OECD  [to 25 January 2014]
http://www.oecd.org/

22-January-2014
OECD Economic Survey of Hungary launches Monday 27 January 2014
The OECD’s latest Economic Survey of Hungary, to be published on Monday 27 January 2014, assesses the country’s exit from recession as well as steps that can be taken to boost its growth potential.

21-January-2014
Employment situation, third quarter 2013, OECD
OECD employment rate nudges up to 65.2% in third quarter of 2013.

20-January-2014
Latin America: Tax revenues continue to rise, but are low and varied among countries, according to new OECD-ECLAC-CIAT report
Tax revenues in Latin American countries continue to rise but are lower as a proportion of their national incomes than in most OECD countries. Revenue Statistics in Latin America 2012 shows that Argentina and Brazil have the highest tax revenue to GDP ratio, while Guatemala and Dominican Republic stand at the lower end.

World Bank [to 25 January 2014]
http://www.worldbank.org/en/news/all
Region/Global actions and announcements

World Bank Group President Jim Yong Kim Remarks at Davos Press Conference
MR. KIM:  [In progress]–in the recent disagreement. And we all have to remember, there’s a number of organizations in the European Union have an extremely diverse set of views on this particular issue.  So, his ability to bring the Union together, I think, is a very important signal for all of us.A year ago, I said at this meeting that we needed a plan for tackling climate change, a plan fit for the challenge that we face.  A year later, we’ve seen great leadership on climate from countries and companies, but emissions are still rising and the poor are still suffering. We don’t have a plan yet and the bits we do have are not equal to the size and challenge. The UN Secretary-General has called for a leadership summit and we all should be very grateful to him for having done so.  This gives us the opportunity to organize our collective leadership. This is the year to take action on climate change.  There are no more excuses. If we fail, our children and grandchildren…
Date: January 23, 2014

World Bank Group President: This Is the Year of Climate Action
In corporate boardrooms and the offices of CEOs, climate change is a real and present danger. It threatens to disrupt the water supplies and supply chains of companies as diverse as Coca-Cola and ExxonMobil. Rising sea levels and more intense storms put their infrastructure at risk, and the costs will only get worse. CEOs know this. They also know there is opportunity in how they respond. But while there are stand-out leaders, many others are holding back until they have more certainty about what governments will do. This week at the World Economic Forum in Davos, World Bank President Jim Yong Kim called on government leaders to break out of the small steps of business as usual and provide that structure. First, by putting a price on carbon and by having financial regulators require companies and financial institutions to assess their exposure to climate-related risks and disclose it. Kim also called for doubling the market for green bonds, which support climate adaptation…
Date: January 23, 2014

World Bank Open Knowledge Repository Introduces Mobile-Friendly Design
In keeping up with the rapid growth in mobile usage worldwide, the World Bank just relaunched the Open Knowledge Repository (OKR)—its open access portal to its publications and research—on an upgraded platform specifically optimized for mobile use. The relaunched OKR website, at openknowledge.worldbank.org, features a “responsive web design” that automatically adapts to the screen size of any device—whether desktop, laptop, tablet, or smartphone. “Knowing that nearly half of OKR users are in developing countries where mobile devices are increasingly being used to access the internet, relaunching the OKR with responsive design was a no-brainer,” said Carlos Rossel, World Bank Publisher. “Now, when users access the OKR from their smartphones or tablets, they will have a greatly improved user experience. ”The benefits of this change will ultimately extend well beyond users of the OKR.
Date: January 23, 2014

Water Shortages Slow Energy Production Worldwide
New Thirsty Energy initiative to help countries mitigate impact of water scarcity on energy security ABU DHABI, January 20, 2014 –The World Bank is launching a new initiative at the World Future Energy Summit and International Water Summit in Abu Dhabi that will help developing countries better plan and manage scaling-up energy capacity to meet rising demand, in tandem with water resource management. Producing energy requires a lot of water. Yet, the availability of and access to water is negatively impacting energy production around the world. Last year alone, water shortages shut down thermal power plants in India, decreased energy production in power plants in the United States and threatened hydropower generation in many countries, including Sri Lanka, China and Brazil. The problem is expected only to get worse. By 2035, the world’s energy consumption will increase by 35 percent, which in turn will increase water consumption by 85 percent…
January 20, 2014

BMC Public Health
(Accessed 25 January 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts
Gian Gandhi and Patrick Lydon
http://www.biomedcentral.com/1471-2458/14/67/abstract

Abstract (provisional)
Background
To achieve globally or regionally defined accelerated disease control, elimination and eradication (ADC/E/E) goals against vaccine-preventable diseases requires complementing national routine immunization programs with intensive, time-limited, and targeted Supplementary Immunization Activities (SIAs). Many global and country-level SIA costing efforts have historically relied on what are now outdated benchmark figures. Mobilizing adequate resources for successful implementation of SIAs requires updated estimates of non-vaccine costs per target population.

