Archive for August 2007
“Morning Edition, August 27, 2007 · Blood and sweat could power a battery that looks just like a piece of paper, scientists say…the new paper battery can run on blood or sweat. That means it might ultimately be used to power medical devices like hearing aids or pacemakers.” NPR full story.
A bit of diversion here, but an important one from the latest issue of Fast Company. I do not yet have an opinion on the 10 year retrospective review below, however, the numbers from Fast Company (if accurate) are dramatic. Dave Richards at “Defeating Global Poverty” has a more detailed post that you should check out and the author of “You Can Here Me Now“, Nicholas Sullivan, has published a letter countering this article (excerpts at the end of this post).
Has Grameen’s Village Phone Program Gone Obsolete? Fast Company Magazine September 2007
“At first, they all came…And then, one by one, each talked on Laily Begum’s wondrous new possession, a cellular telephone. A caller might come to check on money that her husband was supposed to send from his job as a day laborer in Dubai…But that was in the beginning, a decade ago; these days, cell phones are so commonplace that most visitors come only for a haircut, a shave, groceries, or a place to sleep, all of which Begum offers now. The few wireless calls are no longer made from her home but from one of her nearby shops–usually the one with the barrels, drums, and cans of motor oil out front and lining its walls. In March, when I visited her home in Patira, a stretch of dusty intersections 90 minutes northeast of Dhaka, she told me, “Hardly anyone uses my phone anymore.”
“Begum’s success has become legendary, embraced by the media and the world of economic development as an example of how microcredit and technology can help those born in poverty escape it, largely through their own entrepreneurship. The Grameen organization continues to boast that its Village Phone Program “has been incredibly successful … establishing a clear path out of the poverty cycle”…But as it turns out, the legend is far out of date…In Bangladesh today, the only one making real money on GrameenPhone’s wireless service is … GrameenPhone.”
The Village Phone Program no longer sustains its entrepreneurs — yet Grameen continues to recruit operators…” Full story
Counterpoint by Nicholas Sullivan:
Re: “Unplanned Obsolescence” (September), I wonder if you don’t miss the forest for the trees. The big story is that Bangladesh has increased its phone penetration from 1 per 500 people in the mid-‘90s to 1 per 7 people today. The phone ladies, whose income and profits are surely declining as noted, and who represent at most 3% of GrameenPhone subscribers, are not the raison d’etre of GrameenPhone; distributing tens of millions of phones throughout the country is the company’s mission and has been from the start. Utilizing Grameen Bank’s network in 60,000+ villages was merely a way to deliver phones into remote rural areas where there was and still is no reliable electricity or roads. The fact that the foreign investors behind GrameenPhone (Telenor of Norway, Marubeni of Japan, and Gonofone of New York) endorsed this strategy while also perceiving its developmental impact in lifting people out of poverty is one of the most positive business stories in recent memory.
Read the full letter here…
Ever since I saw the “Migrations: Humanity in Transition” exhibit I have been a huge fan of Sebastiao Salgado (UN bio). He has now taken his skills to the global health realm to document the largest public health initiative in history. Some of the pictures can be viewed online and for those in Atlanta, “his photographs documenting the eradication efforts can be viewed by the public in the Global Health Odyssey on the CDC campus at 1600 Clifton Road on August 27, 2007 through January 4, 2008.” Visit www.endofpolio.org for a preview of the photos (one sample below).
“Early in 2001 in Somalia, Brazilian photojournalist Sebastio Salgado began to document the global effort to eradicate the crippling disease poliomyelitis. By the end of the year, he witnessed mass vaccination campaigns against polio in Somalia, Sudan, India, the Democratic Republic of Congo and Pakistan.” Full CDC press release.
Speaking of polio, Sociolingo has linked to some news on eradicating polio in the Niger-Nigeria region (link).
