Can demographic growth drive society forward?

By Karl Hofmann, President and CEO of PSI

rtr238hd.34207af05ae2b510307d72e41c1b0d0eDemography is a powerful thing. Only two years ago, the UN projected a “medium variant” global population in 2050 of 9.3 billion; just recently the UN upped this projection by 300 million people to 9.6 billion. What’s striking about this upward drift in the UN’s projections is that the growth comes from a surprisingly small set of countries, mainly in sub-Saharan Africa. These include Nigeria and the Democratic Republic of Congo, as well as Niger, which currently has the world’s highest fertility rates.

Elsewhere the world has recorded general declines in fertility. Family size is falling and incomes are rising. And the relationship between those two trends is the subject of ongoing debate over whether one causes the other, and if so, which way the causality flows.

The experience of some emerging economies demonstrates that what’s most important to general societal health and well-being is not necessarily how rapidly the population is growing, but rather what policies are in place to leverage these additional brains into productive uses for society. The demographic dividend that India has reaped, for example, means that even though huge social challenges remain, the growing Indian population has been able to power middle class economic growth and social progress. Population matters, but so do policies.

Are we falling behind against drug resistant malaria?

Credit: Yannick Tylle/ CorbisThe Guardian Development Professionals Network hosted a conversation this morning on the progress and missteps against malaria drug resistance. PSI deputy director of the malaria and child survival department Angus Spiers joined other experts for a conversation about the present challenges and what is being done to slow down resistance. Here is an excerpt of the conversation:


AngusSpeirsPSI: Hello, this is Angus Spiers from PSI. Very happy to be part of this discussion. Prudence, (I hope you’re well, it’s been too long), you make a number of very pertinent points, particularly the need for rapid identification of resistance foci and measures to effectively target them.

We have been focusing on a number of areas in the Mekong region to help combat artemisinin resistance, particularly with case management in the private sector where a large proportion of people seek treatment (see ACTwatch) but receive little in the way of effective diagnosis and are often treated with sub-standard monotherapies which only help drive resistance.

Resistance and Artemisinin Combination Therapy (ACT)

PrudenceHamade: I know PSI is working in Myanmar to try to replace monotherapies with ACTs as well but I am afraid it might be too little too late.

ACTs still cure patients with malaria but they are taking longer to do so allowing the ‘resistant parasite’ which remains when all the non-resistant parasites are cleared to be transmitted to others Being positive 72 hours after treatment ( Day 3) is only a proxy measure of resistance how can we better determine resistance and when we do what can be done to make sure the resistant parasites are not passed on to others.

Ensuring a Healthy and Safe Delivery

By Dr. Leslie Mancuso, PH.D., R.N., F.A.A.N., President and CEO, Jhpiego Frozan Admadi places her ear on one end of a pinard horn. She holds the other end of the stethoscope on the belly of her pregnant client, smiling as she hears the fetus’ steady heartbeat. Frozan is the only midwife in Marabad, a rural community in Afghanistan’s Helmand Province, which is in the southern part of the country and has a population of 17,000. “There was no full-time midwife here before me,” she recalls. “Some used to come to the village for one or two weeks at a time.” As one of 3,000 newly trained midwives in Afghanistan, Frozan travels to the homes of pregnant women in her community to check on their health. It’s a routine with a single purpose – to ensure a healthy and safe delivery. Frozan checks their blood pressure for any indications of preeclampsia, a potentially fatal pregnancy-related hypertensive disorder. She educates her clients about the signs of labor, provides iron pills to ward off anemia, and helps craft birth plans to get to a health facility in time. “Many women are unable to get to the hospital if they were having problems. I try and treat them in the ... Read more

Collaborating to support people with NCDs in Uganda

By Greg Paton, Technical Advisor, Uganda NCD Alliance.  Kampala, Uganda

“What could I have done to prevent my cancer?”

UNCD Premises

This question was posed to me by a mother living in a small hut on the outskirts of Kampala, Uganda. The nurse informed me that the women had advanced colorectal cancer and was no longer responding to treatment. I found myself at a loss for words.

I was accompanying the mobile palliative care team at Hospice Africa Uganda on their weekly rounds to distribute free morphine. As the nurse shared key cancer prevention strategies – early screening, avoiding tobacco, eating healthy and regular exercise – the woman pledged to educate others in her village, offering hope that her experience with cancer could be used to empower and educate her peers.

Eight months after moving to Uganda, the overwhelming statistics that framed my perception of these conditions have been replaced by human stories. Poverty is the narrative of these stories, and the poor and vulnerable are the central characters.

Let Us Measure Up As Men

By The Elders

On November 25, we mark the International Day for the Elimination of Violence Against Women. It is deeply saddening, though perhaps not shocking, to learn that around 70 percent of all women experience physical or sexual abuse during their lifetime. Despite the progress we have made, this world remains a cruel and arbitrary one for too many women and girls.

Do not be fooled, however: this is not some so-called “women’s issue”. After all, we know that more often than not, the violence suffered by women is inflicted by the men they share their lives with – their fathers, husbands, intimate partners. If the majority of women in this world have suffered at the hands of their men, how many millions of men must have hurt and abused women? How many millions of men have stood by and let it happen?

If men overwhelmingly brutalize women, then men are overwhelmingly brutal.

This is something I cannot accept. This is why I call on men and boys everywhere to take a stand against the mistreatment of girls and women. It is by standing up for the rights of girls and women that we truly measure up as men.

