Showing posts from category global health.
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Three UN Millennium Development Targets Reached and a Review of the Human Drivers of Climate Change
›“It is plausible that key transitions in human evolutionary history have been driven in large part by climate change,” write Eugene A. Rosa and Thomas Dietz in “Human Drivers of National Greenhouse-Gas Emissions,” a literature review published by Nature Climate Change. “Changes in climate will doubtless be a key force in the future evolution of social systems, including all aspects of social, economic, and political life, while impinging on the health and well-being of the individuals who populate them.” Rosa and Dietz cite numerous studies to argue that nearly every facet of society will be affected by climate change. “The critical point,” they write, “is that population, affluence, technology, and all other drivers act not alone or additively but in a multiplicative fashion.” For example, rapid population growth can lead to an increase in urbanization, which generates “substantial demand for goods and services that can induce emissions in distant places.” They conclude that huge changes must be made in technology and consumption in order to combat the effects of climate change that are being caused by a growing population and an increasingly affluent world.
The United Nations’ 2012 Millennium Development Goals Report, released last month in New York City, announces that three of the eight major human development goals have been reached ahead of their 2015 targets. The Millennium Development Goals, set at a conference in 2000, were established to “uphold the principles of human dignity, equality, and equity at a global level.” The 2012 report indicates that the number of people living in extreme poverty has been halved since 1990; the proportion of people in the world without sustainable access to safe drinking water has also been halved; and more than 200 million slum dwellers have “gained access to either improved water sources, improved sanitation facilities, or durable or less crowded housing.” At the report launch, UN Secretary-General Ban Ki-moon noted that “these results represent a tremendous reduction in human suffering and are a clear validation of the approach embodied in the MDGs, but they are not a reason to relax.” Goals that have yet to be achieved include universal primary education; gender equality; reduced child mortality and improved maternal health; reducing rates of diseases such as HIV and malaria; and creating a global partnership for development.
Keenan Dillard is a cadet at the United States Military Academy at West Point and an intern with the Woodrow Wilson Center’s Environmental Change and Security Program. -
Lawrence K. Altman, The New York Times
A World Without AIDS, Still Worlds Away
›August 6, 2012 // By Wilson Center StaffThe original version of this article, by Lawrence K. Altman, appeared on The New York Times.
Is the world on the verge of ending the AIDS epidemic and creating an AIDS-free generation, even though a cure and a vaccine are still distant hopes?Yes, roared enthusiasts among the nearly 24,000 participants at the 19th International AIDS Conference here last week. Their hopes are based on the extraordinary scientific gains made since the conference was last held in the United States, 22 years ago, when an AIDS diagnosis was a sure death sentence.
Among those gains: antiretroviral drug combinations for women to prevent infection of their newborns; drugs to treat and prevent infection with HIV, the virus that causes AIDS, among adults; and evidence that voluntary male circumcision can reduce the risk of female-to-male transmission by 50 to 60 percent.
Today, HIV has become a chronic disease that, if treated appropriately, can be held at bay in a newly infected young adult for decades — if the patient adheres to the rigid daily drug regimen.
Continue reading on The New York Times.
Lawrence K. Altman is a senior scholar for the Woodrow Wilson Center’s United States Studies Program.
Photo Credit: “Secretary of State Hilary Rodham Clinton speaks at the International AIDS Conference,” courtesy of Roxana Bravo/World Bank. -
Population Aging: A Demographic and Geographic Overview
›The original version of this article, by Richard Cincotta, appeared on the National Intelligence Council’s Global Trends 2030 Blog. It is the first post in a series on population aging, featuring Jack Goldstone, Richard Jackson, Jennifer Dabbs Sciubba, Ronald Lee, Andrew Mason, Toshi Yoshihara, Elizabeth H Stephen, David Coleman, and Eric Kaufmann.
