ECHO [to 28 June 2014]
http://ec.europa.eu/echo/index_en.htm

Ebola outbreak in West Africa: EU scales up its humanitarian assistance
24/06/2014 – In view of the alarming spread of the Ebola outbreak in West Africa, the European Union has stepped up its relief assistance.

OECD [to 28 June 2014]
http://www.oecd.org/

24-June-2014
OECD Development Centre launches Perspectives on Global Development 2014
The weight of developing nations in the world economy has grown rapidly, but low productivity levels compared with advanced economies could slow down this convergence process and hold back income growth in emerging nations in the years ahead.

24-June-2014
OECD launches interactive website on regional well-being
Life expectancy, air quality, safety and other indicators of well-being can vary dramatically within countries, depending on which region you live in. Looking beyond national averages is vital to get an accurate picture of quality of life and to guide local government policy. The OECD today launched a regional well-being website based on an interactive map covering the Organisation’s 34 member countries. It rates 362 sub-national regions with a relative score out of 10 in eight categories: income, health, safety, services, civic engagement, education, jobs and environment and reveals some large disparities.

World Bank [to 28 June 2014]
http://www.worldbank.org/en/news/all

Levelling the Field report calls for African governments to help empower women farmers
June 25, 2014
Women farmers in Africa produce between 13% and 25% less than their male counterparts
A new report from the World Bank and the ONE Campaign identifies factors holding back women farmers and provides policy guidelines to reduce inequality. Addressing the agriculture gender gap will help drive economic growth across Africa:
:: Press Release: Levelling the Field
:: Full Report: Levelling the Field

On June 5, in Berlin, Markus Goldstein and Malcolm Ehrenpreis from the World Bank’s Africa Gender Team presented Levelling the Field: Improving Opportunities for Women Farmers in Africa, published jointly by the World Bank Group and the ONE Campaign. The report, the first of its kind, with access to better data and new approaches to analyzing gender gaps, reveals deep rooted inequalities in African agriculture, identifies factors holding back women farmers, and sets out concrete actions that policy makers can take to reduce inequality.

The Sphere Project [to 28 June 2014]
http://www.sphereproject.org/news/

Linda Poteat appointed Sphere Project Interim Director
23 June 2014 | Sphere Project
The Sphere Board has appointed Linda Poteat as Sphere Project Director (interim). Poteat will take over the position at the end of June for a period of three months.
Poteat is a humanitarian response specialist with 20 years of experience and is currently the Discussion Chair for the World Humanitarian Summit Global Online Consultation.

BMC Infectious Diseases
(Accessed 28 June 2014)
http://www.biomedcentral.com/bmcinfectdis/content

Research article
Migration intensity has no effect on peak HIV prevalence: an ecological study
Chris Kenyon, Robert Colebunders, Helene Voeten and Mark Lurie
Author Affiliations
BMC Infectious Diseases 2014, 14:350 doi:10.1186/1471-2334-14-350
Published: 24 June 2014
Abstract (provisional)
Background
Correctly identifying the determinants of generalized HIV epidemics is crucial to bringing down ongoing high HIV incidence in these countries. High rates of migration are believed to be an important determinant of HIV prevalence. This study has two aims. Firstly, it evaluates the ecological association between levels of internal and international migration and national peak HIV prevalence using thirteen variables from a variety of sources to capture various aspects of internal and international migration intensity. Secondly, it examines the relationship between circular migration and HIV at an individual and population-level in South Africa.
Methods
Linear regression was used to analyze the association between the various measures of migration intensity and peak national HIV prevalence for 141 countries and HIV prevalence by province and ethnic group in South Africa.
Results
No evidence of a positive ecological association between national migration intensity and HIV prevalence was found. This remained the case when the analyses were limited to the countries of sub-Saharan Africa. On the whole, countries with generalized HIV epidemics had lower rates of internal and external migration. Likewise, no association was found between migration and HIV positivity at an individual or group-level in South Africa.
Conclusion
These results do not support the thesis that migration measured at the country level plays a significant role in determining peak HIV prevalence.

BMC Medical Ethics
(Accessed 28 June 2014)
http://www.biomedcentral.com/bmcmedethics/content

