The Tsunami legacy
Disasters Emergency Committee
19 December 2014
…This week DEC member agencies Oxfam and CARE International have both released new reports on how the Tsunami influenced the changing humanitarian system. Swiss Solidarity (a fellow member of the Emergency Appeals Alliance) also launched a new evaluation of the response earlier this month.

These top ten lessons are thanks to their research:
1. Evaluating the needs of survivors quickly is crucial and this means listening to those affected and designing projects with them. We are now much better at sharing analysis and evaluations amongst ourselves. In the Philippines after the 2013 super typhoon, some member agencies worked with local people to design their own shelter kits and feedback mechanisms such as helpdesks are common place.

2. Humanitarian agencies are now much more likely to provide people with materials, grants or skills training to help them build their own home rather than build it for them. Shelter kits help people be part of their own recovery and design their own shelters according to their own needs. Some agencies work with affected people to design their own kits, acting as the advisors and advocates for new safe homes. We know that training local people to lead reconstruction and recovery increases the acceptance of the project and allows us to reach more people more quickly.

3. In the fourth year of the Tsunami response, DEC member agencies focused on helping people at-risk of emergencies prepare for the next disaster. Resilience and Disaster Risk Reduction are now a core part of what we do. We help local communities map the potential risks in their area and train people in construction, conservation agriculture, micro-insurance, or early warning systems.

4. The Tsunami helped us better understand the importance of designing projects that meet the varied needs of boys, girls, women and men in emergencies. For example women were between 1.2 and 2.1 times as likely to have died as men across tsunami-affected areas. Rapid gender analysis, assessments and the collection of sex and age disaggregated data are now routine. For example in Syria CARE has been able to share information on the increased numbers of pregnancies amongst displaced women, which helps agencies provide more targeted services for pregnant women.

5. The geographical scale of the disaster and the generous international funding meant that for part of 2005, there were close to 200 international NGOs operating in Aceh province alone. Numerous evaluations showed the need for better coordination among humanitarian agencies. So the UN set up the cluster system to bring agencies together to coordinate around different sectors such as education, protection or shelter.

6. A new evaluation of the Tsunami response by Swiss Solidarity found that helping experienced small-scale entrepreneurs recover the business they lost in the disaster was very successful. It helped people restart their business and sometimes expand production. However start-up entrepreneurs without prior experience were less successful with very few start-ups continuing their new businesses. Aid agencies are now much more conscious of existing inequalities and try to make sure interventions do not exacerbate the vulnerability of marginalised groups.

7. A 2008 review of reconstruction in post-tsunami Indonesia and Sri Lanka found that community involvement is essential to building back safer, stronger communities and since the tsunami there has been a shift towards building the capacity of local organisations. For example just as Christian Aid allocated £250,000 to their national partners on Boxing Day 2004 so they could start work straight away, agencies are always striving to equip local people to respond.

8. Many have argued that the humanitarian response acted as an incentive for peace in Indonesia. This finding is supported by a 2008 survey, which found that 57 percent of Aceh’s population think the tsunami, and the response to it, had a positive effect on peace in the region. In Sri Lanka it is thought the tsunami increased tensions in the long-running conflict. In its new report Oxfam argues there is an ongoing need for humanitarian agencies to devote more effort to designing conflict-sensitive approaches that either de-escalate or at least avoid exacerbating tensions between different groups.

9. After the tsunami, CARE provided survivors with vouchers for basic food items that could be exchanged for food at pre-approved local shops. This relatively new method at the time, helped local businesses to get back on their feet but meant people could make choices about what they needed. This approach is now widely recognised as an effective way of meeting people’s essential food needs.

10. The UK Public always gives generously to disasters. The outpouring in response to the DEC’s Tsunami appeal was the largest ever but British people consistently respond to calls for support. However international government giving is declining. For the humanitarian community to continue to learn lessons and improve our support to those most in need, we need the backing from global leaders and institutions. More people are now affected by humanitarian crises and funding has to keep up with this growing need.

The Rockefeller Foundation, IFC to Create New Project Development Facility for Resilient Infrastructure
The Rockefeller Foundation / December 19, 2014 / Press Releases
WASHINGTON—The Rockefeller Foundation and IFC, a member of the World Bank Group, are launching a project development facility aimed at unlocking private sector investment for infrastructure that helps build resilience across emerging markets.

