There is a new paper from JOURNAL OF HEALTH DIPLOMACY that is worth of taking the time to read. Just the impact to combating Global Health issues associated with and tangential to WASH efforts is huge, not to mention many other areas of global health. This 21 page paper does a great job of addressing / itemizing the complexities of a problem, that laymen would think could be solved in a fortnight.
Global Health Diplomacy and the Governance of Counterfeit Medicines: A Mapping Exercise of Institutional Approaches
By Tim K. Mackey*
AbstractObjective. Counterfeit medicines are a global, multi-faceted, and complex public health problem. Global health diplomacy and cooperative efforts relying on governance systems have been limited in effectively addressing proliferation of this dangerous trade. Methods. This review conducts a comprehensive mapping exercise of governance efforts by international organizations to address counterfeit medicines, including analysis of related international treaties and conventions that may be applicable to anti-counterfeit efforts. This work also reviews governance and global health diplomacy proposals from the literature that addresses counterfeit medicines.Summary of Findings. A number of international organizations have become active inaddressing the global trade of counterfeit medicines. However, governance approaches by international organizations, including the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC), Interpol and the World Customs Organization (WCO), have varied in scope and effectiveness. Treaty instruments with applicability to counterfeit medicines have also not been fully leveraged to combat this issue. Results indicate that a formalized and multi-stakeholder governance mechanism is needed to address the issue. The UNODC is uniquely situated to act as a forum for such a proposal in partnership with other international organizations.Implications of Findings. Global health diplomacy efforts to combat counterfeit medicines require multi-stakeholder and formalized governance structures that can leverage stakeholder participation and resources. Through cooperative arrangements leveraging the strengths of partners such as UNODC (combating transnational crime), Interpol (lawenforcement purposes), the WCO (customs and border control), and the WHO (for public health science and analysis), the international community can mobilize a coordinated, inclusionary, health diplomacy response to the crisis of global counterfeit medicines.
* Tim Mackey, MAS, is a Senior Research Associate with the Institute of Health Law Studies, California Western School of Law; a Ph.D. Candidate with the Joint Doctoral Program on Global Health, University of California San Diego-San Diego State University; an Investigator with the San Diego Center for Patient Safety, University of California San Diego School of Medicine; a Clinical Instructor (Health Services) with the Department of Anesthesiology, University of California San Diego School of Medicine; and the Coordinator for Global Health Research with the Joint Program on Health Policy, University of California, San Diego-California Western School of Law. He is a recipient of the 2012 Horowitz Foundation for Social Policy Grant for graduate researchers, the 2011-2012 Carl L. Alsberg, MD Fellow, Partnership for Safe Medicines and the Rita L. Atkinson Fellow, and gratefully acknowledges that support. E-mail: firstname.lastname@example.org
Citation: Mackey, T. (2013). Global Health Diplomacy and the Governance of Counterfeit Medicines: A Mapping Exercise of Institutional Approaches. Journal of Health Diplomacy. Published online June 13, 2013.
Editor: Rachel Irwin, Stockholm International Peace Research Institute
Managing Editor: Mark Pearcey, Carleton University
Published: June 13, 2013
Type: Review Article – Peer Reviewed
Journal of Health Diplomacy:
The Journal of Health Diplomacy (JHD) is an open-access, peer-review journal that publishes editorials, original research papers and commentaries on issues pertaining to the field of health diplomacy. In keeping with its objective – of generating and disseminating research to ensure foreign policy decisions and discourses on global health are informed by the best available evidence – issues are published twice annually on a thematic basis; themes are selected based on their timeliness and relevance to the field. JHD welcomes contributions from all academic disciplines, including anthropology, geography, history, international relations, legal studies, political science and sociology.
- Africa: 550 million counterfeit medicine seized in 10 days (custom-ised.com)
- The World Customs Organization (WCO) and the Institute of Research Against Counterfeit Medicines (IRACM) issue a new warning about the health and safety of African populations (nlipw.com)
- Firm hopes end to fake drugs is on Horizon (independent.ie)
2.4 billion people will lack improved sanitation in 2015
World will miss MDG target
GENEVA/NEW YORK, 13 May 2013 – Some 2.4 billion people – one-third of the world’s population – will remain without access to improved sanitation in 2015, according to a joint WHO/UNICEF report issued today.
The report, entitled PRogress on Sanitation and Drinking-Water 2013 Update, warns that, at the current rate of progress, the 2015 Millennium Development Goal (MDG) target of halving the proportion of the 1990 population without sanitation will be missed by eight per cent – or half a billion people.
