HIV/AIDS has caused a steady increase in the number of orphans in South Africa. Credit: Kristin Palitza/IPS

By Sarah McHaney
WASHINGTON, Nov 14 2012 (IPS)

After weathering the departure of its executive director amidst a misallocation scandal earlier this year, the world’s largest funder of programmes to address HIV/AIDS, tuberculosis and malaria is poised to announce a new leader Thursday.

The performance-based Global Fund is a giant in the field of multilateral health financing, channeling 82 percent of the funds for TB, 50 percent for malaria, and 21 percent of the international financing against HIV/AIDS. To date, it has approved 30 billion dollars’ worth of spending.

“They need to do reform 2.0 which focuses on better measurement and accountability on actual disease results,”
Amanda Glassman, director of global health policy at the Centre for Global Development, told IPS.

“We focus too much on paperwork being consistent instead of on what we want the paperwork to achieve,” she said.

The former executive director, Michel Kazatchkine, resigned at the beginning of this year after the AIDS Health Foundation wrote a report in September 2011 urging him to step down amidst a funding misallocation scandal.

More than a year later, the Global Fund is still attempting to recover from that experience, which saw millions of dollars go unaccounted for in four African countries.

“The Global Fund has a terrific record of saving lives,” Deb Derrick, the president of Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria, told IPS. “They have cut their staff by 20 percent and are operating under a tightened budget. I think a good manager is very well-positioned to do even more with the resources at hand.”

The vast majority of that money, 95 percent, has come from the public sector. The United States leads donations, followed by France, Japan, Germany and the United Kingdom.

For this reason, however, the global financial crisis has hit the Global Fund hard, resulting in a large decrease of public sector donations. In May 2011, the Fund stated that it was 1.3 billion dollars short of its proposed budget for 2011-13.

The Global Fund gives grants based not only on need and vulnerability, but also on the results that recipient countries are able to show. Countries apply for each new round of funding and measure their results against the goals set by previous grants.

In November 2011, the Global Fund was forced to cancel its 11th round of funding due to inadequate resources from donors.

The Fund also suffered, both politically and financially, following the misallocation scandal that came to light in early 2011. Months prior, the Global Fund’s independent Office of the Inspector General had published reports finding that 34 million dollars had gone unaccounted for in four African countries receiving grants.

Germany and Sweden both suspended their donations following this discovery, although they resumed funding in 2011.

In direct response, in September 2011 the Global Fund announced a new five-year strategy for 2012-16 that supports more “aggressive management and oversight of grants, encourages more flexibility in tailoring activities to specific country’s needs, and embraces more country ownership of programs through increased involvement of country governments.”

Still, the Global Fund remains one of the most transparent aid organisations in the world – a fact that led to the discovery of misallocation in the first place. According to the Aid Transparency Index, a ranking of 77 aid-giving organisations and countries, the Global Fund is the fourth in the world.

“I think the inspector-general has done a fabulous job in looking at how to make the Fund more transparent and has undertaken a lot of the reforms and activities to achieve this,” Derrick told IPS.

In September, the Board approved a new funding model for the Global Fund based on the decrease in donations. The new model changes the way in which countries apply for grants, with the aim of putting more money into the most vulnerable populations.

However, there is concern that this will stray slightly from the performance-based funding for which the Global Fund is renowned.

“In order for the Global Fund to remain distinguishable from other organisations that can handle the money such as the World Bank, it needs to build out their performance base model and their accountability for results,” Glassman told IPS.

“If the Global Fund does this it will thrive in the next 10 years of its existence.”

Others are concerned that the new funding model would virtually leave Latin America and the Caribbean out of the Global Fund’s granting, due to how the Fund categorises income levels.

Commenting on this criticism, Derrick says, “Part of this whole reform effort is adjusting to this fiscally constrained environment, getting the money to where it is most needed, and trying to make sure that all vulnerable populations have money allocated to them.”

In October, the U.S. government passed a budget that included a 27-percent increase in funding for the Global Fund. However, the budget also included significant cuts to programmes that addressed only one of the diseases focused on by the Global Fund.

This will likely result in an increase of applications for grants from the Global Fund as money dries up from the U.S. malaria and TB programmes.

“In my view, this budget assignment shows a moving towards multilateral efforts and away from U.S. bilateral efforts. In terms of multilateral aid, the Global Fund performs well,” Glassman told IPS.

The new executive director will have to manage the new funding plan as well as the likely increase of applications while still maintaining the Global Fund’s defining principles.

Three-quarters of Christian evangelicals gave Republican challenger Mitt Romney their vote, but their numbers proved insufficient. Credit: Torres21/cc by 2.0

By Sarah McHaney
WASHINGTON, Nov 8 2012 (IPS)

For decades, right-leaning white Christian evangelicals, currently at least 25 percent of the U.S. electorate, have been a significant and influential voting demographic.

During Tuesday’s highly anticipated presidential election, however, the evangelical movement suffered a huge loss of candidates and social reform propositions.

Eight years ago, the Christian right’s agenda and support helped sweep George W. Bush into a second term as president, and set in motion a series of state-level moves to ban same-sex marriage. But Tuesday, the electorate seems to have largely rejected this agenda.

Today, conservative evangelicals are forced to ask themselves whether their days of political influence are over.

“I don’t think the Christian right has declined in politics,” Roberta Combs, president of the Christian Coalition, a conservative political organisation, told IPS. “Evangelicals turned out in record numbers and voted for Mitt Romney, but it just wasn’t enough.”

