD estimates project up to 33,000 eventual deaths over 70 years, using a particular assumption. However, the assumption is that of a "linear dose response relationship with no threshold" (LNT), and if the same logic is applied to background radiation (normally experienced by all people) … "for the 70 years…the collective dose from natural background would be… 1500 times larger, therefore theoretically causing 1500 times as many fatalities (~50 million) due to exposure to natural background radiation…” Clearly the validity of the LNT model is controversial at best, and some consider it discredited.

With nuclear accidents being so rare, and data on resulting adverse health and safety outcomes therefore being so limited, the OECD analysis also uses an alternative technique called “probabilistic safety analysis”. Applied to a Swiss nuclear power plant, this shows a 1 in 1 million-year probability of an accident serious enough to cause 2000 latent fatalities. Overall, the likelihood of an accident and radiological release at a new nuclear plant is 1600 times lower than it was when the first reactors were built.

Interestingly, latent deaths from accidents in non-nuclear energy sources were not included, although premature deaths caused by particulates from fossil fuel generation are estimated at around 288,000 per year worldwide.
Translation: Consider this in terms of over a million dead every four years from inhaling the emissions of burning fossil fuel!

From such OECD analyses and observations therefore, it is difficult not to recognize and concur with their observation that...
"Overall, accident-related deaths from (nuclear) energy use are much smaller than those that result from the health effects of fossil fuel emissions, but they attract much more media and public attention."

Discussion
The US Academy of Sciences, like scientific advisory bodies of other nations, has recognized for decades that all energy systems entail some health, environmental, or socio-political risks. But there is considerable difference among various energy systems in the magnitude, timing, and nature of these associated risks. It is this difference that allows (and requires) a degree of choice,…with regard to selecting energy alternatives.[2]

However, Japan’s current nuclear power plant emergency is being utilized by at least some of the world media to focus concern on the global expansion of nuclear power as an alternative to fossil fuel. Although there may be some special interests also involved in this position, such concerns have a completely legitimate foundation, especially in Japan, the only country ever to have experienced the human tragedy of nuclear bombing. Nonetheless, issues surrounding the development of nuclear power are highly complex and choices between nuclear and alternative sources should involve relevant comparisons of risks and benefits.

The body of up to date scientific evidence presented in the referenced OECD report indicates that nuclear power may be the safest available option to meet the energy demands of developed and developing nations.[1] By contrast, based on the evidence, fossil fuels are actually the most hazardous, whether through the perspective of human health (short or long term) and environmental impacts e.g., global warming due to greenhouse gas emissions. Hydroelectricity appears safe (notwithstanding that the worst energy-related accident is the Banqiao/Shimantan dam failure in China, when ~30,000 people were killed in 1975), but the reality is that most hydro opportunities are already exploited. The potential of biofuels, wind and tidal power, also appear to have significant trade-offs (e.g., crops for food versus fuel; environmental and aestheic impacts of wind power; fish migration, bird habitat disruption, silt build up with regard to tidal power); however, there may be more potential in these options than currently realized as technologies advance, and this may be true also for solar and geothermal power.

Conclusion
In the end, it is obvious that risks are associated with every source of energy. And of course, in each setting decisions must be made as to the viability of available choices. However, rather than the media exploiting reactor damage associated with Japan’s major earthquake and tsunami, surely it would be more responsible journalism to promote a debate better informed by scientific evidence, taking into account long term biological and environmental sustainability, and placed in the global context.

References:
1. Organization for Economic Cooperation and Development. Comparing Nuclear Accident Risks with Those from Other Energy Sources OECD Nuclear Energy Agency NEA No. 6861. ISBN 978-92-64-99122-4. http://www.oecd-nea.org/ndd/reports/2010/nea6862-comparing-risks.pdf Accessed March 14, 2011.
2. Energy Policy and Strategy. National Center for Atmospheric Research. In: Proceedings of a Conference on Non-Fossil Fuel and Non-Nuclear Fuel Energy Strategies. Volume 4, Issue 5, October 1979, Pages 919-931 Honolulu, Hawaii.

REGULATORY CAPTURE – A CASE STUDY FROM CANADA: Dietary Sodium Regulation

2011-02-14T11:43:00.000-08:00

PREAMBLE:
The theory of regulatory capture was set out by Richard Posner, an economist and lawyer at the University of Chicago, who argued that "Regulation is not about the public interest at all, but is a process, by which interest groups seek to promote their private interest ... Over time, regulatory agencies come to be dominated by the industries regulated."[1] More descriptively he referred to this as "Gamekeeper turns poacher, or at least helps poacher".

The ethical principle stated here has long roots and other important ramifications across many areas of activity. For example, in the field of public health, it is well recognized that "People who work on not only tobacco control, but on chronic disease control, should be critical about receiving money from revenue generated through tobacco sales."[2]

Beyond the tobacco industry, there are numerous examples where the credibility of policy makers, regulators, researchers and practitioners may be undermined on the basis of their association with industry e.g., the energy industry, mining interests, agricultural chemical companies, pharmaceutical firms, beverage industries, arms manufacturers, the gambling industry… and so on. This is why government needs to remain at arms length from such industries, and not be involved simultaneously in regulating and operating such industries. Regulation needs to be based on the best scientific objective evidence; while industrial interests are also relevant, those interests should follow, not lead.

Our blog for this month focuses on regulatory capture recently facilitated by Canada’s Conservative government in favour of the food industry. For the source of this story, we have taken verbatim an article in the Globe and Mail, fully acknowledged, as cited.

1. Posner R. The Economist - Business School: Research Tools. http://www.economist.com/research/economics/alphabetic.cfm?letter=R)
2. White F. Pacific Health & Development Sciences Inc. Uneasy money: Tobacco philanthropy and conflict of interest in global health. ProCor Global Dialogue. Dec 13, 2010. http://www.procor.org/globaldialogue/globaldialogue_show.htm?doc_id=1435171

CASE STUDY
Canada’s federal government has dismantled its sodium reduction task force and is handing responsibility over to a group with heavy ties to the food industry. Clearly this jeopardizes efforts to curb Canada’s excessive sodium consumption. Why is this important? Sodium intake is strongly linked to the risk of hypertension and stroke, which are major preventive causes of morbidity and mortality in our country. The government is also proposing new sodium reduction targets for food that are clearly not tough enough and give too much leeway to manufacturers. For the purpose of this case study, we are quoting the entire report verbatim below, as it appeared in the Globe and Mail:...

According to the report:
“The federal government has dismantled its sodium reduction task force and is handing responsibility over to a group with heavy ties to the food industry, a move many medical and consumer experts fear jeopardizes efforts to curb Canada’s excessive sodium consumption. The government is also proposing new sodium reduction targets for food that experts say are not tough enough and give too much leeway to manufacturers.

The developments have taken many key players in the initiative by surprise and are raising doubts about the government’s commitment to cutting the population’s salt consumption. ‘It’s certainly a cause for concern because there’s lots of work still to be done,’ said Kevin Willis, director of partnerships at the Canadian Stroke Network and a member of the former Sodium Working Group. ‘My major overall fear is that we will make slow progress on reducing the sodium in the food supply.’

The working group was created by the government in 2007 to develop a comprehensive strategy to slash the country’s dangerously high sodium intake, a key risk factor for high blood pressure and subsequent heart problems or stroke. The average Canadian consumes 3,400 milligrams of sodium a day, and nearly 80 per cent comes from processed foods such as soups, sauces, bread and salad dressings.

The group released a report last summer that called for a voluntary program to reduce sodium consumption to 2,300 milligrams a person by 2016. The goal hinges on the ability of the food industry to lower the amount of sodium in its products. The working group had planned to monitor and evaluate the effectiveness of the voluntary program by 2016, and, if necessary, call on the government to create binding regulations.

But Dr. Willis said he and others in the working group were told during a conference call in December their responsibilities would be handed to a group called the Food Regulatory Advisory Committee.

Members of the former working group say that they had expected to be involved in national sodium reduction efforts for years to come and that Health Canada has not told them why responsibility is being transferred. ‘I’m pretty upset by [the disbandment],’ said Norm Campbell, a pre-eminent sodium expert who was a member of the working group and holds the Canadian Research Chair in hypertension prevention and control.

Health Canada spokeswoman Leslie Meerburg said in a statement the department is moving to the next phase of the sodium reduction strategy and ‘will continue to consult’ former members of the working group when necessary.

Many members of the new Food Regulatory Advisory Committee are involved in the food industry, or have little or no experience in matters related to sodium or high blood pressure. For instance, chair Paul Paquin, a professor at Laval University, is also vice-president of the Canadian arm of the International Dairy Federation, which represents the dairy industry. Associate chair Keith Mussar heads the food committee of the Canadian Association of Importers and Exporters and has held management positions with companies such as Kraft-General Foods and Labatt Brewing Co., according to his Health Canada biography.

Bill Jeffery, national coordinator of Ottawa’s Centre for Science in the Public Interest and former Sodium Working Group member, said Health Canada’s moves are ‘indirect evidence they don’t place a high priority’ on sodium reduction. Sodium experts are also criticizing new proposed sodium reduction targets for food. The proposals use a ‘sales weighted average’ approach, which would allow manufacturers to keep higher levels of sodium in some of their products as long as they are reduced in others.

In a consultation document that contains the proposed targets, Health Canada said the approach ‘provides companies the ability to plan their sodium reduction efforts according to which products are most amenable to reformulation or discontinuation. …’
But Dr. Willis said that rationale means Canadians will continue to be exposed to high-sodium food products that could be detrimental to their health. 'Obviously, I would have liked to have seen more aggressive targets,’ he said. ‘We want reduction of sodium in all products across the board.’”

Reference: Weeks C, Galloway G. Ottawa Disbands Sodium Reduction Task Force. The Globe and Mail. Published on-line Thursday, Feb. 03, 2011 8:40PM EST. Also published in hard copy as Doctors Fear for Canadian’s health after Ottawa disbands task force into sodium consumption. The Globe and Mail. A4 February 4, 2011.

Commentary
Under Canada’s Conservative government, there are other examples of regulatory capture, most visible being the oil sands industry where adverse environmental impact is becoming more daily more evident. The industry has been given disproportionate representation over independent scientists, for example on advisory groups now examining the contamination of fresh water sources. Later this year, we will examine this as a case study. The political mentality, having nothing to do with “conservation”, is increasingly revealed as an ideology that places commerce above science or public health as a basis for public policy. Regulatory Capture appears part of their modus operandi.

The VIENNA DECLARATION - Evidence-Based Drug Policy and the Need for a Paradigm Shift

2011-01-15T13:39:00.000-08:00

PREAMBLE Canada’s minority Conservative government is currently considering Bill S-10, the Penalties for Organized Drug Crime Act. This Bill proposes amendments to the Controlled Drugs and Substances Act and other related Acts, including the introduction of mandatory minimum prison sentences.

Unfortunately, this proposed legislation and its provisions demonstrate an approach to policy development that is ideological and not evidence-based and that will likely not meaningfully improve health and safety in Canadian communities.

Research indicates that the approach proposed by Bill S-10 will only serve to create greater health and social harms. Canada needs an evidence-based approach to drug policy that prioritizes public health, not costly incarceration schemes that will take resources away from effective prevention and treatment initiatives.

As health professionals and health systems researchers, our goal is to improve public health and safety. Pacific Health & Development Sciences Inc. recently joined the Canadian Public Health Association, the Urban Health Research Initiative and the BC Centre for Excellence in HIV/AIDS in petitioning the federal government on behalf of doctors, scientists, researchers, and scholars concerned about this proposed legislation, and particularly the potential impact of introducing mandatory minimum sentences.

In support of this position, this issue of PacificSci Global Perspectives draws attention to the Vienna Declaration (www.viennadeclaration.com). The Declaration is a scientific statement seeking to improve community health and safety by calling for the incorporation of evidence based research into the development of illicit drug policies.

The Vienna Declaration was the official declaration of the XVIII International AIDS conference (AIDS 2010) held in Vienna, Austria from July 18-23, 2010.

Since its launch on June 27, 2010, the Vienna Declaration has been endorsed by six Nobel Laureates, thousands of scientific experts, law enforcement leaders, and former heads of state including Fernando Henrique Cardoso (former President of Brazil), Ernesto Zedillo (former President of México) and César Gaviria (former President of Colombia). In Canada, the declaration has been signed by five chief provincial medical health officers, the Canadian Public Health Association, the Health Officers Council of British Columbia, and a growing number of municipalities which deal with these issues first hand. Pacific Health & Development Sciences Inc. also has signed.

The VIENNA DECLARATION
[Note: We took the liberty of adding italics to highlight particular areas of emphasis. The wording is otherwise unchanged.]

In response to the health and social harms of illegal drugs, a large international drug prohibition regime has been developed under the umbrella of the United Nations.(1) Decades of research provide a comprehensive assessment of the impacts of the global “War on Drugs” and, in the wake of the XVIII International AIDS Conference in Vienna, Austria, the international scientific community calls for an acknowledgement of the limits and harms of drug prohibition, and for drug policy reform to remove barriers to effective HIV prevention, treatment and care.
The evidence that law enforcement has failed to prevent the availability of illegal drugs, in communities where there is demand, is now unambiguous.(2),(3) Over the last several decades, national and international drug surveillance systems have demonstrated a general pattern of falling drug prices and increasing drug purity—despite massive investments in drug law enforcement.(4),(5)

Furthermore, there is no evidence that increasing the ferocity of law enforcement meaningfully reduces the prevalence of drug use.(6) The data also clearly demonstrate that the number of countries in which people inject illegal drugs is growing, with women and children becoming increasingly affected.(7) Outside of sub-Saharan Africa, injection drug use accounts for approximately one in three new cases of HIV.(8),(9) In some areas where HIV is spreading most rapidly, such as Eastern Europe and Central Asia, HIV prevalence can be as high as 70% among people who inject drugs, and in some areas more than 80% of all HIV cases are among this group.(10)

In the context of overwhelming evidence that drug law enforcement has failed to achieve its stated objectives, it is important that its harmful consequences be acknowledged and addressed. These consequences include but are not limited to:

• HIV epidemics fuelled by the criminalisation of people who use illicit drugs and by prohibitions on the provision of sterile needles and opioid substitution treatment.(11), (12)
• HIV outbreaks among incarcerated and institutionalised drug users as a result of punitive laws and policies and a lack of HIV prevention services in these settings.(13),(14),(15)
• The undermining of public health systems when law enforcement drives drug users away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.(16),(17),(18)
• A crisis in criminal justice systems as a result of record incarceration rates in a number of nations.(19),(20) This has negatively affected the social functioning of entire communities. While racial disparities in incarceration rates for drug offences are evident in countries all over the world, the impact has been particularly severe in the US, where approximately one in nine African-American males in the age group 20 to 34 is incarcerated on any given day, primarily as a result of drug law enforcement.(21)
• Stigma towards people who use illicit drugs, which reinforces the political popularity of criminalising drug users and undermines HIV prevention and other health promotion efforts.(22),(23)
• Severe human rights violations, including torture, forced labour, inhuman and degrading treatment, and execution of drug offenders in a number of countries.(24),(25)
• A massive illicit market worth an estimated annual value of US$320 billion.(26) These profits remain entirely outside the control of government. They fuel crime, violence and corruption in countless urban communities and have destabilised entire countries, such as Colombia, Mexico and Afghanistan.(27)
• Billions of tax dollars wasted on a “War on Drugs” approach to drug control that does not achieve its stated objectives and, instead, directly or indirectly contributes to the above harms.(28)

Unfortunately, evidence of the failure of drug prohibition to achieve its stated goals, as well as the severe negative consequences of these policies, is often denied by those with vested interests in maintaining the status quo.(29) This has created confusion among the public and has cost countless lives.

Governments and international organisations have ethical and legal obligations to respond to this crisis and must seek to enact alternative evidence-based strategies that can effectively reduce the harms of drugs without creating harms of their own.

We, the undersigned, call on governments and international organisations, including the United Nations, to:

• Undertake a transparent review of the effectiveness of current drug policies.
• Implement and evaluate a science-based public health approach to address the individual and community harms stemming from illicit drug use.
• Decriminalise drug users, scale up evidence-based drug dependence treatment options and abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights.(30)
• Unequivocally endorse and scale up funding for the implementation of the comprehensive package of HIV interventions spelled out in the WHO, UNODC and UNAIDS Target Setting Guide.(31)
• Meaningfully involve members of the affected community in developing, monitoring and implementing services and policies that affect their lives.

Basing drug policies on scientific evidence will not eliminate drug use or the problems stemming from drug injecting. However, reorienting drug policies towards evidence-based approaches that respect, protect and fulfill human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.

