Friday, July 10, 2009

My Final Thoughts from L'Aquila

L'AQUILA, Italy -- I found out only eight days ago that I was coming to Italy to promote global health. I know global health and I know communications but I know little about the G8, and even less about how to budge this immense geo-politico-media mountain. But I came up with a plan and started learning quickly as soon as I hit Italian soil. Let me give you my plan, how I think I did and what I learned.

My communications plan was three-pronged: 1) Social media (mostly blogging), 2) major media relations and 3) U.S. government engagement.

1) The social media prong went brilliantly with lots of great support from colleagues in DC and Vermont. Earlier this week, I posted daily blogs. Once the summit began, I started posting multiple blogs per day. As I learned more and saw more, I had more and more ideas for blogs. Today, the last day, I have more ideas than I have time to write. I’ve been advised by the Council’s office in Washington that 700 people looked at my blog on Wednesday and I’ve received a dozen appreciative comments, some with questions, others with ideas. GHC/Vermont also had the idea of putting a link to the blog on our Facebook page, and we’ve received several comments there as well. We’ve also tweeted the G8, both from Italy and the U.S. and we’ve been “retweeted” by several GHC members like White Ribbon Alliance, PATH , Intrahealth, Women Deliver and others. Links to this blog have been placed on a number of other websites covering the G8 like this one put together by the Global Call for Action Against Poverty: link text

2) Major media engagement has been less successful even though all of us who work for non-governmental organizations are working out of the same media centres as the 3,500-some journalists covering this Summit. I heard from the diplomatic correspondent of the BBC the first day who wanted to talk to me about “backsliding” on the Millennium Development Goals. But I haven’t been able to get in touch with him since that first contact. I’ve also been trying to run down the phantom from the Financial Times (the friend of a friend) who staked out a computer in the media centre early on (marked “Financial Times”) but then never showed. Or at least I never saw him. Oddly, my single media success was when New York Times Columnist Nicholas Kristof, who was not at the Summit, wrote a column on the G8 using information supplied by me: link text

3) I failed totally to interact with the Administration except for the climate change briefing I attended by President Obama and five other G8 leaders yesterday which I don’t count because it had nothing to do with health (and, oh yeah, I didn’t actually talk to the President). There was absolutely no contact between the U.S. NGO delegation and the Administration of any kind during the Summit. In fact, we couldn’t get a meeting with them in Washington before the Summit either. The British NGOs met with their government. One member of our U.S. delegation even met with the head of the Japanese delegation. But none of us had any contact with our own government. This was surprising and disappointing.

The other thing that was surprising and disappointing is that neither global health nor water and sanitation came out very clearly in the comments of President Obama and his Administration or in the mainstream media except for two notable exceptions — the Kristof column already mentioned and French First Lady Carla Bruni-Sarkozy, who wrote a commentary in the Guardian of the U.K. Tuesday called “My Message to the G8 Leaders in L’Aquila,” one of them being her husband. As a global ambassador for the prevention of HIV in women and children, she wrote: ”Knowing that millions remain in need while effective interventions exist, I am more determined than ever to add my voice to the global effort to fight Aids and other infectious diseases.As the G8 meets in L’Aquila, leaders should feel proud of the revolution in global health they started eight years ago. I hope they will celebrate their achievements by expanding their investment in saving lives and reducing inequities. It is not only possible – it is happening, it works, and there is much more still to do.” Here is the commentary and check out the first comment following it: link text

As far as I know, that was the most prominent voice at the G8 advocating for global health, and I am grateful to Ms. Bruni-Sarkozy for that.

President Obama left L’Aquila about an hour ago, took a helicopter direct to Vatican City and has now been received with much pomp and pageantry by Pope Benedict II as we can see on the monitors in the media centre. Later tonight, Air Force One will touch down in Ghana, his first visit to sub-Saharan Africa as president. We have heard that the President and First Lady will be visiting a USAID-funded maternal health project at an Accra hospital, and we will be watching carefully in hopes that that visit takes place so that the U.S. First Lady joins with her fellow first ladies Carla Bruni-Sarkozy and Sarah Brown as a global health advocate.

G8 Talks the Talk, but Breaks Prior Promises

L’AQUILA, Italy — The G8 released its communiqué on health, water and sanitation commitments to Africa Wednesday and, as I predicted in an earlier blog, the NGO community here is not impressed. But neither are they surprised. The communique largely reaffirms previous promises, at which the G8 has become quite accomplished.

