MALNUTRITION, MALARIA and the MYCOBACTERIUM

POVERTY: Analysis: Agriculture in a changing environment

2012-01-24T14:02:00.000-05:00

JOHANNESBURG, 24 January 2012 (IRIN)

Photo: Jaspreet Kindra/IRIN

Cows release huge amounts of warming methane every year- Agriculture has been seen either as a cause or victim of global warming at the UN climate change talks over the past few years - something that has thwarted efforts to attract the investment it needs, say scientists.
Some at the talks see a more dominant role for agriculture - an emitter of major greenhouses gases such as nitrous oxide and methane - in reducing global warming. The Intergovernmental Panel on Climate Change estimates agricultural emissions account for 13.5 percent of all man-made greenhouse gas emissions.
At the same time, poor countries want more money and better technology to help farmers adapt to the impact of climate change such as frequent droughts, flooding and increased salinity.
“It is really a bad split for agriculture,” said John Beddington, the UK’s chief scientific adviser, and one of the authors of a paper calling for a more integrated approach, combining mitigation and adaptation efforts.
The paper, published in the current edition of Science with contributions from several scientists, calls for a better understanding of agricultural practices with the aim of delivering multiple benefits - reducing emissions, helping agriculture to adapt, and using limited resources (like water) efficiently.
One model to emulate could be Denmark, where one of the world’s strictest agriculture control systems is in place - including, for example, the use of environmentally friendly practices such as substituting pig slurry (pig waste and water) for artificial fertilizers. The country has managed not only to reduce emissions from agriculture by 28 percent but also increase productivity.
This kind of win-win agriculture would attract more funding from a wider range of sources, said Beddington.
Climate change’s impact is likely to be greatest in low and middle-income tropical regions, where pressure will mount to produce more food because of population and income growth, says agricultural economist Christopher Barrett, who teaches at Cornell University. The global focus, therefore, has to be on helping agriculture in those regions adapt, and not just produce more or reduce emissions. “And that agenda needs to encompass post-harvest storage, distribution and transformation.”
Despite growing support for an integrated approach to agriculture encompassing adaptation and mitigation efforts, policy actions have been slow to materialize in most countries and at the UN climate change talks, the paper says.
A first step, say the scientists, is to get commonly agreed definitions of concepts like “climate-smart agriculture” and “sustainable intensification”, which integrate the two approaches.
The authors of the paper include ecologist Bob Scholes of South Africa’s Council for Scientific and Industrial Research; Mohammad Asaduzzaman, research director of the Bangladesh Institute of Development Studies; and Judi Wakhungu, executive director of the African Centre for Technology Studies in Kenya.

“Climate-smart”
The “climate-smart” concept as developed by the UN’s Food and Agriculture Organization (FAO) advocates practices which generate both adaptation and mitigation benefits such as the efficient use of organic fertilizers; the development of efficient seed systems which produce crops naturally resilient to climatic shifts; the harvesting of water for irrigation; the production of biogas from livestock manure; and greater reliance on forage from maize crops to feed animals.
Such initiatives would not only improve food production but also reduce harmful gas emissions, says FAO.
About 70 percent of agriculture-related emissions are associated with the manufacture and use of nitrogen-based fertilizers -in large part through the emission of nitrous oxide - according to a 2011 review by the UK Biotechnology and Biological Sciences Research Council (BBSRC).
The livestock sector generates 65 percent of human-related nitrous oxide, which has 296 times the Global Warming Potential (GWP) of carbon dioxide. Most of this comes from manure.
Belching cows, goats and sheep emit 80 million tons of methane into the atmosphere every year. Though methane remains in the atmosphere for a short time (9-15 years), it has 23 times the GWP of carbon dioxide. Irrigated rice farming is another major source of methane emissions.
Soil carbon sequestration
But the “climate-smart” concept was given another interpretation at the Durban climate change talks in December: The World Bank announced it had launched a “climate-smart agriculture” pilot project in Kenya. The project (which is still running) aims to get small farmers to adopt agricultural practices such as low-tillage, which trap carbon in the soil in such a way that it is not re-emitted into the atmosphere (soil carbon sequestration). The carbon is then sold as credits in carbon markets.
Think-tanks like the Institute for Agriculture and Trade Policy (IATP), and scientists at BBSRC, point out that sustainable agriculture can increase the sequestration of carbon in the soil but it is difficult and costly to measure.
IATP’s senior policy analyst, Steve Suppan, said the very high transaction costs of converting Kenyan farmers’ work into carbon credits would be better spent on more rapidly adapting Kenya’s agriculture to climate change.
“Because the project's transaction costs are nearly half of the project budget, the main project co-benefit is not for the farmers but for the carbon accounting methodology that the Bank wishes to sell globally.”
Tosi Mpanu-Mpanu, Africa’s chief negotiator at the climate talks, who had been lobbying for a stronger presence for agriculture in the adaptation track, said they wanted predictable funds for agriculture, and not from shaky carbon markets, which in this case - for credits based on soil carbon sequestration - did not exist. “Our farmers will also be told to grow certain crops which sequester more carbon rather than what the farmers need, compromising their security.”
NGOs like ActionAid warn of the possibility of “soil grabs” in developing countries by big business to offset their emissions. Mitigation cannot be the predominant objective of any project aimed at benefiting agriculture, said ActionAid’s Harjeet Singh.
“Mitigation projects in agriculture need to begin in industrialized agriculture and land-clearing for agribusiness. The agro-ecological techniques of climate-smart agriculture should be deployed for adaptation, not in the service of carbon derivatives markets,” said Suppan.
Beddington said linking “climate smart agricultural practices” with carbon markets was “unfortunate”. The Science paper he co-authored calls for unpacking the term in such a way that addresses concerns that it might be giving more weight to agriculture’s role in reducing emissions, rather than focusing on improving production and ways to adapt.
Leslie Lipper, a senior environmental economist with FAO, said soil carbon sequestration is one example of an integrated approach but she was not against sourcing finance from carbon markets. “Identifying, crediting and financing mitigation co-benefits that can be generated from improving agricultural systems offers the potential to open a new and additional source of finance to help meet the investment gap” in agriculture.

“Sustainable intensification”
In agriculture, the term “sustainable intensification” as defined by FAO, refers to an increase in production either by using more inputs such as labour, land, time , fertilizer, feed or cash; or the maintenance of production at a certain level with the effective use of smaller amounts of fertilizer, or mixed cropping in smaller fields.

“Sustainable intensification”, said Scholes, focused more on increasing production not by physical expansion but the efficient use of inputs.
The UN Framework Convention on Climate Change has called for views on agriculture within the climate change context to be submitted to its Subsidiary Body for Science and Technological Advice by 5 March 2012.
http://www.irinnews.org/report.aspx?reportid=94711

MALNUTRITION: NIGER: Thousands of villages hit by severe food shortages

2012-01-24T13:57:00.000-05:00

NIAMEY, 24 January 2012 (IRIN)

Photo: Boureima Balima/IRIN
Pounding millet in the village of Boukanda, 50km west of Niamey, capital of Niger

Nearly half Niger’s population does not have enough to eat and the government says it is facing a grain shortfall of 692,501 tons, following another severe drought across the Sahel.
The government says it needs 3.8 million tons of cereals to feed six million people spread across 6,981 villages, equating to 49.4 percent of the affected zones.
In a survey conducted in November 2011, the government’s Early Warning System projected the 2011-2012 “winter” gross cereal production for millet, sorghum, rice, wheat and fonio (one of West Africa’s most ancient cereals) at 3.8 million tons - 27 percent down on 2010-2011. Grain production last season was about 3.2 million tons.
The Early Warning System, which monitors and forecasts food security needs, has identified three major areas as reporting deficits: Tillabéry in the west; Agadez in the north; and Diffa in the east; with respective shortfalls of 164,146 tons, 123,576 tons, and 68,115 tons.
Boukanda, a village with a population of 1,000 about 50km west of the capital Niamey, is typical of many food insecure villages which have been largely abandoned by their younger residents.
"The able-bodied and young people of the village preferred to leave for big cities or abroad. They have little to do here,” Adamou Talba, the marabout (religions teacher) of Boukanda, said.
Only a few “wealthier” families pound sorghum instead of millet, the main staple of the village. These people still have small supplies but they will not last long.
"There's just a little bit in the granary," said Balkissa Adamou, a villager.
Boukanda village chief Seyni Seydou said the rains ended just when the plants needed water, and grasshoppers and other insects finished off the crops.
"In our village, some people have been left with just seven bundles [of grain], whereas previously nearly 700 could be harvested," he added. The Early Warning System puts Boukanda’s food deficit at 90 percent.

Appeals for help
Concerned by the current situation, Cheick Boureima Abdou Daoud, a citizen of Niger, donated 3,000 tons of cereal to the relief effort. "I want to kick-start action so that other citizens of Niger, who can afford it, can also help those in need,” he said.
While previous governments tended to avoid admitting to food crises, the current government is different: In August 2011, it asked for 100 billion francs CFA (about US$198 million) in donor aid.
President Mahamadou Issoufou, addressing the UN General Assembly in September 2011, said: “Knowing that we would have a very large deficit this harvest crop, we decided... to alert the international community. I would like, at this highest level of this forum, to renew once more our appeal to help Niger.”
Donors have pledged help, and the UN has launched a Consolidated Appeals Process (CAP) for $229 million.
"The CAP aims to provide humanitarian aid and to strengthen the resilience of millions of men, women and vulnerable children," said Guido Cornale, the UN Children’s Fund (UNICEF) representative in Niger who is also acting humanitarian coordinator in the country.
http://www.irinnews.org/report.aspx?reportID=94713

POVERTY: New Zealand: Poverty trap set at birth - study

2012-01-24T09:20:00.000-05:00

Simon Collins Jan 18, 2012

Wealth-gap problems are growing. Photo / Thinkstock

New Zealand researchers have put hard numbers to the adage that success breeds success - and failure breeds failure.
A long-term study of 1265 children born in Christchurch in 1977 has found that those whose families were poor in their first 10 years of life earned about $20,000 a year less by the age of 30 than those who grew up in rich families.
Those from poor families were more likely to leave school without qualifications, have babies before they were 20, commit crimes, go on welfare and have addiction and other mental health problems in adulthood.
Most of these effects were explained by factors which tended to vary in line with family incomes, such as parents' education, addictions, criminality and marital conflict and breakup, and the children's own intelligence.
But study director Professor David Fergusson said the effects of childhood income on later educational and career achievement persisted even after allowing for all other factors.
"So in a sense success or failure drives educational and economic success or failure, but the things that drive behavioural outcomes are not so much income and are more familial and personal," he said.
"It could be that competent, bright families transmit their skills to their children and also earn higher incomes.
"It could also be that being bred in a high-income family provides children with role models and resources for both educational achievement and career success."
Deputy Prime Minister Bill English and Maori Party co-leader Tariana Turia are setting up a ministerial committee on poverty under the Maori Party's post-election agreement with the National Party.
The study results are reported in a newsletter published by Children's Commissioner Dr Russell Wills, who has said that attacking child poverty should be the first of seven goals in an "action plan" arising out of a Government paper on vulnerable children.
The newsletter also reports a Social Development Ministry finding that in 2010, 26 per cent of children lived in "poor" families earning under 60 per cent of the net median income after housing costs - down from a peak of 30 per cent of children in 2001, but still roughly double the proportion in poverty during the 1980s when the children in the Christchurch study were growing up.
Professor Fergusson said children being born in poor families today might face even worse outcomes than their parents born in the 1970s and 80s because of the greater disparity in earnings.
The study asked detailed questions about people's lives which also enabled the researchers to diagnose whether they had depression, anxiety disorder, drug or alcohol addictions or anti-social behaviour.
On average, those from poor families had slightly more of these disorders than those from rich families.
Professor Fergusson said the study showed that income inequality and behavioural issues, such as parents' addictions, both had to be tackled to fix social problems.
"For example, increasing the income of substance-using parents may be counter-productive since it will give them more access to purchasing alcohol or drugs," he said.
A spokesman for Mr English said the poverty committee would focus on "providing opportunity through things like education and jobs and ensuring we are getting the best results from the hundreds of millions of dollars already being spent on social service delivery".
Schooling
Almost 40 per cent of those in the poorest fifth of families left school without qualifications, compared with fewer than 10 per cent of those in the richest fifth.
Pregnancy
A third of those from the poor families but fewer than a tenth of those from rich families fell pregnant, or got someone pregnant, before they were 20.
Crime
A third of those from poor families, but only a sixth from rich families, committed a violent or property crime between the ages of 18 and 30.
Welfare
20 per cent of those from poor families, but only 4 per cent from rich families, spent some time on welfare before they were 30.
Income
Those from poor families earned an average of just under $40,000 a year by age 30, while those from rich families averaged $60,000.
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10779433

MALNUTRITION: MYANMAR: Rice harvests lost in Kachin conflict zones

2012-01-06T10:02:00.000-05:00

KACHIN STATE, 6 January 2012 (IRIN) -
Photo: Contributor/IRIN
Kot Nan worries about feeding her family

The annual harvest season in Myanmar's northern Kachin State has come and gone but much of the rice crop has not been harvested or was never planted after fighting between government forces and the Kachin Independence Army (KIA) erupted on 9 June 2011 after a 17-year ceasefire was broken.
Traditionally, farmers transfer their rice seedlings in June with harvests in November and December before the winter sets in.
"This year's harvest was next year's investment, but now we have nothing for the future. We will have to cross the mountains and scavenge for wild vegetables so that we will have something to eat," says Kot Nan, 35.
"When the conflict started we were planting rice but the soldiers came into our village so we couldn't plant," the mother-of-two told IRIN at the main camp for internally displaced people (IDPs) outside Laiza, a border town between Myanmar and China.
There are more than 40,000 IDPs in Kachin State, local aid groups say, including an estimated 20,000 in camps around Laiza, controlled by the political wing of the KIA, the Kachin Independence Organization.
For many Kachin families, farming is the primary source of livelihood, with rice being the main crop, along with sugar cane and corn.

Impact
Bill Davies, a researcher with Physicians for Human Rights (PHR), says the food security issue is of major concern.
"The fighting starting when they were preparing the seedlings so some of them put the seeds right into the paddy in the hope that they would grow and others planted a lot later, which decreases the yield."
Davies led a fact-finding mission for PHR in the border areas of Kachin state last September, visiting six camps and four shelters for IDPs.
The group's findings were released in a report on 30 November.
"Not being able to plant 100 percent of their fields, planting it late, and also not transplanting it at the right time were the three main problems. A lot of people are worried that they were going to have a smaller crop yield than normal," Davies said.
Sporadic fighting has also restricted travel for civilians, including those farmers who were able to plant but could not return to their fields to tend their crops.
And while there are no official figures yet on the area's overall harvest shortfall for 2011, the impact on the population is already evident.
At a relief line in one of the main refugee camps near Laiza, 24-year-old Moo Pan breastfeeds her baby girl as she waits for food rations - almost seven months after fighting first erupted.
"We were forced to leave our village and we can't go back because government forces have taken over our houses and land," she said.
Compounding matters are reports that the Burmese army is regularly pillaging food and supplies from civilians in the area, a key finding of the PHR study.
With local supplies diminishing and the ability of local aid groups to provide assistance on the decline, the situation on the ground underscores the importance of further outside aid.
According to Human Rights Watch (HRW) at the end of December, the tens of thousands now displaced are in "great need of humanitarian assistance".

Photo: Contributor/IRIN
Workers tend a field near an IDP camp in central Kachin to supply food for the displaced

Access
But getting into the most-affected areas will only be the first step, Marcus Prior, spokesman for World Food Programme (WFP) Asia, told IRIN on 5 January.
"Even with improved access, WFP will need funding to provide the kind of assistance we think may be necessary in Kachin," he explained.
"Our operations across the country are facing significant shortfalls - right now WFP only has funds to guarantee food deliveries into February."
The UN food agency is able to reach about 15,000 of the displaced in Kachin State, but hopes that following a recent humanitarian convoy across the conflict line, the next convoy will include WFP food, Marcus said.
http://www.irinnews.org/report.aspx?reportID=94595

POVERTY: SOUTHERN AFRICA: Floods leave Angolan returnees stranded

2012-01-06T09:57:00.000-05:00

JOHANNESBURG, 6 January 2012 (IRIN) -

Photo: Tomas de Mul/IRIN
The Zambezi is prone to flooding annually
Several thousand Angolan returnees from the neighbouring Democratic Republic of Congo (DRC) are stranded by floods in northeastern Angola. They are among the first casualties of what promises to be a very wet rainy season in parts of southern Africa.
“At least 50,000 people - 24,000 of them returnees - in 10 villages in Uige Province [northeastern Angola near border with DRC] have been affected by the flooding, rains and hailstorms in the past four months,” said Antonio Maiandi, head of the Evangelical Reformed Church of Angola, which has been trying to help those affected. The rainy season here tends to be longer than elsewhere in Angola.
“It is still pouring hard. At least 1,142 houses have been destroyed by the rains. Each family with shelter is now hosting other families,” said Maiandi, adding that the returnees, who had sought refuge from the civil war in Angola which ended in 2002, were putting enormous pressure on locals, and organizations such as his.
“The local population who are mostly farmers have been severely affected. Their cassava [staple food in Angola] and groundnut crops have been destroyed, so there is not enough food to go round.”
The UN Refugee Agency (UNHCR) restarted formal repatriation of Angolans in November 2011 after logistical and other problems forced the process to stop in 2007. DRC is home to some 80,000 Angolans refugees, according to UNHCR.
The new return initiative comes after a UNHCR survey in 2010 found that 43,000 wanted to return home, and following a tripartite agreement between Angola, DRC and UNHCR (signed in June 2011), around 20,000 people signed up for help to return. The agreement came about after years of tense relations between the two countries: Angolan and Congolese nationals have been expelled from the two countries regularly.
Each family with shelter is now hosting other families
“The local population is extremely poor and unable to support the returnees,” and “people are still coming in every day,” said Maiandi.
UNHCR in Angola told IRIN they took a break in December 2011 and would resume formal repatriation on 17 January, but did not have an update on the number of people who had already arrived.
According to aid workers, increasing instability in the DRC following the recent disputed elections could be prompting more people to leave.
Maiandi said the returnees had not received adequate support from the authorities and church organizations had limited resources.
Meteorologists for the Southern African Development Community (SADC) have predicted normal to above normal rains for most of the region from January to March 2012 largely because of the continuing effects of the 2011 La Niña event. Thousands of people in the region were displaced and scores killed in early 2011 as a result of heavy rains and flooding associated with La Niña.

Zimbabwe
As the rainy season begins here, aid workers and disaster prevention teams are closely monitoring water levels in the all-important Zambezi river, the continent's fourth largest.
The authorities have issued a flood alert after being forced to release water from the swollen Kariba Dam on the Zambezi earlier than usual in the rainy season.
The Zambezi River Authority (ZRA) which usually opens the spillway gates of Lake Kariba in the last two weeks of January was forced to open one of the gates on 3 January. It has advised people living downstream to evacuate their homes.

Zambia
Zambia is in for a mixed season. Dominicano Mulenga, national coordinator of Zambia's Disaster Management and Mitigation Unit, said a plan had been drawn up to help 368,953 people likely to be affected by rain and dry spells. While northwestern and western parts of the country had seen heavy rain, southern, eastern and parts of central Zambia were likely to receive little or no rain, he said.
The water level in the Zambezi was higher than at the same time in 2011, he added. “We have had three seasons of heavy rainfall and the ground is saturated with water, making it more prone to flooding.”

Namibia
Namibians, currently experiencing a heat wave, are eager for rain, said Guido van Langehove, chief of the Namibia Hydrological Services. Southern African Development Community (SADC) meteorologists have forecast normal to above normal rains for Namibia over the next three months. “It was the same forecast last year and we recorded three times the normal rain,” van Langehove pointed out.
The Caprivi Region, Namibia’s poorest area, is prone to annual flooding.
Japhet Itenge, director of Disaster Risk Management in the Office of the Prime Minister, said they were prepositioning essential commodities and relief tools as part of their contingency plans.

Lesotho
Lesotho has not received adequate rainfall in the past few months, a spokesman for the country’s meteorological services told IRIN. “SADC has forecast heavy rains for Lesotho in the coming weeks. We are worried it can cause early frost and destroy crops that have already been planted,” he said.
Lesotho and Namibia have food insecurity levels greater than their five-year averages due to the severe flooding experienced during the last growing season, according to FEWSNET.

Mozambique
The Mozambican authorities have begun to release water from the Cahora Bassa Dam on the Zambezi. People living mainly along the lower Zambezi basin and in Buzi, Save, and Pungue basins, including Beira city, are on alert.
Sofala Province in central Mozambique is currently distributing items such as bicycles, stretchers, masks, gloves, megaphones and boats, according to the Mozambique Red Cross; and members of seven local disaster risk management committees established in Beira City are cleaning the drainage system.
The National Institute of Disaster Management (INGC) is monitoring the rivers Montepuez, Licungo, Mutamba, Pungué, Buzi, Save, and Maputo, said FEWSNET. In the Zambezi and Limpopo river basins, FEWSNET warned of a near-average-to-high probability of flooding.
João Bobotela, CARE’s emergency response coordinator in Mozambique, said INGC and local authorities had been running flood simulation exercises since November 2011 to prepare communities for sudden evacuations.

Botswana
Arid Botswana has not received good rains in the past few months. “We are expecting average rains which might help crops,” said a spokesman for the Botswana Meteorological Services.

Malawi
More rains have been forecast for southern Malawi, where land adjacent to the River Shire, one of the most food-insecure parts of the country, is prone to flooding. Parts of the region, which has seen an outbreak of foot and mouth disease and a hike in food prices, are in crisis mode, warned FEWSNET.

South Africa
Much-needed rain has fallen in South Africa’s major maize-producing northern Free State area in the past few weeks. The government and USAID’s Famine Early Warning Systems Network (FEWSNET) say the country has adequate supplies, but global maize stocks are low, putting considerable upward price pressure on South African white maize.

http://www.irinnews.org/report.aspx?reportID=94598

POVERTY: SENEGAL: Talibés turn traders

2011-12-09T09:33:00.000-05:00

PIKINE, 8 December 2011 (IRIN)

Photo: Aurelie Fontaine/IRIN
A trainer teaches ex street kids market gardening

It is widely assumed that few of the estimated 50,000 ‘talibés’ in Senegal - boys in Koranic schools, or ‘daaras’, studying to become Islamic teachers - who roam the streets begging for money to support their religious leader (‘marabout’) will end up teaching, and most will become vagabonds, delinquents and robbers. Now, child protection experts say their future is not always so bleak - the skills that talibés develop on the streets can turn them into successful traders.
“There is no correlation between these adolescent talibés and youths who rob and mug… I don’t believe these theories,” said Biram Mbagnick Ndiaye, a youth programme team leader at Environment and Development Action in the Third World (ENDA-TM), an NGO that supports training programmes for street children, including talibés.
“We take care of lots of troubled youths, and those emerging from daaras are often the least aggressive and the easiest to reintegrate [into society],” Ndiaye told IRIN in the capital, Dakar.