References
1. William B McAllister. Drug diplomacy in the twentieth century: an international history. Routledge, New York, 2000. [↩]
2. Reuter P. Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction 2009;104:510-7. [↩]
3. United States Office of National Drug Control Policy. The Price and Purity of Illicit Drugs: 1981 through the Second Quarter of 2003. Executive Office of the President; Washington, DC, 2004. [↩]
4. United States Office of National Drug Control Policy. The Price and Purity of Illicit Drugs: 1981 through the Second Quarter of 2003. Executive Office of the President; Washington, DC, 2004. [↩]
5. World Drug Report 2005. Vienna: United Nations Office on Drugs and Crime; 2005. [↩]
6. Degenhardt L, Chiu W-T, Sampson N, et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: Findings from the WHO World Mental Health Surveys. PLOS Medicine 2008;5:1053-67. [↩]
7. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. Lancet 2008;372:1733-45. [↩]
8. Wolfe D, Malinowska-Sempruch K. Illicit drug policies and the global HIV epidemic: Effects of UN and national government approaches. New York: Open Society Institute; 2004. [↩]
9. 2008 Report on the global AIDS epidemic. The Joint United Nations Programme on HIV/AIDS; Geneva, 2008. [↩]
10. Wolfe D, Malinowska-Sempruch K. Illicit drug policies and the global HIV epidemic: Effects of UN and national government approaches. New York: Open Society Institute; 2004. [↩]
11. Lurie P, Drucker E. An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA. Lancet 1997;349:604. [↩]
12. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS 2002;16:F25. [↩]
13. Taylor A, Goldberg D, Emslie J, et al. Outbreak of HIV infection in a Scottish prison. British Medical Journal 1995;310:289. [↩]
14. Sarang A, Rhodes T, Platt L, et al. Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study. Addiction 2006;101:1787. [↩]
15. Jurgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infectious Disease 2009;9:57-66. [↩]
16. Davis C, Burris S, Metzger D, Becher J, Lynch K. Effects of an intensive street-level police intervention on syringe exchange program utilization: Philadelphia, Pennsylvania. American Journal of Public Health 2005;95:233. [↩]
17. Bluthenthal RN, Kral AH, Lorvick J, Watters JK. Impact of law enforcement on syringe exchange programs: A look at Oakland and San Francisco. Medical Anthropology 1997;18:61. [↩]
18. Rhodes T, Mikhailova L, Sarang A, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Social Science & Medicine 2003;57:39. [↩]
19. Fellner J, Vinck P. Targeting blacks: Drug law enforcement and race in the United States. New York: Human Rights Watch; 2008. [↩]
20. Drucker E. Population impact under New York’s Rockefeller drug laws: An analysis of life years lost. Journal of Urban Health 2002;79:434-44. [↩]
21. Warren J, Gelb A, Horowitz J, Riordan J. One in 100: Behind bars in America 2008. The Pew Center on the States Washington, DC: The Pew Charitable Trusts 2008. [↩]
22. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Social Science & Medicine 2005;61:1026. [↩]
23. Ahern J, Stuber J, Galea S. Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence 2007;88:188. [↩]
24. Elliott R, Csete J, Palepu A, Kerr T. Reason and rights in global drug control policy. Canadian Medical Association Journal 2005;172:655-6. [↩]
25. Edwards G, Babor T, Darke S, et al. Drug trafficking: time to abolish the death penalty. Addiction 2009;104:3. [↩]
26. ref:3 [↩]
27. ref:3 [↩]
28. The National Centre on Addiction and Substance Abuse at Columbia University (2001). Shoveling up: The impact of substance abuse on State budgets. [↩]
29. Wood E, Montaner JS, Kerr T. Illicit drug addiction, infectious disease spread, and the need for an evidence-based response. Lancet Infectious Diseases 2008;8:142-3. [↩]
30. Klag S, O’Callaghan F, Creed P. The use of legal coercion in the treatment of substance abusers: An overview and critical analysis of thirty years of research. Substance Use & Misuse 2005;40:1777. [↩]
31. WHO, UNODC, UNAIDS 2009. Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injection drug users. [↩]

SOURCE: http://www.viennadeclaration.com:80/the-declaration/

INTERNATIONAL & GLOBAL DEVELOPMENT - YEAR IN REVIEW 2010

2010-12-18T15:33:00.000-08:00

PREAMBLE: This is our 4th annual review of topics that we covered over the year. 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 12 blog themes throughout the year.

1. Global Stewardship
This year our pick of flowers for world leadership must go to South Africa for its enormous success in hosting the 2010 FIFA World Cup of Football with evident warmth, safety and competence. This nation, much more than most, symbolizes the universal striving for world peace. So much is evident in its peaceful overthrowing of apartheid, and efforts to seek truth and reconciliation in its internal affairs. A standard is set for others to follow - we can all learn from South Africa. The blog itself celebrates the role of sport in the cause of world peace.

Our pick for the Fertilizer Prize is the recently concluded UN Climate Conference in Mexico. Its not that it was a complete failure, but that it – thanks to countries like our own (Canada) that have been foot-dragging their way forward (some would say backward) in finding ways (not) to meet this challenge – fall far short of what the world community should be doing.

We want to remain positive about the progress in Cancun, but it is very obvious that more fertilizer (this time in a positive sense) is needed. For those interested in examining an authoritative assessment of the outcome, we recommend visiting http://climateprogress.org/2010/12/02/un-climate-summit-in-cancun-mexico/

2. International Development
We make a post-humus gesture of flowers on this occasion to Frank Fenner who passed away at the ripe old age of 95. Fenner, an Australian, was a giant in the field of international and global health, most notably leading the WHO smallpox eradication certification effort, achieved in 1980.

Our choice of Fenner for flowers in this category is doubly relevant, given the poor progress achieved by the world on climate change (see: 2nd paragraph above, under Global Stewardship), as he is recently famous for the following quotation:

“Homo sapiens will become extinct, perhaps within the next 100 years” he told the Australian newspaper in June. “A lot of other animals will too. It’s an irreversible situation. I think it is too late.” Surely we must do more now than simply hope that he is wrong about this.

The Fertilizer award in this category, now in negative sense, goes collectively to the G8 group of countries, for their continuing dismal performance, especially when set against their continued failure to live up to a UN agreement in 1970 that committed rich nations to allocating 0.7% of their GNP for this purpose. Although Sweden, Norway, Luxembourg, Denmark and the Netherlands comfortably meet this target, no G8 nation gets close to it (range = UK 0.52, Italy 0.16). In fact, when compared with other nations monitored by the OECD, the G8 whose brief meetings cost billions of dollars, perform even less well than the rest.
Really now, with a G8 like this, who needs it?

3. Human Rights
We offer flowers to the International Criminal Court (ICC) the permanent tribunal to prosecute individuals for genocide, crimes against humanity, war crimes, and the crime of aggression (although it cannot currently exercise jurisdiction over the crime of aggression). The creation of the ICC is commonly viewed as the most significant reform of international law since 1945, giving teeth to the two bodies of international law that deal with treatment of individuals: human rights and humanitarian law. The court came into being on 1 July 2002 and can only prosecute crimes committed on or after that date. The official seat of the court is in The Hague, Netherlands, but its proceedings may take place anywhere.

We take this opportunity to draw attention to the ICC’s recently launched Outreach Report 2010 and related video, which presents the ICC Outreach Unit’s work from 1 October 2009 to 1 October 2010. The English-language version of this report, the video, and previous annual reports are available on the ICC website.

And we close our awards section this year with a very big pile of very smelly Fertilizer for French President Nicholas Sarkozy for his treatment of the Roma. We agree with the findings of EU Justice Commissioner Viviane Reding, who, in September, likened the recent deportation of almost 1,000 Gypsies to Romania and Bulgaria to Vichy France's treatment of Jews in the second world war. No amount of histrionic pirouetting by the perfidious Sarkozy can allow his decision to stand as other than another blow to France’s patchy record in the annals of human rights.
[http://www.guardian.co.uk/world/2010/sep/14/roma-deportations-france-eu-disgrace].

2010 AS WE RECORDED IT...

January: FOOD 2030 - A NATIONAL REPORT WITH GLOBAL IMPLICATIONS
This issue highlighted the British Government’s new Food Strategy, released January 5th, 2010. It is a timely document, with implications for both the UK and the rest of the world. Here are some of the key findings:

Demand for food and energy will jump 50% by 2030 and for fresh water by 30%, as the world population tops 8.3 billion. Climate change will exacerbate matters unpredictably. The United Nations Environment Programme (UNEP) predicts widespread water shortages across Africa, Europe and Asia by 2025. The amount of fresh water available per head of population will decline sharply during that time. The issue of food and energy security rose high on the political agenda last year during a spike in oil and commodity prices, but then slipped in priority with falling prices. At present, 30-40% of all crops are lost due to pest and disease before they are harvested, and future droughts and increasing salinity will affect growth and produce.

February: CHILD SEXUAL ABUSE BY PRIESTS AND COVER-UP BY CATHOLIC CHURCH
In this issue, we posted verbatim, a CNN report that outlined a decades old cover-up of child sexual abuse at the hands of Catholic priests in Ireland. The actions of Irish priests and the inaction of their church hierarchy represent the height of hypocrisy and flagrant criminal behavior, and bring into disrepute the entire edifice of organized Catholicism.

Although the action now being taken came about as a result of a commission of inquiry put into motion by the nation of Ireland, one then had to ask why this took so long and why no criminal charges have ever been laid.

The world has since learned from a leaked US diplomatic cable that the Irish government was forced to grant Vatican officials immunity from testifying.

[Reference: http://www.guardian.co.uk/world/2010/dec/10/wikileaks-vatican-child-sex-abuse-investigation]

In our view, this clearly does not absolve the state itself from some share of the responsibility and the consequences. Clearly it does not absolve the Vatican, which now appears to have used its enormous influence to engage in obstruction of justice.

March: OVER A BILLION HUNGRY PEOPLE IN THE WORLD - IMF AND FAO REPORT
This issue gives space to the text of an International Monetary Fund report entitled “Hunger on the Rise” developed by David Dawe and Denis Drechsler, and based on The State of Food Insecurity in the World, published by the Food and Agriculture Organization of the United Nations (FAO) in 2009 (full citations provided in the blog).

In summary, world hunger spiked sharply in 2009, significantly worsening an already disappointing trend in global food security since 1996. The combination of food and economic crises has pushed the number of hungry people worldwide to historic levels.

April: DEVELOPMENT ASSISTANCE FOR HEALTH – NEW IMPLICATIONS ABOUT COMPARATIVE AID EFFECTIVENESS OF GOVERNMENT VS NON-GOVERNMENTAL FUNDING
This issue extracted from a report recently distributed by the Pan American Health Organization, PAHO/WHO, referring to work jointly published in the Lancet by Harvard University, and the University of Washington, revealing that investment in the non-government sector may result in more favourable health spending by government than by investing directly in the government sector itself.

Specifically, the study found that debt relief, and development assistance for health (DAH) to government had a negative and significant effect on domestic government spending on health such that for every US$1 of DAH to government, government health expenditures from domestic resources were reduced by $0•43 (p=0) to $1•14. However, debt relief, and development assistance for health DAH to the non-governmental sector had a positive and significant effect on domestic government health spending.

May: MATERNAL MORTALITY – AN INTEGRITY TEST FOR POLITICIANS
For the lead item of this month’s blog, we presented the polite but authoritative view of the Lancet on Canada’s G8 Leadership, emphasizing the inadequacy of Canada’s approach to maternal health as a global public health issue, and followed this by the first good news in many decades, that maternal mortality globally is finally being reduced.

This issue was labeled “an integrity test for politicians” because many of (what Canadian Conservative politicians like to refer to themselves as) the “political class” appear intellectually challenged by scientifically sound evidence regarding the nature of the problem, and what works or doesn’t. It is also an ethical test… whether our ruling party is in it for cheap political gains among their home base, or whether higher reasoning will prevail in the interests of the health of millions of women around the world.

Postscript: Canada’s eventual funding commitments to address maternal and child health (MCH) excluded access to safe abortion, and made only weak provisions for family planning. (This observation was further elaborated in the September blog).

June: THE GAZA FOG OF ASYMMETRICAL VIOLENCE Need for International Inquiry
This issue presented verbatim, a recent report by Amnesty International, outlining the desperate situation of the people of Gaza due to the Israeli blockade. While this seemingly archaic military tactic continues to be excused by Israel as an act of self-defence, independent analyses have revealed this to be capricious in terms of the range of prohibited items, and it is obviously counter-productive to the peace effort although apparently good politics in Israel itself. On the ground however, the situation is nothing less than a humanitarian disaster, especially as over half the Gaza population are children.

July: FOOTBALL WORLD CUP PROMOTES SPORTS AS A FORCE FOR WORLD PEACE
We took the opportunity of the World Cup as a timely moment to take note of initiatives to bond international sport to the cause of world peace. Interestingly, this particular issue turned out to be the most frequently visited issue of our blog since it commenced in 2006!

August: HISTORIC UN RESOLUTION ON WATER AND SANITATION AS HUMAN RIGHTS
On 28th July, the UN General Assembly adopted a resolution calling on States and International Organizations to provide financial resources, build capacity and transfer technology, particularly to developing countries, in scaling up efforts to provide safe, clean, accessible and affordable drinking water and sanitation for all. The Assembly, in a text on the human right to water and sanitation, highlights that 884 million people lack access to safe drinking water and more than 2.6 billion are without access to basic sanitation.

Regretfully a full consensus was not achieved and the resolution was approved with 122 votes in favour, none against and 41 abstentions. We noted disappointment in our own Canadian government, which abstained from the vote, giving no adequate explanation.

September: MILLENNIUM DEVELOPMENT GOALS – OUR UNDERACHIEVING “LEADERSHIP”
Under United Nations auspices, from 20 to 22 September, a Summit on the Millennium Development Goals (MDGs) was held in New York. With five years left until the 2015 deadline to achieve the MDGs, Secretary-General Ban Ki-Moon called on world leaders to accelerate progress towards these goals, the overall aim being to reduce World Poverty.

Despite the dire need of over a billion people living in poverty around the world, it is increasingly clear that few if any of the MDGs will be achieved by the target year of 2015. Clearly there is a crying need for a strong reaffirmation with donor policies and resources to match.

Unfortunately, recent years have witnessed a track record littered with false promises and broken commitments and in some instances shallow comprehension of what is needed to resolve on the major issues underlying world poverty. All too often, “world leaders” have pandered to their domestic political bases rather than genuinely taking on these issues.

October: CANADA LOSING ITS INFLUENCE IN THE WORLD – FOREIGN POLICY FAILURES AND "MAPLE SYRUP DIPLOMACY"
On October 12th, 2010, Canada lost in its bid for a seat on the United Nations Security Council. Despite Canada’s tradition of global leadership, and having gained this seat on every prior bid for it, impoverished Portugal (pop 11.6 million) beat Canada by a virtual landslide. It is no exaggeration to say that, approaching the vote, Canada’s Conservative government revealed a sense of entitlement to the seat, being 7th largest donor of the UN, and hosting this year’s G8 and G20 meetings. Besides Prime Minister Stephen Harper making two appearances before the General Assembly during the run-up (having otherwise mostly ignored the UN), as a bizarre gesture, Maple Syrup gifts were given to representatives of UN members before the vote.

The juxtaposition of these events suggest that a combination of clumsy leadership and diplomatic ineptitude may lie at the root of this foreign policy failure. While Canada’s stated principles do create positive images, when you look closely at how they are interpreted under the Conservative government, the reality reveals a narrow vision that is too often arrogant, ignorant and ignoble.

November: CHINA SHAMES ITSELF - IMPRISONS MAN FOR PUBLIC HEALTH ADVOCACY
In this issue we draw attention to how China is persecuting a man following his advocacy on behalf of public health, especially the health of children.
This is the first time we have given space to the issue of human rights in China. Like many other observers, we are impressed by China’s material advances and recognize its growing importance on the world stage. However, until human rights are elevated in importance, it will fall short of global expectations as a potential world leader.

December: INTERNATIONAL & GLOBAL DEVELOPMENT – YEAR IN REVIEW 2010…
This Issue!

AND A HAPPY NEW YEAR!We extend to readers our best wishes for 2011, 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. PacificSci will continue to offer an independent view.

CHINA SHAMES ITSELF - IMPRISONS MAN FOR PUBLIC HEALTH ADVOCACY

2010-11-14T15:56:00.001-08:00

PREAMBLE
According to the Universal Declaration of Human Rights, public health measures and access to medical care constitute a human right, as stated in Article 25 (1):

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Reference: The Universal Declaration of Human Rights, 1948. http://www.un.org/en/documents/udhr/

In this issue we draw attention to how China is persecuting a man following his advocacy on behalf of public health, especially the health of children.

THE STORY
A Chinese man who organized a support group for fellow parents of children sickened in one of the country's worst food safety scandals was found guilty of inciting social disorder and sentenced on November 10, 2010 to 2 1/2 years in prison.

According to an Associated Press report of that date, “Zhao Lianhai had pushed for greater official accountability and compensation for victims and their families after the 2008 scandal that shocked China. His sentence (is) particularly severe because the case related to a public safety incident that the embarrassed leadership had pledged to tackle in a bid to restore consumer confidence.”

In 2008, six children died and nearly 300,000 were sickened by baby formula tainted with melamine, which can cause kidney stones and kidney failure. The industrial chemical, used in the manufacture of plastics and fertilizer, was added to watered-down milk to increase profits and fool inspectors testing for protein. Several dairy industry figures were prosecuted and punished, including three people sentenced to death. The epidemic of toxic renal disease itself also spread to numerous other countries through the export of dairy products, thus defining this as a threat to the health of children around the world.

However, prosecutors subsequently leveled three charges against Zhao Lianhai: That he organized a gathering of a dozen parents of sick children at a restaurant, held a paper sign in front of a court and factory involved in the scandal as a protest, and gave media interviews in a public place. According to his lawyer, “the court wouldn't receive our evidence and testimony and even wouldn't allow our witnesses to speak”. Thereby found “guilty”, his sentence is being condemned in China by those with the courage to speak up, and around the world.

Amnesty International states: "We are appalled that the authorities have imprisoned a man the Chinese public rightly view as a protector of children, not a criminal," said Catherine Baber, Amnesty’s Asia-Pacific deputy director.

Because Zhao Lianhai was in effect upholding The Universal Declaration of Human Rights 1948, Article 25 (1), cited above, within which the World Health Organization (in part) operates, it is our view that the Director General of WHO, Dr Margaret Chan, should convey concern directly to the relevant Chinese government authorities regarding the persecution of this public health advocate.

China clearly has made a serious mistake in this instance, both in terms of public health and universal human rights. By so doing, it is suppressing the tradition of advocacy on which public health measures around the world owe their origin. Everyone expects better from China today: at this point in its history, when it is emerging as an economic power, not to reverse this punitive legal decision at a higher level will illustrate to the world that China is far from ready to lead in matters of public health, let alone human rights.

Reference: Associated Press November 10, 2010. Chinese father punished for food safety activism. http://www.google.com/hostednews/ap/article/ALeqM5jaj3zrfNc_Bfr6sI5q43ycIBD1pQ?docId=62d9798ca29a4cd4b26fadfdc5206d58

THE ISSUE IN GLOBAL PUBLIC HEALTH PERSPECTIVE
For additional perspective on China’s outmoded, corrupt and vindictive approach to public health advocacy, we extract the following item from Human Rights Watch.

Chinese Corruption Is Hazardous to Your Health - Local officials often prioritize economic gain at the expense of public health. By Joe Amon, Health and Human Rights Director. Published in: Asia Wall Street Journal. May 13, 2010

"At the end of March (2010), a Chinese newspaper reported that four children died and many more fell ill in Shanxi province after receiving vaccines that were not properly stored. The heat-sensitive vaccines had been taken out of air-conditioned rooms because government labels-required to show that the vaccines had been bought from official suppliers at inflated prices-would not adhere to cold vials. The result? An untold number of children are now vulnerable to polio and other diseases.
Instead of investigating the matter, local health officials denied the story as "basically untrue," threatened outraged parents and prevented them from seeking help from higher authorities. The whistleblower, an employee of the Shanxi Center for Disease Control and Prevention, was demoted.

