Guidelines on the Use of Foreign Military and Civil Defence Assets in Disaster Relief – “Oslo Guidelines” – Rev. 1.1 (November 2007) 40 pages
https://docs.unocha.org/sites/dms/Documents/Oslo%20Guidelines%20ENGLISH%20(November%202007).pdf

Overview
The “Oslo Guidelines” were originally prepared over a period of two years beginning in 1992. They were the result of a collaborative effort that culminated in an international conference
in Oslo, Norway, in January 1994 and were released in May 1994. The unprecedented deployment in 2005 of military forces and assets in support of humanitarian response to natural disasters, following an increasing trend over the past years, confirmed the need to update the 1994 “Oslo Guidelines” eventually resulting in the current version from November 2007.

[Excerpts]
Aim
9. The aim of the present Guidelines on the Use of Military and Civil Defence Assets in Disaster Relief (hereinafter referred to as «Oslo Guidelines») is to establish the basic framework for formalizing and improving the effectiveness and efficiency of the use of foreign military and civil defence assets in international disaster relief operations….

Core Principles
20. As per UN General Assembly Resolution 46/182 humanitarian assistance must be provided in accordance with the principles of humanity, neutrality and impartiality.
:: Humanity: Human suffering must be addressed wherever it is found, with particular attention to the most vulnerable in the population, such as children, women and the elderly. The dignity and rights of all victims must be respected and protected.
:: Neutrality: Humanitarian assistance must be provided without engaging in hostilities or taking sides in controversies of a political, religious or ideological nature.
:: Impartiality: Humanitarian assistance must be provided without discriminating as to ethnic origin, gender, nationality, political opinions, race or religion. Relief of the suffering must be guided solely by needs and priority must be given to the most urgent cases of distress.
21. In addition to these three humanitarian principles, the United Nations seeks to provide humanitarian assistance with full respect for the sovereignty of States. As also stated in General Assembly Resolution 46/182:
“The sovereignty, territorial integrity and national unity of States must be fully respected in accordance with the Charter of the United Nations. In this context, humanitarian assistance should be provided with the consent of the affected country and in principle on the basis of an appeal by the affected country.”…

Key Concepts For Use Of Military and Civil Defence Assets (MCDA) by UN Agencies
32. In addition and in the framework of the above-mentioned principles, the use of MCDA by UN agencies in response to a natural disaster shall be guided by the six following standards:
i. Requests for MCDA to support UN agencies must be made by the Humanitarian
Coordinator/Resident Coordinator, with the consent of the Affected State, and based solely on humanitarian criteria.
ii. MCDA should be employed by UN humanitarian agencies as a last resort, i.e. only in the absence of any other available civilian alternative to support urgent humanitarian needs in the time required.
iii. A UN humanitarian operation using military assets must retain its civilian nature and character. While MCDA may remain under military control, the operation as a whole must remain under the overall authority and control of the responsible humanitarian organization. This does not infer any civilian command and control status over military assets.
iv. Humanitarian work should be performed by humanitarian organizations. Insofar as military organizations have a role to play in supporting humanitarian work, it should, to the extent possible, not encompass direct assistance, in order to retain a clear distinction between the normal functions and roles of humanitarian and military stakeholders.
v. Any use of MCDA should be, at its onset, clearly limited in time and scale and present an exit strategy element that defines clearly how the function it undertakes could, in the future, be undertaken by civilian personnel.
vi. Countries providing MCDA to support UN humanitarian operations should ensure that they respect the UN Codes of Conduct and the humanitarian principles.
33. Implementing and operational partners and members of international civil society, are expected to adhere to these core principles and have been encouraged to adopt the «Code of Conduct for the International Red Cross and Red Crescent Movement and Non-Governmental Organizations (NGOs) in Disaster Relief”…

HelpAge International launches Global AgeWatch Index 2014 ranking 96 countries according to the social and economic wellbeing of older people
1 October 2014
Norway tops the list, Latin America leads pension revolution, life expectancy continues to rise
HelpAge used the United Nations International Day of Older Persons to launch the Global AgeWatch Index 2014, representing 91 per cent or nine out of ten people over 60 across the world. It measures wellbeing in four key areas: income security, health, personal capability and an enabling environment.

Globally Norway (1) tops the Index this year, closely followed by Sweden. Apart from Japan (9) all the top 10 countries are again in Western Europe, North America and Australasia. Five new countries have been added – Bangladesh, Iraq, Mozambique, Uganda and Zambia.