Employment higher-than-average
Three years ago ENDA did a study of 50 talibés emerging from the daaras of Kaolack in the south of Senegal and Dagana in the north, and found that around 80 percent of them were earning money in small businesses, while the rest were masons or carpenters. Only one did not have a job.
These statistics are better than the national average: some 48 percent of the working population in the formal economy is unemployed, according to the World Bank.
“Some manage to escape [their religious master] and become good traders,” said Ndiaye. “Others migrate to Europe and eventually come back and invest in businesses here.”

Photo: Aurelie Fontaine/IRIN
Ex-talibé gardening apprentices

Yves Olivier Kassoka, child protection officer at the UN Children’s Agency (UNICEF) in Dakar, said most talibés learn the Koran by rote and many leave daaras unable to read or write or with training in other skills, but they are used to collecting and saving money.
A Dakar-based teacher, Bernadette Ndiaye, notes that they are also highly resilient and persistent - traits that, with the right guidance, can help them thrive in a competitive market place.

Training a challenge
Engaging in small trade can work for talibés and ex-street kids, but those who want to pursue a vocation or career often have a harder time. Unused to learning, many ex-talibés find it hard to apply themselves to apprenticeships, said trainers at adolescent rehabilitation centres around the country, and there are too few centres and programmes to help all the young people who need assistance.
Pope Ndoye, director of one of the two state-led rehabilitation centres in Dakar, Centre de Sébikotane, which takes in children and youths aged 13-21, told IRIN that they “are not educated, they are idle, they wander the streets, they commit petty thefts, [and] they drink.”
Springboard, a rehabilitation centre in Pikine, 30km from Dakar, is home to some 40 young people aged 16-25, most of whom stay for more than two years. They usually come from broken homes or were once talibés, but there are also some from neighbouring villages to create a good mix, said the centre’s co-founder, Loic Treguy.
At the centre they learn to read and write, and are taught masonry, carpentry, gardening and civic education. They also receive counselling and play sports. Many have never participated in any of these activities and may have taken drugs for years or have learning difficulties, said Treguy.
Students and trainers at the centre grow salad greens, beets, papayas, mangoes, chilli, lemon grass, banana ginger and herbs. Each youth must pitch his or her own tent on arrival and will eventually graduate to a dorm if they behave.
One of the biggest challenges for trainers is dealing with behaviour, said ENDA’s Ndiaye. “Usually, in Koranic schools you learn Islamic values, like respect for others, but it’s not always the case. You can see some quite uncivil behaviour in the streets.” This includes spitting, fighting, and washing in public, much of which the boys consider to be normal, he said.
Springboard’s masonry trainer, Abdoulaye Gueye, told IRIN: “We have to constantly negotiate with them in order to progress, even when they are keen to learn.” The seven apprentices he has taken on are building a new storage room at the centre.
Adjusting to life in the centre “can take a long time” said Treguy. “At first, there are always problems.” Despite the difficulties, most young people eventually take to the training. Moussa Diarra, 18, who once roamed the streets, is now pruning trees in the garden.
He fled his home in Tambacounda, 400km from the capital and the biggest city on eastern Senegal, in his early teens because his brother used to hit him. Now he wants to return home and help support his family. “I could do this gardening there and help them… I’m proud to have learned this business,” he told IRIN.

The right help
Talibés do best when they try to make it in the informal sector, trainers told IRIN. “The problem for that even with all the training in the world, it is hard to find them jobs,” Ndoye told IRIN at the Sébikotane centre. Staff there, try to direct some rehabilitated youths into the army, others to football training academies, he said, but opportunities are few and far-between.
More resources need to be put into training talibés and street children, said UNICEF’s Kassoka. The agency has been helping the government to modernize daaras in Kaolack, and at Diourbel in central Senegal, so that students graduate with some life skills. “It’s working, but it’s very resource-intensive and the government needs to be more engaged,” said Kassoka. “It has the will to take on [the task], but not completely.”
Many talibés are considered at-risk teens and end up in centres for troubled young people, when they actually need more targeted help. More partners are needed to take on the “constant flow of ex-talibés,” Kassoka said.
Ndoye said the state has expanded its efforts in recent years by putting more resources into such centres, particularly in terms of staff training. “There has been a shift in mentality,” he noted. “Before, it was considered shameful for a family to have a child like that… today things are more open - the media discuss it, people are starting to try to understand these youths.”
http://www.irinnews.org/report.aspx?reportID=94428

POVERTY: Swaziland:The misery of a mismanaged monarchy

2011-12-09T06:24:00.000-05:00

geoffrey york: Dec. 02, 2011
MANZINI, SWAZILAND— When she arrived at her school one morning last month, Simangele Mmema discovered that the food and water were nearly gone.
She had already seen some of her students collapse from hunger at morning assemblies this year. Now she didn’t have food for their lunches. And so she had to send the children home and close the school a week before the end of term. “We can’t keep them here if they can’t eat,” she said.

In Photos: Hardship in Swaziland Ms. Mmema, principal of Kholwane primary school in rural Swaziland, is struggling to keep her school alive in the face of severe budget cuts, which have forced many of the country’s schools to close for weeks at a time. The schools are the latest victims of Swaziland’s financial crisis – a crisis largely due to mismanagement by the autocratic King who has ruled this impoverished country for the past 25 years.

As revolution swept across North Africa this year, a growing number of people in sub-Saharan Africa have challenged authoritarian regimes. They are increasingly aware of the link between autocracy and poor economic governance, and they are less willing to accept it.
Long-ruling dictators, including King Mswati III of Swaziland, have faced mounting protests this year. Thousands of Swazi demonstrators have taken to the streets, although so far the King’s police and soldiers have crushed the protests with tear gas and water cannons.
King Mswati, with his 13 wives and a personal fortune estimated at $200-million, is an extreme example of Africa’s autocrats. As one of the world’s last absolute monarchs, he appoints the government and presides over the world’s longest-running “state of emergency,” with all political parties banned since 1973.
Among foreign tourists, the Swazi monarch is famous for his annual Reed Dance, where thousands of bare-breasted virgins dance in front of the king, hoping to become one of his wives. But many of the king’s subjects are angry at the contrast between his vast wealth and the poverty of the people. While schools are shut down for lack of money, the king and his wives have lavish palaces, luxury cars and frequent shopping sprees in Europe on chartered private jets.
He has spent millions of dollars on armoured Mercedes-Benz limousines for his wives and a Rolls-Royce Phantom for himself. He is building a new multimillion-dollar international airport, with a separate royal terminal.Next to one of his palaces, he is building a luxurious new meeting hall for visiting dignitaries, complete with ornamental pillars and domed roof.
When trade unions objected to his spending, King Mswati said the masses should “work even harder and sacrifice even more.”
Swaziland’s financial crisis became severe this year when its customs revenue dropped by 60 per cent under a new regional customs union. South Africa offered a $350-million loan to bridge the gap, but the loan was attached to a series of conditions, including political and economic reforms, and the King’s government refused to accept the deal. Instead it sought other loans, and when the money failed to materialize, it threatened to chop the salaries of public servants.
The King and his friends, including the police and army, have been largely immune from the crisis. But ordinary people are feeling the pinch. Grants to pensioners have been delayed. Supplies of life-saving HIV medicine have been disrupted. Swaziland’s only university was shut down for weeks, and its students have been deprived of meal and book allowances, forcing many to leave school. University programs in law and journalism have been virtually shut down, and the university’s enrolment has dropped in half.
“We feel like a cursed generation,” says Othile Mthethwa, an 18-year-old university student. Because of the cancelled meal allowances, she has to beg her parents for food. “At the end of the month,” she said, “you get really hungry and you can’t study.”
Even before the latest crisis, the Swazi people already had the world’s lowest life expectancy – barely 33 years. Two-thirds of them earn less than a dollar a day. And they suffer the world’s highest rate of HIV, with 26 per cent of the adult population infected.
At Kholwane primary school, about two dozen of the 138 students are orphans because one or both of their parents have died of AIDS. The government promised to support the country’s 69,000 orphans with special payments to schools where they are taught and fed, but the money has stopped arriving, and the government now owes $10-million to the orphans.
Without money for the orphans, Ms. Mmema had to buy maize with the school’s limited budget, carrying it in her own car and milling it herself – until the money ran out. In desperation, she visited government offices and even tried to phone the Deputy Prime Minister, but got no response.
“The officials don’t know how frustrated we are,” she said. “I sacrifice a lot to keep the school going. But when I see the children walking to school barefoot in the winter, that’s when I break down and cry.”
Swaziland’s protest movement was slow to emerge. Most people revere the royal family, believing the King to be a living messiah. Even now, many pensioners refused to complain when their monthly grants were cut off. “It’s from the royalty, and we have to appreciate what they are giving us,” says Abraham Nkambule, a 70-year-old farmer.
In primary schools, children are taught to sing songs of praise for the monarch. “You are the sun, you shine over all of us,” they sing. “You are the lion, your word is final.”
Stephen Lewis, the former UN ambassador on AIDS in Africa, remembers meeting King Mswati and seeing the King’s female aide crawling on her knees into the room and then crawling out backward so that her back would never be turned to him. When Mr. Lewis expressed his horror at this, the King just laughed. “He laughed at everything,” Mr. Lewis recalled.
This year, however, more Swazis have been willing to defy their King and protest against his government. Teachers danced and applauded last month when their leaders called for democracy. “Let us tell the truth and liberate our country,” said Sibongile Mazibuko, president of the Swaziland National Association of Teachers, in a speech to the teachers.
“Revolution came to Egypt and Libya. The people will lead us, they shall fill the streets. I am ready to pay with my blood for democracy.”
http://www.theglobeandmail.com/news/world/africa-journal/the-misery-of-a-mismanaged-monarchy-in-swaziland/article2258429/singlepage/#articlecontent

MALARIA: New mapping

2011-12-08T10:56:00.000-05:00

Philadelphia, Pa., USA – December 5, 2011) As One Type of Malaria Declines, New Map Reveals another Strain – Impervious to Interventions – Holding Steady in Parts of Asia and Latin America New data on prevalence of “the last parasite left standing” unveiled in first-of-its kind map by malaria experts at
ASTMH meeting, along with new data on deadliness, lack of treatment
(With signs of declining malaria deaths in Africa raising hopes of eradicating the disease worldwide, researchers unveiled today at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) a new malaria map that is the first to identify on a global scale where the long-lasting and potentially deadly form of malaria—a parasite known as Plasmodium vivax—has a firm foothold in large swaths of South Asia and parts of Latin America.

“This map helps us understand just how difficult it is going to be to eradicate malaria,” said Peter Gething, PhD, who led the University of Oxford’s Malaria Atlas Project (MAP) team that produced the study of vivax burden. “It shows that in substantial parts of the world, vivax malaria is endemic and transmission is significant. Unfortunately, the tools for fighting this type of malaria range from ineffective to non-existent.”
Other studies being discussed at ASTMH—the world’s largest gathering of public and private sector malaria scientists, clinicians and program professionals—and published in the December issue of the American Journal of Tropical Medicine and Hygiene, add to mounting evidence that vivax malaria may be killing people far more often than previously thought; confirm that existing treatments are inadequate and potentially toxic to millions; and shed light on the level of precaution that travelers should take when visiting these regions (see Backgrounder for further information).
While not as deadly as the Plasmodium falciparum malaria parasite that is predominant in Africa, vivax is more common throughout the world, with an estimated 2.85 billion people at risk of infection. And with its unique ability to relapse by hiding in the liver for months or even years, vivax is harder to detect and cure.
The MAP team produced an analysis last year depicting only where vivax is known to exist. Malaria experts immediately called for a map pinpointing where the disease is most prevalent, noting that such a tool is essential to mounting an effective fight against this form of malaria.
Hotspots for vivax malaria highlighted by MAP include substantial parts of India. Rates are high even in urban areas like Mumbai, where malaria—once thought of largely as a disease of rural areas—was previously uncommon. Papua New Guinea also has a high rate of infections and transmission, as do significant parts of Indonesia and Myanmar (including Yangon). In the Americas, the area of greatest concern is a large but sparsely populated portion of the Northern Amazon, most of which is in Brazil. But the hotspot also includes parts of Peru, Colombia and Venezuela. In Central America, almost all of Nicaragua is a hotspot for vivax malaria, as are parts of Honduras and Guatemala.
In Africa, Gething said that while vivax is known to exist, infection rates appear to be “very, very low” for most of the continent, though the map indicates a moderate but stable level of vivax transmission in parts of the Horn of Africa and throughout Madagascar.
Stealth Disease Burden: “Large Reservoir” of Vivax Infections Hiding in the Liver
Researchers considered an area to be a vivax malaria hot spot if the data analysis yielded infection rates that exceeded 7 percent. Gething noted that this threshold might be considered relatively low for falciparum infections. But he said it’s high for vivax in part because the figure accounts only for parasites that are detectable in the blood, and also because vivax disease rates have proven hard to reduce.
He noted that in areas where vivax is endemic, at any given time, there are many people carrying vivax parasites only in their liver, from which they periodically emerge to cause new infections in the blood stream. But, he said, this “large reservoir” of vivax is difficult to quantify with existing surveillance tools, chiefly because there is currently no simple test for detecting the liver parasites.
“One person with vivax actually can represent multiple malaria infections over many years in a single community and each time the parasite moves from the liver to the blood, it contributes anew to disease burden and transmission,” Gething said.
The disease burden caused by vivax relapse, he said, is exacerbated by a lack of treatment options. Medicines such as the artemisinin combination therapies (ACTs) that are used to cure falciparum infections can help treat acute bloodstream vivax infections. But only one drug—primaquine—can clear vivax parasites from the liver and thus provide a long-term cure to this type of malaria.
However, in a cruel twist of evolution, a hereditary condition that may have evolved in response to malaria exposures can make the drug toxic, sometimes fatally so, to some people who live in vivax-endemic areas. At ASTMH, another team of researchers from the Malaria Atlas Project will present a map depicting the prevalence of the condition, known as G6PD deficiency, within malaria-endemic countries. Preliminary data indicate that this condition is relatively common in vivax-endemic Southeast Asia, though the highest rates are found in sub-Saharan Africa. The condition is also observed in the Americas, though at lower rates.
“We hope that by mapping the prevalence of G6PD deficiency we can provide evidence that will help contribute towards determining the risks and benefits of using primaquine, which is an important, yet potentially dangerous drug,” said Rosalind Howes, the lead investigator on the project.
Even when primaquine is not toxic, the fact that it requires a 14-day regimen has made it impractical for areas where people have little or no access to even modest levels of health care—which is the majority of the malaria-endemic regions of the world.
Meanwhile, bednets and indoor spraying, which, coupled with ACTs, have helped reduce malaria deaths in Africa, appear to have had little impact on vivax. One reason is that the mosquitoes that transmit vivax typically bite outdoors, rather than indoors in the home. And RTS,S, the malaria vaccine candidate in Phase 3 trials that may soon be commercially available, does not target vivax.
This persistence of the vivax parasite in the face of a massive global campaign to eliminate malaria has prompted some malaria fighters to dub it “the last parasite standing.”
Malaria experts say even though vivax still appears to be less deadly than falciparum, growing evidence of its link to fatalities warrant giving it a higher profile in the global malaria eradication campaign.
“It’s time to step-up the fight against vivax malaria and stop looking at this form of the disease as relatively mild and tolerable,” said Peter J. Hotez, MD, PhD, noted infectious disease expert and president of ASTMH. “We expect to emerge from this year’s conference with a far better view of the state of vivax infections around the world and with new knowledge on treatment challenges that can guide a global strategy focused on eradicating all forms of malaria.”
Preeti Singh, +1 301.280.5722, psingh@burnesscommunications.com

MALARIA: Ghana: Household cost in treating fevers in the Dangme West District, Ghana

2011-12-08T10:52:00.000-05:00

Bill Brieger : 07 Dec 2011

Is malaria treatment affordable in a rural district of Ghana? - a poster presentation at the American Society of Tropical Medicine and Hygiene annual meeting.
Alexander A. Nartey, Patricia Akweongo, Christine Clerk, Elizabeth Awini, Jonas Akpakli, Margaret Gyapong: Dodowa Health Research Centre, Accra, GhanaAlthough Ghana has instituted a national health insurance scheme (NHIS) as a measure to lessen the burden of health care cost to households, majority of people continue to pay cash directly to seek care, a study has revealed.

The study which was conducted in Dangme West District from October 2009 to August 2011 under the INDEPTH Effectiveness and Safety Studies of Antimalarials in Africa (INESS) platform was to assess household cost in treating fevers and the socio-economic burden of fever/malaria to households in the district. Malaria ranks first on the top ten list of most important diseases within the district.

The study showed that 78.9 per cent of the 511 people interviewed from pre-selected households paid out of their own pockets for the treatment of fever while the remaining 21.1 per cent used their health insurance. The majority of the people had health insurance cover but paid directly for care because they claimed it took too long for them to be attended to at the hospital if they presented their health insurance card. Additionally, some of the respondents paid out of their pockets because they preferred the private clinics where they received prompt care for their fevers.

The study also showed that 79.5 per cent of the respondents sought care outside home by visiting a drug store or health facility. An average of ¢5.00 ($3.3 USD) was spent before seeking care at the health facility and direct average cost per visit to health facility was ¢11.5 ($7.8 USD).

The average number of days lost due to malaria was six days while reduction of productivity due to malaria accounted for 28 per cent. About 1.6 per cent of the patients borrowed money to access health care.
It is evident that a household spends substantial amount on drugs, transport and food for an episode of fever within the district. Out-of-pocket payment is very high and places a high burden on household income. A household may spend an average of 12 working days of the daily minimum wage for the treatment of a fever episode.
The study, therefore, recommended that there is the need to investigate why individuals who are insured with the NHIS have to pay to get prompt treatment at NHIS accredited health facilities. Additionally, home based management of fever should be rolled out in rural communities to help reduce household burden of treating fevers.
http://www.malariafreefuture.org/blog/?p=1345

POVERTY: SUDAN: Security “volcano” ready to blow in the east

2011-12-08T10:48:00.000-05:00

KASSALA, 8 December 2011 (IRIN) -

Photo: IRIN
Guns galore - disarmament operations in the east have only been partially successful (file photo)

Five years after a peace deal was signed to end a rebellion in eastern Sudan, a perceived failure to address the marginalization that sparked the uprising could unleash a new wave of violence, according to several officials.
Although the region has been overshadowed by war in Darfur, the secession of the South and fighting between Sudanese forces and rebels on the border with South Sudan, the east is “a volcano waiting to erupt”, an official working with the UN Development Programme (UNDP) in Kassala, who wished to remain anonymous, told IRIN.
“Beja soldiers are right now in the Hamid mountains, on the Eritrean side,” he said.
Bejas form the largest ethnic group in the east. The October 2006 peace accord was signed by the Sudanese government and the Eastern Front, an alliance of the Beja Congress and the smaller Rashaida Free Lions.
“Unofficial sources have already reported that they organized attacks in Sudanese territory three months ago,” said the UNDP source, predicting that conflict on the scale now taking place in South Kordofan and Blue Nile could erupt in Kassala state within a few months.
The prevalence of weapons in the region heightens this risk.
Yassin Abdallah, who manages the government disarmament office in Kassala, told IRIN that an operation conducted after the peace deal netted “guns and ammunition from 598 Beja fighters and 792 Free Lions fighters. This was only some of the fighters at that time, not the majority.
“And the Free Lions are nomads. They always use guns to protect the cattle,” he said.
Ahmed Tirik, a member of parliament, described the situation in Kassala, his home region, as “unpredictable”.
“But if relations between Sudan and Eritrea [which facilitated the peace talks] remain good, the border will stay safe and it will be very difficult for Beja fighters led by Cheikh Mohamed Taher to cross it,” he said.
The Beja Congress has joined the Sudan Revolutionary Front, an umbrella group set up in November with the aim of overthrowing the government of Omar el-Bashir

"Humiliation and tyranny"
Beja community leader Mohamed Ali Adam said many in his community “think that the situation hasn’t improved for them even five years after the war. They have still no access to facilities such as schools as promised by the government. This is an important issue.
“But, since 2006, discussions with the authorities are better. For instance, they gave us the technical support to build water pumps,” said Adam, who chairs the Al-Gandoul network of 30 villages dotted around the town of Kassala, with about 36,000 residents.
This support was not enough for some in the Beja Congress, which on 15 November threw in its lot with the Sudan Revolutionary Front, an umbrella group set up a few days earlier with the aim of overthrowing the government of Omar el-Bashir.
Explaining why it joined the likes of Darfur’s Justice and Equality Movement and two wings of the Sudan Liberation Army, as well as the northern wing of the Sudan People’s Liberation Movement, the Congress said the “misery and suffering of the [Beja] people is increasing due to poverty, starvation and other deadly diseases. The ruling regime in Sudan is subjecting its people to humiliation and tyranny. They are arrogant and killing the marginalized people. ”
According to a recent report by Japan’s International Cooperation Agency, “91 percent of households [in Kassala state] do not have enough food, only 39 percent have access to safe water and the maternal mortality rate has risen to 1,414 per 100,000 births compared with 500 pre-war.”
Humanitarian response is greatly impeded by landmines and unexploded ordnance (UXO) left over from the war, which is being removed.

Photo: Maryline Dumas/IRIN
Season of discontent - Kassala's population feels increasingly marginalized

“We should manage to clear the area by 2014 as expected,” said Kelly McAulay, country director for the Mines Advisory Group, which says Kassala is the most mine- and UXO-contaminated state in Sudan. “We have good support from the government. And we have got deminers who used to work in Blue Nile and South Kordofan. Now, we have about 80 deminers to clear some 2 million square kilometres.”

