global health weekly update

February 1 2016

Good day,

Happy Monday and February! Per a request, this week I've included a longer section at the end on what's been happening in Burundi. After this week, I'll also be regularly including a short section dedicated to Burundi headlines.

This newsletter is in the New York Times style, where everything blue/underlined is a hyperlink to a related article on that sentence/idea. The clovers at the end of stories are links to all source articles.
The Zika virus is a growing concern. Early this morning the WHO began a crisis meeting in Geneva to decide whether the explosive spread of the mosquito-borne virus should be declared a global health emergency. The WHO says it is likely to spread to every country in the Americas, except perhaps Chile and Canada. The link between microcephaly and the virus has not been confirmed, but is highly suggestive and concerning. The WHO attributes the rapid spread of Zika to the fact that the population of the Americas had not previously been exposed to it and so lacks immunity. Laura Rodrigues, professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, said there had previously been little research on Zika as it was seen as of “no public health importance”, but the suggestion that it could cause congenital infections and microcephaly had changed that view. The last global emergency declared by the WHO was Ebola in 2014. The hope is that we have learned something from it.

As far as other mosquito-borne diseases go, and on a happier note, African countries have been congratulated for driving down malaria deaths on the continent. The African Leaders Malaria Alliance (Alma) has presented awards of excellence to 14 African countries, including Liberia, Rwanda and Senegal for their performance in controlling malaria over the past four years, and Comoros, Guinea and Mali for showing the biggest improvements. A further eight awards were given to countries that achieved the millennium development goal (MDG) target of halting and reversing the incidence of malaria. They were Botswana, Cape Verde, Eritrea, Namibia, Rwanda, São Tomé and Príncipe, South Africa and Swaziland. Since 2000, deaths from the virus in Africa have fallen by 66% among all age groups and by 71% among children under five. Alma’s executive secretary, Joy Phumaphi, says the WHO have demonstrated that prevention efforts have saved an estimated $900m in case management costs between 2001 and 2004 in direct costs. Some economists have shown we can save up to $34bn a year in direct and indirect costs by eradicating malaria.

Our global population is set to increase to 10 billion by 2060 from the 7.5 billion alive today. Adam Greenfield, a teaching fellow in urban design at the Bartlett School of Architecture, takes a look at how urbanization is expanding in the developing world. The planet’s newest cities are to be found in the places where its population is most rapidly urbanising: India, China and sub-Saharan Africa. Vanessa Watson, an urban planning expert at the University of Cape Town, has written extensively about the dynamic as this plays out in Africa. The new wave of cities seem designed not so much to house existing local populations as to mimic developed countries' styles. Interestingly, many of the cities remain empty. In China, some they are being used mostly as backdrops for wedding pictures. For Adam and Vanessa, these new cities are demonstrating how complexes of land can become comprehensively urbanised without ever really acquiring the character of a city. It's an extremely odd dynamic with millions close at hand clamouring for a decent home. They may, with a few decades’ in-dwelling, habit and custom, someday feel like real urban places, but for many years to come they will almost certainly remain as sterile and empty as any new master-planned development. With some better attention and awareness these empty sparkling cities could become very important places for our bursting population to establish homes.
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UK’s international development secretary Justine Greening is pushing for a plan to persuade Syrian refugees to stay nearer home. “So many refugees are now having to confront the fact they may be refugees for a long time. Their first choice is to stay close to home, and to return to Syria, but we have got to make that choice viable.” An important conference in London on Thursday aims to map out a new way to get a grip on the situation. The day-long event is likely to reveal tensions over the extent to which, and on what terms, leaders in the Middle East will allow Syrians to work legally in their countries. The plan is not only to raise as much cash as possible for food, but also to promise investment that might make it easier for governments to allow refugees access to formal jobs and schooling. Greening says Europe will resolve its migration crisis only by giving people fleeing the Middle East new reasons to stay there. She concluded: “The world faces a choice. Are we going to make sure the children growing up in the region – and they are going to grow up – do so reading and writing with a future, or instead [leave them feeling] fundamentally cheated because they have had no education through no fault of their own but because the international community could not get organized or resourced?” Bravo, Greening.
The growth in renewable energy is fueling new jobs in Africa, where the need and potential for employment is perhaps greatest. The fast-growing economy and population is driving demand for energy, but two-thirds of people in sub-Saharan Africa still lack access to electricity. The renewables revolution is witnessing the rise of a generation of African “solar-preneurs” who are creating small-scale businesses by taking solar energy – in the form of lights, radios and mobile-phone charging facilities – into local communities. Here are a couple happy stories:

  • In Zambia, Sheila Mbilishi, a 67-year-old widow and mother of six, buys small solar lights for $5 and sells them at a 50% profit margin. According to her, they "sell like cupcakes." After three years, she raised enough to open a shop and build a two bedroom house. With solar lights, people like herself can continue working through the constant power outages. Mbilishi says she has "built a house out of lights."

  • In Kenya, Mohamed Abdikadir has a new life as a solar panel installer. He was born in a refugee camp in Dadaab, where the average family spends $17.20 per month – 24% of their income – on energy. His parents came to the camp after fleeing the civil war in Somalia over 20 years ago. They have since passed away, and Mohamed now looks after his ten younger siblings. He was trained in a six-month program about a year ago to install solar panels as part of a programme in Kenya and Ethiopia organised by the Norwegian Refugee Council (NRC). Before he started the program, Abdikadir only made enough to provide one meal a day for his family. Now, with the extra income from solar installations – $10 on an average day – his siblings are eating three meals daily, have new clothing and are able to attend a fee-paying school.
The NRC recently announced plans to deliver a similar program to the one Abdikadir attended, but on a larger scale for Syrians at Zaatari refugee camp in Jordan. The promise of renewable energy in refugee camps could save humanitarian agencies hundreds of millions of dollars and provide job opportunities for thousands of young refugees.