Global institutional investors are keen to invest in infrastructure, but there aren’t enough well-structured projects. The major challenge lies in the early stages of project development. Often, governments lack the capacity to structure, negotiate, and manage complex infrastructure transactions. This is a critical bottleneck that delays and often stalls the development of projects. As a result, not enough projects are coming to market.

The Rockefeller Foundation is committing $10 million to this new facility. The facility will provide grant funding to support legal, technical, and financial advice to governments working with IFC on infrastructure projects that help cities build resilience and support poor and vulnerable people. This will accelerate the development of projects, and increase the number of bankable projects that reach financial close. The Foundation and IFC will aim to jointly raise an additional $40-$90 million from other partners, which could help the development of up to 80 medium-to-large scale projects globally.

“Governments often need sound advice to navigate complex agreements when they work with private sector companies to develop infrastructure projects,” said Karin Finkelston, IFC’s Vice President for Global Partnerships. “This partnership provides a crucial link that can help accelerate the development of bankable infrastructure projects across the world.”

This facility is part of a broader collaboration effort between The Rockefeller Foundation and the World Bank Group to expand financing solutions for resilience and infrastructure across emerging markets.

“Rapid urbanization, globalization, and the rise of extreme weather events are giving rise to a new set of shocks and stresses that threaten our collective wellbeing, so it is critical that we invest in infrastructure that builds resilience,” said Dr. Judith Rodin, President of The Rockefeller Foundation. “We are delighted to be working together with IFC to create more bankable infrastructure projects that build resilience and help communities that are particularly susceptible to associated shocks and stresses.”

United Nations – Selected Press Releases [to 20 December 2014]
Secretary General, Security Council, General Assembly
http://www.un.org/en/unpress/

19 December 2014
SG/SM/16434
At Ebola Treatment Centre in Sierra Leone, Secretary-General Tells Caregivers ‘You Are Bringing Your Country and the Entire World to a More Hopeful Place’
Following are UN Secretary-General Ban Ki-moon’s remarks, as prepared for delivery, at the Ebola Treatment Unit in Hastings, Sierra Leone, today:
[Concluding comments]
… Ebola remains a global crisis, and we must stop it at its source. The only acceptable goal is zero cases. A single case is all it takes to start an outbreak. All of us, whoever we work for, must remain super-vigilant. Our task is to prevent Ebola from becoming endemic in the region.
The crisis will end when the last person to experience Ebola is under treatment and there is no other case for at least 42 days. To do this, there will be a constant need for reliable data, skilled professionals, good management, effective coordination, and finance.
Our task, within the UN system, is to help you locate and access these resources. We cannot rest till you have what you need to complete the task. There can be no let-up.
We need to get kids back in school, fields planted, and markets up and running again. And beyond halting Ebola, we need to build up health systems and other infrastructure that will forestall something similar occurring in the future.
We owe this to millions of people across West Africa whose lives have been disrupted and plunged into misery. We owe this to the health-care workers who have made the ultimate sacrifice in answering the call of service.
To all the people of Guinea, Liberia and Sierra Leone, I say: The United Nations has stood with you for years in your quest for development and peace, and we will continue to be your close partner now.
Thank you again for your leadership in the Ebola response. It has been an honour to see you in action here today. In your person and in your work, you are the embodiment of compassion and commitment. In bringing comfort to those in need, you are bringing your country and the entire world to a more hopeful place.

19 December 2014
SC/11717
Security Council, Adopting Resolution 2195 (2014), Urges International Action to Break Links between Terrorists, Transnational Organized Crime
During an all-day open debate presided over by the Foreign Minister of Chad, the Security Council called for international action to prevent terrorists from benefiting from transnational organized crime, through securing borders and prosecuting illicit networks.

19 December 2014
GA/11605
Acting upon Recommendation by Second Committee, General Assembly Adopts 43 Texts, Defers Action on Sovereign Debt Restructuring Framework Draft
The General Assembly, acting on the recommendation of its Second Committee (Economic and Financial), today adopted 38 resolutions — seven requiring recorded votes — and five decisions on a range of issues relating to strengthening the post-2015 agenda. Those included external debt, creation of a new international economic order, the multidimensional nature of development and poverty, South-South cooperation, liberalization of world trade, promotion of new and renewable sources of energy, and problems of countries in special situations.

