Mixed Grades for US Reproductive Health Report Card

If states were people, the parents of California, Washington, Oregon, and Maryland would be pretty darn proud. They are the only states to receive A’s on the Population Institute’s annual State of Reproductive Health And Rights report card.

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On the other hand, the disappointing set of states are Texas, South Dakota, Mississippi, Missouri, Louisiana, and Indiana. All an F-. Given that F stands for failure, doing worse than a plain old F is pretty bad.

The overall picture is not too great. The report scores the US as a whole with a C-. Though it is not all bad news.

“This year we have seen a lot of victories at the national level, but with states limiting the full scope of that progress. The major victories include: HHS ruling that Plan B One Step be made available over the counter without an age restriction, the Affordable Care Act giving women access to family planning services without a co-pay requirement, and expanded Medicaid eligibility ensuring that millions more women would be eligible to access reproductive health services,” said Population Institute President Robert Walker.

“Unfortunately, at the state level, attacks on reproductive health care have continued unabated and 25 states have refused to expand their Medicaid program denying millions of women access to health care.”

Here are how all the states fared:

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The scores are on a 100 point scale and broken down by the following criteria:

- Thirty percent of the grade is based on measures of effectiveness. This includes the latest available data on the teenage pregnancy rate (15%) and the rate of unintended pregnancies (15%).
- Twenty percent of the grade is based upon prevention. This includes mandated comprehensive sex education in the schools (15%) and access to emergency contraception (5%).
- Thirty percent of the grade is based upon affordability. This includes if states are expanding Medicaid under the Affordable Care Act (10%), Medicaid eligibility rules for family planning (10%), and funding for family planning clinics serving low-income families (10%).
- The final twenty percent of the grade is based upon clinic access. This includes abortion restrictions (10%) and percent of women living in a county without an abortion provider (10%).

Read the report here.

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The Daily Impact: Global Fund and UNAIDS Concerned by Nigeria Gay Ban

January 15, 2014

The Global Fund and UNAIDS are worried that the passage of a new law criminalizing homosexuality in Nigeria will harm progress against HIV/AIDS.

image001The new law could prevent access to essential HIV services for LGBT people who may be at high risk of HIV infection, undermining the success of the Presidential Comprehensive Response Plan for HIV/AIDSwhich was launched by President Goodluck Jonathan less than a year ago.

The health, development and human rights implications of the new law are potentially far-reaching. Homosexuality is already criminalized in Nigeria. The new law further criminalizes LGBT people, organizations and activities. The law states: “A person who registers, operates or participates in gay clubs, societies and organisation, or directly or indirectly makes public show of same sex amorous relationship in Nigeria commits an offence and is liable to conviction to a term of 10 years imprisonment.

The law also criminalizes any individuals or group of people who support “the registration, operation and sustenance of gay clubs, societies and organisations, processions or meetings in Nigeria.” The conviction is also 10 years imprisonment.

The provisions of the law could lead to increased homophobia, discrimination, denial of HIV services and violence based on real or perceived sexual orientation and gender identity. It could also be used against organizations working to provide HIV prevention and treatment services to LGBT people.

Nigeria has the second largest HIV epidemic globally––in 2012 there were an estimated 3.4 million people living with HIV in Nigeria. In 2010, national HIV prevalence in Nigeria was estimated at 4 percent among the general population and 17 percent among men who have sex with men.

In the 2011 United Nations Political Declaration on HIV/AIDS, all UN Member States committed to removing legal barriers and passing laws to protect populations vulnerable to HIV.

UNAIDS and the Global Fund call for an urgent review of the constitutionality of the law in light of the serious public health and human rights implications and urge Nigeria to put comprehensive measures in place to protect the ongoing delivery of HIV services to LGBT people in Nigeria without fear of arrest or other reprisals. UNAIDS and the Global Fund will continue to work with the Nigerian authorities and civil society organisations to ensure continued and safe access to HIV services for all people in Nigeria.

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Global Health and Development Beat

Women - A women’s group says the military in Burma is still using rape as a weapon of war, with more than 100 women and girls raped by the army since a 2010 election.

UHC - The rollout of universal health coverage in Indonesia has been greeted with public enthusiasm, but health experts warn that inadequate funding could undermine the quality of care.

Haiti - Thousands of Haitians sought refuge on the island of La Gonave after the earthquake, but little help arrived reports the GlobalPost.

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The Players

Syria - NGOs pledged $400 million in support of the humanitarian response to the crisis in Syria, in Kuwait. International donors are expected to pledge more today.

WFP - Is very concerned about food security as Zimbabwe enters the peak of its so-called hunger season — the last three months before the traditional harvest.

HRW - Human Rights Watch called on international donors to demand access for relief deliveries to Syrian civilians trapped by the fighting.

