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Is malaria prevalence really declining?

Malaria study areas. Note the non presence of the DRC and  Angola.. along with all of the other areas that are missing. Do we really know what's going on with malaria?

Malaria study areas. Note the non presence of the DRC and Angola.. along with all of the other areas that are missing. Do we really know what’s going on with malaria?

The development community (and the world) has been celebrating dramatic and unprecedented reductions in the number of malaria cases around the world throughout the past decade and a half. Billions of dollars have been thrown at the disease, which is a major killer of children and an incredible hindrance to development.

A new study which just appeared in Malaria Journal, however, calls this optimism into question.

This review presents two central arguments: (i) that empirical studies measuring change are biased towards low transmission settings and not necessarily representative of high-endemic Africa where declines will be hardest-won; and (ii) that current modelled estimates of broad scale intervention impact are inadequate and now need to be augmented by detailed measurements of change across the diversity of African transmission settings.

So, our ability to accurately determine whether transmission intensity has declined is hampered by the fact that most studies of the disease occur in areas of low transmission. This would make sense. It is much easier for us to evaluate the malaria situation in Kenyan context than in the Democratic Republic of Congo due to availability of surveillance infrastructure, official mechanisms which allow research projects to move forward, and security issues.

The obvious problem with this, is the relationship of governance, economy an instability to malaria itself. People in the poorest countries are at the highest risk for malaria and people in the poorest parts of the poorest countries are at the highest risk of all. The trouble is, despite being the populations we are most concerned about, they are the hardest to reach, and the hardest to help.

Worse yet, the estimates of malaria prevalence found in a number of studies were considerably lower than estimates for the entire African continent.

The combined study area represented by measurements of change was 3.6 million km2 (Figure 1), approximately 16% of the area of Africa at any risk of malaria [9]. The level of endemicity within these studied areas (mean PfPR2-10 = 16%) was systematically lower than across the continent as a whole (mean PfPR2-10 = 31%) (Figure 2). While 40% of endemic Africa experienced ‘high-endemic’ transmission in 2010 (PfPR2-10 in excess of 40%) [9], only 9% of the studied areas were from these high transmission settings.

This is a huge issue and one that shouldn’t be limited to malaria. While it is helpful to hear good news of malaria declines in formerly afflicted areas, we need to be careful about overstating the impact of interventions. Funding for malaria projects such as the distribution of insecticide treated bed nets was incredibly high throughout the 00’s but it is unlikely that trend will continue. Offering an positive picture can show that our efforts are valuable, but might also lead policy makers and donors to suggest that money be put toward other goals. If Sri Lanka is any indication, where malaria was nearly eliminated at one time but experienced a rapid and devastating resurgence, even a brief relaxation of malaria control efforts could erase current gains completely.


A map of poor livestock owners

LivestockThis map (from “Mapping of poverty and likely zoonoses hotspots”) is pretty eye-opening. Looking at this, I’m thinking that the next big disease event will most certainly come out of India.

Note that the most virulent of infectious diseases in humans are often associated with animals. India’s high density, close contact with animals and poor regulatory environment make for a frightening mix.

Food Week Post 2: How a Few Guys on Wall Street Control the Price of Food

Worldwide Price of Food

Anyone who has been to a grocery store in the past 2 years can tell you that food prices have increased. Intuitively, one would think that a few key factors have contributed to this rise in food costs.

Rising fuel prices increase the price of delivery. Rising demand for food from an increasing world population, and demand for protein rich foods from a rapidly urbanizing world, specifically from the emerging economies of China, India and Brazil increase demand for grains. A turn toward using biofuels increases competition for grains that would normally go to feed humans and livestock. Climate change and extreme weather events create a volatile agricultural market.

However, despite all these very obvious players, the amount of volatility seen in the food commodity markets is unprecedented. Agricultural production, though regionally volatile, has not experienced the same level of fluctuation as that of prices in the food commodities markets. Energy demand and production, though increasing, also do not exhibit the same behavior. Conflicts have negatively affected market prices in certain commodities, most notably that of cocoa due to recent political conflict in the Ivory Coast, but, the large ag-producing countries of the United States, China, India and Brazil have experienced no such disruptions. In fact, China and Brazil, despite a growing population and experiencing an expansion of the middle class, are still largely able to maintain food security.

In short, demand is rising, though not volatile. Supply also, is rising, though not volatile. One can make the argument that volatility in the oil markets is spilling over into grain commodity markets, but biofuels still only account for a small percentage of energy use. These factors do little to explain the large fluctation of the of the food commodity markets that we are experiencing today.