UNHCR [to 20 December 2014]
http://www.unhcr.org/cgi-bin/texis/vtx/hom

UN and partners launch major aid plans for Syria and region
Press Releases, 18 December 2014
BERLIN (18 December 2014) – As Syria’s war heads towards a fifth year, the United Nations and partners today launched a major new humanitarian and development appeal, requesting over US$8.4 billion in funds to help nearly 18 million people in Syria and across the region in 2015.
The appeal includes two main elements: support for over 12 million displaced and conflict-affected people inside Syria, and addressing the needs of the millions of Syrian refugees in the region and the countries and communities hosting them.
Presented to donors at a meeting in Berlin, the 2015 appeal incorporates, for the first time, significant development aspects in addition to the life-saving humanitarian needs of the largest number of displaced people in the world.
The Syria Strategic Response Plan 2015 (SRP) addresses acute humanitarian needs inside Syria, aiming to provide 12.2 million people with protection, life-saving assistance and livelihoods support. It requires $2.9 billion in funding and brings together humanitarian organizations working inside Syria and in neighbouring countries.
“Conflict has devastated millions of Syrians’ lives, trapping them in conflict areas and denying them access to basic provisions and healthcare. Many live in fear, children can’t go to school and parents can’t go out to work,” said Valerie Amos, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator. “This plan, if fully funded, can help us provide food and medicine for children, shelter families from the cold, and support those who are desperate and traumatized. Syria is a very difficult and dangerous place to work but the humanitarian community remains committed to helping the most vulnerable people caught in this crisis.”
The Regional Refugee and Resilience Plan (3RP), represents a strategic shift in the approach to delivering aid for the region. It brings together emergency humanitarian operations and host community support with longer-term programmes aimed at boosting resilience. Requiring $5.5 billion in funding to directly support almost 6 million people, it is based on planning projections of up to 4.27 million refugees in countries neighbouring Syria by the end of 2015 (representing a slight decline in the rate of outflow from Syria seen in 2014) and help to over a million vulnerable people in host communities…

WHO & Regionals [to 20 December 2014]

:: Global Alert and Response (GAR): Disease Outbreak News (DONs)
– Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia 17 December 2014
Between 20 November and 7 December 2014, the National IHR Focal Point for the Kingdom of Saudi Arabia (KSA) notified WHO of 11 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 4 deaths….
– West Nile virus – Brazil 15 December 2014
On 9 December 2014, the Ministry of Health of Brazil reported a case of West Nile Virus (WNV) in the state of Piauí (PI). This is the first detection of a human case of WNV infection in Brazil…

:: The Weekly Epidemiological Record (WER) 19 December 2014, vol. 89, 51/52 (pp. 577–588) includes:
.- Index of countries/areas
– Index, Volume 89, 2014, Nos. 1–52
– Revised guidance on meningitis outbreak response in sub-Saharan Africa
– Monthly report on dracunculiasis cases, January– October 2014

:: Syria Response Plan 2015 launched in Berlin
December 2014 — The Syria Response Plan 2015 incorporates, for the first time, the whole of Syria approach by bringing together humanitarian actors working inside Syria and in neighbouring countries under a single framework to increase the effectiveness of the response. Health partners are requesting a total of US$ 318 million, 182 million of which are for inside Syria.

:: Eight mobile health clinics to serve vulnerable populations in Iraq
December 2014 — These urgently needed clinics, procured by WHO and flown in by the World Food Programme from Amman, Jordan, will be immediately deployed to parts of Iraq and the Kurdistan Region of Iraq to help address the health needs of displaced populations residing in areas with limited access to health care services – in camps, informal settlements, and in urban and remote areas across the country.

