CGIU 2009 – Jon’s Impressions

I thought that this year’s Clinton Global Initiative University was a really impressively run conference where I had the opportunity to meet an incredible number of equally impressive students who were passionate about making a positive change in the world. However, I can’t help but feel that there were many things missing. Sure, President Clinton showered us with praise for our commitment and energy, he paraded around his celebrity friends, and he threw one hell of a party, but I felt that what the events had in glitz and glamor, they lacked in substance and depth.

A frequent refrain was that the conference was an opportunity to focus on the “how”: how can we as students go out and build a better world. Unfortunately, the conference was completely lacking in any conversation of the “why”: Why is the world the way it is? Why is it that a person in Zambia is expected to live until their mid 30′s while the Japanese live to be more than 80? Why should we as students even engage in these issues?

I think that the question, “why?” must be the starting point for any well planned student led initiative in global health or development. This is because insightful reasons for why the world is how it is must inform and drive how we proceed with our intervention. If we fail to think about why the world is unequal, unjust, unsustainable, and unstable, then we are much more likely to create “solutions” that unintentionally perpetuate or reinforce the very harmful social structures that we are trying to dismantle.

I guess I just feel like these are immensely complex problems which will require equally complex solutions. The CGIU did not reflect this reality at all, and infact, it presented global problems as having relatively simple, one step solutions. If anything, the conference reinforced the idea that by the virtue of being young, American, wealthy, and powerful: we can walz in anywhere and simply fix stuff. Ivan Illich is rolling in his grave.

Clinton Global Initiative University

Your trusty student-bloggers just arrived in Austin, Tx for the second annual Clinton Global Initiative University. Hopefully, it will be an opportunity to meet,  network, and learn with a ton of smart and motivated university students who want to build a better world.

We’ll be trying to throw up a few daily posts about panels that we attend, interesting discussions that we have, as well as progress that we are able to make on our “commitment to action.” Our commitment to action is to create a student-led seminar at Northwestern titled “Student Engagement for Global Health Equity.” We’ll be discussing more about this as well over the coming days. Stay tuned!

The Old Salary Question

A few months back, a commentary on a NYT op-ed noted that the argument about whether people ought to be allowed to make good salaries while working with charity organizations is ultimately harmful to the work that needs to be done:

This is not something about which reasonable people should disagree. The attitude that professionals should not get paid what they are worth is poisonous to aid programs. Aid organizations have jobs to do. Doing that work costs money. They may be funded by donations, but that doesn’t mean they don’t have to pay for stuff! No one thinks that it’s immoral for NGOs to pay market rates for food, or plane tickets, or socks. Why is it worse for them to pay market rates for professional expertise?

Certainly, just as it is ridiculous to expect community health workers in poor countries to not be paid for their work, it would be ridiculous to ask that nonprofit professionals, managers and executives in the U.S. to not receive reasonable salaries as well.  The problem, arises when the driving motive becomes profit (though there may be a time in the future where Muhammad Yunus’ world of ‘social businesses’ rule the day, we have a long way to go in righting injustices from the past, first).  Taking a Kantian view of things, ultimately  it is the motivation that matters in ending poverty. Nonprofit work must be driven at the core by a sense of equity. When this fundamental motivation starts to get clouded by other things – be it personal ambition, money or the overwhelming state of the world that makes us think that some things “just can’t be done”- then we start to run into the problems we’ve seen so many times in global health, from the arguments a decade ago about whether Africans could receive AIDS treatment to today’s parallel arguments about why African mothers with H.I.V. should breastfeed.

Nonprofit professionals should get paid. But the reason for being a nonprofit professional must continue to be based in a sense of justice.

Quote for the Day

“But the poor person does not exist as an inescapable fact of destiny. His or her existence is not politically neutral, and it is not ethically innocent. The poor are a by-product of the system in which we live and for which we are responsible. They are marginalized by our social and cultural world. They are the oppressed, exploited proletariat, robbed of the fruit of their labor and despoiled of their humanity. Hence the poverty of the poor is not a call to generous relief action, but a demand that we go and build a different social order.”

- Gustavo Gutierrez

Recommendations for the New Administration

Six of the leading organizations in the fight for global health equity have come together to publish a white paper proposing a set of global health recommendations for the Obama Administration.  The paper focuses on how meeting the MDGs (which Obama has pledged to support) can help advance equity in global health:

The MDGs are well suited to serve as benchmarks of success or failure in achieving universal health equity. The inter-related dynamic of health and poverty underlines why any serious effort to eliminate poverty must place a strong focus on health, and why a focus on health best highlights the connections between the MDGs.

The paper highlights a number of key areas which the administration should drive forward improvements including:

• Commit to a comprehensive approach to health
• Address inefficiency in aid
• Build local & national capacities of countries
• Redefine foreign aid policy and goals (including the role of the U.S. Department of Treasury and IMF policies)
• Recognize the full scope of human rights by ratifying a number of currently signed treaties  such as:  The Convention on the Elimination of All Forms of Discrimination Against Women,  The International Criminal Court, and The Kyoto Protocol

There is a long-overdue need for the U.S. to provide at least it’s committed share of 0.7% of its GDP to countries that actually need it. But, while achieving the MDGs are a good first step, what is ultimately needed is the type of foreign aid that reflects justice after years of structural violence and oppression of the world’s poorest by countries like our own.

