The Crossing

BLOG FROM THE WORLD CONGRESS ON HEALTH ECONOMICS, BEIJING

noreply@blogger.com (Julia Day) — Mon, 13 Jul 2009 06:06:24 PDT

By JULIA DAY, STEPS Centre member

'Harmonising health and economics' sounds like a tall order, nonetheless it is the title of this year's World Congress on Health Economics being held in Beijing.

Our colleagues from Future Health Systems and POVILL, Samantha Reddin and Adrijana Corluka, are blogging live from the event, and have already covered subjects including the role of the private sector, social franchising, innovation and training, as well as giving a flavour of what's happening behind the scenes in Beijing.

Check out their blog on the Eldis Community site to keep up-to-date with all the goings-on at the International Health Economics Association event.

AID FOR AIDS: HOW DO COMMUNITY GROUPS NEGOTIATE THE NEW FINANCIAL ARCHITECTURE?

noreply@blogger.com (Kate Hawkins) — Mon, 29 Jun 2009 08:28:19 PDT

By Kate Hawkins, STEPS Centre member

The past decade has witnessed a change in the public health funding landscape - with the rise of global health initiatives as well as increases in bilateral funding for health sector development. Action on HIV/AIDS has been associated with high profile programmes such as the Global Fund to Fight AIDS, TB and Malaria and the US President’s Emergency Plan for AIDS Relief as well as large philanthropic initiatives such as the Bill and Melinda Gates Foundation.

How to improve the aid architecture for health is a hot topic. Recent weeks have seen publication of a report from the World Health Organization’s Maximizing Positive Synergies Collaborative Group and a widely read editorial in the Lancet about the effect of global health initiatives on efforts to strengthen health systems.

Critics of global health initiatives have claimed they lead to inefficiency, duplication, lack of country ownership and the co-option of national agendas by international agencies and the private sector. Many health actors have called for greater simplification of the way that aid for health delivered often favouring sector wide and general budgetary support. However, others have cautioned that budget support needs good governance, transparency and real ownership by the citizens of countries if it is to deliver the health outcomes that are needed.

In some respects explorations of the aid architecture have tended to represent the view ‘from above’ or to concentrate on tracking the flow of funds. Very little research has been conducted into how community groups experience the new aid for AIDS - how sovereignty and the politics of knowledge at local level are influenced by these global health relationships. Whilst funding directives might provide constraints they may also open up new possibilities in the negotiation of appropriate local responses to the epidemic. These may influence the relationship between citizens and the state.

To address this gap in the knowledge base IDS is working with the Research for Equity and Community Health (REACH) Trust (Malawi), Institute of Economic and Social Research of the University of Zambia and the African Population and Health Center (Kenya) on a three-country research project, ‘Aid for AIDS’, which will highlight community level stories, as well as perspectives of government and international representatives, and will provide lessons for future donor policy.

The long-term vision underpinning this study is of a World where local people have appropriate resources, knowledge and informed access to options for transcending significant health and social challenges.

To find out more about the project contact Hayley MacGregor.

BEYOND SCALING UP: PATHWAYS TO UNIVERSAL ACCESS

noreply@blogger.com (Kate Hawkins) — Wed, 24 Jun 2009 07:27:18 PDT

By Kate Hawkins, STEPS Centre member

The STEPS Centre and our affiliate Future Health Systems are launching a series of activities that challenge the thinking behind prevailing concepts of “scaling up” in the health sector.

There is an increasing awareness amongst policy-makers in developing countries that their government's health services do not adequately meet the health-related needs of the poor.

Opinions on how to improve access to services vary. There is a long standing debate on the relative merits of blue-print approaches, which involve the replication of a well-designed intervention in multiple settings, and locally driven approaches, which rely exclusively on local innovation. Both have limitations.

The dominant response of developing country decision makers and donors has been to identify interventions which have been cost-effective in meeting health-related needs, often through pilot projects, and propose that these interventions are “scaled up” through the design of large programmes. Most discussions of scaling up focus explicitly or implicitly on the public sector and on the interventions which increased public resources should fund, whether through integrated or vertical approaches.

But a growing body of evidence indicates that the translation of increased resources into improved access is much more complex than the language of “scaling-up” implies. Health-related needs are diverse; they vary by setting and group. Blue-print approaches are rarely adaptive enough to work in predictable ways in different contexts, and are likely to produce unintended consequences, which can lead to poorly functioning and unsustainable interventions. In the case of locally driven approaches, it is more difficult to move to institutional scale and transmit learning from one site to another, so the impact may be local and modest.

Our work on “Beyond Scaling Up: Pathways to Universal Access” will explore emerging approaches that support local and scaled up innovations and facilitate rapid organisational learning about what works and what does not. It will contribute to discussions of practical approaches for ensuring that substantial increases in health financing lead to significant improvements in access to health services.

We are in the midst of a number of simultaneous transitions in demography, epidemiology, medical technology, information and communications technologies and economic and governance arrangements. We need to identify strategies for working with the uncertainties that these changes bring in addressing major health-related needs. We need to recognise that socio-technical systems and social institutions move along pathways that are profoundly influenced by their historical development. This both produces path dependency and opens opportunities for different models to emerge, and for alternative pathways to be built and promoted.

BLOG FROM THE SCIENCE FORUM 2009

noreply@blogger.com (Julia Day) — Thu, 18 Jun 2009 07:32:33 PDT

By JULIA DAY, STEPS Centre member

Former STEPS member Dominic Glover was blogging earlier this week for The Broker from the Science Forum 2009, in Wageningen, the Netherlands. Dominic, now a Postdoctoral fellow in technology and agrarian development at Wageningen University, provided a blogger’s perspective on the sessions, conversations and general atmosphere at the forum.

The Science Forum is organized by the Consultative Group on International Agricultural Research (CGIAR) Science Council, in partnership with the CGIAR Secretariat, the Alliance of the CGIAR Centers, the Global Forum on Agricultural Research (GFAR) and Wageningen University and Research Centre (Wageningen UR).

noreply@blogger.com (Julia Day) — Thu, 18 Jun 2009 07:26:16 PDT

By JULIA DAY, STEPS Centre member

Like many, I have been following recent events in Iran with interest. The use of social media (Twitter, YouTube, Facebook etc) via mobile and the net to organise and reveal ordinary Iranians’ perspectives has been fascinating and ground-breaking.

Timothy Garton Ash says in today's Guardian: “Probably the single most important thing the US state department has done for Iran recently was to contact Twitter over the weekend, to urge it to delay a planned upgrade that could have taken down service to Iranians for some crucial hours of people power protest. Welcome to the new politics of the 21st century.”

Sky News reports: “2.25 million blog posts were written about Iran in the last 24 hours, a significant sign of the way the political crisis in Tehran has captured the attention of a global web audience. But in a single hour on Wednesday, more than 220,000 messages on that topic were sent via Twitter.” Although it is getting harder to find tweets from inside Iran, says the report.

