The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
Week ending 26 September 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

pdf version: The Sentinel_ week ending 26 September 2015

blog edition: comprised of the 35+ entries to be posted below on 27 September 2015

Pact [to 19 September 2015]

Pact [to 19 September 2015]

Systemic change still far off, but ‘space is opening up’ for civil society improvements in Belarus, panel says
Corinne Reilly | September 17, 2015
Although significant challenges remain, civil society improvements are taking place in Belarus, according to a panel of experts who spoke Sept. 1o in Washington, D.C. They described the changes as fragile but important, as many civic activities happening in the country today were unimaginable as recently as a few years ago.

Save The Children [to 19 September 2015]

Save The Children [to 19 September 2015]

In Serbia One In Four Refugee Children Arrive Alone, Save the Children Reports
Belgrade, Serbia (Sept. 18, 2015) — Save the Children is stepping up its emergency response to the refugee crisis in Serbia, where more than 25,000 children have arrived this year alone, including at least 5,753 unaccompanied minors.
Based on the latest data provided to UNHCR by the Serbian government, Save the Children estimates that there has been a 66 percent increase in the arrival of unaccompanied minors in Serbia between July and August this year alone, with more than one in four recently-arrived children having been separated from their parents and families, leaving them particularly at risk of trafficking, abuse, and exploitation…

More Than Half of All School Attacks Have Been in Syria, New Data Shows
FAIRFIELD, Conn. (Sept. 16, 2015) — More than half of all attacks on schools worldwide in the last four years have occurred in Syria, according to Save the Children, compounding the humanitarian crisis that has already forced four million Syrian refugees to flee to camps in over-crowded surrounding states, or onwards towards Europe…

Google’s Global Public Giving Campaign to Support Assistance for Child Refugees
Sept. 15, 2015

SOS-Kinderdorf International [to 19 September 2015]

SOS-Kinderdorf International [to 19 September 2015]

SOS Children’s Villages Germany increasing capacity for refugees
17.09.2015 – With decades of experience supporting vulnerable families and children without parental care, including many asylum seekers, SOS Children’s Villages Germany is gearing up to provide homes and help for more refugees.

Unaccompanied refugee children given SOS homes in Austria
15.09.2015 – More than 30 refugee children and young people who came into Austria without their parents or caregivers have already found new homes through SOS Children’s Villages in Austria. Plans are underway to provide homes for at least 70 more before the end of the year.

The Elders [to 19 September 2015]

The Elders [to 19 September 2015]

News Martti Ahtisaari 17 September 2015
A decent start
In our first of seven films leading up to the launch of the Sustainable Development Goals, Martti Ahtisaari describes his object and what fairness means to him. Join in the discussion yourself on Facebook or Twitter.
Read our first blog about fairness

Guest blog Frances Stewart 16 September 2015
One flaw in the Sustainable Development Goals may make the difference between success and failure
Frances Stewart, Emeritus Professor of development economics at the University of Oxford and former Chair of the United Nations Committee for Development Policy, wonders if the weak coupling between economic growth and sustainability will do enough to change our reliance on non-renewable energy.

Opinion Gro Harlem Brundtland, Graça Machel 15 September 2015
Securing a sustainable future
Writing for Project Syndicate, Gro Harlem Brundtland and Graça Machel call on world leaders attending the launch of the Sustainable Development Goals in September to commit to putting the words of the Goals into action, justly and effectively.

Global Humanitarian Assistance (GHA) [to 19 September 2015]

Global Humanitarian Assistance (GHA) [to 19 September 2015]

Displacement in Colombia
Report Synopsis
Date: 2015/09/18
On 16 September 2015 we responded to a funding alert in response to displacement in the departments of Norte de Santander, Arauca, La Guajira and Vichada in Colombia.

Due to political disputes between Venezuela and Colombia, an approximately 21,434 people are thought to have been deported or returned to Colombia since 21 August. UN Office for the Coordination of Humanitarian Affairs (OCHA) estimates a further 19,952 Colombians have returned without having registered as deported. A total of 1,482 are registered as deported to Colombia at crossings.

