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Saving Asia’s Mothers

BANGKOK – With all the talk about the impending “Asian century,” one might imagine that the region had moved beyond what are often viewed as poor-country health challenges, like high rates of maternal mortality. The reality is very different.


In 2015, an estimated 85,000 women died of complications related to pregnancy and childbirth across the Asia-Pacific region – 28% of the global total. Up to 90% of those deaths, which were concentrated in just 12 countries, could have been prevented through quality antenatal, obstetric, and perinatal care.

In the absence of such care, the average maternal mortality rate (MMR) in the Asia-Pacific region is extremely high: 127 per 100,000 live births, compared to the developed-country average of 12 per 100,000. The 12 countries with the highest MMRs, exceeding 100 deaths per 10,000 live births, are Afghanistan, Bangladesh, Cambodia, India, Indonesia, Laos, Myanmar, Nepal, Pakistan, Papua New Guinea, the Philippines, and Timor-Leste.

These countries, together, accounted for about 78,000 known maternal deaths in 2015. The actual figure is probably higher. In fact, MMRs are notoriously difficult to estimate, with conflict, poverty, poor infrastructure, weak health systems, and inadequate resources causing many deaths to go unreported.

MMR data do, however, provide an indication of general trends, which are not promising. Indeed, if they persist, hundreds of thousands of mothers in those 12 high-MMR Asia-Pacific countries alone could lose their lives by 2030.

To be sure, substantial progress has been made in the last 15 years, and efforts are being made to sustain it. The United Nations development agenda, underpinned by the Sustainable Development Goals (SDGs), aims to reduce the MMR to 70 deaths per 100,000 live births by 2030. If that target is met, up to 100,000 lives could be saved across the Asia-Pacific region.

Achieving the goal presupposed faster progress, with annual rates of MMR reduction particularly low (2%) in Papua New Guinea and the Philippines. On current trends, only four of the Asia-Pacific region’s 12 high-MMR countries will be able to meet the SDG target for maternal mortality. The remaining eight will require an average of 26 years.

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At a time when family-planning policies are becoming increasingly restrictive, accelerating the pace of progress could prove difficult. Indeed, for some countries, progress is at risk of slowing.

The UN Population Fund (UNFPA) is working hard to counter this trend. We are committed to ensuring that all pregnancies are safe and wanted, and that all women and girls are empowered not just to make their own choices about their own families and bodies, but also to contribute more to poverty reduction and economic development.

In the 12 high-MMR Asia-Pacific countries, the UNFPA advocates the development of responsive and inclusive health systems with sufficient numbers of trained personnel, from midwives to community-health workers. And we are already working to advance that objective.

In Afghanistan, the UNFPA and its partners have supported the expansion of community health services, including the creation of 80 family health houses and nine mobile support teams. Those initiatives had reached more than 420,000 people by 2015.

In Lao PDR, the UNFPA has helped the Ministry of Health train midwives and village health volunteers to provide basic sexual and reproductive care, providing the information that women need to avoid unwanted pregnancies. This contributed in a steep drop in the MMR, from 450 to 220 per 100,000 live births, between 2005 and 2015.

In Fiji, the UNFPA, with the support of the Australian government, pre-positioned thousands of dignity and reproductive-health kits. Following the devastation caused by Cyclone Winston in February 2016, these strategically placed supplies help to address women and girls’ immediate reproductive-health needs, saving the lives of mothers and children.

But, while such initiatives are already having a powerful impact, more investment must be channeled toward ensuring that comprehensive health services are available and accessible to all, especially the most vulnerable groups. In particular, additional resources must be allocated to sexual- and reproductive-health services – and to ensuring access to them. Strengthening the provision of antenatal care, ensuring safe delivery through skilled birth attendance, and expanding emergency obstetric care are all key interventions that can reduce MMRs across the region.

Of course, women also need access to family-planning services, to help them avoid unwanted pregnancies and reduce the number of unsafe abortions. The rights of all women and their partners to choose the family-planning method that is appropriate for them must be respected, and a full range of quality contraceptives must be readily available to all.

When women have full control over their sexual and reproductive health, society as a whole reaps enormous benefits. In fact, every $1 invested in modern contraceptive services can yield as much as $120 in social, economic, and environmental returns. Such investment should come partly from international development assistance, which must place a higher priority on sexual- and reproductive-health services, and partly from national governments.

