POVERTY: COTE D'IVOIRE: On-hold aid projects set to resume

29 September 2010 (IRIN) - The World Bank says it will give a record US$540 million over three years to finance post-conflict recovery and development projects in Côte d'Ivoire.

Aid agencies hope the money will enable several on-hold projects to resume after an almost five-year election impasse that has set back the country's development prospects. [[http://www.irinnews.org/Report.aspx?ReportID=90367 ]

The UN Children's fund (UNICEF) says many of its projects have been on hold until World Bank funding is confirmed, including a project aimed at special needs children, according to communications director Louis Vigneault-Dubois.
"What happens [now] depends on if we and the Ministry of Education are able to get adequate funds," he told IRIN. 
 Of the total allocation, the World Bank announced it will channel $20 million to provide health care for people living with HIV; $120 million for post-conflict rebuilding; and $13 million to improve government transparency. The bank is carefully targeting money to specific projects and aid partners, due to "mistakes" made in the past, its Côte d'Ivoire director, Madani Tall, told reporters in Abidjan.
Altogether, donors committed $750 million to the country between April 2008 and July 2010.

Poverty in Côte d'Ivoire has risen steadily over recent years: 39 percent of people lived on less than US$2 a day in 2002, versus 49 percent in 2008, according to the World Bank.

Tall said the World Bank needed to continue to support what it called the "backbone" of West Africa. Elections are due to be held on 31 October.



Http://www.irinnews.org/report.aspx?ReportID=90622

MALNUTRITION: Aquaculture "vital" to Asia's food security

Photo: Courtesy of FAO


22 September 2010 (IRIN)
One out of every two fish consumed throughout the world comes from aquaculture
Improvements in aquaculture could be an important tool in combating Asia's increasing food insecurity, specialists say.


"We have to produce 30 million more [metric] tons of fish - 50 percent more - by 2030 or people will not be able to eat," Rohana Subasinghe, a senior aquaculture specialist for the Food and Agriculture Organization (FAO), told IRIN from Phuket, Thailand. "There is nothing more we can bring from the sea so the gap has to be filled by aquaculture."


Subasinghe's remarks coincide with the beginning of a four-day global conference on fish farming, an industry that provides nearly half the world's fish for human consumption. Scientists and policy-makers from 60 countries have gathered in Phuket to discuss the industry's progress since the last meeting in Bangkok 10 years ago.


FAO estimates more than half the world's undernourished people - 642 million - live in the Asia and Pacific.


http://www.irinnews.org/report.aspx?Reportid=90549

MALARIA: India: acute febrile illness, differential diagnosis

Loccal prevalences of individual diseases influence the prioritization of the differential diagnoses of a clinical syndrome of acute undifferentiated febrile illness (AFI). This study was conducted in order to delineate the aetiology of AFI that present to a tertiary hospital in southern India and to describe disease-specific clinical profiles. An 1-year prospective, observational study was conducted in adults (age >16 years) who presented with an undifferentiated febrile illness of duration 5–21 days, requiring hospitalization. Blood cultures, malarial parasites and febrile serology (acute and convalescent), in addition to clinical evaluations and basic investigations were performed. Comparisons were made between each disease and the other AFIs. A total of 398 AFI patients were diagnosed with: scrub typhus (47.5%); malaria (17.1%); enteric fever (8.0%); dengue (7.0%); leptospirosis (3.0%); spotted fever rickettsiosis (1.8%); Hantavirus (0.3%); alternate diagnosis (7.3%); and unclear diagnoses (8.0%). Leucocytosis, acute respiratory distress syndrome, aseptic meningitis, mild serum transaminase elevation and hypoalbuminaemia were independently associated with scrub typhus. Normal leukocyte counts, moderate to severe thrombocytopenia, renal failure, splenomegaly and hyperbilirubinaemia with mildly elevated serum transaminases were associated with malaria. Rash, overt bleeding manifestations, normal to low leukocyte counts, moderate to severe thrombocytopenia and significantly elevated hepatic transaminases were associated with dengue. Enteric fever was associated with loose stools, normal to low leukocyte counts and normal platelet counts. It is imperative to maintain a sound epidemiological database of AFIs so that evidence-based diagnostic criteria and treatment guidelines can be developed.







http://td.rsmjournals.com/cgi/content/abstract/td.2010.100132v1

MALARIA: mosquito odor receptor

Researchers at Vanderbilt University have identified a new family of odor receptors that mosquitoes use to locate their prey. Their discovery could help explain the puzzling mechanisms behind the mosquito’s sense of smell. Funded by NIAID, the study was published in the journal PLoS Biology in August 2010.



Mosquitoes’ olfactory system is crucial for their survival but poorly understood. A team led by Vanderbilt’s Laurence Zweibel, Ph.D., found differences between two sets of odor receptors in mosquitoes, which could help explain how they are attracted to human odors. Such knowledge may lead to new ways to repel mosquitoes that spread infectious diseases such as malaria, dengue, and West Nile virus.



http://www.niaid.nih.gov/topics/vector/Pages/mosquitoeOdorSensor.aspx.









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MALARIA: Worldwide spread of Plasmodium falciparum drug resistance

Worldwide spread of Plasmodium falciparum drug resistance to conventional antimalarials, chloroquine and sulfadoxine/pyrimethamine, has been imposing a serious public health problem in many endemic regions. Recent discovery of drug resistance-associated genes, pfcrt, pfmdr1, dhfr, and dhps, and applications of microsatellite markers flanking the genes have revealed the evolution of parasite resistance to these antimalarials and the geographical spread of drug resistance. Here, we review our recent knowledge of the evolution and spread of parasite resistance to chloroquine and sulfadoxine/pyrimethamine. In both antimalarials, resistance appears to be largely explained by the invasion of limited resistant lineages to many endemic regions. However, multiple, indigenous evolutionary origins of resistant lineages have also been demonstrated. Further molecular evolutionary and population genetic approaches will greatly facilitate our understanding of the evolution and spread of parasite drug resistance, and will contribute to developing strategies for better control of malaria.



http://www.scopus.com/record/display.url?eid=2-s2.0-67650397861&origin=inward&txGid=uVIA_6LZlE4XnCNi3IPl8hk%3a4

MALARIA: India: Persistent transmission of malaria in Garo hills of Meghalaya bordering Bangladesh, north-east India

Malaria Journal 2010, 9:263doi:10.1186/1475-2875-9-263
Published: 22 September 2010

Abstract (provisional)
Background
Malaria is endemic in Garo hills of Meghalaya, and death cases are reported annually. Plasmodium falciparum is the major parasite, and is solely responsible for each malaria-attributable death case. Garo hills are categorized high-risk for drug-resistant malaria; however, there exists no data on malaria transmitting mosquitoes prevalent in the region. Included in this report are entomological observations with particular reference to vector biology characteristics for devising situation specific intervention strategies for disease transmission reduction.

Methods
The epidemiological data of the West Garo hills have been reviewed retrospectively for 2001-2009 to ascertain the disease transmission profile given the existing interventions. Point prevalence study was conducted in Dalu Community Health Centre that lies in close proximity to international border with Bangladesh to ascertain the true prevalence of malaria, and parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination, and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT.

Results
Investigations revealed that the West Garo hill district is co-endemic for Plasmodium falciparum and Plasmodium vivax, but P. falciparum was the predominant infection (>82%). Malaria transmission was perennial and persistent with seasonal peak during May-July corresponding to months of high rainfall. Entomological collections revealed that Anopheles minimus was the predominant species that was incriminated by detection of sporozoites in salivary glands (infection rate 2.27%), and was ascertained to be fully susceptible to DDT.

Conclusion
For the control of malaria, improved diagnosis and sustained supply of drugs for artemisinin-based combination therapy are strongly advocated, which should be enforced for treatment of every single case of P. falciparum. Greater political commitment is called for organized vector control operations along border/ high-risk areas to contain the spread of drug-resistant malaria, and averting impending disease outbreaks.


http://www.malariajournal.com/content/9/1/263

MALNUTRITION: Concern for water safety

 

 

 

 

 

 

 

 

MALARIA: Who Are the MDG Trailblazers?