Indeed, Christian evangelicals did come out in force, and three-quarters of them gave Republican challenger Mitt Romney their vote. But their strengths proved insufficient.

Not only did Democrats maintain control of the White House and the U.S. Senate, but both Maryland and Maine voted in a popular election to allow same-sex marriage in their states. This was the first time in history a state had voted to allow same-sex marriage by a popular majority.

Tuesday night, as the polls were closing, Albert Mohler, president of the Southern Baptist Theological Seminary, posted on Twitter, “If the marriage votes in (four states) go as now trending, we are witnessing a fundamental moral realignment of the country.”

Wednesday morning, Mohler expressed the concerns felt by many evangelicals. “We are rightly and deeply concerned,” he wrote. “We must pray that God will change President Obama’s heart on a host of issues, ranging from the sanctity of unborn life to the integrity of marriage.”

Not all evangelicals, however, are in such despair over the election results.

“I think that the positions taken by young evangelicals on the issues of same-sex marriage and immigration are beginning to vary greatly from what their faith traditionally has held,” Kevin Wright, a pastor at Foundry United Methodist Church here in Washington, told IPS.

“It’s not that these young people have any less use for the Bible, but rather that they are adopting a fuller faith that embraces a personal relationship with Jesus as well as a corporate responsibility towards social justice,” he said.

Some pundits had predicted that Romney’s Mormon faith would hurt his chances with evangelical voters, but he received more evangelical votes than John McCain did in 2008. Comb agrees that Romney’s faith is not what lost him the election.

“I don’t think evangelicals voted for his religion, they voted for him. Romney had all of the credentials to lead our country,” she said.

Still, while religion may not have been directly responsible for Romney’s loss, the values he articulated may have, particularly among younger evangelicals.

“I don’t think the religious title mattered as much as the values articulated,” Tim King, director of communications for Sojourners, a national Christian organisation that focuses on social justice issues, told IPS. “Romney failed to articulate basic economic values – that we are a country that takes care of one another.”

Sojourners has taken a keen interest in the young evangelical vote in 2012. A survey it completed a month ago found that this demographic finds itself torn between the two political parties.

“I think young evangelicals are going to find themselves encouraged in some areas and disappointed in others,” King said. “Our survey found young evangelicals polling with Democrats on issues of immigration, same-sex marriage and domestic policies. Yet, they polled with Republicans on issues of foreign policy and abortion.”

This disconnect between young evangelicals and the evangelical leadership could be a contributing factor to the religious right’s decline in power.

“I do see the decline of the Christian right’s influence on America, and much of this has to do with dramatic changes in age dynamics,” Wright said.

Young evangelicals are connecting less and less with their religion’s leadership. Strong and often controversial positions on social issues such as abortion is one reason young evangelicals have begun to move away from the evangelical conservatives.

“Young people are leaving Christianity because of the types of things they are hearing from the mouths of the Christian right leaders and are no longer affiliating with a Christianity that maintains strict conservative politics,” King said.

For instance, conservative evangelicals took a big chance when they continued to support Senate candidates Todd Akin and Richard Mourdock, both favourites of the religious right, after both made controversial comments about rape and abortion. The Republican Party asked each to withdraw from their races, but evangelical Christians maintained support for each candidate.

On Tuesday, both lost.

“We should never leave our core values, but we need to expand them and we need to talk more about economic issues and issues that affect the family on everyday values,” Combs cautioned.

“We have to begin reaching out to other demographics and engaging them in issues that affect their day to day life.”

The Republican Party and the Christian right alike need to expand their issues and reach out to non-traditional conservative demographics if they hope to continue political influence.

“They (the Christian right) are going to try and blame others for these election results, but the fact is the world is changing and they need to change with it,” King said.

A few weeks ago, President Barack Obama was seen as certain to collect the majority of women’s votes in the Nov. 6 presidential election. Four days before the election, however, the women’s vote is thought to be divided equally between Obama and his Republican challenger, Mitt Romney.

A poll released last week by the Associated Press-GfK found women are split right down the middle, with each candidate receiving 47 percent of the vote. These numbers mirror the tightness of the popular vote overall and are a significant turnaround from a month ago, when the same poll showed Obama with a 16-point lead among women voters.

“Presidential races always tighten towards the end as local trends come to the national level – this is not a surprise,” Judy Lloyd, executive editor of Thoughtfulwomen.org and an appointee for former presidents Ronald Reagan and George W. Bush, told IPS.

Even so, Obama does appear to have suffered a dramatic loss in his lead with women voters. According to many analysts, the shift could be due to women focusing on the economy rather than on the “women’s issues” for which Obama has been fighting, such as equal pay in the workplace or funding for family planning.

The fight for the women vote has grown more heated as each candidate vies for women’s attention by criticising his opponent’s policies.

“The Obama campaign has engaged in a despicable game of gender politics and fear-mongering this election in an effort to shore up a critical Democratic constituency – single women.” Sabrina Schaeffer, executive director of Independent Women’s Forum, a group with “a mission to expand the conservative coalition”, told IPS. “But it’s clear the War on Women rhetoric has failed.”

Such rhetoric refers to the Obama campaign’s claim that Republican policies run counter to women on issues that are critical to them.

According to the AP-GfK poll, Obama’s rhetoric may not be bringing him female votes, but he is still seen as the better candidate for women’s issues. Of likely voters polled, 53 percent think Obama is making the right decisions on issues directly affecting women, compared to 40 percent who think Romney is doing so.

Even so, it now appears many women are not basing their vote on women’s issues.

“The economy is undoubtedly the number one issue for women going into this election,” Lloyd told IPS.

