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Aphoto of malnutrition from the WFP

Africa’s “Hidden Hunger”

Ed note. This post, by Dr. Ramadhani Abdallah Noor, originally appeared in Project Syndicate and is reprinted with permission. 

DAR ES SALAAM – Just over 20 years ago, South African photographer Kevin Carter shocked the world with a controversial photograph of a famished young Sudanese child being watched by a vulture during a famine. Critics slammed the shot as “disaster porn,” calling it yet another example of how the international media sensationalize African problems.

But what disturbs me is not the photograph. Rather, it is that two decades later, the conditions that the photograph depicts remain basically the same. Every year, 3.1 million children around the world still die of hunger.

As an African doctor, I know that the ravages of serious malnutrition and hunger are not always visible. They are not always as manifest as they are in the protruding ribs of ghostly children hooked up to feeding tubes, like those I used to see in hospital wards in Tanzania. Chronic malnutrition, or “hidden hunger,” shows itself in other ways – but it can be just as devastating and deadly. And while deaths from many other diseases, including acute malnutrition, have declined, hidden hunger remains pervasive.

In the last two decades, astounding success has been achieved in the fight against HIV, tuberculosis, and malaria. New HIV infections have dropped by as much as 50% in some countries in Africa, with AIDS-related deaths down by 30-48%; TB cases have declined by 40%, and malaria cases by 30%.

But the stunting of early childhood growth as a result of malnutrition remains high, dropping by only about 1% over the same period. In Africa, hunger remains the leading cause of death in children, accounting for half of all deaths of children under the age of five and killing more than AIDS, TB, and malaria combined.

In fact, many scientific studies have shown that a malnourished child is much more likely to contract an infection, to suffer from other illnesses, and to suffer from them longer. Diarrhea, for example, is a deadly disease for severely underweight children, who are 12 times more likely to die from an ailment that should be easily treated. And severely underweight children are 9.5 times more likely to die from malaria as well.

Indeed, childhood malnutrition is now confirmed to be the leading cause of the global disease burden, with the World Health Organization attributing to it 45% of all deaths under the age of five in 2011. Recent reports from the war-ravaged Central African Republic indicate that more children there are dying from hunger than from bullets.

These numbers make the problem of malnutrition look insurmountable. But what works is no secret: vitamin A, iodized salt, and fortified foods. The lack of vitamin A alone results in blindness in a half-million children every year, with half of them dying within 12 months of losing their sight. Similarly, half of all women of childbearing age in developing countries suffer from weakened immune systems, owing to anemia caused by iron deficiency.

The long-term damage caused by malnutrition has a domino effect, impeding educational achievement, and ultimately, hobbling national economies. Addressing this ongoing crisis requires money – an estimated $10 billion per year – and new and better strategies to bring life-saving solutions to the mothers and children who most need them.

But the cost looks far less daunting when one considers the cost of hunger. UNICEF estimates that the cost of Africa’s child malnutrition is $25 billion a year. And this is not the whole story. Malnutrition costs an estimated $3.5 trillion every year to the global economy, owing to loss of productivity and higher health-care costs.

To meet this challenge, save lives, and improve economies, Africa needs a comprehensive strategy and increased investment in agriculture.

The Africa Union has declared 2014 the year of agriculture and food security in Africa, and the continent’s agriculture sector is expected to grow significantly. In theory, that should improve overall nutrition; but increased investment in agriculture is not a panacea. We need to concentrate on building nutrition-sensitive agriculture programs that include small-scale farmers, households, women, and children.

A big step would be to increase women’s control over land ownership and farming decisions, along with access to agricultural credits and subsidies designed to encourage domestic food production through home gardening and cattle and poultry husbandry. Studies show that women are much more likely than men to spend additional income on food and health. Increasing their farming income and decision-making power ultimately has a greater impact on children’s health and nutrition.

Moreover, agricultural policies, subsidies, and investments have traditionally benefited cereal farmers. But policymakers need to concentrate on increasing access to more nutritious foods, such as meat, fruit, and vegetables, which are too expensive for the poor.