Research article
Linking international clinical research with stateless populations to justice in global health
Bridget Pratt, Deborah Zion, Khin Maung Lwin, Phaik Yeong Cheah, Francois Nosten and Bebe Loff
Author Affiliations
BMC Medical Ethics 2014, 15:49 doi:10.1186/1472-6939-15-49
Published: 26 June 2014
Abstract (provisional)
Background
In response to calls to expand the scope of research ethics to address justice in global health, recent scholarship has sought to clarify how external research actors from high-income countries might discharge their obligation to reduce health disparities between and within countries. An ethical framework–‘research for health justice’–was derived from a theory of justice (the health capability paradigm) and specifies how international clinical research might contribute to improved health and research capacity in host communities. This paper examines whether and how external funders, sponsors, and researchers can fulfill their obligations under the framework.
Methods
Case study research was undertaken on the Shoklo Malaria Research Unit’s (SMRU) vivax malaria treatment trial, which was performed on the Thai-Myanmar border with Karen and Myanmar refugees and migrants. We conducted nineteen in-depth interviews with trial stakeholders, including investigators, trial participants, community advisory board members, and funder representatives; directly observed at trial sites over a five-week period; and collected trial-related documents for analysis.
Results
The vivax malaria treatment trial drew attention to contextual features that, when present, rendered the ‘research for health justice’ framework’s guidance partially incomplete. These insights allowed us to extend the framework to consider external research actors’ obligations to stateless populations. Data analysis then showed that framework requirements are largely fulfilled in relation to the vivax malaria treatment trial by Wellcome Trust (funder), Oxford University (sponsor), and investigators. At the same time, they demonstrate that it may be difficult for long-term collaborations to shift the focus of their research agendas in accordance with the changing burden of illness in their host communities and to build the independent research capacity of host populations when working with refugees and migrants. Obstructive factors included the research funding environment and staff turnover due to resettlement or migration.
Conclusions
Our findings demonstrate that obligations for selecting research targets, research capacity strengthening, and post-trial benefits that link clinical trials to justice in global health can be upheld by external research actors from high-income countries when working with stateless populations in LMICs. However, meeting certain framework requirements for long-term collaborations may not be entirely feasible.

Globalization and Health
[Accessed 28 June 2014]
http://www.globalizationandhealth.com/

Research
Commentary
Accelerating learning for pro-poor health markets
Sara Bennett, Gina Lagomarsino, Jeff Knezovich and Henry Lucas
Author Affiliations
Globalization and Health 2014, 10:54 doi:10.1186/1744-8603-10-54
Published: 24 June 2014
Abstract (provisional)
Background
Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets.
Discussion
Notable challenges to learning in health markets include the difficulty of acquiring data from private health care providers, designing evaluations that capture the complex dynamics present within health markets and developing communities of practice that encompass the diverse actors present within health markets, and building trust and mutual understanding across these groups.
The paper proposes experimentation with country-specific market data platforms that can integrate relevant evidence from different data sources, and simultaneously exploring strategies to secure better information on private providers and health markets. Possible approaches to adapting evaluation designs so that they are better able to take account of different and changing contexts as well as producing real time findings are discussed. Finally capturing informal knowledge about health markets is key. Communities of practice that bridge different health market actors can help to share such experience-based knowledge and in so doing, may help to formalize it. More geographically-focused communities of practice are needed, and such communities may be supported by innovation brokers and/or be built around member-based organizations.
Summary
Strategic investments in and support to learning about health markets can address some of the challenges experienced to-date, and accelerate learning that supports health markets that serve the poor.

Private sector, for-profit health providers in low and middle income countries: can they reach the poor at scale?
Elizabeth Tung and Sara Bennett
Author Affiliations
Globalization and Health 2014, 10:52 doi:10.1186/1744-8603-10-52
Published: 24 June 2014
Abstract (provisional)
Background
The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.
Methods
We searched published and grey literature and databases to identify PFP companies that provided more than 40,000 outpatient visits per year, or who covered 15% or more of a particular type of service in their country. For each included provider, we searched for additional information on location, target market, business model and performance, including quality of care.
Results
Only 10 large scale PFP providers were identified. The majority of these were in South Asia and most provided specialized services such as eye care. The characteristics of the business models of these firms were found to be similar to non-profit providers studied by other analysts (such as Bhattacharya 2010). They pursued social rather than traditional marketing, partnerships with government, low cost/high volume services and cross-subsidization between different market segments. There was a lack of reliable data concerning these providers.
Conclusions
There is very limited evidence to support the notion that large scale bottom of the pyramid models in health offer good prospects for extending services to the poor in the future. In order to be successful PFP providers often require partnerships with government or support from social health insurance schemes. Nonetheless, more reliable and independent data on such schemes is needed.

Journal of Medical Ethics
July 2014, Volume 40, Issue 7
http://jme.bmj.com/content/current

Theoretical ethics
Paper
Islam and the four principles of medical ethics
Yassar Mustafa
Author Affiliations
Queen Elizabeth Hospital, Birmingham, West Midlands, UK
Abstract
The principles underpinning Islam’s ethical framework applied to routine clinical scenarios remain insufficiently understood by many clinicians, thereby unfortunately permitting the delivery of culturally insensitive healthcare. This paper summarises the foundations of the Islamic ethical theory, elucidating the principles and methodology employed by the Muslim jurist in deriving rulings in the field of medical ethics. The four-principles approach, as espoused by Beauchamp and Childress, is also interpreted through the prism of Islamic ethical theory. Each of the four principles (beneficence, non-maleficence, justice and autonomy) is investigated in turn, looking in particular at the extent to which each is rooted in the Islamic paradigm. This will provide an important insight into Islamic medical ethics, enabling the clinician to have a better informed discussion with the Muslim patient. It will also allow for a higher degree of concordance in consultations and consequently optimise culturally sensitive healthcare delivery.