During the second presidential debate on Oct. 16, each candidate was asked what he would do to achieve equal pay for men and women in the workplace. This is a significant economic issue, as women currently make less than three-quarters what men typically make for the same job.

Obama immediately referenced the first bill he signed as president, a law that makes the pursuit of wage discrimination claims easier.

Romney cited his record of hiring women as part of his cabinet while he was governor of Massachusetts. But he also said that the priority should be getting women into the workplace in the first place.

Indeed, the question many women voters seem to be asking themselves is simply who will create a better economy for them and their families.

“As for women’s issues, although I’m retired, I understand that women need jobs, and Romney is the best hope for restoring the economy,” Judy Smith, a retired voter in the state of Virginia, told IPS.

Yet Romney’s specific plans on how to strengthen the economy also worry many women who work and benefit from government programmes he plans to end.

“Many of Romney’s budget policies are job killers for women, such as his plan to slash funding for social programmes that disproportionately serve and employ women,” wrote Terri O’Neill, president of the National Organisation of Women, a group of feminist activists, after the second debate.

Beyond the economy

Although the economy is front and centre for many as the Americans head to the polls, some voters, particularly young ones, are looking beyond the country’s dire financial state to changes in social and foreign policies that could be a large part of their adult lives.

“I realise that the economy is a disaster and we need to get to a balanced budget. However, I can’t justify solving this problem by voting for someone who would take us backwards in terms of social policies,” Taylor Dempsey, 22, a New York state voter and Peace Corps volunteer, told IPS.

Feminists disagree that the economy is even the central issue for the presidential race.

“The issues women are voting on are the big health care issues,” Eleanor Smeal, the president and founder of Feminist Majority Foundation, told IPS. “They are voting for the right to birth control, to affordable health care, and health care coverage throughout their retirement.”

“The gender gap is alive and well, and Romney has chosen to be against us women on the issues that are most important to us,” Smeal continued.

Obama has worked hard throughout his administration and campaigns to appeal directly to women voters on  issues he thinks drive their vote. Yet many women voters are frustrated with the Obama campaign’s isolation of women from men on voter’s issues.

“I am frustrated by what I perceive to be the Obama campaign’s pandering to women on a very narrow range of women’s health issues, and I do not appreciate the assumption that women vote solely on such issues,” Julissa Milligan, a research assistant at the American Enterprise Institute, a conservative think tank, told IPS.

Despite Romney’s attempt to keep the conversation focused on the economy and job creation, his Republican colleagues around the country continue to stoke controversy on women’s issues.

When asked about his “no exceptions” stance on abortion last month, Representative Todd Akin, the Republican Senate nominee in Missouri, said that “legitimate rape” rarely causes pregnancy.

During a debate last week, Richard Mourdock, the Republican Senate nominee in Indiana, said in defence of his opposition to abortion, “I think even when life begins in that horrible situation of rape, that it is something that God intended to happen.”

While Romney and his running mate, Paul Ryan, have distanced themselves from these comments, they continue to support their fellow Republicans’ candidacy.

With four days left before votes are cast, candidates have no more time to waste on issues that won’t drive people to the ballot box.

“The fact is, women voters today know that there is a lot of good news for women and girls in the United States today, and they want a president who wants to help grow our economy, not play gender politics,” said Schaeffer.

In 2011, 300,000 women, almost all of whom live in developing countries, died from issues related to pregnancy and childbirth. Credit: Patrick Burnett/IPS

By Sarah McHaney
WASHINGTON, Oct 26 2012 (IPS)

In most developing countries, where a woman gives birth still determines whether she lives or dies, despite the availability of inexpensive new medication that is proven to save lives.

Most women dying from childbirth complications in developing countries do so simply because their need for medication is unknown, according to PATH, an international non-profit organisation focused on global health.

“We know maternal health medicines are safe, and we know they are effective and essential to keeping women healthy throughout pregnancy and childbirth. We also know these medicines are frequently not reaching women and community-based health facilities,” Kristy Kade, the primary author of a new PATH report, told IPS.

“What we do not know is the precise number of women for whom these essential maternal health medicines are not available – that is, women with an unmet need.”

This lack of data has led to a significant potential funding shortage. It is simply unknown how much money is being spent by affected countries and, therefore, how much more they need.

“It is very difficult to advocate for more supplies when we have almost no data on when, where, how much, how correctly, and to what standards these drugs are being used,” Kade said.

Last year, 300,000 women, almost all of whom live in developing countries, died from issues related to pregnancy and childbirth. The most common causes are postpartum haemorrhage, excessive bleeding after childbirth, and pre-eclampsia, hypertension during pregnancy.

Childbirth complications are almost nonexistent in the developed world because of effective medicines and high-quality health facilities. As these facilities are often rarely available in many developing countries, however, other medical means have been developed to address this need.

For years, Oxytocin and magnesium sulphate have been used as the primary drugs to treat complications. However, both drugs require specific storage temperatures and trained professionals to administer them, making these drugs inaccessible or even counterproductive at times.

There is also the chance that no one present at the birth will be trained in the correct way to treat the mother.

Misoprostol, a drug commonly used to treat stomach ulcers, has recently been hailed as a solution. It has the potential to reach women whose needs are currently unmet due to a lack of storage ability or trained medical professionals.

“Misoprostol is proven effective, proven safe, it is temperature stable, and no special training is required,” Adam Deixel, director of communications at Family Care International, told IPS. “This means it can be used when women birth at home or rural health facilities or where there is unreliable electricity for storing purposes.”

This drug is distributed in tablet form in the correct dosage needed if postpartum haemorrhage were to occur.

