Eighty years ago,when Japan first decided to engage militarily with the Southeast Asian countries, it resulted in an arguably ferocious occupation, creating an anti-Japanese sentiment throughout the region, still mounted even decades later. For the second time, however, the military crafts cruising through the South China Sea are welcomed with open arms. Not far in the northeast, a dragon has risen, generating concerns that soon, it will tighten its clutch in the region.
Japanese Military Revival
Japanese military supremacy in Asia came to an end after World War II. The United States, in the capacity of an occupier, helped make sure that it was deprived from aggressive military activity, through imposing a constitution in 1947 that specifically “forbade possession of a military”. Japan, nonetheless, was still permitted to form the Self Defense Force to protect its territory. In addition, the US, through the 1954 Mutual Defense Assistance Agreement, pledged to provide militaristic support through establishing military bases, most notably in Okinawa.
Some have argued that Japan has violated the mandate by engaging in cross-border military activities, although mainly as an aide to the US. In fact, Japan has developed its Self Defense Force into one of “the most sophisticated armed forces in Asia,” albeit with a spending ceiling of 1% of GDP. At the same time, Japan has not been allowed to possess a full capacity of “offensive weapons” nor do the Japanese citizens feel ready for the increasing military role.
However, things have changed in Asia, including the power dynamics. Although Japan – North Korea relations have long been strained, the leadership transition and recent missile tests in the latter country have made Japan feel further threatened. As a response to the recent threat from North Korea that pinpointed Tokyo as the number 1 target, Japan deployed “missile-defense systems at three sites around Tokyo.”
Then there is the rising power, China, which is also North Korea’s strongest ally. Historical tension has dominantly characterized the two countries’ relations. In recent years, tensions have escalated further because of the Senkaku/Diaoyu islands dispute. The Japanese government’s decision to nationalize the island has undoubtedly sparked more tensions between the two countries. In fact, three Chinese maritime surveillance ships were observed around the disputed area on May 5, making it the 42nd of such an incident after the nationalization.
Southeast Asia and the South China Sea Dispute
Southeast Asia, meanwhile, has emerged not only economically, but also as an indispensable region for Japan and China that is undoubtedly a “decisive territory, on the future of which hangs the outcome of a great contest for influence in Asia.” By and large, the region’s alluring market power of 500 million people has attracted the two big nations to deepen their engagement.
Both China and Japan have increased their economic ties with the Southeast Asian countries. In fact, Japan doubled its foreign direct investment in the region to $19.6 billion in 2011. On the other hand, China-ASEAN trade reached a value of $400.9 billion in 2012, implying that Southeast Asian countries are inherently important trading partners. This growing China-ASEAN trade, however, can potentially be dampened by the ongoing South China Sea dispute.
The development of the South China Sea conflict, as well as the need to counter China’s growing influence, has led Japan to deliver its first military aid after the World War II. In its Japan-US Joint Statement of the Security Consultative Committee, Japan confirmed that there is a need to use aid “to promote safety in the region…through providing coastal states with patrol boats.” Japan has indeed approved the provision of $2 million for training troops in Timor Leste and Cambodia.
In addition, it has agreed to fulfill the Philippines’ request of 12 patrol vessels to “strengthen the Filipino coast guard,” 10 of which will be provided as part of the official development assistance while two more are given as grants. Although the Japanese government announced that the patrol vessels are merely for maritime safety instead of regional security issues, the Philippines is known as one of the most aggressive claimants of the disputed territory, most notably over the Spratley Islands with China. Aside from the Philippines, Japan has also planned to disburse military aid to Indonesia and Vietnam next year.
The aforementioned military aid that Japan provides is unequivocally a double-edged sword. First, by helping strengthen the military capacity of Southeast Asian countries, particularly the claimants of the South China Sea, Japan is able to divide China’s focus and arguably weaken its grip in the region. China now has to divide its resources to focus on both maritime conflicts in the North and South.
Second, Japan can strengthen its ties with the United States through forging what’s undoubtedly a US agenda of soft-balancing China in Asia. The remark made by the Obama administration, which pointed South Korea as the “linchpin of regional security,” has concerned Japanese policymakers that the US government sees South Korea as a “more dynamic ally.” In addition to the military aid to the Southeast Asian countries, Japan has announced early this year that they will support the US in negotiating the Trans-Pacific Partnership, a policy central to the US’ “pivot to Asia.”
