Attempts to genetically modify food staples, such as crops and cattle, to increase their nutritional value and overall performance have prompted world-wide criticism by environmental, nutritionists and agriculture experts, who say that protecting and fomenting biodiversity is a far better solution to hunger and malnutrition.

Two cases have received world-wide attention: one is a project to genetically modify bananas, the other is an international bull genome project.

In June, the Bill & Melinda Gates Foundation announced that it has allocated some 10 million dollars to finance an Australian research team at the Queensland University of Technology (QUT), working on vitamin A-enriched bananas in Uganda, by genetically modifying the fruit.

On the other hand,  according to its project team, the “1000 bull genomes project” aims “to provide, for the bovine research community, a large database for imputation of genetic variants for genomic prediction and genome wide association studies in all cattle breeds.”“It makes little sense to support genetic engineering at the expense of (traditional, organic) technologies that have proven to substantially increase yields, especially in many developing countries” – ‘Failure to Yield’, a study by the U.S. Union of Concerned Scientists

In both cases, the genetic modification (GM) of bananas and of bovines is an instrument to allegedly increase the nutritional value and improve the overall quality of the food staples, be it the fruit itself, or, in the case of cattle, of meat and milk.

James Dale, professor at QUT, and leader of the GM banana project, claims that “good science can make a massive difference here by enriching staple crops such as Ugandan bananas with pro-vitamin A and providing poor and subsistence-farming populations with nutritionally rewarding food.”

In the ‘1000 bull genomes project’, the scientists involved (from Australia, France, Germany, and other countries) have sequenced – that is, established the order of – the whole genomes of hundreds of cows and bulls. “This sequencing includes data for 129 individuals from the global Holstein-Friesian population, 43 individuals from the Fleckvieh breed and 15 individuals from the Jersey breed,” write the scientists in an article published in Nature Genetics of July 13.

The reactions from environmental activists, nutritionists, and scientists could not be more critical. The banana case has even prompted a specific campaign launched in India – the “No to GMO Bananas Campaign”.

The campaign, launched by Navdanya, a non-governmental organisation founded by the international environmental icon Vandana Shiva, insists that “GMO bananas are … not a solution to” malnutrition and hunger.

The group argues that so-called bio-fortification of bananas – “the genetic manipulation of the fruit, to cut and paste a gene, seeking to make a new or lost micronutrient,” as genetic expert Bob Phelps has put it – is a waste of time and money, and constitutes a risk to biodiversity.

“Bananas are highly nutritional but have only 0.44 mg of iron per 100 grams of edible portion,” a Navdanya spokesperson said. “All the effort to increase iron content of bananas will fall short the (natural) iron content of indigenous biodiversity.”

The rationale supporting bio-fortication suggests that the genetic manipulation can multiply the iron content of bananas by six. This increase would lead to an iron content of 2.6 mg per 100 grams of edible fruit.

“That would be 3,000 percent less than iron content in turmeric, or lotus stem, 2,000 percent less than mango powder,” the spokesperson at Navdanya said. “The safe, biodiverse alternatives to GM bananas are multifold.”

Scientists have indeed demonstrated that the GM agriculture has so far failed to deliver higher yields than organic processes.

In a study carried out in 2009, the U.S. Union of Concerned Scientists demonstrated that the yields of GM soybeans and corn have increased only marginally, if at all. The report, “Failure to Yield“, found out that increases in yields for both crops between 1995 and 2008 were largely due to traditional breeding or improvements in agricultural practices.

“Failure to Yield” also analyses the potential role in increasing food production over the next few decades, and concludes that “it makes little sense to support genetic engineering at the expense of (traditional, organic) technologies that have proven to substantially increase yields, especially in many developing countries.”

Additionally, the authors say, “recent studies have shown that organic and similar farming methods that minimize the use of pesticides and synthetic fertilizers can more than double crop yields at little cost to poor farmers in such developing regions as Sub-Saharan Africa.”

Yet another ground for criticism is the fact that Bill Gates has repeated an often refuted legend about the risk of extinction of the banana variety Cavendish, grown all over the world for the North American market.

In his blog, Gates claims that “a blight has spread among plantations in Asia and Australia in recent years, badly damaging production of … Cavendish. This disease, a fungus, hasn’t spread to Latin America yet, but if it does, bananas could get a lot scarcer and more expensive in North America and elsewhere.”

The risk of extinction, however, is practically inexistent, as the United Nations Food and Agricultural Organisation (FAO), among other institutions, had already shown in 2003.

“What is happening is the inevitable consequence of growing one genotype on a large scale,” said Eric Kueneman, at the time head of FAO’s Crop and Grassland Service. That is, monoculture is the main cause of the fungus.

