Showing posts by Gib Clarke.
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Gates: More Money for Global Health Is Good for the Environment
›January 28, 2010 // By Gib Clarke
Bill Gates gave the PHE community a much-needed upgrade in his foundation’s 2nd Annual Letter, released this week. Unfortunately it still has a few bugs.
“In the long run, not spending on health is a bad deal for the environment because improvements in health, including voluntary family planning, lead people to have smaller families, which in turn reduces the strain on the environment,” concludes Gates.
This statement could dramatically raise awareness of and funding for population-environment programs. Any time Bill Gates talks, the world listens, as evidenced by the barrage of coverage from Reuters, AFP, and top IT newswires. For the public, it offers a rare glimpse into development strategy, so Gates’ thoughts (and financial commitments) could be seen as representative of the foundation community’s approach to global health problems.
Although it may seem obvious that fewer people place less strain on the environment, this connection has been largely absent from the environmental agenda, including the efforts to combat climate change. Some environmental leaders and organizations have dismissed population as an unimportant distraction from the real business at hand. Others have noted that population growth’s impact on climate change is far greater in the rich world than in poor countries, whose per capita emissions are a fraction of developed countries’.
Gates’ comment may cause those in the first camp to re-evaluate the importance of family planning, and it is likely to energize the converted. But it will have less impact on those focused on consumption. But if it encourages the environmental community to put population and family planning issues back on the table, it will have gone a long way.
However, Gates could have gone further, by explaining that family planning is a relatively inexpensive way to mitigate climate change, compared to complex and emerging technological solutions. He also could have pointed out that climate change is expected to increase the prevalence of vector-borne diseases such as malaria, or that sick or malnourished individuals may be forced to mismanage natural resources.
Because Gates didn’t make these explicit connections, many in the media missed his point. The wire headlines pit health against environment, when Gates was in fact pointing out how interdependent they are. This distortion is symptomatic of the media’s tendency to highlight the horserace. But maybe they would pay closer attention if the Gates Foundation put its money where its mouth is—and funded programs that integrate family planning and the environment.
Perhaps several years from now, we will look back and say that this letter marks the start of the Gates Foundation’s integrated approach to development. But we may need to wait for Letter 3.0 for a complete install.
Photo: Courtesy Flickr User World Economic Forum -
Welcome Back, Family Planning
›January 8, 2010 // By Gib Clarke“When women and girls have the tools to stay healthy and the opportunity to contribute to their families’ well-being, they flourish and so do the people around them,” Secretary of State Hillary Clinton declared today in a speech renewing U.S. support for universal access to reproductive health services and supplies around the world. “Investing in the health of women, adolescents, and girls is not only the right thing to do; it is also the smart thing to do.”
Introduced by Melanne Verveer, the first ever ambassador-at-large for global women’s issues, Clinton’s much anticipated statement marked the 15th anniversary of the International Conference on Population and Development (ICPD) and reconfirmed a U.S. commitment to meeting Millennium Development Goals 4 (reducing child mortality) and 5 (reducing maternal mortality and increasing the proportion of births attended by skilled health personnel). Reproductive health and development luminaries Nafis Sadik, UN Foundation President and former Senator Tim Wirth, and newly installed USAID Administrator Rajiv Shah were also in attendance.
Clinton began with a look back to the ICPD—which she called the “first ever global forum that recognized the connection between women’s health, the quality of women’s lives, and human progress on a broader scale”—and the progress since. Declaring that “we have made measurable progress since 1994 in improving the health and the lives of women and children, especially girls,” she cited a number of improvements, including higher child survival rates, use of modern contraceptives, and female education enrollment.
Switching from the past to the present, Clinton described how women and girls continue to bear the brunt of a variety of social ills: they have higher rates of poverty, illiteracy, and malnutrition, and are the most adversely affected by conflict, “from the Congo to Bosnia to Burma.”
After reciting the data on unsafe abortions, STDs and HIV/AIDS, fistulas, and female genital cutting, she declared that “these numbers are not only grim…they are intolerable.” She added, “We can not accept it morally, politically, socially, economically.”
But Clinton’s remarks were not solely focused on health and family planning issues. Echoing arguments made by Nicholas Kristof and others, Clinton described how women’s health and women’s rights directly and significantly impact most major problems in the world, including economics, natural resource conflicts, and national security.