The Lancet
Jun 28, 2014 Volume 383 Number 9936 p2185 – 2268
http://www.thelancet.com/journals/lancet/issue/current

Viewpoint
Improving access to vaccines through tiered pricing
Dr Seth Berkley MD a
Immunisation is now widely recognised as one of the most efficient, successful, and cost-effective health investments in history, but despite a substantial effort over the past 50 years, nearly one in five deaths of children younger than 5 years is still caused by a vaccine-preventable disease. With more than 22 million children in the world still unimmunised against common but life-threatening diseases (as measured by a vaccine containing a third dose of diphtheria-tetanus-pertussis [DTP]), almost all in developing countries, there is clearly still a long way to go…

The Lancet Infectious Diseases
Jul 2014 Volume 14 Number 7 p533 – 656
http://www.thelancet.com/journals/laninf/issue/current

Comment
Polio eradication in Syria
Balsam Ahmad a, Sanjoy Bhattacharya b

The negative public health effects of the Syrian conflict were dramatically underlined by confirmation of a polio cluster in the northeastern rebel-held city of Deir al-Zour in October, 2013. The re-emergence of polio, 14 years after a WHO Eastern Mediterranean Regional Certification Commission certified the country to be rid of naturally occurring poliovirus, has caused vigorous discussion. Accusations and counter-accusations have flowed, with the Syrian health authorities and WHO’s networks coming under scrutiny. Several commentators queried the effectiveness of the so-called Early Warning Alert and Response System that was established in September, 2012, by the Syrian Ministry of Health with technical support from WHO.1 Others argue that the early warning system has succeeded in tackling the consequences of local polio outbreaks.2 Parallel systems of reporting and immunisation have been created in opposition-held governorates, and are reportedly supported, financially and technically, by the US Centers for Disease Control and Prevention.3

Questions have been raised about the transparency and impartiality of WHO and its ability to ensure the vaccination of all children, irrespective of their location inside Syria.1, 3 WHO’s representatives have not remained silent through these interactions. They have provided explanations as to why the Syrian polio outbreak was confirmed as late as October, 2013, when a case was identified as early as July of that year.4 WHO sources acknowledged that the current polio outbreak in Syria had been one of the biggest challenges facing the global eradication initiative.4 The organisation, unsurprisingly, has associated itself with efforts to counter the issue, such as initiation of vaccination campaigns in Syria and across the borders. WHO has also engaged itself with recent negotiations intended to strengthen cross-party cooperation for tackling of the polio outbreak. This approach is most notable in relation to the recent declaration made by the First Global Islamic Advisory Group Meeting on Polio Eradication, held in Jeddah, Saudi Arabia, on Feb 26—27, 2014. The gathering issued an appeal that every community, government, civil society, and religious organisation should ensure that all children benefit from access to the polio vaccine.5 The collaborations underpinning the event are noteworthy; it was organized by Al Azhar Sharif, the International Islamic Fiqh Academy, the Organization of Islamic Cooperation, the Islamic Development Bank, WHO, and UNICEF.

However, there are further issues to consider. For instance, the polio outbreak in Syria might be attributable to trends that predate the civil war. In a letter published in The Lancet, Sahloul and colleagues1 assessed WHO figures about routine polio immunisations and noted that vaccination coverage in rebel areas had been below accepted standards in the past. In a media report, WHO has acknowledged that Deir al-Zour had been excluded from a mass vaccination campaign associated with the Global Polio Eradication Initiative in 2012 because of the relocation of most of its residents to other areas.6 These trends raise deeper questions about the collection, analysis, dissemination, and use of data relating to the presence and transmission of polio in Syria (and elsewhere) by the Global Polio Eradication Initiative and WHO. How has the search for poliovirus been done? Have researchers relied too long on intermittent and incomplete data collection, with relatively uninformed projections made about the regression of polio incidence and the scale of the dangers from the disease? The definition of the basis for the certification of polio eradication has not remained stable since the Global Polio Eradication Initiative was launched in 1988. Even the choice of polio as an eradicable disease has been questioned.7 Robust data collection and attendant certification processes are of utmost importance. These measures, necessarily, require impartiality and transparency, the lack of any conflicts of interest, and the absence of interference from governments or funders. The case of Syria seems to suggest that such high standards have generally been rare. The dream of global polio eradication will remain a chimera until reliable frameworks for immunisation and evaluation are put in place.

