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Infectious diseases, especially those transmitted from person to person through the respiratory route, continue to pose a threat to the global community. Public health surveillance systems and the International Health Regulations are intended to facilitate the recognition of and rapid response to infectious diseases that pose the risk of developing into a pandemic, but the response to the 2009 H1N1 influenza pandemic illustrates the continuing challenges to implementing appropriate prevention and control measures. The response to the 2009 H1N1 influenza pandemic will be discussed and its implications examined.


Speaker biography:

Arthur Reingold, MD is Professor and Head of the Division of Epidemiology and Associate Dean for Research in the School of Public Health (SPH) at the University of California, Berkeley (UCB). He holds concurrent appointments in Medicine and in Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). He completed his BA and MD degrees at the University of Chicago and then completed a residency in internal medicine at Mt. Auburn Hospital in Cambridge, Massachusetts. He is board certified in internal medicine and holds a current medical license in California, but has devoted the last 25 years to the study and prevention of infectious diseases in the U.S and in developing countries throughout the world.

He began his career as an infectious disease epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC), working there for eight years. While at CDC, he worked domestically on Toxic Shock Syndrome, Legionnaires’ disease, bacterial meningitis, fungal infections, and non-tuberculous mycobacterial infections and internationally on epidemic meningitis in West Africa and Nepal.

Since joining the faculty at UCB in 1987, he has worked on a variety of emerging and re-emerging infections in the U.S.; on acute rheumatic fever in New Zealand; and on AIDS, tuberculosis, malaria, and acute respiraatory infections in Brazil, Uganda, Ivory Coast, Zimbabwe, India and Indonesia. He has directed the National Institutes of Health (NIH) Fogarty AIDS International Training and Research Program at UCB/UCSF since its inception in 1988; co-directed (with Dr. Duc Vugia of the California Department of Health Services), the CDC-funded California Emerging Infections Program since its inception in 1994; and served as the Principal Investigator of the UCB Center for Infectious Disease Preparedness (CIDP) since its inception in 2002.

He also has ongoing research projects concerning malaria in Uganda; HIV/AIDS and related conditions in Brazil; and tuberculosis in India.  He regularly teaches courses on epidemiologic methods, outbreak investigation, and the application of epidemiologic methods in developing countries, among others. He also teaches annual short courses on similar topics in Hong Kong, Brazil, Switzerland, and other countries.

He has been elected to membership in the American Epidemiological Society; fellowship in the American Association for the Advancement of Science and the Infectious Diseases Society of America; and membership in the Institute of Medicine of the National Academy of Sciences. In Hong Kong, He has a close working relationship with Chinese University, particularly with its School of Public Health and its Centre for Emerging Infectious Diseases. Dr. Reingold gives short courses at the School of Public Health each year and he serves on the Advisory Board of the Centre for Emerging Infectious diseases.

Reuben W. Hills Conference Room

Arthur Reingold Professor of Epidemiology and Associate Dean of Research Speaker UC Berkeley School of Public Health
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Promotion of smallholder irrigation is cited as a strategy for enhancing income generation and food security for sub-Saharan Africa’s poor farmers, but what makes this technology a successful poverty alleviation tool? In the short run, the technology should pave the way for increased consumption, asset accumulation, and reduced persistent poverty among users. Over the longer run, it should lead to institutional feedbacks that support sustained economic development and nutritional improvements. Our conceptual model and review of case studies reveal the importance of three sub-components of irrigation technology—access, distribution, and use—and the ways in which the design of the technology itself can either bridge, or succumb to, institutional gaps. These critical features are illustrated in an experimental evaluation of a solar-powered drip irrigation project in rural northern Benin, which provides a controlled study of technology impacts in the Sudano-Sahel. The combined evidence highlights the technical and institutional requirements for project success and points to two important areas of research in the scale-up of any small-scale irrigation strategy: the risk behavior of water users, and the evolution of institutions that either support or obstruct project replication over space and time.

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Rosamond L. Naylor
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Paul Kim, the assistant dean for technology & CTO at Stanford University's School of Education, led the Nov. 3 Liberation Technology Seminar Series on “Global Inequalities, Achievement Gaps, and Mobile Innovations.” Kim has been reconceptualizing the whole education system, with a particular focus on the education of children in deprived areas.