If you want to have a look at some of the activity, here are some links, but please do note that there are some graphic violent images flying around, particularly on the Flickr site:

YouTube: Iran videos

Twitter feeds:
#IranElection
#Iranvote

Flickr: Iran feed

KILLER DUST: NEW ASBESTOS REPORT

noreply@blogger.com (Julia Day) — Tue, 16 Jun 2009 05:59:17 PDT

By JULIA DAY, STEPS Centre member

STEPS member Linda Waldman has co-aurthored a new academic report commissioned by construction union UCATT. Linda and Heather Williams have uncovered huge deficiencies in the rules covering the management of asbestos in people’s homes. Potentially exposing both residents and maintenance workers to asbestos exposure.

Householders undertaking standard DIY functions are at particular risk of unknowingly exposing themselves to asbestos. This was due to a combination of ignorance and a lack of readily accessible information and advice.

The report As Safe as Houses? by Dr Linda Waldman and Heather Williams, will be formally launched at a meeting in Parliament today (June 2). It primarily examines how asbestos is managed and removed in social housing but also uncovers major flaws in legislation concerning properties containing asbestos in the private sector.

Alan Ritchie, General Secretary of UCATT, said: “Everyone has a right to feel safe in their own homes. This excellent new report details how thousands of householders’ health is being put at risk because they do not know that asbestos is present in their home.”

A copy of the report, As Safe as Houses?, can be viewed here . Media coverage of the report includes pieces by The Mirror and Local Government Chronicle.

MANIFESTO SEMINAR: DR. PADMASHREE GEHL SAMPATH ON IP

noreply@blogger.com (Julia Day) — Tue, 16 Jun 2009 07:34:58 PDT

By JULIA DAY, STEPS Centre member

See photos from this event (Flickr link)

We're delighted to have Dr Padmashree Gehl Sampath of the United Nations University with us today to talk about 'Promoting Knowledge Generation through Intellectual property in Late Development', as part of the Innovation, Sustainability, Development: A New Manifesto project.

While the centrality of knowledge, technology and innovation to the process of economic development is broadly agreed upon, the precise mechanics of overcoming economic development challenges in different contexts vary. Dr Gehl Sampath's paper presents important findings on the role of intellectual property in latecomer development both from a theoretical and empirical point of view.

Her paper seeks to position IPRs and their role within a framework on innovation and knowledge for latecomer development. This is followed by evidence gathered by the author through empirical surveys on the impact of IPRs (as opposed to a range of other factors) at firm and organizational level innovation in some latecomer countries across Asia and Africa.

We'll have video, audio, photos and Dr Gehl Sampath's presentation on the STEPS website soon. The links will be here on The Crossing.

A NEW MANIFESTO: STUDENT ROUNDTABLE REPORT

noreply@blogger.com (Julia Day) — Thu, 11 Jun 2009 08:33:41 PDT

By ELISA AROND, Research Assistant for the Innovation, Sustainability, Development: A New Manifesto project

A group of students and Visiting Fellows gathered at the Institute of Development Studies in Brighton on May 27 for the second of our Innovation, Sustainability, Development: A New Manifesto roundtable events. Although the event was local, for the Brighton-based STEPS Centre, it was global in the scope and backgrounds of its participants. Participants came from across the Sussex University campus, with diverse disciplinary approaches, originating from across the globe.

Students from SPRU Science and Technology Policy Research, the Centre for Development and Environment (CDE) and IDS, grappled with each others’ perspectives and the vocabulary and ideas of the STEPS Centre.

Among the questions that arose were: What do you mean by governance? What do you mean by innovation systems? What are sustainable pathways? What does that mean for policy? Who chooses, designs, or implements these pathways and policies? What is meaningful participation? How can bureaucracy be re-designed to not just nominally take into account but authentically empower local knowledge and contexts? Yet how to avoid participation from being romanticised? Should we be talking about sector-specific recommendations, or across sectors using other cross-cutting themes?

After a general introduction to the New Manifesto project and the day’s roundtable activity by project convenor, Adrian Ely, the group of about 15 divided in half, to discuss the first question: ‘What are your principle Sustainability/development objectives?’

Each individual approached the discussion from their personal experiences and interests. The group I joined began with a comment by Salena on problems with the provision of energy in Nepal, leading to regular blackouts. Hence she identified energy security as a basic sustainability objective. Another participant, Hloniphile, pointed out that improved agriculture, especially in Africa, was vital for meeting basic needs, requiring consideration of production technologies that rely on local capacity, while simultaneously keeping attention to environmental sustainability. Farah, from her work experience in India, highlighted the need to sustain and maintain incomes in rural areas and how improved livelihoods were closely linked to better health outcomes.

The discussion on how to rank such diverse objectives led to an observation by Ingrid, a Visiting Fellow from Norway, on the need to consider common threads in each example, to examine where there are interactions and inter-dependencies across sectors. Most participants agreed, acknowledging that the ‘sector’ approach might be partly blamed for a lack of more holistic thinking about development and sustainability problems. In conclusion, it was proposed that a broader, multi-sectoral approach embracing interlinkages, and with greater attention to governance might be the mainstay of sustainable development.

Leonard Joy from the UK, one of the founding members of IDS and current Visiting Fellow, argued that it was important to start from the point of identifying concerns precise to the context and moment in time. He suggested that the best way to do this was to create monitoring mechanisms which enable assessment at multiple scales, and that monitoring infrastructure would also create employment opportunities at various levels, requiring varying levels of skills, from basic technical skills to managerial.

This led to a discussion of the broader picture - that the task wasn’t just one of how to identify the concerns, but of who is identifying the concerns, and how this decision-making process might be made more democratic, transparent, and responsible to those whom decisions might impact most directly, and to encourage the decision-makers themselves to be reflexive.

Lastly, Hloniphile made a valuable self-reflective point about how as academic researchers, we often critique what major international organisations do in practice, but when we ourselves go to ‘practice’, we often do exactly what we recommend against! The discussion then led to why this occurs - perhaps because educational, funding, institutional, and personal constraints/opportunities reinforce these practices, while reflective practices are not rewarded. The question then remained: How can we restructure the institutions and incentives to allow and encourage reflective, effective practices at all levels?

LAUNCHED TODAY! BIOTECHNOLOGY RESEARCH ARCHIVE AND NEW GM PAPER

noreply@blogger.com (Julia Day) — Wed, 10 Jun 2009 03:45:57 PDT

By JULIA DAY, STEPS Centre member

I am pleased to announce the launch of the STEPS Centre Biotechnology Research Archive – spanning ten years of IDS research – and a new Working Paper and briefing from Dominic Glover, Undying Promise: Agricultural Biotechnology’s Pro-poor Narrative, Ten Years On.

To launch the archive and paper we are holding a Dangerous Ideas in Development event – GM Crops and the Global Food Crisis – in Parliament today with the APPG on Debt, Aid and Trade and Erik Millstone, Peter Newell and Dominic Glover speaking. If you are unable to make it, we will have a podcast of the session and photos available online afterwards - keep an eye on this blog or on the STEPS website. We have also worked with id21 to produce a Viewpoints on GM Crops and with Eldis to update the Biotechnology Key Issues Guide (which is not quite complete but will be online very soon).