In this working paper, the authors introduce an MDG Progress Index to assess how on or off track countries are toward MDG targets. They find evidence of dramatic achievements by many poor countries, such as Honduras, Laos, Ethiopia, Uganda, Burkina Faso, Nepal, Cambodia, and Ghana. These countries’ performance suggests that they may achieve most of the highly ambitious MDGs. Moreover, sub-Saharan Africa accounts for many of the star MDG performers. Interestingly, poor countries perform nearly on par with middle-income countries. Not surprisingly, the list of laggards largely consists of countries devastated by conflict over the last few decades, such as Afghanistan, Burundi, the DRC, and Guinea-Bissau. Most countries fall somewhere in between, demonstrating solid progress on some indicators and little on others. BUT ..
We also have excluded seven environmental indicators and five malaria indicators because of the lack of available data – especially for baseline years. For some indicators, multiple data sources were examined, which produced slightly different results in select instances.
 
http://www.cgdev.org/content/publications/detail/1424377/

MALNUTRITION: Subsidies won't keep bread on Mozambican tables

29 September 2010 (IRIN) - In response to food price riots in early September, the Mozambican government has laid on a range of price cuts and subsidies to make life easier for the poor, and has promised to do some belt tightening of its own, but observers say the measures are unaffordable and will not address the deeper issues.
"When you have riots you need to do some damage control," Fernando Lima, a prominent Mozambican publisher and journalist, told IRIN. "This is a short-term solution as an emergency measure."
Mozambicans in the capital, Maputo, and the nearby town of Matola, took to the streets after the government announced on 1 September that the price of bread and other basic goods would rise.
In defence of its decision, the government pointed to external factors like drought and wildfires in Russia - one of the world's major wheat suppliers - to justify the higher prices and quell violent protests and looting that left hundreds injured and at least 10 dead.
Antonio Fernando, Minister of Trade and Industry, noted on state-run television that global oil prices had increased, while climate change and "other factors" had brought about a worldwide slump in wheat production. "We have to understand that the financial crisis has still not passed and will take time ... we are still suffering the impact [of it].
"A day later president Armando Guebuza told Mozambicans that his government understood the hardship of the poor, "which is aggravated by external factors, such as the financial crisis and the rising price of food and fuel". Security forces cracked down hard on what they called a group of raiding "bandits".
Lima suggested that while external factors might have added to the growing discontent in the capital, other issues closer to home - like poverty and unemployment - were also to blame. "The very poor are very angry, and they have the sympathy of most of the country," he said.


Cheap bread back on menu
The unrest subsided only when, on 7 September, the government announced a u-turn on measures it had previously called "irreversible". Fernando told Mozambique's official news agency, AIM, that the bread subsidy would require "a major financial effort from the government", but no exact figures were given.
On 21 September, two weeks after the first riots, AIM reported that registered bakers would receive a subsidy of 200 meticais (US$5.6) for every 50 kg bag of wheat flour - costing 1,050 meticais (US$28) - they purchased.
Other relief measures include halving water connection fees for low-consumption households, considerably reducing the cost of piped water to the poor, and giving free electricity to households consuming 100 kwh or less; prepaid electricity consumers will no longer pay for trash collection.


Generalized fuel price subsidies will be converted into a direct subsidy for urban public transport, which will avoid giving subsidies to the rich who have their own vehicles.
The price of low-grade rice will be reduced by 7.5 percent, the surtax on imported sugar will be temporarily removed, and customs duties will be lower on vegetables like potatoes, tomatoes and onions imported from South Africa.
The government would also do its bit: the wages and allowances of all senior officials, board members of parastatals, and companies in which the state is the major shareholder would be frozen pending the outcome of an assessment of the wages policy. Wages would also have to be paid in local rather than foreign currency to bolster the national monetary unit.
State air travel would also be restricted; Guebuza promptly cancelled a scheduled trip to New York to attend the recent gathering at the UN to discuss the Millennium Development Goals (MDGs).
Richard Cornwell, Director of Current Affairs at the Africa Public Policy and Research Institute in South Africa, a think-tank, said the gestures were nice but not enough, and described them as "just a stopgap". "The pro-poor attention embodied in every measure announced by the government is a significant change," Young Kim, the World Bank's acting representative in Mozambique, told IRIn
Triggers
"The protests seem to have been a manifestation of underlying frustration ... depreciation of the metical since the beginning of the year led to rapidly rising inflation and accentuated the frustration over joblessness and poverty," Kim said.
International Monetary Fund (IMF) figures show that the metical depreciated by more than 30 percent in nominal terms against the currencies of Mozambique's major trading partners - up to 50 percent against a strengthening South African rand, and 30 percent against a recovering US dollar - and by August 2010 year-on-year inflation had reached 17 percent.
Victor Lledó, Resident Representative of the IMF in Mozambique, said the cost of living for most ordinary Mozambicans had risen sharply since the beginning of 2010, and although "food prices played a very important role in the riots", the increase in the price of bread, along with the announced increases in the water and electricity tariffs, were only "the triggers"."Because of the depreciation [of the metical], and because Mozambique imports quite a significant amount of its consumption goods [mainly from South Africa], there was a marked increase in living costs," Lledó told IRIN. "High and accelerated inflation has a significant impact, particularly on the poorest segments of society ... High inflation is a high tax on the poor."


Economic growth without jobs
Kim said the country had come a long way, but at the heart of the recent problems there was a growing feeling among Mozambicans that years of high growth in the gross domestic product had not significantly benefited the poor or translated into desperately needed jobs.
Economic growth hit double digits after a brutal civil war came to an end in 1992, and since 1996 the economy has grown by an average of 8 percent a year; government figures project growth in 2011 at 7.2 percent, but most experts agree that the type of growth Mozambique has experienced has not really been "pro-poor".
Foreign aid inflows and capital-intensive "mega-projects" - like the state-owned HCB power-station on the Cahora Bassa Dam, one of Africa's most powerful hydroelectric plants, and the Mozal aluminium smelter, which contributes almost three-quarters of the country's exports - add significantly to GDP figures but do not do much for jobs.
"Unemployment is a serious problem but it's not really measured," Kim said. Joblessness is officially estimated at just over 25 percent but is generally believed to be higher.
"It's about cost of living, and food is a core component of that," said Joseph Hanlon, Senior lecturer at the Development Policy and Practice department of Britain's Open University. "Half of Mozambique's population is poorer than it was 10 years ago, and all indications are that poverty in Maputo city is increasing sharply."
A widely quoted figure by government as well as donors is that the number of people living below the poverty line fell dramatically from 69 percent in 1997 to 54.1 percent in 2003, but the figure in the government's September Report on Millennium Development Goals 2010 was 54.7 percent.


Opportunity in agriculture
After almost three decades of peace Mozambique still depends heavily on aid and the domestic economy has failed to develop or diversify. "It's classic Dutch disease," Kim noted, referring to an economic term that describes how an increase in revenues from natural resources (or inflows of foreign aid) can lead to an immediate currency appreciation, making domestically produced goods less competitive internationally.
"Mozambique has got to start taking seriously the business of agricultural development. Aluminium smelters are all very well and good, but the linkages with the rest of the economy are too poor for it to be sustainable as a national development strategy," Cornwell noted.
"The [mega-projects] are essential ... because they create a cash cow for governments, but they do little to uplift the peasant in the countryside." Hanlon agreed, calling for urgent state intervention to help create the necessary domestic markets to help boost small- and medium-scale farmers.
"An area that the government itself is very aware of is the need to increase agricultural production; Mozambique has large areas of arable land that are not well used," the IMF's Lledó commented.
"If this dynamic could be changed, the food supply would be improved and Mozambique would need to import less, and that would shield it from movements in the volatile international markets," he said.
"The crisis has provided the government with a very good opportunity to show the donors how committed they are to improving the targeting of their expenditures, and making those expenditures more pro-poor," Lledó noted.
"With the World Bank, we [IMF] have been strongly advocating for the government to look at the possibility of introducing new social safety-net systems, or to scale up existing ones. One strong candidate would be conditional cash transfers."