But money is not all governments can offer. They can and must develop inclusive policies that address the needs of vulnerable and marginalized groups, including in ways that go beyond the health sector. This includes fighting harmful practices such as child marriage and gender-based violence; removing legal barriers to contraception; and working with communities to address misconceptions around sexual and reproductive health.

Safe pregnancy and childbirth should be a top priority for all societies, as it is for the UNFPA. If we are to meet the SDG target for maternal mortality, we must work together to advance targeted, tailored interventions that respect the rights of women and girls to make decisions about their sexual and reproductive health.

Anderson Stanciole is a Health Economics Advisor at the United Nations Population Fund’s Asia-Pacific Regional Office. Federica Maurizio is Health Economics and SRHR Fellow at the United Nations Population Fund’s Asia-Pacific Regional Office.

By Anderson Stanciole and Federica Maurizio

Lutter contre la mortalité maternelle en Asie

BANGKOK – À l’heure où beaucoup évoquent l’imminence d’un « siècle asiatique », nous pourrions supposer que la région a désormais surmonté les défis souvent associés aux pays pauvres en matière de santé, tels que l’existence de taux de mortalité maternelle élevés. Or, la réalité est tout autre.


Pour l’année 2015, on estime à 85 000 le nombre de femmes décédées de complications liées à la grossesse et à l’accouchement dans la région Asie-Pacifique – soit 28 % du total mondial. Pas moins de 90 % de ces décès, concentrés dans seulement 12 pays, auraient pu être évités grâce à des soins de qualité en médecine prénatale, obstétrique et périnatale.

En l’absence de tels soins, le taux de mortalité maternelle moyen (TMM) dans la région Asie-Pacifique est extrêmement élevé : 127 décès pour 100 000 naissances viables, contre 12 pour 100 000 en moyenne dans les pays développés. Les 12 pays présentant les plus forts TMM, supérieurs à 100 décès pour 10 000 naissances viables, sont l’Afghanistan, le Bengladesh, le Cambodge, l’Indonésie, le Laos, la Birmanie, le Népal, le Pakistan, la Papouasie-Nouvelle-Guinée, les Philippines, et le Timor oriental.

Ces pays représentent ensemble environ 78 000 des décès maternels connus pour l’année 2015, les chiffres réels étant certainement plus élevés. En effet, les TMM sont toujours difficiles à estimer, dans la mesure où les conflits, la pauvreté, le manque d’infrastructures, la fragilité des systèmes de santé, et l’insuffisance des ressources conduisent à l’absence de prise en compte de nombreux décès.

Les données relatives aux TMM fournissent néanmoins une indication sur les tendances générales, qui ne sont pas prometteuses. En effet, si ces tendances se prolongent, plusieurs centaines de milliers de femmes, rien que pour les 12 pays d’Asie-Pacifique aux TMM les plus élevés, pourraient d’ici 2030 décéder en donnant la vie.

Bien entendu, des progrès significatifs ont été accomplis ces 15 dernières années, et nombre d’efforts sont fournis pour pérenniser ces avancées. Le programme de développement de l’ONU, sous-tendu par les Objectifs de développement durable (ODD), vise à réduire le TMM à 70 décès pour 100 000 naissances viables d’ici 2030. Si cet objectif était atteint, pas moins de 100 000 vies pourraient être sauvées dans la région Asie-Pacifique.

L’accomplissement de cet objectif nécessite des progrès plus rapides, la réduction annuelle du TMM étant particulièrement insuffisante (2 %) en Papouasie-Nouvelle-Guinée et aux Philippines. Dans le cadre des tendances actuelles, seuls quatre des 12 pays à TMM élevé de la région Asie-Pacifique pourront atteindre les chiffres ciblés par les ODD en matière de mortalité maternelle. Il faudra en moyenne 26 ans aux pays restants pour y parvenir.

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À l’heure où les politiques de planning familial deviennent de plus en plus limitées, l’accélération du rythme de progression pourrait se révéler difficile. Pire encore, pour certains pays, les progrès risquent de ralentir.

Le Fonds des Nations Unies pour la population (FNUAP) redouble d’efforts pour contrer cette tendance. Nous travaillons pour qu’un jour toutes les grossesses soient souhaitées et médicalement suivies, et pour que toutes les femmes et jeunes filles soient en mesure non seulement de faire leurs propres choix quant à leur famille et à leur corps, mais également de contribuer davantage à la réduction de la pauvreté ainsi qu’au développement économique.