WFP - The WFP delivered rations to a record 3.8 million people in Syria in December, but civilians in eastern provinces and besieged towns near the capital remain out of reach.

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Spotlight on PSI

Despite a decreasing prevalence of HIV/AIDS among commercial sex workers, stigma and the harsh laws are undermining sex workers’ access to HIV-related services. IRIN spoke to PSI, UNAIDS and others about the challenges:

“Prevalence has been decreasing in all risk groups other than drug users,” Anne Lancelot, director of the Targeted Outreach Programme at Population Services International (PSI) confirmed.

Surveys reveal that in 2008, prevalence among sex workers stood at 18.4 percent, whereas 7.1 percent of sex workers were HIV positive in 2012.

While government data estimates that there are currently 60,000 sex workers in Myanmar, PSI puts the real number at closer to 80,000. The national HIV infection rate is 0.5 percent, making HIV/AIDS a concentrated epidemic, said Murphy, adding, “However there have been quite a lot of deaths due to a lack of access to treatment.”

The stiff penalties for commercial sex work contained in Myanmar’s Suppression of Prostitution Act (1949) are a major barrier to accessing HIV treatment. The punishment is one to three years in prison for sex workers, but clients are not punished under the law.

“Very harsh laws are in place against sex workers, instead of the mobilizers, the traffickers and the gangs who push women into sex work,” said Sid Naing, the country director for Marie Stopes, an international NGO working to improve sexual and reproductive health.

Even possessing a condom could be used as circumstantial evidence of prostitution until 2011, when the Ministry of Home Affairs issued a directive to the contrary, yet according to UNAIDS most of the public are unaware of the directive.

“People are still not comfortable about carrying large amounts of condoms because they could be targeted as sex workers,” PSI’s Lancelot noted.

Another barrier to the prevention and treatment of HIV is the stigma surrounding commercial sex work – the word “prostitute” literally translates to “bad woman”.

“Myanmar isn’t like other countries where sex work is more organized, with red-light districts which are brothel-based. There’s a great deal of indirect sex work, such as in massage parlours and karaoke bars,” said Krittayawan Tina Boonto, the UNAIDS investment and efficiency advisor.

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Buzzing in the Blogs

The cross-cutting effects of NTDs make it crucial that the international community prioritize them in the post-2015 development agenda, says Neeraj Mistry in the Guardian.

To build on these commitments, we must ensure that endemic countries have the capacity to deliver medicines to the most at-risk communities and achieve sustainable progress. Endemic countries have a critical role to play in demonstrating political will to prospective development partners by expanding “last mile” access and raising in-country support for NTD control and elimination efforts. This increase in demand will encourage donor governments to include NTDs in their future global health and development investments. As the millennium development goals expire in 2015, we have a great opportunity to focus on NTDs and identify effective areas of integration of NTD control into broad development programmes, but to take advantage of that opportunity, three things must happen:

The first step is to encourage UN decision-making bodies to embrace the recommendations issued by the UN high-level panel of eminent persons on the post-2015 development agenda, and incorporate NTDs in the revised post-2015 development framework and related sustainable development goals.

Civil society organisations and individuals must also continue to play a key role in influencing the discussion. Last autumn, over 3,000 people worldwide urged the UN to include NTDs in the post-2015 development agenda. The UN secretary general’s special adviser on post-2015 development planning positively responded: “I share your view that the fight against NTDs is paramount to the global efforts to eradicate poverty and achieve sustainable development.”

It will take broad resources to overcome the current funding gap of approximately $300m (£220m) each year (pdf). WHO’s regional director for Africa Luis G Sambo emphasised this in October: “We need sustained support from all stakeholders.” This requires intensive advocacy that urges policymakers in donor and endemic countries alike to recognise how NTD control and elimination will help advance progress in many of their current health and economic development priorities.

Ultimately, endemic countries must self-finance NTD programmes within existing budgetary structures to ensure sustainability; however, leadership from both donor and endemic countries is needed now to quickly develop and expand programmes.

By including NTDs and specific targets in the post-2015 development agenda, we will support country-led efforts to reach control and elimination goals, improve the health and well-being of hundreds of millions of people, and accelerate progress in global poverty reduction by 2030 and beyond.

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Capital Events

Wednesday

10:00 AM - Powering Africa – A Conversation about Progress and Prospects - CGD

2:00 PM - Subcommittee Hearing: A Report on the G-8 Dementia Summit - US House Committee on Foreign Affairs

2:00 PM - Global Youth Workforce Development - CSIS

Thursday

4:00 PM - How Social Movements Succeed: Lessons from HIV/AIDS - CGD

Friday

12:00 PM - The Organization of Islamic Cooperation: Free Speech Implications of a Proposed Ban on “Islamophobia” - Hudson Institute

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By Mark Leon Goldberg and Tom Murphy

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Come Learn about the Equity Measurement Toolkit

The Social Franchising Metrics Working Group is pleased to invite all interested participants to the webinar launch of the Equity Measurement Toolkit. This toolkit, sponsored by the International Finance Corporation, includes everything a health program needs to measure the wealth distribution of its clientele. Contents include text and video tutorials; surveys; and training, planning and pre-programmed data analysis tools.

