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The blog of the Wilson Center's Environmental Change and Security Program
Showing posts from category global health.
  • Hans Rosling Animates DHS Data, Moves Debate

    ›
    June 1, 2009  //  By Brian Klein
    “Statistics should be the intellectual sidewalks of a society, and people should be able to build businesses and operate on the side of them,” said Gapminder Foundation Director Hans Rosling at a discussion hosted by the Wilson Center’s Environmental Change and Security Program on May 26, 2009. In his spirited and often humorous remarks, Rosling praised the 25-year-old Demographic and Health Surveys (DHS) program, which is funded by the U.S. Agency for International Development (USAID) and implemented by Macro International, Inc., as “public-private partnership at its best.” The DHS program works with countries’ health ministries to collect data on family planning, child and maternal health, disease prevalence, and other health indicators, and makes the data freely available for public use.

    The Beauty Behind the Data

    Rosling uses Gapminder’s signature “moving bubble” Trendalyzer software—which Google purchased and made available as “Motion Chart”—to graphically demonstrate global health, economic, and environmental trends. Gapminder uses data from several sources, including DHS surveys, to generate its illuminating displays.

    “Sweden, during the last hundred years, didn’t achieve [the] Millennium Development Goal rate” for yearly reductions in child mortality, Rosling explained. “We are putting goals for Tanzania, Bangladesh that [were] never…achieved by any country in West Europe or North America.” The remarkable thing, said Rosling, is that many low-income countries are achieving or even surpassing these demanding targets.

    Free Access, Unified Formatting Are Top Priorities

    Rosling stressed that access to data must be free, and admonished the World Bank, the Organisation for Economic Co-operation and Development (OECD), and others who charge for their statistics. “They say, ‘No, we can’t give the data to the people because they will make wrong comparisons, and they will make wrong conclusions,’” Rosling continued, “and I say ‘Yes, we call it freedom.’”

    Rosling cautioned against “database-hugging disorder,” or statisticians’ tendency to guard their data because of concerns about budgets or misinterpretation. A better approach, he insisted, is to embrace innovations like the Creative Commons license, which encourages sharing information by offering a range of easy-to-understand legal protections and freedoms for creative works, data, and information.

    In addition, “we don’t have a unified format for data,” Rosling said, and “that’s why the transaction costs are so enormously high, and that’s why those who put data together in unified format charge for it.” He cited YouTube as an excellent medium for broadening public distribution of data. To the audience’s delight, a live Google search for “sex, money, and health” returned a YouTube clip of one of his own presentations as its top hit.

    Improving Lives With Data

    “The worst environmental problem today is that two million children die of diarrhea [each year], and that billions of people drink their neighbors’ lukewarm feces,” said Rosling, and yet “water and sanitation data is very, very weak.” Collecting information from remote areas—often the most impoverished—is difficult. Measuring access to potable water is complicated because it requires community-based calculations, which do not fit into DHS’ household-centric methodology.

    Rosling called upon young adults to work to “eradicate unnecessary disease and poverty in the world.” He also advocated improved post-graduate training in statistics, particularly in low-income countries.

    Better statistical data will foment more effective solutions to development challenges—provided there are ambassadors like Rosling willing and able to unveil the beauty behind the numbers.

    Photo: Hans Rosling. Courtesy of Dave Hawxhurst and the Wilson Center.
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  • Women’s Rights: A Silver Bullet for Development?

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    May 21, 2009  //  By Rachel Weisshaar
    Any veteran of the international development field will be familiar with the disclaimer that no single intervention, no matter how effective, is a “silver bullet.” But in The Means of Reproduction: Sex, Power, and the Future of the World, journalist Michelle Goldberg argues forcefully that there is one change that is key to solving environmental degradation, food insecurity, water scarcity, global health challenges, skewed gender ratios, poverty, and both under- and overpopulation: women’s empowerment.

    Malthusian Anxieties

    As Matthew Connelly documents in his book Fatal Misconception: The Struggle to Control World Population, the family-planning movement sometimes lapsed into questionable moral territory during its early years, when women’s rights were not among its chief motivations. Fortunately, it turns out that family planning is actually more successful when motivated by a larger desire to empower women than when spurred by fears of overpopulation (The Means of Reproduction, pp. 74-76; 84-85). Educated women are more likely to delay marriage, have fewer children, obtain good maternal care, and be less vulnerable to HIV/AIDS, write Caren Grown et al. in a literature review of gender equality and women’s health in The Lancet.

