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submitted by Jim Dobbin, MP
11/21/2012 at 13:06

I would like to take this opportunity to welcome World Toilet Day, an annual event which takes place on the 19th of November to highlight the fact that many people in the developing world lack access to a clean and safe toilet. This situation is so concerning that one in three women risks shame, disease, harassment and even attack because they do not have a safe place to go to the toilet.

As Co-Chair of the All Party Group for Child Health and Vaccine Preventable Diseases I have spent many years working to raise awareness of the burden of preventable diseases in the developing world. Speaking as a former microbiologist one of the issues which concerns me most is access to clean water and proper sanitation facilities. I know very well the effect that improved water, sanitation and hygiene (WASH) can have in reducing child mortality in the developing world.

Despite the progress which has seen diarrhoea-related child deaths decline from 12 million to 7 million in the past two decades, diarrhoeal disease remains the second largest killer of children worldwide and is the most common cause of all diseases. Today around 760,000 children die from diarrhoeal disease every year making it a significant obstacle to achieving Millennium Development Goal 4.

Aside from child deaths, diarrhoeal disease can have even more long-lasting effects. It can cause malnutrition which can be a huge contributing factor to stunted growth and can impact negatively on future cognitive development. These effects are intergenerational as they can prevent affected children from attending education and being economically active and can further limit their chances of raising healthy and productive families.

I have seen for myself the effects of diarrhoeal disease when I participated in UK parliamentary delegations to Kenya and Bangladesh. In spite of the excellent efforts of wonderful and committed medical staff, hygiene remains a significant problem. In conjunction with improving access to appropriate vaccines and medication, more must be done to support initiatives aimed at promoting hygienic practices like regular hand washing and exclusive breastfeeding. We should also ensure that where diarrhoeal disease does occur, it can be effectively treated with oral rehydration therapy (ORT), oral rehydration solution (ORS), zinc and other micronutrients alongside regular feeding.

The UK has always been a leader in international development policy and I want to make sure that we continue to provide investment, expertise and leadership on the issue of access to clean water and sanitation. Whilst great strides have been made in creating effective tools to combat diarrhoeal disease there is a real need for greater action and to build on our progress.

I welcome the commitment made by the Government in April 2012 to double the number of people that will be reached by WASH by 2015 and I call on the Government to work further with international partners such as PATH, WaterAid and Tearfund to prioritise these vital issues and to roll out the tools that have been developed.

Preventing and controlling diarrhoeal disease and improving access to clean, safe toilets can significantly transform the lives of many people across the world and help them to build healthy, prosperous communities to raise their children.

Photo: PATH/Gareth Bentley

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submitted by Eileen Quinn
11/20/2012 at 11:35

Did you see the blog posts yesterday (World Toilet Day) from elected officials in the United States reminding us of the importance of safe toilets for the health and safety of children and communities? Oh, that’s right, there weren’t any.

But in the UK, several Members of Parliament spoke out. Lord Eric Avebury blogged that “Absence of clean toilets and inadequate sanitation facilities are key causes of diarrhoeal disease, the second largest killer of children worldwide, causing around 760,000 child deaths every year.” MP Jim Dobbin wrote about his first-hand experience seeing the devastating toll of diarrhea when visiting Bangladesh and Kenya, and notes that “Aside from child deaths, diarrhoeal disease can have even more long-lasting effects. It can cause malnutrition which can be a huge contributing factor to stunted growth and can impact negatively on future cognitive development.”

Perhaps my favorite is a letter to The Times of Londonfrom MP Annette Brooke, Baroness Anne Jenkin, and Baroness Glenys Kinnock that begins: 

“Sir, The humble toilet is not a subject we’re accustomed to hearing about in campaign speeches and political pledges. But with one in three women having no access to adequate sanitation, it’s a subject we cannot ignore. We are therefore calling on governments around the world to make good on their promises to provide the world’s poorest people with safe toilets and clean water.”

What’s that old saw about Brits being stuffy and Americans telling it like it is? Turns out, these British politicians have the courage to call attention to the importance of several topics that can be taboo – toilets and diarrhea among them. They know that if we don’t talk about these challenges, we will never rally enough will to defeat them.

Hats off to these parliamentarians for their candor. Here at DefeatDD, we know we agree: Let’s Talk About It.

If we do, maybe then signs like this one (from PATH President Steve Davis’s recent trip to Burma) will say Toilets for All.


-- Eileen Quinn, Director of Communications for the Vaccine Development Program at PATH


For more information:

-- Wanted: your potty pics. Raise your voice for sanitation and flush for a cause!

-- Who gives a crap? These guys do! Amazing social entrepreneurship -- and brave photos -- featured on the blog.


