International Journal of Epidemiology
Volume 43 Issue 3 June 2014
http://ije.oxfordjournals.org/content/current

The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems
Osman Sankoh1,2,3,*, Paul Welaga1,4, Cornelius Debpuur1,4, Charles Zandoh1,5, Stephney Gyaase1,5, Mary Atta Poma1,6, Martin Kavao Mutua1,7, SM Manzoor Ahmed Hanifi1,8, Cesario Martins1,9, Eric Nebie1,10, Moubassira Kagoné1,10, Jacques BO Emina1 and Peter Aaby1,9
Author Affiliations
1INDEPTH Network, Accra, Ghana, 2School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, 3Faculty of Public Health, Hanoi Medical University, Hanoi, Viet Nam, 4Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana, 5Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana, 6Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana, 7African Population and Health Research Centre, Nairobi, Kenya, 8Chakaria Community Health Project Community Health Division, ICDDRB, Mohakhali, Dhaka, Bangladesh, 9Bandim Health Project, Bandim, Guiné-Bissau and 10Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
Accepted April 3, 2014.
Abstract
Most childhood interventions (vaccines, micronutrients) in low-income countries are justified by their assumed effect on child survival. However, usually the interventions have only been studied with respect to their disease/deficiency-specific effects and not for their overall effects on morbidity and mortality. In many situations, the population-based effects have been very different from the anticipated effects; for example, the measles-preventive high-titre measles vaccine was associated with 2-fold increased female mortality; BCG reduces neonatal mortality although children do not die of tuberculosis in the neonatal period; vitamin A may be associated with increased or reduced child mortality in different situations; effects of interventions may differ for boys and girls. The reasons for these and other contrasts between expectations and observations are likely to be that the immune system learns more than specific prevention from an intervention; such training may enhance or reduce susceptibility to unrelated infections. INDEPTH member centres have been in an ideal position to document such additional non-specific effects of interventions because they follow the total population long term. It is proposed that more INDEPTH member centres extend their routine data collection platform to better measure the use and effects of childhood interventions. In a longer perspective, INDEPTH may come to play a stronger role in defining health research issues of relevance to low-income countries.

Commentary: Potential implications of non-specific effects of childhood vaccines
Harshpal Singh Sachdev
Author Affiliations
Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, B-16 Qutab Institutional Area, New Delhi 110016, India.
Abstract
The World Health Organization states that: ‘A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and ‘remember’ it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters’.1 This statement is in conformity with the usual scientific and lay perceptions that vaccines have only specific disease-protective effects. However, historically it has been suspected that Vaccinia2 and BCG vaccination3 confer protection against non-targeted infectious diseases. Emerging evidence suggests that vaccines can positively or negatively affect the resistance to other infectious diseases—the so-called non-specific effects of vaccines or non-specific immunomodulation by vaccines. The bulk of this evidence has been generated from Guinea-Bissau by researchers led by Peter Aaby. The current status of global evidence has been summarized by them in this issue of IJE4 and elsewhere.5 On this basis, they also suggest a new definition of vaccines: ‘A vaccine is a biological preparation that improves immunity to a particular disease and at the same …

International Migration Review
Summer 2014 Volume 48, Issue 2 Pages 283–574
http://onlinelibrary.wiley.com/doi/10.1111/imre.2014.48.issue-1/issuetoc

Original Article
The Globalization of Migration: Has the World Become More Migratory?
Mathias Czaika and Hein de Haas
Article first published online: 20 MAY 2014
DOI: 10.1111/imre.12095
Abstract
Although it is commonly believed that the volume, diversity, geographical scope, and overall complexity of international migration have increased as part of globalization processes, this idea has remained largely untested. This article analyzes shifts in global migration patterns between 1960 and 2000 using indices that simultaneously capture changes in the spread, distance, and intensity of migration. While the results challenge the idea that there has been a global increase in volume, diversity, and geographical scope of migration, main migratory shifts have been directional. Migration has globalized from a destination country perspective but hardly from an origin country perspective, with migrants from an increasingly diverse array of non-European-origin countries concentrating in a shrinking pool of prime destination countries. The global migration map has thus become more skewed. Rather than refuting the globalization of migration hypothesis, this seems to reflect the asymmetric nature of globalization processes in general.

The Lancet
Jun 14, 2014 Volume 383 Number 9934 p2019 – 2098 e19 – 21
http://www.thelancet.com/journals/lancet/issue/current

Editorial
Ending sexual violence in conflict and beyond
The Lancet
Today’s Lancet has a special focus on sexual violence in conflict to coincide with the first Global Summit to End Sexual Violence in Conflict in London, June 10–14. War zone sexual violence and other forms of gender-based violence inflict extreme suffering and represent serious violations of human rights. These crimes leave physical, psychological, social, and economic scars on individuals, families, and communities. And shamefully, most of the perpetrators are never brought to justice.

