The deadline to meet the Millennium Developmental Goals is only three years away, causing many UN officials to reflect. The ability to achieve these goals is still a matter of much debate, as countries who have pledged help are now falling short of in their promises.

However, the question raised during this year's General Assembly is the matter of what should be done once the deadline has been reached and the goals (ideally) met? This was the matter at hand for the High-Level Panel on the Post-2015 Development Agenda held at UNHQ on September 25.

Hosted by the Permanent Mission of Japan, the panel was composed of the UN Development Programme (UNDP) Administrator Helen Clark, Special Adviser on Post-2015 Development Planning Amina J. Mohammed, and led by Minister of Foreign Affairs in Japan Koichiro Gemba. While there was importance placed on the fulfillment of the MDGs by the allotted time, the event was meant to invite high-level stakeholders, NGOs, and private foundations to discuss and establish a new global agenda, hopefully to be built upon the success of the MDGs.

"Achieving the MDGs we have is still a top priority," declared Clark. "The international willingness to support a new Global Agenda will be influenced by how successful the MDG process has been seen to be."

Panelists brought forth evidence for newfound ideas based on what has already been working in favor of achieving the goals. The presentations underlined the status of the current hard work, and also reinforced the idea that those who wish for change cannot afford to wait for a recipe to be formulated.

"The evidence of what has worked in MDG achievement needs to inform the Post-2015 agenda," Clark stated. The UN task team proposed three main principles, based on global trends, for the post-2015 agenda: "Achieving human rights, reducing inequality, and ensuring sustainability." Panelists decided that proposals for future goals should be limited and concrete so as to better achieve economic and social development, environmental sustainability, peace, and security.

To reach consensus about the future goals, many of the contributions that have been discussed within the UN forums and Rio+20 conference will contribute to the new agenda. However, Ms. Clark highlighted the importance of the participatory process on a worldwide scale.

"We also need to find ways to fully incorporate the voices and priorities of the world's citizens, civil society groups, and independent experts," Clark said. "To these ends, the UN development group has begun a rather large consultation exercise, with national level dialogues being organized in at least 50 developing countries."

Clark and Mohammed both expressed their hope for constructive dialogue and discussions in order to contribute to an ambitious post-2015 Development Agenda that aims at eradicating poverty, building a greener environment, and reach a more equitable future for the world's peoples.

(sumber : blog.mediaglobal.org)

Alfredon, who will turn 1 next month, cries as a community health worker slips a measuring band around his upper arm at his home in Magepanda subdistrict, East Nusa Tenggara.

The health worker does not pay much attention to the toddler's tears. She is pleased with the reading of 12.5 centimeters, which shows that the circumference of Alfredon's arm is 2.5 centimeters longer than two months ago when he was classified as severely malnourished.

Long-term consequences

Child malnutrition affects 37 percent of Indonesian children whose growth has been stunted by ill health and a lack of vital micronutrients in their diet. While Alfredon has recovered from his acute malnutrition, there is a good chance that the chronic, long-term lack of nutrients has impaired his growth and development, which unfortunately cannot be reversed.

Stunting, one of the outcomes of child malnutrition, is linked to a decrease in cognitive functioning and IQ and negatively impacts on both educational achievement and employment prospects. Studies suggest those who have been stunted earn 20 percent less over the course of their lives than those from similar backgrounds who receive adequate nutrition. Most worryingly for Indonesia's booming economy, it has been predicted that stunting costs developing countries 2 percent to 3 percent of their gross domestic product.

With 240 million people, about 32 percent of Indonesia's population is under 18, with 9 percent below the age of 5.

So how can Indonesia do better for these children? Health experts have identified a number of simple, low-cost solutions that dramatically reduce the incidence of stunting in young children and could save the lives of 36,000 children under the age of 5 in Indonesia each year. These strategies target children from conception until they are 2 years old, when the damage caused by malnourishment is largely irreversible.

One of these solutions is to give pregnant mothers and children supplements in iron and vitamin A as well as zinc for children suffering from diarrhea. A yearly supply of capsules containing these micronutrients typically costs between $1-$2 per person.

