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Pedantic Name Dispute Makes its Way to the General Assembly

One of the most inane international disputes today is over the name of a country that is referred to in official documentation as “The Former Yugoslav Republic of Macedonia, (FYROM).”  Understandably, the government of this country prefers to simply be called, “The Republic of Macedonia.” (Who wants to be associated with Yugoslavia, anyway?)

The thing is, there is a large province of Greece called “Macedonia,” and the Greeks very much do not want their northern neighbors to co-opt the name.

Back and forth on this dispute has been ongoing since the end of the Balkan civil wars.  The UN has even had an American diplomat, Matthew Nimitz, try and resolve the issue. He’s been on the case since 1999! Alas, positions on this issue are very hardened.  To wit, consider these statements in the UN General Assembly speeches last week by Greece and Macedonia.

Greek foreign minister Н.Е. Мг. Dimitrios Droutsas:

There аre several other ореn issues in the Balkans. Оnе of them revolves around the name of the Former Yugoslav Republic of Macedonia. This is not а bilateral, pedantic dispute about historical symbols, as some try to portray it, but а regional question, with deep historical roots, related to good neighbourliness.

In order to reach а compromise оn the name issue, the two sides must meet in the middle Ьу taking reciprocal steps to bгidge the gap and reconcile their conflicting positions. Greece has already done its part. А fair and lasting solution саn only bе based оn а name with а geographic qualifier,  to bе used for all purposes, erga omnes. Macedonia is а large geographic region, most of which lies in Greece. А small part is in the FORMER YUGOSLAV REPUBLIC OF MACEDONIA and а smaller part in Bulgaria. The part саnnоt represent the whole and the FORMER YUGOSLAV REPUBLIC OF MACEDONIA’s exclusive claims to the name “Macedonia” саnnot bе allowed to fuel nationalism. Any solution must be universally implemented because otherwise today’s situation will simply bе perpetuated.

Meanwhile, the President of the Former Yugoslav Republic of Macedonia Gjorge Ivanov did not issue any geographic qualifiers when he referred to his country as the “Republic of Macedonia” no less than twelve times in his speech.

The Republic of Macedonia is fully committed to the process of resolving the difference with Greece within the frameworks of the mechanism established by the UN Resolutions. Our name is concerned, our right to self-identification and human dignity. We do everything in our capacity to nurture close and friendly relations with neighboring Greece, with its people. A solution can be reached only if the UN Charter, the Resolutions, the international law and principles, on which the international order rest, are respected.

So that’s what is in a name!

Security | | 2
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How Much Will the Financial Crisis Impact Global Fund(ing) for AIDS, TB and Malaria?

How much will the global financial crisis impact funding for the fight against AIDS, Tuberculosis, and Malaria? By the end of next week, we may have a fairly precise answer to that question when donors meet for a replenishment conference of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Back in 2002, donor countries combined their resources into a single pool to pay for treatments for these diseases and to strengthen the health care systems of recipient countries. The outcome was the advent of the Global Fund to Fight AIDS, Tuberculosis and Malaria. So far, the Global Fund has raised about $19 billion and paid for approximately one quarter of all AIDS treatments in the developing world and two thirds of treatment for Malaria and TB. In all, 2.5 million people are on ARV treatments because of the Global Fund. Also, about 35% of the Global Fund’s funds are directed toward strengthening health delivery systems in recipient countries (i.e. training doctors and nurses and strengthening drug supply chains.)

The Global Fund requires new funding every three years and at the UN next week donors are meeting for a replenishment conference for 2011 to 2013.  Already, there are concerns that the financial crisis will give traditional donors pause.  Doctors Without Borders warns that  the will “fall far short” of the $20 billion over the next three years to do its job.

“If the current funding situation continues, patients will be left with fewer options as the global response to HIV will increasingly fall on smaller private programs, such as those run by MSF.

Germany, the third largest donor after the United States and France, poses the greatest threat to the Fund’s replenishment. There are plans within the German government to cut its contribution by two-thirds, possibly even ending its contributions to the Fund by the end of 2011.  Italy is likely to not pledge any funds at all.”

The United States is by far the largest contributor to the fund. (Last year, it contributed $1.05 billion. This year, it has pledged $1 billion). The relevant budgetary committees of the United States congress have approved a $1.3 billion contribution, but it looks like congress will not actually pass that budget anytime soon.  A close observer of this process suggested to me that the Obama administration is still trying to figure out the kind of contribution it will bring to next week’s conference.

So, stay tuned. I’ll stay on this story until throughout the next two weeks. Send me tips!

Health | | 3
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Health Information is Health Aid: How Data Can Revolutionize Health Care

The following is a series of guest posts from participants in the November 8-10, 2010 mHealth Summit in Washington, D.C., organized by the Foundation for the National Institutes for Health (NIH) in partnership with the mHealth Alliance and NIH.

By Jody Ranck
Imagine a world in which public health decision-makers can reach informed decisions about where to distribute vaccines, or where to deploy critical healthcare resources, based on a complete understanding of the real needs generated by empirical realities, as opposed to out-of-date data.