Kim firmly believes that education, as is expressed in the U.N. Declaration of Human Rights, is a basic human right that should be available to all children, but the fact is that a large number of children are out of school, and many receive a poor quality of education. In this context, technology could enable the realization of the right to education.

Kim argues that donation of computers in a large scale was the main mode of introducing technology in education, but this model has its problems. Often computers are donated to schools but are not used either because people do not know how to use them or there is no access to electricity. Kim emphasized the importance of creating tools that are simple and likely to work in highly challenging conditions. With this in mind, he has started focusing on the use of mobile phones as a learning tool, given their low power consumption, low cost, ubiquitous availability and increasing capabilities.

He also pointed out that there have been many initiatives such as one laptop per child, where even the distribution of 110,000 in a place like Rwanda has not made a major contribution to educational achievements. He argued that such projects are detached from curriculum, and are focused on technology. In order to be successful, you have to understand the ecosystem, not just particular pieces of technology. You have to understand the value perceptions of everybody in the ecosystem: teachers, parents and students and make sure that all of the values are aligned. Otherwise the project will not succeed.

Kim further suggested that there is often a block at the teacher training stage and that there is a problem of pedagogy. Kim suggested that we should focus more on student centered exploration based learning because if you merely teach, the students switch off. However, if you engage with them, they will be more responsive. He suggested that instead of using words such as ‘teaching’ and ‘students’, we should use words such as ‘coaching’ and ‘agents’ and Kim’s own innovations follow are based on the philosophy of enabling student-led learning with the teachers playing a supportive role.

When using technical devices, Kim argued, it is incredibly important to empower the children themselves to learn how to use them rather than just telling them what to do. Students will express their creativity and extensive knowledge when they are given the opportunity to do so.

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This past Thursday, on the 10th of November 2011, former U.N. Secretary-General, Kofi Annan delivered a speech at Stanford University on the occasion of the launch of the Freeman Spogli Institute for International Studies' Center on Food Security and the Environment. Citing UN estimates, more precisely the UNFPA State of the World Population 2011 report, he highlighted that the world population had recently reached seven billion and growing. Advancements in healthcare and technology have increased our life expectancy, affording 'man' the ability to escape a life that is, in Hobbesian parlance, "poor, nasty, brutish, and short." Yet this apparent human success story eclipses the "shameful failure" of the international community to address an indiscernible fact: that in the contemporary technological age, an astonishing number of people in the world go hungry each day. The marriage of a globalized economy and scientific innovation was supposed to - at least in theory - increase and spread wealth and resources to enhance the human condition. And yet today - talks of unfettered markets and the financial crisis aside -, we lay witness to close to one billion people around the world who lack food security (both chronic and transitory). Citing numbers from the World Bank, Annan stated that rapidly rising food prices since 2010 have "pushed an additional 70 million people into extreme poverty". Adding to these disturbing figures is the fact that one of the world's most ravenous culprits of infanticide is no other than hunger, which claims the young lives of 17,000 children every day.

Dwindling incentives to farm and increasing pressures on farmers are not helping the food insecurity crisis. Frequently, companies who contract local farmers to produce cash crops for export do not employ "strategic agricultural planning" or take into account the impact their policies and modus operandi may have on local farming communities and their immediate (food) needs. Artificially low prices for agricultural goods force farmers from their land and discourage investment in the sector, Annan warns. Agricultural subsidies in the US and Europe against farm produce injected into the market by farmers from developing countries have also added to the problem. Agricultural subsidies in Europe in particular have had a devastating impact on farmers from other parts of the world - mostly in Asia and Africa - who simply cannot compete with the existing market conditions and the low price tags attached to their goods. This phenomenon is most acute in Africa where a significant segment of the population lives modestly by working the land and these subsidies are choking the lifeline that feeds their families. To bring home the point of the sheer imbalance between the conditions of Western farmers and the 'rest', Annan stated that with a fraction of the funds generated by a reduction of subsidies, one "can fly every European cow around the world first class and still have money left over". Without a more balanced approach to international trade policy making, subsidies will continue to be a factor in food insecurity.