Although Japan has long disbursed official development assistance in Southeast Asia, the military aid is nonetheless a significant step on the ladder of their aid policy and manifestation of the national interest. Previous aid programs have been centered on technical assistance that promotes a” nuts and bolts on the ground” approach as part of their “low-profile” stance. However, the threats to their power and economic grip have triggered them to step up to the rise of the “increasingly assertive China.”
“Japan is a big global player. It’s just not an obvious global player.”
As the world holistically tackles global issues in accordance with Millennium Development Goals (MDGs), numerous studies have been conducted on the global giving pattern in order to raise the cost-effectiveness of development assistance. However, few of them focus specifically on the global health sector.
To fill in this gap, PSI partnered with Devex and Fenton Communications to publish a survey report on the global health funding . The report compiles global giving data from donors, and documents interviews with representatives from the pivotal global funding organizations. Although the aggregate giving data on global health is unavailable as explained in the letter from the editors, the work seeks to inspire further explorations and attentions into the “future of global health financing and inspire collaboration that leads to sustainable global health solutions.”
The report analyzes the giving patterns of government sector of the 23 members of OECD/DAC and the foundation sector including corporate and private donors.
The report shows that the total commitment of 23 OECD/DAC members to the global health sector increased 200% from 2001 to 2008, although it fell in 2009 in response to the global financial crisis. This soaring funding has been largely utilized in the battle with HIV/AIDS epidemic. The U.S, U.K. and Canada contributed the most to the global health from 2005-2010 among these 23 countries, with the U.S spent about $25.5billion in total. 
According to the report, the OECD/DAC donors’ regional focus has shifted to the sub-Saharan Africa, South Asia and, East Asia and Pacific. Part of this focus change might be attributed to the prevalence of HIV/AIDS and infectious diseases in the sub-Saharan Africa and Asia.
It’s also worth mentioning that besides developed countries represented by the OECD/DAC members, BRICS — the five giants in the developing world have been playing a prominent role in improving global health as well, despite the fact that their contribution is poorly documented in years and thus hard to be interpreted in aggregate monetary figures.
For instance, over the past five to ten years, Brazil has accomplished about 150 global health projects through the Brazilian Cooperation Agency (ABC), a governmental agency working on “all international technical cooperation” under the Ministry of External Relations of Brazil. Russia, also a fast-growing development assistance donor, has shown its muscle in the global health sector in recent years. During its presidency of G-8 in 2006, Russia set health as priority on its agenda for the first time and actively organized a series of international meetings on both infectious and non-communicable diseases. China, on the other hand, has been dispatching medical assistance groups overseas since 1963. In 2009, about 60 Chinese medical groups were providing medical service in 57 developing countries’ medical agencies.
As recipients of global health funding, BRICS countries also expanded efforts in tackling domestic health issues. China spent $398.5 billion through 2005-2009, the most among all surveyed health funding recipients, followed by South Africa and India.
In the meantime, corporate and private foundations both started exploring more sustainable giving to the global health sector. The top 10 corporate foundation donors committed $325 billion to global health in total from 2006-2010. With such a considerable contribution, the corporate philanthropy achieved a transformation from purely cash donation to the “more hands-on partnership”, according to the report. For example, the Abbott Fund, which ranks the first on the top 10 list, convened “a 10-year public-private partnership” with the Tanzanian government dedicated to improving healthcare system and other areas with urgent needs. 
On the top 10 list of private foundation donors (2006-2010), 8 of them are prominent American foundations such as Gates Foundation and Rockefeller Foundation. Gates Foundation alone donated $8 billion in total from 2006-2010.
In addition to the presentation of facts and data, the report also documents interviews with several representatives from each sector, including Justine Greening, the UK Secretary of State for International Development and Karl Hofmann, the President and CEO of PSI. These interviews have further shed a light on the trends in global health giving as the world moving into the post-2015 era. Based on these accounts, we can anticipate an expanding focus on women and children, more holistic promotion of social innovation, more organic partnerships between corporate and NGOs, and a more interwoven contribution of public and private sectors.
