UNICEF [to 25 January 2014]

UNICEF [to 25 January 2014]

AVOS: MDG Advocates Join UN SG Ban Ki-moon and Global Leaders on urgent need to empower adolescent girls

European Commission’s Humanitarian Office supports fight against child malnutrition in Sudan with grant of €2 million for UNICEF
KHARTOUM, Sudan/ BRUSSELS, 22 January 2014 UNICEF Sudan will receive €2 million from the European Commission’s Humanitarian Office to help in the fight against child malnutrition in Sudan.

Measles outbreak threatens children’s lives in Guinea
CONAKRY, 21 January 2014 UNICEF and its partners have begun to organize a campaign to vaccinate over 1.6 million children to stop a measles outbreak in Guinea amid growing number of cases among children especially in the capital Conakry.

UNICEF airlifts urgent supplies to humanitarian crisis in South Sudan
JUBA, South Sudan, 21 January 2014 The first of two UNICEF charter planes, each carrying 35 tons of urgently needed supplies for children and women in South Sudan, landed this morning at Juba International Airport.

UNICEF airlift in response to humanitarian crisis in South Sudan
Media Advisory: UNICEF airlift in response to humanitarian crisis in South Sudan

Central African Republic’s children urgently need healing, hope and funding, says UNICEF chief
BANGUI, Central African Republic/DAKAR, Senegal/GENEVA/BRUSSELS, 20 January 2014 Over the past 72 hours, senseless violence has resulted in many deaths and created tension throughout the Central African Republic in the lead-up to today’s vote to select an interim president of the country.

Measles outbreak threatens children’s lives in Guinea
CONAKRY, 21 January 2014 – UNICEF and its partners have begun to organize a campaign to vaccinate over 1.6 million children to stop a measles outbreak in Guinea amid growing number of cases among children especially in the capital Conakry.

Since November last year, 37 cases have been confirmed in the capital–all children under 10 years old. Over the past few weeks, the number of cases of measles has been increasing sharply and led to the death of one child.

This recent spike has prompted the Ministry of Health and Public Hygiene of Guinea to officially declare an outbreak in the Conakry municipalities of Matam, Matoto, and Ratoma. The disease has also been reported in other parts of the country –namely the prefectures of Boké, Coyah, Dubreka, Kissidougou, and Mandiana.

“We are very concerned about this outbreak. Measles is highly contagious and extremely dangerous—especially for young, malnourished children. As we’ve already seen, it can be fatal. In a densely populated city like Conakry, disease spreads quickly,” said UNICEF Representative in Guinea Dr. Mohamed Ayoya.

The Government of Guinea, UNICEF, the World Health Organization (WHO) and Médecins Sans Frontières (MSF) are joining forces to set up coordinated mechanisms to contain the outbreak. For the initial response, UNICEF will provide vaccines, refrigerators, needles, and other medical supplies and logistical support to the Government for the vaccination of children in the Kaloum and Dixinn neighbourhoods of Conakry as well as in the affected areas outside the capital. MSF and WHO will support vaccination efforts in the outbreak-declared areas of Conakry –namely Matam, Matoto, and Ratoma.

The vaccination phase of the national campaign will begin in the coming weeks as soon as vaccines, supplies and funding to ensure a continuous rollout are available…

UNOCHA [to 25 January 2014]

UNOCHA [to 25 January 2014]

Latest Press Releases
25 Jan 2014
Central African Republic: Humanitarian Coordinator to the Central African Republic
Source: UN Office for the Coordination of Humanitarian Affairs Country: Central African Republic (Bangui, 24 January2014) : The international community has mobilized its efforts in the Central Africa Republic towards responding to the humanitarian crisis on-going in the country. An international high-level conference on the humanitarian situation in CAR was held on 20 January 2014 in Brussels. The main objective of this meeting was to report on the humanitarian situation and the emergency…

24 Jan 2014
Democratic Republic of the Congo: R.D. Congo : « La protection des civils et l’accès humanitaire ne doivent pas être mis en sursis au Nord-Kivu »
Source: UN Office for the Coordination of Humanitarian Affairs Country: Democratic Republic of the Congo, Uganda (Goma/Kinshasa, 24 janvier 2014) : Plusieurs dizaines de milliers de personnes vivant dans la zone de Kamango, dans le Territoire de Beni au Nord-Kivu, pourraient encourir de graves risques de protection suite au lancement de nouvelles opérations militaires par les forces armées congolaises. L’armée congolaise a démarré, le 16 janvier 2014, une opération baptisée SOKOLA – « nettoyez…