Growing discontent
Drought has compounded these problems. This year, water flowed along the seasonal Gasch River only between August and September, rather than starting in July as usual. The just-completed harvest is expected to be poor and consequently the region is braced for higher food prices.
“Popular discontent is boiling,” warned Mohamed Dualeh, head of the UN Refugee Agency’s eastern Sudan sub-office. (There are thousands of Eritrean refugees in the area.)
“During the Eastern peace agreement, the authorities talked about development. It has not materialized as expected. The area is poorer than Darfur. If something has to happen, it will start from within the population, and not from abroad,” he said.
Discontent has already surfaced among students, hundreds of whom demonstrated in late October. There were several injuries and one death in these disturbances.
“The Arab Spring pushed people to act. In response, the authorities settled on very strict security plans,” said Ibrahim Omer Osman, local coordinator for Practical Action, an NGO.
“The atmosphere is like in 1964,” said Tirik, the Kassala parliamentarian, referring to the year when widespread strikes led to the fall of a military government.
“The difference is that the government can still ease the situation, if it helps the population to get food,” he said, suggesting failure to do so carried significant risks.
“Eastern Sudan is a strategic area for Khartoum. There is a big airport in Kassala, roads and the [oil] pipelines. You know, the region is big enough to hide in after attacking a pipeline.”
http://www.irinnews.org/report.aspx?reportID=94421

POVERTY: MIGRATION: Misperceptions of migration fuel tensions

2011-12-08T10:42:00.000-05:00

JOHANNESBURG, 8 December 2011 (IRIN)

Photo: Tebogo Letsie/IRIN
Thousands of migrants living in South Africa were displaced by xenophobic violence in 2008

About 214 million people were living and working outside their home country in 2010, and international migration has continued to grow despite the global economic crisis, but in many countries negative attitudes towards migrants are also rising.
The International Organization for Migration (IOM), focusing on the importance of communicating more effectively about migration in its World Migration Report 2011, released on 6 December, notes that such attitudes stem in part from misinformation and misperceptions about migration that have been fuelled by opportunistic politicians and poor media reporting.
"Few areas of public policy are subject to greater misrepresentation... yet more influenced by public opinion, than international migration," write the report's authors. "Accurately informing relevant stakeholders and the wider public about migration may be the single most important policy tool in all societies faced with increasing diversity."
During periods of economic recession, national debates on migration issues are often politicized, and evidence of the economic benefits that migration can bring is ignored in favour of assumptions that migrants are fuelling unemployment and draining public resources.
People in migrant-receiving countries tend to significantly overestimate the size of their country's migrant population, and often blame them for social ills ranging from crime to unemployment.
A 2010 public opinion poll, cited in the report, found that 57 percent of Americans felt immigration had a negative effect on the country. Another recent study of eight migrant-receiving countries found that an American perception of 39 percent of the US population being migrants differed significantly from the actual figure of 14 percent. Italians believed 25 percent of their population were migrants, more than three times the actual number.
With more and more migrants heading to rapidly developing nations in their own regions, such views are not limited to the developed world. A 2006 survey of South African citizens found that 84 percent felt "too many" foreign nationals were being allowed into the country and 37 percent wanted a total ban on immigration.
Bernardo Mariano-Joaquim, IOM's regional representative for southern Africa, commented that not enough had been done in South Africa, the region's largest recipient of migrants, to highlight the positive effects of migration on the country's economic development.
"In the Mpumalanga region, strong development has been thanks to Mozambican visitors and migrants, who come and purchase good and services and work on the farms," he told IRIN, adding that even in countries with high rates of unemployment like South Africa, certain jobs, particularly of a seasonal nature, are more attractive to migrants than to locals.
Few areas of public policy are subject to greater misrepresentation...yet more influenced by public opinion, than international migration
Southern Africa has a long tradition of intra-regional migration, with South Africa's mining sector attracting workers from neighbouring Lesotho, Swaziland, Mozambique and Botswana. Since the end of apartheid in 1994, however, the country's booming economy and progressive refugee legislation have attracted much larger numbers of economic migrants and asylum seekers from all over the continent.
The influx has led to rising tensions, especially in townships where migrants have started businesses and are perceived to be faring better than the locals. In May 2008, hostilities erupted in widespread xenophobic violence that left 60 people dead and displaced about 100,000 others. Commentators have since accused the government of not doing enough to prevent continuing sporadic attacks on foreigners.
The IOM report asserts that such episodes could be avoided by "a fundamental shift in the way we communicate about migration" so as to foster more informed debate and "prevent migration from being used as a platform for other political, social and economic issues".
Mariano-Joaquim notes that in South Africa, as in many migrant-receiving countries, politicians tend to use anti-migrant rhetoric to gain votes and also to make migrants the scapegoats for much wider socio-economic problems.
With their focus on the sensational and the dramatic, local media portrayals of migrants have not helped. "We need more balance," he said. "There are South African business people who are becoming richer thanks to migrant workers; there are migrant workers who have started from nothing employing South Africans."
The IOM report makes the point that "distorted communication about migration can trigger a vicious cycle that leads to misinformation being perpetuated through government policy, the mass media, the public at large and... can, in turn, skew discourse at all levels."
The way forward, according to Mariano-Joaquim, includes de-politicizing debates around migration. "If you looked at migration through the lens of economic development, policies would be completely different," he said, citing the example of Canada and Switzerland, where annual quotas are set for migrant labour depending on the country's needs.
He also called for discussions about migration to include migrants themselves, and for the perspectives of migrant-sending as well as receiving countries to be considered in formulating migration policies.
http://www.irinnews.org/report.aspx?reportID=94423

MALARIA: Zimbabwe: at pre-elimination stage

2011-12-08T10:37:00.000-05:00

"Zimbabwe is doing very well as far as malaria control is concerned," she said in Harare. "In fact, in some areas of Matabeleland we have reached the pre-elimination stage which means our system is very advanced and meets WHO standards.”
However, when asked why the same World Health Organisation, which has developed a new drug to combat malaria, had side-lined Zimbabwe from receiving the drug, the official said: "I am not aware of this information."
The WHO said Zimbabwe was very disappointing because its malaria cases were increasing instead of decreasing, therefore it would not test its new vaccine until the disease was "fully" controlled.
At a closed workshop, a WHO spokesperson said: "The WHO has indeed developed a new drug to combat malaria. Unfortunately Zimbabwe will not benefit from this drug just yet because its cases have not been consistent with WHO standards. While we are happy about the progress made by Zimbabwe, its cases go up and down, and we want them to remain down."
She said other African countries, mainly in the West, were already benefitting from the new drug.
http://www.thezimbabwean.co.uk/news/zimbabwe/55248/malaria-campaign-impressive-nihr.html?utm_source=thezim&utm_medium=homepage&utm_campaign=listarticle&utm_content=textlink

POVERTY: MYANMAR: Landmine survivor needs outstrip aid

2011-12-07T10:02:00.000-05:00

BANGKOK, 7 December 2011 (IRIN) -

Photo: Zin Win/IRIN
Zaw Lwin, 42, lost his leg to a landmine 12 years ago in the eastern part of Myanmar's Bago Region

Myanmar has one of the world's highest casualty tolls by landmines, but for years the country has received little international aid for survivor assistance, risk education and other mine action. The numbers are changing, however.
"Myanmar gets very, very little funding compared to any other country that has a landmine victim population of its size," said Yeshua Moser-Puangsuwan, with the Geneva-based International Campaign to Ban Landmines (ICBL).
While international donations for mine action worldwide have doubled over the past decade, contributions have remained low in Myanmar because the government has refused humanitarian groups access to mine-affected areas, and the country has not signed the 1997 Mine Ban Treaty, according to NGOs.
Of the 4,191 recorded landmine casualties in 2010, 274 occurred in Myanmar - the fifth highest in the world after Afghanistan (1,211), Colombia (512), Pakistan (394), and Cambodia (286).
Those countries, respectively, received US$102.6 million, $12.1 million, $3.4 million, and $24.3 million in 2010 from international donors - versus Myanmar's $36,000 from Norway's government, according to ICBL's 2011 Landmine Monitor.
This figure excludes monies not reported to ICBL, which for Myanmar included funds from the International Committee of the Red Cross (ICRC) and the UN Refugee Agency (UNHCR), said Moser-Puangsuwan.
The Norwegian government backed a study in 2010 on the humanitarian impact of landmines and has increased its contribution to about $500,000, said Arne Jan Flølo, the Myanmar desk officer at the Norwegian embassy in Bangkok.
The US government has pledged $200,000 to help survivors.

Progress report
Campaigners against landmines point to recent developments in the country as signs the time has come to "be more brave" in fighting landmines in Myanmar, noting its participation in a recent gathering in Cambodia of signatories to the mine ban treaty.
"There seem to be openings," said Katherine Kramer, Asia's programme director for the NGO Geneva Call. "There are venues to start a dialogue with the government... by offering assistance for humanitarian mine action."
U Win Naing, Myanmar's deputy director-general in the Ministry of Foreign Affairs, said "careful consideration" was the most appropriate way forward on the issue of landmines, during an address at the annual Meeting of States Parties from 28 November to 2 December in Phnom Penh, Cambodia.
"Myanmar also believes that the legitimate right of every state to self-defence in matters of its national security must be recognized and respected in considering this issue," he said, according to a transcript of the speech.
It was the first time a Myanmar official had addressed the gathering.
"I'm really hoping that, with the government's presence at this meeting, they [the government] might be more open to humanitarian mine activity, and then I'm sure funds will increase," said Kramer.
"If you can't do activities openly, then it becomes much more difficult to put large amounts of funds into projects."
An "extremely significant" development came in November when a government minister met five major armed groups to discuss a ceasefire, said Moser-Puangsuwan. Since then, the government has signed a formal ceasefire agreement with the Shan State Army-South, according to local media.
Any ceasefire agreement must prohibit landmine use and allow NGOs access to mine-affected communities, said Moser-Puangsuwan.

Non-state armed groups must sign on, too.
"For the people living in the conflict areas, not much has changed," Moser-Puangsuwan said. "Until there's an end to armed conflict in that country, there's still going to be mine use."
Myanmar was one of four countries worldwide where government forces used anti-personnel landmines in 2011 and the only country where both state and non-state armed groups used them in 2010-2011, according to ICBL.
Since 1999, at least 2,861 people in Myanmar have been injured or killed by landmines but the actual figure is believed to be much higher, campaigners say.
http://www.irinnews.org/report.aspx?reportID=94417

POVERTY: PAKISTAN: Girls fight for the right to education

2011-12-07T09:56:00.000-05:00

PESHAWAR, 7 December 2011 (IRIN) - Photo: Groundreporter/Flickr
Pakistani girls are becoming agents of change in the fight for education

Armed with only a slightly used copy book sent by her aunt from Peshawar, the capital of the northwestern Khyber Pakhtoomkhw’a province, Azeera Gul, 12, is fighting for the rights of girls to an education.
Although her school in the tiny town of Kabal in the Swat Valley is still in a ramshackle state after being burnt down during the Taliban insurgency in 2008, which ended in 2009 after a Pakistan military operation, Gul insists she wants to become a school teacher and educate other girls in her village.
Gul is not alone in wishing to bring change to her valley. One story that galvanized the international media is that of Malala Yousafzai. In 2009, she began campaigning from her remote village in Shangla in Swat against the Taliban for the right to education for girls.
She was nominated for the International Children’s Peace Prize, presented annually by the Dutch organization KidsRights, for her pioneering efforts to raise awareness about the treatment of girls in her homeland. Though she did not win the award, her nomination brought home the problems of Swat to millions in the country and won her national recognition with an award from the prime minister.
“This award is a great prize for me. I want education for the girls of Swat,” Yousafzai, now 13, told IRIN.
She is not the only young campaigner. “I want to become a doctor,” said Ludia Bibi, 14, in Mingora. “That is the only way I can help people here and make sure women in particular get the care they need.”
Maria Toor Pakai, 19, grew up in South Waziristan, where women rarely venture out of their homes. She defied tradition by playing squash and is today a top-ranked national player.
There are so many little girls here who could change the future
“I knew my daughter was different and wished to encourage her,” said Maria’s father, Shamsul Qayyum Wazir, who took her to Peshawar in 2002, eager to grant her the opportunity she would have been denied at home. “We had received threats from the Taliban warning us to stop her playing,” he told IRIN.
Today, Pakai lives and trains in Toronto, her story inspiring others. “I always think of the hard rocks of my land, and how tough they made me,” she said.
But while such young women have fought back, others find it harder to do so. “I want my daughters to have a better life than I do, but it is hard here,” said Ujala Gul, 40, a mother of three girls who lives in a village near Saidu Sharif, the capital of Swat. “I am afraid they will end up as powerless housewives just like me, subservient to their husbands.”

Determination
Even so, the girls seem more determined than the boys given the harder struggle that lies ahead for them and the struggle they have had to gain any education at all.
“I feel I must do something with my life. Things here must change, otherwise lives for girls and women will never ever change,” Samira Ahmed, 12, told IRIN. She is helping to run classes near Kabal for girls who are not able to go to school.
“There are so many little girls here who could change the future. I have educated daughters and I know they can change the lot of a family. That’s why I want to help all those that I can,” said Mullahzai Tauqir, 65, a grandfather and retired teacher who now runs voluntary classes for out-of-school children near Mingora. “I think my efforts and theirs will one day make a real difference and create real change here.”
http://www.irinnews.org/report.aspx?reportID=94418

MALNUTRITION: Scaling up innovations to fight hunger

2011-12-07T09:50:00.000-05:00

29 November 2011

Flickr/Feed My Starving Children (FMSC) Source: Nature

Childhood malnutrition can be prevented using available knowledge to improve food security

Building sustainable food security, rather than concentrating on food aid, is a better way to help the people most vulnerable to food crises, says Josette Sheeran, head of the UN World Food Programme (UNWFP).
"Food aid has saved millions of lives, but it cannot, by itself, solve hunger," she says. The UNWFP is shifting its focus towards building local capacity to deal with future crises compounded by ongoing food price volatility, climatic changes and conflict.
Sheeran points to programmes underway in several countries that aim to "transform the fight against hunger" by developing and scaling up innovative ideas and tools at the grassroots level.
For example, in Cameroon — where 2.8 million people are food insecure — the UNWFP makes a one-time donation of ten tonnes of cereal to each community granary but also trains farmers in management and financial aspects of food storage. Community members can withdraw stocks with little interest and replenish them from their own crops, while funds from the interest and sales help with buying more stock.
In Pakistan, food technologists have created a chickpea paste fortified with micronutrients, which requires no water or cooking — helping to guard children from irreversible damage caused by malnutrition. And in Palestinian territories, 'digital food vouchers' delivered to mobile phones have helped increase local dairy production by 30 per cent, as well as helping people to buy nutritious food.
"Ending hunger does not require major scientific breakthrough," says Sheeran. "For the first time in history we have the scientific knowledge, programmes, tools and policies to defeat hunger but we need global political will".
http://www.scidev.net/en/agriculture-and-environment/food-security/opinions/scaling-up-innovations-to-fight-hunger-1.html

MALNUTRITION: US–Nepal hybrid maize project runs into criticism

2011-12-07T09:44:00.000-05:00

[KATHMANDU] Smriti Mallapaty : 30 November 2011
Flickr/CIMMYT: Critics are concerned about the loss of local maize varieties

Uncertainty hangs over a proposed partnership between US and Nepalese scientists to promote hybrid maize in the Himalayan country, after the project sparked local concerns over the potential loss of traditional local varieties and weak biotechnology regulation.
The pilot project of the US Agency for International Development (USAID), Nepal's Ministry of Agriculture and Cooperatives and US agricultural corporation Monsanto — announced earlier this year (13 September) on USAID's website — aims to train 20,000 farmers on hybrid maize production practices, and facilitate links between producers and end-users.
But concerns have been expressed by civil society organisations, as well as some government officials, and now neither USAID nor the ministry will confirm whether the project is going ahead.
Nepal imports half of the estimated 270,000 tonnes of maize it uses a year, at a cost of about 200 million Nepalese rupees (US$2.5 million).
Hybrid seeds are formed under controlled pollination conditions between two plants selected for specific traits such as high yield or pest resistance. The first generation of hybrid seeds has higher yields than the locally available varieties, but farmers need to obtain new seeds from suppliers each year if they are to maintain these high yields.
Members of civil society organisations expressed concerns at a meeting this month (15 November) that foreign hybrid maize seed could replace local varieties, increase Nepal's dependence on imported seed and pave the way for the introduction of genetically modified (GM) crops later because of weak biotechnology regulation.
But Monsanto's Nepal representative, Kiran Dahal, told SciDev.Net: "The farmers are already using hybrid seed; we are just trying to support them".
Monsanto has been importing conventionally bred seeds into Nepal for the past 15 years, including 100 metric tonnes of hybrid seeds in 2010, he said. He added that the partnership was pending the Nepalese government's approval.
But government officials declined to comment on when this might happen or what the final deal will look like.
Hari Dahal, a spokesperson for the ministry, said it was unlikely the agreement would be signed in its current form.
"Mass importation of hybrid seed goes against our obligations under the International Treaty on Plant Genetic Resources for Food and Agriculture," he told SciDev.Net. "If the partnership seeks to improve our own hybrid seeds, then an agreement is possible."
A senior ministry official told SciDev.Net on the condition of anonymity: "If we import hybrid seed our local varieties will disappear. The rights of the farmers will be in the hands of private companies."
Nepal's agriculture policy, announced in 2004, encourages the production and use of hybrid seed varieties; and their distribution after testing, certification and registration.* Since 1960, Nepal approved 25 maize varieties, hybrid and non-hybrid, of which 16 are local. The nine foreign maize varieties include three Monsanto varieties listed in the pilot project.
http://www.scidev.net/en/agriculture-and-environment/agri-biotech/news/us-nepal-hybrid-maize-project-runs-into-criticism.html

POVERTY: GUINEA: Avoiding ethnically-driven elections

2011-12-07T09:37:00.000-05:00

CONAKRY, 6 December 2011 (IRIN)
Photo: Anna Jefferys/IRIN
Some Peulh traders feel they are being targeted by the administration

Politics remain ethnically divisive in Guinea a year after violent clashes marred a bitterly divided Presidential election. Analysts and civil servants say more concerted reconciliation efforts between ethnic groups are needed on the part of the President and opposition leaders to avoid another pitched battle in upcoming legislative elections.
Voting was originally scheduled for the end of 2011, but senior officials told IRIN it is more likely to take place early next year as the census, registration process and other key preparations are nowhere near complete.
“Ethnic tensions are getting worse, not better,” said Vincent Foucher - a researcher at the International Crisis Group (ICG), a conflict thinktank - who wrote Putting the transition Back on Track. “Everyone is playing the ethnic card… horrible statements are being made from all sides.”
The main political party, President Alpha Condé’s Rally the Guinean People (RPG) is supported by the Malinke, while main opposition leader Cellou Dalein Diallo’s party, the Union des Forces Democratiques de Guinée (UFDG), is closely associated with the Peulh community. Peulhs are the dominant ethnic group in Guinea, followed by the Malinke and Sousou.

Favouritism
Corinne Dufka, head of Human Rights Watch (HRW) in West Africa, says the current administration has fomented ethnic tension rather than trying to reduce it. The President has shown clear favouritism in appointing Malinke to civil service and ministerial posts, and has used the judicial system - based on French civil law, customary law, and decree - to discriminate against Peulh political groups.
Currently, Peulhs hold just six ministerial positions, including the Youth and Tourism portfolios, while the military is Malinke dominated.
Many people fear that Condé is concentrating power in the executive. “Past Presidents had to balance the ethnic positions at least a little, but now there is not as obvious a need,” said Foucher. Even military junta leader Dadis Camara had to put more effort into getting the support of different ethnicities during his short-lived time in power, he added.
Public discourse has been peppered with ethnic rhetoric in recent months. On 21 September 2011, the Governor of Conakry Region, Resco Camara, talked of ordering containers of water from the Mayimbo River to pour on protesters - the river is popularly believed to have dangerous powers against members of the Peulh community.
Mouctar Diallo, leader of the New Democratic Forces party (NFD) and President of a group of opposition parties, Collective Parties Politique Finalisation de la Transition, told IRIN he has never seen Guinea as divided as it is now. “You say your name and you know your ethnicity - and that is how people are defining themselves. An ethno-strategy has become part of the Guinean politics… the situation is very serious.” He too, has shocked many with his strong statements – earlier this year saying President Condé would need to expand his cemeteries and hospitals to bury protesting militants - referring to strong crackdowns by security forces on protesters.
A rice vendor at Concasseur market in the capital, Conakry, told IRIN that Peulhs feel increasingly marginalized in society and politics. Those in the diaspora have made a number of vitriolic statements, with online news site Guineé Presse speaking of impending civil war and a “genocide“ being planned against the Peulh community. “They talk of genocide when there are arrests. Key officials are making strong statements - it is worrying,” said Foucher.
Nevertheless, strained relations between the President’s party and the opposition improved recently when Condé held meetings with opposition leaders to discuss the upcoming elections. He described the meeting as “cordial and rewarding”.
Moustapha Naïte, director general of the Patrimoine Partie Politique, which is linked to the Presidency, told IRIN that although ethnic division is at a high pitch, poverty, not politics, is the root cause of tension between the various communities.

Economy not ethnicity
“People are mistaking economic issues for ethnic issues. What people are really concerned about is the economy and jobs, and that is starting to look up,” he told IRIN, referring to a recent spike in investment in the mining sector, and mining reform that could increase the government’s share in the sector by up to 35 percent.
“We are committed morally and religiously to reconciliation,” Naïte said. “We need to have a debate about the problems that have been posed. There is a sense of frustration in the country, and deepening poverty has accentuated some tensions, but the roots are much more in poverty than in ethnicity.”
Guineans have become poorer in the past 15 years. In 1995 some 40 percent of the population was living in poverty, but in 2010 this figure reached 58 percent, according to the UN.
Oumar Baldet, head of International Alert, a conflict resolution non-profit, agrees. “The biggest danger in Guinea is poverty. One percent of the population takes most of the country’s revenue - it is very corrupt - yet this is somehow socially tolerated.”
HRW’s Dufka said poverty need not be divisive. “All ethnic groups have suffered from bad governance, corruption and a weak rule of law,” she pointed out.

Marriages, baptisms
Some worry that politically driven ethnic division has seeped into communities, creating tension where previously there had been inclusion and tolerance. For instance, in the city of Conakry, most marriages and baptisms have traditionally been inclusive events to which all ethnic groups were invited. Dufka told IRIN that lately she has heard of more ceremonies being limited to one group or another.
In the marketplaces, a few Peulhs, who are angry with what they see as the government’s efforts to undermine them economically and politically, have started to set different prices for Peulhs and for others, say traders.
A Malinke woman at Concasseur market, who asked to remain unnamed, said she was charged 18,000 GF(US$2.67) for a bottle of milk, while the Peulh woman just before her had been charged 15,000 ($2.21). But, she said, this practice was far worse during the election period in 2010.
President Condé has tried to break up monopolies in the import market, traditionally dominated by Peulhs, causing some to feel targeted, said a vendor. Many Peulhs left Guinea for neighbouring Cote d’Ivoire when its President Alassane Ouattara eliminated taxes for traders there.
“Had President Condé pushed for inclusion - ‘let’s all work together; how can I encourage Peulhs to continue to invest in Guinea?’ - this could have mitigated some of these problems and would not have sabotaged the economy,” said Dufka.
Others feel it is high time that the power of what they call “mafias” - who manipulate the market and fix prices - is broken. “It is the President who says monopolies in the market should be broken up to help everyone compete for the benefit of the population… he has not stigmatized one ethnic group over another,” Diallo, a Conakry resident, told IRIN.

