Change.org's Global Health Blog

Climate Change Will Exacerbate Gap Between Rich and Poor

Mike Smith — 2009-11-20T11:18:00-08:00

Climate change won't just hit the poorest the hardest, with those in developing countries bearing the brunt of climate change — losing access to crucial water supplies, and feeling the effect of rising sea levels. Climate change will additionally exacerbate gaps between the rich and poor. The effects of climate change is likely to reverse many of the hard earned and costly developments gains of the Millennium Development Goals. Specific setbacks will include increased water scarcity, and changes in the availability of food. Quite simply, climate change is the perfect storm. And oh yeah, climate change is already producing more ferocious natural disasters.

The increased necessity of migration due to the failure of crops and rising sea levels will further impact health from both a perspective of the stress and strain of mass migration, and also due to increased potential for civil strife.

Altering family planning, reproductive health care and improve the rights of women could reduce population stress and in turn reduce greenhouse emissions. But in the short term, there is nothing better than rapidly cutting emissions. The long term strategy will continue to be a challenge as the richer get richer and consume more, and the poor get poorer and continue to be hit even harder.

Photo: Suburbanbloke

Spread the Word about Good Hygiene: World Toilet Day

Mike Smith — 2009-11-19T16:24:00-08:00

World Toilet Day isn't the easiest day of the activist's year to promote. But ensuring good public hygiene is a very effective method of slowing the spread of disease and illness. The problem is that toilets and adequate sanitation just isn't cool, and it isn't much of an aspirational campaign.

The people behind World Toilet Day are trying to change that. They explain to Reuters that "It is a sensitive issue, but a serious one that has to be a shared responsibility of the government, companies and people."

One method is to keep toilets clean on trains, in return for advertising space, thus spreading the message that good sanitation is the norm, and that public defecation is damaging to society. The World Trade Organization, reports the Hindustan Times, is attempting to mainstream a culture of cleanliness. In the run up to the Commonwealth Games, being held in India, they want to eliminate the stigma around sanitation. Another method, as we recently reported, involves the 'No Toilet, No Bride' campaign. Rather than provide toilets, they are working to change society and make people desire toilets, then using the private sector to provide toilets. It's not the easiest campaign to sell, but that doesn't make it any less important.

Photo: runran

Gates Foundation: Celebrating Success and the Importance of Storytelling

Mike Smith — 2009-11-18T09:12:00-08:00

This is a guest post by Joe Cerrell, director, global health policy and advocacy, Bill & Melinda Gates Foundation.

Too often in global health, we zero in on the obstacles and neglect to celebrate the successes. While the health challenges facing the developing world are very real, many poor countries are making real progress against diseases like HIV and malaria, often with support from the American government.

That’s the message that Bill and Melinda Gates recently brought to Washington, D.C. In a presentation titled, “Living Proof: Why We Are Impatient Optimists,” they showed lawmakers and foreign policy experts something that rarely makes the global health news: success. I encourage you to watch the presentation—it’s both moving and inspirational.

Bill and Melinda’s speech is part of The Living Proof Project: U.S. Investments in Global Health Are Working, a campaign to share success stories from the field and put a human face on the millions of lives that have been saved and transformed through U.S. government investments in global health.

Take the story of Grace Ngoto, who delivered her baby girl two months early in Malawi. Thanks to the Kangaroo Mother Care program supported by USAID, Grace’s child was able to thrive despite being born premature in one of the world’s least developed countries. Grace now teaches other mothers about Kangaroo Mother Care and protecting newborns from hypothermia and infection. Grace and her daughter are Living Proof that investments in global health are changing the world.

I know that when Americans hear about Grace’s little girl and the millions of other lives saved by U.S. government investments in global health, they’ll be eager to do more. I hope that you’ll help us get the word out. Visit the Living Proof website to see more personal stories and data from the field, and then share what you’ve learned with someone else in your community, whether it’s your elected representative, your next-door neighbor, or your Twitter followers.

Spread the word: U.S. investments in global health are working.

UN Photo/Evan Schneider

What Next as Parasites Become Resistant to Best Malaria Treatment?

Mike Smith — 2009-11-15T14:29:00-08:00

Mosquitoes are becoming resistant to artemisinin, "the only remaining effective drug in the world's arsenal against malaria's most deadly strain"? On the Thai-Cambodia border this is happening due to a rouge strain of malaria. The race is on to eliminate malaria before its too late — before more resistances are established around the world.