Dans les 12 pays d’Asie-Pacifique aux TMM les plus élevés, le FNUAP aspire au développement de systèmes de santé réactifs et inclusifs, employant en nombre suffisant un personnel formé, allant des sages-femmes aux agents de santé de proximité. Et nous œuvrons d’ores et déjà pour atteindre cet objectif.

En Afghanistan, le FNUAP et ses partenaires soutiennent le développement de services de santé de proximité, notamment à travers la création de 80 maisons de santé destinées aux familles, et de neuf équipes mobiles d’assistance. De leur mise en place jusqu’en 2015, ces initiatives ont permis à plus de 420 000 personnes de bénéficier d’une aide médicale.

Au Laos, le FNUAP a aidé le ministère de la santé à former des sages-femmes et des bénévoles intervenant dans les villages pour fournir les soins les plus essentiels en matière sexuelle et reproductive, et apportant aux femmes les informations leur permettant d’éviter des grossesses non souhaitées. Ces démarches ont contribué à une importante réduction du TMM, qui est passé de 450 à 220 décès pour 100 000 naissances viables entre 2005 et 2015.

Aux îles Fidji, avec l’aide du gouvernement australien, le FNUAP a distribué plusieurs milliers de kits d’hygiène et de santé reproductive. Après le désastre provoqué par le cyclone Winston en février 2016, ces stocks stratégiquement déployés ont contribué à répondre aux besoins immédiats des femmes et jeunes filles en matière de santé reproductive immédiate, et à sauver la vie des mères et de leurs enfants.

Bien que ces diverses initiatives produisent d’ores et déjà d’importants résultats, il est nécessaire que davantage d’investissements soient déployés pour faire en sorte que des services de santé complets soient disponibles et accessibles pour tous, en particulier pour les catégories de population les plus vulnérables. Il est notamment important que des ressources supplémentaires soient allouées aux services de santé sexuelle et reproductive, d’une manière qui garantisse à tous un accès à ces services. Le renforcement de la fourniture de soins en médecine prénatale, la possibilité d’accouchements sûrs via un encadrement médical, et le développement de la médecine obstétrique d’urgence sont autant d’aspects fondamentaux sur la voie d’une réduction des TMM dans la région.

Bien entendu, les femmes doivent également pouvoir accéder à des services de planning familial, afin qu’elles puissent éviter les grossesses non souhaitées, et que le nombre d’avortements pratiqués dans des conditions dangereuses puisse diminuer. Le droit de toutes les femmes, et de leur partenaire, de choisir la méthode de contraception qui leur convient doit être respecté, de même qu’une gamme complète de contraceptifs de qualité doit être facilement accessible pour tous.

Lorsque les femmes ont pleinement le contrôle de leur santé sexuelle et reproductive, la société dans son ensemble en bénéficie considérablement. En effet, chaque dollar investi dans les services modernes de contraception peut produire jusqu’à 120 $ de rendement sur le plan social, économique et environnemental. Il est nécessaire qu’un tel investissement émane en partie de l’aide internationale au développement – à laquelle il incombe d’accorder une plus grande priorité aux services de santé sexuelle et reproductive – et en partie des gouvernements nationaux.

Mais certains gouvernements peuvent agir au-delà des considérations financières. Ils sont en capacité, et dans l’obligation morale, d’élaborer des politiques inclusives consistant à répondre aux besoins des catégories vulnérables et marginalisées, y compris au-delà du secteur de la santé. Interviennent ici la lutte contre les pratiques préjudiciables telles que les mariages d’enfants ou les violences sexistes, la levée des barrières légales à la contraception, ainsi qu’un travail auprès des communautés pour remédier à la méconnaissance des aspects de santé sexuelle et reproductive.

Grossesse et accouchement sans danger doivent s’inscrire au plus haut des priorités de toutes les sociétés, comme c’est le cas pour le FNUAP. Si nous entendons atteindre la cible des ODD en matière de mortalité maternelle, il nous faut œuvrer dans le cadre de démarches orientées et adaptées aux situations, qui respectent le droit qu’ont les femmes et les jeunes filles de prendre leurs propres décisions quant à leur santé sexuelle et reproductive.

Traduit de l’anglais par Martin Morel

Anderson Stanciole est conseiller en économie de la santé au sein du bureau régional Asie-Pacifique du Fonds des Nations Unies pour la population. Federica Maurizio intervient en économie de la santé, ainsi qu’en droits des femmes en matière de santé sexuelle et reproductive, au sein du bureau régional Asie-Pacifique du Fonds des Nations Unies pour la population.