Covering up corruption and official mismanagement in health care is a common response among Chinese officials. That's despite government promises that lessons were learned in 2008, when producers of baby formula discovered it was cheaper to poison infants than sell authentic formula. Thousands of babies became sick from ingesting milk tainted with melamine-an industrial product more commonly used to make plastics.

Like the tainted vaccines, the melamine scandal is a story about local officials sacrificing the health of Chinese citizens to make a profit. Factories that produced the tainted milk were able to slide through the regulation pipeline by partnering with local government officials. And when children became sick, the local government's response was to threaten and arrest parents rather than offer help to the sick children.

This month the Chinese government announced a new set of health-care priorities. These goals include strengthening the rural health insurance system and raising production standards for pharmaceuticals. But the government's health-care wish list ignores the corruption, greed and mismanagement that are key barriers to providing essential medical care. These issues are clearly illustrated in what will likely be the next big scandal, brewing on an even larger scale.

Industrial pollution is causing heavy-metal poisoning in almost every corner of the country. Local government officials in the cities where the poisoning occurs deny and cover up the health consequences rather than providing help for thousands of adults and children suffering from lead poisoning. In one village, local officials prevented a bus carrying parents seeking medical help from reaching the hospital in a nearby town.

Perhaps most troubling are consistent accounts that hospitals have been paid to withhold or give false results for children who are tested for lead poisoning. Many of these children have serious neurological and developmental problems, but treatment and sustained medical care have been practically nonexistent.
Medical care for victims of industrial pollution is guaranteed under the Chinese constitution, yet victims' care has apparently taken a backseat to the protection of local officials with a financial stake in the polluting factories. In Fengxiang, Shaanxi province, where thousands of children have lead poisoning, local officials demonstrated their priorities by allowing the polluting factory to re-open, with no change in its operations.

The Chinese government has laws on the books designed to tackle corruption and protect the health of the Chinese population, but these laws lack an enforcement mechanism to ensure accountability. It's no surprise then that local officials prioritize economic gain at the expense of public health. Penalizing corruption and rewarding local officials for improvements in public health should be recognized as a critical part of legal and health-care reform.

In a globalized world, the effects of cover-ups by corrupt officials are felt far from China's borders. Melamine-tainted dairy products from China were found in countries all over the world. In February, three Chinese babies headed to the U.S. for adoption were rushed to the hospital with extremely high levels of lead in their blood. From fake cough syrup killing children in Panama to toys coated in lead harming children in the U.S., the cases exposed by the free media outside China suggest that we all face hidden risks."

Source: Amon J. Human Rights Watch. Chinese Corruption Is Hazardous to Your Health - Local officials often prioritize economic gain at the expense of public health. Published in: Asia Wall Street Journal. May 13, 2010
http://www.hrw.org/en/news/2010/05/13/chinese-corruption-hazardous-your-health

CANADA LOSING ITS INFLUENCE IN THE WORLD – FOREIGN POLICY FAILURES AND "MAPLE SYRUP DIPLOMACY"

2010-10-14T19:58:00.000-07:00

PREAMBLE On October 12th, 2010, Canada lost in its bid for a seat on the United Nations Security Council. Despite Canada’s tradition of global leadership, and having gained this seat on every prior bid for it, impoverished Portugal (pop 11.6 million) beat Canada by a virtual landslide. It is no exaggeration to say that, approaching the vote, Canada’s Conservative government revealed a sense of entitlement to the seat, being 7th largest donor of the UN, and hosting this year’s G8 and G20 meetings.

Besides Prime Minister Stephen Harper making two appearances before the General Assembly during the run-up (having otherwise mostly ignored the UN), as a bizarre gesture, Maple Syrup gifts were given to representatives of UN members before the vote. The juxtaposition of these events suggest that a combination of clumsy leadership and diplomatic ineptitude (maple syrup diplomacy?) may lie at the root of this foreign policy failure.

In response to the stinging electoral defeat on October 12, 2010, the first such loss sustained by Canada since the UN’s inception in 1946, Canada’s Foreign Affairs Minister Lawrence Cannon declared, "I do not in any way see this as a repudiation of Canada's foreign policy… The principles underlying our foreign policy, such as freedom, democracy, respect for human rights and the rule of law, were the basis of all our decisions." [CBC News October 13, 2010 8:00 PM ET.]

Our take on Cannon’s so very defensive declaration is that these stated principles do create positive images, but when you look closely at how they are interpreted under the Conservative government, the reality reveals a narrow vision that is at once arrogant, ignorant and ignoble. The focus of this issue of PacificSci Global Perspectives therefore is to examine this assertion, uttered by Cannon on behalf of a Canadian government currently led by Prime Minister Stephen Harper.

Historical Note: Canada has been a driving force behind the formation of the Internatinal Criminal Court, the Treaty Banning Landmines, the interdiction of blood diamonds, and an array of other worthy and respected global initiative. This tradition of Canadian leadership at the global level was built on a sound foundation laid by former Prime Minister (Liberal) and 1957 Nobel Peace Laureate Lester B Pearson. As President of the UN General Assembly in 1952, Pearson led UN efforts to mediate a settlement to the Korean War. His work gave rise to Canada’s reputation for fairness and balance, and the effective use of diplomacy rather than militarism. His leadership also gave rise to the (now diminished) Canadian military tradition of peacekeeping. It is out of respect for this legacy that Global Perspectives includes a quotation from Pearson in our masthead.

FOREIGN POLICY MISSTEPS & ABERRATIONS
Our view of this situation is that Canada’s foreign policy under the current Conservative government of Stephen Harper is largely responsible for its inability to win this UN Security Council seat in a contest with Portugal. Consider the following selected actions (often inactions) of the Harper government, which we have organized according to the following headings - global, international and national with global implications:

Global
o Refusal to Sign the Treaty for the Rights of Indigenous Peoples.

o Refusal to Sign the Treaty recognizing Water as a Human Right.

o Undermining the Copenhagen Climate Change Conference.

o Withdrew financial support for UNRWA (UN Relief & Works Agency).

o Shifting Aid Priorities from Africa to Latin America, despite human needs.

o Promoting a maternal health initiative deficient in family planning and excluding access to safe abortion within this (a discredited Bush-era policy).

o Down-grading Canada’s contribution to UN peacekeeping — Canada (almost unbelievably) now ranks 57th, behind Yemen and Uganda.

International
o Uncritical support for Israel e.g., in 2006, the only vote at the UN supporting Israel’s policy on settlements. Note: Most nations support Israel’s right to exist but not illegal settlements.

o A clear lack of anything close to comparable compassion for displaced Palestinians (in occupied territories and refugees).

o Refusing entrance to 4 term British MP George Galloway, alleging that he supported terrorism. Note: this view was recently over-ruled by the Supreme Court of Canada, and lays the government open to criminal proceedings.

o Belated attention to Canada’s relationship with China, first opened up by former Liberal Prime Minister Pierre Trudeau, and now of major economic importance.

National Policy Failures with International & Global Ramifications
o Refusal to release files that may indicate knowledge of torture in Afghanistan, and when forced to do so these were so heavily redacted as to render them virtually useless. They have thereby challenged the freedom of Canadians to know what their government is doing - the freedom of information process.

o Refusal to act even on its own Charter of Rights and Freedoms regarding certain Canadian citizens abroad e.g., Abousfian Abdelrazik stranded in Sudan for 6 years after Canada refused to issue a new passport to him because he was on the UN Security Council terrorist blacklist. Now in Canada thanks to a Supreme Court of Canada ruling in his favour, Abdelrazik accuses the government of blocking his repatriation and helping to arrange his imprisonment.
Note: There is a double standard here (perhaps even overt racism) where others, like Brenda Martin (white, Canadian born) charged with money laundering in Mexico, obtain Ministerial intercession and a prompt flight home.

o Refusal to act on international law regarding Canadian prisoner Omar Khadr (a child soldier no less) in Guantanamo, the only western government not to repatriate its nationals from US military tribunals which lack legitimacy even in the eyes of the US Supreme Court. The Harper regime has in effect redefined human rights by supporting the suspension of habeas corpus and allowing indefinite imprisonment with no charges.

o Canada grossly overspent on this years G8 and G20 meetings. At >$1 billion, 50 times more than other nations spent in previous hosting, the Conservative government placed Toronto at predictably high risk of civil disturbances so as to impress visiting dignitaries. The mass arrest of >900 people, a large majority without charge, was unprecedented in Canadian history, and lowered the esteem of Canada within and outside our borders. To have so wasted so much money at a time of severe economic hardship was a disgraceful use of public funds.

o Discontinuing funding support for Canadian NGOs such as Kairos (an ecumenical organization), the Canadian Arab Foundation (language services to new immigrants) and disrupting the governance of advocacy group Rights and Democracy, out of ideological misrepresentations of humanitarian work.

COMMENT: Any of these actions and inactions (and others like them) can be debated, but taken together they reveal an ideological mindset that represents a deviation from Canada’s more honourable past. It has been described by one of the Harper government’s own government members (on this month’s loss of its use of an airbase in the United Arab Emirates seemingly due to a Canadian failure of good faith) as “hard core, truculent, unreasonable and against Canada’s short and long term interests”. (Globe and Mail, Oct 13th, 2010) Note: Source un-named – presumably to avert political reprisals.

This selection of examples represents on the global stage a pattern that is increasingly evident within Canada itself: a government out of touch with the needs of real people.

Conclusion: For Minister Cannon therefore, and ultimately Prime Minister Harper himself, to contend that the outcome of the UN vote was “not” a repudiation of Canada's foreign policy is actually quite stupid. Obviously we lost our bid for a seat primarily due to our foreign policy. To quote from a viewer’s comment published on the CBC website (http://www.cbc.ca/politics/ October 12):

“The Harper government's inability to actually consider or accept that their foreign policies may affect other countries' opinions of Canada and the Harper government is a perfect illustration of their fundamental flaw: they're absolutely incapable of accepting opinions that are in opposition to their own, and blame everyone else for the consequences of the failures that result from that inability.”

Long before the world passed judgment on us this week, Robert Fowler, Canada’s former top diplomat, said last year: “I’m not sure that Canada deserves to win this election, for we no longer represent the qualities which we Canadians have long insisted that candidates for the council should bring to such responsibilities . . . The world does not need more of the kind of Canada they’ve been getting.”
[Reference: Haroon Siddiqui. Editorial: World passes judgment on Harper’s foreign policy. The Star. Thursday Oct 14, 2010.]

In closing , for those interested in exploring this collapse in Canada's global prestige, we wish to draw attention to the following excellent article by Robert Silver in the Globe and Mail (Its Stephen Harper’s Loss Tuesday, October 12, 2010 3:22PM EDT) which illuminates his hypocrisy on foreign policy: http://www.theglobeandmail.com/news/politics/second-reading/silver-powers/its-stephen-harpers-loss/article1753829/

MILLENNIUM DEVELOPMENT GOALS – OUR UNDERACHIEVING “LEADERSHIP”

2010-09-14T21:37:00.000-07:00

PREAMBLE: Under the auspices of the United Nations, from 20 to 22 September 2010, a Summit on the Millennium Development Goals (MDGs) will be held in New York. With only five years left until the 2015 deadline to achieve the MDGs, UN Secretary-General Ban Ki-Moon has called on world leaders to attend the summit to accelerate progress towards these goals, the overall aim of which is to reduce World Poverty. Visit the Summit website! http://www.un.org/en/mdg/summit2010/

Despite the dire need of over a billion people living in poverty around the world, the initial intentions behind the goals and efforts to showcase what had been achieved, it is increasingly clear that few if any of the MDGs will be achieved by the target year of 2015. Clearly there is a crying need for a strong reaffirmation with donor policies and resources to match.

Unfortunately, recent years have witnessed a track record littered with false promises and broken commitments and in some instances shallow comprehension of what is needed to resolve on the major issues underlying world poverty. All too often, “world leaders” have pandered to their domestic political bases rather than genuinely taking on these issues.

A case in point is Canada’s minority Conservative government whose leader Stephen Harper and fundamentalist colleagues ensured that this country’s commitment to address maternal and child health (MCH) excluded access to safe abortion, and made only weak provisions for the inclusion of family planning within Canadian funding commitments.

In fact, it is estimated that 20 million unsafe abortions occur around the world annually and that 70,000 of these result in the woman's death. Clearly there must be more emphasis on the provision of family planning, and removal of barriers to this practice and also quite obviously access to safe abortion, as a core element of a harm reduction strategy.

Harper’s approach to maternal health is in effect a northern echo of the Bush administration’s “global gag rule” (no funding for MCH unless abortion is specifically excluded), since repudiated by the Obama administration. Ironically, women in Canada long ago won the right to chose, so it is invidious that “Harper’s Canada” discriminates against these practices abroad.

There is still hope that Canada may amend this approach reasonably soon, with the return of a more compassionate philosophy. What is needed is to change the party in power, the only currently viable alternative being the Liberal Party of Canada, with (virtually guaranteed) support from all other parties: only the Conservatives (with little more than 30% public support) are holding up the need for enlightened policy.

We therefore endorse the following statement (Globe and Mail, Feb 2, 2010) made by the leader of that party, and of the official opposition Michael Ignatieff: “We want to make sure that women have access to all the contraceptive methods available to control their fertility because we don’t want to have women dying because of botched procedures, we don’t want to have women dying in misery.” This quote regains resonance in light of the looming MDG Summit next week in New York.

This example of Maternal and Child Health (MDG 5) is but one of the MDGs falling short of sufficient progress for any of them to be achieved by 2015 without an infusion of more genuine commitment by “world leaders” such as Mr Harper.

The eight MDGs are now listed for ease of reference:

Goal 1: Eradicate Extreme Poverty and Hunger
Goal 2: Achieve Universal Primary Education
Goal 3: Promote Gender Equality and Empower Women
Goal 4: Reduce Child Mortality
Goal 5: Improve Maternal Health
Goal 6: Combat HIV/AIDS, Malaria and other diseases.
Goal 7: Ensure Environmental Sustainability
Goal 8: Develop a Global Partnership of Development.

NOTE: This internationally agreed framework of 8 goals and 18 targets is complemented by 48 technical indicators to measure progress towards the Millennium Development Goals. These indicators have since been adopted by a consensus of experts from the United Nations, IMF, OECD and the World Bank.

As our feature for this issue, we present below a September 10, 2010 IPS Inter-Press Service report by Aprille Muscara (full reference below).

GLOBAL DEVELOPMENT BLUEPRINT REVEALS URGENT UPHILL BATTLE
By Aprille Muscara

UNITED NATIONS, Sep 10, 2010 (IPS) - A document outlining the U.N.'s strategy to achieve the Millennium Development Goals (MDGs) by 2015 was finalised Thursday after months of heated negotiations.

The text, titled "Keeping the Promise – United to Achieve the Millennium Development Goals", will be formally signed off on by world leaders at the upcoming MDG summit, which is to be held here from Sep. 20-22.

The final 27-page version, obtained by IPS, differs considerably from the 14-page "zero draft" base text from which member states inserted, amended and removed passages.

However, non-governmental organisations (NGOs) worry that the completed text, called an outcome document, falls short of the substantial action plan it was hoped to be and is instead a rehash of already-made promises and generalised commitments.

"This document lacks the adrenaline boost to accelerate the MDGs, and with only five years left, world leaders coming together in New York must commit to concrete actions that will ensure all people are lifted from poverty in our lifetime," said Emma Seery, a spokesperson for Oxfam International.

Over the years, NGOs and aid groups have advocated for a human rights-based approach to tackling the MDGs. A review of the document at different draft stages reveals the addition of key human rights language, such as inclusion of the right to development, the right to food, the right to health and the right to education.

"We recognize that the respect, promotion and protection of human rights is an integral part of effective work towards achieving the MDGs," the final document states.

But notably absent from the list is access to clean water and sanitation, which the U.N. in a resolution declared a basic human right in late July. The resolution proved to be a divisive one, however, with 41 countries, including the United States, Britain and Canada abstaining from the vote.

Although water and sanitation is not explicitly framed as a human right in the final outcome document, they appear frequently throughout as basic needs essential to achieving the MDGs.

Absent, as well, is the assertion "that gender equality is a basic human right, a fundamental value and an issue of social justice" – a statement that was inserted during the draft process but failed to make it through to the end. The final version reads: "We acknowledge the importance of gender equality and empowerment of women to achieve the MDGs."

Indeed, the evolution of the outcome document, which at one point ballooned to 38 pages, reflects a process of political wrangling over touchy wording. With its numerous additions and amendments, the final product is at once more specific in its language yet still general in its pledges.

Language on peace and security matters appears to have been especially contentious. For instance, references to "armed violence," present in the zero draft, and "transnational crime" and "trafficking in persons," introduced in subsequent drafts, as posing threats to the attainment of the MDGs have been removed entirely in favour of the more benign "conflict."

However, one instance of both "foreign occupation" and "terrorism" – new additions – as hindering achievement of the MDGs appear in the final version, reflecting a political compromise between the Group of 77, a coalition of developing countries, and the European Union and the United States.

In the final stages of ironing out problematic language, the E.U. and U.S. and the G77 were often on opposing sides in typical developed-developing, North-South fashion.

It is common practice, a U.N official told IPS, for the relevant parties to go to extremes in their proposed amendments in anticipation of having to make concessions.

Thus, the G77's insertions that claim the current global financial structure – from trade to aid – is "non- inclusive," "ineffective" and "inadequate" for developing countries were removed in place of more watered down wording stressing the need to further reform international financial systems.

A greater focus on the particular needs of the developing world, rural populations and specific mention of regional efforts by the global South in attaining the MDGs are also additions, reflecting G77 bargaining.

Meanwhile, the importance of parliaments, national ownership in developmental efforts and mutual accountability for commitments made towards achieving the MDGs suggest concessions made to the West.

Among the other numerous differences from the zero draft is an acknowledgement of the impact of the world financial crisis, volatile food and energy prices and humanitarian emergencies in stunting developmental gains. And of the eight goals, the document characterises maternal health, MDG5, as making the slowest progress. [Emphasis Added]

Also added is a litany of references to U.N. conventions, agreements and agencies, which serves to reinforce the commitments and goals made in those forums, but also highlights the world body's role in ensuring the accountability of governments.

To this end, the final document requests a "Special Event" to take place during the 68th session of the general assembly in 2013, two years shy of the deadline, to follow up on efforts made toward achieving the MDGs.

Ultimately, despite its acknowledgement of the uneven advances made thus far, the document reflects the urgent uphill battle left on the path to 2015.

"Progress on other MDGs is fragile and must be sustained to avoid reversal," it states.

