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March WHO Bulletin

In the editorial section, Sulaiman Bah (134) discusses the possibility of dropping door-to-door enumeration in the next South African census. Priya Agrawal (135) points to Read More

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Essential surgery: key messages from Disease Control Priorities, 3rd edition

The World Bank will publish the nine volumes of Disease Control Priorities, 3rd edition, in 2015–16. Volume 1—Essential Surgery—identifies 44 surgical procedures as essential on Read More

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A twenty-first century development policy

This blog post first appeared on Views from the Center.  It drives me crazy that so many people equate development policy with foreign aid. That’s why I welcome this week’s landmark report from the British parliament’s Select Committee on International Development. As the UK nears the end of a five-year parliament, this well-respected cross-party committee has delivered its legacy report, which argues that development is about much more than aid. As Alex Evans and I argued in evidence to the committee, the three key tasks of development policy are now to help fragile states become stable, make growth in middle-income countries more inclusive, and address cross-border problems that affect us all. Yes, aid is needed for all three of these tasks, but aid isn’t the answer to any of them.  Nor is the new development agenda merely a matter of finding new sources of finance to replace or supplement aid.

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March WHO Bulletin

WHO

In the editorial section, Sulaiman Bah (134) discusses the possibility of dropping door-to-door enumeration in the next South African census. Priya Agrawal (135) points to Read More


Fixing Windows drivers for my iPod

I use both Microsoft and Apple products. My MP3 player of choice is an Apple iPod nano.  Sometimes the Windows drivers seem to get messed up, and iTunes gives me a message that my iPod has not been recognised. I’ve tried Apple’s solution, which includes a fresh installation of iTunes. That doesn’t work for me


Pull Yourself Together

Walking back from dinner in London’s South Bank on Friday night, we stumbled across this installation by Alex Chinneck in the Hungerford Car Park. It is a Vauxhall Corsa, apparently suspended on a piece of tarmac that has been upended. Pick Yourself Up and Pull Yourself Together by Alex Chinneck. Hungerford Car Park, South Bank, London. Photos by Owen Barder, February 2015 The post Pull Yourself Together appeared first on Owen abroad.


The Aid Industry. The Media

It was only a matter of time before a bunch of journalists decided to get together and let us, aid workers, know how they collectively feel about us. Not that we had no inkling previously, but anyway, here it is in black and white: The Aid Industry: What Journalists Really Think. It’s a 14-page +/- […]


Plain packaging tobacco: a global battle not yet won

This week, we hear from Dr Genevieve Bois, MD and spokesperson for the Québec Coalition for Tobacco Control on the important but unfinished battle that is plain packaging of tobacco products. Tobacco use is the number one cause of preventable deaths in Canada today, and in the UK, and in the United States – in fact in most countries around the world. Even in low-income countries that still face significant burdens from maternal health issues and infectious diseases, non-communicable diseases are on the rise, with tobacco-use leading the way as an ever-present first risk factor. We should probably say that tobacco use remains the number one cause of preventable death, and this nuance is important because although the tremendous progress done in certain countries in terms of tobacco control should be applauded, and despite all of it, we still have long way to go. Tobacco remains the number one cause of preventable mortality.


New Times Op Ed – Why We Must Strengthen Our Institutions for Rwanda’s Health

I hope you will take a moment to read my OpEd published by the New Times this week regarding the need to strengthen our institutions to assure a better health system for Rwandans.

