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Global Call to Action: Maximize the public health impact of intermittent preventive treatment of malaria in pregnancy in sub-Saharan Africa.
Malaria Journal. 2015; 14:207.Intermittent preventive treatment of malaria in pregnancy is a highly cost-effective intervention which significantly improves maternal and birth outcomes among mothers and their newborns who live in areas of moderate to high malaria transmission. However, coverage in sub-Saharan Africa remains unacceptably low, calling for urgent action to increase uptake dramatically and maximize its public health impact. The ‘Global Call to Action’ outlines priority actions that will pave the way to success in achieving national and international coverage targets. Immediate action is needed from national health institutions in malaria-endemic countries, the donor community, the research community, members of the pharmaceutical industry and private sector, along with technical partners at the global and local levels, to protect pregnant women and their babies from the preventable, adverse effects of malaria in pregnancy © 2015 Chico et al. Open Access.
Expanding contraceptive choice in West Africa: Building the capacity of local nongovernmental organizations to program holistically.
New York, New York, EngenderHealth, RESPOND Project, 2013 Jun.  p. (Project Brief No. 15)This project brief looks at how nongovernmental organizations can expand access to contraception in West Africa and specifically looks at member associations of the International Planned Parenthood Federation in Benin, Burkina Faso and Togo.
Third World Quarterly. 2011; 32(3):435-52.Governments, UN agencies and international and local NGOs have mounted a concerted effort to remobilise sport as a vehicle for broad, sustainable social development. This resonates with the call for sport to be a key component in national and international development objectives. Missing in these efforts is an explicit focus on physical education within state schools, which still enroll most children in the global South. This article focuses on research into one of the few instances where physical education within the national curriculum is being revitalised as part of the growing interest in leveraging the appeal of sport and play as means to address social development challenges such as HIV/AIDS. It examines the response to the Zambian government's 2006 Declaration of Mandatory Physical Education (with a preventive education focus on HIV/AIDS) by personnel charged with its implementation and illustrates weaknesses within the education sector. The use of policy instruments such as decrees/mandates helps ensure the mainstreaming of physical education in development. However, the urgency required to respond to new mandates, particularly those sanctioned by the highest levels of government, can result in critical pieces of the puzzle being ignored, thereby undermining the potential of physical education (and sport) within development.
Finnish Official Development Aid for sexual and reproductive health and rights in sub-Saharan Africa.
Finnish Yearbook of Population Research. 2010; 45:143-170.Finland is one of the donor countries that is most supportive in family planning (FP), Sexual and Reproductive Health and Rights (SRHR) and gender issues. This study examines Finnish ODA for FP and SRHR: its decision-making structure, other stakeholders and funding levels. Data consists of documents from the Ministry for Foreign Affairs (MFA) and interviews conducted at the MFA and with other experts. While Parliament decides on the overall level of ODA funding, the Minister for Foreign Trade and Development has considerable autonomy. Other stakeholders such as the All-Party Parliamentary Group on Population and Development and the Family Federation of Finland (Väestoliitto) engage in advocacy work and have influenced development policy. Although the Development Policy 2007 mentions the importance of health and SRHR issues and HIV/AIDS is a cross-cutting issue, interviewees stated that the importance of health and SRHR in ODA has declined and that the implementation of cross-cutting issues is challenging. Multilateral funding for UNFPA, UNAIDS and GFATM, and thus the proportion of SRHR funding within the health sector, is however currently rising. Funding for population-related activities has increased and represented 4.8% of Finland's total ODA in 2009. Almost all of this funding is directed towards basic reproductive health and HIV/AIDS issues and the majority is directed through multilateral channels (78% in 2009), mainly UNFPA and UNAIDS. IPPF, Ipas and Marie Stopes International also receive support.
Development. 2010; 53(2):267-273.Successive post-independence governments have embraced women's empowerment in one form or another, either because of their own ideological positioning, or because of demands by their 'donor friends/partners' and/or organized domestic groups and NGOs. What has emerged is a varied landscape on women's rights and empowerment work comprising the state bureaucracy, multilateral and bilateral agencies, NGOs, and women's rights organizations, with their accompanying discourses. In the Ghanaian context, Nana Akua Anyidoho and Takyiwaa Manuh look at what the discourses of empowerment highlight, ignore or occlude, the convergences and divergences among them, and how they speak to or accord with the lived realities of the majority of Ghanaian women. Given that the policy landscape in Ghana is highly influenced by donors, they ask which discourses dominate, and how are they used for improving women's lives in ways that are meaningful to them.