Source: Muscara A. Development Blueprint Reveals Urgent Uphill Battle. IPS Inter-Press Service. Geneva Sept 10, 2010. http://www.ipsnews.net/news.asp?idnews=52788

HISTORIC UN RESOLUTION ON WATER AND SANITATION AS HUMAN RIGHTS

2010-08-14T19:12:00.001-07:00

PREAMBLE: On Wednesday, 28th July, the UN General Assembly adopted a resolution calling on States and international organizations to provide financial resources, build capacity and transfer technology, particularly to developing countries, in scaling up efforts to provide safe, clean, accessible and affordable drinking water and sanitation for all. The assembly, in a text on the human right to water and sanitation, highlights that 884 million people lacked access to safe drinking water and more than 2.6 billion were without access to basic sanitation.

Regretfully a full consensus was not achieved and the resolution was approved with 122 votes in favour, none against and 41 abstentions. We are disappointed to note that our own Canadian government, the Conservative regime of Stephen Harper, abstained from the vote, giving no adequate explanation for this.

For the substance of this months blog, we provide below (verbatim) the full text of the speech by the Permanent Representative of the State of Bolivia, delivered July 28, 2010.

UN SPEECH: “The Human Right to Water and Sanitation”

Mr. President,
Allow me to begin the presentation of this Resolution by recalling that human beings are essentially water. Around two thirds of our organism is comprised of water. Some 75% of our brain is made up of water, and water is the principal vehicle for the electrochemical transmissions of our body.

Our blood flows like a network of rivers in our body. Blood helps transport nutrients and energy to our organism. Water also carries from our cells waste products for excretion. Water helps to regulate the temperature of our body.
The loss of 20% of body water can cause death. It is possible to survive for various weeks without food, but it is not possible to survive more than a few days without water. Water is life.

That is why, today, we present this historic resolution for the consideration of the plenary of the General Assembly on behalf of the cosponsoring countries of: Angola, Antigua and Barbuda, Azerbaijan, Bahrain, Bangladesh, Benin, The Plurinational State of Bolivia, Burundi, Central African Republic, Congo, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Eritrea, Fiji, Georgia, Guinea, Haiti, Madagascar, Maldives, Mauritius, Nicaragua, Nigeria, Paraguay, Saint Lucia, Saint Vincent and the Grenadines, Samoa, Saudi Arabia, Serbia, Seychelles, The Solomon Islands, Sri Lanka, Tuvalu, Uruguay, Vanuatu, The Bolivarian Republic of Venezuela, and Yemen.

The right to health was originally recognized by the World Health Organization in 1946. In 1948, the Universal Declaration of Human Rights declared “the right to life,” “the right to education,” and “the right to work,” among others.

In 1966, these were furthered in the International Covenant on Economic, Social and Cultural Rights with the recognition of “the right to social security,” and “the right to an adequate standard of living,” including adequate food, clothing and adequate shelter.

However, the human right to water has continued to fail be fully recognized, despite clear references in various international legal instruments, such as: the Convention on the Elimination of All forms of Racial Discrimination, the Convention on the Elimination of All Forms of Discrimination Against Women, the Convention on the Rights of the Child, and the Convention on the Rights of Persons with Disabilities.

This is why we, the cosponsors, present this resolution in order that we now recognize the human right to water and sanitation, at a time when illness caused by lack of drinking water and sanitation causes more deaths than does war.
Every year, 3.5 million people die of waterborne illness.

Diarrhea is the second largest cause of death among children under five. Lack of access to potable water kills more children than AIDS, malaria and smallpox combined.
Worldwide, approximately 1 in 8 people lack potable water.

In just one day, more than 200 million hours of women’s time is consumed by collecting and transporting water for domestic use.

The situation of lack of sanitation is far worse, for it affects 2.6 billion people, or 40% of the global population.

According to the report on sanitation by the Independent expert,
“Sanitation, more than many other human rights issue, evokes the concept of human dignity; consider the vulnerability and shame that so many people experience every day when, again, they are forced to defecate in the open, in a bucket or a plastic bag. It is the indignity of this situation that causes the embarrassment.”

The vast majority of illnesses around the world are caused by fecal matter. It is estimated that sanitation could reduce child death due to diarrhea by more than one third.

On any given day, half of the world’s hospital beds are occupied by patients suffering from illnesses associated with lack of access to safe water and lack of sanitation.

Mr. President,
Human rights were not born as fully developed concepts, but are built on reality and experience. For example, the human rights to education and work included in the Universal Declaration on Human Rights were constructed and specified over time, with the International Covenant on Economic, Social and Cultural Rights and other international legal instruments such as the Declaration on the Rights of Indigenous Peoples. The same will occur with the human right to water and sanitation.

That is why we emphasize and encourage in the third operative paragraph of this resolution that the independent expert continue working on all aspects of her mandate, and present to the General Assembly “the principal challenges related to the realization of the human right to safe and clean drinking water and sanitation and their impact on the achievement of Millennium Development Goals.”

The Summit on the Millennium Development Goals is approaching, and it is necessary to give a clear signal to the world that drinking water and sanitation are a human right, and that we will do everything possible to reach this goal, which we have only 5 more years to achieve.

That is why we are convinced of the importance of the second operative paragraph of this resolution, which “Calls upon States and international organizations to provide financial resources, capacity‐building and technology transfer, through international assistance and cooperation, in particular to developing countries, in order to scale up efforts to provide safe, clean, accessible and affordable drinking water and sanitation for all.”

All resolutions contain a passage that we can point to as the heart of the matter, and the heart of this resolution is in its first operative paragraph. Throughout many informal consultations, we have striven to accommodate the different concerns of the Member States, leaving aside issues that do not pertain to this resolution and always seeking balance, but without loosing the essence of the resolution.
The right to drinking water and sanitation is a human right that is essential for the full enjoyment of life.

Drinking water and sanitation are not only elements or principal components of other rights such as “the right to an adequate standard of living.” The right to drinking water and sanitation are independent rights that should be recognized as such. It is not sufficient to urge States to comply with their human rights obligations relative to access to drinking water and sanitation. Instead, it is necessary to call on states to promote and protect the human right to drinking water and sanitation.

Mr. President,
In our effort to seek transparency and understanding without losing perspective on the essence of this resolution, in the name of the cosponsors we would like to propose an oral amendment to the first operative paragraph of the resolution that would replace the word “declares” with the word “recognizes.”

Mr. President,
Before moving to the consideration of this resolution, I would like to ask all delegations to bear in mind the fact that, according to the 2009 report of the World Health Organization and UNICEF entitled “Diarrhoea: Why children are still dying and what can be done,” 24,000 children die in developing countries every day from preventable causes like diarrhea contracted from unclean water. That is one child death every 3.5 seconds.

One, two, three…
As my people say, “Now is the time.”

Thank you very much.

Source: Speech delivered by Ambassador Pablo Solón of the Plurinational State of Bolivia before the General Assembly of the United Nations on 28 July, 2010. “The Human Right to Water and Sanitation”. http://pwccc.wordpress.com/2010/07/28/speech-the-human-right-to-water-and-sanitation/

FOOTBALL WORLD CUP PROMOTES SPORTS AS A FORCE FOR WORLD PEACE

2010-07-11T18:08:00.000-07:00

PREAMBLE: We take the opportunity of the World Cup concluding today, to issue our blog a few days earlier than usual. This is a timely moment to take note of initiatives to bond international sport to the cause of world peace.

Congratulations are due to South Africa for its success in hosting this year’s event with evident warmth, safety and competence; this nation, more than most, symbolizes the universal striving for world peace, in its peaceful overthrowing of apartheid, and efforts to seek truth and reconciliation in its internal affairs. A standard is set for others to follow - we can all learn from South Africa.

We congratulate Spain as winners, and all other countries who competed, even those not selected to play in south Africa. We are sufficiently old-fashioned to think that participation lies at the heart of all sport; after all, without participants, there will be no ultimate "winner". With participation, at a more fundamental level, everyone is a "winner".

Our selection of this topic is not a new idea, but reflects a growing reality over many years that sports can be a force for international relations. Historically, this force has been used in various ways, from negative to positive. However, taking the high road, we note the following development in 2006:

In July 2006, the European Commission and the Fédération Internationale de Football Associations (FIFA) signed a Memorandum of Understanding (MOU) to promote football as a factor for development in Africa, in the Caribbean and in Pacific countries. According to the Commission, around 50 million people across Africa play football regularly and for many of these people, football is "an act of survival" and a means of rebuilding confidence and promoting tolerance and solidarity. It believes that linking football with development programmes can help make a difference to the lives of millions of people.

The Commission-FIFA MoU covers areas ranging from development cooperation and humanitarian aid to racism, post-conflict reconstruction, nation-building, health and education.

This background is extracted from the webpage cited below for the article which we showcase as this months blog topic.

SPORT FOR DEVELOPMENT PLAN ADOPTED
Ahead of the football World Cup in South Africa,... the United Nations (UN) together with the International Olympic Committee (IOC)... adopted a series of recommendations on harnessing the power of sport as a tool for development. The 19 recommendations cover humanitarian assistance, peace-building, education, gender equality, the environment and the fight against HIV/AIDS. They were adopted on 21-22 May during the first joint UN-IOC forum, entitled 'The Importance of Partnership', in Lausanne. The participants, including NGOs and academic experts, stressed the need to embed sport in national development policies to leverage its instrumental potential in the field. The forum also underlined the need to avoid creating parallel structures between the various different players and duplicating activities.

2010 FIFA World Cup
In the forum, the UN stressed that this year's football World Cup, which kicks off in South Africa on Friday (11 June), presents the country and the rest of the continent with a unique opportunity to build peace and development. "The World Cup in South Africa is a unique occasion to transform the African people's pride and enthusiasm into a positive dynamic of solidarity, tolerance and development," said Wilfried Lemke, special adviser to the UN secretary-general on sport for development and peace. A number of UN funds, programmes and specialized agencies are making use of the World Cup as a platform for outreach and collaboration to leverage the power of the event. Last October, the UN General Assembly adopted a resolution urging the international community to harness the World Cup for the development of the whole African continent.

Action plan on development through football
Earlier this spring, representatives of 63 development NGOs, football clubs, players' unions, sport organisations, academic institutions and governmental bodies gathered at an international conference on “Development through Football” in Vienna to adopt an action plan on football for development. The action plan calls for football governing bodies to support initiatives in the area of development through sport, especially at grass-roots level, and assign at least 0.7% of total revenue to social responsibility initiatives, for example. It further suggests the establishment of a strategy to raise media awareness of development through sport and using football as a tool for preventing violence, gender inequality, ethnic tensions and war.

Source: United Nations Office on Sport for Development and Peace (UNOSDP) http://www.euractiv.com/en/sports/sport-development-plan-adopted-ahead-world-cup-news-494939 07 June 2010

RECOMMENDATIONS
1. To recognise the honour accorded to the IOC through the
granting of UN Permanent Observer Status and the historic
milestone which this represents in giving an authoritative voice
to the sporting movement within the international community,
with the power to act as an advocate for the role of sport in the
service of peace and development.

2. To resolve to maximise the opportunity afforded by the granting of Observer Status to build on the IOC’s relationship with the UN and to sustain and complement the UN’s efforts to shape a peaceful future. Furthermore, mindful of the need for close cooperation with government authorities, to leverage this unique and seminal opportunity to interface with and influence national governments in the formulation of their development policies and to entrench sport within those policies by emphasizing its enormous power as an indispensable tool for peace and development.

3. To emphasise that it is incumbent on the Olympic Movement to
fulfil its collective responsibility and moral duty, in accordance
with the principles and values of Olympism, by identifying and
implementing best practice in the use of sport to promote
economic and social development; and further, to recognise the
need to think beyond the competitive character of sport to
maximise its contribution to development.

4. Mindful of the fact that the IOC will need to be proactive in its
relationship with the UN, to prioritise a dialogue with the UN on
the mainstreaming and embedding of sport within UN
programmes for humanitarian development and to seek the
UN’s active support and specific proposals with regard to this
undertaking.

5. To acknowledge and harness the power of partnership in sport
at all levels, from local, regional, international and sectoral, in
order to translate the vision of a peaceful, healthy society into
reality; and to recognise the need for a collaborative, sharing,
networking and learning approach which engages all key
stakeholders including the private sector, civil society and the
military. Furthermore, to facilitate all such partnerships by
building new alliances, defining new areas of co-operation,
creating fresh synergies and identifying the organisations and
institutions with whom the Olympic Movement can most
effectively collaborate to further our common goals, while at the
same time mindful of the need for a co-ordinated approach,
which complements ongoing initiatives and avoids the creation
of parallel structures and the unnecessary duplication and
overlap of activities.

6. To develop the IOC’s working relationships with the Other
Entities who have Permanent Observer Status at the UN in
order to realise our common goals, in particular the Red Cross
Movement, given their similar structures and shared objectives;
and to encourage the national affiliates of the International
Federation of the Red Cross and Red Crescent Societies and
the NOCs to work together, particularly in areas where they
have joint programming activities, such as in the field of
HIV/AIDs, disaster prevention and disaster response.

7. To underline the commitment of the Olympic Movement to
continue its efforts to combat HIV/AIDs, including the
dissemination of the ‘Tool Kit for the Sports Community:
Together for HIV and AIDS Prevention’, as widely as possible.

8. To recognise the contribution that the IOC has made in support
of the UN Millennium Development Goals to date and to stress,
on the occasion of this UN-IOC Forum, the Olympic Family’s
continuing commitment to engage with all of the MDGs and to
accelerate efforts to facilitate their delivery specifically through
the medium of sport and education by the 2015 target date,
including appropriate IOC participation in the UN Summit on
MDGs in September 2010.

9. To recognise the responsibility of the sporting movement to
strive for environmental protection and sustainability at all times:
and to commit the Olympic Family to the promotion of
environmental sustainability in all aspects of its work.

10. To acknowledge the unique contribution of the forthcoming
Youth Olympic Games in the promotion of Olympic values to
young people, including peace and development, and to
recognise the importance of outreach to young people in
tackling social challenges, by taking steps to connect with them
effectively, making full use of digital communications, the
internet and social media. Furthermore, in recognition of the
fact that the education system is the most comprehensive way
of reaching young people, to work with all relevant partners and
stakeholders, in particular national and local government
authorities, to ensure that the promotion of participation in sport
and physical activities is included in school curricula worldwide
in view of the contribution of sport to health, wellbeing and
education.

11. To commend the achievements of the International Olympic
Truce Foundation in its endeavour to encourage the study of
world peace and the creation of progress in its pursuits; and in
addition, the achievements of the World Taekwondo Federation
Sport Peace Corps in its successful outreach to young people
and its aims of building a better and more peaceful world; and
to advocate the consideration of its global expansion, in close
cooperation with key stakeholders, including the IOC, the UN,
national and international sports federations and NOCs, firmly
believing that together, we have the ability to promote global
peace and harmony through sport.

12. Mindful of the priority given to gender equity and the
empowerment of women in the UN Millennium Development
Goals, to affirm the importance of sport as a vehicle for the
achievement of gender equality and to continue to strive for
equal opportunities for women in and through sport, both at
grass roots levels and in leadership positions, while avoiding
generalised, one-size-fits-all approaches. Furthermore, to give
full recognition to the high-quality female role models in sport
and to increase the target number of women in leadership
positions and decision-making structures within the Olympic
Family and in the wider sporting world.

13. To ensure a fully inclusive approach, additionally by making
it a priority to include girls and women with disabilities in sport
for development and peace initiatives.

14. To resolve to promote more health-enhancing initiatives, in
particular to tailor and develop activities designed to reach
inactive groups and to forge new alliances with all stakeholders,
including public health authorities and the WHO for the purpose
of promoting healthy lifestyles and addressing the challenges of
obesity, poor nutrition and ill health.

15. To recognise that while sport alone cannot prevent the evils
of society and solve the world’s political socio-economic
problems, it can contribute to a climate of peace and to the
making of improved life for its citizens. That being the case, to
reflect on how to implement the UN Secretary-General’s
request for the IOC to consider organising more activities on the
ground in conflict or post-conflict situations and to identify
appropriate partners in this endeavour, both with UN agencies
and elsewhere, while remaining humble and realistic about the
contribution that the IOC and sport can make to peace-making,
peace-building and peace consolidation efforts.

16. To consider the creation of a web-based informationsharing
network for sport in peace and development, through
which information, expertise and know-how on local, national
and regional initiatives, case studies, research, best practice
and impact measurement and evaluation of projects can be
shared by all members of the Olympic Family.

17. To explore further the vast potential of ‘healing through
sport’, both in post-conflict situations and in equipping
communities to cope with the profound trauma caused by
natural disasters, recognising the need to customize sports
interventions according to the situation on the ground and the
need for collaborative efforts with established local community
development networks including coaches and volunteers, as
well as with UN agencies and NGOs, to build resilience and
create durable, sustainable change within devastated
communities.

18. To recognise the enormous contribution of volunteers to
efforts to advance peace and development through sport and to
encourage the IOC and the Olympic Family to participate in the
celebrations during 2011 to mark the 10th anniversary of the
International Year of Volunteers.

19. To recommend the holding of further UN-IOC Forums and
the continuation of the Working Party of the International Forum
on Sport for Peace and Development established by the
President of the IOC, whose remit would include the provision
of full assistance with all aspects of the preparation of the
second International Forum on Sport for Peace and
Development as well as a comprehensive review of the
outcome of the 2010 UN-IOC Forum.

Source: United Nations Office on Sport for Development and Peace (UNOSDP). UN-IOC FORUM: THE IMPORTANCE OF PARTNERSHIP Lausanne 21st-22nd May 2010. http://www.olympic.org/Documents/Development_through_Sport/Recommendations_UN-IOC%20Forum.pdf

THE GAZA FOG OF ASYMMETRICAL VIOLENCE Need for International Inquiry

2010-06-15T20:05:00.000-07:00

PREAMBLE: For this issue we present verbatim, a recent report by Amnesty International which outlines the desperate situation of the people of Gaza due to the Israeli blockade. While this seemingly archaic military tactic continues to be excused by Israel as an act of self-defence, independent analyses have revealed this to be capricious in terms of the range of prohibited items, and it is obviously counter-productive to the peace effort although apparently good politics in Israel itself. On the ground however, the situation is nothing less than a humanitarian disaster, especially as over half the Gaza population are children.

