Thursday, 16 December 2010

Table of Contents, Vol 12, No 2 (2010), Health and Human Rights (open access)

Table of Contents, Vol 12, No 2 (2010), Health and Human Rights

Social determinants of health: Convergences and dysjunctures

Table of Contents and Frontmatter

HHR 12.2 Journal

file ABSTRACT file PDF

Collaborative imperatives, elusive dialogues [Editorial]

Alicia Ely Yamin, Alec Irwin

file ABSTRACT file HTML file PDF

Critical Concepts

The right to sutures: Social epidemiology, human rights, and social justice

Sridhar Venkatapuram, Ruth Bell, Michael Marmot

file ABSTRACT file HTML file PDF

The social determinants of health, health equity, and human rights

Audrey R. Chapman

file ABSTRACT file HTML file PDF

Social conditions, health equity, and human rights

Paula Braveman

file ABSTRACT file HTML file PDF

Wednesday, 1 December 2010

Laurie Garrett, Council on Foreign Relations

December 1, 2010

Dear Friends and Colleagues;

The CFR Global Health Program devoted considerable time this year to the preparation of a Declaration and Statement for the UNAIDS High Level Commission on HIV Prevention. I chaired the Scientific Advisory Panel that painstakingly prepared the consensus documents. The Declaration was released today by the Commission, which is cochaired by Nobel laureates Desmond Tutu and Françoise Barré-Sinoussi.

· Declaration of the UNAIDS High Level Commission on HIV Prevention

· Press Release

· The Commissioners on World AIDS Day

Given recent successes in innovations for HIV prevention, there is hope that leaders worldwide can put attention and resources to pushing the pandemic backwards at a high pace.

Meanwhile, of course, there is great concern that the new Congress, taking their seats after the New Year in Washington, DC, will slash the budgets for foreign assistance, overall, and HIV treatment and prevention in particular. With this as background, former President George W. Bush penned an opinion piece in today's Washington Post, calling for continued support of HIV treatment and PEPFAR, the program he created during his first term.

As has been tradition in the United States since the presidency of George H. W. Bush, President Barack Obama issued a statement for World AIDS Day today.

Unfortunately, President Barak Obama did not mention prevention of the further spread of HIV. During his administration, Bush promoted the ABC's -- Abstinence, Be faithful, and as a last resort, use Condoms. This policy, which failed to stem the tide of spread of HIV, was not referred to in today's editorial. Former Bush speechwriter Michael Gerson and former PEPFAR Ambassador Mark Dybul co-authored another editorial of support for continued financing of HIV programs, appearing in Huffington Post.

Yesterday the Global Health Program convened an important meeting in New York regarding the impact of the world financial crisis on funding for global health, writ large, and HIV specifically. Dr. Christopher Murray presented the latest assessment of financing trends, from the Institute for Health Metrics (IHME). And Dr. Alexander Preker, Head Health Industry and Investment Policy Analysis for the Investment Climate Department at the World Bank, offered responding comments and analysis. Among the most important findings highlighted by Murray and Preker are:

- While support for global health in general, and HIV in particular, continued to grow in 2008 and 2009, despite the financial crisis, the rate of growth slowed. This trend overall is worrying.

- Globally, philanthropic and private giving dropped considerably, leaving a single player -- the Gates Foundation -- responsible for 57 percent of all nongovernmental support for global health. That is worrying because any policy changes executed by the Gates Foundation will have a disproportionate impact.

- Also globally, the United States was responsible for more than half of all government giving for global health, and a far more considerable percentage of HIV support. This renders the entire global health effort highly vulnerable to Congressional whims, budget cuts, or prioritizations.

IHME Report- Financing Global Health 2010: Development assistance and country spending in economic uncertainty


Laurie Garrett

Senior Fellow for Global Health

College Campuses Are Producing a New Style of AIDS Activist

New York Times

November 30, 2010

College Campuses Are Producing a New Style of AIDS Activist

NEW HAVEN — David Carel was never a rabble-rouser. But amid the clutter of his dorm room at Yale University, Mr. Carel, baby-faced and slight-shouldered at 19, keeps evidence of his new life as an AIDS activist: posters, banners and the flier demanding “$50 bn for Global AIDS” that he concealed in his fleece jacket one Saturday in late October when, heart pounding, he sneaked past security into a Democratic campaign rally in Bridgeport.

There, Mr. Carel did something he “never would have imagined”: he heckled the president of the United States.

Cameron Nutt, a medical anthropology student at Dartmouth, says he backs President Obama “100 percent.” But, incensed over the president’s “failure to remain true” to a campaign promise to spend $50 billion over five years fighting the AIDS epidemic overseas, Mr. Nutt disrupted Mr. Obama this fall at a Boston rally. His co-protesters included Luke Messac, a University of Pennsylvania medical student and a field organizer for Mr. Obama’s presidential campaign, and Krishna Prabhu, a Harvard University senior who caucused for Mr. Obama in Iowa in 2008 — and rescheduled his final exam in global health to attend the president’s inauguration.

“The promise has not been fulfilled,” Mr. Prabhu said, sounding more disappointed than angry.

Roughly a quarter-century after gay men rose up to demand better access to H.I.V. medicines, a new breed of AIDS advocate is growing up on college campuses. Unlike the first generation of patient-activists, this latest crop is composed of budding public health scholars. They are mostly heterosexual. Rare is the one who has lost friends or family members to the disease. Rather, studying under some of the world’s most prominent health intellectuals, they have witnessed the epidemic’s toll during summers or semesters abroad, in AIDS-ravaged nations like Rwanda, Tanzania and Uganda.

College activism, and AIDS activism in particular, is nothing new. On Wednesday, World AIDS Day, students across the nation will participate in speeches, fund-raisers and the like. But a loose-knit band of about two dozen Ivy Leaguers, mostly from Harvard and Yale, is using more confrontational tactics, as well as some high-powered connections, to wangle encounters with top White House officials in a determined, and seemingly successful, effort to get under Mr. Obama’s skin.

Their protests — which have drawn a sharp rebuke from the president (not to mention some disapproving parents) — come as many in the AIDS advocacy community are wondering aloud whether Mr. Obama is as devoted to their cause as his immediate predecessor, George W. Bush. In 2003, Mr. Bush began vastly increasing spending on lifesaving antiretroviral medicines for AIDS patients in impoverished nations; the number receiving the drugs has shot up from 50,000 to more than five million today. Yet the World Health Organization says as many as 10 million lack needed therapy.

While spending on global AIDS has gone up on Mr. Obama’s watch, and the United States remains the world’s largest contributor to such programs, independent analysts say that the rate of increase has slowed significantly and that it will be difficult for the president to keep his $50 billion pledge — or even meet a lesser goal, set in 2008 by Congress, of $48 billion for AIDS, tuberculosis and malaria by 2013. The task may grow even harder under a new Congress, with the incoming House Republican majority intent on cutting spending and Tea Party-backed Republicans in both chambers expressing skepticism about all types of foreign aid.

