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SDG 5.3 targets include eliminating harmful practices such as Female Genital Mutilation (FGM). Limited information is available about levels of investment needed and realistic estimates of potential incidence change. In this work, we estimate the cost and impact of FGM programs in 31 high burden countries. This analysis combines program data, secondary data analysis, and population-level costing methods to estimate cost and impact of high and moderate scaleup of FGM programs between 2020 and 2030. Cost per person or community reached was multiplied by populations to estimate costs, and regression analysis was used to estimate new incidence rates, which were applied to populations to estimate cases averted. Reaching the high-coverage targets for 31 countries by 2030 would require an investment of US$ 3.3 billion. This scenario would avert more than 24 million cases of FGM, at an average cost of US$ 134 per case averted. A moderate-coverage scenario would cost US$ 1.6 billion and avert more than 12 million cases of FGM. However, average cost per case averted hides substantial variation based on country dynamics. The most cost-effective investment would be in countries with limited historic change in FGM incidence, with the average cost per case averted between US$ 3 and US$ 90. The next most effective would be those with high approval for FGM, but a preexisting trend downward, where cost per case averted is estimated at around US$ 240. This analysis shows that although data on FGM is limited, we can draw useful findings from population-level surveys and program data to guide resource mobilization and program planning.

The paper projects the contribution to 2011-2015 international targets of three major pandemics by programs in 140 countries funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest external financier of tuberculosis and malaria programs and a major external funder of HIV programs in low and middle income countries. Estimates, using past trends, for the period 2011-2015 of the number of persons receiving antiretroviral (ARV) treatment, tuberculosis case detection using the internationally approved DOTS strategy, and insecticide-treated nets (ITNs) to be delivered by programs in low and middle income countries supported by the Global Fund compared to international targets established by UNAIDS, Stop TB Partnership, Roll Back Malaria Partnership and the World Health Organisation. Global Fund-supported programs are projected to provide ARV treatment to 5.5-5.8 million people, providing 30%-31% of the 2015 international target. Investments in tuberculosis and malaria control will enable reaching in 2015 60%-63% of the international target for tuberculosis case detection and 30%-35% of the ITN distribution target in sub-Saharan Africa. Global Fund investments will substantially contribute to the achievement by 2015 of international targets for HIV, TB and malaria. However, additional large scale international and domestic financing is needed if these targets are to be reached by 2015.

The results show the rapid scale-up of services to people in need, doubling each year, with financed programs providing 1.1 million people with HIV treatment, 2.8 million people with TB treatment, and 30 million people with insecticide-treated bednets (ITNs) to protect families from malaria. Performance-based funding was developed in the 1970s in the education sector, and is used by a number of recent development initiatives, including the GAVI Alliance (formerly known as the Global Alliance for Vaccines and Immunisation), the Millennium Challenge Account (see http://www.whitehouse.gov/infocus/developingnations/millennium.html), and the European Commission, as well as more general health initiatives [3-6]. [...]two million long-lasting ITNs were distributed within four months before the onset of the malaria season.

Background Donor funding for HIV programs has flattened out in recent years, which limits the ability of HIV programs worldwide to achieve universal access and sustain current progress. This study examines alternative mechanisms for resource mobilization. Methods Potential non-donor funding sources for national HIV responses in low- and middle-income countries were explored through literature review and Global Fund documentation, including data from 17 countries. We identified the source, financing agent, magnitude of resources, frequency of availability, as well as enabling and risk factors. Results Four non-donor funding sources for HIV programs were identified: earmarked levy for HIV from country budgets; risk-pooling schemes such as health insurance; debt conversion, in which the creditor country reduces the debt of the debtor country and allocates at least a part of that reduction to health; and concessionary loans from international development banks, which unlike grants, must be repaid. The first two are recurring sources of funding, while the latter two are usually one-time sources, and, if very large, might negatively affect the debtor country’s economy. Insurance schemes in five African countries covered less than 6.1% of the HIV expenditure, while social health insurance in four Latin American countries covered 8–11% of the HIV expenditure; in Colombia and Chile, it covered 69% and 60%, respectively. Most low-income countries will find concessionary loans hard to repay, as their HIV programs cost 0.5–4% of GDP. Even in a middle-income country like India, a US$255 million concessionary loan to be repaid over 25 years provided only 7.8% of a 5-year HIV budget. Earmarked levies provided only 15% of the annual HIV funding needs in Zimbabwe and Kenya. Debt conversion provided the same share in Indonesia, but in Pakistan it was much higher - the equivalent of 45% of the annual cost of the national HIV program. Conclusions Domestic sources of funding are important alternatives to consider and might be able to replace donor HIV funding in specific country contexts, coupled with effective prioritization and efficiency measures. Successful resource mobilization design and implementation require close collaboration with other sectors, particularly with the Ministry of Finance, to make sure that the new financing mechanism is fully synchronized with economic growth and that HIV investments yield returns in the form of higher social benefits.