Methods
This assessment updates the evidence base on the SIA operational costs through a review of literature between 1992 and 2012, and an analysis of actual expenditures from 142 SIAs conducted between 2004 and 2011 and documented in country immunization plans. These are complemented with an analysis of budgets from 31 SIAs conducted between 2006 and 2011 in order to assess the proportion of total SIA costs per person associated with various cost components. All results are presented in 2010 US dollars.

Results
Existing evidence indicate that average SIA operational costs were usually less than US$0.50 per person in 2010 dollars. However, the evidence is sparse, non-standardized, and largely out of date. Average operational costs per person generated from our analysis of country immunization plans are consistently higher than published estimates, approaching US$1.00 for injectable vaccines. The results illustrate that the benchmarks often used to project needs underestimate the true costs of SIAs and the analysis suggests that SIA operational costs have been increasing over time in real terms. Our assessment also illustrates that operational costs vary across several dimensions. Variations in the actual costs of SIAs likely to reflect the extents to which economies of scale associated with campaign-based delivery can be attained, the underlying strength of the immunization program, sensitivities to the relative ease of vaccine administration (i.e. orally, or by injection), and differences in disease-specific programmatic approaches. The assessment of SIA budgets by cost component illustrates that four cost drivers make up the largest proportion of costs across all vaccines: human resources, program management, social mobilization, and vehicles and transportation. These findings suggest that SIAs leverage existing health system infrastructure, reinforcing the fact that strong routine immunization programs are an important pre-requisite for achieving ADC/E/E goals.

Conclusions
The results presented here will be useful for national and global-level actors involved in planning, budgeting, resource mobilization, and financing of SIAs in order to create more realistic assessments of resource requirements for both existing ADC/E/E efforts as well as for new vaccines that may deploy a catch-up campaign-based delivery component. However, limitations of our analysis suggest a need to conduct further research into operational costs of SIAs. Understanding the changing face of delivery costs and cost structures for SIAs will continue to be critical to avoid funding gaps and in order to improve vaccination coverage, reduce health inequities, and achieve the ADC/E/E goals many of which have been endorsed by the World Health Assembly and are included in the Decade of Vaccines Global Vaccine Action Plan.

Disaster Medicine and Public Health Preparedness
Volume  7  – Issue 06 – December 2013 http://journals.cambridge.org/action/displayIssue?jid=DMP&tab=currentissue

Brief Report
Second Evidence Aid Conference: Prioritizing Evidence in Disaster Aid
Philippe Vandekerckhovea1, Michael J. Clarkea2a3a4, Emmy De Bucka1, Claire Allena2 c1 and Bonnix Kayabua2a4
a1 Belgian Red Cross-Flanders, Mechelen, Belgium
a2 Evidence Aid, Oxford, England
a3 Queen’s University of Belfast, United Kingdom
a4 Trinity College Dublin, Ireland
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9154974&fulltextType=BT&fileId=S1935789313001092

Abstract
The Second Evidence Aid Conference took place in Brussels, Belgium, in October 2012, jointly organized by Evidence Aid and the Belgian Red Cross–Flanders. It provided an opportunity to build on the discussions from the 2011 First Evidence Aid Conference in Oxford, England, and prioritize the future work of Evidence Aid. Within the plenary presentations, discussions, and small work groups, the more than 80 international participants addressed issues regarding the need, use, and prioritization of evidence. Three parallel workshops focused on the prioritization of research, systematic reviews, and data to be collected during disasters, leading to a suggested prioritization framework and a commitment to identify key areas for evidence in disasters. Working with a wide variety of people and organizations from the disaster and humanitarian sectors, Evidence Aid will take this framework and develop a list of top priority questions in need of research and systematic reviews. Although Evidence Aid will not be able to address all of the research questions that will be identified in this process, it will collect them for sharing with relevant agencies. (Disaster Med Public Health Preparedness. 2013;7:593-596)

Disaster Medicine and Public Health Preparedness
Volume  7  – Issue 06 – December 2013 http://journals.cambridge.org/action/displayIssue?jid=DMP&tab=currentissue

Commentary
The Promise and Pitfalls of Community Resilience
Lori Uscher-Pinesa1 c1, Anita Chandraa1 and Joie Acostaa1
a1 RAND Corporation, Arlington, Virginia

Abstract
An important shift in terminology has occurred in emergency preparedness, and the concept of community resilience has become ubiquitous. Although enhancing community resilience is broader than preparedness, and emphasizes a distinct set of activities and participants, the terms are often used interchangeably. The implications of this shift have not been fully explored. This commentary describes the potential promise and pitfalls of the concept of community resilience and recommends strategies to overcome its limitations. We believe that resilience has the power to dramatically change this field in immense, positive ways, but some important challenges such as confusion about definitions and lack of accountability must first be overcome. (Disaster Med Public Health Preparedness. 2013;7:603-606)