The level of Internet access and ICT training for health information professionals in sub-Saharan Africa.
Health Information and Libraries Journal. 2008 Sep; 25(3):175-85.BACKGROUND: Information and Communication Technologies (ICTs) are important tools for development. Despite its significant growth on a global scale, Internet access is limited in sub-Saharan Africa (SSA). Few studies have explored Internet access, use of electronic resources and ICT training among health information professionals in Africa. OBJECTIVE: The study assessed Internet access, use of electronic resources and ICT training among health information professionals in SSA. METHODS: A 26-item self-administered questionnaire in English and French was used for data collection. The questionnaire was completed by health information professionals from five Listservs and delegates at the 10th biannual Congress of the Association of Health Information and Libraries in Africa (AHILA). RESULTS: A total of 121 respondents participated in the study and, of those, 68% lived in their countries' capital. The majority (85.1%) had Internet access at work and 40.8% used cybercafes as alternative access points. Slightly less than two-thirds (61.2%) first learned to use ICT through self-teaching, whilst 70.2% had not received any formal training in the previous year. Eighty-eight per cent of respondents required further ICT training. CONCLUSIONS AND RECOMMENDATIONS: In SSA, freely available digital information resources are underutilized by health information professionals. ICT training is recommended to optimize use of digital resources. To harness these resources, intergovernmental and non-governmental organizations must play a key role.
Forced Migration Review. 2007 Dec; (29):72.The Norwegian Refugee Council (NRC) strongly believes that the Cluster Approach holds promise for improving the international response to internal displacement. The approach represents a serious attempt by the UN, NGOs, international organisations and governments to address critical gaps in the humanitarian system. We want this reform effort to succeed and to play an active role in northern Uganda to support the work of the clusters and improve their effectiveness. (excerpt)
Lancet. 2007 Dec 1; 370(9602):1817-1818.Progress towards making male circumcision for HIV prevention a reality in Africa has been slow because of cultural hurdles in a few countries, financial constraints in most, and a serious shortage of skilled practitioners throughout the continent. Joint Programme on HIV and AIDS made one of the most important policy statements in recent times on the fight against HIV in developing countries. After a 2-day consultation in Montreaux, Switzerland, the UN agencies released a document that urged countries with high rates of heterosexually transmitted HIV to consider adding male circumcision to their armamentarium against AIDS. The recommendation had a sound scientific basis. The results of three randomised controlled trials undertaken in Kisumu, Kenya, Rakai District, Uganda, and Orange Farm, South Africa had shown that male circumcision reduces the risk of heterosexually acquired HIV infection in men by around 60%. (excerpt)
Lancet. 2007 Dec 1; 370(9602):1821.One Sunday morning last year, an elderly Zambian woman, four grandchildren in tow, showed up at Elizabeth Mataka's door. "I'm looking for Mrs Mataka-people said she will help me. She's the one who helps grandmothers", the woman said. She had found exactly the right person. Mataka, herself a grandmother of three, heads the Zambia National AIDS Network (ZNAN) and helps coordinate funds fl owing in from donors. And earlier this year she was elevated to the highest levels of the global response to the pandemic. In April, 61-year-old Mataka was elected Vice Chair of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The next month, she got a surprise midnight call from New York with the news that she had been chosen to replace the outgoing United Nations Special Envoy for HIV/AIDS in Africa, Canadian diplomat Stephen Lewis. (excerpt)
International Affairs. 2006 Mar; 82(2):269-284.This article attempts to lay out a set of broad theoretical questions, illustrated with material from two visits to sub-Saharan Africa, including interviews with government officials and international organization representatives in Botswana and Malawi, about 70 interviews with staff from AIDS NGOs across sub-Saharan Africa, and an initial effort at mapping the universe of organizations responding to Africa's AIDS pandemic. The article focuses on four issues: (1) the nature of the organizations responding to AIDS in Africa; (2) the relation of AIDS governance to existing patterns of African governance, including the possibilities of syncretism and, conversely, a stand-off between the organizational models created by AIDS NGOs and existing patterns of authority and cooperation in African societies; (3) the problems and possibilities of 'cultural match' between existing repertoires of 'collective action schemas' and those proffered by NGOs and international organizations;1 and (4) the slippery matter of the play of power, money and identity in a field of power with very unequal players. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2007.  p.The influence behind faith-based organizations is not difficult to discern. In many developing countries, FBOs not only provide spiritual guidance to their followers; they are often the primary providers for a variety of local health and social services. Situated within communities and building on relationships of trust, these organizations have the ability to influence the attitudes and behaviours of their fellow community members. Moreover, they are in close and regular contact with all age groups in society and their word is respected. In fact, in some traditional communities, religious leaders are often more influential than local government officials or secular community leaders. Many of the case studies researched for the UNFPA publication Culture Matters showed that the involvement of faith-based organizations in UNFPA-supported projects enhanced negotiations with governments and civil society on culturally sensitive issues. Gradually, these experiences are being shared across countries andacross regions, which has facilitated interfaith dialogue on the most effective approaches to prevent the spread of HIV. Such dialogue has also helped convince various faith-based organizations that joining together as a united front is the most effective way to fight the spread of HIV and lessen the impact of AIDS. This manual is a capacity-building tool to help policy makers and programmers identify, design and follow up on HIV prevention programmes undertaken by FBOs. The manual can also be used by development practitioners partnering with FBOs to increase their understanding of the role of FBOs in HIV prevention, and to design plans for partnering with FBOs to halt the spread of the virus. (excerpt)
Washington, D.C., World Bank, 2004 Nov. 132 p.It is estimated that 98 percent of Somali women and girls have undergone some form of genital mutilation. About 90 percent have been subjected to the most drastic form. Since the 1991 collapse of its central government, Somalia has lacked established institutions, infrastructure, human resources and a secure environment suitable for development programs. Despite a harsh and uncertain environment, a vibrant civil society has been born in Somalia. Hundreds of NGOs, including women and youth groups, are actively involved in assisting victims of war, displaced persons, ethnic minorities, orphans, returned refugees, drought-stricken nomads and rural communities. These civil society groups receive significant humanitarian and development assistance from U.N. agencies and 40 international NGOs operating in Somalia. The Somalia Aid Coordination Body (SACB) was established to coordinate and facilitate information sharing among donor agencies, mostly based in Nairobi, Kenya. FGM/FGC eradication programs andactivities are coordinated through the SACB FGM/FGC Task Force, which meets every month. This assessment is aimed at guiding the World Bank, UNFPA and their partners in current and future anti-FGM/FGC initiatives. Programmatic and policy issues which emerged during the assessment are reflected in the relevant sections of the report. (excerpt)
New York, New York, Human Rights Watch, 2007 Feb. 111 p. (Human Rights Watch Vol 19, No. 3(A))South Africa's vibrant and diverse economy is a powerful draw for Africans from other countries migrating in search of work. But the chance of earning a wage can come with a price: If undocumented, foreign migrants are liable to be arrested, detained, and deported in circumstances and under conditions that flout South Africa's own laws. And as highlighted by the situation in Limpopo and Mpumalanga provinces, both documented and undocumented foreign farm workers may have their rights under South Africa's basic employment law protections violated by employers in ways ranging from wage exploitation to uncompensated workplace injury, and from appalling housing conditions to workplace violence. Human Rights Watch has conducted research on the situation and experiences of migrant workers around the globe. Its research demonstrates that migrant workers, whether documented or undocumented, are particularly vulnerable to human rights abuses. Such abuses can be the result of many different factors includinginadequate legal protections, illegal actions of unscrupulous employers or state officials, and lack of state capacity or political will to enforce legal protections and to hold abusive employers and officials to account. The focus of this report is principally the situation of Zimbabweans and Mozambicans in South Africa's Limpopo and Mpumalanga provinces. (excerpt)
Public-private mix for TB care and control. Focus on Africa. Report of the fourth meeting of the Subgroup on Public-Private Mix for TB Care and Control, 12-14 September 2006, Nairobi, Kenya.
Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2007. 27 p. (WHO/HTM/TB/2007.378)The Subgroup on Public-Private Mix for DOTS Expansion (PPM Subgroup) was established by the global Stop TB Partnership's DOTS Expansion Working Group (DEWG) to help promote and facilitate active engagement of all relevant public and private health care providers in TB control. The members of the Subgroup include representatives from the private sector, academia, country TB programme managers, policy-makers, field experts working on the issue, international technical partners and donor agencies. At the first meeting of the Subgroup in November 2002, generic regional and national Public-Private Mix (PPM) strategies were developed and endorsed. The Subgroup's second meeting, which was held at the WHO Regional Office for South-East Asia in New Delhi in February 2004, reviewed the growing evidence base emerging from numerous PPM initiatives. This meeting also broadened the scope of PPM to include the involvement of public sector providers not yet linked to national tuberculosis programmes (NTPs). Consequently, PPM has since stood for the engagement of all public and private health care providers through public-private, public-public and private-private collaboration in TB control. The third meeting of the Subgroup, held in Manila in April 2005, identified barriers and enablers for scaling up and sustaining PPM, and discussed how to mainstream PPM into regular TB control planning and implementation. The Subgroup's current fourth meeting in Nairobi, Kenya, in September 2006 had PPM for TB control in Africa as the main focus. The problems related to the HIV epidemic, human resources for health and health sector reforms pose special challenges to countries in Africa. The meeting examined how successful PPM approaches within Africa could be scaled up and how approaches applied in other regions could be adapted to African settings. Based on a global overview, the African experience in diverse country settings and field visits to examine working PPM models and after a great deal of deliberations and discussions, the Subgroup made recommendations which are presented in Section 6 of the report. A large part of the funding for the meeting was provided by USAID's Tuberculosis Control Assistance Program (TB CAP). (excerpt)
[Unpublished] .  p.What is the Partnership Fund for? The Partnership Fund is designed to target grant funds at specific activity areas that will complement and directly impact Partnership Project component activities through localization of implementation. For each grant award cycle, specific technical areas will be identified for the cycle's grant round announcement based upon Partnership Project programmatic priorities, funding sources, and recognized gaps in the HIV/AIDS activities and response. Who is eligible to apply? Organizations that are eligible to receive grants from the Partnership Fund include civic organizations such as NGO's, faith-based organizations, community-based organizations, cooperatives, producers associations, professional associations, research centers, and other organizations with activities relevant to Partnership Project objectives. Grants will not be awarded to state or government institutions. (excerpt)
Notes from the Field. 2001 Sep; (9): p..Representatives from the Asociación Pro-Bienestar de la Familia Colombiana (PROFAMILIA) in Colombia visited the Family Guidance Association of Ethiopia (FGAE) in the second half of a technical assistance exchange project. FGAE is expanding its institutional focus from family planning to sexual and reproductive health with a special emphasis on young people. Representatives from the Family Guidance Association of Ethiopia (FGAE) and the IPPF Africa Regional Office visited PROFAMILIA/Colombia in March 2001 to see PROFAMILIA's youth programs and services first-hand. The exchange was the first half of a technical assistance project that is funded by the IPPF "i3" Youth Program (Innovate, Indicate, Inform). IPPF/WHR had identified PROFAMILIA as a "best practices" FPA which could offer its expertise in developing youth programs to the FPA in Ethiopia. Zhenja, the IPPF/WHR Communications Manager, was there to facilitate the visit and identify needs for technical assistance. (excerpt)
Notes from the Field. 2001 Apr; (3): p..Representatives from the Family Guidance Association of Ethiopia (FGAE) and the International Planned Parenthood Federation, Africa Regional Office visited the Asociación Pro-Bienestar de la Familia Colombiana (PROFAMILIA) in March 2001 to see PROFAMILIA's youth programs and services. The exchange was the first half of a technical assistance project; PROFAMILIA was identified as a "best practices" organization that could offer its expertise to FGAE. Representatives from PROFAMILIA/Colombia visited the Family Guidance Association of Ethiopia (FGAE) in August 2001 for the second half of a technical assistance exchange project. The project, which in March 2001 allowed for FGAE representatives to visit Colombia, is funded by the IPPF "i3" Youth Program (Innovate, Indicate, Inform). FGAE is expanding its institutional focus from family planning to sexual and reproductive health with a special emphasis on young people. PROFAMILIA was identified as a "best practices" organization to provide technical assistance on youth programs. (excerpt)
Effect of an armed conflict on human resources and health systems in Cote d'Ivoire: Prevention of and care for people with HIV/AIDS.