This series, Population Aging to 2030, begins with an introductory essay aimed at familiarizing readers with some of the demographic and geographic particulars of this phenomenon, and with several key demographic terms. The term most in need of definition is, of course, “population aging.” -
Linking Water, Sanitation, and Biodiversity Conservation in Sub-Saharan Africa
›July 25, 2012 // By Kate DiamondWater, poverty, and the environment are “intrinsically connected,” and the development programs targeting them should be as well, writes David Bonnardeaux in Linking Biodiversity Conservation and Water, Sanitation, and Hygiene: Experiences From sub-Saharan Africa, a new Africa Biodiversity Collaborative Group briefing. In a review of 43 programs across sub-Saharan Africa, including four in-depth case studies, Bonnardeaux finds that natural synergies between water, sanitation, and hygiene (WASH) programming and conservation work provide opportunities for greater effectiveness in addressing both.
Integrating WASH and Conservation: A Natural Match
“WASH interventions are generally reliant on natural resources and processes, whether indirectly or directly,” he writes, and “WASH services produce outputs that are potentially detrimental to the environment if not managed properly.” At the same time, poor ecosystem management can “threaten biodiversity and jeopardize the vital services that these ecosystems in turn provide to humanity, in the form of regulation of stream flow, erosion prevention, water filtration, aquifer recharge, carbon sequestration, wildlife habitat, outdoor recreation, and flood abatement.”
Given the connections between the two, WASH and conservation efforts would benefit from programmatic integration, according to Bonnardeaux. To bring the two closer together, he recommends three tools for policymakers and development programmers: integrated river basin management and basin planning; payments for watershed services (also known as payments for environmental services); and population, health, and environment (PHE) programming.
A Whole-of-Basin Perspective
“The causal link between WASH and ecosystem health and integrity is most accentuated when
dealing with freshwater ecosystems,” writes Bonnardeaux.
In Tanzania’s Pangani River Basin, one of his in-depth case studies, a growing reliance on hydropower, urbanization, and increased agricultural demand is altering a valuable ecosystem marked by endemism and iconic landscapes, including Mount Kilimanjaro.
In response, the government and international organizations are partnering through the Pangani River Basin Management Project to developing a greater understanding of the basin’s hydrology and ecosystem, how local populations interact with that ecosystem, and how potential development scenarios could impact the basin in the future. That knowledge, paired with an intensive training program for local water officials, is enabling stronger integrated resource management, which in turn could lay the groundwork for integrating WASH and conservation interventions, writes Bonnardeaux.
Economic incentives – in this case, payments for watershed services – offer another valuable tool for building support for conservation efforts, especially when upstream communities bear a disproportionate burden of safeguarding watersheds.
In South Africa, another case study country, “increased economic development and urbanization have taken its toll on” the country’s wetlands, while unemployment and poverty have remained a persistent problem in slum areas, writes Bonnardeaux. Through the government-run Working for Wetlands program, both the environmental and socioeconomic problems of development are being targeted for improvement. The program hires “the most marginalized from society” to clear wetlands of invasive plants in order to improve its natural filtration capabilities and, in turn, improves the quality of water feeding the burgeoning urban areas.
Although Working for Wetlands, now 17 years old, has been “hugely successful,” Bonnardeaux warns that such economic incentive programs are, more often than not, extremely difficult to carry out effectively. “While there is great potential for this incentive-based conservation approach,” Bonnardeaux notes, “the reality is there are many barriers to its effective implementation.”
Building Long-Term Support for Conservation With Near-Term PHE Successes
Building support for conservation can be a difficult task. The impacts of conservation programming are “often undervalued,” Bonnardeaux writes, in part because results tend to become apparent only over the longer term. By pairing conservation efforts with nearer-term programming, like PHE efforts targeting immediate health needs, development workers can foster the kind of local support that is essential for pursuing long term goals.
The Jane Goodall Institute’s Lake Tanganyika Catchment Reforestation and Education Project (TACARE), in northwest Tanzania, offers a case in point. Established in 1994, TACARE began as a conservation program meant to protect the areas around Gombe National Park, where Goodall first began her chimpanzee research in the 1960s. Local communities, however, were more interested in better health, “with an emphasis on clear water and reduction in water-borne diseases like cholera,” writes Bonnardeaux.
