Archive for February 2009
Economist Dambisa Moyo is on the interview circuit promoting her new book (Dead Aid). Dr. Moyo is at odds with celebrity spokespeople (the title is a play on lyrics from a U2 song). Fantastic set of quotes below from a couple of interviews. Her criticism of Bono might be a bit harsh, for another take, see MinneAfrica which discusses some of the limitations of Moyo’s thinking.
NY Times, Questions for Dambisa Moyo – The Anti-Bono Feb 19, 2009
NYT: As a native of Zambia with advanced degrees in public policy and economics from Harvard and Oxford, you are about to publish an attack on Western aid to Africa and its recent glamorization by celebrities. ‘‘Dead Aid,’’ as your book is called, is particularly hard on rock stars. Have you met Bono?
MOYO: I have, yes, at the World Economic Forum in Davos, Switzerland, last year. It was at a party to raise money for Africans, and there were no Africans in the room, except for me.
NYT: You argue in your book that Western aid to Africa has not only perpetuated poverty but also worsened it, and you are perhaps the first African to request in book form that all development aid be halted within five years.
MOYO: Think about it this way — China has 1.3 billion people, only 300 million of whom live like us, if you will, with Western living standards. There are a billion Chinese who are living in substandard conditions. Do you know anybody who feels sorry for China? Nobody.
“She is venturing into a debate that has to date been colonised by white men – be they rock stars such as Bono, politicians such as Tony Blair or the academics Jeffrey Sachs and Bill Easterly…”
FT: So what of the rock and Hollywood stars, who have appointed themselves advocates of making poverty history? She is withering:
MOYO: “Most Brits would be irritated if Michael Jackson started offering advice on how to resolve the credit crisis. Americans would be put out if Amy Winehouse went to tell them how to end the housing crisis. I don’t see why Africans shouldn’t be perturbed for the same reasons”…
Purely as entertainment I enjoyed Slum Dog Millionaire and because of the Oscar victory people have become more curious about global slums. How do I know this? The hits on this blog have increased in the past two days with people specifically drawn to a previous post we did: Dharavi: Mumbai’s Shadow City. Take the following with a grain of salt, but note the increase in interest:
“Movies have a powerful ability to evoke a sense of the exotica about the locations in which they are filmed. They are widely acknowledged to inspire travel to those destinations….According to Expedia sources, post ‘Slumdog Millionaire’, Mumbai now tops the chart of global tourist destination.” Source Yahoo News
Additionally, OneWorld Health has decided to explicitly use the movie as a avenue to educate people more about global health needs:
The Institute for OneWorld Health, the non-profit pharmaceutical company that develops drugs for people with neglected infectious diseases, announced it is launching a new awareness campaign inspired by the highly acclaimed Oscar-winning film, Slumdog Millionaire…OneWorld Health is running a full-page ad in the New York Times on Monday, Feb. 23. Slumdog Millionaire, an underdog story about poverty, love and hope, won eight Oscars at last night’s Academy Awards ceremony, including Best Picture. For the full story see OWH here.
A by product of Slum Dog is that tens of millions of people who previous had very little knowledge about global poverty got a little glimpse into that world. Picking up on this curiosity, another place to learn more is a fantastic multimedia project by Magnum Photos that is well worth your time (hat tip to TinkuB) :
Sunday night there were two films related to global health and poverty that were nominated for an Academy Award in the best short documentary category. Smile Pinki took the award in the short’s category this year. The other film was The Final Inch (about polio eradication efforts, see the Google.org link below):
- Smile Pinki: Pinki, a girl in rural India whose cleft lip has made her a social outcast, has a chance for a new life when she meets a dedicated social worker.
- The Final Inch: Contributing to the global efforts to eradicate polio worldwide, dedicated individuals in India travel throughout the country urging parents to vaccinate their children against the disease.
Oscar’s past have been given to other global health related films -Born into Brothels which one the best overall documentary in 2004 – and it is good to see this continue. Megan Mylan, a UC Berkeley graduate, who also did the Lost Boys of Sudan, directed Smile Pinki, below are excerpts of an interview with her:
IDA: What inspired you to make Smile Pinki?
Mylan: As a filmmaker who focuses on social issue documentaries, it’s rare that I get into a film knowing we’re likely to have a happy ending. I was excited to tell the story of this beautiful hospital and a team of doctors and social workers treating their patients with such compassion and quality care and making a positive impact. I continue to be inspired by the simple idea that the better we know each other, the better this world is, and I hope people come away from my documentaries feeling like they better understand the life of someone living a very different reality.