Just Another BRICS in the Wall
In 2001, Goldman Sachs analyst Jim O’Neill coined the term BRIC to loosely align a group of rapidly growing emerging economies in Brazil, Russia, India and China. In 2010 this group was expanded to also include South Africa, forming the acronym BRICS.
The economic clout and influence of BRICS nations is staggering. Collectively, the five BRICS nations account for 42% of world population, 20% of output, and nearly all of current growth in the global economy.’ And they are looking to capitalize on this collective influence. During the most recent BRICS summit, these countries met in South Africa to begin the unprecedented steps toward establishing BRICS institutions. Out of this, the measure that has garnered the most attention is their plan to form a new international Development Bank to rival the Western dominated IMF and World Bank. Funded by BRICS nations, the aim is to deliver infrastructure and aid to developing markets by bypassing traditional Western structures. 
Despite the economic promise of BRICS nations and their ambitious plans to realign international development institutions away from the West, critics are quick to point out many of the challenges facing the BRICS agenda.
China has become too big for BRICS. At the formation of BRIC, many forecast that the economic growth rates of Brazil and India would soon match China. It was believed that these countries economic growth would continue unabated, and a new global power structure would emerge capable of challenging US preeminence in global affairs. This has not been the case. While China’s growth has continued at unparalleled rates, other developing markets have not, and the result is a China that has left behind its fellow BRICS nations. “The Chinese economy is not only the second largest in the world but also larger than the economies of the other four members combined.”
And it is projected to grow even wider. As Oxford Analytica, a global analysis and advisory firm, points out, China accounted for around 70 percent of the growth in the BRICS’ share of global economic output between 2000 and 2011.’
This disparity in power between China and the rest of the BRICS nations has made some emerging countries nervous of the role and influence they will play in this New International Order. These countries are separated by more than just money. BRICS countries do not trade or invest in each other, they do not share a common language, culture, currency, or regime type (with autocratic regimes in Beijing and Moscow, and democratic traditions in Brazil, India, and South Africa.)
What binds these developing countries is the shared pursuit of an alternative to US led dominance and the neoliberal development model of the past several decades and the western-dominated IMF and the World Bank that still advocate it. With the United States as the largest economic and military power in the world, weaker countries seek to align and coalesce their collective power to increase a shared influence.
BRICS a Political Tool for China
The problem with their collective power is that it is not shared power. BRICS countries represent a dominant economic political force only because China’s growth has risen to the point where it is more closely identified with the US than other emerging markets. 
“They are pressing for a new balance of power.”
A coalition that began in 2001 is now looking to exert its influence on the world stage. Led by China, they seek to create a new power center away from the West, and democratize the political influence of emerging markets away from unipolar US leadership. What remains to be seen is if this coalition can really institutionalize itself and actually rival the West and American leadership, and if so, will this really help transition to a more multipolar world order? It is one thing to try and transition to a multipolar world where emerging countries have a seat at the table. It is another thing entirely to simply shift from a US dominant international order to a Chinese one.
Waving the REDD Flag in Indonesia’s Forests
As an archipelagic nation, Indonesia consists of around 17,000 islands with 98 million-hectare tropical forests, the third largest in the world after Brazil and Democratic Republic of Congo. Home to “twelve percent of all mammal species, 16% of reptile and amphibian species, and 17% of bird species,” Indonesia’s tropical forests are undoubtedly an important sanctuary and essential source of the world’s oxygen supply and carbon sink function.
The world, however, has been alerted that this lung of the earth is deteriorating, piece by piece, at a disturbing rate. One of Indonesia’s five big islands, Sumatra, for instance, has lost 85% of its forests. Meanwhile, another island, Borneo, experienced an average annual loss of 2.1 million acres of its forest area between 1985 and 2005. Although the nation has been lauded for its economic bounce after the devastating 1998 financial crisis with a 6% GDP growth on average over 8 years, it seems that Indonesia’s staggering economic growth is having an inverse trend to its environmental record.
The trade-off between two E’s: Economic development vs. Environmental degradation
Does the inverse trend of economic growth and forest degradation in Indonesia posit an outlier to the global trend? Apparently not, as this is the common case experienced by low-income and developing countries. Developing countries still largely depend on subsistence and natural resource economics that they often prioritize short-term profitability over long-term environmental sustainability.