Still, armed with data from Health Gap, an AIDS advocacy group, the students are determined to hold Mr. Obama to his word. When Ezekiel Emanuel, a bioethicist and health adviser to the president (and brother of the former White House chief of staff, Rahm Emanuel) spoke at Yale two weeks ago, he wound up sparring with Mr. Carel at a fruit-and-cereal breakfast at the campus Hillel House, a meal arranged by a fellow Yale student, Dr. Emanuel’s daughter. Later that day, Mr. Carel led a demonstration outside Dr. Emanuel’s talk, which ended with students chanting at the adviser as they followed him down the street.

When Eric Goosby, Mr. Obama’s global AIDS coordinator, traveled to Boston in November for a panel discussion with Senator John Kerry, Democrat of Massachusetts, he was collared at a cocktail party by Mr. Prabhu, the Harvard senior. Also on the panel was Mr. Prabhu’s professor, Dr. Paul E. Farmer, founder of the global nonprofit Partners in Health.

“These students are my retirement plan,” Dr. Farmer said in a telephone interview from Haiti, where he is treating cholera patients. “A lot of them are doing much more than going to protests; they’re writing papers and articles, they’re doing graduate studies.”

Mr. Messac, the University of Pennsylvania medical student, explored the origins of Mr. Bush’s AIDS program in a 120-page paper, “Lazarus at America’s Doorstep,” for his Harvard undergraduate thesis. Mr. Carel, who spent last summer working at a hospital in the rural South African village of Tugela Ferry, now studies Zulu and persuaded a visiting professor from South Africa to let him take her upper-level course on “the political economy of AIDS.” (He had to skip Zulu class for the Emanuel protest; he said his professor understood.)

The students have also befriended a longtime veteran of the AIDS wars, Gregg Gonsalves, who at 47 is completing his undergraduate degree in evolutionary biology on a full scholarship at Yale. Mr. Gonsalves often lectures public-health classes on what he calls “ancient history” — the work of groups like Act Up in the 1990s.

“Theirs is not a first-person commitment, in the sense that none of them is living with H.I.V.,” Mr. Gonsalves said of the new AIDS protesters. “It’s all based out of a sense of solidarity and social justice. I used to wonder where the next generation would come from. They’re here.”

Inside the White House, Dr. Emanuel, for one, is not impressed. He says the students are serving up tired arguments about dollar amounts that ignore the Obama administration’s emphasis on spending money more efficiently and offering services, like circumcision, that can reduce the spread of H.I.V. While Mr. Bush emphasized AIDS and malaria, Mr. Obama is promoting a six-year, $63 billion “global health initiative” that seeks to address a range of diseases, with emphasis on women and children.

“To be honest, and this is no put-down to the sincerity of the students, I didn’t hear a new argument that I haven’t heard for months,” Dr. Emanuel said in an interview after his breakfast with Mr. Carel. “I’ve not seen a blog post on the number of people we have circumcised, or the number of mothers we treat in maternal-child health. Those are real performance measures.”

Dr. Emanuel would not discuss any conversations with the president about the students, but Mr. Obama’s reaction when he was disrupted in October at the rally in Bridgeport made clear he was irked. “You’ve been appearing at every rally we’ve been doing,” the president complained, telling them it was not “a useful strategy.”

The students were pleased that he addressed them directly, but their heckling prompted even some fellow AIDS activists to take issue with their tactics. Regan Hofmann, editor in chief of Poz, a magazine for people living with or affected by H.I.V., questioned the wisdom of disrupting the president on the eve of a critical election for Democrats.

Mr. Carel says he and his fellow protesters thought long and hard about that. It was his first demonstration; his parents told him they wished he would be “more respectful.” His friends were shocked. Still, he says it was worth it.

“There are very few ways we could have any access to him,” he explained. “This was a way to get Obama’s ear.”

Thursday, 18 November 2010

A New (more effective!) Way to Talk About the Social Determinants of Health

The Robert Wood Johnson Foundation has produced a very interesting document that reports on its effort to translate the science of "social determinants of health" into messages that resonate with all Americans, across the political spectrum. The full report is really worth looking at. (click on the title above to go to page and report)

Here is a small excerpt.

" Below you’ll find one long-form message that was developed, revised,
tested and revised again based on what the research showed us.
It was consistently the most persuasive message among all groups,
regardless of their political perspective. While we are not necessarily
recommending that you use this in its entirety, it is helpful to understand
why the phrase worked."

America leads the world in medical research and
medical care, and for all we spend on health
care, we should be the healthiest people on Earth.
Yet on some of the most important indicators,
like how long we live, we’re not even in the top 25,
behind countries like Bosnia and Jordan. It’s time
for America to lead again on health, and that
means taking three steps. The first is to ensure
that everyone can afford to see a doctor when
they’re sick. The second is to build preventive
care like screening for cancer and heart disease
into every health care plan and make it available
to people who otherwise won’t or can’t go in for
it, in malls and other public places, where it’s easy
to stop for a test. The third is to stop thinking
of health as something we get at the doctor’s
office but instead as something that starts in our
families, in our schools and workplaces, in our
playgrounds and parks, and in the air we breathe
and the water we drink. The more you see the
problem of health this way, the more opportunities
you have to improve it. Scientists have found that
the conditions in which we live and work have an
enormous impact on our health, long before we
ever see a doctor. It’s time we expand the way
we think about health to include how to keep it,
not just how to get it back.


• Audiences flat out didn’t believe the
statement, “America is not among the top
25 countries in life expectancy,” and they
responded negatively to any message
that led with that statement. However,
when we start off with something most
Americans already believe, “Americans
lead the world in medical research and
medical care,” they are more likely to
believe everything that follows.

• Words like “insured or “uninsured” are
politically loaded. But the phrase “ensure
everyone can afford to see a doctor when
they are sick” doesn’t touch existing
political hot buttons.

• Framing our message in the context of
accepted beliefs like the importance
of access to care or prevention helps our
message fit into the broader thinking of
what it takes to be healthy.

• The inclusion of specific solutions increased
acceptance of the core message.

• Illustrating with examples like “playgrounds
and parks” and “in the air we breathe and
water we drink,” makes the concept of
social factors more tangible.

• In the statement, “Scientists have found,”
other options were tested with more
specificity, such as “Scientists at the
Centers for Disease Control and at
universities around the country have
shown that the conditions in which
people live and work have more than
five times the effect on our health
than all the errors doctors and hospitals
make combined.” Presenting the fact
in a more colloquial, relatable way,
stripped of the academic support, is
more effective than a longer statement.