Other solutions to reverse the malnutrition rate involve behavioral changes, including exclusive breastfeeding for the first six months of an infant's life, followed by complementary feeding of frequent, quality food to supplement breast milk intake until the age of 23 months. The World Bank estimates that educating households on these practices costs $7.50 per child.

The reality of the situation

While these solutions are not complex or expensive, implementing them often is. Government health worker Anastasia, who works in the Sikka district, says that she is only able to screen for malnutrition in children who visit the village health posts. However, more than a quarter of children do not attend or complete the program, which may take as long as 10 weeks. According to Anastasia, "A lot of people, they come for four weeks, see their child is better and then stop coming."

One of these mothers, Susana Beni, explains that she did not continue to take her 16-month-old son Riomundus back to the clinic after he was identified as malnourished by a local health worker in March because he caught tuberculosis and was in hospital for two weeks.

After Riomundus became sick, Susana stopped focusing on her son's nutrition and assumed the hospital would have given him any treatment she needed. When asked whether child malnutrition and its causes had been explained to her, Susana said that this had not taken place.

On a field trip sponsored by the UN Children's Fund, Dorothy Foote, a program specialist at Unicef, said that these types of stories indicate that even in areas where there is extensive coverage of communities by health services addressing malnutrition, the quality of care may not be adequate.

"Quality can be a real issue. One solution is to make sure that health workers and counselors are trained properly so that they pass on the right information, but also so that they are engaging with the mothers in the community, that they are having a conversation with them and listening to their situation, not just giving them a lecture," she said.

As part of Unicef and the European Union's joint action on Improving Nutrition Security in Asia, Unicef has targeted three districts in which to focus its efforts to support and train health clinics, workers and community volunteers. The Klaten district in Central Java, Jayawijaya in Papua and Sikka, where Alfredon lives, were chosen by Unicef due to both the high rates of stunting and the strong leadership present in these areas.

Evidence of this can be seen in Makendetung, a village in Sikka, where the community has banded together to ensure their children are better nourished. Under the leadership of their chief, Ibu Maria Feligonda, village members took part in a Participatory Action and Learning (PLA) exercise facilitated by Unicef in July 2011.

This three-day process allowed the village to identify how many children were stunted or at risk of malnourishment and the likely causes.

As well as paying more attention to breastfeeding, clean water and sanitation, the village has set up a nutrition post to ensure that its 130 children under the age of 5 are regularly monitored. Any child identified as underweight is fed on a diet supervised by the nutrition post for 12 consecutive weeks.

The bigger picture

With Indonesia's economic growth surging, the government has begun to recognize the investment that is represented by ensuring every child in the country reaches his or her full potential. In 2010, the government announced its commitment to the Scaling Up Nutrition project, a global movement that pushes for action on maternal and child nutrition. The Ministry of Health claims that it allocates Rp 700 billion ($77.7 million) annually to combat child malnutrition.

Indonesia now boasts a 2.6 percent reduction in its stunting rate each year on average, putting it among the top 15 nations making the fastest gains against malnutrition. But the country also contains the fourth highest number of children under 5 who are stunted globally.

Even accounting for Indonesia's status as a highly populous developing country, this is a poor figure. Indonesia falls well below the level expected of a country with its $3,500 GDP per capita, which should put its stunting rate at one in five children, rather than the more than one in three children.

Alfredon's mother Maria agrees that nutrition needs to be a priority not only for the government, but also for parents.

"I don't know why mothers don't take their children to the health post enough, but if I see any of them, I will tell them to go," she said.

"Alfredon is better now. Before, all he would do was sleep. Now he plays all the time."

(sumber : Thejakartaglobe.com)

The World Health Organization (WHO) has developed a road map to help countries in the Western Pacific Region eliminate neglected tropical diseases to the pages of history.

Dr Shin Young-soo, WHO Regional Director for the Western Pacific, presented to the Regional Committee for the Western Pacific, WHO's regional governing body, the draft Regional Action Plan for Neglected Tropical Diseases in the Western Pacific (2012–2016) on September 27.