23 Jan 2014
South Sudan (Republic of): UN Humanitarian Chief Valerie Amos to visit South Sudan
Source: UN Office for the Coordination of Humanitarian Affairs Country: South Sudan (Republic of) WHO: Valerie Amos, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator WHAT: Mission to the Republic of South Sudan WHEN: 27-29 January 2014 WHERE: The capital, Juba, and Lakes and Jonglei States UN Humanitarian Chief Valerie Amos is scheduled to visit South Sudan from 27 to 29 January 2014 to draw attention to the humanitarian consequences of the current…

23 Jan 2014
Central African Republic: Assistant Secretary–General for Humanitarian Affairs and Deputy Emergency Relief Coordinator, Kyung-wha Kang remarks to the Security Council on the Central African Republic
Source: UN Office for the Coordination of Humanitarian Affairs Country: Central African Republic NEW YORK, 22 JANUARY 2014 Checked against delivery Mr. President, Thank you for this opportunity to update the Security Council on the human rights and humanitarian situation in the Central African Republic (CAR). During the two months since the Arria formula briefing by OCHA’s Emergency Operations Director, the humanitarian crisis in the CAR has deepened: the political system has failed;…

23 Jan 2014
Myanmar: Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Valerie Amos – Statement on Myanmar
Source: UN Office for the Coordination of Humanitarian Affairs Country: Myanmar (Geneva, 23 January 2014) I am deeply concerned about reports of alarming levels of violence, including the killing of many civilians and a policeman, in Maungdaw Township, Rakhine State, Myanmar. I ask the Government of Myanmar to take all necessary measures to ensure the full protection of all civilians and to enable safe and continued access by humanitarian staff to the affected areas in order to assess needs…

22 Jan 2014
Syrian Arab Republic: Top humanitarian leaders pen open letter to Geneva II peace talk participants calling for urgent action to protect Syrian children
Source: European Commission Humanitarian Aid department, UN Office of the SRSG for Children and Armed Conflict, World Health Organization, UN Development Programme, Norwegian Refugee Council, International Crisis Group, UN Office for the Coordination of Humanitarian Affairs, World Food Programme, UN Children’s Fund, Oxfam, International Rescue Committee, Save the Children, UN High Commissioner for Refugees, World Vision Country: Syrian Arab Republic With the parties in Syria’s conflict…

22 Jan 2014
Tonga: Government of Tonga accepts support from Pacific Humanitarian Team
Source: UN Office for the Coordination of Humanitarian Affairs Country: Tonga (Suva, 22 January 2014): The Government of Tonga has formally accepted support from the Pacific Humanitarian Team (PHT) to provide assistance to the thousands of people in Ha’apai affected by Tropical Cyclone Ian. The UN Resident Coordinator (RC), Ms Osnat Lubrani, and Head of the UN Office for the Coordination of Humanitarian Affairs (OCHA) in the Pacific, Mr Sune Gudnitz, have recently returned from Tonga after…

Latest Map
Yemen: Yemen: 3W Operational Presence (as of December 2013)

UNDP United Nations Development Program [to 25 January 2014]

UNDP  United Nations Development Program [to 25 January 2014]

22 Jan 2014
UN opens global call for nominations to identify local sustainable development solutions that can change the world
A United Nations-led partnership that “shines a spotlight” on local sustainable development innovations today launched its global call for nominations for the Equator Prize 2014.

21 Jan 2014
Combatting inequality key to combatting poverty, says UN Development Chief
Despite evidence that inequality prevents countries from developing in a wide number of areas, little progress has been made combatting it, said United Nations Development Programme (UNDP) Administrator Helen Clark today at the London School of Economics where she was giving a lecture at the International Growth Centre.

21 Jan 2014
Helen Clark: The London School of Economics, International Growth Centre Public Lecture “The next global development agenda: From aspiration to delivery”
The London School of Economics, London, UK  [see excerpt in Week in Review above]

20 Jan 2014
Donors pledge US $500 million for the Central African Republic
As the violence in the Central African Republic (CAR) continues, the United Nations Development Programme (UNDP) has called on the international community to help prevent the conflict from leaving a legacy of even greater deprivation and poverty in the country.

