By Emily Hoch
On Monday, as locals flock to successive showings of Contagion, the United Nations General Assembly will meet in New York for its second ever high-level meeting on health, on the comparably mundane topic of non-communicable diseases (NCDs): heart and chronic respiratory disease, diabetes, and cancer, among others. With all the high-drama causes out there, it might seem odd that the U.N. is focusing its attention on what are typically considered codas to the lives of the rich and the elderly. But NCDs have become a universal threat. They kill three in five people a year, and 80 percent of the victims in 2011 will live in developing countries. Roughly a third will be younger than 60. Even larger numbers of people are living disabled by these illnesses.
As such, low- and middle-income countries are facing what demographers call a double burden: Policymakers must balance prevention and treatment of diseases typical of the young and impoverished, such as diarrhea, pneumonia, and malaria, with stemming an NCD pandemic that the World Health Organization predicts will increase deaths by 15 percent by 2020. And despite the announcement today that Ely Lilly will donate $30 million to developing-country diabetes research, only 3 percent of all development assistance for health (worth a total of $22 billion) is dedicated to NCDs.
The only other U.N. General Assembly meeting on health was the 2001 session on HIV/AIDS, a turning point in the struggle to curtail that pandemic. Since 2001, billions of dollars have been spent on HIV/AIDS prevention and treatment, and almost every country includes an action plan for HIV/AIDS in their policy framework. The biggest achievement of the HIV meeting was the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has been lauded for reducing the human burden of these maladies while improving efficiency and country-level leadership.
A Declaration of Commitment on NCDs is likely this time around, too, and countries, activists, and corporations have found common ground on low-cost interventions. But real action is likely years away. While many in the global health community want to expand the Global Fund's mandate or to establish funds for other causes, neither of these options is likely. Experts have concurred that a new institution or funding pledge might distract cash-strapped governments from key tasks, such as strengthening overall health systems and regulating risk factors, including changes in the food and beverage industry. Instead, the United Nations will probably encourage member states to insert line-items for NCDs in their health budgets, develop national NCD plans, and take a strong stand on prevention.
Even there, the challenges will be considerable. In nearly every country, the sale and distribution of tobacco, alcohol, and unhealthy foods -- key risk factors for NCDs -- is big business. Governments dependent on tax revenue from the sale of these products may be hesitant to compel their citizens to change their lifestyles. China recently passed its first smoking ban, for example, but the state-owned China National Tobacco company generated $76 billion in taxes and profit for the country in 2010. Russia, the number three beer-consuming nation (after China and the United States), delayed any attempts at improving behavior by only recently classifying beer as alcoholic. And in Brazil, where 40 percent of the population is overweight and 10 percent is obese, the government has been accused of welcoming Nestle plants and micro-distribution networks that specialize in fatty and salty foods. So while the U.N. meeting next week is a significant step forward, as with losing weight, these changes will take years (if not decades) to implement.
Emily Hoch is an associate in Eurasia Group's global health practice.
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By Philippe de Pontet
On Sunday, Goodluck Jonathan was sworn in as the fourth president of Nigeria, guarded by security personnel and shadowed by the country's double-digit inflation. He's not alone. Rising food prices threaten governments across Africa, where food costs consume more than 50 percent of urban dwellers' average incomes. A handful of countries face a heightened risk of unrest as a result, and in a year of multiple elections, incumbents will struggle to cling to power. That said, the intensity of the threat varies widely across the continent, and the widespread upheaval rocking the Middle East isn't in the cards. Here's a cheat sheet for the continent:
Philippe de Pontet is head of Eurasia Group's Africa practice.
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By Philippe de Pontet and Anne Fruehauf
The price of your favorite chocolate treat may not have gone up yet, but there is a real chance it will, despite the resolution to the impasse in Cote d'Ivoire, the world's leading exporter of cocoa. The arrest of former President Laurent Gbagbo after a four-month standoff significantly improves the prospects for a full resumption of cocoa exports. But there are still significant political and logistical hurdles that could affect how much you'll pay for a candy bar.
The immediate situation in commercial capital Abidjan is broadly reassuring. Gbagbo urged his supporters to stand down while the incoming President Alassane Ouattara struck a note of national reconciliation in his address to the country. These developments, together with the presence of about 10,000 U.N. peacekeepers, should limit regime-threatening instability, despite the charged atmosphere and the presence of armed militias that represent a potential source of unrest. There was further positive news on April 13 when the Ivorian government reported that the nation's two main ports would reopen and that cocoa exports would resume within days.
But there are several obstacles to the resumption of full exports that some observers may be missing. Even though the EU and Ouattara have lifted their export bans, cocoa revenues have long been funneled to Gbagbo's cronies. The incoming government will want to ensure that cocoa sales do not enrich the ex-president's associates at the expense of the state. That sets the stage for potentially disruptive reforms to the industry.
The other factor is the security situation both in Abidjan and in the restive western regions where most cocoa is produced. Cote d'Ivoire's west has been the scene of significant turmoil and ongoing retributions in recent weeks. This instability could threaten key transportation corridors from the cocoa fields to San Pedro, the port of departure for about a third of Cote d'Ivoire's exports.
Additionally, migrant farmers will need to travel back to the planting regions by the end of April in time for the May-July harvest that accounts for about a third of annual production. Instability, roadblocks, and bank closures could be a real deterrent. Commercial banks will need to resume operations for small traders to buy the harvest. Any delays or problems at this level could also influence international prices, despite expectations for a bumper crop.
Philippe de Pontet and Anne Fruehauf are analysts in Eurasia Group's Africa practice.