Http://www.irinnews.org/report.aspx?ReportID=90618

MALNUTRITION: MALI: Cured meat as a cure

BAMAKO, 23 September 2010 (IRIN) - Destocking weak animals has long been considered part of the emergency and recovery response to help pastoralists survive, and protect their livelihoods in droughts, but experts say destocking must come sooner - before emergencies develop.
In northern Mali, 40 percent of herders' animals are believed to have died from starvation or disease due to lack of pasture this year - a stark statistic in a region where 80 percent of people rely on stockbreeding and agriculture to survive.
"The crisis has been known for a long time - since November 2009. If we had all responded a lot earlier [to livestock needs] we could have reduced pastoralists' stress movements, and remaining animals would have stayed alive," said Marc Chapon, head of NGO Agronomes et Vétérinaries Sans Frontières (AVSF), in Mali.
Aid agencies Oxfam and the International Committee of the Red Cross (ICRC) have been leading destocking programmes in northern Mali to help inject cash into pastoralists' pockets; improve the prospects for the remaining healthy flock; reduce pressure on the fragile environment; and in ICRC's case, improve food security by redistributing slaughtered animals as cured meat.
ICRC staff buy sheep, goats and cattle at pre-crisis prices - US$ 40 for a sheep or goat, $150 for a cow - from herders with 50 animals or less, so they can buy grain to fill the hunger gap, said Christian Wabnitz, ICRC's deputy head in Mali and Niger. Thus far, ICRC has bought 36,000 animals in Agadez (northern Niger) and in Gao and Timbuktu (both in northern Mali); and given veterinary help and fodder to 60,000 stronger animals that remain.
"The main aspect is a cash injection, but the meat is also available which can boost nutrition," Wabnitz said. "And allowing weakened or sick animals to die can protect the health of the remaining herd."

The agency works with district vets to kill the weakened animals, and with women's cooperatives to cure the meat, before distributing it to beneficiaries, prisons, hospitals and schools.
Community members inform how the animals are killed, to ensure it is done in line with traditional practice, said Wabnitz. Women cure the meat by cutting it into strips which are then marinated in salt and dried in a protective cage.
"There are some other more advanced [curing] techniques, but we want to fine-tune our approach to suit cultural habits," he pointed out.

Resistance
But some herders are reluctant to give up their animals, despite their deteriorating health, says World Food Programme head in Mali Alice Martin-Dahirou. "Some nomads would rather keep their animals to the end, and see them die, rather than selling them en masse," she said.
Weakened goats and sheep were selling for just $10 at the height of the crisis; while in neighbouring Niger, cattle worth $300 were reportedly sold for as low as $6.
Herd size is an important cultural status symbol. "A large herd is like a large bank account - and it is a way to accumulate further wealth, as well as ensuring social functions can be acted upon, so some nomads will resist culling," Wabnitz told IRIN.

Resistance to destocking - with or without slaughter - is common in African pastoralist zones, said Food and Agriculture Organization (FAO) animal production officer Nacif Rihani. "There is often confusion between the early and accelerated livestock off-take [culling], which is the main objective sought, and the distress sale of livestock, which herders fear the most," he said.

["Distress sales] can cause psychological and cultural shock, in addition to the loss of livestock assets, which are crucial for their livelihood, food security and social status," he said.

Reluctance can also come from bad past experiences in which agencies have taken a top-down, non-consultative approach, to destocking, said Rihani. Local and indigenous organizations must take the lead in selecting beneficiaries and stocks; organizing stock sales; and agreeing on pricing and meat preparation and preservation methods if destocked animals are slaughtered, he pointed out.

This approach is in line with the Livestock Emergency Guidelines and Standards, which were issued in 2009 to improve the quality of livestock relief interventions. [http://www.livestock-emergency.net/about-legs/index.html]
As the Sahel crisis deepened, reluctance among herders dissipated in northern Mali, said Wabnitz, which he says is "an indication of how bad the situation was". [[http://www.irinnews.org/IndepthMain.aspx?IndepthId=81&ReportId=89910]


Timing
Despite ample early warning, in northern Mali, destocking came late, said AVSF's Chapon: it should always be addressed in the first emergency phase of a crisis.
But FAO's Rihani says in slow-onset droughts destocking can get started even sooner. "Specific indicators can trigger the appropriate response, and [enable] adequate resources - such as a flexible local fund - to be put in place to start destocking," he said.
If done this early, animals will retain their market value.
Indeed, experts recommend continual destocking to regulate herd numbers and not over-pressure the fragile ecosystem. "In many pastoral and agro-pastoral zones in Africa, herd sizes expand to unsustainable numbers [encouraged by]. subsidies or direct aid through animal feed," explained Rihani.

Herders do regulate their herds to some extent, but complex social and ethnic issues are at play which can encourage herd-growth. An indirect approach is needed, says Rihani, involving a stress on improving milk production per animal; improving access to livestock markets; and helping herders attain fair prices for their animals, so they can get more out of a smaller herd.



Http://www.irinnews.org/report.aspx?ReportID=90566

TUBERCULOSIS: SOMALIA: Khat-chewing contributes to rise in Burao TB patients

BURAO, 23 September 2010 (IRIN) - The number of tuberculosis patients in Burao, in Somalia's self-declared independent republic of Somaliland, has increased because of khat use as well as rising displacement due to drought and conflict, say officials. "Currently, Burao General Hospital has 130 male and 30 female patients admitted to the TB ward," Abdijibar Mohamed Abdi, a director of the TB unit at hospital, told IRIN. "One of the reasons for the high rate of infection among men is the chewing of khat, which is done in poorly ventilated rooms for many hours. Such men are also at greater risk due to hunger and sleeplessness as the chewing takes place mostly at night."
Since 2009, Abdi said, the hospital has handled 1,200 TB patients. The hospital provides medication to 250-300 TB patients quarterly under the World Health Organization (WHO) DOTS system - directly observed treatment short course - whereby health workers ensure the patient takes the dose, he added.
Another contributor to the increase, Abdi said, was lack of access to health facilities by nomadic communities.
"Such people do not settle anywhere and may not have enough TB education. As it is difficult to reach them since many often graze their herds far from health facilities, some of them end up spreading TB," he said.
Moreover, he said, many people displaced due to either drought or conflict do not seek treatment. "When people are in such emergency conditions, personal health is not a priority."
Abdi said the hospital recently built two extra TB wards to cope with the rise in patient numbers.
Public health concerns
Hussein Mohumed Hog, a doctor in the Somaliland Ministry of Health, said TB was a "huge" public health problem in the Togdheer region, where Burao is located, and that the management of the disease had been complicated by non-payment of health workers in the past four months.
"Togdheer region [in the east] has one of the highest rates of TB yet the health workers have not received salaries in the transition period since presidential elections in June; this is one of the staff complaints we have received," Hog said. "The ministry is currently processing these payments and is planning to reopen most of the MCH [mother-child health centres] in urban areas in eastern Somaliland to follow up TB cases."
Hog said Togdheer, Mudug and Bay were some of Somaliland's regions with high TB infection rates, according to former Somalia health ministry reports.
Burao General Hospital was constructed in 1945 when the region was a British colony.
Abdi said the local authority in Burao had since renovated the facility, which also receives funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria. This, he said, had given the urban population easy access to a health facility offering TB services.
"There is no shortage of drugs, which we get from the Global Fund through World Vision International and WHO," Abdi said. "The local business community also supports some facilities in the hospital."

Http://www.irinnews.org/report.aspx?ReportID=90564

MALARIA: SUDAN: Southern hospital cannot cope with demand

MALAKAL, 23 September 2010 (IRIN) - Doctors are working 12-16 hour shifts to cope with the increasing demand at Malakal teaching hospital in Upper Nile State of Southern Sudan, say officials.
"We are trying to encourage more doctors to come work here," Upper Nile State health minister Steven Lor said. The relatively poor living conditions in Malakal, however, made it difficult to convince Southern Sudanese doctors working in the capital Khartoum to move.

The hospital director, Tut Gony, said in the past two months, more than 2,000 people had sought treatment at the hospital. These included 700 malaria cases, many of whom were children.

"Our capacity and resources at this hospital do not match the high demand for services," Gony told IRIN. The hospital, the only such facility in the state, has 14 doctors for the state's population of 126,000, according to the 2006 national census.

To cater for this population, as well as some patients from neighbouring Jonglei State, the hospital needed more beds, new surgical equipment and a steady stream of drugs, Gony said.

The current rainy season, which has left four of Upper Nile's nine counties partially under water, was likely to increase health risks. "We have a serious problem with sanitation in Malakal," he added. A survey by the NGO Relief International in 2007 found that 80 percent of the residents had no access to latrines or any other toilet facilities.

The town used to have a piped water supply system but it collapsed during the civil war between the Southern Sudan People's Liberation Movement and the Sudan national army. The war ended in 2005, but by then the pipes were blocked or had been looted.

