What does Syrah wine have to do with pneumonia?

NEW YORK, NY — In June, New York Times Wine Critic Eric Asimov started his wine column with a joke: “What’s the difference between a case of syrah and a case of pneumonia? You can get rid of the pneumonia.”

That column, which analyzed why American Syrah wine, which can be superb, had never achieved much success, has led to one of the strangest partnerships in global health — a coalition fighting child pneumonia and the Rhone Rangers, America’s leading non-profit organization dedicated to promoting American Rhone varietal wines such as Syrah.

Last month, I witnessed the partnership in a wonderful event in the New York Times Center here on the first day of the United Nations Summit on the Millennium Development Goals cleverly marketed as “Pneumonia’s Last Syrah,” a wine reception and photography exhibit, which displayed striking images and stories that provided a window into the human face of pneumonia and the burden of the disease.

After sampling the wares of the 12 Syrah producers present at the event (11 from California, one from Virginia) , which were all excellent, the audience was educated about pneumonia:

* It is the leading cause of death among children under 5, with more than 1.5 million dying from it every year.

* Vaccines against two of the main causes of life-threatening pneumonia are used throughout the developed world. However, millions of children in developing countries still lack access to these vaccines.

* Life-saving antibiotic treatment for serious pneumonia typically costs less than one dollar. However, only an estimated one of every five children with pneumonia receives antibiotics.

Wine Critic Asimov, who helped ferment this partnership, spoke at the reception, saying he was humbled to be part of such a significant issue while he usually spent his time worrying about nothing more than excessive oakiness in chardonnay.

The Global Coalition against Child Pneumonia, made up of more than 100 organizations, will mark World Pneumonia Day on Nov. 12 to bring attention to pneumonia and promote policies that will prevent the millions of avoidable deaths.

The Global Coalition suggests five things people can do to take action. One of those things is to buy a case of American Syrah wine during the month of November from one of these producers, and they will donate $10 to provide pneumonia vaccines to children in the world’s poorest countries.

This will help save the American Syrah wine industry, but it will produce the even happier effect of saving the lives of children who might have died from pneumonia.

Disclaimer: I won a large bottle of Syrah wine in the raffle at the event but these opinions were in no way influenced by that fact. I was going to write this anyway.

High tech TEDx event shows that child health is within reach

NEW YORK, NY — On the opening day of the United National Summit on the Millennium Development Goals (MDGs) Monday, I participated in a most unusual media and educational event organized by TEDxChange, a collaboration between TEDx and the Bill & Melinda Gates Foundation.

The live event from the Paley Center for Media on 52nd Street featured Melinda Gates, Hans Rosling, Mechai Viravaidya and Graça Machel in front of a live audience of, as TEDx host Chris Anderson put it, luminaries and changemakers (Ted Turner was in the audience along with NGO and foundation leaders). A live webcast of the event was viewed my millions around the world, and from 82 TEDx events, several of which we saw on camera in live shots, and and is now available to view online.

I viewed the event from “Bloggers’ Alley,” several floors above the event, with about 20 other bloggers and new media journalists, most of whom had laptops and smart phones to extend the salient facts of the event even further into the world. We viewed the event on two screens at either end of the room. And we had a third screen, which displayed a constant stream of all tweets including the #TEDxChange hashtag. The deluge of the Twitterstream produced a continuous stream of concise Tweets that came about one per second for the entire 90 minutes of the event and even after it ended.

It was a fabulous display of what is possible with communications technology in the 21st century. But the content revealed at the event several floors below was even more compelling.

The speakers were all terrific – Melinda Gates and Graça Machel displayed their passion and commitment to improving the world and Hans Rosling and Mechai Viravaidya (Mr. Condom of Thailand) regaled us with their knowledge, energy and sense of humor.

I particularly enjoyed Dr. Rosling, a professor of international health and co-founder of the Gapminder Foundation, who dazzled us with his computer graphics, which convert international statistics into moving interactive graphics showing us the history of child mortality.

In one part of his presentation, Dr. Rosling showed us the fall in child mortality in Sweden (starting with 400 child deaths per 1,000 born in 1800), Egypt (with 300 deaths in 1960) and Thailand (with 150 deaths in 1960), and ending with all three countries ending with roughly the same low level of child mortality.

Later, he presented a graph of the relationship between child mortality and family size in 1960, with “developing countries” clumped together in the upper right (high mortality and high family size) and the “Western” countries in the lower left (low mortality and low family size). Then, in an amazing and awe-inspiring display of computer graphics, he made the graph come alive and move through time to 2000. Many of those developing countries in the upper right moved rapidly into the lower left quadrant, with Dr. Rosling urging them on: “Come over to our side,” he exclaimed. “Welcome to a decent life.”

The conclusion of his presentation, which made clear the association between child mortality and falling family size: “The MDG on child mortality is fully possible.”