:: Fact Sheet – Human papillomavirus (HPV) and cervical cancer 16 December 2014

:: GIN December 2014 pdf, 1.07Mb 19 December 2014
WHO Regional Offices
WHO African Region AFRO
:: How to save the lives of newborns in Africa 17 December 2014
Brazzaville, 17 December 2014 – According to a new WHO report, one third of all neonatal deaths occur in the African Region. Approximately three quarters of these deaths occur during the first week of life and almost half within the first 24 hours.
The first 28 days of life, called the neonatal period, is a very risky period for babies. For every newborn baby that dies, another 20 will face illness or disability from conditions such as birth injury, infection, the inability to breathe normally after birth, neonatal tetanus, congenital anomalies, and the complications of premature birth.
Too many babies are also being born to mothers who have not had adequate nutrition and antenatal care during pregnancy and who were not given skilled care during the birthing process. These mothers are at the greatest risk of dying during or after delivery – leaving newborns at an even greater risk of dying from inadequate care and suboptimal feeding practices.
According to statistics, quality care with simple, accessible, cost–effective interventions can prevent up to two thirds of all neonatal deaths. One method that has worked to reduce neonatal deaths in the African Region is kangaroo mother care (KMC). KMC is caring for preterm infants by carrying the baby skin-to-skin, usually by the mother…

WHO Region of the Americas PAHO
:: Number of babies born with HIV declined 78% in Latin America and the Caribbean, says new PAHO/WHO report (12/15/2014)

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: Rehabilitation: key to an independent future for children with poliomyelitis in Tajikistan 18-12-2014
:: Mobile clinics in Ukraine to bring health services to people in need 15-12-2014

WHO Eastern Mediterranean Region EMRO
:: WHO and partners release manual on psychological first aid during Ebola outbreaks
15 December 2014

WHO Western Pacific Region
:: The Wantok Effect: Key populations and the HIV response in Papua New Guinea
PORT MORESBY, 18 December 2014 – Papua New Guinea has the highest HIV prevalence in the Pacific region, estimated at 0.8% in 2012. The nation is grappling with an HIV epidemic that is concentrated in marginalized and criminalized key populations including female sex workers and men who have sex with men (MSM). Stigma associated with HIV and advice from influential churches for people to rely on prayer rather than antiretroviral treatment (ART) to heal themselves further complicate the situation.
:: Ensuring a future that is free from measles and rubella 13 December 2014

UN Women [to 20 December 2014]
http://www.unwomen.org/

Innovative “Voices against Violence” curriculum mobilizes efforts to address the pandemic
December 18, 2014
In Pune, western India, at the World Association of Girl Guides and Girl Scouts’ (WAGGGS) World Centre, more than 50 national trainers and youth leaders from the girl guiding movement across the Asia-Pacific region gathered for the first regional “Training of Trainers Workshop” on delivering “Voices against Violence”, a unique non-formal education curriculum that will teach young people how to stop violence against girls and women. At the end of the week-long training session from 12 to 18 December, where seven facilitators are providing support in running the workshop, participants will return to their countries to conduct national trainings among Girl Guides and Girl Scouts.

UNDP United Nations Development Programme [to 20 December 2014]
http://www.undp.org/content/undp/en/home/presscenter.html

19 Dec 2014
Mobile money for 16,000 Ebola workers
A mobile money transfer scheme has been implemented for the first to pay 16,000 Ebola workers in Sierra Leone

FAO – Food & Agriculture Organization [to 20 December 2014]
http://www.fao.org/news/archive/news-by-date/2014/en/

Maize, rice, wheat farming must become more sustainable
FAO estimates that over the next 35 years farmers will need to increase the annual production of maize, rice and wheat to 3 billion tonnes. Experts say this can only be achieved through eco-friendly agriculture that results in higher productivity while conserving natural resources, adapting to climate change, and delivering economic benefits to the world’s 500 million small-scale family farms.
19-12-2014

ILO International Labour Organization [to 20 December 2014]
http://www.ilo.org/global/lang–en/index.htm

Argentina
New law leads to new life for migrant domestic workers
16 December 2014
After decades of labor organizing and with the support of the ILO, Argentina has passed a new migration policy to make life better for domestic workers.