Lor said the current flooding had created a potential problem of disease outbreak. "After the water comes down, we're expecting there will be more problems," he said, noting that possible diseases included Bilharzia and Kala-azar, which is endemic in some parts of Southern Sudan, with outbreaks every five to 10 years.

A team led by Jalal Mohammed, a northern Sudanese internal medicine specialist, is in Malakal now to distribute anti-malarial drugs and administer treatment to patients with diarrhoea-related conditions, using mobile health clinics.

According to data compiled by the Norwegian Refugee Council, Southern Sudan has one of the highest infant mortality rates in the world at 89 deaths per 1,000 live births, and a maternal mortality rate of 2,038 deaths per 100,000 live births, which is more than 10 times that of Europe.


Http://www.irinnews.org/report.aspx?ReportID=90563

MDG's: Two successes of the MDGs

 22 Sep 2010 Many agree that the Millennium Development Goals will not be reached by the target year of 2015. Despite possibly falling short, the Goals have done something positive in giving the world benchmarks to measure progress. Even though the goals may be unrealistic, they still gave many something to strive for.
An article in today's Christian Science Monitor tires to relate what good the Goals have done. The Monitor article from Drew Hinshaw gives the top 5 MDG success stories. For our snippet, we are limited to giving you the top 2. Liesbet Steer of the Overseas Development Institute in London provides some quotes for Hinshaw.
1. Africa's future
There's one sector where Africa has undoubtedly soared: Education.
The percentage of children in school desks leaped from 52 to 74 percent since 1990. The continent started the race with many of the lowest enrollment rates, but even in absolute terms, Africa boasts nine of the top performers on boosting enrollment. Look at Madagascar – the country was temporarily overthrown and ruled by a disc jockey last year, but has managed to put 99 percent of its kids in school.
2. Ghana, Ethiopia, and Africa’s success stories
Viewed through the unflattering lens of bad governance, Africa’s less-than-stellar performance on poverty reduction during the financial crisis makes sense, says Steer. The continent’s poverty rate has dropped only 12 percent in the past 18 years. Infant mortality has barely fallen at all.
But the first decade of the new millennium hasn’t been a complete wash for the earth’s oldest continent, Hay says.
"Sub-Saharan [Africa] is moving more slowly, but it’s moving,” he offered.
The West African nation of Ghana stands out as a success story. It's cut hunger levels by 75 percent since 1990.
Across the continent, in Ethiopia, the percentage of people scraping by on $1.25 a day cascaded from 60 percent to 16 percent.
Angola and the Senegal have already halved their poverty rates.
http://www.csmonitor.com/World/Global-Issues/2010/0922/Top-5-Millennium-Development-Goal-success-stories/Southeast-Asia

POVERTY: AFGHANISTAN: Pressure on wheat prices

DUBAI, 23 September 2010 (IRIN) - Abundant global wheat stocks and unusually good wheat harvests in Afghanistan in 2009 and 2010 have kept prices in the country relatively stable so far. According the Ministry of Agriculture, Afghanistan will only need to import 14 percent of its wheat needs this year (about 700,000 tons) - down from recent levels of 25-33 percent.
However, there are indications prices could rise in the coming months, placing an additional burden on poor people in a country considered one of the most food insecure in the world.
The floods in Pakistan, which traditionally accounted for more than half of all Afghan wheat imports, could drive up wheat prices. Kazakhstan, another major exporter of wheat to Afghanistan, has seen prices rise following news that the 2010 Kazakh cereal harvest is anticipated to be 22 percent below average. The Russian export ban adds to the pressure on prices. On the other hand Uzbekistan may well be in a position to fill the gap.
On the domestic front, the US Agency for International Development's Famine Early Warning Systems Network (FEWS NET) [ http://www.fews.net/docs/Publications/afghanistan_FSOU_08_2010.pdf ] said in August that food security conditions were expected to deteriorate in production-deficit provinces in southern, eastern, and central Afghanistan where poor harvests and recent flooding had constrained supplies.
Additional pressure on wheat prices is usually triggered by demand for wheat during September, October, and November as Afghans build stocks ahead of winter.
According to a 6 April report [ http://ftp.info.usaid.gov/our_work/humanitarian_assistance/disaster_assistance/countries/afghanistan/template/fs_sr/fy2010/afghanistan_ce_sr01_04-06-2010.pdf ] by the US Agency for International Development, the Afghan government has 70,000 tons of wheat in a newly created Strategic Grain Reserve for use in food emergencies. The government procured the excess wheat from areas with agricultural surpluses in order to support local farmers and meet emergency food needs, but the reserve accounts for only 10 percent of this year's wheat shortfall.

Http://www.irinnews.org/report.aspx?ReportID=90559

POVERTY: MOZAMBIQUE: Hoping to reach the MDG on water

MACHAZE, 21 September 2010 (IRIN) - Every day Ster Mamboza, 37, covers 19 km on a bicycle over sand and gravel roads to the well at Machaze, in the southern Mozambican province of Manica, carrying two 20-litre plastic water containers and a two-month-old baby. It's quite a balancing act. The better part of her day is spent fetching water from this well, the nearest safe source in the area, "even when I am sick", because "we need water for everything we do in life. I only leave the baby at home when it is really hot, but I get anxious because sometimes it takes me more than six hours to get back," she told IRIN.
Other women waiting their turn at the well, like Kessina Muchanga, said they had come from villages up to 40 km away and spent well over 8 hours a day fetching water. "Sometimes I leave home at four in the morning and only get back at five in the afternoon. My two daughters always come with me so that between us we can bring back 120 litres - I have a family of eight," she told IRIN.
Poor access to safe water and adequate sanitation facilities lead to outbreaks of waterborne diseases like cholera and diarrhoea, a major cause of mortality, particularly among children.

"I would prefer to spend less time fetching water so that I could do other things, like enter an adult education programme or start a business to contribute to our household income," Mamboza said.

Off target

Although there have been improvements in recent years, government figures show that only 43 percent of Mozambicans have access to safe water, and a scant 19 percent have access to improved sanitation.
The situation in rural areas - where over 70 percent of the estimated 22 million people live - is worse than in urban areas, and only 30 percent have access to safe water and just 6 percent have access to improved sanitation.A 2009 joint assessment by the Ministry of Public Works and Housing, and the National Directorate of Water, found that main source of water for 36 percent of the population was unprotected wells.

These figures indicate that Mozambique will be hard pressed to achieve the Millennium Development Goal (MDG) of "To Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation." According to the UN MDG monitor, Mozambique is "off track" for the whole of goal 7, which is to "Ensure environmental sustainability".

Conditions in Machaze district reflect those in other parts of the country: of the 98 boreholes and wells to supply a population of 105,000 only 57 are in operation. On average over 1,842 people depend on a single source, while government policy stipulates that only 500 people should benefit from each water point.
Taking aim

To improve its chances of reaching the water-related MDG targets, in March 2010 government launched the National Rural Water and Sanitation Programme (PRONASUR) with a budget of US$300 million to ensure that 70 percent of the population has access to clean water by 2015, and 50 percent can access basic sanitation. The programme includes building 12,000 new water sources to benefit an additional 4.5 million Mozambicans.

"Water has always been a problem in here," said Matchaze district administrator Gabriel Machate. "This year we should have built 30 new boreholes but bureaucratic issues delayed the plans."