We declare no competing interests.
References
1 Sahloul Z, Coutts A, Fouad FM, et al. Health response system for Syria: beyond official narrative. Lancet 2014; 383: 407. Full Text | PDF(91KB) | PubMed
2 Muhjazi G, Bashour H, Abourshaid N, Laham H. An early warning and response system for Syria. Lancet 2013; 382: 2066. Full Text | PDF(50KB) | PubMed
3 Coutts A, Fouad MF. Response to Syria’s health crisis—poor and uncoordinated. Lancet 2013; 381: 2242-2243. Full Text | PDF(1493KB) | PubMed
4 Aylward RB, Alwan A. Polio in Syria. Lancet 2014; 383: 489-491. Full Text | PDF(364KB) | PubMed
5 First Global Islamic Advisory Group Meeting on Polio Eradication. Final communiqué. http://www.polioeradication.org/Portals/0/Document/Resources/Declaration_Resolution/Jeddah_Declaration_EN.pdf. (accessed June 3, 2014).
6 WHO Regional Office for the Eastern Mediterranean. Measles and polio vaccination campaign targets 2.5 million children in the Syrian Arab Republic, 6 December 2012. http://www.emro.who.int/media/news/vaccination-campaign-syria.html. (accessed March 26, 2014).
7 Muraskin W. Polio eradication was an ideological project. BMJ 2012; 345: e8545. PubMed
Dengue outlook for the World Cup in Brazil: an early warning model framework driven by real-time seasonal climate forecasts
Rachel Lowe, Christovam Barcellos, Caio A S Coelho, Trevor C Bailey, Giovanini Evelim Coelho, Richard Graham, Tim Jupp, Walter Massa Ramalho, Marilia Sá Carvalho, David B Stephenson, Xavier Rodó
Preview
This timely dengue early warning permits the Ministry of Health and local authorities to implement appropriate, city-specific mitigation and control actions ahead of the World Cup.

PLoS One
[Accessed 28 June 2014]
http://www.plosone.org/

Research Article
Costs of Introducing and Delivering HPV Vaccines in Low and Lower Middle Income Countries: Inputs for GAVI Policy on Introduction Grant Support to Countries
Ann Levin, Susan A. Wang, Carol Levin, Vivien Tsu, Raymond Hutubessy mail
Published: June 26, 2014
DOI: 10.1371/journal.pone.0101114
Abstract
Background
In November 2011, the GAVI Alliance made the decision to add HPV vaccine as one of the new vaccines for which countries eligible for its funding (less than $1520 per capita income) could apply to receive support for national HPV vaccination, provided they could demonstrate the ability to deliver HPV vaccines. This paper describes the data and analysis shared with GAVI policymakers for this decision regarding GAVI HPV vaccine support. The paper reviews why strategies and costs for HPV vaccine delivery are different from other vaccines and what is known about the cost components from available data that originated primarily from HPV vaccine delivery costing studies in low and middle income-countries.
Methods
Financial costs of HPV vaccine delivery were compared across three sources of data: 1) vaccine delivery costing of pilot projects in five low and lower-middle income countries; 2) cost estimates of national HPV vaccination in two low income countries; and 3) actual expenditure data from national HPV vaccine introduction in a low income country. Both costs of resources required to introduce the vaccine (or initial one-time investment, such as cold chain equipment purchases) and recurrent (ongoing costs that repeat every year) costs, such as transport and health personnel time, were analyzed. The cost per dose, cost per fully immunized girl (FIG) and cost per eligible girl were compared across studies.
Results
Costs varied among pilot projects and estimates of national programs due to differences in scale and service delivery strategy. The average introduction costs per fully immunized girl ranged from $1.49 to $18.94 while recurrent costs per girl ranged from $1.00 to $15.69, with both types of costs varying by delivery strategy and country. Evaluating delivery costs along programme characteristics as well as country characteristics (population density, income/cost level, existing service delivery infrastructure) are likely the most informative and useful for anticipating costs for HPV vaccine delivery.
Conclusions
This paper demonstrates the importance of country level cost data to inform global donor policies for vaccine introduction support. Such data are also valuable for informing national decisions on HPV vaccine introduction.

PLOS Currents: Disasters
[Accessed 28 June 2014]
http://currents.plos.org/disasters/

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes
June 23, 2014 • Perspective
Caroline Clarinval, Nikola Biller-Andorno
Abstract
Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues.
Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship.
Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively.
Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

PLoS Neglected Tropical Diseases
June 2014
http://www.plosntds.org/article/browseIssue.action

Viewpoints
Social Sciences Research on Infectious Diseases of Poverty: Too Little and Too Late?
José Azoh Barry mail
Published: June 12, 2014
DOI: 10.1371/journal.pntd.0002803
Excerpt
Introduction
Infectious diseases of poverty, also labeled tropical diseases or neglected tropical diseases (NTDs) and caused by pathogenic agents (viruses, bacteria, fungi, and other parasites), are viciously more prevalent among poor people. Though being preventable for the most part in a cost-effective way, they are devastating. These are, to name a few, Chagas disease, schistosomiasis, malaria, leprosy, visceral leishmaniasis, lymphatic filariasis, Buruli ulcer, and onchocerciasis. Besides the vicious circle these diseases maintain with dire conditions of poverty, an increased microbial resistance to some therapeutic drugs adds to the complexity of health disparities and human suffering among the socially disadvantaged, marginalized, and prejudiced against. Fostering virtuous circles (as opposed to vicious circles) against infections of poverty and putting the disenfranchised first are primary concerns for social scientists engaged with research into infectious diseases of poverty. The historical role of social science research into these diseases, its current impacts, substantial contributions, and opportunities and interests for future endeavors are the focus of this article. Persistent disruptions and their propensity to wholly hamper productivity, derail economic and social progress, and deny child development are part of the complex reality to look into. In forcing the displacement of populations and creating chaos, they increase the risk for the spread of infections and maintain the infected poor in a downward spiral of poverty through their capacity of securing the vicious relationship with NTDs. Rather than compassion for inequalities, vulnerabilities, deprivations and misery, or bad fate, foci such as social justice, preparedness, and empowerment are of utmost importance. The case for bridging the divide among scientific disciplines has been strongly made over the years by scholars and outside of academic institutions. Acknowledging the importance of interdisciplinary science and contemplating the need for funded multidisciplinary research is hopeful for broadening the expertise needed to tackle these multidimensional afflictions. However, it should also call for a cautious enthusiasm…