AIDS Care. 2006 May; 18(4):356-365.In September 2002, an armed conflict erupted in Cote d'Ivoire which has since divided the country in the government-held south and the remaining territory controlled by the 'Forces Armees des Forces Nouvelles' (FAFN). There is concern that conflict-related population movements, breakdown of health systems and food insecurity could significantly increase the incidence of HIV infections and other sexually-transmitted infections, and hence jeopardize the country's ability to cope with the HIV/AIDS epidemic. Our objective was to assess and quantify the effect this conflict had on human resources and health systems that provide the backbone for prevention, treatment and care associated with HIV/AIDS. We obtained data through a questionnaire survey targeted at key informants in 24 urban settings in central, north and west Cote d'Ivoire and reviewed relevant Ministry of Health (MoH) records. We found significant reductions of health staff in the public and private sector along with a collapse of the health system and other public infrastructures, interruption of condom distribution and lack of antiretrovirals. On the other hand, there was a significant increase of non-governmental organizations (NGOs), some of which claim a partial involvement in the combat with HIV/AIDS. The analysis shows the need that these NGOs, in concert with regional and international organizations and United Nations agencies, carry forward HIV/AIDS prevention and care efforts, which ought to be continued through the post-conflict stage and then expanded to comprehensive preventive care, particularly antiretroviral treatment. (author's)
Primary health care in complex humanitarian emergencies: Rwanda and Kosovo experiences and their implications for public health training. [Soins de santé primaire dans le cadre d'urgences humanitaires complexes : les expériences du Rwanda et du Kosovo, et leurs implications dans le domaine de la formation en santé publique]
Croatian Medical Journal. 2002; 43(2):148-155.In a complex humanitarian emergency, a catastrophic breakdown of political, economic, and social systems, often accompanied by violence, contributes to a long-lasting dependency of the affected communities on external service. Relief systems, such as the Emergency Response Units of the International Federation of Red Cross and Red Crescent Societies, have served as a sound foundation for fieldwork in humanitarian emergencies. The experience in emergencies gained in Rwanda in 1994 and Kosovo in 1999 clearly points to the need for individual adjustments of therapeutic standards to preexisting morbidity and health care levels within the affected population. In complex emergencies, public health activities have been shown to promote peace, prevent violence, and reconcile enemies. A truly democratic and multiprofessional approach in all public health training for domestic or foreign service serves as good pattern for fieldwork. Beyond the technical and scientific skills required in the profession, political, ethical, and communicative competencies are critical in humanitarian assistance. Because of the manifold imperatives of further public health education for emergency assistance, a humanitarian assistance competence training center should be established. Competence training centers focus on the core competencies required to meet future needs, are client-oriented, connect regional and international networks, rely on their own system of quality control, and maintain a cooperative management of knowledge. Public health focusing on complex humanitarian emergencies will have to act in prevention not only of diseases and impairments but also of political tension and hatred. (author's)
Africa Renewal. 2005 Apr; 19(1): p..When a reporter first met seven-year-old Bongani in a hardscrabble shantytown near Johannesburg in 2003, it was evident the child was dying. He was too weak for school, stunted and racked by diarrhoea. There was little question that he, like his deceased parents, was infected with the human immunodeficiency virus that causes AIDS. It seemed equally certain that he would soon lie in a tiny grave next to theirs -- joining the 370,000 South Africans who died from the disease that year. But when the journalist, Mr. Martin Plaut of the BBC, returned a year later, he found a healthy, laughing Bongani poring over his lesson book. “The transformation,” Mr. Plaut wrote last December, “was remarkable.” That transformation -- and the difference between life and death for Bongani and a growing number of people living with HIV and AIDS in Africa -- has resulted from access to anti-retroviral drugs (ARVs) that attack the virus and can dramatically reduce AIDS deaths. For years high costs severely limited their use in Africa. The Joint UN Programme on HIV/AIDS (UNAIDS) estimated that only about 50,000 of the 4 million Africans in urgent need of the drugs were able to obtain them in 2002. But with prices dropping in the face of demands for treatment access and competition from generic copies of the patented medications, the politics and economics of AIDS treatment have finally begun to shift. (excerpt)
At ICPD+10 mark, UNFPA intensifies efforts to promote RH commodity security. [Approchant le dixième anniversaire de la CIPD, le FNUAP intensifie ses efforts pour promouvoir la sécurité de la santé de la reproduction]