And it gets worse. The 'Four Horsemen of the Apocalypse' of our times - (i) an ever emerging global water crisis, (ii) land misuse and degradation, (iii) climate change, and (iv) kleptocratic governance - have combined to aggravate an already dire international food insecurity predicament. The hard truth is that without countering the forward gallop of these ills, food insecurity cannot be adequately addressed.

The facts on the ground and projections into the future do not paint a promising picture. Food prices are expected to rise by 50 percent by the year 2050, Annan warns, and this at a time when the world will be home to two billion more inhabitants. In 40 years from now, there simply isn't enough food to nourish and satisfy the world's population.

The growing world food crisis also stifles development. It is the cyclical brutality of poverty that keeps the hungry down. Without the means or access to proper and adequate nutrition, the impoverished who are always the first victims of food insecurity invariably suffer from poor health, in turn resulting in low productivity. This vicious cycle traps the less privileged to a seemingly inescapable downward spiral.

During the course of his poignant remarks, Annan stated that without addressing food insecurity "the result will be mass migration, growing food shortages, loss of social cohesion and even political instability". He is correct on all counts.

The fact is that a world which 'cultivates' and then neglects the hungry is a dangerous and volatile world. Since time immemorial, dramatic human migrations have had a direct correlation with changes in climate, habitat and resource scarcity. Survival instincts are engrained in our genetic make-up. When the most basic and fundamental necessities of life are sparse and hard to come by, our natural inclination is to look for 'greener pastures'. An unaddressed and lingering food insecurity crisis will mean the world will witness significant and rapid migration trends in the 21st century (a phenomenon very much in motion today). The injection of mass flows of people into other foreign populations will cause friction and conflict induced by integration challenges, both social and economic (surmountable, but conflicts no less).

Moreover, the desperation and unmet basic needs of the underprivileged can translate into open outbursts of conflict and violence. Tranquility and social harmony are virtues enjoyed by countries that can provide for their people. Leaving the growing food insecurity dilemma unaddressed will be to invite inevitable political instability and violence in countries and fragile regions of the world grappling with high poverty rates and concomitant food insecurity challenges. More often than not, history has shown a positive nexus between hunger and social upheaval (it bears noting that La Grande Révolution of 1789-99 was preceded by slogans of "Du pain, du pain!"). Further, it does not take too much of a forethought to recognize that it is precisely in environments of destitute and despondency where autocratic rule can easily take root and grow to inflict further suffering.

Food insecurity can also lead to wars, but similarly wars contribute to food insecurity by destroying both the land and the ability to cultivate the land. Conflict represents formidable barriers to the access and availability of otherwise usable land (countries like Somalia, Sudan, Burundi, Ethiopia and Liberia come to mind).

To be sure, "[w]ithout food, people have only three options: they riot, they emigrate or they die" (borrowed from the often cited words of Josette Sheeran, the Executive Director of the UN World Food Program).

How are we to tackle this grave problem in a realistic and effective manner? Annan rightly tells us that the "[l]ack of a collective vision is irresponsible". Implicit in Annan's remarks is also a lack of leadership to effectively tackle and untie the Gordian Knot of food insecurity. The nature and colossal character of food insecurity demands action and cooperation on a global scale. Climate change and its negative impact on the environment - e.g. diminishing arable lands, water resources, recurring drought -, one of the accelerators of food insecurity, requires robust and committed international agreement and action to reduce the emission of greenhouse gases. Strict adherence and compliance with the Kyoto Protocol and the Copenhagen Accord are a must in this regard. With strategic agricultural planning, knowledge transfer and investment, uncultivated arable lands - abundant in many parts of the world, including in Africa - can become productive and bear fruit, reducing in turn the hunger crisis. Efforts to implement more balanced international trade policies which make farming viable across continents as well as efforts to eradicate corruption (by promoting good governance) are also part and parcel of the fight against hunger. So are innovative ways of thinking about establishing, say rapid response mechanisms to preempt and effectively counter famine and other food emergencies by bolstering the capacities of relevant existing international and regional organizations. We could also reduce the threat of hunger by doing more than just pay lip-serve to the UN Millennium Development Goals (MDGs) and uphold our commitments to the MDGs through sustained funding and support.