Malnutrition causes the greatest damage during the first thousand days of life, leading to grievous and irreversible changes in infant health. To make real inroads against hidden hunger, African governments, supported by global development partners, must act quickly. Childhood hunger in Africa does not have to be as dramatic as that depicted in Carter’s 1993 photograph to be just as deadly.

Ramadhani Abdallah Noor, a Tanzanian doctor and research associate at the Harvard School of Public Health, is a New Voices Fellow at the Aspen Institute

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Credit: UNICEF/SOKOL

UNICEF’s Shocking New Report

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The report is called Hidden in Plain Sight. It’s a first-of-its-kind study of global data on violence against children. The results are chilling. “One in 10 girls worldwide have been forced into a sexual act, and six in 10 children ages 2 to 14 are regularly beaten by parents and caregivers, according to a report issued Thursday by the United Nations’ children’s agency, Unicef. The report, drawing on data from 190 countries, paints a picture of endemic physical and emotional violence inflicted daily on children, mostly at home and in peacetime rather than on the streets or during war. Homicide is especially common in some of the Latin American countries from which children are fleeing by the tens of thousands into the United States: It is the leading killer of adolescent boys ages 19 and under in El Salvador, Guatemala and Venezuela. Central and Eastern Europe report the lowest rates of homicide among children.” (NYT http://nyti.ms/1nzlSfc)

The report: http://uni.cf/1nzlTzL

Surprising Facts About Suicide Around the World…One person commits suicide every 40 seconds — more than all the yearly victims of wars and natural disaster — with the highest toll among the elderly, the United Nations said Thursday. (AP http://yhoo.it/Wi8Uej)

Plus…The New York Times discovers that the WHO is totally underfunded and understaffed! A must-read: http://nyti.ms/1nzm2TK

Africa

Amid fears that Islamist militants were closing in on the major city in Nigeria’s northeast, hundreds of residents were said to be fleeing Maiduguri on Thursday in the face of doubts that the army could repel an attack on the metropolis of more than one million people. (NYT http://nyti.ms/1nzm26d)

Cameroon’s military says some 400 Nigerian soldiers have sought refuge in the country after fleeing intense fighting against Boko Haram militants in Nigeria’s Borno State. (VOA http://bit.ly/Wi9xVk)

Malawi President Peter Mutharika, who took office in May, is considering all options for cracking down on a recent surge in violent crime in the country. (VOA http://bit.ly/1twFOXe)

Nigerian authorities are monitoring nearly 400 people for signs of Ebola after they came in contact with a Port Harcourt doctor who died of the disease but hid the fact that he had been exposed, a senior Nigerian health official said. (VOA http://bit.ly/1twFNm1)

Nearly 200 experts on Ebola are meeting in Switzerland to discuss possible cures and vaccines for the deadly disease, as the number of cases in West Africa continues to rise. (VOA http://bit.ly/WicQfg)

South Africa’s main opposition party said on Thursday it would seek a reopening of a corruption inquiry against President Jacob Zuma after the release of secret evidence cited in a 2009 decision to drop the case. (Reuters http://bit.ly/1twGax1)

Fear of contracting the deadly Ebola virus is hampering efforts to recruit international health workers and slowing the delivery of protective garments and other vital materials to stricken areas in West Africa, World Health Organization officials. (Reuters http://bit.ly/1twGonN)

USAID is providing $75 million to fund 1,000 more beds in Ebola treatment centers in Liberia and tens of thousands of protective suits for health care workers. (AP http://yhoo.it/1o2qqut)

MENA

Four months of fighting by militias in Libya’s two biggest cities, Tripoli and Benghazi, has forced some 250,000 people to flee, including 100,000 who have been internally displaced, finds a new UN report. (AP http://yhoo.it/Wikpm7)

Hundreds of thousands of children in Iraq’s northern Kurdish region are facing an “education emergency” after being forced from their homes, with hundreds of schools used to shelter displaced families. (AFP http://bit.ly/1twDOOC)

Saudi Arabia is changing tack in its labor reforms, softening the blow to companies with money for subsidies and training while trying to lure Saudis to the private sector with more attractive working conditions. (VOA http://bit.ly/Wi9Uz3)