Comment
Mass gatherings medicine: international cooperation and progress
Ziad A Memish a b, Alimuddin Zumla c, Brian McCloskey d, David Heymann e f, Abdullah A Al Rabeeah a, Maurizio Barbeschi g, Richard Horton h
Excerpt
In July, 2012, we discussed plans to move the complex public health issues surrounding mass gatherings into a formal scientific discipline, and to create a global network for mass gatherings research, training, and capacity development.1, 2 We believed that it was important for this network to be led by Saudi Arabia, since the country has extensive experience through many decades of managing millions of pilgrims from 184 countries at the largest yearly recurring religious mass gathering in the world—the Hajj. Subsequently, the Saudi Government and WHO3 strongly supported mass gatherings medicine as a scientific discipline, establishing the Saudi Global Center for Mass Gathering Medicine (GCMGM), with its headquarters in Riyadh and membership from other Gulf countries,4 and a virtual research network linked with other WHO collaborating centres for mass gatherings. This network has brought together global academic and public health institutions with complementary expertise to gather and translate the most appropriate public health policy evidence for use by countries that host, or plan to host, mass gathering events…
…Mass gatherings medicine provides an opportunity to generate a wealth of knowledge and expertise, and sharing the experiences of organisers can assist in shaping a positive legacy and provide valuable lessons for organisers of future events. The value to planners of mass gatherings and their governments in sharing best practices is clear, as is the need for new operational research into mass gatherings, with systematic collection and analysis of data to inform planning activities for future events. Through provision of scientific evidence, the GCMGM aims to drive the best health promotion and prevention guidelines and practice, including health education for attendees of mass gatherings across different contexts. The Hajj provides an ideal model for research into mass gatherings that recur yearly in the same location, and the very large sporting events provide a different context and complementary opportunities for research and training. Substantial gaps in research remain, particularly in relation to mass gatherings in low-resource settings and in unplanned or spontaneous mass gatherings….

Lancet Series –mass gatherings medicine
Hajj: infectious disease surveillance and control
Prof Ziad A Memish FRCPC a b c d, Prof Alimuddin Zumla FRCP a e f, Rafat F Alhakeem MD a d, Abdullah Assiri MD d, Abdulhafeez Turkestani MD d, Khalid D Al Harby MD d, Mohamed Alyemni PhD d, Khalid Dhafar MD d, Philippe Gautret MD g, Maurizio Barbeschi PhD a h, Brian McCloskey MD a i, Prof David Heymann MD a j k, Abdullah A Al Rabeeah FRCS a d, Jaffar A Al-Tawfiq FACP l m
Summary
Religious festivals attract a large number of pilgrims from worldwide and are a potential risk for the transmission of infectious diseases between pilgrims, and to the indigenous population. The gathering of a large number of pilgrims could compromise the health system of the host country. The threat to global health security posed by infectious diseases with epidemic potential shows the importance of advanced planning of public health surveillance and response at these religious events. Saudi Arabia has extensive experience of providing health care at mass gatherings acquired through decades of managing millions of pilgrims at the Hajj. In this report, we describe the extensive public health planning, surveillance systems used to monitor public health risks, and health services provided and accessed during Hajj 2012 and Hajj 2013 that together attracted more than 5 million pilgrims from 184 countries. We also describe the recent establishment of the Global Center for Mass Gathering Medicine, a Saudi Government partnership with the WHO Collaborating Centre for Mass Gatherings Medicine, Gulf Co-operation Council states, UK universities, and public health institutions globally.

The Lancet Global Health
Jun 2014 Volume 2 Number 6 e301 – 363
http://www.thelancet.com/journals/langlo/issue/current
Early Online Publication, 10 June 2014

Cost-effectiveness of female human papillomavirus vaccination in 179 countries: a PRIME modelling study
Mark Jit PhD a b, Marc Brisson PhD c d e, Allison Portnoy MSPH f, Dr Raymond Hutubessy PhD g
Summary
Background
Introduction of human papillomavirus (HPV) vaccination in settings with the highest burden of HPV is not universal, partly because of the absence of quantitative estimates of country-specific effects on health and economic costs. We aimed to develop and validate a simple generic model of such effects that could be used and understood in a range of settings with little external support.
Methods
We developed the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programmes or vaccine uptake. We validated PRIME against existing reports of HPV vaccination cost-effectiveness, projected outcomes for 179 countries (assuming full vaccination of 12-year-old girls), and outcomes for 71 phase 2 GAVI-eligible countries (using vaccine uptake data from the GAVI Alliance). We assessed differences between countries in terms of cost-effectiveness and health effects.
Findings
In validation, PRIME reproduced cost-effectiveness conclusions for 24 of 26 countries from 17 published studies, and for all 72 countries in a published study of GAVI-eligible countries. Vaccination of a cohort of 58 million 12-year-old girls in 179 countries prevented 690 000 cases of cervical cancer and 420 000 deaths during their lifetime (mostly in low-income or middle-income countries), at a net cost of US$4 billion. HPV vaccination was very cost effective (with every disability-adjusted life-year averted costing less than the gross domestic product per head) in 156 (87%) of 179 countries. Introduction of the vaccine in countries without national HPV vaccination at present would prevent substantially more cases of cervical cancer than in countries with such programmes, although the disparity has narrowed since 2012. If 71 phase 2 GAVI-eligible countries adopt vaccination according to forecasts, then in 2070 GAVI Alliance-funded vaccination could prevent 200 000 cases of cervical cancer and 100 000 deaths in some of the highest-burden countries.
Interpretation
Large between-country disparities exist for HPV vaccination, with countries with the most to gain yet to introduce national HPV vaccination. Support from the GAVI Alliance could help to reduce such disparities, but a substantial burden will remain even after presently projected vaccine introductions.
Funding
WHO.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 14 June 2014)

Policy Forum
Antiretroviral Therapy for Refugees and Internally Displaced Persons: A Call for Equity
Joshua B Mendelsohn mail, Paul Spiegel, Marian Schilperoord, Nadine Cornier, David A. Ross
Published: June 10, 2014
DOI: 10.1371/journal.pmed.1001643
Summary Points
:: Available evidence suggests that refugees and internally displaced persons (IDPs) in stable settings can sustain high levels of adherence and viral suppression.
:: Moral, legal, and public health principles and recent evidence strongly suggest that refugees and IDPs should have equitable access to HIV treatment and support.
:: Exclusion of refugees and IDPs from HIV National Strategic Plans suggests that they may not be included in future national funding proposals to major donors.
:: Levels of viral suppression among refugees and nationals documented in a stable refugee camp suggest that some settings require more intensive support for all population groups.
:: Detailed recommendations are provided for refugees and IDPs accessing antiretroviral therapy in stable settings.