    A Birth Dearth—or an Empowerment Dearth?

    As Goldberg points out, empowering women is also the solution to slowing the rapid population decline being experienced in many European countries and some wealthy Asian ones. “In contemporary developed societies, birthrates are highest where support for working mothers is greatest, a fact conservatives simply ignore in their doomsday surveys of future European decrepitude,” says Goldberg (p. 204).

    Thus, comparatively religious, socially conservative European countries like Italy and Poland have some of the lowest fertility rates on the continent (both 1.3 children per woman), while more secular countries like France and Sweden, with their generous paid parental leave policies, public day care, and after-school programs, have some of the highest (2.0 and 1.9, respectively).

    Strong Women, Healthy Families

    Women’s empowerment is key to human health. The more education a woman has, the healthier her children are likely to be, explains Goldberg (p. 75). In addition, as Grown et al. point out, “in societies such as Bangladesh, where husbands control most household resources, when women did own assets, household expenditure on children’s clothing and education was higher and the rate of illness among girls was reduced.”

    But the connection between empowerment and health also works in the other direction: In sub-Saharan Africa, women constitute 57 percent of people living with HIV/AIDS—a direct result of women’s sexual, social, political, and economic subordination (pp. 224-225). Women often do not have the standing to refuse sex, or to demand that a man wear a condom. They also frequently lack the financial and educational resources needed to leave violent or unfaithful husbands (p. 225).

    Bare Branches: Sex Ratios and Security

    A preference for sons persists in many parts of the world—especially Asia—and the spread of ultrasound, which can detect the sex of a four-month-old fetus, has made sex-selective abortion hugely popular for couples seeking to have a son. But the growing imbalance between men and women has potentially grave security implications for countries such as China and India, warns Goldberg. As Valerie Hudson and Andrea den Boer point out, Indian states “with high sex ratios, such as Uttar Pradesh, have much higher violent crime rates than states with more normal sex ratios, such as Kerala.”

    As Goldberg puts it, “as long as women lack an identity without a husband or a son, sex-selective abortion will continue to deform India’s—and Asia’s—demographics” (p.194). She isn’t hopeful about quick progress: “Like any democracy, India will probably find it easier to slouch toward disaster than to infuriate the defenders of patriarchy. Ultimately, though, unless the country finds a way to break through the encrustations of centuries of misogyny, its democracy itself could be in danger from an unmanageable excess of men” (p. 198).

    Toward Nine Billion Hot, Hungry, Thirsty People

    Goldberg’s take on the links among population, the environment, and security is admirably nuanced—although I would have appreciated a more extensive discussion of demographic security and population-environment links. She acknowledges that the food riots of 2008, combined with growing concern about water scarcity and climate change, may have generated more attention for family planning and reproductive health.

    But she reminds us that the main population-related response to these problems—a commitment to decrease fertility in the developing world—misinterprets the causes. The food shortages were largely the result of growing consumption by middle-income people, combined with continued high consumption in the rich world. Climate change will undoubtedly become much worse if all people in the developing world start to live the high-carbon lifestyles we do in the West, but to date, climate change has been caused almost entirely by industrialized countries.

    The Micro and the Macro

    Goldberg’s storytelling skills are superb, making The Means of Reproduction both an exciting and enlightening read. She illustrates her broader arguments about women’s rights with compelling stories about individual women and men. She demands that we respect these people’s experiences while arguing powerfully against succumbing to the temptations of political correctness and relativism:

    “In thinking about the situation of women in vastly different contexts, there are a number of dangers. One is assuming that Western ways are self-evidently superior and that all women would choose them, if only they could. But another is assuming that women in other cultures are so different from us that situations we would find intolerable—bearing child after child into grinding poverty; being utterly at the mercy of fathers, husbands, and brothers; having one’s clitoris sliced off with a razor—do not also cause them great pain” (p. 9).

    Goldberg has pulled off an impressive feat: The Means of Reproduction is accessible enough to serve as an introduction to the debates around population and family planning, but complex enough to inform readers about the latest controversies and battlegrounds in the field. Goldberg does have an opinion, but it’s based on reams of research. Here’s hoping The Means of Reproduction finds a place in the canon.