According to the UN OCHA’s Financial Tracking Service (FTS), donors have committed or contributed US$49.5 million of humanitarian assistance to Colombia so far in 2015. The European Commission’s Humanitarian Aid and Civil Protection (ECHO) department is the top donor, having contributed or committed US$23.6 million to the crisis.

So far in 2015, US$3 million has been disbursed to the affected Norte de Santander, Arauca and Vichada departments of Colombia, of which 13% is for assistance to displaced populations. Out of total funding in 2015, US$9.9 million is allocated to support displaced populations elsewhere in the country…

Read our full analysis of the current funding situation.

ODI [to 19 September 2015]

ODI [to 19 September 2015]

Give people cash, not goods, to make humanitarian aid more effective
News | 13 September 2015
Humanitarian assistance could be more effective, more efficient and more transparent if aid was given in the form of cash directly to people struggling to survive in crises, according to a high-level panel of experts in a new report published by the Overseas Development Institute (ODI) and the Center for Global Development (CGD).

Providing cash means that limited humanitarian aid can go further to help more people in need. That means greater value for money for taxpayers. Cash is also less wasteful as it means aid recipients can decide for themselves exactly what they most need.

The panel found that cash-based aid programmes can improve accountability and transparency of aid while also helping to support local markets and industries.

“Humanitarian organisations owe it to aid recipients and taxpayers to deliver the best possible aid programmes. As the report outlines, cash transfers have the potential to reduce vulnerability, help rebuild lives, and deliver value for money. As part of a broader menu that includes partnerships with the private sector, investment in digital technology, and the development of a more inclusive humanitarian system, cash transfers can transform the effectiveness of humanitarian aid at a time of unprecedented need,” said Kevin Watkins, Executive Director of ODI…

MacArthur Foundation [to 19 September 2015]

MacArthur Foundation [to 19 September 2015]

Assessing American Attitudes on Foreign Policy
Published September 17, 2015
American public opinion on foreign policy, including on issues like immigration, climate change, and advancing U.S. global interests, is sharply divided among Republicans, Democrats, and Independents, according to a survey from The Chicago Council on Global Affairs. The survey shows that despite historic differences on issues that even a decade ago were more bipartisan, the American public remains committed to engagement in the world, with 64 percent of Americans supporting an active U.S. role in world affairs.

Identifying Evidence Gaps in Secondary Education
Published September 17, 2015
Research by 3ie, supported by MacArthur in partnership with the Mastercard Foundation, identifies evidence gaps in the application of transferable skills programs in low- and middle-income countries. Transferable skills provide youth with critically needed tools for success in employment, health, and personal well-being. The scoping paper and report reveal needs for evidence in several categories, including teacher training programs and curriculum reform, learner-centered teaching, and institutional management and capacity building.

Gordon and Betty Moore Foundation [to 19 September 2015]

Gordon and Betty Moore Foundation [to 19 September 2015]

Sustainable ranching program receives 11.5 million Euros to reduce deforestation in Brazil
September 17, 2015
Instituto Centro de Vida (ICV) has announced that Novo Campo, a sustainable cattle ranching initiative in Brazil’s Mato Grasso state, received an investment of 11.5 million Euros from the Althelia Climate Fund to support the program’s efforts to increase economic, social and environmental performance of local ranches…

Gordon and Betty Moore Foundation awards $2.3M for plant disease resistance
September 15, 2015
PALO ALTO, Calif. Sept. 15, 2015 — The Gordon and Betty Moore Foundation awarded $2.3M to the Two Blades Foundation (2Blades), a charitable organization that supports the development of durable disease resistance in crop plants and their deployment in agriculture.
Four well-recognized research teams will investigate plant immunity…

Open Society Foundation [to 19 September 2015]

Open Society Foundation [to 19 September 2015][0]=type%3Anews

European Roma Institute for Arts and Culture Endorsed by Council of Europe
September 16, 2015News
The 47 member states of the Council of Europe will join the initiative to establish a European Roma Institute for Arts and Culture. This decision means that the Council of Europe will be a cofounder of the Institute, next to the Open Society Foundations and the Alliance for the European Roma Institute, a coalition of Roma civil society organizations, activists, and artists.
Zeljko Jovanovic, director of the Open Society Roma Initiatives Office, said, “The European Roma Institute will be a place to encourage the resilience and creative power of Roma communities across Europe; it will help create a sense of pride among Roma and respect for Roma among all Europeans.”…