“The Cavendish banana is a “dessert type” banana that is cultivated mostly by the large-scale banana companies for international trade,” recalled Kueneman, today an independent consultant on agriculture.

On the other hand, as FAO numbers show, the Cavendish banana is important in world trade, but accounts for only 10 percent of bananas produced and consumed globally. Virtually all commercially important plantations grow this single genotype, and by so doing, make the fruit vulnerable to diseases. As FAO said in 2003, “fortunately, small-scale farmers around the world have maintained a broad genetic pool which can be used for future banana crop improvement.”

Actually, the most frequent reasons for malnutrition and starvation can be found in food access, itself a consequence of poverty, inequity and social injustice. Thus, as Bob Phelps, founder of Gene Ethics, says, “the challenge to feed everyone well is much more than adding one or two key nutrients to an impoverished diet dominated by a staple food or two.”

The same goes for the genome sequencing of bulls and cows, says Ottmar Distl, professor at the Institute for Animal Breeding and Genetics at the University of Hannover. “Some years ago, we thought that it would impossible to obtain more than 1,000 kilograms of milk per year per cow,” Distl said. “Today, it is normal to milk 7,000 kilograms, and even as much as 10,000 kilograms per year.”

But such performance has a price – most such “optimised” cows calve only twice in their lives and die quite young.

And yet, the leading researchers of the “1000 bull genomes project” look at further optimising the cows’ and bulls’ performance by genetic manipulation of the cattle in order to, as they say in their report, meet the world-wide forecasted, rising demand for milk and meat.

Distl disagrees. “Whoever increases the milk output hasn’t yet done anything against worldwide malnutrition and hunger.” In addition, he warned, the constant optimisation of some races can lead to the extinction of other lines, thus affecting the populations depending precisely on those seldom older races.

It goes without saying that such an extinction would hardly serve the interests of the world’s consumers.

New studies argue that mobile technologies can be more effective than microcredit in promoting entrepreneurship and fighting poverty in developing countries, like Mauritania. Credit: Kristin Palitza/IPS

By Farangis Abdurazokzoda
WASHINGTON , May 31 2014 (IPS)

Mobile-finance and direct cash grants are revolutionary tools that can substitute for under-developed financial sectors and help reduce poverty and promote entrepreneurship in developing countries, according to researchers here.

Rodger Voorhies of the Bill & Melinda Gates Foundation and Christopher Blattman, a Columbia University political scientist, say these two potentially empowering mechanisms can help global efforts to provide needed assistance to vulnerable and poor populations.

In a teleconference hosted by the New York-based Council on Foreign Relations (CFR), one of the country’s most influential think tanks, the two men argued that mobile technologies can help poor people in developing countries manage their personal finances, including savings, insurance, credit, and cash transfers that many in the developed world take for granted.

Mobile technologies can help fill the gap by providing easy and free access to financial tools, according to an article published in CFR’s journal, ‘Foreign Affairs’, co-written by Voorhies and Jake Kendall, who also works at the Gates Foundation.

The article, ‘The Mobile Finance Revolution’, cites World Bank statistics showing that, on average, nearly nine out of every ten people living in a developing country have a cell-phone account, although some users may, of course, have multiple accounts.

Mobile technologies are more effective than much-lauded microcredit programmes in promoting entrepreneurship and fighting poverty, according to the article.

Among other advantages, they eliminate the bureaucracy and routine banking costs associated with in-person and cash transactions. In addition, mobile-finance clients generate data that can be further used by banks and investors as an alternative for the traditional credit scores, according to Voorhies and Kendall.

In a second article titled ‘Show Them the Money’, Blattman and Paul Niehaus, who teaches economics at the University of California San Diego, detail recent studies that show the effectiveness of cash grants and outline the comparative disadvantages of microloans and related programmes, such as donating money to buy cows, goats, seeds, beans, tools, and other agricultural inputs, as well as schoolbooks and clothing for poor families.

Not everybody wants a cow

Despite the fact that the microcredit movement brought significant positive results – recognised in 2006 when the Bangladesh-based Grameen Bank and its founder, Muhammad Yunus, were awarded with a Nobel Peace Prize – a series of more recent studies on the effects of microloans have put their success into question, according to Blattman and Niehaus.

In one study, the economist Abhijit Banerjee of the Massachusetts Institute of Technology (MIT) and a number of collaborators examined the case of the Indian non-profit Spandana that provided 250 dollar loans to women in Hyderabad at low-interest rates. Over three years, they found no measurable improvements in the education, health, poverty, or women’s empowerment among the recipients.