Monday, 15 November 2010

“Claptrap” from the UK's Department of Health

The Lancet, Volume 376, Issue 9753, Page 1617, 13 November 2010 Original Text

The Lancet

The Lancet remembers well the genuine excitement we felt at the commitment that the Labour government made in 1997 to attack health inequalities in Britain. The dismal record of the Conservatives before them—who hated the very idea of inequalities, preferring instead “variations” in health—left a deep scar on the National Health Service. The creation of Donald Acheson's Independent Inquiry into Inequalities in Health was a new opportunity to recalibrate the health service to meet the needs of the most deprived communities in the UK. Our sense of hope was, it turned out, misplaced. Labour presided over 13 years of failure. Inequalities in health widened despite huge investment in the NHS. The reasons for this failure have now been exposed in an astonishingly candid report, published last week by the House of Commons Public Accounts Committee. This committee examines how taxpayers' money is spent. It is chaired by a Labour Member of Parliament, Margaret Hodge. She has produced a tale of decrepitude at every level of the health system.

Labour was elected in 1997 with a promise and mandate to tackle inequalities in health. Yet it took 9 years (to 2006) before ministers and their civil servant officials made inequalities an NHS priority. “What on earth went wrong?”, asked Hodge. She was questioning the Department of Health's Permanent Secretary, Richard Douglas, together with Ruth Hussey (a regional director of public health) and Mark Davies (the Department's Director of Health Inequalities). Douglas was evasive. Hodge dismissed his “claptrap” as “despairing”. Eventually, he admitted that his Department's interpretation of ministers' election commitments was merely “aspirational” (ie, it did not have to be taken seriously).

The picture of government he painted was far from flattering. Figures showing the worsening situation for health equality would be sent to the Department and forwarded to ministers. But civil servants—including, it seems, the Chief Medical Officer—did little to address the growing problem. The best officials could do collectively was send out “toolkits” of guidance to primary care trusts and cross their fingers that they might trigger a response. But the Department had no mechanism to monitor or evaluate the implementation of what limited guidance it did provide. It was a “fair criticism” to say that “we were slow off the mark”, conceded Douglas. Members of the Public Accounts Committee were clearly shocked by this admission. As Hodge put it: “It takes us nine years—that is just gobsmacking.” Another said, “it's a mess, it's a tragedy really.”

The government and civil service were not wholly to blame. Where was the medical profession? Doctors are supposed to feel an acute responsibility to deliver the best health service to the whole population. It is on this basis that they ask the public and government to support generous pay increases and terms and conditions of service. These attitudes and behaviours are what we commonly mean by professionalism. It seems that doctors failed completely to live up to the rhetoric of their commitment to professional values. Members of Hodge's committee tried to find out why doctors had been so reluctant to address inequalities themselves. There are some simple and proven interventions that, if implemented evenly across the population, would go a long way to reduce inequalities in health—notably, smoking cessation and the treatment of high blood pressure and raised cholesterol. But doctors did not respond to the clear public and political call to take action on inequalities (and nor did the media). Instead, they sought to massively increase their salaries in a new general practitioner (GP) contract in 2005, one that itself was empty of commitment to reduce inequalities. People died because of this professional failure. The negotiators of that GP contract, together with the Department of Health, share a responsibility for those deaths.

During the course of this systemic failure, the Department of Health employed over 2300 people. Mr Douglas earns £170 000. Yet this great number of civil servants and their highly paid Permanent Secretary (including Mr Douglas's predecessors) failed to deliver on a public promise, democratically endorsed. A bureaucracy's first priority is usually to protect itself. Only secondarily will it try to deliver on the pledges of its political leaders. To call this period in the Department's history shameful does not even begin to do justice to the way it let down the millions of people to whom it owed a duty to serve. Despite the bland reassurances made to the Public Accounts Committee, there is not one shred of evidence that the Department has learned the lessons of this agonising debacle.

Wednesday, 27 October 2010

India - conditional maternity benefit scheme launched

Notes: 1 crore = 10,000,000 rupees
1000 crore = 10,000,000,000 rupees

    NEW DELHI: To improve maternal and child health, the Cabinet Committee on
    Economic Affairs on Wednesday approved the Indira Gandhi Matritva Sahyog
    Yojana (IGMSY) — a monetary scheme for pregnant women and lactating mothers
    — on a pilot basis in 52 districts in this Five-Year Plan.

    Each pregnant and lactating woman will receive Rs. 4,000 in three
    instalments between the second trimester of pregnancy until the child is six
    months old.

    Each beneficiary has to open an individual account (if she does not have one
    already) in the nearest bank or the post office for cash transfer, Union
    Home Minister P. Chidambaram told journalists after the Cabinet meeting,
    which was chaired by Prime Minister Manmohan Singh.

    The scheme, to be implemented through the Integrated Child Development
    Services (ICDS) Scheme infrastructure and personnel, will cost Rs. 1,000
    crore. Some personnel will be hired on a contractual basis.

    The scheme will be fully funded by the Centre and Rs. 390 crore and Rs. 610
    crore have been allocated for 2010-11 and 2011-12 respectively.

    Under the scheme, cash transfers will be made to all pregnant and lactating
    women as incentives based on fulfilment of specific conditions relating to
    mother and child health and nutrition. However, government employees and
    Central and State Public Sector employees have been excluded from the scheme
    as they are entitled to paid maternity leave.

    It is expected that in the initial years, about 13.8 lakh pregnant and
    lactating women in 52 districts could avail themselves of the benefit.

    The beneficiaries will be pregnant women of 19 years and above and for the
    first two live births (benefits for still births will be as per the norms of
    the scheme).

    Since the IGMSY will be implemented by the States through the existing ICDS
    system and supported by additional contractual staff, anganwadi workers and
    helpers will receive an incentive of Rs. 200 and Rs. 100 respectively a
    pregnant and lactating woman after all the due cash transfers are made.

    There will be steering and monitoring committees at all levels to oversee
    the scheme. A special cell to monitor the scheme will be set up within the
    Ministry of Women and Child Development.

Monday, 27 September 2010

the Guardian newspaper's new development blog

The Guadian newspaper has launched a development blog at the time of MDG summit. Hopefully, others will follow!