According to a UN Conference on Trade and Development report

• “these factors (rising food demand, biofuels, climate change) alone are not sufficient to explain recent commodity price developments; another major factor is the financialization of commodity markets. Its importance has increased significantly since about 2004, as reflected in rising volumes of financial investments in commodity derivatives markets – both at exchanges and over the counter (OTC). This phenomenon is a serious concern, because the activities of financial participants tend to drive commodity prices away from levels justified by market fundamentals, with negative effects both on producers and consumers.”-UNCTAD, 2011

Effects of 1% Change in Worldwide Food Prices on Local Prices

Prior to the private equity bubble (remember the dot-com bubble?) of 2000, financial markets relied on investments into stock equities. Following the burst of what was up until then an unheard of rise in the financial markets, investors, speculators and hedge fund managers moved increasingly toward commodities investments outside of the traditional equity markets. Financial investors seeking new opportunities, moved toward to commodities markers, including oil and food, anticipating rising worldwide demand. Commodities of all kinds were financialized and brought into the portfolios of hedge funds and money markets.

I am not an economist. Through my limited understanding of futures markets, I think that what I understand is this: Prices of commodities are usually set on a supply and demand basis, with considerable elasticity. If one wants to buy gold, for example, demand and supply work to set prices. If one wants to take advantage of cheap gold now, all one has to do is buy and store to sell it later. The storage costs must be rolled into the final resale price. With oil and agriculture, the model is similar, but these commodities can only be stored temporarily, before they are unsalable (rot). Thus, as there is little to hedge against future risk, speculators will buy contracts for future, as yet unproduced, goods at set prices. This practice is not uncommon and was originally conceived to protect American and European farmers from risk and to insure consistent supply and price in the market.

What is different now is that interest prices are rolled in based on the length of contract, linking worldwide financial markets with the prices of commodities and distorting the true supply and demand relationship. As futures, by definition, are conceived to protect investors from risk, they are a perfect target for large hedge funds, which protect large investors from long term risk. The tying of interest rates into commodity prices means that end prices will fluctuate wildly with the market, while protecting investors from losing their shirts.

One important way that hedge funds minimize long term risk, is through machine trading. Computers and mathematical models available market information, predict future fluctuations and sell when necessary. What this does is insert an even greater level of volatility into the market. Sudden sales of commodity futures will induce other funds to sell as well, creating a herd effect of commodity sales that has little to do with true supply and demand models. Imagine how flocks of birds or schools of fish move in response to one change in direction by a member of the group and you can get an appreciation for how machine trading works.

We are already seeing the effects of the financialization of food commodities. There was an unprecedented rise in food prices during the period of 2000-2007. The financial crash of 2007, brought in part by the activities of the very same financial players that are driving food prices up, saw a drop in prices, but as the market rebounds, prices are increasing once again, now higher on average than they were in 2007.

In fact, futures markets in commodities are exploding with the number of contracts rising to never before seen levels over the past decade as can be seen in the figure to the right.

Der Spiegel recently penned an excellent article on the rising price of food. In it, they spotlighted scumbag of the week, Alan Knuckman. Mr. Knuckman and a host of other US and worldwide speculators are unconcerned as long as the money is flowing to them. To Mr. Knuckman, he could be investing in GM, a new chain of box hardware stores, big pharma, copper, oil or food for kids, it’s all the same as long as it brings him a profit. In fact, he is quoted as saying, without a hint of irony, “the age of cheap food is over. Most Americans eat too much, anyway.” Yep, these dirtbags are just like the rest of America, blind to whatever happens outside their own gated communities.

Rising food prices are not a problem for Americans. In fact, we only use, on average, 13% of our income on food. In places like Kenya, however, food can consume nearly 100% of a household’s monthly income. In Kenya, food must be imported to account for shortages due to underdeveloped ag and transportation infrastructure, which prevents Kenyans from protecting themselves against extreme weather events and disruptions in supply. Even a 1% shift in the worldwide price of food can spell death for an Kenyan infant. What we have seen, however, is not a 1% shift, but rather a 71% increase in the worldwide price of grains since 2007. In Kenya, the price of corn meal has shot up 100% in the past five months. To Knuckman, this is just “an undesirable side effect of the market,” kind of like having to drink coffee that sat in the pot too long and turned bitter.

The American Empire

Number of US Military Deployed Around the World, by Country

On this Fourth of July, while everyone celebrates the past struggle for independence from Britain, let us not forget the extent of US influence in the world. The United States posts military in just about every country of geographic consequence in the world, effectively creating an military and economic Empire of proportions never seen in human history.

It would be unconscionable to the US government to allow China to build a military base in British Columbia or Mexico, let alone in Southern California, yet our largest deployments of military might sandwich China between Japan/Korea and Afghanistan. In fact, besides the smallest of states, there are very few countries where we haven’t yet set up shop, which of course include North Korea and Iran**.