While UNICEF and WHO announced last year that the MDG drinking water target had been met and surpassed by 2010, the challenge to improve sanitation and reach those in need has led to a consolidated call for action to accelerate progress.
“There is an urgent need to ensure all the necessary pieces are in place – political commitment, funding, leadership – so the world can accelerate progress and reach the Millennium Development Goal sanitation target,” said Dr Maria Neira, WHO Director for Public Health and Environment. “The world can turn around and transform the lives of millions that still do not have access to basic sanitation. The rewards would be immense for health, ending poverty at its source, and well-being.”
The report echoes the urgent call to action by United Nations Deputy Secretary-General Jan Eliasson for the world community to combine efforts and end open defecation by 2025. With less than three years to go to reach the MDG deadline WHO and UNICEF call for a final push to meet the sanitation target.
“This is an emergency no less horrifying than a massive earthquake or tsunami,” said Sanjay Wijesekera, global head of UNICEF’s water, sanitation and hygiene (WASH) programme. “Every day hundreds of children are dying; every day thousands of parents mourn their sons and daughters. We can and must act in the face of this colossal daily human tragedy.”
Among the key findings from the latest 2011 data, the report highlights:
- Almost two-thirds (64 per cent) of the world’s population had access to improved sanitation facilities, an increase of almost 1.9 billion people since 1990.
- Approximately 2.5 billion people lacked access to an improved sanitation facility. Of these, 761 million use public or shared sanitation facilities and 693 million use facilities that do not meet minimum standards of hygiene.
- In 2011, 1 billion people still defecated in the open. Ninety per cent of all open defecation takes place in rural areas.
- By the end of 2011, 89 per cent of the world population used an improved drinking-water source, and 55 per cent had a piped supply on premises. This left an estimated 768 million people without improved sources for drinking water, of whom 185 million relied on surface water for their daily needs.
- There continues to be a striking disparity between those living in rural areas and those who live in cities. Urban dwellers make up three-quarters of those with access to piped water supplies at home. Rural communities comprise 83 per cent of the global population without access to improved drinking- water source and 71 per cent of those living without sanitation.
Faster progress on sanitation is possible, the two organizations say. The report summarizes the shared vision of the water, sanitation and hygiene (WASH) sector including academia, human rights and global monitoring communities for a post-2015 world where:
- No one should be defecating in the open
- Everyone should have safe water, sanitation and hygiene at home
- All schools and health centres should have water, sanitation and hygiene
- Water, sanitation and hygiene should be sustainable
- Inequalities in access should be eliminated
Download the entire report and get more information at:
About the JMP
The WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation is the official United Nations mechanism tasked with monitoring global progress towards the Millennium Development Goal (MDG) relating to access to drinking water and sanitation. The JMP data helps draw connections between access to clean water and private sanitation facility and quality of life.
The World Health Organization is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. From its inception, WHO has recognized the importance of water and sanitation. Visit www.who.int for more information.
UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.
Community Approaches to Total Sanitation (CATS), now being supported by UNICEF in 50 countries around the world, including crucial ones in sub-Saharan Africa and South Asia, have led to more than 39,000 communities, with a total population of over 24 million people, being declared free of open defecation within the last five years.
For more information about UNICEF and its work visit: www.unicef.org.
For further information, please contact:
Rita Ann Wallace, Communications Officer, UNICEF New York,
Tel: + 1 212 326 7586 / Mobile: + 917 213 4034, email@example.com
Nada Osseiran, Communications Officer, WHO Geneva,
Tel: + 4122 791 4475 / Mobile: + 4179 445 1624, firstname.lastname@example.org
- When Sanitation Does Not Have Clear Institutional Home or Accountability, Progress Lags: UN Deputy Secretary-General (washlink.wordpress.com)
- Everyone needs a place to go (thehindu.com)
- Third World Problems (cameronkoizumi.wordpress.com)
- Global Health Plan Aims to End a Third of Childhood Deaths (ipsnews.net)
- Diarrhoea kills 10,000 under five children in Ghana annually – Minister (ghanabusinessnews.com)
- Post-2015 development agenda must reflect all dimensions of sustainability (guardian.co.uk)
High Level Forum Calls for Improved Targeting of Aid for Sanitation and Water, Donor Coordination, and Practical Solutions
Financial commitments and coordinated action needed to trigger positive outcomes for water and sanitation sector
Washington D.C. / USA, April 28, 2010 – Finance and Water Sector Ministers representing 18 countries met Friday with representatives of 13 donors, seven UN agencies and civil society for the First Annual High Level Meeting (HLM) of Sanitation and Water for All. The meeting, held at the World Bank, was hosted by UNICEF on behalf of the new Sanitation and Water for All partnership, and aimed to shape sector dialogue and to stimulate aid targeting, donor coordination, and on-the-ground action to ensure access to sanitation and safe drinking water for the billions who have none.