The Lancet
Volume 383, Issue 9914, Pages 309 – 320, 25 January 2014

The state of health in the Arab world, 1990—2010: an analysis of the burden of diseases, injuries, and risk factors

Prof Ali H Mokdad PhD a, Sara Jaber MD a, Muna I Abdel Aziz PhD b, Fadia AlBuhairan MD c, Abduljabbar AlGhaithi MD d, Nawal M AlHamad PhD e, Suad N Al-Hooti PhD f, Adel Al-Jasari MD d, Mohammad A AlMazroa MD g, Ahmed Mohamed AlQasmi MD h, Shirina Alsowaidi MD i, Majed Asad MD j, Charles Atkinson BS a, Alaa Badawi PhD k, Talal Bakfalouni MD l, AbdelAziz Barkia PhD m, Stan Biryukov BS a, Charbel El Bcheraoui PhD a, Farah Daoud BS a, Mohammad Hossein Forouzanfar MD a, Diego Gonzalez-Medina BA a, Prof Randah R Hamadeh DPhil n, Mohamed Hsairi MD o, Seifeddin Saleh Hussein MD j, Nadim Karam MD q, Shams Eldin Ali Hassan Khalifa MD p, Prof Tawfik A M Khoja MD r, Faris Lami MD s, Katherine Leach-Kemon MPH a, Prof Ziad A Memish MD g, Ali A Mokdad MD a, Mohsen Naghavi PhD a, Jamal Nasher MD d, M Bassam Hijawi Qasem MD j, Mohammad Shuaib MD t, Al Anoud M Al Thani MD p, Mohamed H Al Thani MD p, Mohammed Zamakhshary MD g, Prof Alan D Lopez PhD u, Prof Christopher J L Murray MD a
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962189-3/abstract
Summary
Background
The Arab world has a set of historical, geopolitical, social, cultural, and economic characteristics and has been involved in several wars that have affected the burden of disease. Moreover, financial and human resources vary widely across the region. We aimed to examine the burden of diseases and injuries in the Arab world for 1990, 2005, and 2010 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010).

Methods
We divided the 22 countries of the Arab League into three categories according to their gross national income: low-income countries (LICs; Comoros, Djibouti, Mauritania, Yemen, and Somalia), middle-income countries (MICs; Algeria, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, occupied Palestinian territory, Sudan, Syria, and Tunisia), and high-income countries (HICs; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For the whole Arab world, each income group, and each individual country, we estimated causes of death, disability-adjusted life years (DALYs), DALY-attributable risk factors, years of life lived with disability (YLDs), years of life lost due to premature mortality (YLLs), and life expectancy by age and sex for 1990, 2005, and 2010.

Findings
Ischaemic heart disease was the top cause of death in the Arab world in 2010 (contributing to 14·3% of deaths), replacing lower respiratory infections, which were the leading cause of death in 1990 (11·0%). Lower respiratory infections contributed to the highest proportion of DALYs overall (6·0%), and in female indivduals (6·1%), but ischaemic heart disease was the leading cause of DALYs in male individuals (6·0%). DALYs from non-communicable diseases—especially ischaemic heart disease, mental disorders such as depression and anxiety, musculoskeletal disorders including low back pain and neck pain, diabetes, and cirrhosis—increased since 1990. Major depressive disorder was ranked first as a cause of YLDs in 1990, 2005, and 2010, and lower respiratory infections remained the leading cause of YLLs in 2010 (9·2%). The burden from HIV/AIDS also increased substantially, specifically in LICs and MICs, and road injuries continued to rank highly as a cause of death and DALYs, especially in HICs. Deaths due to suboptimal breastfeeding declined from sixth place in 1990 to tenth place in 2010, and childhood underweight declined from fifth to 11th place.

Interpretation
Since 1990, premature death and disability caused by communicable, newborn, nutritional, and maternal disorders (with the exception of HIV/AIDS) has decreased in the Arab world—although these disorders do still persist in LICs—whereas the burden of non-communicable diseases and injuries has increased. The changes in the burden of disease will challenge already stretched human and financial resources because many Arab countries are now dealing with both non-communicable and infectious diseases. A road map for health in the Arab world is urgently needed.

Funding
Bill & Melinda Gates Foundation.