Moving forward
Ethnic tensions have long simmered in the country, but with so many Guineans having seen first-hand the impact of such violence in West African neighbours Sierra Leone and Liberia, the appetite for violence is low. Thousands of refugees from these countries fled to Guinea during their civil wars. “Ethnic problems are not fundamental here [Guinea], they’re power-related,” International Alert’s Baldet told IRIN.
Diversity is so fundamental to most city-dwellers’ lives that any degree of ethnic politicking will only go so far, a Conakry-based journalist says. “Many Guineans have more than one wife, each of a different ethnicity. It’s not unusual to find a Guinean with a Peulh mother, a Malinke wife and a Soussou or Forestier father… things are mixed here.”
Lounceny Camara, President of the Independent Election Commission (CENI) in Guinea, told IRIN he hoped ethnicity would play a far smaller role in upcoming legislative elections. The problem is that political debate remains highly polarized in the fledgling democracy. “We have never before seen a second round [of voting in an electoral process] - there is no real middle ground yet,” he said.
Before political campaigning begins, political parties should sign up to a code of conduct committing them to refrain from any comment that risks stirring up inter-communal tensions, says the International Crisis Group.
Most analysts agree that on top of imposing limits and rules, a deep countrywide reconciliation process needs to take place. “It is easier to move ahead with elections than to open such delicate debates as reconciliation,” Baldet told IRIN. “But if you do not address the problems of the past, they’ll just recur... the state has always acted with impunity here, and there has still been no catharsis.”
For years, International Alert has been hosting a dialogue on reconciliation and peace-building with political figures, religious leaders, security sector representatives and civil society organization representatives.
“The President came with intentions to take a South African model [of reconciliation]. Then the reality of power changed and it dampened his ardour,” said Baldet, referring to the assassination attempt against the President in July 2011. According to the ICG, ethnic resentment probably played some role in the event, and most of the people in the first group indicted for the crime are Peulh
The government recently appointed religious leaders to set up a reconciliation commission to address past tensions as well as the roots of inter-community divisions. Baldet told IRIN he hopes it will be as inclusive as impossible.
Dufka supports the idea. “I cannot emphasize enough the importance of pushing this,” she said. “This could help focus Guineans on what they have in common…Corruption and impunity affect all Guineans and all ethnic groups - Guineans often lost sight of that.”
But if the initiative is to work it needs buy-in from all sectors of society, she said, and at the moment many civil society members have not even heard of it.
http://www.irinnews.org/report.aspx?reportID=94405

POVERTY: DRC-CONGO: Thousands flee election tension

2011-12-07T09:31:00.000-05:00

BRAZZAVILLE, 6 December 2011 (IRIN)

Photo: Laudes Martial Mbon/IRIN
Seeking security: thousands of DRC residents are fleeing potential election conflict

At least 3,500 people have arrived by boat in recent days in Congo’s capital, fearing violence in the run-up to the announcement, due before midnight on 6 December, of the outcome of the presidential election in the Democratic Republic of Congo (DRC), according to an official.
Yves Ikiaye, a captain in Congo’s immigration service, said those crossing the Congo River, which separates Brazzaville from the DRC capital, Kinshasa, between 4 and 6 December included politicians and their families, diplomats and UN officials.
“We came here to escape war,” said Dorcas Mukaku, a schoolgirl, who arrived with her two younger sisters.
“The Lubas [one of DRC’s ethnic groups] said that if Etienne Tshisekedi was not elected they would set Kinshasa on fire and shed blood,” she told IRIN.
Others, “who support President Joseph Kabila [who is running for re-election], said it had to be him or no-one”, she said.
“I decided to leave my parents and studies behind to observe the situation from afar and save my life. I am too young and have nothing to do with what’s going on,” she said.
However, Congo’s Interior Minister, Raymond Mboulou, said: “We are not in a crisis situation,” adding that it was normal for people from Kinshasa to travel to Brazzaville.
Brazzaville’s chief of police, Général Benoît Moundélé-Ngollo, said a special camp would be set up if the numbers arriving increased significantly.
http://www.irinnews.org/report.aspx?reportID=94406

POVERTY: YEMEN: Children at risk as aid access denied

2011-12-07T09:27:00.000-05:00

SANA’A, 6 December 2011 (IRIN)

Photo: Contributor/IRIN
Children in Dammaj village, northern Yemen, are cut off from food and healthcare

Thousands of people under “siege” by armed rebels in northern Yemen lack food and healthcare, which has already resulted in deaths and risks killing many more, local leaders and aid workers say.
Four children under five have died of hunger since Houthi gunmen cut off access to Dammaj village more than a month ago, Ahmad al-Qurashi, of the local NGO Seyaj Organization for Childhood Protection (SOCP), told IRIN.
The village, 9km southeast of Sa’ada City, the capital of Sa’ada governorate, is home to about 12,000 people. The area is controlled by the rebels but is home to an institute for Islamic Salafi teachings, Dar al-Hadith, which is at the centre of the conflict.
Up to 200 other children are at high risk due to the lack of food, water and medical supplies, according to Hussein al-Hajouri, a spokesman for Dar al-Hadith. They could die if aid organizations are not allowed access, he said.
"The situation is getting much worse for those stranded children amid lack of food, fuel and medical supplies,” said SOCP chairman Ahmad al-Qurashi. “Healthcare centres in the area have become inaccessible."
All the roads to medical centres are blocked or unsafe. “For this reason, mothers are compelled to deliver at home unattended,” Al-Hajouri told IRIN. “Last week, a woman died in labour at home after [being in pain] for six days. A number of new-borns have died due to lack of medical services."
Three elderly men have also died because they could not obtain their regular medication, according to the local independent news website, Sahafah.net.

Appeal
An armed conflict between the Houthi rebels, who belong to an extreme Shi’a sect of Islam, and Salafi residents of the town, who subscribe to the fundamentalist Sunni branch of Islam taught at Dar al-Hadith, has now killed 30 people and injured dozens more since it erupted in the final week of October, according to Dhaifallah Solaiman, a local council member from Sa’ada.
On 3 December, SOCP made a humanitarian appeal to save the lives of some 3,000 children stranded in Dammaj.
This is taking its toll on the population there, namely the sick, the elderly, women and children, but also the injured
A team with the International Committee of the Red Cross (ICRC) was finally able to enter the area on 2 December to provide urgently needed humanitarian assistance, said communication coordinator Rabab al-Rifai.
According to Al-Rifai, the initial assistance consisted of 500 rations of food, which included wheat grain, rice, beans, sugar, salt and cooking oil.
The ICRC also provided medical items – dressing kits, intravenous fluids, painkillers and antibiotics – and several people were transferred to hospital for treatment. In view of the cold winter, the ICRC also made available 1,000 blankets, soap and nappies to help improve hygiene conditions.
“Thousands of people who live in this part of Sa'ada governorate have been denied access to essential commodities, including their daily needs in food and basic medicines,” said Eric Marclay, head of the ICRC delegation in Yemen. “This is taking its toll on the population there, namely the sick, the elderly, women and children, but also the injured.”

Fuel shortages
Complicating matters further, the stranded civilians say they cannot use the wheat grains they received from ICRC because of a lack of fuel in their village.
"We don't need wheat,” Moflih Hajar told IRIN from Dammaj. “How can we have it grinded into flour? All the grinding machines in the village have been closed down due to lack of diesel."
He said almost all the families that received wheat were still without food. "Our children and ourselves need bread, which is impossible to make under the status quo.”

Source of conflict
Sectarian tensions between the Shi’a Houthis and the Salafi students have existed for years, with each trying to spread their ideology in the area. Politics are also at play. The rebels support the popular uprising against President Ali Abdullah Saleh, while the Salafis believe that a ruler must be obeyed and respected and have issued edicts banning protests.
But according to the local weekly Yemen Times, the current conflict surfaced last month after a letter, written by Yahya al-Hajouri, head of Dar al-Hadith, was leaked to the Houthis. The letter expressed thanks to both the Yemeni and Saudi governments for fighting the Houthis in 2009. The Houthis attacked Dar al-Hadith and residential homes suspected of housing armed Salafis. The latter fired back. The Houthis then resorted to heavy artillery and banned entry and exit from the village.
Dar al-Hadith is run by a hard-core Salafi group and teaches about 7,000 students, including women and children, from Yemen and foreign nations.
Mohammed Abdussalam, a spokesman for the Houthis, accused Salafi students at Dar al-Hadith of attacking them from time to time. "They have been attempting to take over strategic military positions outside their area," he said.
The Houthis have been waging attacks and provoking war inside Yemen since 2004.
http://www.irinnews.org/report.aspx?reportID=94407

POVERTY: SWAZILAND: Contesting the Global Fund audit

2011-12-07T09:20:00.000-05:00

MBABANE, 7 December 2011 (PlusNews)

Photo: FreeFoto.com
Released in late October, the Global Fund audit recommends Swaziland repay US$5.8 million

On the heels of a decision by the Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria to cancel its next round of funding, the Swazi government is calling on donors to come to the impoverished country's aid. However, there are fears that the result of a recent Global Fund audit may dissuade donors even as HIV organizations contest its findings.
Economic constraints forced the Global Fund to cancel Round 11 grants at its board meeting in late November in Ghana's capital, Accra. HIV activists in Swaziland say the cancellation has jeopardised the scale-up of HIV programmes. The country is also contesting a recently released Global Fund audit that alleges nearly US$6 million in aid was misused.
With an HIV prevalence of about 26 percent, Swaziland cannot afford to fund HIV treatment domestically - an estimated 90,000 Swazis are in need of antiretroviral (ARV) drugs, according to international medical humanitarian organization Médecins Sans Frontières.
In early 2010, the Swazi government announced it would take over funding for all ARVs, excluding paediatric drugs, from the Global Fund, but a lack of money led to ARV shortages in 2011. Swaziland recently received stopgap funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR) to help supply first-line ARVs until the end of April 2012.

HIV organizations contest audit findings
The audit report released on 31 October by the Global Fund's Office of the Inspector General (OIG) recommended that Swaziland pay back $5.8 million of around $100 million in grants it had received between 2003 and 2010.
The report says the money due for repayment has been misspent as part of budget overruns, or unbudgeted or unapproved expenses, and the situation has been compounded by a dearth of supporting documentation and oversight.
Swaziland's Country Coordinating Mechanism (CCM), which handles the disbursement of Global Fund grant money, denied any corruption, theft or fraud in a statement.
"We are completely transparent," said Derek von Wissell, director of the government's National Emergency Response Council on HIV and AIDS (NERCHA). "There is a lack of understanding about the way things work in Swaziland.”

NERCHA has joined the CCM in insisting that no money was misspent. Both bodies say inadequate local accounting practices were largely to blame for the appearance of financial discrepancies that in fact did not exist.
Among the audit's findings were poor controls in terms of unbudgeted expenditure, such as the purchase of vehicles used to support feeding schemes but not included in original work plans. In its report, the OIG does not question the need for the vehicles, but has asked NERCHA to provide evidence that the nearly 40 vehicles purchased were used in line with Global Fund grant objectives.
Without this evidence, the OIG has recommended that the roughly $1.8 million used to purchase the cars be refunded.
The money went to vehicles that you can plainly see are transporting food to neighbourhood care points," said Alicia Dlamini, a systems manager with a HIV testing and counseling NGO that depends on international donations. "This is not money that disappeared into someone’s overseas bank account.”
Unapproved expenditure was also found in the construction of rural centres built for the care of orphaned and vulnerable children, where costs ran about $1 million over budget, despite fewer than the projected number of centres being built.

Keeping up with the times
Dlamini maintains that the Global Fund Secretariat approved the expenditure, but the audit disagrees, highlighting the need for better guidance from the Secretariat to Fund recipients in order to avoid similar situations in future.
Von Wissell says these situations are historically rooted. "The original plan of the Global Fund was, ‘Let’s get the money out there and get the results’. We were told go buy the drugs we need and get vehicles if they are needed," he told IRIN/PlusNews.
"At the Global Fund now, such flexibility is gone. We started getting money in 2003 and the Global Fund was just starting up, so monitoring systems were just starting up for both of us. You can’t apply 2010 rules to what was done in 2003," Von Wissell said.
Since its inception in 2002, the Fund has tried to implement increasingly tighter financial controls, most notably after the Fund discovered fraud in several countries in 2010. The Fund subsequently instituted a high-level panel to review financial management.
The OIG conceded that financial reporting guidelines had changed over the years but urged NERCHA to improve its financial oversight, and produce missing supporting documentation.
"We order a big batch of drugs on behalf of the Global Fund, to be sent to government’s Central Delivery Stores, which then may lose an order or an invoice - this is Swaziland, and it happens," von Wissell said.
"We go back to the suppliers for a certifiable invoice, but this is not accepted by the Global Fund. The drugs are there. The money was legitimately spent, but the OIG says there is no proof - 60 000 people are alive today because of those drugs,” he added.
The UN recommends that the principal recipients of Global Fund monies, such as NERCHA, should use 14 percent of the annual grants received for programme monitoring and evaluation.
According to von Wissell, NERCHA has never received more than about 2 percent of annual grants for evaluating Global Fund expenditures.
In its audit, the OIG recommended a commitment of Global Fund money and expertise to improve the monitoring and evaluation capabilities of the Fund’s recipients in Swaziland.

Wooing the donors?
Prime Minister Sibusiso Dlamini has called on the international donor community to come to Swaziland’s assistance “in this hour of need”, but his call may encounter some resistance if donors are alarmed by the findings of the Global Fund’s audit report.
HIV organizations and government maintain that the audit has created false impressions, which may jeopardise future funding for a country that has already seen shortages of HIV treatment, testing kits and related laboratory tests, according to Alicia Dlamini, a systems manager at an HIV testing and counselling NGO that depends on international donations.
“If donors think monies were squandered in Swaziland, they will write off the country," she told IRIN/PlusNews. Thembi Nkambule, director of the Swaziland Network of People Living with HIV and AIDS, an umbrella body, said the cancellation of Round 11 may already have jeopardised the government's commitments to scale up HIV treatment and prevention of mother-to-child HIV transmission.
http://www.plusnews.org/report.aspx?reportID=94413

MALARIA: Do we have tools and guidelines for malaria elimination?

2011-12-07T09:15:00.000-05:00

Bill Brieger : 07 Dec 2011

Sessions at the current American Society of Tropical Medicine and Hygiene in Philadelphia have focused on progress in the global elimination of lymphatic filariasis (LF). Filariasis and malaria have some elements in common, such as some mosquito vectors, and possibly malaria elimination efforts could learn from LF elimination.
The duration of a typical filariasis elimination program might span around 10 years, much shorter than expected for malaria, where Roll Back Malaria has already been working hard for 13 years. Even with this difference LF elimination has important surveillance tools needed for the end game that can be adapted for malaria. As the figure here shows, the first step is mapping which can take at least a year.
Then there are at least five annual mass drug administrations (MDA) with ivermectin or DEC and albendazole. Monitoring goes along with distribution, and as pointed out at a panel presentation at ASTMH, determines whether the program can enter Step 3 (three rounds of annual surveillance) or complete a few more MDA rounds. Eventually the project site is certified as having eliminated filariasis.
An ASTMH symposium highlighted the challenges: “The decision to implement a mass drug administration (MDA) program for LF is based on convenience sampling to demonstrate that the prevalence of infection is greater than 1% in a selected district or implementation unit. Making the decision to stop MDA has been a challenge for countries,” when prevalence drops below 1%.

Fortunately those involved in LF have tools and guidelines to focus their efforts. These guide initial mapping and choice of diagnostic tools, ongoing program monitoring and endline Transmission Assessment Surveys (TAS) The purpose of the guidelines is …

“Effective monitoring, epidemiological assessment and evaluation are necessary to achieve the aim of interrupting LF transmission. Th is manual is designed to ensure that national elimination programmes have available the best information on methodologies and procedures for (i) monitoring MDA, (ii) appropriately assessing when infection has been reduced to levels where transmission is likely no longer sustainable, (iii) implementing adequate surveillance aft er MDA has ceased to determine whether recrudescence has occurred, and (iv) preparing for verifi cation of the absence of transmission.”
The guideline manual provides general guidance to national programmes but reminds program managers that each program is unique and may require further technical guidance.
Several countries, especially in the Asia-Pacific Region and Southern Africa are working toward malaria elimination. Such tools adapted to malaria program needs are required. One of the challenges for the TAS is that while countries have received donations of medicines to eliminate LF, they have found it harder to find or allocate funds to do the necessary surveillance to know when to stop interventions and verify elimination. This also rings true for malaria - donors and governments should not stop funding malaria elimination until certification has been achieved.
http://www.malariafreefuture.org/blog/?p=1342

POVERTY: Super 'floodway' mooted for Thai floods

2011-12-06T09:43:00.000-05:00

Pratchaya W: 2 December 2011 A new floodway would help prevent flooding in Bangkok
Flickr/*petitpor*

[BANGKOK] Researchers from a Thai university have come up with a proposal for a 'super express' floodway to help reduce the impact of future flooding on Thailand's capital, Bangkok.
The idea came from Chulalongkorn University's Unit for Disaster and Land Information Studies and would make use of existing irrigation canals that run in parallel to the Chao Phraya River.
Thanawat Jarupongsakul, the leader of the study, said the team proposed to widen the canals and leave a kilometre-wide stretch of empty land alongside them. Motorways running to and from Bangkok would be raised six metres from the ground on both sides of the expanded floodway to act as its dykes.
He said the project would cost about 30 billion Thai baht (around US $1 billion) but, by utilising existing canals, would be much cheaper than digging a new waterway. It would also need less energy as it would mainly rely on gravity, rather than pumps, to drain the water, he added.
The expanded floodway could hold 1.6 billion cubic metres of water and it could drain about 500 million cubic metres of water a day — equivalent of 2.5 Olympic-sized swimming pools a second.
This year's flooding in Thailand has been described as the worst ever, affecting over 2.3 million people.
Thanawat said that this is only one of the 11 non-structural measures that they are proposing to help Bangkok remain safe from severe flooding.
Other measures include: an overhaul of the disaster warning system; urban development control for Bangkok and new satellite towns; flood taxes and insurances and flood risk maps for urban development and city planning.
The researchers have also proposed: water management plans and ground water use control; climate risk and farming plans; water retention area conservation plans; disaster management plans; and a new disaster management agency.
"The floodway is good, but it alone can only partly help the city to deal with severe flooding," admitted Thanawat. "It needs to be implemented with the other measures."
A source in the government's flood command centre said that senior officials were interested he team's super floodway idea but said that long-term maintenance could be a problem given that even maintaining the capacity of existing floodways is problematic.
Sutat Weesakul, director of research projects at the Asian Institute of Technology's School of Engineering and Technology, said the idea is good in principle as the city desperately needs a channel through which the floodwaters can flow through.
But there is need for more discussion on details to ensure its effectiveness and concerns about its maintenance, said Sutat.
http://www.scidev.net/en/agriculture-and-environment/natural-disasters/news/super-floodway-mooted-for-thai-floods.html

POVERTY: Côte d'Ivoire one year on

2011-12-06T09:36:00.000-05:00

ABIDJAN, 1 December 2011 (IRIN)

Photo: Olivier Monnier/IRIN
People scan news headlines in Abidjan, where life for many is back to normal

One year on from the presidential elections that caused conflict across Côte d'Ivoire, ex-President Laurent Gbagbo has been charged with crimes against humanity by the International Criminal Court (ICC), tensions have eased in most areas, the economy has improved, and almost all schools have reopened and hospitals are functioning. But reconciliation has a long way to go.
Many feel that international justice, by pursuing Gbagbo and not others, is one-sided. Rifts remain between communities, much of the west remains lawless, and thousands of Ivoirians are too frightened to return home. Many residents are not looking forward to parliamentary elections set for December 2011.
Response to the news of the ICC's arrest warrant for ex President Laurent Gbagbo has been deeply divided. Some are relieved, but many people IRIN spoke to said it smacked of victor’s justice. Many analysts say justice has not been even handed, and that only pro-Gbagbo associates - whether civilian or military - have been charged.
"It's a good thing because it is necessary for the stability of the country, but it is unfair,” said Paul, a financial executive in Abidjan. “Of course Gbagbo has to account for what he did, but he's not the only one - both Gbagbo and Ouattara's camps have had responsibilities in the crisis.” He acknowledged that the solution is not clear-cut: if the ICC pursued President Alassane Ouattara and Prime Minister Guillaume Soro, former rebel leader, the country “would, for sure, face another crisis”.
Others say the ICC is ignoring Côte d’Ivoire’s turbulent history. “If the International Criminal Court wants to run a genuine investigation, it has to investigate what happened in the past ten years, not only during the latest crisis", said Aimée, a recent university graduate who lives in Abidjan’s Yopougon neighbourhood.
Ouattara has pledged on several occasions that Ivorian justice will investigate all sides, and in October the International Criminal Court opened an investigation into alleged war crimes committed by both camps.

Reconciliation
The appointment of former warlords, some of whom are alleged to have committed war crimes, to significant positions in the new national army, Forces Républicaines de Côte d'Ivoire (FRCI), has not always inspired confidence, but such appointments are reportedly a strategy by Ouattara to weaken their influence in the long term, and appears to be having some impact.
A South-African-style Dialogue, Truth and Reconciliation Commission (DTRC), led by former Prime Minister Charles Konan Banny, was inaugurated in September but Ivoirians are sceptical of its ability to heal the country. “Ivoirians don’t really understand how it is going to work,” Patrick N’Gouan, who heads a civil rights umbrella group, Convention for Civil Society, told IRIN, adding that civil society was not adequately consulted on the commission’s membership.
Albert Gerard Koenders, Special Representative of the UN Secretary General in Côte d'Ivoire, welcomes the commission while recognizing that “it faces lots of challenges. There is a need for a nationally led justice and reconciliation dialogue - the UN needs to support this,” he told IRIN at a UN security meeting in Senegalese capital Dakar.
Dismantling the mistrust will not be easy. "I don’t really believe in this idea of reconciliation," said Hervé, a mechanic from the neighbourhood of Blokosso, told IRIN. "Gbagbo's supporters are not yet accepting the situation and too many people are too resentful about what happened."

Security better but violations continue
In the commercial capital, Abidjan, shops and businesses have reopened, the port is busy again, security has improved significantly, the city is being cleaned up, and road works are in progress since former President Laurent Gbagbo's capture on April 11, putting an end to a five-month political crisis in which at least 3,000 people died, according to the International Criminal Court.
But in the west of the country - a region with a long history of tension between indigenous and non-native populations - residents and observers say the security situation is still precarious.
President Alassane Ouattara’s government has not yet been able to bring the west or the north under control - both run by rebel group Forces Nouvelles for 10 years - partly because of the lack of security forces, and weak police and judicial systems, which have allowed a “climate of impunity” to remain, said UNICEF spokesperson Louis Vigneault-Dubois.
The United Nations Operation in Côte d'Ivoire (ONUCI) recorded 26 extrajudicial killings from 11 July to 11 August - the most recent figures available - mostly committed in the west by the Forces Républicaines de Côte d'Ivoire (FRCI), the national army.
A report published by UNICEF and Save the Children on 23 November cited over 1,000 violations, including 415 sexual assaults, committed in Abidjan and the west since November 2010, most of them against women and girls. UNICEF representative Hervé Ludovic de Lys says this is just the “tip of the iceberg”, given that the vast majority of assaults are not recorded.
Violations continue elsewhere in the country too, according to UN spokesperson Touré, who has just returned from Bouaké, in the centre of the country, where he heard “dreadful” reports of sexual abuse from women and girls, including of babies having been assaulted.

