Journal of Immigrant and Minority Health
Volume 16, Issue 3, June 2014
http://link.springer.com/journal/10903/16/3/page/1

HPV Awareness and Vaccine Acceptability in Hispanic Women Living Along the US-Mexico Border
Jennifer Molokwu Norma P. Fernandez Charmaine Martin
Abstract
Despite advances in prevention of cervical cancer in the US, women of Hispanic origin still bear an unequal burden in cervical cancer incidence, morbidity and mortality. Our objective was to determine the HPV vaccine knowledge and acceptability in a group of mostly Hispanic females. In this cross sectional survey, 62 % of participants heard of HPV; 34.9 % identified HPV as a cause of cervical cancer. 63 % of participants reported willingness to receive vaccine and 77 % were willing to vaccinate daughters. Those with previous abnormal PAPs were more likely to have heard of HPV and Vaccine. No other factors examined showed association with willingness to get vaccine or administer to daughters. Knowledge level remains low in this high risk population. Willingness to receive vaccine is high despite lack of access to care. Increased targeted community based education and vaccination programs may be useful in closing disparity in cervical cancer morbidity.

Journal of Immigrant & Refugee Studies
Volume 12, Issue 2, 2014
http://www.tandfonline.com/toc/wimm20/current#.UyWnvIUWNdc

Special Issue: Irregular Migration in Southern European Islands
Islands and Undesirables: Introduction to the Special Issue on Irregular Migration in Southern European Islands
Nathalie Bernardie-Tahira & Camille Schmollb*
DOI: 10.1080/15562948.2014.899657
pages 87-102
Abstract
This introduction presents the challenges to studying irregular migration in the southern European islands. After presenting the debates surrounding the category of irregular migration and recent developments in irregular migration to southern European islands, we argue that the situation of islands needs to be contextualized within the broader scheme of Euro-Mediterranean irregular migration. We then propose considering islands as remarkable “places of condensation” in the Euro-Mediterranean migratory setting. The article introduces two themes that will be developed throughout the special issue: (1) analyzing and challenging narratives of islandness and (2) policing and bordering the islands.

Nature
Volume 509 Number 7502 pp533-656 29 May 2014
http://www.nature.com/nature/current_issue.html

Global health: Deadly dinners
Polluting biomass stoves, used by one-third of the global population, take a terrible toll. But efforts to clean them up are failing.
Meera Subramanian

New England Journal of Medicine
May 29, 2014 Vol. 370 No. 22
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Embracing Oral Cholera Vaccine — The Shifting Response to Cholera
Jean William Pape, M.D., and Vanessa Rouzier, M.D.
N Engl J Med 2014; 370:2067-2069 May 29, 2014 DOI: 10.1056/NEJMp1402837
Cholera, a rapidly dehydrating diarrheal disease, is caused by ingestion of Vibrio cholerae, serogroup O1 or O139. The World Health Organization (WHO) estimates that 1.4 billion people were at risk for cholera in 2012.1 More than 90% of reported cases occur in Africa, and most of the remainder occur in southern Asia. In 2010, only 10 months after it was hit by a major earthquake, Haiti experienced the most severe cholera epidemic of the past century, with 699,579 cases and 8539 related deaths reported as of February 11, 2014. This was the first time cholera had been documented in Haiti, despite the occurrence of devastating outbreaks in the Caribbean in the 19th century and in Latin America between 1991 and 2001 (see
Cholera is a disease of poverty, linked to poor sanitation and a lack of potable water.

Establishment of an adequate sanitation and potable-water system is the most definitive way to prevent and limit its spread. However, the cost of instituting adequate sanitation systems, one of the United Nations Millennium Development Goals, is prohibitive for the countries that are affected by cholera: it would cost an estimated $2.2 billion, for example, to adequately improve access to water and sanitation in Haiti. Water, sanitation, and hygiene (WASH) practices are the cornerstones of cholera prevention and control. The promotion of WASH practices, the creation of rehydration centers, use of antibiotics, and training of health personnel during the first months of the Haitian epidemic led to a dramatic reduction in cholera-associated mortality, from 4% to 1.5%.2 Yet a survey in the slums of Port-au-Prince showed that although people were aware of hand-washing methods, they did not have soap and water to implement them. What role should oral cholera vaccine (OCV) play, in combination with WASH practices, in epidemic conditions?

The three currently licensed OCVs are formulations of killed V. cholerae cells. Two of them, Dukoral and Shanchol, have been prequalified by the WHO for purchase by United Nations agencies. The third one, mORCVAX, is licensed and produced exclusively in Vietnam. For all three vaccines, there is evidence of safety and efficacy (66 to 85%) after two doses, with inferred herd protection and immunity lasting up to 5 years (in the case of Shanchol). Dukoral includes a cholera toxin B subunit requiring administration with a buffer, and it costs $3.64 to $6.00 per dose. Shanchol does not require a buffer and costs $1.85 per dose. Despite the evidence of safety and efficacy, international agencies cited several reasons for not including OCV in the prevention package during the 2010 Haitian epidemic.2

First, there was a limited number of OCV doses available worldwide. Second, Shanchol, the cheaper and easier-to-administer vaccine, could not be purchased by United Nations agencies until it received WHO approval in 2011. Third, there was concern that OCV implementation would compete with other WASH interventions in countries with fragile health systems.

