My condom wars with Catholics on three continents

This blog was first published in the Huffington Post on Dec. 3, 2010.

Pope Benedict XVI’s comments last month that condom use can be justified in some cases to help curb the spread of AIDS were surprising to me only because they came from the very top of the Catholic Church. But in my 10 years of managing condom social marketing programs for HIV prevention and family planning, I have come across shocking discrimination as well as enlightenment and compassion from Catholics working with people at the grass roots.

Almost precisely 18 years ago, on World AIDS Day 1992, I launched “Maximum” condoms (“Strong for Maximum Protection, Sensitive for Maximum Pleasure”) in Zambia, a country that had double digit HIV prevalence but no reliable source of high quality, low-priced condoms. Zambia also had a newly-elected president, Frederick Chiluba, who was a born-again Christian and stridently anti-condom.

We had a big launch event at the Pamodzi Hotel with lots of speeches and exhortations on the importance of using condoms. Surprisingly to me, we also had a Catholic priest and nun in attendance. They had come separately and neither was wearing religious attire.

YouTube + Wikipedia = Social Change

WASHINGTON, DC -- What do you get if you combine the video-sharing power of YouTube, the depth of information of Wikipedia and the social change aspirations of an advocacy website? Something called ViewChange.org, as I found out last week when I attended its formal launch at AED headquarters here.

U.S. independent television broadcaster, Link TV, launched “the next generation multimedia platform for global development” that combines powerful video stories with the latest “semantic” technology that allows a person, after viewing one of the many powerful short videos showing "good news" development stories, to extract more information about that issue, and then to take action in a variety of ways. ViewChange.org is funded by the Bill & Melinda Gates Foundation.

After watching a video, you have three options: “Watch More” (as in, watch more videos), “In the News” (to explore an issue in more depth) and “Take Action” (which presents you with a variety of concrete actions ranging from taking political action, donating to a cause or writing a letter to the editor). Every video is tied specific actions that the viewer can take.

ViewChange.org goes way beyond YouTube, where the end point is the merely emotion elicited by the video. With ViewChange.org, the idea is that after the viewer is moved emotionally, the viewer will be moved practically to action.

Two continents, one AIDS epidemic

WASHINGTON, D.C. - The speakers talked about a society with an AIDS epidemic driven by a devaluation of girls and women, young people denied evidence-based sex education, parents in denial about their children’s behavior and religious leaders who sometimes do more harm than good.

They were talking about sub-Saharan Africa.

And they were also talking about the District of Columbia.

The most striking fact to emerge from a panel discussion at Howard University this week on “UN Millennium Development Goal #6: Combating HIV/AIDS” was how similar some of the drivers of HIV/AIDS are in Africa and in Washington, D.C. Indeed, it was said several times that D.C. has the HIV prevalence of a developing country. The event was organized by the D.C. League of Women Voters, Howard University Hospital and the United Nations Association in observance of United Nations Day.

Women heroes of conservation are also improving health

WASHINGTON, D.C. - Earlier this month, I stepped out out of my comfort zone and went to an event on Capitol Hill that had nothing to do with global health, at least not directly. The event, “Women Heroes of Global Conservation,” honored six women who had done extraordinary things to save the planet.

Truth be told, I went to see Wangari Maathai, the 2004 Nobel Peace Prize winner for her work transforming women’s lives and the environment of her country Kenya through the Green Belt Movement she founded in 1977 and which has spread to 15 countries in Africa. Ms. Maathai was ill and could not be present but I heard from five other equally amazing women.

The overall event reinforced my perception that conservation and the environment has a lot to do with health. More and more, I see the links between health, climate change and the environment. We heard from these “Women Heroes of Global Conservation”:

* Mary Mavanza, Tanzania, manager of the TACARE program of the Jane Goodall Institute, has helped hundreds of Tanzanian women start environmentally sustainable business through microcredit loans and training. By improving economic conditions among women in and around Gombe National Park, the TACARE program has protected nearly 200,000 acres of forests and worked with 22 villages to create land use plans.

* Suzan Baptiste, Trinidad, founded Nature Seekers in 1990 and stopped turtle poaching. NatureSeekers is the largest employer in her region of Trinidad and has reforested large areas by hiring women to rehabilitate areas that were destroyed by fires or logging companies. She was named a CNN Hero in 2009.

* Sangduen “Lek” Chailert, Thailand, challenged and transformed traditional wildlife management techniques by setting up elephant sanctuaries and ecotourism program in northern Thailand, a country where there were once 300,000 elephants and now are not more than 3,000. Ms. Chailert has expanded this work to other areas of Thailand.

* Habiba Sarabi, Afghanistan, is the governor of Bamyan Province, the country’s first and only female governor. To improve the lot of women and communities, Governor Sarabi has increased tourism through conservation by creating Afghanistan’s first national Park, Band-e-Amir, protecting 220 square miles of pristine lakes and limestone canyons.

* Lucy Aquino, Paraguay: I was especially keen to hear from Ms. Aquino, who comes from Paraguay, a country where I lived four years and which has a special place in my heart. As the Paraguay director of the World Wildlife Fund, she has improved conservation and empowered women and communities for nearly 30 years. Paraguay once had had one of the highest rates of deforestation in the world in the Atlantic Forest Region, a highly threatened region where indigenous communities have been displaced with the men often going to work on cattle ranches or soybean farms, while their wives and children go to the cities to engage in begging, or worse. Ms. Aquino helped establish a Zero Deforestation Law, which resulted in a reduction in deforestation rates by 85%.

Several speakers, including Ms. Maathai, lamented the fact that the U.S. does not have a conservation strategy. “The U.S. has a thoughtful strategy for improving the well-being of women and girls around the world,” wrote Ms. Maathai in her statement. “It also has a global food security strategy, a global health strategy and a global climate change strategy. It will soon have a global development strategy. But because natural resources underpin each of these goals, there must also be a conservation strategy. None of these other strategies can truly succeed over the long term with one.”

To that end, Democrats and Republicans in the Senate and the House have come together to propose the Global Conservation Act of 2010 to prevent the destruction of our world’s forests, reefs and other ecosystems. On June 17, 2010, Senators Tom Udall, a liberal Democrat, and Sam Brownback, a conservative Republican, introduced legislation that would coordinate the work of all U.S. agencies involved in international conservation and establish a national strategy for promoting conservation.

According to the Alliance for Global Conservation, the main organizer of this event, health is one of the major benefits of conservation. Half of the new drugs created in the past 25 years have an ingredient derived from nature, according to the Alliance, and over 70% of all cancer drugs are based on natural compounds.

As the most senior representative of the U.S. government at the event, Undersecretary of State for Democracy and Global Affairs Maria Otero recounted a personal manifestation of climate change: The mountain she used to ski on when she was a child in her native Bolivia is now brown and barren of snow, she said.

Undersecretary Otero said that the U.S. is committed to international conservation, spending $300 million on it every year, and mentioned one recent example — the announcement of a Global Alliance for Clean Cookstoves, a public-private partnership led by the United Nations Foundation and several U.S. government agencies, to save lives, improve livelihoods, empower women and combat climate change by creating a market for clean and efficient cookstoves. Exposure to smoke from traditional stoves and open fires accounts for nearly 2 million premature deaths annually, with women and young children the most affected, according to the World Health Organization. This is one of the many ways conservation can improve human health.

So if you support global conservation, you are also supporting global health.

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.