Http://www.irinnews.org/report.aspx?ReportID=90543

MDGs: Tracking progress on MDG six

NAIROBI, 21 September 2010 (PLUSNEWS) - Significant strides have been made in the global fight against HIV, but major gaps remain that could prevent many countries from achieving UN Millennium Development Goal (MDG) six [ http://www.undp.org/mdg/goal6.shtml ] relating to HIV/AIDS, malaria and other diseases.
Access to treatment - More than five million people [ http://data.unaids.org/pub/Report/2010/20100917_mdg6_report_en.pdf ] currently have access to life-prolonging antiretroviral drugs, a 12-fold increase over the past six years. However, this still represents just one third of people who need HIV treatment.
In 2008, 38 percent of the 730,000 children estimated to need antiretrovirals (ARVs) in low- and middle-income countries had access to them.
The Joint UN Programme on HIV/AIDS (UNAIDS) is calling for the implementation of a new treatment approach called "Treatment 2.0", to drastically scale up testing and treatment. UNAIDS estimates that successful implementation of "Treatment 2.0" could avert 10 million deaths by 2025, and reduce new infections by a third.
New infections - Twenty-two of the worst affected countries in sub-Saharan Africa have reduced HIV incidence by more than 25 percent in the last eight years, according to UNAIDS. Some of the best performers in reducing new infections are Ethiopia, Nigeria, Zambia and Zimbabwe; HIV incidence is on the rise in Uganda, once a leader in the fight against HIV.
Eastern Europe and Central Asia remain the only regions where incidence is increasing.
Globally, there are still five new infections for every two people put on ARVs.
Prevention of mother-to-child transmission - According to the UN World Health Organization's (WHO) Towards Universal Access report [ http://www.who.int/hiv/pub/tuapr_2009_en.pdf ] for 2009, the 20 countries with the highest burden of HIV among pregnant women have scaled up HIV counselling and testing to at least 75 percent of their antenatal care facilities.
Kenya, Malawi, Mozambique, South Africa, Tanzania and Zambia are among the countries that provided HIV testing to 60-80 percent of pregnant women, while Botswana, Namibia and São Tomé and Principe exceeded the 80 percent mark.
In 2008, 45 percent of pregnant women living with HIV in low- and middle-income countries received ARVs to prevent HIV transmission to their infants - up from just 10 percent in 2004.
HIV-related maternal and child mortality - In 2008, 9 percent of all maternal deaths in sub-Saharan Africa were HIV related, according to a new report, Trends in Maternal Mortality: 1990-2008 [ http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf ] by WHO and the UN Children's Fund, UNICEF. In Latin America and the Caribbean, HIV/AIDS was responsible for 5.2 percent of maternal deaths.
The report notes that there is evidence that women with HIV infection have a higher risk of maternal death.
Access to prevention of mother-to-child-transmission (PMTCT) improves outcomes for children as well, with studies [ http://journals.lww.com/aidsonline/Fulltext/2010/02200/Decline_in_early_life_mortality_in_a_high_HIV.12.aspx ] showing that in KwaZulu Natal, South Africa, child mortality declined by 34 percent following improvement in PMTCT. According to UNICEF, HIV is one of four diseases that accounted for 43 percent of all deaths in children under five worldwide in 2008.
Condom availability and use - Globally, condom use has doubled over the past five years, according to UNAIDS. An estimated 13 billion condoms per year will be needed by 2015 to help halt the spread of HIV, but only four condoms were available for every adult male of reproductive age in sub-Saharan Africa.
Female condoms are even less accessible. According to the UN Population Fund, UNFPA, [ http://www.unfpa.org/webdav/site/global/shared/factsheets/media_fact_sheet_condoms.pdf ] in 2009, one female condom was distributed for every 36 women worldwide.
Condom use remains low in many high prevalence countries. According to UNAIDS, [ http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf ] in South Africa, the proportion of adults reporting condom use during last sex rose from 31 percent in 2002 to 65 percent in 2008, but in Burundi, only about one in five people reported using a condom during commercial sex episodes.
New prevention technologies - The first positive results from a microbicide trial [ http://www.plusnews.org/Report.aspx?ReportId=89895 ] have injected fresh hope into efforts to halt the spread of the virus; the gel, containing the ARV Tenofovir, was found to be 39 percent effective in reducing a woman's risk of becoming infected with HIV.
"Treatment 2.0" also promises benefits for prevention, with evidence showing that people on ARV treatment are much less likely to transmit the virus.
A Thai vaccine trial completed in 2009 also provided the first evidence [ http://www.plusnews.org/Report.aspx?ReportId=86279 ] that a vaccine can provide some protection against HIV.
Male circumcision [ http://www.plusnews.org/IndepthMain.aspx?ReportId=73184&IndepthId=61 ], proven to reduce men's risk of infection through sexual intercourse by up to 60 percent, is being rolled out [ http://www.plusnews.org/report.aspx?ReportID=88286 ] in several African countries.
Several trials [ http://www.avac.org/ht/d/sp/i/3507/pid/3507 ] are under way to test the efficacy of pre-exposure prophylaxis (PrEP) whereby HIV-negative people take a single ARV drug or a combination of drugs with the hope that it will lower their risk of infection if exposed to HIV.

Tuberculosis - TB remains a major cause of death for people living with HIV. WHO estimates that in 2008, there were 1.4 million TB cases among people living with HIV and over 500,000 deaths. Drug-resistant TB is on the rise in several countries, but diagnosis [ http://www.plusnews.org/Report.aspx?ReportId=88489 ] remains very low.
TB research remains under-funded and the most widely used TB diagnostics are over 100 years old. For many co-infected patients in the developing world, late diagnosis leads to death.
The authors of a recent article published in medical journal The Lancet [ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61428-6/fulltext ] argue that TB control is crucial to achieving the MDGs, given its link to HIV mortality as well as maternal and child mortality.
Recent developments such as a new drug [ http://www.plusnews.org/Report.aspx?ReportId=84888 ] to treat TB and rapid, more accurate TB tests [ http://www.plusnews.org/Report.aspx?ReportId=90493 ] could lead to improvements in the diagnosis and management of the highly infectious disease.
New research showing that starting TB patients on ARVs earlier leads to better outcomes could also reduce mortality in co-infected patients.

Http://www.plusnews.org/report.aspx?ReportID=90534

MDG's: Next Millennium Development Goals 'should be more holistic'

Mićo Tatalović

16 September 2010
Goals focused on wellbeing might have been more effective, argues the report

The Millennium Development Goals (MDGs) were conceived with an outdated, fragmented approach to international development, and a new way forward will be needed after their due date in 2015, according to a report.
"Patchy" progress towards achieving the eight goals reflects fundamental problems with the way they were set up, says the report, launched ahead of the international summit on the goals in New York next week (20 September).

In particular, they were not designed to interact and support each other, says the London International Development Centre (LIDC) and the Lancet, which have set up the Lancet–LIDC Commission, producer of the report launched this week (13 September).
The eight United Nations MDGs were agreed in 2000 and are due to be met by 2015. A UN report published in June showed that countries have made only partial progress. But a draft declaration, expected to be formally adopted at next week's summit, maintains that the goals are achievable despite setbacks caused by the global financial and economic crises.
"MDGs do address many but not all key development challenges," said Andy Haines, director of the London School of Hygiene and Tropical Medicine. "This report for the first time really casts an interdisciplinary spotlight on the MDGs, what they will have achieved and where we need to go afterwards."
"The broad picture of MDGs is patchy progress, and not at a pace capable of achieving the goals by 2015," said Jeff Waage, director of the LIDC, who added: "Is this just a matter of effort or are there fundamental problems with the MDGs themselves that will hamper their achievement?"
The commission's report identifies a number of common features across the goals that have limited their implementation, he said.
First, the goals were put forward as separate, unconnected targets by the relevant communities working in those sectors, and each community had its pre-existing aspirations. Secondly, the goals were brought together without broader analysis of what was needed for them to work as a set, or how the different targets might interact, according to Waage.
As a result "there are considerable gaps between goals that undermine their capacity to achieve some interaction and synergy in development".
For example, the focus on children's early years in the education goal has meant it could not support one of the aims of the health goal, to build the workforce of health professionals in higher education.
The report also highlights the plight of those not targeted by the goals — such as those living on just over US$1 a day.
Another key problem has been ownership, according to Elaine Unterhalter, professor of education and international development at the Institute of Education in the United Kingdom.
"Certain MDGs have powerful advocates at international level or in certain ministries in individual countries, but the other MDGs do not," she said.
The commission has concluded that future goals should be centred on 'wellbeing', which has human, social and environmental components.
"We propose a conceptualisation of development as a dynamic process operating at multiple scales and with multiple agents, involving sustainable and equitable access to improved wellbeing ," said Andrew Dorward, professor of development economics at the School of Oriental and African Studies in the United Kingdom.
But Anthony Costello, head of the Centre for International Health and Development at University College London, said the term 'wellbeing', was vague and might be difficult to define and measure.
He said there was a need to engage stakeholders in developing countries in any post-2015 plans.
And Viroj Tangcharoensathien, from the International Health Policy Program, Thailand, a country that has already achieved all of the goals, said it was crucial for all countries to achieve them before considering further, more ambitious action.