UNFPA United Nations Population Fund [to 25 January 2014]

UNFPA  United Nations Population Fund [to 25 January 2014]

22 January 2014 – Press Release
Reproductive Rights Are Crucial for Development, Asia-Pacific Meeting Reaffirms
MANILA—Twenty years on, the International Conference on Population and Development (ICPD) retains its relevance, the 7th Asia-Pacific Conference on Reproductive and Sexual Health and Rights is affirming this week. more

UNESCO [to 25 January 2014]

UNESCO [to 25 January 2014]

24 Jan 2014
UNESCO Director-General Condemns Destruction to the Museum of Islamic Art in Cairo, Egypt

24 Jan 2014
Call to contribute to the Madrid Action Plan evaluation

22 Jan 2014
Supporting the Coastal Zone Management and Marine Spatial Planning in the Mediterranean and Black Sea

22 Jan 2014
Davos : Empowering Girls to Accelerate MDG Progress

22 Jan 2014
Irina Bokova welcomes the International Centre for Interreligious and Intercultural Dialogue (KAICIID) to UNESCO

22 Jan 2014
Strengthened observation network to protect people from coastal hazards in the Caribbean

USAID [to 25 January 2014]

USAID [to 25 January 2014]

New Tools, Ideas, and Approaches for a Changing Global Environment
January 24, 2014
On Monday, January 27th, USAID will launch its new framework for integrated environment and development programs, entitled “Nature, Wealth, and Power 2.0: Leveraging Natural and Social Capital for Resilient Development”.

USAID and DuPont Announce Commitment to Increase Farmer Productivity and Food and Nutrition Security
January 23, 2014
Efforts will include increasing access to technology, crop biofortification and capacity building
On the margins of the World Economic Forum at Davos, the U.S. Agency for International Development (USAID) and DuPont formally announced a joint agreement to deepen efforts to reduce global hunger and poverty by enabling smallholder farmers access to proven, safe, and transformative agricultural innovations.

Additional $30 Million in Humanitarian Assistance for the People of the Central African Republic
January 20, 2014
On the heels of a two-day visit to the Central African Republic (CAR), U.S. Agency for International Development (USAID) Assistant Administrator for Democracy, Conflict, and Humanitarian Assistance Nancy Lindborg announced today in Brussels that the United States is providing nearly $30 million in additional U.S. humanitarian assistance to address urgent needs resulting from the crisis in CAR, for a total commitment of nearly $45 million in humanitarian assistance since increased hositilities in December.

Impact Blog
Let’s Stand Up For Inclusion, Not Exclusion
January 22, 2014 — Denise A. Herbol, Mission Director USAID/Jamaica
The stigma and discrimination faced by people living with HIV/AIDS continues to be a roadblock for access to critical prevention and care. Yet every day I see significant steps that are being taken to overcome this obstacle, especially efforts led by USAID. I was invited to speak at the USAID-…
Read More

Adventures in Wildlife Screening: Monitoring Wildlife Farms to Prevent Disease
January 22, 2014 — Laurel Fain, USAID Vietnam Health Office Chief
Recognizing the potential threat of new pandemics, USAID partners with Vietnam’s Ministry of Agriculture and Rural Development to build capacity for monitoring diseases in wildlife farms.
Read More

ECHO [to 25 January 2014]

ECHO  [to 25 January 2014]

EU airlifts urgently needed humanitarian aid to the Central African Republic
23/01/2014 – Amid the violent conflict in the Central African Republic (CAR) , the European Commission continues to airlift urgently needed relief supplies into the country…
[Read more]

EU and UN mobilise EUR 366 million in aid to Central African Republic
20/01/2014 – The international community pledged over EUR 366 million at a high-level meeting on the humanitarian crisis in the Central African Republic (CAR) today, as donors rallied to help the stricken country in response to a dramatically deteriorating situation….
[Read more]

OECD [to 25 January 2014]

OECD  [to 25 January 2014]

OECD Economic Survey of Hungary launches Monday 27 January 2014
The OECD’s latest Economic Survey of Hungary, to be published on Monday 27 January 2014, assesses the country’s exit from recession as well as steps that can be taken to boost its growth potential.

Employment situation, third quarter 2013, OECD
OECD employment rate nudges up to 65.2% in third quarter of 2013.