PLoS Neglected Tropical Diseases
May 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
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…

Resilience: International Policies, Practices and Discourses
Volume 2, Issue 2, 2014
http://www.tandfonline.com/toc/resi20/current#.U3im6SjDU1w

The promise of security: resilience, surprise and epistemic politics
Claudia Aradaua*
DOI: 10.1080/21693293.2014.914765
pages 73-87
Published online: 13 May 201
Abstract
Over the past decade, resilience has become a quasi-universal answer to problems of security and governance, from climate change to children’s education, from indigenous history to disaster response, and from development to terrorism. This article places the proliferation of resilience in relation to the earlier proliferation of security discourse and practice. Why resilience today? It answers this question by unpacking the epistemic regimes that underpin the move to resilience. Rather than tracing the differences between protection, prevention, pre-emption and resilience, the article argues that the political transformation that resilience entails becomes explicit in relation to the promise of security. Although the language of ‘promise’ and ‘promising’ has been widely used in relation to security, its political implications have remained unexplored. Underpinned by an epistemology of surprising events, resilience discourses reconfigure the promise of security. Through an empirical engagement with the turn to resilience in DFID’s humanitarian policy in the UK and a theoretical reconsideration of Hannah Arendt’s conceptualisation of the promise, I offer a critical vantage point on the transformation that resilience portends for our contemporary condition.

Resilience, rights and results in Swedish development cooperation
Ian Christoplosa*
DOI: 10.1080/21693293.2014.914767
pages 88-99
Abstract
Resilience is an amorphous concept for a development agency. This article, reflecting on the findings of a review of how resilience to natural hazards is addressed within Swedish development cooperation, looks at how resilience has been conceptualised and the implications of the emergence of attention to ‘resilience’ as both a new catchword and perhaps a new perspective on development. A key factor is the interplay of human rights and resilience goals in the relations between vulnerable people and duty bearers. In addition, the implications are considered of resilience in relation to the incentives and monitoring and evaluation frameworks that steer today’s results-based management systems for development cooperation. A conclusion is that resilience is a problematic concept in development cooperation, but may provide added value if it is tied to greater understanding of vulnerability, struggles over resources and recognition of the complexity and uncertainty of the development enterprise.

Science
13 June 2014 vol 344, issue 6189, pages 1197-1316
http://www.sciencemag.org/current.dtl

Policy Forum
Public Health
Measuring the path toward malaria elimination
Thomas S. Churcher1, Justin M. Cohen2, Joseph Novotny2,3, Nyasatu Ntshalintshali2,3, Simon Kunene4, Simon Cauchemez1,5,*
Author Affiliations
1Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
2Clinton Health Access Initiative, Boston, MA 02127, USA.
3Global Health Group, University of California, San Francisco, CA 94143, USA.
4National Malaria Control Program, Manzini, Swaziland.
5Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France.
Summary
In many parts of the world, malaria elimination—defined by the World Health Organization (WHO) as the absence of locally acquired malaria cases in the country—is being considered as a target because of recent successes in reducing disease burden (1, 2). Rigorous evaluation of malaria elimination programs is essential for financial and political support to be maintained. Yet such evaluation remains challenging, and appropriate metrics to ascertain “success” are needed.

Sustainability
Volume 6, Issue 6 (June 2014), Pages 3124-
http://www.mdpi.com/2071-1050/6/5

Exploring Reasons for the Resistance to Sustainable Management within Non-Profit Organizations
by Claus-Heinrich Daub, Yvonne M. Scherrer and Arie H. Verkuil
Sustainability 2014, 6(6), 3252-3270; doi:10.3390/su6063252
Received: 1 April 2014; in revised form: 8 May 2014 / Accepted: 13 May 2014 / Published: 26 May 2014
Abstract:
The numerous empirical and conceptual studies that have been conducted over recent years concerning the social responsibility of enterprises and their contributions towards sustainable development have given very little consideration to non-profit organizations (NPOs). This is surprising, because NPOs are confronted with very similar challenges to profit-orientated enterprises regarding their evolution into sustainable organizations. This paper is a preliminary conceptual study and explores the question of why the corporate social responsibility, or corporate sustainability, of NPOs has to date been both neglected by research establishments and also extensively ignored by the NPOs during their day-to-day practical management. The example of church and pastoral institutions in Germany is used to demonstrate the extent to which they take account of ecological and social aspects in their management systems and processes and, thus, implement sustainable management within their day-to-day practice. The paper concludes with some proposals for further empirical and conceptual research projects, which are designed to analyze developments within NPOs with relation to the integration of sustainability into their management systems and processes

Vulnerable Children and Youth Studies
An International Interdisciplinary Journal for Research, Policy and Care
Volume 9, Issue 3, 2014
http://www.tandfonline.com/toc/rvch20/current#.Uzg2bFcWNdc