The UN and other multilateral bodies and pacts are tools we have created to work collaboratively - as best as human frailties permit - to confront global challenges and ills that threaten the social fabric of human society (whether they be food insecurity, dearth in development, war and the crimes that emanate from aggression which threaten peace and security, inter alia). Our capacity to reason, innovate, communicate and cooperate is hence an indispensible tool in our struggle to keep the peace, to protect our fundamental human rights and to satisfy our most basic needs for survival. It's time to put these faculties to work in confronting the world's food security challenges.

It is only fitting to conclude these brief remarks by quoting from the man and the lecture that inspired them. "If we pool our efforts and resources we can finally break the back of this problem", stated Annan in his call for action to defeat food insecurity. If there's a will, history tells us, change is within grasp, no matter how daunting the task. It only takes the trinity of courage, commitment and leadership.

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FSI's second major conference on global underdevelopment brought together worldwide thought leaders to explore the root causes of global underdevelopment and to provide fresh insights on the links between international security and universal access to adequate food, health care and water.

Redefining Security Along the Food/Health Nexus Conference website

Frances C. Arrillaga Alumni Center

Kofi Annan former Secretary-General, the United Nations, Nobel Peace laureate, chairman of the Alliance for a Green Revolution in Africa Keynote Speaker
Jeff Raikes CEO, the Bill & Melinda Gates Foundation Keynote Speaker
Robert Gates former U.S. secretary of Defense Keynote Speaker
David Bloom Clarence James Gamble Professor of Economics and Demography; chair, Department of Global Health and Population, Harvard School of Public Health Panelist
Mariano-Florentino Cuéllar Professor and Deane F. Johnson Faculty Scholar, Stanford Law School; co-director, Center for International Security and Cooperation Panelist

473 Via Ortega, Y2E2, Room 255
Stanford, CA 94305-4020

(650) 725-9170
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jennadavis.jpg PhD

Jennifer (“Jenna”) Davis is a Professor in the Department of Civil and Environmental Engineering and the Higgins-Magid Senior Fellow at the Woods Institute for the Environment, both of Stanford University. She also heads the Stanford Program on Water, Health & Development. Professor Davis’ research and teaching is focused at the interface of engineered water supply and sanitation systems and their users, particularly in developing countries. She has conducted field research in more than 20 countries, including most recently Zambia, Bangladesh, and Uganda.

Higgins-Magid Faculty Senior Fellow, Stanford Woods Institute for the Environment
Jenna Davis assistant professor, Department of Civil and Environmental Engineering; center fellow, Woods Institute for the Environment Panelist
Alex Evans head of research, Program on Resource Scarcity, Climate Change and Multilateralism at the Center on International Cooperation, New York University Panelist
Donald Francis co-founder, Global Solutions for Infectious Diseases Panelist
David Lazarus former senior advisor for rural affairs, Domestic Policy Council, the White House, and former senior advisor to the secretary of agriculture Panelist
Jenny Martinez professor of law and Justin M. Roach Faculty Scholar, Stanford Law School Panelist

Encina Commons Room 101,
615 Crothers Way,
Stanford, CA 94305-6006

(650) 723-2714 (650) 723-1919
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Henry J. Kaiser, Jr. Professor
Professor, Health Policy
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Stanford Institute for Economic Policy Research
Professor, Economics (by courtesy)
grant_miller_vert.jpeg PhD, MPP

As a health and development economist based at the Stanford School of Medicine, Dr. Miller's overarching focus is research and teaching aimed at developing more effective health improvement strategies for developing countries.

His agenda addresses three major interrelated themes: First, what are the major causes of population health improvement around the world and over time? His projects addressing this question are retrospective observational studies that focus both on historical health improvement and the determinants of population health in developing countries today. Second, what are the behavioral underpinnings of the major determinants of population health improvement? Policy relevance and generalizability require knowing not only which factors have contributed most to population health gains, but also why. Third, how can programs and policies use these behavioral insights to improve population health more effectively? The ultimate test of policy relevance is the ability to help formulate new strategies using these insights that are effective.