Pew Charitable Trusts [to 19 September 2015]

Pew Charitable Trusts [to 19 September 2015]

Pew Scholar Stephen Elledge Wins 2015 Lasker Award
September 17, 2015
Stephen Elledge, Ph.D., an investigator at the Howard Hughes Medical Institute, professor at Harvard Medical School and 1991 Pew scholar, has been named co-winner of the 2015 Albert Lasker Basic Medical Research Award for his groundbreaking work to uncover how cells respond to damaged DNA. First given in 1945, the Lasker Award is considered one of the world’s highest scientific honors and is given to scientists who have made significant contributions to the “understanding, diagnosis, treatment, cure, and prevention of human disease.”

Elledge, who shares the prize with Evelyn Witkin of Rutgers University, discovered that cells have a massive signaling network for sensing and repairing DNA damage. Human cells encounter damaged DNA every day, and if the damage is not repaired quickly it can lead to mutations in genes that typically protect us from diseases such as cancer. Elledge’s work identified the mechanisms for response that keep our genes intact, and his discoveries pave the way to a greater understanding of how these diseases occur…

Robert Wood Johnson Foundation [to 19 September 2015]

Robert Wood Johnson Foundation [to 19 September 2015]

Three Lessons on Improving Quality of Care in Communities
Sep 15, 2015, 10:16 AM, Posted by Anne Weiss
Aligning Forces for Quality not only transformed care in 16 communities, but it provided insights to help shape efforts building a national Culture of Health through high value care.

Wellcome Trust [to 19 September 2015]

Wellcome Trust [to 19 September 2015]

Wellcome Trust announces three Engagement Fellows for 2015
Three new Engagement Fellows will be taking up Wellcome Trust Engagement Fellowships in September 2015. Bella Starling, Delia Muir and Steve Cross have been awarded the-two year Fellowships, with plans to work on projects that will take the field of public engagement in new and exciting directions.
17 September 2015.

American Journal of Disaster Medicine – Spring 2015, Volume 10, Number 2

American Journal of Disaster Medicine
Spring 2015, Volume 10, Number 2

Assessment of the accuracy of the Medical Response to Major Incidents (MRMI) course for interactive training of the response to major incidents and disasters
Kristina Lennquist Montán, RN; Per Örtenwall, MD, PhD; Sten Lennquist, MD, PhD
Spring 2015; pages 93-107
Background and aims:
The benefit of simulation models for interactive training of the response to major incidents and disasters has been increasingly recognized during recent years and a variety of such models have been reported. However, reviews of this literature show that the majority of these reports have been characterized by significant limitations regarding validation of the accuracy of the training related to given objectives. In this study, precourse and postcourse self-assessment surveys related to the specific training objectives, as an established method for curriculum validation, were used to validate the accuracy of a course in Medical Response to Major Incidents (MRMI) developed and organized by an international group of experts under the auspices of the European Society for Trauma and Emergency Surgery.
The studied course was an interactive course, where all trainees acted in their normal roles during two full-day simulation exercises with real time and with simultaneous training of the whole chain of response: scene, transport, the different functions in the hospital, communication, coordination, and command. The key component of the system was a bank of magnetized casualty cards, giving all information normally available as a base for decisions on triage and primary management. All treatments were indicated with attachments on the cards and consumed time and resources as in reality. The trainees’ performance was recorded according to prepared protocols and a measurable result of the response could be registered. This study was based on five MRMI courses in four different countries with altogether 235 participants from 23 different countries. In addition to conventional course evaluations and recording of the performance during the 2 exercise days, the trainees’ perceived competencies related to the specific objectives of the training for different categories of staff were registered on a floating scale 1-10 in self-assessment protocols immediately before and after the course. The results were compared as an indicator of to which extent the training fulfilled the given objectives. These objectives were set by an experienced international faculty and based on experiences from recent major incident and disasters.
Comparison of precourse and postcourse self-assessments of the trainees’ perceived knowledge and skills related to the given objectives for the training showed a significant increase in all the registered parameters for all categories of participating staff. The average increase was for prehospital staff 74 percent (p < 0.001), hospital staff 65 percent (p < 0.001), and staff in coordinating/administrative functions 81 percent (p < 0.001).
The significant differences in the trainees’ self-assessment of perceived competencies between the precourse and postcourse surveys indicated that the methodology in the studied course model accurately responded to the specific objectives for the different categories of staff. DOI:10.5055/ajdm.2015.0194