Regarding the boarding of a relief ship on which 9 relief workers were killed by Israeli military, while it is obvious that this must be subjected to an internal inquiry, it is doubtful that this will prove satisfactory in the eyes of world opinion. An international inquiry appears to be in order, as proposed by the United Nations and many countries which have voiced criticisms of Israel's blockade.

We also note that the Harper government of Canada has aligned itself so completely with the Israeli position that it appears to have lost the capacity for impartial analysis. The presence on the Israeli tribunal of a former Canadian military judge advocate (one of only two international observors) will surely be tainted by this, at least as a matter of perception. For a June 14 BBC article on the tribunal membership, see: http://news.bbc.co.uk/2/hi/world/middle_east/10309872.stm

In the present politically disingenuous fog of asymmetrical violence, organizations such as Amnesty Internatinal play an indispensable role in bringing an independent view to bear on this example of massive unresolved human rights abuse.

AMNESTY INTERNATIONAL REPORT:
Suffocating Gaza - the Israeli blockade's effects on Palestinians

Israel's military blockade of Gaza has left more than 1.4 million Palestinian men, women and children trapped in the Gaza Strip, an area of land just 40 kilometres long and 9.5 kilometres wide.

Mass unemployment, extreme poverty and food price rises caused by shortages have left four in five Gazans dependent on humanitarian aid. As a form of collective punishment, Israel’s continuing blockade of Gaza is a flagrant violation of international law.

The situation in Gaza has been made worse by the Egyptian government’s general closure of the Rafah crossing, although this was opened following the deaths of activists on the Gaza flotilla.

However, it is Israel, as the occupying power, that bears the foremost responsibility for ensuring the welfare of the inhabitants of Gaza.

Closed crossings
Since the blockade of Gaza was imposed in June 2007, none of the Israeli-controlled crossings between Gaza and Israel has been open in a regular or consistent way, and relatively little aid is getting through.

The one other land crossing at Rafah, on the border between Gaza and Egypt, is kept shut most of the time. The closures prevent the movement of Palestinians into and out of Gaza in all but a handful of cases, generally in exceptional humanitarian cases.

Basic goods
The blockade prohibits most exports and restricts the entry of basic goods, including food and fuel. Much of the available food is provided by the UN and other aid agencies, or smuggled in through tunnels running under the Egypt-Gaza border and then sold on at exorbitantly high prices to Gaza’s beleaguered residents.

The situation has been made worse by the Egyptian government’s construction of a steel wall along the border at Rafah to disrupt the cross-border smuggling that has become Gaza’s lifeline, as well as the bombing of tunnels by the Israeli airforce.

Economic collapse
Rather than targeting armed groups, the blockade mainly hits the most vulnerable, such as children (who make up more than half of the population in Gaza), the elderly, the sick and the Gaza Strip's large refugee population.

According to the United Nations Relief and Works Agency, the number of refugees living in abject poverty in the Gaza Strip has tripled since the blockade began. These families lack the means to purchase even the most basic items, including soap, school materials and clean drinking water. According to the UN, more than 60 per cent of households are currently "food insecure".

Lack of facilities
There are worsening problems with the supply of electricity in the Gaza Strip, with many residents enduring 8-12 hours of power cuts each day. There are also recurrent shortages of cooking gas, requiring the implementation of a rationing scheme in which hospitals and bakeries are prioritized.

Aid blocked
While Israel allows some humanitarian supplies from international aid agencies into Gaza, these are strictly limited and frequently delayed. UN agencies have said that additional storage and transportation costs incurred from delays due to the blockade totalled around $5 million in 2009.

Health
Gaza's health sector has been plagued by shortages in equipment and medical supplies during the blockade.

Following the Israeli closure of crossings, people with medical conditions that cannot be treated in Gaza have been required to apply for permits to leave the territory to receive treatment in either foreign hospitals or Palestinian hospitals in the West Bank.

The Israeli authorities frequently delay or refuse these permits; some Gazans have died while waiting to obtain permits to leave the territory for medical treatment elsewhere.

World Health Organization (WHO) trucks of medical equipment bound for Gazan hospitals have repeatedly been turned away, without explanation, by Israeli border officials.

The Gaza conflict
From 27 December 2008 to 18 January 2009, Gaza was subjected to a devastating Israeli military offensive – Operation “Cast Lead” – which Israel said it carried out to stop Hamas and other Palestinian armed groups firing indiscriminate rockets into Israel.

More then 1,380 Palestinians were killed, including more than 300 children and other civilians, and thousands were injured. Many thousands of homes were destroyed or severely damaged, as were the electricity and water systems. Civilian buildings, including hospitals and schools, were also damaged or destroyed by Israeli attacks.

Operation “Cast Lead” pushed the humanitarian crisis in Gaza to catastrophic levels. Since it concluded, the blockade has severely hampered or prevented reconstruction efforts. With many construction materials barred or limited by Israel, Gaza’s inhabitants are unable to rebuild their shattered lives.

Continued violence
In November 2009, Hamas declared a unilateral cessation of rocket fire, although this has since been breached on several occasions by members of Palestinian armed groups.

Since the ceasefire following Operation “Cast Lead” in January 2009, one person in southern Israel has been killed by mortars and rockets fired by Palestinian armed groups.

Israeli military forces, meanwhile, have conducted regular raids into Gaza and have continued to bomb the tunnels under the border at Rafah used for smuggling between Gaza and Egypt. In the year following Operation “Cast Lead”, 71 Palestinians were killed and 130 injured in the Gaza tunnels from tunnel collapse, accidents or airstrikes.

Israeli soldiers also continue to shoot at Palestinian farmers, fishermen and other civilians when they venture near Gaza’s perimeter or approach the three nautical mile limit that Israel imposes on Gaza’s coastline causing deaths and injuries.

Collective punishment
The Israeli authorities have put forward a range of justifications for the blockade - saying variously that it is a response to attacks from Palestinian armed groups, a reaction to the continued holding of the captured Israeli soldier Gilad Shalit, and a means to pressure the Hamas de facto administration.

But whatever its stated justification, the blockade is collectively punishing the entire population of Gaza, the majority of whom are children, rather than targeting the Hamas administration or armed groups.

SOURCE: Amnesty International June 1, 2010. http://www.amnesty.org/en/news-and-updates/suffocating-gaza-israeli-blockades-effects-palestinians-2010-06-01

MATERNAL MORTALITY – AN INTEGRITY TEST FOR POLITICIANS

2010-05-14T22:51:00.000-07:00

PREAMBLE: One of the world’s most intractable public health problems is the high mortality of women due to pregnancy related causes. Over several decades (until recently), maternal mortality in developing countries appears to have been non-responsive to a range of interventions, perhaps because of inadequate intervention design or the inability to scale these to a level that can have impact on population health. In many countries, social and health policies that could facilitate the status of women, particularly in their right to make independent decisions with regard to their own health, have remained underdeveloped; it is of low priority in the world’s male-dominated political systems. Health services also have been inadequate to help lower maternal mortality: insufficient attention to prevention and inadequate access to treatment services of quality when critically needed.

Most donor countries recognize maternal health as a global public health priority. However, in Canada (under the regime of Conservative Prime Minister Stephen Harper), this global imperative is being sacrificed to partisan politics of the most ill-informed kind: it risks becoming a platform for the “religious right” to rail against the use of donor funds for abortion rather than to address in a holistic manner the most important needs of women that can assure improvement in their health.

Only last year, the administration of US President Barack Obama rescinded the global “gag order” of the preceding Bush regime, that required recipients of US aid – even in the realm of reproductive health – to deny access to safe abortion services if accepting US funds. This enlightened policy shift brings the US international development policy in line with that of the global community generally. It is ironic therefore that Canada – once a leader in this respect – appears to be taking a giant step backwards. Given the removal of access to safe abortions from the frame of reference, it is extremely doubtful that a recent Request for Proposals to guide the policy of the Canadian government in this regard, could attract anyone with a rigorous track record in this area of international health development.

Taking Africa as an example, as the recent "African Century" series of articles in the Globe and Mail (ref: May 11, 2010 issue) makes clear, more than 90% of Africans live in countries where abortion is restricted. It is legally prohibited in 14, while in others it is only permitted only to preserve the life or physical health of the woman. As a result, virtually all of the estimated 5.6 million abortions performed annually in Africa are unsafe, carrying with an unconscionable risk of complications and death.

Simply put, along with access to contraception, antenatal care, safe deliveries, reliable transportation to advanced care when this is urgently required (otherwise known as emergency obstetric care, which includes surgical intervention if needed as well as prompt treatment of post-partum infection and hemorrhage), access to safe abortion is part of any coherent plan to improve reproductive health and reduce maternal mortality. Knowing all this, and both the health and international development arms of the Canadian government surely should know this, to specifically and deliberately exclude funding of safe abortions in an aid package aimed at reducing maternal mortality would render the donor complicit in those deaths.

We labeled this issue “Maternal Mortality – an Integrity Test for Politicians” after realizing that many politicians are intellectually challenged by the technical nature of what is scientifically sound evidence regarding the nature of the problem at hand, and what works or doesn’t in addressing it. It is also an ethical test… in essence whether they (the ruling political party) are in it for cheap political gains among their home base, or whether higher reasoning will prevail in the interests of the health of millions of women around the world. Just how the G8 countries deal with this in their upcoming meetings will be a direct reflection of their collective political integrity. Based on public utterances to date, it seems like all the G8 countries except Canada may pass this test.

For the lead item of this month’s blog, we therefore attach below the polite but authoritative view of the Lancet on Canada’s G8 Leadership. This we follow by the first good news in many decades, that maternal mortality globally is finally being reduced.

CANADA'S G8 HEALTH LEADERSHIP
The Lancet May 8th, 2010
As a World Report in The Lancet today shows, Canada's pledge, as host of this year's G8 Summit, to make maternal and child health one of its key issues is moving forward. At a meeting in Halifax, Nova Scotia (April 27—28), the G8 development ministers agreed to back Canada's provisional set of principles to improve the health of women and children in developing nations.

Canada should be praised for making maternal and child health a priority issue for the G8. As an Article by Margaret Hogan and colleagues in today's issue shows, around 350 000 women die during childbirth every year. 9 million children younger than 5 years also die every year. Most of these deaths are preventable. Canada's health plan to address this situation is still thin on details but it promises to include training and support for frontline health workers; better nutrition and provision of micronutrients; treatment and prevention of diseases such as pneumonia, diarrhoea, malaria, and sepsis; screening and treatment for sexually transmitted diseases, including HIV/AIDS; family planning; immunisation; and clean water and sanitation.

However, a few key elements are missing from the framework. For example, there is no talk of emergency obstetric care. This omission is likely to be an oversight and should be rectified. Improving access to safe abortion services is also absent from the plan. Sadly, this omission is no accident, but a conscious decision by Canada's Conservative Government not to support groups that undertake abortions in developing countries.

This stance must change. 70 000 women die from unsafe abortions worldwide every year. The Canadian Government does not deprive women living in Canada from access to safe abortions; it is therefore hypocritical and unjust that it tries to do so abroad. Although the country's decision only affects a small number of developing countries where abortion is legal, bans on the procedure, which are detrimental to public health, should be challenged by the G8, not tacitly supported. Canada and the other G8 nations could show real leadership with a final maternal health plan that is based on sound scientific evidence and not prejudice.

Source: The Lancet, Volume 375, Issue 9726, Page 1580, 8 May 2010

SUMMARY: Maternal mortality for 181 countries, 1980—2008: a systematic analysis of progress towards Millennium Development Goal 5
(Note: Details of source and authorship given below)
Background: Maternal mortality remains a major challenge to health systems worldwide. Reliable information about the rates and trends in maternal mortality is essential for resource mobilisation, and for planning and assessment of progress towards Millennium Development Goal 5 (MDG 5), the target for which is a 75% reduction in the maternal mortality ratio (MMR) from 1990 to 2015. We assessed levels and trends in maternal mortality for 181 countries.

Methods: We constructed a database of 2651 observations of maternal mortality for 181 countries for 1980—2008, from vital registration data, censuses, surveys, and verbal autopsy studies. We used robust analytical methods to generate estimates of maternal deaths and the MMR for each year between 1980 and 2008. We explored the sensitivity of our data to model specification and show the out-of-sample predictive validity of our methods.

Findings: We estimated that there were 342 900 (uncertainty interval 302 100—394 300) maternal deaths worldwide in 2008, down from 526 300 (446 400—629 600) in 1980. The global MMR decreased from 422 (358—505) in 1980 to 320 (272—388) in 1990, and was 251 (221—289) per 100 000 livebirths in 2008. The yearly rate of decline of the global MMR since 1990 was 1•3% (1•0—1•5). During 1990—2008, rates of yearly decline in the MMR varied between countries, from 8•8% (8•7—14•1) in the Maldives to an increase of 5•5% (5•2—5•6) in Zimbabwe. More than 50% of all maternal deaths were in only six countries in 2008 (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo). In the absence of HIV, there would have been 281 500 (243 900—327 900) maternal deaths worldwide in 2008.

Interpretation: Substantial, albeit varied, progress has been made towards MDG 5. Although only 23 countries are on track to achieve a 75% decrease in MMR by 2015, countries such as Egypt, China, Ecuador, and Bolivia have been achieving accelerated progress.

Funding: Bill & Melinda Gates Foundation

Source: Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL. Maternal mortality for 181 countries, 1980—2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet, 375, 9726, 1609 - 1623, 8 May 2010.

DEVELOPMENT ASSISTANCE FOR HEALTH – NEW IMPLICATIONS ABOUT COMPARATIVE AID EFFECTIVENESS OF GOVERNMENT VS NON-GOVERNMENTAL FUNDING

2010-04-15T10:07:00.000-07:00

PREAMBLE: In this issue we extract a report recently distributed by the Pan American Health Organization, PAHO/WHO, as part of their effort to disseminate information on contemporary public health issues. This refers to work jointly published in the Lancet by Harvard University, Boston and the University of Washington, Seattle, which reveals that investment in the non-government sector may result in more favourable health spending by government than by investing directly in the government sector itself.

Specifically, the study reported below found that debt relief, and development assistance for health (DAH) to government had a negative and significant effect on domestic government spending on health such that for every US$1 of DAH to government, government health expenditures from domestic resources were reduced by $0•43 (p=0) to $1•14.

However, debt relief, and development assistance for health DAH to the non-governmental sector had a positive and significant effect on domestic government health spending.

A counterpoint, implying that full understanding requires further examination, as explanations may vary widely depending on the situation of individual countries, is offered by another set of authors, whose comments are also extracted below.

Our topic choice for this issue is based on recognition that the findings of this Gates Foundation supported study have potentially major implications for donor funding. While there is a need to examine the findings further, especially in light of individual country situations, major questions about aid effectiveness emerge.

REPORT ON PUBLISHED ARTICLE - Public financing of health in developing countries: a cross-national systematic analysis
“…….Government spending on health from domestic sources is an important indicator of a government's commitment to the health of its people, and is essential for the sustainability of health programmes. We aimed to systematically analyse all data sources available for government spending on health in developing countries; describe trends in public financing of health; and test the extent to which they were related to changes in gross domestic product (GDP), government size, HIV prevalence, debt relief, and development assistance for health (DAH) to governmental and non-governmental sectors.

Methods
… a systematic analysis of all data sources available for government expenditures on health as agent (GHE-A) in developing countries, including government reports and databases from WHO and the International Monetary Fund (IMF). GHE-A consists of domestically and externally financed public health expenditures. We assessed the quality of these sources and used multiple imputation to generate a complete sequence of GHE-A. With these data and those for debt relief, and development assistance for health DAH to governments, we estimated government spending on health from domestic sources. We used panel-regression methods to estimate the association between government domestic spending on health and GDP, government size, HIV prevalence, debt relief, and DAH disbursed to governmental and non-governmental sectors. We tested the robustness of our conclusions using various models and subsets of countries.

Findings
In all developing countries, public financing of health in constant US$ from domestic sources increased by nearly 100% (IMF 120%; WHO 88%) from 1995 to 2006. Overall, this increase was the product of rising GDP, slight decreases in the share of GDP spent by government, and increases in the share of government spending on health. At the country level, while shares of government expenditures to health increased in many regions, they decreased in many sub-Saharan African countries. The statistical analysis showed that debt relief, and development assistance for health DAH to government had a negative and significant effect on domestic government spending on health such that for every US$1 of DAH to government, government health expenditures from domestic resources were reduced by $0•43 (p=0) to $1•14 (p=0).

However, debt relief, and development assistance for health DAH to the non-governmental sector had a positive and significant effect on domestic government health spending. Both results were robust to multiple specifications and subset analyses. Other factors, such as debt relief, had no detectable effect on domestic government health spending.

Interpretation
To address the negative effect of debt relief, and development assistance for health DAH on domestic government health spending, we recommend strong standardised monitoring of government health expenditures and government spending in other health-related sectors; establishment of collaborative targets to maintain or increase the share of government expenditures going to health; investment in the capacity of developing countries to effectively receive and use DAH; careful assessment of the risks and benefits of expanded DAH to non-governmental sectors; and investigation of the use of global price subsidies or product transfers as mechanisms for debt relief, and development assistance for health DAH.

Funding
Bill & Melinda Gates Foundation…..”

Source and Reference: Lu C, Schneider MT, Gubbins P, Leach-Kemon K, Jamison D, Murray CJL. Lancet 2010; published online April 8. 2010 - DOI:10.1016/S0140-6736(10)60233-4 Website: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960233-4/fulltext#

THE FOLLOWING COUNTERPOINT WAS ALSO PUBLISHED BY ANOTHER GROUP, IN COMMENTING ON THE ABOVE REPORT

VIEWPOINT: Crowding out: are relations between international health aid and government health funding too complex to be captured in averages only?
“…..In today’s Lancet, Lu and colleagues show that for every dollar of international health aid provided to governments, government health funding falls by US$0•43–1•14. Irrespective of whether this outcome is named fungibility or crowding out, mean estimates from many countries suggest a pattern. Without questioning the mean findings of today’s study, we argue that explicit policy choices are behind crowding-out effects, unfolding very differently dependent on the individual countries’ situations. To try to understand why some countries make these choices that result in crowding-out effects, and not only whether they do, is of importance…..”

Source and Reference: Ooms G, Decoster K, Miti K, Rens S, Van Leemput L, Vermeiren P, Van Damme W. www.thelancet.com Published online April 9, 2010 DOI:10.1016/S0140-6736(10)60207-3
URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60207-3/fulltext

OVER A BILLION HUNGRY PEOPLE IN THE WORLD - IMF AND FAO REPORT

2010-03-14T13:39:00.000-07:00

PREAMBLE: World hunger spiked sharply in 2009, significantly worsening an already disappointing trend in global food security since 1996. The combination of food and economic crises has pushed the number of hungry people worldwide to historic levels.