Webinar participants are invited to preview the toolkit ahead of the event. Upon registration confirmation, you will receive a link to the password-protected site.

Date: Tuesday January 28, 2014
Time: 5:20 AM PST

Agenda (in Pacific Standard Time):

5:20 – 5:30 am: Audience members sign in and fine-tune their audio set-up

5:30 – 5:35 am:  Introductions and welcome (Speaker: Andrei Sinioukov)

5:35 – 6: 25 am: Orientation on the equity measurement toolkit (Speaker: Kenzo Fry)

6:25 – 6:45 am: Questions and answers

Participants are encouraged to submit questions to the speaker ahead of time. The webinar organizers will follow this notice with an email invitation to you to join the online Social Franchising Community of Practice. Simply accept the invitation and post your questions on the discussion board.

This event is hosted by the Private Sector Healthcare Initiative, Global Health Group, University of California at San Francisco.

To register, go here.

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Is the Female Condom the New It Thing?

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You can’t really call it a comeback. The female condom initially failed to gain support and use when it was introduced two decades ago. Now, groups like PSI, Pathfinder and others are helping to revitalize the once cast-aside family planning tool by working with partners at the government, business and individual level.

Success is coming thanks to innovative new condoms and changing the ways to sell them to women. For example, PSI is working with hair salons to sell condoms to women. The informal atmosphere allows for freewheeling discussions and a safe space for women to learn about family planning options.

New research about the female condom is promising. The BBC summarized a trial published in the Lancet, by Mags Beksinska from the University of the Witwatersrand in South Africa.

- The Woman’s Condom, already available in China and soon to be distributed in South Africa, is the fruit of a 17-year project by Path – an NGO that specialises in health innovation – which has tested more than 50 versions. Out of the packet, it’s smaller than the FC2. It looks like a tampon, with most of the condom gathered into a rounded polyvinyl capsule, which dissolves inside the vagina. Once it has expanded, dots of foam help keep it in place.
- The Cupid is available in India, South Africa and Brazil. It is vanilla scented and comes in pink or natural colours. It is currently the only model besides the FC2 to have been qualified by the World Health Organization (WHO) for public-sector purchase. A smaller version aimed at the Asian market is in trial.
- The VA Wow, like the Cupid, contains a sponge which helps users to insert the condom and prevents it slipping.

It goes on to speak with various advocates and people working on the frontlines of women’s health, including PSI affiliate the Society for Family Health.

In Africa, the free availability of female condoms at clinics has led to an unexpected fashion trend. Women have taken to removing the flexible ring from the device and using it as a bangle. “If you are [romantically] available you have a new bangle on,” says Marion Stevens from the female health campaigning body Wish Associates. “If you are in a long-term relationship your bangle is old and faded.”

Meyiwa Ede, from the Society of Family Health in Nigeria (sic), says that while men are often excited by the prospect of sex without having to wear a regular condom, women are taken aback by their first glimpse of the device.

“They look at it and say ‘OK – are you saying I have to put that in myself?’” she says.

Ede’s team of demonstrators use a mannequin to show the condom is inserted and compare the task to using a new phone – bewildering at first, but second nature after a while.

In most developed countries there is still that 20-year-old image problem to overcome.

“I think the issue is when you open the package they’re already open – they’re not like male condoms that are in these neat little packages and then they’re unrolled,” says Mags Beksinska from the University of the Witwatersrand in South Africa. “In fact, they’re the same length as a male condom so if you hold the two together open, they’re not that different.”

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The Daily Impact: India Makes it Three Years Polio Free

January 13, 2014

It has been three years since the last case of polio in India, a major achievement celebrated by the country. From AP:

India has made great strides against polio in recent years through a rigorous vaccination campaign. But for many in India, where polio victims with withered, twisted limbs are a common sight on the streets, these advances have come too late.

“My parents were very poor and couldn’t afford medical treatment for me,” said Sonu Kumar, 24, who contracted the disease when he was 10. Paralyzed from the waist down, he begs outside a temple in central Delhi and uses a wheelchair to move around.

Polio is a vaccine-preventable disease that has been eradicated in most countries. But it still causes paralysis or death in some parts of the world, including Nigeria, Pakistan and Afghanistan.

Polio usually infects children under age 5 when they drink contaminated water. The virus attacks the central nervous system, causing paralysis, muscular atrophy, deformation and, in some cases, death.