Photo: Olivier Monnier/IRIN A young mechanic in Abidjan waits for clients

UN spokesman Hamadoun Touré said the setting up of eight new UN military camps should help secure the zone.

Military reform
To produce more professional security forces, reform is urgently needed. Planned reforms are underway and include demobilizing thousands of inexperienced volunteers who joined the FRCI during the war, and strengthening the role of the police and gendarmes.
Initial reforms have already diminished the influence of warlords who once operated across the country, and the parallel economy they put in place in the north is no longer working, said an Abidjan-based African diplomat who preferred to remain anonymous.

Elections
Parliamentary elections, scheduled for 11 December, will take place on time, according to Yacouba Bamba, a spokesman for the nation's Independent Electoral Commission.
UN representative Koenders, told IRIN at a regional security meeting in the Senegalese capital, Dakar: “The military, police and gendarmerie have put in place a security plan for the elections... we hope to see open, free and transparent elections in CDI."
Laurent Akoun, general secretary of the former ruling party - Front Populaire Ivoirien (FPI) - said no candidates from the party are running because of the continued detention of ex-President Laurent Gbagbo and several civilian and military members of the opposition.
He also cited a lack of dialogue with the government as a problem, and said the party has security concerns. A meeting of the FPI on 20 November in Abidjan was broken up by members of the army and civilians wearing pro-Ouattara T-shirts. "What is surprising is that the government is not trying to deny it or blame those who did it," said Akoun. Security forces continue to crack down on active supporters of Gbagbo.
Upcoming elections are vital to the credibility of President Ouattara and the reconciliation process, but, given the legacy of last year’s elections, many Ivoirians IRIN spoke to are lukewarm.
"I'm not sure I'm going to vote - I'm not interested in politics anymore," said Laurent, a physical education teacher and former political enthusiast in Abidjan's Cocody neighbourhood.

Mixed picture for education, health
Most public schools re-opened at the beginning of the school year, but in the west some remain closed as their teachers have not returned, while some families say they don't have enough money to send their children to school.
Jennifer Hofmann, the education cluster coordinator at the UN Children’s Fund (UNICEF) said despite the government trying to lure the teachers back, many remain in Liberia About 1,000 intern teachers across the country are waiting to be appointed, but Hofmann said some villages in the west may be forced to hire voluntary teachers. Public universities will not open until October 2012 because so many were vandalized in the crisis.
Although all the main hospitals in Abidjan are up and running, staff numbers are slightly lower than before the crisis, and in the west the health situation is “in a state of humanitarian emergency”, with crumbling structures and lack of stocks forcing health staff to work in mobile clinics, said Dr Juma Kariburyo, head of the World Health Organization (WHO) in Abidjan.
Money for healthcare support is “running out” for most WHO partners, and medicine stocks and the equipment needed to run mobile clinics are dangerously low, he said. In the aftermath of the crisis the government announced free healthcare, but such a policy requires an effective funding strategy, which has not yet been thought through completely, Kariburyo noted.

Big business
Overall, the economy is growing - surprising many - and is expected to expand by 8-9 percent in 2012, according to the IMF and World Bank. "We hope that Côte d'Ivoire will once again become the economic motor of the region,” said Koenders.
Several large infrastructure projects are already underway, including a third bridge over Abidjan's lagoon, expansion of an Abidjan-based power plant, and plans for a highway between Abidjan and the city of Grand Bassam, 100km to the east.
The Tongon gold mine in northern Côte d'Ivoire was inaugurated in October and should help the country produce 13 tons of gold a year from 2012, said the ministry of Mines and Energy. The cocoa harvest hit a record last season with almost 1.5 million tons of beans exported.
The IMF and the World Bank have made reform of the cocoa sector one of the conditions for US$3 billion of debt relief under the Heavily Indebted Poor Countries initiative. The IMF resumed its programme in Côte d'Ivoire and agreed to loans of $745 million, while the World Bank has made a gift of $200 million.
Investors are clearly starting to have confidence in Ouattara’s economic vision, said Ranie-didice Bah, an economist at the University of Bouaké. Since his election the President has travelled widely to promote investment in Côte d’Ivoire and a few Western companies are opening branches in Abidjan, including a French food chain, a high-end bakery, and a furniture outlet.
However, many small firms are “still waiting for the recovery”, noted Innocent N'Dry, an adviser at the economic mission of the French Embassy.
And many are not experiencing the benefits of these gains, while the cost of living is high. "There is work", said Hervé, who runs a garage in Blokosso. "But people don't have money, so they pay half of the cost [of vehicle service and repairs] and give the rest when they can,” he said.
http://www.irinnews.org/report.aspx?reportID=94353

POVERTY: LESOTHO: Pastoralists fear land “modernization” act

2011-12-06T09:30:00.000-05:00

MASERU, 1 December 2011 (IRIN)

Photo: Tomas de Mul/IRIN
A new land tenure system is raising concerns among pastoralists

Livestock herders in Lesotho are suspicious of the government’s motives for “modernizing” the land tenure system, fearing it will bring about a radical change in their way of life and deprive them of their birthright to land.
“This land act is not for us, it’s for people sitting in the highest seats of government and in the fancy chairs in the city,” Khotso Lehloka, secretary general of the Lesotho Herders Association (LHA), which represents between 17,000 and 20,000 livestock herders, told IRIN.
About three-quarters of Lesotho’s 1.8 million people derive their livelihood from agriculture, although only around 10 percent of the land is suitable for arable farming.
Constitutionally, all the land belongs to King Letsie III and is held in trust by all Basotho males or heads of household. Land acts passed in 1968 and 1979 did not contain a formal lease-based tenure system because land was regarded as communal.
The 2010 Land Administration Authority Act has broken from past practice by allowing security of tenure, in the hope of luring foreign direct investment to act as a stimulus for the rural economy. A growing population and land degradation are also putting greater pressure on a limited resource.
“The Land Act is part of an overall strategy to modernize the economy of Lesotho, so that investors can come, start a business and receive mortgage financing and insurance,” planning and finance minister Timothy Thahane told IRIN. “This is the kind of process that is necessary in a modern economy.”
The Land Act is part of an overall strategy to modernize the economy of Lesotho, so that investors can come, start a business and receive mortgage financing and insurance
The Human Development Index of the UN Development Programme (UNDP) ranks this mountainous country, which is completely surrounded by neighbouring South Africa, at 160 out of 180 nations.
Each year about 350,000 people routinely face food insecurity, and falling food production necessitates importing between 60 and 70 percent of the national requirement.
The Act establishes the Land Administration Authority (LAA), an autonomous agency of the Ministry of Local Government and Chieftainship that will be responsible for record keeping, the regulation and allocation of land and rentals, and the approval of foreign ownership, which will now be permitted in partnership with a local national holding at least a 20 percent stake.
The goal of these measures is to provide “secure land tenure for all citizens and promote economic growth”. Section 77 of the LAA says “A citizen of Lesotho shall be entitled to the lease free of ground rent of land, which he leases and occupies for his own residential use.”
The Authority has conducted pilot projects in a few selected villages and LAA leasing director Letele Mosae says the system will start rolling out in 2012.

Inefficient land management
Tsoeu Petlane, a researcher who works in Maseru, capital of Lesotho, for the Johannesburg-based think-tank, South African Institute of International Affairs (SAIIA), told IRIN the traditional communal system of land ownership had led to inefficient land management.
“Every male Basotho is entitled to inherit plots of land, but while families expand, land does not, so the plots kept getting smaller and smaller. Because this was all done informally, eventually there were a lot of disputes” he explained.
The government is constantly involved in resolving land disputes, and the Act will ensure property is surveyed and documented, along with foreign ownership boosting investment, but there are concerns about how the new system will affect pastoralists.
“There are some unresolved questions,” Petlane pointed out. “What happens to traditional grazing lands? If those formerly communal grazing lands are bought up, where will herders without land feed their cattle?”
A SAIIA report in September 2011, Implementing the ARPM [African Peer Review Mechanism] Views from Civil Society, noted: “It remains unclear to what extent the new system will also address the conflict between chiefs and the state in regard to land allocation and management, as well as inter-communal conflict over land resources which are managed by chiefs.”

“Use it or lose it”
In a direct challenge to land as a Basotho birthright, the inclusion of a “use it or lose it” clause permits the authorities to take land that has not been cultivated for at least three years.
“Sometimes you cannot use land due to economic reasons - it’s not fair that it would be taken away from you just because of that. Governments are supposed to empower people to teach them to use the land to produce food more effectively, rather than enabling outsiders to come in and do it,” said Lehloka.
“The possibility of land being bought and sold, and the payment of ground rent, are highlighted as a possible cause of poverty and landlessness. Those who cannot afford the rent will be forced to sell, which will leave them landless and even more vulnerable. The ‘use it or lose it’ principle, which gives powers to authorities to dispossess lease holders of their right to land for not using it, is seen as another effect of the act that will promote poverty,” the SAIIA report said.
Mosae said it was wrong to term it a “use it or lose it” clause - it was a reference to “abandoned land”.
He said, “Where land is required for either public purpose or public interest, there is a stipulated procedure whereby, among others, the occupier of the land in question must be consulted and agreement must be reached. Thereafter, an amount of compensation must be agreed.”
News of the new land tenure system does not appear to have reached rural communities. Victor Letlaka, 33, a herder and subsistence farmer providing for his wife and five children, told IRIN he was unaware of the new Act and the changes it may bring.
“We were given this by our chief,” he said, pointing to his half-acre plot on the side of a hill in Mokhotlong, the main town in Mokhotlong Province, about 150km from Maseru. The local chief has the authority to dispossess Letlaka of his land at any time, but he is unconcerned.
People simply weren’t made aware of the Act and what its impact will be, so we feel the government may use these laws to hurt or take advantage of the very poor or marginalized
“We are grateful that he gave us this piece of land. If we had to move we would probably get given another... I don’t think there’s a problem with how this happens, it works fine without Maseru government rules.”
The LHA intends to raise greater awareness of the Act. “The government didn’t do enough to talk to people when they were debating and signing the Land Act. People simply weren’t made aware of the Act and what its impact will be, so we feel the government may use these laws to hurt or take advantage of the very poor or marginalized.” Lehloka said.
“The herdboys feel like their autonomy and freedom is jeopardized by this formalizing process, but the reality is we need to coordinate grazing and land recovery better,” said minister Thahane. “Land issues cast against so many vested interests is always controversial, but it is necessary for Lesotho’s modernization.”
http://www.irinnews.org/report.aspx?reportID=94364

POVERTY: THAILAND: Two days in the life of an urban flood expert

2011-12-06T09:18:00.000-05:00

BANGKOK, 2 December 2011 (IRIN)

Photo: Shermaine Ho/IRIN
Adri Verwey visiting water pumping station at the Bang Sue canal in Bangkok, November 2011

As 16 billion cubic metres of flood water bore down on Bangkok in early October, international experts flew in to help the government deal with an unprecedented potential calamity.
One was Adri Verwey, an urban flood specialist from the Netherlands, another low-lying "delta" country that has honed its international reputation for water management through investments that protect the country's highest-density areas from even unlikely catastrophes that would only occur once in 10,000 years.
Verwey has worked for the past 40 years on flood forecasting systems, mostly in Asia, and is now the senior specialist on modelling systems at the Netherlands-based water resources management think tank, Deltares.
IRIN followed Verwey and his team in the Thai government's flood command centre from 10-11 November, when three out of Bangkok's 50 districts were ordered to evacuate while rising waters threatened to overwhelm the city's hastily constructed sandbag dykes and water pumping system.
"We do not have experience in dealing with such a serious flood; many local experts have never expected a flood would happen in Bangkok," said Barames Vardhanabhuti, a lecturer in the engineering department at Kasesart University.
One of the first steps was to gather data and satellite images from multiple government agencies, and then enter the information on topography, water levels and the city's drainage system (number of water pumps, canals, drainage capacity and speed) into a multi-dimensional modelling software, which generated worst-case flood scenarios.
The result was cartoon-like images of water spreading through the city, frame by frame.

Brainstorming
With northern Bangkok already under 1.6m of water and the capacity of existing dykes far too low to handle such a massive flood, Verwey proposed using soldiers to speed up sandbagging.
The city's main 170km King's Dyke needed to be sandbagged up to 1-2m higher to save the city's business and tourist hub from flooding, said Verwey.
According to the Ministry of Interior's department of disaster prevention and mitigation, 350,000 sandbags had been produced as of 2 November. The department planned to distribute an additional 250,000 sandbags to save the country's administrative and economic heart from the deluge.

Photo: Shermaine Ho/IRIN : Sandbagged and waiting

In case water pumps and sandbagging failed to hold back the deluge from inner Bangkok, Verwey and army officials brainstormed possible next steps: cargo containers placed in openings under the railway tracks to block water from flowing into central Bangkok? Blowing up the sea dykes near the Gulf of Thailand to quicken drainage if floodwater made it to the southern coast?
But the focus was still on gathering data and working with the army on sandbagging plans.
Verwey met the army's chief of staff and presented the plan to the prime minister, who agreed to mobilize about 1,000 soldiers to inspect 80km of The King's Dyke twice a day and to help local residents place additional sandbags.
If the dykes were not reinforced by sandbags in time, said Verwey, water sneaking under the dykes could lead to a breach up to 100m wide - causing widespread flooding across almost all areas in Bangkok; at the time only 30 percent of the city was flooded.

Water pump inspection
Besides sandbagging to hold back floodwaters, the excessive amount of water that had already inundated the northern and eastern parts of the city needed to be drained.
Verwey's team inspected three of the city's 14 water pumping stations and declared two sites functional. At the third station, the team found eight out of 45 pumps non-functioning and the remaining ones working at less than capacity.
It was almost 9pm on 11 November when Verwey waded through floodwaters to inspect the Bang Sue canal, the last barrier between the water and Bangkok's inner city. He declared all of them functional.
"We are monitoring the pumps around the clock," said the water pump station master, who had used his own money to buy a fan to cool down overheated control units.
Nearby, residents filled the waterways with lotus-shaped boats made from curled banana leaves and marigold flowers as the country celebrated Loy Krathong - an annual full-moon festival to pay tribute to the water goddess.
Verwey left Bangkok on 20 November - one day after the prime minister declared central Bangkok safe, with floodwaters receding from most parts of the city, much in line with his simulations.

But for Verwey, the job is far from complete.
"We can expect the flood to continue to recede, but it will still take quite some time before outer Bangkok is completely dry," he said. "What is needed next is a thorough analysis of what has happened and how such a flood can be prevented in the future."
In December he and his colleagues will help the government draft a new plan for water resources management for the Chao Phraya Basin - which covers 30 percent of the country and houses 40 percent of the population.
http://www.irinnews.org/report.aspx?reportID=94367

MALARIA: President Bush urges US not to abandon Africa projects

2011-12-06T09:12:00.001-05:00

Former president George W Bush urged his country to continue supporting Africa as he arrived in Ethiopia to promote US-funded projects fighting HIV/AIDS, malaria and cervical cancer. Bush, who is on a regional tour, said the US should “not retreat from the world”. “It’s also important for the American people to know if we don’t continue to support people who have HIV or are dying because of mosquito bites more and more people will die,” he told reporters in Addis Ababa. Bush and his wife visited a hospital supporting people living with HIV/AIDS and providing cervical cancer screening and also toured a compound where people living with HIV/AIDS receive home-based care.
http://www.gulf-times.com/site/topics/article.asp?cu_no=2&item_no=473888&version=1&template_id=43&parent_id=19

POVERTY: SUDAN-SOUTH SUDAN: Returnees left in limbo

2011-12-06T09:09:00.000-05:00

NAIROBI, 5 December 2011 (IRIN)

Photo: Hannah McNeish/IRIN
Homeward bound... Southern Sudanese arrive by barge in Juba

Some have camped for months waiting for promised transport to South Sudan, others have been and returned, disappointed with life in the world's newest state.
Five months after the South gained independence, the fate of hundreds of thousands of southerners living north of the border remains uncertain, particularly so as the Northern military battles borderland rebels it - and Washington - accuse Juba of supporting.
Even their numbers lack any consensus: 700,000, according to the UN, 150,000 according to Khartoum.
Most lost their Sudanese citizenship after secession on 9 July and were given nine months - until 9 April 2012 - to "regularize their status", but were not told what this means in practice.
Many have spent their entire lives in the north; dual nationality has been ruled out.
More than 350,000 people of southern origin have headed south on their own over the past year, another 130,000 with help from the UN Refugee Agency (UNHCR) and the International Organization for Migration. By the end of the year, UNHCR expects a further 140,000 to register for assisted return.
Tens of thousands still in the north, who have made the first steps to returning, selling their homes and many of their possessions, have found themselves stuck in temporary camps with limited access to basic amenities.
"The hardest thing is that nothing has changed since the independence of South Sudan," said Victor Rabbi, leader of a camp called Al-Andaluz, in Mayo near Khartoum.
"We sold everything months ago because we thought we would go back to our homeland in July. We have nothing left. Not even a job. Since independence, as South Sudanese we no longer have the right to work in the public sector or for NGOs," he said.
The camp consists of hundreds of shelters made from wood and fabric and is home to 3,600 people.
Water is brought in by mules, and two four-litre jerry cans are sold for five pounds (US$1.80), a considerable expense for the residents.
Children cannot go to school any more, as they are no longer considered Sudanese. In the absence of electricity, power cables serve as skipping ropes for the girls.
"We are waiting for someone to tell us to leave," said Rabbi.
Forty families arrived at Al-Andaluz over a year ago. In the run-up to independence, there were promises of lorries paid for by the South Sudan government.

Roads closed
But the conflict in the border states of South Kordofan and Blue Nile has led to the closure of all land routes between the two countries. In any case, seasonal rains also make it almost impossible to travel by road.
Since April, the journey south can only be made by river barge or train.
While six train services have been funded, departures are not easy to programme.
"The train is protected by soldiers from Sudanese army until [the railway junction at] Babanusa. Then, SPLA [South Sudanese army] soldiers take over. The train goes through areas vulnerable to attacks. The journey to [the southern railhead town of] Wau takes 17 days," said Paul Urayo, who works in the Khartoum office handling the registration of South Sudanese from the Bahr al-Ghazal region.

Photo: Maryline Dumas/IRIN
And back again...Many southerners return to the north because of insecurity and harsh conditions in the south

"It is impossible to say how long the return trip will take in such difficult conditions," Urayo said.
After independence, the local government in some states in South Sudan chartered 16 trucks to carry returnees' luggage.
Months later much of the luggage is still stuck in Al-Andaluz, held by transport companies, which say they have not yet been paid for their services by local authorities in South Sudan.
"If it goes on like this, we'll have to write off our things," said Rabbi. "Then we really will have nothing when we arrive in South Sudan to rebuild our lives."

Slow boat to Juba
The main departures point for those heading to the southern and central states of South Sudan are the near-adjacent river Nile ports of Kosti and Renk, which more or less straddle the border.
But in the absence of commercial traffic, the 12-day passage to Juba is only possible on barges operated by the International Organization for Migration (IOM), meaning an average wait of more than 100 days. According to the IOM, once barges carrying 3,000 people leave Kosti soon, some 8,000 to 10,000 people will still be left waiting there, with another 22,000 in Renk, on the South Sudan side of the border.

Doubling back
Many returnees, if they have the means to do so, double back to the north, despite the uncertainty. This is particularly the case in South Sudan states experiencing armed conflict. Some 12 percent of those who travelled to Upper Nile, Unity as well as Western and Northern Bahr el-Ghazal have returned north, according to Ismael Ibrahim, an internal displacement expert working in North Sudan's Ministry of Humanitarian Affairs.
Among them was Paul*, who arrived with his wife and three children in Unity's capital, Bentiu, to the sound of landmine explosions and clashes between government forces and rebels.
"It was too dangerous. One day, I was the victim of an ambush on the way to my job as a school teacher. I decided to come back to Khartoum," he told IRIN, adding that he plans to send his children to school in either Uganda or Ethiopia.
The stark contrast between living in a city with some semblance of amenities and trying to get by in a rural area almost entirely lacking in public services and infrastructure is another reason returnees head back north.
"I sent my wife and my children to Juba in March [2011]," Santurino, an English teacher, told IRIN in Khartoum.
"There was no electricity or running water in their hut. My two eldest children [eight and five years old] couldn't go to school because the classes were overcrowded, and it was hard for them to understand Juba Arabic [a mix of Arabic and Kiswahili spoken in Juba], which the other children spoke.
"My children were happy to come back to Khartoum. I agree that everyone has to make sacrifices, but only if it is to build the country. But six years after the peace agreement [ending years of north-south civil war], the government has done nothing and I absolutely don't believe that there will be an improvement by April," he said.
But most southerners living in Khartoum lack the means to make such choices and some do not even believe anyone doubles back once they have headed south.
"That's just propaganda from the Khartoum government!" insisted Garang Akog Madi, who lives in Al-Youssif, a northern district of the capital.
Exactly what status the "foreign" South Sudanese will be accorded if they stay in the north after the April deadline - whether, for example, they will be allowed, like Egyptian nationals, to travel freely in and out of the country - depends on the outcome of post-secession negotiations between the two governments.
But there has been little sign of progress in these stop-start talks, which also focus, with seemingly more priority, on oil, financial arrangements, border demarcation, and the status of the Abyei region.
http://www.irinnews.org/report.aspx?reportID=94395

POVERTY: BANGLADESH: Border killings mount despite no-shooting decree

2011-12-06T09:02:00.000-05:00

RANGPUR, 6 December 2011 (IRIN)

Photo: Maher Sattar/IRIN
Bangladeshi brothers Anis Ahmed (L) and Shohir Jamal (R). Shohir is standing on the border between the two countries, with Bangladesh located on the right side of the photo. Anis is on the Indian side

The death toll at the Bangladesh-India border continues to mount three months after the Indian government instructed its border security forces to stop shooting civilians suspected of being undocumented migrants or a threat to national security, say local residents.
NGOs have denounced the border killings as extrajudicial.
The abuse continues, according to Bangladeshi human rights NGO, Odhikar, which accuses India's border security force (BSF) of circumventing the recent no-shooting decree with beatings, stonings or poisoning.
However, the First Secretary of the Indian embassy in Bangladesh's capital, Dhaka, told IRIN that any killings had been linked to border crime.
"The BSF does not attack civilians. This is not happening any more. Only in a few cases, they have acted in self-defence," said Manoj Kumar Mohapatra.
Some 347 Bangladeshis and 164 Indians have been killed by Indian forces since 2006, when the Indian government built the wall, according to BSF.
Mohammad Baten, the latest man allegedly killed by the BSF - the 24th this year - was reportedly beaten to death, according to Bangladesh's border security.
The 4,000km fence has been dubbed the "Great Wall of India" by international media, while locals simply know it as the "wall of death".
India's government built the wall to restrict movement of "illegal immigrants, smugglers and suspected Islamic militants", according to officials quoted in local media.
Farmers corralled by the barbed wire find it increasingly difficult to lead ordinary lives.
"They have surrounded the people of Bangladesh on three sides with barbed wire," said Adilur Rahman, secretary of Odhikar. "It's like the Berlin Wall. You have brothers, even husbands and wives, separated on both sides."
Distant neighbours
"When they turn [the floodlights] on, the night becomes day here," says nine-year-old Anis Ahmed.
The barbed wire is visible from Ahmed's house at the border near the village of Amgaon in Bangladesh's Dinajpur District. Ahmed and his 11-year-old cousin, Shohir Jamal, work on their family's farm every day. Their crops grow right up to what is known as the zero point of the border, where Bangladeshi and Indian soil meets.
On this particular day, Ahmed and Jamal walked towards the border while two guards monitored them with binoculars.
"We go up to the fence all the time," they told IRIN. Wary adults lingered behind, warning them not to go further.
Ahmed and Jamal work on their farm side by side with Indian farmers, who cross the border to work on their land.
"The Indian farmers never speak to us," says Ahmed, "If they do, the BSF yells at them. If we try to talk to them, they don't pay any attention to us. They are worried that the BSF will accuse them of being smugglers, or helping illegal immigrants."

