Five key steps to making the health workforce a post-MDG priority


There is a global shortage of 7.2 million doctors, nurses, and midwives, according to new estimates by the World Health Organization. By 2035, that number could reach 12.9 million. We missed the opportunity to make health workers part of the Millennium Development Goals in 2000—we should not miss it again.

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The Daily Impact: Foreign Aid rebounds to record high in 2013 – OECD

April 9, 2014

Foreign aid for development in poorer countries hit a record high last year, says a new OECD report published yesterday. From the Guardian:

Figures released by the Organisation for Economic Co-operation and Development (OECD) on Tuesday show official development assistance (ODA) grew by 6.1% in 2013 to $134.8bn (£80.3bn) after falling for two years in a row in as donors grappled with austerity measures and increasingly divided public opinion in many countries.

Seventeen countries in the OECD’s development assistance committee (DAC) increased their aid spending last year, with huge jumps recorded by some donors. The UK’s spending grew by 27.8% to hit for the first time the international target to spend 0.7% of gross national income (GNI) as aid.

Iceland’s aid spending also rose by more than 27% in 2013, and Japan’s by 36.6%. Norwegian and Italian aid rose by more than 10%. Other countries, not part of the OECD-DAC group, also recorded significant spending increases. Estonia, Russia and Turkey each reported rises of more than 20%.

Aid from the United Arab Emirates, meanwhile, soared by 375.5%, largely because of exceptional support extended to Egypt. In 2013 it spent 1.25% of its GNI as aid – more than any OECD-DAC donor. At the same time, aid spending fell in almost a dozen countries, with the biggest decreases in Canada (-11.4%), France (-9.8%) and Portugal (-20.4%).

The OECD also warned that the share of aid going to some of the world’s least developed countries was falling, despite the overall increase in spending. In 2013, aid to Africa fell by 5.6% in 2013, to $28.9bn.

The OECD secretary-general Angel Gurría said: “It is heartening to see governments increasing their development aid budgets again, despite the financial constraints they are currently facing. However, assistance to some of the neediest countries continues to fall, which is a serious concern.”

The Paris-based forum also noted that more donors were giving aid in forms other than grants, with countries counting a growing amount of equity investments and loans – which developing countries must pay back – as ODA. In 2013, grants grew by only 3.5% while other forms of spending rose by 33%.

A survey of donors’ spending plans suggests aid levels could rise again in 2014 and stabilise thereafter. However, the share of aid going to the countries most in need, including in sub-Saharan Africa, will decrease even further.

The survey suggests donors will focus spending on middle-income countries including Brazil, China, Chile, Mexico, India and Pakistan. Aid to these countries will probably be in the form of loans, it says.

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Advancing global health through innovation


U.S. investments in global health protect millions of people from malaria with insecticide-treated bed nets, effective treatments and innovative diagnostics. These targeted investments have lifesaving impacts, and they are also cost-effective! Our entire foreign assistance amounts to only about 1 percent of our overall budget. With this we are able to help the world’s poorest women and children.

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The Daily Impact: Two UN workers shot dead in Somalia

April 8, 2014

A pair of aid workers – French and British respectively – were shot dead while arriving at an airport in Galkayo, central Somalia. From the Guardian:

A UN source confirmed the pair were international staff members with the UN Office on Drugs and Crime (UNODC).

A statement issued by the government of the northern breakaway state of Puntland in Somalia identified the two victims as Briton Simon Davis and Frenchman Clement Gorrissen.

Nicholas Kay, special representative of the UN secretary-general for Somalia, said: “Our UN colleagues were working in support of the Somali people’s aspiration for a peaceful and stable future. There can be no justification for such a callous attack. I call on the authorities to conduct a full investigation immediately and bring the perpetrators to justice without delay.”

The UK Foreign Office said it was aware of the death of a British national in Somalia on Monday and was ready to provide consular assistance to the family. AFP reported that sources identified the second victim as French.

“Two white men have been shot inside the airport as they got off a plane,” local security official Mohamed Mire said. An airport official said the attacker was dressed in a police uniform.

“One of them died inside the airport and the other one was rushed to hospital where he later died of the injuries. Both of them were white men,” said Hassan Ahmed, who said he witnessed the incident.

Galkayo is 370 miles (575km) north of the capital Mogadishu and lies on the border with Puntland.

