The Global Pulse Journal Blog

The World Bank and USAID are hosting a series of debates exploring emerging issues in global responses to HIV/AIDS and worldwide evolving approaches to development aid, .  The debates attempt to lay out the best evidence and information available to assist world governments, civil society organizations, and other development organizations in interpreting and responding to the shifting dynamics of the epidemic and our collective responses to the challenges it presents.

This global discussion series began this past May with a debate entitled “Test and Treat: Can We Treat Our Way Out of the HIV Epidemic?” which looked at testing and treating strategies with a focus on their role in Africa.

In June, a debate on “Behavior Change in HIV Prevention” took place looking at dynamics involved in behavior change approaches and their past ineffectiveness.

Check out these past debates and the ones still to come including theis week’s August 26th debate on “Discordant Couples and HIV Transmission” and continue to follow this debate series for future conversations.

Recently members of several major corporations including Nike, EBay and the Modernizing Foreign Assistance Network (MFAN) presented an open letter calling on the US government and President Obama to take an innovative approach to carrying out the goals and visions committed to at the recent G8 summit and to develop a US global development strategy. They call on US leaders and Congress to develop a rewritten US development Act to replace the outdated 1961 Foreign Assistance Act. They discuss an approach to modernize foreign assistance in the global arena.

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.

Despite being one of the world’s poorest nations, Rwanda has had national health insurance, know as health mutual, for the past 11 years. With two dollar a year premiums, an overwhelming 92 percent of the nation’s 9.7 million people are currently covered. While the coverage is not extravagant, it covers the major causes of illness and death in the region including diarrhea, malaria, pneumonia, malnutrition and infected wounds. Further, this basic health insurance provides access to local health centers which usually have all the medicines on the World Health Organization’s list of essential drugs as well as laboratories providing routine blood and urine analyses, in addition to tuberculosis and malaria tests. This access to health care has had a measurable impact on average life expectancy, which has risen from 48 to 52 years of age since the introduction of health mutual despite a continuing AIDS epidemic.

In order to achieve such coverage for only two dollars a year, the government of Rwanda must receive supplemental help from outside organizations such as Partners in Health, The Global Fund to Fight AIDS, Tuberculosis and Malaria, and the US government. Additionally, the plan requires co-pays which can be cost prohibitive for many patients. For example, a Caesarean section requires a five dollar co-pay which many patients cannot afford.

For more on this issue check out the New York Time’s recent article, this info sheet from the World Bank and this article in the bulletin of the World Health Organization.

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.

Researchers at the J. Craig Venter Institute announced in Science that they created an experimental one-cell organism, Mycoplasma mycoides JCVI-syn1.0, that has the ability to reproduce.

An article written in the Wall Street Journal discusses the process used to create the cell:

To begin, they wrote out the creature’s entire genetic code as a digital computer file, documenting more than one million base pairs of DNA in a biochemical alphabet of adenine, cytosine, guanine and thymine. They edited that file, adding new code, and then sent that electronic data to a DNA sequencing company called Blue Heron Bio in Bothell, Wash., where it was transformed into hundreds of small pieces of chemical DNA, they reported.

To assemble the strips of DNA, the researchers said they took advantage of the natural capacities of yeast and other bacteria to meld genes and chromosomes in order to stitch those short sequences into ever-longer fragments until they had assembled the complete genome, as the entire set of an organism’s genetic instructions is called.

They transplanted that master set of genes into an emptied cell, where it converted the cell into a different species”

It may be possible for this new field, called synthetic biology, to one day provide alternatives to standard practices in many different industries. For example, the industrial life forms can be used to produce renewable fuels as well as vaccines.

This development also raises questions about concerning the ethics, law and public safety of artificial life. So I ask you all, what are some specific issues do you see needing to be addressed concerning synthetic life?

According to the World Health Organization, non-communicable diseases such as heart disease, cancer and diabetes, account for 60% of deaths worldwide, claiming more than 35 million lives per year. In all regions of the world except Africa, mortality rates among men and women age 15 to 59 are higher for non-communicable diseases than for communicable diseases. Further, The World Economic Forum recently highlighted the economic costs of non-communicable diseases, naming this health threat as one of the three most likely and severe risks to the global economy alongside fiscal crises and asset bubbles, a form of inflation. Yet despite this significant impact, non-communicable diseases tend to be overlooked and underfunded. For example, a Center for Global Development report estimates that less than 1% of public and private health funding is allocated to the prevention and control of non-communicable diseases in low- and middle-income countries. In response to this need for a greater focus on non-communicable diseases globally, a recent United Nations resolution has been introduced calling for a summit on non-communicable diseases “in order to develop strategic responses to these diseases and their repercussions.”

The CEOs of the American Heart Association, the American Cancer Society, and the American Diabetes Association comment on this issue in a recent (5/13) CNN opinion article.

Four months after the earthquake in Haiti, it is being argued that the poor are receiving better healthcare than before the quake due to the influx of medical volunteers and donated medicines, working under the supervision of the Ministry of Public health and Population.  In an effort to address the question of what will happen after the foreign medical aid leaves, the Post- Disaster Needs Assessment estimates that the earthquake resulted in US $169 million in damages to health infrastructure alone and in addition to that, their three-year plan to improve the country’s health profile beyond pre-January 12th levels will cost US $546 million. Currently, “Outside medical organizations are now the backbone of Haitian medical care,” says Dana Van Alphen, regional adviser for disaster management at the Pan American Health Organization who has been involved in discussions with a Haitian presidential health commission. In an effort to make these improvements in access to healthcare permanent, the PDNA identified primary health (along with  adequate  follow-up) and the establishment mobile clinics and health centers as a means to provide universal access, quality services and essential medications. This would allow care to be available nationwide instead of concentrated in Port-au- Prince.

The PDNA also recommends a massive investment in training for Haitian medical professionals because it is believed that now that the need for urgent care has subsided and the consequences of the earthquake are no ;longer front page news, the influx of foreign health professionals is fading. This transition would include pairing Haitian medical personnel with foreign staff for training and transferring functional control of hospitals and clinics to locals.

To begin the process proposed by the PDNA, a company called Containers to Clinics will transport a ready-made clinic, which will be transported in two pieces to the grounds of Graces Children’s Hospital in Port-au-Prince . The clinic is set to leave Boston around May 15 in a truck, which will haul it to Brooklyn, New York, where it will be loaded on a freight ship and be set up by June.

Please follow this link to read an executive summary of the PDNA.