Child and caregiver concordance of potentially traumatic events experienced by orphaned and abandoned children
Divya Guru Rajana*, Kristen Shireyb, Jan Ostermannc, Rachel Whettend, Karen O’Donnelle & Kathryn Whettenf
DOI: 10.1080/17450128.2013.855346
pages 220-233
Abstract
Exposure to trauma is associated with significant emotional and behavioral difficulties among children. Overall, reports of trauma and violence experienced by children are discrepant from those of their caregivers. Even less is known about the extent of concordance between orphans and their caregivers. This study examines the correlates of concordance in reported traumatic experiences between 1269 orphaned and abandoned children (OAC) and their caregivers. The OAC lived in family-settings in five low- and middle-income countries (LMICs) and were part of a longitudinal study, “Positive Outcomes for Orphans” (POFO) that enrolled children aged 6 to 12 at baseline. By examining concordance with respect to specific types of trauma reported, this study expands the understanding of who reports which types of traumas experienced by OAC, thereby improving the potential to provide targeted interventions for children who have experienced such events. In this study, children and caregivers were asked separately if the child had experienced different types of potentially traumatic events (PTEs). Children were significantly more likely to report physical abuse, sexual abuse, and family violence than were caregivers. Caregivers were significantly more likely than children to report natural disasters and accidents. High levels of concordance were found in the reporting of wars, riots, killings, and deaths in the family.
The impacts of trauma on behavior and mental health are profound, and highly effective interventions targeting sequelae of childhood trauma are currently being developed for use in low-resource areas. Findings from this study demonstrate that it is feasible to conduct screening for PTEs utilizing child self-report in resource limited settings and that child self-report is crucial in evaluating trauma, particularly family violence and physical or sexual assault.

Indicative evaluation of psychological disturbance amongst young children affected by the January 2010 Haiti earthquake, in Port-au-Prince
Yoram Mouchenikab*, Alexandra Marty-Chevreuilc, Caroline Marquerd, Nephtalie Eva Josephe, Jean Weber Ducassee, Casseus Ryswicke, Alex Dejeane, Rogenette Georgese, Judith Blancf, Daniel Derivoisg, Thierry Baubeth & Marie Rose Moroi
DOI: 10.1080/17450128.2014.901589
pages 247-257
Abstract
The article presents a research for the indicative evaluation of psychological disturbance amongst young children following the 2010 earthquake in Haiti. We used a new psychological evaluation questionnaire for young children, the PSYCa 3–6. It is a hetero-evaluation tool and is completed on site by the interviewer. The questionnaire was conducted in Port-au-Prince. The average age of the 166 children taking part in the study was 58 months. Psychological disturbance score appears to be high amongst our child population in Port-au-Prince. This corroborates other research into the psychological condition of natural disaster victims. A higher score of psychological disturbance was observed amongst boys and in the youngest group of children. This first application of the PSYCa 3–6, in a natural disaster area, highlights its capacity to identify children in great difficulties, the acceptability of the questionnaire and its appropriateness for use in humanitarian crisis areas.

Information needs for OVC program management and evaluation: a framework
J. Chapmana* & M. Cannonb
DOI: 10.1080/17450128.2014.923961
pages 270-278
Abstract
Programs serving orphans and vulnerable children (OVC) have become increasingly complex over the last decade, necessitating programs to collect more information to ensure adequate management. Programs are also facing greater pressure to demonstrate an interest in understanding impact and value for money, which is similarly leading to changes in the ways programs collect information and the types of information collected. In order to gather such information and contain costs, governments and programs are collecting increasing amounts of information at every interaction with program beneficiaries. This has led to a high burden on those providing, gathering, and inputting information and low data quality overall.
In this paper, we present a framework for categorizing different information needs for OVC program management and evaluation. The purpose of this framework is to support OVC program staff and donors to more clearly define information-collection strategies based on the information needed, why it is needed, and by whom it is needed. This will improve the efficiency of data-collection efforts, and improve the availability of the right (high-quality) data for various decision-making processes.

From Google Scholar+ [to 14 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.

Journal of Surgical Education
Available online 7 June 2014
Original reports
Scaling Up Short-Term Humanitarian Surgery: A Global Surgery Elective for Senior Medical Students
Lee A. Hugar, MD, MSc, Chelsea M. McCullough, BA, Megan E. Quinn, BS, Sameer M. Kapadia, MD, Barbara J. Pettitt, MD
Abstract
Objectives
The proportion of US medical students participating in global health has increased by 24%. These experiences are generally self-directed and lack a formal educational component. This article describes a structured, comprehensive, community-driven global surgery elective for senior-year students.
Design
“Surgery and Global Health” is a month-long elective during which students shadow in the university hospital, lead discussions of an assigned text, attend lectures, and participate in a clinical rotation in rural Haiti. The first week is didactic and takes place in Atlanta, GA. Weeks 2 through 4 are clinical and are conducted in Haiti. Urological and general surgery procedures are performed during weeks 2 and 3, while the final week is reserved for follow-up care. This experience was institutionally supported.
Setting
Emory University Hospital, Atlanta, GA; L’Hôpital St. Thérèse, Hinche, Centre, Haiti.
Participants
Emory University School of Medicine students, years 2 through 4, supervised by faculty from the departments of Urology, General Surgery, and Anesthesiology. Senior-year students spent 21 days in central Haiti working in a rural clinical setting.
Results
Students participated in all facets of surgical care including preoperative clearance, postanesthesia care, discharge planning, and follow-up. Students felt a level of supervised responsibility that was not afforded at their home institution and were able to take on more advanced clinical roles.
Conclusions
Students planned and executed this innovative experience with multidisciplinary, departmental, and institutional support. Stateside components introduced students to Haitian culture, global surgery ethics, and humanitarian surgical trip logistics. Structured global health experiences such as this give students practical skills and incentive to pursue careers involving global surgery.