Photo credits, top to bottom: PATH/Gareth Bentley, PATH/Steve Davis.

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submitted by Simon Griffiths
11/19/2012 at 11:19

The sanitation problem is huge – if you’re reading this blog you’re probably well aware that 2.5 billion people, or one in three people in the entire world, don’t have access to a clean toilet. That leads to a hell of a lot of diarrhea-related disease, which ultimately fills half of the hospital beds in sub-Saharan Africa. What’s worse is that this problem is not being solved very quickly. At current rates of improvement, global sanitation won’t be achieved until around 2075.

A couple of friends and I thought that was pretty crappy, so in July this year we launched a new brand of toilet paper called Who Gives A Crap. Our product is an environmentally friendly toilet paper that uses 50% of its profits to build toilets in the developing world.

Our launch involved pre-selling $50,000 of product via the IndieGoGo crowdfunding platform.  To help things along, I agreed to sit on a toilet on a live webfeed until we hit the $50k target. The campaign went viral, and we hit our $50,000 target in 50 hours. You can still see our campaign here. We’re now expecting to have our full online store open next month, which is really exciting!


People often ask why we created Who Gives A Crap. When I look back now, I realise that it was for three reasons:

-- First and foremost, we wanted to build toilets and improve sanitation in the developing world. We wanted to start chipping away at that 2.5 billion figure.

-- Secondly, we knew that the vast majority of people don’t understand the size of the sanitation issue or why it is so problematic. We realized that a major reason for this is that no one wants to talk about toilets - they’re dirty and disgusting. Toilets just aren’t sexy!  We saw a tongue in cheek opportunity to bypass the taboo by making sanitation fun.

-- Finally, we felt that society was reaching its donation saturation point – that the amount of money being donated was hitting a glass ceiling. We thought it was necessary to revisit the way that social impact is funded. We wanted to create an opportunity for people to make a difference without donating more, or changing what they do everyday.


Today is World Toilet Day! Yep, there is a World Toilet Day. It started 11 years ago to help create conversation around the importance of sanitation. Unfortunately, even after 11 years, we’ve still got a long way to go. So maybe at some point today, take a couple of minutes to think about what you might be able to do to help speed things up. You don’t have to start a toilet paper company – sometimes creating change can be as simple as switching the products that you buy.

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submitted by Jim Dobbin
11/13/2012 at 12:19

As Co-Chair of the All Party Group for Child Health and Vaccine Preventable Disease I have spent many years working to raise awareness of the burden of pneumonia in the developing world, where 99% of pneumonia related deaths occur. Pneumonia remains the leading killer of children aged under five worldwide and in 2011 alone accounted for the deaths of around 1.3 million children.

Today is World Pneumonia Day and an ideal opportunity to discuss progress on tackling this terrible but largely preventable disease and to address what more needs to be done. It is to the great credit of NGOs, development agencies, Governments and all other development and healthcare stakeholders that we have made such great progress in the last decade. Through improving access to effective vaccines against pneumonia and diarrhoea we have seen drastic reductions in child mortality.

Despite this progress, we cannot afford to lose momentum. It is only through investing in prevention and treatment that we can protect children against pneumonia and diarrhoeal disease, the two leading killers of children in the developing world, and make substantive progress on meeting our commitment to Millennium Development Goal 4, to reduce by two thirds the child mortality rate by 2015.  

Last year, I marked World Pneumonia Day in Bangladesh, as part of a UK parliamentary delegation to the country, and saw for myself the vital work being done to protect children in both urban and rural areas. From the slums in Dhaka to rural health centres in Rajendrapur, I saw communities working together to deliver vaccines to those who need it most. I was hugely impressed by the work being done by dedicated medical professionals, doctors, nurses and care workers and this highly organised and successful model showed what can be achieved when local communities take ownership of their healthcare systems.

However, in spite of all the expert medical and nursing care being provided,what I saw in Bangladesh wasn’t all positive and, as a former microbiologist, I was greatly concerned by low levels of hygiene and sanitation. Alongside access to vaccines and medicines, particularly antibiotics, improving sanitation, improving access to clean water and frequent hand washing practices are vital to protecting children against diarrhoeal disease and other waterborne diseases. Other initiatives such as promoting exclusive breast feeding and encouraging the use of clean cookstoves can also make a huge contribution to reducing childhood mortality.  

This is the fourth annual World Pneumonia Day and also the fourth that I have participated in. Whilst recognising the progress that we have made, I would like to ask all Governments to prioritise efforts and investments to reduce the number of preventable child deaths through supporting and implementing the measures outlined in the Global Action Plan for the Prevention and Control of Pneumonia (GAPP). The APPG will continue to support these efforts and to raise awareness of the global burden of pneumonia and other preventable diseases. 