Par Anderson Stanciole et Federica Maurizio

House reviews Code of Conduct

The controversial Code of Conduct shockingly surfaced on the agenda of the House of Representatives for revision on Tuesday, 4 April; roughly a month after Liberia’s Supreme Court endorsed the instrument as being legal.


It is not yet clear who submitted the Code of Conduct and for what purpose, but lawmakers in the chambers appeared to be in the know of the reappearance of the Code of Conduct which was passed since 2013.

Though, the agenda of the lawmakers did not reveal anything as it relates to the appearance of the controversial Code of Conduct, House Speaker James Emmanuel Nuquay’s leadership reverted to executive session apparently to discuss the act which has created tension among politicians that are vying for elected posts.

Information gathered within the corridors of the House of Representatives Tuesday, 4 April suggests that some influential politicians and stakeholders are appealing to Liberian lawmakers to amend some portions of the Code of Conduct to avoid tension here ahead of the 2017 Representatives and Presidential elections.

In 2009, the Executive Branch of Government submitted a bill to the Legislature to have a National Code of Conduct passed into law. The instrument prescribes activities of public officials.

After languishing at the Capitol for nearly five years, the Code of Conduct was ratified by lawmakers, subsequently signed by the President and took effect since 2014. The Code received huge public commendations especially provisions regarding the conduct of public officials who many see here to be flouting the laws.

But there are criticism however that the Code of Conduct is allegedly being violated by some officials appointed by the President, over claims that they are now actively participating in politics while still serving in appointed officers.

At the ongoing national convention of the ruling Unity Party, several presidential appointees actively took part in political activities, with some being elected to party positions.
Part V of the Code of Conduct prohibits all officials appointed by the President from taking part in active politics. It says all officials appointed by the President shall not engage in political activities, canvass or contest for elected offices.

The intent of the instrument is to prevent the use of government facilities, equipment or resources in support of partisan or political activities by officials who may be seeking elected jobs.

They are not also allowed to serve on a campaign team of any political party, or the campaign of any independent candidate while still serving on appointed jobs.
Notwithstanding, appointed officials who seek to contest for elected offices are required to resign from the appointed offices two years ahead, while those holding tenured jobs are to resign three years ahead of such elections.

By E. J. Nathaniel Daygbor-Editing by Winston W. Parley

Clinical training course in Liberia

The Joint West Africa Research Group or JWARG Monday began a week-long clinical training course in tropical and emerging infectious diseases for clinicians and lab professionals in Monrovia.


A press release issued in Monrovia says the training will help strengthen clinical skills needed to enhance research capability in West Africa.The 2014 Ebola epidemic highlighted gaps in local and regional disease data, research capabilities, and resources available to address epidemics in West Africa.

The course will include training on several specific diseases of concern in Liberia, including Ebola, Lassa fever, malaria, typhoid, and HIV, as well as training on sepsis from any cause, the release says.

Lectures will also address clinical response to infectious disease threats, including diagnostics, prevention, treatment and ethics. Students include clinicians from Liberia, Ghana, and Nigeria who are partnering with JWARG to conduct research.

Physicians and scientists from JWARG’s partner institutions in West Africa and the United States are teaching the course. “This initiative is a unique collaboration between military and civilian partners in West Africa,” said U.S. Ambassador Christine Elder. “Each group brings unique perspectives and strengths to the table, enabling the Group to develop strategies and capabilities that will help prepare the region for future disease outbreaks.”

The training follows on the establishment of Liberia’s first clinical microbiology lab in 40 years at Phebe Hospital, implemented in late 2016 with support from JWARG. Prior to that, Liberia had no advanced microbiology diagnostic capabilities.

This improved capability is critical to the management of infectious diseases. JWARG efforts in Liberia will also enhance the capabilities of West African physicians, scientists, and institutions to conduct clinical research, build and strengthen research capabilities in the region.

It is also expected to provide an effective surveillance mechanism, develop effective countermeasures and also broaden understanding of relevant infectious disease threats. A local partner, Africabio Enterprises, Inc., supports JWARG efforts in Liberia.
--Press release

Gov’t unprepared for chiefs’ elections

The Senate Committee Chair on Internal Affairs, Good Governance and Reconciliation, Nimba County Senator Sumo Grupee says government is not prepared at this time to underwrite the cost of conducting elections for Liberia’s Traditional Council of Chiefs while the country is also faced with conducting presidential and representative’s elections.