Obstetrics & Gynecology
June 2014 – Volume 123 – Issue 6 pp: 1151-1411
http://journals.lww.com/greenjournal/Pages/currenttoc.aspx
Steps Toward a National Disaster Plan for Obstetrics.
Daniels, Kay; Oakeson, Ann Marie; Hilton, Gillian
POST AUTHOR CORRECTIONS, 4 June 2014
Abstract
Hospitals play a central role in disasters by receiving an influx of casualties and coordinating medical efforts to manage resources. However, plans have not been fully developed in the event the hospital itself is severely damaged, either from natural disasters like earthquakes or tornados or manmade events such as a massive electrical failure or terrorist attacks. Of particular concern is the limited awareness of the obstetric units’ specialized needs in the world of disaster planning. Within the same footprint of any obstetric unit, there exists a large variety of patient acuity and needs including laboring women, postoperative patients, and healthy postpartum patients with their newborns. An obstetric-specific triage method is paramount to accurately assess and rapidly triage patients during a disaster. An example is presented here called OB TRAIN (Obstetric Triage by Resource Allocation for Inpatient). To accomplish a comprehensive obstetric disaster plan, there must be 1) national adoption of a common triage and evacuation language including an effective patient tracking system to avoid maternal-neonatal separation; 2) a stratification of maternity hospital levels of care; and 3) a collaborative network of obstetric hospitals, both regionally and nationally. However, obstetric disaster planning goes beyond evacuation and must include plans for shelter-in-place and surge capacity, all uniquely designed for the obstetric patient. Disasters, manmade or natural, are neither predictable nor preventable, but we can and should prepare for them.

Reproductive Health Matters
Volume 22, Issue 43, June 2014, Pages 53–64
Population, sexual and reproductive health, rights and sustainable development: forging a common agenda
Karen Newmana, Sarah Fisherb, Susannah Mayhewc, Judith Stephensond
Abstract
This article suggests that sexual and reproductive health and rights activists seeking to influence the post-2015 international development paradigm must work with sustainable development advocates concerned with a range of issues, including climate change, environmental issues, and food and water security, and that a way of building bridges with these communities is to demonstrate how sexual and reproductive health and rights are relevant for these issues. An understanding of population dynamics, including urbanization and migration, as well as population growth, can help to clarify these links. This article therefore suggests that whether or not sexual and reproductive health and rights activists can overcome resistance to discussing “population”, become more knowledgeable about other sustainable development issues, and work with others in those fields to advance the global sustainable development agenda are crucial questions for the coming months. The article also contends that it is possible to care about population dynamics (including ageing and problems faced by countries with a high proportion of young people) and care about human rights at the same time. It expresses concern that, if sexual and reproductive health and rights advocates do not participate in the population dynamics discourse, the field will be left free for those for whom respecting and protecting rights may be less of a priority.

Reproductive Health Matters
Volume 22, Issue 43, June 2014, Pages 75–83
Resilience, integrated development and family planning: building long-term solutions
Roger-Mark De Souza
Abstract
For the many individuals and communities experiencing natural disasters and environmental degradation, building resilience means becoming more proficient at anticipating, preventing, recovering, and rebuilding following negative shocks and stresses. Development practitioners have been working to build this proficiency in vulnerable communities around the world for several decades. This article first examines the meaning of resilience as a component of responding to disasters and some of the key components of building resilience. It then summarises approaches to resilience developed by the Rockefeller and Packard Foundations, the Intergovernmental Panel on Climate Change, USAID and DFID, which show how family planning services can contribute to resilience. Next, it gives some examples of how family planning has been integrated into some current environment and development programmes. Finally, it describes how these integrated programmes have succeeded in helping communities to diversify livelihoods, bolster community engagement and resilience, build new governance structures, and position women as agents of change.

Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative: Ninth Report
May 2014 52 pages
Excerpts from Executive Summary; Editor’s bolded text

…As the end-2014 deadline fast approaches, Nigeria and Pakistan are both at risk of failing to stop transmission in time (with Pakistan’s risk extreme). There is a significant risk of one or more of the current outbreaks becoming prolonged. There is serious risk of failure to anticipate and prevent an outbreak elsewhere. Given these factors, the IMB’s considered analysis is that the latest strategic plan goal of interrupting transmission by the end of 2014 stands at extreme risk.

The World Health Assembly has rightly declared polio eradication a programmatic emergency for global public health. WHO has rightly called the spread of polio a public health emergency of international concern. There is every reason why polio must be eradicated – and fast. Failure to do so is inexcusable. This last 1% cannot be allowed to drag on any longer. The program is failing children and families in the poorest parts of the world. These broken promises mean that every child paralysed in 2015 will be a child grossly let down, their paralysis an avoidable catastrophe…

The Brussels G7 Summit Declaration
European Commission – MEMO/14/402 05/06/2014
Excerpt: “Development” discussion; Editor’s bolded text

…Development
12. The pursuit of sustainable and inclusive development and greater prosperity in all countries remains a foundational commitment that unites our people and our countries. We continue to implement the commitments we have made at previous Summits. To be accountable we will provide a report in 2015 on progress toward their attainment.

