Syndicate content


Weekly wire: The global forum

Roxanne Bauer's picture
World of NewsThese are some of the views and reports relevant to our readers that caught our attention this week.

The State of Broadband 2015: Broadband as a Foundation for Sustainable Development
Broadband Commission
Broadband Internet is failing to reach those who could benefit most, with Internet access reaching near-saturation in the world’s rich nations but not advancing fast enough to benefit the billions of people living in the developing world, according to the 2015 edition of the State of Broadband report. Released today just ahead of the forthcoming SDG Summit in New York and the parallel meeting of the Broadband Commission for Sustainable Development on September 26, the report reveals that 57% of the world’s people remain offline and unable to take advantage of the enormous economic and social benefits the Internet can offer.

POWER PEOPLE PLANET: Seizing Africa’s energy and climate opportunities
Africa Progress Panel
Can the world prevent catastrophic climate change while building the energy systems needed to sustain growth, create jobs and lift millions of people out of poverty? That question goes to the heart of the defining development challenges of the 21st century, and is the focus of this year’s report. It is a vital question for Africa. No region has done less to contribute to the climate crisis, but no region will pay a higher price for failure to tackle it.

The things we do: How a simple text message is the difference between success and failure

Roxanne Bauer's picture

A woman and her child get the anti-malaria drugs distributed in Freetown.Mobile phones are increasingly prevalent throughout the world, and researchers have found that sending text message reminders can help people follow-through with their intentions, significantly increasing the success of development interventions.

“People need to be reminded more often than they need to be instructed.”

These are the wise words of Samuel Johnson, an English author, critic, and lexicographer.  Even though he lived more than 200 years ago, international development interventions are proving him correct today. 
Reminders for Malaria
It’s widely known that failure to adhere to a full course of antibiotic treatment results in treatment failure can also encourage bacterial resistance to antibiotics, threatening the sustainability of current medications. This is extremely important for malaria, which, according to the World Health Organization, results in 198 million cases each year and around 584,000 deaths.  The burden is particularly heavy in Africa, where around 90% of call malaria deaths occur and in children under 5 years of age who account for 78% of all deaths. Low rates of adherence to artemisinin-based combination therapy (ACT) treatments has led to prevalence of antibiotic-resistant Malaria in many parts of the world, particularly Africa.  One of the biggest and simplest reasons why people fail to complete the full treatment for Malaria is that they forget.

Thinking about stakeholder risk and accountability in pilot experiments

Heather Lanthorn's picture

ACT malaria medicationHeather Lanthorn describes the design of the Affordable Medicines Facility- malaria, a financing mechanism for expanding access to antimalarial medication, as well as some of the questions countries faced as they decided to participate in its pilot, particularly those related to risk and reputation.

I examine, in my never-ending thesis, the political-economy of adopting and implementing a large global health program, the Affordable Medicines Facility – malaria or the “AMFm”. This program was designed at the global level, meaning largely in Washington, DC and Geneva, with tweaking workshops in assorted African capitals. Global actors invited select sub-Saharan African countries to apply to pilot the AMFm for two years before any decision would be made to continue, modify, scale-up, or terminate the program. One key point I make is that implementing stakeholders see pilot experiments with uncertain follow-up plans as risky: they take time and effort to set-up and they often have unclear lines of accountability, presenting risk to personal, organizational, and even national reputations. This can lead to stakeholder resistance to being involved in experimental pilots.

It should be noted from the outset that it was not fully clear what role the evidence from the pilot would play in the board’s decision or how the evidence would be interpreted. As I highlight below, this lack of clarity helped to foster feelings of risk as well as a resistance among some of the national-level stakeholders about participating in the pilot. Several critics have noted that the scale and scope and requisite new systems and relationships involved in the AMFm disqualify it from being considered a ‘pilot,’ though I use that term for continuity with most other AMFm-related writing.
In my research, my focus is on the national and sub-national processes of deciding to participate in the initial pilot (‘phase I’) stage, focusing specifically on Ghana. Besides being notable for the project scale and resources mobilized, one thing that stood out about this project is that there was a reasonable amount of resistance to piloting this program among stakeholders in several of the invited countries. I have been lucky and grateful that a set of key informants in Ghana, as well as my committee and other reviewers, have been willing to converse openly with me over several years as I have tried to untangle the reasons behind the support and resistance and to try to get the story ‘right’.

What you don't know can hurt you: Malaria edition

Markus Goldstein's picture
You are feeling not so well.   You go to the doctor.   She is a good doctor.   She runs some tests, tells you nothing is wrong with you and you leave, ready to get back to work.   Why are you so much more ready to work now then you were before you saw your doctor?  