These challenges will require sustained effort and funding, said Clinton, adding that the Obama Administration’s $63 billion Global Health Initiative would address the health challenges of HIV/AIDS and maternal and reproductive health in an integrated manner. All of the administration’s programs would seek to help countries strengthen their own health systems to meet their unique needs—both of their women and girls, but also their populations in general. In all of these efforts, she said including men and boys as “advocates and allies” remains important.
Praise for the speech has been swift—a letter of commendation from a number of foundations was sent to the secretary immediately afterwards.
Maternal and reproductive health have experienced elevated and perhaps unprecedented funding and attention in recent years, especially over the last few months. Secretary Clinton’s impassioned speech is almost certain to keep this momentum alive.
Photo: Courtesy SEIU International -
‘DotPop:’ Copenhagen’s Collapse: An Opportunity for Population?
›December 22, 2009 // By Gib ClarkeWhile the negotiators failed to reach a comprehensive agreement in Copenhagen, the population and reproductive health community might find a silver lining in the stormclouds that derailed COP-15.
Developing countries’ strong protests of their lack of culpability for the climate problem, on one hand, and the dramatic examples of their vulnerability on the other, have focused the world on the problems of poor people—and on potential solutions, including family planning.
The Case of the Missing “P”
The New York Times’ Andrew Revkin complained that population was the “The Missing ‘P’ Word in Climate Talks,” but PAI’s Kathleen Mogelgaard argues in New Security Beat that “there is encouraging evidence that voices of those advocating for increased attention to the role of population and reproductive health and rights in climate change responses are being heard” in Copenhagen, including new funding from the Danish government for family planning.
At a breakfast last week, luminaries including Gro Harlem Brundtland and IPCC Chairman Rajendra K. Pachauri discussed UNFPA’s latest report, Facing a Changing World: Women, Population and Climate in Copenhagen.
According to lead author Robert Engelman, the report is “helping many more people to see population and climate in a more hopeful light, linked as they are through the right of women to equal standing with men and access to reproductive health care for all.”
Women, Population, and Climate
“Climate change is ultimately about people,” declared Congresswoman Carolyn Maloney at the recent Washington, DC, launch of the report. Though the issues are complex and multi-faceted, Engelman said that the report’s message is “stark and optimistic”: that “women in charge of their own lives” can have positive impacts on change climate mitigation and adaptation.
“Women are more sustainable consumers,” said UNFPA’s José Manuel Guzmán at the launch, noting that in many cases women make buying decisions for their families, so empowering them with information and tools is a wise approach to combating climate change.
Inequitable Impacts
Women – especially poor women – contribute fewer greenhouse gas emissions than men, yet are more vulnerable to the impacts of climate change. Unfortunately, this fundamental inequality is difficult to quantify, since most data sources are not disaggregated by gender. The report recommends improving data quality to better informing policy decisions.
Tim Wirth, president of the UN Foundation and the Better World Fund, noted that women face a “double whammy”: they are already less likely to go to school and to have access to paying livelihoods, and more likely to have HIV. Climate change will only increase the inequity.
People Power
PAI’s Karen Hardee called on the population community to focus their efforts on the next phase of negotiations – adaptation. A recent PAI report found that while 37 of 41 National Adaptation Plans of Action say that population pressures exacerbate the effects of climate change, only six include slowing population growth or addressing reproductive health and family planning as a key priority.
“The focus has been on where and what the impacts of climate change will be,” said Guzman, but the conversation needs to shift to who will be affected, and an analysis of their vulnerabilities and their capacities to adapt.
For real progress to occur, said Engelman, “climate needs to be seen through a more human lens.” -
Missives From Marrakech: Growing and Slowing, and a Letter From the King
›October 5, 2009 // By Gib ClarkeHere in Morocco, where I am attending the IUSSP conference on population, if you never went to elementary school or if you married at a young age, you are likely to have more children.
A Bangladeshi couple is more likely to have a third child if they have 0-1 sons, but a European couple is increasingly likely to prefer daughters because they take better care of their aging parents.
Globally, a forthcoming Harvard study shows that the “Reproductive Health Laws Index”—which includes the legal framework governing abortion, condoms, IUDs, and birth control pills—can predict fertility (more liberal laws = fewer children) and potentially increase female participation in the labor force.
