Start Network [to 16 May 2015]
http://www.start-network.org/news-blog/#.U9U_O7FR98E
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Start Fund disburses £442,327 for displaced people in Burundi
May 11, 2015
Posted by Tegan Rogers in News.
Following a recent injection of funding from the Start Fund for Burundian refugees in Rwanda, the Start Fund was alerted again last week to provide support to hundreds of thousands of people affected by violence in Burundi itself. On Friday 8 May a local project selection committee agreed to fund four agencies to respond for a total of £442,327.
The alerting agency explained the current situation in Burundi:
“The roots of the current insecurity relate to the nomination of the incumbent President Nkurunziza for a third Presidential term and the recruitment and training of former rebels and youth to support his political party to pressure communities to vote in favour of their party. As reported by media and human rights organisations, security threats against those perceived as opposing Nkurunziza and unrest in the capital have already prompted people to move across the border. To date, 24,795 people have crossed to Rwanda, 4,000 people to DRC and 2,105 to Tanzania. There have been some reports of people travelling north within Burundi to try and cross the border but not succeeding.”

Start Fund double alert supports response to conflict in Yemen and Burundi
May 11, 2015
Posted by Tegan Rogers in News.
On Friday 1 May the Start Fund disbursed a total £891,613 in a double allocation for Yemen and Rwanda. £616,332 of this went to support a response to the ongoing violence in Yemen, where the Start Fund has already been activated once this year in April. The remaining £275,281 was allocated to agencies supporting the recent influx of refugees from Burundi into Rwanda. Both alerts were received at 11am on Tuesday 28 April, meaning funding was transferred to agencies to begin their responses within 72 hours.

ODI [to 16 May 2015]
http://www.odi.org/media

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The rising cost of a healthy diet: changing relative prices of foods in high-income and emerging economies
Research reports and studies | May 2015 | Steve Wiggins and Sharada Keats with Euan Han, Satoru Shimokawa, Joel Alberto Vargas Hernández and Rafael Moreira Claro
This report investigates the prices of different foods in some of the rapidly-growing emerging economies, where incomes have risen notably in the last 20 years. We ask what effect this has had on growing rates of overweight and obese people and whether this trend could…

Comment
Migration is capitalism’s unfinished business – it cannot and should not be stopped
Articles and blogs | 12 May 2015 | Claire Melamed
A tin of beans has more freedom to travel the world than a person does. We’ve reduced trade restrictions – are we brave enough to do the same for people?

Comment
Citizens and engagement: moving beyond slogans
Articles and blogs | 12 May 2015 | Alina Rocha Menocal
‘As the protest movements in Egypt and elsewhere have shown, citizen engagement alone is not enough to bring about change; collective organisation is essential.’

Comment
Is extreme poverty going to end by 2030?
Articles and blogs | 11 May 2015 | Chris Hoy
‘Over the next 15 years, the bulk of the reduction in poverty is expected to occur in South Asia, leaving almost all the world’s extreme poor living in sub-Saharan Africa.’

IOM: Scaling Program Investments for Young Children Globally: Evidence from Latin America and the Caribbean—Workshop in Brief
May 14, 2015
Authors: Amanda Pascavis, Rapporteur
Forum on Investing in Young Children Globally; Board on Children, Youth, and Families; Board on Global Health; Institute of Medicine; National Research Council
Pdf: http://www.nap.edu/catalog.php?record_id=21748
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Overview
On November 11, 2014, the Forum on Investing in Young Children Globally of the Institute of Medicine and National Research Council, in partnership with Fundação Maria Cecilia Souto Vidigal (FMCSV) in São Paulo, Brazil, held a 1-day workshop. The purpose of this interactive public workshop was to highlight efforts made to scale program investments across health, education, nutrition, and social protection that aim to improve children’s developmental potential. Invited speakers and public participants explored four topics on scaling up program investments: evidence of impact for effective investments in young children; scalability of investments; sustainability of investments; and governance.
Presenters highlighted evidence on effective investments in programs and interventions in Latin America, including an account of their strengths and challenges. Speakers addressed scalability and sustainability of program investments and how to maintain quality at scale, with a focus on approaches in culturally and ethnically diverse contexts and issues of decentralization, local capacity, and information systems for monitoring and evaluation. Presentations and discussions included policy perspectives on scaling up programs. This brief summary of the workshop highlights the topics raised by panelists, moderators, and public participants, while also including possible directions for further discussion. It represents the viewpoints of individual session participants and should not be viewed as consensus conclusion or recommendations of the workshop as a whole. A full summary of the workshop will be available in summer 2015

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 16 May 2015)

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Research article
Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: case studies from Malawi and Ghana
Michelle Stanton, Square Mkwanda, Alexander Debrah, Linda Batsa, Nana-Kwadwo Biritwum, Achim Hoerauf, Matthew Cliffe, Abigail Best, Andrew Molineux, Louise Kelly-Hope BMC Infectious Diseases 2015

BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 16 May 2015)
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Review
Urban health indicators and indices: current status
Richard Rothenberg1*, Christine Stauber1, Scott Weaver1, Dajun Dai2, Amit Prasad3 and Megumi Kano3
Author Affiliations
BMC Public Health 2015, 15:494 doi:10.1186/s12889-015-1827-x
Published: 16 May 2015
Abstract (provisional)
Though numbers alone may be insufficient to capture the nuances of population health, they provide a common language of appraisal and furnish clear evidence of disparities and inequalities. Over the past 30 years, facilitated by high speed computing and electronics, considerable investment has been made in the collection and analysis of urban health indicators, environmental indicators, and methods for their amalgamation. Much of this work has been characterized by a perceived need for a standard set of indicators. We used publication databases (e.g. Medline) and web searches to identify compilations of health indicators and health metrics. We found 14 long-term large-area compilations of health indicators and determinants and seven compilations of environmental health indicators, comprising hundreds of metrics. Despite the plethora of indicators, these compilations have striking similarities in the domains from which the indicators are drawn—an unappreciated concordance among the major collections. Research with these databases and other sources has produced a small number of composite indices, and a number of methods for the amalgamation of indicators and the demonstration of disparities. These indices have been primarily used for large-area (nation, region, state) comparisons, with both developing and developed countries, often for purposes of ranking. Small area indices have been less explored, in part perhaps because of the vagaries of data availability, and because idiosyncratic local conditions require flexible approaches as opposed to a fixed format. One result has been advances in the ability to compare large areas, but with a concomitant deficiency in tools for public health workers to assess the status of local health and health disparities. Large area assessments are important, but the need for small area action requires a greater focus on local information and analysis, emphasizing method over prespecified content.

BMC Research Notes
(Accessed 16 May 2015)
http://www.biomedcentral.com/bmcresnotes/content

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Research article
A community-based participatory research methodology to address, redress, and reassess disparities in respiratory health among First Nations
Punam Pahwa, Sylvia Abonyi, Chandima Karunanayake, Donna C Rennie, Bonnie Janzen, Shelley Kirychuk, Joshua A Lawson, Tarun Katapally, Kathleen McMullin, Jeremy Seeseequasis, Arnold Naytowhow, Louise Hagel, Roland F Dyck, Mark Fenton, Ambikaipakan Senthilselvan, Vivian Ramsden, Malcolm King, Niels Koehncke, Greg Marchildon, Lesley McBain, Thomas Smith-Windsor, Janet Smylie, Jo-Ann Episkenew, James A Dosman BMC Research Notes 2015, 8:199 (16 May 2015)
Abstract | Provisional PDF

British Medical Journal
16 May 2015(vol 350, issue 8008)
http://www.bmj.com/content/350/8008

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Editorials
Who should be vaccinated against HPV?
BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h2244 (Published 12 May 2015) Cite this as: BMJ 2015;350:h2244
Karen Canfell, director1

As richer countries consider vaccinating males, the focus for lower income countries should remain on cervical cancer prevention
Vaccination of girls against the human papillomavirus (HPV) has been implemented in most developed countries, driven by prevention of cervical cancer as a public health priority. Bivalent (Cervarix, GSK) and quadrivalent (Gardasil, Merck) vaccines protect against subsequent infection with oncogenic HPV16/18, and quadrivalent vaccine protects against HPV6/11, which cause anogenital warts. Although HPV vaccination effectively protects against external genital lesions and anal intraepithelial neoplasia in males, only a few jurisdictions have so far recommended universal vaccination of boys. These include Australia, Austria, two Canadian provinces, and the United States. In other countries, a cautious approach has been due, in part, to uncertainties around the population level impact and cost effectiveness of vaccination of boys.

In a linked article, Bogaards and colleagues (doi:10.1136/bmj.h2016) estimated the benefits to men of offering HPV vaccination to boys.1 They used a dynamic simulation and a bayesian synthesis to integrate the evidence on HPV related cancers in men. The analysis takes account of indirect protection from female vaccination: heterosexual men will benefit from reduced HPV circulation in females, so if coverage in girls is high the incremental benefit of vaccinating boys is driven by prevention of the residual burden of anal cancer in men who have sex with men.

The findings reinforce those of prior analyses that found that adding boys to established vaccination programmes in girls becomes less cost effective as female coverage increases.2 The cost effectiveness of vaccination of boys also depends on other local issues, especially vaccine type and vaccine and administration costs. A threshold total cost per vaccinated boy for cost effectiveness can be identified at any level of coverage in girls: such analyses can provide policy makers with the maximum rational vaccine price appropriate to the local environment. If vaccine coverage in girls is lower, however, the most effective use of resources is likely to involve increasing coverage in girls, if feasible.2 3

In some countries, vaccination of boys might not be cost effective, even at lower vaccine prices, due to higher administration costs.3 Recent developments towards reduced dose schedules could help. In 2013 the European Medical Agency recommended a two dose schedule for the bivalent vaccine in girls, in 2014 the United Kingdom switched to a two dose schedule, and the World Health Organization now recommends two doses for girls <15. Two dose schedules are the most cost effective option for girls provided protection lasts for ≥20 years4 and reduced dose schedules in boys are also likely to increase cost effectiveness if adequate efficacy is maintained.