Artemisinin hasn't been around for long as a purified treatment for malaria, but it has been used to fight the disease in China for thousands of years, and it has been taken across Southeast Asia for 30 years, allowing parasites longer to adapt. So how can this problem be solved? The Global Fund hope that undercutting sales of alternative and counterfeit treatments with genuine effective treatments will help make access to anti-malarials. Compared to HIV and tuberculosis prevention (the top one and three most deadly diseases, with malaria between them), subsidizing malaria treatments, alongside other efforts, could eliminate the disease entirely. The longer we wait, the more time parasites have to build up resistance to our best weapons.

Photo: UN Photo/Martine Perret

Afghan Gov Fears Swine Flu: Not Enough Antivirals, Not Enough Graves

Mike Smith — 2009-11-13T09:00:00-08:00

The Afghan government has launched a swine-flu education campaign and declared an emergency after 11 people died of H1N1. You may think the government have more important things to worry about, but in Afghanistan there may not be enough graves to contain all the causalities, (due to the harsh winters, graves must be dug before the coldest weather sets in) and officials fear the effect the virus will have on their armed forces. Although only 11 people have so far died, the toll could rise considerably.

The Health Ministry fears that over 6 million people would contract the virus, with 5 per cent likely to develop severe symptoms that would put severe strain on the limited healthcare system, reports the LA Times. Supplies of antiviral medicine will not be sufficient to treat all the severe cases. Some government critics wonder whether this crisis has come at a good time for President Hamid Karzai, allowing him to close universities, the site of much political activism, following a disputed election.

Despite the shortage of vaccine, Taliban detainees will be receiving the vaccine. The US military also fears its soldiers and Afghan soldiers will contract the disease — one Afghan soldier has already died. The spread of the disease is not being helped by rumors that you won't contract the disease if you don't eat pork. Just like Egypt's ridiculous slaughter of all of its pigs, this rumor is only likely to compound problems.

Photo credit: UN Photo/Fardin Waez

UNICEF: Undernutrition Leads to Intergenerational Cycle of Ill-Health and Poverty

Mike Smith — 2009-11-12T15:38:00-08:00

Hunger statistics are always big, but it's hearing the impact that puts those numbers into perspective. This is more than hunger, this is undernutrition leading to "an intergenerational cycle of ill-health and poverty," explains Ann M. Veneman UNICEF Executive Director.

200 million children under five experience stunted growth due to chronic undernutrition explains a UNICEF report released this week. The report explains that a third of deaths in children under five are linked with poor diet. Worse, malnutrition is often invisible until it becomes severe — children may seem healthy when in fact they can be at serious risk. The first 1,000 days of a child's life are cruicial for development, with nutritional deficiencies cutting a child's ability to fight disease, as well as impairing social and mental capacties.

But we have responses to undernutrition: exclusive breastfeeding for the first six-months and nutritional adequate food from then can cut child mortality by 20 per cent. Suppling micronutrients is further improving things and “Global commitments on food security, nutrition and sustainable agriculture are part of a wider agenda that will help address the critical issues raised in this report,” explained Veneman. Solutions exist to reduce undernutrition in Asia and Africa, the rest of the world just needs to recognize the value in doing as much as they can to help the world's youngest and neediest.

Photo credit: © UNICEF/BANA2007-0055/Siddique

President Obama Finally Appoints USAID Administrator

Mike Smith — 2009-11-11T10:27:00-08:00

After hundreds of days of waiting, President Obama has finally nominated an administrator for USAID (United States Agency for International Development). Dr. Rajiv Shah currently works as Under Secretary for Research, Education and Economics and Chief Scientist at the Department of Agriculture, so be sure that hunger and malnutrition will be paid close attention, as will to agricultural development. Prior to working for the government, Dr. Shah was Director for Agricultural Development at the Bill and Melinda Gates Foundation.

Of the nomination, President Obama explained "The mission of USAID is to advance America’s interests by strengthening our relationships abroad. Rajiv brings fresh ideas and the dedication and impressive background necessary to help guide USAID as it works to achieve this important goal." Mr Obama made specific recognition of the work that the acting-administrator and the whole agency had done to jump-start the $20 billion initiative for agricultural development in developing countries.