By adopting local health and poverty priorities, he writes, TACARE was able to establish trust and goodwill with the communities it served, which in turn enabled it to pursue longer-term conservation goals aimed at protecting the region’s natural biodiversity.
Bonnardeaux’s work shows that regardless of how policymakers choose to combine WASH and conservation goals, well-implemented integration can yield immense benefits for practitioners, funders, and local communities.
“Linking various sectors such as WASH, forestry, agriculture, population, and community development,” he writes, “can result in cost and effort sharing which in turn can increase the effectiveness of the project including improved conservation and improved livelihoods and health.”
Sources: Bonnardeaux 2012.
Photo Credit: “Intaka Island towards Table Mountain,” courtesy of flickr user Ian Junor. -
‘Motherland Afghanistan’ Shows Maternal Mortality Not Just A Health Issue
›Afghanistan has one of the highest rates of maternal mortality in the world: 327 out of every 100,000 women who give birth die during childbirth. Despite some recent improvements, political, social, cultural, and economic factors present enormous challenges. Last month, the Center for Population and Development Activities hosted an online viewing and dialogue discussion of the PBS Independent Lens film Motherland Afghanistan, which follows Afghan-American filmmaker Sedika Mojadidi and her father, Dr. Qudrat Mojadid, as they return to their home country and visit the Laura Bush Maternity Ward in Kabul. The conditions they find are devastating and underscore not only the need for greater commitment to reproductive health services, but also the advancement of women’s and girl’s access to education, security, and political participation.
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Nine Strategies to Stop Short of Nine Billion
›Although most analysts assume that the world’s population will rise from today’s seven billion to nine billion by 2050, it is quite possible that humanity will never reach this population size.
My chapter in this year’s State of the World 2012: Moving Toward Sustainable Prosperity, “Nine Population Strategies to Stop Short of 9 Billion,” outlines a series of strategies that would prompt significant declines in birth rates. Based purely on the intention of women around the world to have small families or no children at all, these initiatives, policies, and changes in attitude could end population growth before mid-century at fewer than nine billion people.
Examples from around the world demonstrate effective policies that not only reduce birth rates, but also respect the reproductive aspirations of parents and support an educated and economically active society that promotes the health of women and girls. Most of these reproduction policies are relatively inexpensive to implement, yet in many places they are opposed on the basis of cultural resistance and political infeasibility.
In creating this list, I sought to eschew the language and approaches of “population control” or the idea that anyone should pressure women and their partner on reproduction. Instead, I hoped to highlight strategies that could put human population on an environmentally sustainable path:- Provide universal access to safe and effective contraceptive options for both sexes. With two in five pregnancies reported as mistimed or never wanted, lack of access to good family planning services is among the biggest gaps in assuring that each baby will be wanted and welcomed in advance by its parents.
- Guarantee education through secondary school for all, especially girls. In every culture surveyed to date, women who have completed at least some secondary school have fewer children on average, and have children later in life, than do women who have less education.
- Eradicate gender bias from law, economic opportunity, health, and culture. Women who can own, inherit, and manage property; divorce; obtain credit; and participate in civic and political affairs on equal terms with men are more likely to postpone childbearing and to have fewer children compared to women who are deprived of these rights.
- Offer age-appropriate sexuality education for all students. Data from the United States indicates that exposure to comprehensive programs that detail puberty, intercourse, options of abstinence and birth control, and respecting the sexual rights and decisions of individuals can help prevent unwanted pregnancies and hence reduce birth rates.
- End all policies that reward parents financially based on the number of children they have. Governments can preserve and even increase tax and other financial benefits aimed at helping parents by linking these not to the number of children they have, but to parenthood status itself.
- Integrate lessons on population, environment, and development into school curricula at multiple levels. Refraining from advocacy or propaganda, schools should educate students to make well-informed choices about the impacts of their behavior, including childbearing, on the environment.