Power cuts hit many parts of Egypt on Thursday, causing blackouts and halting some public transport in the Arab world’s most populous country. (Reuters http://bit.ly/WidWYc)

Two Britons researching migrant worker issues in Qatar, the Gulf nation that is due to host the 2022 World Cup, have gone missing after one of them reported being harassed by police, according to the Norwegian human rights group that employs them. (AP http://yhoo.it/1o2rMp4)

Asia

Bangladesh announced this week that it will send back over 2,000 Muslim Rohingya refugees to Myanmar, stoking concerns about the prospect of returning them to an increasingly dire situation. (IRIN http://bit.ly/1twEe7y)

An estimated 135 million children under the age of five in the Asia-Pacific region have not been registered by any government agency. That leaves them unable to claim national identities needed for access to rights and critical services. A major push is about to commence to get such children, and those of all ages, a legal identity. (VOA http://bit.ly/1twFAPV)

Child trafficking is one that is earning front-page headlines in Indian states where thousands of children are believed to be victims of the illicit trade. (IPS http://bit.ly/WigJk8)

Private orphanages have mushroomed across Nepal in the absence of a state-run welfare system, their growth fuelled by corruption and the prospect of attracting donations from foreigners, activists say. http://yhoo.it/1twI6p7

The completed a nationwide polio immunization campaign in all districts of Afghanistan’s 34 provinces. The national immunization days campaign was carried out during three days between 17 and 19 August. http://bit.ly/1o2sdjh

The Americas

A severe drought has ravaged crops in Central America and as many as 2.81 million people are struggling to feed themselves, the WFP said on Friday, though the region’s coffee crop has been largely unscathed. (Reuters http://yhoo.it/WikS7R)

Torture is still rife in Mexico and routinely used to extract confessions, human rights organisation Amnesty International says. (BBC http://bbc.in/1twEJyy)

The dengue vaccine developed by the French pharmaceutical Sanofi has shown an efficacy of 60.8 percent in tests with children and teenagers in Latin America, and is effective against all four serotypes of the disease, the company said today. (El Universo http://bit.ly/1twFYxH)

Oregon researchers developing a vaccine that has shown promise in preventing HIV infection in primates said on Wednesday they have been awarded a $25 million grant from the Bill & Melinda Gates Foundation. (Reuters http://bit.ly/Wie61Q)

Opinion/Blogs

Can Constitution Respond to Challenge of Addressing Inequality? (SACSIS http://bit.ly/1twDX4A)

A Development Agenda without Developing Countries? The Politics of Penurious Poverty Lines (CGD http://bit.ly/1twE6ow)

Sexual health isnt just about health its about sex too (Guardian http://bit.ly/Wi9nx5)

Lesotho coup: a squabble among elites or a sign of social instability? (Guardian http://bit.ly/Wib8dK)

Sanctions and Retaliations: Simply Unconscionable (IPS http://bit.ly/1twHiR6)

Obama’s Syria Dilemma: Global Dispatches Podcast http://bit.ly/1nyAgUR

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A UNHCR staff member at the Jordan border hands out juice and biscuits to newly arrived Syrian refugees. Aid workers often work in dangerous areas to help the needy.
UNHCR / J. Kohler / January 2014

Obama’s Syria Dilemma

It looks increasingly likely that the United States will expand its military operations against ISIS to Syria. I speak with William McCants of the Brookings Institution about the prospects and pitfalls of a potential US-led international military campaign against the Islamic State in Syria. We also discuss the role of another Islamist rebel group, al Nusra, in Syria’s conflict and what might befall about 40 UN Peacekeepers in the Golan who were abducted by this group. Have a listen.

