Depending on where you stand, President Barack Obama's Friday decision to lift the Mexico City Policy, better known as the global gag rule, was either wonderful or appalling. For the last seven years, the gag rule stipulated that charities promoting and supporting abortion services could not recieve funding from the U.S. Government. Now, they can. I say: it's about time.

My position is not drawn from either side of the abortion debate. It's drawn from what I saw as a reporter and as a person living in Nigeria. HIV/AIDS is the open secret there -- a growing problem with a whispered name.

To put it politely, the gag rule created a rift -- at times gaping -- between U.S. government-funded projects and those of private NGOs trying to prevent HIV infection. The U.S. government brought the buck -- President Bush's PEPFAR program boasted $39 billion for HIV/AIDS work -- but it also brought rules about how to get the work done. The foundations brought less money and a sometimes different approach. Both sides fought to win the support of the local government for their strategies. From what I saw, that debate could get ugly. Friends working in the field were frustrated and saddened by the result: inertia and politics, instead of posters and condoms.

There was one particular problem that brought it home for me. In 2006, a Nigerian lawmaker announced that 55,000 women die in the country each year from unsafe illegal abortions. The evidence was everywhere -- from women that my colleagues and I met to Nigerian films on exactly that topic.

What was the best way to get that statistic down? Some will say abstinence. But sex is not always a choice. It's in those situations where women seek -- or are forced by their partners to seek -- unsafe abortions. Some counseling and a sterile doctor's office would go a long way.

That's just one example. The real "gag" was that you didn't hear a lot of stories about birth control or HIV prevention in Nigeria. So my few are only the beginning. Maybe now we'll start to hear a few more.

Photo: TIM SLOAN/AFP/Getty Images

Results of the latest malaria vaccine trials will be published today in The New England Journal of Medicine, and from the looks of it, the news is good -- fantastic, in fact. "We are closer than every before to having a malaria vaccine for use by children in Africa, says Christian Lucq, director of the PATH Malaria Vaccine Initiative.

First, some background: The new trials use a vaccine candidate known as RTSS, the most clinically advanced malaria vaccine in development. The two tests took place in Kenya and Tanzania, and included 340 and 894 children, respectively. After vaccination, children were visited in their homes to follow up on their health and most importantly, their contraction (or not) of malaria.

Here are some highlights from the results:

• Unlike previous trials, these studies administered the malaria vaccine in conjunction with the normal WHO schedule of vaccines like polio, MMR, and others. There was no interference on either side. That matters because if a malaria vaccine is every to be administered, it is likely to be administered in tandem with others.

• In infants of 8, 12, and 16 weeks, the vaccine reduced malaria infections by 65%.

• In children aged five to 17 months, the incidence of clinical malaria was reduced by 53%.

The results today set the stage for more Phase 3 trials--the last needed before lisencing of the vaccine. Future trials will continue to test safety, efficacy, and the possibility of a "booster" shot lengthening the already lengthy 18-month protection observed. 16,000 children will be involved in 11 sites found in 7 countries.

As I wrote last month, a malaria vaccine would be a huge boost to the battle against the capricious and classically difficult-to-fight parasitic infection. The human race has never created a vaccine to fight a parasitic infection before. Here's hoping!

Photo: John-Michael Maas/Darby Communications

Imagine living in a country with 231 million percent inflation, a failed power-sharing agreement, closing schools and hospitals, and an astronomical emigration rate of refugees into neighboring South Africa.

Now, add a cholera epidemic that has left more than 300 people dead and thousands more sick. And President Robert Mugabe, instead of ending the crisis, seems to be using it as an "excuse to clamp down on everyday life," according to SW Radio Africa.

Power sharing talks were set to reconvene today under former South Africa President Thabo Mbeki's mediation, but serious disputes remain about the allocation of ministries between President Robert Mugabe and his opposition-party prime minister, Morgan Tsvangirai. In a sign of his unwillingness to yield power, Mugabe accussed a delegation of "elders," including Jimmy Carter, Kofi Annan, and Graça Machel (the former wife of Nelson Mandela) of trying to oust his government. He refused them entry to the crippled country.

But after everything else, it might be cholera that pushes the limits of how far failed this failed-state can go. South Africa is doing its best to keep the cholera on one side of the border, but further collapse could send an flood of refugees where there has always been a trickle. That would further destabilize a politically shaky South Africa in the midst of its presidential transition.

It's time to change our rhetorical terms on Zimbabwe. No longer on the brink of collapse: over the edge.

Does anyone really wonder why sperm donors might prefer anonymity? It's not like donating an old car -- the desire for privacy is quite understandable. So, it's not surprising that Britain, which abandoned sperm-donor confidentiality laws in 2005, is now facing a sperm-donor deficit. 

The numbers don't lie. Immediately after anonymity disappeared, the number of women who received donor sperm went from 2,727 in 2005 to 2,107 in 2006. It's estimated that 500 donors are needed to match the 4,000 women who undergo donor insemination in Britain each year. Reports show only 307 donors registered in 2006, not nearly enough.