Modernizing stockpiles of medical countermeasures against smallpox: Benefits, risks, and knowledge gaps
Martin B. Oleksiewicz, DVM, PhD; Nina R. Steenhard, DVM, PhD; John-Erik Stig Hansen, MD, DMSc
Spring 2015; pages 109-120
Objective: New smallpox medical countermeasures are entering the marketplace, offering the opportunity to modernize existing stockpiles. However, new smallpox countermeasures are developed under the animal rule, meaning that human efficacy data are lacking, and human safety data may be limited. Also, stockpile modernization would require prioritization of increasingly limited public funds. Approaches to address these issues are needed. Methods: Smallpox vaccine data were gathered by literature search. The financial value of vaccination in the face of an outbreak was evaluated using a threat-based cost/benefit analysis model, involving i) estimation of the efficacy of new smallpox vaccines based on available clinical data on virus-neutralizing seroconversion in vaccinees, ii) estimation of the likelihood for a smallpox outbreak in Denmark, and iii) estimation of the expected life-saving effects of postevent vaccination. Results: The authors estimated that i) the likelihood of a smallpox outbreak in Denmark is very low (one event in 200,000 years), ii) the expected efficacy of currently available and new vaccines is 95 and 75 percent, respectively, iii) the expected frequency of serious side effects from vaccination is between 100 and 10,000 fold lower for new than for existing vaccines, depending on modes of action. Conclusions: Despite the very low likelihood for a smallpox outbreak, the potentially large consequences combined with the protective effect of vaccination make maintenance of the smallpox vaccine stockpile justified and valuable. For vaccination in the face of a smallpox outbreak, a high efficacy rather than a lowered rate of adverse effects would maximize the number of lives saved.


The Ebola Spatial Care Path(TM): Accelerating point-of-care diagnosis, decision making, and community resilience in outbreaks
Gerald J. Kost, MD, PhD, MS, FACB; William J. Ferguson, MS; Jackie Hoe; Anh-Thu Truong; Arirat Banpavichit, MS, MBA; Surin Kongpila, MS
Spring 2015; pages 121-143
To present a vision where point-of-care testing (POCT) accelerates an Ebola Spatial Care Path™ (SCP) and future molecular diagnostics enable facilitated-access self-testing (FAST POC); to design an alternate care facility (ACF) for the SCP; to innovate an Ebola diagnostic center (DC); and to propel rapid POCT to the frontline to create resilience that stops future outbreaks. Design:
PubMed, literature, and web searches. Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Medicine Without Frontiers, and World Health Organization (WHO) document analyses. Investigations in China, the Philippines, Thailand, and the United States. Review of SE Asia, US, and West Africa isolation-treatment centers. Innovation of a SCP, ACF, and DC suitable for American and other communities.
The authors designed an ACF and DC to integrate SCP principles for urgent Ebola care. FDA emergency use authorizations for Ebola molecular diagnostics were discovered, but no portable, handheld, or self-contained molecular POC instruments are yet available, although feasible. The WHO initiated design criteria and an acceptance protocol for testing. Financial investment in POCT will downsize Ebola outbreaks.
POCT is facilitating global health. Now, global health problems are elevating POCT to new levels of importance for accelerating diagnosis and evidence-based decision making during disease outbreaks. Authorities concur that rapid diagnosis has potential to stop disease spread. With embedded POCT, strategic SCPs planned by communities fulfill CDC recommendations. POC devices should consolidate multiplex test clusters supporting patients with Ebola in isolation. The ultimate future solution is FAST POC. New technologies offer minimally significant risks. Diagnostic centers in ACFs and transportable formats also will optimize Ebola SCPs. Key words: alternate care facility, biosafety cabinet, diagnostic center, empowerment, facilitated-access self-testing, hemorrhagic fever, isolation, near-patient testing, needs assessment, newdemic, outbreak, personal protective equipment, persons under investigation, point-of-care culture, POC technologies, POC testing, return on investment, small-world network, treatment center DOI:10.5055/ajdm.2015.0196