It was an inspiring way to begin the MDG Summit.

NOTE: Some of Dr. Rosling’s amazing graphics are available are available at Gapminder World and on this website.

In malaria prevention, positive change in Mali, and elsewhere

WASHINGTON, DC — As a young development worker for Lutheran World Relief in Mali 20 years ago, I engaged in high-risk behavior occasionally. In my extended journeys around the country, I slept in villages from the Sahara Desert in the north to the Niger River Delta and Dogon Country in the center to the southern savanna, but rarely with a mosquito net hanging over me, and certainly not an insecticide-treated one.

I paid for my sins: I was struck down by malaria after an overnight stay in a southern Mali village in the middle of the rainy season. Malaria made me feel so awful, so lethargic, that I thought I might die and worse, I didn’t much care. In those days, mosquito nets were hard to come by, especially if you were a poor, rural Malian. And most Malians are poor and rural.

But a lot has changed in 20 years. Today, a new report unveiled at the National Press Club shows that Mali is an important part of a pan-African malaria success story. In 2000, there were an estimated 22,663 malaria deaths among children 1 to 59 months in Mali. From 2001 to 2010, the global investment in malaria control prevented 65,065 malaria deaths, the most of any of the 34 malaria endemic countries in Africa.

And Mali is only one piece of an even bigger story: The new report "Saving Lives with Malaria Control: Counting Down to the Millennium Development Goals" — authored by Tulane University, Johns Hopkins University, the World Health Organization and PATH and published today by Roll Back Malaria — reveals that the lives of almost three quarters of a million children in these 34 countries were saved in the last 10 years through the use of insecticide-treated mosquito nets and other preventive measures.

Most importantly, the report estimates that an additional 3 million lives could be saved by 2015 if the world continues to increase investment in tackling the disease.

This should provide a clarion call for world leaders who gather in New York next week for the UN Summit on the Millennium Development Goals as they seek ways to meet the eight goals in the five years remaining in the 15-year timeline of the MDGs.

The report shows clearly what is required: U.S. and other international donors should just keep investing in malaria control the way they have been doing the last few years, and 3 million more lives could be saved in the next five years.

Here is the press release on the report.

Male circumcision, a proven HIV prevention strategy, overshadowed by another one years from fruition

VIENNA, Austria – Much of the buzz at the XVIII International AIDS Conference that just finished here was around the encouraging news of a microbicidal gel that trials have shown to be almost 40% effective, although we are still years away from having a product on the market. Meanwhile, male circumcision (MC), a proven and effective HIV strategy that reduces transmission by nearly 60% and is already available, got much less attention, though it finally got some, and for that we can be grateful.

Two years ago in Mexico City, nary a word was said about male circumcision — and certainly not in a plenary meeting — despite its proven effectiveness. I organized a press conference on male circumcision for PSI, which was successful in generating some media buzz and attention, including The Economist, which called it the one bright spot in prevention at the conference. In fact, I think that press conference resulted in an improved environment for MC. However, donors and governments, for the most part, continued to do nothing to scale up an intervention that could have saved millions of lives with one notable exception.

In December 2008, the Gates Foundation became the first donor to scale up MC, quietly providing funding for PSI to expand its male circumcision pilot project in Zambia to two other countries (a third country was added later). There was no fanfare, no announcement, as everyone was concerned about provoking a negative reaction for an intervention that addressed long-standing cultural practices.

However, there was no significant negative reaction and now the environment seems to have changed. MC seems to be going mainstream. Both Bill Clinton and Bill Gates mentioned MC in their speeches in Vienna. In particular, Bill Gates could hardly stop talking about the wonders of MC, calling it and prevention of mother-to-child transmission two of the interventions that “are so effective that in endemic countries it is more expensive not to pursue them.” While more than 41 million men in sub-Saharan Africa could benefit from the procedure, he said, just 150,000 have been circumcised in the past few years.

“I have to admit: When it comes to circumcision, I used to be one of the sceptics,” he said in his speech. “I thought: ‘Sure, it reduces transmission by nearly 60%. But there’s no way that large numbers of men will sign up for it. I’m glad to say I was wrong. Wherever there are clinics available, men are volunteering to be circumcised in far greater numbers than I ever expected.”

The Council attempted to monitor the major media coverage of this conference, and our unscientific analysis showed male circumcision to be the second most covered story on the first two days of the conference (after the microbicidal study, of course), with stories in Agence France Presse, Bloomberg News, Los Angeles Times, The Guardian, die Presse, Frankfurter Rundschau, Le Point, Le Figaro, Prensa Latina, Radio Canada, Radio France Internationale and Reuters, among others.