Link to 'The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015'[2.23MB]


http://www.scidev.net/en/news/next-millennium-development-goals-should-be-more-holistic-.html

MALARIA: Antenatal care

20 September 2010


The relationship between antenatal care (ANC) visits and coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), and barriers to IPTp-SP access were examined. Four hundred and fifty-three women who had given birth during the study period were interviewed using a semi-structured questionnaire. Of these, 425 (93.8%) attended ANC at least once, but only 90 (21.2%) made four or more visits. Primigravidae 25 (29.8%) were more likely than multigravidae 65 (17.6%) to make more than four visits (P=0.012). Only 237 (52.3%) women accessed two or more doses of IPT-SP, which increased with the number of ANC visits (X2 for linear trends, 117.7, P<0.001). However, 131 (28.9%) women made two or more ANC visits, which were sufficient for them to access two or more doses of IPTp-SP, but they did not. The main reasons were: not given SP by the midwife for unknown reasons 36 (27.5%), SP stock-outs 34 (26%) and irregular ANC attendance 18 (13.7%). Frequent ANC visits do not seem to ensure access to IPTp-SP in the presence of other barriers. The Roll Back Malaria target of 80% of women accessing two or more doses of IPTp-SP by 2010 appears unachievable unless alternative channels of delivery are found.
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 104, Issue 8, August 2010, Pages 536-540

Richard Ndyomugyenyi, James Katamanywa

http://www.malarianexus.com/articles/read/83/intermittent-preventive-treatment-of-malaria-in-pregnancy-iptp-do-frequent-antenatal-care-visits-ensure-access-and-compliance-to-iptp-in-ugandan-rural-communities/

MALNUTRITION: MALI: Pockets of extreme vulnerability persist

20 September 2010 (IRIN) - Good rains in much of northern Mali over recent months have caused pasture to regenerate and animals to begin to recover in parts of Gao, Timbuktu and Kidal regions, but extreme vulnerability persists for Gao-based farming communities, who have exhausted all their coping mechanisms and are unable to recover their livelihoods, say aid agencies. "The pastoralist crisis is on the point of ending... and the price of animals is rising again, but for non-pastoral communities who depend on a good harvest, we have not yet seen the end. We are still in the peak of crisis, and emergency activities need to continue," said Philippe Conraud, Oxfam's West Africa emergency coordinator. Rains started slowly in June but became more intense in mid-July and August in much of the north, according to Action Against Hunger (ACF), and have continued into September. The practice of seasonal livestock movements has again picked up in much of the north, and the latest US Agency for International Development FEWS NET report [ http://www.fews.net ] predicted the 258,000 food-insecure would start to meet more of their food needs in coming months, though they may continue to face moderate food insecurity until the end of the year. Grain prices have risen to the five-year average, and the price of goats and sheep is rising to pre-crisis levels - up to US$50 from just $10 per animal in the peak of the pastoralist crisis, estimates head of NGO Agronomes et Vétérinaires sans Frontières (AVSF) Marc Chapon. But sedentary, farming communities in Gao continue to live in a situation of extreme stress as the pre-harvest lean season continues. They lack the option to up and leave to greener pastures, and must wait until harvest to repay debts. Repeat shocks, including the 2008 food price crisis and repeat drought have led households to go into extreme debt, said ACF head in Mali David Kerespars, and Oxfam's Conraud. ACF estimates 40 percent of households in Ansongo, on the Niger river in Gao are in debt and have no means to pay back creditors. Without help, Conraud predicts, "in the middle and long-term it could get even worse." Global acute malnutrition rates among under-fives in Ansongo are 18.5 percent, according to ACF's latest June nutrition assessment, up from 15.9 percent at the same time in 2009. With UK backing, ACF runs therapeutic feeding clinics through 17 regional health centres, and is providing wider food security interventions to all under fives to prevent them from becoming malnourished. Cases of acute malnutrition with complications are referred to regional health centres. Meanwhile, across the north, the government is subsidizing grain prices, and aid agencies, including the World Food Programme (WFP), the UN Children's Fund (UNICEF), the International Committee of the Red Cross, ACF, Oxfam, Save the Children and CARE, continue to support the government's response efforts to treat malnourished children, provide supplementary food, food and healthcare for animals, and help improve stock management. Variegated vulnerability Vulnerability is highly variegated among different livelihood groups in the north, say aid agencies. In areas surveyed in the Kidal and Timbuktu regions, global acute malnutrition is no higher than 10 percent, estimates UNICEF's nutrition manager Katrien Ghoos, though UNICEF's recent malnutrition assessment results are yet to be verified or published. While pastoralists are also highly vulnerable to shock, given "they have milk and animals, but no alternatives," and their acute malnutrition tends to rise sharply in a crisis, their prospects can shift dramatically when grazing land improves as animals are quick to recover milk production. Semi-sedentary agro-pastoralist populations who settle for months at a time along the River Niger, are slightly more protected from shock, says ACF's Kerespars. "They have more ability to cope with shocks such as droughts as they can migrate, find odd jobs, do artisanal work, or borrow money," he said. But the poorest of these communities in Gao have also exhausted their coping mechanisms, and are finding it hard to turn to short-term construction or labour in the fields, which can supplement over half of their income, given such work opportunities are down by a third this year, according to FEWS NET. Early recovery Early recovery efforts must start as soon as possible to help people bring their livelihoods back to pre-crisis levels, says Conraud. Oxfam hopes to start a cash transfer programme to help households pay off their debts and avoid having to sell grain at rock-bottom prices. The NGO and other aid agencies are meeting donors to try to encourage them to support such middle-term recovery efforts. The need to get communities back on their feet is all the more important, given the likelihood of northern communities facing more problems in the future, say aid agency representatives. The problems facing northern Mali - including drought, ongoing tension over pastoralist routes, continually growing populations, and ongoing insecurity - are not going to go away, warned WFP head Alice Martin-Dahirou.
Http://www.irinnews.org/report.aspx?ReportID=90522

MALARIA: Nigerians claim malaria drugs have failed to cure them

Many Nigerians claim that the malaria drugs they have been prescribed have failed to cure them of the disease. This is said to be the case even when recommended treatments (artemisinin combination therapies [ACTs]) have been given. Dr Babajide Coker, Coordinator of the National Malaria Control Programme (NMCP), has said that public concerns over this issue will be taken seriously and that 14 sentinel sites have been established across Nigeria to monitor the efficacy of the drugs currently being used.
The problem may well be attributable to counterfeit drugs; it is well known that many of the antimalarials available on the Nigerian market (including ACTs) are fake or substandard. However, the NMCP must be applauded for addressing what seems to be a growing belief in the country that even the recommended treatments for malaria are no longer effective. Dr Coker is reported to have stated that he can vouch for the effectiveness of recommended antimalarials but that public concerns “will not be treated with kid gloves”.
Dr Coker made his comments at a workshop at which concerns were also raised as to the lack of information provided to the public on the correct use of insecticide-treated mosquito nets.
Further details area available in an allAfrica.com report.
http://blog.tropika.net/tropika/2010/09/22/nigerians-losing-confidence-in-antimalarials/

MALNUTRITION: NEPAL: Lack of fertilizer hampers food security

21 September 2010 (IRIN) - Farmers in Nepal face an acute lack of fertilizers that could aggravate food insecurity, experts warn.

"There is definitely a shortage of [chemical] fertilizers. This will have a direct impact on the food security situation," Hari Dahal, a senior government official with Nepal's Ministry of Agriculture, told IRIN. The World Food Programme (WFP) estimates 3.6 million people are food insecure in Nepal.

While usage of chemical fertilizers is growing, budget cuts have limited Nepalese farmers to only a fraction of what their regional counterparts depend on.

Two thirds of paddy farmers in Nepal use fertilizers, and about half of wheat farmers, according to The Food Security Atlas of Nepal released in July by the government, WFP and the Nepal Development Research Institute. But on average Nepalese famers use 400 grams per hectare compared to 40kg in Japan, according to the Ministry of Agriculture.

The ministry's budget for this year is about US$100 million - barely 2.5 percent of the national budget - a dramatic decrease in 15 years from when a quarter of the budget was dedicated to agriculture - the livelihood of more than three-quarters of the nation's households.

In recent years fertilizer usage has risen 10 percent annually. In 2004, 285,000 tons was used compared to more than 500,000 tons this year, the Central Bureau of Statistics said. The government has provided only 100,000 tons of this amount.

