Today is United Nations World Population Day. This year's theme: "Family Planning: It's a Right, Let's Make it Real." Thoraya Ahmed Obaid, Executive Director of the United Nations Population Fund explains the critical nexus between maternal health, family planning and poverty alleviation

Maternal death and disability could be reduced dramatically if every woman had access to health services throughout her lifecycle, especially during pregnancy and childbirth. Today millions of women lack access to health services, which puts their lives at risk.

Now is the time to accelerate action to ensure that health services reach women in the communities in which they live. Three reproductive health services are vital for maternal health: skilled attendance at birth, emergency obstetric care and family planning to time and space births.

Family planning is also essential to women's empowerment and gender equality. When a woman can plan her family, she can plan the rest of her life. Information and services for family planning allow individuals and couples to realize their right to determine the number, spacing and timing of their children.

All true. Maternal heath is the foundation upon which other public health solutions in the developing world can emerge. Unfortunately, the United Nations says it has only received about half of the $1.2 billion necessary to provide critical maternal health and family planning services to the developing world this year.

Over at On Day One, users have their own ideas on how the next American administration can promote women's health across the world. Have your say.

Over at his blog, On the Ground, New York Times columnist Nicholas Kristof is incensed that the Bush administration has, for the seventh consecutive year, decided to withhold any funding for the United Nations Population Fund. He's not alone, as voices on the Hill are already registering their outcry. Why would the U.S. object to helping fund an organization that provides reproductive health services for women across the world (not to mention assistance in development, human rights, and gender equality initiatives as well)? Kristof explains:

The reason given for withholding the U.S. funds is that the Population Fund (universally called UNFPA, after its old acronym) supports forced abortions in China. Even if that were true, it would be ridiculous to withhold funds for UNFPA activities against maternal mortality in Africa because of its work in China. But in any case, UNFPA has been a major force against compulsion of any kind in China, as the U.S. blue-ribbon committee that investigated the charges found. In the areas in China where UNFPA set up a model program, there is no compulsion and the abortion rate is lower than in the U.S.

It seems that the administration is assuming that, simply because China has a one-child policy -- and because yes, like everywhere else in the world, some women in China do get abortions -- that abortions there must be non-voluntary, and that the UNFPA, merely by operating in the country, is guilty by association. This logic is clearly flawed, its assertions are wholly unsubstantiated by the evidence, and, perhaps worst of all, it contradicts the findings of the U.S. government's own investigative panel. Moreover, as Kristof suggests, depriving UNFPA of support for any of its work -- even in places like Africa, where President Bush has trumpeted his development efforts, such as PEPFAR, as a staple of his legacy -- out of either political or ideological posturing makes for nonsensical policy.

Cross-posted on On Day One.

UPDATE: Tamara Kreinin, the Executive Director of the Women and Population program at the United Nations Foundation, issues a strong statement on UNFPA funding (read it below the fold).

UPDATE II: As commenter Tyler LePard notes, the news only gets worse. Check out Craig Lasher's post over at RH Reality Check for more.

"The United Nations Foundation joins the international community in expressing its deep disappointment that the administration has decided--for the seventh straight year--to withhold the $39.7 million authorized by Congress to the United Nations Population Fund (UNFPA), the world's leading voice on sexual and reproductive health and rights.

"In a statement notifying Congress of the administration's decision to withhold funds from UNFPA, Deputy Secretary of State John Negroponte once again cited UNFPA's program in China as a violation of the Kemp-Kasten Amendment, which bars funding for programming that "supports or participates in the management of a program of coercive or involuntary sterilization."

"UNFPA does not--and has never--supported coercive or involuntary sterilization. In fact, the decision to withhold funds from UNFPA is inconsistent with the reports from the State Department and several other blue-ribbon investigative teams, which included descriptions of UNFPA's work as "a force for good" in China.

"Working in 150 countries, UNFPA is on the front lines reducing maternal and infant mortality, decreasing HIV/AIDS rates, and protecting women and girls from rape and violence, particularly during conflict situations. The $34 million that the United States has withheld each year is close to 10 percent of UNFPA's regular income. The amount withheld every year could have helped UNFPA prevent 2 million unintended pregnancies, 800,000 abortions, 4,700 mothers' deaths, and more than 77,000 infant and child deaths. Approximately 181 industrialized and developing countries, including all the countries in sub-Saharan Africa and Latin America, contribute to UNFPA. The United States is the only country to withhold funding for political reasons.

"The UN Foundation is looking forward to working with the next administration to restore funding for UNFPA and to strengthen the U.S.'s role as a global health leader. During the 2000 UN Millennium Summit, the United States pledged to work to respond to the world's most pressing development challenges, including poverty, gender inequality and disease. It is past time that the administration acknowledges how fundamental UNFPA is to addressing these global challenges and that the U.S. funds UNFPA's work.

In 1988, polio paralyzed 350,000 children in 125 countries. Twenty years later, there are fewer than 1500 cases of polio around the world, and just four countries remain endemic (Afghanistan, India, Nigeria and Pakistan). How did this happen? In 1988, United Nations agencies like UNICEF and the World Health Program teamed up with the United States Centers for Disease Control and Prevention and a number of private philanthropies to form the Global Polio Eradication Initiative.