“India was once thought to be the most difficult country in which to achieve polio eradication,” Global Polio Eradication Initiative said in a statement.

Monday’s milestone was significant, but the World Health Organization stills need to confirm there are no undetected cases before making the official declaration that India is polio-free in March.

Still, Junior Home Minister R.P.N. Singh sent a triumphant message on Twitter: “Proud day for all of us as Indians … India is polio free for three years.”

Widespread poverty, dense population, poor sanitation, high levels of migration and a weak public health system made the task of reaching out to every child under age 5 that much more difficult.

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Global Health and Development Beat

GMOs - The Kenyan government may change its stance on genetically modified foods, as the technology appears to be winning support from farmers struggling to deal with climate stresses.

Polio - Health officials in a Pakistani tribal region hailed the success of an anti-polio drive that had been threatened by a vaccine volunteer boycott and said the program would be extended.

Tonga - Relief agencies were sending aid to Tonga amid reports of extensive damage to low-lying islands in the South Pacific archipelago after they were battered by a strong cyclone at the weekend.

WASH - China’s wetlands have shrunk nearly 9 percent since 2003, forestry officials said on Monday, aggravating water scarcity in a country where food production, energy output and industrial activity are already under pressure from water shortages.

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The Players

PIH - Supported by Partners in Health, the University Hospital of Mirebalais is helping to train the next generation of Haitian doctors.

MSF - Is opening access to its clinical and research data so that others can learn from its operations and to improve the humanitarian sector.

WFP - Is using the internet to monitor and prevent the spread of disease in the Philippines city of Tacloban.

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Spotlight on PSI

New research shows that two MTV shows have helped to reduce teen pregnancy in the US. Vice reported on the news and also discussed examples of similar success from around the world.

This isn’t the first time that media typically thought of as sort of trashy has been used to teach about the advantages of family planning. In Tanzania, a radio soap opera broadcast nationally from 1995-1997 was found to have “strong behavioral effects on family planning adoption; it increased listeners’ self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception.” A similar program is being planned in Burundi, with the backing of UNICEF, the United Nations Population Fund, Population Services International, and the Dutch government, and is slated to begin airing this year.

In Brazil, the telenovela “Páginas da Vida” had a plot line that dealt with a teenage pregnancy that was “was highly entertaining, yet able to raise many important questions throughout Brazil concerning social and reproductive health issues,” according to the Population Media Center. Sixty percent of women interviewed were watching the show, and 65.4 percent of female viewers said they would be more careful to prevent unwanted pregnancy.  Brazil’s birthrate has also been dropping over the last five decades and is now below that of the United States.

The economists who looked at MTV noted that the recession was still the biggest factor, but the shows “drew in teens who actually were at risk of teen childbearing and conveyed to them information that led them to change their behavior, preventing them from giving birth at such a young age.” For a network often derided as mindless at best, and responsible for such social ills as Carson Daly’s career, this latest research suggests that MTV and its influence can also have a socially positive function.

By showing the lives and hardships that teen moms face, their shows, which were after all developed with guidance from the National Campaign to Prevent Teen and Unplanned Pregnancy, have proven to be at least partly educational.

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Buzzing in the Blogs

Michael Sheldrick celebrates India’s anti-polio achievement by considering lessons learned for Nigeria, Pakistan and Afghanistan. He blogs for the Guardian:

With poor sanitation, densely populated areas and large numbers of people living in extreme poverty, northern states like Uttar Pradesh and Bihar were the ‘perfect storm’ when it came to the spread of polio. And without the vital collaboration between the Indian government and the global polio eradication initiative– a partnership among Rotary International, Unicef, WHO and the US Centre for Disease Control and Prevention – this may not have been possible.

Long recognised as one of the most difficult places to eradicate polio, India stands as an example for how to mount a successful disease response effort under the most complex circumstances.

When I visited India’s National Polio Surveillance project in Delhi in 2012, I was joined by a delegation of local health officials from Afghanistan. They had come to learn how India had leveraged sophisticated global positioning technology to map the movements of the mobile and migrant population to successfully reach children consistently missed by previous vaccination campaigns. Simple, but effective.

And there are more examples that can prove useful to reaching missed children in other polio-affected countries. For example, India involved religious and community leaders to help build support for vaccination among local families. In cities like Ghaziabad, announcements by local imams in mosques actively encourage congregations to immunise their children, persuading parents to accept the polio vaccine where they otherwise may have resisted.

These lessons learned are now part of the global strategic plan to secure a polio-free world by 2018. At the Global Vaccine Summit in April last year, the global polio eradication initiative announced the new polio eradication and endgame strategic plan 2013-2018. Global donors pledged $4bn (£2.4bn) to support the strategic plan – the first long-term strategy that comprehensively lays out what is needed to cease transmission of wild poliovirus and eradicate polio once and for all.