The meeting was co-chaired by HRH Prince Willem-Alexander from the Netherlands, Chair of the United Nations Secretary-General’s Advisory Board on Water and Sanitation and Mr. Saad Houry, Deputy Executive Director of UNICEF. Event participants took stock of progress, shared best practices, explored the linkages between water, sanitation, economic growth and health, and committed to addressing appropriate allocations for these basic services.
Hon. Buyelwa Patience Sonjica, Minister of Water and Environmental Affairs, South Africa and Chair of the African Ministers’ Council on Water (AMCOW), on behalf of the 15 water and sanitation Ministers in attendance, specifically urged donors to increase the percentage of sector aid allocations to basic services from the current 16% to 27% and the percentage of sector aid going to low-income countries from 42% to 50%.
She noted that sixty Africans die every hour because of water-related diseases, and an estimated 672 million have no access to safe drinking-water. To address what she described as an untenable situation with staggering health, social, and economic impacts, participants needed to “stop talking and start acting. We have the capacity and commitment to turn this situation around. It is a matter of life and death.”
Citing the Secretary of State Clinton’s recent “water defines our planet” statement, Under Secretary of State for Democracy and Global Affairs Maria Otero explained that for the US, water is a global imperative and one of the most pressing foreign policy challenges of the 21st century, and that the US is ramping up its efforts to build capacity, strengthen diplomatic efforts, build political will, mobilize support, and harness water and sanitation technologies, in addition to proposing a multi-donor technical assistance mechanism.
“No one country can address the challenges alone. Each must take responsibility for local and regional solutions, investing in people, infrastructure, and cutting-edge technologies. Sound water and sanitation sector planning and strategic donor planning and coordination are also needed,” she explained. She challenged donors to better align their assistance to national priorities and to work with partners, and she challenged all meeting participants to leave with greater resolve and to translate words into concrete action on the ground.
Dr. Maria Neira, Director of the Department of Public Health and Environment at the World Health Organization (WHO) presented findings and analysis from the UN-Water Global Annual Assessment of Sanitation and Drinking-Water (GLAAS) to provide context and inform the deliberations. “Forty percent of the global population is without access to basic sanitation and 13% without access to safe drinking-water. This trend cannot continue. We need to improve and target investments, make the most of limited resources, and push for stronger partnerships and better donor coordination. It’s time for committed involvement by all parties,” she said. “The economic case for sanitation and drinking-water is no longer in doubt. It is the key to development, human progress and dignity. Water defines our health, and for WHO, there is no health without sanitation and drinking water.”
“There is clearly a shift in sector dialogue indicating that water and sanitation are the missing link in achieving many of the Millennium Development Goals. In preparation for this meeting, Ministries of Finance in 18 countries worked with Ministers responsible for sanitation and water to examine current progress, determine national budget allocations and identify investment gaps,” explained Clarissa Brocklehurst, UNICEF Chief of Water, Sanitation and Hygiene (WASH). “This process has engaged government officials at the highest levels and increased their knowledge and understanding of the economic impacts of sector investments and the huge potential benefits for public health, gender equity, poverty reduction and economic growth,” she said.
Overall, the High Level Meeting participants called for more synergies and commitment, continued dialogue, better use of resources, capacity building, human resource development, increased water and sanitation sector planning, public-private partnerships, development of integrated approaches, and evidence-based decision-making.
As a framework for action, Sanitation and Water for All will serve as a means to coordinate efforts globally and link those efforts to country level dialogue and actions. Commitments from this first annual meeting have been documented and the GLAAS report will be one of the mechanisms partners use to monitor these commitments and progress over time.
“This event is a testament to the seriousness of our intention to chart a new course for the sector. Sanitation and water are a cornerstone of development and crucial to ensuring the survival and development of children. The sector needs more attention, more investments, and better targeting of those investments,” noted UNICEF Deputy Executive Director Saad Houry.
About Sanitation and Water for All SAN4ALL
Sanitation and Water for All is a global partnership aimed at achieving universal and sustainable access to sanitation and drinking-water for all, by firmly placing sanitation and water on the global agenda with an immediate focus on achieving the MDGs in the most off-track countries.