    Photo: Women and children at the health post at Sam Ouandja refugee camp in the Central African Republic. Courtesy of Pierre Holtz/UNICEF and Flickr user hdptcar.
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  • World-Renowned Inventor Dean Kamen Talks Water, Energy

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    May 20, 2009  //  By Rachel Weisshaar
    “If you tell the world you’re going to do something and they go, ‘Yeah…?’ it’s probably that you’re making an incremental change in something that the world is already doing reasonably well,” said renowned inventor Dean Kamen at a May 2009 meeting co-sponsored by the Wilson Center’s Environmental Change and Security Program and Program on Science, Technology, America, and the Global Economy. “I’d rather work on the really big stuff.”

    His track record proves it: He holds more than 400 U.S. and international patents, and his most famous inventions include an implantable insulin pump, a portable dialysis machine, and an artificial arm, as well as the Segway personal transporter.

    Kamen now seeks to provide clean water to the 1.1 billion people who lack it with the Slingshot, a washing machine-sized device that uses just 500 watts of electricity to produce 10 gallons of clean water an hour.

    Tackling the Big Problems: Water and Power

    Kamen’s career as an inventor began in high school, when he would invent medical devices for his older brother, a doctor. The Slingshot grew out of a portable dialysis machine Kamen developed for patients with renal failure. After inventing a way to make perfectly sterile water for the dialysis machine, he explored whether he could adapt the water-purification technology for the developing world, where millions of people die each year from dirty water.

    The data “take your breath away,” said Kamen. More than one billion people lack access to clean water, and 1.6 billion do not have access to electricity. Kamen thought he could address both of these problems with the Slingshot, which uses a Stirling-cycle generator to vaporize and condense the water, removing the impurities.

    The generator runs on any kind of fuel, including the methane gas in cow dung, which is readily available in the Bangladeshi villages where Kamen conducted a six-month test of the Slingshot. The generator not only powers the water vaporizer, but also produces enough surplus electricity to power a light, cell phone, and computer for every household in a small village.

    The Skepticism of Experts: A Bigger Problem?

    In meetings with the World Bank and other international development organizations, Kamen was told that the Slingshot was more expensive than other ways of purifying water, including chlorine tablets, activated-charcoal filters, and reverse-osmosis desalination. But unlike these technologies, the Slingshot can remove any kind of contaminant from water; does not need filters, membranes, or chemicals; and does not require any technical know-how to use.

    Kamen granted that the cheaper technologies might be more practical for urban areas, but argued that the Slingshot could have advantages in remote villages without access to technical expertise or a steady supply of chemicals or other components. He also suggested that microfinance might be a way to overcome the large initial cost of the Slingshot—although he emphasized that his expertise lies in developing the technology, and then partnering with experts who know how to surmount the various barriers to distribution.

    “If everything I now say by way of recalling my history here seems to you like I’m frustrated, and angry, and disappointed, it’s mostly because I’m frustrated, angry, kinda disappointed,” said Kamen, adding, “But you’re going to fix all that.” Suggestions from audience members included learning from the experiences of venture capitalists who have invested in water technology in the developing world, as well as partnering with the military and defense contractors to manufacture and distribute the Slingshot.

    Water, Electricity, and National Security

    Kamen suggested that the Slingshot could be used to support U.S. foreign-policy and national-security objectives. For instance, the U.S. armed forces could bring water and electricity to an Afghani village with the Slingshot and Stirling-cycle generator. A telephone and camera mounted on the generator would provide communications technology.

    “I would suspect that the Taliban…would be way more worried that everybody in town is happy, and healthy, and has light, and is communicating and showing pictures of everything going on” than about the threat of attack by the United States, said Kamen.

    Photo: Dean Kamen. Courtesy of Dave Hawxhurst and the Wilson Center.
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  • Weekly Reading

    ›
    Reading Radar  //  May 15, 2009  //  By Wilson Center Staff
    Focus author Gladys Kalema-Zikusoka, who founded and directs the Ugandan NGO Conservation Through Public Health, won the Whitley Gold Award (see video of her work) for her efforts to protect the endangered mountain gorillas while improving local communities’ quality of life. The other five finalists were also seeking to reduce human-wildlife conflict in diverse contexts.

    In Seed magazine, seven experts—including Peter Gleick and Mark Zeitoun—weigh in on whether “water wars” are a serious menace or an improbable threat, inflated by breathless media coverage of water shortages.

    A major report on managing the health effects of climate change, co-authored by University College London and The Lancet, claims that climate change is the biggest health threat of the 21st century.

    On his blog, Signs From Earth, National Geographic editor Dennis Dimick has collected a variety of resources about the possibility of “climate refugees.”