To eliminate measles disease, countries must now intensify their efforts to immunize all children, WHO says

The focus of the five-year plan will be seven key diseases: leprosy, lymphatic filariasis, foodborne trematodiases, schistosomiasis, soil-transmitted helminthiases, trachoma and yaws.

WHO has set 2020 as the target to eliminate the burden of some of these diseases, such as lymphatic filariasis, yaws and leprosy, through expanded interventions and intensive monitoring. An integrated approach is crucial for scaling up and sustaining access to medicines and other interventions against these neglected tropical diseases.

Limited funding for scaling up interventions has impeded progress. Success requires sustainable program management.

In addition, feasible action plans require innovative and collaborative solutions to barriers, such as reaching populations in remote and conflict-stricken areas.

Well-trained health-care staff are also imperative for success. Front-line health workers need adequate training in detecting and treating neglected tropical diseases, especially as patients with chronic diseases, such as leprosy and lymphatic filariasis, may need lifelong care.

WHO also wants the Western Pacific Region soon to become the second of its six regions to eliminate measles. Endemic measles virus transmission has likely been stopped in 32 of the Region's 37 countries and areas. To eliminate the disease, countries must now intensify their efforts to immunize all children, particularly those in harder-to-reach communities and remote areas.

Measles incidence in the Region declined to a record 12 cases per million in 2011 from 82 cases per million in 2008.

(sumber : saigon-gpdaily.com.)

HANOI, 26 September 2012-"With the deadline for attainment of the Millennium Development Goals (MDGs) only three years away, wide disparities between and within countries need to be urgently addressed if the goals are to truly benefit vulnerable populations," World Health Organization (WHO) Regional Director for the Western Pacific Dr Shin Young-soo said today.

"Unless urgent action is taken, we will likely fall short in some areas, especially in reducing maternal and child mortality and improving maternal health," Dr Shin told the WHO Regional Committee for the Western Pacific in Hanoi, convened to review WHO's work in the Region. "The battle must continue."

The under-five mortality rate has dropped by 60% in the Region, from 48 deaths per 1000 in 1990 to 19 per 1000 in 2010. However, six countries still account for an estimated 97% of the under-five deaths-Cambodia, China, the Lao People Democratic Republic, Papua New Guinea, the Philippines and Viet Nam.

Disparities in child mortality also persist within countries. In Cambodia, for example, the overall under-five mortality rate is 54 per 1000 live births. However, it ranges from 18 per 1000 live births for areas with the highest socioeconomic status to 118 per 1000 live births among the poor.

Urban versus rural disparities also exist, such as in the Philippines, where the under-five mortality rate is 28 per 1000 live births in urban areas and 46 per 1000 in rural areas.

Despite a decreasing trend in maternal mortality in most countries and areas in the Western Pacific, large disparities and inequalities exist both between and within countries. In low-income countries, such as the Lao People's Democratic Republic, the maternal mortality ratio (MMR) is 470 per 100 000 live births - far higher than in middle-income countries, such as Malaysia, where the ratio is 29 per 100 000, and Viet Nam with 59 per 100 000. The MMRs in Cambodia and Papua New Guinea also remain high at 250 and 230 per 100 000 live births, respectively.

In the Region, the HIV epidemic has shown signs of stabilizing with increased coverage of preventive interventions for most-at-risk populations. However, only 43% of those who need treatment for HIV have access to antiretroviral drugs. Access to treatment still needs to be scaled up, particularly in low- and middle-income countries.

Lack of universal access to health care is also a pressing issue, with high costs and direct out-of-pocket payments putting health care beyond the reach of many people in the Region. Other barriers include weak health systems and widening health inequities. Also, countries need more reliable civil registration and vital statistics systems to better monitor the burden of diseases and properly target health interventions.

"Universal coverage needs to be improved to enable people to have access to good-quality services without being financially strapped," said Dr Shin. "Particular attention should be given to underserved groups. Failure to act now will further widen health inequities."