For further SAN4ALL information please visit:
For further information please contact:
# UNICEF: Ms. Saira S Khan, UNICEF Media, New York, Tel: 1 212 326 7224, Email:email@example.com
for other perspectives see
UN-Water Global Annual Assessment of Sanitation and Drinking-Water (GLAAS)
The Global Annual Assessment of Sanitation and Drinking-Water (GLAAS) is a UN-Water initiative implemented by the World Health Organization (WHO). The objective of UN-Water GLAAS is to provide policy makers at all levels with a reliable, easily accessible, comprehensive and global analysis of the evidence to make informed decisions in sanitation and drinking-water.
With over 2.6 billion people living without access to improved sanitation facilities, and nearly 900 million people not receiving their drinking-water from improved water sources, UN-Water GLAAS highlights where efforts stagnate in achieving the Millennium Development Goal Target 7.C.−to halve, by 2015, the proportion of people without sustainable access to safe drinking-water and basic sanitation. It also highlights the post-2015 challenges that need to be addressed by the United Nations system to collectively support its Member States.
The findings from the UN-Water GLAAS report will be presented at the first annual High-Level Meeting of Sanitation and Water for All, hosted by UNICEF on 23 April 2010 in Washington, DC. The High Level Meeting will provide a forum for Ministers of Finance from developing countries, accompanied by Ministers responsible for sanitation and water, and representatives from donor countries to gain a greater understanding of the linkages between water, sanitation, and economic growth, in order to commit the appropriate resources, as well as to promote a culture of mutual accountability, partnership and shared responsibility.
The Guardian posted whats surly to be controversial article, speaking with Prof Asit Biswas, where he make the statements leading to the byline Water pollution expert derides UN sanitation claims. The artilce by Juliette Jowit guardian.co.uk, quotes Prof Biswas as saying:
“If somebody has a well in a town or village in the developing world and we put concrete around the well – nothing else – it becomes an ‘improved source of water’; the quality is the same but you have ‘improved’ the physical structure, which has no impact,” said Biswas. “They are not only underestimating the problem, they are giving the impression the problem is being solved. What I’m trying to say is that’s a bunch of baloney.”
This is in apparent frustration to reports fro the UN
according to Juliette Jowit : ‘In its latest report on the progress of the UN Millennium Development Goal to halve the proportion of people lacking access to safe drinking water and basic sanitation, the World Health Organisation said that since 1990 1.3 billion people had gained access to improved drinking water and 500 million better sanitation. The world was on course to “meet or exceed” the water target, it said, but was likely to miss the sanitation goal by nearly 1 billion people.’
I assume people in the field will be backing Prof Asit Biswas, while I fear those in the mas media and in power will take the UN finding at face value, diminishing the focus of the on Watsan and millennium goals.
worthy of reprinting: Here is the beginning of a great article by Francisca Oluyole in the Daily Triumph
Impact of sanitation on survival
By Francisca Oluyole
UNICEF reports recently indicated that diarrhea prevalence rate in Nigeria is 18.8 per cent.
The rate, according to the report, is “one of the worst in sub-Saharan Africa”.
For many experts, the situation is “just not good enough” for a leading producer of crude oil, especially as children remain the worst victims of such a preventable disease.
Associated mostly with vomiting, purging and dehydration, diarrhea has been identified by the Nigerian health authorities as the second largest direct cause of child morbidity and mortality in Nigeria.
According to statistics from UNICEF, diarrhea accounts for more than 16 per cent of child deaths. That is a total of 150,000 deaths amongst children under five, annually.
Experts trace the disease to a lack of access to basic sanitation facilities and poor hygiene practices.
They say it is closely connected with malnourishment, as undernourished children usually have a compromised immune system and are also at a higher risk of developing pneumonia.
Recent reports from the World Health Organisation (WHO) have confirmed that Nigerian children will continue to be victims of diarrhea as the country is said to be one of the seven high-population countries with
total sanitation coverage of less than 50 per cent.
In effect, less than half of the population has access to improved sanitation and the access is as low as 10 per cent in some states with the situation worse in the rural areas.
The situation, according to the reports, has worsened in the last two decades, with environmental sanitation problems resulting in an escalating negative impact on public and environmental health.
Experts say poor environmental sanitation in Nigeria is characterised by the presence of heaps of refuse in cities, indiscriminate disposal of solid and other wastes, blocked drains, overgrown weeds, among others.
The state of food sanitation in homes, markets and abattoirs is equally appalling and unwholesome as food meant for human consumption is exposed to dust, flies, bacteria and other micro-organisms, they say.
The experts say that such probably accounts for the increasing cases of food-borne diseases such as cholera, food poisoning and typhoid fever.
According to Mr Jones Abari, an Abuja-based community health expert, the lack of safe and private toilets and hand-washing facilities in schools has ensured a quicker development of sanitation-related diseases on children. ….
to read full article by Francisca Oluyole in Daily Triumph go to http://www.triumphnewspapers.com/impact1522010.html R/AUWAL 1 1431 A.H. published MONDAY FEBRUARY 15 2010.