After collecting an additional 20 years of data on Spandana’s lending and their borrowers, Banerjee found “no evidence of large sustained consumption or income gains as a result of access to microcredit.”

As for the effectiveness of training programmes, economists David McKenzie and Christopher Woodruff reviewed the outcomes of the International Labour Organisation’s ‘Start and Improve your Business Programme’ that has provided training to over 4.5 million people in over 100 countries since 1977. They found that there was little lasting effect on the sales or profits of the business owners in the recipient countries.

“No wonder people in developing countries, when given the choice, don’t necessarily choose to invest in skills training,” write Blattman and Niehaus.

The two authors argue that providing cash grants to poor people directly is also preferable to supplying goods that will presumably be used by recipients to increase their income or skills.

They argue that poor people in developing countries often use the cash to buy the same things that aid organisations would provide, such as livestock, tools, or training, in any event, but giving people cash directly provides them with more flexibility.

“Not everyone, after all, wants a cow,” the authors write.

Blattman and Niehaus do not deny the benefits of aid, training programmes, and microloans but insist that significant improvements are possible depending on how the money is allocated.

In a study conducted in Uganda, 250 groups of 15-25 young adults were each given 400 dollars in cash to spend as they wished, so long as the purpose was to enhance their livelihood.

The study found that most of the money was spent on acquiring the physical tools and materials they needed to start working, and only ten percent was used for training. It turned out that over four years, the participants’ incomes rose by an average of 40 percent.

A similar study was conducted in Liberia, where unconditional 200 dollar grants were given to drug addicts and petty criminals. The recipients “did not waste the money,” but used it to fund legitimate enterprises.

“Fears that poor people waste cash are simply not borne out by the available data,” the authors write.

Cash or cell phones?

Blattman and Niehaus outline the benefits of cash transfers over traditional aid programmes. They emphasise the importance of money transfers in places where the population has been hit by unexpected crises – conflicts, natural disasters, or extended periods of political uncertainty.

“Think of Southeast Asia after [the] tsunami or the Middle East flooded with Syrian refugees, where the returns on capital after a recovery period are likely to be unusually high and the challenge of making smart investments without localised knowledge unusually large,” the authors write.

Further, cash transfers are essential to emerging markets that have relatively stable economies but where few firms offer jobs and where most workers, by necessity, are self-employed.

More specifically, the authors suggest that cash transfers better enable entrepreneurs to start businesses in countries where banks and other credit institutions are weak or under-developed.

Just as Blattman and Niehaus argue that cash transfers can be particularly helpful in emergency situations, Kendall and Voorhies insist that cell phones may actually prove more effective.

“A study in Niger by a researcher from Tufts University found that during a drought, allowing people to request emergency government support through their cell phones resulted in better diets for those people, compared with the diets of those who received cash handouts,” according to the authors.

In addition, studies have shown that cell phones encourage financial discipline and savings. In Malawi, for example, farmers were offered an option to have their harvest proceeds directly deposited into savings accounts. Those farmers who chose this option ended up investing 30 percent more in farm inputs and had a 22 percent increase in revenues compared to those who chose not to participate.

But while both articles articulate valid criticisms of how aid and microloan organisations operate, they fail to address important aspects. The most obvious are literacy rates, especially low financial literacy that is often prevalent in developing countries. The issues that need to be considered with mobile-finance are the access of affordable network providers as well as a very basic one – electricity.

Schools around the world, like this one in Melilla, Uruguay, are trying to introduce healthy eating habits to bring down rates of obesity and overweight. Credit: Victoria Rodríguez/IPS

By Farangis Abdurazokzoda
WASHINGTON , May 31 2014 (IPS)

Over two billion people – or 30 percent of the world’s population – are either obese or overweight, and no country has successfully reduced obesity rates to date, according to a new study published this week by the British medical journal, The Lancet.

The number of overweight and obese people increased from 857 million in 1980 to 2.1 billion in 2013, according to the research, which was conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and funded by the Bill & Melinda Gates Foundation.

Titled “Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013,” the study calls obesity a “major public health epidemic” in both the developed and the developing regions of the world.

An individual is considered to be overweight if he or she has a Body Mass Index (BMI), or weight-to-height ratio, greater than or equal to 25 and lower than 30, while obesity is defined as having BMI equal to or greater than 30.

“Obesity is an issue affecting people of all ages and incomes, everywhere,” said Dr. Christopher Murray, director of IHME and a co-founder of the Global Burden of Disease (GBD) study.

Not surprisingly, the largest proportion of the world’s obese people are found in the United States (13 percent).

In the Middle East and North Africa (MENA), Central America, and the island nations of the Pacific and the Caribbean, overweight and obesity rates have skyrocketed over the past 30 years – to 44 percent or higher.