This issue gives space to the text of a report published in the International Monetary Fund on-line bulletin: Finance & Development, March 2010, Vol 47, No 1.. The report, entitled “Hunger on the Rise” was developed by David Dawe and Denis Drechsler, based on The State of Food Insecurity in the World, published by the Food and Agriculture Organization of the United Nations (FAO) in 2009 (see below for full citations).

OVER A BILLION HUNGRY PEOPLE
The Food and Agriculture Organization of the United Nations (FAO) estimates that 1.02 billion people were undernourished in 2009—about 100 million more than in 2008. As a result, reaching the World Food Summit target and the Millennium Development Goal for hunger reduction looks increasingly out of reach.

Poor harvests are not to blame. The FAO estimates that total cereal production in 2009 was only slightly below the record high set in 2008. Instead, the increase in hunger is mainly a result of poor people’s inability to afford the food that is produced. Many drew down savings during the food price crisis and have now lost jobs as a result of the global economic crisis.

Food prices increased considerably in developing countries during the 2006–08 world food crisis and were still high when the economic crisis started. Domestic prices of staple foods were typically 17% higher at the end of 2008 than two years earlier, after adjusting for inflation. This seriously hurt the purchasing power of poor consumers, who often spend 40% of their income on staple foods.

Thus, the global economic crisis hit developing countries at a very bad time. It further reduced access to food by lowering employment opportunities, remittances from abroad, development aid, foreign direct investment, and export opportunities.

How can hunger be eliminated? Improving world food security calls for both measures for immediate relief and more fundamental structural changes. In the short term, safety nets and social protection programs must be improved to reach those most in need.

In the medium and long term, the structural solution to hunger lies in increasing agricultural productivity to increase incomes and produce food at lower cost, especially in poor countries. The importance of longer-term measures is evidenced by the unacceptably high number of people who did not get enough to eat before the crises and are likely to remain hungry even after the food and economic crises have passed. In addition, these measures must be coupled with better governance and institutions at all levels.

Source: Dawe D, Drechsler D. Hunger on the Rise, available online at: http://www.imf.org/external/pubs/ft/fandd/2010/03/picture.htm
Text material attributed to the following source: The State of Food Insecurity in the World Economic crises – impacts and lessons learned, FAO Food and Agriculture Organization of the United Nations, Rome, 2009 is available from PDF [61p.] at: ftp://ftp.fao.org/docrep/fao/012/i0876e/i0876e.pdf

CHILD SEXUAL ABUSE BY PRIESTS AND COVER-UP BY CATHOLIC CHURCH

2010-02-15T20:22:00.000-08:00

PREAMBLE: On December 14, 2009, PacificSci Global Perspectives issued its 2009 summary of International and Global Development – Year in Review. In this, under the heading of Human Rights, we stated: “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.”

In this month’s issue, we post verbatim, a CNN press report that outlines a decades old cover-up of child sexual abuse at the hands of Catholic priests in Ireland. The actions of Irish priests and the inaction of their church hierarchy represent simultaneously the height of hypocrisy and flagrant criminal behavior, and bring into disrepute the entire edifice of organized Catholicism.

Although the action now being taken came about as a result of a commission of inquiry put into motion by the nation of Ireland, one has to ask why this took so long and why no criminal charges have ever been laid. This clearly does not absolve the state itself from some share of the responsibility and the consequences.

POPE MEETS IRISH BISHOPS OVER ABUSE REPORT
By Richard Allen Greene, CNN
February 15, 2010 -- Updated 2102 GMT (0502 HKT)

Rome, Italy (CNN) -- Alleged victims of child abuse by Catholic priests in Ireland called on the Vatican Monday to hold its own investigation into the scandal and punish those responsible.

"We ask that you take action now according to the laws and traditions of our Holy Church and discover how and why the teachings of Jesus Christ were so flagrantly abrogated over many decades," John Kelly said in a letter to Pope Benedict XVI.

"We ask that you convene a special commission ... to examine all aspects of the historical misconduct of Catholic religious orders in Ireland as well as those priests who betrayed their most sacred vows," he said.

Kelly, the founder of Survivors of Child Abuse, or SOCA, released the letter as Irish Catholic bishops met the pope in Rome after a damning report on the abuse of children by Catholic clergy.

The report, which came out in November, found that the Catholic Church in Ireland covered up widespread child abuse from 1975 to 2004.

The pope already has met with senior Irish bishops about the report, produced by the Dublin Archdiocese Commission of Investigation. The Irish government created the commission in 2006 to examine abuse allegations.

The Vatican now needs to order a major housecleaning, Kelly told CNN.
"They need to clean the stables up. They need to inquire into all the bishops, and if that means the majority of them would have to resign, then so be it," Kelly said.
"The bishops themselves are the problem. Somebody has dishonored this nation," said Kelly, who says he was himself abused in a Catholic institution in Dublin, Ireland, as a child.
"Nobody has been locked up or prosecuted for these crimes in Ireland," he said, saying it is now the Vatican's responsibility to punish the guilty. "The pope could do an awful lot if he is sincere.
"We are entitled to have great expectations," he told CNN by phone from Ireland. "I want strong leadership from the pope."

"We are asking the curia to examine the facts before them," said Patrick Walsh of SOCA, using a term for the leadership of the Catholic church.
"This is not a time for high Mass. That time is finished," he said. "It is time to pass judgment under Roman law."

The Irish Catholic bishops attended Mass in Rome on Monday morning before meeting with the pope. Benedict did not attend the Mass, his spokesman, Father Federico Lombardi, told CNN.

Cardinal Tarcisio Bertone, the Vatican secretary of state, presided, and addressed the scandal directly in his homily, calling the alleged abuse "abominable acts."

"Trials can come from either outside or inside the church. Both are painful, but those that come from within are naturally harder and more humiliating," he said, according to Lombardi.
"Such is the grave trial that at this moment your communities are going through, which see some men of the church involved in such particularly abominable acts," he said.

The Irish bishops prayed for the victims, said their spokesman, Martin Long.
"Prayers were offered to the survivors of abuse, the people, priests, and religious of Ireland. Prayers were also offered for the success of the meeting," he said.

One of the bishops meeting the pope said Sunday that the church in Ireland had been badly damaged by the revelations of abuse and cover-up.

"I would admit quite frankly what everybody else knows, shouted from housetops, that the church has been seriously wounded," Bishop Joseph Duffy said in Rome.

"This has done an immense damage to the authority of the church as the mouthpiece of the gospel of Jesus Christ. Of that there is no doubt," he said.

Each of the bishops will have seven minutes to speak at the meeting with the pontiff, Duffy said. The meeting was to go on all day Monday and resume Tuesday morning.
The bishops are staying at the Vatican, in the same hotel the cardinals of the church used when they last chose a new pope.

Benedict last week reiterated the Vatican's condemnation of child abuse.
"Unfortunately, in various instances, some [church] members, acting in contradiction with these commitments, have violated [children's] rights: a behavior that the church has not ceased to -- and will never cease to -- deplore and condemn," he said February 8.
The pope said after that meeting that he was "deeply disturbed and distressed" by the report's findings. He promised that the Catholic Church would try to develop strategies to make sure abuses don't happen again.
"He wishes once more to express his profound regret at the actions of some members of the clergy who have betrayed their solemn promises to God, as well as the trust placed in them by the victims and their families, and by society at large," the Vatican said in a statement then.

Four Irish bishops resigned in December after the report.

Source: Richard Allen Greene, Rome, Italy CNN
February 15, 2010 -- Updated 2102 GMT (0502 HKT)
http://edition.cnn.com/2010/WORLD/europe/02/15/ireland.pope.abuse/

Envoi: We will continue to monitor this apalling situation. Clearly the expressions of remorse by the Catholic church are nowhere near enough. Justice must be done, and must be seen, and believed, to be done.

FOOD 2030 - A NATIONAL REPORT WITH GLOBAL IMPLICATIONS

2010-01-15T11:19:00.000-08:00

PREAMBLE Demand for food and energy will jump 50% by 2030 and for fresh water by 30%, as the world population tops 8.3 billion. Climate change will exacerbate matters unpredictably. The United Nations Environment Programme (UNEP) predicts widespread water shortages across Africa, Europe and Asia by 2025. The amount of fresh water available per head of population will decline sharply during that time. The issue of food and energy security rose high on the political agenda last year during a spike in oil and commodity prices, but then slipped in priority with falling prices. At present, 30-40% of all crops are lost due to pest and disease before they are harvested, and future droughts and increasing salinity will affect growth and produce.

In this issue, we highlight the British Government’s new Food Strategy, released January 5th, 2010. It is a timely document, with implications for both the UK and the rest of the world.

UK GOVERNMENT’S NEW FOOD STRATEGY
A National Report with Global Implications
On January 5th, 2010, the UK Government released its new food strategy: Food 2030: How we get there is the first of its kind in over 50 years, and the UK’s first food security assessment. The report states observes that "the natural environment and the economy are intrinsically linked", and discusses issues ranging from how to create a sustainable food system locally and globally, to the challenges of rising global demand for food and how food contributes to greenhouse gas emissions (GHG).

"We need to think differently about food," said Prime Minister Gordon Brown in his Foreword to the report, produced by the Department for Environment, Food and Rural Affairs (DEFRA). 2008 was a wake-up call to world governments, as food prices rose sharply for the first time in a generation, provoking riots in some parts of the world. Many countries have reacted to protect food supplies in the face of climate change, a growing world population, and the spectre of “sudden shocks” such as natural disasters or price spikes.

[Ed Note: In Haiti, people are already reduced to eating mud cakes (clay with little added nutritional content); the January 13th 2010 earthquake will further exacerbate this extreme situation.]

As Secretary of State for DEFRA Hilary Benn states: “…the consequences of the way we produce and consume our food are unsustainable to our planet and to ourselves… we are at one of those moments in our history where the future of our economy, our environment, and our society will be shaped by the choices we make now.” Food production, he continues, must occur “without damaging the air, soil, water and marine resources, biodiversity and climate that we all depend on". For the UK, the aim by 2030 is to ensure that consumers are informed, can choose and afford healthy, sustainable food; that this demand is met by profitable, competitive, highly skilled and resilient farming, fishing and food businesses, supported by first class research and development. Food security is ensured through strong UK agriculture and food sectors, and international trade links with EU and global partners which support developing economies.

Globally, the report calls for a fairer international trade system that addresses import restrictions and subsidies, and the support of fair trade products, will work towards food that is produced, processed, and distributed to feed a growing global population in ways which:

o use global natural resources sustainably
o utilizes a low carbon food system which is efficient in using resources – any waste is reused, recycled or used for energy generation
o enable the continuing provision of the benefits and services that results from a healthy natural environment
o promote high standards of animal health and welfare
o protect food safety
o make a significant contribution to rural communities, and
o allow for global leadership on food sustainability.

Sustainability is a central theme throughout the document, but with the onus for this left mostly up to consumers. More government regulation and intervention may be required, given that many consumers will find it difficult to change food purchasing habits; otherwise, the agribusiness will find new ways to appeal to consumers without truly changing their activities. Related target areas:

 education to help consumers know how and where food is produced and how to grow and cook it themselves;
 programmmes to provide schoolchildren with opportunities to grow food;
 the public sector would lead by example and purchase healthy and sustainable foods.

A broader understanding of sustainability is advocated that would address GHG emissions, water use, animal welfare, and supporting rural communities in the UK and in developing countries. The report suggests that the previous focus on ‘food miles’ was too narrow, as the transportation of food only accounts for 9% of the carbon footprint of a food product.

Food 2030 repeatedly links what is happening in the UK and the need to support communities in the developing world regarding resource use, improving technologies, purchasing fair trade products. Such endeavours could benefit communities by supporting farmers, improving infrastructure and supports, and mitigating the impacts of climate change. Or, such support could amount to another “Green Revolution”, benefiting the few and disadvantaging the many.

Sources:
HM Government. Food 2030: How we get there. Released Jan 2010. http://www.defra.gov.uk/foodfarm/food/pdf/food2030strategy-summary.pdf
Manitoba Alternative Food Research Alliance. Evaluating Food 2030, Jan 6, 2010. http://www.localandjust.ca/?p=432
Christine McGourty. Global crisis 'to strike by 2030'. Mar 19, 2009. http://news.bbc.co.uk/2/hi/uk_news/7951838.stm.
Tom MacMillan. Hilary’s contradiction casserole. Jan 5, 2010. http://www.guardian.co.uk/commentisfree/2010/jan/05/hilary-contradiction-casserole-can-worms.
Food Ethics Council. Food security. http://www.foodethicscouncil.org/topic/Food%20security. Accessed Jan 14, 2010.
Food Ethics Council. Food poverty. http://www.foodethicscouncil.org/topic/Food%20poverty. Accessed Jan 14, 2010.
Food Ethics Council. Hunger. http://www.foodethicscouncil.org/topic/Hunger Accessed Jan 14, 2010.

DISCUSSION: Looking back: how far have we really moved ahead? Defined at the 1996 World Food Summit, food security: “… exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life”. Leaders at that meeting committed to tackling hunger. By June 2009, however, the world’s hungry had increased to 1.02 billion people.

In the aftermath of high global food prices in 2008, amid growing concern about the effects of climate change on agriculture, much of the focus shifted to boosting food production. Yet, people go hungry because they cannot afford to eat rather than because there is no food available, and agricultural investment could exacerbate problems unless it is focused on reducing economic inequalities.

For examples: increasing meat and dairy consumption in the fastest growing economies will increase pressure on supplies; the roles played by financial speculation and biofuel promotion on the 2008 price hikes shows how developed country politics, consumption and spending power, not food production, adversely impact hunger globally.

Despite increasing choice and affordability of food in some countries, many people eat “what they can afford”, not what they “want” let alone what nutrition “experts” tell them they “should”. Food poverty means that an individual or household isn’t able to obtain healthy, nutritious food, or can’t access the food they would like to eat. This often results in lower nutrient intake, bad dietary patterns, hunger, low fruit and vegetable consumption and problems accessing food. The resulting poor diets lead to heart disease, obesity, diabetes and cancer, and inadequate levels of many vitamins and minerals. Obesity is now a sign of poverty in rich countries, as hunger is in poor countries.

Food poverty and economic poverty are linked. Policy-makers often view food security as a strategic issue of national security, dependent on logistics and global trade relations. At global level, how to feed a growing population that demands more resource-intensive diets, while tackling climate change and environmental degradation, are key questions of food security.

Envoi: According to a 2002 report from the UN Food and Agriculture Organization (FAO), global food production will continue to exceed population growth through 2030, but hundreds of millions of people in developing countries will remain hungry, and many environmental problems associated with agriculture will remain serious. Although growth in demand for food will be lower and population growth will slow, agricultural pressure on natural resources will continue to increase, albeit at a slower pace, and agricultural trade deficits in developing countries will increase drastically. Because most of those in extreme poverty live in rural areas, giving rural people better access to land, water, credit, health and education is essential for alleviating poverty and hunger, according to the report.

International trade plays an important role in achieving these aims, the agency says, calling for greater agricultural trade liberalization, better access to OECD (Organization for Economic Cooperation and Development) markets, the elimination of export subsidies and the reduction of tariffs. The FAO recommended openness toward international markets, investments in infrastructure, promotion of economic integration and limits on market concentration to make globalization work for the poor.

Citing Asia as a region where globalization has generally led to progress in reducing poverty, FAO notes that… " it has also led to the rise of multinational food companies with the potential to disempower farmers in many countries". "Developing countries need the legal and administrative framework to ward off the threats while reaping the benefits".

Source: World Agriculture: Towards 2015/2030 http://www.unwire.org/UNWire/20020820/28440_story.asp

INTERNATIONAL & GLOBAL DEVELOPMENT – YEAR IN REVIEW 2009

2009-12-14T20:29:00.000-08:00

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.

DESERTIFICATION, FOOD SECURITY & CLIMATE

2009-11-15T14:25:00.000-08:00

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

DRAWING ATTENTION TO A GLOBAL PANDEMIC - Diarrhoeal Disease

2009-10-15T20:17:00.000-07:00

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

U.N. RELEASES MILLENNIUM DEVELOPMENT GOALS 2009 Reports

2009-09-15T21:26:00.000-07:00

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

THE GLOBAL ECONOMIC, HEALTH & SOCIAL IMPACTS OF AGEING POPULATIONS

2009-08-17T12:41:00.000-07:00

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

FAMILY PLANNING & REPRODUCTIVE HEALTH FALL OFF GLOBAL DEVELOPMENT RADAR

2009-07-14T19:29:00.000-07:00

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

ACTING ON CLIMATE CHANGE TO PROTECT HUMAN HEALTH

2009-06-13T19:04:00.000-07:00

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

INDIGENOUS PEOPLE'S GLOBAL SUMMIT ON CLIMATE CHANGE

2009-05-15T00:35:00.000-07:00

PREAMBLE: Indigenous peoples from 80 nations gathered for a 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 Indigenous Peoples' Global Summit on Climate Change was also designed to help strengthen the communities’ participation in and articulate recommendations to the December UN conference in Copenhagen, at which a successor agreement to the Kyoto protocol will be negotiated. The Summit concluded Friday, April 24 with the signing of the Anchorage Declaration and action plan.

Says Sam Johnston of Tokyo-based United Nations University, a Summit co-sponsor: "The rich and detailed insights of Indigenous Peoples reflects and embodies a cultural and spiritual relationship with the land, ocean and wildlife. The world owes it to both the Indigenous Peoples and itself to pay greater heed to the opinions of these communities and to the wisdom of ages-old traditional knowledge."

Source: Adapted from: United Nations University, Institute for Advanced Studies. Press Release April 20, 2009. http://www.unutki.org/default.php?doc_id=145

INDIGENOUS PEOPLES AT WORLD SUMMIT SHARE CLIMATE CHANGE OBSERVATIONS, EXPERIENCE, TRAIDITIONAL COPING TECHNIQUES
With the first climate change-related relocation of an Inuit village already underway, some 400 Indigenous People and observers from 80 nations convened in Alaska for a UN-affiliated conference April 20-24 to discuss ways in which traditional knowledge can be used to both mitigate and adapt to climate change.

Hosted by the Inuit Circumpolar Council, the Indigenous Peoples' Global Summit on Climate Change was also designed to help strengthen the communities' participation in and articulate messages and recommendations to the December UN climate change conference in Copenhagen, at which a successor agreement to the Kyoto protocol will be negotiated.

