By G. Youngman, Consultant, Nanaimo, BC
Appended below are my thoughts on the annual World Economic gathering in Davos, Switzerland. This year the meetings took on a very sombre tone as the world faces the worst economic meltdown in many years. People like those suffering from AIDS, other diseases in the developing world as well the poor and homeless in the developed countries have become the innocent victims of the greed of the western capitalists.
Exploring philanthropy, non-profits and socially motivated business, from the Gates Foundation to your donation. A fresh look at the economy of good intentions.
From Davos: U.S. funds executive bonuses but breaks health promises
While U.S. bailout funds will help pay $18 billion in holiday bonuses for Wall Street executives, the U.S. has broken its promise to fund a global health program that saves millions of lives.
That was the scathing assessment of Jeffrey Sachs, director of the Earth Institute at Columbia University and special adviser to the U.N. Secretary General, speaking on a conference call this morning.
The economic crisis has resulted in a $5 billion funding gap for the Global Fund because countries, led by the U.S., are falling short on their pledges, Sachs and others said.
The Global Fund to Fight AIDS, TB & Malaria is the main source of finance for programs to prevent and treat the three diseases. The fund gathers money from donor countries and provides a quarter of all international financing for AIDS, two-thirds for tuberculosis and three quarters for malaria.
“I would suggest the U.S. reclaim those bonuses, which are absolutely unjustified and completely unconscionable, and put the money in the Global Fund immediately,” Sachs said.
The $5 billion shortfall is less than one-half of one percent of what G8 countries have approved to bail out failing banks in the last three months, he added. The Merrill Lynch bonuses alone would be enough to close the gap in U.S. contributions, Sachs said.
The Fund projects it will need $8 billion to continue its work in 2009 and 2010, yet current pledges total only $3 billion. The U.S. and other donor countries pledged to support all valid Global Fund programs by committing about 0.7 of 1% of GNP in aid.
Despite a 2002 pledge made by the Bush Administration to honor that commitment, “the United States is not only not on track; it’s fallen back to become the donor with the smallest donation as a share of income of all the rich countries,” said Sachs. “We’re at 0.16 of 1% of our income for development assistance. It’s the lowest level of all 22 donor countries.”
As a result, the Fund is delaying programs and cutting costs, and using this week’s World Economic Forum to call attention to the issue.
The world shouldn’t squander progress on major diseases for short term gains, said Peter Chernin, president of News Corp. and chairman of Malaria No More.
Goals include guaranteeing global access to antiretroviral drugs for HIV by 2010 and reducing malaria deaths to near zero by 2012.
Malaria control is an example of a good return on investment, Chernin said.
Programs are showing real results such as a 66 percent drop in malaria-related deaths in Rwanda in one year following increased use of bednets to prevent bites and treatment with effective medicine.
“In today’s uncertain marketplace,” Chernin said, the Global Fund “delivers proven results in both economic and humanitarian terms.” Malaria alone costs Africa $12 billion a year in lost productivity, he noted.
Chernin said he’s working to boost donations to the fund from the private sector.
Chevron was the first private company to step up, with a $30 million donation, said Rajat Gupta, a McKinsey senior partner who chairs the Global Fund. The (Product) Red project has raised about $150 million.
Tomorrow, Chernin will join with Exxon Mobil and Standard Charter Bank to launch a campaign to raise $100 million from private companies, primarily for malaria programs funded through the Global Fund. The campaign will also ask companies to provide technical and business assistance, such as logistics for bed net delivery and marketing efforts to increase the use of bed nets.
Kenya: Healthcare Threatened By Political Crisis
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Health officials are concerned about the long-term impact of Kenya’s political crisis on healthcare, especially in areas hardest hit by violence since the end of December 2007.
“The most worrying issue is that of drug resistance among patients of chronic diseases,” Ian van Engelgem, the medical coordinator of Médecins Sans Frontières (MSF), stated.
He said HIV and Tuberculosis (TB) patients who had missed out on their regular medication for up to a month due to displacement and violence could develop resistance to the drugs.
“Right now a lot of HIV patients are on first-line drugs; they could require second-line drugs, which are more expensive, if they develop resistance as a result of skipping their ARV [anti-retroviral] medication for a period of time,” Van Engelgem said.
The fact that internally displaced persons (IDPs) have better access to healthcare compared with the host community where the camps are located is another concern.
“If IDPs have access to free healthcare, the same should also apply to them [host communities] as they are equally affected by the unrest,” Van Engelgem said.
Displaced health workers
Joanne Greenfield, malaria adviser for the UN World Health Organization (WHO) in Nairobi, said displacement and ongoing violence in parts of the country could lead to a crisis in the provision of healthcare in the affected regions.
“The security situation, especially in the Rift Valley [Province], is affecting the provision of health services to the general public as a significant number of health workers are either displaced and/or cannot report to their duty stations,” Greenfield said.