After sustained lobbying by multiple institutions and organizations, a pilot intervention was initiated in Haiti using OCV with other WASH measures to control the outbreak (“reactive vaccination”). An urban project was conducted by the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), and a rural project was conducted by Partners in Health, both in collaboration with the Haitian Ministry of Health. The outcomes showed that OCV can be effectively employed as part of a comprehensive cholera-control program: 91% of 97,774 participants received two vaccine doses during a 90-day period.3,4

The WHO has since changed its policy and promotes OCV use in outbreaks worldwide.5 During the past 3 years, more than 1.6 million doses of Shanchol have been administered in Asia, Africa, and the Caribbean. A remaining challenge to OCV implementation was the lack of field evidence for its effectiveness early in an epidemic. The matched case–control study in Guinea, reported on by Luquero et al. in this issue of the Journal (pages 2111–2120), clearly illustrates the role OCV can play in countering cholera epidemics, with greater than 86% protection after administration of two doses.

Although the global stockpile of Shanchol is growing — the WHO has 2 million doses, and the Global Alliance for Vaccines and Immunization (GAVI) has pledged support for 20 million doses over the next 5 years — the world will need millions more doses. Moreover, many questions remain. For instance, how should priorities be set for use of the stockpile when there are multiple simultaneous epidemics (requiring reactive vaccination), other high-risk situations (e.g., encampments of refugees who could benefit from preemptive vaccination), and regions where cholera is endemic and peaks in incidence are expected during the rainy season? Risk evaluation and cost-effectiveness will certainly be important considerations.

In addition, because of their study’s small sample size, Luquero et al. could not test the efficacy of one versus two doses of OCV. A one-dose regimen would reduce the cost and logistic constraints for national scale-up programs. A collaborative double-blind, placebo-controlled study that the International Vaccine Institute and the International Center for Diarrheal Disease Research, Bangladesh, are conducting in Dhaka may provide this information.

Another question is whether OCV can be stored at room temperature so that the cold-chain requirement can be bypassed. In the study by Luquero et al., the vaccine was refrigerated during storage, but the cold chain was not maintained in the field. It will be important to determine how long the vaccine can retain its efficacy at room temperature.

Furthermore, can Shanchol be used in pregnancy and in children younger than 1 year of age? Although WHO recommendations suggest targeting pregnant women at high risk for cholera, the manufacturer has not approved use of the vaccine in pregnancy, and there are no guidelines for children under 1 year old.

Since 2010, some major obstacles preventing the use of OCV have been overcome. Shanchol, the cheapest and easiest-to-administer vaccine, is being stockpiled. OCV has been used in 13 countries on three continents (Asia, Africa, and the North American Caribbean) and in three risk settings. The study by Luquero et al. provides further evidence in favor of using OCV in emerging outbreaks.

Original Article
Use of Vibrio cholerae Vaccine in an Outbreak in Guinea
Francisco J. Luquero, M.D., M.P.H., Lise Grout, D.V.M., M.P.H., Iza Ciglenecki, M.D., Keita Sakoba, M.D., Bala Traore, M.D., Melat Heile, N.P., Alpha Amadou Diallo, M.Sc., Christian Itama, M.D., Anne-Laure Page, Ph.D., Marie-Laure Quilici, Ph.D., Martin A. Mengel, M.D., Jose Maria Eiros, M.D., Ph.D., Micaela Serafini, M.D., M.P.H., Dominique Legros, M.D., M.P.H., and Rebecca F. Grais, Ph.D.
N Engl J Med 2014; 370:2111-2120 May 29, 2014 DOI: 10.1056/NEJMoa1312680
Abstract
The use of vaccines to prevent and control cholera is currently under debate. Shanchol is one of the two oral cholera vaccines prequalified by the World Health Organization; however, its effectiveness under field conditions and the protection it confers in the first months after administration remain unknown. The main objective of this study was to estimate the short-term effectiveness of two doses of Shanchol used as a part of the integrated response to a cholera outbreak in Africa.
Full Text of Background…
Methods
We conducted a matched case–control study in Guinea between May 20 and October 19, 2012. Suspected cholera cases were confirmed by means of a rapid test, and controls were selected among neighbors of the same age and sex as the case patients. The odds of vaccination were compared between case patients and controls in bivariate and adjusted conditional logistic-regression models. Vaccine effectiveness was calculated as (1−odds ratio)×100.
Full Text of Methods…
Results
Between June 8 and October 19, 2012, we enrolled 40 case patients and 160 controls in the study for the primary analysis. After adjustment for potentially confounding variables, vaccination with two complete doses was associated with significant protection against cholera (effectiveness, 86.6%; 95% confidence interval, 56.7 to 95.8; P=0.001).
Full Text of Results…
Conclusions
In this study, Shanchol was effective when used in response to a cholera outbreak in Guinea. This study provides evidence supporting the addition of vaccination as part of the response to an outbreak. It also supports the ongoing efforts to establish a cholera vaccine stockpile for emergency use, which would enhance outbreak prevention and control strategies. (Funded by Médecins sans Frontières.)
Full Text of Discussion…
Read the Full Article…

PLoS One
[Accessed 31 May 2014]
http://www.plosone.org/

Research Article
Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning
Miles Parker mail, Andrew Acland, Harry J. Armstrong, Jim R. Bellingham, Jessica Bland, Helen C. Bodmer, Simon Burall, Sarah Castell, Jason Chilvers, David D. Cleevely, David Cope, Lucia Costanzo, James A. Dolan, [ … ], William J. Sutherland , [ view all ]
Abstract
Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 31 May 2014)