Bogaards and colleagues highlight the importance of vaccination for prevention of anal cancer in men who have sex with men. In part due to uncertainties in natural history, the effectiveness of anal cancer screening is not established.5 Primary prevention with targeted vaccination of men who have sex with men is an attractive option and is potentially more cost effective than universal vaccination of boys. The US Advisory Committee on Immunization Practices already recommends vaccination of men who have sex with men up to the age of 26 years.6 Older men who have sex with men could also potentially benefit. The UK’s Joint Committee on Vaccination and Immunisation, as an interim position, recently stated that a programme to vaccinate men aged 16-40 who have sex with men with a quadrivalent vaccine should be considered, if cost effective.7 Lower coverage rates expected with targeted versus universal male vaccination are an important consideration, and the two approaches are not mutually exclusive.

Several other new developments should be factored in to future policy decisions. A recent study showed that the bivalent vaccine is effective in women aged ≥25 without a history of HPV disease.8 With a transition to primary HPV screening occurring in several countries, an interesting possibility to be evaluated involves “screen and vaccinate” strategies in older women—that is, offering HPV screening, followed by vaccination for HPV negative women with extended (or perhaps no) recall for this group. Secondly, a nonavalent vaccine (Gardasil9, Merck), which protects against an extra five HPV types,9 has recently been recommended for use in the US.6 In women, this will increase protection against cervical cancer in those who are fully vaccinated (from about 70% to about 90%)10 but as most HPV cancers in men are attributed to types included in current vaccines,1 tiered pricing structures for new generation vaccines based on differential incremental benefits (and thus differential cost effectiveness thresholds) in girls versus boys could be considered.

All these policy decisions must consider burden of disease, safety, effectiveness, acceptability, equity, and cost effectiveness. Although the focus in developed countries has now, appropriately, shifted to considering these issues for boys, men who have sex with men, and older women, broader efforts to prevent cervical cancer should remain the priority in low and middle income countries. Of the 610 000 cancers annually attributable to HPV worldwide, 87% are cancers of the cervix, and three quarters of these occur in countries with a low or medium human development index.11 Even if a substantial majority of young girls in such counties were vaccinated, hundreds of millions of older women would remain at risk—vaccination alone will not prevent an expected increase in cervical cancers in the next few decades, driven by population ageing. Here, the priority focus should be the development of integrated programmes for vaccinating young girls and screening older women. Based on experience in developed countries, this will also provide benefits for men through indirect vaccine protection.

Footnotes
Research, doi:10.1136/bmj.h2016

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Research
Direct benefit of vaccinating boys along with girls against oncogenic human papillomavirus: bayesian evidence synthesis
BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h2016 (Published 12 May 2015) Cite this as: BMJ 2015;350:h2016
Johannes A Bogaards, senior researcher12, Jacco Wallinga, senior researcher2, Ruud H Brakenhoff, professor3, Chris J L M Meijer, professor4, Johannes Berkhof, associate professor1
Author affiliations
Abstract
Objective
To assess the reduction in the vaccine preventable burden of cancer in men if boys are vaccinated along with girls against oncogenic human papillomavirus (HPV).
Design
Bayesian evidence synthesis approach used to evaluate the impact of vaccination against HPV types 16 and 18 on the burden of anal, penile, and oropharyngeal carcinomas among heterosexual men and men who have sex with men. The reduced transmission of vaccine-type HPV from vaccination of girls was assumed to lower the risk of HPV associated cancer in all men but not to affect the excess risk of HPV associated cancers among men who have sex with men.
Setting
General population in the Netherlands.
Intervention
Inclusion of boys aged 12 into HPV vaccination programmes.
Main outcome measures
Quality adjusted life years (QALYs) and numbers needed to vaccinate.
Results
Before HPV vaccination, 14.9 (95% credible interval 12.2 to 18.1) QALYs per thousand men were lost to vaccine preventable cancers associated with HPV in the Netherlands. This burden would be reduced by 37% (28% to 48%) if the vaccine uptake among girls remains at the current level of 60%. To prevent one additional case of cancer among men, 795 boys (660 to 987) would need to be vaccinated; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2162, 3486, and 1975, respectively. The burden of HPV related cancer in men would be reduced by 66% (53% to 805) if vaccine uptake among girls increases to 90%. In that case, 1735 boys (1240 to 2900) would need to be vaccinated to prevent an additional case; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2593, 29107, and 6484, respectively.
Conclusions
Men will benefit indirectly from vaccination of girls but remain at risk of cancers associated with HPV. The incremental benefit of vaccinating boys when vaccine uptake among girls is high is driven by the prevention of anal carcinomas, which underscores the relevance of HPV prevention efforts for men who have sex with men.