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Previous Episodes

Episode 31: Ambassador Michael Guest, LGBT Trailblazer

The Deadly Fear of Ebola

South Sudan’s Looming Famine

Episode 30: Jeff Sachs, economist

Sex Slaves in Iraq, an interview with Zainab Hawa Bangura, the UN Special Representative for Sexual Violence in Armed Conflict

Episode 29: Chris Hill, former Ambassador to Iraq and North Korea nuke negotiator

Kevin Jon Heller discusses the  International Criminal Court’s Palestine Problem

Episode 28: Nancy Birsdall, founder of the Center for Global Development

The WHO explains Why this Ebola Outbreak is So Hard to Contain

Episode 27: Daniel Drezner, counter-intuitive wonk

Michael W. Hanna on How to Negotiate a Gaza Ceasefire

Episode 25: Helene Gayle, CEO of CARE, USA. Long-time AIDS-Fighter

One Campaign’s Erin Hofhelder How Humanity is Winning the Fight Against AIDS

Episode 24: Joseph Cirincione, Nuclear Policy Wonk 

A Migrant’s Story: Why are So Many Children Fleeing to the USA?

Episode 23: Live from the UN 2014 (Volume 2); A special edition with a slew of UN officials.

Inside the Iran Nuke Talks

Episode 23: Jillian York, Digital Free Speech defender

Turkey’s Strategic Interests in Iraq

Episode 22: Live from the UN, 2014 (Vol 1); A special edition, featuring the President of the General Assembly,  the UN Ambassadors from Vietnam and Jamaica, the head of the UN Association, and more!

The UN’s View of the Iraq Crisis

Episode 21: Thomas Pickering, former Ambassador to the UN, Israel, Jordan, Russia, India and more.

Dying for the World Cup

Episode 20: Jessica Tuchman Matthews, foreign policy trendsetter

Egypt After the Counter Revolution 

Episode 19: Louise Arbour, human rights pioneer.

What Obama Left Out of His Big Foreign Policy Speech

Episode 18: Zalmay Khalizad, former US Ambassador to Afghanistan, Iraq and the UN.

Why Libya is Suddenly on the Verge of a Civil War 

Episode 17: Gov Bill Richardson, he frees hostages.

The Foreign Policy Implications of India’s Elections

Episode 16: Carolyn Miles, CEO of Save the Children

What Boko Haram Wants

Episode: 15 Laura Turner Seydel, philanthropist

Episode 14: Douglas Ollivant, Iraq expert

Episode 13: Gary Bass, historian

Episode 12: Mark Montgomery, demographer

Episode 11: Kenneth Roth, Human Rights Watcher

Episode 10: Live from the UN, Volume 2.

Episode 9: Mia Farrow, humanitarian activist and Goodwill Ambassador

Episode 8: Suzanne Nossel, Big Thinker

Episode 7: Live from the UN, Volume 1. 

Episode 6: PJ Crowley, former State Department Spokesperson

Episode 5: Octavia Nasr, reporter

Episode 4: Arsalan Iftikhar, “The Muslim Guy”

Episode 3: Dodge Billingsley, filmmaker.

Episode 2: Laura Seay,  @TexasinAfrica

Episode 1: Heather Hurlburt, national security wonk

 

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iraq

Human Rights Council Targets ISIS Crimes

The United Nations Human Rights Council (UN HRC) adopted a resolution earlier this week to launch an investigation into the human rights abuses being committed by the Islamic State organization in Iraq (also known as ISIS, ISIL, or just IS). The resolution, adopted during a Special Session on the situation in Iraq, calls for dispatching a team of 11 experts to Iraq as soon as possible to document the abuse being wrought upon the people of Iraq.

Over the course of the last several weeks, media outlets have been documenting extensively the way in which ISIS fighters have subjugated populations and taken over entire cities in Iraq. According to the UN HRC, the most reported severe violation has been the killing and maiming of children – 693 cases have been reported since the beginning of the year. Today, there are 1.4 million internally displaced people in Iraq, and thousands have died in recent months (in June, 2,700 civilians were killed, the most civilian deaths in Iraq since 2005.)  The tactics used by ISIS have elicited disgust and fear in Iraq, Syria and globally. The group, which has few, if any, allies, has been targeting civilian populations directly, without restraint or rules, and, seemingly with only a hazy agenda of establishing a caliphate in the region. Interviewed in the Financial Times, Fawaz Gerges, professor of international relations at the London School of Economics and an expert in al-Qaeda and Islamic extremism explains “groups like al-Qaeda used violence in a tactical way, in a way proportional to their aims. For Isis [and AQI] the savagery is the point. The action is what matters, not the ideas.”

