2013 Make Poverty History Electoral Forum: Denison

By Gina Olivieri and Jeremy Picone

Recently 120 people gathered at the University of Tasmania to hear about the aid policies and opinions of the seven candidates for the seat of Denison at the Make Poverty History electoral forum. Eight members from RESULTS Hobart attended, and two asked questions of the candidates. Well done to the awesome young people at VGen Tasmania and Oaktree Tasmania for organising the event.

The forum was an eye-opening experience. It was heartening to hear the genuine expressions of interest and passion for ending extreme poverty from a number of candidates, while quite disappointing to hear the out-dated and inaccurate perceptions of aid and development from others.
Unsurprisingly, all candidates seemed to agree that ending extreme poverty was a worthwhile pursuit, and that Australia should contribute its fair share to achieving this goal. Where the candidates differed, of course, was how they felt this could be best achieved.

Suggestions included abandoning international frameworks that were perceived to impinge on our sovereignty, withdrawing support for multilateral organisations to focus solely on bilateral aid, and deferring action on the climate crisis in order to cater to material needs perceived as more immediate.
This was somewhat frustrating to observe, as a greater familiarity with aid and development on the part of these candidates would have informed them these suggestions were not only unlikely to help, but plain unnecessary. As advocates, we are not calling for our aspiring leaders to reinvent the wheel, but to recognise that we already have the wheel. it’s getting us to where we need to go – it just needs more air in the tyre.

Australia has for the past 13 years been a signatory to the Millennium Declaration, and working towards achieving the Millennium Development Goals. Since 1970 Australia has been ostensibly aiming to increase its foreign aid spending to 0.7% of Gross National Income (GNI). And Australia has a track record of supporting effective global institutions such as the Global Fund to Fight AIDS, TB and Malaria, which has resulted in 29 million mosquito nets being distributed in our region alone, for example.

Australia’s aid spending already has significant and effective measures in place against corruption, a fact that seems to have bypassed some candidates. We do not simply hand over money to foreign governments and hope for the best.

There isn’t actually a great need to come up with a whole lot of new ideas of where and how to spend our aid money. We’re not waiting for a political party to come up with their own MDGs and a local alternative to the Global Fund. We just need to fulfil the promises we have already made. This means reaching 0.7% GNI in aid spending – something the UK will achieve this year.

We need to increase our contribution to the Global Fund to $US 375 million for the period 2014-16; a smart, strategic investment that will save lives and reduce the burden of disease. It is possible that AIDS, TB and Malaria can be eliminated within 15 years if we make a big funding push now.
We need enthusiastic, genuine bipartisan support for the next set of goals that will succeed the Millennium Development Goals in 2015 – the Sustainable Development Goals.

And we need to realise that the challenges of climate change and poverty go hand in hand. The UN Human Development Report for 2013 predicted that 3 billion people will be in extreme poverty by 2050 if we do not act to prevent the catastrophic effects of climate change. Our leaders need to realise that irrespective of their beliefs about why or how the sea levels are rising and weather patterns are changing; their impact on human lives will be devastating, and we need to be planning for this now.

Fortunately, several of the candidates spoke with a deep appreciation of and personal commitment to these issues. It was also a proud moment when the incumbent Andrew Wilkie MP, spoke about the role of RESULTS volunteers in championing the Global Fund, saying RESULTS is an organisation he “has a lot of time for”.

We hope our incoming Government have a lot of time for ending poverty.

Why we need the Global Fund

 By Gina Olivieri, RESULTS Grassroots Engagement Consultant

In September 2009, I was lucky enough to meet with Dr Akhtar Hussain, Head of the Antiretroviral Program at Prince Mshiyeni Memorial Hospital in Umlazi. I arrived at the hospital under a blanket of grey clouds and drizzling rain. The weather seemed to highlight the mood of the hospital from the outside – dark, shabby and desperate, with people lined up to get inside. Once inside it was very busy, with a constant stream of people treading a path past the reception where I waited nervously for Dr Hussain. People walked, limped and were wheeled past. People wore face masks; whether due to Tuberculosis (TB) or the new threat of swine flu I wasn’t sure.