“We know how far we have come to be where we are today. As I reflect upon several achievements attained not only as the health sector but the entire nation, I am also reminded of the long journey ahead to meet the set goals in the interest of all Rwandans.A good example is the positive outcomes we have witnessed following the decentralization of our health system. Decentralization in Rwanda has translated into real and meaningful empowerment, placing critical responsibility in the hands of the local leaders.This empowerment has grown in parallel with the increasing capacity of the central government to monitor, evaluate, and strengthen its auditing role. This has helped improve accountability across all levels to ensure we are doing all we can to better the healthcare system.For instance, by applying the fiscal decentralization with the national budget, hospitals have been assigned their funds through the district budgeting process. Also, other health financing strategies for the country are based on decentralization.This includes the community-based health insurance known as Mutuelles de Sante, which serves as a useful example to demonstrate how the local and central governing structures work together. It also shows how we are continually learning and adapting to improve the program.Mutuelles was created about 15 years ago and it is now undergoing its third major reform. The first reform involved changing the amount that each household paid for their health insurance premiums.At first, each household paid for a single household, but the reform ensured that each household would contribute the amount appropriate to reflect the number of people in their domicile to improve fairness of the contributions across the country as well as financial access for all.The second reform involved the implementation of the stratification system, so that each person would pay in accordance with their income as opposed to a flat fee per person. The third reform is ongoing.The government is transitioning the management of Mutuelles to the financial professionals at the Rwandan Social Security Board which has the mission to provide quality management of health insurance. This will ensure the sustainability of the programme.All of these reforms have relied upon an effective decentralization of responsibility and authority to the local governments that also oversee Mutuelles starting at the district level; the direct management of the Mutuelle staff by the local administration puts the Mayor in charge of this programme in that district.In general, this decentralization structure has been working well. Having local leadership overseeing the local implementation of Mutuelles has been helpful. These local leaders have, on the whole, been loyal, trustworthy and hardworking, and are dedicated to their mission vis-a-vis their administrees.Unfortunately, however, there have been a handful of local leaders who have been dishonest – acting as though they were more powerful than Rwandan institutions. They did so by stealing the hard-earned money that people had placed to get their health insurance locally.And such dishonest acts were discovered through the complementary, central auditing system in place through the Ministry of Internal Affairs, the Ministry of Local Government, Ministry of Finance and Economic Planning, and the Ministry of Health.In Rwanda, we have a zero tolerance for corruption. Thus, at all levels, we create institutions, such as the auditing system noted above, that reinforces accountability and discourages dishonest actionsby making the cost of corruption high.In this case, those local leaders who unjustly took money from the health insurance pool for their own personal gain were appropriately identified by this system. These individuals will be held accountable for their criminal actions and will reimburse up to the last penny of what they have taken, even if this means that they have to sell their assets.Rwandans should rest assured that their investment into their health insurance will not be lost. We have learned from this experience that we can be even more vigilant in our fight against any form of corruption, nepotism, or any crime moving forward.Creating systems that reinforce honesty and accountability is very vital to protecting our integrity, our rights, and development as a country, especially as we strive to reach our Vision 2020 goals.Yet this experience has taught us that we need to foster the growth of honest local leaders coupled with improved central level institutions that bolster accountability and reassure the people that their interests are being protected.I am grateful to live and work in a country where systems are strong enough to identify and correct problem areas or loopholes. Our effort to learn from both our successes and mistakes allows us to continuously improve every day in our efforts to protect public goods, community assets and people’s rights. The writer is the Minister of Health “*Published in the New Times on 18 February 2015. Available at: http://www.newtimes.co.rw/section/article/2015-02-18/186076/


Blog revamp

Observant readers of this blog will notice that I’ve done a little spring cleaning around here. I tried to make the design feel more contemporary by making it simpler, and more readable, especially on a mobile phone or tablet.  I’ve also tried to make the site load much faster.  I’ve tried to make it easier to leave comments. And I want to do a better job of managing photos: to ensure that pictures have credits and text alternatives for people whose sight is impaired


From Ferguson to Freetown, Black Lives Don’t Matter.

By Drs. Sriram Shamasunder & Phuoc Le December 2014 “We must name them and know their stories. They must not remain anonymous.” A year ago this month marks the first case of Ebola in rural Guinea. Emile Ouamouno, a two-year old boy born into a poor farming village, contracted and died from the virus. Within…


Zero inbox – an update

I was told recently by a senior DFID official that my greatest contribution to DFID so far has been my system for managing email overload, which apparently has been widely adopted. (I’d like to think he was joking, but I fear not.) If you missed my 2012 previous post about managing email, here is a summary. Without wanting to sound smug, I normally have zero inbox. I achieve this by triaging my inbox several times a day into three categories: (a) I deal immediately with anything that can be answered in a few minutes; (b) things that will take longer, I defer to the day on which I plan to do it; and (c) I file the things that need no further action.  Then I leave my (empty) inbox and look at my Today folder, which contains the things that I have previously tagged to deal with today


Essential surgery: key messages from Disease Control Priorities, 3rd edition

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The World Bank will publish the nine volumes of Disease Control Priorities, 3rd edition, in 2015–16. Volume 1—Essential Surgery—identifies 44 surgical procedures as essential on Read More


World Cancer Day: 10 +3 Simple Ways to Reduce Your Cancer Risk

Fact: In 2012, there were 14 million new cancer cases worldwide, and 8.2 million cancer related deaths. Fact: About 70% of all cancer deaths occur in low- and middle-income countries. Fact: The number of global cancer cases is expected to rise by 70% in the coming 2 decades. Fact: More than 30% of cancers can be prevented. Cancer is a very scary beast.


A twenty-first century development policy

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This blog post first appeared on Views from the Center.  It drives me crazy that so many people equate development policy with foreign aid. That’s why I welcome this week’s landmark report from the British parliament’s Select Committee on International Development. As the UK nears the end of a five-year parliament, this well-respected cross-party committee has delivered its legacy report, which argues that development is about much more than aid. As Alex Evans and I argued in evidence to the committee, the three key tasks of development policy are now to help fragile states become stable, make growth in middle-income countries more inclusive, and address cross-border problems that affect us all. Yes, aid is needed for all three of these tasks, but aid isn’t the answer to any of them.  Nor is the new development agenda merely a matter of finding new sources of finance to replace or supplement aid.


Thoughts on a plane: Inequality exists even up in the air

Rich poor divide courtesy of Project Syndicate

Oxfam’s frequently cited fact that 85 billionaires have the same wealth as the bottom half of the world’s population has garnered a lot of attention. Read More


Is ketamine about to become inaccessible in low-income countries?

nickerson graph

A storm is brewing with the potential to create a global “public health crisis”, denying access to safe surgery and anesthesia for roughly a billion Read More


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