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Public Health - March 2009

Fifth World Water Forum: Paper Tiger or Path for Progress on Mideast Water Crisis?

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5th World Water Forum Logo DEVELOPMENTS

From March 16th to March 22nd, representatives from private industry and international organizations, activists, and government officials – in sum a record-breaking 28,000 participants – attended the Fifth World Water Forum in Istanbul, co-hosted by The World Water Council and the Turkish government. The Forum assembles every three years since its first convening in 1997 to address the affects and effects of population growth, climate change, pollution, and flooding on the world’s water resources. The forum was open to the public and featured a Virtual Meeting Space to allow those interested in water issues to share information and debate issues with others from around the world. The Forum also coincided with the release of the third edition of the United Nations World Water Development Report.  

This year’s Forum focused on how the international credit crunch has hindered the progress of water and sanitation projects in developing nations, a theme of interest to countries in the Middle East and North Africa (MENA), parts of which in 2008 experienced their worst drought in recent history. Water shortages in the MENA region continue to pose public health challenges and foment major regional conflict.  

The Forum did not transpire without criticism from attendees and non-attendees alike. Forum critics claimed the conference was nothing more than a trade show for private industry seeking to privatize water resources. Others, citing the cost of registration, starting at 240 Euros for developing country participants, said the Forum was not easily accessible to all stakeholders. Activists staged protests outside the Forum, which resulted in violent clashes with riot police, arrests and deportations.  Other critics staged an Alternative Forum to represent the needs of rural poor, the environment and organized labor.

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The Respiratory Disease Capital of the World: What Guangdong Province May Mean for Health Policy in a Globalizing World

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source: Global Voices DEVELOPMENTS

Guangdong Province in China is widely considered the primary point of origin for the Chinese Diaspora, as evidenced by the predominance of Cantonese–a Guangdong dialect–across the world’s Chinatowns. Unfortunately, this region is also the birthplace of many infectious diseases now posing a significant threat of global contagion, including SARS and more recently, the H5N1 avian influenza virus.  

Over the past three decades the emergence of more than 30 new infectious diseases has created a tremendous growth in awareness surrounding the possibility of a global pandemic.  In the past decade especially, almost all emergent diseases have begun as zoonotic–or, animal–diseases, mutating to make the leap to human-to-human transmission. The last flu pandemic in 1918 infected 30% of the global population, causing roughly 50 million deaths. Throughout the 2002 SARS outbreak, Chinatowns worldwide suffered significant business losses due to widespread fear of infection, despite a lack of cases reported in those communities. Such losses were intensified by the highly-publicized story of a doctor from China who traveled to Hong Kong where he spread SARS to 16 hotel guests, who in turn infected people in Canada, Singapore, Taiwan and Vietnam. The Chinese government further aggravated the situation as they attempted to cover-up the SARS outbreak out of fear that an epidemic would disrupt social order and  damage the tourism sector. 

As global migration increases the distance germs can travel, it raises the question of whether diaspora communities like the global Chinatowns constitute particular micro-zones of risk for infection. Thus, policymakers must address the need for international cooperation and transparency in combating infectious diseases so that the dual status of Guangdong Province, as the source of the world’s largest diaspora population and some its most dangerous diseases, does not become undue cause for concern as we combat the current threat of avian influenza. 

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Re-restructuring Foreign Aid: A Response to Dambisa Moyo

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Dead Aid by Dambisa Moyo DEVELOPMENTS

The Government of Rwanda recently declared its intention to significantly decrease its dependence on foreign aid within the next five years. For a country that relies on donors for between 60-70% of its government expenditures, this statement might seem brash and irresponsible. However, Dambisa Moyo, the former Head of Economic Research and Strategy for sub-Saharan Africa at Goldman Sachs and a former employee of the World Bank, believes that rejecting foreign aid is the only way to ensure lasting development in sub-Saharan Africa. Moyo’s arguments are provocative, but to reject foreign aid entirely is to discount the benefits aid has brought and can continue to bring to Africa. Rather than rejecting it, foreign aid should be restructured to strengthen the capacities of, and synergies between, governments and the private sector.

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A Healthy Debate: Does the Brazilian Healthcare Model Offer a Guide to the U.S.?

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Universal Healthcare Protest Sign DEVELOPMENTS 

Recently, the Brazilian Minister of Health, José Gomes Temporão, defended his country’s unified healthcare system, Sistema Único de Saúde (S.U.S.), and recommended that U.S. President Barack Obama adopt a similar system for universal health care, stating that S.U.S. has been well-recognized for its successes in combating the health care problems facing Brazil.  

As pressure grows within the U.S. to enact reforms that make healthcare more accessible, other countries’ healthcare systems that have made strides towards universal health should be looked at as models.  Brazil, which has its own universal healthcare system that has become increasingly effective in recent years, offers both strengths that might be emulated by the U.S. and weaknesses that should be avoided.
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The Global HIV/AIDS Epidemic and Eastern Europe

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Global Aids Protester DEVELOPMENTS

Recent statements by the Pope have revived the controversy surrounding the Catholic Church’s stance on condom provision, underscoring the role of this type of intervention in global efforts to combat HIV/AIDS. While condoms represent an effective and inexpensive prevention tool within the context of many epidemics, condoms might not be as effective in countries where the spread of HIV/AIDS is fueled by non-sexual transmission. 

There is a growing HIV/AIDS epidemic in Eastern Europe with distinctive characteristics of its own – notably the non-sexual transmission of the virus.The spread of HIV/AIDS in this region is driven primarily by intravenous drug use. In Eastern European and Central Asian countries, the populations most at risk are injecting drug users, commercial sex workers, men having sex with men (MSM), and each group's various sexual partners. The challenge is to develop national HIV/AIDS strategies that address the unique qualities of the epidemic in their respective countries.
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