Youth employment
Lack of higher education leaves millions of young people out of decent work in developing countries
15 December 2014
GENEVA (ILO News) –Youth with post-secondary education living in middle and low-income countries have a much higher chance of finding a decent job than those with only secondary or primary education, says a new ILO publication Is education the solution to decent work for youth in developing economies? .
Building on the results of school-to-work transition surveys conducted in 28 countries worldwide in 2012-2013, the study highlights that having the highest level of education “serves as a fairly dependable guarantee” towards securing a formal job.
On average, eight in ten (83 per cent) young people with post-secondary education were in non-vulnerable employment in the 27 low-to-upper middle income countries examined. The “guarantee” was slightly less prominent among low-income countries, but still 75 per cent of young workers with university degrees managed to find a paid job…

UNESCO [to 20 December 2014]
http://en.unesco.org/

21.12.2014 – UNESCO PRESS
Reinforce the immunity of our common heritage under threat
States urged to implement 1954 Convention and its 1999 Second Protocol to protect cultural property in armed conflict
The Ninth Meeting of UNESCO’s Committee for the Protection of Cultural Property in the Event of Armed Conflict today urged all countries not yet party to the 1954 Convention for the Protection of Cultural Property in the Event of Armed Conflict and its Protocols, to ratify and fully implement them. The Convention, known as the Hague Convention, has so far been ratified by 126 nations. The Second Protocol has been ratified by 67 of the Convention’s States Parties.
At the end of its two-day meeting, the Committee also encouraged States Parties and the international community to take measures to prevent any new tensions that could result in threats to cultural property, and to explicitly include the protection of cultural property in the mandates of armed forces. Finally, it condemned repeated and deliberate attacks against cultural property around the world and in particular in the Syrian Arab Republic and the Republic of Iraq…

World Trade Organisation [to 20 December 2014]
http://www.wto.org/english/news_e/news13_e/news13_e.htm

18 December 2014
ENHANCED INTEGRATED FRAMEWORK
Programme for helping poorest countries trade is to be extended
A multi-donor programme that helps the poorest countries be more active in global trade — the Enhanced Integrated Framework (EIF) – will have its mandate extended into a new phase, the EIF Steering Committee decided on 18 December 2014. Director-General Roberto Azevêdo, in addressing the Committee, said: “Trade can be an effective tool for economic growth and poverty reduction when the right conditions exist. The EIF was established precisely to help LDCs create those conditions.”
The EIF Steering Committee, which includes representatives of all least-developed countries (LDCs) and the donor community as well as EIF partner agencies, decided to extend the mandate of the programme into a second phase, starting from 2016. The Steering Committee urged the EIF to build on the achievements of the first phase while addressing the need for reforms in key areas in order to improve the efficiency, effectiveness and sustainability of the programme.
The EIF is currently helping 50 of the poorest countries worldwide. The WTO is one of six partner agencies of the programme and also hosts the Executive Secretariat…

World Bank [to 20 December 2014]
http://www.worldbank.org/en/news/all

International Debt Statistics 2015
December 18, 2014 — International Debt Statistics 2015 features 2013 data on external debt stocks and flows, as well as other major financial indicators on the 124 developing countries that report to the World Bank Group’s Debt Reporting System… PDF

PRESS RELEASE
WB Helps DRC Strengthen Health Systems to Improve Women and Children’s Health; Prepare for Potential Ebola Outbreaks
December 18, 2014
WASHINGTON, December 18, 2014—The World Bank Group’s Board of Executive Directors today approved a total of U$226.5 million to the Democratic Republic of Congo (DRC) to strengthen its health systems to improve maternal and child health services. The project will also support an Ebola preparedness plan for DRC and enable the country to be better equipped to respond to anew Ebola outbreak…

World Bank Group Supports Budget Management and Fiscal Transparency as Sierra Leone Responds to the Ebola Crisis
WASHINGTON, December 17, 2014—The World Bank Group’s Board of Executive Directors today approved a US$30 million grant to support the Government of Sierra Leone in its efforts to respond to the unprecedented challenges posed by the Ebola crisis. Today’s financing includes a US$10 million grant from the World Bank Group’s International Development Association’s (IDA)* Crisis Response Window (CRW), which is designed to help low-income IDA countries recover from severe disasters and crises. The Emergency Economic and Fiscal Support Operation will support Sierra Leone as it seeks to bring the Ebola epidemic under control by strengthening government budget management and reducing fiscal risks heightened by the crisis…

Partners In Health [to 20 December 2014]

