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The Thirsty Planet – Part I: An Insight into the Growing Global Water Scarcity Problem

Pradyut Hande is The Future Forum’s Program Director for India and an award-winning youth leader and writer. He has over 250 publications in leading national and international dailies to his credit. This is the first in a three part series aimed at addressing critical aspects of the global water scarcity problem.

Water is truly the essence of life – a natural resource that has been and continues to be critical to our very evolution and existence. However, over the years, our well chronicled profligacy coupled with gross mismanagement fuelled by detrimental developmental activities has resulted in an alarming depletion in the precious resource that is freshwater. Add to that; an ever burgeoning global population, dangerous climate change disruptions and the absence of a clear action plan; have exacerbated the global water scarcity problem.

Let’s look at the basic statistics to begin with. 86% of the total freshwater reserves on the planet are used for agricultural purposes and food production. A further 9% is employed in industrial activities. That leaves a paltry 5% for domestic consumption. Just 5% to support a population of 7 billion inhabitants. Thus, the water scarcity issue today is a twofold conundrum – one of fundamental resource inadequacy and inequity, i.e., not only is water an increasingly scarce natural resource, but the distribution or lack thereof, of the available resources further compounds the acuity of an already dire situation. Read more

Why World Water Day Should be Every Day

Aaron Kinnari is the founder of The Future Forum. Learn more about the world water crisis at TheFutureForum.org/water.

Today is World Water Day. For most folks reading this post, potable water is a short walk to the closest faucet. But for one in nine people around the world, accessing clean water is a much more arduous task.

The absence of this most basic necessity has far reaching consequences. From water-borne diseases that claim millions of lives annually to the billions of dollars in lost productivity and economic opportunity, the global water crisis bares tremendous costs for nations around the world and is crippling long-term growth and development. Read more

Supreme Court Ruling Marks Milestone for Women’s Health

While many are calling Thursday’s Supreme Court ruling a triumph for the Obama Administration, the decision to uphold the heart of the Affordable Care Act also marks a major milestone for women’s health.

The decision is a win for reproductive health organizations, such as Planned Parenthood, that have been an easy target in the recent attacks on organizations that provide abortions.

Women’s health activists lauded the 5-4 Supreme Court ruling as the “greatest achievement” for reproductive health in a generation.

“Affordable, quality health care will now be available to millions of women who had no coverage or inadequate coverage before. Today, we are closer than ever to realizing the promise of health care for all,” president of Planned Parenthood Cecile Richards said in a statement. Read more

Increasing the Cost-Effectiveness of Government Healthcare Programs

By the end of June, the Supreme Court is expected to rule on the constitutionality of the Patient Affordability Act. Much of the debate centers around the individual mandate that would require virtually all US citizens to obtain health insurance or face a penalty. But there is a much lesser known element of the law that may have as great an impact on our nation’s healthcare system as the adoption of the individual mandate. The Center for Medicare & Medicaid Innovation, which was created by and is funded by the Patient Affordability Care Act, is the first nation-wide initiative to focus purely on improving the cost-efficiency of government healthcare programs.

The enormous costs of our government healthcare programs is frequently acknowledged by politicians and policy analysts. The latest CBO report expects between 6% and 10% of our total GDP to be spent on Medicare and Medicaid over the next ten years—where the actual figure will fall depends primarily on the GDP growth rate and whether the Bush tax cuts are allowed to expire. It remains that under almost any plausible fiscal scenario, healthcare outlays are the federal government’s largest source of spending growth over the next decade. Read more

Borrowing a Revolution

This post was originally published on the Center for Strategic and International Studies’(CSIS) “Smart Global Health Blog.”

It was written in response to a question posed by CSIS: Do you think it’s possible to create a unified social movement for NCDs, akin to the movements that already exist for individual chronic diseases? If so, why? If not, what initiatives can we implement in the place of an effective social movement to move an NCD agenda forward?