Writing to collegues, Dr. Shah explained that he would be sad to leave US DoA: "While this is an amazing opportunity to contribute to the Obama Administration’s priorities, today has been a bit bittersweet as well." In order to really amplify his role ModernizeAid suggests giving him a seat at the National Security Council and entirely revitalizing USAID in order to strengthen development and foreign assistance.

Photo credit: Simminch

US Fears Feeding Terrorists, Delays Emergency Food Aid for Somalia

Mike Smith — 2009-11-09T16:27:00-08:00

The U.S. recently delayed emergency food aid to Somalia out of concerns that it would end up in the hands of terrorists. Now, the impact of the interruption is becoming clear and causing huge problems, with rations to starving people being cut. The decision in October to suspend millions of dollars worth of aid came due to fears that food and money was going to an Islamic insurgent group, with the U.S. assuring the UN that the delay would be brief.

But now the World Food Program has suggested “The food supply line to Somalia is effectively broken.” Food is stuck in Kenya until bureaucrats can decide better regulations — regulation that makes demands that the UN fear are unrealistic in such a chaotic environment like Somalia. The US donates almost $1 billion in aid to Somalia, but the distribution of this aid is only loosely monitored. The UN has communicated the urgency of the situation to USAID, but as I wrote yesterday, with USAID still lacking an administrator, the call may go unanswered. New mechanisms for distributions and monitoring must be constantly considered and reworked, but surely that can happen whilst aid is being delivered. This operation needn't shutdown completely to reboot with new regulations: millions of people rely on the US keeping the aid coming.

Photo credit: UN Photo/M Grant

Obama Still Hasn't Appointed Leader to US Agency for International Development

Mike Smith — 2009-11-08T17:36:00-08:00

The United States Agency for International Development (USAID) still doesn't have a confirmed leader. Issues that need a full-time voice lack the volume necessary to really move the White Hosue. All five previous administrations appointed someone quicker than President Obama, and confirmation hearings need to happen within a month else USAID will have been left without an administrator for over year.

The Center for Global Development is appalled by the speed of the Obama Administration to appoint someone considering the huge importance of restoring America's standing in the world. Someone needs to be secure at the helm in order to fully consider how the US will execute its promises in global health, food security and even climate change/

A petition was started on Change.org back in August to get someone on board, but we still lack a leader. Back then we explained "An acting administrator just doesn't have the stature to guide the agency at a time of huge change for US foreign assistance." Now, nothing has changed, and the longer the post is left vacant, the more that international development will be neglected — it clearly isn't a priority at the moment and it should be.

Photo credit: US Army Africa

Climate Change is Biggest Health Threat to Children of 21st Century

Mike Smith — 2009-11-06T09:24:00-08:00

Climate change could kill up to 400,000 children a year. That's the assessment of Save The Children who explain that not only will does climate change represent a huge global health problem that will kill hundreds of thousands every year, but it's singled out as the biggest health threat to children in the 21st century. Save the Children estimate that up to 175 million a year will be effected as natural disasters increase over the next decade.

There of course is no-one immune to climate change, and no immunization being developed, or hopes that the Gates Foundations can step in and fund research to diagnose the causes. We know the causes, and know some things to can do to fight it. We are relying on governments to pass strong climate change legislation, cut emissions, and help the developing world do the same. If this doesn't happen, deaths by diarrhea will increase to kill an extra 100,000 kids every year, whilst malnutrition, which today effects 178 million, will hit another 25 million children by 2050.

Photo credit: suburbanbloke

Lower Fertility Rate is Improving the World in Incredible Ways

Mike Smith — 2009-11-05T18:59:00-08:00

Climate change, hunger and malnutrition, women's rights, war and conflict are all causes in which the situation is likely to dramatically improve should global fertility rates continue to decrease. Soon a milestone will be reached as "only half of humanity will be having only enough children to replace itself," writes the Economist. We aren't going to disappear as a race, oh no, but population growth is likely to slow and with it more people will enjoy a higher standard of living at no-one's expense. More pairs of hands won't be needed to improve your family's chances of survival, and the incentives to having a large family will decrease.

Incentives will change as more people live in urban areas, close to schools, markets, and factories. Women will work more, and education will increasingly need be funded — both will lead to smaller families. Family planning improves things further.