The new resolution by the UN HRC – which was adopted without a vote – will likely not act as a deterrent for ISIS fighters, who, as mentioned above, are hardly bound by the rules of war. ISIS is obviously not a member state of the UN HRC – as a non-state actor, it does not have the same treaty obligations. ISIS is also not subject to the same laws – national or international – that bind and impose limits on state’s military action  and provide an avenue for accountability and justice. The UN HRC investigation is, nevertheless, an important and necessary step in ensuring that human rights violations are documented, and that evidence that can eventually support accountability measures is being collected by a legitimate body. This is the proper and appropriate role for the Human Rights Council in a situation like this., Where and how perpetrators will be punished, however, remains to be determined.

Global Dispatches Podcast: ISIS’ War on Women

Security | | Leave a comment
Screen shot 2014-09-04 at 9.26.39 AM

The Trillion Dollar Scandal

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The activists at the ONE Campaign are setting their sights on a type of corruption that stymies international development. “Anti-poverty organization ONE is urging leaders of the 20 largest economies to act decisively at an annual summit in November against money laundering, bribery, tax evasion and corruption which it estimates costs the world’s poorest countries more than $1 trillion a year. The Washington, D.C.-based advocacy group launched its report on the economic cost of corruption on the developing world on Wednesday in the Australian capital Canberra at a Parliament House event attended by diplomats from the United States, Canada, Saudi Arabia and South Africa. ONE is lobbying Australia to use its presidency of the G20 leaders’ summit in the city of Brisbane on Nov. 15-16 to end what it calls a culture of secrecy that allows corruption and criminality to thrive in many countries. (AP http://yhoo.it/1vOmVjo)

And here’s ONE’s report: http://bit.ly/1uBhuAl
Ebola

Nigeria now has 18 Ebola cases, after a fourth case surfaced in Port Harcourt, home to Africa’s biggest oil and gas industry, the health minister said on Wednesday. (Reuters http://bit.ly/1oDEQkd)

Another American missionary doctor has tested positive for Ebola in Monrovia, Liberia. He is the third American health care worker to contract the virus. (NPR http://n.pr/1oDIkTB)

Decades of corruption, deep-rooted mistrust of government and weak public services in Liberia have hastened the spread of the Ebola virus, and much more needs to be done to bridge a communication gap between government and citizens, say civil society groups and analysts. (IRIN http://bit.ly/1vOfkkA)

Guinea’s government said on Wednesday that Ebola had spread to a previously unaffected region of the country, as U.S. experts warned that the worst ever outbreak of the deadly virus was spiralling out of control in West Africa. (Reuters http://bit.ly/1oDF3E2)

The cost of getting supplies needed to West African countries to get the Ebola crisis under control will be at least $600 million, Dr David Nabarro, the senior United Nations Coordinator for Ebola Disease, told reporters on Wednesday. (Reuters http://bit.ly/1oDFoX6)

The Ebola outbreak in Africa is beginning to have an impact on agriculture and shipping as far away as Asia, with Thailand’s rice industry among the first to experience a serious impact. (VOA http://bit.ly/1oDJDBX)

A British nurse infected with Ebola while working in Sierra Leone was discharged from a London hospital on Wednesday after recovering from the disease following treatment with the experimental drug ZMapp. http://yhoo.it/1oDOCma

More than 1,900 people have died in the world’s worst outbreak of Ebola in West Africa, the head of the World Health Organization said on Wednesday, marking a major acceleration in fatalities from just over 1,500 last week. (Reuters http://yhoo.it/1xbWG83)

Africa

Lesotho’s Prime Minister Thomas Thabane returned to State House in the capital Maseru on Wednesday, four days after he fled to South Africa following an apparent bid by the military to oust him, an aide said. (Reuters http://bit.ly/1vOi0yW)

One group is addressing the problem of public health by providing sealed floors to households that once had dirt ones, in Rwanda. (NPR http://n.pr/1vOj7yl)

African leaders are meeting in Nairobi Tuesday to discuss how to tackle terrorism and extremism across the continent. (VOA http://bit.ly/1oDIYAD)