Editorial
The Role of Open Access in Reducing Waste in Medical Research
Paul Glasziou mail
Published: May 27, 2014
DOI: 10.1371/journal.pmed.1001651
[Full text]
Twenty years ago an editorial by Doug Altman in the BMJ [1], “The Scandal of Poor Medical Research”, decried the poor design and reporting of research, stating that “huge sums of money are spent annually on research that is seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect methods of analysis, and faulty interpretation”. Since then, change has been gradual, while the list of problems has lengthened, and documentation of their magnitude has accumulated. Recent years, however, have seen a crescendo of concern. Public awareness has been accelerated with the publication of Ben Goldacre’s Bad Pharma [2], which clearly articulated the problems posed by biased non-publication and reporting of pharmaceutical research. Wider awareness of these issues helped spark the AllTrials campaign (http://www.alltrials.net/), which asks for “all trials registered; all results reported”. Of course, the problems of poor design and reporting, as well as selective non-publication, extend well beyond drug trials to most areas of research: drug and non-drug, basic and applied, interventional and observational, animal and human. A 2009 paper in The Lancet [3] estimated that three problems—flawed design, non-publication, and poor reporting—together meant over 85% of research funds were wasted, implying a global total loss of over US$100 billion per year. This year, a follow-up series [4] more extensively documented this wastage, confirming the earlier estimate, but adding details and a series of more explicit recommendations for action.

The waste sounds bad, but the reality is worse. The estimate that 85% of research is wasted referred only to activities prior to the point of publication. Much waste clearly occurs after publication: from poor access, poor dissemination, and poor uptake of the findings of research. The development of open access to research [5] is important to reduce this post-publication waste. Poor access—including paywalls, restrictions on re-publication and re-use, etc.—limits both researcher-to-researcher and researcher-to-clinician communications. As PLOS Medicine editorial leaders pointed out in a PubMed Commons response to the Lancet series [6], open access is more than free access and includes “free, immediate access online; unrestricted distribution and re-use rights in perpetuity for humans and technological applications; author(s) retains rights to attribution; papers are immediately deposited in a public online archive, such as PubMed Central” [7]. Globally, the most important access problem is arguably due to language barriers, and with the growth of research in non-English-speaking countries, particularly China, this problem is likely to grow. Language barriers make even free-access research unusable, but by eliminating restrictions on re-publication and re-use, open access can at least reduce barriers to translation.

Solving the problems of pre-publication waste and post-publication access could hugely accelerate medical research. Even the complete solution of these problems, however, would be insufficient to close the research–practice gap. Paradoxically, the plethora of research is itself a barrier to its use. A recent analysis of trials and reviews by specialty found an unmanageable scatter of research [8]. For example, in neurology the annual output was 2,770 trials across 896 journals, and 547 systematic reviews across 292 journals. So, in addition to access, clever systems of synthesis, filtering, findability, and usability are needed if the users of research are to cope with this information deluge [9]. The enormous marketing budgets of pharmaceutical companies demonstrate the importance they place on investing resources in getting the message of their research to decision makers. Unfortunately, little such investment is made in non-commercial research, and this research is consequently neglected. This concern has led to the development of different approaches given names such as “evidence-based medicine”, “knowledge translation”, and “implementation science”.

To get full value from research investment, we need to reduce both the annual US$100 billion of pre-publication (research production) waste and the unquantified cost of post-publication (research dissemination) barriers (Figure 1). Open access will not in itself fix the problems of poor research question selection, poor study design, selective non-publication, or poor or biased reporting, but these can be ameliorated considerably through appropriate editorial policies and peer review processes. Open-access medical journals must maintain particularly high standards for these processes in order to avoid merely increasing access to a biased selection of (often flawed) research. At the same time, improving research quality but keeping access restricted would mean continued waste in the use and uptake of good science.

“As the system encourages poor research,” wrote Altman in 1994 [1], “it is the system that should be changed. We need less research, better research, and research done for the right reasons.” To that must be added a need for research that is communicated effectively to those who need it. If over a 100 billion dollars of medical research money were being wasted by corruption, the public and political outcry would be overwhelming. That resources of this magnitude are being wasted through incompetence and inattention should be seen as a similar scandal. Badly designed and poorly thought through systems of research and dissemination subtract massively from global human health: they demand attention—and action.
References
1. Altman DG (1994) The scandal of poor medical research. BMJ 308: 283.
View Article
PubMed/NCBI
Google Scholar
2. Goldacre B (2012) Bad pharma: how drug companies mislead doctors and harm patients. London: Fourth Estate.
3. Chalmers I, Glasziou P (2009) Avoidable waste in the production and reporting of research evidence. Lancet 374: 86–89 Accessed 23 April 2014.
View Article
PubMed/NCBI
Google Scholar
4. Macleod MR, Michie S, Roberts I, Dirnagl U, Chalmers I, et al. (2014) Biomedical research: increasing value, reducing waste. Lancet 6736: 1–6.
View Article
PubMed/NCBI
Google Scholar
5. Joseph H (2013) The open access movement grows up: taking stock of a revolution. PLoS Biol 11: e1001686 Accessed 23 April 2014.
View Article
PubMed/NCBI
Google Scholar
6. Glasziou P, Altman DG, Bossuyt P, Boutron I, Clarke M, et al. (2014) Research: increasing value, reducing waste 5 Reducing waste from incomplete or unusable reports of biomedical research. Lancet 383: 267–276.
View Article
PubMed/NCBI
Google Scholar
7. Barbour V, Peiperl L (2014) Comment on PMID 24411647: Reducing waste from incomplete or unusable reports of biomedical research. PubMed Commons. Accessed 28 April 2014.
View Article
PubMed/NCBI
Google Scholar
8. Hoffmann T, Erueti C, Thorning S, Glasziou P (2012) The scatter of research: cross sectional comparison of randomised trials and systematic reviews across specialties. BMJ 3223: 1–9 doi:10.1136/bmj.e3223.
View Article
PubMed/NCBI
Google Scholar
9. Glasziou P, Haynes RB (2005) The paths from research to improved health outcomes. Evid Based Med 10: 4–7.
View Article
PubMed/NCBI
Google Scholar