Several oil-rich states in the MENA region – including Saudi Arabia, Kuwait, Qatar, and Libya – account for the world’s largest increase in obesity over the past generation.
But rates are also increasing the world’s two most populous nations – China and India. They currently account for 15 percent of the world’s overweight or obese population.

“These trends have nothing to do with genetics, but rather our lifestyle that has increasingly become indoors and immobile,” Ali Mokdad, who teaches at the University of Washington in Seattle, told IPS.

“We are paying the price for progress,” Mokdad, one of the study’s co-authors, added. “Machines have made our lives easier; thanks to machines, we can produce food faster and cheaper than ever, while microwaves make meals quick and easy. All these contribute to the problem.”

“It’s not a cosmetic issue, but a major risk factor for morbidity and mortality,” he said.
Particularly disturbing is the rise in obesity among children and adolescents. In the three decades covered by the study, the number of overweight or obese children and adolescents increased by 50 percent.

While in the developed world countries, 22 percent of girls and 24 percent of boys are overweight or obese, boys and girls in developing countries are catching up, as nearly 13 percent of them are overweight or obese.

“We know that there are severe downstream health effects from childhood obesity, including cardiovascular disease, diabetes, and many cancers. We need to be thinking now about how to turn this trend around,” said the study’s lead author Marie Ng.

The study stresses the need to mobilise not only the people, but also governments in the fight against obesity and its consequences.

“It’s not only the Ministry of Health that has to be concerned, but also the Ministry of Agriculture which needs to take into account how to build programmes and develop infrastructure in a way that would encourage people to be more healthy,” according to Mokdad.

He saluted U.S. First Lady Michelle Obama’s initiative “Let’s Move!” – a four-year-old effort “to end the epidemic of childhood obesity in a generation so that kids born today will grow up healthy.” In addition to encouraging exercise among youths, “Let’s Move!” urges schools to reduce the excessive consumption of sugar, salt, and fat and include more fruits and vegetables in meals served to students.

In a column published Thursday by the New York Times, the First Lady wrote that the U.S. spends 190 billion dollars a year treating obesity-related conditions in the general population. ”Just think about what those numbers will look like in a decade or two if we don’t start solving this problem now,” she wrote.

Her efforts have drawn criticism from right-wing Republican sectors and their allies in the press. The Wall Street Journal Thursday called Obama’s efforts “cuisine central planning” and cited recent statistics showing that consumption of federally funded school lunches has declined nearly four percent since the government’s new standards were first enforced, presumably because the recommended menus no longer included items popular with young consumers.

Qatar was found to suffer the highest rates of obesity and overweight at 73.9 percent, followed by Egypt (73.6 percent), Kuwait (73.4 percent), Libya (71.9 percent), Saudi Arabia (69.4 percent), Jordan (69.3 percent), Syria (69.1 percent), Mexico (68.9 percent), Iceland (68.5 percent), and the U.S. (67.4 percent).

Among South Americans, Chileans and Paraguayans led the region, with 66.1 percent and 63.9 percent, respectively.

In sub-Saharan Africa, where obesity and overweight were least prevalent among all regions, oil-rich Equatorial Guinea was the regional leader, with 58.7 percent of the population obese or overweight. It was followed by South Africa, at 52.9 percent, and another oil-rich country, Gabon, at 47.7 percent. In Ethiopia, by contrast, only 5.5 percent of the population was obese or overweight.

South and East Asia were also relatively slim, compared to wealthier regions. Malaysia was the heavyweight at 45.3 percent, followed by South Korea (33.2 percent), Pakistan (30.7 percent), and China (28.3 percent). By contrast, less than one out of five Indians were obese or overweight (19.5) percent.

The leanest, however, included Vietnam (12.4 percent), while North Korea and Timor Leste tied for the world’s lowest prevalence at 4.6 percent, according to the study. Rates in neighbouring Australia, on the other hand, neared those of the world’s heaviest, at 63.3 percent.

Most of the countries that are heaviest today, including Libya, Egypt, Iceland, as well as many wealthy countries, were also heaviest 30 years ago. But the obesity and overweight gap between them and most developing countries, particularly in sub-Saharan Africa and Asia, has since closed.

In 1980 China, for example, only about ten percent of the population was overweight or obese – or about one-third of the percentage in 2012.

More country data can be found here.

Jim Lobe contributed to this article.

In Swaziland, which has been hard-hit by the AIDS pandemic, an HIV-positive mother sits next to her 18-month-old baby girl. Credit: Mantoe Phakathi/IPS

By Jim Lobe
WASHINGTON, Dec 3 2013 (IPS)

The gap in health standards between the world’s poorest countries and the more advanced middle-income nations could close by the year 2035, according to a major new report published Tuesday by Britain’s The Lancet medical journal.