Health in the Arab world: a view from within
Governance and health in the Arab world
Rajaie Batniji, Lina Khatib, Melani Cammett, Jeffrey Sweet, Sanjay Basu, Amaney Jamal, Paul Wise, Rita Giacaman
Preview | Summary | Full Text | PDF

Non-communicable diseases in the Arab world
Hanan F Abdul Rahim, Abla Sibai, Yousef Khader, Nahla Hwalla, Ibtihal Fadhil, Huda Alsiyabi, Awad Mataria, Shanthi Mendis, Ali H Mokdad, Abdullatif Husseini
Preview | Summary | Full Text | PDF

The path towards universal health coverage in the Arab uprising countries Tunisia, Egypt, Libya, and Yemen
Shadi S Saleh, Mohamad S Alameddine, Nabil M Natafgi, Awad Mataria, Belgacem Sabri, Jamal Nasher, Moez Zeiton, Shaimaa Ahmad, Sameen Siddiqi
Preview | Summary | Full Text | PDF

The Lancet Global Health
Feb 2014  Volume 2  Number 2  e58 – 116
http://www.thelancet.com/journals/langlo/issue/current

Comment
Persistence of poliomyelitis in Nigeria
Festus D Adu, Itam Hogan Itam
Preview | Full Text | PDF
The World Health Assembly launched the Global Polio Eradication Initiative in 1988 and declared the year 2000 as the target by which to achieve poliomyelitis eradication.1 After aggressive mass immunisation, backed up by effective routine immunisation, cases of poliomyelitis reduced from 350 000 in 165 countries in 1988 to 355 occurring mainly in three countries—Nigeria, Afghanistan, and Pakistan—by 2013.2 Nigeria is the only country in the world where the three poliovirus types are still circulating; as of December, 2013, it had contributed 14·1% of all poliomyelitis cases worldwide.

Key issues in the persistence of poliomyelitis in Nigeria: a case-control study
Dr Tara D Mangal PhD a, R Bruce Aylward MD b, Michael Mwanza BComm c, Alex Gasasira MBChB d, Emmanuel Abanida MBChB e, Prof Muhammed A Pate MD f, Prof Nicholas C Grassly PhD a
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X%2813%2970168-2/abstract
Summary
Background
The completion of poliomyelitis eradication is a global emergency for public health. In 2012, more than 50% of the world’s cases occurred in Nigeria following an unanticipated surge in incidence. We aimed to quantitatively analyse the key factors sustaining transmission of poliomyelitis in Nigeria and to calculate clinical efficacy estimates for the oral poliovirus vaccines (OPV) currently in use.

Methods
We used acute flaccid paralysis (AFP) surveillance data from Nigeria collected between January, 2001, and December, 2012, to estimate the clinical efficacies of all four OPVs in use and combined this with vaccination coverage to estimate the effect of the introduction of monovalent and bivalent OPV on vaccine-induced serotype-specific population immunity. Vaccine efficacy was determined using a case-control study with CIs based on bootstrap resampling. Vaccine efficacy was also estimated separately for north and south Nigeria, by age of the children, and by year. Detailed 60-day follow-up data were collected from children with confirmed poliomyelitis and were used to assess correlates of vaccine status. We also quantitatively assessed the epidemiology of poliomyelitis and programme performance and considered the reasons for the high vaccine refusal rate along with risk factors for a given local government area reporting a case.

Findings
Against serotype 1, both monovalent OPV (median 32·1%, 95% CI 26·1—38·1) and bivalent OPV (29·5%, 20·1—38·4) had higher clinical efficacy than trivalent OPV (19·4%, 16·1—22·8). Corresponding data for serotype 3 were 43·2% (23·1—61·1) and 23·8% (5·3—44·9) compared with 18·0% (14·1—22·1). Combined with increases in coverage, this factor has boosted population immunity in children younger than age 36 months to a record high (64—69% against serotypes 1 and 3). Vaccine efficacy in northern states was estimated to be significantly lower than in southern states (p≤0·05). The proportion of cases refusing vaccination decreased from 37—72% in 2008 to 21—51% in 2012 for routine and supplementary immunisation, and most caregivers cited ignorance of either vaccine importance or availability as the main reason for missing routine vaccinations (32·1% and 29·6% of cases, respectively). Multiple regression analyses highlighted associations between the age of the mother, availability of OPV at health facilities, and the primary source of health information and the probability of receiving OPV (all p<0·05).

Interpretation
Although high refusal rates, low OPV campaign awareness, and heterogeneous population immunity continued to support poliomyelitis transmission in Nigeria at the end of 2012, overall population immunity had improved due to new OPV formulations and improvements in programme delivery.

Funding
Bill & Melinda Gates Foundation Vaccine Modeling Initiative, Royal Society.