Now we need the donor community to back this plan. Current commitments of $4bn go a long way, but eradicating polio will require coming up with the remaining $1.5bn needed to fully fund the strategic plan. And while some donors like Canada – the first country to support the polio eradication initiative in 1988 – have shown steadfast support, others need to renew their commitment. In Australia, for instance, the newly elected Abbott government has so far stopped short of reaffirmingthe $80m contribution announced by the previous government in May 2013.

Ultimately, by capitalising on India’s achievement, we all have a stake in the fight to end polio around the world. This exciting anniversary in India is proof of what is possible when the global community bands together in support of polio eradication. Yet, polio outbreaks in previously polio-free countries – Somalia, Syria, Cameroon – and the presence of the polio virus in Egypt and Israel are constant reminders of the need to act quickly; as long polio remains anywhere, it is a threat everywhere.

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Capital Events

Tuesday

8:30 AM - Universal Health Coverage in Emerging Economies featuring World Bank Group President Jim Kim - CSIS

12:00 PM - How Latin America Weathered the Global Financial Crisis - PIID

5:00 PM - Premiere of Water Everlasting? The Battle to Secure Haiti’s Most Essential Resource - IADB

Wednesday

10:00 AM - Powering Africa – A Conversation about Progress and Prospects - CGD

2:00 PM - Subcommittee Hearing: A Report on the G-8 Dementia Summit - US House Committee on Foreign Affairs

2:00 PM - Global Youth Workforce Development - CSIS

Thursday

4:00 PM - How Social Movements Succeed: Lessons from HIV/AIDS - CGD

Friday

12:00 PM - The Organization of Islamic Cooperation: Free Speech Implications of a Proposed Ban on “Islamophobia” - Hudson Institute

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By Mark Leon Goldberg and Tom Murphy

Sign up on the right-hand column to receive the Daily Impact in your inbox each morning!

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HIV/AIDS Fight Needs Innovative Financing Model

More sustained financing is needed to continue global progress against HIV/AIDS. Given the current challenges to global health financing, new solutions are vital to changing the current rate of progress.

“There is a moral obligation to maintain treatment for those who need it, and considerable resources have been implicitly pre-committed to lifelong HIV treatment and care,” say the authors of a recent paper published in the PLoS Medicine journal.

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More money also needs to be better spent, they argue. HIV work must be linked to health systems strengthening, a move that will both increase the reach of HIV work and support the underlying health problems that contribute to the problem.

Financing the HIV response must also be achieved without damaging investments in health systems more broadly and other development sectors that are essential for social welfare (in turn addressing a number of the barriers to scaling up the HIV response). An HIV programme may have important external benefits for sexual and reproductive health; maternal and child health; or provide the necessary health system platforms for managing chronic conditions. Similarly, investments in strengthening health systems or addressing related co-morbidities that compound HIV vulnerability or worsen treatment outcomes are critically important to individuals living with HIV. Although core HIV interventions have been demonstrated to be cost-effective, total HIV spending in sub-Saharan African countries was an estimated 19.4% of total health spending in 2007 (range: 0.7%–64.4%). This amount exceeds the relative burden of HIV disability-adjusted life years and is at least partly due to the relatively high costs of HIV treatment compared to treatment for other prevalent diseases. There remains a difference between the amount spent on the HIV response across countries with a similar GDP per capita and HIV prevalence, and more work is required to understand the optimal level of domestic resourcing for HIV, given competing health sector priorities.

There are examples of innovative financing schemes, but they face challenges. The authors recognize that overtaxing and a hyper-focus on HIV/AIDS can do more harm than good. A careful approach that applies lessons learned can ensure changes are effective.

Innovative revenue streams are currently being explored in several countries. These schemes can generate significant funds, as seen in Zimbabwe with the 3% AIDS levy deducted from businesses and formal sector workers’ salaries since 2000 [7]. Other options, such as increased “sin taxes” on alcohol, could generate a “double dividend” by simultaneously increasing revenues and decreasing HIV-related risk behaviours [20]. The development of social health insurance could help attract further household resources and may be an important new source of financing in middle-income countries as development assistance scales down

Read the full research paper here.

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The Daily Impact: 10,000 South Sudanese Flee for Sudan, says UN

January 13, 2013

An estimated 10,000 people have fled the fighting in South Sudan to neighboring Sudan, says the UN’s refugee agency. From AFP:

south-sudan-map-2011“Ten thousand, this is something we are confident with, that these are confirmed people who have crossed the border, who have been fleeing the conflict,” Nicolas Brass, external relations officer with the United Nations High Commissioner for Refugees (UNHCR), told AFP.