UN security in Galkayo, which is outside of effective central government control, is normally extremely tight.

The UNODC has been working to combat piracy in Puntland and has built a new prison in the state capital, Garowe, which opened last week to house pirates who have been sentenced in other countries in the region, notably the Seychelles. The UNODC said the building was a key part of its maritime crime programme in the Horn of Africa.

“The two were a Frenchman and a Briton and they were supposedly staying in Galkayo for two days before heading to Garowe,” said Abdirisak Mohamed Dirir, general director of Puntland’s anti-piracy department.

The two men had flown into Galkayo to meet Somali officials on the issue of regulating the money transfer services that replace a formal banking system in Somalia, and were looking at the financial flow of money related to Somalia’s pirate attacks, according to reports.

The executive director of UNODC, Yury Fedotov, said: “I condemn in the strongest possible terms the killing of two of my colleagues in a cruel and senseless attack. I hope the relevant authorities in Somalia will undertake every effort to ensure that their killers are swiftly apprehended and brought to justice.

“I would also like to offer my most profound condolences to the family, loved ones, friends and colleagues of these two individuals, who were so committed and dedicated to UNODC’s work.”

UN staff members have been regularly targeted in Somalia, where the fragile internationally backed government, supported by African Union troops, is battling al-Qaida-linked al Shabaab rebels, although the assaults have tended to be on a larger-scale.

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World Health Day 2014: Small bite, big threat

Today, for World Health Day this year, the World Health Organization has chosen to highlight the serious and increasing threat of vector-borne diseases. Every year, more than one billion people are infected and more than one million die from these diseases, which include malaria, dengue, leishmaniasis, lyme disease, schistosomiasis, and yellow fever, carried by mosquitoes, flies, ticks, water snails and other vectors.

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The Daily Impact: World Remembers Rwandan Genocide 20 Years Later

April 7, 2014

Rwanda will commemorate the 20th anniversary of the genocide that saw nearly 1 million people killed in the span of only 100 days. VOA on how the country has progressed since 1994. A clip:

Busingye Johnston says the commemoration of the tragedy is a period of stocktaking, to remember, renew and for Rwandans to commit to the country’s unity, as well as the legacy of the genocide and its aftermath.

“It is also to take stock of what is happening to the world 20 years down the road.  Is genocide still, never again?  Is it still crime against humanity?  Is the world behaving as if genocide will never happen again?  Are people being brought to account who got involved in the perpetration of the genocide?  So we are taking stock of the 20 years and looking at the future with a lot of hope,” said Johnston.

Rwanda’s economy, infrastructure, social services, education systems and health system, were totally shattered after the genocide, according to Johnston.

He says President Paul Kagame’s government has since made significant efforts to reconcile the people after the genocide and has implemented policies that have improved the lives of the people.

“We came to a point that we wrapped around policies that can foster unity, working together, building a nation, having diverse views, but also knowing the limit of what we do, and being sure that we don’t rupture our society again,” said Johnston.  “We are not 100 percent, but we have made very good progress.  We are working on all facets of national, political, social and economic life and Rwandans feel one nation again.”

The government in Kigali says Tutsis were mainly targeted to be wiped out during the 1994 genocide, although moderate Hutus were also killed during the same period.

Some Rwandans contend the administration’s insistence the genocide mainly targeted Tutsis could breed divisions among the population.

But Johnston disagreed.  He says the government honors and commemorates those non-Tutsis who stood up to the ethnic cleansing, but lost their lives as a result of their effort.

“The genocide happened certainly against the Tutsis, but there are people of all walks of life who died standing up against the genocide,” said Johnston.  “For us it is giving everything its proper place and those who fought against the genocide, we really do commemorate with them, every remembrance week.”

Johnston says there is need for politicians to be cautious about their utterances that could undermine efforts made to reconcile the people as well as maintain the country’s peace and stability. He outlined some of the lessons learned from the legacy of the genocide.

“We have learned that divisive politics, we have learned that an ideology that is capable of nothing else but hatred of one community against another community, of one people against the other ends up causing you mass atrocity.  And the mass atrocity that we saw in 1994 was without an action process that preceded it many years, and then it culminated in the 1994 genocide,” said Johnston.