Vaccine
Volume 32, Issue 33, Pages 4111-4242 (16 July 2014)
http://www.sciencedirect.com/science/journal/0264410X/32/33

Vaccination in Southeast Asia—Reducing meningitis, sepsis and pneumonia with new and existing vaccines
Review Article
Pages 4119-4123
Alice Richardson, Denise E. Morris, Stuart C. Clarke
Abstract
Streptococcus pneumoniae, Haemophilus influenzae type b and Neisseria meningitidis are leading causes of vaccine-preventable diseases such as meningitis, sepsis and pneumonia. Although there has been much progress in the introduction of vaccines against these pathogens, access to vaccines remains elusive in some countries. This review highlights the current S. pneumoniae, H. influenzae type b, and N. meningitidis immunization schedules in the 10 countries belonging to the Association of Southeast Asian Nations (ASEAN). Epidemiologic studies may be useful for informing vaccine policy in these countries, particularly when determining the cost-effectiveness of introducing new vaccines.

Lessons learned during the development and transfer of technology related to a new Hib conjugate vaccine to emerging vaccine manufacturers
Review Article
Pages 4124-4130
A. Hamidi, C. Boog, S. Jadhav, H. Kreeftenberg
Abstract
The incidence of Haemophilus Influenzae type b (Hib) disease in developed countries has decreased since the introduction of Hib conjugate vaccines in their National Immunization Programs (NIP). In countries where Hib vaccination is not applied routinely, due to limited availability and high cost of the vaccines, invasive Hib disease is still a cause of mortality. Through the development of a production process for a Hib conjugate vaccine and related quality control tests and the transfer of this technology to emerging vaccine manufacturers in developing countries, a substantial contribution was made to the availability and affordability of Hib conjugate vaccines in these countries. Technology transfer is considered to be one of the fastest ways to get access to the technology needed for the production of vaccines. The first Hib conjugate vaccine based on the transferred technology was licensed in 2007, since then more Hib vaccines based on this technology were licensed.
This paper describes the successful development and transfer of Hib conjugate vaccine technology to vaccine manufacturers in India, China and Indonesia. By describing the lessons learned in this process, it is hoped that other technology transfer projects can benefit from the knowledge and experience gained.

Identifying human papillomavirus vaccination practices among primary care providers of minority, low-income and immigrant patient populations
Original Research Article
Pages 4149-4154
Denise M. Bruno, Tracey E. Wilson, Francesca Gany, Abraham Aragones
Abstract
Objective
Minority populations in the United States are disproportionally affected by human papillomavirus (HPV) infection and HPV-related cancer. We sought to understand physician practices, knowledge and beliefs that affect utilization of the HPV vaccine in primary care settings serving large minority populations in areas with increased rates of HPV-related cancer.
Study design
Cross-sectional survey of randomly selected primary care providers, including pediatricians, family practice physicians and internists, serving large minority populations in Brooklyn, N.Y. and in areas with higher than average cervical cancer rates.
Results
Of 156 physicians randomly selected, 121 eligible providers responded to the survey; 64% were pediatricians, 19% were internists and 17% were family practitioners. Thirty-four percent of respondents reported that they routinely offered HPV vaccine to their eligible patients. Seventy percent of physicians reported that the lack of preventive care visits for patients in the eligible age group limited their ability to recommend the HPV vaccine and 70% of those who reported this barrier do not routinely recommend HPV vaccine. The lack of time to educate parents about the HPV vaccine and cost of the vaccine to their patients were two commonly reported barriers that affected whether providers offered the vaccine.
Conclusions
Our study found that the majority of providers serving the highest risk populations for HPV infection and HPV-related cancers are not routinely recommending the HPV vaccine to their patients. Reasons for providers’ failure to recommend the HPV vaccine routinely are identified and possible areas for targeted interventions to increase HPV vaccination rates are discussed.

From Google Scholar+ [to 28 June 2014]
Selected content from beyond the journals and sources covered above, aggregated from a range of Google Scholar monitoring algorithms and other monitoring strategies.

