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Working With the Private Sector to Improve Maternal, Newborn, and Child Health
Innovations From Development to Delivery
›“Challenging and dynamic partnerships [with the private sector] are difficult to pull together, but when you look at sustainability, impact, and effectiveness, they can also be great levers of change,” said Kari Stoever, senior advisor for global advocacy at the Global Alliance for Improved Nutrition (GAIN) at the Wilson Center on March 22. [Video Below]
Stoever was joined by panelists Laura McLaughlin, environmental engineer at Cascade Designs, Inc., Hugh Chang, director of special initiatives at the NGO PATH, and Laura Birx, senior food security and nutrition specialist at the U.S. Agency for International Development (USAID) for a discussion of the private sector’s role in developing innovative health technologies to increase access to safe water, prevent infectious diseases, and improve maternal health nutrition.
Collaborating to Provide Safe Water
“NGOs have different strengths and different perspectives from the private sector, and we’ve found an area where we can really complement each other,” said McLaughlin. Cascade Designs, Inc., collaborated with PATH to create a smart electrochlorinator, which produces a chlorine solution to purify water using just salt water and a simple battery, because “we wanted to make a bigger difference than we could do with philanthropy alone,” said McLaughlin.
“Products need to be designed specifically for the end user, particularly for women and children, who are often times left out of the design process,” said McLaughlin. Cascade’s smart electrochlorinator was designed with this in mind. One charged battery can treat up to 40,000 liters of water, 200 liters at a time. The device is easy to use, requires simple resources, is significantly more affordable than existing solutions, and lends itself to an entrepreneurial business model that can deliver safe water to small community households. The current prototype is being field-tested in 10 countries globally, with the aim of providing safe water in resource-poor communities while generating income for local entrepreneurs.
The PATH-Cascade partnership was successful in part because it combined “private-sector expertise in efficiency, cost-effectiveness, and meeting market demands” with knowledge about the health needs in developing countries, said McLaughlin. By “pushing each other to a common end goal, this partnership really multiplied our strengths.”
Engaging the Private Sector
“One of the reasons we work closely with the private sector…is because we recognize an efficiency of resource usage that comes with building bridges between the public sector and the private sector,” said Chang of PATH’s work with Cascade and others. Engaging the private sector to advance health technologies can complement PATH’s goals, like encouraging healthy behaviors and strengthening health systems, he said. “But, we are not averse to profits,” he added, stressing that partnerships with NGOs can be mutually beneficial. “We understand for this to be sustainable, these companies need to make a profit.”
PATH is working with the private sector to develop injection and vaccine technologies that “produce a product that not only benefits the recipient of the vaccine but also produces a revenue stream,” said Chang. The SoloShot, for example, is a low-cost, disposable syringe that locks after a single injection, preventing needle reuse and contamination that can increase the risk of HIV, hepatitis B, and other infections. To address the challenge of maintaining the proper refrigeration of vaccines in low-resource settings, private sector collaboration has helped to develop the vaccine vial monitor (a sticker that changes color when a vaccine has been exposed to too much heat) and to create more stable vaccine formulas that are less vulnerable to extreme temperatures. “By combining innovation with on-the-ground presence,” concluded Chang, “private sector engagement can be a powerful tool for global health.”
A “Win-Win Partnership”
“There is a tremendous role for the private sector to play in the intersection of agriculture and health as they relate to nutrition,” said Birx. Engaging the private sector can be a “win-win partnership,” she said. The Obama Administration’s hunger initiative, Feed the Future, for example, uses the resources, expertise, and innovation of the private sector to encourage sustainable, market-driven approaches to reducing poverty and food insecurity, said Birx.
USAID sees innovation as a “research-to-use continuum,” said Birx. “When we look at innovation, it’s not just about the development of a specific product, but about the entire system that goes around that product,” she added. New technologies must not only respond to a major development challenge in poor and rural communities but need to be affordable, culturally appropriate, gender sensitive, easy to use, and durable.
But solutions don’t have to be complicated. “Often times it’s about a really simple technology that can improve accessibility,” said Birx. The nevirapine pouch, for example, a simple foil packet that allows health care workers to give women single doses of nevirapine syrup, can reduce the risk of mother-to-child transmission of HIV by more than half.
“There’s a lot of excitement, but we need to do some serious work to capitalize on [it],” said Birx. Moving forward, health, development, and private-sector organizations must work together to create innovative financing mechanisms, build institutions in developing countries, and encourage enabling policy environments.