The trade-off between environment and per capita income is best captured by the environmental Kuznets curve. This famous downward-sloping economic curve illustrates how low and lower middle-income countries experience worsening environmental degradation and pollution until the trend eventually reverses once the countries reach a certain threshold of per capita income. It is believed that such a threshold lies at around $4,000 to $5,000 (1985 dollars). Another way to interpret this hypothesis is that high-income countries possess the necessary capital to undergo environmental preservation initiatives that can reduce the pollution rate. However, Indonesia, currently a middle-income country with around $3,495 per capita income, should not wait any longer to initiate significant efforts to reduce the degradation rate and preserve its valuable environmental resources.
Like many other developing countries, Indonesia also had to make the difficult choice of pursuing economic development over environmental preservation. This decision should not come as a surprise for a country endowed with an abundance of natural-resource as Indonesia. Over the last several decades, forest-based industries have risen to prominence and currently contribute for approximately $21 billion to Indonesia’s GDP, in which timber and oil palm plantations have make up the lion’s share.
Within the same period, unfortunately Indonesia has witnessed massive forest destruction at an exponential rate. This deforestation has mostly impacted local communities, particularly their food security, in which around eight million affected people live in Kalimantan alone. Furthermore, “it is estimated that 15% of all greenhouse gas emissions are the result of deforestation.” As a progressive economic power on the swing, it is important for the Indonesian government to improve their environmental record.
Patching the “lung”
“REDD, to which Norway has committed $1 billion in Indonesia, in essence pays developing countries not to chop down trees.” – The Economist
The initiative came as an external influx called REDD+. The United Nations’ Reducing Emissions from Deforestation and Forest Degradation (REDD+) program is an initiative that aims to respond to climate change by attempting to create a “financial value” as incentives for developing countries to reduce their emissions. The Indonesian program was launched in 2009, concluding Phase One in in late 2012. The initiative in Indonesia aims to preserve the “Rimba Raya”, an area equivalent to the size of Singapore, located in the heart of Borneo. Although the move deserves to be lauded, several issues remain.
First, an emphasis on community-based approaches is needed, as communities play an intrinsic role of ensuring that the program runs effectively and that such a focus will provide a direct channel for local communities to reap the benefits. The forest communities in Indonesia have long been the victims of forest destruction, directly impacting their livelihoods. This has also been complicated by local’s inability to attain legal recognition of their customary land rights .
Fortunately, the Indonesian REDD+ Working Group has recognized this dire need to involve communities, as illustrated in the results of the Asia REDD+ Working Group Meeting in January 2013. The meeting was seen as a pivotal move as the group consisted of representatives from not only the governments of the developing countries, but also from the civil society organizations, pledged to incorporate REDD+ forest communities.
Second, related to the community-based approach, the working group can work with local and provincial governments, under the auspices of the national government, to develop mechanism in resolving land administration issue. As mentioned earlier, many of the forest communities have had difficulties in obtaining legal land rights, in which the communities believe that the forest land is their inheritance right, passed along from generation to generation. This will inadvertently result in claim disputes and may represent one of the greatest hurdles for the implementation of the REDD+ program. To complicate the matter, the government has the rights to lease the lands to companies. When “carbon trading” is an integral part of REDD+, the question that arises then is who “owns the carbon” and will eventually be eligible to “sell the credits” and benefit from it?
Third, since the Suharto era, Indonesia’s forestry management has been infamously associated with rent-seeking activities. As REDD+ initiative provides an alluring potential emission trading of approximately $500 million dollars, a monitoring scheme needs to be carefully devised. Such a scheme should involve a public-private partnership that allows room for non-governmental organizations to voice their opinions and take an active role in ensuring non-discriminatory and non-corrupt practices. One renowned environmental advocacy group in Indonesia, WALHI, has been staunchly criticizing the initiative, in which they argue that REDD+ places too much emphasis on the commercial aspect of carbon trading. It is thus valuable for the REDD+ working group in Indonesia and other developing countries to foster public-private dialogues to both minimize possible frictions and more importantly to encourage bottom-up ideas and solutions.
