Wednesday, 30 March 2011

Global campaign to Stop Torture in Health Care launched

Global campaigns against forced sterlizations, restrictions and/or denial of pain relieving pallative care, and detention as treatment

Today, a coalition of health and human rights groups has launched the Campaign to Stop Torture in Health Care . This global effort builds on the recent groundswell of civil society activity to protect and advance human rights in health care settings. The Campaign seeks to hold governments accountable for the most egregious abuses perpetrated against citizens in the name of health care.

One particular focus of the Campaign is forced and coerced sterilization. Across the globe, women continue to be forced or coerced by medical personnel to submit to permanent and irreversible sterilization procedures, sometimes even without their knowledge. Cases of forced and coerced sterilization have been reported in North and South America, Africa, Asia, and Europe. Women who are poor or stigmatized - Roma women, women living with HIV, indigenous women, women with physical or intellectual disabilities, women who use drugs - are most likely to be deemed “unworthy” of reproduction. Governments turn a blind eye to these practices in their own public hospitals. Perpetrators are seldom held accountable. Victims rarely obtain justice for this violent abuse of their rights.

From Namibia, Hilma shares with us her fight to overcome the shame and anger she feels after being sterilized without her knowledge in a public hospital because she is HIV+. See her story here: .

The full announcement about the Campaign launch is here:

You can also follow the Campaign on Twitter at @carenottorture.

Thursday, 24 March 2011

Buffet and the Gates are in India to encourage billionaire philanthropy

An appeal to India’s rich: Start giving back
NEW DELHI— From Thursday's Globe and Mail

Warren Buffett and his friends Bill and Melinda Gates are hosting dinner in Delhi Thursday night, in the marble embrace of the Oberoi Hotel. The guest list, like all else about the evening, is hush-hush, although an insider did let slip that dinner would be, fittingly enough, buffet. The subject of conversation, however, we know: money.

The three uber-wealthy Americans, now as famed for giving money away as for earning it, have brought their “Giving Pledge” to India. They have already talked about 60 rich Americans into committing to give away half their wealth to the charity of their choice, and they had some success in China last autumn. So now they are after India, the country with the world’s fastest-growing list of billionaires.

Good luck, sniff pundits in the astringent India press.

The Giving Pledge dinner has triggered a fit of self-appraisal, a national debate about philanthropy that has Indians asking hard questions about what’s being done with all this new money. Private giving and volunteering in India is less than 0.4 per cent of GDP, compared with more than 2 per cent for the United States and more than 4 per cent for Sweden, according to analysis from the Johns Hopkins Comparative Nonprofit Sector Project. While India is adding billionaires, some 450 million people still live below the World Bank’s global poverty line, on less than $1.25 (U.S.) a day.

“You look at our high-net worth individuals, and they don’t give – I’m not talking about giving to your driver’s children’s school fees or your local temple – they don’t do organized philanthropic giving,” said Priya Viswanath, co-founder of Singapore-based Dana Asia, which advises the wealthy on philanthropy, and former head of the Charities Aid Foundation India.

“In my experience, people who make $250,000 [a year] give less than $500,” she said. The United Way and the other top two payroll-contribution organizations have only 100,000 donors – in a country of 1.25 billion people, she noted.

Thus, Ms. Viswanath said, the Giving Pledge conversation may founder in cultural translation. “[The Gates and Buffetts] are right in their context but wrong in ours – all the big business barons here do their own kind of giving but whether [they] would leave all or part of their wealth to a public charity? I don’t think so. They will all give to stuff they care about but if tomorrow someone stands up and says, We need the money, nobody is going to write a cheque to them, or not their whole wealth in any event.”

But other truths have also emerged from this debate: Indians give, but they give differently than philanthropists in the West, or other Asian countries – for a host of cultural and logistical reasons.

Many of the wealthiest businesses in India are controlled by families who face pressure to pass capital on to future generations, Rohini Nilekani said. She heads a water access equity charity called Arghyam, is the wife of one of the country’s great technology tycoons and has emerged as a leading voice in the philanthropy discussion.

Surveys show India’s successful business people have a deep mistrust of the charitable sector, fearing money will be wasted, misused, or, in a best-case scenario, not spent as efficiently as it would be in the private sector, she said. (Ms. Viswanath noted sardonically that the same people who fret about entrusting funds to charities are the ones who make fortunes in a volatile stock market).