- Put prices on environmental costs and impacts. In quantifying the cost of an additional family member by calculating taxes and increased food costs, couples may decide that the cost of having an additional child is too high. Such decisions, freely made by women and couples, can decrease birth rates without any involvement by non-parents in reproduction.
- Adjust to an aging population instead of boosting childbearing through government incentives and programs. Population aging must be met with the needed societal adjustments, such as increased labor participation, rather than by offering incentives to women to have more children.
- Convince leaders to commit to stabilizing population through the exercise of human rights and human development. By educating themselves on rights-based population policies, policymakers can ethically and effectively address population-related challenges by empowering women to make their own reproductive choices.
Kathleen Mogelgaard assisted with research for this piece.
Robert Engelman is the president of the Worldwatch Institute and contributing author to State of the World 2012: Moving Toward Sustainable Prosperity.
Sources: Bloom et al. (2011), Guttmacher Institute, Kohler et al. (2008), Population Reference Bureau, UN, UNFPA, The Wall Street Journal, Yadava and Yadava (1999).
Image Credit: Worldwatch Institute, State of the World 2012: Moving Toward Sustainable Prosperity. -
Pop at Rio+20: Despite Failure Narrative, Progress Made at Rio on Gender, Health, Environment Links
›July 13, 2012 // By Sandeep BathalaA month ago this weekend I boarded a plane to Rio de Janeiro for the UN Conference on Sustainable Development. Over the past few weeks, I have had some time to reflect on the amazing (and exhausting) experience afforded to me. Unfortunately, the final Rio+20 outcome document (considered by some to be misnamed as “The Future We Want”) failed to recognize the connections between reproductive rights and sustainability. However, since I returned I’ve also found myself in conversations with colleagues eager to celebrate the successes of the conference.
Jason Bremner, program director at Population Reference Bureau, reminds me that the initial “zero draft document” that was circulated prior to Rio had absolutely no mention of reproductive health, family planning, or population. “Though the ultimate conference document wasn’t a success by many measures, I commend the efforts of the many advocacy organizations that resulted in the inclusion of reproductive health and family planning as a key aspect of sustainable development,” he said.
Other wins were recognized at Rio as well. On a panel organized by the International Planned Parenthood Federation, Brazilian Minister of Policies for Women Eleonora Menicucci de Oliveira pointed out that the presence of women this year was much stronger than at the 1992 conference. And she stressed that the overall importance placed on the reduction of poverty will have a big impact for women.
Though the official language was weakened in the final outcome document, there was much more support expressed at side events and off the record conversations. Speaking at the same event as Oliveira, Christian Friis Bach, Minister for Development Cooperation in Denmark, said that “one leader after another has stood up for reproductive rights, and we’ve started a campaign which will go on until ICPD+20.”
In fact, as the Wilson Center’s Brazil Institute Director Paulo Sotero points out, there was a great deal of progress made by non-government representatives alongside the main conference:I left Rio more hopeful about the future than the official part of Rio+20 would allow. As governments clearly fumbled in the face of the complex challenges of imagining and building a more equitable and sustainable economic growth model in the decades ahead, I saw senior business executives and leaders of civil society engaged in intelligent and productive dialogue about difficult issues at hundreds of thematic panels held at the Corporate Sustainability Forum and other sessions held in Rio.
I felt the same energy. And many groups there seemed to already be planning for next steps.
On the first day of side events I attended, members of the Population and Climate Change Alliance discussed strategies to ensure that in the post-2015 (i.e. post-Millennium Development Goals) international development agenda sexual and reproductive health and rights are explicitly recognized as core to sustainable development. The panel included Mialy Andriamahefazafy of Blue Ventures Madagascar, Joan Castro of PATH Foundation Philippines, Inc., and Negash Teklu of PHE Ethiopia Consortium, who all shared examples of efforts in their countries to integrate reproductive health with other sustainable development programs.Joan Castro on PATH Foundation’s work in the Philippines
The Rio+20 conference was, at the very least, a re-affirmation of the tenets set down by the ‘92 Earth Summit – that is, that there is middle ground between full-tilt economic development and uncompromising environmentalism, called “sustainable development,” and we ought to be moving towards it. It was also a fantastic gathering place for disparate groups of people to come together on to similar issues and to build momentum and networks on their issues.