Dr Hussain emerged from the throng of people, beaming a warm smile. He had a relaxed and friendly demeanour, no mean feat for someone with a no doubt highly stressful and busy job. He immediately offered a tour of the hospital. He took me first to the hospital’s crisis centre. Called ‘Place of Comfort’, it is a place where rape victims can be treated, tested for HIV, and report the crime to police. The centre has 5 to ten people per day report to the centre for help, with victims ranging from 2 month old babies to adults. I was also shown around the small TB clinic where a few people waited and watched TV. We then headed to Vusithemba Clinic, the hospital’s HIV/AIDS clinic. On the way a trolley was wheeled past and a pair of anonymous feet poked out from under the sheet. The head was covered.

On the way across the car park to Vusithemba Clinic Dr Hussain remarked that today was a quiet day. The people lining the entire length of the veranda suggested otherwise, but Dr Hussain told me that usually the line extends to the other side of the car park. This line begins forming at 5am, and people will often wait all day to be seen. Men, women, teenagers and children all wait patiently with simple red numbered stickers indicating their place in line. I saw a girl with number 168 on her hand, a sticker marked 225 lay abandoned on the floor. The waiting room and hallways were all packed with people. On the day I visited it looked as though about 80-90% were women, and indeed Dr Hussain confirmed that men face increased stigma and are reluctant to seek help.

The name Vusithemba roughly translates to ‘building hope’. The hospital had to find an alternative to calling it the HIV/AIDS Clinic, due to the stigma surrounding the disease. The name also acts as a form of encouragement to patients, reminding them that they can live long and healthy lives whilst being HIV positive. The Vusithemba Clinic started its HIV program in about 2004, without access to any antiretroviral drugs (ARVs; HIV-treating medications). Initially staff would only be able to offer testing, counselling and education. In the early days patients would sell their test results, as they could be used to get food parcels, but Dr Hussain believes this problem has been overcome. In 2005, the clinic had about 60 patients. Now that number stands at 8,500. Considering the national HIV rate is officially estimated to be about 18% and Umlazi has a population of 1.6 million people, the clinic treats a maximum of 3% of the Umlazi’s HIV positive population. Dr Hussain estimates that Umlazi’s HIV rate is more like 40% based on compulsory testing of pregnant women in the hospital. Between 60% and 70% of people reporting to the hospital have HIV-related sicknesses such as TB. Seeing the crowded waiting room and calculating these figures highlighted the enormity of South Africa’s HIV/AIDS pandemic.

The clinic is under-resourced and limited in the patients they can treat. Until recently patients needed to have a CD4 count of less than 200 to receive treatment. A CD4 count is a measure of how many immune cells are left in a person’s body. The lower the count, the more HIV has attacked the immune system and the sicker the person is. If a person comes to the clinic with a CD4 count above 200 they are encouraged to stay healthy and called back every three months. Recently the CD4 cut-off was changed to 350, meaning more people can access treatment and stay healthy for longer.

The clinic faces a big problem in staff shortages. New guidelines from the Department of Health require more work from the same number of staff, so burnout is common. The staffing requirements of the clinic are significant; the clinic doesn’t just need doctors but also cleaners, security and clerks to keep the clinic clean, safe and organised. Despite the challenges, Dr Hussain tries extremely hard to put all mothers on ARVs, regardless of their CD4 count, to try and protect their children from the disease. The clinic does a lot to educate people and empower them to live healthy lives. There is a three day training program for patients to learn to take their medication properly, and a big emphasis on helping them find support. Inside the training room I saw a piece of cardboard stuck to the wall with various pills taped on it to show the daily regimen of medication for patients.
The stigma surrounding HIV/AIDS remains a significant barrier to people seeking treatment, and Dr Hussain even says ‘I think some die of their stigma’. Umlazi is thought to be in a stage of denial, and within the community people avoid speaking to Dr Hussain publicly as he is well-known as the HIV/AIDS doctor. The stigma means HIV/AIDS isn’t spoken about openly, fuelling myths and misinformation. Even a medical intern recently asked Dr Hussain if HIV was introduced to Africa by American scientists. Zulu people will often see a traditional healer for muthi (traditional herbal medicine) instead of or as well as their doctor. Muthi can cause problems such as liver damage and can interfere with the effectiveness of ARVs. Sometimes people will stop taking their ARVs altogether.