Britain has sent another $50 million to help South Sudanese who are suffering in the young country’s conflict, International Development Minister Lynne Featherstone said at the start of a three-day visit to South Sudan. (VOA http://bit.ly/1vOkWLW)

Ugandan MPs have begun work on reintroducing tough anti-gay legislation, a month after the east African nation’s constitutional court declared a previous law “null and void”, a report said. (AP http://yhoo.it/1vOpim4)

MENA

The International Monetary Fund approved a $553 million loan for Yemen to help the struggling country stabilize its finances and boost growth. http://yhoo.it/1vOmlBY

The UN peacekeeping chief strongly denied on Wednesday allegations from the Armed Forces of the Philippines chief that Filipino peacekeepers in the Golan Heights were ordered to surrender their weapons to Islamist militants who had trapped them.(GMA News http://bit.ly/1uBhalj)

Asia

Police have arrested three men over the suspected rape and murder of a teenager who had protested against village elders’ harassment of her father in India’s east, an officer said. http://yhoo.it/1vOotJY

Activists in Asia warn of a harmful regression in the World Bank’s safeguard policies, claiming that proposed changes being considered this autumn could weaken the rights of indigenous people, and others in danger of displacement and abuse as a result of Bank-funded development projects. (IRIN http://bit.ly/1xbWTrQ)

The Americas

The number of immigrant children caught alone illegally crossing the Mexican border into the United States continued to decline in August, according to figures disclosed Wednesday by the Homeland Security Department. (AP http://yhoo.it/WbXxED)

The racist Peruvian television show La Paisana Jacinta loses prime-time slot following a UN admonishment, but racism against indigenous people and African-Peruvians far from eradicated. (Guardian http://bit.ly/1oDy7qf)

A United Nations panel reviewing the US record on racial discrimination has expressed unusually pointed concern over a new pattern of laws it warns is criminalising homelessness. (IPS http://bit.ly/1vOfuZo)

Mass deportations and obstacles to travel are not keeping Hondurans from migrating to the US. (IPS http://bit.ly/1vOfSHf)

US major pharmacy, CVS Caremark, has pulled cigarettes from its shelves a month ahead of schedule. (NPR http://n.pr/1vOiJAa)

Central America’s years of neglect of agriculture, poor water management and lack of planning to help farmers cope with climate change are worsening food shortages caused by a widespread drought, aid agencies say. (TRF http://bit.ly/1oDLl6m)

Opinion/Blogs

With Sewing and Sowing, Self-reliance Blooms in Central Asia (UN Women http://bit.ly/1vOfF6X)

Israel’s Settlement Push Damages Peace Chances (VOA http://bit.ly/1vOl7qC)

Africas economic rise does not reflect reality (Guardian http://bit.ly/1xbWdCR)

Global Prosperity Wonkcast: Unpacking WHO’s Shocking Ebola Maps (CDG http://bit.ly/1xbWx4n)

Who Are You Calling Corrupt? Good Governance Begins at Home (Think Africa Press http://bit.ly/1t0Gno4)

‘Beyond our two minutes’: which international bodies are good/bad at consulting civil society organizations? (From Poverty to Power http://bit.ly/1u1afDE)

Solving Political and Development Issues in Africa’s Food Security (Development Diaries http://bit.ly/1u1aNt0)

How to (Not) Win Friends and Influence Voters (Cherokee Gothic http://bit.ly/1t0HN1K)

Research/Reports

The Executive Director of the Stockholm International Water Institute Torgny Holmgren said water should be a dedicated Sustainable Development Goal in the UN’s post-205 development agenda. (IPS http://bit.ly/1oDEGJC)

More women are choosing to have bilateral mastectomies when they are diagnosed with early-stage breast cancer, even though there’s little evidence that removing both breasts improves their survival compared with more conservative treatments.The biggest study yet on the question has found no survival benefit with bilateral mastectomy compared with breast-conserving surgery with radiation. (NPR http://n.pr/1oDIryu)

A new study says the growing popularity of the Western diet could help worsen climate change. As more people make meat a principal part of their diet, the authors say it will be very difficult to reduce greenhouse gas emissions. (VOA http://bit.ly/1oDKRxj)