Some fertility experts, like doctors Mark Hamilton and Allan Pacey, from the British Fertility Society are looking to work around the shortage.

They've suggested raising the limit on the number of families who can use the same sperm donor -- currently only 10 babies are allowed to result from each donor, a measure they feel lacks real scientific backing. They've also suggested a sperm-sharing program (an arrangement where men whose partners need in vitro fertilization become donors), but rejected a proposal to allow older donors to donate because of health concerns, like gene mutation.

Dr. Pacey says the countries with enough sperm to go around, especially the United States and Spain, are those "that pay donors or allow anonymity." While he also said that Britain is importing sperm from Scandinavia, he suspects that with such long waiting lines for sperm donors, Brits will simply have to shop elsewhere.

Photo: iStockphoto.com

First, they came for the small-chested people... 

A ban on small-chested people riding motorbikes is just one of the novel criteria recently proposed by Vietnam's Ministry of Health. People whose chests measure less than 28 inches would be prohibited under this new recommendation, as well as people who are too short or too thin. This proposal is meant to improve driver safety in Vietnam, which has one of the world's highest road death tolls, presumably because waifish Vietnamese are at greater risk of sustaining serious injury when in a motorbike accident.

Despite being obviously insane, the Ministry of Health's proposal could affect the travel plans of a large number of Vietnamese. Motorbikes make up 90% of the traffic on Vietnam's roads. Many Vietnamese are naturally slight, and malnutrition often stunted the growth of those born during the Vietnam War. The affair has nevertheless been great fodder for Vietnamese bloggers. "From now on, padded bras will be bestsellers," predicted Bo Cu Hung, a Ho Chi Minh City-based blogger.

When you're a herdsman in Kenya experiencing a particularly nasty drought desperate times call for, well, a fairly practical and simple measure: birth control, or as some are naming it, the goat condom.

The "condom" is actually a square piece of rawhide or plastic called an "olor" that is tied around the male goats belly and "blocks" them from mating with the female goats.

Herdsmen in the Maasai community -- where livestock is often the only means of income -- live in a region outside Nairobi that usually has erratic and unreliable rainfall that increasingly threatens their livelihood. The fear is that if the goats breed before the rainy season comes, the females will not be healthy enough to nurture their kids and there will be more goats than there are resources necessary to sustain the herd.

The olor may not be a modern measure, but it's certainly effective. Separating the males from the females is not an easy alternative and is, in fact, far more expensive since another herdsman is needed. Once the rains come and the land is rich and green, the olors will be removed and the goats will be free to live free and procreate.

All in all, it sounds quite sensible. Thank goodness the global gag rule doesn't apply to livestock.

 

In a grand gesture, three government ministers and one member of parliament publicly announced this week that they had been circumcised in secret. This is a particularly bold effort to help curb the taboo against circumcision among Kenya's Luo tribe -- the third largest ethnic group in the country -- in which, unlike the Luhya community, the practice is not a rite of passage.

The hope is that this highly public display of solidarity for the scientific findings on the success circumcision has in preventing the spread of HIV and AIDS -- reducing the risk of infection by as much as 60 percent -- will spur men in the community to follow suit.

In Kenya, where nearly 2.5 of its 32 million citizens are currently living with HIV and AIDS, there is often resistance when it comes to bowing to medical findings over age-old traditions. This past July, after the ministry of health began offering free circumcision services in Nyanza Province, the Luo Council of Elders refused to sanction the practice. However, not all of the protests were in defense of culture. Some fear that those who have the surgery will no longer feel compelled to use condoms which are far and away the best method of prevention.

Men in the Nyanza province have been coming out in droves for the free "cut," and the government hopes that at least two million men in the province will be circumcised. At least five other government officials have agreed to the surgerical procedure. Prime Minister Raila Odinga did his part to encourage listeners:

All there is to circumcision is availing your male organ for the foreskin to be removed, like 'ting' [snip] and it is all over."

That's quite a sales pitch.

We try to keep the focus here on international issues, but some items are too good to pass up. I hope taxpayer dollars aren't paying for this billboard in Kansas City, or anywhere else:

Via Matt Yglesias, who comments:

If anything, characterizing the sex-engineering link in this manner seems overwhelmingly more likely to reduce interest in engineering than to reduce interest in sex.

If you plan on being in London any time soon, you might end up disappointed if you try ordering Peking duck at a restaurant. Inspectors have been going around with tape and sealing shut the special ovens used to prepare the Chinese delicacy.

The ovens, which—surprise—are made in China, lack a Conformité Européenne (CE) mark indicating that they comply with safety regulations on carbon monoxide emissions as established by Eurocrats in Brussels. For the record, there have been no reports of injuries, accidents, or other health problems caused by the 6-foot-tall ovens.