Here are all the links to the new material:

STEPS Biotechnology Research Archive

Theme 1 - Poverty reduction & food security: impacts of GM crops
Theme 2 - Regulating GM crops
Theme 3 - The role of the private sector and corporate control
Theme 4 - Public participation and the politics of policy

STEPS Working Paper 15 – Undying Promise: Agricultural Biotechnology’s Pro-poor Narrative, Ten Years On, by Dominic Glover

STEPS briefing 15 – Transgenic Cotton: a ‘pro-poor’ success

Id21 Viewpoints: GM Crops – Ian Scoones and Dominic Glover

Eldis Biotechnology Key Issues Guide

Many thanks to Ollie Burch, Charlie Matthews, Carol Smithyes, Shanti Mahendra and Fatema Rajabali for their hard work on this project.

INNOVATION, SUSTAINABILITY, DEVELOPMENT: A NEW MANIFESTO - THE STUDENTS' VIEW

noreply@blogger.com (Julia Day) — Wed, 27 May 2009 04:16:22 PDT

By JULIA DAY, STEPS Centre member

With British summertime underway in the usual fashion (horizontal rain battering the windows) a 16-strong group of MA and DPhil students and visiting fellows from the Institute of Development Studies and SPRU Science and Technology Policy Research are gathered here in Brighton to take part in the STEPS Centre's second Innovation, Sustainability, Development: A New Manifesto project roundtable.

The group will be discussing where we want to go – what they believe are the most urgent sustainability and development objectives – and, crucially, how we are going to get there – the kinds of innovations that can help us meet the sustainability and development objectives that have been identified.

With some of the brightest young brains in science, technology and development together in one room, we are expecting some sparky debates and interesting ideas to emerge.

Video, audio and photographic material will be posted online, on the Manifesto web pages, as will a report from the event. So you will hopefully be able to get a nice, rounded view of what is being discusssed today.

INDIAN ELECTION: A STEPS TOWARDS CHANGES IN HEALTH PROVISION?

noreply@blogger.com (Julia Day) — Tue, 26 May 2009 07:25:59 PDT

By BARUN KANJILAL, Institute of Health Management Research, Jaipur and member of the Future Health Systems consortia

The 2009 parliamentary election in India meant a roller-coaster journey for the country in April and May of this year. The results are now out and the Congress Party, with a few other regional parties, has resurged with more seats and confidence. Dr. Manmohan Singh, who is well known for his strong commitment to economic reforms and liberalisation policies, has returned as the Prime Minister.

The current scenario projects a very challenging set of tasks for the new government. On the one hand, there is an urgent need to address the unfinished agenda of market reforms and get the economy quickly back on fast-track growth; on the other, it is necessary to break the dualism between impressive growth and persistent poverty coupled with emergence of newer vulnerabilities and inequalities.

The Indian health sector epitomizes the challenge. There has been an unprecedented structural transformation in the health care market in the last two decades. In the curative care (treatment and therapies) market, the private sector, largely unregulated, has taken a dominant role in place of a miserable public sector. It has a mixed result; while people, especially the middle and richer section, have more choices, they are also more exposed to the risk of catastrophic financial shocks due to the staggering rise in health care costs. Highly subsidized public facilities provide some protective shield, but, as the Future Health Systems (FHS) research reflects, they still fail to protect a significant number (15%) of their client households (i). Clearly, poor people want better governance in service delivery so that public hospitals can play a more protective role; it is, however, not clear how the central government will meet this need since this is primarily a matter for each state in India to decide.

The progress in health outcomes in the last decade, especially in infant and child mortality, has been promising, as are the downward trends in public health problems, such as TB, HIV/AIDS, and leprosy. However, unacceptably big gaps remain in maternal health and child nutrition. The most prominent response of the last (central) government was the National Rural Health Mission - a comprehensive health programme for the rural population which integrates all public health programmes in a single package. The programme has triggered the public expenditure on health to some extent; yet it falls far short of the target (2% of GDP) and is significantly low by even Asian standards. Given that the new government has got the mandate of the people, it is expected that investment on health and education will get a substantial boost as a pay-back strategy.

The direction of public investment in health, however, will depend on how the central government aligns itself to the transforming health market. There are two clear options: (1) it may encourage the state authorities to be a more active market actor (i.e., less of a financier and more of a provider and regulator) especially in secondary / tertiary care, and (2) it may regain the lost position of the public sector by increasing subsidy and focusing exclusively on better governance in service delivery at public facilities. The federal structure of the country does not allow the central government to be the sole player in exercising any one of them. However, it will be interesting to see whether and to what extent they could activate the state governments towards adopting one of these directions.

(i)See “Catastrophic health care payment: how much protected are the users of public hospitals?” by FHS-India.

POSTDOCTORAL FELLOWSHIPS WITH THE STEPS CENTRE

noreply@blogger.com (Julia Day) — Mon, 18 May 2009 14:07:50 PDT

By HARRIET LE BRIS, STEPS Centre member

The ESRC STEPS Centre is pleased to be able to offer one-month postdoctoral fellowships, based here in Sussex.

The ESRC STEPS Centre (Social, Technological and Environmental Pathways to Sustainability) is a global research and policy engagement hub based in Sussex, drawing together researchers at the Institute of Development studies (IDS) and SPRU (Science and Technology Policy Research) with partners in Asia, Africa and Latin America. The STEPS Centre’s overall goal is to help link technology and environmental sustainability with poverty reduction and social justice, in ways that work amidst the complexity, diversity and dynamism of today’s world. The Centre works across three themes (dynamics, governance, designs) and three domains (food and agriculture, health and disease, water and sanitation), and through a variety of field-based projects.

We are pleased to offer the opportunity for postdoctoral researchers to engage with the STEPS Centre during a one month period based in Sussex. To apply, from any part of the world, you should have completed your doctorate within the last three years. You should have an original, exciting research interest, idea or plan which engages with some aspect of the Centre’s work. As a postdoctoral fellow, you will work closely with a mentor from the Centre to develop your interests and produce a paper to be published in the STEPS Working Paper series. STEPS will cover any necessary international travel costs, and you will receive a stipend of £1500 to cover local accommodation and subsistence in Sussex.

To apply, please send a one-page note outlining the topic you would focus on, a one-page CV and a letter of reference (e.g. from a PhD supervisor). Please also include an indication of the preferred dates of your fellowship between October 1st 2009 and 31st March 2010. Applications should reach the STEPS Centre Co-ordinator, Harriet Le Bris (h.lebris@ids.ac.uk) by the closing date of 30 June 2009.

GM CROPS: TEN YEARS ON

noreply@blogger.com (Julia Day) — Mon, 18 May 2009 13:25:55 PDT

By IAN SCOONES, STEPS Centre Co-director

A decade ago there was much hope – and even more hype – about the potentials of GM crops. GM crops were going to feed the world, solving issues of poverty and development, seemingly at a stroke. Technologies for dealing with drought or nutrient deficits were, it was claimed, in the pipeline. Even the pest-resistant Bt technologies that were already available offered the opportunity of reducing pesticide use and improving farmers’ incomes. GM crops were going to be of particular help, it was argued, to poorer farmers in the developing world, ushering in a new ‘gene revolution’ to succeed the ‘green revolution’ of previous decades.