(sumber : nzdoctor.co.nz)

President Susilo Bambang Yudhoyono is in New York with an important mission for humankind. He, alongside British Prime Minister David Cameron and Liberian President Ellen Johnson Sirleaf, will be co-chairing the United Nation's High Level Panel (HLP) of Eminent Persons.

Appointed by UN Secretary-General Ban Ki-moon, the HLP consists of 26 prominent figures including former heads of government and representatives of civil society, youth, academia and the private sector.

To successfully perform this important and noble job, Yudhoyono is assisted by a national committee, which was recently formed through Presidential Decree No. 29/2012 and is chaired by Kuntoro Mangkusubroto, the head of the Presidential Working Unit for Supervision and Management of Development (UKP4).

One of the President's tasks is to lead the HLP in advising the UN Secretary-General on the vision and shape of a post-2015 development agenda, responding to the global challenges of the 21st century and building upon the Millennium Development Goals (MDGs), with an aim of eliminating poverty.

Having been agreed upon by all 193 UN member states and at least 23 international organizations to achieve by the year 2015, the MDGs consist of eight global development goals. They are: 1) eradicate extreme poverty and hunger; 2) achieve universal primary education; 3) promote gender equality and empower women; 4) reduce child mortality rates; 5) improve maternal health; 6) combat HIV/AIDS, malaria, and other diseases; 7) ensure environmental sustainability; and 8) develop a global partnership for development.

Nearing the deadline set for MDGs accomplishment in 2015, the panel therefore is tasked to advise the UN Secretary-General on building and sustaining broader political consensus on an ambitious yet achievable post-2015 sustainable development agenda around three pillars: economic growth, social equity and environmental sustainability.

Learning from the uneven progress toward reaching the MDGs and criticisms from development practitioners, experts and civil society, the HLP should rectify the drawbacks and deficiencies of the MDGs implementation in 2001-2011. According to the 2011 UN MDG Progress Report, some countries have reached many of the goals, while others have failed or have struggled to achieve any. Progress toward some goals and targets has disappointedly been stagnant and even regressed. For example, the proportion of hungry people (goal 1) has increased by 16 percent since 2000/2002.

Criticisms that beg the HLP's response can be classified into two categories (Fukuda-Parr, 2012). First, those that relate to the composition of the goals, targets and indicators of the MDGs. Under this category, the critics have spoken out against poorly designed development goals; the narrow composition and dimensions of development; a lack of attention to equality, important norms and principles, in particular falling short of human rights standards; an unbalanced international political economy; and a distortion of national priorities.

Second, critics have raised concerns about the process to formulate and implement the MDGs. These criticisms include the lack of broad consultation in formulation; the national adaptability of the global goals; criteria for success and methodology of measuring progress; and an aid-centric process.

But why have some of the MDGs not or unsatisfactorily been achieved? First, those goals are unrealistic and unattainable. They do not truly represent the interest or policy priorities of some countries. Moreover, these countries lack strong incentives, and thus lack the political commitment to achieve those goals. Thus, there is no effective "reward and punishment" mechanism to push states to reach these goals.

Furthermore, there is no global, effective and integrated system for monitoring and evaluating progress. More importantly, developed countries do not genuinely and fully support and help developing countries, in particular least developed countries to attain these goals. And lastly, "external" factors, such as the recent economic crisis in Europe, have badly affected the financial and economic capacities of some countries to realize the MDGs.

Therefore, in recommending sustainable, inclusive and equitable development goals (SIEDGs) and an agenda to the Secretary-General, the HLP should learn from the drawbacks in the formulation and implementation of the MDGs. SIEDGs must be based on both the common problems faced by all states and those specific to developing countries. Thus, the goals are split into two levels: common and specific SIEDGs.

Developed and developing countries face new and common challenges in the 21st century. Some of these challenges are climate change with all its destructive effects; food, energy, and water crises; poverty; corruption; human trafficking; drug abuse; environmental degradation; unsustainable use of resources and development; terrorism and extremism; unemployment; unilateralism and the use of force in resolving disputes; HIV/AIDS and communicable diseases; and global capitalist economy which is prone to economic crisis.

