India Becomes Front for Terror; Russia Responds to U.S. Missile Plan

To accommodate the increasing visibility of the Rising Powers on the world stage in recent weeks, this post needs a double focus.  If you want to read the full discussion, be sure to click “Read the rest of this entry” below.

First, we are all at this point familiar with the tragic events in India over the week.  As India becomes a front for the “war on terror,” it is going to face heightened tensions with Pakistan and a reevaluation of its identity.

Should President-Elect Barack Obama engage early-on with the Pakistani government to uproot terrorists out of the lawless regions?  Will the events in Mumbai allow a change in the status quo to allow for such an incursion?  Will India threaten to move militarily against Pakistan?  All of these are vital questions for the coming weeks.

Also, in direct response to U.S. policy to build missiles in Poland, Russia announced plans this week for a counter-missile installation.  Obama will need to decide whether Russia is merely posturing, whether they will install the new missiles no matter what in a sort of power grab, or whether the U.S. needs to change policy in response.

While the move by the Russians is simply another move toward intimidating President-Elect Obama into backing away from the missile shield, it is an important signal that the pressure will not recede by the time Obama takes office, and he needs to have a firm plan ready to go on day one to deal with this flare up.

Although these are the biggest stories coming out of the world of the Rising Powers this week, there is plenty of other stuff to catch up on.  Next week, I will be profiling the role of the Rising powers in the World Trade Organization talks, and how the global economic crisis is bringing the world together in important ways.  Be sure to check back on Mondays for the weekly recap of the world’s Rising Powers and U.S. foreign policy.

A Message from Rep. Jim McDermott on World AIDS Day

“We Must Never Forget and Never Relent in Our Fight Against AIDS”
Rep. Jim McDermott (D-WA)
World Aids Day, December 1, 2008
Original source:  Huffington Post Article

World Aids Day is a day to bear witness, to celebrate the progress we have made and to re-dedicate ourselves to the fight by telling our own personal stories. When experiences are shared from every corner of the globe, we remind the world of the urgency to act, and we renew our faith in the belief that one day soon we will eradicate the AIDS pandemic.

I witnessed the first outbreak of the AIDS pandemic in the 1980s in Africa. As a physician and psychiatrist in the U.S. State Department, I traveled across the African continent serving U.S. missions and working with local leaders. At the time the AIDS virus was largely unknown and mysterious, and it spread with stunning and devastating ferocity from country to country, killing millions.

One couldn’t help but feel a sense of helplessness, but many of us resolved to fight this scourge from whatever vantage point we occupied. For me, that was the U.S. House of Representatives, which I entered in 1989. At the urging of then-Speaker Thomas S. Foley, I co-founded a congressional caucus on HIV/AIDS. It gave America a platform in which to educate and organize Congress against the threat.

Congressional colleagues representing every political viewpoint across America spoke with one passionate and determined voice to ensure that we would lead, not merely respond to this global crisis. And we have. Led by the United States, the world has gained ground against AIDS, inch by inch, but inextricably forward.

In 2003, an estimated 50,000 people in Sub-Saharan Africa were receiving antiretroviral treatments to fight AIDS through various programs. Then, the U.S. launched PEPFAR, the President’s Emergency Plan For AIDS Relief, to urgently concentrate our efforts and it has been a tremendous success. Today in Sub-Saharan Africa, 1.7 million people are being treated, and we have provided care for almost seven million worldwide.

What’s more, our commitment remains strong. A few months ago, Congress passed and the President signed into law a PEPFAR re-authorization bill that takes major steps forward. It includes provisions I co-authored to strengthen our efforts to prevent mother-to-child transmission of HIV, and to significantly increase the number of infected children who will receive treatment. Every day, 1,000 children are born into the world infected with AIDS, and we believe this new legislation will cut that number in half.

Still, many of us are concerned. We fear the global economic crisis will jeopardize the life-saving success. Last year, the World Bank warned that poverty is much greater than previously estimated: 1.4 billion people worldwide live on about a dollar a day. And this alarm was sounded largely before the current economic crisis had unfolded. We have to address global poverty as part of our commitment to eradicate AIDS.

Furthermore, we know that the developed world is enticing trained personnel to relocate to meet our medical needs, but this leaves fragile and vulnerable developing countries dramatically short of healthcare professionals. Unless we address this shortage globally, we will undermine on one hand the very health and humanitarian efforts we support on the other hand.

There is no easy solution to the AIDS crisis, but there is a path to hope and those who have walked it, as I have, know that awareness unites the world. That’s why watching a PBS documentary like “We Will Not Die Like Dogs,” by filmmaker Lisa Russell, is so important. It can be seen at: www.SnagFilms.com. Many do not realize the impact AIDS is having on women and children worldwide, but the film will open our eyes and that is a major step forward.

We all hope for the day when medical research discovers an AIDS vaccine and it will come. Until then, we must never forget that we honor those who have died by fighting for those who are alive and for those yet to be born. In the final analysis, the shield that can protect us is our humanity that unites us.

Misoprostol – A Cost-Effective Way to Save Women’s Lives

On Monday, I was incredibly blessed to be able to witness the birth of my new baby sister. While labor and delivery is always a nerve-wracking experience, I was reassured knowing that my mother and sister were able to receive the best possible medical attention. Walking around the hospital in the “Mother and Baby” wing, my father joked that the hospital was one indoor pool away from being a holiday resort.

Although, when compared to other developed nations, the U.S. actually lags behind in maternal mortality rates, the lifetime risk of an American woman dying from pregnancy-related causes is about 1 in 4,800, as of 2005. In Niger that number is closer to 1 in 7. In fact, over 99% of all maternal deaths occur in the developing world, and 84% are in sub-Saharan Africa and South Asia alone. Due to poor medical conditions, high fertility rates, teenage pregnancies, unmet need for contraception and several other factors, 1,440 women will die from pregnancy-related causes today.

Unfortunately, bringing the level of care that my mother received during her pregnancy, labor and deliver to all women would be unreasonably expensive and impossible considering the state of the healthcare system in many developing nations. Nevertheless, there is a cost-effective and simple solution available right now to help reduce the risk of maternal mortality and morbidity in regions where there is a lack of access to adequate medical services.

Misoprostol is a drug that can be administered orally and stimulates uterine contractions (although the drug’s labeled use is for the treatment of gastric ulcers). This mechanism can induce abortions in early stage pregnancies, induce labor in full-term pregnancies and reduce the risk of postpartum hemorrhaging (PPH), the leading cause of maternal death in Africa and Asia. Because this drug can be used for inducing abortions, many countries, including several in sub-Saharan Africa where the drug would be the first option to prevent PPH in a resource-limited setting, have not approved the sale or use of misoprostol. Fortunately, it seems that some countries are catching on and misoprostol has been recently approved in Uganda, Nigeria and Ethiopia for the prevention of postpartum hemorrhaging.

Research has shown that a single dose of misoprostol, costing only $1, at the time of delivery can half the risk of postpartum hemorrhaging, when compared to a placebo group. The low cost of misoprostol, combined with the easy administration of the drug, makes it an effective method to save the lives of women all over the world. One dollar is a very small price to pay to ensure the health of a new mother and her baby. Hopefully the medical necessity of using misoprostol will overcome the ideological challenges that the drug currently faces.