Opinions: Global health top foreign policy issue; Global food security; Opiate-substitution programs in Eastern Europe; Feed the future; Foreign aid lessons

Jan 7 2011

Global Health Is A Top Foreign Policy IssuesFor 2011

In response to a story examining 2011's top foreign policy issues, Serra Sippel, president of the Center for Health and Gender Equity, writes in a letter to the editor, published in The Hill, that "[g]lobal health was disturbingly absent from" the story. "Global health policy is at a critical turning point right now with the impending implementation of President Obama's Global Health Initiative, which will change our fundamental approach to health programs and policy," according to Sippel.

Sippel writes that last month's defeat of a bill aimed at preventing child marriage in the developing world was an example of "politicizing global health, particularly women's health," instead of an effort to "mak[e] sure U.S. assistance is spent wisely." The letter concludes: "There is great need for improved efficiency in the foreign assistance budget, as there is with all areas of government. Yet we cannot mistake funding cuts for increased efficiency. Failure to fully fund necessary programs that benefit entire communities and countries - such as voluntary family planning, child marriage reduction, maternal health and HIV/AIDS prevention and care - would be a setback. Given all that is in motion and all that is at stake, global health policy should be on everyone's top five foreign policy issues list for 2011" (1/5). 

G20 Must Take 'Practical Action' To Ensure Global Food Security

"The G20 should agree to put food first - because food is the essence of life, and because practical action by the G20 could help make a real difference to hundreds of millions of people," World Bank President Robert Zoellick writes in a Financial Times opinion piece. Zoellick notes the U.N. Food and Agriculture Organization's recent index showing a jump in food prices and writes that "rising prices are re-emerging as a threat to global growth and social stability."

"The overarching goal should be to ensure that the most vulnerable people and countries are no longer denied access to nutritious food," according to Zoellick. He goes on to list several "practical and interconnected steps" aimed at achieving that goal. Among the recommendations, he includes: "Improve long-range weather forecasting and monitoring, especially in Africa. ... Establish small regional humanitarian reserves in disaster-prone, infrastructure-poor areas. ... Agree on a code of conduct to exempt humanitarian food aid from export bans. ... Help smallholder farmers become a bigger part of the solution to food security." He concludes: "The answer to food price volatility is not to prosecute or block markets, but to use them better. By empowering the poor, the G20 can take practical steps towards ensuring the availability of nutritious food" (1/5).

Eastern European Governments' Indifference To Opiate-Substitution Treatment Programs Threatens HIV Control Efforts

In a Project Syndicate opinion piece, Jon Cohen, the author of Shots in the Dark: The Wayward Search for an AIDS Vaccine, looks at why governments in Eastern Europe haven't widely adopted opiate-substitution treatment programs to prevent HIV/AIDS among injecting drug users (IDUs), even though the WHO, the U.N. Office on Drugs and Crime, UNAIDS and the U.S. Institute of Medicine have come out in favor of such treatment. In Eastern Europe, "leftover Soviet distrust of outsiders colors many opinions, and there's an oft-repeated claim that the culture is different: an intervention that works in the West might fail in the East. There is also a suspicion that dirty capitalist pigs want to profit from the sale of opiate substitutes, regardless of whether they work," he writes.

"This is as silly as contending that antiretroviral drugs won't work in the region, and that treating HIV is all a giant plot on the part of big pharmaceutical companies," according to Cohen. "Playing ostrich about harm reduction does not harm only IDUs. HIV-infected IDUs of course have sex with non-users," he writes. Cohen notes the "Vienna Declaration," which endorsed harm reduction, "gathered more than 10,000 signatories. But the most influential Eastern European signatory was the First Lady of Georgia, a country whose estimated 2,700 HIV-infected people account for just 0.018% of the regional total. Judging by their governments' indifference, the remaining 99.982% of the HIV-infected people in Eastern Europe - and all those they place at risk of harm - can just rot," he concludes (1/4).

USG Editorial Highlights Feed The Future

A VOA News editorial reflecting the views of the U.S. government discusses the Feed the Future initiative, noting that the "QDDR also made it clear that USAID will be the lead agency" to oversee the initiative. The editorial references USAID Administrator Rajiv Shah's recent interview with ABC News' Christiane Amanpour. "Feed the Future, a whole-of-government initiative launched by the Obama Administration, is aimed at helping countries produce more and higher quality local foods, said Dr. Shah. It's about finding ways to improve the nutrition of children under the age of two and pregnant women, so that they get better micronutrients and sufficient proteins. In doing so, said Dr. Shah, we are reinvesting in agriculture to essentially create the conditions that allow us to move away from food aid and allow countries to take care of their own people and their people's nutrition and welfare," the editorial states (1/3).

Five Lessons In Foreign Aid

In a Foreign Policy opinion piece, Paul Farmer, a medical anthropologist at Harvard University, lists five foreign aid lessons stemming from the earthquake in Haiti last January. The first lesson is: "Jobs are everything." According to Farmer, "All humans need money - they need it to buy food and water every day. And no matter how hard the government or the aid industry tries, people will want for all three things until they are employed." The second lesson focuses on the importance of working with a country's government. "The international community doesn't know best. Local people do. ... We don't have the expertise, and we won't stay forever. We don't have the same stake in building a community that the locals themselves have," he writes. "Give them something to go home to" is lesson number three. "Enticing them to return home will mean providing exactly what they lacked before: housing, education, and health care," Farmer writes.

The fourth lesson is caution against wasting funds: "At least half of aid money probably never reaches its recipients, eaten up by overhead; often it's even more. I know of no other business or enterprise in which this would be an acceptable operational strategy." His final point is about the long-term challenges after a disaster. "Disaster relief is not reconstruction. ... What's most important in getting started? Economic growth. Yet it is a challenge hardly mentioned in aid documents or strategies," he writes (December 2010).