Much has changed in Accra but not everything...

ACCRA, Ghana -- The last time I was in Ghana was 1985, when I had just finished two years of Peace Corps service and my wife and I had traveled there from Togo in order to catch an Egypt Air flight to Cairo. Here's what I wrote in my diary on Oct. 13, 1985:

"We didn't particularly enjoy Accra. It's a decaying city where it's hard to find items we would take for granted in Lome. The first night we ate dinner at a Chinese restaurant. Fewer than half the items available on the menu were available. On the second day, we took a taxi into the decaying and filthy downtown and found a decaying hotel on the ocean. We looked down on a once-beautiful swimming pool that was now empty and decaying. We were very thirsty. All they had to drink was beer and tonic. I didn't want beer or tonic so I stayed thirsty. When I asked for a glass of water the water said 'It is finished.' That remark will be one of my strongest impressions of Ghana: 'The water is finished.'"

Note the number of times I used the word "decaying" in that short passage.

Those were the bad old days, when Ghana had a dysfunctional economy and food shortages so severe that Peace Corps Ghana had to truck in food from Togo for its volunteers. Fortunately, those days are gone and Ghana now has a vibrant economy and democracy that recently had a peaceful transfer of power after a closely contested election. That is why President Obama had chosen to make it the destination of his first trip to Africa as president.

I arrived here yesterday for my second visit. The Global Health Council manages the AIDS Candlelight Memorial, the world's largest and oldest AIDS awareness raising event, and we are meeting with our regional coordinators from around the world. I found that many things have changed, and for the better, but a few have not.

On my first night in Accra, my two colleagues and I went out to eat at Buku, an African restaurant in the Osu neighborhood, as the Lonely Planet Guide to West Africa had recommended it for its Ghanian, Nigerian, Togolese and Senegalese food. It was a lovely place but I ran into a similar problem from my first trip, albeit no quite so severe. They had no dressing for my salad, they had run out of guinea fowl and had no ginger beer. But they did have most things and we had a delicious dinner in the open air and under a straw roof. I had groundnut (peanut) stew with goat (instead of guinea fowl!), fried plantains and Star beer. All in all, Ghana is vasty improved and I am thrilled to be back in West Africa.

G20 proves frustrating but Pittsburghers a delight

PITTSBURGH -- I just spent two days at the G20 Summit here trying to keep global health on the leaders' agenda, as it had been in Washington in November 2008 when they pledged to work on achieving the Millennium Development Goals. But it was completely absent from their agenda in Pittsburgh. This was a disappointment, but the incredible graciousness of Pittsburghers helped make up for it. A few examples:

The night before the opening of the summit, I was having a drink with a friend at a bar across the street from Pirates Stadium where the Pirates were playing the Reds. I would have like to have gone but we were headed for a party in a couple of hours. Imagine my delight when a man came by and dropped two free tickets on us. Five minutes later we were inside the stadium with a very sparse crowd (people were not coming downtown because of the G20) on a beautiful September evening sitting in very good seats!

We had to leave early to attend a party hosted by Teresa Heinz Kerry to raise support for the fight against global warming at the Andy Warhol Museum which, by the way is fantastic. There was great New Orleans music - Cajun, rock and jazz -- and great food and drink. Not to mention the art of Andy Warhol. When we were leaving about midnight, we could not find a taxi and when we called were told that one could not come in less than 45 minutes. A lovely couple overheard us and offered us a ride to our hotel -- even though it was in the opposite direction from their house!

And on the last day of the summit, two Save the Children colleagues and I were walking to the media center through downtown Pittsburgh with a very high level of security. Even though it was Friday, very few places were open. But when we spotted a coffee shop with the catchy name of "Crazy Mocha" we had to stop. When we walked into the shop, the two employees cheered and applauded us. They were so bored from the lack of customers, that they had to express their joy at seeing us!

Pittsburgh is a far more interesting city than I every imagined populated by warm, wonderful and quirky people and I would go back anytime. A very underated and very American city! I highly recommend it.

Berlin Delegates Demand Adoption of ICPD Agenda

BERLIN, Germany – Four hundred delegates from 130 countries released the “Berlin Call to Action” earlier this month at the NGO Forum on Sexual and Reproductive Health and Development that followed up on the historic International Conference on Population & Development held in Cairo 15 years ago.

After long and sometimes heated discussions, the delegates demanded that donors and governments accelerate implementation of the ICPD Program of Action “as fundamental to achieving equality and equity, human rights and social and economic development.” They urged the following actions to be taken immediately:

1. Guarantee that sexual and reproductive rights, as human rights, are fully recognized and fulfilled. This reflects the delegates’ desire to go beyond the realm of public health and position sexual and reproductive rights as fundamental human rights.
2. Invest in comprehensive sexual and reproductive health (SRH) information, supplies and services as a priority in health system strengthening. The new idea here is to acknowledge the fact that the current aid architecture emphasizes health system strengthening and the delegates belief that associating SRH with health systems can help our cause.
3. Ensure the sexual and reproductive rights of adolescents and young people. Approximately 25% of all of the delegates were under the age of 30 and the focus on youth was a recurring theme of the conference. Jill Greer, chair of the Steering Group, said that it was vital that the movement develop new leaders for the future.
4. Create and implement formal mechanisms for meaningful civil society participation in programs, policy and budget decisions, monitoring and evaluation. The message here is that governments have to bring civil society organizations to the table as meaningful partners.
5. Ensure that donor contributions and national budgets and policies meet the needs of people for sexual and reproductive health and rights. This financial aspect was enhanced considerably from the earlier draft and reflects the delegates’ recognition that their lofty visions will not be realized without the financial resources to carry them out.

Sivananthi Thanenthiran, a co-chair of the Steering Group, recognized that the most intractable hurdle to overcome in finalizing the text was the split between those who preferred ICDP language, and those who preferred the language of the Millennium Development Goals. “We have positioned ourselves in the middle,” said Ms. Thanenthiran. “We want to move beyond Cairo and leverage the MDGs.”

Another key issue was toning down the rhetoric because of the fundamentalism of many countries where the legitimacy of governments is based on religion. To overcome this, the Drafting Committee tried to find language that would not offend.