Such causes of population growth are favorite topics for demographers and family planning experts here at the conference, and were quite well attended. However, perhaps due to the large number of European attendees, the panels on this popular topic were empty in comparison to those examining aging, fertility decline, and migration—issues at the forefront of European policymakers’ agendas.
A Message From His Majesty
“One of the characteristic features of our population policy stems from our firm belief that [its] impact … cannot be determined in isolation from economic, social, cultural and political factors,” wrote Morocco’s King Mohammed VI in a welcome letter delivered to the conference, which also discussed aging, climate change, food security,natural resource scarcity, the economic crisis, and growing levels of income inequality.
Morocco is taking steps to tackle this complicated set of problems. The government has launched a National Initiative for Human Development to fight poverty and social inequalities, and help Morocco meet the Millennium Development Goals (MDGs). He also notes that the country’s “political and social reforms aimed at increasing the scope of democratic participation and ensuring the advancement of women.”
Like all leaders, Morocco’s will be measured not by his words—eloquent as these may be—but by his deeds and the country’s progress. Morocco has some work to do to reach the MDGs and other social and economic goals. -
Missives From Marrakech: Enter the Environment
›October 2, 2009 // By Gib Clarke
“Contraception is the cheapest way to combat climate change,” read the headline of The Telegraph in mid-September, announcing the release of “Fewer Emitters, Lower Emissions, Less Cost,”a study from the Optimum Population Trust (OPT) and the London School of Economics (LSE). Similar stories appeared in newspapers around the world.
Though there has been near-universal agreement that the OPT-LSE paper oversimplifies the link between demography and climate change, the buzz among the family planning and environment communities has continued during the IUSSP conference in Marrakech. Perhaps this is because demographers are not used to appearing in the press except when discussing census results. More likely it is the timing of the report, with the Copenhagen conference on climate change coming in December.The buzz hit a peak on Thursday at the IUSSP, with a plenary presentation examining the links. Wolfgang Lutz jumped right in, noting that it’s not as simple as the OPT-LSE study makes it. Population growth is important, but size is not the only thing that matters; other aspects such as age distribution, household structures, and levels of urbanization come into play as well.
In addition, between population size and climate change lie a number of intermediary factors, such as consumption levels, technology improvements, and greenhouse gas (GHG) emissions. Lutz argued that demography has a unique contribution to make to the climate discussion, for no other discipline understands the composition of different populations in different places both now and in the future. Therefore, demographers should explain how different groups will contribute to climate change, and how they will suffer the consequences, so that adaptive capacities can be strengthened and social programs can fill the gaps.
Leiwen Jiang described research conducted by some of the giants in climate and demography: National Center for Atmospheric Research, International Institute for Applied Systems Analysis, and Population Action International. Their work uses a “PET” model – Population, Environment, and Technology – which looks at how the PET elements impact four critical predictors of GHG emissions: consumption, energy use, labor, and savings. A forthcoming paper by this group will delineate the complete findings, including the potential for GHG “savings” brought by decreases in fertility and thus reduced population growth, as well as the added GHG due to future urbanization.
Susana Adamo took a step back to show the audience the view from 30,000 feet – literally, with maps demonstrating that population density is highest in areas most vulnerable to impacts of climate change, such as sea-level rises, droughts, floods, and other severe weather events.
Unfortunately, one of the stars of this research, Brian O’Neill, was unable to attend, due to health reasons. His research, to be published soon, is highly anticipated, and should add additional quantitative fuel to the fire.
Not Just Climate
Environmental links with population and demographic factors have also factored in other parts of this “demography” conference. A host of sessions, many organized by the Population-Environment Research Network, have explored linkages between population growth, migration, and urbanization on the demographic side; and deforestation, natural resource management, and environmental degradation on the environmental side. Questions concerning these and other environmental factors have surfaced at panels exclusively dedicated to other topics such as family planning. Some sessions examined how population and environment concerns can be jointly addressed.
It is encouraging to see demographers and reproductive health specialists taking climate and environmental factors so seriously. The response from the environmental community has been mixed, with some interest in population issues, but also some opposition from the climate community to including discussions of family planning in an already controversial topic. At a similarly large gathering of environmentalists and conservationists, the 2008 IUCN conference in Barcelona, only two sessions addressed health or population. So we have a long way to go progress to unite these communities of researchers and practitioners, and come together in a truly fruitful engagement.