Fighting Drug-Resistant TB
Posted on December 18, 2014
Nearly 100 people from 14 countries traveled this month to the Harvard Medical School Center for Global Health Delivery–Dubai. They came from Russia and Bulgaria, Romania and Belarus, Georgia and Moldova. Some worked for the Ministry of Health of their respective countries, others worked for nongovernmental organizations. They all shared a common goal: to stop the spread of drug-resistant tuberculosis, a global scourge that killed more than 210,000 people in 2013.
Hosted by Partners In Health/Russia and the Harvard Medical School Center for Global Health Delivery–Dubai, participants discussed how to best design, implement, and operate programs to treat drug-resistant TB in collaboration with The Global Fund to Fight AIDS, Tuberculosis and Malaria. Treating multidrug-resistant TB (MDR-TB) is a grueling and complicated process that can take two years and thousands of doses of medication, some of which can cause painful side effects. It’s also a programmatic challenge that requires stellar management and deeply committed staff.

GAVI Watch [to 20 December 2014]
http://www.gavialliance.org/library/news/press-releases/

:: US approves US$ 200 million for Gavi in fiscal year 2015 budget
Washington, DC, 17 December 2014 – Gavi, the Vaccine Alliance welcomed final approval of the fiscal year 2015 appropriations bill that includes US$ 200 million for Gavi. It is the largest single year contribution ever made to Gavi by the United States…
“Gavi is grateful for the unbending, bipartisan support to vaccinate children in the world’s poorest countries, especially in a challenging budget environment,” said Gavi CEO Dr. Seth Berkley. “We want to specifically thank House and Senate State and Foreign Operations subcommittee leaders Rep Kay Granger, Rep Nita Lowey, Sen. Patrick Leahy and Sen. Lindsey Graham. This support will help Gavi purchase and deliver vaccines that will protect tens of millions of vulnerable children in poor countries around the world.”…

:: Gavi announces appointment of new Board members
Geneva, 16 December 2014 – Gavi, the Vaccine Alliance has announced the appointment of 10 members to the Board. The appointments were confirmed at the Board meeting held in Geneva on the 10th and 11th of December 2014.

Global Fund [to 20 December 2014]
http://www.theglobalfund.org/en/mediacenter/announcements/

Press releases
Global Fund Approves Emergency TB Funding for Syrian Refugees
18 December 2014
GENEVA – The Global Fund to Fight AIDS, Tuberculosis and Malaria has approved emergency funding to support the prevention, diagnosis and treatment of tuberculosis among Syrian refugees in Lebanon and Jordan.
The assistance, totaling US$3.3 million, comes from the Global Fund’s Emergency Fund, a special initiative designed to provide quick financing to fight HIV, TB and malaria in emergency situations. The Global Fund tapped the Emergency Fund for the first time in November to expand a mass-distribution campaign of mosquito nets in Liberia, a country severely hit by the Ebola outbreak.
The International Organization for Migration (IOM), which operates in Lebanon and Jordan, will be implementing the programs. The IOM is already providing active and early TB interventions among Syrian refugees, as well as TB drugs, equipment and awareness-raising…

Conrad N. Hilton Foundation
http://www.hiltonfoundation.org/news

Hilton Foundation approves record number of new grants totaling $50 million
Funding supports 42 organizations, furthering the foundation’s priority areas
Los Angeles, December 19, 2014 – The board of directors of the Conrad N. Hilton Foundation has awarded nearly $50 million in grants to a record 42 organizations working in key program areas, including Catholic Sisters, foster youth, homelessness, substance use prevention, access to safe water, disaster preparedness, Catholic education, hospitality, Multiple Sclerosis research, safeguarding vision, and other areas of priority.
“This is the largest number of grants in both number and dollar amount ever approved by our board,” said Ed Cain, Vice President, Grant Programs. “This record-breaking number of grants reflects the momentum of the Foundation’s strategic grantmaking, the intent of our board, and the vital work of our partners.”…

Robert Wood Johnson Foundation
http://www.rwjf.org/en/about-rwjf/newsroom/news-releases.html

“Outbreaks” Report Finds Gaps in Nation’s Ability to Respond to Ebola and Other Infectious Diseases; 25 States Reach Half or Fewer of Key Indicators
December 18, 2014 | News Release
The Ebola outbreak exposes serious underlying gaps in the nation’s ability to manage severe infectious disease threats. Understand how states perform against key indicators.