“We have also learned that you can do your best to reconcile the people and also that you can pick up from a shuttered and written off state with determination with modest efforts to continue moving and you can get to where we are,” said Johnston.  “We are certainly not where we want to be, but we have made some progress and we now have something that we can proudly call a nation.”

Critics say the government has narrowed the country’s political space making it difficult for opponents to freely operate without fear of intimidation or harassment.

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Strong health systems: “The secret ingredient”


As a global health community, we have the skills and know-how to accomplish these goals, but we must work together and recognize that the ‘secret ingredient’ that binds all of our collective knowledge, skills and interventions is a strong health system. The Lancet Commission on Investing in Health reported this past year that such goals are indeed feasible and would bring about a grand convergence in life expectancy between poor and rich nations in our lifetime. The required investment would pay off 9 to 20 times in full-income returns, and to succeed, half of the resources should be used to strengthen health systems – from human resources to better governance of the sector’s public and private components.

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The Daily Impact: USAID Unveils $1 billion development innovation lab

April 4, 2014

Yesterday saw the launch of a $1 billion innovation lab by USAID that brings together scientists, corporations, universities and charities in a collective to dream up and test new tools to fight poverty. From the Guardian:

The lab is being billed as USAid‘s equivalent of the Defence Advanced Research Projects Agency (Darpa), the US Defence department wing known for its development of the stealth fighter and involvement in the creation of the internet.

The agency describes it as a new way of working, but some anti-poverty campaigners have received news that the lab’s 150 staff will collaborate with several corporate “cornerstone partners” – among them Coca-Cola, DuPont, Unilever, Walmart, Syngenta and GlaxoSmithKline – as further proof of the increasing commercialisation of development.

The Oakland Institute said the initiative’s science and technology-based approach to development challenges was “a case of emperor with no new clothes”, while the World Development Movement said it would do nothing to tackle the root causes of poverty.

USAid, however, argues that the creation of the lab, other partners in which include Save the Children, World Vision, the Smithsonian Institution and the Massachusetts Institute of Technology, marks a fundamental shift in its approach to development innovation. “Instead of selecting a proposed answer, we bring together a whole group of partners to attract ideas, test them and take them to scale,” said Lona Stoll, senior adviser to Rajiv Shah, the head of USAid.

“The lab has ambitions of disruptive technologies and game-changing solutions really helping improve the lives of 200 million people in five years: things like eliminating the transmission of HIV/Aids from mother to child using the Pratt Pouch – a two-cent package [of antiretroviral drugs] that looks like a ketchup packet – or looking at how you get electricity access out to rural communities without building the kinds of grids that previously were a big part of development programmes.”

In addition to the manure-powered fridge and the Pratt Pouch, the agency has helped fund trials of the Odón device, a low-cost instrument that resembles a bicycle pump but has been hailed by some as the greatest aid to assisted births since the invention of the ventouse suction cup.

There are also innovations that fall into a more nebulous bracket. “We consider electronic payments to be in this category – the ability to reach communities that have never been reached with infrastructure with financial services; the ability to save,” Stoll said. “We are very focused on scaling both broadband access and electronic payment systems to hundreds of millions of people.”

The agency hopes the lab will one day yield “a handful of real game-changers” in development thinking and technology. “We use the reference points of oral rehydration therapy and the seeds of the green revolution or microfinance as things that are akin to the kinds of breakthroughs that we would like to help shepherd,” Stoll said.

The initial focus will be on six areas deemed consistent with US development and foreign aid priorities: food security and nutrition; maternal and child survival; energy access, sustainable water solutions; child literacy; and connected technologies. To that end, it is looking into everything from climate-resilient cereals to off-grid energy services and electronic educational devices.

“This is a win-win for our country: bringing America’s scientific and entrepreneurial capability to the service of those intractable global challenges is something that we think we really need to do,” Stoll said. “At the end of the day, the results get us to development goals better, faster and cheaper.”

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Smart investments in maternal health

From the Impact Magazine-Devex survey of over 1,000 global health professionals: 85 percent believe public-private partnerships are important or extremely important.

Impact interviews Dr. Naveen Rao, lead of Merck for Mothers. In 2011, Merck, known as MSD outside the United States and Canada, created Merck for Mothers, a 10-year, $500 million initiative to reduce maternal mortality globally. Rao shares his thoughts on public-private partnerships and the importance of engaging local partners in efforts to improve maternal health.

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