“Six million lives can be saved over the next few years with these new commodities,” Jagdish Upadhyay, with the United Nations Population Fund, told IPS. “We know the problem, we know the solution – we just need to work harder.”

Misoprostol has a fair share of complications as well, however. Although there are written instructions with the medication, it is not always in local languages and assumes the user is literate.

As with any new drug, the medical community is reluctant to see it become widespread without an appropriate level of oversight. There is also concern that women will see these pills as a lifesaving solution at home and fail seek out proper medical attention for their childbirth complications.

“The clear long-term solution is that every woman has access to the best care, well-trained medical staff and high-quality facilities,” Deixel said. “However, we cannot just write off the lives of those women because right now those facilities are just not there. This is a lifesaving option that can save lives right now.”

Misoprostol, similar to the other drugs, is easily manufactured, and developing countries, such as Ghana, have manufacturers making the drug locally. This keeps the drugs inexpensive to transport and sell.

The standards at these local manufacturers, however, often do not meet international regulation.

“Though these drugs are inexpensive, they are often sub-standard,” Kennedy Chibwe, from the U.S. Pharmacopeial Convention, told journalists in Washington earlier this week. “We need to demand quality products and keep the same standard for developed and undeveloped countries. To die from sub-standard medicine is just inexcusable.”

There is hope that these inexpensive and easily applied drugs will soon reach everyone who needs them.

“We have seen the incredible gains that can be made when there is the public support and the political will to save lives such as the millions of people receiving (drugs) as a result of HIV/AIDS activism,” Kade told IPS. “We have not seen the same amount of outrage and mobilisation for maternal mortality.”

Shale gas extraction is putting some U.S. communities at risk of health issues, new research released here Thursday warns.

Close to 70 percent of participants in a new study reported an increase in throat irritation, and almost 80 percent stated they have had more sinus problems after being exposed to natural gas extraction in the U.S. state of Pennsylvania.

“For too long, the oil and gas industry and state regulators have dismissed community members’ health complaints as ‘false’ or ‘anecdotal’,” said Nadia Steinzor, the project’s lead author. “With this research, they cannot credibly ignore communities any longer.”

The report, by Earthworks’ Oil & Gas Accountability Project, a non-profit environmental organisation, surveyed 108 residents in 14 Pennsylvania counties in addition to conducting air and water tests.

“Twenty-two households reported that pets and livestock began to have symptoms (such as seizures or losing hair) or suddenly fell ill and died after gas development began nearby,” Earthworks reported.

This report focused specifically on Marcellus Shale in central New York and Pennsylvania and the small communities affected by the extraction process.

“Though the areas studied in Pennsylvania are very rural and small, the process for all shale gas extraction is very similar and so it has the same potential impacts on any community,” Wilma Subra, the president of Subra Company, an environmental consulting firm, told IPS.

According to researchers, the results from the surveys constituted an obvious pattern of negative health symptoms due to the communities’ proximity to gas facilities.

This study compared domestic water samples from two counties to control groups by the Pennsylvania Department of Environmental Protection. The results showed a higher concentration ethylbenzene and xylene, volatile compounds found in petroleum hydrocarbons, at the households than the control site.

Overall, the participants reported a total of 24 health symptoms with a higher concentration and severity of symptoms closer to the gas development plants.

“For example, when facilities were 1500-4000 feet away, 27 percent reported throat irritation; this increased to 63 percent at 501-1500 feet, and 74 percent at less than 500 feet,” writes Steinzor.

Sixty-two percent of participants in the survey reported an increased sense of fatigue. The other highest percentage reported symptoms including sinus and respiratory problems (58 percent), and the survey also found a high level of behavioural and mood changes.

“The clear association between gas development and public health impacts revealed by this research demands that states stop ignoring the problem and start developing the standards necessary to protect the public,” Subra told IPS.

Shale gas, a natural gas trapped within shale formations, has been hailed by some as a potential solution to reconcile the issue of climate change and the growing need for energy resources.

It is widely believed that shale gas releases fewer greenhouse gas emissions then other fossil fuels, yet new technology has only recently provided the tools to begin extracting shale gas, led by U.S. companies.

“Broad development of shale gas resources — with proper ecological safeguards — could be the best way to achieve the quick cuts in carbon dioxide emissions that we need to maintain a habitable environment on Earth,” Alan Riley, a professor of energy law at City University London, wrote in August 2012.

Shale gas has become an important source of natural gas for the United States over the past decade, creating international interest in this new source of energy.

In 2010, shale gas provided over 20 percent of the United States’ natural gas production. By 2035, this figure is estimated to increase to 46 percent, according to the official figures.

Yet concerns about health problems – particularly extraction-related chemicals seeping into groundwater sources – have continued to increase, though these allegations have long been denied by the industry. Meanwhile, shale gas formations in other parts of the country are receiving increased attention for exploration.

The world’s largest and fastest growing economies are no strangers to the need for more energy sources. India and China each rely heavily on a constant supply of energy to fuel their booming economies.

China is estimated to have the world’s largest shale gas reserves, thought to be more than the U.S. and Canada combined.

“Both policy pronouncements and emerging investments into North American shale basins suggest that Chinese and Indian interests in exploring the potential of their shale gas resources are real,” wrote Jane Nakano in a recent report for the Centre for Strategic and International Studies (CSIS), a Washington think tank.

Neither China nor India has yet begun to extract shale gas, but if they do the health impacts on the communities could be far worse those than the Pennsylvania data suggests. The counties surveyed in Pennsylvania are all in rural areas, but the majority of India and China’s shale gas reserves are very close to densely populated areas.