The initiative has obviously been hugely successful, but it has not yet put itself out of business. So, to help give global polio eradication one final push, Rotary International (one of the founding partners of the initiative) today announced a new $100,000 campaign. The Bill and Melinda Gates Foundation are matching the campaign dollar for dollar.

$200 million may be all it takes to one and for all give polio the boot. Why not pitch in?

The Washington Post's Colum Lynch relays both the good news about the UN's work combatting AIDS --

About 3 million people infected with the AIDS virus in the developing world received life-prolonging antiretroviral drugs last year, a 42 percent increase over 2006 in the number with access to the medicines, a U.N. report said Monday.

-- and the bad news of the daunting hurdles that remain.

But U.N. officials cautioned that 70 percent of AIDS victims still have no access to the medicines and that the number of newly infected people worldwide in 2007 was still 2.5 times the number receiving treatment. HIV/AIDS remains the leading cause of death in sub-Saharan Africa.

This story of progress and remaining challenges is anything but a contradiction. HIV/AIDS is unprecedented as a modern epidemic, and even as the world mounts an increasingly robust response to this devastating disease, the scope of the problem continues to expand, setting the stage for what will remain a prolonged battle to prevent infection and to help the millions already living with HIV/AIDS. The UN will discuss the next steps in this battle tomorrow, when world leaders and health officials meet to discuss both AIDS and the related threat posed by tuberculosis.

According to conservative estimates, over 15 million children worldwide have lost at least one parent to AIDS. That population, equivalent to the population of New York, Paris, and Bangkok combined and mostly living in sub-Saharan Africa, is vulnerable to exploitation, including forced labor, prostitution, and child soldiering, and stands a greater chance of suffering from malnutrition and contracting HIV themselves. That population also constitutes a tremendous strain on communities already straining under the weight of other significant health and development challenges.

Simply put, resources are needed. As such, in 2002 FXB International founded World Aids Orphans Day, a grassroots campaign to push all nations to direct at least 10 percent of their HIV/AIDS funding to the care of orphans. So far, the US, UK, and Ireland are the only nations to do so. To join the effort, go to www.worldaidsorphans.org.

Our friends at Global Voices Online asked us to pass along the following announcement:

Rising Voices Seeks Micro-Grant Proposals for Health-Related New Media Outreach

Rising Voices, the outreach arm of Global Voices, in collaboration with the Open Society Institute Public Health Program's Health Media Initiative, is now accepting project proposals for the third round of microgrant funding of up to $5,000 for new media outreach projects focused especially on public health issues involving marginalized populations.

More info after the jump.

Ideal applicants are dynamic NGOs or individuals who:

* Represent the vital voices of communities affected by stigmatized health issues whose stories, viewpoints, and experiences are often marginalized, unheard, or misrepresented in mainstream media. These communities include people living with HIV and AIDS and/or tuberculosis, people with mental illnesses or intellectual disabilities, injecting drug users, sex workers, LGBTI individuals, people in need of palliative care services, and Roma facing discrimination in healthcare settings.
* Are enthusiastic about using new, interactive modes of communication to build relationships and establish dialogue on the important advocacy issues of their community.
* Envision and highly prioritize media and communication strategies to achieve the advocacy goals of their organization.

Pre-requisite for the competition:

* Organizations must have their own website or participate in a network website.

Rising Voices and OSI aim to bring new voices from new communities and speaking new languages to the conversational web, by providing resources and funding to local groups reaching out to underrepresented communities. Examples of potential projects include:

* Working with a tuberculosis or HIV clinic or local drop-in center with the offer of training health workers, local harm reduction or sex worker outreach workers, patients, and their families to blog and upload video, in order to document their work, their experiences, and their community.
* Use blogs, podcasts, and online video to help give voice and representation to LGBTI communities and advocate for their rights.
* Distribute mp3 recorders to a local NGO working on palliative care issues, and help them produce monthly audio testimonials and/or interviews featuring stories and experiences of participants, for uploading to the NGO's website.
* Organizing a regular workshop on blogging and photography at a legal aid center representing the rights of people living with mental disabilities. Part of the budget could be used to purchase affordable digital video cameras and internet café costs, so that participants can describe their challenges and life experiences to a global audience.
* Purchasing an affordable digital video camera and teaching a group of local Roma community outreach workers how to produce an ongoing video-blog documentary about their work, which could then be posted to the organization's website and linked to other networks' websites.

Rising Voices outreach grants will range from $1,000 to $5,000. Special consideration will be given to proposals from Sub-Saharan Africa and the Eastern Europe, Central Asia, and the Caucusus. Please be as thoughtful, specific, and realistic as possible when drafting your budgets.

Successful projects will be prominently featured on Global Voices.

Completed applications will be accepted no later than Sunday, June 1st in either English or Russian. Please submit your application on the Rising Voices apply page. Russian-language proposals should be submitted here. All applicants will receive a confirmation email by June 3. Grantees will be announced on June 28 at the Global Voices Citizen Media Summit in Budapest, Hungary.

***

The OSI Public Health Program's Health Media Initiative aims to increase public awareness of health issues, especially stigmatized health issues involving marginalized populations. The initiative focuses on supporting health NGOs to develop their relationships with journalists across all media platforms so they may communicate health and human rights issues effectively with the public. Where the media environment is especially hostile, OSI also supports "community journalism" initiatives to encourage NGOs to use digital technology to communicate their stories and issues to each other and to the world at large. The initiative also seeks to build the capacity of media professionals to report responsibly on public health issues.