A decade ago, of course, there were also those who predicted disaster and calamity – and still do. GM crops were going to result in all sorts of environmental and health catastrophes, and provide the basis for global domination of agriculture by a few large corporations. Just as the pro-GM lobby could be accused of excessive and unfounded hype, anti-GM campaigners often generated doomsday scenarios based on limited evidence.

Ian's full article is posted on the STEPS Centre website

GM CROPS: JUNE LAUNCH

noreply@blogger.com (Julia Day) — Mon, 18 May 2009 12:55:55 PDT

By JULIA DAY, STEPS Centre member

On June 10 the STEPS Centre is launching a Biotechnology Research Archive and a new paper on Bt Cotton by Dominic Glover at a free event in London.

The STEPS Centre Biotechnology Research Archive will span over a decade of substantive, evidence-based research. A series of core projects, supported by DFID, the ESRC and the Rockefeller Foundation among others, provide the foundation of the archive. But there will be much else besides, with some early work stretching back to the early 1990s, and recent work focusing on contemporary experiences with GM crops across the world. The archive will go live on June 10 on the STEPS Centre website

On the same day, a new Working Paper by Dominic Glover, post-doctoral fellow at Wageningen University, on the Bt Cotton experience in India will be launched at an event in Parliament entitled GM Crops and the Global Food Crisis, part of the IDS Dangerous Ideas in Development series.

Speaking alongside Glover will be Erik Millstone, SPRU Science and Technology Policy Research, University of Sussex and STEPS Centre food and agriculture co-convenor and Peter Newell, University of East Anglia.

Entrance to the event is free - starting at 6pm in Committee Room 17, Palace of Westminster - and you can book a place by emailing Charlie Matthews at IDS on c.matthews@ids.ac.uk

SWINE FLU: SOME EMERGING LESSONS

noreply@blogger.com (Julia Day) — Mon, 11 May 2009 06:19:05 PDT

By IAN SCOONES, STEPS Co-Director

Read a short version of this piece, published in The Guardian.

The back-story of the swine flu outbreak is gradually seeping out. There are some vitally important lessons that can be learned. Here I outline five:

1. Risks, uncertainties and mortalities

A favourite media narrative in the face of a potential pandemic is the estimation of potential human mortalities. Huge numbers are bandied around, based on highly suspect data and assumptions. While the scientists concerned cover their articles with footnoted qualifications, these are stripped out for the media sound-bite. The result is often wild speculation and potential panic. The counter move is to keep quiet, cover up and assure the populace. Neither approach helps, as actually we don’t know what will happen, when and to whom. This acceptance of uncertainty and ignorance in a public debate is tough. But is also vital. Otherwise inappropriate public policy arises and misguided signals are given.

Preparing for a pandemic means preparing for surprises – and being ready to respond rapidly and flexibly under conditions of uncertainty requires a new set of skills, bureaucratic routines and incentive systems in the large public agencies charged with protecting the world from emerging infectious diseases.

Beyond a broader recognition of uncertainty and ignorance – features not easily captured in simple epidemiological modelling exercises or simple response plans – there is the need to improve overall system reliability. As Emery Roe and Paul Schulman argue in their recent book ‘High Reliability Management’, reliability must be a feature of any system operating in a complex, uncertain world. This requires, they argue, high reliability professionals who can track between local understandings of particular situations and unfolding scenarios and the macro situation.

These professionals are currently absent from the international effort – creating a missing middle, a vacuum at the heart of the response. In response to swine flu, these would be the people who would make sense of what was happening on the ground where the first outbreaks were spotted (the broader policy, liaising between agencies and across scales. This vital role is absent because authoritative knowledge, often codified in simple models and plans which do not accept uncertainty, ignorance or complexity, is created only at the top through particular types of accepted expertise. The problem, as the swine flu outbreaks are showing vividly, is that this is not enough.

2. Health inequalities and preparing for a pandemic

In a potentially global pandemic situation, it is all well and good offering a global assessment based on global statistics, but in reality major structural inequalities will affect the likely outcomes of rapid disease spread. We don’t know why so many more people have died in Mexico from swine flu than anywhere else. This may have a complex medical, virological cause. But it also may be to do with access to health care and effectiveness of response.

In the UK there is much brash talk of how we are ‘the best prepared’ country in the world. But being prepared means having resources – stockpiles of drugs, an effective surveillance system and a functioning national health system, for example. But in many places such conditions do not exist – and other diseases affect people’s health status and ability to resist new viruses. Poverty and inequality play a big part in the dynamics of diseases, and the highly differentiated social dimensions of disease control efforts should not be forgotten in the rush to construct a global public response to a potential pandemic.

Over the last few years, in response to avian influenza, there has been much emphasis on pandemic preparedness planning. According to the UN and the World Bank, there have been around 120 national plans produced, alongside numerous organisation-specific efforts in the UN, government departments and private businesses. Simulations have been developed, stockpiles of drugs secured and often highly detailed plans for response elaborated. It is on this basis that Alan Johnson, UK Health Minister, proudly asserts that Britain is ready.

But again this picture is not universal. Even among those countries which have spent time and money on preparing a national plan, there are huge variations. Some have been cut and pasted from standard templates and never done any rehearsals; others are so absurdly unrealistic that they could never be implemented. And beyond national plans, there are many, many organisations around the world – both public and private – that do not have a pandemic preparedness plan and would be caught unawares if something happened fast.

3. Local knowledge and disease surveillance

The swine flu story is showing how poor surveillance and reporting systems can mean an outbreak can soon get out of control and spread across the world. While diplomatic niceties prevent much criticism of the Mexican authorities, it is clear that there were big gaps in detection and reporting over the last months – dating back to February.

But it is also apparent that local people knew of the disease, and have some strong hypotheses about its origins. Anselma Amador from La Gloria, the village where the first known case of swine flu occurred commented to the Guardian newspaper: "We are not doctors, but it is hard for us not to think the pig farms around here don't have something to do with it….The flu has pig material in it and we are humans, not pigs." A large, industrial pig farm, owned by multinational company Smithfield Foods, is blamed. According to the Guardian, residents in La Gloria say the prevailing wind invariably blows the fetid air their way, where it gets stuck because of the hills that rise just behind the village.

These explanations are dismissed out of hand by the health minister and the company, but why are such leads not being tested and followed up? And why, perhaps more importantly, are such early-warning approaches, based on local knowledge about disease incidence and its dynamics, not part of the standard surveillance system. Why is such knowledge of the ‘not doctors’ so easily dismissed?

The lessons from the avian influenza outbreaks in south-east Asia and beyond point to the vital importance of local understandings of disease and its spread, as well as the significance of engaging with the ‘cultural logics’ of local people in its control. Medical doctors, epidemiologists, virologists, veterinarians and other specialists need to work hand-in-hand with local people in order for surveillance to be effective.

4. Naming, labelling and the politics of international organisations.

A fascinating debate has emerged about the naming of ‘swine flu’. This reveals much about the politics of a disease. An Israeli health minister has objected, so have a number of muslim groups on religious grounds. The World Animal Health Organisation, the OIE, has also argued that the flu should be relabelled ‘North American Influenza’, as the virus had not been isolated in animals, “no current information on influenza like animal disease…could support a link between human cases and possible animal cases including swine”.