Partly because of my recent visit to Beijing I am fascinated by what is happening in/with China. In addition, because China is now front and center stage and because they play such an important role in the lives of those living not only in the West (see living without “Made in China”, via Treehugger; Amazon book) but for those in various regions (see Africa and China) there are substantial implications to what happens in China on many important levels (global business & finance, global health, global environmental conditions). With the 2008 Olympics just around the corner, you will only hear more and more about these issues and hopefully the media blitz will have some positive impact on governance and policy issues going forward. With that I want to highlight what prominent bloggers have been recently talking about with respect to China and health/global health issues with a couple of articles mixed in:
- China’s Ticking Gender Bomb, Wired blog
- What Do China’s Scandals Mean For Public Health? Epidemix blog
- Mounting Poverty, Health Risks for China’s Sex Workers, Think Girl
- China to ban tobacco advertising from 2011, Forbes
- China health threat: much bigger than paint, Zenbowl over at Daily Kos
- Drug trials made in China, Rx Brandweek blog
- Top Ten Posts on China, Health Care and Globalization, AJFortin.com
- Red Package Health Care in China, AJFortin #1 post
- Weekly Roundup on PharmAsia news, PharmAsia blog
Bonus: The Atlantic, audio photo essay on “Made in China”, worth a quick look, link
An account manager from Scientific American’s PR firm let me know about their latest issue on Obesity and Malnutrition (many thanks to Scott for the email) which you should check out. This special issue focuses on “Food, Fat and Famine” and has some of the world’s leading experts writing for the issue (Barry Popkin, world food prize laureate Per Pinstrup-Andersen, and others) along with a bonus article by Jeffery Sachs. I got a chance to quickly skim the introduction to the issue and this line struck me (paraphrased from memory): “For the first time in the world’s history the number of obese people has surpassed the undernourished” (roughly 1.3 billion vs 1 billion).
The shift to sedentary lifestyles (use of mopeds vs bikes) and drive to “Westernization” (fast food, sweetners, mass produced food, urbanization) is dramatically altering the landscape and will lead to a substantial rise in chronic diseases. As Barry Popkin says in his excellent article, The World is Fat, these changes have “paved the way for a public health catastrophe”. A couple of facts from Popkin’s article about the radical change that has taken place in Mexico in just 20 yeras:
-1989: Less than 10% of Mexicans were considered overweight
-2006: Over 66% of Mexican men and women are overweight or obese
-1990: Diabetes was almost non-existent in Mexico, not so today
The above rapid change maybe compounded in developing regions where evolution may have altered genetic makeup such that people in those regions have a greater ability to store fat due to the need to conserve in times of famine. Add in the lack of access to drugs, obesity leads to greater rates of diabetes and hypertension and in China for example, only 1/3 of hypertension patients receive medications. This issue is fascinating and I highly recommend perusing it. For a blog that posts on obesity in general as well as other issues, I would recommend the Med Journal Watch. Unfortunately the online links below only have free abstracts and not full articles, but you will get a decent sense of the article content:
The Global Paradox of Obesity and Malnutrition
A Question of Sustenance, abstract
Globalization ushered in a world in which more than a billion are overfed. Yet 800 million or so still suffer from hunger’s persistent scourge
The World Is Fat, abstract
How can the poorest countries fight obesity?
Still Hungry, abstract
One eighth of the world does not have enough to eat
Sowing a Gene Revolution, abstract
A new green revolution based on genetically modified crops could help reduce poverty and hunger, but only if formidable institutional challenges are met
Is Your Food Contaminated?, abstract
New approaches to protect the food supply
Sustainable Developments: Breaking the Poverty Trap by Jeffrey D. Sachs, abstract
Targeted investments can trump a region’s geographic disadvantages
The new Bill Clinton book, Giving, features global health hero Paul Farmer and many others. He will be interviewed by Oprah on Sept. 4, 2007, the day his book on philanthropy and civic action is released. He will also be interviewed by Larry King and David Letterman (full press release here). Hat tip: Gift Hub.
“Here, from Bill Clinton, is a call to action. Giving is an inspiring look at how each of us can change the world. First, it reveals the extraordinary and innovative efforts now being made by companies and organizations—and by individuals—to solve problems and save lives both “down the street and around the world.” Then it urges us to seek out what each of us, “regardless of income, available time, age, and skills,” can do to help, to give people a chance to live out their dreams.”
An interesting commentary piece in yesterday’s Washington Post, excerpts below:
Health diplomacy: Rx for peace
Susan J. Blumenthal/ Elise Schlissel
The Washington Times
August 26, 2007
“A survey of Americans’ political and social values reveals that belief in the effectiveness of military power as a foreign policy tool has dropped to the lowest point in the last 20 years…This diminished confidence in military intervention as a cornerstone of international relations raises an obvious question: What other tools are available to advance U.S. interests in the world? Health diplomacy is an important and underutilized instrument in our nation’s foreign-policy toolbox.”
“More than 63 percent of the people infected with HIV live in Africa; 79 percent of the chronic disease burden is in the developing world. Whether “over there” is Africa, Southeast Asia or Latin America, inhabitants of the United States for far too long have seen little reason to worry. But Americans — and the world — have much to gain from increasing our focus on global health.”