American Journal of Public Health
Volume 105, Issue 1 (January 2015)
http://ajph.aphapublications.org/toc/ajph/current

Coupled Ethical–Epistemic Analysis of Public Health Research and Practice: Categorizing Variables to Improve Population Health and Equity
S. Vittal Katikireddi, MRCP, MFPH, PhD, and Sean A Valles, PhD
S. Vittal Katikireddi is with the Medical Research Council and the Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Sean A. Valles is with Lyman Briggs College and the Department of Philosophy, Michigan State University, East Lansing.
Abstract
The categorization of variables can stigmatize populations, which is ethically problematic and threatens the central purpose of public health: to improve population health and reduce health inequities. How social variables (e.g., behavioral risks for HIV) are categorized can reinforce stigma and cause unintended harms to the populations practitioners and researchers strive to serve.
Although debates about the validity or ethical consequences of epidemiological variables are familiar for specific variables (e.g., ethnicity), these issues apply more widely.
We argue that these tensions and debates regarding epidemiological variables should be analyzed simultaneously as ethical and epistemic challenges. We describe a framework derived from the philosophy of science that may be usefully applied to public health, and we illustrate its application.

EDITORIAL The Moral Challenge of Ebola
Mark A. Rothstein
American Journal of Public Health: January 2015, Vol. 105, No. 1: 6–8.
Citation | Full Text | PDF (651 KB) | PDF Plus (653 KB)

Assessing the Expected Impact of Global Health Treaties: Evidence From 90 Quantitative Evaluations
Steven J. Hoffman, BHSc, MA, JD, and John-Arne Røttingen, MD, PhD, MSc, MPA
Steven J. Hoffman is with the Faculty of Law, University of Ottawa, Canada, and the Department of Global Health and Population, Harvard School of Public Health, Boston, MA. John-Arne Røttingen is with the Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway, and the Institute of Health and Society, University of Oslo, Norway.
Abstract
We assessed what impact can be expected from global health treaties on the basis of 90 quantitative evaluations of existing treaties on trade, finance, human rights, conflict, and the environment.
It appears treaties consistently succeed in shaping economic matters and consistently fail in achieving social progress. There are at least 3 differences between these domains that point to design characteristics that new global health treaties can incorporate to achieve positive impact: (1) incentives for those with power to act on them; (2) institutions designed to bring edicts into effect; and (3) interests advocating their negotiation, adoption, ratification, and domestic implementation.
Experimental and quasiexperimental evaluations of treaties would provide more information about what can be expected from this type of global intervention.

Cognitive Dissonance in the Early Thirties: The League of Nations Health Organization Confronts the Worldwide Economic Depression
Theodore M. Brown, Elizabeth Fee
American Journal of Public Health: January 2015, Vol. 105, No. 1: 65–65.
Citation | Full Text | PDF (163 KB) | PDF Plus (165 KB)

Human Papillomavirus Vaccination Among Young Adult Gay and Bisexual Men in the United States
Paul L. Reiter, PhD, Annie-Laurie McRee, DrPH, Mira L. Katz, PhD, and Electra D. Paskett, PhD
Paul L. Reiter and Electra D. Paskett are with the Division of Cancer Prevention and Control, College of Medicine and the Comprehensive Cancer Center, Ohio State University, Columbus. Annie-Laurie McRee and Mira L. Katz are with the Division of Health Behavior and Health Promotion, College of Public Health and the Comprehensive Cancer Center, Ohio State University.
Abstract
Objectives. We examined human papillomavirus (HPV) vaccination among gay and bisexual men, a population with high rates of HPV infection and HPV-related disease.
Methods. A national sample of gay and bisexual men aged 18 to 26 years (n = 428) completed online surveys in fall 2013. We identified correlates of HPV vaccination using multivariate logistic regression.
Results. Overall, 13% of participants had received any doses of the HPV vaccine. About 83% who had received a health care provider recommendation for vaccination were vaccinated, compared with only 5% without a recommendation (P < .001). Vaccination was lower among participants who perceived greater barriers to getting vaccinated (odds ratio [OR] = 0.46; 95% confidence interval [CI] = 0.27, 0.78). Vaccination was higher among participants with higher levels of worry about getting HPV-related disease (OR = 1.54; 95% CI =  1.05, 2.27) or perceived positive social norms of HPV vaccination (OR = 1.57; 95% CI =  1.02, 2.43).
Conclusions. HPV vaccine coverage is low among gay and bisexual men in the United States. Future efforts should focus on increasing provider recommendation for vaccination and should target other modifiable factors.