While religious sensibilities might be understandable, the position of the OIE needs a bit more probing. Why has the veterinary establishment only belatedly engaged with the swine flu outbreaks, and why? Only on the 27th of April did the Chief Veterinarian of the FAO, Joseph Domenech, issue a statement, with experts dispatched to explore the links between the outbreaks of influenza in humans and animals. Domenech still insisted that “there is no evidence of a threat to the food chain; at this stage it is a human crisis and not an animal crisis.” The vets, it seems, have tried to distance themselves from the swine flu outbreaks: “this is a public health issue, animals have not (yet) been implicated” goes the storyline.

But what does this tell us about a coordinated international response? The integration of animal and human health efforts as part of the international avian influenza response has been much celebrated – and highlighted by the snazzy slogan ‘One World, One Health’ proclaimed by Bernard Vallat, the director general of the OIE, in a comment piece on the front page of their website as the way forward. But underlying the rhetoric, organisational competition and politics has handicapped many efforts, particularly at national level. As studies of the avian influenza response from across southeast Asia show, human and animal health efforts were often (although with some notable exceptions) poorly coordinated, lacking coherence and effectiveness.

The OIE is a membership organisation made up of Chief Veterinary Officers from around the world. As the WTO-recognised body dealing with trade in animals and their products, it has enormous influence on – and is enormously influenced by – the international livestock and meat trade. Pressures not to declare an animal disease outbreak can be immense, and slow reporting and a commitment to facilitating certain types of trade, for certain countries and certain business interests may sometimes be part of the political economy of decision-making. Who knows whether the reluctance of the veterinary authorities – in Mexico and internationally – to engage with the swine flu outbreak fulsomely is an indication of this.

5. The political economy of agriculture – and the impacts on global health.

A strong lesson from the avian influenza experience is that attention to the changing structure of the livestock industry is essential to understanding how diseases emerge and spread. While it is easy to blame big agribusiness and industrial farming techniques, it is often more complex than this. The rapid growth of industrial poultry production – particularly medium-sized units with poor bio-security – which is linked to informal trade patterns and unregulated marketing and located near fast-growing urban centres creates new health hazards, including the risk of outbreaks.

While the so-called ‘livestock revolution’ is much celebrated as a source of economic growth in the developing world, the rapid restructuring of the livestock sector has brought many downsides. Local back-yard production of poultry or pigs can be replaced by poorly regulated industrial units aimed at maximising returns but with little attention to safety, animal welfare, disease control or environmental pollution. Investors in such enterprises are often well connected in national political circles and are sometimes backed by internationally powerful individuals and companies who can pull the strings when needed.

This changing political economy of agriculture has major implications for how industries are regulated and diseases are managed. Poor reporting and lack of transparency often surrounds such businesses – public veterinarians may never get past the well-guarded fences, and whistle-blowing by employees (of companies or public services) is rigorously clamped down on. Independence, transparency and effective and timely information flows is essential for international efforts to control emerging diseases. Given the changing political economy of agriculture, this may be a call too far. As the details begin to emerge on the swine flu outbreaks, a more comprehensive assessment of the political economy of agriculture – and the pig industry in particular – in Mexico will be essential in learning lessons for the future.

INNOVATION, SUSTAINABILITY, DEVELOPMENT: A NEW MANIFESTO - THE VIEW FROM NEPAL

noreply@blogger.com (Julia Day) — Wed, 06 May 2009 06:16:43 PDT

By JULIA DAY, STEPS Centre member

See photos from this event

We are hoping to link up this lunchtime with the Innovation Asia-Pacific Symposium being held in Kathmandu, Nepal, for the first in a series of roundtables events for the STEPS Centre Innovation, Sustainability, Development: A New Manifesto project.

A group of delegates at the symposium in Kathamndu are gathering to discuss a series of questions around rethinking science, technology and development policies.

The New Manifesto project - 40 years after the original Sussex Manifesto was published - seeks to recommend new ways of linking science and innovation to development in order to address dynamic, uncertain global contexts and challenges of environmental sustainability, poverty reduction and social justice.

This event -organised in Nepal by David Grimshaw of Practical Action - is part of the process of bringing together cutting-edge ideas and diverse perspectives from around the world.

And, after a couple of minutes of anticipation, we are live and direct to Kathmandu's Everest Hotel, via the magic of video conferencing.

Adrian Ely, the convenor of the New Manifesto project and Professor Geoff Oldham, one of the authors of the original Sussex Manifesto, have just given opening addresses from here at SPRU on the Sussex University campus, followed by delegates in Nepal arranging themselves into small groups to discuss the roundtable questions (which I will endevour to make available on our website, so you can have a peak at what people are discussing).

Unfortunately I am unable to link you through to the Nepal event from this blog, but David's team is collecting video and audio material in Kathmandu, which we will also put on the website as soon as we can. And Practical Action's webpage for this event is here.

LETTER FROM DHAKA: HOW CAN WE REINVENT PUBLIC HEALTH?

noreply@blogger.com (Julia Day) — Tue, 05 May 2009 10:21:56 PDT

By HILARY STANDING, Fellow on Health in the IDS KNOTS Team and Director of Realising Rights

Living in Dhaka is a daily lesson in the extremes of human urban existence. This is a city of around 12 million packed into a surprisingly small area. It has huge slum populations and dense housing even in the “smart” areas. There is an uncountable population of domestic livestock of every description. One figure that grabbed my attention is that maximum desirable population density in urban areas is apparently 40,000 per sq kilometre. In old Dhaka it is 150,000.

The city is a serious environmental danger zone. The four rivers which surround and run through the city are so polluted that they are officially dead due to industrial and other toxic wastes. There is a picture in one of the daily papers of a stretch of dark blue river which probably reflects its proximity to a local dyeing factory. There is no functioning sewage system to speak of and the storm water drains are completely choked with garbage. The city’s water supply comes entirely from increasingly polluted groundwater and the top level aquifers are all exhausted. This year it hardly rained at all, a most unusual situation.

In April we experienced a severe heat wave for several weeks which only came to a halt a few days ago. One of the worst immediate results was that large areas of the city had either little or no water, or have been getting heavily polluted water which is too badly contaminated to be made fit for domestic consumption. As a consequence, there has been an epidemic of diarrhoea with significant numbers of deaths.

I am particularly aware of this on a daily basis as ICDDRB, where I am partly based and which is one of our partners, runs the only free hospital in Dhaka which treats acute diarrhoea cases. Since March, it has had double the daily number of admissions and I look out of my office onto what was the car park and which is now taken up with two large tents treating the overspill from the main hospital. And as the mortuary is in our building, it is distressing to see the ones who got there too late being wheeled over to the mortuary.