Another additional point but nonetheless crucial is that the working group needs to proactively consider how to further engage companies in forest-based industries. The Indonesian government is faced with two options. The first is to increase the export tax, which has recently been raised to 9% from 7.5%, being the first tax hike in nine months. The second option is to provide financial reforestation incentives, which might include exemptions from property and inheritance taxes and special reforestation fund for companies that successfully carry out the reforestation initiative.
By and large, the enticement of profitable carbon trading should not overshadow the more dire need of reforestation and forest preservation.
Conclusively, despite ongoing arguments against the initiative, the REDD flag has already been raised in Indonesia and it is an important initial step towards what will hopefully be a more community-centric and collaborative effort at sustainable development. It is about time that all parties; the government, for-profit and non-profit private organizations, and the civil society, recognize the signaled urgency to collaborate and carry the “initiative flag” together, in a way that our future generations will not be rendered to say, “They have failed us.”
Pacific Pumas
As the United States and Europe continue to fight long term stagnant economic growth amid crushing national debts, another region is shining bright. Latin America, an area once referred to as the “development of underdevelopment,” has emerged from the global financial crisis as a model of growth for emerging markets. A group of Latin American countries managed to not only survive the financial instability that rocked global markets, but actually grow during this period, and the World Bank forecasts that the region’s economy will grow 4.5 percent this year. This regional success was fueled by a block of countries in Chile, Mexico, Peru, and Columbia, dubbed the ‘Pacific Pumas’, which have positioned themselves through sound policy and open trade to become drivers of Latin American economic growth in the burgeoning Pacific markets.
Led by the continued emergence of Chile as a regional economic power, each of these Puma countries has enacted pro growth policies to liberalize free trade agreements and open markets and diversified their economic base to ensure stability. Mexico has signed more free trade agreements than any country in the world, and today, “Mexico exports more manufactured products than the rest of Latin America put together.” Even as the global economic crisis resulted in a weaker demand for Mexican exports, this was largely offset by an increase in domestic demand and private consumption. This fact suggests the 4-5 percent growth which Mexico has seen over the past 10 years is sustainable. Many of these developing countries have long been predominantly dependent upon export revenues for economic growth. This same economic model would have been crushed by the global financial shock begun in 2008, yet Mexico has been able to diversify itself from not just being an export nation, but also a consumer on the global market.
Similar results have played out in Chile. Ranked the ‘most free’ economy in Latin America and 7th in the world, Chile has averaged 4 percent growth annually since 2009, and the lack of trade barriers has seen direct foreign investment quadruple in the country since 2004. The country has booming exports, while still effectively diversifying its economy to avoid the over-reliance on export commodities that have afflicted “oil-cursed” neighbors such as Venezuela.
Columbia joins fellow Puma countries Chile and Mexico on the Forbes India ‘7 hottest emerging markets to live and work in’ due to its sustained 4-5 percent growth over the past decade, expanding free trade agreements with the EU and low corporate tax rates which have attracted growing foreign investment.
And finally there is Peru-a country that has averaged 7 percent growth over the past eight years, and is set to lead Latin American growth over the next five years. Cited as “one of the most open economies of Latin America,” governmental regulations are low, and consumer confidence is high, with Peruvian businessman found as the most optimistic among 44 surveyed countries.
With an eye towards the future of Pacific markets, this group of Puma countries is poised to see continued growth moving forward. This Pacific alliance “is born not only as a group of countries seeking economic integration and free trade, but also designed to project Latin American countries as a whole toward the Asia-Pacific economy.” The Asia Pacific region offers great potential and growing markets to a Pacific alliance which has achieved its success in large part due to free and expanding trade. But the marriage between the two is not perfect.
With economic power underlying all geopolitics, matters of trade are by nature highly politicized. Latin America’s growth largely reflects a deepening engagement with Asia, where China and other countries are also growing fast. Despite all the talk of the US welcoming China as an economic superpower, it is clear that America’s ‘Pivot to Asia’ is designed to prevent Chinese hegemony in the Pacific and ultimately promote US interests and influence in the Asia-Pacific region. This Pivot to Asia has both military and economic components, one of the latter being the pursuit of a US led free trade agreement in the Pacific known as the Trans Pacific Partnership (TPP). The TPP does not include China. It does include Puma countries Mexico, Peru, and Chile, with Columbia reportedly expressing interest. But each country has its own set of interests to pursue and must hedge its bet on the future of Pacific power in the 21st century.