It wasn’t quite that high profile at the conference itself but it was certainly more evident than in Mexico City, with a number of oral and poster presentations on different aspects of MC. This has not come a day too soon. For every man we reach with male circumcision services that he already wants, the fewer new HIV infections will be produced in the future. It is an intervention whose time seems to have come.

AIDS activists need new communications strategies

VIENNA, Austria — In the history of AIDS, activists certainly deserve a place of honor for their persistence in pushing governments and donors to do more than they would have done on their own or, at least, not done as fast. But the new generation of AIDS activists sure don’t seem to be winning over the rest of non-activists here at the XVIII International AIDS Conference. And they could use some communications training.

At the opening ceremony on Sunday, they annoyed the vast majority of the audience — many of whom had arrived early to secure good seats — by disrupting the screening of a film produced by the Global Fund to shout for more funding. Ironically, the whole point of the Global Fund film was to raise awareness about the need for more funding in this, the third round of Global Fund replenishment. The Global Fund film makes this point more eloquently and convincingly than the protestors. But I know that only because I had seen the film previously, without disruptions; the audience could not hear the film because of the continuous chanting.

Another irony was that the official speakers at the podium continually agreed with the protestors, and agreed with great patience and politeness. And even some of these speakers were shouted down by much less articulate and more impolite activists. When the protestors finally left the state after an interminable period of time, the audience applauded, not in support but for gratitude that they were finally leaving.

Today, in the Media Centre, I witnessed another disruption, this one even more strident. A couple dozen demonstrators were allowed into the Media Centre — I’m not quite sure how the super alert security staff allowed them in when they don’t normally anyone, however inoffensive, to enter without media credentials — to disrupt a PSI press conference on male circumcision.

Now the demonstrators had no beef with PSI, nor with male circumcision. They were offended by the presence of U.S. Global AIDS Coordinator Eric Goosby, who was on the panel and who they blame for “the ongoing harm of PEPFAR’s anti-prostitution pledge requirement.”

Their indignation over the requirement is justified; their tactics are not. They were aggressive, they were rude. One or two of them sounded hysterical, screaming at Goosby, for 10-15 minutes.

This is the same Eric Goosby to whom former President Bill Clinton gave a huge shout-out in the opening plenary on Monday: “This man is your friend. He’s been working on AIDS since before the youngest people in this room were born. He is a good man.” Apparently, the demonstrators did not get that message, or chose to ignore it. The journalists working in the Media Centre were not impressed and mainly just ignored them, and deservedly so.

They need to find a more effective way of making their point, which is actually a point Clinton made in his speech: “You have two options here. You can demonstrate and call the President names or we can go get some more votes in Congress to get some money. My experience is that the second choice is a better one with a far better payoff.”

Yesterday, in the Media Center, the activists won no friends; they might have lost a few.

My take on the G8/G20 summits in Toronto

TORONTO, Canada — It’s been a raucous and, in some ways, surprising three days here at the overlapping G8 and G20 Canadian summits. I was struck by four issues that emerged at the summits — logistics, media access, NGO reaction and media interest in maternal and child health

First, there have never been two summits at the same time in the same country. The G8 ran Friday and Saturday in a remote area two hours north of here by road called Muskoka, in the town of Huntsville. Because of the limited facilities there, very few journalists (and no NGO representative that I know of) had access and those few that did had to be up at 3:00 am to go through security and catch the bus in Toronto for the long trip north to Huntsville. Reporters on these buses did one of two things — sleep and work on their laptops and cell phones — and so the only sound in the buses was the clacking of keys on electronic devices. And the G20 was Saturday and Sunday in Toronto, but the leaders were still separated from the media and NGOs, albeit by one mile instead of 200.

Second, the issue of media access to NGOs has been a big issue for the NGOs throughout the summits and continues to be. At recent summits, including both of those last year in Italy and Pittsburgh, NGOs, for the most part, had full access to the international media. This worked to the advantage of both parties and ensured that journalists had just as much access to civil society as they did to governmental delegations who, understandably, want to spin things in their favor (as does civil society).

For some reason which no one understands, the Canadian government thought this was a bad idea and decided to put the NGOs in an “Alternative Media Center” and segregate the two groups in separate buildings across the street from each other. The difference is that the one for the media is surrounded by a high fence and concrete barriers and NGOs are not allowed in without an invitation from someone with proper media credentials. Most of us in civil society have not been invited across the street, and few reporters leave the comfort of their media center to come to us.

The Global Health Council was one of 12 non-governmental organizations that put out a statement critical of the Canadian government for this “media apartheid” which produced an article in Saturday's Toronto Star.

But another aspect of media and civil society access was less commented upon. At the 2009 G8 in L’Aquila, Italy, we all — journalists and NGOs — had access to the heads of state and the country delegations. That is, we were all in the same facility, inside the same perimeter. Because of that, I was able to attend a press conference with President Obama, Prime Minister Harper and other G8 leaders without going through security again. That was not the case in Pittsburgh. And here in Toronto, even most of the mainstream media does not have access to the heads of state, who are in the Toronto Convention Center a mile away from here. In a press briefing this morning by South Korea, the host of the next G20 in November, we were told that Seoul will revert to the L’Aquila model, where we are all together in the same location.