    It’s not news that the U.S. and U.K. militaries are studying climate change’s potential security impacts, or seeking to increase energy efficiency on bases and in combat zones. But Geoffrey Lean, the environment editor of the Independent, is surprised that legendary Vietnamese General Vo Nguyen Giap has come out against bauxite mining in Vietnam’s central highlands, which he says “will cause serious consequences on the environment, society and national defense.”

    Photo: Gladys Kalema-Zikusoka receives the Whitley Gold Award from Her Royal Highness The Princess Royal. Courtesy of the Whitley Fund for Nature.
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  • Projecting Population: A Risky Business

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    May 6, 2009  //  By Sean Peoples
    Assumptions about human behavior drive our knowledge of future global population trends. Demographers analyze population and other survey data in order to forecast trends, but uncertainty colors these projections.

    In the 2008 Revision of World Population Prospects, the UN Population Division projects that our planet will grow to 9.15 billion people by 2050. Yet this medium-variant projection is just one of several possible scenarios released in this latest round of number crunching. The low- and high-variant projections—7.96 billion and 10.5 billion, respectively—could instead become reality, given slight shifts in fertility rates in developing countries, where growth rates remain higher than in more developed nations. Although both developing and developed nations are susceptible to shifts in fertility rates, uncertainties are greater in the developing world due to factors such as inconsistent data collection, weak health system infrastructure, and low government capacity.

    Elizabeth Leahy and I investigate the underlying assumptions behind population projections in an article in the May/June edition of World Watch magazine. By comparing three of the leading population-forecasting institutions, we find that small variations in assumptions can lead to significant differences in projections.

    Uganda’s demographic outlook is a prime example. Between 1960 and 2005, Uganda’s population grew by 22 million people, while the country’s fertility rate fell by less than 3 percent. The UN medium-variant population projection assumes the country will buck precedent and experience a 61 percent fertility rate decline between 2005 and 2050, resulting in a population of 91 million people. The U.S. Census Bureau, on the other hand, assumes a less drastic fertility decline and projects a population of 128 million people by 2050. The International Institute for Applied Systems Analysis (IIASA), an Austrian institution that projects population on a regional basis, recently revised its population projections to reflect greater growth in sub-Saharan Africa due to stalling fertility decline and stagnant educational-attainment rates.

    Fertility rates rarely decline when governments have not made the proper investments in health and education. The UN medium-variant projection is commonly cited as an inevitable scenario; few people know that one of its underlying assumptions is that access to modern contraception will continue to expand. Without real-world development investments to match these assumptions, a very different scenario could easily materialize. By empowering women, bolstering access to education, and providing comprehensive family-planning services to citizens, governments and policymakers can translate these assumptions into reality.
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  • Weekly Reading

    ›
    Reading Radar  //  May 1, 2009  //  By Wilson Center Staff
    How Do Recent Population Trends Matter To Climate Change?, from Population Action International, offers the latest research from this constantly changing area of inquiry.

    U.S. Global Health and National Security Policy, a timely report by the Center for Strategic and International Studies, examines major threats to human health and international stability, including HIV/AIDS, SARS, pandemic influenza, and bioterrorism.

    In the coming decades, Russia will confront “accelerated population decrease; a dwindling of the working-age population; the general ageing of the population; the drop in number of potential mothers; a large immigrant influx; and a possible rise in emigration rates,” warns a new report from the UN Development Programme.

    In The National Interest and the Law of the Sea, the Council on Foreign Relations’ Scott Borgerson argues that ratifying the Law of the Sea Convention is vital to protecting the United States’ national security, economic, and environmental interests.

    David Sullivan of Enough debates Harrison Mitchell and Nicolas Garrett of Resource Consulting Services (RCS) on the links between conflict and mining in the Democratic Republic of the Congo (DRC). RCS recently published a report arguing that mineral extraction is key to DRC’s development and not the primary cause of conflict in North Kivu.

    Responding to the ubiquitous Monsanto ads that ask, “9 billion people to feed. A changing climate. Now what?,” Tod Preston of Population Action International responds, “family planning and empowering women, that’s what!”