A unified social movement for NCDs isn’t in the cards.

Building a movement around a diverse set of diseases with broad and varying constituencies just won’t work.

What we need is evolution and revolution in the way we think about combating chronic disease.

In 2009, Michel Sidibé, the Executive Director of UNAIDS, announced that it was time for a “prevention revolution” in the fight against HIV/AIDS. He articulated what we learned in epidemiology 101—treating those who are sick is absolutely essential, but the only way we can actually beat an epidemic is to prevent it from growing.

Those hoping to build a movement for NCDs have focused on the lessons that can be garnered from the early days of the fight against HIV/AIDS. But we can’t forget that we are in very different situation from the AIDS activists of the 1980s and early 1990s, who were fighting a mysterious illness with unknown origins and no treatment options.

Instead, we are at an incredibly unique moment and vantage point in time, with knowledge and tools that those early HIV/AIDS activists could not have dreamed of. We know our epidemic. We know how it is caused, we know what the risk factors are, and we have even estimated how and when it will hit us and how much it will cost.

What we need is “prevention revolution” for NCDs that will use the information we have to change the way we think about combating illness. This revolution would shift the focus from what currently divides the NCD community—specific diseases and conditions—to what unites it—the need to address shared risk factors.

Many will lament, correctly, that changing lifestyles—eating, drinking, and smoking habits—is incredibly difficult.

But we have examples of real success, from the change in attitudes in the United States around tobacco use, to growing awareness in India and China about the dangers of diabetes and unbalanced diets.

Currently, initiatives like President Clinton’s Alliance for the Healthier Generation and First Lady Michelle Obama’s “Let’s Move” campaign are demonstrating how top-down approaches can bring diverse constituencies together to focus on healthy lifestyles (here’s to hoping that they will be equally successful in encouraging their spouses to attend the UN NCDs Summit!).

This kind of broad based coalition building, with government educating and regulating, civil society advocating, and industry becoming a responsible stakeholder, is what will lead to a prevention revolution and real success in the fight against NCDs.

The movement will be more diffuse, less focused, and perhaps more chaotic than past initiatives. But it will also be more flexible and adaptable. It will bring advocates together, rather than separate them over a competition for resources. It will allow cash strapped governments to take the most cost-effective and sustainable path toward preventing economic catastrophe. Even industry will be able to realize benefit in a healthier population ready and able to consume more nutritious products.

Rather than searching for the next viral video or social media campaign to launch the NCDs movement, we must get down to the much harder work of revolutionizing the way we think about how to combat chronic disease.

BRICS on the Brink…of A Heart Attack

Do you remember those Lipitor commercials from a few years ago? A cocky man struts his stuff around the pool, flexing his overly tanned muscles and prepares to dive in. Instead of impressing the ladies with his double pike, he lands flat on his stomach, suffering from a premature heart attack caused by a cholesterol problem he was completely unaware of.

How is this at all relevant to global health or larger world politics? I’m sure you can think of a few countries now strutting their stuff on the world stage. Empowered by high economic growth and a debilitated West, Brazil, Russia, India, China, and the newest member of their club, South Africa, are increasingly optimistic (and perhaps even cocky) about their position in the world and their potential for economic dominance in the future.

But these BRICS are walking around carrying their own heart stopping baggage. They all face enormous challenges in what many predict will be growth crushing epidemics of noncommunicable chronic diseases (NCDs) like heart disease, diabetes and cancer.

In China, 80% of deaths are caused by NCDs, and the country’s rapidly aging population in addition to its declining population growth ensure that the burden of these diseases will only grow, in both absolute numbers and economic cost.

Nearly three out of every four deaths in Brazil is caused by NCDs.

Indians have their first heart attack six years earlier than the rest of the world—killing or disabling a startling number of people during their most productive years of life.