Burundi Special

Brief Overview of the Conflict

The current conflict in Burundi started with President Pierre Nkurunziza running for a third term last April and winning the election. Nkurunziza's decision to seek re-election touched off street protests that led to a failed coup in May and a rebellion that has left the country on the brink of civil war and, more recently, in fear of a renewed ethnic conflict. The United Nations estimates the death toll at 439 people but says it could be higher. More than 240,000 people, poor and elite, have fled abroad to live in refugee camps, and the economy is suffering. Belgium has cut financial support and other foreign donors are being alienated as well. Due to the insecurity, travel and trading have slowed substantially, affecting everyone. In Bujumbura, market prices have doubled due to short supply. Gilbert Niyongabo, a professor of economics at the University of Burundi, estimates that "tax revenue has fallen by 50 percent." Months of talks between the government and the opposition last year failed to make much progress. New negotiations begun at the end of December in Uganda were stalled, despite Ugandan President Yoweri Museveni having Nkurunziza's full support in the mediation efforts, as "somebody who knows very well the problems of Burundi."

December / January

In December, the African Union announced a plan to deploy 5,000 peacekeepers to quell the country's unrest. However, Nkurunziza has been firm in his opinion that sending peacekeepers into his country would constitute "an invading force," and he would attack them as such. According to Alice Nakuto, a member of Imbonerakure (the ruling party's militia), "the majority of Burundians don’t want them and they should not impose themselves on the people of Burundi." According to The Washington Post, on December 26th, thousands of Burundi citizens protested against the AU's plan. However, others report the weekend's protests and burst of social media were a ploy by the government, giving a false impression of the general opinion. In the first week of January, Tanzania became the first and only East African Community member to openly support the deployment. So far they have taken in over 175,000 refugees. Tanzania, a member of the EAC just like Burundi, was to host peace talks in Arusha in early January. The talks were postponed indefinitely when Burundi Government representatives failed to turn up.

Ten days ago, the U.N. security council traveled to Burundi for the second time in less than a year. The day before the U.N. meeting, a group of soldiers and police declared themselves an official rebel movement, with General Godefroid Niyombare as their leader (the former intelligence chief who led the failed coup in May), which deepened concerns that Burundi is sliding back into ethnic conflict. The rebels welcome international mediation but have also called for Burundians to support their fight against Nkurunziza. The Burundi government asserts there is no risk of return to an ethnic war.

During the U.N. meeting, The African Union sought U.N. Security Council backing for the deployment of peacekeeping troops. Members of the African Union Peace and Security Council expected leaders to endorse its proposal to protect civilians, despite Burundi's rejection of the idea in mid-December. There was debate among the U.N. on the best course of action. Russia's U.N. Ambassador, Iliichev, criticizes foreign intervention, arguing that Burundi does not need peacekeepers and instead needs help increasing its own police capacity. He admits, however, that "it will be very difficult to oppose any resolution from the African Union because we always say that there should be African solutions to African problems." Russia is a council veto power. In the meantime, ambassadors urged the African leaders to be planning in advance for the African Annual Summit, in order to work on convincing Burundi to accept a deployment of international troops. A confidential report from the U.N. peacekeeping department said peacekeeping troops should be deployed to Burundi only as a last resort if violence worsens. It states the best option in the event of escalating violence would be intervention by a single country or a coalition of nations, but the focus now should be on trying to promote political dialogue.

This week

Last Monday, Nkurunziza's ministers traveled to Arusha for the East African Legislative Assembly (EALA), a positive step forward, after being conspicuously absent at the peacetalks held there earlier in the month. They were answering to a petition filed by human rights activitists. During the public hearing, Rwanda was accused of supporting the rebels. Rwanda has denied these allegations multiple times, and their government has refused to get involved in the AU's plan since early December. President Kagame says, "we can contribute in any way required [...] but it is not our responsibility."

On Friday, France suspended its security and defense cooperation activities in Burundi. They support mediation by the African Union and others in efforts to calm the unrest.

Africa's annual summit took place this weekend in Addis Ababa, Ethiopia. U.N. Secretary General Ban Ki-moon told African leaders on Saturday they should not use legal loopholes or undemocratic constitutional changes to "cling to power", and that they should respect term limits. U.N. assistant secretary general for human rights, Ivan Simonovic says that the African Union, if it did not send peacekeepers, should at least boost the number of human rights monitors it has there or send some police.

As of today, the AU will not be forcing any peacekeepers on Burundi, given their reluctance to worsen the conflict. They will, however, send a mission to press the government to accept the peacekeeping force.


Fun Tidbit

On a fun renewable energy note, Microsoft has taken to the sea. They have tested a prototype of a self-contained data center that can operate hundreds of feet below the surface of the ocean. Today’s data centers, which power everything from streaming video to social networking and email, contain thousands of computer servers generating lots of heat. When there is too much heat, the servers crash. Putting the gear under cold ocean water could fix the problem. Microsoft is also considering pairing the system either with a turbine or a tidal energy system to generate electricity. The underwater server containers could also help make web services work faster.

Microsoft researchers said they studied the impact their computing containers might have on fragile underwater environments. They used acoustic sensors to determine if the spinning drives and fans inside the steel container could be heard in the surrounding water. What they found is that the clicking of the shrimp that swam next to the system drowned out any noise created by the container. One aspect with obvious potential is the harvest of electricity from the movement of seawater. This could mean that no new energy is added to the ocean and, as a result, there is no overall heating.

Have a wonderful week!