BMC Health Services Research (Accessed 19 September 2015)

BMC Health Services Research
(Accessed 19 September 2015)

Research article
Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens
Rapeepong Suphanchaimat, Kanang Kantamaturapoj, Weerasak Putthasri, Phusit Prakongsai BMC Health Services Research 2015, 15:390 (17 September 2015)
In recent years, cross-border migration has gained significant attention in high-level policy dialogues in numerous countries. While there exists some literature describing the health status of migrants, and exploring migrants’ perceptions of service utilisation in receiving countries, there is still little evidence that examines the issue of health services for migrants through the lens of providers. This study therefore aims to systematically review the latest literature, which investigated perceptions and attitudes of healthcare providers in managing care for migrants, as well as examining the challenges and barriers faced in their practices.
A systematic review was performed by gathering evidence from three main online databases: Medline, Embase and Scopus, plus a purposive search from the World Health Organization’s website and grey literature sources. The articles, published in English since 2000, were reviewed according to the following topics: (1) how healthcare providers interacted with individual migrant patients, (2) how workplace factors shaped services for migrants, and (3) how the external environment, specifically laws and professional norms influenced their practices. Key message of the articles were analysed by thematic analysis.
Thirty seven articles were recruited for the final review. Key findings of the selected articles were synthesised and presented in the data extraction form. Quality of retrieved articles varied substantially. Almost all the selected articles had congruent findings regarding language andcultural challenges, and a lack of knowledge of a host country’s health system amongst migrant patients. Most respondents expressed concerns over in-house constraints resulting from heavy workloads and the inadequacy of human resources. Professional norms strongly influenced the behaviours and attitudes of healthcare providers despite conflicting with laws that limited right to health services access for illegal migrants.
The perceptions, attitudes and practices of practitioners in the provision of healthcare services for migrants were mainly influenced by: (1) diverse cultural beliefs and language differences, (2) limited institutional capacity, in terms of time and/or resource constraints, (3) the contradiction between professional ethics and laws that limited migrants’ right to health care. Nevertheless, healthcare providers addressedsuch problems by partially ignoring the immigrants’precarious legal status, and using numerous tactics, including seeking help from civil society groups, to support their clinical practice.
It was evident that healthcare providers faced several challenges in managing care for migrants, which included not only language and cultural barriers, but also resource constraints within their workplaces, and disharmony between the law and their professional norms. Further studies, which explore health care management for migrants in countries with different health insurance models, are recommended.

Research article
A systematic review of social, economic and diplomatic aspects of short-term medical missions
Paul Caldron, Ann Impens, Milena Pavlova, Wim Groot BMC Health Services Research 2015, 15:380 (15 September 2015)
Short-term medical missions (STMMs) represent a grass-roots form of aid, transferring medical services rather than funds or equipment. The objective of this paper is to review empirical studies on social, economic and diplomatic aspects of STMMs.
A systematic literature review was conducted by searching PubMed and EBSCOhost for articles published from 1947–2014 about medical missions to lower and middle income countries (LMICs). Publications focused on military, disaster and dental service trips were excluded. A data extraction process was used to identify publications relevant to our objective stated above.
PubMed and EBSCOhost searches provided 4138 and 3262 articles respectively for review. Most articles that provide useful information have appeared in the current millennium and are found in focused surgical journals. Little attention is paid to aspects of volunteerism, altruism and philanthropy related to STMM activity in the literature reviewed (1 article). Evidence of professionalization remains scarce, although elements including guidelines and tactical instructions have been emerging (27 articles). Information on costs (10 articles) and commentary on the relevance of market forces (1 article) are limited. Analyses of spill-over effects, i.e., changing attitudes of physicians or their communities towards aid, and characterizations of STMMs as meaningful foreign aid or strategic diplomacy are few (4 articles).
The literature on key social, economic and diplomatic aspects of STMMs and their consequences is sparse. Guidelines, tactical instructions and attempts at outcome measures are emerging that may better professionalize the otherwise unregulated activity. A broader discussion of these key aspects may lead to improved accountability and intercultural professionalism to accompany medical professionalism in STMM activity.