Rising Voices aims to help bring new voices from new communities and speaking new languages to the conversational web, by providing resources and funding to local groups reaching out to underrepresented communities.

The Vodafone Foundation and the United Nations Foundation released a new report on innovative uses of mobile technology by NGOs working to achieve the UN Millennium Development Goals. The report identifies emerging trends in "mobile activism" through 11 case studies, and highlights the results of a global survey of NGO usage of mobile technology.

Here's a taste of some of the findings from three of the case studies:

Cell-Life, a non-governmental organization based in Cape Town, South Africa, created its "Aftercare" program to work with the public health system and its health workers to provide home-based care for HIV/AIDS patients receiving Anti-Retroviral Treatments. Each Aftercare worker is assigned to monitor 15 to 20 patients. The worker visits the patient in his or her home, and in a one on one session discusses the patient's current treatment. Using their mobile phones for data capture, Aftercare workers record information about patient medical status, drug adherence, and other factors that may affect a patient's ART therapy. Aftercare workers then relay this information via text message to a central Cell-Life database. The data sent via text message reaches the Cell-Life server, where a care manager uses a web-based system to access and monitor the incoming patient information. The manager can also respond to Aftercare workers' questions and provide supplemental information to improve patient care. The information collected not only facilitates individual patient care, but is also used to build a database of information on the severity and prevalence of the South African AIDS epidemic in these regions.

More examples like this after the jump.

EpiSurveyor
In 2002, Dr. Joel Selanikio teamed up with computer scientist Rose Donna to form the DataDyne Group, a non-profit dedicated to increasing access to public health data through mobile software solutions. Inspired by an earlier Centers for Disease Control product called Epi Info, Selanikio created EpiSurveyor, a free, open source mobile data collection software tool. EpiSurveyor offers health data collection forms that can be downloaded at no cost and modified by anyone with basic computer skills.

Through the pilot, thirty provincial health supervisors in Zambia and Kenya were trained in how to use EpiSurveyor on Palm Zire handheld computers. The health officers then used EpiSurveyor to collect management data about public health clinics--such as medical supply quantities and levels of staff training. In both countries, officers went beyond the purpose of the pilot to gather additional health data as new needs arose. In Zambia, for example, the supplied PDAs and EpiSurveyor software were used by health officers to conduct a post-measles vaccination campaign coverage survey--the very first time that such a survey had been independently conducted by in-country staff using PDAs.

HOW IT WORKS: EpiSurveyor incorporates a Windows- based "Designer" forms creation application, and a Java-based engine that can run on personal digital assistants (PDAs), smart phones, and soon, common mobile phones. Users start by downloading the software from the DataDyne.org website (www.datadyne.org). Then, using a desktop or laptop computer, they enter the health survey questions into the Designer program. The resulting form can then be published to a mobile device. For data that is collected via PDA or smart phone, once data is collected from the field the mobile device is synchronized with the computer. Data from multiple handsets can then be combined into a single data table for analysis.

And here in the United States
SexInfo
It was while standing in front of the Mission High School near her home in San Francisco, California that Deborah Levine, executive director of internet Sexuality Information Services (ISIS-Inc.), a nonprofit she founded that develops "high-tech solutions for sexual health education," conceived of a potential solution to a pressing public health problem.

Levine had recently been approached by the San Francisco Department of Public Health (SFDPH) to develop a website to address rising rates of sexually transmitted diseases among at-risk youth. In 2005, rates of gonorrhea among African-American youth, ages 18 to 25, had gone up over 100 percent, with African-American women being infected by the disease at 12 times the rate of American women of Caucasian descent. With 85 percent of the city's youth owning a mobile phone, a text-based approach simply made sense.

ISIS hired HipCricket, Inc., a mobile marketing firm in Australia, to program a service it developed known as SexInfo. Next came the task of working with mobile operators to provide mobile phone subscribers with access to the service. HipCricket offered to let ISIS-Inc use its five-digit 'short code' during the project's
start-up phase. Levine was then able to work through an aggregator in the United States to obtain the short code (61827) now being used to access SexInfo.

During the first 25 weeks of the project (April–October 2006), 4,500 individuals accessed the service, with 2,500 taking the steps to retrieve content and referrals. The top three messages accessed were: "What 2 do if ur condom broke,: "2 find out about STDs" and "if u think ur pregnant."

Eight more case studies are examined in the report. And be sure to check out our interview with report co-author Katrin Verclas.

Over at the Huffington Post, the University if Chicago health care economist Harold Pollack gets into the spirit of World Malaria Day.

One of the few brights spots these days is that millions of Americans finally realize the importance of global health. Today is world Malaria Day. If you're reading this, you probably already know that this is a huge killer, particularly of kids in sub-Saharan Africa. I was hoping to party with Brad and Angelina to celebrate the occasion. That probably won't happen since my daughter has soccer.

Instead, to honor the occasion I am buying bednets for some African kids. You should too. These cost maybe $7 each, and are among the most gloriously cost-effective things you can ever do to save lives and improve health. The charity link is [here.]

This is a great organization.

Oh, buy buy a mosquito net in honor of your actual or hoped-for significant other. The UN Foundation will send him/her a cool email. Your love object wil receive this missive, and believe you are way cooler than you actually are.