Photo courtesy World Bank Photo Collection. -
Missives From Marrakech: 50 Years of Counting. And Counting.
›September 29, 2009 // By Gib ClarkeDemographers often get a bad rap for being boring. There’s a saying that demography is all about sex—but the details aren’t as much fun. To find out, I’m in Marrakech, Morocco, reporting on the biennial gathering of number crunchers, the 26th conference of the International Union for the Scientific Study of Population (IUSSP). After the first day, I have only 4 days, 86 panels, 327 presentations, 5,340 PowerPoint slides, and 426 poster presentations left to go.
To most of you, this may not seem exciting. But it is terrifically important. For example, at a panel on maternal health, the presenters offered easier, more accurate, and less expensive ways to collect maternal mortality data, which led to a discussion of strategies for meeting MDG 5 and for improving maternal and infant health throughout the world. Similar panels addressed the challenges facing scientists and programmers working on issues as disparate as water, migration, and the effect of armed conflict on children.
For its 50th Anniversary, IUSSP also indulged in a bit of navel-gazing. Wolfgang Lutz called for more research on predictions and more policy recommendations—what he dubbed the “Demographers’ Transition” (an inside joke, to be sure). Ndola Prata’s “Opportunity Model” (developed jointly with Malcolm Potts and Martha Campbell), argues that use of contraceptives may increase simply if they are more available. Borrowing from marketing theory and such examples as remote controls and Post-It notes, the model generated quite an uproar. A UNFPA-hosted plenary on “After Cairo” closed the day with a strategic discussion about future population, family planning, reproductive health, and development strategies.
A Visit to the Hospital
At the Ibn Zohr Hospital’s crisis center in Marrakech, victims of sexual, physical, and psychological violence are treated and counseled free of charge. Though only founded in 2006, the clinic has defied expectations by helping hundreds of women and children each year, thanks in large part to an effective referral network comprising NGOs, media (especially radio), the police, hospitals, and health professionals. “Listening centers,” local outposts offering basic education on health and rights, are responsible for 56 percent of all referrals.
Ibn Zohr’s services are funded by the Moroccan government and UNFPA. Data has been collected since service delivery began, and shows that the overwhelming type of abuse suffered by women is physical (86 percent), while children under 15 report a mix of sexual (40 percent) and physical (43 percent) abuse, with more sexual abuse occurring among boys than girls.
Other IUSSP site visits included a rural reproductive health clinic, a center for abandoned children, and a house for female students. Too often, site visits are far away from the conference and before or after the main events, costing attendees extra time and money. Instead, the IUSSP site visits are here in Marrakech, where even the most experienced practitioners can learn more about Morocco’s unique blend of modernization and religious and cultural conservatism. These trips are truly unique and invaluable learning opportunities—organizers of similar conferences take note.
Gib Clarke reported from Marrakech, Morocco.
Photo courtesy flickr user DavidDennisPhotos. -
Dutch Minister for Development Cooperation Bert Koenders on the Future of Family Planning
›September 22, 2009 // By Gib Clarke“I think everybody…will agree that family planning is one of the biggest success stories of development cooperation. I also consider the paradigm shift in this field from top-down family planning (FP) to programs of reproductive health (RH) and rights for couples and individuals adopted in Cairo in 1994 to be a success story,” said Bert Koenders, the Dutch Minister for Development Cooperation, in a statement prepared for a roundtable discussion at the Wilson Center on future strategies in FP and RH.
Looking beyond the successes of the past, Koenders identifies a series of opportunities and challenges facing the RH community. He cites as the first opportunity the potential to “join forces” with the United States to meet Millennium Development Goal #5 (which focuses on maternal, sexual, and reproductive health, and family planning). He calls MDG 5 “the mother of all MDGs” and says that if it is not met, “then the other MDGs will not be attained either. It is smart economics to invest in MDG 5.” Other opportunities include public-private partnerships and the “growing awareness” in developed and developing countries alike.
The challenges, however, are significant. Youth, he notes, account for half of the world’s population and face barriers in access to reproductive health information and commodities. To overcome these barriers, we must first identify what adolescents and unmarried women and couples need, and recognize their rights to the same quality services as older and married women and couples. Koenders also says there is a growing opposition in many parts of the world to sexual and reproductive health and rights, and that programs must address this in order to be successful.