Sen. Grupee announced the postponement of the chiefs’ elections when he appeared on a local radio talk - show over the weekend, following a longstanding opposition that has encountered Chief Zanzan Karwah’s administration in demand for his replacement.

Sen. Grupee had said his committee received two petitions, one calling for the establishment of an interim administration that would lead the council to elections, while the other called for the postponement of the exercise to a later date.

After reviewing the two petitions, Sen. Grupee said it was not feasible to conduct elections for the Council considering the fact that the national elections were in full swing.

A key obstacle cited as justification for postponing the Council’s election was that government would be required to make budgetary allotment to facilitate the process.

While announcing that his comments personal and not for the Senate Committee that he chairs, the Nimba County Lawmaker said he believed that the Karwah led-administration should hold onto power until at such time when the government has concluded with the conduct of the national elections which he says are cost intensive.

He suggested that following the national elections, government would be in the position to galvanize the needy financial resources to fast track the chiefs’ electoral process.


Meanwhile, Sen. Grupee has raised concerns that there are no clear criteria as to who is an elder, noting that most of the local government officials were appointed by the President and not elected by the people.

He cited alleged violation of elections laws here which called for the holding of “chiefdomship” elections for local government officials working under the Ministry of Internal Affairs or MIA, claiming that the National Elections Commission or NEC was not adhere to such laws.

Sen. Grupee concluded that the Council was not accountable to any board or the MIA due to the absence of a Board of Directors.
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Rebuilding the World’s Forests

OXFORD – Humankind has always had a tricky relationship with forests. We depend on them to regulate the climate and rainfall, clean our air and water, sustain myriad species of plants and animals, and support the livelihoods of over a billion people. Yet we continue to destroy them, to the point that only half the world’s original forest cover remains.


The price of deforestation can hardly be overstated. Trees consume large amounts of carbon dioxide as they grow, making them vital tools for absorbing the greenhouse-gas emissions – from cars, factories, power stations, and livestock – that result in climate change. If we continue to lose forest cover, the Paris climate agreement’s goal of limiting global warming to less than two degrees Celsius (above pre-industrial levels) by 2050 will be impossible to achieve. In fact, to meet that target, we will need to restore a significant amount of forest cover that is already gone.

There are two ways to approach reforestation. The first is to allow agricultural lands to fall into disuse, and then wait for them to revert naturally to forest. This wouldn’t cost much, but it would take decades. The second option is more proactive: plant billions of new trees.

As part of the New York Declaration on Forests, signed in 2014, governments pledged to restore hundreds of millions of hectares of forests. But, with most governments short on cash these days, financing the pledge has proved challenging. Against this background, we must try to engage the private sector to deliver the needed investment.

When forests have an economic value, they are more likely to be cultivated than destroyed. And, indeed, trees have been cultivated for profit for millennia. Today, productive forests cover an area of more than a billion hectares, or about one-quarter of the world’s forested land.

Such forests produce fuelwood, which accounts for about half of tree removals. They also produce materials for clothes, oils for soaps and lubricants, fruits, and other foods, such as cocoa. Demand for these products is growing, though not as fast as demand for newspaper print falls as a result of computerization.

How can demand for forest products be increased? A promising opportunity lies in construction.

Timber has always been an important building material, and remains so for residential construction in places like the United States, Scandinavia, and parts of Southeast Asia. But most buildings today are constructed using bricks and mortar, concrete, and, for larger structures, steel – all materials that produce substantial carbon emissions during the manufacturing process.

While it is unlikely that timber can fully replace any of these materials, new types of engineered wood are making it more competitive. One of these is cross-laminated timber (CLT), which is made by gluing together layers of wood to create panels that are as strong as steel or concrete, and thus can replace those materials in buildings.

More research is required to determine the precise benefits of using timber to cut CO2 emissions. One estimate comes from architect Anthony Thistleton-Smith, one of the United Kingdom’s leading experts on wooden buildings. He recently noted that, whereas a typical British home has a carbon footprint of around 20-21 tons, a CLT home has a negative footprint of 19-20 tons. In other words, every home built with CLT saves 40 tons of CO2 emissions. If the 300,000 new

homes targeted for completion in the UK this year were built using CLT, it would be like taking 2.5 million cars off the road. The climate benefits could be massive.