Faculty Fellow, Stanford Center on Global Poverty and Development
Faculty Affiliate, Stanford Center for Latin American Studies
Faculty Affiliate, Woods Institute for the Environment
Faculty Affiliate, Interdisciplinary Program in Environment & Resources
Faculty Affiliate, Stanford Center on China's Economy and Institutions
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Grant Miller assistant professor of medicine, Center on Health Policy/Center for Primary Care and Outcomes Research core faculty member Panelist
Onesmo K. ole-MoiYoi chair, Kenya Agricultural Research Institute & Consortium; senior advisor, Aga Khan University Panelist
Gary Schoolnik professor of medicine (infectious diseases), and microbiology and immunology, Stanford School of Medicine; senior fellow, Woods Institute for the Environment and FSI Panelist
Ray Yip director, China Program, Global Health Program, the Bill & Melinda Gates Foundation Panelist
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Blaming leaders in America and abroad for not doing enough to combat climate change, former United Nations Secretary-General Kofi Annan said continued failure to tackle the problem will result in worldwide hunger, social unrest and political turmoil.

“Without action at the global level to address climate change, we will see farmers across Africa – and in many other parts of the world including here in America – forced to leave their land,” the 2001 Nobel Peace Prize winner told a crowd of about 1,400 people at Stanford’s Memorial Auditorium on Thursday. “The result will be mass migration, growing food shortages, loss of social cohesion and even political instability.”

Citing numbers from the World Bank, Annan said rapidly rising food prices since 2010 have “pushed an additional 70 million people into extreme poverty.” He called a lack of food security for nearly 1 billion of the world’s population “an unconscionable moral failing” that is also a stumbling block to a strong international economy.

“It affects everything from the health of an unborn child to economic growth,” he said.

Annan’s talk, “Food Security Is a Global Challenge,” was delivered as part of a daylong conference on global underdevelopment sponsored by Stanford’s Freeman Spogli Institute for International Studies. The event drew the world’s leading experts in the field and featured panel discussions that explored the connections between global security and food supplies, health care and governance. Keynote speeches were delivered by Annan and Jeff Raikes, CEO of the Bill & Melinda Gates Foundation. Former Secretary of Defense Robert Gates also planned to deliver a talk to a private audience.

The conference marked the launch of FSI’s Center on Food Security and the Environment.

“With this facility, and the creative thinkers and inquisitive minds for which Stanford is famous, you are well-equipped to undertake research which advances our knowledge and helps to shape our response to the many global challenges we face,” Annan said. “And with the resources at your disposal, you also have the capacity to actively engage to influence policy, implement solutions and thus improve the lives of the most vulnerable people on the planet.”

Annan also lauded government initiatives such as America’s Feed the Future program that focus on alleviating global hunger. He recently met with Secretary of State Hillary Clinton, Secretary of Agriculture Tom Vilsack and Raj Shah, head of the U.S. Agency for International Development, to discuss ways to address food insecurity.

“If we pool our efforts and resources, we can finally break the back of this problem,” he said.

But he challenged wealthier nations to do more than pay lip service to the problem.

“We need to make sure that promises of extra support from richer countries are kept and involve fresh funds rather than the repackaging of existing financial commitments,” he said.

Annan, who is the chair of the Kofi Annan Foundation, the Africa Progress Panel, and the Alliance for a Green Revolution in Africa, said Africa represents both the greatest problem and the greatest promise when it comes to food security.

The continent is home to 60 percent of the world’s uncultivated arable land, but cannot produce enough food to feed its own people, he said. But if Africa can grow just half the world’s average yield of staple crops like wheat, corn and rice, it would end up with a food surplus.

Transforming Africa into one of the world’s biggest crop producers will take more than supporting farmers, he said. It entails sound environmental stewardship.

 “I hope this is an area where the Center on Food Security and the Environment can make a major contribution to finding solutions,” Annan said.

Without those solutions, the future is bleak.

In Sub-Saharan Africa, where global warming brings the threat of persistent drought, current crop production is expected to be cut in half by the end of the century and 8 percent of the region’s fertile land is expected to dry up.