-- Jim Dobbin MP is Co-Chair of the APPG for Child Health and Vaccine Preventable Disease


Photo credit: PATH

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submitted by Leith Greenslade
11/12/2012 at 12:30

On a recent visit to a local children’s ward in the northern part of Ethiopia over 70% of the children were suffering from pneumonia.  When a child in this region goes to the hospital, most often the parents move in as well, sleeping in the same bed and living there until they are discharged.

Global health is like a juggernaut.  It is very hard to turn around if it gets set on the wrong course.  Yet when it comes to the health of the world’s most vulnerable children, this is basically what has to be done if we want to save children’s lives on the scale required to achieve global health goals.  We need to turn the juggernaut around and set it on a path towards a new goal – fighting the leading killers of children.

If you don’t work in global health you might be surprised to learn that fighting the leading killers of children has not been a global priority.  You might also be surprised to learn exactly what the leading killers of children under 5 are – two diseases, pneumonia and diarrhea.  These two kill more children under 5 than AIDS, malaria and measles combined.  They cause 2 million children to die every year and account for a massive 30% of all under 5 deaths.  And yet they attract less than 5% of global health funding.

To add insult to injury we have very cost effective vaccines, antibiotics and other treatments like oral rehydration salts and zinc that can prevent and treat the leading causes of pneumonia and diarrhea.  If we made them widely available, pneumonia and diarrhea would kill a fraction of the children that they do now.  Vaccines alone have the power to prevent almost 1 million child deaths from pneumonia and diarrhea every year.  When you add in antibiotics, oral rehydration salts, zinc and vitamin A supplements – each of which cost cents per dose – you can probably double that figure and wipe out almost all deaths.

So why haven’t we done it?  The answer has a lot to do with our global health architecture and our failure to mobilize and focus global health resources on the areas where the greatest number of children can be saved – and of course the two are related.  We have separate organizations that deliver vaccines, medicines and nutritional supplements and they typically compete over scarce donor dollars rather than collaborate to introduce these interventions in the countries where most children are dying.  They are rewarded for the amount of funding they can attract rather than for the number of children’s lives they are actually saving, so the incentive is to focus their resources on raising money rather than collaborating to save children.

If we did have one global health organization responsible for halving child mortality by 2015 – saving about 3.5 million lives per year – with the power and resources to coordinate vaccine delivery with access to antibiotics and other interventions, you would start to see some real progress.  And if that organization focused on the most vulnerable children in the countries where child deaths are concentrated – India, Nigeria, Democratic Republic of Congo, Pakistan, Ethiopia, Afghanistan and China (precisely the countries where our existing health organizations often struggle to have impact), then you would start to see child mortality reductions on the scale required to achieve global health goals.

But we don’t live in a perfect world and we won’t see a more effective global health architecture anytime soon. So what can we do in the countdown to 2015 to save more children from pneumonia and diarrhea? We can continue to argue that the big donors in child health put pneumonia and diarrhea to the top of their lists.  We can ask the major UN agencies and NGOs in child health to account for the proportion of their budgets allocated to pneumonia and diarrhea – are they spending ~30% to fight the leading killers of children?  We can create structures that make it easier for all partners to collaborate in the regions where child deaths are concentrated because if we want to achieve impact at scale, we have to work at scale and that is beyond the capacity of any one organization.  

We need large, multi-stakeholder public-private partnerships mobilized against pneumonia in the northern states of India and the northern states of Nigeria and we need the prevention and treatment communities working hand in glove to reach the most vulnerable children in these critical geographic areas.  And we need World Pneumonia Day!  Because the real value of this day is to shine a light on all of these opportunities and to draw together the many stakeholders committed to advancing the health of children so we can save more children, quickly.                                                                                                            


-- Leith Greenslade is Co-Chair of Child Health at the MDG Health Alliance. The Alliance operates in support of Every Woman Every Child, an unprecedented global movement spearheaded by the United Nations Secretary-General to mobilize and intensify global action to improve the health of women and children. We work closely with many partners, especially the UN Foundation, the Partnership for Maternal, Newborn and Child Health, and the Global Compact to help optimize the engagement of the private sector toward the goals of Every Woman Every Child.The Alliance is comprised of eminent leaders from the private, public, and nonprofit sectors working in conjunction with the Health and Education Cluster of the Secretary General’s MDG Advocates.


For more information:

-- INFOGRAPHIC: Tackling the deadliest diseases for the world's poorest children.


Photo credit: David Rotbard

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