13. We commit to work with all partners to agree an ambitious and universal post-2015 agenda, anchored in a single set of clear and measurable goals. That agenda should complete unfinished business of the Millennium Development Goals. It should be centred on people and focused both on the eradication of extreme poverty, promoting development and on balancing the environmental, economic and social dimensions of sustainable development, including climate change. It should also promote peace and security, democratic governance, the rule of law, gender equality and human rights for all. We are committed to build a global partnership with shared responsibility and mutual accountability to ensure its implementation. We await the synthesis report of the United Nations Secretary General in the second half of 2014. We welcome the African Union’s common position.

14. We will continue to promote inclusive and resilient growth in Africa, working with governments and citizens in Africa to enhance governance and transparency, improve infrastructure, notably in the energy sector, eliminate trade barriers, facilitate trade and investment, and strengthen the responsible and sustainable management of natural resources and the revenues they generate. We welcome the active role of the African Union and the New Partnership for Africa’s Development in the process of reforming the Africa Partnership Forum.

15. Security and development are the prerequisite of a lasting peace in regions affected by the scourge of war, terrorism, organized crime, corruption, instability and poverty, notably the Sahel region, Somalia, Nigeria, South Sudan and Central African Republic. We welcome efforts by African partners and the African Union, supported by the international community, aimed at building their capacities to respond to crises and support stabilisation.

16. We confirm our strong commitment to the Deauville Partnership and our support to Arab countries in transition in their efforts to improve governance and stimulate inclusive growth and job creation, particularly for their youth and women. Our Foreign and Finance Ministers will meet in the margins of United Nations General Assembly, and the International Monetary Fund/World Bank Annual Meetings, to take forward the Partnership.

17. We remain committed to work towards common global standards that raise extractives transparency, which ensure disclosure of companies’ payments to all governments. We welcome the progress made among G7 members to implement quickly such standards. These global standards should continue to move towards project-level reporting. Those governments that are signing up to the Extractive Industries Transparency Initiative standard will voluntarily report their revenues. We confirm our commitment to implement fully the extractive partnerships launched in 2013.

18. We today announce a new initiative on Strengthening Assistance for Complex Contract Negotiations (CONNEX) to provide developing country partners with extended and concrete expertise for negotiating complex commercial contracts, focusing initially on the extractives sector, and working with existing fora and facilities to avoid duplication, to be launched in New York in June and to deliver improvements by our next meeting, including as a first step a central resource hub that brings together information and guidance.

19. We will continue to work to tackle tax evasion and illicit flows of finance, including by supporting developing countries to strengthen their tax base and help create stable and sustainable states. We renew our commitment to deny safe haven to the proceeds of corruption, and to the recovery and return of stolen assets. We remain committed to prevent the misuse of companies and other legal arrangements such as trusts to hide financial flows stemming from corruption, tax evasion, money laundering, and other crimes, ensuring that beneficial ownership information is available in a timely fashion to financial intelligence units, tax collection and law enforcement agencies, for example through central registries or other appropriate mechanisms, leading by example in implementing the Financial Action Task Force and other relevant international standards and our national action plans in line with the principles we agreed at Lough Erne. Greater transparency in this area will help developing countries.

20. Recent events illustrate that corruption undermines trust in governments and limits economic growth. We will build on existing efforts, including in the G20, to take additional steps to prevent this. We continue our engagement to and support of United Nations Office on Drugs and Crime and the World Bank’s Stolen Asset Recovery Initiative. We welcome the outcomes of the Ukraine Forum on Asset Recovery and look forward to the third Arab Forum on Asset Recovery. The G7 remains committed to working with governments and global financial centres to follow up on asset recovery efforts.

21. We remain committed to the Muskoka Initiative on maternal, newborn and child health, and welcome the call made at the Saving Every Woman, Every Child Summit in Toronto to accelerate progress on this global priority. In addition we are committed to ensuring sexual and reproductive health and reproductive rights, and ending child, early and forced marriage and female genital mutilation and other harmful practices. The health and well-being of women and children are improved through ensuring universal access to affordable, quality, essential health services, strengthening health, education and child protection systems and improving nutrition and access to immunisation. We recognise the impact of the GAVI Alliance (Global Alliance for Vaccines and Immunisation) and welcome its efforts to expand access to vaccines to an additional 300 million children during 2016-2020. We welcome Germany’s offer to host the second replenishment in early 2015, reaffirm our commitment, and call on other public and private donors to contribute to the replenishment of the GAVI Alliance. We reaffirm our commitment to an AIDS free generation and to the Global Fund to fight AIDS, Tuberculosis and Malaria to reduce the burden of these three major infectious diseases on eligible countries and regions.

22. To address the threat posed by infectious diseases, we support the Global Health Security Agenda and commit to working with partner countries to strengthen compliance with the World Health Organisation’s (WHO) International Health Regulations and enhance health security around the world. We commit to working across sectors to prevent, detect and respond to infectious diseases, whether naturally occurring, accidental, or the result of a deliberate act by a state or non-state actor. That includes building global capacity so that we are better prepared for threats such as the recent Ebola outbreak in West Africa and working together, in close cooperation with WHO, to develop a Global Action Plan on antimicrobial resistance.

23. We continue to strongly support comprehensive approaches to achieve global food security and nutrition. We look forward to the second International Conference on Nutrition in November 2014 and the Expo Milan 2015, which will provide a platform for the global post-2015 debate on sustainability and food and nutrition security. We continue to support the New Alliance for Food Security and Nutrition under strong African leadership and the successful completion of principles for responsible agricultural investment by the Committee on World Food Security. These will better enable smallholder farmers, especially women, to benefit from sustainable rural development. We continue to support the consistent implementation of the Voluntary Guidelines on Responsible Governance of Tenure of Land, Fisheries and Forests, including by building on the land partnerships we launched in 2013 and the Global Agriculture and Food Security Programme….