UK’s “Volatile” Aid Policy to Rwanda
After suspending aid to Rwanda for the second time in 2012, UK’s Department of International Development (DfID) controversially restored its aid package in early March.
UK’s aid to Rwanda was said to be “funding a dictator” by a former aide to the President of Rwanda.
Tracing back to UK’s first halt on the Rwanda-destined aid in last July, it’s clear that DfID’s aid policy to Rwanda can be inconsistent. The first halt was announced due to an interim UN report that unveiled Rwanda’s military involvement in the DRC conflict, according to the Guardian. Contentiously, DfID resumed the aid, claiming that Rwanda was shown to have ended its support of rebels in DRC. Roughly two months later, the new DfID Secretary, Justine Greening made the decision of suspension again because of the international criticism and subsequent evidence from the UN. But now, DfID presents the world with a “reprogrammed” aid plan to the same Rwandan government.
Based on Greening’s statement on March 1st and the Guardian’s report, UK’s “reprogrammed” funding enjoys the following “advantages” that target on the needy Rwandans directly while bypassing the Rwandan government:
- NOT distributed as general budget support, which means it will not count as the government’s fiscal budget.
- Mainly channeled through Vision 2020 Umurenge Programme (VUP), which is “a social protection initiative owned and led by the Rwandan government”.
- “Cash transfers and cash for work opportunities” are disbursed to different bank accounts and monitored.
Even though DfID’s restructured aid is said to aim at the poor population in Rwanda, it is indeed constrained by several shortcomings related to the aid’s definition and enforceability.
Because it’s not the general budget support, theoretically it will not be restrained by UK’s aid partnership principles, which generally refer to the aid usage requirements of poverty reduction and MDGs; human rights; governance and financial management; and accountability to citizens. So, is it a sector budget support that will contribute specifically to the poverty-reducing sectors? According to the Guardian, a recent DfID summary report indicates that the aid is defined as the “financial aid and technical co-operation” but not concretely as the sector budget support. In other words, the funds can technically be applied to the sectors that are not necessarily related to the poverty reduction.
In addition, it seems that the UK has been distributing aid to VUP since 2008 based on the DfID’s project information on its website. The information shows that the funding is attached to “special conditionality”, though it has not been identified clearly. If it refers to the “conditionality” mentioned in the DfID’s glossary section, it is somewhat equivalent to the partnership principles for the general budget support. But undoubtedly, the real meaning of the “financial aid and technical cooperation” to Rwanda is left for DfID to explain.
The second issue is how the UK will ensure this “cash” aid could reach the poor through the local partners and organizations rather than governmental agencies?
From one aspect, VUP — the major aid distribution channel, is said to be a “collaboration” between the Rwandan government, private sector and nonprofits under the supervision of the Ministry of Local Government. The funds will be allocated to different bank accounts and audited separately as mentioned before. Moreover, the UK seemingly has a clear strategy to prevent the misuse of aid and corruption in Rwanda. “DFID’s Anti-Corruption Strategy for Rwanda”, a report published by the DfID in Jan, 2013 reiterates that the corruption scenarios in Rwanda have largely decreased in recent years. DfID makes efforts to preserve the integrity of its aid in Rwanda via multifaceted precautions including “risk assessments”, “internal and external audits”, “risk management” and regularly updating information of aid partners’ fund usage on its website.
From another aspect, VUP is often criticized for its strong government control. Stephen Devereux, a research fellow at the Institute of Development Studies who used to conduct assessment for DfID on the VUP programmes commented that in VUP, most decisions are made by the government regardless of what private and nonprofit partners want to do.
Questions arise over hos DfID will help Rwanda’s poor and simultaneously draw a clear line between itself and the Rwandan government, since this affects UK’s credibility as a global aid donor. Therefore, DfID can first clarify what it means by “foreign aid to the government” and explain the ad hoc restrictions and principles attached to the aid distribution and utilization.