IDA: What were some of the challenges and obstacles in making this film, and how did you overcome them?
Mylan: The biggest challenge for me was communicating and finding common ground with the patients and families in the film. Like many of the patients, Pinki’s parents are illiterate dirt-farmers. They had never seen a movie or met a foreigner. I really wanted them to understand my motivation for making the film and gain their trust. I worked with a great field producer, Nandini Rajwade, who along with Pankaj Kumar, one of the social workers in the film, patiently translated my conversations from English to Hindi to the family’s dialect and back, but it was still hard to know through the levels of translation that I was being respectful and clear. I chose to trust the sensitivity of my team and rely on eye contact and instinct.
Global health could certainly use more in the way of video, film, and other creative outlets that help spread success stories. Check out out previous post on global health video outlets.
Good read with insight into how Melinda Gates sets priorities for the Gates Foundation, also some fun tidbits with a more personal article, excerpts below (I should mention there has been some recent criticism of Melinda and the data she has cited on antimalarial efforts, see here and here):
- “without Melinda there would have been no Gates Foundation. She is the reason they focus so heavily on improving the health of the world’s neediest inhabitants.”
- “You have to be humble in what we are doing, but you also have to be bold,” she says. “You have to ask yourself, Are we going to feed people or sit behind ivory towers and argue about how to do it? I want people to live and to survive, so we will get out there and try something. If it doesn’t work, we will try something else. And we will keep trying until we find something that works.”
- “the philanthropy’s true power lies in its willingness to apply the merciless principles of the business world to charity.”
- “There won’t be any Gates Foundation grants for National Public Radio or the Metropolitan Opera. (For that matter, the foundation does not fund research into heart disease, diabetes, or many types of cancer, either, despite the fact that those diseases kill millions of people in the developing world. They also happen to kill millions of people in the developed world, and that means governments and pharmaceutical companies have all the incentive they need to address them.) Instead, Bill and Melinda Gates focus on problems that nobody else seems to care about.”
- “Melinda has become immersed in the financial-services issue, which she sees as an essential prelude to providing security and equality for women…“When a woman’s husband dies of AIDS in Malawi, she becomes the property of her brother-in-law,” Gates explains. “And he goes to collect all the assets. But they belong to her, and if she has the smart card, he will take it to the bank and demand the money. But the bank will say, ‘This is not your card; it’s not your account, because it’s not your thumbprint.’ He can’t get her money. And these cards,” she adds triumphantly, “have become so popular that they are the number-one wedding gift in the country.”
The above two headlines on global health funding flows and allocation caught my attention. The original study was published in PLoS Medicine. The article has some great figures (some of which I have reproduced below). A few things immediately stick out – the amount concentrated on HIV/AIDS, TB and malaria is astounding. Second the US is providing 70% of the funding and on the surface one could argue that other countries really could be pitching in more. On that note, the Gates Foundation by itself is out funding the European Commission almost 4 to 1 – if that isn’t embarrassing I don’t know what is. Finally, the US Department of Defense is high on the list (surpassing USAID). Interesting stuff:
“HIV/AIDS, tuberculosis and malaria initiatives accounted for about 80% of the $2.5 billion that was spent on research and drug development for developing countries in 2007… However, pneumonia and diarrheal illness, which are two major causes of mortality in developing countries, received less than 6% of funding.”
For Feb 2009 TrendWatching.Com focuses on “generation G” – the giving, generous generation that they think is baked in due to the ubiquitous development of online culture. I don’t agree with everything they have spotted, but it’s a really interesting piece worth checking out:
“GENERATION G | Captures the growing importance of ‘generosity’ as a leading societal and business mindset. As consumers are disgusted with greed and its current dire consequences for the economy—and while that same upheaval has them longing more than ever for institutions that care—the need for more generosity beautifully coincides with the ongoing (and pre-recession) emergence of an online-fueled culture of individuals who share, give, engage, create and collaborate in large numbers.”
In fact, for many, sharing a passion and receiving recognition have replaced ‘taking’ as the new status symbol. Businesses should follow this societal/behavioral shift, however much it may oppose their decades-old devotion to me, myself and I.”
Here is the outline of the piece:
1. Recession and consumer disgust
2. Longing for institutions that care
3. For individuals, giving is already the new taking and sharing is the new giving
8 Ways for corporations to join Generation G: co-donate, eco-generosity, free love… read the rest here.
From Giving in a Digital World, read their full detailed post, excerpt below:
“Play It Forward (named after the movie, presumably) is a start-up that plans to launch a new online giving platform next month, offering individuals or groups of individuals the opportunity to fund specific projects around the world.