There are some things I like a lot, especially the G8’s pledge to ”accelerate progress” on combating child mortality and on maternal health, “including sexual and reproductive health care and services and voluntary family planning.” I think those areas of health have been long neglected but regret that the G8 countries did not establish a more formal mechanism from making those laudable goals reality.

I also like a reaffirmation of a $60 billion pledge to fight infectious diseases and strengthen health systems by 2012 and the establishment of a mechanism to monitor health commitments made at the last three summits, which may be the only significant new health commitment made here at L’Aquila.

What I don’t like, and this feeling is widespread among civil society representatives here, is the indisputable fact that the G8 has not come close to meeting past commitments. In fact, The DATA Report, the most credible source of information on this subject link text, says that the G8 had delivered only one-third of all assistance increases it had promised to deliver to Africa by the end of 2010. I write about this more in my last blog.

I must hasten to add, though, that the U.S. is one of the least guilty of the G8 members on this score. The DATA Report points out that the U.S. increased its assistance to Africa by 26% in 2008, a significant increase that outpaced the global average of 16%, and is now on track to meet or even exceed its 2010 target. It may surprise many that former President George W. Bush can take much credit for this development.

However, the NGOs represented at the G8, largely European, were not pleased with the communique’s language on global health, water and sanitation, climate change, education, and the economy as laid out in a letter to Italian Prime Minister Silvio Berlusconi and the other seven G8 leaders earlier this week.

“The communiqué is pretty disappointing with no real new initiatives or recognition of the dire state of the progress to meeting their previous commitments,” said Kel Currah, chair of the Global Call to Action Against Poverty G8 Working Group, which represents a broad cross-section of NGOs at the G8. “On the good side, they did produce an accountability annex but again, this was only for a few of their commitments and there are a lot of holes in the report.”

Thursday, July 9, 2009

Is the G8 Meeting its Targets?

L'AQUILA, Italy -- When I learned I was coming to the G8 Summit to promote global health, I sought advice from friends I thought might know about the arcane machinations of the annual summit. A British friend responded: "I'm rather disillusioned about the G8, to be honest. It seems like a PR event for world leaders to talk about the stuff they would do if only everyone else would get behind them!"

That pretty much reflected my own superficial views but I wanted to get beneath the surface and answer the question, "How is the G8 really doing in meeting the objectives it sets every year?" in an objective and unemotional way.

There is probably no better source of information than "The DATA Book," published annually by the ONE Campaign: link text The 2009 report, just out, analyzes the G8's progress on their commitments to Africa made at the 2005 Gleneagles Summit and since. They have good news and bad but, to my way of thinking, it is mostly bad.

At the end of 2008, the reports says, the G8 collectively had only delivered one-third of the Official Development Assistance increases it had promised by 2010. While the overall view is bleak, progress by specific countries in specific areas brings more cheer.

In 2005, for example, the G8 committed to help Africa by reducing the burden of HIV/AIDS, malaria, TB and polio and improving access to basic health care. In later summits, additional commitments were made to strengthen the disease-specific goals and support health system strengthening, the training and retention of health workers and the control or elimination of neglected tropical diseases.

Perhaps more than in any other sector, the report says, where concentrated investments have been made, measurable results have been delivered: HIV infections are declining and more people living with HIV are receiving care and treatment, rates of new cases of TB are declining, malaria mortality has been reduced in targeted countries and child mortality has declined.

However, Africa is seriously off the rails in terms of meeting the health MDGs especially in maternal and child health.

Similarly in water and sanitation, the G8 committed to a Water Action Plan at the 2003 Evian Summit and this plan was reaffirmed in the 2005 and 2008 summits. Despite this attention, the G8 has set no quantitative targets in the sector. And the report notes that "improvements in access to clean water and sanitation serve as a catalyst for progress in almost every other area of development, providing the foundation for good health, education and economic productivity." Meanwhile, more than 4,000 children die daily from diarrheal diseases, which are spread through dirty water and poor sanitation and hygiene.

The ONE Campaign also analyzed the performance of each country and found that Italy and France "are performing so poorly that they are threatening to cause the G8 as a whole to default." Indeed, in 2008, France fell behind Germany for the first time in terms of the quantity of aid it is delivering to Africa, where it was once a major colonial power.

