The FDA’s CD-3, already deployed for drug authentication in the U.S., is designed to work under real-world conditions for drugs in developing countries. The CD-3 device is based on sample illumination at specific wavelengths of light and visual comparison to a standard. It is a non-destructive, rapid, portable device that requires little training for effective use. The study in Ghana will allow for understanding of the capability of the CD-3 to discriminate between authentic and falsified medicines in the field in real time.  For the Skoll Global Threats Fund, we are testing the implementation of a technology that, if successful, will be in line for implementation at scale in other endemic malaria regions as well, including South East Asia.

We’re testing this out with malaria first as the real world crisis of counterfeit and substandard drugs threatens global health efforts to combat this illness. But we hope the technology can be proven effective for other drugs and other uses as well. It will help prevent ineffective or detrimental interventions on known diseases, such as malaria. But it could prove particularly useful in cases of sudden epidemic outbreaks, where desperate people could provide a ready market for unprincipled opportunists willing to sell fake drugs.  At a higher level, we see the ability to take these types of technologies effectively into the field as critical for tackling global health threats from infectious diseases. The ability to scan a medication is not too different technologically than the ability to scan, say, a blood or sputum sample for telltale signs of disease in a point of care diagnostic platform.This is what makes the CD-3 particularly interesting to us, because it can serve as a proof of concept of what might be possible for point of care diagnostic tools going forward.

Navigating the ‘vast sea of unknowns’ of water risk

We know less about one of world’s most pressing challenges today than we did 10 years ago. It’s no secret that water – or the lack thereof – will be one of the defining issues of the 21st century. And yet, the United Nations World Water Report, in 2009, stated that when it comes to water, “less is known with each passing decade.”

The World Economic Forum recently named the water supply crises as one of the top risks facing the planet – edging out issues like terrorism and systemic financial failure. Water risks permeate almost every aspect of global society. We got a taste last year with crops scorched by drought, shipping lanes threatened and energy plants shut down by low water levels, and coastlines devastated by flooding. Exacerbated by climate change and population growth, such crises will become more common and costly. Yet, the world largely lacks the data we need to monitor, understand, and respond to these water challenges. We are flying blind when it comes to global water issues.

History shows us the power of information to avert crisis. For example, as a result of a dramatic increase in data, the public health community has transformed its ability to identify and respond to a pandemic. Less than 20 years ago, it took, on average, 167 days to detect and verify a disease outbreak.

Today, it takes less than 20 days largely because of advances in data collection and availability, including leveraging passive data through tools like Google Flu Trends and web scrubbers like the Global Public Health Intelligence Network. The health sector has invested in better information to detect pandemics. It’s time for the water sector to invest in better water data to respond to devastating water-related disasters and increasing water risks.

Unfortunately, directly observed data on water is patchy at best, non-existent at worst. The Global Runoff Data Centre is the closest thing to an international clearinghouse for information on how much water is in rivers worldwide. But the number of data collection stations reporting to the Centre has fallen steadily since the 1980s; only about one-third of the observing stations report their data to the Centre. Many stations are no longer being maintained, have been eliminated, or are reluctant to publicly share the data. Of particular concern are the region’s most at risk – the Middle East, South Asia, and Africa – where publicly available water data is nearly absent.

Even in the United States, the story is not so different. The country is still recovering from impacts of Superstorm Sandy, which cost over $60 billion, and the ongoing drought, which may turn out to the be the costliest natural disaster in U.S. history.

Meanwhile, the U.S. Geological Survey reported that between 1980 and 2004, over 2,000 stream gauges to measure river levels were shut down, a loss of more than a quarter of the nation’s total network. These gauges help predict floods and droughts and provide the data needed to monitor changes in water stress. The current budget “sequestration” could force USGS to shut down an additional 375 gauges.

To prepare for an increasingly water-insecure future, we urgently need to bridge this data gap.