For Dr Hussain, this is but one challenge. He says his greatest challenge in his work is seeing people so incredibly sick with HIV/AIDS every day. His greatest reward comes from seeing people getting better enough with treatment to return to work. About 70-80% of patients treated at Vusithemba return to work. Seeing children become well enough to go to school is also a great reward.

Preventing the spread of HIV further is a huge public health concern in South Africa, and one that has attracted considerable attention. Dr Hussain believes that there is a greater need for more VCT (voluntary counselling and testing) and empowering young people through sex education. He says that simply distributing condoms does not work. He believes young people have a vital role in stopping the spread of HIV, saying ‘young people must understand HIV, get tested, and change their behaviour. They must understand ABC (Abstain, Be faithful, use a Condom) and not get trapped by HIV/AIDS. They must be young leaders and stay HIV-negative’.

I wrote this piece in 2009 after visiting Prince Mshiyeni Memorial Hospital in Umlazi as a volunteer with The Oaktree Foundation’s Schools4Schools program.. Stats and facts undoubtedly have changed since then. What hasn't changed, is the need for countries like Australia to increase their contribution to the Global Fund to Fight AIDS, TB and Malaria to prevent future illness and deaths. In November 2013 the replenishment conference is taking place where donors will decide how much they give the Global Fund for the 2014-2016 period.

Australia must commit $395million for this period. We can end AIDS, TB and Malaria if we make smart, strategic decisions now.

Join the conversation and show your support by tweeting #thebigpush to @RESULTS_AU

Or visit theglobalfund.org/en/thebigpush

Microfinance in Sri Lanka

Mixing business with pleasure was no problem for RESULTS National Manager, Maree Nutt who stumbled upon and then visited a Grameen microfinance replication program while on her recent holiday in Sri Lanka.

After a number of wrong turns we finally found ourselves at the remote and idyllic surfing spot.  Fortunately, ‘remote’ still meant that our post surfing reward was breakfast at the equally remote and simple Hilltop Canbanas and café run by the ever friendly owner, Dilani.

Imagine my surprise when my son Jack spotted that our tea was served in mugs emblazoned with the words ‘Grameen microcredit’! I soon learned that Dilani’s husband Indika was the manager of a nearby branch of what is now called “Prime Grameen”.

Starting with some talk about Muhummad Yunus and RESULTS, it didn’t take long before Dilani had arranged for me to visit her husband’s branch of Prime Grameen in the bustling town of Monaragula, the following week..

Prime Grameen has 48 branches around Sri Lanka. The Monaragula branch has fifteen staff, most of whom spend Monday to Wednesday going out to the villages to collect weekly loan repayments and savings deposits from their 2.600 women clients.

My visit was at the end of the week when approved new clients come to the branch to receive their first loan. The process had begun two weeks earlier with discussions with Branch staff go into villages to identify potential clients who interested in improving their lives financially and who are sufficiently poor by the Bank’s formal assessment process.

Apart from credit, a package of financial services is provided. For example a $2 life insurance policy provides immediate cancellation of the loan plus 50,000  (approximately $400) rupees to the family should the woman borrower die accidentally.  Each woman must also open an interest bearing savings account (9%) and save a minimum of 60 rupees or 50 cents per week over 51 weeks of the loan.

A very important part of Prime Grameen’s business model for sustainability is to offer a range of other savings products to the non-poor.  Fixed deposits and children’s savings accounts offer good incentives and are available to any member of the public. These deposits help provide the loan capital as well as cover other costs.

At the branch that day I met Soma, a smiling and gentle 55 year old woman who would receive her first loan of 25,000 Rupees (just over $200) for a sewing business. She is widowed and her son lives in Colombo but does not visit or support her to any extent. She planned to buy 2 sewing machines and have one worker assisting her from her home. She seemed very sensible, modest and capable, and also very excited. I look forward to seeing Soma one day with her life improved

I also thank Muhammad Yunus for the gift of Grameen which has been replicated to near and far corners of the world. 