They also found that the U.S., Canada and Japan were meeting or beating commitments (the U.S. is actually on track to exceed its 2010 target a year ahead of time) while the U.K. and Germany were pushing hard to meet more ambitious goals (the U.K. is on target to be the first G8 country to meet the UN goal of spending 0.7% of national income in ODA).

Wednesday, July 8, 2009

Mood of NGOs at L'Aquila Not Optimistic

L'AQUILA, Italy -- The heads of state are arriving here for the G-8 Summit in the mountains northeast of Rome --- President Obama and Chancellor Merkel are already here and President Sarkozy is arriving as I write this at 3:00 PM -- but the non-governmental organizations are mainly frustrated, angry or both with a few notable exceptions.

This morning I talked to civil society experts in most of the main areas of concern -- global health, water and sanitation, education, food security, climate change and labor -- and all but one expressed varying levels of disquiet. Only a Dutch expert in food security -- who was one of the key speakers on this issue at a civil society meeting in Rome earlier this week -- said he was "slightly optimistic" about the prospects for food at this summit.

When I asked a long-time global health advocate (who has been involved in several G-8 summits over the last several years) how he was feeling about the prospects for global health, he gave me the thumbs down. He cited his opinion that since commiting to an additional $60 billion by 2011 to fight pandemics and strengthen health systems, as agreed at the G-8 Summit in Germany in 2007 and Japan in 2008, the G-8 has not produced even one additional dollar. This point is certainly debatable but this particular advocate apparently chose not to include the Global Fund, PEPFAR or PMI in his calculations.

Steve Cockburn of End Water Poverty UK observed at how one can walk around Rome and admire ancient aqueducts and sewage systems that were providing clean water and sanitary sewage disposal 2,000 years ago, services that are available in 2009 in huge parts of the developing world. He called the current draft of the communique on water and sanitation "very disappointing" and predicted the the Millennium Development Goal for "watsan" will not be met until 2109. The last G8 in Japan committed to concrete results by the end of 2009 and when the officials saw that was not going to happen, he said, they "watered" the language down to merely making "progress" by the end of 2009.

Those fighting against climate change are equally disillusioned after seeing the latest draft of the Summit communique this morning. They characterized the situation as the European Union countries doing the right thing -- and even offering to increase their commitments to reduced emissions -- while the other members of the G-8 -- notably the U.S., Canada, Russia and Japan -- dragging their feet. Furthermore, they say the non-Europeans' recalcitrance is discouraging developing countries like China, India and Brazil from committing than they already have. They don't blame President Obama for this but say his feet are tied by Congress.

Those of us who care about global health (in which we include water and sanitation) are waiting with bated breath to see the final communique on those two issues. We are hearing two rumors on its release -- either this afternoon or on Friday. I will pass along the information here as soon as it becomes available.

The Global Health Council view of the current language in the communique on global health is positive: We like the language on the need to strengthen health systems, the call for a comprehensive and integrated approach, the emphasis on maternal and child health and on sexual and reproductive health which, as I noted in my previous post, is back in the G-8 communique after eight years in the wilderness during the Bush Administration.

In my three days in Italy, I have heard some amazing statistics: One of the most amazing and disconcerting is this provided by Angela McClellan of Transparency International in Berlin: The financial industry has received almost 10 times more in bailout money in the last year than poor countries have received in aid in the last 49 years (source: UN Millennium Campaign).

G-8 Summit Opens Today in L'Aquila

L'Aquila, Italy -- Driving to the site of the 2009 G-8 Summit this morning was an eerie experience. After numerous security checkpoints, there was no more traffic and, other than security personnel, no more people -- except for the tents housing the thousands of local people without homes.

Until April, the summit was going to be held at a luxurious seaside resort in Sardinia. But then a devastating earthquake hit L'Aquila, in the mountains northeast of Rome, killing 300 and leaving tens of thousands homeless.

So the Italian government moved the summit to an out-of-the-way military school here in L'Aquila to draw attention to the plight of the victims and give a boost to the local economy.

As a reminder of the forces of nature at work here, a powerful aftershock hit the town last Friday, just days ahead of the arrival of world leaders.