PLoS Neglected Tropical Diseases
May 2014
http://www.plosntds.org/article/browseIssue.action

Editorial
Ten Global “Hotspots” for the Neglected Tropical Diseases
Peter J. Hotez mail
Published: May 29, 2014
DOI: 10.1371/journal.pntd.0002496
Initial text
Since the founding of PLOS Neglected Tropical Diseases more than six years ago, I have written about the interface between disease and geopolitics. The neglected tropical diseases (NTDs) are the world’s most common infections of people living in poverty [1]. Where they are widespread in affected communities and nations, NTDs can be highly destabilizing and ultimately may promote conflict and affect international and foreign policy [2]. Many of the published papers in this area were recently re-organized in a PLOS “Geopolitics of Neglected Tropical Diseases” collection that was posted on our website in the fall of 2012, coinciding with the start of our sixth anniversary [3]. From this information, a number of new and interesting findings emerged about the populations who are most vulnerable to the NTDs, including the extreme poor who live in the large, middle-income countries and even some wealthy countries (such as the United States) that comprise the Group of Twenty (G20) countries [4], as well as selected Aboriginal populations [5]. Together, the PLOS “Geopolitics of Neglected Tropical Diseases” collection and the G20 analyses identified more than a dozen areas of the world that repeatedly show up as ones where NTDs disproportionately affect the poorest people living at the margins. Here, I summarize what I view as ten of the worst global “hotspots” where NTDs predominate (Figure 1). They represent regions of the world that will require special emphasis for NTD control and elimination if we still aspire to meet Millennium Development Goals (MDGs) and targets by 2015; they are regions that may need to be highlighted again as we consider post-MDG aspirations and new Sustainable Development Goals (SDGs).

Viewpoints
The Gulf Coast: A New American Underbelly of Tropical Diseases and Poverty
Peter J. Hotez, Kristy O. Murray, Pierre Buekens
PLOS Neglected Tropical Diseases: published 15 May 2014 | info:doi/10.1371/journal.pntd.0002760

From Haiti to the Amazon: Public Health Issues Related to the Recent Immigration of Haitians to Brazil
Tom Rawlinson, André Machado Siqueira, Gilberto Fontes, Renata Paula Lima Beltrão, Wuelton Marcelo Monteiro, Marilaine Martins, Edson Fidelis Silva-Júnior, Maria Paula Gomes Mourão, Bernardino Albuquerque, Maria das Graças Costa Alecrim, Marcus Vinícius Guimarães Lacerda
PLOS Neglected Tropical Diseases: published 08 May 2014 | info:doi/10.1371/journal.pntd.0002685

Building Endogenous Capacity for the Management of Neglected Tropical Diseases in Africa: The Pioneering Role of ICIPE
Daniel K. Masiga, Lilian Igweta, Rajinder Saini, James P. Ochieng’-Odero, Christian Borgemeister
PLOS Neglected Tropical Diseases: published 15 May 2014 | info:doi/10.1371/journal.pntd.0002687

Refugee Survey Quarterly
Volume 33 Issue 2 June 2014
http://rsq.oxfordjournals.org/content/current

Despair as a Governing Strategy: Australia and the Offshore Processing of Asylum-Seekers on Nauru
Caroline Fleay and Sue Hoffman*
Abstract
As part of its efforts to deter the arrival of asylum-seekers by boat to Australia in 2001, Prime Minister John Howard’s Coalition Government established the offshore processing of refugee claims. Known as the Pacific Solution, this policy included an agreement with Nauru and Papua New Guinea’s Manus Island for asylum-seekers arriving to Australia by boat to be transported to either of these islands where they would wait in camps while their refugee claims were processed. The majority of the asylum-seekers subjected to offshore processing at this time were held on Nauru, and most had fled Afghanistan. Governmentality, as introduced by Michel Foucault and developed by later scholars, provides insight into the institutions, methods, techniques, strategies, and tactics used by governments to achieve its ends. This article explores Australian Government policy and the experience of Afghan asylum-seekers held on Nauru from 2001 using a governmentality approach. Given that people seeking asylum in Australia are once again being transported to Nauru and Papua New Guinea, this time initiated by a Labor Government and continued by the current Coalition Government, this article’s findings are pertinent for insight into understanding current Australian policy.

From Google Scholar+ [to 31 May 2014]
Selected content from beyond the journals and sources covered above, aggregated from a range of Google Scholar monitoring algorithms and other monitoring strategies.

The Lancet Oncology
Volume 15, Issue 7, June 2014, Pages e290–e297
http://www.sciencedirect.com/science/journal/14702045/15/7
Policy Review
Cancer in refugees in Jordan and Syria between 2009 and 2012: challenges and the way forward in humanitarian emergencies
Paul Spiegel, MDa, Adam Khalifa, MDb, Farrah J Mateen, MDc, d
Summary
Treatment of non-communicable diseases such as cancer in refugees is neglected in low-income and middle-income countries, but is of increasing importance because the number of refugees is growing. The UNHCR, through exceptional care committees (ECCs), has developed standard operating procedures to address expensive medical treatment for refugees in host countries, to decide on eligibility and amount of payment. We present data from funding applications for cancer treatments for refugees in Jordan between 2010 and 2012, and in Syria between 2009 and 2011. Cancer in refugees causes a substantial burden on the health systems of the host countries. Recommendations to improve prevention and treatment include improvement of health systems through standard operating procedures and innovative financing schemes, balance of primary and emergency care with expensive referral care, development of electronic cancer registries, and securement of sustainable funding sources. Analysis of cancer care in low-income refugee settings, particularly in sub-Saharan Africa, is needed to inform future responses.