The roundtable discussion, to be held on September 22 at the Wilson Center, features Musimbi Kanyoro of the Packard Foundation, José “Oying” Rimon of the Gates Foundation, and Scott Radloff of the U.S. Agency for International Development. -
Half the Sky, All the Promise: The Personal is Political in NYT Special Issue
›“The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution,” write Nicholas Kristof and Sheryl WuDunn in the lead article of this Sunday’s The New York Times Magazine.
In this special issue devoted to “Saving the World’s Women,” five articles document global failures and personal horrors, but also offer forward-looking solutions from the individual to the institutional. As the subtitle says—“changing the lives of women and girls in the developing world can change everything”— this vital effort can help us not only improve the lives of women, but meet larger goals including international security, global health, and economic development.
In “The Women’s Crusade,” Pulitzer Prize-winners Kristof and WuDunn, whose new book Half the Sky will be published on September 8, outline the ways in which the world’s women and girls are abused, neglected, and overlooked. They use devastating data to detail how women around the world suffer from lack of education, maternal mortality, sexual violence, trafficking, and economic and political oppression, and then bring these figures to life with women’s personal stories.
They argue that elevating women is not a “soft” issue, but rather has the power to transform economies and address security threats—a point echoed in an interview with Hillary Clinton, in which she calls women and girls “a core factor in our foreign policy.”
“I happen to believe that the transformation of women’s roles is the last great impediment to universal progress,” says Clinton, long an informed and passionate advocate for global women’s issues. She encouraged President Obama to create a new ambassadorship for global women’s issues, and filled the opening with Melanne Verveer, a respected activist and former head of the Vital Voices Global Partnership.
Clinton most strongly emphasizes the connection between women’s issues and national security, calling it “an absolute link”: “If you look at where we are fighting terrorism, there is a connection to groups that are making a stand against modernity, and that is most evident in their treatment of women.” She goes so far as to agree that spending taxpayer money on education and healthcare for girls and women in Pakistan would be more effective than military aid to the country.
“A woman who is safe enough in her own life to invest in her children and see them go to school is not going to have as many children. The resource battles over water and land will be diminished,” she says. “And it’s an issue of how we take hard power and soft power, so called, and use it to advance not just American ends but, in advancing global progress, we are making the world safer for our own children.”
Also in the magazine:
The New York Times’ website adds a slide show of Katy Grannan’s portraits of women in South Asia and Africa, and launches a contest soliciting personal stories from the field. Submit your photos and blog posts to Kristof’s blog by September 19.- Dexter Filkins investigates the acid attacks on girl students in Afghanistan in the horrifyingly vivid storytelling he displayed in his best-seller, The Forever War.
- Lisa Belkin takes note of an emerging generation of female philanthropists using their money to “deliberately and systematically to aid women in need,” spurred by the Hunt sisters’ “Women Moving Millions” campaign.
- Tina Rosenberg describes how sex-selective abortion and inadequate health care for young girls has led to a “daughter deficit” in China and India, where, somewhat paradoxically, “development can worsen, not improve, traditional discrimination.”
- Africa’s first female President, Liberia’s Ellen Johnson-Sirleaf, tells NYT that if women ran the world, it would be “better, safer and more productive.”
To me, such vital voices are the most powerful, proving that the personal is political. The quotes in the lead article from academic studies, local NGO personnel, and women themselves map the way forward:- “When women command greater power, child health and nutrition improves” – Esther Duflo of MIT, on micro-finance.
- “Girls are just as good as boys” – An unidentified man who once beat his wife for not having sons, but changed his mind when a micro-loan turned her into the family breadwinner.
- “Gender inequality hurts economic growth” – Goldman Sachs, Global Economics Paper, 2008
- “I can’t talk about my children’s education when I’m not educated myself … If I educate myself, then I can educate my children” – Terarai Trent, a Zimbabwean woman now completing a PhD in the United States.
Bill Gates gave the 
“When women and girls have the tools to stay healthy and the opportunity to contribute to their families’ well-being, they flourish and so do the people around them,” Secretary of State 
Here in Morocco, where I am attending the 
Demographers often get a bad rap for being boring. There’s a saying that demography is all about sex—but the details aren’t as much fun. To find out, I’m in Marrakech, Morocco, reporting on the biennial gathering of number crunchers, the 