“Health diplomacy is a means of self-preservation in an increasingly interconnected global community. SARS, H5N1 avian influenza, AIDS, TB — the list goes on and on — are only a jet plane away from America’s shores. Globalization facilitates the rapid response to health problems between rich and poor nations by quick mobilization of health professionals, medicines and supplies, and deployment of information technology for surveillance of diseases and sharing health information and best practices worldwide…”
“The United States spent $571.6 billion on defense last year alone, but spends only 0.14 percent of its gross national product on global health and development, the least of any major industrialized nation…”
“For example, the tsunami relief efforts in Indonesia: A poll found after the visit of two former U.S. presidents coupled with a commitment to invest significant funds toward rebuilding communities, support for the United States rose from 36 percent to 60 percent virtually overnight in the world’s largest Muslim country, while support for Osama bin Laden dropped from 58 percent to 28 percent.” Full commentary here.
Great article in the NY Times about China’s pollution, a country where cancer is now the leading cause of death. As the article mentions, China unlike any of the industrialized nations will be forced to deal with this extremely serious problem while they are still a poor country. The catch 22 is that this may curb China’s development and hence also its future. This NY Times feature article includes additional audio and visual material. Below are some highlights from the article:
As China Roars, Pollution Reaches Deadly Extremes, NY Times
No country in history has emerged as a major industrial power without creating a legacy of environmental damage that can take decades and big dollops of public wealth to undo…its pollution problem has shattered all precedents. Environmental degradation is now so severe, with such stark domestic and international repercussions,
Public health is reeling. Pollution has made cancer China’s leading cause of death, the Ministry of Health says. Ambient air pollution alone is blamed for hundreds of thousands of deaths each year. Nearly 500 million people lack access to safe drinking water…
Chinese cities often seem wrapped in a toxic gray shroud. Only 1 percent of the country’s 560 million city dwellers breathe air considered safe by the European Union…China is choking on its own success.
China’s problem has become the world’s problem. Sulfur dioxide and nitrogen oxides spewed by China’s coal-fired power plants fall as acid rain on Seoul, South Korea, and Tokyo. Much of the particulate pollution over Los Angeles originates in China, according to the Journal of Geophysical Research…
Other sources and perspectives:
In China, Global Environmental Injustice Kills Millions, It’s Getting Hot in Here
China is choking on growth, China Law Blog
As China Roars, Pollution Reaches Deadly Extremes, 8Asians
China’s Pollution Problem – Our Pollution Problem? Working Life (Labor Research Association)
Here is another story on the growth of medical technology consumption and production in emerging regions. A few days ago we had a related post (Trends in Global Pharmaceutical Manufacturing). According to the McKinsey report, the rural health services sector will provide significant growth in the demand for pharmaceuticals.
India’s fast-growing economy, expansion in health care insurance and infrastructure, to grow national drug sales to triple by 2015. The report said India will undergo a “significant transformation” to become one of the top 10 pharmaceutical markets in the next decade.
In addition, improvements in medical infrastructure – like rural hospitals and clinics – would contribute to 20 percent of the projected growth, while the strengthening of health insurance within the country would contribute to 15 percent of the growth, the report said. Full news release at CNN Money.
Pharma boom: Drug market to hit $20 bn by 2015, The Economic Times
Table: Global Insight, Link
KPMG Pharmaceutical Practice Report: The Indian Pharmaceutical Industry, (PDF)
India: The Next Pharma Superpower?, IPA Convention 2007, Trade Group
Pharma & Biotech in India Presentation, (PDF)
There will surely be challenges to adapting the “Tournistrip” to low resource settings, however, it is a cheap and simple way to cut hospital infections due to the high volume reuse of traditional tourniquets. I am just shocked that they don’t already do this in hospitals found in the West:
“Two recently qualified doctors believe they could have found an important weapon in the fight against hospital acquired infection – and it costs just pence.” Full story at BBC News: Simple band could cut hospital bugs.
Conducting clinical trials overseas is nothing new, however, increasing access to capital and investment in emerging countries does appear to be relatively recent. Two new pieces (links at end) detail the move into China by pharmaceutical companies. I have covered this notion in a previous post.
Even though there has not been much discussion of this trend, it really is not surprising with the increasing attention and acknowledgment of the major chronic disease threats facing developing countries and particularly high growth economies. In addition to the pharmaceutical companies moving into Asia, the largest managed care company in the US (by revenue), the United Health Group, through a subsidiary is looking to establish five chronic disease centers (more information at the Center for Global Dev blog), hoping to replicate the success of infectious disease centers:
“Ovations plans to replicate this success. Centres will be expected to train and develop individuals who will become leaders and be ready to capitalise on the large flow of funds that is likely soon to be available for countering chronic disease in the developing world.”