(The six organizations who prepared the recommendations  are: Partners In Health; Harvard’s FXB Center for Health and Human Rights; Physicians for Human Rights; Health Alliance International; RESULTS; and ActionAid International.)

Poisonous Medicine in Nigeria

The New York Times reported today that at least 84 have been killed and many more have been made sick by a medicine called ‘My Pikin Baby Teething Mixture’ that was tainted with the industrial solvent diethylene glycol. Diethylene glycol is also used in antifreeze and brake fluid.

Diethylene glycol has figured in mass poisoning cases across the globe. In Panama, 365 people were killed after taking medicine inadvertently tainted with the chemical in a government factory in 2006. The sweet but deadly syrup was labeled glycerin, but it was in fact diethylene glycol from a factory in China. Dozens of children in Haiti died a decade ago after taking contaminated medicine for fevers. In 1990, 109 children died in Nigeria after taking medicine tainted with a similar compound.

Nigeria’s often lax enforcement of counterfeiting laws and its corruption-riddled bureaucracy left the country’s pharmacies full of tainted or fake drugs for decades. But since democratic rule returned in 1999, the government has been cracking down on makers of counterfeit or dangerous medicine.

This tragic case provides another example of how complex, and often harmful, our globalized economy can be. In the US, we have had to grapple with the question of how to deal with products tainted with harmful substances produced in China. Considering that it has been a struggle for the United States – with massive and powerful regulatory agencies – to guarantee safe imported foods, medicines, and toys, imagine how impossible it must be for a struggling (some may say corrupt) democracy such as Nigeria to guarantee safe products for its population. I think that this is another example of how the current global economic structure contributes to the harm of people living in poor countries.

Quote for the day

¡Hoy decimos basta! Today we say enough is enough! To the people of Mexico, Mexican brothers and sisters: We are a product of 500 years of struggle – first against slavery, then during the War of Independence against Spain led by insurgents, then to promulgate our constitution and expel the French empire from our soil, and letter [when] the dictatorship of Porfirio Díaz denied us the just application of the Reform laws and the people rebelled and leaders like Villa and Zapata emerged, poor men just like us.  We have been denied the most elemental education so that others can use us as cannon fodder and pillage the wealth of our country.  They don’t care that we have nothing, absolutely nothing, not even a roof over our heads, no land, no work, no health care, no food, and no education.  Nor are we able freely and democratically to elect our political representatives, nor is there independence from foreigners, nor is there peace or justice for ourselves and our children.

- Comandancia General del Ejército Zapatista de Liberación Nacional, 1993

Video for the day: Stephen Lewis, IAS 2006

New Global Health Magazine: tackling the global food crisis

Just got an email from the Global Health Council about their new Global Health Magazine. I think its an interesting idea trying to use a more traditional form of media to publicize global health issues. However I doubt that its popularity will extend much beyond global health nerds such as myself and those of you reading this blog.

Its inaugural issue focuses on the global food crisis and how the failing economy has exposed more and more people to the risk of going hungry. In an interesting article How did we get here?, Peter Timmer analyzes the major factors which have driven up the price of staple foods since 2007. He see three major, interrelated factors that are to blame:

1. Rapid economic growth and structural transformation, especially in China and India, put pressure on a variety of natural resources such as oil, metals, timber and fertilizers. Demand simply increased faster than supply for these commodities, and prices for non-food commodities climbed steadily after 2004.
2. A sustained decline in the U.S. dollar since mid-decade added to the upward price pressure on dollar-denominated commodity prices directly, and indirectly drove a search for speculative hedges against the declining dollar—often in commodity futures.
3. A combination of high fuel prices and legislative mandates to increase production of bio-fuels established a price link between fuel prices and ethanol/bio-diesel feed stocks—corn in the U.S. and vegetable oils in Europe. The legislative mandates in both the U.S. and Europe stem from longstanding efforts to increase agricultural prices in these rich societies to ease the pressure of rapid structural transformation on their rural economies.

But, he fails to mention subsidies provided to American farmers, which has allowed cheap grain to be dumped in poor economies and has prevented small scale farmers in poor countries to be able to compete in the global market. Hasn’t this devastated domestic food production in these poor countries? Was this not a significant factor that set the world up for a global food shortage? I don’t know that much about the topic, and would love to see some discussion!

60,000 Cases of Cholera in Zimbabwe

The BBC reports that this is the “worst case scenario” for a people who have endured some unimaginably horrible scenarios. Over 3,000 people – mostly young children and babies – have died. See the epidemic in pictures here. This come along with news that Zimbabwe has completely abandoned its currency:

BBC southern Africa correspondent Peter Biles says the Zimbabwean dollar has become a laughing stock. A Z$100 trillion note was recently introduced.