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Less Money for AIDS Treatment

If you think about it, PEPFAR was never a great idea. An ambitious, idealistic, somewhat glorious idea. But not actually a good one. There was no way we could keep expanding it forever. Now, the Obama administration has made the difficult decision that we cannot keep increasing PEPFAR budgets to keep pace with new HIV infections. We can’t treat our way out of an AIDS crisis and we just spent ten years focusing on treatment and neglecting prevention.

We ignored AIDS prevention because it was political. It involved a whole lot of things that are hard it talk about in public – homosexuality, casual sex, marriage, abstinence – almost every hot button issue in human politicos. It was a whole lot easier to keep spending money on anti-retroviral treatment than to talk about sex like reasonable adults.

And now, here we are, without the money or the will to keep expanding HIV treatment and we have no idea what prevention efforts actually work. The New York Times reported on the grim situation in Uganda, but Uganda is just the beginning. If PEPFAR’s budget is going to stay at the same level, and HIV infections continue to increase, people are going to be left without treatment.

A few countries have shown success in slowing the spread of AIDS, but we don’t really know why. Uganda took their HIV rate from around 30% to 6% in 2006, but it[‘s hard to know exactly what caused that success. Changes in cultural attitudes toward success? Increased condom use? Increased mortality of people with AIDS?  We don’t know, so we can’t replicate it.

Thailand gives us a little more hope. A national effort focused on ensuring condom use in sex industry reduced the rate of new HIV infections fivefold from 1991-1995. It’s a valuable model for countries with large sex industries. However, it only works in that one case. Thailand was not able to increase condom use in non-transaction casual sex encounters or among men who have sex with men.

We are really, really good at treating people with AIDS. We’re not good at keeping the disease from spreading. If we want to fight AIDS, that needs to change. People are going to die because of limitations on AIDS treatment. That’s the horrible truth. If we’d been paying more attention to prevention all along, there would be a lot fewer people in this position.

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Hillary Clinton Rolls Out New U.S. Policy to Support Nutrition in the Developing World

Secretary of State Hillary Clinton devotes her keynote address to the CARE conference in Washington, DC to the topic of nutrition. In the speech, she argues that nutrition is a cross cutting issue in which American dollars and attention can make the biggest difference.  She outlines a new US approach to the issue around minute 12.


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Israel, Estonia and Slovenia Join the OECD (UPDATE)

Israel, Slovenia and Estonia were invited to join the Organization for Economic Cooperation and Development, a group of (now 34) wealthy democracies.  The OECD does a host of things, from helping to stabilize its members’ economies to serving as a focal point for assisting in the economic development of poorer countries.

My favorite OECD product is its annual tally of the amount of money that its member countries allocate in Official Development Assistance. They measure this as a percentage of the country’s Gross National Income, so it serves as a pretty good way to compare the relative generosity of wealthier countries.  The UN recommends that donor countries set aside 0.7% of their gross national income for development projects in poorer countries. Some OECD members are above that target, but most are below.

So where would the newest members fall on the generosity scale?  I asked the OECD.  They will not have the 2009 data until the end of the year. And there is no information yet for Slovenia and Estonia.   But using 2008 figures, Israel would fall at the bottom of the pack, at 0.07% of its GNI going to Official Development Assistance. (In 2009, the most generous country, Sweden, was at 1.12%; the United States, 0.2%; and Korea — the lowest — at 0.1%). 

I guessed it would be fairly low.  After all, until it joined the OECD yesterday Israel was not considered a “donor” country. But now that it is a part of this elite group, we can probably expect that figure to rise. 

UPDATE: The OECD helpfully sends along data on Slovenia and Estonia.  Slovenia’s ODA/GNI ratio in 2008 was 0.13%; Estonia’s ODA/GNI ratio in 2008 was 0.1%. 

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Plugging the Leak Update

Bad news: the cap didn’t work.  The 40-foot-tall, 98-ton, iron cap that BP was hoping to use to clog the leak over the weekend has become clogged itself, by “deep-sea crystals…a slushy mix of gas and water, and been tossed aside.

As Yahoo notes, the cap took two weeks to build and 3 days to put into place.  During that time 85,000 barrels of oil have spilled into the Gulf.

Possible next steps include “the top hat,” a much smaller, five-foot-tall cap that might be less likely to become clogged…and, two to three weeks from now, shooting gunk, including old tires, golf balls, and mud into the blowout preventer, which was supposed to stop the leak in the first place. High-end salons are already donating hair to help clog the drain, seriously.



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UN Human Rights Experts Criticize Arizona Law

A group of six UN rights experts are warning that Arizona’s controverisal new immigration law may be in violation of America’s international human rights obligations. From the Office of the High Commissioner for Human Rights:

“A disturbing pattern of legislative activity hostile to ethnic minorities and immigrants has been established with the adoption of an immigration law that may allow for police action targeting individuals on the basis of their perceived ethnic origin, and a law that suppresses school programs featuring the histories and cultures of ethnic minorities,” warned the UN experts on migrants, racism, minorities, indigenous people, education and cultural rights.


“The law may lead to detaining and subjecting to interrogation persons primarily on the basis of their perceived ethnic characteristics,” the UN independent experts noted. “In Arizona, persons who appear to be of Mexican, Latin American, or indigenous origin are especially at risk of being targeted under the law,”

The UN independent experts stressed that “legal experts differ on the potential effects of recent amendments to the immigration law that relate to the conditions for the official detention of suspected illegal aliens,” and expressed concern about the “vague standards and sweeping language of Arizona’s immigration law, which raise serious doubts about the law’s compatibility with relevant international human rights treaties to which the United States is a party.”

“States are required to respect and ensure the human rights of all persons subject to their jurisdiction, without discrimination,” they said. “Additionally, relevant international standards require that detention be used only as an exceptional measure, justified, narrowly tailored and proportional in each individual case, and that it be subject to judicial review.”


The immigration law was adopted around the same time as the enactment of a law prohibiting Arizona school programs that “are designed primarily for pupils of a particular ethnic group” or that “advocate ethnic solidarity instead of the treatment of pupils as individuals.”The state superintendent of schools, the primary state official who promoted this legislation, has repeatedly stated that the law is aimed at eradicating particular existing ethnic studies programs that provide instruction featuring the history, social dynamics, and cultural patterns of Mexican-Americans in the United States.

The independent experts noted that “such law and attitude are at odds with the State’s responsibility to respect the right of everyone to have access to his or her own cultural and linguistic heritage and to participate in cultural life. Everyone has the right to seek and develop cultural knowledge and to know and understand his or her own culture and that of others through education and information.”

While the independent experts recognize the prerogatives of States to control immigration and to take appropriate measures to protect their borders, “these actions must be taken in accordance with fundamental principles of non-discrimination and humane treatment.” Furthermore, “States are obligated to not only eradicate racial discrimination, but also to promote a social and political environment conducive to respect for ethnic and cultural diversity.”

If Arizona was seeking international notoriety, they found it. 

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UN Budget 101

Our friends at the Better World Campaign put together a helpful primer on how the United States pays the United Nations and its agencies. To accompany it, they organized a Q and A with the Better World Campaign’s executive director Peter Yeo who answers questions about the UN’s budget process. If you want to sign up for the Campaign’s email list, click on over.   

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