As my wife will attest, it works for me. You can see my picture. So this must be working.

The Pulitzer Center on Crisis Reporting launched a new, amazingly interactive site LiveHopeLove that brings together poetry, essays, documentaries, short video interviews, music, and photography to explore the AIDS crisis in the Caribbean. In the video below, poet and writer Kwame Dawes who returns to the country of his youth to speak with Jamaicans about the impact HIV has had on them and their country.

The UN Foundation has teamed up with the United Methodist Church and Lutheran World Relief in a new, $200 million effort to combat malaria deaths in in Africa. Full release after the jump.

UN Foundation Launches Global Partnership to Help End Malaria Deaths

United Methodist Church and Lutheran World Relief to Lead Initiative to Raise $200 Million

April 1, 2008 (NEW YORK) - Today, telling the United Nations General Assembly that "you've got to have faith to build a better world," Ted Turner launched a new global effort, led by the People of the United Methodist Church (UMC) and Lutheran World Relief (LWR), to raise $200 million to fight malaria in Africa. The new initiative, organized by the United Nations Foundation, will:

-- Educate and mobilize the UMC and LWR's combined constituency of more than 20 million people concerned about malaria and related diseases of poverty;

-- Provide financial support to the Global Fund to Fight AIDS, Tuberculosis, and Malaria;

-- Support malaria prevention and health system strengthening efforts; and

-- Advance the churches' on-the-ground health missions.

"In today's interdependent world, we can't successfully address the great global challenges unless businesses and NGOs, philanthropic leaders and the faith community work together. This groundbreaking new partnership, which we have developed with generous support from the Bill & Melinda Gates Foundation, will take our malaria prevention efforts to an entirely new level," Turner, chairman of the United Nations Foundation, said. "Our collective efforts demonstrate resolve across faiths, countries, and sectors to stamp out malaria."

Turner was joined at the UN General Assembly's special thematic session on the Millennium Development Goals (MDGs) by Bishop Janice Huie of the United Methodist Church and youth leader Chad Amour, on behalf of Lutheran World Relief. The MDGs are eight goals slated to be achieved by 2015 that respond to the world's main development challenges, including poverty, children's health, empowerment of women and girls, and combating HIV/AIDS.

"Lutheran World Relief is incredibly honored to be joining in this important effort to combat malaria," said LWR President John Nunes. "By bringing together the power, unity, and passion of 8 million Lutherans, we know we can have a significant impact on one of the world's most debilitating diseases. We are so appreciative of the United Nations Foundation for their work to marshal attention and resources toward the goal of containing malaria and for including LWR as a key partner in the effort."

"Some say that envisioning a world without poverty is naive. I say that accepting a world of rampant poverty is cowardly. Some say that poverty alleviation hasn’t produced enough results. I say that we just haven't tried hard enough," Turner said. "Stopping malaria will go a long way toward giving people in poor and rich countries alike new hope and confidence that we can succeed in the fight against poverty and realize the MDGs."

"This partnership will make a difference across our churches and across the world," said Bishop Huie. "We have worked with the UN Foundation on the groundbreaking Nothing But Nets Campaign and we're honored to work with them and the Lutherans to eliminate malaria deaths in Africa. We are also excited about the energy, enthusiasm, and drive that our more than 12 million members worldwide will bring to this important endeavor."

In addition to this faith-based partnership, the UN Foundation's Malaria Partnership Initiative includes efforts to strengthen health systems (through the Global Fund to Fight AIDS, Tuberculosis, and Malaria and the Measles Initiative), build grassroots constituencies through the award-winning Nothing But Nets campaign, and work with Roll Back Malaria on global advocacy efforts.

About the United Nations Foundation

The United Nations Foundation champions the United Nations and is a platform that connects people, ideas, and capital to help the UN solve global problems. Through our campaigns and partnerships, the UN Foundation makes it easy for individuals, businesses, and non-governmental organizations to work with the UN on key global challenges. The UN Foundation is a public charity. For a complete listing of UN Foundation grants and programs or to learn more about the United Nations Foundation, visit www.unfoundation.org.

Cross posted at On Day One

Over the weekend, Matt Yglesias and Brad Plumer posited that an auctioned carbon cap and trade system would yield significant benefits to public health. Among other things, "increases in CO2 can worsen the adverse respiratory effects of ozone and other air pollutants" and people would be incentivized to drive less, and walk more, and thus live healthier and longer. (This latter point has been researched by the New America Foundation's Phillip Longman.)

One Health-Climate nexus less relevant here in the United States but of critical importance in much of the developing world is that warming temperatures have resulted in the appearance of disease vectors where they were previously absent. Mosquitos carrying Malaria and Dengue fever are suddenly showing up in places where the risk of these diseases used to not be so acute. Check out the World Health Organization's climate change page, for a rather exhaustive explication of the links between human health and climate change in the developing world.

From the Associated Press:

The United Nations health agency said Wednesday that it was monitoring vaccine supplies for yellow fever as it confirmed the first cases of the disease in a Latin American urban area in six decades. The World Health Organization said that there had been nine confirmed cases in the suburbs of Paraguay's capital, Asuncion, and that three people had died.