The worst place for an older person is Afghanistan (96). Just above it come Mozambique (95), West Bank and Gaza (94) and Malawi (93).

All regions are represented in the lowest quarter, with African countries making up half of those with low income security rankings and poor health results. Venezuela (76), Serbia (78) and Turkey (77) are included in this section in similar position to countries in sub-Saharan Africa and Asia.

Chile (22) leads a cluster of Latin American countries including Uruguay (23), Panama (24), Costa Rica, (26) Mexico (30), Argentina (31), Ecuador (33) and Peru (42) which do well in the Index particularly on income security.

There are currently 868m people over 60 – nearly 12 per cent of the global population. By 2050, it’s predicted to rise to 21 per cent, nearly as many people aged 60 or over as those under 15 – 2.02 billion compared with 2.03 billion.

The Index tells us that economic growth alone will not improve older people’s wellbeing and specific policies need to be put in place to address the implications of ageing. More than one third of countries trail significantly behind the best-performing countries.

The report this year focuses on pension policy and how this is being managed across the globe. Only half the world’s population can expect to receive even a basic pension in old age and although policies supporting people in later life exist they need to be implemented faster and more systematically.

Full report: https://helpage.box.com/s/dns35q1ndbm561v1pum4

Florence Declaration emphasizes role of culture in post-2015 development agenda
UNESCO
04 October 2014

“Cultural vitality is synonymous with innovation and diversity. Culture creates jobs, generates revenues and stimulates creativity. It is a multifaceted vector of values and identity. Moreover, culture is a lever that promotes social inclusion and dialogue,” the Director-General of UNESCO, Irina Bokova, declared today at the close of UNESCO’s Third World Forum on Culture and Cultural Industries, which took place in Florence from 2 to 4 October.

At the end of the Forum, its 300 participants adopted the Florence Declaration that advocates the integration of culture in the post-2015 development agenda, which the United Nations is scheduled to adopt in the autumn of 2015.

The declaration reflects the findings of national consultations on culture and development conducted jointly in five countries—Bosnia and Herzegovina, Ecuador, Mali, Morocco and Serbia—by UNESCO, the United Nations Development Programme (UNDP), and the United Nations Population Fund (UNFPA)…

…The Florence Declaration notably calls on governments, civil society and the private sector to enhance:
:: human and institutional capacities;
:: legal and policy environments;
:: new partnership models and innovative investment strategies;
:: benchmarks and impact indicators to monitor and evaluate the contribution of culture to monitor and evaluate the contribution of culture to sustainable development.

FAO calls for “paradigm shift” towards sustainable agriculture and family farming
Director-General urges support for science-based options in pursuit of global food security
29 September 2014, Rome
Excerpt

Policy makers should support a broad array of approaches to overhauling global food systems, making them healthier and more sustainable while acknowledging that “we cannot rely on an input intensive model to increase production and that the solutions of the past have shown their limits,” FAO Director-General José Graziano da Silva said today in his opening remarks to the 24th session of the Committee on Agriculture (COAG).

Calling for a “paradigm shift,” he said that today’s main challenges are to lower the use of agricultural inputs, especially water and chemicals, in order to put agriculture, forestry and fisheries on a more sustainable and productive long-term path.

Options such as Agro-ecology and climate-smart agriculture should be explored, and so should biotechnology and the use of genetically modified organisms, FAO’s director-general said, noting that food production needs to grow by 60 percent by 2050 to meet the expected demand from an anticipated population of 9 billion people. “We need to explore these alternatives using an inclusive approach based on science and evidences, not on ideologies,” as well as to “respect local characteristics and context,” he said.

Graziano da Silva also asked the COAG, which will conclude its biannual meeting on Friday, Oct. 3, to consider the importance of family farming in all aspects of its agenda…

Emergency Economies: The Impact of Cash Assistance in Lebanon
IRC Evaluation
29 September 2014
Full report here.

In what it described as “the first ever scientifically rigorous evaluation of cash distribution for refugees in an emergency setting,” the IRC said it found “strikingly positive impacts for Syrian refugees in Lebanon.” The evaluation was conducted in partnership with Daniel Masterson of Yale University and Christian Lehmann of the University of Brasilia.