As with so many climate measures, cost can be a major barrier to implementation. And, according to a United Nations report, CLT is more expensive than concrete in Europe. But CLT is still in its infancy, with only a handful of factories in operation. As the CLT supply chain develops, costs will inevitably fall, as has happened with renewable energy.

Moreover, builders report that the total costs of building with CLT already end up similar to those of building with concrete, because it takes less time. After all, unlike concrete, CLT doesn’t need time to set.

Of course, delivering such a transformation will not be easy. Vested interests – pressure from industries producing traditional building materials – must be overcome, including by ensuring a level playing field in terms of subsidies. Furthermore, public concerns – for example, regarding fire safety or infestation prevention – must be addressed, and builders will have to learn new skills. Most important, monitoring will have to be improved considerably, so that increased demand does not result in more deforestation.

For many countries, the economic opportunities should be sufficient to make addressing these challenges worthwhile. New plantations could regenerate rural areas, as new factories created opportunities for investors and entrepreneurs. Governments and larger companies would be able to tap the fast-growing green-bond market to fund the early transition, including the creation of systems using drones and satellite imaging to monitor for unsustainable forestry practices.

Opportunities to align economic development with the reduction of greenhouse-gas emissions are rare. Yet that is what reforestation offers. We must take advantage of this opportunity, by pursuing a construction transformation based on restoring trees, the world’s most effective carbon-capture tool. In this “new age of timber,” we would grow wood, build with wood, and allow our forests to thrive.

By Justin Adams

Power outage disrupts House’s regular session

Regular session at the House of Representatives on Tuesday,7 March was interrupted due to power failure. Lawmakers had gathered Tuesday in the Chamber of the House ofRepresentativesto conduct normal business as usual when the currentsupplying the Capitol Building abruptly went off.



After waiting for some time, Speaker J. Emmanuel Nuquay instructed the Chief Clark of that august body to announce that there willbe no session because of power outage.
Reporters at the Capitol went to the Chief Clark’soffice to take a look at the agenda for the day, but a staffin the office said the agenda was about to printed when power failed, sothere was no way to have it printed.

This is the second time in less than a month lawmakers in the House ofRepresentatives have abruptly closed session due to lack of power since they returned from annual break and the start of the voter’s registration process here.

The 1986 Constitution of Liberia mandates members of the legislatureto meet every Tuesday and Thursday to conduct official business, butthat have not been the case for 24 of February and the March 7,2017, respectively.

By Bridgett Milton-Editing by Jonathan Browne

Pres. Sirleaf receives new Irish envoy’s Letters of Credence

President Ellen Johnson Sirleaf has received the Letters of Credence of the new Ambassador Extraordinary and Plenipotentiary of the Republic of Ireland, H.E. Catherine Campbell. President Sirleaf recounted the longstanding Liberia-Ireland relationship culminating in Ireland’s support in the areas many sectors of Liberia’s development processes.


According to an Executive Mansion release, President Sirleaf noted that it is interesting to see how far Liberia-Ireland relationship has come as well as the role of Irish missionaries deployed to Liberia many years ago to spread the gospel of Christ through the Catholic Church. “The civil interrupted the relationship before your return in 2003. Since then, Ireland has helped greatly with Liberia’s peace keeping and peacebuilding efforts in a strong way. We vividly remembered your gallant troops deployed with UNMIL and we remain grateful”, President Sirleaf said.

President Sirleaf also praised Ireland for helping with the education of the young people of Liberia by sponsoring several Liberians at GIMPA in Ghana and personally thanked the new Ambassador for her participation in the recently held International Women’s Colloquium in Monrovia.

“Liberia has had very difficult times, but 12 years of peace since the conflict ended is good for us as a nation and people. It has helped us improve governance, built infrastructures and bring general development to the people; this is a process that Ireland has been involved with and we thank you for that”, the Liberian leader concluded.
Responding, the Ireland Ambassador presented warm greetings from the President and people of Ireland. She personally acknowledged President Sirleaf’s leadership in peacebuilding, fight for justice and the battle against Ebola.

“Your personally achievements as well the what has been achieved by Liberia under your leadership is purely remarkable. You have promoted sustainable development and your country has made a lot of progress”, she noted. She assured President Sirleaf of her readiness to work with Liberia in the next few years, promising to strengthening the already strong relationship.

The Mispriced Risk of Infectious Diseases

NEW YORK – Global business leaders and investors are largely transfixed by two kinds of risk: macroeconomic and geopolitical. In the near term, this means a focus on the US Federal Reserve’s impending rate hikes and the upcoming elections in France and Germany. Over the longer term, it means awareness of structural risks like high sovereign debt, demographic shifts, and natural-resource scarcity. But there is a third, arguably more pernicious, risk lurking below most decision-makers’ radar: infectious diseases.


