Bush/Cheney and Global Public Health Challenges

Let's consider for a moment the article currently front and center on WaPo:

Bush Appointee Blocked Surgeon General's Draft

I don't yet have a copy of the report, but its draft includes the following:

"we cannot overstate . . . that problems in remote parts of the globe can no longer be ignored. Diseases that Americans once read about as affecting people in regions . . . most of us would never visit are now capable of reaching us directly. The hunger, disease, and death resulting from poor food and nutrition create social and political instability . . . and that instability may spread to other nations as people migrate to survive."

Yes. And without provoking a flame war by getting involved in the partisan debate associated with the release (or non-release) of this report, let me tie this article to the world's largest public challenge: unsafe water and inadequate sanitation. They are not only the world's largest public health challenges but also the most solvable.

Safe water is not gun control or abortion or Iraq. It is noncontroversial, and supported by all save a few rabid isolationists. So let's ask this White House to fully fund 2005's Senator Paul Simon Water for the Poor Act and include this request in their FY09 budget to Congress this fall. Further updates shortly on how the FY08 process is going, btw.

Water, Education, and American Express: priorities...

Just this morning I received an email from an old (I should say long-time) friend of mine suggesting I vote for the DonorsChoose project for education at the Amex Members Project contest here:

Members Project

She positioned DonorsChoose as the "David" and the UNICEF Children's Safe Drinking Water Project as the "Goliath," as does a recent interesting NY Times article here. My response to her (and to the dozens of other friends she had included in her To: line (most always a bad idea) was that Yes, UNICEF is large, but the word"Goliath" unjustly positions the Amex contest as a David vs. Goliath battle which fails to account for the real beneficiaries of both projects: children who either die from unsafe water or do not receive an adequate education.

Unsafe water is the #1 killer of children throughout the developing world. Period. Bad water kills five times as many kids as HIV/AIDS, twice as many as malaria. Period. More germane to this conversation: Without safe water, girl children in particular will not have the opportunity to enroll in school (they spend their childhoods either sick and hauling 45 pound buckets of dirty water on their heads). If their schools do not have single-gender sanitation facilities, they will drop out of school once they start menstruating and lack privacy. Safe water is in many cases the single biggest determinant of whether or not a girl receives an education.

For more information on the water/education nexus:

Water and Sanitation: The Education Drain (WaterAid)

The Education Millennium Development Goal: What Water, Sanitation and Hygiene Can Do

Water, Sanitation and Hygiene Education for Schools - Oxford Roundtable Statement

UNESCO – Focusing Resources on Effective School Health

Homo sapiens vs. "lower primates"

The Washington Post published a very interesting piece this weekend:

In an Eastern Congo Oasis, Blood Amid the Greenery
In Africa's Oldest National Park, Gorillas Are Being Killed and Their Guardians Are Endangered, Too

Plenty of justifiable disgust with poachers, and I agree with that. But poachers are the symptom of a much more grave problem, the insecurity of the local populations of homo sapiens.

As I commented on the WP site, "At the risk of starting a flame war, let me suggest that we see homo sapiens as part of the solution, not just part of the problem. The better off humans are in that part of the world, the less likely they are to threaten "lower" primates."

One of the most effective ways to enhance basic human security in many parts of sub-Saharan Africa is to see that the locals have sufficient access to safe drinking water and sanitation. As an example, see what Daryl Hannah is doing in Rwanda:

Daryl Hannah Turns It On for World Water Day

The more safe drinking water is available in human villages, the less frequently those humans need to encroach on gorilla habitat. The unfortunate reality is that when homo sapiens encounter other primates, homo sapiens typically win. We should do what we can to avoid those instances, as should the local and national government authorities in Rwanda, Uganda and elsewhere.

The one other thing I would add in this forum is that if human waste in the villages is treated properly (e.g. pit latrines), the more likely that the bodies of water supporting the gorilla habitats will remain at least relatively unspoiled, so it is important to not omit consideration of environmental sanitation as well.

And in the red corner - our next 2008 contender

Senator Sam Brownback, a longstanding friend of Africa and water, continued his committed leadership by speaking at a group of national water leaders organized by Water Advocates on World Water Day March 22, 2007. In a speech given at that meeting, Sen. Brownback stated that "[t]he global water crisis is currently one of the greatest public health issues, condemning billions of people to a perpetual struggle to survive at the subsistence level. It is unconscionable that in 2007 so many people are dying from waterborne diseases." Talk to me Senator - I need a subscription to that sort of thinking.