This won't happen for at least another generation, not quick enough for us to disregard changing how much we are destroying and polluting the planet. But creating a lower population helps: it's five times cheaper than conventional solutions to combating climate change. Quite simply fewer feet mean a smaller footprint. A smaller population won't weigh so heavily on Earth, especially for those least able to shoulder the burden.

Photo credit: UN Photo/John Isaac

Anti-Malarials Often Ineffective But Historic First Vaccine Could Save 500,000 a Year

Mike Smith — 2009-11-03T11:24:00-08:00

It's not just a lack of funding causing millions to die from malaria. Even where provision for anti-malaria medicine exists, too often it's ineffectual. But there is hope with a new vaccine.

ActWatch have just released a study of seven African countries which explains that most people were receiving ineffective anti-malarials. The study, funded by the Bill and Melinda Gates Foundation, found that the lack of quality medication is usually down to the high-cost and low-availability of the better drugs which can cost twenty times as much — up to 65 times the average daily wage in some of the studied countries. Dr Chevasse, Project Director of ActWatch, says that "this is ultimately what’s leading to the fact that most children in Africa are either not being treated at all for malaria - or they’re being treated with ineffective drugs."

So quite simply, even where malaria medication does exist, we've got to ensure it works. But there is hope due to a new vaccine which appears able to prevent malaria in 50% of children. This could account for an incredible 500,000 lives saved each year. When it passes final testing it will become the first vaccine against a human parasite. It will only prevent the African strain, but it's a huge leap forward in squatting malaria. Children, who are at high-risk, will be immunized and then left to develop a natural immunity as they grow older. Developing the vaccine has cost more than $500 million, funded in part by GlaxoSmithKline and ... you guessed it ... the Bill and Melinda Gates Foundation who fund part of the PATH Malaria Vaccine Initiative. Even better news is that "pricing will never be a barrier to access for this vaccine" said GlaxoSmithKline.

Photo credit: UN Photo/Astrid-Helene Meister

World Pneumonia Day 2009: Join The Fight

Mary Beth Powers — 2009-11-02T06:06:00-08:00

Pneumonia is preventable and treatable; so why does a child die from pneumonia every 15 seconds? Today is the first World Pneumonia Day, and Save the Children is taking action to protect children from a disease that takes nearly 2 million lives each year – that is one child every 15 seconds. Every day in 40 countries around the world we work with parents and community health workers to provide these children with the medicine and expertise to help children survive pneumonia.

Why all the effort around the first World Pneumonia Day? It's not just the toll that pneumonia takes on children that has created an organized movement to combat this life-threatening infection. It's the fact that affordable, effective treatments exist but children in developing countries are not getting them. This is both heartbreaking and frustrating.

Many low-income countries have developed effective health strategies for protecting children from pneumonia and other childhood illnesses. Where hospitals and health clinics are beyond the reach of families, community health workers are trained to diagnose and treat pneumonia and other childhood illnesses in their own communities.

Consider 1-year old Marta who lives with her family in a Mayan community in the highlands of Guatemala. She came down with pneumonia when she was 7 months old. Her grandfather took her to the community health worker, Juan Lux, who quickly diagnosed Marta with pneumonia and gave her a dose of antibiotics. But Marta was still not out of danger and Juan referred her to the nearest hospital -- an hour-long walk over the mountains to catch a bus for the 19-mile trip to the hospital. (And on those treacherous mountain roads, 19 miles is a long, long trip!) Marta was hospitalized, treated with antibiotics and is now doing fine.

Marta is one of the lucky ones: Lucky because her grandfather sought help quickly. And luckier still because Save the Children had trained and equipped Juan Lux to provide health care for children in their little village. Without his correct diagnosis, proper treatment and referral, Marta might not have survived.

Now we are asking you to join this fight by going to www.missionpneumonia.org and getting the facts about childhood pneumonia. Should you accept your mission, this site will provide you with opportunities to make a real world difference by:

Recruiting friends, family and colleagues to play www.missionpneumonia.org by sharing on Facebook, Twitter and email with different facts about pneumonia and the obstacles family and community health workers face

Signing our petition to Congress on the Newborn, Child and Mother Survival Act. Show your elected officials that you support expanding the reach of life-saving tools – vaccines, antibiotics and trained health workers – to more mothers and babies in poor countries.

Helping to provide the supplies and training Community Health Workers around the world need to help diagnose and fight pneumonia.