The good news is we do not have to start from scratch. Using available data from satellites and state-of-the-art modeling techniques, it is possible to collect critical information needed to monitor and evaluate emerging water risks across the globe.

One example is Aqueduct, the global water risk mapping tool recently released by the World Resources Institute, with the support of the Skoll Global Threats Fund, and multinationals like Goldman Sachs, GE and Shell. Aqueduct offers free and open data, across twelve indicators of water risk, ranging from floods and droughts to access to clean drinking water. It also provides the ability to project changes in water risks in the coming years, according to the effects of climate change, and population and economic growth.

While Aqueduct represents an important resource, it is not enough. There is no substitute for directly observed, locally collected data. Bringing together such information can be a daunting task, but there are several important steps that must be taken to improve water data. We need increased investment in gathering local water data; and more stream gauges need to be installed, rather than shuttering those we already have. We need to meter groundwater, so we know how quickly these water suppliers are being depleted. We need to take advantage of new technologies, such as satellite remote sensing and crowd-sourced data, to fill the gaps. And perhaps most important, we need to change the paradigm from secrecy to transparency by negotiating ways to make existing data held by governments, companies and academic institutions freely available.

In 2012, a UNESCO report compared our understanding of water to “islands of knowledge in a vast sea of unknowns.” As we mark World Water Day 2013, it’s clear that this is no way to handle one of the defining challenges of our generation. Now more than ever, we have the capability to address our woeful lack of water data. We just need the will to do so.

The Commission was co-chaired by Judith Rodin, Rockefeller Foundation, and Felix G. Rohatyn, Special Advisor to the Chairman and CEO,Lazard Frères & Co. LLC. I was delighted to have been asked to be a commissioner.

The preliminary report focused on improving the strength and resilience of New York State’s Infrastructure. The Governor announced plans in the State of the State to implement and accelerate the development of more resilient critical infrastructure systems. The Governor will be reviewing the recommendations as part of the effort to help protect New York from future storms and natural disasters. The full report is located here.

The report highlights nine major cross-cutting recommendations relevant to multiple sectors and systems.

• Enhance institutional coordination
• Improve data, mapping, visualization, communication systems
• Create new incentive programs to encourage resilient behaviors and reduce vulnerabilities
• Expand education, job training and workforce development opportunities
• Protect, upgrade, and strengthen existing systems
• Rebuild smarter: ensure replacement with better options and alternatives
• Encourage the use of green and natural infrastructure
• Create shared equipment and resource reserves
• Promote integrated planning and develop criteria for integrated decision-making for capital investments

Additional recommendations are categorized by different sectors: transportation, energy, land use, insurance, and infrastructure finance.

CORDS works on four primary objectives to improve global disease surveillance: improving capacity; advancing One Health (human, animal and environmental health together); promoting innovation; and building sustainable networks. CORDS complements the work of the leading global human, animal and food health organizations. The World Health Organization, the World Organization for Animal Health and the Food and Agriculture Organization of the United Nations have all welcomed the creation of CORDS (see their joint letter here).

Funding of CORDS as an independent entity comes from the Rockefeller Foundation, the Bill & Melinda Gates Foundation and the Skoll Global Threats Fund following initial project support from the Nuclear Threat Initiative, the Peter G. Peterson Foundation and the Rockefeller Foundation.

The six founding networks of CORDS are

-       The Asian Partnership on Emerging Infectious Disease Research
-       The East African Integrated Disease Surveillance Network
-       The Mekong Basin Disease Surveillance Network
-       The Middle East Consortium on Infectious Disease Surveillance
-       The Southeastern Europe Health Network
-       The Southern Africa Center for Infectious Disease Surveillance

More details on CORDS, as well as case studies from several of its member networks, can be found in a special supplement to the Emerging Health Threats Journal here (or via PDF). For more information, visit www.cordsnetwork.org. Follow CORDS on Twitter at @CORDSNetwork.