Food Security
Volume 6, Issue 3, June 2014
http://link.springer.com/journal/12571/6/3/page/1
Food security governance: a systematic literature review
Jeroen J. L. Candel
Abstract
The role of governance has been receiving increasing attention from food security scholars in recent years. However, in spite of the recognition that governance matters, current knowledge of food security governance is rather fragmented. To provide some clarity in the debate about the role of governance in addressing food (in)security, this paper reports the results of a systematic review of the literature. The synthesis revolves around seven recurring themes: i) the view of governance as both a challenge and solution to food security; ii) a governability that is characterized by high degrees of complexity; iii) failures of the current institutional architectures; iv) the arrival of new players at the forefront; v) calls for coherency and coordination across multiple scales; vi) variation and conflict of ideas; and vii) calls for the allocation of sufficient resources and the integration of democratic values in food security governance. Two lines of discussion of this synthesis are raised. First, the researcher argues that a large proportion of the food security governance literature is characterized by an optimist governance perspective, i.e., a view of governance as a problem-solving mechanism. Complementing this body of literature with alternative governance perspectives in future research may strengthen current understandings of food security governance. Approaching food security as a ‘wicked problem’ could provide valuable insights in this respect. Second, food security governance as a research field could make headway by engaging in further empirical investigation of current governance arrangements, particularly at sub-national levels.

.GI_Forum 2014. Geospatial Innovation for Society.
Applying Satellite Imagery and Geospatial Techniques to Explore Patterns of Buruli Ulcer Prevalence in Central Cameroon
Elisabeth SCHÖPFER
German Aerospace Center (DLR), Oberpfaffenhofen / Germany • elisabeth.schoepfer@dlr.de
Abstract
Geospatial information obtained from satellite data can contribute in various ways to
assessing and dealing with humanitarian issues and tasks. In this study, patterns of Buruli
Ulcer in Central Cameroon were explored using satellite imagery and GIS approaches, in
order to provide a better understanding of spatial characteristics and a possible causal
mechanism of Buruli Ulcer.
Using Student Volunteers to Crowdsource Land Cover Information
Franziska ALBRECHT1*, Mario ZUSSNER1, Christoph PERGER2, Martina DÜRAUER2,
Linda SEE2, Ian MCCALLUM2, Steffen FRITZ2 and Wolfgang KAINZ1
1 Dept. of Geography and Regional Research,
University of Vienna / Austria • franziska.albrecht@univie.ac.at
2 IIASA, Ecosystem Services and Management Program, Laxenburg / Austria
Abstract:
Accurate geospatial cropland information is one of several critical input parameters needed for the assessment of food security and for achieving sustainable development. However, current land cover products are either not accurate enough or lacking in many food insecure countries. Here we demonstrate how we can use the Geo-Wiki crowdsourcing tool and student volunteers to generate a cropland map of Myanmar, and validate a global hybrid cropland map. The preliminary results clearly indicate that the method could be applied in a similar manner to other countries.

Humanitarian Exchange Magazine
Issue 61 May 2014
http://www.odihpn.org/humanitarian-exchange-magazine/issue-61
Path-dependency culture in humanitarian decision-making: why it was hard to change direction in Haiti
Kate Crawford, Jim Kennedy and Alison Killing
Abstract
The humanitarian industry collectively chose to spend $500m of the $6bn in aid money on timber-framed transitional shelters in Haiti after the 2010 earthquake. This analysis of that decision suggests that the international community recognised within months the flaws in its strategy but was unable to change direction. Early decisions will often be made with limited information and in the face of rapid, unpredictable change: mechanisms and leadership that make it possible to adapt are critical not only to better longer-term outcomes but also to the sector’s accountability to the people and governments affected by disasters.

Global Environmental Change
Volume 27, In Progress (July 2014)
http://www.sciencedirect.com/science/journal/09593780/27/supp/C
Using community led development approaches to address vulnerability after disaster: Caught in a sad romance
John F. McCarthy,
Highlights
:: Community based approaches addressed vulnerability in limited ways.
:: Despite huge expenditures, very high levels of vulnerability remained.
:: Social capital ideas provided a useful heuristic.
:: Projects attempting to mobilize social capital ideas did not generate sustained outcomes.
:: Interventions need to address drivers of vulnerability in agrarian livelihoods.
Abstract
A reading of the social capital literature suggests that the networks and the social relationships which enable collective action can be used to address critical livelihood needs, even in disaster contexts. Yet even when such community-led approaches are combined with substantial resources, too often these interventions (re)produce vulnerabilities without recovering prior levels of development. Examining the outcomes of community-led approaches in post-tsunami Aceh after the gaze of the aid industry has moved elsewhere, this paper finds that in a few cases, interventions worked with social networks to revive livelihoods successfully, albeit in complex, contingent ways. Yet, given the nature of post-disaster contexts and the exigencies driving NGO and donors actions, the research concludes that the capacity for community based approaches to address the underlying drivers of vulnerability remains limited. The paper calls for a rewriting of intervention narratives and a reworking of intervention practices, to address the deeper determinants of disadvantage and vulnerability.