However, developing countries confront new challenges specific to them, such as population booms, limited resources and capacity, debt crises, a lack of technology, human rights abuses, poor access to justice and health, high child mortality rates, extreme hunger, low education levels and low trade competitiveness.

Importantly, the HLP should focus more on overcoming the acute problem of global corruption and bad governance. To some extent corruption, as many researchers have found, is primarily responsible for poverty, deforestation and environmental degradation, economic injustice, poor access to healthcare, social injustice, human rights abuses and even wars.

Instead of achieving the goals in 15 years, all the goals of the SIEDGs should be realized by all countries in 20 years (2015 – 2035). However, some goals can be fully achieved before that time. The progress and performance of countries in attaining the SIEDGs should fairly be evaluated and judged according to their capacity and specific circumstances. The UN and developed states should establish a "global SIEDG fund" to reward developing countries that have performed well in realizing

(sumber : thejakartapost.com)

Australian Ambassador to Indonesia Greg Moriarty visited a number of health facilities in East Nusa Tenggara (NTT) that were established with financial aid from the Australian government to contribute toward improving people's health in the province.

Upon his arrival on Friday, Moriarty and his entourage made a field tour of public health centers in Pasir Panjang and Naikoten II, Kupang, which were a few of the 97 health clinics and public health centers under the programs funded by AusAid.

He said he was proud of the aid programs because of the increasing number of pregnant women giving birth at the public health centers and maternal clinics, which was reflected in a decreasing maternal mortality rate in the province.

"Australia is committed to working with the government of Indonesia in East Nusa Tenggara as it is a province with some of Indonesia's highest rates of poverty. It is good to see the valuable work being undertaken to help reduce NTT's high incidence of maternal mortality. Since 2008, there has been a 20 percent increase in women giving birth in safer health facilities rather than at home," said Ambassador Moriarty.

He explained that the Australian government has also provided training programs for health wokers on emergency obstetrics and neonatal care, and supported the campaign program for pregnant women to give birth at health facilities.

The ambassador also visited the South Timor Tengah hospital in Soe, one of the region's 11 district hospitals participating in the AusAID-funded Sister Hospital program.

"This hospital is now better equipped to deal with emergency obstetrics and neonatal services, thanks to training provided by medical specialists from a tertiary hospital in Surabaya. The sister hospital program is clearly effective and achieving results," said the ambassador.

In his field tour to Kefamenanu, North Timor Tengah regency, the Ambassador is opening a resource center built under AusAID's decentralization program.

"This center will serve as an information and data repository for the district. Staff at the center will provide information to public servants, civil society organizations and members of the public, to help with better planning and allocation of local resources," he said.

The ambasador also held a meeting with farmers in Oenaen village to see the Australian government's aid program in the agriculture sector in the regency. Through AusAID's rural program, farmers are being supported to increase productivity and yields.

Moriarty also said Australia would continue negotiating with the Indonesian government to seek a solution to the marine pollution on the Timor Sea, caused by the recent explosion at the oil field in Montara.

(Sumber : thejakartapost.com)

bangkok - Scientists have edged closer to a dengue vaccine following trials in Thailand, where dengue fever is endemic, that have shown a vaccine candidate to be safe and effective, although more evidence is needed to prove its effectiveness.

The results of the clinical phase II trial, showing the vaccine to be 30 per cent effective in protecting from dengue, were published in The Lancet last week (11 September). The vaccine CYD-TDV, which was developed by the drug company Sanofi Pasteur, has been tested on 4,000 children aged four to 11 from 57 schools in Thailand's Muang District.

Dengue fever is the world's most widespread mosquito-borne viral disease with around half of the global population at risk. There is no vaccine to protect against it, although there are several being developed.

It is difficult to develop an effective vaccine because dengue fever is caused by four different strains of virus — known as DENV 1, 2, 3 and 4. The challenge is to develop a vaccine that can protect against all types of dengue virus.

"The results of this trial show that the vaccine can protect against dengue fever caused by three virus types [DENV 1, 3 and 4]," said Pascal Barollier, a Sanofi Pasteur spokesperson. "The vaccine was well tolerated and safe, with no serious effects on those who received it."