Global Annual Assessment on Sanitation and Drinking-water
WHO is leading the GLAAS initiative on behalf of UN-Water. Publication of the first GLAAS report is scheduled for March 2010.
The UN-Water Secretariat requested a report on progress in the assessment and how its results will fit into the Global Framework for Action on Sanitation and Water Supply. The information is available on the following web
UN-Water, an inter-agency mechanism formally established in 2003 by the United Nations High Level Committee on Programmes, has evolved out of a history of close collaboration among UN agencies. It was created to add value to UN initiatives by fostering greater co-operation and information-sharing among existing UN agencies and outside partners
UN-Water focuses on:
- Providing information policy briefs and other communication materials for policy- makers and managers who work directly with water issues, other decision-makers that have an influence on how water is used, as well as the general public.
- Building the knowledge base on water issues through efficient monitoring and reporting systems and facilitating easy access to this knowledge through regular reports and the Internet.
- Providing a platform for system-wide discussions to identify challenges in global water management, analyse options for meeting these challenges and ensuring that reliable information and sound analysis informs the global policy debate on water.
Interview with Federico Properzi who is a technical officer with the World Health Organization (WHO) and the project manager for UN-Water’s Global Annual Assessment of Sanitation and Drinking-Water (GLAAS).
While this is being covered everywhere , I thought it is worth mentioning. It seems important that in this report WHO is stressing Zink tablets in conjunction the oral rehydration solution (ORS) The tables and charts provide excellent statistic for fundraisers and agencies wanting to bring help and awareness. For those in the field there are important points to note but ones in the field may ask “tell us something we don’t know”
Recognition of the reality that “WASH/WATSAN” address seems to be following the same slow path of Global Warming (and other critical realities) , taking its time to come to be mainstream and get the energy it deserves. Hopefully the material presented within shall be an effective red flag to wave to get recognition and resources.
the publication Diarrhoea: why children are still dying and what can be done is available in pdf format for viewing
from the press release:
Past success and present needs
Campaigns targeting childhood diarrhoea in the 1970s and 1980s achieved success by scaling up the use of oral rehydration solution (ORS) to prevent dehydration and by educating caregivers. In spite of the promising results of these campaigns, in recent years the international community has shifted its focus to other global emergencies. There is now an urgent need to focus once more on preventing and treating diarrhoea.
Treatment with ORS and zinc tablets
WHO and UNICEF recommend treating diarrhoea with low-osmolarity ORS and zinc tablets, which decrease the severity and duration of the attack. These treatments are simple, inexpensive and life-saving.
Access to clean water and good hygiene practices are extremely effective in preventing childhood diarrhoea. Hand washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent, making it one of the most cost-effective interventions for reducing child deaths from this neglected killer.
from the publication:
For a number of years, there was one zinc product that met quality standards for international procurement by UNICEF. Zinc is now procured by UNICEF, governments and
other agencies and is manufactured locally in a handful of countries. However, meeting policy and regulatory requirements for importing a new product continues to present challenges for zinc introduction in many countries. Moreover, changing child health treatment recommendations nationally can also be difficult.
Compounding the problem is the fact that initial start-up funds for these new treatments can be significant, and beyond the scope of regular health budgets. In addition, many countries are hesitant to buy zinc because they have little experience with it as part of diarrhoea management programmes: They are unsure of the demand and are reluctant to devote funds to one-time start-up activities, such as developing training materials. ….
The challenges of scaling up zinc and increasing usage rates of ORS are steep, but not prohibitive. A renewed call to action is needed to ensure that increasing coverage
of diarrhoea treatment interventions becomes an international
pulications Sources: Global Zinc Task Force, 2009; UNICEF Supply Division, 2009.
“Please be advised that the latest version of the WHO Technical Notes for Emergencies prepared by WEDC…”
Please click below to view pdfs of the World Health Organization Technical Notes for Emergencies.
- Cleaning and disinfecting wells
- Cleaning and disinfecting boreholes
- Cleaning and disinfecting water storage tanks and tankers
- Rehabilitating small-scale piped water distribution systems
- Emergency treatment of drinking water at the point of use
- Rehabilitating water treatment works after an emergency
- Solid waste management in emergencies
- Disposal of dead bodies
- How much water is needed
- Hygiene promotion in emergencies
- Measuring chlorine levels in water supplies
- Delivering safe water by tanker
- Planning for excreta disposal in emergencies
- Technical options for excreta disposal
- Cleaning wells after seawater flooding