Disaster Prevention and Management
Vol. 23 Issue 4 2014
Social Capital in Disaster Risk Management; A Case Study of Social Capital mobilization following the 1934 Kathmandu Valley Earthquake in Nepal.
Roshan Bhakta Bhandari, (University of Tasmania)
Abstract
Purpose – This study examines how social capital operated in the lives of fifteen respondents from Lalitpur following the massive 1934 Kathmandu Valley earthquake. Based on experiences of the survivors, it attempts to understand how individuals and families utilized their social capital in the aftermath of the earthquake, and rebuild their lives and communities.
Design/methodology/approach – This is a qualitative study based on non-structured interviews and discussions with disaster victims on their own locality. Following Padgett’s (2008) grounded theory approach, flexible method of data collection is adopted through interactions with respondents and following up on important cues or patterns as additional data emerged.
Findings – Participants described a process through which they relied on bonding, bridging and linking social capital in different stages of earthquake response and recovery. Close ties or bonding social capital were important for immediate support, but bridging and linking social capital offered pathways to longer term survival and wider neighborhood and community revitalization. This paper also discusses how social capital inclusion in pre-disaster communities might be helpful to strengthen their response capacity.
Research limitations/implications – As the study participants were less than ten years old when the earthquake happened, they might have omitted or overlooked some important details about the event. The findings are based not only on participant’s own memories, but they also shared stories told by their parents which were the indirect experiences.
Practical implications – This study indicates the potential value and need for including bonding, bridging and linking social capital and traditional social networks in disaster planning. A key outcome related to disaster policy would be what institutional condition or combinations of different dimensions of social capital may serve the public for better disaster response and recovery.
Originality/value – This study has paid attention to how social capital might be useful in disaster risk reduction both in post disaster phase and in predisaster condition which may be rare in disaster studies. It also provides an insight into how community based disaster management can take into account pre-existing social systems and traditional social networks to build local capacities.

Report: Global Multidimensional Poverty Index 2014
Oxford Poverty and Human Development Initiative (OPHI)
June 2014: http://www.ophi.org.uk/multidimensional-poverty-index/mpi-2014/
[Excerpts from overview content]

The global Multidimensional Poverty Index (MPI) is an international measure of acute poverty covering over 100 developing countries. It complements traditional income-based poverty measures by capturing the severe deprivations that each person faces at the same time with respect to education, health and living standards…

The MPI can be used to create a comprehensive picture of people living in poverty, and permits comparisons both across countries, regions and the world and within countries by ethnic group, urban/rural location, as well as other key household and community characteristics…

The Global MPI in 2014 covers 108 developing countries and spans a number of topics:
1) Destitution: In 2014 we have used more extreme MPI indicators to shine a light on hundreds of millions of people who each day face grinding hardships difficult for most of us to imagine: the destitute, or poorest of the poor. Across 49 countries analysed so far, half of MPI poor people are destitute; over 638 million people. The good news is that where data are available, we can see strong progress being made to improve the lives of the destitute, particularly in the poorest countries.
2) Dynamics: We look at how multidimensional poverty changed in 34 countries covering 2.5 billion people, documenting trends in poverty and destitution across and within those countries, and according to different kinds of deprivation. We discover that the countries which reduced MPI poverty and destitution the most in absolute terms were mostly Low Income and Least Developed Countries, with Nepal making the fastest progress.
3) Rural-urban comparisons: Our rural-urban analysis finds that of the 1.6 billion people identified as MPI poor, 85% live in rural areas – significantly higher than income poverty estimates of 70-75%. We also analyse changes over time by rural and urban regions for 34 countries, looking at the level and composition of that change by each of the Global MPI’s 10 indicators.
4) Inequality: Poverty reduction is not necessarily uniform across all poor people in a country, or across population subgroups; an improvement overall may yet leave the poorest of the poor behind. In 2014 we use a new measure to analyse inequality among poor people in 90 countries, and find the highest levels are to be found in 15 Sub-Saharan African countries; in Pakistan, India and Afghanistan; and in Yemen and Somalia.

Policy Forum: Pediatric Oncology as the Next Global Child Health Priority: The Need for National Childhood Cancer Strategies in Low- and Middle-Income Countries
Sumit Gupta, Roberto Rivera-Luna, Raul C. Ribeiro, Scott C. Howard
PLoS Medicine http://www.plosmedicine.org/
Published: June 17, 2014 DOI: 10.1371/journal.pmed.1001656

Summary Points
:: As is already the case in high-income countries, cancer represents the leading cause of non-accidental death among children in a growing number of middle-income countries
:: Meaningful declines in global childhood cancer mortality will require moving beyond the current situation through the establishment of national childhood cancer strategies
:: Key components of such strategies include financial coverage, accreditation of childhood cancer centers, mandatory childhood cancer reporting and registration, development of national standards of care, and the creation of national childhood cancer governing bodies
:: Challenges to implementing such strategies include a paucity of implementation research, formal policy evaluation, and costing data
:: The ideal structure of such strategies in low-income countries is currently unknown, given severe resource constraints, deficits in infrastructure, and competing health needs