RESULTS has long advocated for increase quality and quantity of microfinance (credit, savings and other financial services) within the Australian aid program. Most recently RESULTS volunteers have also advocated to protect the Grameen Bank from threats to its operations and governance from the Government of Bangladesh. See more at www.results.org.au

Why is undernutrition an important development issue?

by RESULTS Intern Fiona Holdsworth

According to the World Health Organisation, malnutrition claims the lives of over 3 million children each year, predominately occurring in 34 developing countries. Studies report that 165 million children aged under 5 have stunted growth due to malnutrition and an estimated 870 million people go hungry worldwide. The British Medical Journal, The Lancet, has also attributed 45% of all child deaths to malnutrition.

Quality nutrition is important to combat high rates of child mortality, reduced brain development and stunting. Children who have suffered malnutrition face additional hurdles in succeeding in the classroom and beyond.

The economic costs of malnutrition are also considerable. The UN Food and Agriculture Organization reported that globally, malnutrition, including obesity resulting from unbalanced nutrition, could be causing $3.5 trillion in health costs and lost productivity. This translates to 2-3% of Gross Domestic Product on average for developing countries. In Africa, it is estimated that up to 11% of GDP is lost to under nutrition every year, which is more than 10% of lifetime earnings per capita.

Nutrition for Growth: Beating Hunger through Business and Science

Nutrition for Growth was a global summit on 8 June that aimed to eliminate undernutrition in our lifetime through collaboration by civil society groups, governments and businesses. The event was headed by UK Prime Minister David Cameron, Brazilian Vice President Michel Temer and the Children’s Investment Fund Foundation president Jamie Cooper-Hohn.  The main success of the summit was an agreement with 51 countries, businesses and civil society groups to save the lives of 1.7 million children by the end of 2020.

The Summit also aimed to achieve the following outcomes by 2020 –

• Ensure at least 500 million pregnant women and children under two receive adequate nutrition.
• Reduce the number of stunted children under the age of five by at least 20 million.
• Increasing funding to prevent stunting, encourage breastfeeding, and increasing treatment of severe acute malnutrition. This is expected to save the lives of at least 1.7 million children under the age of five. 
• Increase the amount of funding towards nutrition related research.

Funding for nutrition is an excellent return on investment. It is expected that for every $1 spend on nutritional interventions such as those agreed at the Summit, the return from reduced health costs and increased economic opportunities is $15. The Nutrition for Growth summit has been heralded as a great step forward to combat malnutrition. The summit secured new commitments of up to US$4.15 billion to tackle undernutrition up to 2020, $2.9 billion of which is core funding with the remainder secured through matched funding from business and civil society groups.

While the pledges of the summit are a great step forward, according to the World Health Assembly, the $4.15 billion pledge is still well short of the estimated $10 billion required to tackle malnutrition comprehensively.

What is Australia doing about the issue?

The Australian Government pledged at the Summit to:

• provide an extra AUD$40 million over the next four years to support a new initiative to help more than one million people in the Asia-Pacific region improve their nutrition and access better food; and
• join the Scaling Up Nutrition Movement, which provides financial support to countries which have developed national nutrition plans. . 

Despite the absence of a strong Australian presence at the Summit, the pledge to support nutrition in the Asia-Pacific provides some assistance to a region which is not a high priority for other donors, and the decision to join the Scaling Up Nutrition Movement provides a basis for increased Australian support for nutrition programs in the future.

Nutrition focused aid works

Combating malnutrition is vital to combat poverty in the Asia-Pacific region. One of our largest aid recipients, Indonesia, is a fantastic example to demonstrate the importance of aid funding to improve nutrition. The Indonesian Government, with international aid, has been able to combat malnutrition by improving the level and diversity of domestic production.  The UN’s Food and Agriculture Organisation have recognized Indonesia for successfully reducing malnutrition from 20% to 9% in the past 14 years.

What can we do to combat malnutrition?