BMC Public Health
(Accessed 20 December 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Knowledge and attitude of healthcare workers about middle east respiratory syndrome in multispecialty hospitals of qassim, Saudi Arabia
Muhammad Umair Khan, Shahjahan Shah, Akram Ahmad and Omotayo Fatokun
BMC Public Health 2014, 14:1281 doi:10.1186/1471-2458-14-1281
Published: 16 December 2014
Abstract (provisional)
Background
With the increase in prevalence of Middle East Respiratory Syndrome (MERS), healthcare workers (HCWs) are at risk of acquiring and subsequently transmitting this lethal virus. In view of this, HCWs were evaluated for their knowledge of and attitude towards MERS in Saudi Arabia.
Methods
A cross sectional study was performed in two hospitals of Qassim region in Saudi Arabia. A total of 280 healthcare workers were selected to participate in this study. Knowledge and attitude were assessed by using self-administered and pretested questionnaire. Descriptive statistics were carried out to express participants’ demographic information, mean knowledge score and mean attitude score of HCWs. Inferential statistics (Mann-Whitney U test and Kruskal Wallis tests, p < 0.05) were used to examine differences between study variables. Chi squares tests were used to assess the association between study variables and attitude questions. Spearman’s rho correlation was used to identify the association between the knowledge, attitude scores. Result: Participants demonstrated good knowledge and positive attitude towards MERS. The mean scores of knowledge and attitude were 9.45 +/- 1.69 (based on 13 knowledge questions) and 1.82 +/- 0.72 (based on 7 attitude questions). The correlation between knowledge and attitude was significant (correlation coefficient: 0.12; P <0.001). HCWs were less educated about the management (42.4%), source (66%) and consequences of MERS (67.3%), while a majority of them were well aware of the hallmark symptoms (96%), precautionary measures (96%) and hygiene issues (94%). Although the majority of respondents showed positive attitude towards the use of protective measures (1.52 +/- 0.84), their attitude was negative towards their active participation in infection control program (2.03 +/- 0.97). Gender and experience were significantly associated with knowledge and attitude (P < 0.05).
Conclusions
The findings of this study showed that healthcare workers in Qassim region of Saudi Arabia have good knowledge and positive attitude towards MERS. Yet there are areas where low knowledge and negative attitude of HCWs was observed. However, studies are required to assess the knowledge and attitude of HCWs at national level so that effective interventions could be designed as surveillance and infection control measures are critical to global public health.

Development in Practice
Volume 25, Issue 1, 2015
http://www.tandfonline.com/toc/cdip20/current

Community rehabilitation workers as catalysts for disability: inclusive youth development through service learning
Theresa Lorenzo*, Jane Motau, Tania van der Merwe, Elize Janse van Rensburg & Jane Murray Cramm
DOI:10.1080/09614524.2015.983461
pages 19-28
Abstract
This paper explores access to health and education for disabled youth in sites with and without community rehabilitation workers (CRWs). A cross-sectional survey using a structured questionnaire was undertaken in nine sites in South Africa, and a snowball sample of 523 disabled youths of both sexes, aged between 18 and 35 years, was selected. The survey found that a significantly larger proportion of disabled youth living in sites with CRWs were seen by health care workers at home, and that there was a large difference in educational access between sites with and without CRWs. CRWs are well positioned to promote equal citizenship for disabled youth through service learning with occupational therapy final year students to improve access to health and education, so that barriers to their participation in economic development are removed.

Challenges and dilemmas of international development volunteering: a case study from Vanuatu
Adam M. Trau*
DOI:10.1080/09614524.2015.985633
pages 29-41
Abstract
This article looks at the key challenges and dilemmas of international development volunteering (IDV) as experienced within a community project in Vanuatu. By focusing on the nature and significance of IDV engagements at the local community level, it offers critical insights into roles and relationships among international development volunteers and local host communities, together with the complex global–local interface in which projects are negotiated and constructed. The article concludes by offering some ways in which IDV can be more effective in assisting community projects address the needs of contemporary village life.