It's another example of Brits being pushed around by EU diktat. Last year, the contentious issue was whether Britain would have to sell beer by the liter, rather than the beloved pint.

In other questionable food regulation news, Italy's anti-immigrant Northern League party has proposed a law in the Lombardy region that would ban Chinese restaurants and Middle Eastern kebab vendors from historic city centers, on the grounds that such eateries would mar their unique character. (Ironically, that logic is also what got Starbucks to withdraw from Beijing's 600-year-old Forbidden City last year.)

Back in London, it may be a month until restaurants can get CE-marked ovens installed and put Peking duck back on the menu.

Burnt uncollected rubbish in a street of Fuorigrotta, a district of Naples on May, 20, 2008. Tens of thousands of tons of waste have piled up since late last year as a 14-year problem over a lack of incinerators reaches a new peak. Italian Prime Minister Silvio Berlusconi held a cabinet meeting for the first time in Naples yesterday, calling the rubbish Italy's "gravest and most urgent" issue and vowing to resolve the crisis.

Due to skyrocketing rice prices, Liberians are switching to pasta and learning how to twirl spaghetti on a fork. In India, the government has restricted rice exports, and moms are choosing between eating and paying for their children's schooling. Meanwhile in the United States, Wal-Mart's Sam's Club warehouse stores are limiting the sale of 20-pound (9 kg) bags of jasmine, basmati, and long-grain white rice to four per customer.

In the developed world, food shortages might be overhyped. The head of the California Rice Commission told Reuters, "Bottom line, there is no rice shortage in the United States. We have supplies." Plus, how many Americans buy 80 pounds of rice per shopping trip? (Apparently, it's restaurant owners and small-business owners who typically buy in bulk.)

But for people in developing countries, outrageous food prices and shortages are a serious reality. Josette Sheeran, executive director of the U.N. World Food Program, which provides food aid to the needy, told FP in this week's Seven Questions, "This is a silent tsunami." Video, audio, and prepared remarks from her recent talk on global food insecurity at the Center for Strategic and International Studies is also available here.

By the way, if you want to help hungry people get rice, play the Free Rice vocabulary game.

Dignity, a restored sense of beauty, and the spotlight on a serious issue: The goals for Angola's Miss Landmine pageant brought together 18 contestants, all land mine survivors, representing the southwest African nation's provinces. On a television special Wednesday night, the ladies posed in gowns and swimsuits -- and their artificial limbs.  The winner, Augusta Urica, was presented $2,500 USD by Angola's First Lady Ana Paola dos Santos, and will receive a customized artificial limb. You can see some of the contestants' profiles at the event's Web site. (Pictured above is Cuanza Sul, one of the runners-up.)

Each year, between three and four-hundred people are maimed by mines in Angola -- remnants of a 27-year civil war that ended six years ago. Even though significant effort has been put forward to get rid of them, the country remains one of the most mine-laden in Africa.  

There are 80,000 amputees in Angola, most as a result of landmines, according to the International Herald Tribune. Candida Celeste, Angola's minister of family, said, "They showed that they can, that they are able... This will provide encouragement to all those left invalid by the war."

The pageant came ahead of International Day for Mine Awareness and Assistance in Mine Action which falls on April 4 each year.  As the tens of thousands of Angolans can attest, mines are not weapons that can be easily and completely undeployed, and they continue taking lives and livelihoods for generations after hostilities cease. Though, as these women prove, there can be life after landmines as well.

Should we be worried that the Web site for Iraq's Ministry of Health has turned into a conglomeration of dating websites and online car-insurance deals?

The U.S. Department of Commerce and the Library of Congress still link to it, while the World Health Organization offers its own link farm of choice:

Warning: Passport recommends against exploring these Web sites, as your computer could become infested with spyware, or worse.

Zhao Baige, the Chinese vice minister of family planning, announced yesterday that though the details still need to be ironed out, the government would like to gradually amend its controversial one-child policy. The system today is much more fluid than the original name intended. In practice, rural families and ethnic minorities can have more than one child, as can urban couples who are both from one-child familes. For the most part, so can families with money

In its desire to stay in power, perhaps the Communist Party is following Richard Cincotta's advice about mature populations giving rise to democracy. The more mature the Chinese population gets, the more stable society becomes which can yield a definitive, lasting transition to democracy. China seems to have missed the boat in multiple senses. The student protests of 1989 were a bit too early on the national democracy cosmic calendar, and according to Cincotta’s numbers, the People’s Republic passed the democracy threshold in 1998. 

This one-child policy amendment may be an attempt to assure a robust, young generation whose workforce wages will pay for the aging generation; but the higher proportion of youth would also create the unsettledness necessary to prevent democracy. It could be an act designed to draw diplomatic brownie points ahead of the Olympics by easing one of the most intrusive government policies still in place. As controversial as the system has been, population control has definitely been an important factor in curbing poverty and fostering development. It will be interesting to see what the Chinese government's new target will be for a sustainable population in the next century.