And the riches are recent: it is less than two decades since economic liberalization kicked off this frenzy of wealth accumulation. “Twenty years is not very much in the lives of an economy or a country or even a person,” she mused. “First you say, ‘Is this for real?’ I think many people wanted to be sure [before they began philanthropic commitments] … the wealth came, it may go.”

One family that presumably won’t be at dinner tonight is that of N.R. Narayana Murthy, chairman of technology giant Infosys: when his wife Sudha Narayana Murthy was asked about the Giving Pledge by an Indian newspaper, she replied that she thought giving should be a personal and private matter. Ms. Viswanath says this is true across Asia, but especially in India.

This has to do, in part, with religion: The requirement to give is central to the Hindu tradition, but a donor strives to have no expectation for the outcome of a gift – a sharp contrast to a Western philanthropist who gets involved in a charity in the hands-on way exemplified by the Gateses.

And often what is needed here is not money as much as ability – charities have a limited capacity to usefully absorb funds, and despite the funding there is a lack of skilled people or strategic ability to get schools or clinics built or renewable energy supplied to rural communities.

“The capacity of civil society organizations is not that great, so even if you wanted to put in a lot of money it’s a question of where you would put it,” Ms. Nilekani said.

Instead, Ms. Viswanath said, business barons often decide to give on their own, to a cause that interests them. “It’s a control-freak thing,” she said, at best – or an ego one.

But Ms. Nilekani described a new generation of givers seeking to change how philanthropy is done here. “They want to give as they get. These young corporate guys – at age 30 they say, ‘I have more than I need and I don’t want to live in a society that is so unequal.’ ” The new donors have market-driven ideas, and an obsession with outcomes – she compared them to the technology millionaires who emerged in California in the early 1990s.

Sanjith Shetty, who heads a hot renewable energy firm in Bangalore, is on a campaign to get computer labs into rural schools in the areas where his Bangalore-based Soham Energy works.

“I belong to an area that is supposedly the IT heartland of India but kids going to college haven’t seen a computer,” he said. He is working with the existing school system, but providing hardware, teachers and transport to get students technology education.

“I found a gap, to see where we could give our expertise in an intelligent way,” he said. “I need to put our profits back into our business. But we need to do this too. We’re part of this society.

from the Economist. What will become of Barack Obama’s health reforms?

Health care
A not very happy birthday

What will become of Barack Obama’s health reforms?

Mar 17th 2011 | NEW YORK | from the print edition

WHEN Barack Obama signed a sweeping set of health reforms into law on March 23rd 2010, he knew it was a historic moment—and not just because Joe Biden, the vice-president, whispered into his ear that it was a “big fucking deal”. He had successfully ridden the wave of popular support that brought him into office to deliver universal health coverage, a feat that eluded all his predecessors.

But the reality of politics has obstructed that grand dream. Republican leaders in Congress are trying to repeal the law outright. Several federal judges have ruled that one of the central provisions of the new reforms, an “individual mandate” requiring everyone to purchase coverage, is unconstitutional. And a recent poll by the Kaiser Family Foundation (KFF), a non-partisan outfit, revealed that hostility to the laws among politically vital independents has shot up sharply. One year on, how fares Mr Obama’s proudest achievement?

The chief strategy used by the administration to win over sceptics and to undermine legal challenges is to present the new laws as an unstoppable juggernaut. For example, when Kathleen Sebelius, the secretary of health and human services, spoke about the reform to the Senate Finance Committee on March 16th, she pointed to evidence of an “enormous difference it has made in the lives of Americans”.

True, the administration has rushed into force provisions affecting consumers directly, in an effort to win popular support. For example, some forbid insurers from denying coverage to children with pre-existing conditions, or imposing lifetime payout caps on anyone. The new laws also already require insurers to cover children up to 26 on their parents’ policies, which will benefit some 1.2m young people. Nearly 48m people on Medicare, the government health scheme for the elderly, are to get free preventive services such as colonoscopies and mammograms. In 2010 nearly 4m of them got $250 tax-free rebates to help pay for drugs.

All that seems impressive, but here’s the rub: many Americans do not believe Mrs Sebelius. Roughly half of those polled by KFF thought Obamacare had already been repealed or were unsure of its legal footing. It remains the law of the land.