Recent article
Millennium development goals: governments pledge £25.5bn to eradicate world poverty
22 September 2010, 20:19:46 Sarah Boseley, Polly Curtis
Nick Clegg backs drive to combat malaria which kills many pregnant women and children under five
Governments, businesses and aid organisations today made commitments totalling $40bn (£25.5bn) backing the UN secretary general's plan to reach goals on alleviating world poverty and ill-health by 2015.
At a set-piece session at the United Nations, one leader after another stood up to promise to back Ban Ki-moon's strategy to achieve the eight millennium development goals (MDGs) by concentrating on the health of mothers and their children.
"We all know what works to save women's and children's lives, and we all know that women and children are critical to all of the MDGs," said the secretary general. "Today we are witnessing the kind of leadership we have long needed."
Britain's deputy prime minister, Nick Clegg, committed the UK to double the number of women's and children's lives saved by reorienting Britain's aid programme to put their needs at its core – in addition to new funding for malaria.
He acknowledged that all countries found it tough to justify more spending on aid during a recession but urged other leaders not to give up.
"We have a job to explain to people back home that this isn't only the right thing to do for moral reasons, to heal the grotesque divisions between wealth and poverty in the world, to tackle human suffering, to restore a greater sense of balance between one part of the world and another, but that it's also in our own financial and our enlightened self-interest – 22 of the 24 countries that are furthest away from the MDGs are steeped in conflict. Conflict breeds radicalism, extremism, terrorism."
In his first major address on the world stage – his speech was followed by an address from President Obama – Clegg also issued a demand that other countries do not shy away from their responsibilities. "My message to you today, from the UK government, is this: we will keep our promises and we expect the rest of the international community to do the same."
The fifth goal – a pledge to cut the numbers of women dying in pregnancy and childbirth by three-quarters – is the furthest behind of those agreed by the G8, the world's richest countries, in 2000. The deadline set for their achievement was 2015. In some countries, one woman in eight dies in childbirth, Ban said. A major push to improve their health will not only reduce deaths but help keep children alive and in education and out of poverty.
"In many parts of the world, women have yet to benefit from advances that made childbirth much safer nearly 100 years ago," he said. "Millions of children die from malnutrition and diseases which we have known how to treat for decades. These realities are simply unacceptable." The strategy, he added, included women's empowerment. "Women must lead the way," he said.
Not only donor countries but also developing nations promised to spend more on the poorest people in their societies. Tanzania promised to increase health spending from 12% to 15% of the national budget by 2015 and increase the numbers of health workers it trains and employs. Rwanda's president, Paul Kagame, who has played a prominent role in the summit and was warmly praised a few days ago by Ban as a "stellar leader", pledged to spend 15% of the budget on health by 2012. His country has already brought maternal mortality down from 1,071 to 383 per 100,000 births between 2000 and 2008.
Hillary Clinton, the US secretary of state, announced a new alliance on maternal health between USAID, the UK, Australia and the Gates Foundation, which will focus on the dearth of family planning in developing countries. Norway, Australia and France were among those promising substantial new money. Pledges also came from aid organisations, philanthropic foundations and businesses.

Inequalities in Child Survival - Save the Children Report

Save the Children Report

Inequalities in Child Survival

This paper aims to understand the inequalities in child survival in the developing world.
It looks at the disparities in under-five mortality in 65 low- and middle-income countries, from 1990 to 2008, with case studies from India and Bangladesh to complement analysis.
Understanding inequalities in child survival and its wider determinants has important policy implications towards meeting MDG 4.
Download Inequalities in Child Survival (PDF 395KB)

Save the Children blog on MDG Summit

MDG Summit: And the winner is…
Friday 24 September 2010
Heading home at last from New York. As I wait for BA188 to Heathrow (seat 34H, in case you were wondering) here are my top ten heroes from a week of excitement, nervous tension and cautious (OK, very cautious) celebration at the outcome of the UN Summit. Cue the music. Here goes…

At Number 10: Luca de Fraia. Luca is my friend who runs Action Aid in Italy and a stalwart of the Jubilee 2000 and Make Poverty History campaigns. Luca told me he was in a meeting with various government representatives and other campaign leaders at the UN when the government minister sitting next to him (whose identity and nationality will have to remain undisclosed) turned on him and said “you are a disgrace.

You have no credibility here whatsover.” Evidently this minister thought our Luca was working for Silvio Berlucsconi’s government, best known around here for its miserable record of broken promises on aid to the poorest countries. Hats off to poor Luca, who certainly took one for the team (and it wasn’t even his team). And an honorary mention to that unnamed minister whose intentions, at least, were good.

At Number 9: Ian Wright. No, not the cheeky-chappie footballer-turned-TV-pundit — Ian Wright the New-York based artist. Ian is the genius who created our installation that was on display in Grand Central station and was visited by Claire Danes and countless other big-hearted New Yorkers on Monday.

The artwork was made up of thumbprints from some of the three million people who have taken action worldwide as part of our EVERY ONE campaign. I must admit to being slightly taken aback when I met Ian. I had in my mind a particular idea of what a New York based artist would be like, and Ian certainly looked the part. But when he opened his mouth to speak I realised that he in fact comes from London, and if I closed my eyes I could have been talking to — well, the cheeky-chappie footballer-turned-TV-pundit, I guess…

At Number 8: Dr Abhay Bang. Dr Bang’s story of achieving a dramatic reduction in the deaths of children and mothers in his home district of Gadchiroli in rural India captivated audiences here all week. It all comes down to trained and equipped health workers in every village. It’s not rocket science, it’s common sense, and if we can do it there, we must do it everywhere. Thank you Dr B — Save the Children was proud to bring you to New York and proud to be associated with you and your brilliant work.

At number 7, its a joint effort: First up, Michael Klosson, the former US ambassador and now Save the Children’s policy chief in Washington DC. Late on Wednesday afternoon, the team were in the office trying to agree on the thing that we could do the following day that would capture a bit of interest on the last day of the summit and help us get our message across.

We knew what we wanted to say — that the progress so far towards the Millennium Development Goals was too slow and that they needed to pick up the pace in the months ahead if they are to have a chance of reaching the goals and saving millions of women’s and children’s lives. What could we give to the leaders, and to the media and others, that would help get this point across?

For a while we were stuck on sweatbands — but they were too expensive, and just didn’t feel right. Too Flashdance. Then we thought about bottles of water or Powerade or something — but realised that trying to get large quantities of liquids past UN security might just set off the odd alarm.

And just as our enthusiasm began to wane, Michael — who had hitherto been apparently totally immersed in his laptop and some in-depth briefing on US government nutrition policy, looked up over his spectacles and said only two words: “Energy bars.” Genius. The team swung into action and within a few hours, 500 Hersheys bars had been suitably re-designed and were being placed in the hands of the British Deputy Prime Minister and influential figures across the United Nations complex. Hooray for the policy guy — and for policy guys everywhere. We love you all.

And joining him at number 7 – as a surprise entry really: the mysterious masked man who raced across New York City as dawn broke on Thursday. Helping Save the Children get across that message that world leaders need to give themselves a burst of political energy, and armed only with the strange substance that is American chocolate, our tall, black-clad hero sprinted (OK, sort of shuffled quickly, with a slightly wobbly gait) past the city’s famous landmarks and delivered our specially-adapted high-energy bar right to the very heart of power.

It looked like something out of a movie. So, we made one. Sir, whoever you were, wherever you are now, we salute you. And special thanks to the brilliant Liz “Orson Wells” Scarff, who made the film.

Right. I need to hurry up a bit. At Number 6: Peter Singer. The author of The Life You Can Save spoke on a Save the Children platform on Wednesday and moved hearts and minds with his passionate call for each of us to do what we can. If you ever needed help getting over the doubts that get in the way of generosity to the world’s most vulnerable kids, watch his amazing video at It made me cry – and it doesn’t even have any pictures in it.

Into the top 5, and at 5 – it’s @mummytips, aka my video blog partner Sian To. Sian and the British mummybloggers went to Bangladesh a couple of weeks ago and then she came here to tell her story. Well done Sian for getting in front of just about everyone who mattered — and for making our videoblogging so much fun. It wasn’t quite the One Show, more the No Show… but it was fun. Thanks Sian for joining our team. And while I’m on it: the Save the Children team from many countries who made this week happen are all complete heroes, too often unsung. So thank you (deep breath) Fiona, Margaret, Patrick, David, Hadiza, Francesco, Anna, Ben, Cicely, Tanya, Andrew, Wendy, Liz, Steve, Ceri, Sue, Tul, Tricia, Tara, Candace, Michael, Desmond, Gorel, and especially Rachel who did the late shifts back in London and missed all the chocolate.