Suspicion
There is mistrust on the Bangladeshi side of the border too. "At night we put our cows inside the house and lock up all the animals," said Jamal.
Against the backdrop of border crimes, villagers become suspicious, according to a local primary school teacher, Jalal Ahmed.
"Everyone else thinks we're all smugglers here, so our people have to deal with that prejudice. And there are [actual] criminals here, not just cattle smugglers but a lot of drugs are smuggled here too," he said. "It's very bad for our society, for our children."
Felani Khatun, 15, an undocumented Bangladeshi immigrant in India, was shot while climbing the wall to cross back home on 7 January this year. A photo of her lifeless body hanging from the barbed wire sparked widespread uproar in Bangladeshi media.
Nur Islam, Khatun's father, had successfully climbed over the fence seconds before Felani was shot.
"There was no shout, no warning," he told IRIN. "I don't understand why they didn't shout anything. I saw them. They just got up and shot. And my girl cried out."
http://www.irinnews.org/report.aspx?reportID=94399

MALARIA: Improving Quality Performance among Community Health Volunteers

2011-12-06T08:57:00.000-05:00

Bill Brieger : 05 Dec 2011

Improving Quality Performance among Community Health Workers Providing Integrated Community Management of Febrile Illnesses in Nigeria

A Poster Presentation at the 60th ASTMH meeting by Bright C. Orji, William R. Brieger, Emmanuel O. Otolorin, Jones Nwadike, Enobong Ndekhedehe, Olugbenga Ishola, Godfrey Akro, Nancy Ali

Efforts to improve access to quality case management of febrile illness include the engagement of Community Health Workers (CHWs) to use Rapid Diagnostic Tests (RDTs), dispense ACTs and manage pneumonia and diarrhea. Use of CHWs reduces challenges like a weak public sector, human resource constraints, and variable quality of the private sector.
Studies have suggested that CHWs are able to perform case management services in a training setting, but not much has been done to measure quality performance among CHWs in the field. Jhpiego and the Akwa Ibom State, Nigeria health authorities trained CHWs and developed simple quality performance standards (one-page tool) for CHWs providing community services in Akwa Ibom State, Nigeria.
All 131 trained CHWs in two local government areas providing malaria, pneumonia and diarrhea case management were assessed using the standards. The tool has 37 performance criteria (PC) to measure CHW knowledge, skills and competence in 3 sections: History taking and Examination; Conducting RDTs for Malaria and Illness Management,
Trained assessors observed CHWs providing services. Each correctly performed criterion was scored 1 point. Three rounds of assessments were conducted at an interval of two months from May-November, 2011.
At the end of each round assessors provided feedback and refresher training for CHWs during their monthly meetings. During Round 1 CHWs achieved an average of 19 (52.2%) PC. This rose to 25 (67.5%) PC at Round 2 and 28 (75.6%).
PC that needed most improvement included checking signs and symptoms to distinguish among the illnesses. CHWs also needed reinforcement on checking RDT expiry date, entering results on records, safe disposing of sharps, and counseling on preventive measures.
In conclusion feedback after Rounds 1 and 2 helped CHWs improve their performance. Additional quarterly assessments and feedback sessions are planned. CHW supervisors can use this tool to enhance the quality of services provided by the CHWs and improve CHW training.
http://www.malariafreefuture.org/blog/?p=1337

POVERTY: Remittances to developing countries rebound

2011-12-06T08:52:00.000-05:00

JOHANNESBURG, 6 December 2011 (IRIN)

Photo: Maria Font de Matas/IRIN
Remittances to developing countries are expected to continue increasing

A slump in the amount of money migrants sent home during the global financial crisis appears to have ended with officially recorded remittances to the developing world reaching an estimated US$351 billion in 2011, an 8 percent increase from 2010.
"Growth of remittances in 2011 exceeded our earlier expectations in four regions, especially in Europe and central Asia... and sub-Saharan Africa," write lead economists at the World Bank's Migration and Remittances Unit in a brief released on 1 December.
The top recipient countries were India, China, Mexico and the Philippines, but smaller nations such as Tajikistan, Lesotho, Nepal and Lebanon received a greater flow of remittances as a percentage of their gross domestic product (GDP) - Lesotho, for example, relied on remittances for 29 percent of its GDP in 2011.
Money sent home by migrants now represents three times the amount of official development aid to countries receiving assistance and is crucial to alleviating poverty, according to the World Bank.
But the news is not all good. The ongoing debt crisis in Europe and high unemployment in many developed countries "is affecting employment prospects of existing migrants and hardening political attitudes toward new immigration", the World Bank economists note. Saudi Arabia recently introduced an indigenization programme that limits the number of foreign workers companies can hire and the United Kingdom has imposed tougher admission criteria for non-EU migrants.
http://www.irinnews.org/report.aspx?reportID=94401

POVERTY: KENYA: Floods, rains wreak havoc

2011-12-06T08:49:00.000-05:00

NAIROBI, 6 December 2011 (IRIN)

Photo: Richard Lough/IRIN
Over 40,000 people have been affected by flooding since the start of short rains in October (file photo)

Heavy rains in Kenya have washed away bridges and rendered many roads impassable, complicating efforts to reach thousands of people made homeless by the flooding, an official of the Kenya Red Cross Society (KRCS) told IRIN.
"We are currently undertaking an assessment through our branches countrywide to establish the magnitude of the problem [and identify] the most vulnerable of those affected and areas which we have not reached because of logistical challenges," Nelly Muluka, the KRCS public relations and communications officer, said on 5 December.
So far, Muluka said, at least a dozen people have died and more than 40,000 others have been affected since the start of short rains in October.
"Three people died in a mudslide in Keiyo [North Rift] three days ago, bringing the number of those who have died in the [Rift Valley] province to five since October; seven have died in Nyanza [western Kenya] and two at the Coast," Muluka said. "We are concerned about the livelihoods of those displaced by floods or heavy rain in various parts of the country and we have started distributing non-food items to those we have been able to reach.
"In Garbatula [Isiolo district] for instance, hundreds of farmers have lost crops... we now have to look ahead and see how they will be assisted in terms of livelihood support," Muluka said. "In other areas, there is the danger of waterborne diseases breaking out after latrines and boreholes were submerged and in other areas, water pipelines have burst."
According to the Kenya National Commission on Human Rights (KNCHR), whose monitors are on the ground in northern Kenya, floods have affected all of Isiolo County, with Ewaso Nyiro River bursting its banks. Garfarsa, Kombola, Sericho, Merti and Garbatula are some of the worst-affected areas, KNCHR said.
The displaced and those affected by the floods urgently require relief aid such as food, mosquito nets, tents, blankets, cooking utensils and medicine. KNCHR said the situation had been especially dire for 21 people who had been marooned in the past six days on higher ground between two streams in Merti. The group was taken to Merti town by helicopter on 5 December.
River Nzoia burst its banks on 3 December, displacing thousands of people in Budalang'i, Bunyala and Funyula areas of western Kenya. Thousands are also displaced in Nyando and Nyatike areas in Nyanza, as well in Coast Province.
Teams comprising government, KRCS and UN officials are involved in rapid assessments of the flooding situation, a humanitarian official, who requested anonymity, told IRIN.
In October, flash floods in Coast Province claimed several lives, damaged schools and destroyed sewage systems. Some of the affected areas included Changamwe, Kisauni, Kongowea and Likoni estates in Mombasa, where flood waters submerged large areas, making it difficult for residents to access clean water.
In November, the Global Disaster Alert and Coordination System issued a flood alert for Kenya, after more than 300 families were displaced and livestock swept away by flash floods in Wajir, northern Kenya; and 5,000 families relocated to higher ground in Kerio Valley in Rift Valley Province.
http://www.irinnews.org/report.aspx?reportID=94402

MALARIA: More than a shield: The RTS,S malaria vaccine trial

2011-12-06T08:45:00.000-05:00

6 Dec, 2011: Meera Senthilingam
Meera Senthilingam is a freelance science journalist based in London, UK.
My ride to the clinic

The RTS,S vaccine is one of the most promising malaria vaccine for years, currently doing well in clinical trials. And the benefits of the trial go beyond the vaccine itself, as Meera Senthilingam discovered.
On a recent trip to Kenya, I decided to visit the quiet, coastal town of Kilifi. Unlike the busy, tourist laden beaches of Mombasa just 60 kilometres to the North, Kilifi is scenic, peaceful and far less polluted. But it also has one of the highest prevalences of disease in the country. Its warm, moist climate, combined with a poor population, mean that diseases such as malaria are quite common. As a result, Kilifi is a trial site for many malaria treatments and vaccines, including the RTS,S vaccine, the most developed malaria vaccine to date.
RTS,S has now reached phase III clinical trials involving over 15,000 participants across seven African countries. Of the eleven trial sites across these countries, three are in Kenya, taking place at the Kenya Medical Research Institute (KEMRI) bases in Kisumu in Western Kenya and, of course, Kilifi.
Equipped with a four-wheel drive and a few medical deliveries, Dr Patricia Njuguna, the principle investigator on the Kilifi trial, took me to see how such a large-scale trial works in the field. Our destination was the Madamani dispensary, one of the three clinics conducting the trial within Kilifi.
We passed acres of land where drought was evident by the dry soils followed, surprisingly, by a conserved area of natural forest. But as farmland and forest turned to huts, wells and people going about their daily lives, the car made numerous stops for women and their children to come aboard. Although initially confused as to whether the KEMRI vehicle doubled up as a taxi to increase funding, I soon learned this was all part of the service offered as part of the vaccine trial.
“As well as routine visits, if participants are unwell we provide them access to the facility for free healthcare,” says Njuguna. “Our vehicles come in every day bringing in mothers from various homes. This is coordinated by fieldworkers living within the community who have close contact with the mothers who call them when they need to be seen”.
Our driver was one of these fieldworkers and the women on board had called him that morning about various ailments affecting their children. They joined us for the remainder of the journey so their children could be examined examination by the local clinician.
The trial it seems is not just the testing of a vaccine, but a complete health service, and a very good one at that.
Rapid malaria test

Developing a vaccine
In Sub-Saharan Africa, malaria is caused predominantly by infection with the parasite Plasmodium falciparum. Creating a vaccine has been a challenge to date due to the fact that the parasite, and its genome, is larger than bacteria and viruses, the complex nature of the parasite’s life-cycle and the fact that it can alter the proteins on its surface, limiting our ability to design a vaccine to find it and induce an immune response.
“Imagine Joseph and his Technicolor Dreamcoat that’s showing a different colour every time. If you’re trying to take down someone in red and the coat shows blue, you’ll miss it,” says Dr. Njuguna as we draw closer to the dispensary.
“This is the challenge for the vaccine and if it misses it you get malaria. Every time the parasite goes through a life cycle it changes the protein it’s presenting, so your vaccine needs to be very clever”.
Once bitten by an infected mosquito, the parasite enters the body in its immature form, known as a sporozoite, where it then travels to the liver in order to replicate within liver cells before moving on to invade red blood cells. This latter stage is when the main symptoms of disease, such as fever and chills, occur, and it’s also when the rapid production of new proteins takes place as the parasite frantically replicates within the blood cells.
RTS,S aims to overcome these issues of adaptation by targeting the parasite early on in its life cycle the sporozoite stage when the parasite first enters through the skin and travels to the liver This can happen within 3–5 minutes of infection.
When we arrive at the dispensary the first thing I notice is the high degree of organisation on site. As we enter the building, we walk straight into a large waiting room catering comfortably for tens of people at one time. Away from this stems two consultation rooms and a pharmacy. The clinician, Dr Pauline Akoo, is busy examining a child in one of the rooms while the women from our car journey are registered by fieldworkers noting down the symptoms of their children.
The trial targets two age groups of children, both under the age of 5 as this is the group at most risk of infection with malaria. The first cohort is made up of children aged 5 to 17 months and the second are infants aged 6 to 12 weeks all receiving three monthly injections followed by a booster vaccine 18 months later. This is, however, a randomised trial, so half of the participants act as a control group receiving a pretend vaccine. By comparing the number of children experiencing Malaria for the first time within each group, the researchers will see if the vaccine really has an effect.
As I join Dr Akoo for a few of her consultations, mothers bring in children with ear infections, upper respiratory tract infections and fevers. Any child brought in with a fever is given a rapid malaria test to, which diagnoses on site, allowing for immediate prescription of anti-malarials, if need be, while a sample is sent to a lab for confirmation. Medicines for the other ailments are also prescribed.
“Each time the child visits they get an opportunity to be seen by a clinician. Whether they’ve come for screening, vaccination, or some other problem they will always get a thorough medical examination,” says Akoo. This is a complete medical package for participants, and, more importantly, it is free of charge.
With such care provided in an otherwise poor region, it’s easy to imagine the flooding of volunteers to the dispensary but, as with many trials in developing regions, there was some initial anxiety and resistance.
“Initially they were shy because this is a research-naïve area – they don’t understand the difference between research and treatment,” says Akoo. “But with time we have explained the trial and the people realised it would not harm them and there were health benefits.”

Madamani dispensary charter

Vaccine on the horizon?
RTS,S is the first vaccine to reach Phase III of clinical trials, with Phase II trial results demonstrating 53 per cent protection against malaria in children aged 5 to 17 months. Phase III is currently halfway through its intended timeframe, with encouraging preliminary results published recently in the New England Journal of Medicine.
The early results analysed 6000 of the trial participants across Africa and demonstrated 56 per cent protection against standard clinical malaria and 47 per cent against severe malaria (when the parasite enters the brain). However these results are, again, for a subsection of the study – the cohort aged 5 to 17 months – with results from the infant group expected by the end of 2012.
Without getting our hopes up too high, it does look like a vaccine against malaria could soon become a reality. Even the costs of scaling up and production have been accounted for, with pharmaceutical company GlaxoSmithKline promising to provide it almost at cost price with any return invested back into further improvement of the vaccine.
Although incidence of malaria has been on the decline in recent years, according to the World Health Organization, 781,000 people still died of the disease in 2009 – 90 per cent in Africa. Although a 56 per cent success rate may not sound significant enough to justify rolling the RTS,S out in a wider scale, when the burden of disease is considered globally, it’s certainly worth having. And from what I saw at the dispensary, the RTS,S trial has not only provided a possible shield against malaria, but also improved the understanding, and general well-being, of the people most affected by it.
The KEMRI-Wellcome Trust Research Programme is supported by the Wellcome Trust.
http://wellcometrust.wordpress.com/2011/12/06/more-than-a-shield-the-rtss-malaria-vaccine-trial/#more-7757

POVERTY: PAKISTAN: SWAT women face dual burden

2011-12-06T08:38:00.000-05:00

MINGORA, 6 December 2011 (IRIN)

Photo: Sarah Naqvi/Flickr
Women in Swat Valley are struggling to keep their households running (file photo)

Women in the Swat Valley in the Khyber Pakhtoonkh'wa province are working harder than ever to keep their households running.
To some extent this makes them happy, allowing them to reclaim lives put on hold during the militant Taliban reign, which ended in July 2009 after a military operation, allowing tens of thousands of IDPs to return.
"We are no longer compelled to wear the suffocating blue burqas imposed by the Taliban; the girls are back at school and women are again working in the cosmetic factories, the schools and so on from which they were forced out," Aqila Khan, 42, a social activist, who once again is wearing a white chador, told IRIN in Mingora, the principal town of Swat.
But though militancy has receded, women in Swat face a double burden. The devastating floods of 2010, followed by less intense but still damaging flash floods in 2011, took a big toll on agriculture, chiefly the maize crop. "This was our main money-earning crop," farmer Riaz Khan told the media in the town of Kabal in Swat.
The District Coordination Officer of Swat told IRIN that "reconstruction work in the valley following the floods was well on track". Bridges have been built by the military with foreign donor support and some efforts have certainly been made to restore livelihoods.
But still things are difficult and women frequently bear the brunt. "Lots of men work in the tourist industry here. Hotels and cafes were washed away in the 2010 floods, destroying all they had built after the militant conflict, and then there were major agricultural losses in both 2010 and 2011," Aqila Khan said.
Many women are struggling simply to put food on the table. "I sold the bangles I received for my wedding 10 years ago. It was all the gold we had but my husband had lost his job as a hotel waiter, and with the money we bought hens, goats and began replanting vegetables," Salma Bibi, 30, told IRIN.
Her problems are not over, however. "My husband is out all day looking for work. He is desperate. I tend our three young children, the animals, look after the fields, fetch water from a stream [7km] away from our village near Mingora, cut timber to cook and perform all the household chores. Other women work like me too to bring in money - but by the end of the day we are worn out. Look at my cut, torn hands," she said displaying her palms.

Taliban concerns
"I worry about the militants coming back because my sister and I were forced out of college for nearly two years and we cannot seem to catch up again. This means we cannot help our elderly parents by earning an income in the coming years," said Zaitoon Bibi, 18. Her brothers struggle to restore their fields and replant the peach trees they lost.
Many other women must take on the dual burden of earning an income and running the household as their husbands try to rebuild homes, lives and livelihoods. Given the acute losses experienced by the tourism industry, which employed tens of thousands, people are asking for more help.
"We have received no compensation and no help from anyone. We know that right now it is our wives who are keeping the households running. But this is unfair on them. We have to find a way to get back to work, and we believe the authorities must somehow help us," said Sharaft Ahmad, 36, whose wife works as a schoolteacher, as well as looking after the household and cattle.
"Things cannot continue like this for ever. We also live in fear of another disaster and somehow normality has to be found here so that families can live with some peace of mind and without continued strain," he said.
http://www.irinnews.org/report.aspx?reportID=94400

AID POLICY: Cash catches up

2011-12-06T08:33:00.000-05:00

NAIROBI, 6 December 2011 (IRIN)

Photo: The Cash Learning Partnership
Smart cards...cash transfers are deemed more efficient and flexible than in-kind aid...

Cash and voucher transfers are becoming increasingly integrated into humanitarian relief efforts across the Horn of Africa, particularly in areas of protracted conflict and insecurity.
Restrictions on access in Somalia and in areas of northeast Kenya have led the humanitarian community to rethink traditional ways of delivering aid.
“We have to criticize our programming decisions and formulate better ways to get assistance to the people in need,” said Nick Maunder at a recent workshop in Nairobi, where the private sector, NGOs, UN agencies and donors met to debate, share experiences and develop ways to improve and increase the use of cash transfer programming during emergencies.
The World Food Programme (WFP) and several NGOs, notably Horn Relief and Oxfam, have scaled up their cash-based programming across the region this year. According to Horn Relief, US$81 million in cash and vouchers is going into Somalia, reaching more than 1.8 million people.
“This is the largest NGO cash response thus far on this scale, mainly because food aid is no longer an option in south-central Somalia,” said Degan Ali of NGO Horn Relief.
“Cash for assets has also started going to scale in Kenya, targeting just under half a million beneficiaries at KSh3,000 [$33] per household per month,” said Sheryl Harrison of WFP.
Most humanitarian assistance in the Horn of Africa has so far been provided in-kind, through the distribution of food, shelter, tools and seeds. In many areas, relief efforts have been beset by delays, high delivery costs, and in Al-Shabab-controlled areas, high taxation. There is a growing body of experience in the region that is using cash or vouchers as a critical complement, or at times an alternative to in-kind assistance.
“Cash is less visible, more dignified, uses fewer intermediaries, is in transit for less time and a more flexible resource to meet needs beyond food,” said Ali.
When food is available in local markets, or can be supplied quickly through market mechanisms, cash and voucher transfers are perceived to be the most efficient and cost-effective way of delivering humanitarian aid. Once the implementing agency has conducted an in-depth market assessment of the area, and the context is deemed suitable, money can transferred directly to beneficiaries, with or without conditions.
“The reason why there is so much momentum around cash is because the humanitarian world is starting to recognize that more and more people are living in a market economy, taking that into account and beginning to work in it rather than in isolation from it,” explained Breanna Ridsdel, communications and advocacy officer at the Cash Learning Partnership (CaLP), which organized the workshop.
Concerns have been raised about whether injecting cash can disrupt local economies and cause inflation but implementing agencies believe the amount of money being transferred to households is too small to have a detrimental impact on markets; according to a recent report by CaLP, the fear of inflation is disproportionately applied to cash rather than in-kind programmes, which can also have a massive influence on markets. Breanna Ridsdel of CaLP explains “Its all context specific, if you are looking at going into a very remote area and setting up a financial system, then that may not be the most appropriate intervention but if you are looking at a financially insecure community, living in urban area, in a developed financial system, then cash is likely to be more appropriate then food distribution which is working against the market... It’s all about good programming”.

Going private
The challenging environment in which relief agencies are operating in the Horn of Africa, characterized by insecurity and corruption, has led the aid community to create partnerships with the private sector and adopt new technologies to deliver cash safely to hard-to-reach areas.
Representatives from Visa, Equity Bank and Safaricom, a mobile phone operator, attended the workshop to lobby implementing agencies to use their products, saying it would be more efficient.