Sources: PATH.
Photo Credit: “Mission to Ouanda Djallé,” courtesy of flickr user hdptcar. -
The Impact of Environmental Change and Geography on Conflict
›“Environmental Change, Strategic Foresight, and Impacts on Military Power,” published in Parameters by Chad M. Briggs, the Minerva Chair of Energy and Environmental Security at the Air University, USAF, tackles the changing definition of “environmental security” and how the concept can help planners better prepare for the effects of climate change and an elevated focus on energy security. New potentially destabilizing issues like glacial melt, sea-level rise, and Arctic ice melt are on the horizon, writes Briggs. China and others are already planning for these events, and it’s important that the United States does the same, starting with a greater appreciation for the impact of environmental security on vulnerability and risk. “Due to past practices and bureaucratic stovepipes, implementation is limited more by initiative and imagination than actual resources,” he writes.
Clionadh Raleigh of Trinity College Dublin and the International Peace Research Institute finds in “Seeing the Forest for the Trees: Does Physical Geography Affect a State’s Conflict Risk?” that a region’s geography does not have a uniform effect on its likelihood of experiencing conflict. Raleigh’s conclusions, published in International Interactions, run counter to traditional histories which often emphasize the importance of physical geography, specifically with regard to civil war and insurgencies. Focusing on the Great Lakes region of Africa, Raleigh finds that other factors – like how populated an area is and its proximity to valuable natural resources – correlate higher with an area’s propensity for violence than any other factor. -
Integrated Approach Helps “Model Farmers” Increase Productivity in Ethiopia
›March 24, 2011 // By Schuyler NullTo reach the village of Grar Gaber from Addis Ababa, you drive up over the Entoto Mountains overlooking the capital then motor down two hours of new Japanese-built highway to the town of Fiche. From there it’s 20 minutes on a broken dirt road across rocky hills. I was joined there by about 20 others from the PHE Ethiopia Consortium’s general assembly (see day one and day two coverage here) and Population Action International, to visit an integrated population, health, and environment (PHE) development program run by LEM Ethiopia.
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The Continuing Challenges of Integrated Development
›March 20, 2011 // By Schuyler Null“How are we going to feed all these mouths?” asked Bekele Hambissa, director of the Environmental Protection and Development Organization in Addis, on day two of the PHE Ethiopia Consortium general assembly (read about day one here). Environmental resources are directly tied to Ethiopia’s population growth, said Hambissa, during a discussion of balancing efforts to address population growth, environment, and livelihoods. While poverty alleviation is an important goal of population, health, and environment integration (PHE), it must be environmentally sustainable, he said.
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Congressional Hearing: Clean Water Access Is a Global Crisis, Human Right, and National Security Issue
›March 17, 2011 // By Hannah MarquseeUnsafe drinking water causes nearly 1.8 million deaths each year from diarrhea, “a number that dwarfs the casualties associated with violent conflict,” said U.S. Representative James McGovern at a congressional human rights commission hearing earlier this month on water as a basic right. Nearly all of these deaths are children under the age of five, he said. “This is a war against families, children, and women on an ongoing basis,” said Representative Earl Blumenauer, also speaking at the hearing, titled “Realizing the Right to Safe Water and Sanitation.”
There are currently 884 million people in the world without access to safe drinking water, according to UNICEF, and 2.6 billion without improved sanitation. As population growth and climate change place added stress on fresh-water systems, by 2025, two thirds of the world’s population will live in water-stressed conditions, according to the Food and Agriculture Organization. “This is a severe global crisis,” said McGovern.
“A Human Right”
With 2011 World Water Day only weeks away, the hearing harkened back to Secretary Clinton’s widely quoted statement from World Water Day 2010, marking a commitment by the Obama administration to address global water issues:It’s not every day you find an issue where effective diplomacy and development will allow you to save millions of lives, feed the hungry, empower women, advance our national security interests, protect the environment, and demonstrate to billions of people that the United States cares. Water is that issue.
Four months after that statement, the UN passed a resolution to make access to water and sanitation a human right, not just a development priority. Said Catarina de Albuquerque, a UN independent expert who testified at this month’s congressional hearing, the resolution stipulates that water must be “available, accessible, affordable, acceptable and safe.” A “right to water” is an important “sign of political will,” that will place increased obligations on governments to improve access to water and sanitation, she said. But in the meantime, for the millions without access to safe water, “there is no change.”