But scientists not involved with the study say there is not enough data to prove the vaccine's effectiveness against severe dengue disease, and urged for further, larger trials.

Scott Halstead, a physician at the International Vaccine Institute in Seoul, Republic of Korea, said the result was both "surprising and disappointing", pointing out that the vaccine does not protect against DENV 2, "the most common type in Thailand".

He said it is too early to draw any conclusions about the vaccine's safety.

Sutee Yoksan, director of the Center for Vaccine Development at Mahidol University in Thailand, shared Halstead's concerns, and called for further investigations.

According to Barollier, phase III clinical studies involving 31,000 children and adolescents are ongoing in Latin America (Brazil, Columbia, Honduras, Mexico and Puerto Rico) and in five Asian countries (Indonesia, Malaysia, the Philippines, Thailand and Vietnam) where dengue is endemic.

These trial results are expected in 2014. If successful the vaccine could be available in 2015 in countries where dengue is a public health priority.

(Scidev.net)

The Health Ministry is under fire for allocating Rp 1.8 billion ($190,000) to kill cockroaches and flies in its own offices, with one lawmaker wondering aloud whether the ministry staff is aware of proper sanitary habits.

Poempida Hidayatullah, a member of House of Representatives Commission IX, overseeing financial affairs, said that he had no strident objections to the plan, but still found it curious that the Health Ministry would allocate funds for it.

He added that one obvious key to a pest-free environment was preventative cleaning.

"I'm not going to make a fuss about the program to extinguish flies and cockroaches," Poempida said on the sidelines of a meeting with the Health Ministry in Jakarta on Monday. "I see the benefit that it will make the Health Ministry office more hygienic. But is this because they are filthy?

"I'm just going to think positively. Maybe the cockroaches and the flies appeared because the health program failed."

But the $190,000 plan to kill insects wasn't the only Health Ministry budget item that raised eyebrows on Monday.

Poempida also voiced suspicions over a plan to spend Rp 80 billion for certification for 2,500 health lecturers.

That would mean a budget expenditure of over Rp 30 million per certification, an amount the lawmaker said was absurd.

"Rp 30 million for certification training doesn't make sense. It should only cost Rp 2 million to Rp 3 million. That amount just doesn't make any sense," Poempida said.

Rieke Diah Pitaloka, another member of Commission IX, added her own suspicions, singling out a vague budget request for an unnamed number of vehicles for the ministry.

"There was a budget request for a vehicle worth Rp 700 million per unit, which is still not clear yet," Rieke said.

She also harshly criticized the ministry's plan to allocate more money for bureaucracy than for public health services in next year's state budget.

Rieke, a former actress turned outspoken politician, said that the ministry allocated about 49 percent of their total budget, or Rp 15.3 trillion, for public health services, and almost 51 percent, or Rp 15.8 trillion, for bureaucracy.

Out of the 51 percent allocated for bureaucracy, the ministry is allocating 22.7 percent for office maintenance and supplies and 17 percent for monitoring and evaluation activities.

"What good does it do if the state budget is used for bureaucratic needs?" Rieke said. "We should focus more of the budget on public health services."

In response to the criticism, Health Minister Nafsiah Mboi argued that the bureaucratic expenditures included salaries for vital medical staff, such as paramedics.

"This doesn't mean that bureaucracy is more important, but this is for the paramedics. Who's going to serve the public if no paramedics are available? We need many paramedics."

Nafsiah claimed that she had reduced office costs and that most of the bureaucratic budget would be used to assist paramedics on a regional level.

"You must look at the details of the budget," she said. "In this meeting we are talking about the macro aspects. Please discuss the micro aspects with my staff from Echelon I," she said, referring to top-level ministry officials.

Also on Monday, the Indonesian Forum for Budget Transparency (Fitra) criticized the Rp 23 trillion allocated in next year's draft budget for official travel expenses for ministries and government institutions.

A Fitra spokesperson said the amount was too high and prone to graft.

Finance Minister Agus Martowardojo said he is continuing to evaluate the amount budgeted for official travel expenses.

(Thejakartaglobe.com)