Human Rights Quarterly
Volume 37, Number 2, May 2015
http://muse.jhu.edu/journals/human_rights_quarterly/toc/hrq.37.2.html

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After Amnesties are Gone: Latin American National Courts and the new Contours of the Fight Against Impunity
Naomi Roht-Arriaza
pp. 341-382
Abstract
Latin America is the one region that, in the wake of massive and systematic violations of human rights, has made inroads into trying such crimes in national courts. After decades in which cases were dismissed on grounds of amnesty, statutes of limitations, or other impediments to trial, these barriers have fallen in a majority of countries. This turnaround—while fragile and incomplete—is remarkable. It provides important and inspirational lessons for lawyers, judges, and advocates in other regions, and for international justice efforts. Cases involving international crimes in the courts of Latin American countries have experienced distinct phases. In the first phase, advocates confronted barriers to bringing the cases into court at all. In the second and current phase, courts are facing the challenges of organizing trials that involve hundreds of defendants and victims, or using the elements of crimes like genocide to show overall patterns of atrocity. A final, emerging phase shifts the focus from trial to punishment. This phase has led to creative—and controversial—propositions about reduced sentences, suspended sentences, and alternatives to imprisonment in cases involving international crimes.

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World Poverty: Rights, Obligations, Institutions, Motivations
Michael Freeman
pp. 439-463
ABSTRACT:
A common criticism of international human rights declarations is that they lack an adequate account of the corresponding obligations. This criticism is often thought to be particularly apt when applied to economic and social rights. International human rights law imposes these obligations on states, but critics object that this treats the problem (state behavior) as the solution. This article examines the question of the obligations corresponding to economic and social rights in the context of debates about world poverty. It argues that the legal and philosophical emphasis on obligations must be supplemented by an understanding of both institutions and motivations if practical progress to eradicate world poverty is to be made.

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Business and Human Rights Indicators to Measure the Corporate Responsibility to Respect: Challenges and Opportunities
pp. 511-555
Damiano de Felice
ABSTRACT:
Business and human rights indicators, ratings, and indices have proliferated in the past few years. Yet, measuring respect for human rights by corporations is not an easy task. This article offers an overview of the most prominent business and human rights measurement initiatives and draws attention to the normative, methodological, practical, and political challenges related to the production of valid and emancipatory measures of corporate respect for human rights. The objective is to move the debate forward, from the “if” (whether to use indicators) to the “how” (how to create better initiatives).

International Health
Volume 7 Issue 3 May 2015
http://inthealth.oxfordjournals.org/content/current

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Noma: neglected, forgotten and a human rights issue
M. Leila Sroura,*, Klaas W. Marckb and Denise Baratti-Mayerc
Author Affiliations
aHealth Frontiers, Bhan Tat Khao, Vientiane, Laos
bDutch Noma Foundation, De Pôlle 24, 9084BT Goutum, The Netherlands
cGESNOMA (Geneva Study Group on Noma), Service of Plastic and Reconstructive Surgery, Geneva University Hospitals, Geneva, Switzerland
Abstract
Noma, an orofacial gangrene and opportunistic infection, affects primarily malnourished children living in extreme poverty. Neglected, forgotten, unknown by most health workers, noma results in death, disfigurement and disability of some of the world’s most vulnerable children. Noma is a biological indicator of multiple human rights violations, including the right to food. International support and national attention in countries with noma are lacking. The end of neglect of noma can lead to the elimination of this horrific childhood disease.

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Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan
Niamh Nic Carthaigha, Benoit De Gryseb, Abdul Sattar Esmatic, Barak Nizard, Catherine Van Overloope, Renzo Frickee, Jehan Bseisoa, Corinne Bakere, Tom Decroof and Mit Philipsa,*
Author Affiliations
aMédecins Sans Frontières–Operational Centre Brussels, Advocacy and Analysis Unit, Brussels
bMédecins Sans Frontières–Operational Centre Brussels, Afghanistan Mission, Kabul
cMinistry of Health–Afghanistan, Direction Ahmad Shah Baba District Hospital, Kabul, Afghanistan
dMinistry of Health–Afghanistan, Direction Boost Provincial Hospital, Helmand, Afghanistan
eMédecins Sans Frontières–Operational Centre Brussels, Operational Department, Brussels
fMédecins Sans Frontières–Operational Centre Brussels, Operational Research Unit, Brussels
Abstract
Background
The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services.
Methods
Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member.
Results
To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year.
Conclusions
Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare.