It is also the seasonal flu season here, with large numbers of people sick with a particularly nasty bug. So when swine flu started to make headlines in Bangladesh, it mainly provoked the wry comment of “how would we know if it hits Dhaka?” Avian flu is already widespread in every district of Bangladesh as poulty farming is such a major source of livelihood. It caused a few headlines at first, now it’s just something you live with. Meanwhile, today, I read in the paper that several children have died this week in a nearby village from pesticide poisoning due to exposure to the mountains of pesticides poured onto vegetable crops grown on local farmland for the urban market.

I have been reflecting on this a great deal lately as it challenges one’s sense of what constitutes “health” and appropriate research about it. This is a place where ill health is the norm. What are priorities when everything is a priority? Where can most difference be made when the numbers affected by infectious diseases, chronic diseases, toxic chemicals and vehicle emissions, climate emergencies, contaminated food and water supplies are all so staggeringly large?

There is a small attempt going on in the School of Public Health here to train government doctors in public health. But current public health curricula seem to reflect the narrowing of the concept of public health since the health economists have taken over the show. What happened to what we used to call “environmental health” or am I imagining a golden age of public health that in reality never existed, where safe and nutritious diet and public parks for exercise and fresh air were integral to our understanding of a healthy environment? Can we reinvent public health and how?

I sat in a WHO meeting a couple of weeks ago and was struck by the mismatch between what people from the countries were trying to talk about, what I see around me in Dhaka and the Geneva based expert talking about “patient centred care in the community with a dedicated family physician.” If this is a typical response to the challenges of global health, it seems neither realistic nor relevant. I see a bit more hope in the rising tide of demonstrations and awareness raising activities being organised by local environmentalists here. But they are puny compared to the interests stacked against them. Please, can anyone help me out on this one?

BOY 'WAS FIRST TO GET SWINE FLU'

noreply@blogger.com (Julia Day) — Thu, 30 Apr 2009 01:06:48 PDT

From the BBC News website following the authorities in Mexico saying they think they have pinpointed where the swine flu virus began. The video features ABC News' Jeffrey Kofman speaking to a boy who is believed to be the first sufferer, in La Gloria, Mexico.

SWINE FLU: GOVERNING GLOBAL HEALTH IN AN AGE OF EPIDEMICS

noreply@blogger.com (Julia Day) — Tue, 28 Apr 2009 00:50:26 PDT

By IAN SCOONES, STEPS Centre Co-Director

More than 150 deaths in Mexico, a public emergency declared in the US, China banning imports of pigs from the USA and Mexico, health authorities across Asia and the Pacific on red alert, stock market prices for agriculture and travel industries down, while pharmaceutical stocks rise. These are just some of the symptoms of a rising wave of swine flu panic sweeping its way around the world.

As flu experts attempt to make sense of the emerging information about the threat from a new A/H1N1 influenza strain, the response from the top is unequivocally hard-hitting. US President Barack Obama has ordered a "very active, aggressive, and coordinated response,” according to White House homeland security advisor John Brennan. Meanwhile, with 20 confirmed cases of swine flu in the US, the country has procured seven million treatment courses of Tamiflu.

But will an “active, aggressive, and coordinated response” work? Recent disease events and threats, including swine flu, SARS, avian and human influenza and haemorrhagic fevers, have brought epidemics to global attention as never before. But how to address them has become a major challenge for twenty-first century health policy.

The increasing risk from newly-emerging diseases, and particularly those with the potential to become pandemic, is the result of a complex combination of social, ecological, environmental and economic factors. These include shifts in land use and migration, changes in livelihoods and food systems, climate change and increasing global travel and urbanisation. Most experts agree that a pandemic is almost inevitable at some point – and this will most likely be the result of transmission from animals. A global influenza pandemic could, under worst case scenarios, result in massive mortalities and huge economic disruption.

Following the avian influenza outbreaks of the past few years, much effort has been expended on devising pandemic preparedness and contingency plans, as well as improving surveillance and response systems and, in some places, stockpiling drugs and vaccines. But is the world prepared for a pandemic? Do we have effective global disease surveillance and control systems that can prevent a disaster?

The organisational landscape of global health has become increasingly complex. Debates continue over which organisations are in control of global health policy. Issues of national security and sovereignty, coordination, integration and harmonisation have accordingly come to the fore. The World Health Organisation’s revised International Health Regulations provide a global framework, but they rely on effective surveillance, timely reporting and the capacity to respond at all levels.

As the unfolding swine flu story is showing, once an outbreak is declared, international and national responses can swing into action quickly and effectively. So far the spread has been limited and mortality levels variable, although worryingly showing signs of a pandemic pattern. But what happens if the virus spreads? In pandemic situations, difficult trade-offs are presented between, for example, public health concerns, trade revenues, tourist movements and wider economic activity. These inevitably present major challenges for politicians and policymakers. Should the borders be closed? Should the army be called in to prevent movement? And who should decide? Such questions challenge global health governance arrangements to the full.

Identifying any new diseases early must of course be at the centre of any response to emerging infectious diseases. With most new human diseases emerging from animals, getting to grips with the social, economic and ecological drivers of disease emergence, before a deadly outbreak is essential. With increasingly intensified farming techniques and with humans and animals living in close proximity in dense urban settlements, for example, the potential for the emergence of new diseases is ever present.

No-one yet knows the back-story of the current swine flu outbreak. Mexican health officials do not seem to know how the virus emerged, when and from where. Genetic analysis shows an unusual mix of genes from North American and Eurasian pigs, birds and humans. A deeper analysis of the socio-ecological conditions for disease emergence and transmission is therefore essential, if lessons are to be learned. For the longer term, disease surveillance systems that move beyond disease-specific programmes towards integrated disease control systems are needed that look at human and animal diseases in tandem.

To understand the complex dynamic drivers of disease emergence and transmission thus requires solid epidemiological and medical information, but also insights from ecology, land use studies, socio-cultural and economic studies – and perhaps above all local knowledge and insights on changing disease environments. Perhaps pig farmers, meat processors and traders in Mexico know a lot about what has happened over the past months as the disease evolved and spread without detection and reporting. But we don’t know – indeed the virus has never even been isolated in pigs, so the origins remain obscure. Because of the slow reporting and confusion about the early spread in Mexico, the world has been taken by surprise as the virus quickly spread beyond any possibility of localised containment.

Right now, of course, the spotlight is focused on the international public health response. Margaret Chan, the director general of the WHO, has declared the swine flu outbreak a public health emergency of international concern, and governments around the world are gearing up for a full pandemic response – something which hopefully will not be needed. Keiji Fukuda, influenza chief at the WHO, argues that the world is now more prepared for a flu pandemic than it was when the last one struck. He is right, but in the complex, dynamic world of viral disease ecology, uncertainty and surprise are inevitable. Preparing for a pandemic means preparing for surprises – and being ready to respond rapidly and flexibly under conditions of uncertainty. As the experience with avian influenza has shown, this may require more than simply the top-down, “active and aggressive” technocratic response so often urged.