    Water and War, a publication of the International Committee of the Red Cross (ICRC), outlines how the ICRC provides access to clean water during conflict and humanitarian disasters.
    MORE
  • Swine Flu Not Out of the Blue for U.S. Intelligence Community

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    April 27, 2009  //  By Rachel Weisshaar
    Today, the Washington Post’s Ben Pershing called the outbreak of swine flu in North America an “unexpected challenge” for President Obama. Now, Obama’s advisers probably didn’t predict that his first 100 days in office would include this particular threat, but the U.S. intelligence community has been aware of the security threats posed by infectious diseases for a long time.

    Director of National Intelligence Dennis Blair’s annual threat assessment, presented to the Senate Select Committee on Intelligence in February 2009, included the following:

    “Highly publicized virulent infectious diseases—including HIV/AIDS, a potential influenza pandemic, and ‘mystery’ illnesses such as the 2003 outbreak of severe acute respiratory syndrome (SARS)—remain the most direct health-related threats to the United States. The most pressing transnational health challenge for the United States is still the potential for emergence of a severe pandemic, with the primary candidate being a highly lethal influenza virus.”

    The U.S. intelligence community did not just start thinking about these issues a few months ago. In 2000, the Environmental Change and Security Program hosted a presentation of the findings of a National Intelligence Estimate entitled The Global Infectious Disease Threat and Its Implications for the United States. In December 2008, the National Intelligence Council released Strategic Implications for Global Health, which built on the 2000 report but also explored non-infectious health issues like maternal mortality, malnutrition, and chronic disease.

    The current swine flu outbreak has several geopolitical implications. First, governments and international organizations (particularly the World Health Organization) will be perceived as more or less legitimate based on their ability to contain and treat the disease.

    Second, governments’ decisions to issue travel warnings or ban certain products coming from affected countries are made with an eye toward both political and health implications. For instance, after the European Union issued an advisory against traveling to the United States, the acting director of the U.S. Centers for Disease Control and Prevention struck back, saying it was unwarranted.

    Finally, this outbreak of swine flu won’t do anything to burnish Mexico’s image as a tourist destination, which has already suffered from the brutal drug violence of the last year. Lagging economic growth in Mexico, due to fewer tourists and the fallout from the global financial crisis, could help fuel unrest or increase immigration to the United States.

    For more on diseases that can spread between animals and people—and how this relates to the environment—see “Human, Animal, and Ecosystem Health,” a May 2008 meeting sponsored by ECSP.

    Photo: Mexican police officers wear surgical masks to guard against the spread of swine flu. Courtesy of Flickr user sarihuella.
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  • Weekly Reading

    ›
    Reading Radar  //  April 20, 2009  //  By Wilson Center Staff
    “The Arctic could slide into a new era featuring jurisdictional conflicts, increasingly severe clashes over the extraction of natural resources, and the emergence of a new ‘great game’ among the global powers,” argue Paul Berkman and Oran Young, two researchers at the University of California, Santa Barbara, in Science. “However, the environment provides a physical and a conceptual framework to link government interests in the Arctic Ocean, as well as a template for addressing transboundary security risks cooperatively.” In the Washington Times, Paula Dobriansky, former U.S. undersecretary of state for democracy and global affairs, argues that the Antarctic Treaty offers lessons for dealing with competing territorial claims in the Arctic.

    An article by Fred Pearce in Yale Environment 360, “Consumption Dwarfs Population As Main Environmental Threat,” has re-energized the debate over population’s contribution to climate change. For more, see Suzanne Petroni’s article “An Ethical Approach to Population and Climate Change” in ECSP Report 13.

    Time interviews Laurel Neme, author of Animal Investigators: How the World’s First Wildlife Forensics Lab Is Solving Crimes and Saving Endangered Species, about the illegal wildlife trade. Neme will speak at the Wilson Center on May 20.

    Slate’s William Saletan discusses the skewed sex ratio in China. For more on this topic, see Richard Cincotta’s review of Bare Branches: The Security Implications of Asia’s Surplus Male Population.

    According to Rose George, author of The Big Necessity: The Unmentionable World of Human Waste and Why It Matters, “If you invest a dollar in sanitation, you save seven dollars in health-care costs.” Audio is available of a recent talk featuring George and ECSP Director Geoff Dabelko.

    Time reports on Mexico’s water crisis. (See “Water Stories” for more on water and sanitation in Mexico.) It also features photo slideshows on the politics of water in Central Asia and the global water crisis.

    In a paper published in Ecology (subscription required), Kevin Lafferty, a research ecologist for the United States Geological Survey at the University of California Santa Barbara, argues that climate change may not necessarily expand the range of disease vectors, as many scientists have argued.
    MORE
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