According to the UN, the world is on track to meet the Millennium Development Goal target of halving the number of people without access to an improved water source by 2015. But de Albuquerque noted that the reality is not quite so optimistic. On a UN fact-finding mission, she encountered at least one family who by UN definitions had access to an “improved drinking water source,” yet their tap water was literally black. “Water quality is not being monitored” and for many of the people who do have access, it is simply “undrinkable,” she said.
In developed countries as well, there are significant barriers to access, especially for marginalized communities. On a recent mission to the United States, de Albuquerque found that America’s “voiceless” – people of color, Native Americans, and the homeless – face significant discrimination in access to water. “Society closes its eyes to them,” she said. Thirteen percent of Native Americans lack access to safe water, in comparison to 0.6 percent of non-native Americans, she said in a statement to the press releasing her findings. And in Boston, “for every one percent increase in the city ward’s percentage of people of color, the number of threatened cut-offs increases by four percent.” To make the necessary improvements to fill these gaps in America’s aging water infrastructure would cost $4 to $6 billion annually, she said.
A National Security Issue
Water “is a security issue as well as a human development issue,” said Blumenauer. Since, according to UNEP, 40 percent of the world relies on river basins that share two or more political boundaries, water management has enormous potential for both conflict and cooperation. Echoing Clinton’s World Water Day statement, McGovern championed the cross-cutting nature of water:The right to water is inextricably linked with other basic rights…including the right to food, the right to health, and the right to education.
The burden of collecting water in underdeveloped countries often creates a gender gap and exposes women and girls to violence and rape, he said. And it “has been the basis for many territorial and violent disputes between various peoples and even nations.”
Last month, a staff report by the Senate Foreign Relations Committee expressed a similar sentiment with the publication of their report, Avoiding Water Wars: Water Scarcity and Central Asia’s Growing Importance for Stability in Afghanistan and Pakistan. The report commends the Obama administration for recognizing the importance of water: “For the first time, senior government officials are recognizing the critical role that sound water management must play in achieving our foreign policy goals and in protecting our national security.” However, by exclusively focusing on Pakistan and Afghanistan’s water issues and “neglecting the interconnectivity of water issues between Central and South Asia, the U.S. approach could exacerbate regional tensions,” the report says.
To be more strategic about water assistance, the report recommends the United States: (1) provide technical support in data collection to better manage water; (2) help increase water efficiency and reduce demand for water; (3) recognize the transboundary nature of water issues and “provide holistic solutions;” and (4) “safeguard institutions against shocks to water supply and demand.”
Moving Forward
The Obama administration’s commitment to water issues, the UN’s recognition of water as a human right, and the 2005 Water for the Poor Act have all been important steps towards fulfilling the pledge of making access to safe water a human right. “We’ve come a long way,” Blumenauer (who authored the Water for the Poor Act) said at the hearing, but there is still significant work ahead.
“We’re going to have to be more strategic moving forward” in order to meet global water shortages, said Aaron Salzberg, special coordinator for water resources for the U.S. Department of State who testified at the hearing. Salzberg recommended that the U.S. government take steps to integrate water management with the food and health sectors; build political will; mobilize financial support; promote science and technology; and form partnerships with other governments and aid organizations. The United States must also “be smarter” about allocating funds based on the dual criteria of “need” and “opportunity.” Balancing efforts with partners to find out which countries have the greatest need and the least resources will allow limited U.S. funds to make the deepest impact, he said.
John Oldfield, managing director of the WASH Advocacy Initiative, urged Congress to increase funding for foreign assistance, continue appropriations for the Water for the Poor Act, and improve the effectiveness of existing water, sanitation, and hygiene (WASH) assistance. “Each dollar invested in water and sanitation leads to an 8:1 return from reduced healthcare costs and time savings,” he said. “The world does not need to bury millions more of its children in the coming years when we know how to prevent waterborne disease today.”
Sources: FAO, UNEP, UNICEF, United Nations, WHO.
Image Credit: Adapted from “School girl drinks water from new handpump,” courtesy of flickr user waterdotorg. -
Hu Angang and Liang Jiaochen, ChinaDialogue
China’s Green Five-Year Plan: Making “Ecological Security” a National Strategy
›March 16, 2011 // By Wilson Center StaffThe original version of this article, by Hu Angang and Liang Jiaochen, appeared on ChinaDialogue.