Our Post-2015 Agenda: Women

By Caitlin Callahan

CC Headshot

Last month, more than 4,500 leaders from over 2,200 different organizations convened in Kuala Lumpur for the third Women Deliver conference – a meeting dedicated to the health and empowerment of women and girls. Panel discussions and plenary events reinforced the importance of investing in girls and women as catalysts for greater positive change within their families and their communities.

And for that reason, the post-2015 agenda, or the next global strategy for international development following the expiration of the Millennium Development Goals (MDGs), was a common framework for debate; ‘calls to action’ were mirrored by sessions to discuss the previous agendas in Cairo, Beijing, and Rio: the successes and the prospects for improvement to empower women and create opportunity for broader growth.

Contextually, the World Bank’s President Dr. Kim recently declared 2030 as the new deadline for eliminating all extreme poverty in the world, setting the universal $1.25/day income mark as the threshold for success. This may seem like an enormous goal, but we’ve seen unprecedented success in the past few decades that helps to inspire some hope. More specifically, in the past 20 years, the global poverty rate has been reduced by a full 50%: from 43% of the population living in extreme poverty in 1990, to 21% in 2010.1 In other words, Dr. Kim wants to replicate the success of the past 20 years in the next (less than) two decades.

Public-Private Partnerships Strengthen TB Response in Myanmar

By Regina Moore, Associate Manager, Advocacy & Communications, PSI

DSC00538The authors of “Shortages of Drugs Threaten TB Fight” in the Wall Street Journal on June 6 should be applauded for shedding light on important aspects of the tuberculosis burden both globally and in the U.S., but they focus almost exclusively on the government and public sector. To adequately address TB a close partnership between the public and private sector needs to be an important consideration.

I recently returned from a trip to Myanmar where I saw the importance of this public-private mix. Global health organizations, like PSI, work closely with the government’s National TB Control Program in-country, to strengthen both public and private healthcare.

In many developing countries, private clinics and pharmacies are the first places people visit to seek care because private providers are often perceived as friendly, local, open at convenient times and understanding of a family’s needs. Even in this article Reshma’s family turns to a private pharmacy when the public sector cannot help her. Unfortunately, private clinics and pharmacies such as these are often unregulated with varying degrees of quality.


One Year Later: From Promise to Action on Ending Preventable Child Deaths

By Nicole Schiegg, Former USAID Senior Advisor; Strategic Comms Consultant

2013-06-13-430045_10151726897765992_1502893062_n.jpgThis week we celebrate the one-year commemoration of the Child Survival Call to Action held in Washington, DC. Working at USAID at the time, I have a unique insight into the organization of this milestone event, and will always remember the experience fondly. Not only did the Call to Action unite and reenergize the global health and extended community towards a common goal — to end preventable child deaths — it catalyzed momentum at country-level that has been nothing short of extraordinary.

A few months before the Call to Action, USAID turned a conference room into a team room that became the center of the Agency’s activity – one wall was covered with hundreds of 5th birthday photos and the other was entirely dry eraser depicting ideas, logistics, and anything else that was the task of the day. About 6 of us virtually lived in this room, but it packed in 30 staff when we had our all-hands meetings. What inspired me about the team is that it consisted of people who had worked in development for their careers and folks who were brand new to the field. Everyone had a laser-like focus towards June 14-15 and what it represented. No one was committed more to this goal than USAID Administrator Raj Shah who frequented the team room for meetings and updates.

The Call to Action was a special and surreal experience when it finally arrived. A few days after it ended, I had to re-watch the webcast to grasp the enormity of what had transpired. Over 70 countries signed a pledge to accelerate action towards ending preventable child deaths. Private sector leaders committed to new partnerships – as did faith and civil society organizations.

Foreian Aid is Essential say Reps Crenshaw and Smith

Republican Ander Crenshaw of Florida’s 4th Congressional District, and Democrat Adam Smith of Washington’s 9th Congressional District make the case for foreign aid in an OpEd for Politico. The co-chairs for the Caucus for Effective Foreign Assistance say that foreign aid is essential and cost-effective. They write:

Foreign assistance programs are important for spurring our economy, too. More than half of our exports go to the developing world now and that number is growing. The key to expanding our economy and creating jobs here at home lies beyond our shores, and reaching the 95 percent of the world’s consumers who live outside the U.S. requires investment in these rapidly growing markets.

Careful attention must be paid to how we spend every taxpayer dollar. As the co-chairs of the Congressional Caucus for Effective Foreign Assistance, our goal is to help ensure the global investments we make bring the best return possible to America.

Significant strides have been made over the past decade to make these programs more effective, and a new “Report on Reports” released by the U.S. Global Leadership Coalition details areas of consensus on how we can do even better.

Why non-state education and why CEI?

By Nicholas Burnett, Managing Director for Education at Results for Development Institute, leader at the Center for Education Innovations

I was in Ghana earlier this year, where as many as two-thirds of the children living in slum areas outside the capital of Accra are estimated to attend private schools, quite a few of which I visited.  Though some think it unfortunate, the poor are increasingly enrolling in non-state schools in Africa and in South Asia, as they have for many decades in Latin America.  These non-state schools include those run by non-government organizations and those owned and operated by private proprietors.

Why do I say some think it unfortunate? We believe far too many people come to the table with preconceived notions about what works and what doesn’t work in education, all too often based on labels such as “public” and “private,” and too rarely based on evidence and results. But, as we move toward 2015 with the Education for All and Millennium Development goals clearly not going to be met, in terms of either enrolment or quality, it is time to move beyond ideology and focus pragmatically on harnessing all parts of the education system and on what works in practice.