Dr. William Perea, the W.H.O.'s yellow fever chief, said the disease, carried by mosquitoes, could spread quickly in built-up areas with poor sanitation.

A few months back, Dr. Joel Selanikio, co-founder of DataDyne.org (a UN Foundation-Vodafone partnership) wrote in to explain how PDAs are saving lives in Africa. At the time, Selanikio was concluding a pilot program that distributed Palm Ziros equipped with open source software called EpiSurveyor to public health workers in Kenya and Zambia. As Selanikio reported, the PDAs had a transformative effect on the ability of local public health officials to efficiently distribute immunizations and monitor potentially catastrophic outbreaks.

That experience obviously made clear to Selanikio the potential of PDAs to not only revolutionize the public health sector in the developing world, but to transform entire emerging economies. Selanikio explains in an op-ed picked up by All Africa.com.

Along with the internet, with which it is rapidly merging, this is the most astonishing technology story of our time, and one that has the power to revolutionise access to information across the developing world.

Unfortunately, rich country biases limit understanding of this amazing phenomenon: for those in North America or Western Europe the cell phone is primarily or uniquely a phone designed to make voice calls.

In the rich world, even those who use the mobile for other tasks such as e-mail almost always do so as an adjunct to their "computer" (ie, the desktop or laptop in their home or office): the mobile phone is used for those tasks only when the "computer" isn't accessible.

Nearly 3 million children in Niger will be vaccinated against measles as part of a UN-backed immunization campaign.

"The overriding goal is to prevent measles deaths and disability, and to give each child in Niger the best start in life," UN Children's Fund (UNICEF) country representative Akhil Iyer said. "This campaign is testimony to the commitment of the Government and a remarkable example of successful partnership between different players."

The drive is led by the West African country's Ministry of Health, with financial and technical support from UNICEF, the UN World Health Organization (WHO) and a coalition of other partners.

More

In the latest entry in his blog about a massive health drive, Steven Phillips tells of us about the unlikely presence of a navy admiral in landlocked Mali. Cross posted on All Africa

It's 6 a.m. and my hotel phone wakes me. Just as well, because the malaria prevention medication I have been taking has been causing graphic nightmares. It's a message that Admiral Tim Ziemer, the coordinator for the U.S. President's Malaria Initiative (PMI), would like me to join him on a field trip today to witness the Mali integrated Child Health Campaign in action. Having traveled with the Admiral previously in Angola - where ExxonMobil's local company is a major PMI supporter - I jump at this opportunity to view the campaign from his official government perspective.

We set out for the commune Dezan Coulibaly, about 100km east of Bamako, in a convoy of four United States Agency for International Development (USAID) cars. The police escort in the lead shoos away all manner of intervening human and animal traffic by waving a commanding extended arm out the passenger window.

The Admiral and I share our car with Christine Sow, the USAID Mali health team leader who provides our advance briefing. She just happens to be a bilingual PhD epidemiologist with extensive international development experience, married to a Malian and possessing the astute cultural knowledge and sensitivity of a seasoned social anthropologist. During our hour and half drive, Christine pulls back the cultural curtain of local practices, preconceptions and myths around malaria. For example, in the local Bambara language, there is no word for "malaria". Because of its ubiquitousness, "fever" says it all.

It's no secret to anyone who has spent time with the Admiral that he's a hands-on type of guy. A former Navy pilot, submarine hunter, and commandant of the Newport shipyard (the Navy's largest port facility in the world) Tim is simply locked in on getting the job done. Leading the PMI in 15 African countries and being accountable to President George W. Bush for results produces a certain decisive tone of resolve when he talks and steeliness of gaze when he looks. And the magnitude of his task requires him to look and talk with great frequency and precision.

Having arrived at our destination, we are received by a phalanx of local dignitaries who had waited patiently in the vast dirt lot in front of the community health center. We meet the Commune mayor, tribal elders, health committee leaders and local NGO representatives.

The Admiral goes beyond diplomatic protocol in graciously recognizing the personal efforts of those receiving us. He makes everyone feel genuinely valued and respected, yet he exudes an undercurrent of edginess and anticipation to get beyond ceremony and "drill down" to really understand how things are working.

We go inside the center and quickly wade through the now familiar throng of eternally patient mothers and noisy children receiving campaign interventions. Then we hop back in the cars for a 7km drive down a desolate dirt path to a nearby village.

We are escorted to the center of the village, a large dirt clearing ringed by mud huts. Ground, dwellings and sky are all hues of brown-grey and provide the perfect backdrop for the swirl of bright reds, oranges, yellows and greens of the flowing robes worn by the 150 or so village denizens gathered to meet us.

A quick glance around us reveals that we are in a location that time has apparently left untouched. No electricity, running water or visible evidence of anything that might not have been here in, say, the 12th century. We are given the traditional welcome of large wooden bowls of goat's milk, water and some less familiar liquids to quench our thirst.

We then begin another round of ceremonial speech-making when somewhat surrealistically we are jarred by a 21st century intrusion. The 'chef du village' takes a wireless microphone from his robe pocket and his voice is conveyed throughout the village by an acoustically perfect sound system.