“The Chinese government notes that gas-rich regions in China are highly populated, rendering exploration there complex,” reports Nakano.

This immediacy to urban areas would inevitably increase the potential health effects that extracting shale gas could have.

“In fact, urban drilling would likely have a larger impact because with urban drilling you are basically in people’s backyards. As shown in the study, the closer you are to the process, the more impacts you will suffer,” Subra told IPS.

The U.S. State Department has launched a Global Shale Gas Initiative to transfer technical skills to other countries.

But, Subra points out, as long as the extraction process remains the same, then so do the potential consequences.

Secretary-General Ban Ki-moon (centre) speaks with a tuberculosis (TB) patient during his visit to the Institute of Respiratory Medicine in Kuala Lumpur, Malaysia. Credit: UN Photo/Eskinder Debebe

By Sarah McHaney
WASHINGTON, Oct 17 2012 (IPS)

The next several years could see either the elimination of tuberculosis in some regions or millions of otherwise preventable deaths, according to new research released in Washington Wednesday by the World health Organisation (WHO).

The outcome, experts are warning, rests on a three-billion-dollar gap in funding needed to fully address TB next year as well to ensure the proper introduction of new drugs.

“On the one hand we have existing as well as new tools on the horizon which could make a significant difference and even support dreams of elimination (of TB) in some regions,” Dr. Mario Raviglione, director of the WHO’S Stop TB Department, told journalists Wednesday.

“On the other hand, we are at the risk of stagnation if additional resources are not urgently mobilised by the governments of affected countries and the international community.”

The global burden of TB remains enormous. The reported 1.4 million deaths related to the disease last year means that TB remains the second largest killer among infectious diseases.

“The WHO’s new Global Tuberculosis Report reinforces that multidrug-resistant tuberculosis is an escalating public health emergency, yet the global response is abysmal,” Dr. Grania Brigden, TB advisor for Médecins Sans Frontières’ Access Campaign, said in a press release.

Yet experts are optimistic that new drugs, if properly introduced, could see the elimination of TB within their lifetimes. New or re-purposed TB drugs, as well as new regimens to treat drug-sensitive or drug-resistant TB, are advancing in clinical trials and regulatory reviews, according to the report.

“We expect two if not three entirely new compounds that kill the TB virus very effectively to be available in the next few months,” Dr. Raviglione said.

These are the first new TB drugs in nearly a half-century, and the first drugs designed specifically for the treatment of the lung disease.

Out of the 8.7 million new cases of TB in 2011, close to a million were multi-drug resistant (MDR) TB. Only one in five MDR-TB cases are being properly diagnosed and reported, meaning most of the infected population is spreading the disease unknowingly.

Drug-resistant TB results from patients not being treated properly for regular TB.

“These two new drugs have not been used against TB before, so we are not likely to have resistance against them – and they look very promising,” Dr. Anthony Fauci of the National Institutes of Health (NIH) said Wednesday.

If these new drugs are introduced into TB treatment regimes correctly, experts say there is a chance they will start the end of the disease. Yet the gap in funding is putting this goal and millions of lives at risk.

“People can either pay now or pay more later,” warned Dr. Kenneth Castro of the U.S. Centers for Disease Control and Prevention.

Added Raviglione, “History teaches that in the fight against TB, a job not done is a fatal mistake. Efforts have paid off and saved millions of lives.”

These critical funds are needed to properly introduce these new drugs, ensuring that they are used to treat MDR-TB cases and are properly administered. The funding issue is compounded by the fact that the countries with the highest TB rates are often the least developed countries.

Based on past trends of TB funding, at least one billion dollars every year of the three-billion-dollar gap needs to come from the international community.

Africa has 10 of the 22 countries hardest hit by TB. Across the continent, the disease is also the primary cause of death for persons infected with HIV; globally, there are 1.1 million people afflicted with both TB and HIV.

“In Africa, the funding gaps are biggest relative to the need. There is probably a gap of half a billion dollars a year for just TB and another half for TB-HIV related treatment,” Katherine Floyd, coordinator of TB Monitoring and Evaluation at the WHO, said Wednesday.

In order to close this funding gap, Dr. Elizabeth Fox at USAID, the U.S.’s foreign aid arm, emphasises the importance of working with national TB programmes.

“Since 1998, USAID has put 1.6 billion dollars into this programme, and USAID will continue to be a strong supporter of the TB programme,” Dr. Fox said.

Efforts such as these have paid off, the WHO report suggests. In the past 17 years, 51 million people have been cured of TB and an estimated 20 million lives were saved.

“Without that treatment, 20 million people would have died,” said Raviglione. “This milestone reflects the commitment of governments to transform the fight against TB.”

Despite such commitments and successes, the global response is still falling short, a deficit that could lead to millions of additional deaths in coming years.

“I am completely optimistic that we can produce the drugs we need to fight tuberculosis. The question is, are we going to do it?” Dr. Fauci asked. “In my opinion, not addressing this is just not an option. I think we as a global society have a moral obligation to address this problem.”

Large rich nations are falling short in their commitments to global aid and its effectiveness. Credit: Miriam Gathigah/IPS

By Sarah McHaney
WASHINGTON, Oct 16 2012 (IPS)

The United States is lagging far behind other developed countries in its policies aimed at improving global prosperity, according to new research.

The tenth annual Commitment to Development Index (CDI) was released this week by the Washington-based think tank Centre for Global Development (CGD). The report ranked the efforts of 27 developed countries to support developing countries.