But there are few hotels here even in the best of times, and this is not the best of times. For that reason, the 3,000 to 3,500 journalists descending on this region to cover the summit -- as well as the 200 or so of us from civil society -- are being housed an hour-and-a-half drive from here in a "Mediterranean Village" built specially for the 2009 Mediterranean Games which just concluded a few days ago. The accommodations are comfortable but spartan -- though undoubtedly far superior to the tents of L'Aquila -- and we have almost round the clock access to computers, food and wine.

Here at the Summit, I am working out of one of several media centers. The one I am in has space for perhaps 200 journalists and is divided by the language of the journalists -- there are Arabic, French, Italian, Portuguese and Chinese sections among others. Initially, I settled in at an Arabic computer but I quickly discovered my mistake.

The summit will focus on the global economic distress but expected to produce more of a progress report than new policy. Iran, climate change, food security in Africa, Middle East peace and trade are also on the agenda.

L'Aquila is the capital of the Italian region called Abruzzo, and was the second most important town in southern Italy after Naples for centuries. This area, in the Abruzzo's desolate interior, is one of the least touristed parts of Italy even though it boasts considerable rewards, particularly if you are in search of wild mountains and villages where strangers a novelty.

Sunday, July 5, 2009

Keeping Health on the G-8 Agenda

ROME, Italy -- Judging by the numbers of people I saw frolicking in Trevi Fountain and on the Spanish Steps as I arrived here today on a sun-drenched summer afternoon, you would not think the industrialized countries of the world are in the throes of the worst economic crisis since the Great Depression. But that is exactly what will be on the minds of the heads of state of the G-8 when they come here later this week for their annual attempt to find some common ground for making the world a better place not only for the rich countries of the world, but also for the poor.

And that is why I am here - - to add the voice of the Global Health Council to other representatives of civil society, largely European, to try to keep global health from getting lost in the many other pressing issues of the day, such as the recession, Iran, climate change, food security in Africa, Middle East peace and trade.

It will not be easy: In the Civil Society Meeting that begins here in Rome on Monday, immediately preceding the Summit which begins on Wednesday, health is hard to find on the agenda. The meeting is comprised entirely of four roundtables on Food, World Economy and Finance, Climate Change and something called "Public Goods" which, presumably, might include something about health. But that is not at all clear, and my job here is to ensure that global health -- and particularly reproductive, maternal and child health - get a fair hearing as access to these health areas -- and lack thereof -- have enormous effects on the poor's ability to make progress in the other areas of concern to this G-8 Summit.

Saturday, July 4, 2009

Mere Rain Does Not Extinguish Flame of Candlelight Memorial

CAP HAITIEN, Haiti, May 16, 2009 -- On my first overseas assignment with the Global Health Council, I was privileged to be part of the opening ceremony of the 2009 International AIDS Candlelight Memorial, originally planned to take place in front of the spectacular ruins of Sans Souci Palace (a World Heritage site) in Milot, Haiti. The Council has been managing this event, the world's oldest and largest AIDS awareness-raising event, since 2000. Last year, for the first time, they took the opening ceremony overseas, to Malawi; this year, they chose Milot, a village a few kilometers from Cap Haitien, the second largest city in Haiti on its northern coast.

Although the Milot event was rained out, the opening ceremony was still a great success when most of the events associated with it were held at the dinner that had already been scheduled for Cap Haitien after the event. The festivities started when Haitian Prime Minister Michele Duvivier Pierre-Louis arrived at Cap Haitien Airport in the afternoon and drove to Milot. She appeared before an enthusiastic crowd of local people at an event promoting the importance of getting tested for HIV.

Abbott Fund, one of the donors of the Candlelight Memorial, announced that it was donating 500,000 rapid HIV test kits as the kick-off of a nationwide HIV testing campaign. The testing initiative is a cooperative partnership between the Haitian government, the U.S. government, the Abbott Fund and Haitian health implementing organizations.

At the dinner, I had the pleasure of sharing a table with Prime Minister Pierre-Louis and her entourage, including the minister of tourism, who told us of his hopes to bring tourism back to the beautiful northern coast of Haiti, where Christopher Columbus landed in 1492 when he discovered America. The candle-lighting ceremony took place after the dinner, when Prime Minister Pierre-Louis and representatives of the two sponsors of the event -- Vice President Kathryn Guare of the Global Health Council and Dr. Myrna Eustache of Promoteurs Objectif Zero Sida (POZ) -- joined people living with HIV and AIDS to light the candles to remember those lost to AIDS, to advocate for improved programs and policies and to celebrate the courage of Haitians living with the disease.