"We have been asking the government to increase our budget - not just for supplying enough fertilizer but also to provide fresh crop seeds to farmers and [to] invest in irrigation development," the Agriculture Ministry's Dahal said, noting improvements in these three components could greatly help ease food shortages.

Experts say food shortages in the Terai region, the country's breadbasket, have been worsening over the years, with farmers depending heavily on chemical fertilizers to increase productivity.

"The shortage of fertilizers is now a growing problem and is quite seriously affecting the farmers of the Terai - unlike in the hills where farmers have almost given up hope of getting the fertilizers; especially because it is both inaccessible and unaffordable for them," agricultural expert Krishna Raj Aryal of the NGO Support Activities for Poor Producers of Nepal, said.

Imports

As Nepal does not produce its own chemical fertilizers, it purchases them under a special bilateral agreement with neighbouring India.

The government then sells the fertilizers at a highly subsidized rate, based on its formal fertilizer trade deal with India, to farmers who otherwise would not be able to afford them.

According to the Emergency and Rehabilitation Coordination Unit of the UN's Food and Agriculture Organization, in places where fertilizers are not available or not used, there is an urgent need to train farmers how to best utilize the soil and fresh seeds.

Apart from the need for fertilizer, the Food Security Atlas cites lack of irrigation, soil erosion, limited mechanization and poor usage of improved seeds and pesticides as the primary barriers to agricultural production.


Http://www.irinnews.org/report.aspx?ReportID=90539

MALNUTRITION: Aquaculture "vital" to Asia's food security

22 September 2010 (IRIN) - Improvements in aquaculture could be an important tool in combating Asia's increasing food insecurity, specialists say. "We have to produce 30 million more [metric] tons of fish - 50 percent more - by 2030 or people will not be able to eat," Rohana Subasinghe, a senior aquaculture specialist for the Food and Agriculture Organization (FAO), told IRIN from Phuket, Thailand. "There is nothing more we can bring from the sea so the gap has to be filled by aquaculture." Subasinghe's remarks coincide with the beginning of a four-day global conference on fish farming, an industry that provides nearly half the world's fish for human consumption. Scientists and policy-makers from 60 countries have gathered in Phuket to discuss the industry's progress since the last meeting in Bangkok 10 years ago. FAO estimates more than half the world's undernourished people - 642 million - live in the Asia and Pacific.

MALARIA: failing to meet goals?

The goal of combating diseases such as HIV and Aids and malaria by giving universal access to treatment won’t be met. The number of people living with HIV has fallen by 17% since 2002 but 33m still do, 70% of them in Africa.
The target of reducing the mortality of children aged under five by two thirds also looks unlikely to be achieved. The mortality rate has dropped since 1990, but 10m children still die every year, almost half of them from pneumonia, diarrhoea, malaria and Aids.
“We’re still a long way off from ending extreme poverty,” said Judith Robertson, the head of Oxfam Scotland. “Meeting the goals is the first step to a life of dignity, free of poverty, for everyone. The world cannot afford a single broken promise. Failing one will fail all.”
http://www.heraldscotland.com/news/world-news/the-world-s-broken-promises-1.1056068

MALARIA: Fake charity -- fake drug

The treatment, which was banned in the US and Canada this year, was first introduced in Kenya in 2004 by its developer, Jim Humble, through what he claimed to be an international Christian group.
The distributors circumvent the ban by marketing the product through the internet and church groups.
The distributors, who claim the product cures within hours, instruct consumers to mix 28 per cent sodium chlorite with a weak acid like citrus juice....
http://allafrica.com/stories/201009170013.html

MALARIA: Study Shows Malaria Infections Increase Near Ethiopian Dam

September 17, 2010
Reservoirs and stagnant streams created by dams can be conducive for mosquito breeding.
People living less than one kilometer of the Koka Dam in central Ethiopia are nearly three times more likely to get malaria than people living one to two km away, and nearly 20 times more likely to contract the disease than people living more than five km away, according to research by the Sri Lanka-based International Water Management Institute.
The study also found that better management of the water releases from the reservoir can reduce mosquito breeding grounds and decrease malaria transmission.
http://www.circleofblue.org/waternews/2010/world/africa/study-shows-malaria-infections-increase-near-ethiopian-dam/

MALARIA: New tool predicts malaria 90 days before an outbreak

A collaborative nine-year research project in Kenya has created the September launch of a new tool that calculates data based on environmental factors (weather, geography) and mosquitoes' mating schedule to successfully (within 86-100 percent) predict a malaria epidemic.
The Kenya Medical Research Institute (KEMRI), Kenya Meteorological Department and International Centre for Insect Physiology and Ecology tested their tool in Kenya, Tanzania and Uganda according to Canada's International Development Research Centre, which also co-funded the collaboration. KEMRI's director Dr. Solomon Mpoke explained, "This tool will immensely change the way we are going to control malaria in Kenya and the Greater Horn of Africa, since we will have an early warning from the tool three months before it happens."The United Nations had urged this tool be developed before the researchers understood its efficacy."The disease prediction tool should also help policymakers and health officials prepare in time to deal with looming outbreaks," with regards to when and where to spray.
http://www.independent.co.uk/life-style/health-and-families/new-tool-predicts-malaria-90-days-before-an-outbreak-2081847.html

POVERTY: SOUTHERN AFRICA: Social transfers reduce poverty

17 September 2010 (IRIN) - Southern African countries have some of the world's worst income distribution, but can often afford social transfers, which have proved an efficient means of reducing the number of poor, regional experts said at a two-day meeting in Pretoria, South Africa. "Money can always be found - where there is political will there is always a way," said Nicholas Freeland, director of the Johannesburg-based Regional Hunger and Vulnerability Programme (RHVP) funded by the UK and Australian governments, and one of the co-hosts of the meeting. Social transfers cover the various forms of social assistance for low-income or no-income individuals and households, and can include child support grants, non-contributory pensions, school feeding schemes, and agricultural or other inputs. Six countries in Southern Africa - Botswana, Lesotho, Mauritius, Namibia, South Africa and Swaziland - provide non-contributory social pensions modelled on European social welfare policies. Mozambique, Malawi and Zambia, among others, are experimenting with some cash transfer programmes. Poor countries show the way Poor revenue reserves and lack of capacity often stand in the way of cash social transfers. Experts at the meeting lauded the political will of poor countries like Lesotho and Swaziland, whose successful pension programmes make the most of their limited resources. Lesotho provides a large pension of US$25, but has a high eligibility age of 70 years to make it affordable, noted one of a series of papers produced by the RHVP, in collaboration with the South Africa-based Economic Policy Research Institute (EPRI) and the IDS. "Swaziland, on the other hand, decided on a low eligibility age (60 years) to widen access, but set the pension level much lower ($10)." Evidence has shown that more money in people's hands means they spend more on basic needs such as food, health and education, which has helped both countries to advance towards meeting the Millennium Development Goal (MDG) of halving poverty by 2015. Policy-makers at the meeting, which ended on 17 September, reviewed the role of social transfers in reducing poverty, ahead of the UN summit on MDGs in New York. The Universal Declaration on Human Rights includes the right to social security. Lagging behind Southern Africa is lagging behind on most MDGs: about 45 percent of its people live on less than one US dollar a day, and life expectancy in countries with high HIV prevalence rates has dropped to below 40 years, said Agostinho Zacarias, the UN resident coordinator in South Africa. Social transfers generally fall into two categories: long-term transfers, which target people who face life-cycle risks, such as orphaned children; and short-term transfers, which include social insurance for those who face livelihood risks, such as farmers who have had a particularly bad harvest, said Stephen Devereux, of the Institute of Development Studies (IDS) at the UK-based University of Sussex. In South Africa, social transfers like old-age pensions, and the child support grants introduced in the early 1990s, have managed to improve the lot of at least 47 percent of people living on less than two dollars a day, said another papers in the series. Lovemore Moyo, Speaker of the Zimbabwean parliament, commented: "A country like ours does not have the funds and the resources to put such social transfer programmes in place." Domestic savings Zacarias said countries like Zimbabwe needed to work on building the confidence of the people in government policies to improve their domestic savings, "So you know that the money will be spent where it should, and not diverted elsewhere." He made the point that countries needed to spend on social transfers because "we are social beings", and to show that we care about other human beings. RHVP's Freeland pointed out that at the time when developed countries like the UK and Sweden introduced social transfers such as old-age pensions, they had not been not particularly well-off but had gone ahead because of the "huge inequalities" that existed. Devereux noted that Lesotho went ahead with its social transfers programme without the support of donors. The papers released at the meeting cited a recent study by the International Labour Organisation (ILO) of 12 low-income countries - six in sub-Saharan Africa and six in Asia - which put the cost of providing social pensions at less than one percent of the gross domestic product in each country. RHVP's Freeland said donors could help out with start-up costs, which were often formidable. "They could pay for smart cards, registration of beneficiaries, and monitoring and evaluation of the transfers, but the actual transfers must come out of the country's budget." Sylvia Masebo, a Zambian parliamentarian, highlighted the need for political commitment to social transfers. Many countries, including Zambia, depend on donor support, but "The government allocates the money according to its own priorities and hardly any of it goes towards social protection." Beyond pilotsZambia is piloting a cash transfer programme in some of its districts. "The government says we do not have the money to roll out the pilot programme, we need to exploit our domestic revenue base such as the mining sector to raise the money," Masebo commented. Experts said countries needed to move beyond pilot programmes. "Studies have shown that the administrative costs of running pilots are far greater than running a national social transfer programme," said Isobel Frye, director of the South Africa-based Studies in Poverty and Inequality Institute (SPII) Well-known South African activist Mark Heywood, of Section 27, a local civil rights organization, cited the long campaign to roll out treatment for people with HIV/AIDS as the one to emulate to get governments to provide social transfers. "We found that if you get the people who need it the most to campaign for it, it works." The event was co-hosted by RHVP, the Southern Africa Development Community Parliamentary Forum and the SPII.
Http://www.irinnews.org/report.aspx?ReportID=90514