The Summit took place in Anchorage, about 800 km east of the Alaskan village of Newtok, where intensifying river flow and melting permafrost are destroying homes and infrastructure, forcing 320 residents to relocate to a higher site 15 km west, at an expected financial cost in the tens of millions of dollars.

While the move will be financed in part with government funds that would have been spent maintaining the existing village and on periodic emergency evacuations, NGOs say the relocation of Newtok marks an Arctic milestone - the first official casualty among six Alaskan Inuit settlements in urgent need of relocation, including Shishmaref (pop. 560), Kivalina (pop. 377), where autumn storm waves are no longer contained by shore-fast ice, which used to form in September but in recent years has appeared only in December or even January. Dozens of similar settlements are considered threatened.

At the Summit, Indigenous Peoples from every world region shared observations and experiences of early impacts in their part of the planet, as well as traditional practices that could both ease climate change and help all humanity adapt to its anticipated consequences.

With scientific experts now predicting that the effects of climate change will be more severe and appear even faster than previously believed, Indigenous Peoples presented the Summit with new observations of changes, including:

Papua New Guinea: Indigenous People are being forced to relocate due to a combination of population growth and the inundation of coastal land due to sea level rise.

Borneo: The Dayak have documented climate variations based on observations of bird species, rising water levels, and the loss of traditional medicinal plants;

Mexico: Highland Mayan milpa farmers have a shortened rain season, unseasonal frost and unusually large daytime temperature changes, forcing them to find alternative sources of irrigation and crop variations;

Andean Region: Temperature changes in the Andean region have had a drastic impact on agriculture, health and biodiversity, evidenced by an increase in respiratory illnesses, a decrease in alpaca farming and a shortened growing season. In some areas where Indigenous People depend on Alpine flora for medicines, grazing and food, the growing season could be cut in half should the loss of glaciers continue and agriculture become dependent solely on rainfall;

Kenya: Protracted droughts are killing livestock on which the Samburu People depend for food and economic survival;

Nepal: Intense rainfall and droughts have become common, having severe crop effects.

"Indigenous Peoples have contributed the least to the global problem of climate change but will almost certainly bear the greatest brunt of its impact," says Patricia Cochran, Chair of both the Inuit Circumpolar Council and the April Summit.

"Indigenous Peoples are on the front lines of this global problem at a time when their cultures and livelihoods in traditional lands are already threatened by such trends as accelerating natural resource development stimulated by trade liberalization and globalization."

At least 5,000 distinct groups of Indigenous Peoples have been identified in more than 70 countries, with a combined global population estimated at 300-350 million, representing about 6% of humanity.

Their traditional knowledge contributes to understanding climate change - observations and interpretations by Indigenous Peoples of changing Arctic sea ice, for example, has proven important across a wide range of economic and scientific interests. Traditional knowledge of fire, meanwhile, is helping to create more effective strategies for year round forest management and reducing the risk of killer wild fires.

Interestingly, in a world first, the aborigines of Western Arnhem Land (in north-west Australia) have used traditional fire practices to reduce greenhouse gas emissions. As a result, they have sold $17 million worth of carbon credits to industry, generating significant new income for the local community.

Over millennia, Indigenous Peoples have developed a large arsenal of practices of potential benefit in the climate change context, including:

• Traditional methods of shoreline reinforcement, land stabilization and reclamation;
• Protecting watersheds with Indigenous farming techniques; and
• Fostering biodiversity and the growth of useful species through planting, transplantation, and weeding techniques, the benefits of which have often gone unappreciated outside Indigenous communities until traditional peoples are relocated or their practices restricted.

Traditional drought-related practices used to hedge against normal climate variation include:

• Sophisticated small dam systems to capture and store rainfall;
• Temporary migration;
• Planting diverse varieties of crops simultaneously; and
• Using alternative agricultural lands, food preservation techniques, hunting and gathering periods and wild food sources as required.

Among new Indigenous climate change adaptation efforts presented at the Summit:
Honduras: With increasing hurricane strikes and drastic weather changes, the Quezungal people have developed a farming method which involves planting crops under trees so the roots anchor the soil and reduce the loss of crops during natural disasters.

East Cameroon and Congo: The Baka Pygmies of South East Cameroon and the Bambendzele of Congo have developed new fishing and hunting methods to adapt to a decrease in precipitation and an increase in forest fires;

Guyana: Indigenous peoples have adopted a nomadic lifestyle, moving to more forested zones in the dry season, and are now planting manioc, their main staple, in alluvial plains where, previously, it was too moist to plant crops.

Indigenous Peoples most at risk

According to the International Union for the Conservation of Nature, the number of Indigenous Peoples most likely to be impacted to climate change requires additional research. However, those at greatest risk from expected extreme climate change-induced events such as sea level rise and crop-damaging droughts reside in:

• The Arctic,
• The Caribbean
• The Amazon
• Southern Chile and Argentina,
• Southern Africa,
• Pacific islands and other island states,
• Along the Asian coastline
• Across Australia

Beyond temperature flux, climate change is expected to alter the timing, frequency and intensity of precipitation, the direction and intensity of winds, waves, ocean currents and storm circulations, the volume of rivers, and the ranges of plants and animals.

UNU researchers say the greatest number of people will be affected by climate change through more frequent drought and spreading desertification, by rising sea levels that inundate coastal communities, through the expanded range of diseases like malaria and dengue fever, and by the disappearance of glaciers, which will stunt the usual supply of water in areas such as the Indian subcontinent, where more than 2 billion people will reside by 2050.

Source: Adapted from: Press Brief 20 April 2009: Indigenous Peoples at World Summit to Share Climate Change Experience. http://www.unutki.org/default.php?doc_id=144

GLOBAL ECONOMIC CRISIS AND THE MILLENNIUM DEVELOPMENT GOALS

2009-04-15T03:07:00.000-07:00

PREAMBLE: For this issue we have selected a recent UN News Release that addresses 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.

ECONOMIC CRISIS TO DRIVE MILLIONS INTO POVERTY IN 2009
13 February 2009 – The spreading global economic crisis is set to trap up to 53 million more people in poverty in developing countries this year on top of the 130-155 million driven into poverty in 2008 by soaring food and fuel prices, bringing the total of those living on less than $2 a day to over 1.5 billion, according to the World Bank.

The new forecast highlights the serious threat to achieving the United Nation's Millennium Development Goals (MDGs), which aim to slash poverty, hunger, infant and maternal mortality, and lack of access to health care and education, all by 2015. Preliminary estimates for 2009 to 2015 forecast that an average 200,000 to 400,000 more children a year may die if the crisis persists, making a total of 1.4 to 2.8 million over the period.

“The global economic crisis threatens to become a human crisis in many developing countries unless they can take targeted measures to protect vulnerable people in their communities,” World Bank President Robert B. Zoellick said on the eve of the Group of Seven (G7) finance ministers' meeting of leading industrial countries in Rome on Saturday, which he will attend.

“While much of the world is focused on bank rescues and stimulus packages, we should not forget that poor people in developing countries are far more exposed if their economies falter. This is a global crisis requiring a global solution. The needs of poor people in developing countries must be on the table.”

New estimates for 2009 suggest that lower economic growth rates will trap 46 million more people on less than $1.25 a day than was expected prior to the crisis, for a total of an extra 53 million trapped on less than $2 a day, on top of the 1.37 billion before the current crises.

A World Bank policy note issued in the run up to the G7 meeting reports that almost 40 per cent of 107 developing countries were highly exposed to the effects of the crisis and the remainder were moderately exposed, with less than 10 percent facing little risk.

It is critical for exposed countries to finance job creation, delivery of essential services and infrastructure, and safety net programmes for the vulnerable, according to the note, entitled The Global Economic Crisis: Assessing Vulnerability with a Poverty Lens.

Yet three quarters of these countries cannot raise funds domestically or internationally to finance programmes to curb the effects of the downturn. One quarter of them also lack the institutional capacity to expand spending to protect vulnerable groups. The note urges financial support in the form of grants and low or zero interest loans for these countries.

Mr. Zoellick recently called for the establishment of a Vulnerability Fund in which each developed country would devote 0.7 per cent of its stimulus package to aid poorer countries set up safety net programmes, invest in infrastructure, and support small and medium-sized enterprises and microfinance institutions.

Source: UN News Service. http://www.un.org/apps/news/story.asp?NewsID=29897&Cr=financial&Cr1=crisis

LEADERSHIP AND MANAGEMENT OF HEALTH ORGANIZATIONS – 7 QUESTIONS

2009-03-16T22:40:00.000-07:00

PREAMBLE: When this issue was first posted on March 16, we attempted to test a 7-day polling function offered by Google. Our trial topic was “health leadership and management”. However, interest in the poll was insufficient, so we removed the questions from our sidebar on March 23. We also reconstructed the material that now follows, to be consistent with this decision.

Given the role of poorly prepared leaders and managers in the global financial crisis, it is possible that a similar crisis may be developing in health organizations.

As a “backgrounder” we supply extracts from an Opinion piece in the Globe and Mail, in which Henry Mintzberg, Cleghorn Professor of Management Studies, 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.

Reference: Minzberg H. Globe and Mail p A11, March 16, 2009 http://www.theglobeandmail.com/servlet/story/RTGAM.20090313.wcomintzberg16/BNStory/specialComment/home

Comment: One of our concerns 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.

BACKGROUNDER
In his critique of American leadership and management training practices, Minzberg states: “American management is still revered across much of the globe for what it used to be. Now, a great deal of it is just plain rotten - detached and hubristic. Instead of rolling up their sleeves and getting engaged, too many CEOs sit in their offices and deem: They pronounce targets for others to meet, or else get fired.”

Further on he addresses “hubris on a massive scale” from which we extract the following:
“Management is a practice, learned in context. No manager, let alone leader, has ever been created in a classroom. Programs that claim to do so promote hubris instead. And that has been carried from the business schools into corporate America on a massive scale."

Minzberg then comments on the iconic Harvard Business School which, according to its MBA website, is ‘focused on one purpose - developing leaders.’ He states: "At Harvard, you become such a leader by reading hundreds of brief case studies, each the day before you or your colleagues are called on to pronounce on what that company should do. Yesterday, you knew nothing about Acme Inc.; today, you're pretending to decide its future. What kind of leader does that create?"

He notes that Harvard prides itself on how many of its graduates make it to the executive suites. He states: “Learning how to present arguments in a classroom… helps. But how do these people perform once they get to those suites? Harvard does not ask. So we took a look.” He then summarizes a study he carried out with a colleague Joseph Lampel:

“Joseph Lampel and I found a list of Harvard Business School superstars, published in a 1990 book by a long-term insider. We tracked the performance of the 19 corporate chief executives on that list, many of them famous, across more than a decade. Ten were outright failures (the company went bankrupt, the CEO was fired, a major merger backfired etc.); another four had questionable records at best. Five out of the 19 seemed to do fine. These figures, limited as they were, sounded pretty damning. (When we published our results, there was nary a peep. No one really cared.)”

OUR SEVEN QUESTIONS ON HEALTH LEADERSHIP AND MANAGEMENT
These questions were composed by the authors of this blog, and required only “yes” or “no” responses, a format that we recognized would severely limit the scope of the exercise. As already noted, responses were insufficient to form a basis for any comment or interpretation, so we removed the poll from this issue on March 23, and offer the same seven question (below), but now with our own commentary.

Introduction: A wide range of educational institutions (with varying capacities in health, leadership and management, from modest to substantial) have a major impact on the preparation of leaders and managers for the health field, yet health systems everywhere are creaking under the strain of expanding need and constrained budgets. We suggest therefore that the time has surely come to examine some related questions regarding leadership and management in the health sector.

The Seven Questions:

1. Like GM, are some health care organizations now “too big to fail”? COMMENT: We believe that this is very much so, and that examples exist at every level, from the World Health Organization to any number of health service entities within countries. What looms large are issues of accountability.

2. Is too much emphasis now being given to “leadership” training for health organizations at the expense of basic management skills? COMMENT: We are aware of numerous instances where individuals have been inside-tracked into leadership training, without having first gone through the process of learning much about health organizations from working within them.

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? COMMENT: This is a definite risk in political cultures that are more oriented towards cost containment than positive health outcomes.

4. Do such CEOs give enough philosophical commitment (comparable to that of the health professionals they lead) to health goals and objectives? COMMENT: We believe that there is a risk here, and one that needs to be studied. Just how well can "leaders" from outside health identify with health goals, or will business models dominate to the detriment of evidence based services?

5. With such CEOs is there a greater risk of remote leadership with an easy exit out of health in the event of failure? COMMENT: To the extent that health services are viewed as a business, we believe that there is a risk in relation to this trend; while career mobility and sourcing talent are important recruitment considerations, there are also downside risks in relation to loyalty to a health mission e.g, consider the greed and irresponsibility in the financial industry that has surfaced over the past year.

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? COMMENT: We dont know the answer to this, but it is a serious question: if more transparency were to apply to senior levels of the health enterprise, it would be easier for everyone to know.

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? COMMENT: There are many exceptions, but also many people engaged in education and research into health leadership and management have a "product" to promote, not necessarily real experience on how that product actually works.

Disclaimer: The foregoing questions and comments are not cited from any of Minzberg's work, but were stimulated by his opinion piece. We accept responsibility for our exercise, and hope that it may provoke interest in the future of health leadership and management.

CLIMATE CHANGE AND THE EXPANDING GLOBAL REACH OF DENGUE FEVER

2009-02-14T17:18:00.000-08:00

PREAMBLE: We selected dengue fever for this issue because both principals of PacificSci developed this disease while visiting the island of Trinidad in the West Indies in December 2008. Characterized by headache, muscle and joint pains, spiking fever; and (in one of us) a petechial (hemorraghic) rash, the other of us was admitted to hospital for dehydration and a major fall in platelet count (20,000; normal = 150,000-400,000). We tested positive to an IgM laboratory test, indicative of acute infection. We returned to Canada in mid-January and are convalescing.

Given the incubation range for dengue fever, typically 4-7 days, it is likely that we were exposed within 24 hours of entry into Trinidad, either on arrival at Piarco airport, or subsequently at a residential area on the north-west boundary of Port of Spain. Although the Ministry of Health maintains a mosquito control programme at the airport, an active epidemic of dengue fever had been reported by the media for several weeks in adjacent communities to the east of Port of Spain; locally employed baggage handlers could have served as a reservoir. Initially downplayed by the Ministry of Health (according to media reports), the Pan American Health Organization records 2,366 cases including deaths by the 37th week of in 2008 in Trinidad, which translates to well over 3000 cases by year end.
Source: http://www.paho.org/English/AD/DPC/CD/dengue-cases-2008.htm

Since the late 1970s dengue fever reemerged as an expanding public health problem in the Caribbean basin. Because the situation now involves co-circulation of three serotypes, the threat to personal and public health has actually heightened because a primary infection does not immunize against subsequent infection from another strain; to the contrary, it sets up a complex immune response that may result in serious disease e.g, dengue hemorrhage fever and dengue shock syndrome. This threat is compounded by climate change which is having the effect of both extending the range of the mosquito vector and also the length of the mosquito breeding season.
[See: accompanying articles below for more details].

Although there has been plenty of warning about this increasing threat, diminished priorities for public health e.g., education and mosquito abatement, plus deteriorating infrastructures e.g, drains and ditches which trap fresh water (ideal for mosquito breeding), have exacerbated the impact of this condition in many countries. Concerns for the potential impact on tourism have contributed to insufficient recognition by the political establishment, an inappropriate response because ultimately this disease will become more firmly established, and affected countries will become globally recognized as endemic for the disease. The major risk is of course for the people of the affected countries, especially those who live in heavily mosquito afflicted areas. The adequacy of the health care system in many instances may not be sufficient to cope with epidemic surges; clearly therefore the appropriate response is to refocus on prevention.

PRIOR WARNINGS OF GEOGRAPHIC EXPANSION AND INCREASED SEVERITY - HAVE THEY GONE UNHEEDED?
Over a decade ago [1], mathematical models simulating climate change projected that rising global temperatures will increase the range of mosquitoes that transmits the dengue fever virus, even then considered the most serious viral infection transmitted in man by insects, whether measured by number of infections or the number of deaths.

Researchers used three different models to show that dengue's epidemic potential increases with a relatively small temperature rise. The higher a virus's epidemic potential, the fewer mosquitoes are necessary to maintain or spread dengue in a vulnerable population. Most predicted areas of encroachment were temperate regions that border on endemic zones, places where humans and the primary carrier, the mosquito Aedes aegypti, often co-exist, but where lower temperatures until then limited transmission.

Global warming would not only increase the range of the mosquito but would also reduce the size of Ae. aegypti's larva and, ultimately, adult size. Since smaller adults must feed more frequently to develop their eggs, warmer temperatures boost the incidence of double feeding and increase the likelihood of transmission. In addition, the time the virus must spend incubating inside the mosquito is shortened at higher temperatures. Shortening the incubation period can mean a potential higher transmission rate of disease.

NOTE: The foregoing study was co-funded by the U.S. Environmental Protection Agency, the National Institute of Public Health and Environment (RIVM) (the Netherlands), and the Center for Medical, Agricultural, and Veterinary Entomology of the U.S. Department of Agriculture.

According to a recent report [2], published by the US Centers for Disease Control and Prevention, dengue is expanding in tropical and subtropical regions and is now the most frequent arboviral disease globally, with an estimated annual 100 million cases of dengue fever, 250,000 cases of dengue hemorrhagic fever, and 25,000 deaths (a 1% fatality:case ratio). Dengue has been reported in >100 countries, and 2.5 billion people live in areas where it is endemic.

Increasingly reported in travelers, dengue is a major international public health concern because of the expanding geographic distribution of the virus and competent mosquito vectors, increased frequency of epidemics, co-circulation of multiple virus serotypes, and emergence of dengue hemorrhagic fever in new areas.

References:
1. Science Daily Mar 10, 1998 http://www.sciencedaily.com/releases/1998/03/980310081157.htm
2. Wilder-Smith et al in the January 2009 issue of Emerging Infectious Diseases http://www.cdc.gov/EID/content/15/1/8.htm

MORE GLOBAL NEWS ON DENGUE FEVER
The situation as experienced described in our preamble is by no means limited to the Caribbean basin. A report published in Time magazine in 2007 reveals – among other things - that denial and inertia regarding dengue fever is widespread. Political leadership clearly has been insufficient in many countries to respond adequately to this threat. The following is extracted from a TIME Magazine report in 2007 (citation below):

“Across Southeast Asia, doctors and public-health officials are grappling with alarmingly high dengue-infection rates. Cambodia and Vietnam reported double the cases this year (2007) compared with (the prior year), and more than 400 deaths; Thailand and Burma each recorded roughly a third more cases in 2007. The World Health Organization (WHO) says this is the fourth consecutive year of unusually high rates in the region — and doctors are worried that global warming may be partially to blame.