Ethical oversight in quality improvement and quality improvement research: new approaches to promote a learning health care system

BMC Medical Ethics
(Accessed 19 September 2015)

Ethical oversight in quality improvement and quality improvement research: new approaches to promote a learning health care system
Kevin Fiscella, Jonathan Tobin, Jennifer Carroll, Hua He, Gbenga Ogedegbe BMC Medical Ethics 2015, 16:63 (17 September 2015)

BMC Public Health (Accessed 19 September 2015)

BMC Public Health
(Accessed 19 September 2015)

Research article
Subjective health of undocumented migrants in Germany – a mixed methods approach
Anna Kuehne, Susann Huschke, Monika Bullinger BMC Public Health 2015, 15:926 (19 September 2015)

Research article
Experiencing ‘pathologized presence and normalized absence’; understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status
Mei Fang, Judith Sixsmith, Rebecca Lawthom, Ilana Mountian, Afifa Shahrin BMC Public Health 2015, 15:923 (19 September 2015)

Research article
Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews
Isolde Sommer, Ursula Griebler, Peter Mahlknecht, Kylie Thaler, Kathryn Bouskill, Gerald Gartlehner, Shanti Mendis BMC Public Health 2015, 15:914 (18 September 2015)

Coincident polio and Ebola crises expose similar fault lines in the current global health regime

Conflict and Health
[Accessed 19 September 2015]

Coincident polio and Ebola crises expose similar fault lines in the current global health regime
Calain P and Abu Sa’Da C Conflict and Health 2015, 9:29 (16 September 2015)



In 2014, the World Health Organization (WHO) declared two “public health emergencies of international concern”, in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine.


The resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the (2005) International Health Regulations (IHR) framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats.


The securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68 th World Health Assembly address these fundamental issues.

Development in Practice – Volume 25, Issue 7, 2015

Development in Practice
Volume 25, Issue 7, 2015

Overcoming poverty and inequality: Rwanda’s progress towards the MDGs
Pamela Abbott, Roger Sapsford* & John Rwirahira
pages 921-934
Published online: 02 Sep 2015
Despite the 1994 genocide there has been annual growth in Rwanda every year since 2000. Poverty has decreased; while the MDG target of 23.8% is unlikely to be met by 2015, the future looks hopeful. The goal of reducing hunger is measured by underweight children – already down to target – and extreme poverty – likely to hit the target. Key to success is reducing dependency on the land, but a majority of the population still depend on their farm or plot. However, hitting targets for reducing poverty is not the same thing as abolishing it, and achieving targets does not necessarily solve problems.

NGOs as intermediaries in post-disaster rural reconstruction: findings from research in India
Bipasha Baruah*
pages 951-965
Published online: 02 Sep 2015
Drawing upon research conducted in Gujarat, India, this article identifies the potential and limitations for NGOs to serve as intermediaries (between beneficiaries, governments, and international relief/development organisations) on post-disaster rural reconstruction projects. Findings reveal that NGOs can play important roles in facilitating the design and construction of high-quality, culturally appropriate housing; revitalising and diversifying livelihoods; and reducing physical and social vulnerability to future disasters. NGOs should have clearly defined roles, responsibilities, and accountability measures in post-disaster reconstruction projects, but they also need a certain amount of autonomy to protect their organisational philosophies and flexibility to make day-to-day decisions.

Strengthening public health supply chains in Ethiopia: PEPFAR-supported expansion of access and availability
Daniel Taddesse*, David Jamieson & Logan Cochrane
pages 1043-1056
Accepted: 22 Jun 2015
Published online: 02 Sep 2015
When the US President’s Emergency Plan for AIDS Relief (PEPFAR)-supported Supply Chain Management System (SCMS) programme began working in Ethiopia in 2006, the estimated population of people living with HIV exceeded one million, while only 24,000 were on treatment and only 50 treatment sites were in operation. SCMS and other key partners entered into this context to support the Ethiopian government in significantly strengthening the public health supply chain system, with the aim of increasing the availability and accessibility of pharmaceutical products. The country now has 1,047 treatment sites and is nearing complete treatment coverage. This article discusses how priorities were set among many competing challenges from 2006 until 2014, and how the four-step strategy of build, operate, transfer, and optimise has resulted in a successful partnership.