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By Scott Rosenstein
Contamination reports out of Japan have prompted more than just Jeremy Piven to second-guess their consumption of sushi and other Japanese delicacies. With many countries including the United States, Hong Kong, Australia, and Singapore banning selected food imports from Japan, fears of a global food supply riddled with radioactivity have been on the rise. The World Health Organization has characterized the situation as "serious." As a result, Japanese food is suffering from a burgeoning branding crisis.
Continued contamination revelations, including recent reports of plutonium in the soil around the Fukushima Daiichi Nuclear Power Station and trace amounts of radioactive cesium and iodine reaching the United States, will likely exacerbate the situation. For Japan, the resulting economic dislocation will be a small (agriculture only constitutes 1.1 percent of the country's GDP) but notable addition to the long list of challenges it faces.
But should we all stop eating food associated with Japan? When it comes to food safety, emotion sometimes trumps reality. The United States, for example, imports less than two percent of its seafood from Japan. The Food and Drug Administration is now monitoring those imports closely, and many restaurants have already halted whatever remaining food orders they have with Japan. France, Germany, India, China, and South Korea have announced similar measures. These are prudent steps to take. But whether they reassure consumers remains to be seen. Even if none of the food on diners' plates is from Japan, ongoing fears could dent the popularity of Japanese-style cuisine worldwide.
Either way, the risk of elevated trade tensions remains low. As long as the import bans are temporary and not perceived as blanket restrictions intended to favor domestic producers, it is unlikely that conflict will arise. China, for example, consumes a significant proportion of Japan's food exports -- much of which is sold at a premium to high-end consumers with promises of quality and safety. Beijing will need to appear proactive for the sake of public opinion at home, but it won't be easy to replace Japanese imports domestically, making the government less likely to do anything drastic. China probably also wants to maintain good trade relations with its neighbor in order to increase exports of Chinese-made food into Japan, particularly if food shortages there worsen or if consumer confidence in Japanese food takes a serious hit. (Considering China's poor record on food safety, however, confidence in Japan would need to plunge considerably for the latter scenario to play out.)
To be sure, health concerns about the issue are not unfounded. The majority of illness stemming from the Chernobyl accident in 1986 resulted from contaminated dairy consumption. Simply instructing children not to drink milk from affected areas in Chernobyl would have drastically reduced the suffering there. Continued monitoring of the situation in Japan therefore remains critical. But we are still very far from Chernobyl levels of contamination. And as the headline risk about food safety in Japan continues to rise, so too does the possibility that much more immediate emergencies in Japan will receive proportionately less international attention.
Scott Rosenstein is an analyst in Eurasia Group's Global Health practice.
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By Eurasia Group analyst Daniel Kerner
Argentina has seen better days.
Following a dramatic political and economic crisis in late 2001 and the largest sovereign default in recent economic history, Argentina enjoyed a remarkable economic recovery over the next several years. Under President Nestor Kirchner (2003-2007), a favorable international environment helped boost the country's economy at a record pace, enabling him to consolidate power and to become one of the most popular and successful presidents in Argentine history. His popularity (approval ratings of close to 70 percent for most of his mandate) allowed him to transfer political power to his wife, Cristina Fernandez de Kirchner, who was elected president by a comfortable margin in October 2007.
But the trouble began even before Nestor Kirchner stepped aside. Despite his political success, his government's reluctance to address rising inflation, unpaid external debt and energy shortages began to raise doubts over the sustainability of Argentina's growth. Inflation began to climb in 2005. The government responded with expansionary fiscal and monetary policies, manipulated inflation statistics, and heavy and sustained pressure on the private sector to keep prices low. Hopes that the Fernandez de Kirchner administration would more openly address these problems were quickly dashed.
But it was last year's four-month conflict with the farming sector over export taxes that delivered the heaviest blow to the Kirchners' popularity. The conflict began after the government sharply raised taxes on soybean exports and refused to reduce them despite massive protests. The taxes were repealed only after the senate voted against the government's proposal. The government's decision to shore up its fiscal position by nationalizing local pension funds further undermined confidence in both the government and in Argentina's economic prospects.
But it was last weekend's election results that finally closed the door on the Kirchner era in Argentine politics. Months ago, the Kirchners knew they had a fight on their hands. Afraid a bad economy would only get worse, the government surprised many observers by pushing forward the date of mid-term elections from October to June. Aware that even the earlier elections would leave them at a disadvantage in key electoral districts, the Kirchners upped the stakes. Nestor Kirchner himself announced that he would seek a lower house seat representing the province of Buenos Aires.
He lost. And the government lost its majority in both houses of congress. In fact, government candidates fell in most of the country's largest electoral districts, including the Capital, Buenos Aires, Cordoba, Entre Rios, Mendoza and Santa Fe.
The Kirchners were hoping to maintain what was left of their grip on the Peronist Party and to dominate the political agenda heading into the next presidential election in 2011. Instead, the sun rose Monday morning on a new set of opposition leaders, like Vice President Julio Cobos, Senator Carlos Reutemann, and Buenos Aires mayor Mauricio Macri, who are well positioned to challenge for the presidency in two years. The country's most powerful politician, Nestor Kirchner, resigned Monday as leader of the Peronist Party. Though two years remain in her presidency, Cristina Fernandez de Kirchner has become a lame duck.
The key economic policy question is whether the Kirchners, who have refused to negotiate or compromise with rivals both inside and outside the Peronist Party can navigate the newly treacherous political waters.
If so, they'll have to fundamentally shift the way they've done business for the past six years. That's why it probably won't happen -- and why Argentina's political and economic forecast will remain mostly cloudy until a new president is elected in 2011.
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The Call, from Ian Bremmer, uses cutting-edge political science to predict the political future -- and how it will shape the global economy.