The Lancet Global Health
Feb 2014  Volume 2  Number 2  e58 – 116
http://www.thelancet.com/journals/langlo/issue/current

Comment
Rebalancing the global battle against tuberculosis
Mario Raviglione, Mukund Uplekar, Cheri Vincent, Ariel Pablos-Méndez
Preview | Full Text | PDF
Meetings of health ministers from the five BRICS countries (Brazil, Russia, India, China, and South Africa) have produced two joint statements in less than a year: the Delhi Communiqué1 (Jan 12, 2013) and the Cape Town Communiqué2 (Nov 7, 2013). Both statements bode well for global tuberculosis control. The Delhi Communiqué underscores the principle of equity and focuses on populations who are most affected by the disease. The Cape Town Communiqué emphasises promotion of consortia of researchers to collaborate for clinical trials of drugs and vaccines, strengthening of access to affordable, high-quality, effective, and safe medicines, and delivery of high-quality health care.

The Lancet
Volume 383, Issue 9914, Pages 309 – 320, 25 January 2014

Malaria burden and control in Bangladesh and prospects for elimination: an epidemiological and economic assessment
Ubydul Haque, Hans J Overgaard, Archie C A Clements, Douglas E Norris, Nazrul Islam, Jahirul Karim, Shyamal Roy, Waziul Haque, Moktadir Kabir, David L Smith, Gregory E Glass
Preview | Summary | Full Text | PDF
Malaria elimination is an achievable prospect in Bangladesh and failure to push for elimination nearly ensures a resurgence of disease. Consistent financing is needed to avoid resurgence and maintain elimination goals.

PLoS Medicine
(Accessed 25 January 2014)
http://www.plosmedicine.org/

Policy Forum
Scale-up of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy: Challenges and Perspectives in Sub-Saharan Africa
Guido J. H. Bastiaensl, Teun Bousema, Toby Leslie

Summary Points
:: Scaling up and sustaining access to malaria diagnosis and treatment in all public sector, for-profit, and informal health facilities across sub-Saharan Africa is central to current global strategies for malaria control and elimination.

:: The use of malaria rapid diagnostic tests (RDTs) aims to eliminate reliance on signs and symptoms to diagnose and treat malaria but evidence shows health workers do not always test the right patients, nor provide treatment based on the results of the test.

:: Expanding access to malaria RDTs on the scale needed to achieve universal coverage requires retraining of public, private, and retail sector providers as well as sustained supplies and quality assurance.

:: Barriers to rational use of tests and drugs may be overcome through appropriate policy design for the local health service setting, which addresses health worker practice and patient perceptions.

:: Innovative methods have been used to increase access to the most effective antimalarial drugs in the last five years, but these efforts will be incomplete and unsustainable without similar efforts to incorporate RDTs into practice

Prehospital & Disaster Medicine
Volume  28  – Issue 06 – December 2013
https://journals.cambridge.org/action/displayIssue?jid=PDM&tab=currentissue

Special Report
Emergency Medicine Systems Advancement through Community-based Development
Martha M. Bloema1, Christina M. Bloema2 c1, Juliana Rosentsveyga3 and Bonnie Arquillaa2
a1 Institute of International Education, Scholar Rescue Fund, New York, New York USA
a2 Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA a3 School of Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA

Abstract
Humanitarian health programs frequently focus on immediate relief and are supply side oriented or donor driven. More emphasis should be placed on long-term development projects that engage local community leaders to ensure sustainable change in health care systems. With the Emergency Medicine Educational Exchange (EMEDEX) International Rescue, Recover, Rebuild initiative in Northeast Haiti as a model, this paper discusses the opportunities and challenges in using community-based development to establish emergency medical systems in resource-limited settings.

Prehospital & Disaster Medicine
Volume  28  – Issue 06 – December 2013
https://journals.cambridge.org/action/displayIssue?jid=PDM&tab=currentissue

Development of an Evaluation Framework Suitable for Assessing Humanitarian Workforce Competencies During Crisis Simulation Exercises.
Cranmer H1, Chan JL2, Kayden S3, Musani A4, Gasquet PE5, Walker P6, Burkle FM7, Johnson K8.
http://www.ncbi.nlm.nih.gov/pubmed/24429109

Abstract
The need to provide a professionalization process for the humanitarian workforce is well established. Current competency-based curricula provided by existing academically affiliated training centers in North America, the United Kingdom, and the European Union provide a route toward certification. Simulation exercises followed by timely evaluation is one way to mimic the field deployment process, test knowledge of core competences, and ensure that a competent workforce can manage the inevitable emergencies and crises they will face. Through a 2011 field-based exercise that simulated a humanitarian crisis, delivered under the auspices of the World Health Organization (WHO), a competency-based framework and evaluation tool is demonstrated as a model for future training and evaluation of humanitarian providers.