UN: INTRODUCTION AND PROPOSED GOALS AND TARGETS ON SUSTAINABLE DEVELOPMENT FOR THE POST 2015 DEVELOPMENT AGENDA
2 June 2014
[Editor’s Note: Proposed SDG goals condensed to 17, heading over 200 goal targets in latest draft]
Excerpt

Poverty eradication is the greatest global challenge facing the world today and an indispensable requirement for sustainable development. We are therefore committed to freeing humanity from poverty and hunger as a matter of urgency.

We recognize that poverty eradication, changing unsustainable and promoting sustainable patterns of consumption and production and protecting and managing the natural resource base of economic and social development are the overarching objectives of and essential requirements for sustainable development…

…List of Proposed Sustainable Development: Goals to be attained by 2030
1. End poverty in all its forms everywhere
2. End hunger, achieve food security and adequate nutrition for all, and promote sustainable agriculture
3. Attain healthy life for all at all ages
4. Provide equitable and inclusive quality education and life-long learning opportunities for all
5. Attain gender equality, empower women and girls everywhere
6. Secure water and sanitation for all for a sustainable world
7. Ensure access to affordable, sustainable, and reliable modern energy services for all
8. Promote strong, inclusive and sustainable economic growth and decent work for all
9. Promote sustainable industrialization
10. Reduce inequality within and among countries
11. Build inclusive, safe and sustainable cities and human settlements
12. Promote sustainable consumption and production patterns
13. Promote actions at all levels to address climate change
14. Attain conservation and sustainable use of marine resources, oceans and seas
15. Protect and restore terrestrial ecosystems and halt all biodiversity loss
16. Achieve peaceful and inclusive societies, rule of law, effective and capable institutions
17. Strengthen and enhance the means of implementation and global partnership for sustainable development

ILO Report: World Social Protection Report 2014-15: Building economic recovery, inclusive development and social justice
ILO
3 June 2-14 362 pages
Excerpt from Executive Summary

Social protection policies play a critical role in realizing the human right to social security for all, reducing poverty and inequality, and supporting inclusive growth – by boosting human capital and productivity, supporting domestic demand and facilitating structural transformation of national economies.

This ILO flagship report:
(i) provides a global overview of the organization of social protection systems, their coverage
and benefits, as well as public expenditures on social security;
(ii) following a life-cycle approach, presents social protection for children, for women and men of working age, and for older persons;
(iii) analyses trends and recent policies, e.g. negative impacts of fiscal consolidation and adjustment measures; and
(iv) calls for the expansion of social protection in pursuit of crisis recovery, inclusive development and social justice.

While the need for social protection is widely recognized, the fundamental human right to social security remains unfulfilled for the large majority of the world’s population. Only 27 per cent of the global population enjoy access to comprehensive social security systems, whereas 73 per cent are covered partially or not at all.

The lack of access to social protection constitutes a major obstacle to economic and social development. Inadequate or absent social protection coverage is associated with high and persistent levels of poverty and economic insecurity, growing levels of inequality, insufficient investments in human capital and human capabilities, and weak aggregate demand in a time of recession and slow growth…

Report: The State of the World’s Midwifery 2014: A Universal Pathway. A Woman’s Right to Health
UNFPA,
June 2014 228 pages
ISBN: 978-0-89714-026-3 Download PDF English

Midwives are the unsung heroes of maternal and newborn health. They can prevent about two thirds of deaths among women and newborns. And midwives deliver much more than babies: They are the connective tissue for communities, helping women and girls care for their health, from family planning all the way through the postpartum period.
The State of the World’s Midwifery (SoWMy) 2014 presents findings on midwifery from 73 low and middle- income countries. The report, produced by UNFPA, the International Confederation of Midwives (ICM), the World Health Organization (WHO) and several other partners, shows the progress and trends that have taken place since the inaugural 2011 edition, and also identifies the barriers and challenges to future progress. The report focuses on the urgent need to improve the availability, accessibility, acceptability and quality of midwifery services. Despite a steady drop in maternal and newborn deaths since 1990, hundreds of thousands of women and newborns continue to die each year during pregnancy and childbirth: An estimated 289,000 women and about 3 million newborn babies died in 2013 alone. The vast majority lost their lives due to complications and illnesses that could have been prevented with proper antenatal care and the presence of a skilled midwife during delivery.

FAO Report The State of the World’s Forest Genetic Resources
COMMISSION ON GENETIC RESOURCES FOR FOOD AND AGRICULTURE
FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS
Rome, 2014 291 pages
Excerpts from Executive Summary

This first The State of the World’s Forest Genetic Resources constitutes a major step in building the information and knowledge base required for action towards better conservation and sustainable management of FGR at national, regional and international levels.

The report was prepared based on information provided by 86 countries, outcomes from regional and sub-regional consultations and information compiled in thematic studies. It includes:
:: an overview of definitions and concepts related to FGR and a review of their value;
:: a description of the main drivers of change;
:: the presentation of key emerging technologies;
:: an analysis of the current status of FGR conservation, use and related developments;
:: recommendations addressing the challenges and needs.

Blog Post: World Environment Day 2014: Are You Paying Attention?
Pierre Ferrari, President and CEO, Heifer International
Huffington Post Impact Blog
Posted: 06/04/2014 7:01 pm EDT Updated: 06/04/2014 7:59 pm EDT

Today is World Environment Day, and if you’re not scared about climate change yet, you are definitely not paying close enough attention.