The administration is also forging ahead with less visible aspects of the new laws. By 2014, when the bulk of the reform’s provisions kick in, states are required to have put regulated insurance exchanges in place so that consumers can buy plans that meet minimum standards for coverage. All would be required to buy insurance, but the less well-off will get subsidies. The federal government is offering technical assistance as well as money to states to nudge them towards establishing such market-places.

Alas, in this too Mr Obama has hit snags. Some Republican-led states, first among them Alaska and Florida, are refusing to take the money, while many others are demanding flexibility in implementing the rules. To the surprise of some, Mr Obama announced at a recent meeting of governors at the White House that he supports a plan—first proposed by Ron Wyden, a sparky Democratic senator—to grant “innovation waivers” starting in 2014. As long as states meet general goals on covering more people and curbing costs, they will be given flexibility in how they set up their local insurance markets.

That compromise comes only at the point of a gun, however. And Republican attacks on Obamacare will increase as next year’s presidential race gets under way. That points to a second question: can such attacks actually kill the reform? It seems unlikely. While Mr Obama is president, he would veto any such bill. So the legislative path to “repeal and replace”, as conservatives call it, hinges on winning back both the Senate and the White House. But that is far from a certainty, and the short-term strategy of defunding bits of the scheme looks more likely to score points than actually stop the law.

The other great hope for enemies of reform is that the Supreme Court will declare that the individual mandate is unconstitutional, and that this will lead directly to the unravelling of the dread laws. This too may prove unsatisfying for conservatives. For one thing, the court may not immediately take up this matter, giving boosters of the laws the chance to dig in their heels. For another, the individual mandate can be replaced with other policies—a mix of carrots and sticks to get punters to buy insurance—that imitate it. So such a ruling would be a political nightmare, but need not be a death blow to reform itself.

Given all this, what will be the likely long-term impact of Obamacare? Critics say that if the law stays in place, it will destroy employer-provided health coverage. Boosters insist that if it is given a chance to work, it will bring costs down, and not merely extend coverage. Both camps are probably wrong.

Republicans have often claimed that employers will scrap corporate insurance, preferring to pay a fine and dump their workers on the subsidised exchanges. That sounds plausible, but two new studies—by the RAND Corporation and the Urban Institute, both non-partisan think-tanks—debunk the argument. In fact, the boffins at RAND calculate that the new reforms could even increase employer-sponsored coverage, as employees confronted with the new mandate clamour for (tax-assisted) coverage from their employers now that they are obliged to have it.

As for costs, Mr Obama’s reforms deserve praise for expanding coverage, but they do this by adding millions of people to an unsupportably expensive system. Analysts estimate that America’s health spending will continue to soar under the reforms (see chart). That is a point hotly contested by Mr Obama’s team, who usually point to theoretical future efficiency gains and innovations that will save pots of money.

So it came as a shock when Deval Patrick, the governor of Massachusetts and one of Mr Obama’s closest friends, took a different tack. Asked recently about the pioneering health reforms in his state, which served as a model for the national reforms, he first gave a backhanded compliment to Mitt Romney (the state’s former Republican governor, now distancing himself from those reforms as he repackages himself to run for president in 2012). Mr Patrick then revealed the dirty little secret of Obamacare: “What these folks did in Massachusetts is frankly the same thing that the Congress did, which is to take on access first, and come to cost-control next.” In other words, America will soon have no choice but to come to grips with costs. Whatever one thinks of Mr Obama’s reforms, there is no denying that they have brought that day of reckoning closer.

Sunday, 20 March 2011

Melvin and his sister: A gay Kenyan's struggle to survive - vide

Sometimes pictures and videos do say more than a thousands of words

Melvin and his sister: A gay Kenyan's struggle to survive - video

Thursday, 17 March 2011

The Two Poverty Enlightenments Historical Insights from Digitized Books Spanning Three Centuries by Martin Ravallion

World Bank Policy Research Working Paper 5549

Word searches of Google’s library of digitized
books suggest that there have been two “Poverty
Enlightenments” since 1700, one near the end of
the 18th century and the second near the end of the
20th. The historical literature suggests that only the
second came with a widespread belief that poverty
could and should be eliminated. After the first Poverty
Enlightenment, references to “poverty” (as a percentage
of all words) were on a trend decline until 1960, after
which there was a striking resurgence of interest, which
came with rising attention to economics and more
frequent references to both general and specific policies
relevant to poverty. Developing countries also became
more prominent in the literature. Both Enlightenments
came with greater attention to human rights. The
written record reflects the push-back against government
intervention and the retreat from leftist economics and
politics since the late 1970s. Although many debates
from 200 years ago continue today, there is little sign that
the modern revival of the classical 19th century views on
the limitations of government has come with a revival of
the complacency about poverty that was common early in
that century.

