Friday, July 30, 2010

Not to Brag...

The Twelve Apostles

...but I live in one of the most beautiful places on Earth.

The Atlantic, from the top of Lion's Head

Me with the new fellows, Allie and Hannah

Camp's Bay at dusk

Table Mountain and Devil's Peak

Cape Town city lights

Wednesday, July 21, 2010

Nobel Peace Prize Winner vs. Nobel Peace Prize Winner

In an opinion piece in today's New York Times, Desmond Tutu took President Obama to task for his administration's funding cuts to the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Malaria, and Tuberculosis. As you may know, PEPFAR was perhaps the best legacy of the second Bush administration (as much as it galls me to give the man any credit), a United States government (USG) program that funded HIV/AIDS interventions, including getting millions of people living with HIV/AIDS on life-saving antiretroviral drugs (ARVs). Like the Global Fund, it has been instrumental in the great strides taken in the fight against the HIV/AIDS epidemic.

There have been rumblings over the past six months or so about changes in the funding and implementing sectors of public health. That USG would shift its focus to less expensive health interventions and force people needing ARVs onto waiting lists. That funders are looking to shift money from "vertical" interventions--ie, focusing on one aspect of healthcare--in favor of an "integrated" approach. That funding from government and multilateral sources (such as the UN or the World Bank) would be funneled through the local Ministries of Health in nations needing development aid, effectively cutting off direct funding to non-governmental organizations (NGOs), which would encourage even more corruption and slow, or even stop, the progress made in public health, especially in HIV/AIDS prevention and treatment. I wrote a bit about it here, though I didn't know much when I wrote it (I'm certainly no expert now, but I had to research all of this for work).

Now, it's hard to know what's true and what's not, what's rumor or a sensationalist media taking a story and running with it. I haven't seen ARV stock-outs or waiting lists for treatment firsthand. But I hear they're coming. And I know that they've happened already. There is a shift of some kind happening, that's accepted by almost everyone, but no one knows what form it will take.

The Obama administration has insisted over and over that it is not abandoning the fight against HIV/AIDS. I understand that the administration is under huge pressures--the bail out, the healthcare bill, the oil spill, etc--but essentially flat lining funding for PEPFAR and decreasing funding for the Global Fund, which are certain and established facts, is not going to help make progress to achieve universal access to ARVs (we're still well short, and growing, since the WHO has recently upped the threshold for when people living with HIV should begin on the drugs) or to achieve full coverage of prevention of mother-to-child transmission (PMTCT). In these uncertain economic times, which have affected people across the globe, robust support for HIV/AIDS treatment and prevention is even more vital.

There's been some hopeful news recently: for example, scientists may have finally found a microbicide that women can apply before sex to decrease the likelihood of being infected, though it won't be available for years, and preliminary findings are putting prevention at 54%, hardly a grand slam. And all this squawking over USG cuts and the public health shift and the Global Fund not being able to get enough money this year means that there are people out there watching, and there are people out there who care. This week, the International AIDS Society is holding its annual conference in Vienna. It's the top conference for those who work in the HIV/AIDS field, from researchers to implementers to funders. It's also why there's been so much press this week about HIV/AIDS. Yes, a lot of it is about back-patting and bragging. And yes, a lot of it is about setting up meetings and not always about concrete action. But it's also a time to gather together and remind ourselves of why we are working to turn back HIV/AIDS, why we need to do so, and how we can hope that within my lifetime, we can see an end to this epidemic. On top of that, you learn about the discoveries being made in the field and how you can improve the response to the virus (a bunch of m2m-ers are there this week to present and to learn).

So, to President Obama, I'd say: don't give up now. Even though the $1Billion for PEPFAR was just a campaign pledge, people are still going to see a promise as a promise--be true to your word. And when Desmond Tutu chastises you for something, you're probably doing it wrong.

Thursday, July 15, 2010

Harder Now That It's Over?

Well, the World Cup has come and gone. It remains to be seen what will come of it, if anything. There are rumors of xenophobic violence building in the townships, tensions growing from the bombings in Uganda, and millions of Rand to be lost in "white elephant" stadiums. However, I'm not sure things won't be better, after all. The media is supposed to focus on the pessimistic--Pollyanna doesn't sell newspapers. I can't believe I, a diehard cynic from age 2 1/2, am saying this, but there you go. The media has also reported on greater levels of unity in the country, so who knows? All I can say is, beyond the ending of great global sporting events, life goes on. For better and worse.