U.S. health policy expert Donald Berwick once remarked that “information is care” in the context of the debate on how to improve health outcomes in the US.  In the developing world, this issue is even more pressing.

Poverty and poor health outcomes frequently can be tracked back to poor data quality and the blockages in critical information.  Up-to-date data is needed to inform suppliers of essential drugs in supply chains, slow responses to outbreaks, and spotlight inefficiencies in the allocation of human resources.

To improve maternal health globally, we need to understand more about what is causing poor health outcomes: both the real gaps in coverage, and those generated by lack of data.

Some examples will help illustrate the need for innovations that can address information flow blockages in the maternal health care continuum:

(1)   When we look at supply chains in developing countries we find that clinics in a given region typically have little information on stockouts, or excess supplies in neighboring clinics.  This may mean that mothers delivering babies may not have access to essential drugs such as oxytocin, which  can help strengthen labor contractions or control bleeding during a problematic delivery.

(2)   A lack of unique identifiers and vital registration systems that record births, deaths and other major life events, may mean that if a woman receives pre-natal care in a city, but then relocates to her home village to give birth, her records will appear in a country’s aggregate statistics as two unique patients.

(3)   In low and middle income countries, there is a critical shortage of health workers who can attend to women’s health issues.  This shortage is compounded by the challenge that, that frequently there are gaps between the information that the ministries of health use to influence education policies and resources, and the actual needs on the ground in rural health clinics.

So we can see very real effects of disruptions in data systems that can dramatically influence health outcomes.

To make a systemic impact that enables health systems to support healthier mothers and babies, we must understand the key gaps in health information flows throughout health systems.  This will enable health planners and health technologists to adopt innovations and policies to address failures, and help save lives.

The UN Foundation & Vodafone Foundation, together with the mHealth Alliance, is commissioning research on health data flows.  This report, now available as a draft for comment,  is a first step in charting a potential pathway to new innovations for health system strengthening, and improved maternal health outcomes.

Through the identification of existing barriers to efficient data flows, we can map potential innovation spaces for technology developers and health planners.  If addressed in the near future, these innovations may accelerate the process of ehealth adoption, in turn strengthening health systems and leading to improved health outcomes where they are needed most.

At the mHealth Summit, I will lead an invitation-only roundtable discussion about health information flows.   This will incorporate comments from the Data Flows workspace in the HUB: Health UnBound community.  We hope you will register for HUB and join the conversation.

Jody Ranck, MA, DrPH, is a consultant to the mHealth Alliance, launched by the Rockefeller, United Nations and Vodafone Foundations. Join the mHealth Alliance group on Facebook, and follow discussions about the mHealth Summit on Twitter using #mHS10.

Health | | 1 Comment

Security Council Reform: Which countries should be in, which countries should be out? And Why?

Forum | 1 Comment
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Gates, Geitner, Clinton, Shah and Yohannes Talk Global Development

The United States Global Leadership Coalition’s “mega-conference” kicks off this morning. It includes a high powered panel to discuss the new U.S. Global Development Strategy.  Secretary of State Clinton, Secretary of Defense Gates, Secretary of Treasury Geithner, USAID Administrator Shah, and Millennium Challenge CEO Yohannes will discuss the strategy, which was released last week at the UN MDG summit.  Watch live:

The other two panels today include a discussion with military officials and pollsters for the release of new polling results on public support for development and diplomacy and a panel of business leaders who discuss why global development is important for the American economy.

Development | | Leave a comment
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A Response to David Rieff: The MDGs are Not Millennial

David Rieff does not like the Millennium Development Goals very much:

“In reality, of course, these are not millennium goals but millennial ones, their ambition made all the more hubristic since what would amount to, quite literally, the salvation of humanity is to be accomplished by 2015, according to the relevant U.N. documents. I am not making this up.”

Actually, you kind of are making this up. Quite literally, the MDGs say nothing about the salvation of humanity by 2015. Quite literally, they are very narrowly defined policy targets. These include, quite literally, to cut in half the number of people who live on less than $1 a day between 1990 and 2015; to reduce by two thirds the under five years-old child mortality rate between 1990 and 2015 (as measured per 1,000 lives births); and to achieve universal primary education. This is among many other quantifiable goals.

The point is, the Millennium Development Goals are not a Utopian dream. They are verifiable targets. As it happens, some countries have responded to these targets by enacting public policy toward their fulfillment.

For example, Malawi has passed a series of laws to increase the proportion of its national budget that is dedicated to health care. Among other things, this means that thousands of newly trained birth attendants have been deployed throughout the country. Accordingly, Malawi has seen a reduction in maternal mortality from 1,120 per 100,000 live births in 2000 to 807 100,000 live births in 2006. In another example, national legislation in Burundi and Tanzania abolished primary school fees, resulting in sharp progress toward achievement of universal primary education.

It is a wonder that liberals like Rieff would rail against the idea that public policy can and should be harnessed to benefit vulnerable populations.  If this is not a liberal idea, then the good folks at TNR have finally debated away whatever it means to be a liberal these days!

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