After drumming and exuberant dancing that with cajoling includes the unhip visitors, the Admiral takes the microphone. He extends the warm greetings of the President, Congress and the people of the United States to the government and people of Mali. He deservedly recognizes the village leadership and everyone gathered for their remarkable efforts in the fight against malaria. The villagers visibly hang on his every word. Facial expressions reveal a clear satisfaction with the Admiral's strong message of hope dispensed with American compassion and resolve. As his words flow, bonds are being forged with the village and continent.

Translating the Admiral's words is a two-step process. Christine converts English to French; then a local dignitary translates the French to Bambara, the tribal language. Christine and I notice that the Bambara version of each translated segment is about three times as long as the original. There is considerably more reaction, animated laughter and applause than the primary message might convey. We have a master Bambara showman at work.

Admiral Ziemer not only has a strongly inclusive message for Africa but also for PMI's international and U.S. partners. He has recognized and reinforced the important role of the business sector since the advent of PMI. In this context he asks me to address the village on behalf of ExxonMobil and the American business community.

I collect my thoughts and start by congratulating the commune for their projected astounding 95 percent participation rate in the campaign. My speech is suddenly interrupted by a stir in the crowd about 10 yards to my right. Two tall young men have just entered the yard carrying a tree branch around which is coiled a beefy, glistening six-foot boa constrictor. I stop dead in my delivery to try to get a fix on what's going on. The crowd's attention is similarly diverted. I rapidly determine that the snake is dead, because its severed head is impaled on a pole carried by one of the men. The chef du village shoos the attention-seeking caravan away but the damage has been done.

How do I get the crowd back? I have given my share of corporate PowerPoint presentations, but never quite encountered this. So I acknowledge the boa and the bravery of the men and ask for similar heroics in the fight against malaria. Things are back on track.

We conclude our visit with a lunch of grilled hacked mutton and watermelon on the shaded dirt patio behind the commune mayor's modest home. We are all touched by the outpouring of warmth and great hospitality of village leaders and community alike. For a day we were made to feel like members of one large extended family.

After a retracing of our steps back to Bamako, we are guests of Alex and Betsy Newton for dinner at their home. Alex is the USAID mission director in Mali, and he hosted a dozen local staff as a "bon voyage" gathering for the Admiral. Tim lauded the fine work of the mission and of their successful collaboration in the Measles-Malaria campaign. But already on his mind was the full agenda of policy and diplomacy events on his return to Washington DC in less than 36 hours.

As a business sector representative, public health professional and American citizen, I am gratified that Admiral Ziemer is on the job. When he was initially appointed for his position, it may not have been clear that the malaria world need an Admiral. Now almost no one is left unconvinced.

Steven Phillips tells of the impact that American sports stars have on the campaign to make take life-saving health interventions to the children of Mali. Cross posted on All Africa.

Bamako, Mali

Ruth Riley led the University of Notre Dame to the women's NCAA Basketball title in 2001. The 6'5" center went on to win Olympic gold with the U.S. women's basketball team in Athens in 2004. More recently she was named MVP in the WNBA finals as she led the Detroit Shock to the WNBA championship in 2003.

Dwayne De Rosario is a dynamic mid-fielder for Major League Soccer's Houston Dynamo. As a Canadian citizen, he has represented his country as a member of his national team since the age of 16. He was recently named MVP of the 2007 Major League Soccer Cup, where he scored the winning goal.

Diego Gutierrez is an 11-year MLS pro midfielder for the Chicago Fire. He has been a member of five MLS championship-winning sides and received the Humanitarian-of-the-year award in 2007 from the U.S. Soccer Federation.

All three athletes are national spokespersons for the United Nations Foundation's Nothing But Nets campaign which is a partnership of faith based, sports, and business sector participants. ExxonMobil is a financial and program backer.

On this typically bright and hazy early Saturday morning in Bamako, we are off to the Madibo Keita Stadium, a 1960's Soviet-era construction to watch Ruth, Dwayne and Diego in action. Over 200 kids aged 8-16 are already there, decked out in appropriate athletic apparel and awaiting their instructions. The girls are guests of the Mali National Olympic basketball team and the boys are here with the national soccer coach. They represent a broad swath of Malian social strata and know they are among the few lucky ones to have been selected to the high honor of participating in a training clinic with the American athletes.

But before they are allowed to take the field for drills, the excited, hyperactive, but timid group of kids has a price to pay -- sitting still for a 25-minute world health organization-standard malaria training module.

They are led through their malaria paces by Elizabeth McKee Gore, the head of the Nothing But Nets campaign, and the lead of our visitor delegation. Elizabeth can make cold liver oil go down like birthday cake, and predictably does.

The girls go off with Ruth to an indoor court and the boys with Diego and Dwayne to the outdoor field to engage in two hours of intensive drills and skills training. Ruth has a natural magnetic attraction with kids. They clearly regard her with awe and reverence, and are probably asking whether they will ever be able to make lay-ups and fade-away jumpers with such casual assurance.

The boys are not surprisingly simultaneously more aloof and intense than the girls. Evidence that they are part of a soccer-mad Africa abounds. Their jerseys bear the names of Henry, Eto'o, Diarra, Essien, and Diof—testimony that there is a higher status than to be an African playing professional soccer in Europe, especially in the U.K. Premier league.

After the kids are strategically exhausted from the drills, the athletes gather them in seated circles to deliver more malaria messaging of the type only they can convey with conviction. To be able to become community leaders and robust athletes in Mali, the kids are told, they must not allow themselves to succumb to malaria. Prevention and recognizing early symptoms and getting rapid treatment are the keys. The kids attentively take it all in, especially because from the corners of their eyes they detect bundles of bed nets and a cornucopia of athletic goods and gifts that await them.

