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	Global Pandemics: Not If, But When by Institute for Agriculture, Trade Policy & agencies USA   June 2013   795 doctors, nurses and health professionals urge White House to jumpstart stalled FDA on antibiotics, by Dr. David Wallinga. (Institute for Agriculture and Trade Policy)   795 health professionals from across the country sent a joint letter to President Obama urging his leadership in getting the Food and Drug Administration (FDA) to jumpstart its now-stalled policies to help protect the future effectiveness of antibiotics by reducing their overuse in food animal production. The letter was delivered by IATP"s Healthy Food Action, Health Care Without Harm and the Pew Charitable Trusts.   Close to 30 million pounds of the antibiotics are sold for use in U.S. food animals each year. Many of them are identical, or nearly so, to antibiotics used in human medicine. Most are used for non-sick animals, to promote their faster growth and compensate for the risks created by raising such animals in overcrowded and often unhygienic conditions.   “In our hospitals, and in our communities, antibiotics increasingly are failing to treat drug resistant superbugs,” says David Wallinga, MD of the Institute for Agriculture and Trade Policy and Healthy Food Action. “The huge overuse of these antibiotics on our farms, in meat production, is an important—and unaddressed—contributor to the problem.”   What this letter shows is this superbug epidemic is too important for FDA and the White House to sit on the sidelines. We need President Obama to make sure his administration leads in the fight to protect antibiotis.”   The letter asks President Obama to urge FDA to act on mandatory withdrawals of unsafe uses of antibiotics in animal agriculture, such as growth promotion.   FDA must also report to the public the data on livestock antibiotic sales it already collects but fails to disclose. This fuller reporting of data is critical to keep the public health and infectious disease experts informed about emerging disease threats.   http://www.iatp.org/blog/201306/795-doctors-nurses-and-health-professionals-urge-white-house-to-jumpstart-stalled-fda-on   May 2013   Global Pandemics: Not If, But When, by Ralph Nader.   The deadly influenza virus H7N9 was first detected in China this March. “When we look at influenza viruses, this is an unusually dangerous virus for humans,” said Keiji Fukuda, the World Health Organization’s (WHO) assistant director-general for health security.   The new H7N9 avian influenza has infected more than 120 Chinese and taken nearly 30 lives, so far as is known. This strain of the flu has never been detected in humans before. Although Chinese health officials have not located the virus’s origins, they have determined that it comes from an assortment of birds – including domesticated ducks and chickens and migratory wild birds.   What is unique about H7N9 is that it does not seem to make the birds sick, so it is hard to track, unlike the 2003 H5N1 outbreak that killed chickens quickly and led investigators to the sources of the virus.   Another unsolved puzzle is why dead pigs and dead ducks in the thousands suddenly were seen floating down some of China’s rivers in March. Historically, influenza viruses that have spread around the world have started with Chinese chickens, spread to pigs, and then, due in part to the close living proximity of humans with their farm animals, spread to humans in China and then spread to other parts of the world.   The U.S. Centers for Disease Control and Prevention (CDC) is on high alert, receiving samples of the virus and beginning the process of preparing a vaccine. The CDC says that “influenza viruses constantly change and it’s possible that this virus could become able to easily and sustainably spread between people, triggering a pandemic.”   So far H7N9 has only spread to one case in Taiwan – a man who returned from a trip to China.   The problem with the reported numbers of cases is that the Chinese government often delays reports and does not have sufficient experts all over the country to test and provide full and timely information to the world.   Nor does the U.S. have adequate numbers of CDC specialists in China for early detection. The CDC informed us this month that they have “one U.S. direct hire and 3 local employees dedicated to the influenza program in China.” The agency added that it has a total of 54 staff members including one secunded to WHO, adding that “apart from the influenza team, others on the staff have supported the H7N9 outbreak efforts in their area of expertise such as lab, epidemiology, communications and assisting with the embassy’s committee tracking the outbreak.”   The H7N9 virus.Given the immense stakes to the health of the American people, this is a tiny staff allocation – smaller than a normal Obama assassination team in a foreign country. The Influenza Epidemic of 1918-1919, involving the H1N1 virus, took 1.9 million lives in the U.S. and, like many recurrent avian flu epidemics since then that experts believed started in China, the total loss of American life exceeds the loss of lives in all of America’s wars.   Clearly we are now better prepared scientifically and logistically for such epidemics, but the facility of international travel is much greater now as well. Yet, the budgets for detection and prevention of epidemics are much smaller than the cost of a few F-35 fighter planes that Lockheed-Martin is still mired in producing.   What has got some leading U.S. health officials properly worried, such as Dr. Anthony Fauci, the great communicator and director of the National Institute of Allergy and Infectious Diseases, is that H7N9 is showing some adaptation to humans, but doesn’t kill the birds. Though it could mutate further, Dr. Daniel Jernigan, deputy director of CDC’s influenza division, says the virus is presently “somewhere in that middle ground between purely avian and purely human,” which Dr. Fauci calls a red flag.   As if the looming presence of the H7N9 virus from China is not troubling enough, a deadly coronavirus has infected at least 23 people in Saudi Arabia, resulting in 13 Saudi deaths and five more in neighboring countries – a high-fatality ratio. Earlier this year two cases were documented in the U.K. of people who were recent arrivals from Saudi Arabia. This week, a patient, exposed to this coronavirus, suffering from acute respiratory illness has been reported in France.   WHO officials are urging all countries to report faster and more fully what they know about the spread of this virus in order to comply with international health regulations.   When all is said and done, the world is not devoting anywhere near enough resources to combat these viral and bacterial “terrorists.” Governments are far more frightful of sporadic, anthropomorphic, human-based physical terror – whether stateless or state-sponsored – than the grim annual toll of epidemics and the informed warnings by infectious disease specialists of a potential pandemic. They all agree; it is not a matter of if, it is only a matter of when!