Malaria, Ebola, and Saving Lives

Quentin Wodon's picture

Last week, Mali announced a national strategic plan to scale up Community Health Workers in every region of the country. This initiative has the potential to save tens of thousands of lives, including significantly reducing the risk of an Ebola epidemic.
How was this achieved? Roll back a few years and meet Djeneba, a young girl living in Yirimadjo. Today she goes to school but her life was once threatened. Djeneba started getting high fevers but her parents did not have enough money to pay for care. They tried to break the fever by bathing her in herbal remedies and buying unregulated pharmaceuticals but the fevers persisted and became increasingly severe.

How Can Complexity and Systems Thinking End Malaria?

Duncan Green's picture

This is complexity week on the blog, pegged to the launch of Ben Ramalingam’s big new book ‘Aid on the Edge of Chaos’ at the ODI on Wednesday (I get to be a discussant – maximum airtime for least preparation. Result.)

So let’s start with a taster from the book that works nicely as a riposte to all those people who say (sometimes with justification, I admit) that banging on about complexity is just a lot of intellectual self-indulgence (sometimes they’re not so polite). We know what works, why complicate things? Hmmm, read on:

‘Kenya’s Mwea region is especially prone to malaria because it is an important rice-growing region, and large paddies provide an ideal breeding ground and habitat for mosquitoes. The application of insecticides and anti-malarial drugs has been widespread, but there has been a marked rise in resistance among both mosquitoes and the parasites themselves.

A multidisciplinary team developed and launched an eco-health project, employing and training community members as local researchers, whose first task was to conduct interviews across four villages in the region, to give a first view of the malaria ‘system’ from the perspective of those most affected by it.

The factors involved were almost dizzyingly large in number—from history, to social background, to political conflicts. A subsequent evaluation of the programme referred to this as an admirable feat of analysis.

Using a systems analysis approach that placed malaria in the wider ecological context was a critical part of the programme design:

Mosquito Nets in Kenya: Driving Africa’s Fastest Reduction in Infant Mortality

Kavita Watsa's picture

Growing up in India, mosquito nets were an essential part of life. I slept under them as a child in Bangalore, with their ropes tied to bedposts, doors, closets, window grills—anything that would offer support at the right height. It was like pitching a tent every night, and the occasional dramatic collapse would result in much helpless laughter. Later, going to college on the banks of the slow-flowing Koovam river in Madras (now Chennai), I tucked myself under a net in my dormitory at about 6 p.m. to avoid the twilight assault of mosquitos from the water. In fact, particularly after a bad attack of malaria when I was a child, a lot of my life was lived perforce under a mosquito net, until electric repellent gadgets reached the market and nets somewhat lost their popularity.

Recently, sitting in Halima Ibrahim’s house in Majengo, a neighborhood in the coastal city of Mombasa, and talking about the new mosquito nets her family had just received from the Kenyan government, I felt instantly at home in her tiny living room. It was packed from corner to corner with family and friends, all brimming with opinions about nets old and new. Everybody talked about malaria and what a problem the disease was in the community. The nets that had just been distributed to them free of cost would make a huge difference, they said, protecting them from being bitten by mosquitos, and saving them considerable expense. Many of the families on the street simply could not afford to buy durable and effective nets at the prices they commanded in the local market.

Weekly Wire: the Global Forum

Kalliope Kokolis's picture

These are some of the views and reports relevant to our readers that caught our attention this week.

Cell Phones can speed up malaria treatment in remote areas

“Mobile phones along with local knowledge and field support, can help to ensure the effective diagnosis and treatment of malaria in remote rural areas, according to a study in Bangladesh.

Researchers examined almost 1,000 phone calls to report suspected cases of malaria that were made over two years by inhabitants of a hilly and forested part of the country bordering Mynamar. This area, called the Chittagong Hill Tracts, has Bangladesh’s highest malaria rates.”  READ MORE

Dying from malaria in the market for lemons

Markus Goldstein's picture

We know malaria is a big problem and we know fake drugs are a big problem.   What do you get when you put them together?   Bad news.   A recent paper by Martina Bjorkman-Nyqvist, Jakob Svensson and David Yanagizawa-Drott (ungated version here) shows how bad this problem is in Uganda, and provides an innovative way to deal with it.

How does Africa fare? Findings from the Global Burden of Disease Study

Patricio V. Marquez's picture

The Global Burden of Disease Study 2010 (GBD 2010), a systematic effort to assess the global distribution and causes of major diseases, injuries, and health risk factors, was launched last week in London. 

And a special issue of The Lancet has published its results (

What are some of the main findings for Africa that can be drawn from the GBD 2010?

  • Since 1990, the largest gains in life expectancy worldwide occurred in sub-Saharan African countries, especially in Angola, Ethiopia, Niger and Rwanda, where life expectancy increased by 12-15 years for men and women. Overall, male life expectancy increased from 48.8 in 1990 to 53.2 years in 2010 in central sub-Saharan Africa, 50.9 to 59.4 years in eastern sub-Saharan Africa, and 53.0 to 57.9 years in western sub-Saharan Africa.