Written by a group of 25 of the world’s top global-health experts and international economists, Global Health 2035: A World Converging Within a Generation makes the case for the international community, governments and key donors, such as the Bill and Melinda Gates Foundation, to increase investments in health to meet the target.

“Now, for the first time in human history, we are on the verge of being able to achieve a milestone for humanity: eliminating major health inequalities, particularly inequalities in maternal and child health, so that every person on earth has an equal chance at a healthy and productive life,” according to Harvard University professor and former U.S. Treasury Secretary, Lawrence Summers.

“The powerful drugs and vaccines now available make reaching this milestone affordable. It is our generation’s unique opportunity to invest in making this vision real,” said Summers, who 20 years oversaw the preparation of the only ‘World Development Report’ (WDR) devoted to global health when he served as the World Bank’s chief economist.

The 58-page report, which calls for government policymakers to adopt a new approach to measuring the importance of health to their national economies, is being published as the Global Fund to Fight AIDS, Tuberculosis and Malaria – a unique multilateral agency that has approved 29 billion dollars in grants since its founding in 2002 – is meeting here this week to gain new donor commitments for its fourth three-year replenishment.

The three diseases are among the biggest health challenges faced by the world’s poorest countries and poorest people in middle-income nations.

The Fund’s leadership got a big lift here Monday when, at a World AIDS Day ceremony, President Barack Obama pledged continued U.S. support for the Fund, promising to provide one dollar for every two dollars committed by other donors over the next three years, up to a total of five billion dollars.

Bill Gates also announced that his foundation – the single biggest private funder of global health initiatives – will provide up to 500 million dollars through 2016, including 300 million dollars that was previously committed and up to 200 million dollars in new matching grants.

“Don’t leave our money on the table,” Obama said, speaking to many of the delegates who have gathered here for the pledging conference. “Now is the time to replenish the Global Fund.”

The Fund’s new executive director, Mark Dybul, said he was confident that this week’s pledging would significantly exceed the 9.2 billion dollars that was committed at the last replenishment in 2010.

The Lancet report offers what it calls a “roadmap to achieving dramatic gains in global health through a grand convergence around infectious, child and maternal mortality; major reductions in the incidence and consequences of non-communicable diseases (NCDs), and injuries; and the promise of ‘pro-poor’ universal health coverage.”

If followed, the roadmap could result in averting some 10 million deaths across the target countries in 2035 alone, according to the report.

It points to the experience of the “4C countries” – Chile, China, Costa Rica, and Cuba — as models for poor and lower-middle-income countries. All four started off at similar levels of income and mortality as today’s poor countries but, by 2011, had become among the best-performing middle-income nations.

Among the specific goals, according to the report, are reducing under-five mortality to 16 per 1,000 livebirths, and reducing annual AIDS-caused and TB-caused deaths to eight and four per 100,000, respectively.

To achieve these and other aims, the report calls for “aggressively scaling up” efforts to fight HIV/AIDS, TB, and malaria as well as improve maternal- and child-health conditions which were a major focus of the Millennium Development Goals (MDGs); strengthening health systems to focus on the most problematic sectors, including poor rural sub-populations of middle-income countries that are disproportionately affected by infectious diseases; and devoting more and earlier investment to family planning.

In addition, government should be encouraged to pursue fiscal policies – notably by heavily taxing tobacco and other harmful substances, such as alcohol, that can sharply reduce NCDs and injuries, as well as leverage significant new revenue for low- and middle-income countries that can, in turn be used to reduce subsidies on items, such as fossil fuels that produce air pollution which in turn cause NCDs.

Such savings will provide most countries with enough funds to finance many of the steps urged in the report. It thus urges that, while donor countries, which hopefully will include emerging economies, should increase their investment into research and development to produce new drugs, vaccines, and other health technologies.

The report calls for at least a doubling in health R&D from current annual spending of around three billion dollars to six billion dollars by 2020, with half of the increment coming from middle-income countries.

The report argues that the economic returns from investments in health are “much greater” than policy-makers have previously assumed.

The 1993 WDR found considerable evidence that improvements in health increased gross domestic product (GDP) per capita by enhancing childhood educational advances and adult worker productivity, as well as increasing access to natural resources and foreign investment that are encouraged by controlling diseases like malaria.

But the GDP analysis, the Lancet report asserts, measures only the impact of health improvements on economic productivity. It fails to capture the intrinsic value people place on their own improved health, including their greater life expectancy.