Americans love to talk of freedom, but largely (in my opinion) have little clue as to what the word means. Yet, while we proclaim to cherish the often ambiguous concept of “freedom” for ourselves, we deny it to much of the rest of the world by posting weaponry wherever we see fit. Politically, guns in the backyard of a sovereign state castrates that state on the world stage, not to mention creating an environment of dependence on the US to assist in time of military need. The US attitude toward the rest of the world is akin to a mafia led extortion racket, of which Tony Soprano would be proud.

Clearly, though, my opinions on military deployments are not so simplistic, but I felt this an appropriate post for a day which, ironically, celebrates independence from a colonial master. It is a deep and complex issue and I am certainly not going to suggest otherwise. One can argue that some deployments are necessary and do, in fact, contribute to the greater good. However, we, as Americans, must remain aware of the great potential for harm in spreading our influence around the world and continue to question the motivations and aims of the powers that be.

** The data I used to create the map on the left was from 2010, before our incursion into Libya.

2011 Human Trafficking Report

The 2011 Department of Justice Human Trafficking Report has recently been released. It provides country by country profiles of human trafficking and slavery for every country on the planet, and ranks them according to the level of effort given by governments to control the problem of human trafficking and slavery. There are four levels, Tier 1 being the highest (proactive effort) and Tier 3 being the lowest (no effort at all). Naturally, the United States, the author of the report and the creator of the ranking system, ranks at Tier 1.

The report, though, bluntly describes the situation of human trafficking and slavery in the US:

“The United States is a source, transit, and destination country for men, women, and children subjected to forced labor, debt bondage, document servitude, and sex trafficking. Trafficking occurs for commercial sexual exploitation in street prostitution, massage parlors, and brothels, and for labor in domestic service, agriculture, manufacturing, janitorial services, hotel services, hospitality industries, construction, health and elder care, and strip club dancing. Vulnerabilities are increasingly found in visa programs for legally documented students and temporary workers who typically fill labor needs in the hospitality, landscaping, construction, food service, and agricultural industries. There are allegations of domestic workers, foreign nationals on A-3 and G-5 visas, subjected to forced labor by foreign diplomatic or consular personnel posted to the United States. Combined federal and state human trafficking information indicates more sex trafficking than labor trafficking investigations and prosecutions, but law enforcement identified a comparatively higher number of labor trafficking victims as such cases uncovered recently have involved more victims. U.S. citizen victims, both adults and children, are predominantly found in sex trafficking; U.S. citizen child victims are often runaways, troubled, and homeless youth. Foreign victims are more often found in labor trafficking than sex trafficking. In 2010, the number of female foreign victims of labor trafficking served through victim services programs increased compared with 2009. The top countries of origin for foreign victims in FY 2010 were Thailand, India, Mexico, Philippines, Haiti, Honduras, El Salvador, and the Dominican Republic.”

Human trafficking is a global market. Some countries supply modern day slaves and some countries demand their services and profit off the buying and selling of human beings. Clearly, developed countries with their vast financial resources and demand for cheap labor facilitate human trafficking by expanding markets for sex work, domestic servants, construction and agriculture. Until the US is willing to drop conversations on “illegal immigrants” and start facing the real questions of wage slavery and human exploitation, the situation will never change.

Included is a map of country rankings worldwide, which I have posted up to the left. It would have been helpful to include a map of estimated numbers of people enslaved in each country as well, but this obviously would not bode well for developed nations nor for the citizens which are complicit in insuring that more people are enslaved in the 21st century than in any other time in human history.

Japan Earthquake Reporting April 21, 2011

Numbers of confirmed dead continue to increase. Numbers of reported missing have been decreasing in Iwate and Fukushima prefectures but are steadily increasing in Miyagi. For the first time since the event, the ratio of missing to dead has dropped below one. It is disturbing, however, that reports of missing friends and family continue to pour in even though more than 6 weeks have passed since the first earthquake.

Refugees continue to be concentrated in the three hardest hit prefectures. While overall numbers have dropped significantly, a constant flow of refugees being shuffled from one center to another keep refugee numbers in some areas constant.



Japan Earthquake/Tsunami Reporting April 7, 2011

UPDATE: News just came that a magnitude 7.4 earthquake just hit Miyagi Prefecture at 10:32 EST.

As of today, April 7, 2011, the numbers of confirmed dead continue to gradually rise though the number of people reported missing have begun to flatten. New reports of missing individuals continue to be reported to Japanese police, though the ratio of dead to missing has been decreasing.

In total, as of today, 12,608 people are confirmed dead and 15,073 individuals are still missing.

Reporting of number of refugees by prefecture has become spotty, but the worst appears to be over. As of today, Miyagi Prefecture only reported 58,000 refugees, as opposed to a high of 320,000 just two weeks ago. The numbers of refugees in Iwate and Fukushima have remained unchanged for the past two weeks.


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