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Health Systems – This Week in Global Health

This episode of TWiGH will focus on Health Systems. To subscribe to our news-letter and get the “show notes” from each show, click here http://www.twigh.org/…

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Q&A: Peter Piot on the lessons from the Ebola crisis

In this podcast, Ebola’s co-discoverer discusses the new outbreak’s implications for emergency health response.

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#TWiGH – This Week in Global Health

GHHub is excited to promote “This Week in Global Health,” a weekly “live” show on YouTube (every Wednesday at 2pm (EST). TWiGH takes the form of a Read More

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Episode 45: Mind, Society and Behaviour

Behavioural economics is hot. In this edition of Development Drums, I talk to Varun Gauri, Senior Economist with the Development Research Group of the World Bank and Co-Director of the World Development Report 2015: Mind, Society, and Behavior. Varun explains the principles of behavioural economics, and discusses how they apply to development economics. He also discusses how these biases also affect development agencies and their staff, and the implications of behavioural economics for development agencies themselves. Varun Gauri


Patently unfair: On the need for more equitable drug pricing

For this Humanosphere podcast, we are talking to James (aka Jamie) Love, director of an organization that works for social justice and equity in the realm of intellectual property – patents, copyrights and those sorts of things. The organization Love runs, based in DC, has the somewhat inscrutable name of Knowledge Ecology International and it has


Health Systems – This Week in Global Health

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This episode of TWiGH will focus on Health Systems. To subscribe to our news-letter and get the “show notes” from each show, click here http://www.twigh.org/…


Podcast Interview with Young Cancer Survivor and Advocate, Mexico City

This week, the latest in our series of podcasts from around the world. Sandro interviews Abish Romero, a young cancer survivor and advocate living and studying in Mexico City.  – http://blogs.plos.org/globalhealth/files/2014/10/Recording-10.mp3 Abish Romero is an MPH student at the National Institute of Public Health of Mexico. She became a cancer advocate after being diagnosed with breast cancer when she was 24 years old. Her experience with the disease made her realize how important social protection is in developing countries; and how governments can strengthen health systems by improving the quality of multidisciplinary care and treatment. As she has seen, these actions are key in avoiding impoverishment in families caused by catastrophic expenditures. The post Podcast Interview with Young Cancer Survivor and Advocate, Mexico City appeared first on Translational Global Health.


Who Pollutes Most? Surprises in a New US Database – Kevin Ummel

Pollution has no respect for party lines. In the US, Republican and Democratic districts may differ in many ways but when comes to the carbon emissions heating our planet the differences are much smaller than you might expect. This is one of the most surprising and important findings in a remarkable new working paper from CGD visiting senior associate Kevin Ummel. I’m so excited about this paper I took a short break from my new job at the World Resources Institute to discuss with Kevin the far-reaching implications of his work for the design and politics of US carbon pollution fees.  

Kevin’s paper, Who Pollutes? A Household-Level Database of America’s Greenhouse Gas Footprint, is a slender 23 pages that sits on the brawny shoulders of a fresh approach to available data and an muscular number crunching exercise to estimate the greenhouse gas emissions of households all across America.

Kevin tells me that he set out to study the consumption habits of American households based on the recognition that “every kilogram of human-caused emissions can be traced to a consumptive choice on the part of an individual, a household, or in some cases, a government.”

Kevin used data from two massive surveys (the Consumer Expenditure Survey and the American Community Survey) to determine what American households buy with their money. He then combined this survey data with data from the environmental sciences to “translate how people spend their money into an estimate of how much [carbon] pollution they are producing.”

One surprise: the high degree of what Kevin calls “pollution inequality”—the top 10 percent of US polluters are responsible for 25 percent of the country’s carbon footprint, while the least-polluting 40 percent of Americans account for just 20 percent.

Who pollutes most? Low-density, affluent suburbs, where the lifestyle includes big homes, big cars, long commutes and plenty of international air travel. Many of these people also recycle and opt for local produce to reduce their carbon footprint! (Sound like anybody you know?)