For those hoping to see a stronger link recognized between reproductive rights, population, and the environment, the good news is that elsewhere, awareness and momentum seems to be growing. Just this week, The Bill and Melinda Gates Foundation joined the United Kingdom, United States, France, Germany, the Netherlands, South Korea, Norway, Sweden, and Australia to pledge more than $2.6 billion towards meeting global unmet for contraceptives. And the connection to development was explicit: “Contraceptives are one of the best investments a country can make in its future,” reads the summit website.
Coincidence to have followed so closely behind a “disappointing” Rio outcome? Perhaps not.
Sources: The Bill and Melinda Gates Foundation, Estado, UN Conference on Sustainable Development.
Photo Credit: “UN Women Leaders Forum at Rio+20,” courtesy of UN Women. -
Gates Foundation Spearheads London Summit on Family Planning
›July 12, 2012 // By Carolyn Lamere“Given the option, [women in developing countries] will have fewer children,” said Melinda Gates in a TEDxChange talk in April. “The question is: are we going to commit to helping them get what they want now? Or are we going to condemn them to some century-long struggle, as if this were still revolutionary France and the best method was still coitus interruptus?”
Wednesday, The Bill and Melinda Gates Foundation followed through on Gates’ pledge, helping to raise more than $2.6 billion at the London Summit on Family Planning as part of an ambitious goal of helping 120 million additional women in developing countries gain access to contraception by 2020. The summit was co-hosted by the UK Department for International Development and garnered support from other foundations and governments, including the United States, France, Germany, the Netherlands, South Korea, Norway, Sweden, and Australia.
To quote the Population Institute’s Robert Walker on Dot Earth, this is a big deal:Many of the challenges that we face (hunger, severe poverty, energy, food, carbon emissions) are seemingly intractable. Population growth, which is a challenge multiplier, is not intractable. Far from it. There are proven highly cost-effective means of lowering fertility rates: providing access to contraceptives, keeping girls in school, ending child marriage practices, and changing social norms (including attitudes toward women and desired family size) through entertainment media.
The focus on family planning for the Gates Foundation – one of the largest philanthropic organizations in the world – is relatively new (though their commitment to global health and development is not). Melinda Gates announced a commitment to maternal health in 2010, and the foundation first issued a family planning strategy in April of this year.
The move has been unwelcome by some, particularly some Catholic institutions who object to family planning. But Gates has been adamant that contraceptives “should be a completely non-controversial topic.” She argues that 90 percent of Americans find contraceptives “morally acceptable,” including herself and many other Catholics, so there is no reason for the taboo around international aid for family planning to continue.
“We’re not going to agree about everything, but that’s OK,” said Gates in a recent interview with CNN.
In the TEDxChange talk, which helped launch this year’s push, she credits her upbringing for instilling a strong sense of social justice. During her travels with the Gates Foundation, one woman from a slum in Nairobi told her, “I want to bring every good thing to this child before I have another.” That statement resonated with Gates: “We all want to bring every good thing to our children,” she said. “But what’s not universal is our ability to provide every good thing for our children.” Gates pointed to contraception as a way for families to plan for their future and manage their resources. She recognized the controversial history of family planning as population control, but argued that this new initiative is about providing choices to individuals, not imposing values.
Gates remains confident that as long as the foundation makes its mission clear, people will rally behind the cause.
“We’re not talking about abortion. We’re not talking about population control. What I’m talking about is giving women the power to save their own lives, to save their children’s lives, and to give their families the best possible future.”
Sources: BBC, The Bill and Melinda Gates Foundation, CNN, Catholic Family and Humans Rights Institute, Catholics For Choice, Dot Earth.
Video Credit: TEDxChange.