Economic prosperity is the worst enemy of minority languages, said researchers Wednesday who listed parts of Australia and North America as “hotspots” for extinction risk. http://yhoo.it/1vOnzgy

Nearly three billion people risk ill health and early death merely from breathing the air in their homes that is polluted by fires made for cooking and heating, researchers said. (AFP http://yhoo.it/WbXIQ5)

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credit: UN Foundation

3 Truths About the Ebola Outbreak

World Health Organization director Dr. Margaret Chan and the top UN official responsible for coordinating the UN’s response to the Ebola outbreak, Dr. David Nabarro, held a series of meetings in New York and Washington, DC this week to brief officials–and the press–about the ebola outbreak in West Africa. Their remarks provide a stark warning about the current state of the fight against ebola. But we should not despair—not yet at least.

Here are three big takeaways from their remarks this week.

1) The outbreak is out of control. There are over 2,500 cases of ebola and over 1900 deaths–and it will get worse.  Senegal confirmed its first case this weekend, which was imported from Guinea by a student who evaded detection. In Nigeria, the outbreak had been confined to Lagos — and pretty much under control in that city. But today, the WHO warned that an infected individual escaped quarantine in Lagos and travelled to Port Harcourt. There, he spread the infection to a doctor, who in turn likely spread it to many more people–including his patients and family members. There are now three confirmed cases in Port Harcourt.

In Liberia, the situation is as grave as ever, with the country’s health system in freefall. Things are comparably better in Sierra Leone and Guinea where there’s relatively greater awareness about how ebola is spread, but it is still placing an exacting burden on those country’s relatively rudimentary health system. In the meantime, the international community has not been able to effectively respond to the disease. “The outbreak is racing ahead of control efforts,” Dr. Chan forthrightly stated in a press conference today.  And in a report last week, the WHO predicted that as many as 20,000 people may succomb to the disease before it’s brought to heel.  

2) The Outbreak Can Be Brought Under Control.   Ebola is not very easily spread. It is not airborne like flu. Rather, its spread through bodily fluids. The reason that so many health workers have been infected is that they are dealing directly with bodily discharge of affected patients. Similarly, ebola spreads within families because of close contact.

This is doable with the institutions we have,” said Dr. David Nabarro, the UN’s ebola response coordinator.  “But the scale up that is needed is in order of three to four times of what is in place.” In other words, the WHO, CDC, UN system and national governments can curb ebola. They just need more money and resources to do the job — and fast. How much? Dr. Nabarro estimated at least $600 million. That is a great deal of money, but from a budgetary perspective of donor countries it’s a drop in the bucket. Still, the money has not been coming in fast enough. Doctors need to get paid, patients need their hospital bills covered and basic protective equipment needs to be bought and distributed. Several hundred more international experts need to be deployed to affected countries.

The pace at which personpower and resources are harnessed for the ebola fight is the key determinant of whether or not this can be controlled. If sufficient money and manpower arrives quickly, the outbreak can — and will — be contained.

3) There are Very Big Barriers to Bringing It Under Control. The funding issue is key. If the money does not come quickly, the outbreak will get worse.  Another huge impediment to ebola control efforts has been irrational fear of ebola which has resulted in the cancellation of nearly all commercial airline flights to Liberia, Guinea and Sierra Leone.

International experts who want to travel to Liberia to help fight ebola have no way of getting there. “We have experts mobilized by the WHO that are doing pro-bono work to provide infection control, but we are not able to deploy them,” said WHO director Margaret Chan. To make matters worse, some countries in the region have closed their airspace and airports to any planes returning from countries, including UN Humanitarian Air Service flights. CDC chief Thomas Frieden, the WHO’s top epidemiologist Keiji Fukuda, and the UN’s David Nabarro have all had flights to the region cancelled. These are arguably the three most important people on the planet to the fight against ebola!

The big takeaway: Ebola is out of control, but can be brought under control if the international community rapidly scales up its response and removes harmful barriers to getting the job done.

Bonus content: A view from Liberia of the Ebola crisis. I speak with journalist Jina Moore:

 

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