The influx marks an ironic turn of events in relations between Sudan and South Sudan, which became independent in 2011 after an overwhelming vote to separate under a 2005 peace plan that followed 22 years of civil war.

Millions of southerners fled north during the civil war, but about 1.8 million had returned to the South since 2007.

As recently as last September, a survey by the International Organisation for Migration found that almost every single one of about 20,000 ethnic southerners still living in squalid Khartoum-area camps wanted to go home.

But that was before fighting began in mid-December with clashes inside South Sudanese army units, sparking a sharp upsurge in ethnic violence.

The new UNHCR figure makes Sudan the second-largest recipient of refugees from the battles between forces loyal to President Salva Kiir and those of his ex vice-president Riek Machar.

About 32,000 refugees have fled to Uganda and a total of around 10,000 others have gone to Ethiopia and Kenya, while more than 350,000 are internally displaced within South Sudan, the United Nations says.

Brass said most of those who have crossed into Sudan are women and children who have reached the Kordofan region where they are “in need of basic assistance”.

The UNHCR is working closely with Sudanese authorities who are leading the aid response, he said.

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Global Health and Development Beat

WASH - It is estimated that 1,500 women and girls die every year from diseases brought about by lack of access to sanitation and water in Tanzania, reports the Tanzania Daily News.

Cholera - The Nigerian government donated drugs to its Kano state, in support of the region’s cholera outbreak.

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The Players

UN - The UN hopes the humanitarian donor conference for Syria hosted in Kuwait this week will raise more than last year’s $1.5 billion.

Oxfam - Outlines how it has been responding to the ongoing Syrian crisis.

USAID - Raj Shah championed the ‘inspiring results’ from its program in Zambia to save mothers from preventable deaths.

UN - A UN-led campaign against the tsetse fly in the Niayes area near Senegal’s capital has made giant strides towards eradicating the pest’s population.

GAVI - Liberia launched a campaign to vaccinate its children against pneumococcal disease, with support from the GAVI Alliance.

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Buzzing in the Blogs

USAID’s Mission director in Haiti describes the long game to rebuild Haiti. From the USAID Impact blog:

Almost four years after the earthquake, 89 percent of Haiti’s 1.5 million internally displaced persons have left the tent camps for alternative housing options. Almost75 percent of earthquake rubblehas been removed. Security throughout the country has improved and, recognizing the importance of employment, the government is committed to attracting foreign investment, with agriculture, tourism and the apparel industry the most promising growth areas. Health indicators are up, with improvements in infant and child mortality rates and more public access to health services.

International donors — among them the U.S. Agency for International Development — have learned lessons along the way in Haiti in terms of how we can do better.

As the country leaves behind the era of post-earthquake relief and focuses now on longer-term development, USAID is striving to build the capacity of local organizations to lead and manage development initiatives.

This necessarily involves building public and private institutions so Haitians can lead and manage their own development. On our part, we are enhancing the capacity of the Ministry of Health to manage a national healthcare systemusing its own human and financial resources, so it will no longer be dependent on donors. Similarly, efforts are underway to build the financial and programmatic capacity of local NGOs to provide services and advocacy that are too often provided by international organizations. The country must also advance the rule of law, a prerequisite to the creation of durable institutions and economic growth.

Every USAID mission director’s goal is to help the host country one day reach a point when it no longer needs foreign economic assistance. Indeed, all donors and development organizations should be devoted to that goal. In Haiti, this will not happen overnight. But four years after the earthquake, Haiti remains a U.S. government priority to continue and improve our efforts to help Haitians building the opportunity and prosperity they are capable of and that they are so deserving.

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Capital Events

Monday

12:00 PM - Maternal Health and HIV: Global Priorities for Research and Action - Wilson Center

12:00 PM - Measuring Child Wellbeing: Tools & Challenges - SID

Tuesday

8:30 AM - Universal Health Coverage in Emerging Economies featuring World Bank Group President Jim Kim - CSIS

12:00 PM - How Latin America Weathered the Global Financial Crisis - PIID

5:00 PM - Premiere of Water Everlasting? The Battle to Secure Haiti’s Most Essential Resource - IADB

Wednesday

10:00 AM - Powering Africa – A Conversation about Progress and Prospects - CGD

2:00 PM - Subcommittee Hearing: A Report on the G-8 Dementia Summit - US House Committee on Foreign Affairs

2:00 PM - Global Youth Workforce Development - CSIS

Thursday

4:00 PM - How Social Movements Succeed: Lessons from HIV/AIDS - CGD

Friday

12:00 PM - The Organization of Islamic Cooperation: Free Speech Implications of a Proposed Ban on “Islamophobia” - Hudson Institute

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By Mark Leon Goldberg and Tom Murphy

Sign up on the right-hand column to receive the Daily Impact in your inbox each morning!