TUBERCULOSIS: What is the impact of TB on women and children?

TB will claim the lives of more than 4 million women between now and 2015.
That is roughly the equivalent of all the women and girls in New York City.
TB is the number three cause of death among women and therefore has a massive impact on mothers and their children. The stakes are high - up to four million women will die between 2011 and 2015 and millions of children will be orphaned without rapid scale-up of TB care.
What role does TB control play in fighting poverty?
More than three quarters of all TB cases are among people 15–54 years old – those in their prime working years. The disease is a major cause of poverty because people with TB are often too sick to work, and they and their families have to pay for treatment.
A recent World Bank research study found that aggressive TB control could yield
substantial economic gains for low- and middle-income countries. The countries
with the world’s highest numbers of TB cases could earn about 10 times more
than they spend on TB diagnosis and treatment by signing on to the Global
Plan to Stop TB.
How can fighting TB help reverse the tide of deaths from HIV?
One of four deaths among people living with HIV is from TB. Every three minutes
a person living with HIV has his or her life cut off prematurely by TB.
People who have tested positive for HIV need to be routinely screened for TB;
treated if they have active disease or provided with isoniazid preventive therapy if they are unlikely to have active TB; and protected against TB transmission. The
solution is clear, yet in 2008 only 5% of the 33 million people living with HIV were screened for TB.
People known to have TB and those presenting with TB signs and symptoms
need to be offered HIV testing, treatment, care and support; and people who present for HIV testing and care need to receive appropriate TB prevention, diagnosis and treatment. Integration of HIV and TB services in all health care settings is key to achieving these goals.
In July the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the
Stop TB Partnership signed a landmark memorandum of understanding. The
agreement binds the two organizations together in a common goal: to call on
countries to scale up these joint activities sufficiently to halve the number of people living with HIV who die from TB by 2015, compared to 2004 levels.
How much progress has been made on the MDG targets for TB?
There have also been remarkable achievements in the past decade. The
MDG target for halting the incidence of TB is on track and prevalence and mortality are falling slowly. Soon to be released studies will show that as a result
of following WHO recommended standards, tuberculosis mortality among HIVnegative people fell 39% between 1990 and 2009, and could be halved by 2015.
http://www.stoptb.org/assets/documents/resources/factsheets/Tuberculosis%20and%20the%20Millenium%20Development%20Goals_2010.pdf

POVERTY: Philippines: poverty increasing among children

17 September 2010 (IRIN) - A new study by the Philippine Institute for Development Studies (PIDS) [ ] and the UN Children's Fund (UNICEF), estimates that 12.8 million children under the age of 15 are living in poverty, an increase of one million over a three-year period. "Forty-four percent of all Filipino children are living in poverty and also suffer from other dimensions of poverty like deprivations of food, shelter, health and education," Vanessa Tobin, UNICEF country representative, told IRIN. Released on 16 September, but based on data compiled from 2003 to 2006, the key findings of the study demonstrate clear trends across the country, with 9.2 million of the 12.8 million children living in rural areas. According to the study, 5.4 million children were deprived of at least one of the three dimensions of well-being - shelter, sanitation, and water - in 2006. In June 2009, the Child Development Index, released by the National Statistics Coordination Board, indicated the human development of children deteriorated in the period 2003-2006, when the poverty rate rose.

POVERTY: ETHIOPIA-GHANA: MDG success stories

16 September 2010 (IRIN) - Many sub-Saharan African countries are off-track to achieve the Millennium Development Goals, but there have been pockets of success: Ghana is set to become the first country in Africa to halve poverty and hunger before 2015, while primary school enrolment in Ethiopia has increased by more than 500 percent since 1994, according to the Overseas Development Institute. Common to both examples has been the sustained commitment of each government to reform the respective sector, say researchers Jakob Engel and Henri Leturque. [http://www.odi.org.uk/news/documents/196-media-brief-development-progress-stories-showcasing-outstanding-examples-national-progress.pdf]"The story of the past 20 years in Ghana's agriculture sector has been one of incremental yet sustained change, rather than dramatic development," states the Ghana report. Government-led economic reforms in Ghana, including devaluing the currency, liberalizing markets, and restructuring the then-inefficient cocoa marketing board, helped to boost food production by 80 percent per capita over the past 30 years, says the ODI, and enabled Ghana to become almost self-sufficient in staple crops such as yam and cassava. After 1983, agriculture grew at 5.1 percent annually, on average, and wider food availability resulted in a drop from 34 to 8 percent in moderate malnutrition between 1991 and 2003. The percentage of underweight children under five fell from 30 to 17 percent from 1988 to 2008, says the ODI. But there is more to it: "There is a strong link between widening food availability and dropping malnutrition," Leturque told IRIN, "but it is by no means the only answer - improved health and sanitation, and improved childcare practices, also played a role." Despite progress in these areas, Ghana is off-track to achieve MDGs 4 and 5, to improve child and maternal health, according to a report by the National Development Planning Commission, released on 14 September. Education in Ethiopia In Ethiopia, the government set out to improve the education sector when it came to power after the civil war, "recognizing rural poverty was not only a key driver in conflict and inequality, but was also holding the country back and perpetuating the cycle of poverty... and that ensuring children had access to school was key to these broader development goals," Engel told IRIN. The government developed education reform plans and gradually upped its education spend from 8 percent of the total budget in 1985 to 23 percent in 2009, with donor education aid also rising. The increased funds went towards abolishing school fees, constructing and improving schools, and hiring and training teachers, among other activities, says the ODI. Key to meeting MDG 2 (achieving universal primary education) was a move in 1991 to devolve power to regions and districts to run their own schools; and shifting the language of instruction to local languages, says the ODI. In 1994, just three million pupils in Ethiopia attended primary school; by 2008 15.5 million did so, while secondary school attendance increased fivefold. Local authorities involved parent-teacher associations in rehabilitating and reviving schools, said Engel. "Lots of the investments made created access to households to send their children to school for the first time - there was a genuine appreciation of that, and people started to realize its relevance in their lives." But more needs to be done to ensure progress continues - and is equitably spread in both countries. In Ethiopia, high drop-out rates remain in secondary school, quality teaching is still lacking, and some regions, such as Afar and Somali, are lagging behind on primary school enrolment. To get as-yet-unreached children into school, "will take more than school construction; it will take a focus on non-formal education, addressing maternal and child health, and early childhood development", said Engel. Agricultural growth in Ghana has also been inequitably distributed: concentrated in the south to the detriment of the north. "A lot still needs to be done to support the north, where there are fewer resources to work with," said Leturque. aj/sda/mw[END]CLICK ON LINK BELOW TO READ THE REPORT ONLINEHttp://www.irinnews.org/report.aspx?ReportID=90498