At Number 4, a surprise entry – it’s Justin Bieber. The pre-teen heart-throb pop star has been with me all week — although I left him in my hotel room most of the time. It all began when I passed a street stall selling life-size autographed celebrity pictures on the first evening. My nine-year-old daughter had told me that if I saw Justin Bieber I should get his autograph. I didn’t think twice — and I am now sitting in Departures at Newark airport with Justin, too large to fit in my case, staring plaintively across the terminal. And yes, people are definitely staring back.

Getting serious now: Number 3 is Nthabiseng Tshabalala. 12-year-old Nthabiseng is a schoolgirl from Soweto and an ambassador for the 1GOAL Education for All campaign. I met her when I was there during the World Cup. She flew from South Africa to tell world leaders they have to do a lot more to give every child the chance to go to school like her. She is brave, clever and funny and every time she spoke here, the room would get to its feet. Nthabiseng, you’re a star.

At Number 2, credit where credit’s due: it’s UN Secretary General Ban Ki-moon. He didn’t have to do this. He decided there should be a special UN session on the Millennium Development Goals and personally led a specific initiative on women’s and children’s health. The result of that was a Global Strategy mapping out a direction for the next five years.

It isn’t perfect — some governments were pretty shocking in their failure to contribute - and the test of it is in how much actually gets delivered — but it is a whole lot better than nothing (which is what we would have got, if Mr Ban hadn’t been bothered).

And finally, at Number 1: there can only be one winner. Well, actually, there are three million winners. Yes, it’s YOU – and all the rest of the 3,029,659 who’ve taken action in more than 50 countries for the EVERY ONE campaign to save children’s lives. People have marched, run, knitted, donated, petitioned, thumbprinted, shouted, danced, all to help the campaign achieve it’s goal — to get the world on track to achieving its promise to save 15 million lives by 2015.

Together we told leaders we wanted them to focus on that challenge at this summit and agree a strategy for meeting it. They have come, focused, and produced a strategy. Now there can be no excuse for failure. We KNOW this goal is achievable — but we also know the hard work starts here. Each one of those leaders who came here this week must now hear our voices loud and clear, and many more too.

Let’s make saving the lives of children and their mothers the world’s great shared mission of the next few years — bringing together governments, international institutions, organisations like Save the Children (we’ve made our own commitments to save many more lives, so hold us to that), faith groups, business, health professionals, celebrities, schools and individual citizens around the world. We had a tough job in New York this week, but we just about made it. And you know what they say in New York: if we can make it there… It’s up to you…

Tuesday, 21 September 2010

Developing Nations to Get Clean-Burning Stoves

Not very glamorous but significant cause of lung infections in women and children.

September 20, 2010
Developing Nations to Get Clean-Burning Stoves

WASHINGTON — Nearly three billion people in the developing world cook their meals on primitive indoor stoves fueled by crop waste, wood, coal and dung. Every year, according to the United Nations, smoke from these stoves kills 1.9 million people, mostly women and children, from lung and heart diseases and low birth weight.

The stoves also contribute to global warming as a result of the millions of tons of soot they spew into the atmosphere and the deforestation caused by cutting down trees to fuel them.

On Tuesday, Secretary of State Hillary Rodham Clinton is expected to announce a significant commitment to a group working to address the problem, with a goal of providing 100 million clean-burning stoves to villages in Africa, Asia and South America by 2020. The United States is providing about $50 million in seed money over five years for the project, known as the Global Alliance for Clean Cookstoves.

More than a dozen other partners, including governments, multilateral organizations and corporate sponsors, are to contribute an additional $10 million or more.

Mrs. Clinton called the problem of indoor pollution from primitive cookstoves a “cross-cutting issue” that affects health, the environment and women’s status in much of the world. “That’s what makes it such a good subject for a coordinated approach of governments, aid organizations and the private sector,” she said in a telephone interview on Monday.

She acknowledged that the American government’s contribution of $50 million was a modest commitment for a problem with enormous implications for billions of people worldwide.

“Like anything,” she said, “we have to start somewhere.”

Mrs. Clinton is to make the announcement at the annual aid conference sponsored by the Clinton Global Initiative, former President Bill Clinton’s health, development and environmental organization. She will be joined by Lisa P. Jackson, administrator of the Environmental Protection Agency, and officials from a number of partner groups, including the United Nations Foundation.

Although the toxic smoke from the primitive stoves is one of the leading environmental causes of death and disease, and perhaps the second biggest contributor to global warming, after the industrial use of fossil fuels, it has long been neglected by governments and private aid organizations.

The World Health Organization says that indoor air pollution caused by such cooking methods is the fourth greatest health risk factor in developing countries, after unclean water and sanitation, unsafe sex and undernourishment. The gathering of fuel is mainly done by women and children, millions of whom are exposed daily to dangers in conflict-torn regions. The need to forage for fuel also keeps millions of children out of school.

Although researchers have been aware of the health and environmental risks caused by carbon-belching indoor cookstoves for decades, there has been little focus on replacing them until recently, and it is not clear that the alliance’s high-profile initiative can pay the intended quick dividends. An estimated 500 million households depend on burning biomass for cooking and heating, some in the remotest places on earth, and it will not be easy to reach them with affordable and acceptable alternatives.

Even if the alliance’s goal were fully met, it would address no more than a fifth of the problem, according to its sponsors.

Stoves that are coming on the market for as little as $20 are 50 percent more efficient than current cooking methods, which are often simply open fires or crude clay domes, backers of the project say. A $100 model can capture 95 percent of the harmful emissions while burning far less fuel to produce the same amount of energy.

Reid Detchon, vice president for energy and climate at the United Nations Foundation, one of the founding partners of the alliance, said that the plan was not simply to use donations to buy millions of new stoves and ship them out to the developing world.

Rather, he said, the group hopes to create an entrepreneurial model in which small companies manufacture or buy the stoves close to their markets, taking into account local fuel choices, food consumption patterns and methods of cooking. This microproject model is expected to provide business opportunities for women while reducing the fuel-gathering burden of women and children around the world.

“The idea is how to create a thriving global industry in cookstoves, driven by consumers’ desire to have these products at a price they can afford,” Mr. Detchon said.

“These stoves don’t have a long lifetime,” he said. “To produce low cost and high volume, you’ll have to replace them relatively frequently, perhaps every two, three or five years. You’ll need a supply chain and business model that delivers them, not on a one-time basis, but as a continuing enterprise.”

Among the other founding partners of the alliance are the Shell Foundation, the Morgan Stanley Foundation, the World Health Organization, the United Nations Environment Program, the United Nations High Commissioner for Refugees and the governments of Germany, Norway and the Netherlands.

