Health Systems and the Emerging International Health Architecture

Host: Center for Global Development
Date: January 23, 2008
Speaker: Julian Schweitzer
UNDP-USA Representative: Saphonia Foster

In a discussion concerning health systems and collaborative efforts to improve international health initiatives, the World Bank’s Director of Health, Nutrition and Population, Julian Schweitzer, emphasized the need for horizontal integration. He stated that stakeholders in worldwide healthcare projects including the Gates Foundation, the European Union, the United States Agency for International Development (USAID), and other major global actors would be more effective if they fused their efforts into a simpler, joint system. Major actors such as the World Health Organization, the African Development Bank, and UNICEF, have signed this new inter-agency agreement called the International Health Partnership (IHP).

He stated that the too many fragmented global health organizations undermines the ability actors to relieve some of the world’s most ailing problems. IHP is a step forward to combating this stark reality.

The discussion was framed around, arguably, the most prominent driving force in international development today: the Millennium Development Goals (MDGs). With under-five death rates as a proxy measurement, Schweitzer illustrated that if progress toward the MDGs were to continue at the trends trailing back from 1960, then the world’s poor, including those in Asia, Africa, and other less developed regions, would still be plagued by preventable problems. This travesty calls for change.

In addition to convoluted programs that inhibit efficiency and lack of commitment to the MDGs, unpredictable funding flows also greatly undermine health care program success. To mitigate these setbacks, Schweitzer proposed a re-emphasis to the principles of the Paris Declaration. He noted that a clear shift in mentality where partnership, stable investment, and harmony between the different actors involved in international health issues should approach these problems from a similar mindset where achieving better health systems is the objective. This must include paying service to the priority of strengthening on the ground actors with grants, the potential for growth and innovation, the capacity to improve practices, and increased knowledge. This optimistic plan, the IHP, is possible only with support from a global alliance. This means calls for a commitment in civil society to work toward a stronger collaborative approach in improving health care worldwide.

Armed Conflict As A Public Health Problem: Current Realities and Future

Featured Speakers: Dr. Christopher Murray, Dr. Scott Barrett

Dr. David Bishai of the John Hopkins Bloomberg School of Public Health introduced the panel with a famous quote by 20^th century Dr. Albert Schweitzer, advising the audience to “Think occasionally of the suffering of which you spare yourself the sight”. Human suffering is rampant in places invisible to the vast majority of developed nations and it is with this blindness that we allow it to happen around the world, every single day. Recent research and analysis on armed conflict and human casualties suggests that if we can find a way to quantify and measure human suffering, we may be able to come to a better understanding of its causes and, subsequently, its prevention.

In 2002, Dr. Christopher Murray from Harvard’s School of Public Health published a now distinguished paper on conflict as a public health problem. One of the integral concepts presented is the fact that there are essentially two realities in evaluating this problem: the peace and security literature, and the public health literature.

Over the past 50 years, intrastate conflict has significantly increased, making civil conflicts much more prevalent than international war. Through this increase, there has been a steady decline in global number of battle deaths as the conflict itself does not incur large numbers of casualties. From the perspective of the Peace and Security Literature, this indication of low casualties seems to legitimize war because it appears to be a public health benefit. The problem with the analysis is the consideration of only direct mortality. In civil wars, indirect mortality is almost always the dominant cause of civilian deaths.

More recent and productive studies of casualties carried out by the WHO have consisted of the “Sibling Survival Module”. Following this module, surveyors go door-to-door and ask household members about the health status of their siblings to obtain information on disease and mortality incurred by conflict. Previously, epidemiological surveys had vastly underestimated conflict mortality. For example, in the Democratic Republic of Congo, war mortality estimates produced numbers two orders smaller than the eventually determined death counts. With the help of other organizations, the WHO has vastly improved its abilities to determine accurate statistics for conflict and post-conflict societies.

After Dr. Murray finished his presentation of the paper and more up-to-date research on the connections between armed conflict and public health, Dr. Scott Barrett from Johns Hopkins’ SAIS contributed to the event as a discussant. He stressed the fact that the Center for Disease Control has not considered conflict resolution as one of their main objectives, but should work to improve collaboration among organizations concerned with disease from varying perspectives. Exploring data from previous disease eradication efforts, Dr. Barrett concludes that these efforts are highly ineffective in conflict zones from case studies of polio in Somalia, Botswana and Nigeria. If we properly establish the root cause of a conflict through intergovernmental collaboration, we can produce analyses that lead to preventitive measures for the future.

Location and Sponsor: U.S. Institute of Peace
Date: April 20, 2007
Time: 2:00 – 3:00 pm
Approximate Number of Attendees: 25
Intern Attending: Elysa Severinghaus

World Population Day the Youth Surge

Tuesday June 11, 2006 2-4 PM

Speakers:
Opening Remarks: Richard Griffis VP of Programs UNA-NCA
Lester Brown, Founder, President and Senior Researcher, Earth Policy Institute
Carl Haub, Senior Demographer, Conrad Taeuber Chair of Public Information, Population of Reference Bureau
Professor Laurie Schwab Zabin, Population and Family Health Sciences, Bloomberg School of Public Health, John Hopkins University
Mushahida Adhikari, LL.B. LAWA Fellow-South Africa, Leadership Advocacy and Women in Africa Program
Moderator: Lawrence Smith, Jr., Ph.D. President, Population Institute

In the 1900s the world population was 1.6 billion; now it is 6.1, the same numbers but reversed “how convenient is that.” What we can say is the world is never going to be the same again senior researcher Lester Brown kept echoing. There is a crucial interrelation between food, water, and energy supplies. Water will have higher value than oil, and armed conflicts over water resources is already taking place in Pakistan and other conflicts and later it will emerge for food and other limited resources. In fact, we have only two choices left: stabilize population, higher mortality or lower fertility rates. Developed countries do not have significant population problems. It is the developed countries that account for 87% of the global population growth. It is alarming that it occurs in most failed states. Mr. Brown asked how many failed populations does it take to make a failed globe. It is the developed countries that have the precedence of knowledge and means to help developed countries understand the threats of overpopulations on sustaining economic development, food security, and stability. Also, to save our civilizations, political, religious, and economic leaders should have an understanding of the impeding crises of overpopulations. On the civil engagement part, people should choose political candidates that are concerned with saving the human civilization.
Carl Haub explained the demographic aspect of the current and the projected population in 2050. Dr. Laurie Zabin started by defining health to WHO in which health “is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Youth in developing countries constitute 3 billion of the world population; we need to give them education and hope. She added, “hope is the best contraceptive”. Adolescents should be provided with the knowledge of self-protection.
Mushahida is from South Africa. The main purpose of her speech was to describe the challenges she faces everyday trying to take her role in educating adolescents and friends about the importance of contraception and control over fertility rates and also to protect themselves.

by Youmna Diri