A full-income approach combines growth in national income with the value of additional life years (VLY). The report estimates that, on average, across low- and middle-income countries, one VLY – a one-year increase in life-expectancy – is about 2.3 times greater than per capita income.

Using that approach, the report found that, between 2000 and 2011, 24 percent of the growth in full income in those countries resulted from health improvements; that is, in VLYs gained. By the same token, setbacks to life expectancy, such as in countries hit hard by the HIV/AIDS pandemic, resulted in a far greater adverse impact than the impact on GDP per capita would suggest.

“We believe that if nations worldwide adopt a full-income approach to economic planning, the human returns to investing in health can be brought into resource allocation decisions,” said Dean Jamison, a University of Washington professor who co-chaired the Commission with Summers.

“People value a longer and healthier life, and the notion of full income simply places that value in monetary terms. While it does not put a monetary value on an individual’s life, it does place a value on changing mortality risk, which traditional notions of GDP neglect,” he added.

By Anna Shen
NEW YORK, Sep 3 2013 (IPS)

Africa and Pakistan are now battling outbreaks of polio, threatening the extraordinary progress the world has made in fighting the almost-extinct disease. In the Horn of Africa, there are now 121 reported polio cases. Last year, there were 223 worldwide.

Siddharth Chatterjee has served as the chief diplomat, head of strategic partnerships and international relations at the International Federation of the Red Cross and Red Crescent Societies, the world’s largest humanitarian network, since June 2011.

Photo Courtesy of Siddharth Chatterjee.

In his previous work with UNICEF, Chatterjee was on the front lines of polio eradication campaigns in South Sudan, Darfur and Somalia, and remains passionate about the eradication of polio and the advancement of child rights.

Excerpts from his conversation with Anna Shen follow.

Q: Considering all the attention given to fighting polio, what are the causes of these outbreaks now?

A: When the Global Polio Eradication Initiative (GPEI) was launched in 1988, the poliovirus was in 125 countries, paralysing or killing 1,000 people a day. Today, polio cases have been reduced by 99 percent with only 223 cases reported worldwide in 2012.

The GPEI Independent Monitoring Board recently remarked that, ‘Poliovirus has been knocked down but it is certainly not knocked out.’

Outbreaks happen when large populations of children are not immunised. This can happen for a couple of reasons, including operational quality of campaigns, but most often because insecurity, like the recent violence in Pakistan, or mobile populations make children inaccessible.

Ultimately, to stop this outbreak, we need to hammer the virus continuously with vaccines and repeated rounds of immunisation, and find ways of accessing the hard to reach and insecure areas.

Q: What is the biggest obstacle to the eradication of polio and how do you overcome it?

A: Myths and misinformation, high illiteracy, extreme poverty, weak health systems, insecurity and poor infrastructure represent real challenges to vaccination efforts and the overall expansion of access to health care.

I saw this firsthand in 2005 when I was working with UNICEF in Somalia. After two years without a case, polio returned and paralysed 228 children. Herculean efforts were made to ramp up social mobilisation, intensive and wide-scale response activities, overcoming huge security and logistical challenges and massive funding helped in stopping the spread.

Through the Somali Red Crescent we were able to access some of the most insecure areas.

Government leadership, trusted national institutions, social mobilisation, engagement and negotiating with all parties is key to any successful campaign. This was my experience in Darfur too. In insecure areas we have to talk to everyone, each party regardless of their political or ideological position is a stakeholder and we have to get everyone aligned around one central theme-children and their wellbeing.

Q: Why is the focus on polio alone, and what is the international community doing to stop other vaccine-preventable diseases?

A: The world has made an enormous amount of progress against a whole range of vaccine-preventable diseases over the past few years. The GAVI Alliance – a public-private partnership focused on increasing access to vaccines in low-income countries – has contributed to the immunisation of more than 370 million children since 2000. Dr. Seth Berkley, the CEO of GAVI, is leading the charge to ensure a quarter of a billion children are vaccinated by 2015.

The greatest legacy of the polio eradication movement might very well be the foundation for stronger health systems it creates along the way. The polio programme is already finding and reaching previously inaccessible children with the polio vaccine and combining these efforts with other health care resources.

We’re building a system that can increase access not only to vaccines, but to other medicines, bed nets for malaria prevention, clean water, access to proper sanitation, hygiene promotion, improved nutrition, reproductive health services, etc.

Q: Has the international community done enough?

A: The international community has been awesome, and frankly without their support we would not have got this far in our fight against polio.

At the end of April 2013, I was at the Global Vaccine Summit in Abu Dhabi. Leaders attending this meeting signaled their confidence in GPEI’s Strategic Plan. Together, they committed four billion dollars, close to three quarters of the plan’s 5.5-billion-dollar cost over the next six years.