Other Resources:

STEPS Centre work on epidemics

STEPS Centre research on avian influenza and pandemic preparedness

STEPS Working Paper, Health in a Dynamic World

WHO

What you need to know about swine flu from New Scientist

DANGEROUS IDEAS IN DEVELOPMENT: GM CROPS AND THE GLOBAL FOOD CRISIS

noreply@blogger.com (Julia Day) — Tue, 07 Apr 2009 07:31:29 PDT

By JULIA DAY, STEPS Centre member

Genetically-modified (GM) crops are sometimes trumpeted as the solution to the global food crisis, and the route to transforming developing agriculture and reducing poverty for millions. For others they spell doom and disaster, bringing with them unacceptable environmental and safety risks. But what is the reality?

Over the past ten years, GM crops – particularly transgenic insect-resistant crop varieties – have been used widely by farmers in different parts of the developing world. What has been the impact on agricultural production and poverty? What institutional, regulatory and wider policy issues arise?

In the heart of London's political world, at the Palace of Westminster on June 10, the STEPS Centre is holding an event to explore these issues, drawing on more than a decade of research from Africa, Asia, Latin America and Europe. The speakers will be Dominic Glover, Wageningen University; Erik Millstone, SPRU Science and Technology Policy Research, University of Sussex and the STEPS Centre; and Peter Newell, University of East Anglia.

As the world faces a major challenge to feed a growing population, the speakers will examine whether and to what degree GM crops really can make a substantive contribution to increasing food production and strengthening livelihood security. Should European governments and aid agencies back a GM-led push towards boosting agricultural production across the world? What governance measures are required in order to ensure that new technologies work for the poor?

Where and when? June 10, 18.00-20.00, Committee Room 17, Palace of Westminster, London. To reserve a place RSVP to Charlie Matthews: c.matthews@ids.ac.uk

ECOLOGY AND INFECTIOUS DISEASE DYNAMICS - FROM THE FORESTS OF SIERRA LEONE

noreply@blogger.com (Julia Day) — Mon, 06 Apr 2009 06:43:00 PDT

By MELISSA LEACH, STEPS Centre director

Last week I visited Sierra Leone catching up on happenings in its eastern rainforests following a long absence and a decade of civil war, and exploring collaboration possibilities for the STEPS Centre's work on epidemics and the ecology of infectious disease. It was fantastic to be back there, and to feel this wonderful country peaceful and bustling again after such a difficult time. But life and livelihoods are incredibly hard - not least for the communities in the relatively isolated, heavily forested eastern regions.

I lived in one such forest-edge village just before the war and re-visiting now is extraordinary, both in an upbeat way - about half the people I knew have come back, and are rebuilding their lives - but many others have died or scattered, and all have harrowing stories to tell.

As people here struggle to rebuild their houses and re-establish their farming amidst a political economy of diamond mining and timber extraction that continues to rip off their resources, so they are also struggling with a host of diseases and their vectors - some of them inextricably linked to the dynamic environmental situation in which they live.

Malaria and schistosomiasis are associated with the region's streams and inland valley swamps and the re-establishment of swamp rice farming is creating renewed opportnities for infection. Onchocerciasis, or river blindness, is associated with the black flies found in many of the area's faster-moving streams, with farming and the gathering of forest foods and medicines creating vulnerability to infection.

Lassa fever, a serious haemorrhagic fever endemic in eastern Sierra Leone, Guinea and Liberia, is carried by the rat Mastomys natalensis which inhabits forest and domestic buildings. The poor house and rice store construction associated with extreme poverty, together with the crowded conditions of mining encampments, provide ideal conditions for this disease vector to nest, while hunger - and the need to eat rats - and difficulties in dealing with waste provide ideal transmission conditions. In short, the dynamics of infectious disease, and those of agro-ecology, livelihoods and poverty, are inextricably intertwined.

Yet many questions remain about exactly how these dynamics are playing out, and how the Mende women and men of this region understand them. Greater attention to local knowledge and categories, and a fuller understanding of the ecological dynamics of disease from the scale of houses to communities to regions, might inform pathways towards more effective surveillance and response, for instance through strategies for participatory surveillance and integrated vector management.

At least, these are the ideas that Sierra Leonean researchers and I have been discussing at the Mano River Union lassa fever research network based at the government hospital in Kenema, and at the nascent research institute on tropical diseases at the School of Community Health sciences, part of the new Njala University. Both these institutions are struggling to re-establish following the war, and are eager for international collaboration which can work with and complement the tremendous skills here in vector ecology, lab diagnosis and clinical treatment (which in the case of lassa, has recently been strengthened by focused collaboration with Tulane University in the US), and community-based public health.

In the context of the STEPS Centre's ongoing Epidemics project, which has highlighted the need for engaged research on the political and cultural ecology of infectious disease dynamics to offset and complement current short-term, outbreak-focused narratives and responses, I really hope we can build such collaboration. The need is clearly there, and so is the interest. It has been a fascinating and worthwhile - if emotional and disturbing - trip.

NEW APPROACHES TO MONITORING THE MDGs?

noreply@blogger.com (Katharina Welle) — Wed, 01 Apr 2009 05:49:40 PDT

By KATHARINA WELLE, SPRU, DPhil student

Calls for increasing transparency and accountability for water supply and sanitation have been voiced in different sessions at the Istanbul 2009 World Water Forum. But what does that mean and how can it be achieved?

A key element behind increased transparency and equity is monitoring - be it in the form of project-level monitoring of development impacts, sector monitoring and information systems for measuring access to water supply and sanitation facilities or monitoring of increased aid effectiveness for delivering services.

However, challenges to collecting and making relevant data accessible for public scrutiny are considerable. The national government, who is key for ensuring effective sector monitoring, may face the problem of ensuring that sector data is reliable or of not being able to release sensible information according to Mutaekulwa Mutegeki from the Tanzanian regulatory authority. Miguel Solanes who advises the UN Economic Commission for Latin America and the Caribbean on water law and related public utilities, highlighted that there is a significant relationship between perceived levels of corruption and quality of water and sewerage service delivery in Latin America. He warned that, in countries where corruption is high, citizens tend to be intimidated and, in consequence, participatory approaches such as budget monitoring or citizen report cards may be less feasible.

This notwithstanding, such participatory approaches are the most commonly suggested solutions to increase transparency and accountability of service delivery in the water sector promoted e.g. by the Water Integrity Network who heads the discussion of fighting corruption in the water sector.

It was therefore refreshing to also see new approaches to monitoring presented at the forum. Amadou Diallo from PEPAM presented a pilot study in Senegal where PEPAM together with WSP are exploring monitoring of rural water supply schemes performance through mobile to web services. The company has developed a new mobile phone interface that allows for an easy input of data on bulk water production, balance of current and savings accounts and the days per month that services are available. The information is sent to a website on a monthly basis.

Another innovative approach to monitoring is currently supported by google.org under its H2O Inform and Empower initiative. According to Alix Peterson Zwane, representative of google.org, the organisation is less interested in getting sector monitoring perfectly harmonised but rather wants to explore new ways of thinking about monitoring based on tools available through google. The organisation is supporting UN Habitat and others to pilot projects in East Africa that will enable citizens using the GoogleEarth search engine to enter and find out about service levels in their localities. The initiative hopes to use technological innovations such as GoogleEarth to interact with the multiple sources of data and address the increasing complexity faced in the sector today. The H2O initiative's new and totally decentralised approach to monitoring could go beyond the traditional citizen-government relations. This means that the government cannot hide sensitive data any more and citizens may be able to assess services anonymously.

