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Tag: Sanjay Basu

Should We Propose A Global Nutrition Treaty?

In 2003, 168 countries signed the world’s first public health treaty: the Framework Convention on Tobacco Control (FCTC). The FCTC legally bound countries to enforce major tobacco control measures, ranging from tobacco taxes to regulations on public smoking. Through a massive international effort, the FCTC has assisted countries to improve their tobacco prevention programs, and the treaty continues to be a basis for many new programs that are implementing evidence-based tobacco control strategies.

In an article in  PLoS Medicine, we publish new data showing that the food and beverage industry’s activities in low- and middle-income countries parallel that of the tobacco industry in years past; moreover, as cardiovascular disease and diabetes rates rise in poor nations, junk food, soda, and alcohol are statistically the major factors giving rise to deaths among working-age populations, and the newest evidence suggests that educational programs alone aren’t effective when markets are drowned by imports of cheap, unhealthy food and readily-accessible booze. So should the public health community push for a nutritional treaty or governance structure that parallels the successful introduction of the FCTC, but addresses “unhealthy commodities” like junk food? If so, what would such a structure look like?

Zooming out from the debates about soda taxes and similar public health controversies that pit individual freedom against public health desires to reduce disease rates, there are really a few core public health problems now facing global food systems: (1) that undernutrition and famine persist as over-nutrition (malnutrition in the direction of obesity) has appeared in the same poor households in many countries; and (2) that climate change has forced us to think about how to produce food for the world’s 9+ billion people in a manner that is environmentally sound (as highlighted in our recent discussion of Oxfam’s GROW campaign).

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Could Social Impact Bonds Help Restore Public Budgets?

Government budgets are tight during the recession, with cuts to public health budgets being announced on almost daily basis. What strategies are available to enhance revenues for public welfare programs–for the kinds of health and education expenses that won’t “pay for themselves”(at least in the short term), and therefore are often the first to get slashed in hard times? Raising tax rates among the wealthy, and introducing new taxes like a Robin Hood Tax, have been widely discussed. But some researchers have also studied entirely new revenue-generating strategies for social welfare programs that don’t rely on taxes—including a popular pay-for-performance scheme based on “social impact bonds” (SIBs).

How they work

A SIB is one of many “payment by results” plans. Just like other types of bonds (for instance, the municipal bonds we invest in to fund a local community college), SIBs involve private investors paying for a particular program that funds some social welfare operation. But SIBs are organized such that if the social welfare program is successful, there should be some net savings to the government and benefits to society.

For example, if a public health program prevents diabetes by successfully sustaining a weight loss intervention, the government should save money that would have otherwise been spent through Medicaid or Medicare on future hospitalizations caused by diabetes. As part of a SIB, the government agrees to pay a portion of these savings back to the investors who funded the weight loss program. And just like any investment, if the program fails, the investors lose money—theoretically attracting investors towards the most effective social welfare programs.Continue reading…

Can We Design a Heart Healthy Home?

There is increasing evidence that the quality of our homes and cities is a critical determinant of cardiovascular disease, diabetes and lung conditions. As urbanization and economic change occur globally, whether we live in a house free of dust in a city with open parks and traffic regulations, or in a dusty tenement building next to a major road, seems critically correlated with our likelihood for having shortened life expectancy, poor nutrition, heart disease and lung problems. In this week’s blog post, we look at some of the mechanisms relating the “built environment”—our human-made surroundings of daily living—to the risk of illness. We ask the question: can we do for our hearts and lungs what the Bauhaus movement did for functional design?

Indoor air quality

If Dwell Magazine had a feature edition on designing a healthy home, they’d have to tackle the major issue of indoor air quality. Much research on the built environment’s impact on health was revealed through a series of studies on asthma among children living in low-income public housing units in the United States. Poor indoor air quality resulting from dust and dirt in public housing units was a major cause of emergency room visits during the 1980’s and 90’s among these children, leading to new programs for housing quality checks and maintenance, which we featured in a previous post.Continue reading…

Shifts in Humanitarian Aid: A Look at Post-Recession Data

A few agencies have recently published their concerns that the “double dip” recession will negatively affect humanitarian aid, even as the worst famine in decades continues to hit East Africa. Have aid levels really been affected by the recession? If so, which countries are likely to feel the most impact? What factors are shaping aid decisions? In this post, we look at the latest data from the OECD’s Development Assistance Committee (DAC), the definitive source for international humanitarian aid data, and discuss the changes in aid that have transpired since the start of the 2007 recession.

Overall trends

If humanitarian aid shifts during this recession, such a shift would be a new phenomenon; when we investigated global aid trends during prior recessions, we found that aid usually didn’t significantly change during or soon after economic downturns, probably because foreign assistance is such as small part of government budgets, and because aid changes are often driven by disasters and conflicts rather than supply-side politics alone.

The first graph above depicts global humanitarian aid from 2006 to 2009 (all graphs are courtesy of GHA; note that the colors in this graph are incorrect for the last column, which should be black on top and green on the bottom). As shown in the graph, humanitarian aid actually increased a bit during 2008, likely reflecting commitments made before the recession. But aid then decreased 11% to $15.1 billion in 2009. The 2010 numbers won’t be released until later this year. The available figures refer to forms of aid that reach “delivery agencies” such as United Nations subsidiaries, non-governmental organizations and the Red Cross. Of note, while the 2008 contribution from governments is smaller than 2007, it still remains higher than earlier years. Of particular interest is that private donations have increased almost 50% since 2006 and have remained steady during the recession.

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