Last winter, 90,000 Syrian refugee families facing freezing conditions in the Lebanese mountains were given $100 a month through ATM cards by international aid agencies. Families living below 500 meters altitude were given e-vouchers for food, while those living in villages above 500 meters were also given e-vouchers for food, plus the cash to buy winter warmth materials, like blankets and sweaters.

Comparative research confirmed that refugees receiving the cash spent everything on meeting very basic needs ahead of winter. Despite the cash initially being intended by aid agencies for use buying materials to keep warm, the money allowed the refugees to invest in what they knew they most needed: food and water. There was no evidence of spending on alcohol or tobacco. Meals were more frequent and had bigger portions. For each dollar of cash assistance spent, the model calculated $2.13 was created in local markets, boosting the Lebanese economy. The research did not find an inflationary impact — instead, supply moved to meet new demand.

As well as economic impact, social impacts were also measured. Households receiving cash assistance were half as likely to send their children out to work. Cash also increased access to education, and there is evidence of reduced tensions within the household and between the refugee and host community.

A majority (80%) suggested that they would prefer to receive cash to other forms of assistance.

David Miliband, IRC president and CEO, said: “The spate of man-made and natural disasters enveloping innocent civilians raises profound questions not just for international politics, but for NGOs and the humanitarian sector, as well. If we keep doing ‘business as usual,’ the gap between need and provision will continue to grow. Cash distribution – alongside clear humanitarian ‘floor’ targets in the revised Millennium Development Goals, more sustainable local partnerships and better use of evidence overall — could be part of a vital renewal of the humanitarian sector. There will be a new disaster in the near future. And when the calls for donations go out, yes, let’s spend some of it on cash, but let’s also spend that fraction more evaluating it – the lessons are too expensive to miss.”

Start Network [Consortium of British Humanitarian Agencies] [to 4 October 2014]
http://www.start-network.org/news-blog/#.U9U_O7FR98E

New challenges to the humanitarian project: a discussion starter
September 29, 2014
On the 25th September the Start Team presented a discussion starter at the Oxfam Global Learning Event, which addressed future challenges faced by NGO leaders and staff.

“We are caught in a race between the growing size of the humanitarian challenge, and our ability to cope; between humanity and catastrophe. And, at present, this is not a race we are winning”. (The Humanitarian Emergency Response Review, July 2011[i])

The humanitarian system is creaking. The international community is once again dealing with multiple crises at scale. The international community appears increasingly unable to deal with these challenges and the challenges of the future which for sure will include more demand, more surprise, more complexity and the increasing political significance of humanitarian crises set against the back drop of funding limitations in western economies. (For example, despite an overall increase in humanitarian funding to $22bn in 2013, over a third of funding requirements went unmet in UN-coordinated humanitarian appeals alone[ii]. According to Start Network estimates, 70% of initial emergency response is carried out by local actors and yet in 2012 only 2.3% ($51m) of the overall funding went direct to national and local NGOs / CSOs.[iii])…

American Journal of Tropical Medicine and Hygiene
October 2014; 91 (4)
http://www.ajtmh.org/content/current

Formative Investigation of Acceptability of Typhoid Vaccine During a Typhoid Fever Outbreak in Neno District, Malawi
Lauren S. Blum*, Holly Dentz, Felix Chingoli, Benson Chilima, Thomas Warne, Carla Lee, Terri Hyde, Jacqueline Gindler, James Sejvar and Eric D. Mintz
Author Affiliations
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, (NCEZID), CDC, Atlanta, Georgia; Strengthening Immunization Systems Branch, Global Immunization Division, Center for Global Health (CGH), CDC, Atlanta, Georgia; Neno District Health Office, Neno, Malawi; Community Health Services Unit, MOH, Lilongwe, Malawi; Global AIDS Program Malawi, Division of Global HIV AIDS, CGH, CDC, Lilongwe, Malawi; Office of the Director, Division of High Consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, Georgia
Abstract.
Typhoid fever affects an estimated 22 million people annually and causes 216,000 deaths worldwide. We conducted an investigation in August and September 2010 to examine the acceptability of typhoid vaccine in Neno District, Malawi where a typhoid outbreak was ongoing. We used qualitative methods, including freelisting exercises, key informant and in-depth interviews, and group discussions. Respondents associated illness with exposure to “bad wind,” and transmission was believed to be airborne. Typhoid was considered extremely dangerous because of its rapid spread, the debilitating conditions it produced, the number of related fatalities, and the perception that it was highly contagious. Respondents were skeptical about the effectiveness of water, sanitation, and hygiene (WaSH) interventions. The perceived severity of typhoid and fear of exposure, uncertainty about the effectiveness of WaSH measures, and widespread belief in the efficacy of vaccines in preventing disease resulted in an overwhelming interest in receiving typhoid vaccine during an outbreak.