Latin America: Tax revenues continue to rise, but are low and varied among countries, according to new OECD-ECLAC-CIAT report
Tax revenues in Latin American countries continue to rise but are lower as a proportion of their national incomes than in most OECD countries. Revenue Statistics in Latin America 2012 shows that Argentina and Brazil have the highest tax revenue to GDP ratio, while Guatemala and Dominican Republic stand at the lower end.

World Bank [to 25 January 2014]

World Bank [to 25 January 2014]
Region/Global actions and announcements

World Bank Group President Jim Yong Kim Remarks at Davos Press Conference
MR. KIM:  [In progress]–in the recent disagreement. And we all have to remember, there’s a number of organizations in the European Union have an extremely diverse set of views on this particular issue.  So, his ability to bring the Union together, I think, is a very important signal for all of us.A year ago, I said at this meeting that we needed a plan for tackling climate change, a plan fit for the challenge that we face.  A year later, we’ve seen great leadership on climate from countries and companies, but emissions are still rising and the poor are still suffering. We don’t have a plan yet and the bits we do have are not equal to the size and challenge. The UN Secretary-General has called for a leadership summit and we all should be very grateful to him for having done so.  This gives us the opportunity to organize our collective leadership. This is the year to take action on climate change.  There are no more excuses. If we fail, our children and grandchildren…
Date: January 23, 2014

World Bank Group President: This Is the Year of Climate Action
In corporate boardrooms and the offices of CEOs, climate change is a real and present danger. It threatens to disrupt the water supplies and supply chains of companies as diverse as Coca-Cola and ExxonMobil. Rising sea levels and more intense storms put their infrastructure at risk, and the costs will only get worse. CEOs know this. They also know there is opportunity in how they respond. But while there are stand-out leaders, many others are holding back until they have more certainty about what governments will do. This week at the World Economic Forum in Davos, World Bank President Jim Yong Kim called on government leaders to break out of the small steps of business as usual and provide that structure. First, by putting a price on carbon and by having financial regulators require companies and financial institutions to assess their exposure to climate-related risks and disclose it. Kim also called for doubling the market for green bonds, which support climate adaptation…
Date: January 23, 2014

World Bank Open Knowledge Repository Introduces Mobile-Friendly Design
In keeping up with the rapid growth in mobile usage worldwide, the World Bank just relaunched the Open Knowledge Repository (OKR)—its open access portal to its publications and research—on an upgraded platform specifically optimized for mobile use. The relaunched OKR website, at openknowledge.worldbank.org, features a “responsive web design” that automatically adapts to the screen size of any device—whether desktop, laptop, tablet, or smartphone. “Knowing that nearly half of OKR users are in developing countries where mobile devices are increasingly being used to access the internet, relaunching the OKR with responsive design was a no-brainer,” said Carlos Rossel, World Bank Publisher. “Now, when users access the OKR from their smartphones or tablets, they will have a greatly improved user experience. ”The benefits of this change will ultimately extend well beyond users of the OKR.
Date: January 23, 2014

Water Shortages Slow Energy Production Worldwide
New Thirsty Energy initiative to help countries mitigate impact of water scarcity on energy security ABU DHABI, January 20, 2014 –The World Bank is launching a new initiative at the World Future Energy Summit and International Water Summit in Abu Dhabi that will help developing countries better plan and manage scaling-up energy capacity to meet rising demand, in tandem with water resource management. Producing energy requires a lot of water. Yet, the availability of and access to water is negatively impacting energy production around the world. Last year alone, water shortages shut down thermal power plants in India, decreased energy production in power plants in the United States and threatened hydropower generation in many countries, including Sri Lanka, China and Brazil. The problem is expected only to get worse. By 2035, the world’s energy consumption will increase by 35 percent, which in turn will increase water consumption by 85 percent…
January 20, 2014

Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts

BMC Public Health
(Accessed 25 January 2014)

Research article
Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts
Gian Gandhi and Patrick Lydon

Abstract (provisional)
To achieve globally or regionally defined accelerated disease control, elimination and eradication (ADC/E/E) goals against vaccine-preventable diseases requires complementing national routine immunization programs with intensive, time-limited, and targeted Supplementary Immunization Activities (SIAs). Many global and country-level SIA costing efforts have historically relied on what are now outdated benchmark figures. Mobilizing adequate resources for successful implementation of SIAs requires updated estimates of non-vaccine costs per target population.