.

SPIE Proceedings | Volume 9118
Independent Component Analyses, Compressive Sampling, Wavelets, Neural Net, Biosystems, and Nanoengineering XII, 91180B
(May 22, 2014); doi:10.1117/12.2051420Volume 9118
Proceedings Article
3D printed rapid disaster response
Alberto Lacaze ; Karl Murphy ; Edward Mottern ; Katrina Corley ; Kai-Dee Chu
[+] Author Affiliations
Abstract
Under the Department of Homeland Security-sponsored Sensor-smart Affordable Autonomous Robotic Platforms (SAARP) project, Robotic Research, LLC is developing an affordable and adaptable method to provide disaster response robots developed with 3D printer technology. The SAARP Store contains a library of robots, a developer storefront, and a user storefront. The SAARP Store allows the user to select, print, assemble, and operate the robot. In addition to the SAARP Store, two platforms are currently being developed. They use a set of common non-printed components that will allow the later design of other platforms that share non-printed components. During disasters, new challenges are faced that require customized tools or platforms. Instead of prebuilt and prepositioned supplies, a library of validated robots will be catalogued to satisfy various challenges at the scene. 3D printing components will allow these customized tools to be deployed in a fraction of the time that would normally be required. While the current system is focused on supporting disaster response personnel, this system will be expandable to a range of customers, including domestic law enforcement, the armed services, universities, and research facilities.

Press Release: GAVI Alliance sets out opportunity to save up to six million lives through immunisation
20 May 2014

[Excerpt, Editor’s text bolding]
…The GAVI Alliance asked donors to invest an additional US$ 7.5 billion to support developing countries’ immunisation programmes from 2016 to 2020. These commitments would be added to the US$ 2 billion already available to GAVI for the period to ensure that Alliance-supported programmes are fully funded up to 2020…

…An acceleration is necessary because, despite an unprecedented increase in vaccine programmes in developing countries, 1.5 million children die each year of vaccine-preventable diseases and one in five children worldwide do not receive a full course of even the most basic vaccines.

The GAVI Alliance today set out an investment case that demonstrates how donors can support the world’s poorest countries to secure and expand their immunisation programmes, which protect children against illnesses such as pneumococcal disease and rotavirus, the leading vaccine-preventable causes of pneumonia and diarrhoea, between 2016 and 2020.

The economic benefits of fully funded, sustainable vaccine programmes would result in US $80 to $100 billion in gains for developing countries through increased productivity and reductions in the cost of treating illnesses that would have been prevented through immunisation….

African Development Bank announces US $2 billion fund with China
22/05/2014

The African Development Bank (“AfDB”) and the People’s Bank of China (“PBOC”) on Thursday, May 22 entered into a US $2 billion co-financing fund to be known as the Africa Growing Together Fund (“AGTF”). The resources from the AGTF are expected to be provided over a 10-year period and will be used alongside the AfDB’s own resources to finance eligible sovereign and non-sovereign guaranteed development projects in Africa.
Donald Kaberuka, President of the African Development Bank Group, commented that “the AGTF marks an important milestone in the long-standing relationship between China and the African Development Bank Group in particular and Africa in general.” He added that “the AGTF will operate within the strategic framework, policies and procedures of the AfDB, including its integrated safeguards, thereby leveraging on the AfDB’s strengths.”

Commenting on the agreement, Zhou Xiaochuan, Governor of the People’s Bank of China, acknowledged the AfDB’s work over the last 50 years, and the great strides it has made in promoting growth and alleviating poverty. He stated that “the AfDB’s rich experience, convening power and strong results-oriented culture made the Bank China’s ideal partner for channeling resources in support of long-term growth and development on the continent.”

Charles Boamah, Vice-President and CFO of the African Development Bank Group, stated that “the AGTF enables an additional US $200 million in more or larger-sized projects annually throughout Africa, on identical terms and conditions as for loans made by the AfDB itself to the same projects. This builds on the success of similar instruments such as the Nigeria Trust Fund, which has been in operation for close to 40 years.” He expressed a hope that this model will be replicated with many more regional as well as non-regional member countries of the AfDB.
Following the signing, the AGTF will be immediately established, and is expected to be used to co-finance some projects before the end of this year.

Report: Profits and Poverty: The Economics of Forced Labour
ILO – Special Action Programme to Combat Forced Labour (SAP-FL); Fundamental Principles and Rights at Work Branch (FPRW)
20 May 2014 66 pages
ILO’s Director-General urges immediate action to eradicate forced labour

Excerpt

The publication of the new ILO report “Profits and Poverty: The Economics of Forced Labour” is significant because it takes our understanding of trafficking, forced labour and slavery to a new level.

The report builds on earlier ILO studies on the extent, the cost and profits from forced labour and human trafficking.

But this report is different: it looks at both the supply and the demand side of forced labour, and for the first time provides solid evidence for a correlation between forced labour and poverty.

What is more, it provides startling new estimates of the illegal profits generated through the use of forced labour in various economic sectors and industries, and in commercial sexual exploitation.

These new estimates show that progress is being made. State-imposed forced labour is declining in importance. Of course, we must remain vigilant to prevent that type of exploitation from resurging.

But we must also now turn our attention to understanding what continues to drive forced labour and trafficking in the private sector.