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The Thinker and The Doer

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By James and Alida, Global Health Corps

The Thinker

My co-fellow and I have been part of PSI/Burundi’s Marketing and Communication team for the past four months and most of the time what I do is ‘translating’.

I’ve been living outside of my country for the past seven years, sometimes making me feel as though I was ‘missing in action’. But wasn’t this one of the main goals? To get the education and experience that would help me be more useful to my nation?

Thanks to Global Health Corps (GHC), this fellowship has allowed me to come back and work in an area where I get to make an impact. But it comes with a lot of emotions; anger due to a system that’s failing its own people, frustration because of the slow pace at which we work, guilt for being so privileged and sadness because I can do so little.

I find myself spending my days translating my Kirundi emotions, into English thoughts and then French words. And by the time I am done explaining them I always end with “I’m not sure if this makes any sense, what do you think?” At which point The Doer shrugs, takes the time to think and share his thoughts; then we act!

The Doer is my fantastic co-fellow, who is more instinctive but most importantly he knows to stop me and push me to act; to begin somewhere, as the thoughts develop, and the understanding and translations continue.

In all, working with the youth, especially on a sensitive issue such as HIV/AIDS has showed me that sometimes you have to make sure you check all your thoughts and emotions before going into the office. Go in with them, sort them out and then translate them. As we work to make health a human right, we must assure ourselves that our work is a pure translation of the love we have for our fellow human beings.

Alida and James speaking about GHC on the radio

The Doer

When given the title The Doer, in no way must you constitute this individual as being one that just simply takes orders and does whatever is asked of them. We must realize the importance of such a person in any scenario, especially when it relates to the co-fellow relationship that is a vital component of the Global Health Corps Fellowship. Both working within the Marketing & Communication Department at PSI/Burundi, Alida and I realized early on what our individual strengthens and weaknesses are and how we can use them to work effectively and become outstanding additions to our placement organization.

Within the realm of development there are too many occurrences where you find yourself attending high profile seminars or conferences, listening to experts giving their theories on how to end world hunger or ways we can decrease the infant mortality rates amongst the world’s poor. Whatever happens after the seminars conclude?

Here is where the Doers come in. Those who take action when it is most needed. Individuals who seek the opportunity to ask the crucial question; what do we do next?

In relation to our work at PSI/Burundi, we too attend various meetings and seminars, where we discuss the logistics of our projects or the pressing issues facing Burundi’s health system. Working with a Thinker, Alida gives me the opportunity to look at the bigger picture and way out my options before making a conclusive decision on how to make my actions affective. I can honestly say that one fault that comes with being a Doer is that we tend to act out on our first instinct, and as we all know, doing such a thing can actually do more harm than good.

Even when asked to write this blog I immediately thought of an idea, shouted it out to Alida across our office, and began typing. What happened afterwards? Let’s just say this wasn’t the blog that first came to mind.

Global Health Corps selects fellows with diverse skill sets ranging from art to architecture to engineering. Applications are now open for the sixth class of Global Health Corps fellows. If you, like me and my co-fellow Aaron, are passionate about making an impact in global health, we encourage you to apply for a fellowship in Burundi, Malawi, Rwanda, Uganda, Zambia, or the United States.

To apply for a 2014-2015 Fellowship, please visit http://ghcorps.org/fellows/apply/.

All applicants must be 30 years or younger, have earned an undergraduate university degree by July 2014, and be proficient in English. Applications close on January 26.

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The Daily Impact: Philippines Reconstruction Could Cost a lot More

January 10, 2013

The cost of typhoon reconstruction this year could reach $3.1 billion, more than 50% higher than initially estimated, as the Philippines seeks to build back better and put in safeguards for future disasters. From Reuters:

The total cost of a four-year reconstruction effort may also end up steeper than the current estimate of 361 billion pesos, Florencio Abad said.

Typhoon Haiyan, one of the strongest storms to make landfall anywhere, reduced almost everything in its path to rubble when it swept ashore in the central Philippines on November 8, killing at least 6,190 people, leaving 1,785 missing and 4 million either homeless or with damaged homes.

“The plan was 90 billion (pesos) for the year, but I think it will be more,” Abad told Reuters in his Manila office, adding typhoon-related spending would reach 138 billion pesos.

“I don’t think they (reconstruction planners) have factored in the need to introduce resiliency. So that will be 10-30 percent more.”

Apart from the immediate need for temporary shelter, providing jobs and restoring water, health and sanitation services, the government underestimated other costs, including that of identifying and documenting the dead before they are buried.

“There is an international standard for doing it, before you bury them, that wasn’t factored in. That’s a lot of money already,” Abad said, adding the government could adequately finance a higher post-typhoon spending bill this year.

