Yearly Archives: 2008
Earlier this week the New England Journal of Medicine published the results of a promising clinical trial of a vaccine for malaria. UN Dispatch spoke with Dr. Daniel Carucci Vice President of Global Health for UN Foundation, described what this breakthrough means for the global fight against malaria.
Can you explain the significance of news this week that a malaria vaccine has apparently proven effective?
The New England Journal of Medicine reported this week that an experimental malaria vaccine, called RTS,S, that has shown promise in clinical studies in adults in the U.S. and in early studies in adults and children in Africa, showed comparable efficacy in infants, the population that would most benefit from the vaccine. In all of the studies conducted so far in Africa, the vaccine seems to give between 30% and 50% protection against getting ill from malaria, much lower than any vaccine for other infections on the market today. The malaria vaccine was also studied in combination with the standard vaccines that infants typically receive against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b to ensure that the malaria vaccine did not interfere with these vaccines. Despite the fact that the vaccine does not provide 80 to 90% protection that would be hoped for, this vaccine is the best candidate to date that has been tested in Africa. Other vaccines are in earlier stage development and some could potentially be combined with this vaccine to improve its efficacy.
The good news is that there is strong evidence that an effective vaccine can be developed. Two reasons for this beyond this week’s news are that first, children can develop natural immunity to severe malaria if they live in a malaria area and survive being infected. Second, that laboratory volunteers who are bitten by infected mosquitoes that have been experimentally weakened are completely protected against malaria. These two experimental models give researchers hope that an effective malaria vaccine is possible. The results this week represent an important leap towards this important goal.
When can we expect this vaccine to be available for wide-spread use in sub-Saharan Africa?
Once the vaccine completes its final stage of development and if it is licensed, it could be available in 5-8 years. Other vaccines, if there are shown to be effective, may be as much as 10 years away from licensure.
Does a vaccine potentially obviate the need for other anti-malaria measures?
Until a vaccine is developed that is over 90 to 95% effective, children and pregnant women will still need to be protected from the bites of mosquitoes through the use of insecticide treated bed nets and will have to be checked and treated for malaria. Mosquito control through insecticide spraying of houses and eliminating standing water will need to continue.
The United Nations Environmental Program just released a report in graphs, maps and graphics all of which tell the scary story of global water scarcity. Of course, less water means that it is a more valuable commodity, which in turn raises the potential of conflict. In places where the rule of law is not especially strong, the prospects for water resource conflicts are particularly grave.
Consider this map of Lake Chad as it was in 1963 and as it is today. The lake straddles the border between Chad, Cameroon, Nigeria and Niger.
Special to dispatch from Mark Hopkins, Director of International Energy Efficiency at the United Nations Foundation
Poznan, Poland — As an American at the [international conference on global climate change in] Poznan, whenever I talk with someone from somewhere else in the world, the first question asked is, “What is Barack Obama going to do on climate?” There is so much anticipation of greater US engagement on the issue and hope it will lead to an effective international agreement. I am hopeful too, but I keep reminding everyone, the Obama folks will be much focused on crafting not only an effective global agreement, but one that can also pass muster in the US Senate.
There is much discussion here about the role of energy efficiency. The International Energy Agency is highlighting recommendations in their recent global energy report on the importance of significantly enhancing deployment of energy efficiency if we are to successfully address the climate problem. Given its importance, there is emerging discussion on the need to somehow more directly incorporate it in a post 2012 agreement. Some are seeing it as a potential “building block” essential to the success of a comprehensive agreement.
I don’t know how other people feel, but I have to compliment the Polish government and the city of Poznan on their hosting this conference. Other than being spread widely in hotel sleeping arrangements (which is almost inevitable given 10,000 plus attendees) the conference facility itself and its management has been really great. I am now sitting in the computer room, which is big, very big – there must be 500 computer terminals in use, with a good internet connection. And the awaiting lines are being well managed by conference staff. Hats of to the Poles.
To go with the powerful images that Dispatch readers from around the world have sent in, here are what some op-eds and blog posts are saying about what today’s 60th anniversary of the Universal Declaration of Human Rights means.