As in previous years, Denmark, Sweden, Norway and the Netherlands vied for the top spots. This year the United Kingdom, in ninth place, was the sole country from the wealthy Group of Seven (G7) bloc to make the top 10, while the United States ranked nineteenth.

Unlike most rankings of its kind, the CDI does not focus primarily on the quantity of foreign aid each country gives per year. Rather, it takes into account seven different components of development and averages a country’s score in each area. It also focuses on the scope of the integration of a country’s policies.

“All nations are linked in many ways, not just through aid – many policies in wealthy nations affect people all around the world,” David Roodman, a senior fellow at CGD and the chief architect of the CDI, explained in an interview last week.

Comprising each of the index’s seven components, such as quantity and quality of foreign aid, or migration and environmental policies, are multiple factors that contribute to a country’s overall score. In the category of foreign aid, for example, the index looks at what percentage of a country’s gross domestic product is given away, and whether the money is “tied” to certain conditions, goes to corrupt governments, or is given in the form of loans.

After scaling the scores to an average of 5.0, researchers found Denmark to have the highest score in 2012 (7.0), while South Korea had the lowest (2.7).

The United States scores above average on only two of the seven components, and with a score of 4.8 it ranks behind all major industrialised nations except Italy and Japan. Meanwhile, Nordic countries repeatedly stand at the top of the list, for several reasons.

“Superficially it’s about foreign aid; each of these countries gives a large amount of foreign aid for the size of their economy, about 1 percent of GDP,” Roodman said of the Nordic countries. “They are also pretty good with environmental policy, doing more than most countries to reduce the use of fossil fuels.”

Citizens of these countries, Roodman explained, tend to trust more in their government and in how taxes are spent, a sentiment that could potentially allow government officials to feel more comfortable making significant commitments to developing countries.

Owen Barder, a senior fellow at CGD and director for Europe, offered a broader explanation for Nordic countries’ top rankings. In an interview last week, Barder said, “These smaller nations are forced to have an international outlook because of their size. I think this results in a sense of national pride in the role these countries play in international peace and environment negotiations.”

Barder regarded the CDI as an opportunity to evaluate how Europe as a whole scored in individual components and to begin a continent-wide conversation on how improvements can be made.

Not all countries look favourably on the CDI’s metrics. Japan, which is consistently ranked at or near the index’s bottom, responded to the 2006 CDI by criticising its method.

“By using its own method to measure aid effectiveness of each donor and publishing its results…the [CDI] has various problems and has not evaluated fairly developed countries’ policies for international development,” Japan’s ministry of foreign affairs wrote.

Japan received a low score in trade partly because of its high import barriers, especially on rice. Yet the Japanese government has argued that only the negative impact of its trade tariffs were considered, not the positive agricultural subsidies it also provides.

“The CDI does not reflect the fact that major developed countries…take development challenges by making maximum use of their comparative advantages and by complementing one another through aid coordination,” the ministry stated. (Roodman’s response can be found here).

Indeed, the CDI does have some structural flaws. The countries currently listed on the index are all democracies, for instance. These countries “preach concern for human life and dignity within their own borders”, the index’s overseers have written, noting that the CDI “looks at whether rich countries’ actions match their words”.

Yet in the past decade a host of “middle income” countries – China, India, Brazil – have emerged as global economic leaders.

“I don’t think changes in the world mean that Japan or the U.S. are any less obliged to contribute to the prosperity of developing countries,” Roodman said. He added that he is considering broadening the index to a group of countries similar to the Group of 20 (G20) to include rich developing countries that still have a large amount of poverty within their borders.

Incorporating such countries would require the index to be built on a paradigm different from its current “rich world, poor world” model.

The CDI has seen slight improvements in industrialised countries over the past ten years. Nevertheless, as Roodman pointed out, “The richest largest nations are still falling short of their potential.”

WASHINGTON, October 11, 2012 (IPS) – At least 20 countries are currently at either “alarming” or “extremely alarming” levels of hunger, according to new research released here on Thursday.

World hunger has diminished somewhat since 1990 but remains a significant problem in many regions, according to the new Global Hunger Index released by the International Food Policy Research Institute(IFPRI), based here in Washington. IFPRI is a centre that seeks sustainable solutions for ending hunger and poverty.

“Hunger has declined and we have made progress, but it remains serious,” Claudia Ringler, co-author of the report, told journalists Thursday.

The index is the seventh in a series presenting a multifaceted measure of global, regional and national hunger levels. The index weighs three indicators equally: undernourishment, levels of underweight children, and child mortality.

According to IFPRI, “The report shows that progress in reducing the proportion of hungry people in the world has been tragically slow.”

Haiti, Burundi and Eritrea top the index with “extremely alarming” levels of hunger. Sub-Saharan Africa and South Asia continue to be the regions suffering from the highest hunger levels.

The Democratic Republic of Congo is not listed as “extremely alarming”, in contrast to previous years, but only because there was insufficient data available to calculate the country’s score on the index.

Seventeen other countries are listed as having “alarming” hunger levels. India was included in this list with the same hunger level from which the country suffered in 1996.

This year, the report placed particular focus on the unsustainable uses of land, water and energy as drivers of food insecurity. “Hunger is inextricably linked to growing pressure on land, water, and energy resources,” the report stated.

The researchers highlighted reasons for natural resource scarcity, including changes in rural and urban demographics, higher incomes and unsustainable resource consumption, as well as poor policies in conjunction with weak institutions.

Ringler also emphasised natural resource dependency. “The poor rely almost exclusively on natural resources for their well-being,” she said. “Therefore they have been particularly harmed by changes in the climate and the scarcity that creates.”