Photo: Jaspreet Kindra/IRIN
...and help preserve the dignity of those caught up in emergencies

“Exciting new partnerships are being forged between the private sector and humanitarian community to improve the delivery of cash,” said Ginger Baker of Emerging Market Solutions at Visa.
Money is being transferred electronically through mobile-phone service providers, such as MPesa in Kenya, and through traditional remittance networks, such as Somalia’s Hawala system.
“When Al-Shabab closed telecommunications service in Somalia, we began to realize the value of Hawala, which became critical to our relief efforts,” said Ali.
“In Kenya, 21 percent of the population have bank accounts and 87 percent have mobile phones… MPesa can be used as a poverty eradication tool,” according to Safaricom.
With increasing scrutiny from the media, public, and donor governments over the cost-effectiveness of aid and at times, inefficiency of traditional distribution mechanisms, emerging partnerships between the banking and humanitarian sector are being welcomed. “Partnerships with the private sector will encourage more efficient and effective ways of delivering humanitarian assistance,” said head of International Federation of the Red Cross Regional Office, Alexander Matheou.
“The profit motive is not a bad thing. Safaricom and Visa may take a nominal fee for sending cash to impoverished households but at least it will be done quickly in a cost effective manner” said an independent aid consultant at the event.
Over the past few years, the private sector has played an important role in facilitating cash transfer programming yet the engagement of humanitarian actors still appears to be limited.

Some worry that the pursuit of profit sits uncomfortably with humanitarianism.
“The private sector are concerned with the rich, we are concerned with the poor… We need to be careful, but also respectful of each other’s motivations, and meet somewhere in between, ” said the chair of the CaLP steering committee, Austin Davis.
Another challenge is introducing electronic payments in low-income countries which need existing financial institutions and wide mobile-phone network coverage. Safaricom admitted that large parts of the Horn of Africa were still not covered and a proportion of vulnerable populations did not have access to mobile phones. However, according to a recent report on the impacts of mobile cash transfer programmes, the widespread growth of mobile-phone coverage, cheaper handsets and mobile-money services in developing countries suggests these constraints could be easily overcome.

Reservations and recent progress
“The momentum is building but any change happens slowly, any adoption of new techniques meets resistance at first, it has to go through the process of building evidence, proving itself, making mistakes, correcting itself and building systems; this is the biggest obstacle to adoption at scale,” explained Ridsdel.
According to the Oversees Development Institute’s (ODI) Good Practice Review for Cash Transfers in Emergencies, “Experience in very uncongenial environments such as Afghanistan, Somalia and the DRC shows that cash or vouchers are a possible response even where states have collapsed, conflict is ongoing and banking systems are weak or non-existent.”
One of the main challenges is a negative institutional mindset that can be overcome with an increase in such programming, according to advocates.
Sarah Bailey of the ODI says: “Transferring cash directly takes the power away from the humanitarian community and puts it into the hands of the beneficiaries, a notion that people still remain uncomfortable with.”
Experience of cash-based programming is largely based on recovery operations, with less experience at the very early stages of a relief or emergency response phase.
“We should have begun transferring cash much earlier in Somalia where the markets are very important and continue to function despite collapsing livelihoods and weak purchasing power,” said Grainne Moloney, nutrition technical manager at the UN Food and Agriculture Organization’s Food Security and Nutrition Analysis Unit (FSNAU).
In January, FSNAU began assessing 44 markets across Somalia, monitoring the prices of about 40 commodities every week. “In some markets, it became clear that cash transfers at scale were a valid option early on. Unfortunately, there was a lot of hesitation and concerns over inflation, insecurity and cash diversion. Donors were hesitating as the crisis deepened.”
The three major donors to the crisis, the US, the UK and the EU, are now backing cash transfer programmes across the region.
“DfID is successfully using transfers to reach particularly impoverished populations in challenging places in Ethiopia and Kenya. Transfers reach their recipients more quickly and transparently than more widely prevalent ways of delivering aid,” according to the UK’s National Audit Office.
http://www.irinnews.org/report.aspx?reportid=94396

POVERTY: MIGRATION: The risks of rescue at sea

2011-12-05T09:06:00.000-05:00

JOHANNESBURG, 5 December 2011 (IRIN) -

Photo: Kate Thomas/IRIN
A boat carrying migrants from Libya arrives in Lampedusa

Two years ago, Abdiselam Sheik Omar left his home town of Jijiga in Ethiopia’s eastern Somali region and embarked on a journey he hoped would take him across the Gulf of Aden to Yemen and eventually to Saudi Arabia. “It’s easy to find work there,” he told IRIN. “The problem is crossing the sea.”
Omar was well aware of the risks and hardships, having made the journey twice before. He knew that during the three- to five-day crossing from Puntland in northern Somalia there would be little to eat or drink, and his smugglers would not hesitate to beat uncooperative passengers or even throw them off the boat.
When the rickety, overloaded boat he was on started sinking, one of the migrants drowned before the remaining 34 were rescued by the Yemeni Coast Guard. The passengers and their smugglers were arrested and jailed on reaching Yemen, but Omar was glad to be alive.
After 20 days he was released and made it as far as the border with Saudi Arabia before being arrested again. This time he was deported back to Ethiopia. “I won’t try it again, even though I’m jobless,” he said.
Every year, thousands of migrants risk hazardous sea crossings in a desperate bid to escape poverty, persecution or conflict. If they run into trouble, as many do, their only hope of being rescued is a long-standing maritime code of conduct backed by numerous international protocols that compel passing ships to render assistance to any vessel in distress.
In the last year alone, cruise ships have picked up Cuban migrants off the coast of Florida, the Indonesian navy has rescued Afghan nationals trying to reach Australia, and Spanish authorities have assisted African refugees and migrants drifting in the Mediterranean.
Many other sinking or capsized vessels were either missed or ignored, and countless migrants have lost their lives at sea. The UN Refugee Agency (UNHCR) estimates that between February and October this year, 2,000 mostly African migrants fleeing the crisis in Libya drowned while trying to cross the Mediterranean. Since the beginning of 2011, a further 131 Somali and Ethiopian refugees and migrants have perished in the Red Sea and the Gulf of Aden trying to reach Yemen.

Disincentives
The discovery of a small vessel in apparent distress represents a dilemma for ships’ masters, particularly in the Gulf of Aden and the Indian Ocean, where pirates are most active.
“It’s very difficult to distinguish from a distance whether it’s a boat with migrants or with pirates, so they assume it may be pirates,” said Captain Hartmut Hesse of the International Maritime Organization.
It's very difficult to distinguish from a distance whether it's a boat with migrants or with pirates, so they assume it may be pirates
Current guidance to the shipping industry on the threat of piracy advises ships to keep their distance from small vessels. It does not deal with the possibility that they could be carrying migrants in need of assistance, said John Murray of the International Chamber of Shipping (ICS). "The other big issue is that ships must know that coastal states will meet their obligations in disembarking people rescued at sea."
For ships’ masters everywhere, the biggest disincentive for picking up migrants in distress is the real possibility that they will waste time and money looking for a country willing to let them come ashore.
The International Convention for the Safety of Life at Sea (SOLAS Convention) and the International Convention on Maritime Sea and Rescue (SAR Convention) both outline the duty of relevant countries to cooperate and coordinate rescue operations at sea, but many are unwilling to accept undocumented migrants.
“They should be offered a place of safety in the closest country from where they were picked up,” said Christopher Horwood, coordinator of the Regional Mixed Migration Secretariat (RMMS), run by the Danish Refugee Council in Nairobi, which provides information and support for migration responses between the Horn of Africa and Yemen. "There are worrying signs that countries are not living up to their responsibilities... some are not even permitting [ships with rescued migrants] to dock."
Whether the ship is a commercial vessel contracted to deliver cargo by a certain date or a military vessel patrolling a coastline, the probability of a delay in disembarking migrants "is likely to undermine some of the commitment to picking people up," said Murray. "That’s the real world; that’s the world we live in."
Most ships these days have small crews and are not equipped to provide food and accommodation to extra passengers for days at a time.

Lack of cooperation
The problem is not new. A decade ago, Australian authorities refused to permit a Norwegian freighter, the MV Tampa, carrying 438 Afghan nationals rescued from a fishing boat drifting in international waters near Christmas Island, to enter Australian waters. The episode sparked a political controversy in Australia and a diplomatic spat between Australia and Norway.
Despite much debate about how future incidents could be avoided and amendments to maritime law, the problems have continued, said Anja Klug, head of the UNHCR asylum/migration unit. “We think the real problem lies in the lack of cooperation among the different states involved in these situations."
At an experts meeting convened by UNHCR in Djibouti recently, Klug and her colleagues presented some practical tools aimed at improving cooperation and burden-sharing of sea rescue operations between states in regions affected by high levels of migration.
One such tool is a model framework that provides for government cooperation in establishing regional task forces to oversee rescue operations, identifying the most appropriate countries for disembarkation, and ensuring that adequate arrangements are in place to receive and process rescued migrants with varying claims to international protection.
"We’re not aiming for this to be adopted on a binding global level," Klug told IRIN. "We want countries to come together and assess their needs. [UNHCR] can facilitate, but ultimately governments need to come to agreements."
At the meeting, UNHCR also proposed that “mobile protection response teams”, staffed by experts from government, UNHCR and other international organizations, be dispatched to countries lacking the resources or capacity to deal with an influx of migrants and asylum seekers arriving by boat.
"Normally, reception arrangements are a task of governments but they sometimes don’t have the capacity," said Klug. UNHCR, together with the International Organization for Migration and other NGOs, are already providing such assistance along the coast of Yemen and on the Italian island of Lampedusa, where large numbers of migrants have come ashore in recent months as a result of the crisis in Libya.

Need for guidance
Another UNHCR document suggests some basic standard operating procedures for ships' masters who encounter migrants in trouble at sea, such as what constitutes a "distress situation" and what information should be sought from rescued persons.
Murray, who attended the Djibouti meeting for the International Chamber of Shipping, said there was a need for such guidance but emphasized that it was not the role of a ship's crew to categorize people. "We feel very strongly there should be no pressure on the ship’s master to engage in any processing or profiling of people who’ve been recovered. As far as the ship is concerned, they’re people in distress at sea," he told IRIN.
Noting that boats rescued at sea often contain a complex mixture of asylum seekers, economic migrants and people with special needs, such as minors, Horwood of RMMS agreed that "It shouldn’t be the burden of a ship captain to decide if he’s got economic migrants or refugees. Many of the migrants don’t qualify for international protection, even though they might be on the same boat as those that do. This is the phenomenon of mixed migration."
Horwood welcomed the UNHCR initiative. "These people are victims of situations [that cause them to migrate] and on top of that they find themselves rejected when they’re genuinely in distress at sea."
http://www.irinnews.org/report.aspx?reportID=94383

GLOBAL FUND: Further Details on Fund's Tough New Policies for Grant Renewals

2011-12-05T08:58:00.000-05:00

David Garmaise (david.garmaise@aidspan.org),
Funding will be severely restricted for some upper-middle-income countries
Transitional measures will "soften the blow" for countries hardest hit by the new policies
Editor's note: This article is based on documents submitted to the Global Fund Board for its recent meeting in Accra, Ghana; on the decisions made by the Board at that meeting; and on information received from the Global Fund Secretariat. Not all of the decisions made by the Board had been anticipated in advance. The Secretariat is still thinking through the implications of these decisions for the Global Fund's processes related to grant renewals. As a result, there may be changes to the processes described in this article. Readers are advised to watch for future communications from the Secretariat. The Secretariat said that questions should be directed to fund portfolio managers or to Grant.Renewals@theglobalfund.org.

As a result of decisions made at the Global Fund Board meeting in Accra on 21-22 November, significant changes are being made to the policies and procedures for grant renewals. (GFO first reported on this in Issue 167; this article provides more details.)
The main changes can be summarised as follows:
A new, iterative process will be introduced for grant renewals.
Effective 1 January 2012, Group of 20 (G-20) upper-middle-income countries (UMICs) will no longer be eligible for grant renewals unless they have an extreme disease burden (as defined by the Global Fund).
Effective 1 January 2012, certain provisions of the Global Fund's policies on eligibility, counterpart financing and prioritisation (ECFP), which currently apply only to new proposals, will be applied to renewals. The specific provisions are (a) counterpart financing and (b) focus of proposal.
The one-year grace period for changes in country income classification will be rescinded.
Funding for renewals will now be committed in one-year tranches. For a three-year renewal, therefore, the commitments will be 1+1+1, instead of the current 2+1 (the first two years and then the third year).
Transitional measures will be introduced for countries renewing in 2012 that are significantly impacted by the new policies. (This is quite separate from the new Transitional Funding Mechanism which the Global Fund has established for grants that will be expiring before the next new funding opportunity; see Article 2.)
Funding for low income countries must represent at least 55% of the total funding for renewals in each calendar year.

POVERTY: MYANMAR-THAILAND: Slow pace of registering migrants

2011-12-05T08:47:00.000-05:00

MAE SOT, 5 December 2011 (IRIN)

Photo: David Longstreath/IRIN
Burmese family registers their child for a Thai birth certificate as part of a drive to issue identification documents to all children born in Thailand regardless of their parents' legal status. At Mae Tao clinic in Mae Sot, Thailand

For decades, children of Burmese refugees and migrants in Thailand could not obtain an official birth certificate, vital to access healthcare and education. Even though legislation entitling them to a formal identity has been in place since 2008, registering and coaxing forth the undocumented has been "painstaking", according to community groups.
"Birth registration is the basic fundamental right of any human being. If you don't have birth registration, you lose all your rights," said Naing Min, project director for the community-based organization, Committee for Protection and Promotion of Child Rights (CPPCR), at Thailand's border with Myanmar in Mae Sot.
With no proof of identity or age, those without birth certificates are vulnerable to abuse, exploitation and trafficking. When they grew older, their troubles are compounded: unable to get any form of identification, they cannot open a bank account or apply for a formal job.
Following the amendment in 2008 to Thailand’s Civil Registration Act of 1991, all children born in the country are entitled to birth registration and government-issued birth certificates, regardless of their parents’ legal status.
In Burmese refugee camps, more systematic birth registration - coordinated by camp and government authorities with assistance from NGOs and the UN Refugee Agency (UNHCR) - began in September 2010, but only a fraction has been documented.
The law has taken time to be implemented, in part because of the slow pace of assigning and training government staff. It has also been a challenge to register Burmese who cannot provide any proof of identity whatsoever - not registered at birth, they have been unable to get any identity papers later in life.

Backlog
“The law in the Civil Registration Act, as amended in 2008, is retroactive. It went back for all children born in Thailand, so with Myanmar refugees in the camps, you could be dealing with 25 years of birth registrations,”," said James Lynch, Thailand's representative for UNHCR.
About 1,600 people - mostly newborns - have been registered in nine refugee camps along the border housing an estimated 150,000 people, including some 60,000 unregistered refugees, according to the Thailand Burma Border Consortium, an umbrella group of organizations providing services for migrants and refugees.
The next group to register is children born to Burmese refugees between 2008 and September 2010, and then further back to 1984 when the first major waves of refugees, fleeing violence in Myanmar, poured into Thailand.
"I'm not sure of exact numbers [left to be registered], but if you go back 25 years, it's a painstaking task, but an important one," Lynch said.
Each year, about 5 percent of children born in Thailand - about 40,000 babies primarily from poor families, ethnic minorities or migrants - are not registered at birth, according to the UN Children's Fund (UNICEF).

Catch-22
“The issue with the unregistered camp population is that they could report to the district office, but they fear if they’re not registered and they go to report, they might be deported, so they may be reluctant,” Lynch said.
Unregistered Burmese refugees cannot get birth certificates for their children through camp authorities and face the same problem as migrants.
"They have to go to the district office, but practically, this is difficult because they have no permission to leave the camp, and if they do leave the camp, then they can be arrested and deported, so it is a Catch-22 classic ," said Joel Harding, senior protection officer for the NGO International Rescue Committee.
It is a problem UNHCR and other agencies are working with the government to fix, but providing birth registration for even registered Burmese refugees - there are about 100,000 - is taking time.

A better future
When Ma Lay, 27, gave birth in August 2011 to her third son at Mae Tao Clinic, a health centre for Burmese refugees and migrants in Thailand, she immediately registered him. Her two older sons, six and four, were born in Myanmar, and like her and her husband, have no papers.
"For the two boys, there have been no problems yet, but for me and especially my husband, sometimes on our way to work, we run into the police and get arrested," said Ma Lay. "It makes me feel better if my baby is delivered and registered here, for my baby's future."
Some 200 babies born each month at Mae Tao Clinic are registered on site.
CPPCR now encourages people to get Thai civil birth registration, yet still continues unofficial registrations for those who do not in the hopes such documentation will help them access education and health services as well as claim land and inheritance if they return to Myanmar.
"Some are afraid to go to the office or to ask for a recommendation letter from the village chief, because they are here illegally. They don't know their rights," Naing Min said.
Over the past eight years, CPPCR has unofficially registered 180,000 children."When there was no system to recognize the children born in Thailand, we collected the information, so that when there is true democracy [in Myanmar], we can make claims for their [Burmese] citizenship," Naing Min said.
http://www.irinnews.org/report.aspx?reportID=94382

POVERTY: South Sudan: Returning refugees

2011-12-05T08:42:00.001-05:00

JUBA , 5 December 2011 (IRIN) - SOUTH SUDAN: Iklas Monu Ahmed, “Since I’ve been here, nobody has come to talk to me or show us where to go”

Photo: Hannah McNeish/IRIN
Iklas Monu Ahmed and one of her children

A steady stream of barges from the North arrives at Juba Port but Iklas Monu Ahmed and her four children are still camped out at the dock three months after their ship came in. More than 350,000 South Sudanese have come back of their own accord over the past year, and the International Organization for Migration will have helped 20,000 returnees since January, when the country voted to secede from Sudan. Up to a million are thought to be in the North as the 9 April deadline approaches to “get legal or get out”. Many returnees need support with food and basic items, plus a plot of land, to build a new life in a new nation lacking opportunities. Ahmed is desperate as three-year-old Mamdu lies prone on a bare bedframe and the family is stuck, facing sickness and hunger.
“I was taken to Khartoum at the age of 11... Now I’m 31. The life was ok in Khartoum. I was working... and I was able to feed the family.
“But since I came here there is no one to receive us and nobody to take us home. Life is difficult, there is no food, and I came with children. Now the younger one is sick and the elder ones went to town looking for something to treat him.
“Of course, Juba is my place where I want to stay but I have nowhere to go and nobody to take care of me. If only I could take a piece of land to put the family and my luggage that is down here, I would be able to get something to do for myself, like making tea, and the family would be sustained.
“Since I’ve been here, nobody has come, either the government or any of the agencies, to talk to me or at least show us where to go.
“We were given cards, [ration] cards, but we have not been served any food or non-food items up to now.
“I left Juba after my mother died when I was 11 and my father was gone. So when I went to Khartoum I stayed with the relatives of my mother there and got married to a Darfuri and we separated.
“I do work in hotels helping to wash dishes and fetch water. They pay me 10 pounds [US$3.70] a day and I buy food every evening for the children.
“But for three days I have not gone as my son is sick. I took the child to the hospital and he has been prescribed drugs but they are not the easiest to buy from the clinics as we don’t have the money.
“He has malaria and he vomits whenever he tastes something.
“We sleep outside here on this floor.
“I’m here because the country now is at peace and it is a separate nation and I have come back home like any other national.
“If only I can get a piece of land, I can sustain the family, just like in Khartoum.
“There are many changes in Juba, but for me to be able to join in this race of changes, I need a piece of land.
“In the north, you live like refugees as no one is settled and you live under threat. Here with a piece of land, you can settle.”
http://www.irinnews.org/report.aspx?reportID=94393

MALARIA: EurartesimR (dihydroartemisinin-piperaquine)

2011-12-05T08:37:00.000-05:00

November 30, 2011

ACT to combat malaria receives marketing authorization from EMA
EurartesimR (dihydroartemisinin-piperaquine)
ACT to combat malaria receives marketing authorization from EMA
. A fixed-dose combination therapy to combat malaria, EurartesimR, (dihydroartemisinin-piperaquine) the product of Italian research conducted by Sigma-Tau and MMV, approved by the European Medicines Agency (EMA)
Therapy with a simple dosage regimen, up to 3 tablets once a day for 3 days. Studies have demonstrated high cure rates, above 95%, and a significant reduction of re-infection rates compared to leading
antimalarial treatments
Every year almost 250 million people all over the world are affected by malaria. The disease takes the lives of over 780,000 people, mainly in sub-Saharan Africa, 85% of whom are children under 5
Geneva, 30 November 2011. For the very first time, the European Medicines Agency (EMA), using a centralised procedure, has granted regulatory approval to an artemisinin combination therapy (ACT) for the treatment of uncomplicated P. falciparum malaria. This ACT, EurartesimR (dihydroartemisinin-piperaquine), was developed collaboratively by Sigma-Tau s.p.a Industrie Farmaceutiche Riunite, Italy, and the
not-for-profit product development partnership Medicines for Malaria Venture (MMV). The development of Eurartesim has made Sigma-Tau the first Italian company to be granted marketing authorization for an antimalarial drug by the 27 EU Member States from the EMA.

Eurartesim, a fixed-dose combination of two antimalarials, dihydroartemisinin and piperaquine (DHA-PQP), is generally well-tolerated and is administered once a day for 3 days instead of twice a day, making the drug more patient friendly. In addition, clinical trials have shown that compared to other approved ACTs, Eurartesim provides better and longer protection from new malaria infections. This is good news for
children in high transmission areas who often succumb to another life-threatening malaria episode after they have recovered from the first1.

The EMA's authorization is based on the results of a series of large-scale clinical trials that assessed Eurartesim's safety and efficacy in comparison to artemether-lumefantrine or artesunate + mefloquine. The
studies tested this ACT in more than 2,700 patients in Africa (Burkina Faso, Zambia, Kenya, Mozambique and Uganda) and in Asia (Thailand, India and Laos), in around 1,036 African children aged 6 months to 10 years, all affected by uncomplicated P. falciparum malaria.

"Clinical studies carried out on patients treated with Eurartesim have confirmed high cure rates, above 95% - says Marco Corsi, Sigma-Tau's Medical Director. Moreover, compared to comparator drugs, Eurartesim has shown a secondary protective effect - an almost 50% reduction in the number of new infections in the 2 months following treatment. In highly endemic countries, where treated patients often become newly infected,
this secondary protective effect might have a positive outcome on public health. The marketing authorization for Europe will allow us not only to provide a highly effective treatment to vulnerable populations of endemic
countries, where malaria has a devastating impact on health and socio-economic systems, but also to European citizens."

Developed to high internationally recognized standards, Eurartesim meets the therapeutic guidelines outlined by the World Health Organization (WHO) which, on the basis of clinical evidence, recommends the combination of two active ingredients in the same tablet: an artemisinin derivative with a high antimalarial efficacy (dihydroartemisinin) and a second antimalarial drug (piperaquine), which helps protect the artemisinin
component from the risk of resistance.