That's because the mosquito that infects most people with dengue, the striped Aedes aegypti, does better in warm, wet weather. Regions experiencing rising temperatures and longer rainy seasons are seeing large outbreaks year after year, and what has previously been thought of as a tropical disease is popping up in more temperate regions. Nepal and Bhutan saw their first cases in recent years, as did isolated spots such as Easter Island. Today, an estimated 2.5 billion people live in areas where dengue is endemic. The WHO expects millions more will be added in coming years. ‘Dengue is an evolving situation,’ says Dr. Jai Narain, director of communicable diseases for the WHO in Southeast Asia. ‘A lot of people say climate change will impact [the disease] somewhere down the line. But it already is.’

Weather isn't doing the job alone. As more and more people migrate to cities, they create additional opportunities for the mosquito to spread the virus. The problem is particularly acute in developing countries, where inadequate utilities mean residents must store water in jars and tanks — prime breeding grounds for the Aedes aegypti. Increasing air travel is also a factor as infected fliers spread the disease quickly worldwide. ‘It's simplistic to suggest that the increasing outbreak is solely caused by climate change,’ says Simon Hales, a senior research fellow at New Zealand's University of Otago. ‘But those who would suggest that it has nothing to do with it are equally misguided.’ Hales estimates that if global warming advances as predicted by the U.N., more than half the world could be dengue country before the end of this century.

Lacking vaccines or effective treatments [Ed Note: neither option exist for dengue, which has not received adequate attention to this needed research and development], public-health officials are battling the disease with old-school tactics: pest control and education. But fumigation campaigns are too expensive for many Asian governments to carry out effectively; it's also difficult to regularly send out health officials to remind communities to keep their homes dry and water supplies clean. Even wealthy Singapore, a model of dengue control, was floored by an outbreak in 2005. Reported cases went down the following year, but are back up again slightly in 2007. ‘That's a kind of warning to us," says Hales. "As the temperature continues to increase, it gets progressively more difficult to prevent the disease from spreading — even with the best technology.’

Health-care professionals are trying to raise global awareness of the threat. In Cambodia, for example, more funding goes to controlling avian flu, a disease that affects far fewer people but has a higher fear factor worldwide. Health organizations such as the U.S.-based Centers for Disease Control and Prevention are stressing the link between climate change and disease, hoping to get more money to fight mosquito-borne illnesses.

‘This is a critical moment,’ says Dr. Maria Neira, director of the WHO's program on public health and the environment. ‘If the public pressure is maintained, the politicians will act accordingly. Waiting for dengue fever to burn itself out may be the only option for individuals who catch the disease, but that's a lousy prescription for the planet.’ “

Source: Krista Mahr Thursday, Dec. 06, 2007 TIME MAGAZINE http://www.time.com/time/magazine/article/0,9171,1691616,00.html

INTERNATIONAL & GLOBAL DEVELOPMENT – YEAR IN REVIEW 2008

2009-01-14T14:48:00.000-08:00

PREAMBLE: This is our second annual review, 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).

THREE LEADING ISSUES FROM 2008:
Flowers or Fertilizer?
1. GLOBAL STEWARDSHIP: There can be little debate that the leading issue in this category is the global economic crisis. In the latter half of 2008, the world faced an unprecedented near-collapse of its banking systems, ushering in a global recession.

Fertilizer: We assign the prime responsibility for this catastrophe jointly to political leadership in the United States in concert with the greed, negligence and corruption of its financial industry. This does not take the inaction and practices of other countries off the hook, as consequential national and global failures are documented extensively elsewhere, especially in Europe. Clearly, no country (rich or poor) has been spared, and it will take many years for individuals, families, communities and societies as a whole to recover from this crisis of greed, neglect and incompetence. Perhaps needless to say, the necessities of life and the social fabric of all countries e.g, health and educational systems, secure food supply, clothing and shelter depend on integrity in our financial systems. Trust must be restored in those systems.

Flowers: Out of this morass some good is emerging, and in this regard we note the leadership of UK Prime Minister Gordon Brown, who put forward a 5 point plan to galvanize the world financial community around new principles. Implicit in the “Brown Doctrine” is an analysis of what is so seriously wrong with the world financial order. It forms a clear case for supra-national supervision of international finance, which clearly cannot any longer be left to the caprices of any one country. The key features of the Doctrine are presented below (2008 as we observed it) from our October 2008 issue.

2. INTERNATIONAL DEVELOPMENT
In this category we draw attention to the work of a World Health Organization (WHO) Commission on the Social Determinants of Health, released in August 2008, chaired by Sir Michael Marmot. In releasing the report in August, WHO Director-General Dr Margaret Chan stated: "Health inequity really is a matter of life and death,…but health systems will not naturally gravitate towards equity. Unprecedented leadership is needed that compels all actors, including those beyond the health sector, to examine their impact on health. Primary health care, which integrates health in all of government's policies, is the best framework for doing so." It does not seem appropriate to allocate “flowers” to the Commission itself, as this would be like “applauding the messenger”. Instead, we now draw attention to their mention of a few countries for addressing inequities:

Flowers: “Some low-income countries such as Cuba, Costa Rica, China, state of Kerala in India and Sri Lanka have achieved levels of good health despite relatively low national incomes”. Wealth alone therefore does not determine the health of a nation's population. But, the Commission points out, wealth can be wisely used: “Nordic countries,… have followed policies that encouraged equality of benefits and services, full employment, gender equity and low levels of social exclusion”. Also “the feasibility of action is indicated in the change… already occurring. Egypt has shown a remarkable drop in child mortality from 235 to 33 per 1000 in 30 years. Greece and Portugal reduced their child mortality from 50 per 1000 births to levels nearly as low as Japan, Sweden, and Iceland. Cuba achieved more than 99% coverage of its child development services in 2000.”

Fertilizer: This can be applied to a large number of nations for whom "health gradients" within countries are persistent or even deteriorating. Examples: Life expectancy for Indigenous Australian males is shorter by 17 years than all other Australian males. In Indonesia, maternal mortality is 3–4 times higher among the poor than the rich. The adult mortality differential between least and most deprived UK neighbourhoods is more than 2.5 times. Child mortality in Nairobi slums is 2.5 times higher than in other parts of the city. A baby born to a Bolivian mother with no education has 10% chance of dying, while one born to a woman with at least secondary education has a 0.4% chance. In the US, 886 202 deaths would have been averted between 1991 and 2000 if mortality rates between white and African Americans were equalized. In Uganda the death rate of children under 5 years in the richest fifth of households is 106 per 1000 live births versus 192 deaths per 1000 live births in the poorest fifth (almost one in five)…; set this against an average death rate for under fives in high income countries of 7 deaths per 1000.

Comment: All too often our political “leaders”, more interested in short term gains (“looking good”) than in real change, respond to such information with fatuous, even pontifical comments, without intending to deal with the underlying causes. This is worse in some countries than in others, and there is even greater cause for concern wherever relevant social indicators are slipping: deteriorating infrastructure, lack of measurable gains in access to health care and quality education, return of previously controlled preventable diseases (e.g, gastroenteritis, dengue fever), crime of various sorts (often related to mismanaged economies and related poverty), corruption and related trends towards authoritarian politics ignoring the fundamentals of human rights.

3. HUMAN RIGHTS ABUSES
At time of writing, over a thousand people, mostly innocent civilians, have been killed in Gaza by hi-tech Israeli military attacks since mid December 2008, virtually 100 times the number of Israeli casualties (mostly military, including “friendly fire”). In alleged retaliation for Hamas rocket attacks, in themselves a crime under international humanitarian law, this disproportionate and collective punishment of the Palestinian people can only be viewed as an atrocity of far greater magnitude.

In the meantime, long standing legitimate Palestinian grievances continue to be ignored by Israel and by the so-called “international community”.

Apologists for Israel are quick to note the horrific atrocities elsewhere in the world over the past year, such as in the Sudan and the Congo, and complain that their conflict attracts disproportionate condemnation. Israel thereby claims to occupy higher moral ground in its conflict with the Palestinians; yet the facts remain that people driven out of their ancestral land, penned up in refugee camps, impoverished and colonized by settlements on land that many recognize as theirs, also have the right to self-determination.

Flowers: Six international humanitarian NGOs: Amnesty International, Christian Aid, CAFOD, CARE, OXFAM, Save the Children, Trocaire; for documenting the situation in the Gaza as “the worst since the 1967 war between Israel and its neighbours” (March 2008).

Fertilizer: Israel, and through their support for its actions, the US and Canada. The US has funded and armed Israel to become the most powerful military force in the Middle East, on land, sea and air (Gaza has no military capacity, hence the asymmetry of home-made rockets). Canada, once a fair minded country, meanwhile has adopted an almost totally one-sided posture in support of Israel (under the minority government of Stephen Harper). It remains to be seen whether the incoming Obama administration will be more even-handed than its predecessor, given the power of the Israeli lobby on this continent.

With supporters like this, should Israel really be compared with Sudan or the Congo? Or should it be given the same scrutiny as the Balkans, and be referred urgently to a war crimes tribunal?

Comment: It is difficult to see where this is going and who is intended to benefit from the continued stand-off between these two peoples. What are the motivations behind the attacks? There is surely more to this than home-made rockets, especially in the context of unresolved injustices. There is potential here for an even wider regional conflagration. For a world only now starting to emerge from the Bush-Blair distortions of information to prosecute the disaster in Iraq, we must remain alert to the advice of Edmund Burke:

All that is needed for the forces of evil to succeed is for enough good men to remain silent.

2008 AS WE RECORDED IT
⁭ January: WORLD DEVELOPMENT CALLS FOR INVESTMENT IN AGRICULTURE 2008 The World Development Report 2008 (linked) calls for greater investment in agriculture in developing countries. This annual World Bank report warns that the sector must be placed at the center of the development agenda if goals of halving extreme poverty and hunger by 2015 are to be realized: While 75% of the world’s poor live in rural areas in developing countries, a mere 4% of official development assistance goes to agriculture; In Sub-Saharan Africa, a region heavily reliant on agriculture for overall growth, public spending for farming is also only 4% of total government spending and the sector is still taxed at relatively high levels; GDP growth originating in agriculture is about four times more effective in raising incomes of extremely poor people than GDP growth originating outside the sector.

Said World Bank Group President Robert B. Zoellick: “At the global level, countries must deliver on vital reforms such as cutting distorting subsidies and opening markets, while civil society groups, especially farmer organizations, need more say in setting the agricultural agenda.”

In this issue we focused on Malawi as a Case Study of the role of new subsidies to enhance agricultural production, despite decades of donor proscription not to subsidize, and take note of a World Trade Organization investigation into the use by the United States of truly massive trade-distorting farm subsidies in violation of international commerce rules.

⁭ February: CANADIAN POLITICS TRUMPS NUCLEAR SCIENCE, HEALTH AND SAFETY This issue draws attention to the apparent disregard for nuclear safeguards recently revealed by Canada’s minority Conservative government. This failure to respect the independent role of the Canadian Nuclear Safety Commission puts into question whether Canada takes nuclear safety seriously. For a synopsis of this episode, we paraphrased and updated the core content of a January 2008 article in The (Toronto) Star by Walkom (acknowledged). Further down, we summarized a report from the Canadian Medical Association Journal that revealed the manipulative attitude of the Canadian medical isotope industry, paraphrased from a CTV News report. The main story is how Canada’s government put politics ahead of public health and safety. Clearly there are questionable commercial and political practices in Canada at present.

⁭ March: HUMANITARIAN SITUATION IN GAZA WORST IN FOUR DECADES This issue features a report recently released by six international humanitarian NGOs (Amnesty International, Christian Aid, CAFOD, CARE, OXFAM, Save the Children, Trocaire), documenting the situation in Gaza as the worst since the 1967 war between Israel and its neighbours. The deterioration can be attributed mostly to the period since mid-2007 when Israel imposed a blockade. For "balance", we cite two reports from Israeli media; we also recognize that – like Canadians and their government –the views of all Israelis are not necessarily reflected in the policies of their government.

Canadian Complicity: This report should be of particular concern for Canadians, especially because Canada (under the minority Conservative government of Stephen Harper) is the only member country to vote against a recent United Nations Human Rights Council motion calling for immediate international action to force Israel to allow fuel, food, medicine and other essential items to be sent to the Gaza Strip, to reopen border crossings and to end its “grave violations” in the occupied Palestinian territory.

⁭ April: SEX RATIOS DESTABILIZING IN ASIA “Sex ratio” (SR) refers to the ratio of males to females (M:F) in a population. We focused on this topic because dramatic shifts in sex ratio are taking place in some parts of the world that reveal cultural preferences and social practices favoring the birth/survival of one sex over the other (more often favoring males over females). Other factors influencing the sex ratio of societies include: changing composition by ethnicity and race; civil unrest or warfare; large-scale immigration e.g., male labourers unable to travel with their families; ecological factors eg contaminants in environment; variables affecting mother’s health eg social status, smoking, nutrition, access to support networks.

⁭ May: THE GLOBAL ARMS TRADE – An Atrocity? To find out who shares responsibility for global militarization, follow the money trail. Regardless of attempts to legitimize the trade, the historical reality is that bribery, corruption and mercenary as well as national self-interest lie at the heart of the trade. The arms industry is unlike any other. It operates without regulation. It suffers from widespread corruption and bribes. And it makes its profits on the back of machines designed to kill and maim human beings.

So who profits most from this murderous trade? The five permanent members of the UN Security Council—the USA, UK, France, Russia, and China. Together, they are responsible for 80% of reported conventional arms exports. “We can’t have it both ways. We can’t be both the world’s leading champion of peace and the world’s leading supplier of arms.” Former US President Jimmy Carter, presidential campaign, 1976.

⁭ June: HEALTH CARE IN CANADA – An Essay: A public consultation on health care, called the Conversation on Health, took place during 2007 in the Canadian province of British Columbia. Our firm made a written submission, and in this issue we took the opportunity to transform the core of this into an overview of Canada’s health care, on the premise that this may be of global interest.

NOTE: The essay is written for the Canadian context, so we caution that Canada’s model is NOT readily translatable to most other countries. However, it may be a viable option for economically developed ones that still lack universal coverage. We reserve the right to change our views on any aspect of this essay; in this sense it is as a work in progress.

⁭ July: CHILD SOLDIER INCARCERATED IN GUANTANAMO BAY This month we depicted the situation of a Canadian youth held at the offshore US prison camp at Guantanamo Bay, Cuba, a site selected by the US military for detention of “enemy combatants” so as to circumvent the normal jurisdiction of US laws and to exert military control over due process.

The background on Guantanamo Bay itself is instructive. The US assumed territorial control over this Cuban region under the 1903 Cuban-American Treaty, which granted the US a perpetual lease. The Cuban government today considers the US presence to be illegal, arguing that the Treaty violates Article 52 of the 1969 Vienna Convention on the Law of Treaties, which declares a treaty void if its conclusion has been procured by the threat or use of force in violation of international law. Article 4 of the document, however, states that the Convention shall not be retroactively applied.

⁭ August: SELECTED WEB RESOURCES ON GLOBAL HEALTH with an acknowledgement to ProCOR This issue highlights some of the work of an organization we respect for its efforts to bring together a virtual community of health professionals from around the world. ProCOR is devoted to examining health and related social issues of relevance to developing countries, with particular reference to cardiovascular diseases. ProCor's monthly "Resource Update" (edited by Juan Ramos) highlights relevant materials. A recent Resource Update on ProCOR listed a number of websites that offer valuable information about health and/or health resources around the world. Selections are made from this list in order to further disseminate ProCOR’s efforts in this regard, as well as to draw attention to the health communications work of ProCOR.

⁭ September: THE SOCIAL DETERMINANTS OF HEALTH In this month we drew attention to the work of a World Health Organization (WHO) Commission on the Social Determinants of Health, released in August 2008, chaired by Sir Michael Marmot.

In releasing the report in August, WHO Director-General Dr Margaret Chan stated: "Health inequity really is a matter of life and death,…but health systems will not naturally gravitate towards equity. Unprecedented leadership is needed that compels all actors, including those beyond the health sector, to examine their impact on health. Primary health care, which integrates health in all of government's policies, is the best framework for doing so."

⁭ October: GLOBAL ECONOMIC CRISIS, FINANCIAL REFORMS & “THE BROWN DOCTRINE” British Prime Minister Gordon Brown outlined a five-point program on October 14, 2008 to reform the world’s financial system, and serve as a basis for a new set of global institutions to replace those that have governed international finance since 1944. The 5 principles (for elaboration see the October issue) are: Transparency, Integrity, Responsibility, Tighter Regulation, and New Institutions.

The new system of banking cooperation will need “a new international financial architecture for the Global Age”. New institutions will provide “an effective global early warning system for the world economy, to alert us to the risks at hand”, and “globally accepted standards of regulation” and the cross-border supervision of global corporations.

⁭ November: CAN OBAMA RESTORE THE WORLD’S TRUST IN AMERICA’S IDEALS? We dedicate this issue of PacificSci Global Perspectives to Senator Obama’s political victory, and wish him whatever success is achievable in his efforts to turn around the abysmal situation faced by the US following the Bush 2 administration’s widespread failures in global and domestic vision, leadership and management. There are challenges on every front: economy, health, education, security, restoration of democratic and human rights principles in the US itself (including closing Guantanamo Bay, and rejecting torture), and not least rebuilding the nation’s reputation.

⁭ December: PacificSci – FIFTH ANNIVERSARY OF A BUSINESS VENTURE WITH A SOCIAL PURPOSE In this issue we examine the emergence of fourth sector organizations as virtually inevitable: breaking with earlier relationships between the state, the private sector and the voluntary sector, operating outside the world of grants, and inside the economic requirement of surviving as a business, the bottom line is one of social purpose: a modern renaissance of motivation to improve the human condition.

AND A HAPPY NEW YEAR!
We extend to readers our best wishes for 2009, with hopes that the serious challenges facing the world in 2008 and other recent years will be better understood and managed going forward. For this to happen we all need better political leadership. PacificSci will continue to offer an independent view of trends and events.