Such dependency makes it even more necessary to ensure good and sustainable practices with resources such as land, water and energy.

“The stark reality is that the world needs to produce more food with fewer resources, while eliminating wasteful practices and policies,” IFPRI stated.

To tackle this reality, the Global Hunger Index report laid out several policy recommendations on how to use land, water and energy to build sustainable food security. One of the recommendations was to secure local land and water rights.

These rights are at risk because in recent years, higher food and oil prices and the scarcity of farmland have increased the number of international agricultural land deals, particularly in regions where land is relatively inexpensive, such as Sub-Saharan Africa. One result of these deals is greater food insecurity.

Concern Worldwide and Welthungerhilfe, both humanitarian groups that co-sponsored the Global Health Index report, have partnered with farmers in Sierra Leone and Tanzania to try to keep agricultural land in the hands of local farmers.

“Large-scale foreign investments in land should be closely monitored,” Welthungerhilfe President Bärbel Dieckmann said Thursday. “Local organisations are needed to secure transparency and the participation of smallholder farmers whose livelihoods are impacted by land deals.”

Tanzania has proven to be a successful and important case study to which other countries can potentially look as a model.

“In Tanzania, one million people are food insecure, most of whom are farmers. Yet only 10 percent of Tanzanian farmers hold an official title to their land,” Tom Arnold, Concern’s CEO, told journalists.

Concern has been working with the Tanzanian government to provide a new land title, a certificate stating the Right to Occupancy, to over 10,000 farmers. This gives farmers the opportunity to write down the names of their family members who while continue to care for the land when they die.

If farmers have legal rights to their lands, supporters suggest, they will be more likely to invest in and improve the land, in order to see a larger crop produced year after year. On the other hand, if land is not legally owned by a farmer, researchers point to data that suggests it is often sold by the government to external investors.

“Agricultural production must increase substantially to meet the demands of a growing and increasingly wealthy population,” Arnold continued. “Yet to avoid more stress on land, water, and energy resources, and to ensure that all have access to adequate food, that production must be sustainable and must prioritise the poor.”

The report also recommended that governments phase out inefficient subsidies on water, energy and fertilisers.

“Subsidies are a short-term solution that don’t reach the entire population and can cost governments far more than their budgets can sustain,” Ringler explained, citing Malawi as an example.

Other recommendations included scaling up technical solutions, creating a macroeconomic environment that promotes efficient use of national resources, and taming the drivers of national resource scarcity.

“Food security under land, water, and energy stress poses daunting challenges,” the index stated. “But this report shows how we can meet these challenges  in a sustainable and affordable way.”

Rising corn prices in the United States brought about by biofuel mandates have cost developing countries 6.6 billion dollars over the past six years, according to new research released here on Wednesday.

The subsequent increase in food costs has drastically affected levels of world hunger and, in some countries, political stability, according to the report, published by the global watchdog ActionAid. The report also warned of the consequences of current U.S. policies.

“What this report really highlights is our inability to keep up with the current demands of corn for food and fuel – and most certainly future demands,” Kristen Sundell, a policy analyst at ActionAid USA, told journalists Wednesday.

Rising corn prices in the United States have triggered global hunger and political turmoil. Credit: Natural Resources Conservation Service Soil Health Campaign/ CC by 2.0

Timothy Wise, director of the Research and Policy Program at Tufts University and the study’s lead author, noted, “Increased food prices triggered the Arab Spring, and U.S. ethanol production contributed to those food spikes.”

Corn prices in the United States have steadily increased since 2007, when new legislation known as the Renewable Fuel Standard began requiring the use of a percentage of corn in the production of a biofuel called ethanol. Today, ethanol is added to petrol across the country.

According to the report, 40 percent of all U.S.-grown corn is now being used to fulfil these ethanol mandates – up from just five percent a decade ago. And because 40 percent of all U.S.-grown corn translates to 15 percent of global corn production, corn prices have increased by 21 percent over the past six years. That increase has cost the global economy 11.6 billion dollars, 6.6 billion of which fell on developing countries.

This year, the situation in the United States has been exacerbated by the worst drought in fifty years, which resulted in a harvest about 20 percent smaller than expected. Even so, the Renewable Fuel Standard requirements have not changed.

Unfortunate weather circumstances in the United States will only add to the burden felt by developing countries importing U.S.-grown food, Sundell said. “Our ethanol policy cannot be based on a prayer for good weather,” she warned.

Mexico and Egypt have reportedly suffered the highest costs. Over the past six years, the Mexican government has paid an extra 1.1 billion dollars to import corn, and Egypt, 727 million dollars.

Guatemala, which is particularly dependent on corn imports, paid 28 million dollars in 2010 alone, or more than 10 percent of the Guatemalan government’s annual expenditures on agricultural development. That was also six times the amount of U.S. agriculture aid received and almost equalled the amount of food aid that Washington gave to Guatemala.

Nearly half of children under five in Guatemala reportedly suffer from malnutrition.

Even developing countries that grow enough corn to export it are feeling the effects of the U.S. biofuel mandates. Uganda, for instance, has seen a small net gain in its corn exports, but the majority of its population is still seeing a spike in corn prices due to global demand.

“To the extent international prices transmit to Ugandan markets, U.S. ethanol expansion is contributing quite directly to food insecurity among the urban poor, even in a net corn exporting country,” the ActionAid report concluded.

Grain and fuel are not the only staples affected by these biofuel mandates. The U.S. meat industry is suffering from steep feed prices as well. American farmers have been forced to slaughter cattle and poultry they cannot afford to feed. Analysts warn that these actions will affect prices for eggs, dairy products and meat well into next year at least.