Aside from the State Department and the E.P.A., participating United States agencies include the Departments of Energy and Health and Human Services.

Thursday, 9 September 2010

Secretary Clinton on the Global Health Initiative: More on the WHAT and the WHO, but Not the HOW

Secretary Hilary R. Clinton spoke yesterday at SAIS on the objectives of the Global Health Initiative (GHI). The webcast of the event provided a forum for an interesting and interested set of tweeters (I participated) to point out what we heard and did not hear during the talk. My overall impression, echoed by several others (see here and here for two round ups of the discussion) was that while it was encouraging to hear Secretary Clinton reiterate the administration’s commitment to global health and its vision to transform the way in which global health is designed, delivered and managed, we did NOT hear anything new about the GHI: for example, no specifics on HOW the U.S. will “do” the GHI and apply all its commendable principles, metrics for success, and global leadership?

follow the link for rest of blog.

Global Health Policy _ Center for Global Development blog

Global Health Policy is a group blog discussing the issues facing the donor community on everything from HIV/AIDS financing to pharmaceutical R&D to broader health systems concerns. Comments are strongly encouraged, and suggestions for new posts can be sent to us here.

Tuesday, 7 September 2010

The Politics of Poverty: Elites, Citizens and States

What difference does governance make?

A new DFID synthesis report, The Politics of Poverty: Elites, Citizens and States, shows how research from four major DFID-funded research programmes closing this year is changing academic and policy thinking on governance.

Monday, 6 September 2010

Public Health Ethics Conference Feb 2011 Hanover Germany

Public Health Ethics.
Scientific methods, foundational concepts, and case analyses
An interdisciplinary European conference for young scholars
February 14-18, 2011 at Hanover Medical School, Germany
Deadline for Abstracts: October 4, 2010

This five-day interdisciplinary conference takes up questions of public health ethics from 15 European scholars (PhD-students & post-docs) from the fields of public health, health services research, philosophy, biomedical ethics, medicine, nursing sciences, health economics, psychology, law, political science, and social sciences. All participants give an oral presentation of their research findings, which will then be discussed more thoroughly in a plenary session. Additional workshops with experts like Angus Dawson, PhD (Keele University, UK), Marcel Verweij, PhD (Utrecht University, NL), Johannes van Delden, MD, PhD (Utrecht University, NL), Neema Sofaer, PhD (King’s College London, UK) aim to improve international network building and teaching curricula in the field.

Participants are paid all travel and accommodation costs and an additional expense allowance of 300 € for preparing a manuscript that shall be published in an anthology edited by the conference organizers. The conference language is English.

Please send your application containing an abstract (max. 500 words), a curriculum vitae and a publication list to:

After peer review, all applicants will be informed about the acceptance of their proposed talk by November 5, 2010.

Further information and Call for Abstracts

Daniel Strech MD, PhD (Hanover Medical School, Centre for Public Health and Healthcare)
Georg Marckmann, MD, MPH (University of Tübingen)

Irene Hirschberg, MD, MPH
Institute for History, Ethics and Philosophy of Medicine
Centre for Public Health and Healthcare
Hannover Medical School
Carl-Neuberg-Straße 1
30625 Hannover, Germany
phone: 0049-511 532-8241 (Hirschberg) or -2709 (Strech)

Tuesday, 31 August 2010

Lancet: Medical tourism booms in India, but at what cost?

Medical tourism booms in India, but at what cost?

Priya Shetty

As India tries to position itself as a major player in global health care, how will its courtship of rich foreign patients affect the care of India's own people? Priya Shetty reports from Mumbai.
In a plush suburb of Mumbai in India, a doorman guards the entrance of a gleaming building. Inside, past the marble floors, chandeliers, beauty salon, and fine-dining restaurant, is an elevator that takes the elite up to their suites. Mumbai has its share of five-star hotels, but this is not one of them. It is the Kokilaben Dhirubhai Ambani Hospital, one of the latest additions to India's increasing number of private hospitals. These shiny symbols of the country's burgeoning economy have been attracting increasing numbers of medical tourists—patients from other countries who come to India for treatment that ranges from cataract corrections to cardiac surgery.

The medical tourism industry is growing fast, especially in emerging markets like India. The Confederation of Indian Industry predicts that India will see revenues of US$2 billion from medical tourism by 2012. Captivated by this economic potential, the Indian Government is actively courting international patients. Yet despite the industry's predicted growth of 30% in India, the country has not produced any national medical guidelines on this issue.
For doctors and ethicists, the lack of regulation is ringing alarm bells. For one thing, duty of care and accountability are particularly murky issues in cross-border health care. Additionally, Indian doctors are concerned about the knock-on effects of medical tourism on the local health-care system.

Many private hospitals in India are now seeking accreditation by the Joint Commission International (JCI), which has become a crucial stamp of approval for hospitals in developing countries seeking medical tourists. The number of JCI-accredited foreign medical sites worldwide tripled from 76 in 2005 to more than 220 in 2008.
The reasons why patients are willing to travel long distances for surgery tend to vary by region. In the USA, for example, a lack of health insurance can make treatment unaffordable (table). In the UK, patients get frustrated with long National Health Service waiting lists and the high cost of private care. Patients from the Middle East and Africa are drawn to India because the technology or medical expertise is lacking in their own countries.

The Indian Government, eager to expand its economy, has begun to aggressively court foreign patients through tourism campaigns that sell a unique mix of cutting-edge technology with ancient medical traditions in the form of ayurveda and yoga. The government has also created a special medical visa that lasts up to 1 year to make it easier for patients to enter the country. The result of this government cooperation has been an extraordinary expansion of corporate-owned hospitals across the country. Kokilaben is only 18-months old, but other private chains such as the Fortis Hospitals group, known for specialties such as cardiology, have been around for several years. Fortis Chief Executive Officer Vishal Bali says that the chain of 48 hospitals across India was built in less than a decade.

Although the American Medical Association, for example, issued guidelines on medical tourism in 2008, India has so far chosen to leave it to private institutes such as Fortis to make their own rules. This June, researchers concerned about the ethics of such self-regulation met at a conference on medical tourism held by Simon Fraser University (SFU) in Vancouver, Canada.
Valorie Crooks, who studies health services research at SFU organised the conference with Jeremy Snyder, a health ethicist at the university. Crooks says that medical liability is a serious concern. “In societies that are litigious in nature, such as the US, there is a concern that physicians will not want to provide follow-up care for patients treated abroad in case complications arise”, said Crooks. “There are no formal legal frameworks to protect international patients seeking medical care abroad”, agrees Indrajit Hazarika, who researches health-system strengthening at the Indian Institute of Public Health, Delhi. “In the event that some medical malpractice error does occur, it is very unlikely that the patient will receive any financial recourse in the foreign country”, he adds.

