$500 Million Pledged to Fight Childhood Obesity

The Robert Wood Johnson Foundation plans to spend more than $500 million over the next five years to reverse the increase in childhood obesity. It is one of the largest public health initiatives ever tried by a private philanthropy.
“This is an epidemic that is going to cost the country in terms of morbidity and mortality and economically,” said Dr. Risa Lavizzo-Mourey, the foundation’s president and chief executive. “The younger generation is going to live sicker and die younger than their parents because of obesity.”
The foundation estimates that roughly 25 million children 17 and under are obese or overweight, nearly a third of the 74 million in that age group, according to Census Bureau data and a 2006 study published in The Journal of the American Medical Association.
Many of those children are poor and live in neighborhoods where outdoor play is unsafe and access to fresh fruits and vegetables is limited. “In many cases, the environment makes it almost impossible for them to choose healthy lifestyles,” Dr. Lavizzo-Mourey said. “We’re going to try to change that.”
The foundation plans to invest in programs to improve access to healthy food, encourage the development of safe play spaces, increase research to enhance understanding of obesity and prod governments into adopting policies to address the problem, among other things.
Philanthropy has long fueled improvements in health, from John D. Rockefeller, whose money produced a yellow fever vaccine, to Bill and Melinda Gates, who are underwriting new health technologies and vaccines to address a variety of global problems. (lack of gov. fund)
Several states have mandated changes in school menus, increased physical education requirements and begun reporting students’ body mass index scores to parents.

Shackles on the AIDS Program

An expert committee has found that the Bush administration’s ambitious program to combat AIDS abroad is off to a good start but warns that restrictions imposed by Congress or by the administration are hampering efforts to slow the spread of the epidemic. These inflexible barriers are often imposed for ideological, not health reasons.
The midcourse evaluation of the President’s Emergency Plan for AIDS Relief, or Pepfar, was delivered to Congress last week by a panel of experts assembled by the Institute of Medicine, a unit of the National Academy of Sciences. The program assists more than 120 countries in all, but concentrates its resources in 15 countries, mostly in Africa.
Programs to prevent the spread of H.I.V., the virus that causes AIDS, are perhaps the most important tool in that long-term fight. Yet Congress specified that only 20 percent of the money could be spent on prevention, and one-third of that had to be used to promote abstinence until marriage. More money has been spent in that area than on other prevention activities, including distribution of condoms and blocking mother-to-child transmission.
Another restriction that existed even before the creation of Pepfar (President's Emergency Plan For AIDS Relief) forbids the use of taxpayer money to give clean needles to injecting addicts, while a third requires that all antiretroviral medications be approved by the FDA, even those already approved by the WHO.
These restrictions needlessly hamper a program with great potential. Congress should eliminate them and let health professionals devise the most effective strategies.

Taking Aim at All Those Plastic Bags

By a 10-1 Board of Supervisors’ vote, San Francisco became the first major American city to ban the use of non-biodegradable plastic bags by supermarkets, drug stores and other large retailers.
The paper-or-plastic question has long been a vexing one. Paper bags, of course, are biodegradable and recyclable, and are made from trees, a renewable resource. But the production of paper bags generates significantly more air and water pollution; manufacturing and recycling them requires more energy than their plastic cousins do, according to the Environmental Protection Agency.
Paper bags also take up comparatively more space in landfills, where they are slow to degrade, like most everything in a landfill. A study for the American Forest and Paper Association estimated that about seven billion paper bags were used in the United States in 2003.
On the other hand, plastic bags made of polyethylene, which dominate the market, are non-biodegradable and are made from crude oil and natural gas, both nonrenewable resources. They can be recycled, but are mostly discarded.
The E.P.A. estimated that only 5.2 percent of the plastic bags and sacks in the municipal waste stream in 2005 were recycled, compared with 21 percent of paper bags and sacks. And there are also horror stories about animals swallowing them and starving to death.
Plastic bags have virtually taken over the grocery market since they were first put at check-out stands in 1977. Ninety percent of all grocery bags are now plastic, according to the Progressive Bag Alliance, an industry group of plastic bag manufacturers. Estimates of the number of plastic bags used around the world each year vary wildly — from 100 billion to as many as one trillion.
Whatever the number, it’s a lot. And that has made for a lot of plastic bag litter — which, the E.P.A. says, can take 1,000 years to decompose.
One reason for the abundance of plastic bags is economic. A standard plastic grocery bag costs about a penny to produce, according to the plastics industry, compared with 4 cents to 5 cents for a paper bag. Compostable plastic bags would cost from 8 cents to a dime, the industry says, although supporters of the San Francisco action say the cost would drop as more local governments require them.
Because of a tax, Ireland has cut the use of plastic bags by 90 percent, according to the Irish government.
Ikea, the Swedish home furnishings and accessories chain, has just begun charging customers 5 cents per plastic bag in the United States, which it donates to American Forests, a conservation group. On average, its United States stores have gone through about 70 million a year. In Britain, Ikea says, it has seen a 95 percent drop in plastic bag use since it began charging for them there last spring.
Yet another alternative is to sell consumers reusable bags.
“The paper versus plastics question takes us off the issue, which is consumption,” says Vincent Cobb, who offers reusable bags and containers on the Internet. He admits to using plastic bags, which he calls a “fantastic product,” but not as many as in the past.
“Getting into the habit of bringing your own shopping bag,” he says, “can slash this problem across the board.”