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Health worker perceptions of integrating mobile phones into community case management of malaria in Saraya, Senegal
Demetri A. Blanasa,*, Youssoupha Ndiayeb, Matthew MacFarlanec, Isaac Mangab, Ammar Siddiquid, Olivia Veleze, Andrew S. Kanterf, Kim Nicholsg and Nils Hennigd
Author Affiliations
aHarlem Residency in Family Medicine, Institute for Family Health, New York, New York, 10029, USA
bHealth District of Saraya, Senegalese Ministry of Health, Saraya, Senegal
cCenter on Child Protection, Jakarta, Indonesia
dMount Sinai Global Health, Icahn School of Medicine at Mount Sinai, New York, New York, 10029, USA
eICF International, New York, New York, 10028, USA
fEarth Institute, Columbia University, New York, New York, 10027, USA
gAfrican Services Committee, New York, New York, 10027, USA
Abstract
Background
Although community case management of malaria increases access to life-saving care in isolated settings, it contends with many logistical challenges. Mobile phone health information technology may present an opportunity to address a number of these barriers.
Methods
Using the wireless adaptation of the technology acceptance model, this study assessed availability, ease of use, usefulness, and job relevance of mobile phones by health workers in Saraya, Senegal.
Results
This study conducted seven key informant interviews with government health workers, and three focus groups and 76 surveys with lay health workers. Principal findings included that mobile phones are already widely available and used, and that participants valued using phones to address training, stock management, programme reporting, and transportation challenges.
Conclusions
By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal.

Journal of Infectious Diseases
Volume 211 Issue 16 May 1, 2015
http://jid.oxfordjournals.org/content/current

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Can epidemiology inform global health and development targets?
Alan D Lopez
Author Affiliations
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
[Initial text]
In 2015, the global health and development community will collectively assess the progress of nations towards achieving the Millennium Development Goals (MDGs), an ambitious framework for human development based on broad principles of equity, solidarity and poverty reduction. Of the 12 goals established to measure social and economic progress, three (MDG4, MDG5 and MDG6) relate directly to health development; reduction of child mortality, reduction of maternal mortality; and progress against the global epidemics of HIV/AIDS, malaria and tuberculosis, respectively.1 There has been much debate about whether global goals with explicit targets are useful or not in stimulating action by countries and donors to improve health. Whereas broad development goals are likely to receive strong endorsement by countries, the addition of specific targets might well be unwelcome, particularly if they are perceived as being too ambitious. Worse, the global focus on targets for the MDGs has driven a culture of accountability with an almost singular focus on whether a country is likely to achieve the specified targets or not, to the detriment of other important measures of progress. The political imperative that countries have no doubt felt to accelerate progress with health development because of the existence of the MDGs is laudable, and real, but it has not necessarily been the ideal policy environment to do so, for five principal reasons.

First, recent global assessments have suggested that only about one-quarter of all countries, and less than one in five developing countries, will achieve MDGs 4 and 5, obscuring the very substantial progress in reducing child mortality, for example, that has occurred in sub-Saharan Africa, India and much of eastern Europe since 2000.2–4 In many countries, these accelerated declines have been due to the success of bold public policies, and financing, to scale-up and ensure delivery of bed nets …

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Effect on child cognitive function of increasing household expenditure in Indonesia: application of a marginal structural model and simulation of a cash transfer programme
Amelia Maika1,2,*, Murthy N Mittinty1, Sally Brinkman1,3 and John Lynch1,4
Author Affiliations
1School of Population Health, University of Adelaide, SA, Australia, 2Department of Sociology, Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia, 3Telethon Kids Institute, University of Western Australia, Perth, WA, Australia and 4School of Social and Community Medicine, University of Bristol, Bristol, UK
Abstract
Background:
Parental investments in children are an important determinant of human capability formation. We investigated the causal effect of household expenditure on Indonesian children’s cognitive function between 2000 and 2007. We also investigated the effect of change in mean cognitive function from a simulation of a hypothetical cash transfer intervention.
Methods:
A longitudinal analysis using data from the Indonesian Family Life Survey (IFLS) was conducted including 6136 children aged 7 to 14 years in 2000 and still alive in 2007. We used the inverse probability of treatment weighting of a marginal structural model to estimate the causal effect of household expenditure on children’s cognitive function.
Results:
Cumulative household expenditure was positively associated with cognitive function z-score. From the marginal structural model, a 74534 rupiah/month (about US$9) increase in household expenditure resulted in a 0.03 increase in cognitive function z-score [β = 0.32, 95% confidence interval (CI) 0.30–0.35] Based on our simulations, among children in the poorest households in 2000 an additional ≈ US$6–10 of cash transfer resulted in a 0.01 unit increase in cognitive function z-score, equivalent to about 6% increase from the mean z-score prior to cash transfer. In contrast, children in the poorest household in 2007 did not benefit from an additional ≈ US$10 cash transfer. We found no overall effect of cash transfers at the total population level.
Conclusions:
Greater household expenditure had a small causal effect on children’s cognitive function. Although cash transfer interventions had a positive effect for poor children, this effect was quite small. Multi-faceted interventions that combine nutrition, cash transfer, improved living conditions and women’s education are required to benefit children’s cognitive development in Indonesia.