In order to move forward in this fight, we need to look at the socio-economic factors that make people vulnerable to forced labour.
– We need to understand the role of supply and demand, and how some unscrupulous employers can still reap huge profits by underpaying, or not paying workers at all.
– We need to strengthen social protection floors to prevent households from sliding into the poverty that pushes people into forced labour.
– We need to improve levels of education and literacy so that household decision-makers can understand their own vulnerability to forced labour and know their rights as workers.
– We need to address the fact that more than half of all of the victims are women and girls, primarily in commercial sexual exploitation, and we need to reduce the vulnerability of men and boys as well to forced labour in other sectors.
– And finally, we need to examine how the movement of people either within or across international borders contributes to forced labour and build and consolidate a rights-based approach to migration…

WHO: Plan of action of the Commission on Ending Childhood Obesity
May 2014
[WHO Director General Margaret Chan announced formation of the new commission during the World Health Assembly in Geneva last week]

What is the role of the Commission?
The Commission has been tasked with producing a report specifying which approaches and which combinations of interventions are likely to be most effective in different contexts around the world. The report is to arise from consensus between a broad variety of experts. The Commission is to be co-chaired by Sir Peter David Gluckman, Chief Science Advisor to the Prime Minister of New Zealand, and Dr Sania Nishtar, founder and President of Heartfile.

No single discipline can provide the groundwork for a strategic approach to tackling childhood obesity. Social scientists, public health specialists, clinical scientists and economists will join together to synthesize the best available evidence into a coherent plan. Actors responsible for food production, manufacturing, marketing and retail; maternal health and nutrition; child health, education and health literacy; physical activity; and public policy will also engage in the task.

The Commission will deliver its report to the WHO Director-General in early 2015 so that she can convey its recommendations to the 2015 World Health Assembly.
Working groups

The Commission will be supported by two working groups.

An ad hoc Working Group on Science and Evidence consisting of experts in epidemiology, paediatrics, nutrition, development origins, health literacy, and marketing to children, health economics, physical activity and gestational diabetes will:
:: estimate the prevalence of childhood obesity and its consequences
:: evaluate the economic impact of childhood obesity
:: examine the evidence on prevention of childhood obesity and how to reverse it in affected
children; and determine the best combination of policies to put in place to achieve these
goals in different settings
:: evaluate and recommend policy options for monitoring and surveillance.

The Working Group on Implementation, Monitoring and Accountability will consist of experts in monitoring and accountability, joined by representatives of governments, civil society, groups representing children, advocates for child health and nutrition, international organizations and the food industry. This group will develop:
:: a framework for implementation of and accountability for policies recommended by the
Working Group on Science and Evidence
:: mechanisms required to monitor recommended policy options
:: assessment of the feasibility of monitoring recommended policy options
:: an approach ensuring that countries are not unduly burdened by reporting requirements

Report: Cost of Air Pollution: Health Impacts of Road Transport
OECD
21 May 2014 80 pages
ISBN: 9789264210448 (PDF) ; 9789264210424 (print)
DOI: 10.1787/9789264210448-en
Excerpt for Overview
Air pollution is costing advanced economies (plus China and India) an estimated USD 3.5 trillion a year in premature deaths and ill health and the costs will rise without government action to limit vehicle emissions, a new OECD report says.

In OECD countries, around half the cost is from road transport, with diesel vehicles producing the most harmful emissions. Traffic exhaust is a growing threat in fast-expanding cities in China and India, as the steady increase in the number of cars and trucks on the road undermines efforts to curb vehicle emissions.

“The price we pay to drive doesn’t reflect the impact of driving on the environment and on people’s health. Tackling air pollution requires collective action,” said OECD Secretary-General Angel Gurría, presenting the report at the International Transport Forum’s 2014 Summit in Leipzig, Germany (Read the full remarks).

The report calculates the cost to society across the OECD’s 34 members at about USD 1.7 trillion, based on the value people attach to not having their lives cut short by cancer, heart disease or respiratory problems. It puts the cost at nearly USD 1.4 trillion in China and nearly USD 0.5 trillion in India.

More than 3.5 million people die each year from outdoor air pollution. From 2005 to 2010, the death rate rose by 4 percent worldwide, by 5 percent in China and by 12 percent in India.

Main Findings
:: The number of deaths due to outdoor air pollution fell by about 4% in OECD countries between 2005 and 2010. But while 20 of the 34 OECD countries achieved progress, 14 did not.
:: The number of deaths due to outdoor air pollution in China rose by about 5%, in India by about 12% over the same period.
:: The cost of the health impact of air pollution in OECD countries (including deaths and illness) was about USD 1.7 trillion in 2010.
:: Available evidence suggests that road transport accounts for about 50% of this cost in the OECD, or close to USD 1 trillion.
:: In China, the cost of the health impact of air pollution was about USD 1.4 trillion in 2010, and about USD 0.5 trillion in India. There is insufficient evidence to estimate the share of road transport but it nonetheless represents a large burden.

Main recommendations
:: Remove any incentives for the purchase of diesel cars over gasoline cars.
:: Maintain and tighten regulatory regimes, in particular, vehicle standards regimes such as those currently in place in the European Union. Make test-cycle emissions more similar to the emissions the vehicles cause under normal use.
:: Invest in more ambitious mitigation programmes, including improved public transport.
:: Continue the research on the economic value of morbidity impacts of air pollution and on the specific evidence linking it to road transport.
:: Mitigate the impact of air pollution on vulnerable groups, such as the young and the old.

Stanford Social Innovation Review Blog
Nonprofit Management
When the Rhythm Changes, So Must the Dance
Why careful listening is important to starting and scaling positive social change.
By Molly Melching | May. 20, 2014

Bringing an idea or movement to transformative scale is a complex task, especially in a world where the challenges we face often seem insurmountable. It requires innovation, partnership, and planning, as well as much patience. But since founding Tostan (an African community empowerment NGO) in 1991, I have found that something called responsive listening is actually the most essential element of helping a grassroots movement grow. For us, responsive listening has shaped not only what we do, but also how we fund it.