“In the last two years, we have seen a one-billion-dollar increase in the two major feed ingredients in the turkey industry,” Damon Wells, with the U.S. National Turkey Federation, said Wednesday. “The U.S. is world’s largest poultry exporter, and any price increase of this level is going to be felt around the world.” Government forecasters have predicted up to a 4.5 percent increase in poultry prices next year.

Still, ActionAid’s researchers stress that such staggering increases to U.S. corn prices should be preventable in the future. In November, for instance, the Environmental Protection Agency (EPA), the governing body over these biofuel mandates, will rule on whether or not to grant a waiver for the Renewable Fuel Standards. Such a waiver would decrease the amount of corn being used to make ethanol and lead to lower corn prices.

“Putting a shock into the system will reduce the food costs here in the U.S.,” Wise said. “The ripple of such a shock will be felt around the world – everyone feels the impact of American prices.”

The attacks on U.S. embassies in Libya and Egypt last month shocked and scared Americans, but the majority of Americans nevertheless recognise that the violence was the work of extremist minorities and not the majority of the population, according to a new poll.

The poll, conducted by the University of Maryland, was released on Monday during an event at the Brookings Institute, an influential think tank in Washington, DC. It examined how American public opinion towards Arabs and Islam has changed after the recent attacks in Libya and Egypt.

These attacks were triggered by an American-made video insulting Islam, entitled “Innocence of Muslims”. The situation has called into question longstanding U.S. foreign policy in the Middle East and public opinion in the United States towards Arabs and Islam.

The poll attempted to gauge the American public’s early impressions of these events to see how or if American diplomatic efforts in the region need to change.

The report found that Americans are less impressed by arguments previously used to support aid to Egypt, with 61 percent unconvinced that the United States should provide aid to Egypt to help its emerging democracy through the ongoing transition. A larger majority, 74 percent, said it is unwise for the United States to give large amounts of aid to Egypt during difficult domestic economic times.

Earlier this year, U.S. President Barack Obama promised one billion dollars in debt relief aid to Egyptian President Mohamed Morsi. 450 million dollars of this package is currently being blocked in the U.S. Congress, where it needs to receive a majority vote before the money can reach Egypt.

On Monday, William Gallston, a senior fellow at the Brookings Institute and former policy adviser to former President Bill Clinton, commented, “These findings show that Americans are more concerned about nation building at home rather than abroad for now.” The report concluded that there is support to decrease aid given to Egypt, but not for stopping aid completely.

A partisan divide on foreign policy issues was obvious in the poll’s responses. When asked about giving aid to Egypt, many of those who self-identified as Republicans wanted aid decreased (44 percent) or stopped altogether (41 percent). Democrats, on the other hand, were torn between maintaining aid at current levels or decreasing it. Only 15 percent of Democrats suggested stopping aid altogether. These statistics make proposing foreign policy that can garner bipartisan support a challenge for either presidential candidate.

The same divide was also apparent when Americans were asked about Israeli-Iranian relations. A clear majority of Americans think that an Israeli attack on part of Iran’s nuclear programme will result in higher oil prices and increase the likelihood of an Iranian attack on U.S. bases.

Most Americans wanted to take a neutral stand in the matter, but more than a third of Democrats polled wanted to discourage Israel from attacking and only 3 percent of Democrats wanted to encourage Israel to attack. Yet Republicans were split equally between encouraging or discouraging Israel from attacking.

During a widely anticipated speech focused on foreign policy on Monday, Republican presidential candidate Mitt Romney accused President Obama of putting “daylight” between the United States and Israel. Romney vowed to strengthen that relationship once again and stand by America’s “closest ally in that region”.

Although the report showed that Americans mostly see the violent events in Egypt and Libya as tied to extremist minorities, it also found that a large majority of Americans, 75 percent, hold an unfavourable view of Libya and smaller majority, 54 percent, hold an unfavourable view of Egypt. The majority of Americans polled thought that neither country’s government had tried to protect American diplomats and their staff.

Hisham Melhem, Washington bureau chief of the Saudi-owned Al Arabiya News Channel, commented that this negative public opinion is mutual. “There is still a widely negative view of the U.S in the Middle East. The majority of the population continues to see the U.S. as the omnipresent power in the region,” Melhem said on Monday at the Brookings Institute. He pointed to “the legacy that the U.S supported autocratic regimes, which had a negative impact on the people”.

Melhem added that this was not always the case. “When I was growing up in Lebanon we had a very positive view of the U.S. It is not in our genes to be anti-American. There are specific political and economic reasons for this change in perspective.”

Despite these shared unfavourable views, the majority of Americans continue to see U.S. involvement in the Middle East as a top priority. The poll revealed that most Americans want President Obama to become more directly involved in the current uprising in Syria.

The poll found was very little support for arming the rebels and almost no support for sending troops to the region, but a majority of those polled supported both increasing diplomatic and economic sanctions on Syria and enforcing a no-fly zone over Syria.

Gallston, the Brookings senior fellow, noted that these statistics “show a public precedent for a somewhat stronger stand in Syria than the U.S. government has currently adopted”. President Obama has shown reluctance in becoming more deeply involved with the conflict in Syria.

In his speech on Monday, Romney suggested a firmer stance than President Obama’s. “Iran is sending arms to Assad because they know his downfall would be a strategic defeat for them,” he said. “We should be working no less vigorously with our international partners to support the many Syrians who would deliver that defeat to Iran.”