Qualitative Health Research
January 2014; 24 (1)
http://qhr.sagepub.com/content/current

Former Child Soldiers’ Problems and Needs: Congolese Experiences
Steinar Johannessen and Helge Holgersen
Qual Health Res January 2014 24: 55-66, first published on November 20, 2013 doi:10.1177/1049732313513655
Abstract
With this article, we explore how staff working at transit centers and vocational training centers in the eastern Democratic Republic of the Congo experienced the problems and needs of former child soldiers. We argued that the staff’s experience of the children’s daily lives and their understanding of the sociocultural context of the conflict make their perspective a valuable source of information when trying to understand the phenomenon of child soldiering. Additionally, we reasoned that how the staff frame these children’s problems influences how they attempt to aid the children. We conducted 11 semistructured interviews and analyzed these using a hermeneutical-phenomenological approach. We clustered our findings around six themes: unfavorable contextual factors, acting as if still in the army, addiction, symptoms of psychopathology, social rejection, and reintegration needs. The overarching message we observed was that the informants experienced that former child soldiers require help to be transformed into civilians who participate proactively in their society.

Social Science & Medicine
Volume 104,   In Progress   (March 2014)
http://www.sciencedirect.com/science/journal/02779536/104
Fast, cheap, and out of control? Speculations and ethical concerns in the conduct of outsourced clinical trials in India
Original Research Article
Pages 48-55
Vinay R. Kamat

Abstract
The globalization of biopharmaceutical clinical trials and their offshore outsourcing, from the West to low and middle-income countries, has come under increasing scrutiny from academic scholars, practitioners, regulatory agencies and the media. This article reports the results of a study conducted in Bangalore and Hyderabad between 2007 and 2009, to elicit the perspectives of stakeholders, concerning media representations of their work and the ethical issues that emanate from their engagement in the clinical trials enterprise. In acknowledging the inherently problematic nature of the outsourcing of clinical trials to low income countries, I argue that the practice of not prioritizing research on diseases that are most prevalent among communities, from which subjects are recruited, demands a coordinated and sustained critique. I propose that the critical discourse on the outsourcing of clinical trials should not only emphasize the perils of this practice, but also address some broader issues of equity and distributive justice that determine people’s access to basic health care in low income countries. Close attention to the specific context of clinical trials in an increasingly neoliberal medical and health environment in emerging economies such as India can provide critical insights into the on-the-ground complexities and challenges of outsourced global clinical trials.

Sustainability
Volume 6, Issue 1 (January 2014), Pages 1-473
http://www.mdpi.com/2071-1050/6/1
Cultural Resources as Sustainability Enablers: Towards a Community-Based Cultural Heritage Resources Management (COBACHREM) Model
by Susan O. Keitumetse
Sustainability 2014, 6(1), 70-85; doi:10.3390/su6010070
Received: 10 September 2013; in revised form: 7 November 2013 / Accepted: 29 November 2013 / Published: 20 December 2013
Show/Hide Abstract | Download PDF Full-text (992 KB) | Download XML Full-text

Abstract: People inhabit and change environments using socio-cultural and psycho-social behaviors and processes. People use their socio-cultural understanding of phenomena to interact with the environment. People are carriers of cultural heritage. These characteristics make cultural values ubiquitous in all people-accessed and people-inhabited geographic spaces of the world, making people readily available assets through which environmental sustainability can be implemented. Yet, people’s conservation development is rarely planned using cultural resources. It is against this background that a Community-Based Cultural Heritage Resources Management (COBACHREM) model is initiated as a new approach that outlines the symbiosis between cultural heritage, environment and various stakeholders, with a view to create awareness about neglected conservation indicators inherent in cultural resources and better placed to complement already existing natural resources conservation indicators. The model constitutes a two-phased process with four (04) levels of operation, namely: level I (production); level II (reproduction); level III (consumption) that distinguish specific components of cultural heritage resources to be monitored at level IV for sustainability using identified cultural conservation indicators. Monitored indicators, which are limitless, constitute work in progress of the model and will be constantly reviewed, renewed and updated through time. Examples of monitoring provided in this article are the development of cultural competency-based training curriculum that will assist communities to transform cultural information into certifiable intellectual (educational) and culture-economic (tourism) assets. Another monitoring example is the mainstreaming of community cultural qualities into already existing environmental conservation frameworks such as eco-certification to infuse new layers of conservation indicators that enrich resource sustainability. The technical COBACHREM model acknowledges existing academic frameworks of communal identity formation (e.g., indigenity and autochthony) and is designed to add value onto these.