Former U.S. president Jimmy Carter makes an appeal for the new American administration to leverage the full weight of the United States’ “moral footprint” to support and protect freedom and democracy in places like Egypt, Pakistan, and DR Congo. (On the same WaPo pages, Michael Gerson shares my irritation at the EU’s sidestepping of peacekeeping responsibilities in the latter country.)
Chris Blattman’s ever-interesting blog yesterday featured this chart (from Columbia University statistician and social scientist Andrew Gelman), tracking how long it took for various conflicts — some with peacekeeping missions, some without — to return (or not return) to conflict:
The information on the graph is a bit hard to take in right away, but study it for a little while, and the implication is clear: conflicts in which peacekeeping missions operated have had a much lower rate of returning to war; and when they do, they usually take longer to reignite. In analyzing these data, Chris plugs the new book by Page Fortna, Does Peacekeeping Work?, from which this chart is drawn.
One of the best things about Page’s book is that she tries to investigate the (obvious) selection problem that could be driving the result: namely peacekeeping missions tackling the easiest conflicts. It’s difficult to measure, but her evidence actually points in the opposite direction: peacekeepers pick the tougher cases. If anything, we may be underestimating the effect of peacekeeping.
Underestimating the effect that peacekeepers have on conflict-riven societies is unfortunately not something new, but this graph quite literally shows why such underappreciation is both unwarranted and contrary to fact.
The Enough Campaign warns that recent developments in U.S. policy toward Somalia are counterproductive to the cause of peace and stability there.
As the Bush administration prepares to leave office, it is taking three ill-considered actions that threaten to exacerbate the already catastrophic situation in Somalia and tie the hands of the incoming Obama Administration. The Bush administration is: 1) urging Ethiopia to keep its armed forces in Somalia until after the administration leaves office; 2) pushing for authorization of a U.N. peacekeeping mission to protect the fractious and impotent Transitional Federal Government after Ethiopia’s departure; and 3) moving to place Ethiopia’s arch-rival Eritrea on the U.S. State Department’s State Sponsors of Terrorism list. There is little indication that the Bush Administration has thought through the implications of these major steps that would not only prolong the violence on the ground, but would hijack the incoming Obama Administration’s policy prerogatives while leaving it with an even more intractable crisis in the troubled Horn of Africa.
“These eleventh hour shifts in policy will only create more blowback for the United States in the region, and serve as a de facto recruiting tool for the hard-line Islamist militia, or shabaab, that is wrapping itself in a mantle of Somali nationalism fighting foreign forces,” said Enough Project adviser, and long-time Somalia expert, Ken Menkhaus, an Associate Professor of Political Science at Davidson College.
Ethiopia is currently scheduled to withdraw its forces from Somalia by the end of 2008 as part of the fragile U.N.-led Djibouti peace process. The two-year Ethiopian occupation of southern Somalia has been a magnet for violence and a growing insurgency in Somalia. By urging Ethiopia to maintain its presence in the capital, Mogadishu, the Bush administration is handing the shabaab a recruitment bonanza while undermining the credibility of moderate Somalis seeking to advance the Djibouti process.
And also from this release is a very concise summary of why simply pawning off the Somalia situation to UN Peacekeeping is unwise.
The Bush Administration is also pushing for a U.N. Security Council resolution to authorize a U.N. stabilization force for Somalia to replace departing Ethiopian troops. This is a bad idea on a number of fronts, and there is zero indication that the administration or the U.N. is serious about putting in place a genuinely credible force. There is no thirst among member states to contribute troops in Somalia at the current moment, and whatever U.N. forces could be scraped together would surely become the main target of insurgent attacks. In short, the Administration is pushing the United Nations to authorize a force that is designed to fail. This policy is the worst of both worlds: U.N. forces would be unlikely to create political or military stability in Somalia while giving shabaab militias a new foreign occupying force to attack.
The SG: In Ethiopia over the weekend, the SG is now in the United Arab Emirates. Today he met with Sheikh Mohammad bin Rashed Al Maktoum, Vice President and Prime Minister of the UAE, where the two discussed developments in the region, including Syria, Iran, Lebanon, Egypt and Jordan, and in the Middle East Peace Process.