Ok. Sounds just like another Global Giving? However, Play It Forward looks like it’s going to have some special aspects to it that could make it stand-out as a distinctive player in the online nonprofit project crowdfunding world…” More here.
Guest post by Khizer Husain, Owner of Shifa Consulting (see also previous post on healthcare in the Emirates)
Three Observations in Arab Healthcare Delivery
I attended the 34th annual Arab Health Congress in Dubai last week. This is the largest regional conference on healthcare. The event was massive: it drew more than 50,000 visitors and 2,300 exhibitors which span all facets of healthcare including care delivery, technology, consulting, staffing. According to the medical director in Abu Dhabi’s Sheikh Khalifa Medical City, ‘Our institution looks forward every year to Arab Health as a means of reviewing the latest technology; networking with suppliers and vendors and to update medical knowledge. The increased participation and attendance at Arab Health is of value to all of us in the healthcare field.’ Here are some observations on the delivery of healthcare in this part of the world:
Economic Downturn Putting Projects on Hold
The global financial meltdown has not spared the Middle East and the UAE in particular. There are many sites that are empty pits with cranes standing idle. Hospitals have put on ice new expansion plans. Overall, it is estimated that 8% of the labor force in Dubai has left the country in the last four months due to the worsening economic climate. I heard a couple of people talk about the thousands of cars that were left abandoned at the Dubai airport as people could not pay their loans and thought it best to flee the country. Up until last year, healthcare expenditures in the region were growing 16% per year and exceeding $74B.
The silver lining here is that global steel prices are down 75% and smaller construction projects at well-capitalized institutions can for the first time gain traction. A notable exception to the economic dip is Qatar. According to ArabianBusiness.com, Qatar’s economy (http://www.arabianbusiness.com/541046-qatar-economy-could-grow-by-10-in-2009) could grow 10% in 2009 as it expands exports of liquefied natural gas, making it the world’s fastest growing economy.
Thirst for World-class Standard of Healthcare
There is a strong desire in the Gulf to catch up to the healthcare levels of the industrialized world. Until just a few years ago, the only way to bridge the gap between what national populations desired and what was offered in their native countries, was to open the doors (wide open) to medical tourism. The UAE reportedly spent over $2B per year to ship its citizens to foreign countries for medical treatment. Not only were these expenditures unsustainable, but they put these countries at a competitive disadvantage for recruiting highly skilled expatriates. The only way to turn down the medical tourism spigot was to invest locally in building healthcare expertise. Due to poor perceived quality in local healthcare, stymied access to care, and perverse financial incentives to go abroad for care, medical tourism is still a powerful force.
Enter Multinational Healthcare Corporations
The landscape for international healthcare providers with business in the Middle East is becoming increasing crowded with the major players hailing from the US, Europe, and Canada. There seem to a few dominant models:
a. Market Destination Hospital: A number of institutions have outposts in the Middle East that they use to run clinics and make the necessary arrangements to funnel patients to the flagship entities. Mayo, Washington Hospital Center, University of Chicago follow this model. The Great Ormand Street Hospital in London sends in a rotational team of pediatric specialists to run clinics close to the patients.
b. Secure Management Contract: This is where the cash is. Running a tertiary hospital in the UAE can yield $6M per annum. The big players in this sector include Cleveland Clinic—which runs Sheikh Khalifa Medical City and will run the new Cleveland Clinic Abu Dhabi when it finishes in a few years. Johns Hopkins International has three affiliate hospitals in the UAE and a hospital in Beirut. UPMC runs the gamut of managing whole hospitals to managing individual departments like the emergency room. The Methodist has teamed up with property development company Emaar to create an outpatient clinic which they will manage—the Burj Medical Centre. Emaar has aggressive plans to expand clinics and hospitals throughout the Middle East and North Africa.
c. Joint Venture: South African Mediclinic obtained ownership share of Emirates Healthcare in 2007 for $53M. With two hospitals and three clinics in the pipeline, they are the largest private provider of healthcare in Dubai. Mediclinic derives nearly half of its profits from overseas ventures (in the Middle East and beyond).
While it is quite exciting to see all this development in healthcare, everyone agrees that the only way to have real, sustainable progress in region is to build an army of indigenous healthcare workers. Unfortunately, the curse of petrodollars is that it leaves little incentive for nationals to aspire to become nurses and doctors, let alone outstanding clinical managers. In the meantime, India and the Philippines serve as the golden geese.