BMC Public Health
(Accessed 4 October 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Perceptions of consent, permission structures and approaches to the community: a rapid ethical assessment performed in North West Cameroon
Jonas A Kengne-Ouafo, Theobald M Nji, William F Tantoh, Doris N Nyoh, Nicholas Tendongfor, Peter A Enyong, Melanie J Newport, Gail Davey and Samuel Wanji
Author Affiliations
BMC Public Health 2014, 14:1026 doi:10.1186/1471-2458-14-1026
Published: 2 October 2014
Abstract (provisional)
Background
Understanding local contextual factors is important when conducting international collaborative studies in low-income country settings. Rapid ethical assessment (a brief qualitative intervention designed to map the ethical terrain of a research setting prior to recruitment of participants), has been used in a range of research-naive settings. We used rapid ethical assessment to explore ethical issues and challenges associated with approaching communities and gaining informed consent in North West Cameroon.
Methods
This qualitative study was carried out in two health districts in the North West Region of Cameroon between February and April 2012. Eleven focus group discussions (with a total of 107 participants) were carried out among adult community members, while 72 in-depth interviews included health workers, non-government organisation staff and local community leaders. Data were collected in English and pidgin, translated where necessary into English, transcribed and coded following themes.
Results
Many community members had some understanding of informed consent, probably through exposure to agricultural research in the past. Participants described a centralised permission-giving structure in their communities, though there was evidence of some subversion of these structures by the educated young and by women. Several acceptable routes for approaching the communities were outlined, all including the health centre and the Fon (traditional leader). The importance of time spent in sensitizing the community and explaining information was stressed.
Conclusions
Respondents held relatively sophisticated understanding of consent and were able to outline the structures of permission-giving in the community. Although the structures are unique to these communities, the role of certain trusted groups is common to several other communities in Kenya and Ethiopia explored using similar techniques. The information gained through Rapid Ethical Assessment will form an important guide for future studies in North West Cameroon.

BMC Public Health
(Accessed 4 October 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
BCG coverage and barriers to BCG vaccination in Guinea-Bissau: an observational study
Sanne Marie Thysen, Stine Byberg, Marie Pedersen, Amabelia Rodrigues, Henrik Ravn, Cesario Martins, Christine Stabell Benn, Peter Aaby and Ane Bærent Fisker
Author Affiliations
BMC Public Health 2014, 14:1037 doi:10.1186/1471-2458-14-1037
Published: 4 October 2014
Abstract (provisional)
Background
BCG vaccination is recommended at birth in low-income countries, but vaccination is often delayed. Often 20-dose vials of BCG are not opened unless at least ten children are present for vaccination (“restricted vial-opening policy”). BCG coverage is usually reported as 12-month coverage, not disclosing the delay in vaccination. Several studies show that BCG at birth lowers neonatal mortality. We assessed BCG coverage at different ages and explored reasons for delay in BCG vaccination in rural Guinea-Bissau.
Methods
Bandim Health Project (BHP) runs a health and demographic surveillance system covering women and their children in 182 randomly selected village clusters in rural Guinea-Bissau. BCG coverage was assessed for children born in 2010, when the restricted vial-opening policy was universally implemented, and in 2012-2013, where BHP provided BCG to all children at monthly visits in selected intervention regions. Factors associated with delayed BCG vaccination were evaluated using logistic regression models. Coverage between intervention and control regions were evaluated in log-binomial regression models providing prevalence ratios.
Results
Among 3951 children born in 2010, vaccination status was assessed for 84%. BCG coverage by 1 week of age was 11%, 38% by 1 month, and 92% by 12 months. If BCG had been given at first contact with the health system, 1-week coverage would have been 35% and 1-month coverage 54%. When monthly visits were introduced in intervention regions, 1-month coverage was higher in intervention regions (88%) than in control regions (51%), the prevalence ratio being 1.74 (1.53-2.00). Several factors, including socioeconomic factors, were associated with delayed BCG vaccination in the 2010-birth cohort. When BCG was available at monthly visits these factors were no longer associated with delayed BCG vaccination, only region of residence was associated with delayed BCG vaccination.
Conclusion
BCG coverage during the first months of life is low in Guinea-Bissau. Providing BCG at monthly vaccination visits removes the risk factors associated with delayed BCG vaccination.