Our mission doesn't end with World Pneumonia Day, but it can make a strong step in the right direction. Even as I sit at my computer writing this blog post, I know that health workers like Juan Lux are making rounds in remote villages, checking the progress of sick children and following up with their parents. This makes me hopeful that we can save millions more lives by making affordable health measures to the poorest children and by bringing health care closer to children's homes.

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Ecuador Breaking 2,000 Drug Patents, Big Pharma Says No Problem

Mike Smith — 2009-11-01T18:16:00-08:00

Ecuador are breaking drug patents left, right, and center, bypassing patents on 2,000 drugs "in order to produce them locally or buy cheaper versions elsewhere." And that's not the most interesting bit: 14 of the world's biggest pharmaceutical companies accept the decision. So why is big pharma happy for this to happen?

Well, it's legal, so they have little option but to agree.

"We accept the democratic decision... to legally implement this extraordinary measure ... No legal right is superior to the requirements of public health," the companies explained. Under rules agreed by the World Trade Organization, Ecuador is also on solid ground internationally. And they aren't just stealing. WTO rules allow countries to issue "compulsory licenses" to disregard patents. But, and here's the crux, this can only ordinarily happen after negotiating with patent owners and compensating them through royalty payments. But if a national emergency was declared, Ecuador wouldn't even have to negotiation with the pharmaceutical companies. This time around negotiations did occur.

Ecuador join Brazil, Thailand, Malaysia, and Indonesia in the issuing of a "compulsory license" for the importing of certain drugs. Industry groups are eager for this not to happen too often, with Thailand landing itself on a US copyright watch list for its disregard of patetns. But when public health is such a huge concern, this is hardly top of their priorities.

Photo credit: Yamil Salinas Martínez

Save A Village, Learn About World Pneumonia Day

Mike Smith — 2009-10-30T13:56:00-07:00

Want to learn about Pneumonia? Well it's World Pneumonia Day on Monday, so whether you want to or not, you should: Every fifteen seconds a child dies of pneumonia. In global health terms it doesn't receive the sort of status it deserves — it is not enough of a priority on the global health agenda.

Go and learn about pneumonia with Save the Children's game and interactive quiz — work your way around the map learning about pneumonia and help 'cure' each village. After completing each quiz Save the Children explain the work they're doing to help fight pneumonia. Here's some of what I learned: Pneumonia effects children all around the world, those infected with HIV are more susceptible, with poor nutrition also contributing to the disease. Good hygiene can help prevent pneumonia, but most frightening is that pneumonia kills more children than Aids, malaria and measles combined. Save The Children set up the game to raise awareness by testing your awareness, and helping you learn too.

Pneumonia is the "forgotten killer," and a million deaths a year could be prevented if more children received existing vaccinations. Don't take my word for it: Go and play the game and find out for yourself, or jump straight into the success stories, with Save The Children's contribution saving hundreds of thousands of lives.

Photo credit: Save The Children

Obesity Spreads to Developing World, Bigger Killer Than Being Underweight

Mike Smith — 2009-10-29T06:17:00-07:00

Focusing on five health factors could prevents millions of premature deaths, extending global life expectancy by five years the World Health Organization explained this week. A report explains that poor childhood nutrition, unsafe sex, high blood pressure, alcohol, and bad sanitation and hygiene are responsible for 60 million premature deaths.

One of the most startling parts of the report explains that obesity and being overweight causes more deaths worldwide than being underweight. Even worse, though smoking and obesity is one of the main causes of premature deaths in the developed world, these problems are increasingly occurring in the developed world. Reuters report the morbid death statistics: "high blood pressure (responsible for 13 percent of deaths globally), tobacco use (9 percent), high blood glucose (6 percent), physical inactivity (6 percent), and obesity or being overweight (5 percent)."

The World Health Organization explain that the developing world is now experiencing a double burden — having to deal with poverty and under-nutrition, and increasingly facing simultaneous problems of obesity and high blood pressure. Had these issues been dealt with, life expectancy around the world would be a decade longer.

Photo credit: Nick J Webb

Gates Casts Himself as "Impatient Optimist" in Global Health Speech

Mike Smith — 2009-10-28T18:19:00-07:00

Bill and Melinda Gates continue to raise their voices for global health asking the U.S. government to expand its initiatives, specifically targeting child birth deaths. They're hoping to reduce deaths by one third. The Gates Foundation explained that they would not able to accomplish this goal without the help and resources of the U.S. government. They're hoping to also expand program of immunization and step up the fight against malaria.