It’s going to be a rude awakening if the globe gets to the point scientists are predicting. And I’m not talking about snow during spring break in the South or even polar bears searching for ice — though we cannot ignore these signs, either. I am talking about the ability of the men and women around the world who grow the vast majority of the world’s food being seriously compromised.

Oxfam does a good job summarizing key findings from the 2014 IPCC report.
:: Climate change: the impacts on crops are worse than we thought.
:: Climate change also means higher food prices for most people.
:: Without action, climate change will reverse the fight against hunger – perhaps by several decades.
:: It is not too late to act, but we need to get serious about adaptation.
:: We must cut greenhouse gas emissions now.

For those of us in the hunger-fighting sector, this points to serious trouble.

But there is good news: We have a great opportunity to shape the future health and wellbeing of our planet and to feed the world’s growing population at the same time. As Heifer International and our partners reach more and more smallholder farming communities through our work, we are able to share and promote agroecology.

Agroecology is an approach to farming that has the power to provide an abundance of food while also preserving and restoring the environment. It’s not a fad, and it need not be relegated to buzzword status. Many farmers around the world have been practicing agroecology for years, and with great success. It’s accomplished by combining social, cultural, economic, political and ecological systems to work together to achieve sustainable agriculture production.

Heifer International has promoted agroecology by name since the mid-1980s. Our farmers work within an integrated system of plant and animal production practices to satisfy human food and nutrition needs, enhance environmental quality and natural resources, and make the most of on-farm and renewable resources. In 2011, Olivier De Schutter, United Nations Special Rapporteur on the Right to Food, issued a report that clearly demonstrates how agroecology has the power — if adequately supported — to double food production, mitigate climate change and help end rural poverty and hunger.

I’ve had the opportunity to witness smallholder farmers healing the land and feeding their families and communities through agroecology. Several years ago in Ecuador I met a farmer named Don Juan Collaguazo. He and his wife, Flor, live in the dry forest and practice agroecology. Aptly named, the dry forest has a long dry season, so farmers must plan accordingly. For 10 years now they have been putting their Heifer training into practice. They do not have access to enough water to irrigate all of their crops, so they must manage what water they have carefully. Other practices they employ include making their own organic fertilizer and insecticides, terrace farming, cover crops, improving the soil, and, probably most importantly, maintaining an extremely diverse farm.

Don Juan and his family grow many varieties of fruits and vegetables, keep livestock, and have a fishpond in the dense forest. Flowers bloom all over their land, and butterflies made themselves at home. It was absolutely stunning how productive their farm was. The family works hard to care for the soil, and they are rewarded for their efforts. They take their yields to the farmers market in the nearest city, Loja, where market vendors are clearly segregated into agroecological producers and “conventional.”

We need more farmers like Don Juan. Caring for their environment, putting biomass back into the soil, cooling the planet, and growing food all at the same time. We need more equitable land and water distribution, agriculture policies that focus not only on export growth, but also on the smallholder farmer, and access to irrigation and credit for small farmers. If we can empower these farmers, we can end hunger and reverse climate change.

This post originally appeared on Heifer International.

Amref Health Africa [to 7 June 2014]

Maasai Elders Unite To End Female Circumcision
Magadi, Kenya, 22 May 2014 | Ten Maasai cultural elders from Entasopia Sub-Location have vowed to end female circumcision at a ceremony organized by Amref Health Africa in Kenya yesterday. The denunciation ceremony paved way for more than 250 girls to undergo an alternative rite of passage, graduating to womanhood.

BRAC [to 7 June 2014]

Sir Fazle Hasan Abed honoured with Leo Tolstoy International Gold Medal
02 June 2014, Dhaka. BRAC founder and chairperson, Sir Fazle Hasan Abed has been awarded the Leo Tolstoy International Gold Medal by The Russian Children Foundation (RDF) on the occasion of International Children’s Day on 1 June 2014. He received the award at Moscow’s historic Bolshoi Theatre after a Gala concert for orphaned, disabled and disadvantaged children, where he was present as the Guest of Honour. About 11,000 children from all around the country gathered in Moscow to participate…

BRAC @BRACworld • 2h
Why BRAC’s funding 7 #mobilemoney projects in #Bangladesh that could be seminal-http://bit.ly/1jcg7l6 @NextBillion #ict4d #globaldev

BRAC @BRACworld • 4h
Dr Mahabub Hossain, Advisor to the Executive Director, BRAC writes about #Biofortification on @GuardianGDP http://www.theguardian.com/global-development-professionals-network/improving-nutrition …

BRAC @BRACworld • Jun 5
Interested in learning about the #GraduationModel? Attend our e-workshop with @Fonkoze, & NWTF http://wp.me/p2l2ds-1a7

BRAC @BRACworld • Jun 5
BRAC’s senior director @asifsaleh describes how the biggest #NGO in the world works – http://bit.ly/1mWDkdy @YourStoryCo

Retweeted by BRAC
Susan Davis @SusanDavisBRAC • Jun 3
@BRACworld founder Sir Fazle Abed received honorary degree from @Princeton today with Madeleine Albright & others.

BRAC @BRACworld • Jun 1
Seven ways BRAC will #innovate with #mobile #money this year – See more at: http://blog.brac.net/2014/06/7-ways-brac-will-innovate-with-mobile-money-this-year/#sthash.W6A6SoHn.dpuf …