Responsive listening is about really understanding people and working alongside rather than for them. These behaviors are foundational for Tostan and a catalyst for all innovations to our programs and approach. Listening attentively to the needs of our partner communities and directly incorporating their feedback has constantly refined the way we work. One change at a time, we have built an approach that organically brings movements to scale, because the communities with which we partner essentially design and lead them.

Today, the heart of our approach to this work is our Community Empowerment Program (CEP), a three-year, non-formal education program with three main elements:
:: It is human rights-centered. During the first months of our program, community members learn about their human rights. Participants start a dialogue about what these rights mean to them and explore how their existing traditions, values, and religious beliefs support these rights. Likewise, knowledge of their human rights gives them a foundation to question practices or social norms that violate these rights. Learning about human rights has proved powerful, especially for women, giving them new confidence to speak out about issues such as child marriage, female genital cutting, and domestic violence, and to participate in family and community decisions.
:: It is holistic and integrated. The communities we partner with in Africa are dynamic, and work to address a broad range of challenges and experiences. We have found that education functions best in the same way: When holistic and integrated, it prepares participants to find appropriate solutions to the many issues their communities face. Our program has evolved to mirror this need, facilitating learning on topics such as human rights, problem solving, hygiene and health, literacy, numeracy, and project management. In this way, issues intersect and reinforce one another—for example when communities apply new skills to build a school or address a health issue.
:: It is inclusive of networks. When it comes to building support for a movement, it is imperative to include the extended family or social network. This is something I learned from my dear friend Demba Diawara, a village imam (leader) and social change activist in Senegal. He told me: “A person’s family is not their village. The family includes one’s entire social network. … If you truly want to bring about widespread change, they must all be involved.” In other words, neighboring villages, relatives living far away, and all others connected to a given community must engage in the conversation.

A process called organized diffusion helps achieve this broad engagement. First, all members of an individual village or community must connect to the learning process. Our CEP classes include a diverse range of community members—women, men, and adolescents—from different social strata in the village. These participants learn and talk together during class sessions, and commit to sharing the information they gain with their family and community. Second, CEP is not a village-at-a-time model. Instead, we work in clusters of 30-50 communities within a region. That way, the dialogue expands even farther, as entire communities host social mobilization activities and inter-village meetings to discuss information relevant to their extended network—notably, that includes people not participating in our full program and even communities living across borders in other countries. Through this outreach process, entire social networks become engaged, taking ideas and turning them into action for change.

These hallmarks of our approach—human rights-centered, holistic, and inclusive of community networks—are the result of responsive listening, and they are what help empower and mobilize communities to identify and grow their movements for change. Although the cultural contexts and exact needs of communities vary, the same principle applies: We are working with communities to design an approach that can scale and sustain itself.

The practice of reflective learning has also influenced how we fund this work. Our financial support has traditionally taken the form of stand-alone projects lasting one or two years and focused mostly on single issues—a typical funding pattern for many NGOs. We deeply appreciate these partnerships. But as we looked at reaching thousands more villages across West Africa, we realized that we needed something more—multi-issue, multi-year, multi-country support to really follow what we’ve learned and allow our programs to scale up in step with communities’ ambitions.

Launched last year, our Generational Change in Three Years campaign creates that new, holistic funding model by coordinating our work in 1,000 communities and six countries around three goals: 1) ending female genital cutting in Senegal and reducing it in surrounding countries, 2) greatly reducing child marriage and violence against women and girls, and 3) transforming education for a generation of parents and children. The “pooled” funding model of this campaign will allow us to deliver results more efficiently—by reducing administrative costs, streamlining reporting protocols, and ensuring secure cash-flow. In April we launched the first wave of this new effort, starting activities in 150 communities in Guinea, Guinea-Bissau, Mali, and Mauritania.

We have found that CEP is adaptable to almost every community and context, and works most powerfully when deployed at scale. Thus, continuing to run the model as best we could through uncoordinated projects would have embodied unresponsive listening. As we say in Senegal, “When the rhythm changes, so must the dance.” We are excited by where our latest campaign and other innovations can take us, and most importantly, how these innovations can propel the ambitious efforts of our partner communities to build bright futures.

The humanitarian response must be fit for new crises
David Miliband, IRC
The Guardian: Poverty Matters Blog
Changing ‘aidscape’ demands humanitarian goals with clear targets as part of post-2015 development plan

There will be intensive brainstorming about the future of humanitarian action in the next two years. In March 2015, the third world conference on disaster risk reduction will take place in Japan. The UN development summit in September 2015 will establish the successors to the millennium development goals (MDGs) – the sustainable development goals (SDGs). And in March 2016, the global humanitarian community will meet in Istanbul for the first world humanitarian summit.

This kind of focus is essential because the “aidscape” is changing. On the demand side, the growth of the middle class in China and India means a higher concentration of poverty in conflict-affected states. Half of the world’s extreme poor, who survive on less than $1.25 a day, live in these fragile states. As a result, humanitarian crises are becoming more complex and more frequent.

On the “supply” side, the humanitarian community is characterised by fatigue and fragmentation. The fatigue is manifest in what Pope Francis has called the “globalisation of indifference”. The fragmentation can be seen among traditional humanitarian actors, where there are diverse approaches and priorities, and in the entry of new players, whether funded from Muslim majority countries in the Gulf or by the private sector.

This discrepancy between demand and supply explains why, in the face of an unprecedented four crises rated level 3 by the UN in 2013 (Syria, South Sudan, Central African Republic and the Philippines), the global response has been lacking. UN appeals are underfunded by governments; the public is dispirited; humanitarian NGOs are stretched as rarely before.