High-density cities have the lowest household carbon footprint—especially the poorer neighborhoods that tend to vote for Democrats. More surprisingly, less affluent rural communities that tend to vote Republican also have small carbon footprints.

The new data show that these geographical distinctions are much starker than the differences between the carbon footprints of Republican and Democratic districts, which tend to be “very, very small,” Kevin says. 

All this is very good news for the growing number of policy experts and ordinary Americans who see a revenue-carbon pollution fee as the best way to reduce emissions and spark a prosperity-enhancing, poverty-reducing, green technology revolution.

“If the US were to put a carbon tax in place, it’s not the case right off the bat that the members of one party would be disadvantaged relative to the other,” Kevin says.

“The difference in political rhetoric is far greater than the difference in environmental reality,” he adds. “The rhetoric should be: Why are we taxing things we want more of, like income, instead of things we want less of, like pollution?”

It’s the politics, of course. But Kevin doesn’t put all the blame on politicians. Research, he says, can do much more to give policy makers and politicians the tools they need to design a carbon-fee-and-rebate approach that will appeal to voters across the political spectrum.

I heartily agree! I urge you to skim Kevin’s full paper to learn more about his analytical approach and the surprising findings about who pollutes (skip to the Discussion if you are more policy wonk than data nerd). Then, to discover how this could unfold in the political world, read my newly published CGD essay: The Sudden Rise of Carbon Taxes, 2010-2030, a future history. 


Q&A: Peter Piot on the lessons from the Ebola crisis

Untitled

In this podcast, Ebola’s co-discoverer discusses the new outbreak’s implications for emergency health response.


#TWiGH – This Week in Global Health

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GHHub is excited to promote “This Week in Global Health,” a weekly “live” show on YouTube (every Wednesday at 2pm (EST). TWiGH takes the form of a Read More


How the aid and development industry helped cause Africa’s Ebola outbreak

africa-map-wiki-Author-Hristov

Yeah, that’s a provocative headline. No, we’re not talking about some movie thriller like Constant Gardner, in which an evil drug company does some deadly experimentation on hapless Africans. We’re talking about reality with a medical anthropologist, James Pfeiffer, about one of the root causes of the massive outbreak of Ebola now ravaging West Africa. It is


Hospitals for Health – Amanda Glassman

Where do you go when hit with a serious medical condition? “The hospital!” is an obvious answer for people in high income countries, but for people in low-income and emerging market economies, access to a proper hospital is often just a dream. Why are decent hospitals in the developing world so few and far between?  

This week I invite senior fellow Amanda Glassman  on the Wonkcast to discuss a new CGD Working Group  that is studying the problems that result in a lack of effective hospitals in low-income and emerging market countries.  

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Consultation Draft: Send your feedback to Rsilverman@cgdev.org by November 1, 2014.

Why focus on hospitals now? While news from the front lines of Ebola  has made the entire world aware of the dearth of hospitals in the afflicted countries, Amanda notes that within the global health community the shortage of hospitals in the developing world was already a hot topic.

For years donors have focused their attention and resources on primary care and preventive services—the kinds of help that can be provided at low cost in a village or neighborhood clinic.

“We’ve pretty much picked that low-hanging fruit,” Amanda says. “Now we’re thinking about health systems in a more integral way… Not just the hospital buildings but the but structures and policies that are needed to make hospitals function efficiently, contributing to health.”

What can be done?

CGD’s Hospitals for Health Working Group’s newly released consultation draft  of its forthcoming report proposes a “Global Hospitals Collaborative,” an entity that would  facilitate a network of individuals and institutions dedicated to fostering improved policymaking, investment, and management for emerging-market hospitals. Specific activities would include setting benchmarks, gathering and sharing data, analyzing the barriers to more and better hospitals—and finding solutions.

“There’s a need to establish some kind of baseline,” Amanda says. Those studying the problem lack the basic information needed find solutions to the problem, she adds.

“A global collaborative could recommend directions for data and analytics, possible reforms, and for learning one from the other,” she adds.