Five-year plans (FYPs), which set down and clarify national strategy, are one of China’s most important policy tools. Just as they have helped to drive China’s economic success over recent decades, so they will play a pivotal role in putting the country on a green development path. The 12th Five-Year Plan, now under consideration by the National People’s Congress, marks the beginning of that process in earnest (Editor’s note: Since this was originally published, the National People’s Congress voted in favor of the plan).
FYPs embody the concept of progressing by degrees, or developing step by step. This approach has been one of the driving forces behind China’s economic progress in recent decades and will now provide the platform for its green development. It is the methodology underpinning China’s socialist modernization: to reach a new step in development every five years. Unstinting efforts over a number of FYPs have driven China’s transformation.
Climate change presents a long-term and all-encompassing challenge for China. It demands a long-term development strategy and broad goals, as well as near-term action plans and concrete policies. Combining these is precisely the idea behind FYPs.
At the global climate change summit in Copenhagen in 2009, China demonstrated it has the long-term political will to respond to climate change; to work with the world to limit global temperatures to no more than two degrees Celsius above pre-industrial temperatures (the goal set out in the Copenhagen Accord). In November that year, the Chinese government formally put forward its medium-term targets on climate change: a reduction in energy intensity of 40 percent to 45 percent on 2005 levels by 2020, and generation of 15 percent of energy from non-fossil fuel sources by the same date.
Continue reading on ChinaDialogue.
Hu Angang is a professor at the Chinese Academy of Sciences and Tsinghua University and the director of the Centre for China Study. He has worked as the chief editor for China Studies Report, a circulated reference for senior officials. Liang Jiaochen is a PhD student at Tsinghua University’s School of Public Policy and Management.
Sources: Business Green, UN Framework Convention on Climate Change, World Resources Institute.
Photo Credit: Adapted from “China: CREME,” courtesy of flickr user IFC Infrastructure (Alejandro Perez/IFC). -
Congressional Report on Avoiding “Water Wars” in Afghanistan and Pakistan
›March 15, 2011 // By Schuyler Null“Water plays an increasingly important role in our diplomatic and national security interests in [Central and South Asia], and we must ensure that our approach is carefully considered and coordinated across the interagency,” begins a new staff briefing, Avoiding Waters Wars: Water Scarcity and Central Asia’s Growing Importance for Stability in Afghanistan and Pakistan, prepared for the Senate Foreign Relations Committee. “As water demand for food production and electricity generation increases, in part as a result of the quickening pace of climate change, so too must our efforts to provide water security,” write the authors.
The report focuses mainly on Afghanistan and Pakistan but also considers “the interests in the shared waters by India and the neighboring five Central Asian countries – Uzbekistan, Tajikistan, Kazakhstan, Kyrgyzstan, and Turkmenistan.”
ECSP is cited twice in the report, both from “Water Can Be a Pathway to Peace, Not War,” in ECSP Report 13:The Navigating Peace Initiative’s Water Conflict and Cooperation Working Group correctly summarized the current state of water use by saying, “water use is shifting to less-traditional sources such as deep fossil aquifers and wastewater reclamation. Conflict, too, is becoming less traditional, driven increasingly by internal or local pressures or, more subtly, by poverty and instability. These changes suggest that tomorrow’s water disputes may look very different from today’s.”
And again in breaking down the notion of impending water wars:Given the important role water plays in Central and South Asia as a primary driver of human insecurity, it is important to recognize that for the most part, the looming threat of so-called “water wars” has not yet come to fruition. Instead, many regions threatened by water scarcity have avoided violent clashes through discussion, compromise, and agreements. This is because “[w]ater – being international, indispensable, and emotional – can serve as a cornerstone for confidence building and a potential entry point for peace.”
USAID’s “Changing Glaciers and Hydrology in Asia: Addressing Vulnerabilities to Glacier Melt Impacts,” which was launched here at the Wilson Center last fall, also made an appearance:Central Asia and India face critical challenges in monitoring glaciers and tracking changes, particularly differences from year to year. As USAID’s report “Changing Glaciers and Hydrology in Asia: Addressing Vulnerabilities to Glacier Melt Impacts” noted, “[t]he review of scientific information about glacier melt in High Asia revealed, first and foremost, a lack of data and information, a lack that hampers attempts to project likely impacts and take action to adapt to changed conditions.” The United States should engage in collaborative glacier monitoring programs and those that develop local or sub-national water monitoring capacity.
The report concludes that “water scarcity, coupled with how governments address these challenges,” can either exacerbate conflict or promote cooperation in the region. It’s also worth noting that the authors specifically mention the links between increased water use and growing populations in the region, specifically with regard to India and Pakistan:With a population already exceeding 1.1 billion people and forecasts indicating continued growth to over 1.5 billion by 2035, India’s demand for water is rising at unprecedented rates.