The Lancet
May 16, 2015 Volume 385 Number 9981 p1917-2014 e47-e48
http://www.thelancet.com/journals/lancet/issue/current

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Comment
For every woman, every child, everywhere: a universal agenda for the health of women, children, and adolescents
Sarah Zeid, Flavia Bustreo, Maha Taysir Barakat, Peter Maurer, Kate Gilmore
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60766-8
Summary
Preventable mortality and morbidity among women, adolescents, and children are severe in humanitarian settings. Data from the Organisation for Economic Co-operation and Development on 50 fragile states show that 60% of preventable maternal deaths, 53% of deaths in children younger than 5 years, and 45% of neonatal deaths take place in fragile settings of conflict, displacement, and natural disasters.1–3 Worldwide, women and children are up to 14 times more likely than men to die in a disaster.4

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World Report
Ebola vaccine trial in west Africa faces criticism
Miriam Shuchman
Published Online: 12 May 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60938-2
WHO has come under fire for its running of the Ebola ring vaccine trial in Guinea, with critics highlighting inadequate care of participants and patients. Miriam Shuchman report

PLOS Currents: Disasters
[Accessed 16 May 2015]
http://currents.plos.org/disasters/

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Moving Forward after Sendai: How Countries Want to Use Science, Evidence and Technology for Disaster Risk Reduction
May 14, 2015 • Research article
Background:
Following the 2004 Indian Ocean earthquake and tsunami event, the global community adopted the UN Hyogo Framework for Action (HFA) for Disaster Risk Reduction 2005-2015, which set out priorities to help countries achieve disaster resilience by encouraging the establishment of national platforms and strengthening disaster governance. In March 2015, UN member states adopted the successor to HFA, the Sendai Framework for Disaster Risk Reduction: 2015-2030 (SFDRR). The SFDRR recognises the cross-cutting nature of DRR policy and calls on stakeholders to help governments. Over the following months, the international science community as a stakeholder will contribute by outlining guidance, research opportunities and partnerships to help countries implement the new framework. To inform this process, this study examines government’ and national scientists’ perspectives about the needs to use science, evidence and technology to achieve disaster risk reduction (DRR) and put the words of the new framework into action.
Methods:
This study was conducted using qualitative content analysis and quantifiable survey results. Data was collected via extraction from published statements and online survey responses. For statement content analysis, search terms were determined iteratively in a sample of statements until no new terms emerged. Additionally, 167 national scientists were recruited to participate in the online survey with a response rate of 26.3% (44/167).
Findings:
Country priorities are clustered and clear, showing that there is a demand for greater science in DRR decision-making and solutions. The main themes highlighted by countries were promoting research and practitioner engagement; increase technology transfer mechanisms; open data; communication of usable evidence and user’s needs; education and training; and lastly, international cooperation all contributing to national capacity building. As identified, the main difficulties with existing delivery are gaps in knowledge, lack of coordination and a gap in capacity to use scientific evidence for policy-making.
Conclusions:
Countries and organisations have identified a range of science and technology related needs, including through the preparatory and drafting process for the Sendai Framework for DRR. Across regions and development levels, countries are seeking to address the gaps they face in scientific capacities and information. It is hoped that understanding these priorities and challenges will help decision-makers and scientists in developing the implementation plan to consider how science, technology and innovation can be enabling factors for DRR. An implementation plan of action underpinned by scientific evidence has the potential to save lives, more accurately target investment, and contribute to greater resilience over the coming decades.

PLoS Medicine
(Accessed 16 May 2015)
http://www.plosmedicine.org/

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A Global Biomedical R&D Fund and Mechanism for Innovations of Public Health Importance
Manica Balasegaram, Christian Bréchot, Jeremy Farrar, David Heymann, Nirmal Ganguly, Martin Khor, Yves Lévy, Precious Matsoso, Ren Minghui, Bernard Pécoul, Liu Peilong, Marcel Tanner, John-Arne Røttingen
Essay | published 11 May 2015 | PLOS Medicine 10.1371/journal.pmed.1001831
Summary Points
:: Anti-microbial resistance, emerging infectious diseases, and neglected diseases are all important public health concerns and priorities with serious market failures, deficits, and identified needs in biomedical innovation.
:: It is important to reconcile, rather than fragment, the needs of these three priority areas by considering an umbrella framework for specifically financing and coordinating research and development (R&D) that delivers innovation while securing patient access.
:: A sizeable, sustainably financed global R&D fund and mechanism that promotes coordination, collaboration, and utilization of new and innovative incentives should be set up to cover all three priority areas.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 16 May 2015)

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Prospects for Malaria Elimination in Mesoamerica and Hispaniola
Sócrates Herrera, Sergio Andrés Ochoa-Orozco, Iveth J. González, Lucrecia Peinado, Martha L. Quiñones, Myriam Arévalo-Herrera
Review | published 14 May 2015 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0003700
Abstract
Malaria remains endemic in 21 countries of the American continent with an estimated 427,000 cases per year. Approximately 10% of these occur in the Mesoamerican and Caribbean regions. During the last decade, malaria transmission in Mesoamerica showed a decrease of ~85%; whereas, in the Caribbean region, Hispaniola (comprising the Dominican Republic [DR] and Haiti) presented an overall rise in malaria transmission, primarily due to a steady increase in Haiti, while DR experienced a significant transmission decrease in this period.