Wouldn’t the World Health Organization (WHO) be the proper home for such an entity?

Amanda thinks not. “Now more than ever the WHO needs to be focused on those global public goods of disease surveillance, control and prevention, as we see in the case of Ebola,” she says.

While she believe the WHO needs to be deeply involved, she also believes such a collaborative would benefit from the greater flexibility available in a less institutionalized setting.

Learn more about why hospitals may be the missing link in developing country health care and how the proposed collaborative could help. Tune into the  Wonkcast and read the report

My thanks to Kristina Wilson for recording and editing the Wonkcast and for a first draft of this blog post. 


Episode 44: The Data Revolution

Everyone seems to be talking about the data revolution these days. In this episode of Development Drums, I speak with two people who have thought more about what it is, how to make it happen, and what it means for development than just about anyone else. Claire Melamed is the Director of the Growth, Poverty and Inequality Programme at ODI. She was previously the Head of Policy at ActionAid UK. Her work focuses on measurement of poverty and inequality and on how to use the insights from measurement to improve policy and outcomes


Is the world on track for polio eradication by 2018?

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This video describes the tools available and discusses the challenges that remain for wiping out the disease.


Unpacking WHO’s Shocking Ebola Maps–Mead Over

As the Ebola epidemic continued to spread in West Africa, with more than 3,000 cases and 1,500 deaths, I invited CGD senior fellow Mead Over, a health economist and one of the world’s top experts on the economics of HIV/AIDS, to discuss newly released maps from the World Health Organization (WHO) and measures for limiting the economic fallout from the epidemic.

“Ebola is much more like Avian Flu and SARS than AIDS,” Mead tells me. Its gestation period is very rapid, and that stirs a panic that creates an economic impact.

In the case of the SARS epidemic, he notes, there were only about 800 deaths but the economic impact of reduced trade, tourism and investment was estimated at about $40 billion—the equivalent of $50 million per death.

In the case of the Ebola epidemic, where cases will far exceed those of SARS, the economic impact could be far greater, he says.

He emphasizes however that the Ebola epidemic so far is tiny compared to the toll of malaria, tuberculosis, and HIV, “all of which are many multiples more deadly on a continuing basis.”

Our conversation then turns to two maps that the WHO released late last week, one showing the location and spread of the Ebola virus (Figure 1), the other showing the location of laboratories and treatment centers (Figure 2). 

Figure 1:  Location of cases throughout the countries with most intense transmission

Location of cases throughout the countries with most intense transmission

Figure 2: Response Monitoring

Response Monitoring

These maps are very helpful to those of us who are trying to grasp what’s happening in real time in West Africa. What they show is that we have a long way to go, Mead says.

He adds that it is “shocking” how few laboratories able to confirm the diagnosis are shown in the map. While there may be some additional laboratories that are not shown, the WHO maps are presumably the best information available, so either the data or the labs themselves are alarmingly lacking.

“Labs are necessary to confirm a diagnosis of Ebola. The inability to confirm a diagnosis makes it much harder for the physicians and nurses to protect themselves. It means there’s a need to quarantine people who would not otherwise need to be quarantined. And quarantining is extremely difficult,” he explains. 

Released along with the two maps last week was WHO’s “Ebola Response Roadmap” which outlined steps for affected countries and the international community to contain the epidemic. 

WHO projects that if all recommended measures are taken the epidemic may be contained within 6-9 months with perhaps more than 20,000 cases.

Noting that most of the cases shown on the WHO map are recent, Mead says that the toll may be much higher.

“That’s an indication that this epidemic is growing very rapidly in the countries of Liberia, Sierra Leone, and Guinea. The reported cases do not seem to be close to the border of Senegal or Guinea-Bissau, but there are cases close to the borders of Mali and Cote d’Ivoire,” he says.

So while this epidemic has been confined primarily to three countries, the governments of Cote d’Ivoire, Mali, and Guinea-Bissau are all on the alert.