On Tuesday Bill and Melinda Gates delivered a major speech which explained that they are "Impatient Optimists." They continue to emphasize the Living Proof project, highlighting individual examples of where U.S. money has improved lives, not just statistics, but millions of individual lives that have been saved and improved.

Global Health isn't just one of Bill and Melinda Gates' pet projects, they've invested heavily themselves, and now are asking for government support, explaining that the investments they propose provide "America's best investment for saving lives." In addition to the speech, Bill and Melinda Gates met with Congressmen, policy makers, and administration officials, demanding that the progress made during the Bush administration not fall victim to budget cuts, and instead be expanding. With the world's richest couple of Global Health's side, we too have an opportunity for some optimism.

Photo credit: World Economic Forum

Delivering Aid By Text Message

Mike Smith — 2009-10-27T13:44:00-07:00

Iraqi refugees living in Syria has begun receiving vouchers for food aid by text message. The UN food vouchers involve 1000 test families who receive a $22 of vouchers every two months. Beneficiaries are able to exchange the texted voucher for cheese, eggs, canned fish, rice, flour etc at certain shops. But phones would cost substantially more though, right? Surely refugees wouldn't have such widespread access to phones.

Incorrect! A World Food Program spokeswomen explained that all 130,000 Iraqi refugees currently receiving food aid in Syria have phones. The UN deliver news about food distribution by phone, and the project just extends that work. The spokeswoman further explained "It also is better for the economies of the communities ... we're not giving food away but we're actually providing an additional market to the local shopkeepers."

A similar scheme has been run in Kenya by Irish aid agency Cocern, they explained "This technology can get the money here in minutes compared with the very difficult logistics of bringing in food." Rather than dumping food aid and putting farmers out of business, vouchers are exchanged for money which is then spent buying food from local farmers. It allows them to stay in business and helps stimulate the economy.

Photo credit: DVIDSHUB

In Choosing Who Survives Flu, Developing World Most Likely To Suffer

Mike Smith — 2009-10-26T12:09:00-07:00

Who gets the most help to fight Swine Flu in a pandemix? Or more to the point, who should you vaccinate first? Frontline health workers are obviously going to be a priority. And as the New York Times explains, when it comes to allocating ventilators to help people breath, in New York state, "The plan aims to direct ventilators to those with the best chances of survival in a severe 1918-like flu pandemic where tens of thousands develop life-threatening pneumonia."

With not enough resources, the Times wonders, who should get a chance at survival? It's morbid, but worth consideration. But the article finds no time to discuss how the rest of the world is fairing, or what we can do to help. We're too busy refusing vaccines that will save lives, endangering more of us, especially those who are already ill, those for who Swine Flu presents the greatest danger.

Dr Margaret Chan, Director-General of the World Health Organization, warned earlier this year that "the developing world, where populations are most vulnerable, should prepare to see more than the present small number of severe cases."

Photo credit: Hmerinomx

Brazil Shows Tremendous Progress in Poverty and Hunger Fight

Mike Smith — 2009-10-24T07:37:00-07:00

Brazil is leading the way in eradicating hunger and improving literacy. The country continues to show significant progress in social development and poverty alleviation. A recent report published by ActionAid saw Brazil top the anti-hunger scorecard, just ahead of China, with India earning low marks. With two African countries finding themselves in the top 5 of the ActionAid report, the indication is that it's not only wealth that matters in fighting hunger.

In Brazil, a 73 percent decrease in hunger has been put down to food banks, community kitchens, land reform, and support for small farmers, winning them the Future Policy Award, whilst Luiz Inácio Lula da Silva, President of Brazil, was awarded the Félix Houphouët-Boigny Peace Prize, in part for his work to reduce poverty.

Brazil isn't just investing in malnutrition prevention. Through the Bolsa Familia (Family Grant) scheme, 12 million poor families receive cash assistance of up to $80 a month. Running since 2003, the scheme asks families to meet several core requirements including ensuring their children attend school, receive vaccinations, and make regular visits to health centers. Having helped half a million children become literate in 2006 and 2007, the program is helping to improve the social and economic standing of low income-citizens. The income transfer scheme has lifted 20 million Brazilians out of poverty since 2003, and offers a lesson to countries around the world.

Photo credit: Andrea Fregnani