The significant malaria reduction observed recently in the region prompted the launch of an initiative for Malaria Elimination in Mesoamerica and Hispaniola (EMMIE) with the active involvement of the National Malaria Control Programs (NMCPs) of nine countries, the Regional Coordination Mechanism (RCM) for Mesoamerica, and the Council of Health Ministries of Central America and Dominican Republic (COMISCA). The EMMIE initiative is supported by the Global Fund for Aids, Tuberculosis and Malaria (GFATM) with active participation of multiple partners including Ministries of Health, bilateral and multilateral agencies, as well as research centers. EMMIE’s main goal is to achieve elimination of malaria transmission in the region by 2020. Here we discuss the prospects, challenges, and research needs associated with this initiative that, if successful, could represent a paradigm for other malaria-affected regions.

PLoS One
[Accessed 16 May 2015]
http://www.plosone.org/

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Research Article
“The One Who Chases You Away Does Not Tell You Go”: Silent Refusals and Complex Power Relations in Research Consent Processes in Coastal Kenya
Dorcas M. Kamuya, Sally J. Theobald, Vicki Marsh, Michael Parker, Wenzel P. Geissler, Sassy C. Molyneux
Published: May 15, 2015
DOI: 10.1371/journal.pone.0126671
Abstract
Consent processes have attracted significant research attention over the last decade, including in the global south. Although relevant studies suggest consent is a complex negotiated process involving multiple actors, most guidelines assume consent is a one-off encounter with a clear ‘yes’ or ‘no’ decision. In this paper we explore the concept of ‘silent refusals’, a situation where it is not clear whether potential participants want to join studies or those in studies want to withdraw from research, as they were not actively saying no. We draw on participant observation, in-depth interviews and group discussions conducted with a range of stakeholders in two large community based studies conducted by the KEMRI Wellcome Trust programme in coastal Kenya. We identified three broad inter-related rationales for silent refusals: 1) a strategy to avoid conflicts and safeguard relations within households, – for young women in particular—to appear to conform to the wishes of elders; 2) an approach to maintain friendly, appreciative and reciprocal relationships with fieldworkers, and the broader research programme; and 3) an effort to retain study benefits, either for individuals, whole households or wider communities. That refusals and underlying rationales were silent posed multiple dilemmas for fieldworkers, who are increasingly recognised to play a key interface role between researchers and communities in many settings. Silent refusals reflect and reinforce complex power relations embedded in decisions about research participation, with important implications for consent processes and broader research ethics practice. Fieldworkers need support to reflect upon and respond to the ethically charged environment they work in.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 16 May 2015)

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Resilience and reactivity of global food security
Samir Suweisa, Joel A. Carrb, Amos Maritana, Andrea Rinaldoc,d,1, and Paolo D’Odoricob,e
Author Affiliations
Significance
The past few decades have seen an intensification of international food trade and the increase in the number of countries that depend on food imports. As an effect of the associated globalization of food, local shocks in food production, combined with the adoption of new national or regional energy and trade policies, have recently led to global food crises. Here we develop a framework to investigate the coupled global food–population dynamics, and evaluate the effect of international trade on global food security. We find that, as the dependency on trade increases, the global food system is losing resilience and is becoming increasingly unstable and susceptible to conditions of crisis.
Abstract
The escalating food demand by a growing and increasingly affluent global population is placing unprecedented pressure on the limited land and water resources of the planet, underpinning concerns over global food security and its sensitivity to shocks arising from environmental fluctuations, trade policies, and market volatility. Here, we use country-specific demographic records along with food production and trade data for the past 25 y to evaluate the stability and reactivity of the relationship between population dynamics and food availability. We develop a framework for the assessment of the resilience and the reactivity of the coupled population–food system and suggest that over the past two decades both its sensitivity to external perturbations and susceptibility to instability have increased.

Reproductive Health
Volume 12 Supplement 1 [2015]
http://www.reproductive-health-journal.com/supplements/12/S1
Special Supplement – True costs of maternal death
Edited by Jose Belizan and Suellen Miller
An accompanying blog can be found here.
Publication charges for this supplement were funded by Family Care International and the FXB Center for Health and Human Rights. The articles have been through the journal’s standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.