He continued with "the crisis is most prevalent in developing countries, especially in Sub-Saharan Africa and South Asia. Many women and young girls in rural areas in Sub-Saharan African and other parts of the world must walk miles every day to retrieve water for their families."

That's two 2008 contenders on board, 7 Democrats and 9 Republicans to go, I think.

Vote Early Vote Often

Get warmed up for November 4, 2008 by voting at:

American Express - Members Project

I suggest Children's Safe Drinking Water. It's a point-of-use water purification system from UNICEF et al.

Throw Money at It

The global safe drinking water, sanitation and hygiene crisis is one which can surely benefit from additional financial resources. There is little donor fatigue in this sector - there is simply a dearth of donors.

If the Wealth and Giving Forum last week in Greenbrier, West Virginia has its say that may soon be changing.

As Tom Watson reports in onPhilanthropy:

The gathering focused on issues surrounding water - from disease and poverty to environmental and security concerns - and participating families were asked a number of questions during a polling session about their attitudes toward philanthropy. Just half-way through the conference, they were asked whether they'd be more likely to give their resources to water-related issues; 80% answered affirmatively.

Of the high net worth individuals and foundations present, 80% are now more likely to give to water-related issues. I'll settle for that.

Unsafe water and inadequate sanitation, and the mortality (between 3-6 million people die each year from unsafe water) and the morbidity (each year there are over 4 billion serious cases of diarrhea) they cause, are not controversial issues. This is not gun control or immigration, and what is possible (and required) is a massive, nonpartisan response by both developing and developed countries. The scale of the solution must match the scale of the problem.

Where to Start in Africa?

William Easterly had an insightful piece "What Bono doesn't say about Africa" in the LA Times on July 6 which included:

...the typical African is a long way from being a starving, AIDS-stricken refugee at the mercy of child soldiers. The reality is that many more Africans need latrines than need Western peacekeepers — but that doesn't play so well on TV.

Couldn't agree more. The opportunities for education, health, poverty alleviation and real economic development which accrue to an individual who has a place to go to the bathroom are worth contemplating. Also worth contemplating, considering the overall pessimism regarding the potential of sub-Saharan Africa to reach the Millennium Development Goals, is the contribution that the provision of safe drinking water and improved sanitation (viz. latrines) makes to each of the other Millennium Development Goals. Much research exists to quantify the positive impact that safe drinking water and improved sanitation have on the MDGs on maternal and child health, education, poverty alleviation, gender equality and environmental sustainability. Some of the most clear findings on this are here.

The Greatest Story Ever Untold - the Impending Eradication of Dracunculiasis

Smallpox was declared eradicated in 1980, making it the first infectious disease to be wiped off the face of the planet. This is an amazing accomplishment for humanity, and deserves an appearance on the silver screen - anyone want to write the script? Start by talking to D.A. Henderson.

An equally dramatic but under-reported story is the impending eradication of Guinea worm, a parasitic disease directly related to unsafe drinking water and inadequate sanitation. The Guinea worm is a particularly unpleasant critter, with a nine month+ lifecycle that makes it difficult to control much less eradicate.

Eradication protocol differs from that of smallpox in that eradicating Guinea worm relies not on a vaccine but on simple, life-saving water and sanitation infrastructure and hygiene promotion activities: drilling boreholes, purifying surface water, and teaching people (primarily villagers in rural communities in nine African countries) not to enter bodies of water when they are infectious.

The Carter Center and others expect to completely eradicate this parasite by 2009. Succeeding in this will be a testament not to the Carter Center's good works per se but to the ability of the poorest communities in the world to solve their own public health challenges with minimum inputs from the international donor community. It will be a testament to the importance of basic water and sanitation as a foundation for overcoming all public health-related challenges and meeting the Millennium Development Goals. Its success will also give the polio eradication initiative of Rotary International a nice kick in the pants.

John Edwards first of 2008 U.S. field to tackle safe drinking water

Democrat John Edwards recently became the first (of many - stay tuned for reports on Brownback, Obama and others) of the 2008 U.S. presidential contenders to thoughtfully tackle the global safe drinking water and sanitation issue.

His campaign website includes the following commitment:

"Invest in Clean Water: The World Health Organization has found that every $1 invested in clean water yields an economic return of $8. Edwards will double the U.S. investment in clean water. He will also convene an international summit of government, businesses, and non-profits to agree on necessary investments to make water safe worldwide by 2015."

The return on that one dollar investment may be even higher in many instances as reported here. These are both direct financial returns to individuals, families and communities, as well as significant time savings and healthcare cost savings.

For a broader look at the 2008 field and what the candidates are doing to prioritize solutions to global health challenges and extreme poverty, check out One Vote '08.