Suresh Rao, a paediatric cardiologist at Kokilaben hospital, estimates that about 15% of his patients come from abroad. Rao admits that the contract that patients sign with the hospital does not oblige him to provide aftercare. “If there is some issue, they will have to get seen by their home physicians”, he told The Lancet. Nevertheless, he says that he and other doctors at the hospital keep in touch with patients via email or phone because they view good follow-up as their moral responsibility. Vishal Bali says that doctors at Fortis also work hard to maintain links with patients after treatment, and the hospital chain has even subsidised the air fare for patients who have needed to return for follow-up treatment. “We don't at any point in time want to give an indication to our international patients that after the procedure we are not interested in their care.”

So far, there have been no major reports of such hospitals, in India at least, abandoning follow-up care. The competitive market-driven nature of the industry acts as an incentive for hospitals to ensure that patients are happy with their aftercare—hospital administrators say that many people use word-of-mouth recommendations. Bali says that Fortis safeguards both itself and patients by avoiding travel or tourism companies that do not have medical advisers. “All our health-care facilitators must understand the seriousness of medicine.”
In some ways, health insurance companies offer patients protection by vetting hospitals first. Mihir Bapat, a spine surgeon at Kokilaben, says that his international patients' insurance companies are “particularly careful in sanctioning treatment. They ask a lot of questions”.
However, Vivek Jawali, chief cardiothoracic surgeon at Fortis Hospitals, says that although Indian hospitals are behaving responsibly for now, “national guidance will come; it must”. Bapat is also strongly in favour of better national guidance. “Medical tourism is active but there are no laws per se as to how an institution manages it”. The guidance is crucial, he says, because in interactions with international patients “there can be language barriers, sociocultural barriers, and you need to understand those barriers to treat these patients.”

But ethicists are not just concerned about international patients. Increasingly, Indian doctors are worried about how gearing the health care system towards rich foreign patients will affect the care of India's millions of impoverished people. George Thomas, chief orthopaedic surgeon at St Isabel's Hospital in Chennai, India, and editor of the Indian Journal of Medical Ethics, spoke at the SFU conference in Vancouver. Thomas told The Lancet that hospitals designed to attract medical tourists have been built “by lobbying the government for cheap land to build the hospital, cheap loans to finance expenditure, and tax breaks. In a country, where the poorest are taxed on every item they buy, the concessions handed out to the rich are simply obscene.” Not only that, many hospitals are ignoring the responsibilities that such concessions come with, says Sunita Reddy, at the centre for social medicine and community health in Jawaharlal Nehru University in Delhi, who has co-authored a review of the effect of medical tourism on local health care.

A 2005 report by the Indian Government's public accounts committee investigated whether private hospitals in Delhi had kept their promise of providing some free health care in return for being sold land at hugely subsidised rates. Subsidised hospitals were asked to provide free care for 25% of inpatients and 40% of outpatients, explains Reddy. But the report concluded that most institutions had not offered this care. “The policy could have provided life-saving opportunities to some of those who are afflicted with complicated and deadly diseases but [who cannot afford] costly medical treatment”, says the report. “What started with a grand idea of benefiting the poor turned out to be a hunting ground for the rich in the garb of public charitable institutions.”

These criticisms are particularly important since India is trying to position itself as a key player in global health care. Crooks notes that “these countries are buying into the WHO's focus on renewing the commitments to primary health care made at Alma Ata, but instead we see these public dollars being shifted into private health care and the benefits for the public are really unclear.” Private hospitals are defensive about these criticisms. Bali says, for instance, that international patients tend to use high-end hospital suites “that would only be used by 15—20% of the Indian population anyway”. An average 10-min outpatient consultation in a private hospital in India costs between Rs500 and Rs1000. For many Indians, this would be half or more of their monthly salary. But Bali says that poorer sections of the population can still access care through government insurance policies.

Although claims that hospitals are reneging on promises to provide free care do seem to have some evidence behind them, researchers say the lack of data for the ethical fallout of medical tourism is a serious issue. “Countries that see medical tourism as a solution to development of their health-care centres should be cautious”, says Snyder, “because there are a lot of anecdotal stories about how medical tourism can harm health inequity, but without better data it's hard to make the argument that that's always the case or even often the case”.
Hazarika believes that there are genuine ethical concerns, but agrees with Snyder that “almost all the published reports on this issue are based on speculations and assumptions”. As well as better ethical guidelines, it is clear that India also needs government support to document the effects of medical tourism.

Outside Kokilaben's gleaming airconditioned walls, meanwhile, the chaotic reality of India, and the gap between rich and poor, has never been more evident. A sleek black car delivering a patient to the hospital speeds through a monsoon-flooded road, splashing a rag-clad beggar in the process. Used to the inequity of life in his country, he simply shakes himself off, shrugs, and moves to a drier spot.

Monday, 26 July 2010

Global Justice and Global Democracy PhD Opportunity

Doctoral Researcher Political Philosophy
Global Justice and Global Democracy
Katholieke Universiteit Leuven - Leuven Centre for Global Governance Studies

The Leuven Centre for Global Governance Studies of K.U.Leuven is seeking to recruit.

The Leuven Centre for Global Governance Studies, a K.U.Leuven Centre of Excellence, hosts a 7-year research programme on 'Global Governance and Democratic Government' (2010-2017). This research programme aims at the construction of a new paradigm for democratic global governance.

Your opportunities

You are part of an interdisciplinary group of scholars conducting research on 'Global Governance and Democratic Government'.
You conduct doctoral research - as part of the research programme on 'Global Governance and Democratic Government' - in the area of political philosophy.
You specialize in normative political philosophy, with emphasis on analyzing the ideals of global justice and of transnational or global democracy. Your analysis will serve as the theoretical backdrop for the construction of a paradigm for global governance practices which satisfy the demands of democracy and justice.
You publish and hold presentations on topics related to international political theory.
Within a four-year time span, your academic research will result in the submission and defence of a PhD-dissertation.
Your profile

You obtained a Master in Philosophy with a clear and demonstrable interest in political philosophy.
You have excellent command of English.
Foreign experience and knowledge - preferably an additional degree - of law, political science, sociology or linguistics are a plus.
During your studies you obtained excellent results from a leading university. Preferably, you graduated with great distinction (magna cum laude).
You are open to interdisciplinary research.
You are able to work in a research team involving junior and senior colleagues and can organize your own activities.
You are able to handle stress and deadlines and are familiar with multi-tasking.
You have excellent reporting, writing and presentation skills.
Our offer

We offer an employment as full-time doctoral researcher starting on 1 November 2010 for 1 year, renewable up to 4 years.

Please visit and apply online. Applications (including cover letter, CV, and the names of two referees whom we may approach prior to appointment) must be received no later than 31 August 2010. K.U.Leuven carries out an equal opportunity and diversity policy.

For more information about the job description, please contact Prof. Dr. Helder De Schutter (

For more information about the Leuven Centre for Global Governance Studies, please visit

Saturday, 10 July 2010

ESRC DFID Development Research Funding


DEADLINE: 30 September 2010

DFID and ESRC are pleased to announce a second call for applications under Phase 2 of their strategic partnership to provide a joint funding scheme for development research. The purpose of the scheme is to provide a more robust conceptual and empirical basis for development, and the achievement of the Millennium Development Goals (MDGs).