This assessment updates the evidence base on the SIA operational costs through a review of literature between 1992 and 2012, and an analysis of actual expenditures from 142 SIAs conducted between 2004 and 2011 and documented in country immunization plans. These are complemented with an analysis of budgets from 31 SIAs conducted between 2006 and 2011 in order to assess the proportion of total SIA costs per person associated with various cost components. All results are presented in 2010 US dollars.

Existing evidence indicate that average SIA operational costs were usually less than US$0.50 per person in 2010 dollars. However, the evidence is sparse, non-standardized, and largely out of date. Average operational costs per person generated from our analysis of country immunization plans are consistently higher than published estimates, approaching US$1.00 for injectable vaccines. The results illustrate that the benchmarks often used to project needs underestimate the true costs of SIAs and the analysis suggests that SIA operational costs have been increasing over time in real terms. Our assessment also illustrates that operational costs vary across several dimensions. Variations in the actual costs of SIAs likely to reflect the extents to which economies of scale associated with campaign-based delivery can be attained, the underlying strength of the immunization program, sensitivities to the relative ease of vaccine administration (i.e. orally, or by injection), and differences in disease-specific programmatic approaches. The assessment of SIA budgets by cost component illustrates that four cost drivers make up the largest proportion of costs across all vaccines: human resources, program management, social mobilization, and vehicles and transportation. These findings suggest that SIAs leverage existing health system infrastructure, reinforcing the fact that strong routine immunization programs are an important pre-requisite for achieving ADC/E/E goals.

The results presented here will be useful for national and global-level actors involved in planning, budgeting, resource mobilization, and financing of SIAs in order to create more realistic assessments of resource requirements for both existing ADC/E/E efforts as well as for new vaccines that may deploy a catch-up campaign-based delivery component. However, limitations of our analysis suggest a need to conduct further research into operational costs of SIAs. Understanding the changing face of delivery costs and cost structures for SIAs will continue to be critical to avoid funding gaps and in order to improve vaccination coverage, reduce health inequities, and achieve the ADC/E/E goals many of which have been endorsed by the World Health Assembly and are included in the Decade of Vaccines Global Vaccine Action Plan.

Second Evidence Aid Conference: Prioritizing Evidence in Disaster Aid

Disaster Medicine and Public Health Preparedness
Volume  7  – Issue 06 – December 2013 http://journals.cambridge.org/action/displayIssue?jid=DMP&tab=currentissue

Brief Report
Second Evidence Aid Conference: Prioritizing Evidence in Disaster Aid
Philippe Vandekerckhovea1, Michael J. Clarkea2a3a4, Emmy De Bucka1, Claire Allena2 c1 and Bonnix Kayabua2a4
a1 Belgian Red Cross-Flanders, Mechelen, Belgium
a2 Evidence Aid, Oxford, England
a3 Queen’s University of Belfast, United Kingdom
a4 Trinity College Dublin, Ireland

The Second Evidence Aid Conference took place in Brussels, Belgium, in October 2012, jointly organized by Evidence Aid and the Belgian Red Cross–Flanders. It provided an opportunity to build on the discussions from the 2011 First Evidence Aid Conference in Oxford, England, and prioritize the future work of Evidence Aid. Within the plenary presentations, discussions, and small work groups, the more than 80 international participants addressed issues regarding the need, use, and prioritization of evidence. Three parallel workshops focused on the prioritization of research, systematic reviews, and data to be collected during disasters, leading to a suggested prioritization framework and a commitment to identify key areas for evidence in disasters. Working with a wide variety of people and organizations from the disaster and humanitarian sectors, Evidence Aid will take this framework and develop a list of top priority questions in need of research and systematic reviews. Although Evidence Aid will not be able to address all of the research questions that will be identified in this process, it will collect them for sharing with relevant agencies. (Disaster Med Public Health Preparedness. 2013;7:593-596)

Commentary: The Promise and Pitfalls of Community Resilience

Disaster Medicine and Public Health Preparedness
Volume  7  – Issue 06 – December 2013 http://journals.cambridge.org/action/displayIssue?jid=DMP&tab=currentissue

The Promise and Pitfalls of Community Resilience
Lori Uscher-Pinesa1 c1, Anita Chandraa1 and Joie Acostaa1
a1 RAND Corporation, Arlington, Virginia