“There’s a need for all those countries to strengthen their health infrastructure at the borders,” Mead says.

Mead concludes by discussing the international community’s response to minimize the economic fallout, an issue he addresses in greater detail here


The ethical debate over the use of an untested Ebola drug

Ebola

The disease is Ebola. The outbreak is In West Africa. Two infected Americans — and no Africans — got the drug, which is called ZMapp. Kevin Fitzgerald is a medical ethicist at Georgetown University who says there are good reasons not to use untested drugs, but “compassionate use” is part of the ethical consideration.


A Surprising Indigenous View of REDD+ – Mina Setra and Frances Seymour

Mina Setra, the deputy secretary general of the Indonesia’s Indigenous Peoples’ Alliance of the Archipelago (AMAN), recently visited CGD to speak at an event about Indonesia’s efforts to prepare to participate in REDD+, the UN program for Reducing Emissions from Deforestation and Forest Degradation that would offer payments from rich countries to keep tropical forests standing. Afterwards I invited Mina and CGD senior fellow Frances Seymour, the former head of the Center for International Forestry Research to join me on the Wonkcast. Our controversial topic: the complex relationships linking Indonesia’s forests, its indigenous peoples, and REDD+.

REDD+ aims to provide incentives for forest protection. That’s nothing new to Indonesia’s 70 million indigenous peoples, who, Mina tells me, “have been protecting the forests for decades” because “for us, for indigenous peoples, forests are everything.”

Though much of Indonesia’s land has belonged to and been managed by indigenous peoples for centuries, formal documentation of such ownership has typically been lacking. Mina tells me about a 1999 forestry law that claimed traditional indigenous forest as “state forest” to be managed by the ministry of forestry. As a result Indonesia’s indigenous peoples lost millions of hectares to individuals and corporations that seized control and cleared or otherwise degraded the forest through logging or conversion to palm oil plantations. Mina says that the subsequent displacement of many indigenous peoples “created a lot of problems, not only that we lost our forests but further economic and social problems.”

Frances recalls that when she first arrived in Indonesia some 25 years ago, “indigenous peoples were not only invisible, but to talk about indigenous peoples’ rights was a taboo.” Although indigenous people were recognized in the constitution, they did not have any actual operational rights to their traditional lands, she says, adding that conversations about such rights only began to gain momentum three or four years ago.

AMAN had tried to raise the issue of indigenous peoples’ rights nationally without success, Mina said. It was only when “the international community started talking about forests and REDD+ that we had the opportunity to show that we do exist,” she added. “When talking about forests, you cannot escape talking about the people who have been living there nurturing the forests since even before Indonesia existed.”

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Indigenous Peoples Rights and Redd+ by Frances Seymour

Not everybody views REDD+ so favorably. Indeed, a lively debate about the impact of REDD+ on indigenous land rights continues, as Frances explains in a new blog post marking the International Day of the World’s Indigenous Peoples. Some people continue to worry that payments for forest protection envisioned by REDD+ will provide yet another reason for outsiders to push indigenous people out of their forest homes.

“The change in positioning of indigenous groups in recognizing REDD+ as having elements of opportunity and not just threat” is quite recent, says Frances. One reason: REDD+ programs developed in consultation with indigenous peoples, such as Indonesia’s ongoing national mapping initiative.

The maps give indigenous groups the opportunity to prove the legitimacy of their land claims, and Mina hopes it will continue to grow. “We hope that in 2022, we can map forty million hectares of indigenous territories all over Indonesia, as evidence that we do exist,” she says.

However, the continued success of the REDD+ programs depends on international support, Frances explains. With the noticeable exception of Norway, this has yet to happen.

Listen to the full Wonkcast for more on indigenous efforts to be recognized in Indonesia and how Mina and Frances view the interaction between indigenous people’s rights and the global effort to reduce protect forests and thereby reduce the emission of heat-trapping gases.

My thanks to Kristina Wilson for recording and editing the Wonkcast and to Kristin Sadler for a first draft of this blog post. 


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