According to the former director of the US Centers for Disease Control and Prevention, Tom Frieden, the world is at greater risk than ever from global health threats. People travel farther and more often. Supply chains, including for food and medicines, extend across the world. A poorly treated case of, say, tuberculosis (TB) in Asia or Africa can present in a hospital in the United States within days.

Against this background, scientists are concerned about the recent uptick in epidemics of diseases such as Zika, Ebola, and avian flu. And they are alarmed by the resurgence of life-threatening diseases such as influenza, HIV, malaria, and TB.

To be sure, in terms of fatalities, recent disease outbreaks and pandemics are a far cry from past global flu epidemics. Whereas the 2003 SARS epidemic resulted in 774 deaths, and the Ebola outbreak of 2014-2015 left 11,310 dead, the 1918-1920 flu epidemic claimed the lives of 100 million people – more than five times the number killed in the world war that had just ended. Indeed, some 5% of the world’s population perished.

But the risks from infectious diseases that we face today could intensify substantially, owing to the rise of anti-microbial resistance (AMR). According to the World Health Organization, “480,000 people develop multi-drug resistant TB each year, and drug resistance is starting to complicate the fight against HIV and malaria, as well.” Antibiotic resistance, the WHO cautions, is now present in every country, putting patients at risk of worse clinical outcomes and at greater risk of death, while increasing the burden on health systems.

England’s chief medical officer, Sally Davies, has warned that, if left unchecked, the growing impotence of drugs could be catastrophic. By 2050, she estimates, drug-resistant infections could be killing someone “every three seconds.” The Review on AMR estimates that, at that point, some ten million lives could be lost each year, at a cumulative cost to global economic output of $100 trillion. To put that into perspective, world GDP today totals $74 trillion per year.

Yet the potential long-term human and economic consequences of AMR of are not widely appreciated by the public and, in particular, by financial markets. In fact, protection from public health threats is one vital area where markets do not deliver efficiently. As a result, it is governments that usually bear the costs of prevention and treatment.

With government budgets already overstretched, coping with the intensifying health burden from AMR will be difficult, to say the least. Yet governments are unlikely to move fast to mitigate this risk. On the contrary, experience indicates that governments often struggle to align public spending with underlying or mounting problems, such as public-health threats, until they reach a crisis point.

More people died of cancer in the US last year than in combat. In fact, last year’s 580,000 cancer deaths exceed the roughly 430,000 battle deaths, on average, in World War I, World War II, the Korean War, the Vietnam War, and the Gulf War. Yet government spending on cancer averages approximately $4 billion per year. That is just over 0.5% of the annual military budget of roughly $718 billion.

Of course, government budget-allocation decisions are complicated and dogged by political imperatives. The US military employs some three million people, making it the single largest employer in the world, and there is substantial political pressure from some constituencies to place the highest priority on America’s military dominance.

But it is not just a matter of how much is spent; it is also a matter of when. Governments don’t wait for war to break out before investing in the military. Yet they do tend to wait for crises to erupt before they invest in fighting infectious diseases.

The world spent $15 billion on its emergency response to the SARS epidemic and $40 billion on its response to Ebola. In 1918, the crisis response to the flu pandemic cost some $17.5 trillion. Had countries spent more on mitigating the risk of such disease outbreaks – for example, by fortifying their health-care systems and promoting responsible use of antibiotics – those huge emergency payouts may not have been necessary. At the very least, they probably would have been smaller.

In this sense, the fight against infectious diseases closely resembles the fight against climate change. Though the threat is substantial, it is not immediate, so governments continue to pursue other priorities, allowing the threat to grow, largely out of sight. As a result, it is not adequately priced into the markets.

When the crisis finally erupts, the true scale of the threat will become clear. But by that point, it will be much more difficult and expensive to contain, resulting in far more casualties. Unfortunately, that point may be closer than anyone – government or investor – expects. Dambisa Moyo, an economist and author, sits on the board of directors of a number of global corporations.

By Dambisa Moyo

Trump’s Gift to China

NEW YORK – US President Donald Trump’s protectionist threats against China have spurred much concern. If he follows through on his promises and, say, officially labels China a currency manipulator or imposes higher import tariffs, the short-run consequences – including a trade war – could be serious. But, in the longer term, a turn toward protectionism by the United States could well be a blessing in disguise for China.