Third, it was interesting to see the different reactions in the NGO community to the announcement of the $7.3 billion, five-year Muskoka Initiative on maternal, newborn, child and reproductive health championed by Canadian Prime Minister Stephen Harper. Even though this is a huge win for global health advocates, given the relative attention that global health attracted at the 2009 summits, the NGO reaction was somewhat, though not uniformly, negative. Generally, the pure advocacy organizations (like the ONE Campaign) and the large implementing organizations that work in many areas of development (like Save the Children and Oxfam) were negative. But the organizations which focus on health,like the Global Health Council and the Partnership for Maternal, Newborn and Child Health, both organizations representing hundreds of other organizations, were much more upbeat about the Muskoka Initiative. As was the African Medical and Relief Foundation (AMREF), the only indigenous African health organization present in Toronto

The Washington Post, one of the few U.S. mainstream media outlets to give this story any legs, published a story entitled “Aid group slams lack of financial support for maternal and child health initiative.” based on quotes only from Save the Children and Oxfam, two of the NGOs that did get into the media center. Other organizations, with more positive perspectives, were not interviewed because they were not in the media center to be interviewed. The Post later published my letter expressing my concerns about that situation.

In this case, it appears that the Canadian government strategy backfired as they might have gotten a better story out on their flagship G8 initiative if they had allowed full access between media and NGOs.

Finally, the Muskoka Initiative on maternal and child health got very good media coverage in Canada (it was front page news on the front of The Globe and Mail, Canada’s premier newspaper, on Saturday, and it was surprisingly prominent in the Canadian TV coverage that I saw). People on the street knew about it; my taxi driver on Saturday night, originally from Bangladesh, told me it was the best story coming out of the G8 and would improve a lot of lives.

I understand why this initiative was a big story in Canada since it is a Canadian initiative and the summits are taking place in Canada. But I wish that the U.S. media had paid more attention to what may be the only truly positive story coming out of the summits. And I wish the NGO community had been more welcoming of what is a highly positive development and a step — if not a leap — in the right direction.

Stephen Harper said something in his press conference on Friday night about the Muskoka Initiative that I liked so much I put it in our G8 press release: "Of all things we could spend our money on, who wouldn't want to spend to save the life of a mother who would otherwise die?"

NGOs feeling mixed as Canadian summits open

TORONTO, Canada — As world leaders arrive in Canada for the twin G8 and G20 summits, we, in the NGO community who advocate for global health, have decidedly mixed feelings about the annual gatherings of world leaders.

On the one hand, we are excited that Canadian Prime Minister Stephen Harper is pushing for a $1 billion Canadian initiative on maternal, newborn and child health (MNCH), a surprising development when it was announced in January since Harper is not known as a champion of international development, and since MNCH was almost completely ignored at the 2009 G8 in Italy and G20 in Pittsburgh. We are grateful to our colleagues in Canadian civil society for their efforts in making that happen.

At the same, NGOs are profoundly disappointed with the tone the same Canadian government has set by barring NGOs and civil society from the international media center for the first time in recent history. In both L’Aquila, Italy and Pittsburgh last year, NGOs and media shared the same media center in a way that was mutually beneficial for both parties.

We don’t understand why the Canadian government felt it necessary to segregate the NGOS in separate facilities. The International Media Center — the “real” media center — is across the street from the “Alternative” Media Center (where the NGOs are congregated and from where I write this) but the “real” center is surrounded by a wire fence and concrete barriers, apparently to impede aggressive NGO representatives, who have to be invited in by journalists.

The Harper government seems to be going in a different direction from the United Nations, which last week opened its process leading to September’s summit on the Millennium Development Goals to civil society and the private sector for the first time, with informal and interactive hearings to get various perspectives on how to accelerate progress towards achieving the MDGs.

Interaction, the coalition of U.S. NGOs with which Global Health Council shares reciprocal membership), felt so strongly about this adverse development that they decided not to send anyone to Toronto, even though it normally coordinates the U.S. civil society presence at these summits. Yesterday, Interaction issued a statement critical of this lack of access, which makes it more difficult to achieve a “transparent monitoring system” that is needed to evaluate if donor countries actually honor their commitments.

U.S. President Barack Obama just arrived at Toronto airport, the last G8 leader to arrive, and is helicoptering to Muskoka, the remote resort area north of here, for the beginning of the G8 Summit. The G20 Summit starts here in Toronto tomorrow.

For great background information and useful links on the G8 and G20 summits, go to the Council's special G8G20 webpage.