RESULTS Australia is committed to increasing the awareness of and action to improve nutrition to end poverty.  While the Nutrition for Growth Summit is a great step forward, more can be done.

The following actions can raise awareness of and call for action on malnutrition. These can be as simple as:

1. Send a tweet to your local MP about why nutrition is important to you and use the hashtag #nutrition4growth. Make sure you follow us on twitter and like us on facebook for all of the latest updates.
2. Write a letter about the importance of nutrition to your local newspaper or MP 
3. Visit our website for more information - www.results.org.au
   

Delivering life-saving vaccines to every child: Polio can pave the way

Photo Courtesy of www.thenews.com.pk

We know how successful outcomes can be when we coordinate our efforts and resources. Worldwide commitment has seen smallpox eliminated. After more than ten thousand years of blinding, disfiguring and killing humans, in 1979 the highly infectious disease was declared eradicated by the World Health Organization.

Now the eradication of polio is also within our reach. Polio cases have decreased by more than 99% since 1988. Two years ago, India – long regarded as the most difficult place in the world to end polio - was declared polio-free. Last year only five countries recorded cases of polio worldwide.

Australia has shown strong leadership in this push to end polio. At the Commonwealth Heads of Government Meeting (CHOGM) in late 2011, Prime Minister Julia Gillard led a call for much needed financial resources, pledging AU$50 million towards ending polio once and for all.

This incredible opportunity is being coordinated by the Global Polio Eradication Initiative (GPEI) , which is synchronising efforts to reach even the most remote and at risk. If one child remains vulnerable to polio, our efforts have not succeeded.

There is no cure for polio. All of the gains we have made in eradicating polio are due to vaccines. By vaccinating each and every child, even those living in poverty and the most hard to reach places, we will soon see a world free of this disabling disease.

Last week was host to the Global Vaccines Summit in Abu Dhabi, United Arab Emirates, where a 2013-2018 Polio Eradication and Endgame Strategy will be released. The strategy has been endorsed by hundreds of scientists across the globe.

In attendance is the Young Australian of the Year award winner, Akram Azimi, who is travelling with the Global Poverty Project as part of their End of Polio campaign. Akram has been a strong voice for polio eradication in Australia and beyond, drawing on his experiences of receiving a polio vaccine as a child in Afghanistan, and having lived in Pakistan, two of the final frontiers of the battle to end polio.

Acknowledging the life-saving effect of Australian foreign aid, Akram has also highlighted the importance of equitable access to vaccines for all people. At the acceptance of his Young Australian of the Year award, Mr Azimi stressed his belief “that every child deserves the right to a healthy life, whoever they are and wherever they were born – whether in Perth, the heart of the Kimberly or Afghanistan”.

While we are close to defeating polio, more than a million children still die each year from other vaccine-preventable illnesses , and these deaths are disproportionately high in developing countries.  We have vaccines for diseases such as rotavirus, pneumococcal and hepatitis B. We may soon also have vaccines for malaria and TB. But we still aren’t reaching millions of children each year.

Given the role that poverty plays in increasing vulnerability to infection and illness, the same children that miss out on access to vaccines are often those that are most in need of the protection. Through striving for equitable access to vaccines for all we have a real opportunity to turn the tide of the growing disparity between rich and poor.

The significance of eradicating polio should not be underestimated. With strong political will, public engagement and financing, the end of polio could be just a first step towards protecting every last child from preventable disease. This is an opportunity that must not be lost and we all have a part to play: governments, private companies, communities, individuals.

Australia showed great leadership at CHOGM through their commitment towards ending polio, but there is still much to be done. Australia will announce its federal budget on 14 May. This is an incredible opportunity for the country to show continuing leadership in the fight against global poverty, disease and inequity. A strong declaration for foreign aid, in line with the commitment of a growing aid budget, 0.37% Gross National Income (GNI) pledged towards Official Development Assistance, on track to reach 0.5% GNI by 2016/17, would be a clear signal that Australia can be counted on to go that last, and critically important, mile.