Sustainability
Volume 6, Issue 1 (January 2014), Pages 1-473
http://www.mdpi.com/2071-1050/6/1

Integrating Biodiversity and Ecosystem Services in the Post-2015 Development Agenda: Goal Structure, Target Areas and Means of Implementation
by Paul L. Lucas, Marcel T.J. Kok, Måns Nilsson and Rob Alkemade
Sustainability 2014, 6(1), 193-216; doi:10.3390/su6010193
Received: 1 November 2013; in revised form: 16 December 2013 / Accepted: 17 December 2013 / Published: 27 December 2013
Show/Hide Abstract | Download PDF Full-text (851 KB) | Download XML Full-text

Abstract: The United Nations’ discussions on defining a new set of post-2015 development goals focus on poverty eradication and sustainable development. Biodiversity and ecosystem services are essential for poverty eradication, which is also one of the foundations of the Strategic Plan for Biodiversity of the Convention on Biological Diversity (CBD). Based on an assessment of current proposals of goals and targets, and a quantitative pathway analysis to meet long term biodiversity and food security goals, this paper discusses how biodiversity and ecosystem services can be integrated into a broad set of goals and targets, and concludes with relevant target areas and means of implementation for which specific targets need to be defined. Furthermore, it responds to the call of the CBD to consider the Strategic Plan for Biodiversity and the related Aichi biodiversity targets in the post-2015 development agenda. The paper’s analysis identifies three overlapping but also supplemental ways to integrate biodiversity and ecosystem services in the post-2015 agenda: integrated goals, goals addressing earth system functioning and goals addressing environmental limits. It further concludes seven target areas to be included under the goals to address biodiversity and ecosystem services in the context of food and agriculture: access to food, demand for agricultural products, sustainable intensification, ecosystem fragmentation, protected areas, essential ecosystem services and genetic diversity. The Strategic Plan for Biodiversity provides a good basis for integrating biodiversity and ecosystem services in the post-2015 development agenda. Many Aichi targets address the proposed target areas and the means of implementation discussed, while they need to be complemented with targets that specifically address human well-being, as well as institutions and governance.

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

The Case for Collaboration Among Humanitarian Surgical Programs in Low Resource Countries
QA Fisher, G Fisher – Anesthesia & Analgesia, 2014 Anesthesia & Analgesia:
February 2014 – Volume 118 – Issue 2 – p 448–453
doi: 10.1213/ANE.0000000000000053
The overall challenge, in essence, is to seek ways in which in-country hosts can identify their needs, and with their stakeholders co-create actionable solutions to meet them. Working relationships with host country hospital hierarchy and government officials are not …

[PDF] Imaging and GIS for Disaster Response
E Frost – 2014
… Several very special groups led by Open-‐Source groups like Crisis Mappers (http://crisismappers.net ) and commercial companies doing humanitarian assistance disaster relief like Google Crisis Map (http://google.org/crisismap) and the ESRI Disaster response group (http …

[PDF] Health in the Arab world: a view from within 4 Changing therapeutic geographies of the Iraqi and Syrian wars
O Dewachi, M Skelton, VK Nguyen, FM Fouad, GA Sitta… – 2014
… health-care facilities and professionals has been identified as a major threat to public health worldwide.19 A wide range of agencies, including local or national non-governmental organisations (NGOs), local health-care providers, and international humanitarian bodies are …
[PDF] Moving Sustainability Forward: Contributions and Outcomes of the 3rd World Sustainability Forum
MA Rosen, S La Russa – Sustainability, 2014
… highlighting the importance of sustainability and sustainable development, and on the interplay of these key issues: … E. Sustainable Urban Development F. Sustainable Development Policy, Practice and Education G. Sustainability Entrepreneurship and Sustainability Innovation

Facebook: The enabler of online civic engagement for activists
AM Warren, A Sulaiman, NI Jaafar – Computers in Human Behavior, 2014
… All the participants included in this study have a history of engaging in some form of charity or humanitarian work for the betterment of the community and have Facebook accounts. … For example, a humanitarian worker at MyCorps commented, …

WHO: India three years polio-free

Excerpt
Wild poliovirus has not been found in India since 13 January 2011 meaning that, from that date, India is no longer a country where polio is endemic. Three years of being polio free is a notable milestone for the country as a whole, but the success of the immunization and awareness campaign has had a wider impact – with this achievement, it is hoped that soon the entire South-East Asia Region can be considered certifiably free from polio. A commission of experts will meet at the World Health Organization offices at the end of March to analyze the data and determine the polio status for the Region.