The middle class in places like China and perhaps India will certainly start to gain access to many of the treatments the US middle class has, however the question of access to the poor is a big question. As the CNN article states below, China recently ruled in favor of a Pfizer drug patent. Given the trend of big pharma moving into certain emerging markets, this pro industry ruling and big pharma’s obessive fear over generic competition, distributing low cost drugs (brand or generic) to BOP markets may become much more difficult as MNCs enter these markets. However, perhaps this will be mitigated by some sort of tiered pricing system, provided there are guaranteed arbitrage protections (which I am guessing could be very difficult).
In terms of infrastructure and capital investment things are certainly starting to heat up, watch this space in the future to see what happens…
Developing Trends – Recent News:
China: Big Pharma’s new New Jersey, CNN link
Asia Will Become The New Center Of Gravity, Pharmalot post
Indian biotech industry crosses $2 billion, link
Not directly related, but interesting – Call for a Global FDA, link
Jaspal tipped me off to this story that some of you may have heard of before. The state of recall related to China is getting is at a ridiculous level. No time to write a detailed post on this, but you will find below a few headlines for this recall and for the one on the fake diabetes test strips. The first article on fake diabetes test strips (link) provides the most detail and is worth reading. Also worth checking out or bookmarking is a blog devoted to these issues: Made (Deadly) in China.
Fake diabetes test kit linked to Shanghai company, link
As part of the launch tomorrow for global water week in Stockholm, the World Business Council on Sustainable Development (WBCSD) is offering up a free “Water Tool” where by organizations can track their water usage, access country reports, mapping tools and do comparative evaluations. More information here.
In honor of this week below is other recent water related news. One developed country to keep an eye is Australia. They are facing some severe issues and their ability to solve those issues provide valuable lessons for the rest of us, see this story on their water shortage. It is great to see so much coverage, let’s keep the drum beat going:
Study: Toilets Need Radical Redesign, link
Water, Water Everywhere, but Guilt by the Bottleful, NY Times
An Ingenious Way To Turn Salt Water Into Fresh Water, link
School Bans Bottled Water…Where Do I Sign Up? Link
Bottled Water and Snake Oil, The Economist
Tap Water: On Its Way to Being Cool Again, EcoRazi – Green Gossip
Finally, the Appropriate Infrastructure Development Group (AIDG) has had some great global health related posts up over the past two months. Be sure to check out their blog and more importantly their operations. Here are two water related graphs from their blog:
Over the past several months I have noticed what seems to be consistent coverage of development and/or global health issues by the business press. Almost every time I open up Fortune Magazine, Business Week, Forbes, or some other mainstream business publication there seems to be some coverage of the issues we care about (water, clean tech, etc.). You might ask – so what? For those in the public health world, yes “business” is a four letter word, but this is an important development (good and bad) because the private sector unlike never before is having an increasing impact on development and global health issues. Even the financial news channel, CNBC TV, has had consistent coverage of issues such as the global water crisis (probably largely due to one main proponent). To give you an idea of frequency and content covered, below the graph is a sample of articles I have seen in the major business news publications in just the past couple of months.
In addition I decided to do a very quick and dirty check of the number of publications listed on Google Scholar over the past decade to see if there has also been an increase in attention in the academic press. I searched using the following two terms:
“Global Health” and “Private Sector”
“Global Health” and “Business”
You can see the results in the below graph which again is a back of the envelope analysis that has flaws, but gives us a rough idea of changing content being published. In 1996, the use of those words “Global Health or Private Sector” and “Business” was almost non-existent and a decade later we see a tremendous increase that is 12-23 times greater (some of which can be attributed to SARS).
Back to changes by the business press, there seems to be no question that there is much greater interest in development and social issues compared to a decade ago. However, the majority of these articles seem to be clear that their interest is largely driven by profit, as the Smart Money July 2007 issue states: “It’s not a social or moral debate, it’s all economic…”
Business & Development Examples
1. Jeffery Sachs: “How I’d fix the World Bank”, link
Fortune Magazine 6.9.2007
4. BusinessWeek on BOP – A False Dichotomy? via NextBillion
Business Week 8.1.2007
6. MTV Searches for Hope & Profit in Africa, link
8. Money Magazine August 2007 page 61: Full page color ad for VillageBanking.org (sorry no link to the ad)
9. “Reap profits & save the planet…Corporate America is responding to climate change considerably faster than the US.” Smart Money, June 2007 (sorry no link to article available, see print edition)
On a related note, definitely read this-
Environmentalism for Billionaires: “How businesses are looking to cash in on global warming with green-washed plans that aren’t as eco-friendly as they seem.”