This paper is a product of the Director’s Office, Development Research Group. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy Research Working Papers are also posted on the Web at The author may be contacted at

Saturday, 12 March 2011

Oxfam Briefing paper. Achieving a Shared Goal Free universal health care in Ghana


The current health system in Ghana is unfair and inefficient. It doesn’t have to be. The government can and should move fast to implement free health care for all citizens. The findings in this report include:

  • Coverage of the National Health Insurance Scheme (NHIS) has been hugely exaggerated, and could be as low as 18%.
  • Every Ghanaian citizen pays for the NHIS through VAT, but as many as 82% remain excluded.
  • Twice as many rich people are signed up to the NHIS as poor people. 64% of the rich are registered compared with just 29% of the poorest.
  • Those excluded from the NHIS still pay user fees in the Cash and Carry’ system. Twenty five years after fees for health were introduced by the World Bank, they are still excluding millions of citizens from the health care they need.
  • An estimated 36% of health spending is wasted due to inefficiencies and poor investment. Moving away from a health insurance administration alone could save US$83 million each year. Enough to pay for 23,000 more nurses.
  • Through savings, good quality aid but primarily improved progressive taxation of Ghana’s own resources, especially oil, the government could afford to increase spending on health by 200%, to US$54 per capita, by 2015.

This would mean the government could deliver its own promise to make health care free for all - not just the lucky few at the expense of the many.

Key recommendations

For the Ghanaian Government:

  • Commit to a clear plan to remove the requirement of regular premium payments, abolish fees in the parallel ‘cash and carry’ system and make health care free at the point of delivery for all by 2015
  • Within the next six months implement the overdue commitment to make health care free for all people under 18 years old
  • Commit to rapidly expanding and monitoring the health system so that all citizens have access to decent quality health care within 8km of their home
  • Increase and sustain government spending to health to a minimum of 15% of total revenues. Aim to spend at least US$54 per capita by 2015 using progressive taxation, efficiency savings and good quality aid.

For donors:

  • Stop using inaccurate accounts of Ghana’s progress to promote the introduction of health insurance in other low-income countries
  • Support and do not block government and civil society efforts to transform Ghana’s health financing to a universal system free at the point of delivery and financed from general revenues and international aid.

This report was written and produced in partnership with national Ghanaian NGOs and contributes to Oxfam’s global campaign on health care for all.

Oxfam Briefing Paper

Authors: Patrick Apoya (Consultant) and Anna Marriott (Health Policy Advisor, Oxfam GB)

Date of publication: 9 March 2011

Wednesday, 2 March 2011

Two Year Post Doc in Poverty, Justice, and Human Capabilities

Rice University announces a two-year, post-doctoral fellowship in the Program in Poverty, Justice, and Human Capabilities (PJHC). Stipend is $50,000 per year, plus benefits, with appointment beginning July 1, 2011.

Qualified candidates will have a PhD in hand by July 1, 2011 (received no earlier than 2008).. Required are a specialization and demonstrated teaching and research interests in poverty, human capabilities and development, justice, and women, gender, and sexuality studies.

The Fellow will teach two courses per academic year, including the core introductory course for the Program's minor (see and a course focusing on gender, human development, and capabilities in a global context. Research requirement is to engage in a research project relating to the program’s themes; present a public lecture; and play an active role in the intellectual life of the Center for the Study of Women, Gender, and Sexuality in which the Program is housed and in the Kinder Institute for Urban Research.

The Program in Poverty, Justice, and Human Capabilities ( provides students a multi-faceted understanding of human well-being; it also offers a unique interdisciplinary minor. The Program is part of the Center for the Study of Women, Gender, and Sexuality ( whose interdisciplinary programs support scholarly work, innovative teaching in graduate and undergraduate education, and research partnerships with institutions and community organizations. The Kinder Institute for Urban Research ( seeks to advance understanding of pressing urban issues and to foster the development of more humane and sustainable cities.

Please direct specific questions to the Program Manager, Ms. Christine Medina,

For a full description of the position and to apply visit:

Applications deadline is March 15, 2011. Rice is an EO/AA employer.