September 16, 2014
Health workers walked out of an Ebola ward in a district hospital in the east of Sierra Leone. They say that they have not been paid for two weeks. Al Jazeera reports:
Up to 80 workers crowded the entrance compound to the hospital on Friday, deserting their posts and bringing operations at the Ebola treatment ward to a standstill. The workers were peaceful but frustrated.
The action comes after several other strikes at the same hospital by staff protesting poor working conditions, infection rates among colleagues, and rates of pay they say do not make up for the risks they take.
The workers were recruited nationally to boost staff numbers at Kenema Government Hospital, where they operate inside a tented “high-risk” zone as nurses and support staff tasked with treating the sick, disinfecting contaminated equipment, cleaning faeces, vomit and blood, and removing and burying dead bodies.“I started working here one month ago and we have been paid nothing for the last two weeks,” Umaru, a hygienist, told Al Jazeera. “We have stopped everybody from working until we receive our risk incentive.”
The hospital is a critical facility catering to a population of several hundred thousand and began admitting the first Ebola cases in Sierra Leone because it was thought to be the only place with appropriate equipment.
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Global Health and Development Beat
President Barack Obama plans to dramatically boost the US effort to mitigate the Ebola outbreak in West Africa, including greater involvement of the U.S. military, people familiar with the proposal said.
Indian emergency workers on Monday battled to prevent waterborne diseases like cholera from spreading as fetid water swilled around the Kashmir valley more than a week after the worst flooding in more than a century.
Tobacco control: Uruguay requires photos of decaying teeth and gruesome hospital scenes on every pack. Philip Morris sees this as a violation of a trade agreement and is suing the country for $25 million.
USAID donated anti-counterfeit equipment and IT system to Kenya’s Mission for Essential Drugs and Supplier, to help enhance efficiency and strengthen its fight against the counterfeits and sub-standard medicines.
Lack of access to knowledge among mothers in Tanzania is one among the main setbacks in preventing mother-to- child transmission of HIV/ AIDS, the Country Director of Elizabeth Glaser Pediatric AIDS Foundation Dr Joroen Bosch says.
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Buzzing in the Blogs
Rachel Silverman and Amanda Glassman on advances in harmonizing global health data collection. They blog for the Center for Global Development:
The forthcoming consultation draft of the reference list is praiseworthy not just for its contents, but also for the rationale and process behind its creation. The list results from over a year of systematic review by representatives from 19 different donor and international agencies, including PEPFAR, the CDC, USAID, DFID, and the Global Fund, complemented by input from low- and middle-income country governments and civil society organizations. The 100 ‘core’ indicators will be those that ultimately meet an explicit set of sensible criteria, including consistency with previous international agreements and compacts (e.g. the Millennium Development Goals), epidemiological utility, feasibility of measurement, and country-level buy-in. Indeed, the process for generating the list is highly reminiscent of a major recommendation handed down by the Data Working Group of PEPFAR’s Scientific Advisory Board (chaired by our CGD colleague Mead Over). This exercise is potentially even better than the initial DWG recommendation, since it includes not just internal harmonization within a single agency but instead global harmonization among all the biggest global health organizations – assuming they formally sign on.
Yet our excitement over this development is tempered by a few notable concerns. First, at 100 core indicators (plus an anticipated 100+ extra ‘additional’ indicators) calling the list ‘parsimonious’ seems like a stretch, particularly since they specify that these indicators are only intended for results reporting (e.g. excluding routine program/financial management purposes).
Second, the language of the declaration is purposely wishy-washy; signatories will commit only to using the list in a “normative, rather than prescriptive manner,” and to “focus results reporting” around the list of indicators (as opposed to drawing exclusively from it). As a result, holding any donor accountable against specific action items will be essentially impossible.
Third, the document reflects donors’ apparent decision to follow the path of least resistance towards “contribution rather than attribution of results.” With many actors working in every setting, it can indeed be difficult to divvy up ‘credit’ for results; nor is it constructive to set donors and country governments against each other in competing for their respective shares of progress. But a ‘contribution’ approach is also fraught with problems. As we argued in our More Health for the Money report, “attribution is important for determining what does and does not work—whether an intervention is effective. Even if the overall national program is seeing strong epidemiological progress, it is still wasteful to invest scarce resources in an ineffective component.” And when actors are able to merely claim contribution for an undefined share of national progress, results reporting can be non-informative. For example, via vague reporting, the U.S. government seems to claim credit for the entire global decline in child and maternal mortality.
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Capital Events
Tuesday
10:00 AM – The Changing Course of the Brazilian Elections – Wilson Center
Wednesday
10:00 AM – Subcommittee Hearing: Global Efforts to Fight Ebola – US House Committee on Foreign Affairs
Thursday
2:00 PM – What’s Next? Celebrating 20 Years of the Environmental Change and Security Program – Wilson Center
Friday
12:15 PM – Social Origins of Dictatorships: Elite Networks and Political Transitions in Haiti – CGD
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By Mark Leon Goldberg and Tom Murphy
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