An Indonesian mother and her baby outside a North Jakarta health clinic. Photo: Bunga Sirait/Mercy Corps

You may have heard the news that American mothers are breastfeeding their kids at rates higher than ever before, according to data released last week by the U.S. Centers for Disease Control.

The fact that 77 percent of U.S. infants born in 2005-06 were breastfed is good news for child health — studies link breastfeeding to a wealth of benefits, from lower infection rates to higher intelligence — as well as for families' pocketbooks. In the U.S., a year's worth of infant formula can cost well over $1,000. Overseas, the financial bite is even bigger in per-capita income terms.

If breastfeeding is cheaper and healthier, then why do six of every seven Indonesian mothers feed their babies formula?

One reason: Formula companies in Indonesia spend a lot of money convincing mothers their product is as good or better than breast milk, and they've successfully insinuated their product in healthcare settings, according to Mercy Corps.

Dr. Fransiska Mardiananingsih, Mercy Corps' Healthy Start program manager, says formula companies[']... "aggressive marketing has convinced many mothers and health providers that formula feeding is just as healthy for infants," she says, "but in fact it has significant negative effects on children's health."

Dr. Mardiananingsih says formula companies go as far as to deliver gift baskets to new mothers to encourage the continued use of their product.

Mercy Corps, Global Envision's parent, is helping build a more supportive environment for breastfeeding moms in Jakarta's poorest neighborhoods. They're also offering a way for you to help: $75 buys a "Breastfeeding Kit," a symbolic gift that supports the program and equals the cost of training a breastfeeding counselor. It was unveiled last week as a Mother's Day addition to the agency's regular Mercy Kit lineup.

Training midwives, health officials and support-group facilitators is one part of the program; marketing is another. Mercy Corps is working with local government leaders and holding rallies to spread the word about breastfeeding's benefits. They may not be able to match the formula companies' marketing muscle, but with both health and economic advantages on their side, they at least have an easier sell.

Malaria nets. Photo: Tomas de la Maza (flickr)

Is malaria's reign of terror coming to an end?

Every year, 500 million people fall seriously ill with malaria — a disease that induces fever, chills, nausea, flu-like illness and, without treatment, coma and death. More than 1 million people die each year from malaria — almost all in the developing world. The near-universal poverty of its victims is one reason it has not received the attention, and therefore the money, necessary to secure its demise.

Even in the face of these scary statistics, malaria may be about to meet it's match. The Economist reports a renewed sense of interest in its eradication, mainly because it jeopardizes the UN's Millennium Development Goals, a set of benchmarks in health, education and human welfare that world leaders committed to attain by 2015.

There's a cost-benefit rationale, too. Malaria costs Africa upwards of $12 billion a year in health expenses and lost productivity. Yet a five-year eradication plan might cost as little as $2.2 billion a year, according to a report by Malaria No More and McKinsey & Company.

With these numbers in mind, last week the UN unveiled a new campaign to fight malaria at its most critical spots. The Roll Back Malaria (RBM) Partnership — created to "enable sustained delivery and use of the most effective prevention and treatment for those affected most by malaria — staged the first World Malaria Day last week. It coincided with a UN plan to spray inside houses and distribute insecticide-treated bed nets to "all people at risk" of the disease by the end of 2010.

Any effort to stamp out malaria must deal with an added layer of complexity. When diminished but not destroyed, malaria can come back with a vengeance. Any letup in the eradication campaign may end up actually increasing the numbers of those at risk.

But considering how much malaria undermines the war on poverty, a risk taken to ensure its eradication may be a risk worth taking.

Photo: Steve Bailey (flickr)

My attention has recently been drawn to the increasing opposition students, consumers and activists are having to bottled water. A US-based group called Think Outside the Bottle is beginning an advocacy campaign to bring awareness to some of the more dire consequences of our thirst for bottled water, and even government agencies are beginning to act to reduce their consumption.

“City and state governments are looking at the economics of banning bottled water. Citing environmental concerns and a misallocation of resources, Los Angeles; San Francisco; Ann Arbor, Mich.; and the state of Illinois have banned the use of public funds to purchase bottled water for city and state functions…In June, the US Conference of Mayors adopted a resolution to bring attention to the negative impact of bottled water and promote local sources."

The director of a consumer rights group called Food and Water Watch has noticed that people of all types are showing increased awareness about issues involved with bottled water, according to the Christian Science Monitor. "I overhear small children in the grocery store telling their mothers not to buy it."

The negative impacts of bottled water are undeniable, but as a fact sheet the Monitor put out for World Water Day illustrates, the politics of water internationally are extremely complicated. In many parts of the world, bottled water is the only sanitary way to access the resource, and at the moment there is no alternative. The lesson? In places where the water is drinkable, drink it!

Malaria patient. Photo: Ashley Jonathan Clements (flickr)

Josh Ruxin, a community health expert who has spent the last several years living in Rwanda, explains that while the majority of tropical diseases seem archaic and too complex to think about for the average person, trachoma, river blindness, hookworm and the like are devastating over a billion people on the planet. Neglected Tropical Diseases, or NTD’s, are inexpensive to treat in comparison to HIV/AIDS, but don’t seem to carry the same social appeal.

“Together, the NTD’s produce just as much disability as the better known diseases and are a major reason why the poorest people in Africa cannot escape poverty…The great irony is that NTD’s can be effectively treated and controlled for a fraction of the cost of these other diseases.”

Tobacco Farm. Photo: norsenut (flickr)

One of the most ambitious attempts to control tobacco in the world is being ignored.
The World Health Organization’s tobacco control treaty entered into effect almost exactly three years ago today. It was an unprecedented move by global leaders to target the harmful public health outcome of increased tobacco use, notable especially in the developing world.

According to the World Health Organization, if current trends in the expansion of tobacco use worldwide continue, especially in the developing world where currently half of the deaths due to tobacco occur, “seven out of every ten deaths due to tobacco will occur in the developing world by 2020.”

Three years from the day the treaty went into effect, many countries have made no progress toward minimizing this potential public health disaster, according to the editorial board of the New York Times. "With tobacco use declining in wealthier countries, tobacco companies are spending tens of billions of dollars a year on advertising, marketing and sponsorship, much of it to increase sales in these developing countries." This inundation, as well as the tax revenue governments in developing countries can obtain from tobacco companies, have discouraged many of the countries most crucially affected by tobacco use from pushing any harder to promote the changes of this treaty.

Want to know the hot gossip in a small Rwandan village? It's not the latest developments in AIDS treatments. Instead, it's the recent $2000 foreign order for coasters and place mats.

Read The New York Times' guest columnist Josh Ruxin's great article about the importance of supporting business opportunities to combat AIDS and other health problems in Africa.

A Brazilian anti-poverty program known as Bolsa Familia ("Family Fund") is getting attention from governments around the world, writes the Economist. Modeled on a similar program in Mexico, this conditional cash transfer program has been tested successfully in several other Latin American countries, and the World Bank is now looking to start similar programs in Eastern Europe.

In the Brazilian version of the program, poor families with children receive direct transfers of around 70 reals (about $35) a month, on the condition that their children stay in school and have regular health checkups. According to the World Bank, this relatively simple and modest program is unique in that it can help reduce both current and future poverty and inequality in Brazil.

Today the BBC posted a video that took a closer look inside Kibera, a large urban slum of Nairobi. Kibera is experiencing a water and sanitation crisis as nearly one million people are living in the slum without a suitable water supply.