“Those arguing, here and elsewhere, for urgent action and a focus on opportunities to green our economies still find themselves drowned out by those with short-term and vested interests,” Annan said. “This lack of long-term collective vision and leadership is inexcusable. It has global repercussions, and it will be those least responsible for climate change – the poorest and most vulnerable – that will pay the highest price.”

Annan's speech was sponsored by FSI, Stanford in Government and the Stanford University Speakers Bureau.

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Former U.N. Secretary-General Kofi Annan delivers a keynote address on food security and climate change during FSI's global underdevelopment conference on Nov. 10, 2011. | Ben Chrisman
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The Draper Hills Summer Fellows Program is recruiting rising leaders from around the world to join the 2012 program scheduled for July 22-August 10 at Stanford University. Entering its eighth year, the Draper Hills Summer Fellows Program is run by the faculty and staff at the Center on Democracy, Development, and the Rule of Law. The deadline to apply is December 12, 2011.

The program is funded by generous support from Bill and Phyllis Draper and Ingrid von Mangoldt Hills.

A life changing experience I will never forget. I leave a much more informed and networked civil society leader. -Titus Gwemende, Zimbabwe (Class of 2011)

Each year, the program brings together a group of 25 to 30 mid-career practitioners in law, politics, government, private enterprise, civil society, and development from emerging and aspiring democracies. The three-week program provides a unique forum for emerging leaders to connect, exchange experiences, and receive academic training to enrich their knowledge and advance their work. Academic sessions are taught by an interdisciplinary team of leading Stanford faculty who are joined by an all-star roster of outside guest speakers.

Fellows emerge from the training program better equipped with new techniques and approaches to build democracy and economic development in their home countries. The 2012 class of Draper Hills Summer Fellows will join a network of 186 alumni from 57 developing democracies worldwide.

Previous Summer Fellows have served as presidential advisors, senators, lawyers, journalists, civic activists, entrepreneurs, academic researchers, and development practitioners, among others. Strong candidates should have substantial practical experience and play important emerging roles in their country's economic and social development. The program seeks applicants from countries where democracy and development are not firmly established, in the regions of Africa, Asia, Eurasia, Latin America, and the Arab world. Successful applicants will have academic credentials necessary to participate and contribute to advanced academic sessions and a working knowledge of English.

The program is highly selective, receiving several hundred applications each year. To learn more about the program and to apply, please visit: http://draperhills.stanford.edu/. Applicants are encouraged to apply as early as possible, applications will be reviewed on a rolling basis.

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Rod Searcey
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In the October 13 seminar entitled, "The Last Mile: Grassroots Development and Technology in Africa” Joshua Stern, executive director of Envaya, and Jesse Young, CTO of Envaya, shared their insights into how software could be used to strengthen grassroots development in Africa. Envaya’s mission is to build and deploy a software platform that provides “the last mile” of connection between grassroots activists and the larger development sector. 

Stern suggested that one of the biggest challenges in the development space currently was the lack of coordination between the community-based organizations, the NGOs and the foundations. He further argued that a system is only as strong as its weakest links. He therefore suggests that it is important to strengthen the weakest links. In the case of Tanzania and many other developing countries, Stern argued that the weakest link was in the connection between the community-based organizations and the international NGOs that often provided critical financial support. The community-based organizations are essential to focus on because they are embedded within the communities they are working in and have institutional memory, and they stay with the communities unlike international organizations and volunteers that come and go.

In Africa, Stern argued, there is a pretty robust grassroots civil society but often people are working on very similar work and do not know one another. Furthermore, organizations have trouble navigating secure funding. There is therefore a huge potential for collaboration. In particular, there is room for greater leveraging technology. Stern argued, “Despite leaps and bounds in hardware infrastructure, software is still tailored to the developed world.” Community organizations have therefore not been able to take advantage of the IT revolution. Envaya fills this gap by providing software that is optimized to work with infrastructure in these localities, thus enabling these organizations to make use of the connectivity that is now becoming available to them.

Josh and Jesse inspired us with the vision of Envaya to provide a technology platform for civil society organizations in developing countries so that communication and collaboration can take place beyond the occasional conference.  Young discussed the technical details Envaya’s innovation that enabled the rapid spread of their platform among the grassroots organizations in Tanzania and elsewhere.

 

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