Report: UNHCR Global Trends 2013 – War’s Human Cost
June 2013; 52 pages
Overview/Introduction Excerpts

By end-2013, 51.2 million individuals were forcibly displaced worldwide as a result of persecution, conflict, generalized violence, or human rights violations. Some 16.7 million persons were refugees: 11.7 million under UNHCR’s mandate and 5.0 million Palestinian refugees registered by UNRWA. The global figure included 33.3 million internally displaced persons (IDPs) and close to 1.2 million asylum-seekers. If these 51.2 million persons were a nation, they would make up the 26th largest in the world…

The year 2013 was marked by a continuation of multiple refugee crises, reaching levels unseen since the Rwandan genocide in 1994. As such, 2013 has been one of the most challenging years in UNHCR’s history. More than 2.5 million persons were forced to abandon their homes and seek protection outside the borders of their country, most of them in neighbouring countries. These new refugees joined the two million persons who had become refugees in 2011 and 2012. The war in the Syrian Arab Republic, entering into its third year in 2013, was the primary cause of these outflows, as highlighted by two dramatic milestones. In August, the one millionth Syrian refugee child was registered; only a few weeks later, UNHCR announced that the number of Syrian refugees had passed two million. The Syrian Arab Republic had moved from being the world’s second largest refugee-hosting country to being its second largest refugee-producing country – within a span of just five years.

Monitoring Immigration Detention – practical manual
Association for the Prevention of Torture (APT); UNHCR; International Detention Coalition (IDC)
June 2014; 220 pages

Today, the use of immigration detention as a migration management tool is on the rise in a large number of countries. The detention of asylum-seekers and migrants represents a growing human rights challenge worldwide.

This Monitoring Manual was produced jointly by the UN Refugee Agency (UNHCR), the APT and the International Detention Coalition (IDC). It is a step-by-step guide for anyone or any institution carrying out immigration detention visits. It can also be used as a checklist for authorities, detention centre staff and journalists on the standards that need to be applied when asylum-seekers and migrants are detained.

Contents include:
:: Detention in the immigration context
:: Immigration detention: a monitoring methodology
:: What aspects of immigration detention to examine

The principles and standards set out in this Manual are both preventative and corrective in orientation. Monitoring can help prevent human rights violations at either an individual or systemic level, and it can highlight areas that need improvement to ensure the full respect of fundamental rights to dignity and humane treatment. Access to detention facilities is a first step to preventing abuse.

The Manual complements UNHCR’s Guidelines on the Applicable Criteria and Standards relating to the Detention of Asylum-Seekers and Alternatives to Detention (2012), and builds on the APT and IDC’s expertise and prolific work in monitoring forms of detention and in advocating for alternatives to detention, respectively.

Trafficking in Persons Report 2014
U.S. State Department
June 2014

“We each have a responsibility to make this horrific and all-too-common crime a lot less common. And our work with victims is the key that will open the door to real change—not just on behalf of the more than 44,000 survivors who have been identified in the past year, but also for the more than 20 million victims of trafficking who have not.

As Secretary of State, I’ve seen with my own two eyes countless individual acts of courage and commitment. I’ve seen how victims of this crime can become survivors and how survivors can become voices of conscience and conviction in the cause.

This year’s Trafficking in Persons Report offers a roadmap for the road ahead as we confront the scourge of trafficking.” — John F. Kerry, Secretary of State.

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The 2014 Trafficking in Persons Report is available in PDF and HTML formats. Due to its large size, the PDF has been separated into sections for easier download.
-Introductory Material (PDF) [8975 Kb]
-Country Narratives: A-C (PDF) [4743 Kb]
-Country Narratives: D-I (PDF) [3882 Kb]
-Country Narratives: J-M (PDF) [4105 Kb]
-Country Narratives: N-S (PDF) [5513 Kb]
-Country Narratives: T-Z and Special Case (PDF) [3105 Kb]
-Relevant International Conventions/Closing Material (PDF) [963 Kb]

Topics of Special Interest
:: The Vulnerability of LGBT Individuals to Human Trafficking 10
:: The Use of Forced Criminality: Victims Hidden Behind a Crime 1
:: Marginalized Communities: Romani Victims of Trafficking
:: Human Trafficking and Major Sporting Events
:: Promising Practices in the Eradication of Trafficking in Persons
:: Making the Problem Worse: Off-Duty Law Enforcement Officers
:: Providing Security in High-Risk Establishments
:: Reactivating Trauma in Sex Trafficking Testimony
:: Media Best Practices
:: Human Trafficking and the Demand for Organs
:: Victims’ Consent
:: Vulnerability of Indigenous Persons to Human Trafficking
:: Child Soldiers
:: The Intersection between Environmental Degradation and Human Trafficking