Objectives: To understand the stabilization in HIV prevalence in South Africa, and why HIV prevalence has not declined further, despite behavior change and apparently moderate risk behaviors. Study Design: HIV prevalence and 4 HIV-related sexual behaviors in 15- to 24-year old South Africans and Ugandans were compared, before and during HIV prevalence stabilization and decrease, respectively. Results: According to standard indicators, 15- to 24-year-old South Africans have shown behavior change and have moderate risk behaviors. Yet, the HIV prevalence of South African youth is more than twice the prevalence among Ugandan youth, despite 2 times greater reported condom use and an increase in secondary abstinence among young females. We observed inconsistent use of condoms and an extended age distribution of risk together with age and partner mixing. These increase the cumulative risk beyond indicators which are based on sexual behavior in the last year and condom use at last sexual act. In addition, the extended age distribution of risk together with age and partner mixing, increase the cumulative risk beyond standard indicators which are based on sexual behavior in the last year and condom use at last sexual act. Conclusions: Comprehensive HIV prevention in South Africa needs to be intensified beyond individual age groups for example youth, clearly promote consistent condom use and reduction in sexual partners, and focus on the transmission dynamics including older age groups. This should be based on careful behavioral analysis of the epidemic, which goes beyond standard indicators. This study shows the significant risks beyond apparently improving behavioral indicators in Southern Africa, and helps explains the seriousness of the epidemics in this region.

Investigates the factors that transformed the Greek Orthodox Patriarchate of Jerusalem into the owner of a large-scale stock of real estate in the past, as a result of which it is one of the largest non-governmental landowners in the State of Israel today. The Greek Orthodox Patriarchate's large reserve of land has also been one source of the bitter conflict between the clergy and local Arab Greek Orthodox community followers. Many modern Jewish neighbourhoods, such as the garden neighbourhood of Rehavia, were developed on lands purchased from the Patriarchate, as were some Arab neighbourhoods like the Greek Colony and part of Talbiah.

Background In light of the decline in donor HIV funding, HIV programmes increasingly need to assess their available and potential resources and maximize their utilization. This article presents lessons learned related to how countries have addressed the sustainability of HIV programmes in a stakeholder-driven sustainability analysis. Methodology During HIV/AIDS Programme Sustainability Analysis Tool (HAPSAT) applications in six countries (Benin, Guyana, Kenya, Lesotho, Sierra Leone and South Sudan), stakeholders identified key sustainability challenges for their HIV responses. Possible policy approaches were prepared, and those related to prioritization and resource mobilization are analysed in this article. Results The need to prioritize evidence-based interventions and apply efficiency measures is being accepted by countries. Five of the six countries in this study requested that the HAPSAT team prepare 'prioritization' strategies. Countries recognize the need to prepare for an alternative to 'universal access by 2015', acknowledging that their capacity might be insufficient to reach such high-coverage levels by then. There is further acceptance of the importance of reaching the most-at-risk, marginalized populations, as seen, for example, in South Sudan and Sierra Leone. However, the pace at which resources are shifting towards these populations is slow. Finally, only two of the six countries, Kenya and Benin, chose to examine options for generating additional financial resources beyond donor funding. In Kenya, three non-donor sources were recommended, yet even if all were to be implemented, it would cover only 25% of the funding needed. Conclusions Countries are increasingly willing to address the challenges of HIV programme sustainability, yet in different ways and with varying urgency. To secure achievements made to date and maximize future impact, countries would benefit from strengthening their strategic plans, operational plans and funding proposals with concrete timelines and responsibilities for addressing sustainability issues.

Dissent between the clerical establishment and lay followers is not an infrequent phenomenon and has often focused on church appointments, leadership, and political issues. In the Middle East, such tensions are found between churches usually led by European clergy and their predominantly Arab congregations. Here we combine historical and geographical research methods to investigate a neglected source of contention—that of property held by the church. We reconstruct, analyze, and present detailed case studies of long-term disputes over real estate between the Greek Orthodox Patriarchate of Jerusalem (its Greek patriarch and clergy), and its lay Arab community, known as Rum Orthodox, Roman Christians, or Greek Orthodox, and which number about 71,000 members.

We consider the problem of discrimination between two pure quantum states. It is well known that the optimal measurement under both the error-probability and log-loss criteria is a projection, while under an ``erasure-distortion'' criterion it is a three-outcome positive operator-valued measure (POVM). These results were derived separately. We present a unified approach which finds the optimal measurement under any distortion measure that satisfies a convexity relation with respect to the Bhattacharyya distance. Namely, whenever the measure is relatively convex (resp. concave), the measurement is the projection (resp. three-outcome POVM) above. The three above-mentioned results are obtained as special cases of this simple derivation. As for further measures for which our result applies, we prove that Renyi entropies of order \\(1\\) and above (resp. \\(1/2\\) and below) are relatively convex (resp. concave). A special setting of great practical interest, is the discrimination between two coherent-light waveforms. In a remarkable work by Dolinar it was shown that a simple detector consisting of a photon counter and a feedback-controlled local oscillator obtains the quantum-optimal error probability. Later it was shown that the same detector (with the same local signal) is also optimal in the log-loss sense. By applying a similar convexity approach, we obtain in a unified manner the optimal signal for a variety of criteria.

We derive a convex optimization problem for the task of segmenting sequential data, which explicitly treats presence of outliers. We describe two algorithms for solving this problem, one exact and one a top-down novel approach, and we derive a consistency results for the case of two segments and no outliers. Robustness to outliers is evaluated on two real-world tasks related to speech segmentation. Our algorithms outperform baseline segmentation algorithms.