Manila has set aside funding of 54 billion pesos for the rebuilding effort from a supplemental budget passed late last year, this year’s national budget, savings, calamity and other funds. At least 80 billion pesos more would come from concessional loans offered by the World Bank, Asian Development Bank and the Japan International Cooperation Agency.

“We can fund it. The question is can we absorb it? That is why we have to start early,” Abad said.

Going forward, the Philippines, which is hit by an average 20 typhoons a year, is considering not only building typhoon-resilient structures but also permanent evacuation centers equipped with generators and supplies – an initiative that wasn’t part of initial plans.

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Global Health and Development Beat

Family Planning - Women in China are being forced into abortions due to the nation’s population limit policies.

E-Health - A project in Zambia is connecting people who have no access to doctors to medical professionals on the other side of the world.

South Sudan - A ceasefire is urgently needed so that aid agencies can take medicine, food, plastic sheeting and other emergency supplies to tens of thousands of civilians trapped by fighting in South Sudan, say groups on the ground.

Respiratory Health - The Chilean government issued a public health warning regarding the threat posed by recent forest fires. (in Spanish)

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The Players

MSF - Says the conditions are dire for the roughly 75,000 South Sudanese seeking shelter along the Nile.

FEWS-Net - Issued a new warning of a potential food crisis in parts of South Sudan, due in part of the recent conflict.

UNICEF - Is supporting health officials in Liberia who are launching a campaign to vaccinate some 100,000 children against pneumonia.

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Spotlight on PSI

HIV/AIDS - PSI sponsored theater performances in Zimbabwe over the past year to support the growth of the Association of Community Theatre Artists and shows that targeted HIV/AIDS prevention.

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Buzzing in the Blogs

A Gates Foundation-supported concept aims to package and brand condoms that women will buy. From Fast Company:

Mine products are packaged in such a way that women will feel more comfortable having them out on their bedside table or in their grocery bags,” says Mansi Gupta, one the students involved in the project. “We hope to encourage more women to buy condoms, thus adopting healthier sexual behaviors.”

At the start of their project, Gupta, Emi Yasaka, Willy Chan, and Rona Binay surveyed 207 people (70% women) to understand their feelings about condoms. Three-quarters (77%) said they felt embarrassed buying the product, while 60% said they believed women who carry condoms are promiscuous.

The students decided to create packaging that’s less male-oriented, as you can see from the slide show. They also designed refillable bedside holders, and a tube that houses condoms and tampons together. Pairing condoms with everyday products should reduce the potential for embarrassment, they figured.

“If condoms currently make women feel like they are not the target audience and they should not be buying them, Mine is aimed to oppose that feeling and change that stigma,” Gupta says.

The Centers for Disease Control and Prevention, which wants to see a “positive shift in women’s sexual health,” set the challenge for the SVA team. Gupta says the CDC may help make Mine a commercial reality, possibly by working with existing condom or female hygiene companies. But first the students need to do more testing, and get feedback on what they’ve come up with so far.

It may take more than packaging to change stereotypes, but getting women more involved in sexual health ought to be an idea that pays dividends.

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Capital Events

Happy Friday!

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By Mark Leon Goldberg and Tom Murphy

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Dybul and Frenk Urge Engaging Emerging Powers to Propel Development

As the deadline approaches for the Millennium Development Goals, now is a time to reconsider how to engage with developing countries. Global Fund head, Dr Mark Dybul and dean of Harvard’s School of Public Health, Dr Julio Frenk, say that it is time actually move to the reality of shared responsibility and mutual accountability.

The problem is the status quo does not foster such cooperation. They call for a new consensus that moves away from reaction to paternalism and towards shared responsibility and mutual accountability. Their ideas are summed up in a blog post for the Huffington Post.

Principles might include: reaffirmation of the basic principles of shared responsibility and mutual accountability; a commitment to support and participate in the planning processes and funding priorities of low- and middle-income countries rather than create parallel engagement; focusing investments globally or in regions or countries of particular interest as co-investors with other development partners under national strategies; technical exchange, and; over time, increasing participation as a funder of multilateral organizations that recognize the importance and unique roles of the emerging powers in their governance structures.

They argue that it is the emerging powers, countries who have successfully moved away from the grips of poverty, that can share their experiences and knowledge with countries that remain behind. It puts a country like India and China in a much better position that the US and UK to support, teach and learn from countries like Zambia and Sierra Leone.

One way the emerging powers can participate is by expanding their investments in organizations like the Global Fund, say Dybul and Frenk.

But we should not expect emerging powers to simply adapt to existing models of development. They may generate their own models, which the rest of the world should welcome and support. And collectively, those of us in the development community should think hard about how we — in our models and institutions — must evolve to embrace and promote the emerging powers’ potential for effecting positive impact regionally and globally. We will also need to imagine and create new, structured ways of measuring and encouraging accountability around new models and principles.

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