Over the course of the past few days of delegation travel, we have come to know Ruth, Dwayne and Diego. They are not only great athletes, but also exceptional human beings. And here in Mali they are more than ambassadors of hope, but also a vital bridge linking the common interests of American and African continents and people.

Diego and Dwayne are here with their wives, Ginna and Brandy respectively, and the couples are away from their young children. They are actively aware of resource and opportunity disparities between the two continents and are resolved to deploy their "star power" to do something about it. Ruth is in the same league. She has already been to Angola, Nigeria, and South Africa on similar Nothing But Nets and other outreach visits.

It is telling that all three picked malaria and Nothing But Nets as the platform for their personal mission and humanitarian zeal. I ask myself "why," then I ask them. Their wisdom and heart shines through. They intuitively understand the importance of mobilizing a largely unaware American public to face the devastating human scourge of which they know so little. And the athletes know that to have credibility with their legions of American fans, they must first confront that scourge face-to-face.

I observed that it was the three athletes in our delegation who found our local hospital visits to be the most emotionally stirring and physically shocking. Seeing malnourished and emaciated children and some obtunded and glass-eyed with cerebral malaria is difficult for anyone. But for Ruth, Dwayne, and Diego this seemed an abstract notion until they were confronted with the harsh physical reality. So their message to the aspiring young Malian footballers and basketball players took on a more urgent and strident tone... as will their overtures to their fan-bases on their return home. Now they will all be speaking with the conviction of experience.

Dr. Steven Phillips, ExxonMobil's Medical Director for Global Issues and Projects, reflects on the huge campaign to reach millions of children and adults in Mali with life-saving health interventions. Cross posted on All Africa.

Bamako, Mali

Under the merciless rays of an insistent sun which pierces a perennially brown dust-laden sky, we take our positions as international VIPs in a huge dirt schoolyard on the outskirts of Bamako. We are here for the official launch ceremony for the country's integrated health campaign week, and awaiting Mali's president.

The yard is festooned with banners urging parents to bring their children to vaccination posts. It is packed with hundreds of strategically-placed school children sitting in the dirt-layered rows around the perimeter. Scores of Malian guests are bedecked in rainbow-colored flowing robes with matching hats. Westerners are in formal business attire. The VIPs sit in overstuffed lounge-chairs planted in the dust and mercifully shaded under tent enclosures. The stage is set for the arrival of President Amadou Toure.

The audience warm-up includes a half-dozen speakers and animated folklore theatre with actors speaking Bambara playing parts of villagers. The Mali audience laughs uproariously. Prancing children kick up more dust.

The mayor of the commune and the health commune and the health minister speak from a makeshift podium in the middle of the schoolyard. ExxonMobil is mentioned along with several other contributors as a vital partner in the campaign. Then, flanked by generals in splendid military regalia, the president takes the podium. Along the way he stops to receive an impromptu gift from a Major League Soccer player in our delegation -- a Houston Dynamo jersey, which he holds up to the cheers of a gleeful crowd.

The speech is brief, but the president makes his point. This is an opportunity for the entire country to support critical government health and child survival goals. The international community is here to help, and now the mothers and fathers of Mali must do their part by bringing their children to community health posts.

As he concludes, the president takes deliberate strides to navigate his way across the yard to a bed net distribution post. A huge crush of humanity rapidly encloses him. Dozens of mothers with flocks of young children attempt to squeeze through a phalanx of VIPs, reporters, and cameramen to receive free bed nets from the hands of their president. I decide to hang back thinking that personal safety trumps a brief exposure to local press.

A few hours later, we are in a caravan of three SUVs making our way to the town of Segou, about 250 kilometers southeast of Bamako on the inland Niger Delta. We are spending two days in the district to have a first-hand view of campaign mechanics at the village level. On the way to Segou we pass several roadside villages comprised of a few dozen randomly scattered mud huts, with no signs of commercial activity, except for long snaking rows of women and children outside a central hut. This seems a very incongruous sight until the riders in our vehicle finally put it together. Yes, these must be mothers already queuing for the campaign.

The following day we see campaign sites in three small villages, all looking strikingly similar. A rectangular set of tables with health aides and assistants staffing three stations: the first station provides oral interventions (polio vaccine, vitamin A, and a de-worming pill). The second a measles shot. And the third, two long-lasting nets for each household. In addition the fingernails of each child and the mother are marked with indelible ink to discourage repeat visits.

But for our visiting delegation the shock is the queue. Starting as early as 7:00 am, two hours before the health posts even open, mothers begin forming long lines holding and tugging their children behind. The lines are far less than ordinary, but far more disciplined than outright chaos. They wait standing patiently for hours until their children are served. Before the campaign is concluded in four days, it is expected that fully 95 percent of all children under the age of five in the entire country will have received their package of interventions.

What accounts for this level of social cohesiveness (public health professionals call this social mobilization)? In our villages the chef du village received word of the campaign from their district health officer weeks ago. With their endorsement, the village health and women's committees were recruited to help.

