The Global Pulse Journal Blog

With heavy flooding covering much of the country and leaving millions of people homeless in Pakistan, concerns over the potential for a major outbreak of cholera are growing. With continuing rains throughout the region, Dr. Michael Merson, the founding director of the Duke Global Health Institute believes that ”Basically there is no question” there’s a major risk of an outbreak. With a lack of adequate aid to the area to ensure a consistent, clean water supply, the risk of this diarrheal illness is immense. While the flood has already killed over 1,500 people thus far, even more are at risk from a potential cholera outbreak with 3.5 million people in Pakistan lacking access to clean water. In the past year, cholera epidemics in Zimbabwe killed over 4,000 people with over 350 killed by the disease in Nigeria over the last three months, demonstrating the deadliness of this disease. Without adequate rehydration therapy, victims can die within a day or two from overwhelming dehydration secondary to extreme diarrhea with up to a liter of stool output every hour. But with adequate rehydration therapy to replace fluids and restore electrolytes, death rates can be lowered to less than one percent.

A recently released working paper by Joel Cohen of Rockefeller University reviews important demographic trends expected to occur between 2010 and 2050. In this report, based on a lecture that was part of CGD’s Demographics and Development in the 21st Century initiative, the author explores the role of population in development and indicates some of their implications for economic and global development. Additionally, he suggests some possible policies to respond to these trends and their implications.

With the highest recorded global population growth rate and the most enormous demographic shift ever between the more developed and less developed regions, the century from 1950 to 2050 saw dramatic changes in global development. It is still unforeseen whether this pattern of human development will remain sustainable. This paper explores the ways in which policy could respond to unmet human needs, many of which have arisen from human choices rather than biophysical necessities.

A  new survey from the Centers for Disease Control and Prevention (CDC) suggests that  heterosexuals living in impoverished communities are as much as five times more likely to be HIV-positive than the general U.S. population, regardless of race or ethnicity. In the US, the overall HIV prevalence rate for African Americans is eight times the rate for whites, and the rate for Latinos is three times the rate for whites. Yet in very-low income areas this CDC study found that these disparities do not exist. The study examined 9,000 people in 23 cities, finding that 2.1% of heterosexuals living in high-poverty urban areas were infected with the HIV virus, including 2.4% of those living below the poverty line and 1.2% of those living above it. This is in comparison to the 0.45% rate of HIV infection in the general US population. The authors hypothesize that the findings could account for many of the ethnic and racial disparities in HIV infections in this country, since African Americans are 4.5 times as likely and Latinos four times as likely as whites to live in poverty.

The International AIDS Society in partnership with the Kaiser Family Foundation is providing online access to various developments taking place at the XVIII International AIDS Conference (AIDS 2010),  in Vienna, Austria.

Selected sessions are webcast live each day with past sessions also available for viewing. Find the complete guide-to-coverage as well as the webcasts already available for viewing including the Opening Session, Monday’s plenary with former President Bill Clinton, and Tuesday’s session on the study which found Microbicides containing HIV drugs lower the infection risk in women.

Today’s schedule includes:

This week at the International AIDS Conference in Vienna, Austria, the World Health Organization announced that 5.2 million people in low- and middle-income countries received antiretroviral drugs for their HIV infections in 2009. This represents the largest increase in the number of people accessing treatment in a single year, with an additional 1.2 million people added to the four million who received antiretroviral therapy in 2008. While the increasing access to antiretrovirals is encouraging, over 10 million people infected with the HIV virus worldwide are still in need of therapy.

The WHO is calling for earlier treatment of those infected with the HIV virus, suggesting that if people are treated before their immune systems become weakened by the virus, HIV-related mortality can be reduced by 20% between 2010 and 2015. In addition, early therapy also has a benefit in preventing transmission of the virus. These new guidelines expand the number of people eligible for antiretroviral therapy from around 10 million to about 15 million people. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that the cost needed for HIV treatment in 2010 will be about US$ 9 billion.

A recent article in the Christian Science Monitor by the SEVEN Fund’s Michael Fairbanks explores a potential approach to addressing Haiti’s need for long-term economic support. While several different groups have contributed to relief efforts after the devastating January 12th earthquake, many are looking to develop a more long-term solution. A challenge to building private-sector support is the atmosphere in a country where the elite and wealthy have often supported business initiatives which favor big business and are not developed to lend support to those most in need.

In order to create prosperity for the average Haitian citizen, innovative solutions are needed to develop “attractive export market segments to serve with unique products, building new distribution systems, lowering energy costs, and providing skills to Haitian citizens who will be compensated for the high value they create” according to Pierre Marie Boisson, a Harvard-educated, Haitian international banker.

The Bill & Melinda Gates Foundation, the Health Institute of Carlos Slim Foundation and the government of Spain have each contributed $50 million to fund the Salud Mesoamerica 2015 Initiative.  The Inter-American Development Bank will coordinate and commission independent evaluations as well as manage the combined contributions of the donors. The project’s primary aim is to reduce health inequities by fighting dengue fever and malaria and improving nutrition and maternal health in Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama. The funding amount received by each country will be based on their poverty and health inequity status.  While each government will determine what programs to finance with the Initiative,  incentives will be placed for more equitable allocation of domestic funding and for policy that improves the health of the poor.   This project is expected to generate globally-relevant knowledge of how to scale up cost-effective health interventions in poor communities.

This is not the first time that Slim and Gates have partnered up.  They have been working together at Prodigy MSN, which has just celebrated its 10^th anniversary.

The New York Times has an excellent short video in its library on child soldiers in Somalia.   Interestingly, the NYT video points out that many of these young soldiers actually work for the Somali government, which receives financial support from the US.  You can read more about child soldiers in this 2009 Global Pulse article by Laura Janneck, Girls and Boys Gone to War: Gender and Mental Health of Child Soldiers.

For a look at the US government’s role in improving global maternal, newborn, and child health check out the Kaiser Family Foundation’s recently released report entitled “The U.S. Government’s Efforts to Address Global Maternal, Newborn, and Child Health: The Global Health Initiative and Beyond.” The report discusses US efforts towards improving child and maternal health including the recently heightened focus placed on these issues by the Administration’s Global Health Initiative. It provides a detailed overview of the U.S. government’s response thus far, looks at U.S. funding trends for maternal and child health, examines international and domestic agencies’ activities related to maternal and child health, explores U.S. participation in international multilateral efforts and identifies key policy issues surrounding the future of the U.S. involvement in such health issues.

A related webcast and fact sheets on maternal and child health and family planning are also available.

The National Library of Medicine currently features an online exhibit called “Against All Odds: Making a Difference in Global Health,” which can be found here: http://apps.nlm.nih.gov/againsttheodds/exhibit/index.cfm The exhibit offers a wide range of historical material on subjects such as HIV/AIDS, Global Development, the Legacy of War, and Community Health. These exhibits display the legacy of global health from around the world, for example charting the discovery of HIV in the lab and following the story of 13 year old hemophiliac Ryan White, or the 1990 Cosmo article that described how heterosexual women were not at risk from HIV, and following up with AIDS education in Thailand. The website offers a wide variety of historical information and is well worth browsing.

http://apps.nlm.nih.gov/againsttheodds/exhibit/index.cfm