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Research
Intergenerational impacts of maternal mortality: Qualitative findings from rural Malawi
Junior Bazile, Jonas Rigodon, Leslie Berman, Vanessa M Boulanger, Emily Maistrellis, Pilira Kausiwa, Alicia Yamin Reproductive Health 2015, 12(Suppl 1):S1 (6 May 2015)

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Research
Continuing with “…a heavy heart” – consequences of maternal death in rural Kenya
Rohini Pande, Sheila Ogwang, Robinson Karuga, Radha Rajan, Aslihan Kes, Frank O Odhiambo, Kayla Laserson, Kathleen Schaffer Reproductive Health 2015, 12(Suppl 1):S2 (6 May 2015)

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Research
The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya
Aslihan Kes, Sheila Ogwang, Rohini Pande, Zayid Douglas, Robinson Karuga, Frank O Odhiambo, Kayla Laserson, Kathleen Schaffer Reproductive Health 2015, 12(Suppl 1):S3 (6 May 2015)

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Research
Consequences of maternal mortality on infant and child survival: a 25-year longitudinal analysis in Butajira Ethiopia (1987-2011)
Corrina Moucheraud, Alemayehu Worku, Mitike Molla, Jocelyn E Finlay, Jennifer Leaning, Alicia Yamin Reproductive Health 2015, 12(Suppl 1):S4 (6 May 2015)

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Research
“Without a mother”: caregivers and community members’ views about the impacts of maternal mortality on families in KwaZulu-Natal, South Africa
Lucia Knight, Alicia Yamin Reproductive Health 2015, 12(Suppl 1):S5 (6 May 2015)

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Research
Impacts of maternal mortality on living children and families: A qualitative study from Butajira, Ethiopia
Mitike Molla, Israel Mitiku, Alemayehu Worku, Alicia Yamin Reproductive Health 2015, 12(Suppl 1):S6 (6 May 2015)

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Research
The impacts of maternal mortality and cause of death on children’s risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013)
Brian Houle, Samuel J Clark, Kathleen Kahn, Stephen Tollman, Alicia Yamin Reproductive Health 2015, 12

Science
15 May 2015 vol 348, issue 6236, pages 729-832
http://www.sciencemag.org/current.dtl
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In Depth
Infectious Diseases
Ebola survivors fight back in plasma studies
Martin Enserink*
In the Guinean capital, Conakry, 90 people have so far been treated in a clinical trial that aims to seek whether plasma from Ebola survivors can help patients. Animal studies of similar therapies had yielded mixed results, and the findings of a small human study in 1995 were ambiguous. The study aims to recruit 130 patients, but enrollment has ground to a halt because the last Ebola patient in Conakry was discharged on 28 April. Results are expected later this year, but researchers acknowledge that they will be difficult to interpret because the study has no control arm.

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Policy Forum
Public Health
Linking funds to actions for global health emergencies
C. J. Standley, E. M. Sorrell, S. Kornblet, A. Vaught, J. E. Fischer, R. Katz*
Author Affiliations
Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
The failings of the international community’s response to the Ebola virus disease outbreak in West Africa underscore the need for new mechanisms for governance and mobilization of resources for timely, coordinated responses to public health threats (1). Creating a global finance mechanism, ideally tied to existing global health frameworks, is a first step. The World Bank recently announced it would create a Pandemic Emergency Facility (PEF). The next necessary element is a trigger to release those funds to support rapid and effective responses during early phases of a public health event. With the World Health Assembly convening soon, we suggest how the World Health Organization’s (WHO’s) International Health Regulations (IHR) present such an initiator.

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The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 9 May 2015

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf verion: The Sentinel_ week ending 9 May 2015

blog edition: comprised of the 35+ entries to be posted below on 9 May 2015

Nepal earthquake: UN says it has only received fraction of necessary aid
Agence France-Presse in Kathmandu
Friday 8 May 2015 04.23 EDT
UN says aid contributions must be ‘dramatically ramped up’ because it has received only $22m of the requested $415m
The UN resident coordinator for Nepal, Jamie McGoldrick: ‘The relief needs remain great and we urgently need funds to be able to continue our work.’

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WHO committed to helping Nepal deliver health care to its citizens
7 May 2015 — More must be done to protect the health of Nepal’s people following the recent earthquake said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, on a visit to Kathmandu today. High on her agenda are preparations to prevent disease outbreaks ahead of the oncoming rainy season, WHO’s commitment to support the country’s health system, and assistance for its heroic health workers as they recover from the disaster once the emergency phase has passed.

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Nepal earthquake: Emergency immunisation campaign for hundreds of thousands of children – UNICEF
KATHMANDU, Nepal, 4 May 2015 – More than half a million children are being targeted in an emergency vaccination drive in Nepal – as fears grow of measles outbreaks in the informal camps that have sprung up since the earthquake on 25 April.
The campaign was launched by the Nepalese Ministry of Health and Population, with support from UNICEF and the World Health Organisation.