Conflict and Health
[Accessed 4 October 2014]
http://www.conflictandhealth.com/

Review
Human resource management in post-conflict health systems: review of research and knowledge gaps
Edward Roome, Joanna Raven and Tim Martineau
Author Affiliations
Conflict and Health 2014, 8:18 doi:10.1186/1752-1505-8-18
Published: 2 October 2014
Abstract (provisional)
In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances.
Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce distribution, and workforce performance. However, this should apply a longer-term focus throughout the different post-conflict phases, while paying attention to key cross-cutting themes such as leadership and governance, gender equity, and task shifting. The research gaps identified should enable future studies to examine how HRM could be used to meet both short and long term objectives for rebuilding health workforces and thereby contribute to achieving more equitable and sustainable health systems outcomes after conflict.

Emergency Medicine Journal
October 2014, Volume 31, Issue 10
http://emj.bmj.com/content/current

Commentary
Guide to the design and review of emergency research when it is proposed that consent and consultation be waived
Hugh Davies1, Haleema Shakur2, Andrew Padkin3, Ian Roberts2, Anne-Marie Slowther4,
Gavin D Perkins5
Author Affiliations
1Health Research Authority, London, UK
2Clinical Trials Unit, London School of Hygiene and Tropical Medicine, London, UK
3Royal United Hospital Bath NHS Trust, Bath, UK
4Warwick Medical School, University of Warwick, Coventry, UK
5Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, Coventry, UK
Correspondence to G D Perkins, Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, Coventry CV4 7AL, UK: g.d.perkins@warwick.ac.uk
Received 7 February 2014
Revised 3 July 2014
Accepted 13 July 2014
Published Online First 31 July 2014

Like all others, we believe that patients who need urgent treatment should receive evidence-based care. However, until recently, there have been particular difficulties or uncertainties for research when consent and consultation ‘at the time of the emergency’ are impossible or inappropriate and, therefore, should be waived.1 ,2 In this commentary we describe a practical framework of ‘questions and considerations’ for those developing or reviewing such research. The framework was developed in a workshop hosted by the Health Research Authority, UK, with the aim of providing a structured approach to the issues that arise when planning research that involves a waiver of consent or consultation.

Genocide Studies International
Volume 8, Number 2 /2014
http://utpjournals.metapress.com/content/w67003787140/?p=8beccd89a51b49fc94adf1a5c9768f4f&pi=0

The United Nations and Genocide Prevention: The Problem of Racial and Religious Bias
Hannibal Travis
Abstract
Could racial or religious bias within the United Nations be hindering efforts to prevent and punish the crime of genocide? I answer this question by surveying the UN response to a variety of alleged genocides, ranging from Biafra starting in the late 1960s to Syria starting in 2012. In terms of quantitative analysis, this article explores whether the UN response to claims of genocide is proportionate to the scale of actual harm, using absolute death tolls and percentage reductions in the populations of specific minority groups to assess harm. It finds that voting blocs based on racial or religious identity may be warping the UN response to potential genocides, resulting in disproportionate attention across cases. In this regard, the Arab League, the Non-Aligned Movement, and the Republic of Turkey appear to play important roles in shaping UN responses. In terms of qualitative analysis, the article surveys evidence that key actors at the United Nations may have been motivated by bias in framing collective responses to claims of genocide and other mass violence

Globalization and Health
[Accessed 4 October 2014]
http://www.globalizationandhealth.com/

Research
The limits of global health diplomacy: Taiwan’s observer status at the world health assembly
Herington J and Lee K Globalization and Health 2014, 10:71 (1 October 2014)

Research
Country progress towards the millennium development goals: adjusting for socioeconomic factors reveals greater progress and new challenges
Cohen RL, Alfonso YN, Adam T, Kuruvilla S, Schweitzer J and Bishai D Globalization and Health 2014, 10:67 (1 October 2014)

International Journal of Mass Emergencies & Disasters
August 2014 (VOL. 32, NO. 2)
http://www.ijmed.org/issues/32/2/