An important shift in terminology has occurred in emergency preparedness, and the concept of community resilience has become ubiquitous. Although enhancing community resilience is broader than preparedness, and emphasizes a distinct set of activities and participants, the terms are often used interchangeably. The implications of this shift have not been fully explored. This commentary describes the potential promise and pitfalls of the concept of community resilience and recommends strategies to overcome its limitations. We believe that resilience has the power to dramatically change this field in immense, positive ways, but some important challenges such as confusion about definitions and lack of accountability must first be overcome. (Disaster Med Public Health Preparedness. 2013;7:603-606)

The state of health in the Arab world, 1990—2010: an analysis of the burden of diseases, injuries, and risk factors

The Lancet
Volume 383, Issue 9914, Pages 309 – 320, 25 January 2014

The state of health in the Arab world, 1990—2010: an analysis of the burden of diseases, injuries, and risk factors

Prof Ali H Mokdad PhD a, Sara Jaber MD a, Muna I Abdel Aziz PhD b, Fadia AlBuhairan MD c, Abduljabbar AlGhaithi MD d, Nawal M AlHamad PhD e, Suad N Al-Hooti PhD f, Adel Al-Jasari MD d, Mohammad A AlMazroa MD g, Ahmed Mohamed AlQasmi MD h, Shirina Alsowaidi MD i, Majed Asad MD j, Charles Atkinson BS a, Alaa Badawi PhD k, Talal Bakfalouni MD l, AbdelAziz Barkia PhD m, Stan Biryukov BS a, Charbel El Bcheraoui PhD a, Farah Daoud BS a, Mohammad Hossein Forouzanfar MD a, Diego Gonzalez-Medina BA a, Prof Randah R Hamadeh DPhil n, Mohamed Hsairi MD o, Seifeddin Saleh Hussein MD j, Nadim Karam MD q, Shams Eldin Ali Hassan Khalifa MD p, Prof Tawfik A M Khoja MD r, Faris Lami MD s, Katherine Leach-Kemon MPH a, Prof Ziad A Memish MD g, Ali A Mokdad MD a, Mohsen Naghavi PhD a, Jamal Nasher MD d, M Bassam Hijawi Qasem MD j, Mohammad Shuaib MD t, Al Anoud M Al Thani MD p, Mohamed H Al Thani MD p, Mohammed Zamakhshary MD g, Prof Alan D Lopez PhD u, Prof Christopher J L Murray MD a
The Arab world has a set of historical, geopolitical, social, cultural, and economic characteristics and has been involved in several wars that have affected the burden of disease. Moreover, financial and human resources vary widely across the region. We aimed to examine the burden of diseases and injuries in the Arab world for 1990, 2005, and 2010 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010).

We divided the 22 countries of the Arab League into three categories according to their gross national income: low-income countries (LICs; Comoros, Djibouti, Mauritania, Yemen, and Somalia), middle-income countries (MICs; Algeria, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, occupied Palestinian territory, Sudan, Syria, and Tunisia), and high-income countries (HICs; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For the whole Arab world, each income group, and each individual country, we estimated causes of death, disability-adjusted life years (DALYs), DALY-attributable risk factors, years of life lived with disability (YLDs), years of life lost due to premature mortality (YLLs), and life expectancy by age and sex for 1990, 2005, and 2010.

Ischaemic heart disease was the top cause of death in the Arab world in 2010 (contributing to 14·3% of deaths), replacing lower respiratory infections, which were the leading cause of death in 1990 (11·0%). Lower respiratory infections contributed to the highest proportion of DALYs overall (6·0%), and in female indivduals (6·1%), but ischaemic heart disease was the leading cause of DALYs in male individuals (6·0%). DALYs from non-communicable diseases—especially ischaemic heart disease, mental disorders such as depression and anxiety, musculoskeletal disorders including low back pain and neck pain, diabetes, and cirrhosis—increased since 1990. Major depressive disorder was ranked first as a cause of YLDs in 1990, 2005, and 2010, and lower respiratory infections remained the leading cause of YLLs in 2010 (9·2%). The burden from HIV/AIDS also increased substantially, specifically in LICs and MICs, and road injuries continued to rank highly as a cause of death and DALYs, especially in HICs. Deaths due to suboptimal breastfeeding declined from sixth place in 1990 to tenth place in 2010, and childhood underweight declined from fifth to 11th place.