And the economic costs of NCDs are staggering. A recent study estimated that $35 trillion dollars in global economic output will be lost from 2005-2030 because of NCDs. With 80% of chronic disease related deaths occurring in the developing world, we can be sure that the BRICS and other emerging markets will suffer economically if this issue is not dealt with soon.

Despite such scary statistics, the BRICS have a unique opportunity to lead the international community in preventing a public health and economic catastrophe.

In September, the United Nations General Assembly will host a special two-day High Level Meeting on Non-communicable Diseases. Many hope that it will be a turning point in the fight against NCDs. Thus far, it looks like the event will be a bust.

The UN has not been able to get a single head of state/government from a major power to commit to attend the Summit. The Americans and Europeans are tied up with their own economic issues and are largely fatigued by their already extensive commitments in global health. The Caribbean countries, which courageously led the effort to put NCDs on the agenda, don’t have the clout or the resources to influence nations outside of their region.

It is exactly this lack of leadership that opens a door for the BRICS. They have the chance to set the agenda for an issue with incredible global implications without the interference or resistance of the United States or European Union (they could only dream of such circumstances on other global governance issues like the Doha trade talks or climate change negotiations).

The BRICS need to grab this opportunity by the horns. A great start could include the simultaneous launching of national strategies to combat NCDs. This would be followed by a joint proposal for the UN Summit on how the international community can move forward together to combat noncommunicable diseases. While specifics would obviously need to be worked out, a joint proposal from the BRICS, presented ideally by their heads of state/government, would bring much needed attention to the battle against NCDs.

The BRICS, as an unofficial alliance, would gain prestige for finally demonstrating real leadership, rather than acting only as a talking shop.  They would also produce momentum for moving their domestic NCDs agendas forward.

Developing countries would benefit by finally having a global health strategy developed by countries facing similar resource limitations (in comparison to being dictated to from on high by Western donors).

Likewise, rich countries will feel less anxiety that the summit’s only real agenda is to get them to pony up more funds for yet another global health initiative.

There is clearly still a great deal of work to be done before a comprehensive solution to the challenge of NCDs can be developed. However, with no one at the helm, it is unilkely that the international community will be up to the task. The BRICS have domestic and foreign policy incentives for taking up this issue and presenting a united front. Their leadership is not only desirable, but increasingly, necessary.

Without urgent action, we’re headed for a (figurative) belly flop caused by a very real cardiac arrest (or more precisely, several million of them).

Feeding the World, One Cup at a Time.

I remember the first time I saw the red cup.  Josette Sheeran, the Executive Director of the UN’s World Food Program, had brought it with her to the annual meeting of the Clinton Global Initiative.  The cup, smaller than the cup of coffee I buy every morning, represents the size of the meal that, for millions of children around the world, is the only meal they eat all day.

Every year, the World Food Program (WFP) fills these red cups with porridge, rice or beans for more than 20 million school-age children.  Unlike my morning cup of coffee that costs a few bucks, these meals only cost about 25 cents each to deliver.  Still, millions of kids go to bed hungry every day, and WFP estimates that 66 million school-age children around the world attend classes hungry, with one-third of them living in Africa alone.  This hunger creates systemic problems.  Many children are malnourished and cannot perform to their full potential in school, leaving them destined to a lifetime of continued poverty and hunger.  Some children are not even able to attend school, instead having to work to help feed their families.  And sadly, too often when vulnerable children are in the street instead of in a school, they become prime targets for exploitation by those looking to force them into child labor, sex trafficking or extremist groups.

But there is a solution, and it’s not as costly as one would think.  WFP estimates that for about $3.2 billion annually, we can provide meals to all of the 66 million hungry school-age children.  While this is only a fraction of the one billion hungry people around the world, it is a relatively small and manageable commitment that the United States and other developed nations should make today.  Investing in the WFP’s school meals program will encourage youth around the world to attend school, and ensure that they have at least one healthy, substantive meal each day.  By promoting education and providing school meals, we will be taking a tangible step towards breaking the cycle of poverty and hunger that plagues the world.