Developing a Local Recovery Management Framework: Report on the Post-Disaster Strategies and Approaches Taken by Three Local Governments in the U.S. Following Major Disasters
August 2014 (VOL. 32, NO. 2)
Abstract
Comparative case studies of post-disaster recovery are limited, and even fewer have explored organizational approaches to disaster recovery, especially local governments. This paper describes research on the post-disaster strategies and approaches taken by three local governments in the U.S. following major disasters: Los Angeles, California (following the 1994 Northridge earthquake); Grand Forks, North Dakota (following the 1997 Red River flood); and New Orleans, Louisiana (following 2005 Hurricane Katrina). The management practices, recovery timelines, and resulting outcomes were examined for each city. This research proposes a local recovery management framework that can extend the Incident Command System (ICS)-based emergency management structure into recovery, helping to standardize recovery management practices and improve local government effectiveness in recovery. Such a model has diagnostic application to determine gaps in local government capabilities to manage post-disaster recovery and identify needed support and resources—both financial and technical; it can also serve as a framework for recovery exercises and training.

Infectious Diseases of Poverty
[Accessed 4 October 2014]
http://www.idpjournal.com/content

Research Article
Interaction between climatic, environmental, and demographic factors on cholera outbreaks in Kenya
James D Stoltzfus, Jane Y Carter, Muge Akpinar-Elci, Martin Matu, Victoria Kimotho, Mark J Giganti, Daniel Langat and Omur Cinar Elci
Author Affiliations
Infectious Diseases of Poverty 2014, 3:37 doi:10.1186/2049-9957-3-37
Published: 1 October 2014
Abstract (provisional)
Background
Cholera remains an important public health concern in developing countries including Kenya where 11,769 cases and 274 deaths were reported in 2009 according to the World Health Organization (WHO). This ecological study investigates the impact of various climatic, environmental, and demographic variables on the spatial distribution of cholera cases in Kenya.
Methods
District-level data was gathered from Kenya’s Division of Disease Surveillance and Response, the Meteorological Department, and the National Bureau of Statistics. The data included the entire population of Kenya from 1999 to 2009.
Results
Multivariate analyses showed that districts had an increased risk of cholera outbreaks when a greater proportion of the population lived more than five kilometers from a health facility (RR: 1.025 per 1% increase; 95% CI: 1.010, 1.039), bordered a body of water (RR: 5.5; 95% CI: 2.472, 12.404), experienced increased rainfall from October to December (RR: 1.003 per 1 mm increase; 95% CI: 1.001, 1.005), and experienced decreased rainfall from April to June (RR: 0.996 per 1 mm increase; 95% CI: 0.992, 0.999). There was no detectable association between cholera and population density, poverty, availability of piped water, waste disposal methods, rainfall from January to March, or rainfall from July to September.
Conclusion
Bordering a large body of water, lack of health facilities nearby, and changes in rainfall were significantly associated with an increased risk of cholera in Kenya.

Journal of Development Economics
Volume 111, In Progress (November 2014)
http://www.sciencedirect.com/science/journal/03043878/110

Naturally negative: The growth effects of natural disasters
Gabriel Felbermayr, Jasmin Gröschl
Original Research Article
Pages 92-106
Highlights
:: We provide a new global database of the physical intensity of natural disasters.
:: Data based on damage reports lead to biased estimates of the disaster-growth nexus.
:: The new data strongly indicate negative growth effects of natural disasters.
:: Institutional quality and international openness mitigate the negative effects.

Journal of Development Economics
Volume 111, In Progress (November 2014)
http://www.sciencedirect.com/science/journal/03043878/110

The economic consequences of AIDS mortality in South Africa
Cally Ardington, Till Bärnighausen, Anne Case, Alicia Menendez
Original Research Article
Pages 48-60
Highlights
:: Households with an AIDS death are poorer than other households long before the death.
:: Following a death due to AIDS, households are observed being poorer still.
:: The socioeconomic losses following AIDS deaths and sudden deaths are very similar.
:: Funeral expenses and financing explain some of the impoverishing effects of death.
:: ART has not yet changed the socioeconomic status gradient observed in AIDS deaths.