Humanitarian agencies like the International Rescue Committee are responding with a range of innovations to improve efficiency and effectiveness. There is more focus on and accountability to “beneficiaries” – the people we assist; more integration of social and economic interventions; and better partnerships with local civil society.

But the challenge for humanitarian action goes beyond the practice of individual agencies. Too often, the whole of our effort seems less than the sum of the parts. To me, that can only be addressed if we debate and decide clear goals to align our efforts. I’m pleased to have initiated a debate on this blog, it’s time to take the ideas further.

Humanitarian goals (HuGos) could help tackle four fundamental issues. First, they could focus attention and resources on what the humanitarian system is trying to achieve. Second, they could align diverse practical efforts on the ground in response to conflict and disaster. Third, they could establish accountability in and for the system. Finally, they could rally public opinion.

There are difficult questions about whether HuGos should be outcome-based (such as around health or education levels, or number of lives saved) or input-or process-based (such as around funding levels, or timeliness of response). Whether HuGos are separate from the SDGs or integrated within them. How they relate to existing standards (eg sphere standards, or the core humanitarian standard).

But the difficulty of the questions should not lead us to duck them – we should aim for outcome-based standards that are integrated into the SDGs, and articulated in the form of floor or convergence targets.
Floor targets have been developed in domestic policy around the world – health, education, crime – to ensure that overall or average improvements in performance of public services are not at the expense of attention to the poorest performance, which is often correlated with socioeconomic status. In improving health, for example, attention is paid to the health of the poorest as well as to the average age of mortality.

There is a clear and compelling parallel for the humanitarian system. Humanitarian floor targets could mean, for example, that education or health levels in fragile states or level 3 emergencies are given due priority by establishing minimum outcome levels alongside the aspirations for improved overall provision for the poorest. Aspirations for tackling gender violence or inequality could be accompanied by floor targets for the position of women and girls in humanitarian emergencies.

The purpose would be to ensure that the SDGs do not encourage “cream skimming” and a focus on those low-income states and people just below the target level. They should be a key part of the armory in tackling the gravest inequalities.

These outcome-based targets could be complemented by input-targets designed to maximise progress towards the agreed outcomes, and to guard against humanitarian priorities being seen as “second-tier” targets. This could be minimum funding levels for the UN Central Emergency Response Fund, or minimum standards for responses to level 3 emergencies.

The conversation about the SDGs is now at quite an advanced stage. So the case for floor targets needs to be made with urgency and purpose. Real progress would set the stage for the world humanitarian summit to address key issues relating to the performance and focus of the humanitarian system, from how it does prevention to the nature of local partnerships and the integration of economic and social concerns.

The debate about the future of the fight against poverty is important and urgent. But one danger is clear: that people in conflict states are the Cinderellas of the process, left in the “too complicated” box. That must not be allowed to happen.

Amref Health Africa [to 24 May 2014]

Amref Health Africa @AMREFUSA • May 23
See 1st Lady of Kenya, Mrs. Margaret Kenyatta launch our 8th National Fistula Surgical Camp in Nairobi! http://bit.ly/1gpFHas #endfistula

Amref Health Africa @AMREFUSA • May 23
Obstetric #fistula impacts 2mil women worldwide. Join our chat today at 1pmET to learn how we can #EndFistula. @JNJGlobalHealth

Amref Health Africa ‏@AMREF_Worldwide May 23
Reconstructive surgery can mend fistula with a 90% success rate for uncomplicated cases and 60% success rate for more complicated cases.

Amref Health Africa @AMREF_Worldwide May 22
The three-year regional project is funded by the Dutch Government and aims to reach 113,000 women of reproductive age #EndFistula

Amref Health Africa @AMREF_Worldwide May 22
With such statistics, @AMREF_Worldwide in Kenya through the Outreach Programme launched the Staying Alive! Restore Women’s Dignity project

Amref Health Africa @AMREF_Worldwide May 22
In Sub Sahara Africa about 1-2 obstetric fistulas occur per 1000 deliveries &about 4500-5500 new obstetric fistulae in East Africa annually

BRAC [to 24 May 2014]

BRAC @BRACworld • 11h
Here is an account of how BRAC WASH monitors its programme efficacy #quality #information #system #QIS http://www.youtube.com/watch?v=9ilPgXKoCd8 …

BRAC @BRACworld • 11h
Eight ways to learn more about BRAC http://blog.brac.net/2014/05/eight-ways-to-learn-more-about-brac/ …

BRAC @BRACworld • May 21
The #micronutrient distribution challenge http://brac.net/node/1621#.U3xfr6uw39U …

Retweeted by BRAC
Susan Davis @SusanDavisBRAC • May 19
BRAC Liberia Country Rep MA Salam represents @BRACworld at food security event with @rajshah @USAID @ONECampaign

Casa Alianza [to 24 May 2014]
Covenant House [to 24 May 2014]

Article: Homeless Kids Hurt by For-Profit Colleges
Kevin M. Ryan, Updates from President Kevin Ryan
05/21/2014 – 2:30pm

Casa Alianza UK ‏@CasaAlianzaUK May 19
Thanks to the Center for Constitutional Rights for denouncing attempts to silence Casa Alianza #Honduras: https://ccrjustice.org/statement-of-concern-regarding-beating-of-director-of-casa-alianza%2c-honduras …

Casa Alianza UK @CasaAlianzaUK • May 17
Thanks to @unicef for highlighting the “worrying trend of violence against children emerging in Honduras”: http://www.unicef.org/media/media_73515.html … #children