Led by Mr. Bill Gates, chairman of the Bill and Melinda Gates Foundation, and the Crown Prince of Abu Dhabi, along with Rotary International, UK, U.S., Australia, and EU among others, joined to renew their commitment to end polio forever. We saw new partners like the Islamic Development Bank join the fight against polio.

Q: What is the end game that will complete polio eradication and how can the IFRC help?

A: After decades of foreign aid, national investments and philanthropic giving that has produced an impressive record of results, we need a decisive win.

The GPEI’s Polio Eradication and Endgame Strategic Plan 2013–2018, launched earlier this year, sets out a clear framework to not only interrupt the transmission of wild poliovirus, but to introduce a dose of inactivated polio vaccine – or IPV – into routine immunisation programmes globally to simultaneously eliminate the risk vaccine-derived poliovirus.

IFRC reach spans the global to the local. With 187 National Societies, and nearly 100 million staff, volunteers and members, I believe every child can be reached by the Red Cross Red Crescent National Societies. Our volunteers speak the language, live in these communities, engage with community leaders. Our National Societies are trusted at the grassroots, everywhere.

Q: The GPEI Update of Partners’ Report describes you as one of the global influentials and you have been writing a lot about polio eradication. What about this issue compels you the most?

A: I have seen distraught mothers crying inconsolably after their children contracted polio. Many were paralysed and many died. It is really heartbreaking. I have also seen many young people who survived were crippled for life, helpless and their lives a living hell.

And for me, it’s personal: I survived polio and I was very lucky. In fact, many thousands of children in India contracted polio in the not-so-distant past and were forced into lives of infirmity and despondency because of poverty, ignorance, and poor access to health services.

I would certainly want to see this disease eradicated forever. This would be the greatest gift we can give to all children in the world.

Excerpt:

Children in drought-struck Camotán, in Chiquimula province, Guatemala. Credit: Danilo Valladares/IPS

By Sudeshna Chowdhury
UNITED NATIONS, Jun 6 2013 (IPS)

Kevin’s Carter’s disturbing picture of the 1993 famine in Sudan won him a Pulitzer Prize.

The image of an emaciated child being watched by a vulture was etched into the world’s memory forever, drawing attention to conditions where survival becomes the only priority.

Reducing the child mortality rate and improving maternal health prominently figure in the list of the U.N.’s Millennium Development Goals (MDGs) that were adopted by the international community in 2000 in New York with a 2015 deadline.

As the world body draws up a list of new Sustainable Development Goals (SDGs), the medical journal The Lancet published a series of reports Wednesday finding that,among other things, malnutrition is responsible for nearly half (45 percent) of all deaths in children under five.

Around three million deaths of children under five occur from malnutrition, which encompasses undernutrition and overweight, both global problems.

The focus of agricultural programmes should shift towards enhanced nutrition rather than just increasing crop yields, Professor Robert Black of Johns Hopkins Bloomberg School of Public Health told IPS.

“These programmes have not been set up in an ideal way,” he said.

Calling for the idea of “nutritional sensitive agriculture”, Black also emphasised the importance of actions at the community level to address issues on malnutrition.

Collaboration among civil society, humanitarian agencies and the commercial sector would make a difference at the local level, Black told IPS. “More engagement of organisations such as the Food and Agriculture Organization (FAO) is important,” he said.

Martin Bloem, senior nutritional advisor with the World Food Program (WFP), echoed a similar sentiment. He emphasised the role of Anganwadis, government sponsored child-care centres in India, in countries like India.

Reports suggest that lack of resources as well as unhygienic conditions in these centres have raised new challenges when it comes to addressing issues of malnutrition in a country like India.

But inspection and strict monitoring is paramount when local communities are involved, Bloem said.

The findings in The Lancet come ahead of the Group of Eight (G8) summit, which will be preceded by the UK and Brazilian governments co-hosting a high-level event on Nutrition for Growth.

The findings suggest that addressing the problem means addressing the underlying causes of malnutrition, such as, “poverty, food insecurity, poor education, and gender inequity”.

The study also stated that close to 15 percent of all deaths in children under the age of five could be prevented by providing vitamin A and zinc supplements to children up to the age of five, as well as taking care of dietary needs of pregnant women, among many other measures.

But, it is the time of pregnancy and the first 1,000 days that are most crucial for a child’s growth, Bloem told IPS. The health of the mother is equally important, he said.

“Also people do not realise the relation between stunted growth and obesity which can increase the chances of cardiovascular diseases. Also, there is an urgent need to link the health and the food system all around the world,” he said.