	Launching a transparency revolution in nutrition by Molly Kinder, ONE International   May 2013   In Dublin Castle last week, the President of Ireland, Michael Higgins, welcomed 300 delegates from around the world, including more than 100 grassroots activities and farmers from Africa, to a two-day conference on hunger, malnutrition, and climate change.   Time and again, the top audience polling result centred on accountability, and specifically on empowering citizens to hold governments to account. However, without transaprency, citizens will not have the information they need to effectively assess the progress their leaders are making on commitments and results, and to then hold those leaders to account.   Today, a lack of transparent information on nutrition spending, progress and planning is a key binding constraint for effective civil society engagement and accountability – at both the international and national levels.   At the upcoming June 8, Nutrition for Growth event, governments, donors and all partners in the Scaling Up Nutrition (SUN) movement should launch a transparency revolution for nutrition.   This revolution is needed to ensure that SUN is a movement not only of donors, governments, civil society organizations and businesses, but also importantly, of people. The emphasis of this transparency revolution should be on three key pieces of information: spending, stunting progress, and plans.   Firstly, spending. Today, precious little data is publically available on what national governments and international donors are actually spending on nutrition.   Part of the problem is in reporting: most low income countries still do not have a budget line that calculates nutrition spending, and accounting for donor commitments, especially nutrition sensitive spending, is incomplete. There is even less information on what governments commit to spend.   In the nutrition sector, there is neither a target, nor readily available data on spending, nor a commitment to report that spending.   This is in stark contrast to the agriculture sector. At the 2003 African Union Summit, all member states signed the Maputo declaration committing to spend 10% of budgets on agriculture. ONE’s Africa team was able to use this commitment and the publically available budget data as the basis of a new agriculture accountability report to hold African leaders to account for their progress on meeting this spending target and other outcome targets.   A major breakthrough on June 8 would be a commitment from all countries to calculate a nutrition budget line and to report that spending annually, including in their country pages on the SUN website.   Likewise, donors should commit to improving reporting guidelines by the end of 2014 to enable accurate reporting on all nutrition spending, including nutrition sensitive spending. Secondly, stunting progress. Ultimately, the most important information for accountability is progress on impact. This could include data such as stunting and wasting levels, prevalence of micronutrient deficiencies, and undernutrition-related deaths.   The release of UNICEF’s latest report on child nutrition filled an important void by publishing data on how all countries are performing on nutritional outcomes – compared to each other, and over time. This type of information should be presented in a comparable, standardized, easy to understand manner on the SUN website.   Likewise, donors should calculate and disclose their own contribution to progress against key nutritional outcomes.   And finally, plans for the future. To turn nutrition targets into real progress, countries will need effective roadmaps for implementing nutrition interventions. These plans should benefit from public scrutiny and discourse.   Today, only 12 of 34 SUN countries have national nutrition plans publically available on the SUN website. Likewise, few donors have published specific nutrition policies or strategy documents.   A commitment from all countries and partners in the SUN movement at the Nutrition for Growth event could be to make all national nutrition plans and policies available online on the SUN website by the end of 2013.   At the World Economic Forum in January, UK Prime Minister David Cameron declared, “I want this G8 to lead a big push for transparency across the developing world.”   The June 8 Nutrition for Growth event is a perfect opportunity to start.   http://scalingupnutrition.org/ http://www.one.org/c/international/policybrief/4644/ http://www.unicef.org/media/files/nutrition_report_2013.pdf (120 page report) http://www.dci.gov.ie/what-we-do/dublin-conference/conference-overview/ Visit the related web page
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