Since 1990, premature death and disability caused by communicable, newborn, nutritional, and maternal disorders (with the exception of HIV/AIDS) has decreased in the Arab world—although these disorders do still persist in LICs—whereas the burden of non-communicable diseases and injuries has increased. The changes in the burden of disease will challenge already stretched human and financial resources because many Arab countries are now dealing with both non-communicable and infectious diseases. A road map for health in the Arab world is urgently needed.

Bill & Melinda Gates Foundation.

Health in the Arab world: a view from within
Governance and health in the Arab world
Rajaie Batniji, Lina Khatib, Melani Cammett, Jeffrey Sweet, Sanjay Basu, Amaney Jamal, Paul Wise, Rita Giacaman
Preview | Summary | Full Text | PDF

Non-communicable diseases in the Arab world
Hanan F Abdul Rahim, Abla Sibai, Yousef Khader, Nahla Hwalla, Ibtihal Fadhil, Huda Alsiyabi, Awad Mataria, Shanthi Mendis, Ali H Mokdad, Abdullatif Husseini
Preview | Summary | Full Text | PDF

The path towards universal health coverage in the Arab uprising countries Tunisia, Egypt, Libya, and Yemen
Shadi S Saleh, Mohamad S Alameddine, Nabil M Natafgi, Awad Mataria, Belgacem Sabri, Jamal Nasher, Moez Zeiton, Shaimaa Ahmad, Sameen Siddiqi
Preview | Summary | Full Text | PDF

Persistence of poliomyelitis in Nigeria

The Lancet Global Health
Feb 2014  Volume 2  Number 2  e58 – 116

Persistence of poliomyelitis in Nigeria
Festus D Adu, Itam Hogan Itam
Preview | Full Text | PDF
The World Health Assembly launched the Global Polio Eradication Initiative in 1988 and declared the year 2000 as the target by which to achieve poliomyelitis eradication.1 After aggressive mass immunisation, backed up by effective routine immunisation, cases of poliomyelitis reduced from 350 000 in 165 countries in 1988 to 355 occurring mainly in three countries—Nigeria, Afghanistan, and Pakistan—by 2013.2 Nigeria is the only country in the world where the three poliovirus types are still circulating; as of December, 2013, it had contributed 14·1% of all poliomyelitis cases worldwide.

Key issues in the persistence of poliomyelitis in Nigeria: a case-control study
Dr Tara D Mangal PhD a, R Bruce Aylward MD b, Michael Mwanza BComm c, Alex Gasasira MBChB d, Emmanuel Abanida MBChB e, Prof Muhammed A Pate MD f, Prof Nicholas C Grassly PhD a
The completion of poliomyelitis eradication is a global emergency for public health. In 2012, more than 50% of the world’s cases occurred in Nigeria following an unanticipated surge in incidence. We aimed to quantitatively analyse the key factors sustaining transmission of poliomyelitis in Nigeria and to calculate clinical efficacy estimates for the oral poliovirus vaccines (OPV) currently in use.

We used acute flaccid paralysis (AFP) surveillance data from Nigeria collected between January, 2001, and December, 2012, to estimate the clinical efficacies of all four OPVs in use and combined this with vaccination coverage to estimate the effect of the introduction of monovalent and bivalent OPV on vaccine-induced serotype-specific population immunity. Vaccine efficacy was determined using a case-control study with CIs based on bootstrap resampling. Vaccine efficacy was also estimated separately for north and south Nigeria, by age of the children, and by year. Detailed 60-day follow-up data were collected from children with confirmed poliomyelitis and were used to assess correlates of vaccine status. We also quantitatively assessed the epidemiology of poliomyelitis and programme performance and considered the reasons for the high vaccine refusal rate along with risk factors for a given local government area reporting a case.

Against serotype 1, both monovalent OPV (median 32·1%, 95% CI 26·1—38·1) and bivalent OPV (29·5%, 20·1—38·4) had higher clinical efficacy than trivalent OPV (19·4%, 16·1—22·8). Corresponding data for serotype 3 were 43·2% (23·1—61·1) and 23·8% (5·3—44·9) compared with 18·0% (14·1—22·1). Combined with increases in coverage, this factor has boosted population immunity in children younger than age 36 months to a record high (64—69% against serotypes 1 and 3). Vaccine efficacy in northern states was estimated to be significantly lower than in southern states (p≤0·05). The proportion of cases refusing vaccination decreased from 37—72% in 2008 to 21—51% in 2012 for routine and supplementary immunisation, and most caregivers cited ignorance of either vaccine importance or availability as the main reason for missing routine vaccinations (32·1% and 29·6% of cases, respectively). Multiple regression analyses highlighted associations between the age of the mother, availability of OPV at health facilities, and the primary source of health information and the probability of receiving OPV (all p<0·05).