Population 2005. 2004 Jun; 6(2):13.As the 10th anniversary of the Cairo International Conference on Population and Development (ICPD) approaches, there has been no letup in the UN Population Fund’s efforts to promote reproductive health commodity security around the world. Indeed, the Fund is actually intensifying its activities in this sector, leaving the distinct impression that it is all part of a coordinated and continuing response to the Program of Action of the September 1994 conference, and to the ICPD+5 update by the UN General Assembly in 1999. The impression would be neither casual nor accidental, because UNFPA is acting as the lead international agency that is trying to facilitate the creation and implementation of government strategies to meet the growing need for quality contraceptives, essential drugs and other reproductive health commodities. Special attention is also being devoted to assess future condom needs for HIV/AIDS prevention programs. Reproductive health commodity security (RHCS) is accepted as assured in those countries where the strategy has been successfully integrated into the national health program. (excerpt)
The Inter-Agency Network on education in emergencies. [Le Réseau inter-agences d'éducation d'urgence]
Forced Migration Review. 2005 Jan; (22):8-10.The Inter-Agency Network for Education in Emergencies (INEE) builds on the work of its members - UN agencies, NGOs, practitioners, donors and researchers - to ensure the right to education in emergencies and post-crisis reconstruction. Guinea in 1996 highlighted the then state of education in emergencies. An already under-resourced education system was coming under strain due to the presence of large numbers of refugees from neighbouring Sierra Leone and Liberia. As refugee and Guinean students competed for limited places in state schools and Guinea struggled to pay teachers' salaries, a large number of international NGOs established a complementary network of schools in the refugee camps. (excerpt)
International assistance to women's organizations. [Ayuda internacional a las organizaciones femeninas]
In: Women and civil war. Impact, organizations, and action, edited by Krishna Kumar. Boulder, Colorado, Lynne Rienner Publishers, 2001. 205-214.Several factors have led the international donor community to support women's organizations both during and after conflict. One obvious factor is that because of lack of resources, shortage of skilled personnel, and general decline in the morale of the staff, public bureaucracies become extremely fragile in war-torn societies. They are often unable to provide urgently needed social services to the suffering populace. Therefore, the international community tends to develop partnerships with voluntary organizations, including women's organizations, to provide essential assistance to the needy people. There are two additional reasons for the international donor community to support women's organizations. First, by virtue of their leadership and commitment, these organizations are better able to reach women than are male-dominated or mixed civil-society organizations. Their staff members can easily empathize with the intended women beneficiaries, who in turn feel more at ease in sharing their problems with them. Second, the international community also sees in women's organizations potential for empowering women. In addition to channeling assistance, they contribute to the social and psychological empowerment of women by teaching self-reliance and leadership skills. (excerpt)
[Unpublished] . Presented at the 32nd Annual Meeting of the African Studies Association, Atlanta, Georgia.  p.HIV infection with clinical progression to AIDS appears to be among the most severe human infectious diseases documented to date. As of 1st September 1989, the cumulative total of cases of AIDS reported from 152 countries was 177,965 cases of which 30,978 (17.4%) have been reported from Africa. However, it is known that the reporting of AIDS cases from Africa is incomplete and the proportion may be higher. The AIDS situation has been recognized as a global emergency and the World Health Organization has been given the mandate to coordinate global efforts to prevent the infection and control the disease. The World Health Assembly and the United Nations General Assembly have called upon all countries to establish national AIDS prevention and control programmes in line with the Global Strategy. The WHO has developed several guidelines and strategies to assist the development of national AIDS prevention and control programmes. The Global AIDS Strategy has three objectives: (1) to prevent transmission of the human immunodeficiency virus (HIV); (2) to reduce the morbidity and mortality associated with HIV infection; and (3) to unify national and international efforts against AIDS. (excerpt)
Lancet. 2004 Jan 17; 363(9404):215.Health ministers from the world’s six remaining polio-endemic countries— Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan —pledged in a declaration signed in Geneva on Jan 15 to boost their polio-eradication activities in a bid to wipe out the disease. The commitment came amid growing fears that the ongoing outbreak in west Africa—centred in Nigeria and Niger—and the importation of cases to neighbouring countries could derail the 15-year global effort to eradicate the disease. (excerpt)