One important caveat remains though - in many countries in Sub-Saharan Africa access to the internet remains limited and applications such as GoogleEarth may be difficult to access particularly for marginalised citizens. It will be an interesting spot to watch.

THE ALTERNATIVE WATER FORUM

noreply@blogger.com (Anna Walnycki) — Tue, 31 Mar 2009 03:25:07 PDT

By ANNA WALNYCKI, Institute of Development Studies DPhil student

Having spent a few days at the World Water Forum, many of the conversations I’ve had with people came back to participation in the forum. Beyond the high-profile international NGOs, there has been a noted absence of national and local CBOs outside Europe and Turkey. So, in an attempt to find out more I ventured over to Taxim Square on the other side of Istanbul where the Alternative World Water Forum is being held in parallel to the official event.

As noted in earlier blogs, the alternative forum got off to a dramatic start during the opening ceremony where two supporters were for unfolding a banner of opposition. Over at the alternative forum, feelings are still running high over the incident. A series of talks and a press conference led by Maude Barlow were given today denouncing The World Water Forum as elitist and excluding; failing to incorporate any interests beyond those of the private sector. The focus is rooted in the anti-privatisation movement and is heavily supported by the networks of Latin American NGOs seeking to have water cognised as a human right.

The morning was well attended by NGOs, CBOs and government representatives from Latin America. This it seems is where they have all been hiding out! Overall the numbers attending the alternative forum are much less than those at the official forum, however, as has been seen in recent days, they have a big voice that has dominated the coverage of the main event. While there were several passionate speeches about the need to recognise the human right to water in countries all over Latin America, I couldn’t help thinking that an opportunity had been missed. Government representatives, CBO’s, NGOs, multi national organisations and private companies are all in Istanbul this week to focus on water, but they have decided to camp out on opposite sides of the river.

IMPRESSIONS FROM MY FIRST WORLD WATER FORUM

noreply@blogger.com (Katharina Welle) — Wed, 01 Apr 2009 00:47:02 PDT

by KATHARINA WELLE, SPRU, DPhil student

This is the first World Water For um that I am attending - I expected it to be fairly chaotic, not so well organised and buzzing with people from all sorts of backgrounds - government, NGOs and a few people from the private sector from all over the world.

Instead, the logistics around the forum are amazing - one can clearly see that Turkey put a lot of effort into creating a professional, environmentally friendly and water-friendly image - for example, there are no plastic water bottles but there are big water containers and all participants were supplied with re-usable water bottles.

Another surprise is the many Turkish participants in the forum from school children who are having fun around the Learning Centre and the Youth Forum to Turkish participants fromgovernment, the private sector and many Turkish NGOs represented in the Civil Society area.

This, however, takes me to another point - that of where are all the other NGOs, international and from different localities? They seem to be strangely absent from the forum, particularly when looking at the space available for stalls. The private sector and governments have much larger stalls and, altogether, take up far more space than NGOs. The latter can probably be found at the alternative forum or might not have bothered to come altogether. Sadly, this means that their perspective is under-represented although topics at the forum could have accomodated their concerns and would have been enriched by their perspectives. There should be more dialogue between the different groups rather than a continuation of the scism i.e. with regard to public-private debates. With regard to dams and transboundary water issues, however, it is more questionable whether the event would be able accomodate a space for open dialogue on these issues with Turkey as the hosting country. Here is the beginning of my post.

WORLD WATER FORUM, DAY 3

noreply@blogger.com (Lyla Mehta) — Wed, 18 Mar 2009 17:51:33 PDT

By Lyla Mehta, STEPS Centre Member

The World Water Forum means many different things to different people. For the many so called water warriors and activists attending the event and organising alternative water justice events at Taksim Square, the Forum lacks legitimacy because it is organised by the World Water Council, a private think tank with close links with the World Bank and large French water companies. Their credibility suffered further, due to the way in which a peaceful protest was crushed.

Unpromising start

Indeed, the Forum started with police brutality and repression. Peaceful protests against the commodification of water were crushed by the Turkish police. About 17 Turkish activists are languishing in prison and two foreign activists have already been deported from the country. Their crime: They unfurled a banner saying ‘No risky dams.’ Turkey, like India and China, is a big promoter of large dams and has been clearly against democratic debate on alternatives.

For the more cynical and blasé participants, this year’s Forum is like its predecessors. The same phrases are being repeated and it’s nothing more than a talking shop. This is particularly true of the large sessions which are lacklustre and endorse mainstream discourses and narratives of water and the water and sanitation crisis.

Right to Sanitation?

Some exceptions are the side events and sessions where some new issues are being debated and discussed. It is encouraging to see more attention being given to sanitation, usually neglected in big water forums. Unfortunately, I have not heard many references to community-led total sanitation which has attracted a lot of attention in recent years (see communityledtotalsanitation.org). While critics feel that not enough is taking place to endorse the right to water, even less is being done regarding the right to sanitation. For one, it is still very ill defined and its scope is not clear. Does the right to sanitation only encompass having a place to shit and endowing people, especially women, with dignity or does it encompass second and third generation issues such as solid waste management, sewers and so on. What is the role of the state in implementing the right to sanitation when the current discourse is community-based initiatives and organisations, behaviour change and no subsidies? Who should be responsible for this right and which bit of government (e.g. Ministry of Health, Education, Public Works etc) should implement it and provide institutional back-up?

Environmental considerations and climate change

Climate change has also been given a lot of importance. The effect of climate change on water has been the main subject at the ministerial segment of the Forum. Clearly, droughts, floods, storms and rising sea level all impact on access to water and there are increased risks to low-lying river deltas in places like Bangladesh and Holland. Thus, the need to adapt to rapid changes and to create robust water management practices that can cope with variability and new extremes. All these are very important issues`. However, it is important for the water community not to reinvent the wheel and forget all the rich empirical research that has been undertaken on local adaptation and coping with uncertainty and variability. Indigenous knowledge about uncertain environments also needs to be built on and its potential and limitations recognised. It is also important to avoid getting lost in the world of modelling and positing simplistic links about conflicts and the scarcity that climate change is likely to bring about.

Water Footprints

A cotton T Shirt has a water footprint of 2,700 litres of water and a cup of coffee 140 litres. We are now being encouraged to think about the links between consumption in one place and the impacts on water systems elsewhere. The water footprint looks at rainwater (green), surface and groundwater (blue), as well as at polluted water (grey). Researchers from Spain and Holland in a session on water footprints provided us with detailed data on individual and national footprints and have maps with scarcity hotspots charting on the so called environmental water scarcity index. What is the value of this? Clearly, being more aware of the water we consume and the impacts of our consumption on the environment is important. But is gathering all this data merely an end in itself? How useful is this analysis for many poor nations? Is it politically naïve? What about the socio-political dimension of the water footprint? Does this analysis distinguish adequately between high end and low end consumers when it talks about a national footprint? Furthermore, in trying to reduce water footprints, technocratic and market-based solutions are evoked which can generate new scarcity myths.