WHO, the lead agency for the health cluster of humanitarian actors – comprising UN agencies, NGOs and government organisations – has also expressed concern over the health of thousands of IDPs, mostly women and children, in the Rift Valley.
On 1 February, newspaper reports indicated that chicken pox and diarrhoea had broken out in two IDP camps in Naivasha, a town in Rift Valley Province, which has been severely affected by the violence.
“The number of sites hosting IDPs appears to increase by the day,” the agency said in a statement. “Initial WHO assessment has found that these sites are very crowded, with poor shelter, water supply, sanitation (in some camps, toilet to person ratio is 1 for 500), food shortages, no cooking fuel, precarious access to healthcare and shortages of antibiotics, children’s medicines, malaria medicines and life-saving drugs for chronic illness. Nearby hospitals are also facing similar shortages of drugs and supplies.”
Sexual violence
In a worrying development, WHO said, hospitals in the region had reported dramatic increases in cases of sexual violence. The agency said counselling services in most IDP sites were not available, including for reproductive health, sexual violence or HIV/AIDS.
“In many settings, survivors have no access to even the minimum health and psychological support, leaving them vulnerable to a range of potential negative health problems, including HIV/AIDS,” WHO stated.
George Mugenya, the medical superintendent of health at the Rift Valley General Provincial Hospital in Nakuru, said services were slowly returning to normal but the displacement remained a key concern.
“When the violence was intense, we put elective cases on hold to handle only emergency cases; now that it is calmer, we are noticing that some services are still affected because of the displacement of some of the medical staff,” he said. “Some workers have not reported to duty while others come irregularly and this has affected services such as those offered in the maternity section but, overall, things are returning to normal.”
He said the challenge was in re-stocking the hospital’s medical supplies and reviving clinic services for patients of chronic diseases.
Teams led by WHO officials visited the towns of Eldoret and Nakuru to coordinate the health cluster activities. The teams visited IDP camps and hospitals to monitor disease outbreaks as well as the availability of medical supplies and health workers.
According to WHO, the biggest worry at all sites was diarrhoea in children as well as acute respiratory infections. It was also concerned about irregular access to malaria, HIV/AIDS and TB medicines, while patients with asthma, hypertension and diabetes also lacked access.
Kenya’s Ministry of Health, together with WHO, the UN Children’s Fund (UNICEF), the Kenya Red Cross Society and other health NGOs, undertook a joint health assessment on 30 January of Uasin Gishu district in the Rift Valley, which is hosting 150,000 IDPs in 11 camps.
As a result, the medical officer reported that a mass immunisation against measles and polio, as well as the de-worming of children and provision of Vitamin A supplements, would begin in February.
The health officials also discussed the possibility of introducing mobile services for areas where normal services had been disrupted.
Global health gains at risk from economic crisis
Worried that the worldwide economic crisis may roll back gains made in battling diseases in the world’s poorest countries, global health advocates are calling on the richest countries not to renege on their funding pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
One well-known advocate even called on the U.S. government to take back the $18 billion in bonuses that Wall Street bankers paid themselves while receiving taxpayer bailout money, and use the money instead on HIV drugs and mosquito nets.
Calling the bonuses “unbelievably egregious,” Jeffrey Sachs, director of Columbia University’s Earth Institute said:
“Those bonuses are being paid out of our bailout funds… I suggest the U.S. government reclaim that funding and put the money into the Global Fund immediately.”
The public-private Global Fund was created in 2002 to collect and disburse money from governments and foundations to fight the three diseases. It prides itself on squeezing the most out of every dollar and pushes countries submitting requests for funds to develop innovative and cost-effective proposals.
Programs it has funded have resulted in a 66% drop in malaria deaths in Rwanda in a single year, and an 80% drop in malaria deaths in Eritrea over five years.
Now, the group said, it has more good proposals than it can fund, and faces a $5 billion shortfall over the next two years if rich countries don’t pony up.
In a teleconference call from Davos, Switzerland, where world economic leaders are meeting to discuss the money mess, Global Fund Chairman Rajat Gupta said:
“All is not doom and gloom. We have tremendous successes to celebrate in global health, although we have a long way to go.”
Also at Davos, another global health group — the Global Network for Neglected Tropical Diseases announced a stepped-up effort to combat a baker’s dozen of parasitic and bacterial diseases that affect the poorest of the world’s poor.
The diseases include Chagas disease, leishmaniasis and leprosy. Some are found even in the United States.
The campaign received a $34 million grant from the Bill and Melinda Gates Foundation, but it is also calling on regular folks to pitch in, pointing out that many of these neglected diseases can be treated for as little as 50 cents a day a year.
More than 1 billion people are infected with neglected tropical diseases. The Wall Street bonuses alone would have paid for 36 days a year of treatment for every single one of them, with $17.5 billion to spare.
fumed. “We had him nailed.”