Wednesday marked the close of the G8 Summit, where critical topics like climate change, global food security, and development were on the table. Much of the discussion of the latter centered on Africa’s stagnating progress toward achieving the Millennium Development Goals (MDGs), which G8 representatives partially attributed to widespread instability: “Peace and security are fundamental to states’ ability to meet the needs of their people. Fragile and post-conflict states remain farthest from reaching the MDGs,” said the G8 Hokkaido Toyako Summit Leaders Declaration. Investments in health, education, clean water and sanitation, access to electricity, sustainable agriculture, and natural resource management were all identified as essential to attaining the MDGs.

It seems, however, that the G8 may have renewed its commitment to global health, including maternal and child health and nutrition. The declaration stated:

In some developing countries, achieving the MDGs on child mortality and maternal health is seriously off-track, and therefore, in country-led plans, the continuum of prevention and care, including nutrition should include a greater focus on maternal, new born and child health. Reproductive health should be made widely accessible.

The United Nations has urged the G8 to demonstrate its commitment to these areas by increasing funding. Secretary-General Ban Ki-moon has stated that $10 billion dollars would ensure basic coverage of maternal and child health worldwide. The G8 has finally caught on to these critical needs; it is now time to make real financial commitments to global health.

PlusNews recently reported on the harmful impact of rising food prices on HIV-positive Ethiopians. According to the nation’s Central Statistical Agency, the price of food has increased 40 percent since last year. The situation has been particularly devastating for those with HIV, as poor nutrition weakens the immune system and “hastens the development of HIV into AIDS.” For those on antiretrovirals, malnutrition reduces the treatment’s effectiveness and increases its toxicity to the body. As Gideon Cohen of the UN World Food Programme (WFP) explained, antiretroviral treatment “can’t work if people aren’t eating enough.”

The consequences extend far beyond HIV-positive individuals themselves, however. For infected mothers who have been advised against breastfeeding, purchasing milk or formula drastically increases household expenses and is often unaffordable. In addition, HIV augments adults’ energy requirements by 10-30 percent. Without sufficient nutrition, it becomes difficult for these individuals—who constitute almost eight percent of Ethiopia’s urban population—to work and provide for their families, undermining food security even further. So as the current food crisis threatens the lives and livelihoods of the HIV-positive in Ethiopia, it also increases the rest of the population’s susceptibility to the virus and other illnesses.

Unfortunately, this problem is not a new one. At a 2006 Wilson Center event, Jordan Dey, director of the U.S. Relations Office at WFP, said, “Hunger weakens immune systems, increases vulnerability to disease, and creates a platform for disability.” A Wilson Center On the Hill event today from 12:00 noon to 1:15 p.m. in the Rayburn House Office Building will examine what the United States can do to relieve the global food crisis.

According to PlusNews, WFP’s HIV/AIDS feeding programme in Ethiopia has exceeded its budget by 44 percent, and has had to borrow funds from other UN programmes. This alarming situation illustrates the severity of the situation in Ethiopia and calls not only for increased humanitarian aid, but also for mechanisms to ensure long-term food security. Nations will not be healthy, prosperous, and peaceful until their people are properly nourished and given the chance to develop to their full capacity.

“Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict,” argue Frederick Burkle and P. Gregg Greenough of the Harvard Humanitarian Initiative in a new article in Disaster Medicine and Public Health Preparedness. Burkle, who is currently a public policy scholar at the Wilson Center, will discuss public health management after natural disasters at the Center on June 17th.

In their article, “Impact of Public Health Emergencies on Modern Disaster Taxonomy, Planning, and Response,” Burkle and Greenough discuss the public health consequences of disasters, which they classify as natural; failures of human or technological systems; or conflict-based. The authors contend that disasters’ indirect effects are often overlooked, despite the fact that they continue months and even years after the event. Disaster severity is typically measured by direct morbidity and mortality; however, Burkle and Greenough highlight the need to account for the indirect deaths and illnesses caused by the devastation of public health and other infrastructure, poor and overcrowded living conditions, displacement, food insecurity, and disrupted livelihoods. Furthermore, as acute deaths decrease, humanitarian aid wanes—at a time when it is desperately needed to rebuild public health infrastructure.

In the case of conflict-based disasters,“health care and other essential services . . . may not return to baseline for more than a decade.” The authors note that in 2004, the Iraqi Ministry of Health announced that more lives had been lost to insufficient health services than to violence. Yet the former fails to garner the same attention and condemnation as the latter.

The devastation wrought by Hurricane Katrina demonstrated that the safety, health, and infrastructure of even the wealthiest nations are at risk. No nation can afford to overlook the challenges highlighted by Burkle and Greenough.

The authors of “Reassessing HIV Prevention,” an article in the most recent issue of Science, question the assumptions behind current HIV prevention interventions in Africa. The authors challenge the commonly accepted belief that poverty and political instability increase a population’s vulnerability to HIV infection, arguing that it is not supported by the evidence. They point to data demonstrating that “African regions suffering from conflict, genocide, and rape, such as Rwanda, Congo, and Angola, are much less affected by AIDS than peaceful, wealthier, and more literate countries such as Botswana or Swaziland, which have the world’s highest HIV prevalence.”

Studies have shown that civil war and the breakdown of health service delivery result in an increase in preventable deaths—such as those due to malnutrition, diarrhea, and malaria—but perhaps HIV follows a different pattern. Clearly, there is a need for research that compares the spread of HIV/AIDS in politically stable, wealthier African countries with those torn by conflict.

At a 2007 ECSP event on the human cost of war, Dr. Frederick Burkle of the Harvard Humanitarian Initiative—who will discuss public health management after natural disasters on June 17—admitted that the direct impact of poverty, inequality, and cultural incompatibilities on the spread of infectious diseases and mortality during complex emergencies is “difficult, if not impossible,” to measure.

Earlier this week, public health practitioners, scientists, economists, and policymakers gathered at the Wilson Center in Washington, D.C., to launch The Lancet‘s new series on maternal and child undernutrition. The series aims to bring attention to the burden of undernutrition and raise support for evidence-based interventions that are implemented to scale. The speakers—including Joy Phumaphi, vice president for Human Development at the World Bank; Kent Hill, assistant administrator for global health at the U.S. Agency for International Development; and Tadataka Yamada, president of the Bill & Melinda Gates Foundation’s Global Health Program—emphasized the linkages between undernutrition and national productivity and prosperity. “Improved health for the world’s poor is not only a moral imperative, but also a pragmatic investment for peace, security, and worldwide economic growth,” said Hill. It is not surprising that the Japanese government recently gave $300,000 to fund a maternal and child health and nutrition program in Pakistan in an effort to alleviate poverty and increase security in the area.

Robert Black of Johns Hopkins Bloomberg School of Public Policy, the lead author of the series, emphasized that many national plans to improve nutrition have yet to be effectively implemented or have failed to achieve high coverage. He stressed the need to incorporate nutrition priorities into non-health programs and policies such as those addressing poverty, trade, and agriculture. Boldly, Black characterized the international nutrition system as fragmented and dysfunctional and called for reforms that included greater funding, capacity strengthening, and accountability.

According to The Lancet, “3.5 million mothers and children under five die unnecessarily each year due to the underlying cause of undernutrition, and millions more are permanently disabled by the physical and mental effects of a poor dietary intake in the earliest months of life.” It is time national governments and the international community acknowledge the negative impact of undernutrition on health, education, productivity, and human security. Nations will not be healthy, prosperous, and peaceful until their people are properly nourished and given the chance to develop to their full capacity. For more information on this event, visit the Global Health Initiative’s website.