Opinions: Malaria bed net concerns; Catholic Church's humanitarian work; Abortion, global health; Foreign aid reform; Canada's G8 initiative

May 4 2010

Problems With Bed Nets For Malaria Control

"To date, millions of dollars from international agencies, NGOs and USAID have been spent to get treated nets into the hands of impoverished, sub-Saharan Africans [to prevent malaria]. ... But, as even the staunchest advocate will admit, the treated nets were not designed with the cultural preferences of the rural African villager in mind," Sonia Shah, author of upcoming book about malaria, writes in a Los Angeles Times opinion piece.

Shah outlines some of the cultural reasons that prevent bed nets from being used in Africa and writes that "aid agencies and non-governmental organizations are quietly grappling with a problem: Data suggest that, at least in some places, nearly half of Africans who have access to the nets refuse to sleep under them." Though people in the West "see the treated nets as a lifesaving gift, [Africans] see them as a discomfort that provides only partial protection against a trivial illness," she writes before addressing the long-term sustainability of current efforts.

"Perhaps what we need is a whole new approach," Shah suggests. "Instead of masterminding solutions for distant problems and then handing them down from on high ... we should empower the poor to come up with their own solutions, and then help figure out how to implement them. Such a process might not lead to grand, magic-bullet solutions. More likely, we'd get micro-solutions, variable from locale to locale, from village to village. But we'd be supporting self-reliance and building goodwill along the way," she concludes (5/2).

The 'Two Catholic Churches'

In a New York Times opinion piece, columnist Nicholas Kristof discusses the Catholic Church's humanitarian work. "As I've noted before, there seem to be two Catholic Churches, the old boys' club of the Vatican and the grass-roots network of humble priests, nuns and laity in places like Sudan. The Vatican certainly supports many charitable efforts, and some bishops and cardinals are exemplary, but overwhelmingly it's at the grass roots that I find the great soul of the Catholic Church," he writes.

While Kristof writes that the Catholic Church is "so out of touch that it bars the use of condoms even to curb AIDS," he highlights the work of several nuns and priests, including Solidarity With Southern Sudan. "Sister Cathy [Arata of New Jersey] and the others in the project have trained 600 schoolteachers. They are fighting hunger not with handouts but with help for villagers to improve agricultural techniques. They are also establishing a school for health workers, with a special focus on midwifery to reduce deaths in childbirth," according to Kristof (5/1).

'Neutral' Abortion Position Avoids Divisions

In a Washington Post opinion piece reflecting on Secretary of State Hillary Rodham Clinton's position on Canada's G8 maternal and child health initiative, columnist Michael Gerson takes stock how a "culture war is breaking out in American foreign policy" over abortion and notes that "the political alliance on this issue [in global health] has always been fragile."

"Liberals need to understand - however strong their pro-choice convictions - how offensive many conservatives find the global health argument for abortion. ... If the Obama administration and global health advocates place abortion rights at the center of their development agenda, they will not only solidify conservative opposition on child and maternal health but will also undermine Republican support for development spending as a whole," Gerson writes. "Conservatives also need to show some flexibility to preserve the development coalition. ... Effective AIDS prevention is certainly more than just a bowl of condoms at the clinic door - but it includes the use of condoms during high-risk sexual activity," according to Gerson, who also makes the case for voluntary contraception.

"Though it has not pleased everyone, the recent consensus on development spending has been pro-life, or at least neutral on abortion, and pro-contraception ... Challenging either of these commitments may scratch an ideological itch, but it is likely to divide a movement, which could impose a cost on the poor and the sick that no one intends," Gerson concludes (4/30).

Obama Administration Should Offer Clear Vision Of Foreign Aid Reform

The Obama administration is "still trying to address" 21st-century foreign policy challenges "with a 20th-century toolkit," Raymond Offenheiser, president of Oxfam America, writes in a Foreign Policy opinion piece.

Offenheiser discusses the administration's efforts to address confusions in the existing foreign aid system and notes the Quadrennial Diplomacy and Development Review (QDDR). "But without a clear strategy, the QDDR promises to be an operational plan written in the absence of a guiding mission. By merely tinkering with the existing system without a clear a vision for what U.S. development efforts should achieve, the Obama administration could end up making things worse, not better," he writes. According to Offenheiser, "[t]he administration needs to step back and deliver a clear articulation of mission and strategy to guide reform - a National Strategy for Global Development." He goes on to list questions that the strategy should answer and what it might include.

"Currently, much time and effort is being invested in trying to figure out how to make sense of the [foreign aid system's] organizational chart and how to get all the agencies to talk to one another. But no one is articulating any sort of logic for what they should all be doing in the first place. Issuing an 'org chart' without first articulating a clear vision amounts to nothing more than stirring the spaghetti bowl. That would be a loss for both the Obama administration and millions of people living in poverty" (Offenheiser, 4/30).

Canadian G8 Maternal And Child Health Initiative Should Promote Reproductive Rights

"The G8 initiative must promote the reproductive rights of women. The public health evidence is clear and irrefutable: in areas where reproductive rights are respected, maternal outcomes improve. Providing safe and legal access to abortion is an important component of this," according to an Ottawa Citizen opinion piece by Valerie Percival, co-director of the Health and Foreign Policy Initiative at the Norman Paterson School of International Affairs at Carleton University.

"The G8 maternal mortality initiative must also strengthen local systems. ... While important, trained health workers are only one component of a health system. The G8 strategy must also pay attention to the organization, financing and governance of these services," Percival writes, adding that the G8 maternal health strategy "should also promote more effective management of global health initiatives and strengthen the capacity of developing countries to oversee these programs."

According to Percival, "[t]he Canadian initiative, as it stands, will not be fully effective or sustainable. ... Discussion on abortion has overshadowed the maternal health initiative. Yet the most effective health policies do not emerge from emotion - they emerge from public health evidence" (4/30).