WORKSHOPS: A series of workshops are planned for potential applicants in July to give advice on the application process and further detail on the remit of the call.
· 10.00 on 16 July - e-Science Institute, Edinburgh University - register via the National e-Science Centre website at
· 14.00 on 21 July - Priory Road Social Sciences Complex, Bristol
· 14.00 on 22 July - Wellcome Collection, London - hosted by the UK Collaborative on Development Sciences (UKCDS)
· 10.00 on 23 July - The Rose Bowl, Leeds Metropolitan University
To register for workshops in London, Leeds or Bristol please email and include in the email subject the date and venue of the workshop you wish to attend.

THEME: The second phase of funding retains the overall 'poverty alleviation' theme from the first phase, and applications under this broad heading will still be eligible. However, ESRC and DFID have identified three thematic areas for this call where work will be of particular interest:
· Population and Development;
· Development in a Changing World: the Challenge for Theory, Policy and Action;
· Inequality and Development.

FUNDING: This second phase of the joint scheme has a total budget of £23 million and consists of three annual calls for proposals. £7m is set aside for this second call. Full applications are invited between £100,000 and £500,000 (100 per cent FEC).

APPLICATION PROCEDURE: Any UK and non-UK applicant(s) and their institutions intending to apply to this call must ensure they are registered with Je-S.

CONTACT: Email or tel Lyndy Griffin (0) 1793 413135, or Peter Stephenson (0) 1793 442162, or Eloise Stott (0) 1793 413387.

Introducing a new approach to global poverty


The Oxford Poverty & Human Development Initiative (OPHI) and the UNDP Human Development Report Office would like to invite you to participate in a special policy forum at the Commonwealth Club in London on Wednesday 14 July 10.00 – 11.30am. Speakers include Jeni Klugman, Director of the UNDP Human Development Report Office, Sabina Alkire, Director of OPHI at the Oxford Department of International Development, James Foster, Professor of Economics and International Affairs at George Washington University and OPHI Research Associate, and Michael Anderson, Director General for Policy and Global Issues at the Department for International Development.

Our aim is to focus discussion on the impact on global poverty strategy of a new measure, the Multidimensional Poverty Index or MPI, which will be prominently featured in the forthcoming 2010 UNDP Human Development Report, 20 Years On: Pushing the Frontiers of Human Development. In this report the MPI supplants the Human Poverty Index or HPI used in recent Human Development Reports as a tool for measuring the nature and impact of poverty at the household level. The report, which marks the 20th anniversary of the UNDP’s flagship publication, will be released in October but research findings from the introduction of the new internationally comparable measure will be made available at the July policy forum.

The UNDP Human Development Report Office is joining forces with OPHI, who developed the MPI, to promote a debate internationally on how the new instrument can help better analyse the drivers of acute poverty across the world and target development resources more effectively. We hope that you will want to join the specially invited audience of senior development policy-makers, media commentators, academics and aid practitioners at the policy forum.

Please RSVP to Sarah Valenti at or on +44 (0)1865 271528. We hope you will join us for this event and look forward to welcoming you on 14 July.

Warm regards,


Sabina Alkire
Oxford Poverty & Human Development Initiative (OPHI)
Oxford Department of International Development,
Queen Elizabeth House, University of Oxford
3 Mansfield Road, Oxford, OX1 3TB

Thursday, 1 July 2010

Global Justice and the Social Determinants of Health

Global Justice and the Social Determinants of Health
Ethics & International Affairs, Volume 24.2 (Summer 2010)

Sridhar Venkatapuram

June 14, 2010

Public scrutiny and deliberation are central to both the sciences and ethical reasoning. In the sciences, research findings and analyses are put forward in the public arena not simply to announce new evidence but also for public examination, to be either corroborated or disputed. In ethics there is a similar process, whereby reasoned arguments are put forward about what is the good or right thing to do. In either domain, knowledge is expanded through the coherence and acceptance of the analyses and arguments, which depends on their being able to withstand public scrutiny. Therefore, when scientific and ethical arguments are brought together, the task of public deliberation is twofold, as it must encompass the empirical and the normative; and when the arguments concern an issue of such enormous scope as global health inequalities, public deliberation has to include national and global domains.
It is precisely this kind of twofold public deliberation that the World Health Organization's (WHO) Commission on the Social Determinants of Health (CSDH) anticipated when it released its final report at the end of 2008. In that report, the commission combined epidemiological analysis of health inequalities within and across countries with an essentially cosmopolitan ethical argument for motivating global social action to mitigate ill health and health inequalities. By doing so the commission brought together the consideration of scientific evidence, the centrality of global public deliberation to global health, and a view on global social justice.

For rest of article click title above or link here

Monday, 28 June 2010

Global Public Health Fulbright Scholar Program

Dear Colleagues in Higher Education,

I am writing to alert you to the exciting opportunities for Fulbright Scholar awards in Europe in the field of Public and Global Health.Applications for the 2011-12 academic year are currently being accepted for many awards in your field, including, but not limited to:

1165: Azerbaijan: Social Sciences
1176- Bulgaria: All Disciplines
1183- Bulgaria: Pure and Applied Sciences
1202- Estonia: Science Disciplines
1546- Finland: Fulbright-Aalto University Distinguished Chair
1205- Finland: Saastamoinen Foundation Award in Health Sciences
1318- Portugal: Engineering and Public Health
1327- Russian Federation: Community College Administrators
1328- Russian Federation: Community College Faculty
1329- Russian Federation: Science and Innovation
1369- Ukraine: Public Administration, NGO Management, Health Administration or Public Health

The application deadline for all awards listed above is August 2, 2010.

Applicants must be US citizens and hold a Ph.D. or appropriate professional/terminal degree at the time of application.

Please note that many All Disciplines awards: are available in Europe and can be a good option if the above awards do not match your expertise. More information about these and other Fulbright programs can be found on our website at can also explore the ‘My Fulbright’ home page, a resource center and online community of academics and professionals interested in the program.

Please share this information with interested colleagues and feel free to include it in your listserv or newsletter. If you have any questions, please contact the Program Staff listed in the award description or send your initial message to me. I will forward your inquiry to the appropriate program staff.

Jean McPeek
Senior Program Officer-Europe
Institute of International Education
Department of Scholar and Professional Programs
Council for International Exchange of Scholars Division
3007 Tilden St. NW, Suite #5L
Washington, DC 20008
Tel: 202-686-6246; fax: 202-362-3442 /

The Fulbright Program, sponsored by the U.S. Department of State’s Bureau of Educational and Cultural Affairs, is the U.S. government’s flagship international exchange program and is supported by the people of the United States and partner countries around the world. For more information, visit

The Fulbright Scholar Program and the Hubert Humphrey Fellowship Program are administered by the Institute of International Education’s Department of Scholar and Professional Programs, which includes the Council for International Exchange of Scholars. For more information, contact us at or 202-686-4000, or visit