The Lancet
Oct 04, 2014 Volume 384 Number 9950 p1237 – 1320 e47 – 48
http://www.thelancet.com/journals/lancet/issue/current

Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial
Dr Aisha K Yousafzai PhD a, Muneera A Rasheed MSc a, Arjumand Rizvi MSc a, Robert Armstrong PhD b, Prof Zulfiqar A Bhutta PhD a c
Summary
Background
Stimulation and nutrition delivered through health programmes at a large scale could potentially benefit more than 200 million young children worldwide who are not meeting their developmental potential. We investigated the feasibility and effectiveness of the integration of interventions to enhance child development and growth outcomes in the Lady Health Worker (LHW) programme in Sindh, Pakistan.
Methods
We implemented a community-based cluster-randomised effectiveness trial through the LHW programme in rural Sindh, Pakistan, with a 2 × 2 factorial design. We randomly allocated 80 clusters (LHW catchments) of children to receive routine health and nutrition services (controls; n=368), nutrition education and multiple micronutrient powders (enhanced nutrition; n=364), responsive stimulation (responsive stimulation; n=383), or a combination of both enriched interventions (n=374). The allocation ratio was 1:20 (ie, 20 clusters per intervention group). The data collection team were masked to the allocated intervention. All children born in the study area between April, 2009, and March, 2010, were eligible for enrolment if they were up to 2•5 months old without signs of severe impairments. Interventions were delivered by LHWs to families with children up to 24 months of age in routine monthly group sessions and home visits. The primary endpoints were child development at 12 and 24 months of age (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) and growth at 24 months of age. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT007159636.
Findings
1489 mother—infant dyads were enrolled into the study, of whom 1411 (93%) were followed up until the children were 24 months old. Children who received responsive stimulation had significantly higher development scores on the cognitive, language, and motor scales at 12 and 24 months of age, and on the social—emotional scale at 12 months of age, than did those who did not receive the intervention. Children who received enhanced nutrition had significantly higher development scores on the cognitive, language, and social-emotional scales at 12 months of age than those who did not receive this intervention, but at 24 months of age only the language scores remained significantly higher. We did not record any additive benefits when responsive stimulation was combined with nutrition interventions. Responsive stimulation effect sizes (Cohen’s d) were 0•6 for cognition, 0•7 for language, and 0•5 for motor development at 24 months of age; these effect sizes were slightly smaller for the combined intervention group and were low to moderate for the enhanced nutrition intervention alone. Children exposed to enhanced nutrition had significantly better height-for-age Z scores at 6 months (p<0•0001) and 18 months (p=0•02) than did children not exposed to enhanced nutrition. Longitudinal analysis showed a small benefit to linear growth from enrolment to 24 months (p=0•026) in the children who received the enhanced nutrition intervention.
Interpretation
The responsive stimulation intervention can be delivered effectively by LHWs and positively affects development outcomes. The absence of a major effect of the enhanced nutrition intervention on growth shows the need for further analysis of mediating variables (eg, household food security status) that will help to optimise future nutrition implementation design.

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
September 2014 Volume 92, Issue 3 Pages 407–631
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1468-0009/currentissue

Op-Ed
Global Polio Eradication: Espionage, Disinformation, and the Politics of Vaccination
LAWRENCE O. GOSTIN
First published: 9 September 2014
DOI: 10.1111/1468-0009.12065
[No abstract]

Nature
Volume 514 Number 7520 pp5-134 2 October 2014
http://www.nature.com/nature/current_issue.html

Ebola outbreak shuts down malaria-control efforts
Public-health experts fear that one epidemic may fuel another in West Africa.
Erika Check Hayden
As the Ebola death toll spirals into the thousands in West Africa, the outbreak could have a spillover effect on the region’s deadliest disease. The outbreak has virtually shut down malaria control efforts in Liberia, Guinea and Sierra Leone, raising fears that cases of the mosquito-borne illness may start rising — if they haven’t already.
So far, at least 3,000 people are estimated to have died of Ebola in Guinea, Sierra Leone and Liberia in the current outbreak, although World Health Organization (WHO) staff acknowledge that official figures vastly underestimate the total. By contrast, malaria killed more than 6,300 people in those countries in 2012, most of them young children. Overall, malaria deaths have fallen by about 30% in Africa since 2000 thanks to national programmes supported by international funding agencies such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US Agency for International Development and the WHO’s Roll Back Malaria initiative. The schemes distribute free bed nets to protect sleeping children from mosquitoes, train health workers to find malaria cases and offer tests and treatment at no charge to patients.
But the Ebola outbreak has brought those efforts to a standstill in the three affected countries. “Nobody is doing a thing,” says Thomas Teuscher, acting executive director of the Roll Back Malaria Partnership, based in Geneva, Switzerland…