Historically, India has been the largest endemic reservoir of polio in the world with between 50,000 to 100,000 paralytic polio cases occurring each year between 1978 and 1995. It has also been one of the main sources of polio importation for other countries. This achievement has been driven by the partnership between the Government of India, international organizations, local NGOs and other institutions. An extraordinary mobilization of health workers was necessary to reach this point, particularly in the Uttar Pradesh and Bihar states. The outcome of this has been an improved vaccine delivery system, better trained health staff and high quality surveillance, monitoring and research mechanisms…

http://www.searo.who.int/mediacentre/features/2014/sea-polio/en/index.html

Speech: Opening remarks at the Fourth stakeholder meeting: Accountability for women’s and children’s health – now and in the post-2015 agenda
Dr Margaret Chan, WHO Director-General
14 January 2014

Excerpt
Colleagues in public health, development partners, representatives of sister agencies and civil society organizations, ladies and gentlemen,

Welcome to this fourth meeting of stakeholders as we continue our efforts to improve accountability for women’s and children’s health. I thank all of you for coming to Geneva. We have a good mix of perspectives, experiences, and contributions at many levels represented in this room.

We are at the midpoint in a time-bound process of improving accountability. This is a good time to take stock of where we stand, the lessons we have learned, and how we can institutionalize these lessons as the international community moves into the post-2015 era.

When I was asked to serve as a vice-chair for the Commission on Information and Accountability for Women’s and Children’s Health, I knew we were embarking on a journey into largely uncharted territory.

Accountability for resources and results has long been deeply desired, but rarely tackled in a rigorous and systematic way. I also knew that establishing an accountability framework specifically for women’s and children’s health would be an especially hard test case, perhaps even the hardest test case imaginable.

As we all know, maternal and child mortality cannot be brought down without addressing fundamental weaknesses in health systems that have been neglected for decades. Addressing accountability for women’s and children’s health means addressing long-standing problems with health infrastructures and services, inadequate numbers of appropriately trained and motivated staff, and the absence in most countries of reliable systems for civil registration and vital statistics.

Accountability means counting. Transparency is impossible in the absence of reliable data. It means improving the way donors and recipient countries work together, the way information is collected and used, and the capacity to track resource flows throughout the health sector.

It means ensuring equitable access to services, fair financing for care, and, as the independent Expert Review Group so clearly reminds us, high quality care that is person-centred, not intervention-centred…
Full text here: http://www.who.int/dg/speeches/2014/accountability-women-children/en/index.html

Speech: The Global Economy in 2014
Christine Lagarde, Managing Director, IMF
National Press Club, Washington DC
January 15, 2014  AS PREPARED FOR DELIVERY

Excerpt
…what I want to talk about today—how the IMF sees the global economy as the wheels of time roll into yet another year.

If we think about it, 2014 will be a milestone in many respects. It will mark the hundredth anniversary of the start of the First World War, the 70th anniversary of the Bretton Woods conference that gave birth to the IMF, and the 25th anniversary of the fall of the Berlin Wall.

It will also mark the 7th anniversary of the financial market jitters that quickly turned into the greatest global economic calamity since the Great Depression.

This crisis still lingers. Yet, optimism is in the air: the deep freeze is behind, and the horizon is brighter. My great hope is that 2014 will prove momentous in another way—the year in which the “seven weak years”, economically speaking, slide into “seven strong years”.

Is this wishful thinking? No, but it will not simply happen on its own. Getting beyond the crisis still requires a sustained and substantial policy effort, coordination, and the right policy mix. Let me talk about this—I will start with the global outlook, and then touch on the policy path I have in mind.

Global outlook and risks

In just a few days, we will be releasing our updated forecasts. While our numbers are still being finalized, I will talk about the main trends as we see them.

:: Momentum strengthened in the latter half of 2013, and should strengthen further in 2014—largely due to improvements in the advanced economies.

:: Yet, global growth is still stuck in low gear. It remains below its potential, which we think is somewhere around 4 percent. This means that the world could create more jobs before we would need to worry about the global inflation genie coming out of its bottle.
:: Even for the advanced economies, however, the outlook is still subject to significant risks. With inflation running below many central banks’ targets, we see rising risks of deflation, which could prove disastrous for the recovery. If inflation is the genie, then deflation is the ogre that must be fought decisively.

:: During the years of crisis, we have relied on the emerging markets to keep the global economy afloat. Together with the developing countries, they accounted for three-quarters of global growth over the past half decade. However, a growing number of emerging markets are slowing down as the economic cycle turns.

:: We also see risks arising from financial market turbulence and the volatility of capital flows. The reaction to the Fed’s tapering has been calm so far, and this is good news, but there still could be some rough waters ahead.

:: Overall, the direction is positive, but global growth is still too low, too fragile, and too uneven. Moreover, it is not enough to create the jobs for the more than 200 million people around the world who need them.

:: In far too many countries, the benefits of growth are being enjoyed by far too few people. Just to give one example: in the United States, 95 percent of income gains since 2009 went to the top 1 percent. This is not a recipe for stability and sustainability.

This all points to one thing: the need to stay focused on the policies needed for sustainable growth and rewarding jobs, which in the end are needed to make everybody better off…

Full text here: http://www.imf.org/external/np/speeches/2014/011514.htm