And for something kind of cool (shameless plug alert), check out this picture of mothers2mothers' founder, Dr. Mitch Besser, speaking at the TEDGlobal Conference in Oxford. It's just how I always imagined it would be (seriously--I've been thinking about what Mitch would look like on the TED stage for a few months now).

Update 19 July, Shameless Plug #12 & 35: Mitch's TED talk got some coverage over on a Forbes blog. Check it out here.

Thursday, July 8, 2010

La Furia Roja v Clockwork Orange

So Spain will face Netherlands for the final. Which was a surprise to me initially, though I think both teams have played extraordinary soccer throughout the World Cup. Germany had looked so good from game one, and it's so easy to be seduced by the big names--Brazil, Argentina, etc--and by patriotism (not that I really thought USA or Bafana had much of a chance). But now, there will be a new champion to add to the list of seven teams that have won since the tournament started in 1930. That's kind of cool.

We're all wondering what will happen in South Africa once the Cup is over--none of the really bad things we'd all worried about (secretly or out loud) have come to pass. I'd love to see Cape Town continue to be the safe, walking-friendly city it's been for the past few weeks. South Africa has been calm and incredibly welcoming, apart from mostly minor incidents (including a cleaning crew stealing the English team's underwear, which is understandable if inappropriate). I think all Capetonians have appreciated the police presence and the security--so perhaps there will be lasting benefits from all of this hoopla. Better buses and better cops. Freedom from Big Brother FIFA. More sleep. A greater sense of unity.

Monday, July 5, 2010

Ayoba, One More Time

Well, the World Cup has really heated up. After Brazil's defeat by the Netherlands, Ghana's disappointing (and controversial) loss to Uruguay, Portugal's exit (thanks for spitting on the camera, Ronaldo--you stay classy!), USA's elimination, and other surprises, upsets, and all around great games, we're down to the final four: Netherlands, Germany, Spain, and Uruguay. I said back when I watched Germany thrash Australia in their first match that they'd be the team to beat. I got to watch the Netherlands-Cameroon game live at the stadium, and I was impressed by the Dutch team as well.

I have a lot of respect for Brazilian fans. I managed to squeeze into the Cape Town Fan Park for the Brazil-Netherlands game, which was about 50-50 split between Dutch and Brazilian supporters. I spoke a bit with two Brazilians who had been flown out to South Africa to volunteer in the Greenpoint stadium. When their team lost, they said, with a philosophical shrug, It happens. This is soccer.

I watched the Ghana-Uruguay game at Marco's, a local restaurant, with, for all you Thacherites, Martin Sawyer and his dad. The restaurant was packed full of Ghana supporters (though very few Ghanaians, I'd wager), which made for an exciting and tense atmosphere. Like everyone else, we were for Ghana, but unlike everyone else, both Martin and I agreed that if we'd been defending for Uruguay, we'd just as readily have put up our hands to stop a certain goal. It was a shame that Gyan missed the shot and a heartbreaking finish for Ghana.

A South African friend of mine marveled at how quickly this World Cup has gone. After years of anticipation, hand wringing, and construction, it will all be over next Sunday. Cape Town will empty of tourists, bars and restaurants and roads will be less congested, and everyone will get back to work and to life. I might even finally be able to get over this cold/flu/Cape Town bug that's lingered since the USA-England game and taken down more than half of the office. It's been a transformational few weeks, I think, for South Africa. There have been few (or no) big incidents, no crippling strikes or riots. Everyone has been good, has been calm, has accepted defeat of their teams or celebrated in a relatively relaxed way (no turning over cars and setting things on fire--take note, LA). When Ghana defeated the US, the celebrations blocked up Long Street. But most of the fans of Africa United were good winners--they acknowledged the Americans passing by with support. Not to jinx anything--we still have four games to get through, with one more Cape Town based match--but so far, this World Cup has been wonderful. I'm not sure what's going to happen in South Africa after it's all over, but I'm hoping this feeling continues. And from here, I'll be figuring out how to get to Brazil in four years. I'm hooked.