RESULTS Australia: World TB Day 2013

Andrew Wilke MP with RESULTS in Canberra 2013

Each year, March 24th marks World TB Day. It’s a timely moment to renew our commitment to getting to zero TB deaths within our lifetime. While we have the knowledge about what is needed to defeat this disease, it will require a huge effort to get there. We need to reach vulnerable populations, who are often most at risk of contracting TB and missing out on much needed diagnosis and treatment. We also need increased investment into much needed new TB drugs, diagnostics and a vaccine. This infectious and deadly disease, while thought by many to be a thing of the past, still claims around 1.5 million lives a year. In 2011, 8.7 million new cases of TB were detected.

RESULTS  has been busy with activities for World TB Day! We were in Canberra meeting with MPs and Senators the week before World TB Day, where we spoke with a number of parliamentarians about TB, and asked them to hang posters in their parliament house office windows. RESULTS Australia designed and printed four posters to increase awareness of the importance of the Global Fund to defeat HIV, TB and Malaria in the Asia Pacific, particularly given the $11 million shortfall to Australia’s commitment to the Global Fund this year. It is also a replenishment year for the Global Fund, so awareness of the critical role the Global Fund plays in our region is very important. Did you know that in 2012, 100% of TB program funding in Laos, 92% in Indonesia and 89% in Papua New Guinea came from the Global Fund?

Dr Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria holding one of RESULTS' posters

We worked with Greens Senator Lee Rhiannon to table a motion in the Senate, emphasising the need for increased financing for Research and Development for TB, and support for the Global Fund in addressing Tuberculosis around the world and in our region.

It was also encouraging to see Teresa Gambaro make a speech in the House to mark World TB Day that supported our asks around TB in the region, calling for strong support for the Global Fund and zero TB deaths in our region.

Plenty of media was also generated by RESULTS to mark this day. Maree Nutt, our national manager, was interviewed by four radio stations: 2GB, 2SM, 2UE and ABC radio news, where she provided comments on TB and the importance of the Global Fund to defeating TB.

We also had an Op Ed in Online Opinion. Maree Nutt highlighted that the Asia Pacific is home to 60% of world TB cases, and that tragic deaths such as Catherina Abraham’s from multi-drug resistant TB are avoidable if TB is given adequate attention and resources. Again, the imperative role of the Global Fund in tackling this disease was noted.

Global Fund announces new board chair… and she’s from the Asia Pacific!

The Global Fund to Fight AIDS, TB and Malaria has announced a new chair of the Board. Dr. Nafsiah Mboi, the Indonesian Minister of Health and previous secretary of Indonesia’s National AIDS Commission, will take over the role of chair from Simon Bland of the UK from June this year. Guided by a founding principle of partnership, the Global Fund alternates the chair of the Board each two year term between members of donor countries and members of implementer countries.

While the Chair of the Board represents the interests of the Global Fund, rather than those of their country in particular, Dr Mboi’s experiences will undoubtedly be brought to the table. Dr Nafsiah Mboi trained as a paediatrician and has further training in Public Health. She has served as Chair of the United Nations Committee on the Rights of the Child and also as Director of the Department of Gender and Women's Health at the World Health Organization in Geneva.

In their congratulatory statement at the announcement of Dr Nafsiah Mboi’s appointment as Minister of Health last year, The Pacific Friends of the Global Fund commended Dr Nafsiah Mboi for always understanding “the critical role of empowering women and girls in achieving better health outcomes for the entire community”.

We’re excited that the new chair is from the Asia Pacific, and along with her interest in child health and women and girls, Dr Nafsiah Mboi can offer much needed insight and an increased profile for our region. Approximately 60% of the world’s TB cases are found in the Asia Pacific and the Global Fund has been key to the response in our region. This year, 100% of TB programs in Laos will be funded by the Global Fund, 94% of TB programs in Timor Leste, and 92% of TB programs in Dr Nafsiah Mboi’s home country, Indonesia.

On RESULTS National Conference call tonight, Wednesday March 27, we will be discussing the historic opportunity the world now has to defeat AIDS, TB and Malaria. Make sure you join the call to hear why it is so important for Australia to increase their support for the Global Fund this year.