In the meantime, it’s indispensable for DfID to consider other funding routes. Before its announcement of this “reprogrammed” aid, 44% DfID’s funding to Rwanda was sent directly to the Rwandan government as the general budget support and 36% distributed through government-associated channels, while only 13% was directed towards NGOs or other non-governmental channels. Although it’s unclear how much funds will be granted to which sectors in the new aid package, we know that the major channel will be VUP, which is also a government-owned program.
UK’s waste of aid in Nigeria where teachers left children to play in class time.
On the other hand, it’s worth mentioning that besides Rwanda, UK has encountered many aid policy challenges in Africa recently. In Nov. 2012, its Uganda-directed aid was suspended because the funds were reported to be transferred to the Ugandan Prime Minister’s private account. Before the Ugandan aid chaos, DfID’s subsidiary private investment enterprise, CDC Group, was accused of investing in the money laundering companies related to James Ibori, a notorious Nigerian money-launderer. Concerning these adverse impacts on UK’s donor credibility and the previous “up-and-downs” in Rwanda, DfID may need to be more cautious about its aid structuring and enforcement.
Water, Sanitation and Hygiene (WASH) – A Mother-to-Child “Shield” for HIV-affected Families
In the past decades, HIV-affected families have largely benefited from effective medical interventions such as antiretroviral medications (AVRs) to sustain parents’ health and prevent mother-to-child transmission. But the lack in WASH programming – water, sanitation and hygiene can alter the effectiveness of such interventions. Water and sanitation has been found to decrease infections by helping HIV drugs get absorbed, rather than flushed out of the system due to chronic diarrhea.
Often in rural African villages the only water source for villagers is a basin with collected surface water which can be contaminated with bacteria and microorganisms. This untreated water is used for a wide range of daily activities from food preparation to treating people with health issues. Lack of sanitized public toilets and garbage removal exasperate the problem.
The unhealthy nature of the water exposes people to various water-borne diseases, including diarrhea and cholera. While diarrhea is a fairly ubiquitous symptom of HIV , the lack of water and sanitation perpetuates the cycle of illness. Persistent diarrhea due to lack of adequate water and sanitation can inhibit the effectiveness of the ARVs taken to treat HIV, which can accelerate the progression of HIV/AIDS, thus further threatening HIV-infected mothers and their children.
It is widely acknowledged that adequate early medical interventions reduce the risk of mother-to-child transmission drastically, for women who are diagnosed with HIV before or during pregnancy. According to the Centers for Disease Control and Prevention, in the U.S., early intervention could alleviate the chance of transmission to less than 1%, while avoiding breastfeeding. Unfortunately, in rural regions, even if medical treatments are provided, the effect of such interventions will be dismissed due to the paucity of clean water. Among infants with HIV-infected mothers, those with unhealthy mothers bear eight times higher likelihood to get the virus than their counterparts with healthy mothers.
Although most mother-to-child transmissions occur during pregnancy, there is still 33% chance to transmit virus through breastfeeding. While recent research findings demonstrate that providing ARVs to HIV-exposed infants and their mothers prevents mother-to-child transmission, mothers in rural regions usually choose to replace breastfeeding with formula or choose softened food for their babies. However, in an environment without clean water and sanitation, breastfeeding avoidance merely exposes infants to more diseases through water contamination.
For HIV-affected families without access to cheap formula in rural Africa, the only option is to feed infants with soften food mixed with untreated water. Moreover, even if the formula is obtainable, the lack of clean water and sanitation makes the safety of formula milk and bottles impossible. As a result, these bottle-fed infants suffer from six times higher chance to “die from diarrhea, respiratory or other infections compared to breast-fed child”.
Currently, ensuring WASH in developing regions is part of the Millennium Development Goals (MDGs). According to a report issued by WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, 89% of the world’s population has gained access to improved drinking water by 2010. This has resulted in the “target of halving the proportion of people without sustainable access to safe drinking water” to be the first MDG achieved. On the other hand, the report also shows there are still around 783 million people (11%) in the world without safe drinking water. And the target of sanitation is still far from reach.
Hence, a continuous and dedicated commitment is needed for WASH, whether it’s domestic– from a government to its own citizens or cross-border. Bilateral or multilateral means could be jointly used for building piped supplies and protected wells in the needy regions.
