Global Pulse Blog

The UN Population Division recently revised its estimate for global population, editing its initial projections that the world’s population would level off at 9 million by 2050. The new increased estimates suggest that the global population will reach 10.1 billion by 2100. Much of the jump is attributed to growth in 58 high fertility countries in Africa, Asia, Oceania & Latin America.

Rachel Nugent has an interesting take on these new estimates and the methods behind them in her recent op-ed published in the New York Times International Edition. She suggests that we think about how fertility and mortality differentially affect population levels and growth rates instead of thinking about “population.”  Additionally, she suggests that discussions of population growth consider how effective family planning policies can lead to lower fertility and therefore reduce maternal and child mortality. This approach, she suggests, is more effective in bringing about actual change.

According to a recent study by researchers at Johns Hopkins Bloomberg School of Public Health Indonesian children who were exposed to Jalan Sesama over a 14-week period had significantly improved literacy, mathematics, early cognitive skills, safety knowledge and social awareness than those children with no or lesser exposure to the Indonesian Sesame Street program. The study appears in the International Journal of Behavioral Development’s OnlineFirst collection for December 5, 2010 in anticipation of its upcoming print publication.

Jalan Sesama, Indonesia’s version of Sesame Street, is funded via the United States Agency for International Developmental via the Sesame Workshop. The television program employs live action, puppetry and animation to teach lessons on mathematics, literacy, culture, safety, environment and more in a culturally-sensitive manner utilizing visuals and characters which children can find in their local environment. Indonesia is the world’s largest archipelago and fourth most populous country in the world. Its 17,508 islands are strewn across the Indian and Pacific Oceans, straddling the Australian and Asian continents. This unique geographical situation has often presented a challenge to the creation of a common national voice. The creation of Jalan Sesama,which translates to “Togetherness Street” reflects this mentality as does the country’s national motto,“Bhinneka tunggal ika,” which translates loosely to “unity in diversity,” and more literally to “Although in pieces, yet one.”

Photographs from the Sesame Workshop Website

The authors of the current study, Dina L.G. Borzekowski, EdD, associate professor in the Bloomberg School’s Department of Health, Behavior and Society and Holly K. Henry, a current doctoral student at the school, carried out a randomized research study examining the effect of a 14-week intervention on 160 children ages 3 to 6 years in the Pandeglang District of Indonesia’s Banten Province. The children were questioned regarding their skills and knowledge at the start and conclusion of the 14-week intervention. The authors found that the children with the greatest exposure to the television program performed better than those with less exposure when evaluating their literacy, early cognitive and mathematics skills even after adjusting for baseline scores, age, gender, parents’ education and exposure to other media.

This study’s lead author, Dr. Borzekowski, previously carried out a similar study which was published in July 2010 investigating the Tanzanian version of Sesame Street, Kilimani Sesame. Similar to the current study in Indonesia, this study concluded that Tanzanian children with the greatest exposure to the Sesame Street inspired television program showed the greatest gains in social, cognitive and health outcomes.

Today, December 1st, is World AIDS Day, a reminder of the tragedy of the epidemic as well as the progress which is occurring. According to UNAIDS, over 33 million people in the world are living with HIV, including 1.5 million in North America. While great injustices exist in access to care for many of the millions living with HIV/AIDS around the globe, human rights efforts seem to be increasingly integrated into national AIDS strategies with 89% of countries explicitly addressing human rights in their AIDS strategies and 91% implementing programs to reduce discrimination and stigma related to HIV/AIDS. With regards to funding targeting the epidemic, while an estimated US $15.9 billion was spent towards HIV/AIDS efforts in 2009, declining international investments are expected to significantly impact many around the globe, especially those in low-income countries which rely heavily on international funding of their HIV/AIDS programs.

The 2010 UNAIDS report highlights updated information regarding the epidemic, including the growing number of people practicing safe sex, and gaining access to antiretrovirals in many parts of the world. Offering hope that progress is being made to quell the epidemic, UNAIDS reports that at least 56 countries have either stablized or achieved significant declines in rates of new HIV infections, with new HIV infections declining almost 20% in the last five years. At the same time that rates of new infections are declining overall worldwide, the number of new infections are increasing in areas like Eastern Europe and Central Asia, in large part due to injection drug use.

Highlights of the UNAIDS 2010 Report on the Global AIDS Epidemic

This past week an excellent discussion of important global health challenges and developments, including those related to the Millennium Development Goals, took place at the TEDx Change Meeting, “The Future We Make”. TEDx is a new program enabling local communities and organizations to organize, design and host their own independent events to discuss innovative and important ideas.

Check out the webcast from the recent “The Future We Make” meeting on the Bill and Melinda Gates Foundation website for an engaging and insightful discussion of issues related to the Millennium Development Goals such as child mortality rates, birth rates, literacy, HIV/AIDS and more on a global level.

TEDxChange Webcast

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.

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.

In an anti-drug conference held in Moscow recently, Russian President Dmitri Medvedev called for an a more globally unified effort to end the drug trafficking of opium from Afghanistan and the social problems that are a direct result from its trafficking. With over 90% of the world’s opium originating from Afghanistan, President Medvedev believes that that current efforts by international organizations such as the United Nations, NATO and Shanghai Cooperation Organization, are not enough. Opium poppies are the raw material used to make heroin.   According to the U.N. Office on Drugs and Crime, heroin has created a market worth $65 billion and caters to 15 million addicts world-wide.

The effects of Afghanistan’s 375 ton per year opium and heroin export are also felt at home through direct use and passive exposure such as  second-hand and third-hand exposure.  A new study that will be finalized this summer is expected to show that in Afghanistan 1.5 million people out of a total population of 30 million are addicts and that a quarter of those users are thought to be women and children.

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Many news articles have been written recently on the increase in the prevalence in chronic diseases across the globe.  Rapid economic development is seen as one possible cause of the swift spread of chronic diseases in the developing world.

Let’s take the increase in the prevalence of Diabetes Type II for example. China has nearly 250 million and India has about 50 million people with Diabetes and prediabetes.  It is estimated that by 2030, 366 million or 6% or the world’s population will have Diabetes. This condition has two different modes of contraction, one for the wealthy, mainly being obesity resulting from over-nutrition, and another for the poor via changes in the amount of exercise and diet that once consisted mainly of vegetables but now has switched to foods that are high in sugar, salt and fat.    The change of diet is a direct result of the increase in the numbers of people moving from villages to cities in search of work.  A study found that the influence of urbanization and change of living habits have a greater influence than genetic predisposition for  determining whether a person develops Diabetes Type II, these migrants were twice more likely to have hypertension and to have higher blood sugar than villagers.

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In January 2010 PLoS Medicine published a very interesting four-part weekly series on this subject.  I have posted a few excerpts below:

The study had three aims; (1) to advance current understanding of the interplay of actors in the system; (2) to evaluate its performance; and (3) to identify opportunities for improvement.

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All cancers are due to abnormalities in DNA. A complete catalog of mutations in the DNA of the genes responsible for melanoma and lung cancer has recently been completed. Knowledge of these genes will allow earlier detection of the tumor as well as give scientists the ability to develop very specific drugs with the capability of targeting the individual mutated genes. This list will also allow scientists to decipher specific environmental factors for triggering these mutations.

The International Cancer Genome Consortium is made up of scientists from 10 countries, with each country designated to focus on cataloging all the possible mutations responsible for cancers of a specific area of the body. For example, UK is looking at breast cancer, Japan at liver and India at mouth, China is studying stomach cancer, and the US is looking at cancers of the brain, ovary and pancreas.