Public-private partnerships can help create products which are nutritional, affordable and accessible to vulnerable populations all over the world, Ellen Piwoz, senior programme officer for family health and nutrition at the Bill & Melinda Gates Foundation, told IPS.

But what is stalling the fight against malnutrition is “the lack of a real commitment and drive among international governments,” said Werner Schultink, UNICEF’s head of nutrition.

While reducing hunger and poverty have been leading priorities for the U.N., “if you look at the indicators, such as underweight, the progress is insufficient.”

According to the study, emerging problems of obesity and overweight are “resulting in a ‘double burden’ of maternal and child disease and illness,” in countries where undernutrition is already a huge problem.

A right balance of adequate nutritional diet and an affordable food industry spearheaded by public and private sectors as well as community-level initiatives could provide solutions to tackle this “killer”, said experts.

An eight-month-old boy with pneumonia is examined by a doctor at Amana Hospital in Dar es Salaam, Tanzania. Credit: Kristin Palitza/IPS

By Lucy Westcott
UNITED NATIONS, May 22 2013 (IPS)

PATH, a Seattle-based global health development organisation, is aiming to save two million lives by 2015 by jointly tackling diarrhea and pneumonia, the leading killers of children globally.

Steve Davis, president and CEO of PATH, delivered the message at the ninth annual PATH Breakfast for Global Health held in Seattle on Tuesday.

“Today we placed a bold stake in the ground, with partners around the world, to save two million lives by the end of 2015,” Davis told IPS.

PATH will begin its efforts in India, Cambodia and Ethiopia, where intervention is most urgently needed and PATH has resources. While all three countries have seen their child mortality rates from diarrhea drop, India’s pneumonia death rate remains stagnant, accounting for 24 percent of deaths of children under five, the same as in 2000, according to 2013 World Health Organisation statistics.

“No parent should have to bury a child because of something we can help prevent or treat,” Davis said.

Diarrhea and pneumonia are two diseases that overwhelmingly affect children in African and Asian countries, Davis said, with diarrhea claiming around 760,000 lives a year. And while the number of children dying in Africa before the age of five has decreased, it still vastly outnumbers all other parts of the world, according to the 2013 WHO statistics.

Melinda Gates, philanthropist and founder of the Bill and Melinda Gates Foundation, which helps fund health development and vaccines world wide, spoke at the breakfast of the importance of vaccinating children as well as “appropriate” science that meets the needs of communities in the developing countries.

“[The] developing world is littered with pilot programmes,” Gates said.

As he took to the stage, Davis pointed to a tool belt around his suit jacket. A visual aid, the belt allowed Davis to show and carry some of the tools that can prevent the deaths of so many children from diarrheal disease, tools that will be used to achieve PATH’s life-saving goal.

Clean water, soap, zinc tablets for oral rehydration therapy and the rotavirus vaccine, which stops some diarrheal diseases before they start, were all included.

But it’s not just science and vaccines that can improve the lives of communities ravaged by diarrhea. Deeply held cultural traditions and ideas about the disease have to be altered as well.

Dr. Alfred Ochola, PATH’s Technical Advisor for Child Survival and Development in Kenya, spoke about educating Kenyans on how to reduce the risk of diarrhea in their communities through hygiene practices like hand washing.

But Ochola, who lost a brother and sister to a diarrhea outbreak in Kenya as a child, has found that at first, people are reluctant to embrace change.

“A big [challenge] is combatting old beliefs that diarrhea is a curse and not an infection, and that the death of a child is an inevitable part of life. ‘God will give you another one’ is a common saying in Kenya,” Ochola said.

Many people believe a child who has diarrhea is cursed, Ochola said. Vomiting and diarrhea are welcomed because it rids the body of the evil inside it, while it should be taken as a sign that something is seriously wrong.

Poverty is another challenge in combatting the diseases. Although heart disease and diabetes are becoming the new illnesses of poverty, according to Davis, diarrhea and pneumonia still adversely affect children of developing countries in Africa and Asia.

In Africa and Southeast Asia, the percentage of child deaths are higher than the global average and have not significantly decreased in 10 years. Both regions have seen child mortality from diarrhea fall from 13 percent to 11 percent of deaths from 2000 to 2010, but in Africa, the rate of death from pneumonia has actually increased, from 16 percent to 17 percent.

“Too many people lack the financial means to seek care when it’s most needed, like paying for transportation to get to a health facility far from home… We often reach women and their children too late,” Ochola said.

Ochola told the story of Jane Wamalwa, a Kenyan woman who came to understand the reasons behind making a change in long-held practices in treating and preventing diarrhea. Wamalwa lost three children to the disease, and has now become a trusted source of information on good anti-diarrhea practice in her community, Ochola said.

“It has become her calling,” he added.