The drive to meet energy and development demands from both countries has led to plans for extensive hydrological projects that could spark tensions between the two over the Indus Waters Treaty (which has withstood four Indo-Pakistani wars).
The authors praise the attention given to the matter thus far by the Obama administration, but they also write that “although it is still too early to determine the impacts of our efforts in the broader region, now is the time to begin evaluating water-related trends” at a more systematic level.
Sources: U.S. Senate Committee on Foreign Relations. -
Managing the Planet’s Freshwater
›“The impact of human activities on the planet and on its biology has risen to a scale that deserves a commensurate response,” said Tom Lovejoy, professor at George Mason University, introducing a discussion on “Managing the Planet’s Freshwater,” the second of a monthly series led jointly by George Mason University and the Woodrow Wilson Center. Karin M. Krchnak, director of International Water Policy at The Nature Conservancy (TNC), and Dann Sklarew, sustainability fellow at George Mason University, joined Lovejoy to discuss the increasing stress placed by population growth, urbanization, and environmental change on freshwater resources and potential solutions to global water insecurity. [Video Below]
Water: “A Global Crisis”
Water insecurity and pollution is “a global crisis,” said Sklarew. Water scarcity is growing and aquatic biodiversity is declining around the world. According to the World Water Council, over one billion people do not have safe drinking water.
Inadequate water management contributes to these problems, said Sklarew. But, human activities “impact water connectivity, quality, and flows” at all scales, he said, and combined with climate change, have fundamentally altered the global water cycle.
“The water-rich and the water-poor are intimately connected,” said Sklarew. National, international, and global trade “water transfers” often move water from dry rural areas to urban centers, he said. “We’re taking from areas that don’t have [water] and moving water, by itself or via food products, to places where they might actually have more water in their local environment.”
But there are many opportunities – from the incremental to the bold, exciting, and revolutionary – to address these problems, said Sklarew, including growing more food with less water, reducing destructive subsidies, restoring natural river flows via dam re-design or removal, encouraging greener infrastructure in urban areas, and supporting participatory decision-making about water. He also pointed to promoting lower population growth and allowing migration that “brings the people to the water rather than the water to the people” as additional ways to improve water security. In the future, “bio-mimicking and techno-fixes,” may also provide promising solutions, he said.
Clear national goals and a global-scale response are critical to making these solutions a reality, said Sklarew: “Even though these challenges are often local, in the end, we have one interconnected water system.”
Watershed Protection: Innovative Solutions
“I know we all wish that there was a silver bullet for global water challenges,” said Krchnak, “but there’s not just one solution.”
As population grows by an additional 2 billion people before 2050, “solutions must take population growth into account,” said Krchnak. One-third of the world’s population is now subject to water scarcity, which is expected to double in the next 30 years
More water will be necessary to meet growing demands for food, energy, and other commodities, said Krchnak. In particular, “the poor in urban centers will be the dominant challenge for us in the next decades.”
Krchnak described three possible strategies to protect watersheds: market-based mechanisms, integrated water resource management, and incentive approaches.
Water funds, a market-based mechanism in which downstream water users pay for protection of the upper watershed, are one possible way to better manage freshwater, said Krchnak. With the help of local partners, TNC’s Quito Water Fund, for example, creates a sustainable finance mechanism and protects watersheds that supply 2 million people. Similar programs “can be taken to other geographies and replicated across the globe,” she said.
Another TNC program, the Great River Partnership, uses an integrated water resource management strategy that focuses on stakeholder collaboration and working with public and private partners to help create “one vision” for major rivers like the Mississippi, Magdalena, Paraguay-Parana, Yangtze, and Zambezi, said Krchnak.
The Alliance for Water Stewardship uses an incentive-based approach to promote “responsible use of fresh water that is socially beneficial and environmentally and economically sustainable.” One of the main objectives of the Alliance is to develop performance standards and create a certification program that recognizes water providers who work to protect freshwater resources.
Strategies like these may not be appropriate everywhere, and programs need to be adapted to make local implementation possible, said Krchnak, but effectively managing the planet’s freshwater is vital for human health, spiritual and cultural well-being, ecosystems and biodiversity, and economic opportunity.
Sources: World Water Council, UNDP.
Photo Credit: “Rio Magdalena,” courtesy of flickr user Esparta.
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