Paul Farmer recently wrote in this space about Essential Surgery, the first volume released of nine expected in the Disease Control Priorities, 3rd edition series. He characterized that book as shining a spotlight on a long-neglected topic in global health and gave these reasons for the neglect: “Prevailing wisdom dictated that the surgical disease burden was too low, surgical expenses too high, and delivery of care too complicated.”
The latest evidence from a WHO report shows that global road death estimates have plateaued since 2007, at an unacceptable level of 1.25 million deaths per year. A different and bolder approach is clearly needed.
Three major areas require special attention: Africa and low income countries more generally, large middle-income countries, and sprawling urban centers.
Africa is the region with the highest death rates: at 27 deaths per 100,000 population in 2013, it was one and a half times the global average of 18. Road traffic fatality rates have actually increased in Africa over the past few years, despite decreases in other regions. More generally, Low-income Countries, which have just 1% of cars and 12% of the global population, nonetheless suffer 16% of total deaths from road crashes.
We also need to pay greater attention to middle-income countries like Brazil, China, and India which, due to their large populations and motorization rates, together contribute over 40% of the global deaths from road crashes.
Furthermore, by 2050, the world will add 2.5 billion people to our cities, which already account for about half of road fatalities. In the cities, attention to speed management and improving facilities for pedestrians, cyclists and motorcyclists is very important.
Just two weeks ago, the citizens of Sierra Leone celebrated the end of Ebola transmission in their country with cheering and dancing in the streets of Freetown. It’s a milestone worth celebrating in a country that has suffered nearly 4,000 deaths from the deadly virus.
People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.Although illegal in most countries, child marriage remains a common practice. Globally, about 39,000 girls are forced to marry each day; that's another child marriage every 2 seconds. It is often hidden from public discussion, as young girls and boys are often married early to alleviate their family’s financial burden or in hopes of securing a better future for them. While both genders are affected, child marriage disproportionately affects young females.
Few child brides stay in the classroom, which is unfortunate not only because these girls lose out on an aspect of self-development and exploration, but also because the loss of educational achievement prevents them from acquiring more lucrative jobs, thereby improving their household income. The World Bank’s 2012 World Development Report on Gender Equality and Development drew attention to the fact that the exclusion of girls and women from school results in a less educated workforce, inefficient allocation of labor, lost productivity, and consequently diminished progress in economic development. It also identified a multiplier effect: better educated women tend to be healthier, have fewer children, and provide better health care and education to their children, all of which eventually improve the well-being of all individuals and can lift households out of poverty. These benefits also transmit across generations, as well as to communities at large.
Nevertheless, in 26 countries, girls are more likely to be married before age 18 than enrolled in secondary school, according to a report, “Vows of Poverty”, from CARE. The report was released to mark International Day of the Girl on Oct. 11, 2015, and provides an overview of the forces driving young girls into marriage and out of school while also describing what can be done to reverse those trends. The following video is part of their campaign end child marriage for girls worldwide.
Violent conflicts, such as the one experienced by Sri Lanka, are caused by a variety of factors. Even when violent conflicts are concluded, the societies remain fragile. Fragility affects the demand for labour because firms and businesses are reluctant to invest. The poor quality of governance in affected areas further discourages private firms. But the Eastern Revival programme undertaken in Sri Lanka post 2007, enabled the fishing industry to rebound quickly. We look at how this was achieved.
As an intrinsically-optimistic Brazilian, my new assignment following India’s economy suits me well: India is one of the few bright spots in a somber global economy and is set to become the fastest growing large economy in the world. Our recently-released India Development Update projects India’s GDP will grow by 7.5 percent in the fiscal year ending March 2016, and by 7.8 and 7.9 percent in the following two years. Not quite the double-digit growth the Government would like to see, and to be sure there are significant uncertainties about the outlook, but an enviable state of affairs nonetheless.
What is driving the favorable momentum?
The drastic decline in global crude oil prices since June 2014 clearly played an important role. As a net oil importer, the halving of oil prices has been a bonanza for India. External vulnerabilities were greatly reduced as the lower oil import bill shrank the current account deficit despite anemic exports. Lower oil prices also helped contain prices of global commodities, and along with the RBI’s prudent monetary policy led to a significant decline in inflation. This in turn boosted real incomes in urban areas and allowed RBI to lower policy rates by a cumulative 125 basis points in the first nine months of 2015.
If you think about it, snow is a pretty amazing thing. It is nature’s way of storing water in the winter, and then using it in the summer when it is needed, namely during the growing season. If it gets too warm, the water does not stay locked up as snow till the summer. Too much warmth also means that more snow and ice may melt than usual, resulting in floods. But at the same time, if the water comes down the mountain too abundantly and too early, there may not be enough water during the growing season, causing drought-like conditions.
Kazakhstan, Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan are among the Europe and Central Asia Region’s most vulnerable countries to climate change. In these five landlocked Central Asian countries, water resources depend on glaciers and snow pack. In this region, we have already seen average annual temperatures increase since the mid-20th century by 0.5°C in the south to 1.6°C in the north, and impacts are already being observed, from melting glaciers in upland areas (where glaciers have lost one-third of their volume since the 1900s), to droughts and floods in the lowlands (where weather-related disasters are estimated to cause economic losses from 0.4 to 1.3 percent of Gross Domestic Product per year for Tajikistan, Turkmenistan, and Kyrgyz Republic, for instance).
The future looks even more challenging. According to a World Bank report “Turn Down the Heat: Confronting the New Climate Normal,” the region’s glaciers, which account today for 10 percent of the annual stream flow in the Amu Darya and Syr Darya basins, are projected to lose up to 50 percent in volume in a 2°C warmer world, and potentially up to 75 percent in a 4°C warmer world. Melting glaciers and a shift in the timing of rivers’ flow will result in a lot more water in the rivers but this excess availability will not be in sync with growing season’s water needs. In the second half of the century, there would then be too little water flow in the rivers when the glacier volume is reduced. The timing of peak flow of key rivers is projected to shift towards spring with a 25 percent reduction in flow during the critical crop growing season. The report also projects increased heat extremes which mean more of a reliance on irrigated agriculture (the report projects a 30 percent increase in irrigation demand) leading to an increase in water demand, exactly when water availability becomes more unpredictable. In this region, water is also connected to energy security, given the reliance on hydropower, creating further challenges.