Clean tech becomes big business (8/2/2007), link
While I am not aware of blogs that are mostly devoted to covering development or global health issues from a business perspective here are some blogs that have related content. If you know of any others please let me know:
The Heart of Business
Lunch over IP
Silicon Valley Microfinance Network
The Discomfort Zone
In place of unaffordable pap smears, 8 years ago researchers at Johns Hopkins validated a “simple method” for detecting cervical cancer: the use of vinegar. That study was conducted in over 10,000 women across 15 clinics in Zimbabwe (1999 BBC news story). Fast forward to this month and we have a re-validation of this method in 50,000 women in India. A new study was conducted from 2000-2006 (hat tip to Drug Wonks):
A cheap method to detect cervical cancer using vinegar, cotton gauze and a bright light could save millions of women in the developing world, experts reported Friday. The study, published in The Lancet medical journal, found a simple visual screening test to look for the early signs of cervical cancer reduced the numbers of cases by 25%. “This is a landmark study,” said Dr. Harshad Sanghvi, medical director at JHPIEGO…Experts think that the simple, inexpensive technique could be rolled out across the developing world relatively easily. Pilot projects are already under way in a handful of countries in Asia and Africa. Full story: Simple Method Detects Cervical Cancer.
A slight digression, Al Gore will be on Oprah today to discuss global warming. For the uninitiated, Oprah has 30 million plus weekly viewers and has been called by some – the most influential woman in the world. If I get a chance I will watch to see if there is an connection made to global health.
UPDATE: In related news, I was just informed that Treehugger was acquired for $10M recently. See – How do we know that the eco-movement has officially hit the mainstream?
The AfriHealth 2007 conference will be held from Sept 18 – 20th in Nairobi. There may still be panel speaker slots open, so if you are an expert in this area or know anyone who is, please let me know and please spread the word. The press release is here.
I am back from a great trip to Beijing and Seoul and am just getting back into the saddle. Hopefully regular posting will resume soon. While cleaning out my inbox I grabbed a few eclectic links to share. The most important one to note is listed first below; Health Affairs (a leading health policy journal) has a mandate to expand its coverage to global health issues. The latest issue is devoted to global health financing. Enjoy!
Health Affairs: Global Health Financing, link
Some sample article titles:
- Financing Global Health: Mission Unaccomplished
- Universal Coverage In The Land Of Smiles: Lessons From Thailand’s 30 Baht Health Reforms
- Technological And Social Innovation: A Unifying New Paradigm For Global Health
- The Application Of Business Models To Medical Research
Related to this see Ana’s post over at NextBillion’s on Micro health insurance for the poor…
TED Global 2007 Coverage
- TED 100 websites you should know
- Africa Talks online, link
- iPienso suggests Euvin Nadoo’s TED talk, link (also see Zoo Station)
- Related – if you haven’t already, read Jen Brea’s article: Africans to Bono: “For God’s sake please stop!”
- For comprehensive coverage you already know to check out Zuckerman’s site
2. Looking to water to find peace in Darfur, link
5. IBM on emerging infectious diseases, link
6. Sierra Leone’s Refugee All Stars, link (movie trailer below)
With the help of the Canadian NGO CECI Sierra Leone’s Refugee All Stars got instruments and a soundsystem so they could start playing for their fellow refugees, bringing needed hope and relief to the traumatized population…
“MY NAME is Mohammed Sokor, writing to you from Dagahaley refugee camp in Dadaab. Dear Sir, there is an alarming issue here. People are given too few kilograms of food. You must help.
“A crumpled note, delivered to a passing rock star-turned-philanthropist? No, Mr Sokor is a much sharper communicator than that. He texted this appeal from his own mobile phone to the mobiles of two United Nations officials, in London and Nairobi. He got the numbers by surfing at an internet café at the north Kenyan camp.”
The article touches on the benefits that modern technology can bring to humanitarian relief, citing examples as diverse as the UN’s ReliefWeb portal, Mukuru.com (an SMS-based voucher system for connecting the Zimbabwean diaspora community with relatives back home), and Sri Lanka’s tsunami “early-warning system which would send SMS messages to every mobile phone in an area at risk of flooding”.
The most interesting portion of the article for me was about the potential drawbacks of the technology:
“Oisin Walton of Télécoms sans Frontières has a different worry: e-mail may supplant aid workers’ conflict-avoidance skills; they may come to rely too much on e-mailed security warnings, and not enough on their instincts. And the Red Cross’s Florian Westphal fears satellite or mobile phones will make warlords even more suspicious of aid workers;
it is now harder to eavesdrop than it was when aid workers used open radio frequencies.”