Although high refusal rates, low OPV campaign awareness, and heterogeneous population immunity continued to support poliomyelitis transmission in Nigeria at the end of 2012, overall population immunity had improved due to new OPV formulations and improvements in programme delivery.

Bill & Melinda Gates Foundation Vaccine Modeling Initiative, Royal Society.

Comment: Rebalancing the global battle against tuberculosis

The Lancet Global Health
Feb 2014  Volume 2  Number 2  e58 – 116

Rebalancing the global battle against tuberculosis
Mario Raviglione, Mukund Uplekar, Cheri Vincent, Ariel Pablos-Méndez
Preview | Full Text | PDF
Meetings of health ministers from the five BRICS countries (Brazil, Russia, India, China, and South Africa) have produced two joint statements in less than a year: the Delhi Communiqué1 (Jan 12, 2013) and the Cape Town Communiqué2 (Nov 7, 2013). Both statements bode well for global tuberculosis control. The Delhi Communiqué underscores the principle of equity and focuses on populations who are most affected by the disease. The Cape Town Communiqué emphasises promotion of consortia of researchers to collaborate for clinical trials of drugs and vaccines, strengthening of access to affordable, high-quality, effective, and safe medicines, and delivery of high-quality health care.

Malaria burden and control in Bangladesh and prospects for elimination: an epidemiological and economic assessment

The Lancet
Volume 383, Issue 9914, Pages 309 – 320, 25 January 2014

Malaria burden and control in Bangladesh and prospects for elimination: an epidemiological and economic assessment
Ubydul Haque, Hans J Overgaard, Archie C A Clements, Douglas E Norris, Nazrul Islam, Jahirul Karim, Shyamal Roy, Waziul Haque, Moktadir Kabir, David L Smith, Gregory E Glass
Preview | Summary | Full Text | PDF
Malaria elimination is an achievable prospect in Bangladesh and failure to push for elimination nearly ensures a resurgence of disease. Consistent financing is needed to avoid resurgence and maintain elimination goals.

Scale-up of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy: Challenges and Perspectives in Sub-Saharan Africa

PLoS Medicine
(Accessed 25 January 2014)

Policy Forum
Scale-up of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy: Challenges and Perspectives in Sub-Saharan Africa
Guido J. H. Bastiaensl, Teun Bousema, Toby Leslie

Summary Points
:: Scaling up and sustaining access to malaria diagnosis and treatment in all public sector, for-profit, and informal health facilities across sub-Saharan Africa is central to current global strategies for malaria control and elimination.

:: The use of malaria rapid diagnostic tests (RDTs) aims to eliminate reliance on signs and symptoms to diagnose and treat malaria but evidence shows health workers do not always test the right patients, nor provide treatment based on the results of the test.

:: Expanding access to malaria RDTs on the scale needed to achieve universal coverage requires retraining of public, private, and retail sector providers as well as sustained supplies and quality assurance.

:: Barriers to rational use of tests and drugs may be overcome through appropriate policy design for the local health service setting, which addresses health worker practice and patient perceptions.

:: Innovative methods have been used to increase access to the most effective antimalarial drugs in the last five years, but these efforts will be incomplete and unsustainable without similar efforts to incorporate RDTs into practice

Emergency Medicine Systems Advancement through Community-based Development

Prehospital & Disaster Medicine
Volume  28  – Issue 06 – December 2013

Special Report
Emergency Medicine Systems Advancement through Community-based Development
Martha M. Bloema1, Christina M. Bloema2 c1, Juliana Rosentsveyga3 and Bonnie Arquillaa2
a1 Institute of International Education, Scholar Rescue Fund, New York, New York USA
a2 Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA a3 School of Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA

Humanitarian health programs frequently focus on immediate relief and are supply side oriented or donor driven. More emphasis should be placed on long-term development projects that engage local community leaders to ensure sustainable change in health care systems. With the Emergency Medicine Educational Exchange (EMEDEX) International Rescue, Recover, Rebuild initiative in Northeast Haiti as a model, this paper discusses the opportunities and challenges in using community-based development to establish emergency medical systems in resource-limited settings.