There is no doubt that China is going through a difficult phase in its development. After three decades of double-digit GDP growth – an achievement with few historical parallels – the pace of China’s economic expansion has slowed markedly. The combination of rising labor costs and weaker demand for Chinese exports has reduced China’s annual GDP growth to 6.9% in 2015 and 6.7% last year. The Chinese government has now lowered its growth target for 2016-2020 to 6.5-7%.

This is still a respectable pace; but it is not the best China could do. As Justin Yifu Lin and Wing Thye Woo have noted, in 1951, when Japan’s per capita income relative to that of the US was the same as China’s is today, Japan was experiencing sustained growth of 9.2%.

One impediment to such growth for China is a heavy debt burden. A stress-test analysis by the McKinsey Global Institute found that if China continued to pursue its debt- and investment-led growth model, the ratio of nonperforming loans could rise from 1.7% today (according to official figures) to 15% in just two years. That said, the risk of NPLs is not news to the People’s Bank of China, which will, the evidence suggests, take steps to mitigate it.

Unfortunately, debt isn’t China’s only problem. Its dominance in global exports – the main engine of its growth in recent decades – has eroded. India’s trade-to-GDP ratio overtook China’s last year. And, while labor productivity is rising steadily in China, it remains less than 30% of advanced-country levels.

Given these challenges, it may seem strange to assert that China may now be on the verge of ascending to a new level of global influence. But, because of Trump’s policy approach, China has a new and important opportunity to do just that.

While trade and capital flows require regulation, openness, on balance, does vastly more good than harm. Trump’s “neo-protectionist” policies – which aim to limit the flow of goods, services, and people to the US – are rooted in nothing other than myopic xenophobia. In the end, this will isolate the US far more than China or Mexico.

History bears this out. On the eve of World War I, Argentina was among the world’s wealthiest countries, behind the US, but ahead of Germany. Since then, Argentina’s economy has deteriorated substantially for two reasons: inadequate investment in education (a mistake that Trump may also make) and heightened protectionism.

The rise of nationalism in the 1920s culminated in 1930, when far-right nationalist forces overthrew Argentina’s government. The new government – which was bitterly opposed to liberalism, not to mention foreigners – raised tariffs sharply in several sectors. On average, import tariffs rose from 16.7% in 1930 to 28.7% in 1933. Jobs in traditional sectors were saved, but productivity declined. Today, Argentina is not even among the top 50 economies worldwide.

So Trump’s policy approach can be expected to do great damage to the US economy and have far-reaching implications, given America’s prominent global role. But self-imposed economic isolation, combined with an inward-looking “America first” foreign-policy approach, will also create space for other countries – including China, India, and Mexico – to increase their own international clout.

Consider Trump’s withdrawal from the Trans-Pacific Partnership, the mega-regional trade deal involving 12 countries in the Asia-Pacific region, but not China. The TPP certainly had its flaws – not least that it would have conferred disproportionate and unfair benefits on large corporations. But it had plenty of redeeming qualities, and was being celebrated in countries like Malaysia and Vietnam for the access it would give to the US market.

Now that the rug beneath these countries’ feet has been pulled out, China can lend a helping hand. Already, China has boosted its regional investments considerably, including through its “one belt, one road” initiative. Without the TPP facilitating capital flows among its member countries, China is likely to overtake the US as the largest source of foreign direct investment for the ASEAN countries. China is also seeking to deepen its economic ties with TPP signatories Australia and New Zealand.

Likewise, China has seized the opportunity afforded by Trump’s ill-conceived plan to build a wall on the US border with Mexico to reach out to America’s southern neighbor. Just over a month after Trump’s election, Chinese State Councilor Yang Jiechi met with Mexican Foreign Minister Claudia Ruiz Massieu, pledging to deepen diplomatic ties and increase flight connections and trade. China is already Brazil’s top trading partner. It can now aim for the same position in Mexico, and perhaps all of Latin America.

As Trump adopts increasingly closed-minded and xenophobic rhetoric, Chinese President Xi Jinping is toning down his nationalist language and sounding increasingly like a global statesman. China, he seems to recognize, now faces the chance not just to achieve another round of economic expansion, but also to secure a far more prominent role in global decision-making and policy. Kaushik Basu, a former chief economist of the World Bank, is Professor of Economics at Cornell University.

By Kaushik Basu

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