Another key form of mobilization is by griots. These are families within a village with a minstrel-like tradition of singing or chanting the local news. As they walk through the village on their daily rounds they are the human news kiosks of the village. The griots and the women's committee made their rounds through each village as early as 4 am on the day of the campaign to stimulate the turnout. As this phenomenon repeats itself throughout Mali's 15,000 villages, some 2.8 million children are brought to campaign posts.

In the African development world we hear much about the importance of political will. This typically refers to an African head of state demonstrating leadership through direct involvement in a social issue. It is assumed that only a president's will can truly mobilize broad grassroots national action.

This integrated campaign strikingly reinforced the validity of this perspective. President Toure's few words had a monumental impact on his people. Griots chanted up and down every village alley, women elders knocked on hut doors at 4:00 am and colorful-robed women lined up in the hot dust.

On the second day of a visit to Mali, Dr. Steven Phillips, ExxonMobil's Medical Director for Global Issues and Projects, tells of the logistics of a campaign to get bed nets, which protect people against malaria, to hundreds of thousands of people. Cross posted on All Africa.

The long-lasting insecticide-treated net (LLIN) is one of the main weapons in Africa's arsenal against malaria. Based on the continent's distribution of the disease, the estimated annual need of sub-Saharan Africa's 700 million population is 60-80 million nets. When properly used in sleeping areas, LLIN's could decrease childhood cases and deaths from malaria by at least 50 percent.

Some have "run the numbers" on how to save lives with bed nets. It goes something like this: Multiply the nets needed by the cost of nets delivered. Multiply this by five to cover the five-year effective useful life of a net. Bottom line: for $3-4 billion, Africa could be blanketed by the requisite nets.

The Mali integrated child health campaign has allowed our observation team to "get our hands dirty" in looking at the details of how nets are moved from production site to the end of the road. In previous similar campaigns in Nigeria and Angola, ExxonMobil sponsored the United Nations Foundation and the World Health Organization "logisticians" to provide supply chain management support, and to study how to make delivery of nets more efficient on a broad country scale.

Now here in Bamako, I sit down with Steve Lutterback of PSI, a global health NGO, and Doug Mole of the Canadian Red Cross. They have provided full-time logistical support to the campaign for LLIN distribution for the past seven months. Over drinks at the Lybia Hotel, I ask them to map the supply chain of nets for this campaign (we have only 10 minutes for this diversion because they have to get back to REAL work.)

Here is the story of how each of the 2.26 million nets will make their way into the hands of a pregnant Malian mother and all mothers with children under age five (The nets were funded by a consortium including the U.S. President's Malaria Initiative, the Canadian Red Cross, Malaria No More, and the UN Foundation's Nothing But Nets campaign.):

Orders were placed with a manufacturer who sourced the nets from Vietnam, seven months pre-campaign. The nets were contained and shipped in 58 "high cube containers" (40 x 9-1/2 x 8 feet), from Vietnam to a sorting transit point in Spain. Each container holds about 38,000 nets.

The cargo was sorted and re-loaded to a second ship for its journey through the Straits of Gibraltar and down the West African coast to Dakar, Senegal. It took 55 days for the shipment to arrive in the port of Dakar.

Over the next two to three weeks the cargo was transported over 1,200 kilometers of road and rail to Bamako, Mali. It required a further seven days to clear customs.

The 58 containers were transferred to the only three warehouses in the country large to store them. They filled the three 1100 square-metre warehouses.

The distribution plan called for 40 health districts to receive shipments in six regions of the country over a radius of 600 km from Bamako. A single transport company won the tender and used 60 runs by 40 trucks to deliver bales of uncrated nets. Transport was about 50 percent on "tire roads" which are paved, and 50 percent on unpaved dirt roads. It required ten days to accomplish this phase. Many of the roads would have been impassable in the rainy season. The paradox was striking – the nets could only be delivered reliably during the dry season, when malaria risk is the lowest.

From the 40 district locations nets were subdivided for shipment to 975 health centers. It took one to 10 days to accomplish this. While awaiting trans-shipment, the bales of nets were often subject to "outdoor warehousing" with a hired security guard sitting on top of the bales to prevent theft.

From the health centers, the nets were sent to 2,000-3,000 distribution points with a radius of 5-20 km. This was accomplished via a variety of transportation modes including bicycle, donkey-cart, camel and "push-push", a local cart-like conveyance pushed by human power.

For mothers who could not make it to the final distribution points, mobile teams on bicycles and motorcycles would deliver the nets to their villages and dwellings. In the end, all of Mali's 15,000 villages are covered.

Elapsed time: seven months. Number of people coordinating logistics: six. Lost or damaged nets: none.

Listening to Doug and Steve's animated description of their activities left me in awe and wonder. Their enthusiasm, single-minded commitment, and utter conviction that there was no barrier that they could not overcome were clearly evident. This was the source of my awe.

The source of my wonder was the disconnect between the bold overtures of some global campaigners and the gritty reality on the ground. Some think malaria requires a good calculator and money. Figure out the aggregate need, fund it, and procure the requisite commodities. This both discounts the complexity of the delivery of goods to the end beneficiary and undervalues the overwhelming diligence, creativity and dedication of the on-the-ground implementers.

The bed net logistics story reminds us that the integrated Mali child health campaign supplies a package that includes four other interventions: vitamin A, polio and measles vaccinations, and de-worming medication. They all have logistics too.