"The approval of Eurartesim by the EMA comes at a critical time in the fight against malaria - says David Reddy, CEO, MMV. This high quality treatment is a much-awaited addition to the malaria arsenal and will be welcomed by health care professionals in a number of malaria-endemic countries. Eurartesim is the product of a close collaboration between MMV and Sigma-Tau. The partnership between Sigma-Tau and MMV will continue as we focus on the development of a paediatric formulation of the treatment targeted at children under 5 years of age."

Jaya Banerji: e-mail: banerjij@mmv.org

MALARIA TB AIDS: Pakistan may downsize programmes

2011-12-05T08:27:00.000-05:00

December 05, 2011
A meeting is likely to be held in Planning Commission on December 7 to decide the fate of National Aids Control Programme (NACP).
The meeting would also take decisions regarding downsizing and regularisation of the employees working under health sector.
The Malaria Control Programme, National TB Control Programme and Expanded Programme of Immunisation (EPI) would also came under discussion in the meeting.
Well-placed sources told Business Recorder here on Saturday that due to the lack of funds, it has been decided that the above-mentioned health programmes would be downsized especially the NACP.
"The decision regarding regularisation of some employees working on contract basis in NACP would also to be taken in the meeting," the sources added.
Minister for Religious Affairs Syed Khursheed Shah is likely to chair the meeting.
NACP was established in 1986-87 with focus on diagnosis of cases that came to hospitals, but progressively gained community focus.
Its objectives are the prevention of HIV transmission, safe blood transfusions, reduction of STD transmission, establishment of surveillance, training of health staff, research and behavioural studies, and development of programme management.
Pakistan is the second largest country in South Asia that stands only a few steps behind India and Nepal in terms of HIV epidemic.
Until recently Pakistan was classified as a 'low prevalence high risk' country but now Pakistan is in 'concentrated phase' of the epidemic with HIV prevalence among more than 5 percent injecting drug users (IDUs) in at least eight major cities.
Sources revealed that on the directive of the Planning Commission, the senior officials of NACP have prepared a list of 14 employees that are likely to be terminated from their jobs when the process of downsizing would be started.
After the devolution of the Health Ministry to the provinces, it was decided to devolve the National AIDS Programme and it was placed in the devolution list.
But the programme was revived on November 14 due to unknown reasons.
Now it has been decided to downsize the programme by reducing the total number of employees from 30 or 32 to 15 or 16.
The employees have not been provided their salaries for the last 5 months.
Sources said that the employees working under NACP might go for a strong protest after downsizing.
http://www.brecorder.com/general-news/single/599/172/1257972/

MALARIA: Reducing Malaria Misdiagnosis

2011-12-05T08:21:00.000-05:00

BMC Infect Dis. 2011 Nov 3;11(1):308. [Epub ahead of print]

Reducing Malaria Misdiagnosis: The Importance of Correctly Interpreting ParaCheck Pf "Faint Test Bands" in a Low Transmission Area of Tanzania.
Allen LK, Hatfield JM, Devetten G, Ho JC, Manyama M.

ABSTRACT: BACKGROUND:
Although malaria rapid diagnostic tests (RDTs) have been extensively evaluated since their introduction in the early 1990's, sensitivity and specificity vary, limiting successful integration into clinical practice. This paper reviews specific issues surrounding RDT use in field settings and presents results of research investigating how to interpret "faint test bands" on ParaCheck Pf in areas of low transmission in order to reduce malaria misdiagnosis.

METHODS:
A multi-phase cross-sectional study was conducted at a remote hospital in the northern Tanzanian highlands. Capillary blood samples were taken from consenting participants (n=319) for blood smear and ParaCheck Pf testing. Primary outcome variables were sensitivity, specificity and proportion misdiagnosed by ParaCheck Pf and local microscopy. ParaCheck Pf "faint bands" were classified as both true positives or true negatives during evaluation to determine appropriate clinical interpretation. Multivariate logistic regression adjusted for age and gender was conducted to determine odds of misdiagnosis for local microscopy and ParaCheck Pf.

RESULTS:
Overall, 23.71% of all ParaCheck Pf tests resulted in a "faint band" and 94.20% corresponded with true negatives. When ParaCheck Pf "faint bands" were classified as positive, specificity was 75.5% (95% CI= 70.3% - 80.6%) as compared to 98.9% (95% CI= 97.0% - 99.8%) when classified as negative. The odds of misdiagnosis by local microscopy for those > 5 years as compared to those [less than or equal to] 5 years are 0.370 (95% CI=0.1733 - 0.7915, p=0.010). In contrast, even when ParaCheck Pf faint bands are considered positive, the odds of misdiagnosis by ParaCheck Pf for those > 5 years as compared to those [less than or equal to] 5 years are 0.837 (95% CI= 0.459 - 1.547, p=0.5383).

CONCLUSIONS:
We provide compelling evidence that in areas of low transmission, "faint bands" should be considered a negative test when used to inform clinical decision-making. Correct interpretation of RDT test bands in a clinical setting plays a central role in successful malaria surveillance, appropriate patient management and most importantly reducing misdiagnosis.

PMID: 22054069 [PubMed - as supplied by publisher]

MALNUTRITION: Ecuador Vows to Eradicate Malnutrition

2011-12-01T10:21:00.000-05:00

November 8, 2011 : Amara Channell

A group of children outside their school in the Chimborazo region of Ecuador

Last week the President of Ecuador, Rafael Correa, announced that the country will eradicate malnutrition within the next four years. The government will focus on pregnant and breastfeeding women, as well as young children. The pledge is a response to the fact that Ecuador has the fourth highest rate of malnutrition in Latin America, hovering around 19 percent of the country's population. Yet, according to UNICEF, the Chimborazo region of Ecuador -- where MEDLIFE conducts most of its Mobile Clinics and patient follow-up work -- has an even higher malnutrition rate of 44 percent. The Chimborazo region is home to many poor, rural communities, as well as indigenous groups.
“Aliméntate, Ecuador" is a new program that provides pregnant women and mothers of infants with a small stipend to get regular checkups. The program also helps teach mothers about exclusive breastfeeding (when an infant only receives breast milk without any additional food or drink) as well as complementary foods (when additional foods are introduced into a child's diet). According to the program's website, "Aliméntate" has already been successful in reducing rates of anemia by 12 percent during the past year in the community of Manta.
The program uses local residents and trains them to be health promoters. The promoters must attend six workshops, where they learn about healthy food pairings, reducing fats and sugars, and how to incorporate local foods into their diets. The focus on returning to ancestral foods works well with the newly released Food and Agriculture Organization (FAO) report, “The State of Food Insecurity in the World 2011,” which gives suggestions on how to improve the incidents of hunger and malnutrition in Latin America. The report points out that many Latin American countries have become dependent on imported foods which are expensive and subject to huge price jumps based on inflation. Outside of price concerns, there is also a risk that cheap imported foods can replace more nutritious regional options. MEDLIFE staff workers also see this in Peru where processed white rice has replaced traditional protein-rich Inca grains such as Quinoa and Tarweii. The FAO suggestions have already spurred local-food pushes in both Bolivia and Argentina. Bolivia’s campaign is subsidizing farmers who grow nutrient-rich, ancestral foods that are easier on the soil and require less chemical fertilizers. Latin American countries have a wealth of extremely nutritious foods -- hugely significant resources in the fight to overcome malnutrition. Hopefully, Ecuadorian programs will continue to be successful in reducing this crippling disease and be able to convince people to return to some of their ancestral eating habits.
http://www.medlifeweb.org/blog/item/47-ecuador-vows-to-eradicate-malnutrition.html

MALNUTRITION: Kenya: USAID activity

2011-12-01T10:17:00.000-05:00

Jill Richardson :: What Our Friends at USAID Are Up To in Kenya, Part 1

A document entitled "Strategic Review" from the Feed the Future program in 2010 shows what is likely a powerpoint presentation on Kenya. It includes several maps, and honestly, I can't make heads or tails of them. One of them shows poverty in terms of density (density of poor people in an area). As you might guess, where there are more people, there are also more poor people. I don't find that nugget of information very useful.
Next are maps of malnutrition and food insecurity by percent of the population, not absolute number. These are more helpful - or should be - but they have a bit of conflicting data. That is, where the children are the most stunted, they are not the most wasted. (Stunted means low height for age; wasted means low weight for height. Stunting is due to chronic malnutrition, whereas wasting is due to acute malnutrition.) However, the area with the most stunting is also the area with the highest food insecurity. The high population areas seem to have the least amount of malnutrition and food insecurity as a percent of the population, but might have higher absolute numbers of both because they just plain have more people, both rich and poor, well-fed and malnourished. Coast province (the southeastern most province) seems to be moderately bad but not the worst in all three measures.

Out of Kenya's population of 38.6 million people, some 17.8 million are considered poor. Those break down as follows: 7.2 million live in rural areas with high rainfall; 5.5 million are urban poor; 2.9 million live in semi-arid rural areas; and 2.2 million live in arid rural areas. They broke the country down into the following regions:

They chose which areas to focus on based on three factors. First, which regions have the most rural poor? HR1, HR2, SA2, and A2. Of those, which produce the most food? That eliminates A2. From there, which set of regions would represent the most diverse group of people receiving aid? That narrows it down to HR1 and SA2.
As I've noted before, Kenya's ethnically very diverse. The map used by USAID shows Kikuyu majorities in Western and Central provinces. Nyanza province is Luo and Kisii. My friend who I will visit there in Luo. Rift Valley is mostly Kalenjin. North Eastern province and the northern half of Eastern province are dominated by a Somali majority. The southern half of Eastern Province (SA2) is a mix of Kamba, Embu, and Meru. Last, Coastal province (in the southeast) is a mix of Mijikenda, Taita, and Swahili.

Here's an excerpt from a longer, more detailed version of USAID's plan in Kenya.
As part of their intrinsic market-based approach, all Mission value chain programs will be coordinated closely with USAID/EA programs in promoting private- sector-led market and trade development and regional integration and investment.
At the same time, to ensure access to food in lower potential areas, the USG through the Mission and partners will make markets work better for the poor and for women by investing in affordable inputs, delivery of services adapted to their needs, and development of better market linkages.
In other words, they want to turn peasants into entrepreneurs.
In 2010, they planned to focus on 5 areas:
1. Staple food value chain development, including livestock and livestock products;
2. Rural finance;
3. Policy analysis, advocacy and capacity-
building;
4. Agricultural research and technology transfer, and
5. Water and sanitation.

#1. Staple Food Value Chain Development
They list "Current and Potential USG and Development Partners" as:
USDA's Animal & Plant Health Inspection Service (APHIS)
USDA's Foreign Agriculture Service
USAID East Africa
Foreign Commercial Service
U.S. State Dept
Peace Corps
Agricultural Sector Coordination Unit (Govt of Kenya)
Dept for International Development (UK)
EU
UN Food & Agriculture Organization (FAO)
International Fund for Agricultural Development
Japan International Cooperation Agency
World Bank
Kenya Agricultural Research Institute (KARI)
Kenya Bureau of Standards
Kenya Dairy Board
Kenya Plant Health Inspectorate Services
Eastern Africa Grain Council
Kenya Livestock Marketing Council
UNICEF
UN World Food Programme
Gates Foundation
Rockefeller Foundation
Alliance for a Green Revolution in Africa

This investment focuses on improving agricultural productivity through value-added techniques, market linkages, diversification, and off farm income generation. Farmers will be linked to input and output markets through private agribusiness...
Two early areas being targeted are: 1) expanding smallholder farmer participation in structured grain markets, allowing greater use of the nascent grain warehouse receipts system for maize and staple food crops; and 2) addressing key market and trade constraints, including animal health sanitary issues, within livestock value chains.
Programs include: Kenya Maize Development Program (KMDP), Staple Food Crops Program, Kenya Dairy Sector Competiveness Program (KDSCP), Kenya Horticulture Competitiveness Program (KHCP), Kenya Access to Rural Finance (KARF), Drylands Livestock Development Program, and WFP pilot program Purchase for Progress (P4P).

And check this one out:
To further sound market-based policies for agriculture, the Mission value chain programs will undertake interventions to improve the institutional, policy and regulatory environment. They will continue to collaborate with USAID/EA programs such as COMPETE and the USAID/East Africa pastoral livestock and livelihoods activities, to promote policy initiatives and institutional structures that foster more and efficient marketing and trade of food crops and livestock. This includes harmonized commodity standards and inspection systems in the region.
This collaboration will be furthered through expansion of the Eastern Africa Grain Council's Grain Warehouse Receipts System and the strengthening of regional markets for livestock. The Mission will continue to engage with the Kenya Food Security Steering Group to improve early warning systems and build capacity to better integrate data and methodologies with the WFP G/EWS and FAO FAOSTAT systems.
This is getting long, so I'm going to end it here and continue in another post in the next day or so. Ultimately, I'd like to dig deeper into what each of these programs does and where each one is operating.
http://www.lavidalocavore.org/diary/4974/what-our-friends-at-usaid-are-up-to-in-kenya-part-1

MALNUTRITION: Revamp African ag policy to address hunger and poverty - experts

2011-12-01T10:02:00.000-05:00

02 Nov 2011 Katie Murray

A worker prunes tomato plants in the Dube AgriZone greenhouse situated at King Shaka International Airport, north of Durban, South Africa,

LONDON (AlertNet) – New approaches to agricultural productivity could help alleviate widespread poverty, malnutrition and hunger in many African countries, international development and agriculture experts said at a conference this week in Ethiopia focused on boosting agricultural output in Africa.
In 2003, African heads of state agreed to allocate 10 percent of their national budget to agriculture and rural development policy within five years. That target was not reached, but as a whole African countries have since managed to double their spending on agricultural and rural policy from an average of 3 percent to 6 percent of national spending, said Shenggen Fan, the director of the International Food Policy Research Institute, an organization that works to find sustainable solutions to ending poverty and hunger.
The problem is “that is not enough,” Fan said in a telephone interview.
Agricultural productivity in Africa is particularly imperiled by climate change impacts, including more extreme and unpredictable weather. Reducing climate-changing emissions and finding ways to adapt to changes already underway will be key, Fan said.
African countries suffer disproportionately more from climate change than most places in the world, in part because many farmers are poor and lack resources to prepare for climate impacts or respond to setbacks from problems like crop failure, experts say.
African countries are very prone to weather shocks, Fan said, and these will continually happen “more often, more frequently than before.”
Fan stressed the importance of finding new crop varieties that are resistant to drought and more resilient when weather shocks occur. He also said unconventional approaches, like organic farming, should be looked into as potential farming strategies for some parts of the continent.
“Increasing agricultural productivity is not the panacea to all problems, but it can make a significant positive contribution to resolve issues of food insecurity in Africa,” he said.
The conference, which brought together policy makers, academics, member of private companies and representatives from farmer and trader organizations, aimed to help create a broad new policy framework for improving agricultural productivity in Africa.
“Increasing agricultural productivity in Africa calls for broader policy and strategic frameworks that encompass the whole agricultural value chain,” said Josué Dioné, a food security and sustainable development expert from United Nation’s Economic Commission for Africa.
Agro-businesses, as well as small-scale farmers, need to be taken into account and included in the new agricultural policy for it to be effective, he said.
Fan believes the five most effective approaches for African governments can employ to boost agricultural productivity are to increase investment in agriculture, ensure Africans – rather than outsiders – make policy for the continent, focus on the small-scale farmer’s role in the agricultural chain, promote trade and access to markets and enhance agricultural technology and infrastructure.
According to Monty Jones, executive director of the Forum for Agricultural Research in Africa, “Strengthening extension services and infrastructure, and implementing policies that support agricultural productivity and increase rural incomes, will reduce hunger and poverty.”
http://www.trust.org/alertnet/news/revamp-african-ag-policy-to-address-hunger-and-poverty-experts/

MALNUTRITION: Australia: Gates grant helps work on childhood malnutrition

2011-12-01T09:44:00.000-05:00

8 November 2011

Shu Ning Bian (right) demonstrates his device.

If Shu Ning Bian's undergraduate engineering project comes to fruition, newborn babies in the developing world will stand a better chance of staving off malnutrition.
Shu Ning is part of a team, led by Dr Alistair McEwan from the School of Electrical and Information Engineering, to receive a US$100,000 grant from the Bill and Melinda Gates Foundation to further develop a non-invasive, solar-powered device measuring body fat in newborns.
Monitoring body composition helps detect newborn malnutrition, a key to reducing infant mortality worldwide. Non-invasive machines currently available are expensive, bulky and unsuitable for use in areas where there is an unreliable electricity supply and little technical expertise.
The Grand Challenges Explorations grant gives Dr McEwan, Professor Heather Jeffery from the School of Public Health and Shu Ning the resources to further test the efficacy of their prototype.
Shu Ning's work on the device came from his search for an Undergraduate Honours Thesis Project, a requirement of his degree. "This spoke to me because it makes the world a better place and involves hands-on work," he says.
Involved from the project's inception, Shu Ning helped write the grant application and was instrumental to building a prototype. Central to the device is an embedded computer running a small algorithm, developed by Shu Ning to measure body fat.
Utilising infrared technology and other off-the-shelf components, the device is solar-powered and the intention is to build a model costing less than five dollars per unit.
"It won't fix malnutrition by itself," says Shu Ning. "But it will allow more people to detect malnutrition early." This will allow for much earlier intervention and more efficient use of scarce healthcare resources in developing countries, he says.
Currently unnamed, the device is being tested for accuracy at Royal Prince Alfred Hospital. While results to date are encouraging, they are preliminary and more data needs to be collected to advance the project. Funding from the Grand Challenges Exploration grant allows the team to hire a research nurse to develop a more structured and robust patient testing program, delivering solid results to advance the program.
Like all grants from the Grand Challenges Exploration program, this one could potentially receive a follow-on grant of US$1 million from the foundation.
Dr McEwan oversees the University of Sydney's bioelectronics program, combining electrical engineering and biology to make inexpensive physiological monitors that reduce the strain on public health budgets.
http://sydney.edu.au/news/84.html?newsstoryid=8141

MALNUTRITION: Ethiopian child mortality, malnutrition rates drop

2011-12-01T09:36:00.000-05:00

Nov 11, 2011 : Aaron Maasho

ADDIS ABABA (Reuters) - Ethiopia has more than halved its child mortality rates since 1990 through campaigns to increase the number of health workers and clinics throughout the country, government and aid officials said on Friday.
The Horn of Africa nation has long suffered from one of the world's highest death rates of children due to recurring droughts. Twenty years ago the mortality rate for those aged under five was about 20 percent.
"Today, according to the 2011 Ethiopian Demographic and Health Survey, that figure has been slashed by more than half to 8.8 per cent," said Keseteberhan Admassu, Ethiopia's State Minister of Health.
"Reducing malnutrition, which is an underlying factor in at least half of all under-five deaths, has had a profound impact on the survival rates of children," he told a gathering of representatives of United Nations agencies.
Keseteberhan said the nation-wide malnutrition rate has been slashed by 32 percent, with prevalence to being underweight dropping to 28.7 percent in 2010 from 42.1 percent in 2000.
The U.N. Children's Fund (UNICEF) attributed the reductions to increased access to health posts in remote and drought-stricken areas, and a growing number of health workers.
The number of health posts has surged to more than 9,000 in 2011 from a handful in 2004 with priority shifted towards food-insecure areas, UNICEF said.
"The vigorous training of health extension workers who are on the frontline in the work to provide integrated health, nutrition, sanitation and hygiene services to rural communities ... has paid off," said Ted Chaiban, UNICEF's representative to Ethiopia.
Across the Horn of Africa, a fierce drought is forcing more than 13 million people to rely on emergency food aid this year, according to aid agencies.
Some 3.7 million Somalis are at risk of starvation in the worst drought in decades, including some 2 million in rebel-held regions that most major humanitarian agencies cannot reach.
Though 4.5 million of Ethiopia's 80 million people are affected, the United Nations says Addis Ababa is better equipped to tackle the drought's impact on the impoverished country.
http://af.reuters.com/article/topNews/idAFJOE7AA0BD20111111?sp=true

MALNUTRITION: Guatemala: Chronic Malnutrition Crosses Borders

2011-12-01T09:29:00.000-05:00

November/December 2011 : Wende S. DuFlon and Maxine Hillary

credit: Alfredo Calderón, USAID
A boy helps his father prepare the onion harvest for market in Sololá in the Western Highlands region of Guatemala.

credit: Wende DuFlon, USAID
A brother and sister by the family adobe oven in a rural highlands village in Quiché, Guatemala, where the USAID/Save the Children food security program is increasing income and improving nutrition. credit: Wende DuFlon, USAID
Felix Mayor, a Kaqchikel Maya leader of a Guatemalan farmers cooperative, holds freshly picked strawberries.

The soil is fertile and the people have been farming it for generations. The climate is right for several growing seasons of corn, wheat, beans, and myriad other crops. Why then does Guatemala have more chronically malnourished children than any other country in the Western Hemisphere, ranking sixth among nations globally for this human development indicator?
Food insecurity is not only a barrier to development in Guatemala—it has direct implications for neighbors in Central America and, ultimately, points north.
Guatemala’s crisis has been the subject of international press in the last couple of years—finally, the world is learning that one out of every two Guatemalan children younger than 5 years old is chronically malnourished. The national data mask an even worse situation among indigenous populations (mostly Maya people) where malnutrition stunts the growth of 65.9 percent of indigenous children ages 3 months to 59 months, compared with only 36.9 percent among non-indigenous children.
In Guatemala, leaders are just beginning to see how this situation holds everyone back, not just the malnourished and the poor who make up 51 percent of the population. Kevin Kelly, USAID/Guatemala mission director, explains: “Public awareness is growing that high levels of chronic malnutrition have far-reaching repercussions, including poverty and crippled economies that result in large numbers of disenfranchised youth migrating or engaging in criminal activities.”
How does this happen? Malnutrition stymies cognitive and physiological growth in the first 1,000 days of life—from a mother’s pregnancy through her child’s second year of life. This irreversible stunting dooms children to repetitive illness, inhibits them intellectually and physically, and ultimately reduces their productivity as adults by roughly a third. For society, this adds up to a dire scenario: Results from a recent UNICEF study show that chronic malnutrition costs Guatemala $8.4 million each day in reduced productivity, hospitalization, student failure, and repetition in the first three years of primary school.

Crisis Cross-Pollination
In an increasingly globalized world, one country’s crisis quickly penetrates the borders of another. “When large numbers of people in a society cannot meet their basic needs, the situation evolves to political instability, social conflict, and violence as Guatemala’s neighbors, trading partners, tourists, and citizens are discovering,” says Casey de Vides, USAID/Guatemala democracy and governance adviser. Since 2008, each year nearly 30,000 Guatemalans who have migrated north to look for work have been deported by the United States, according to Guatemalan Government migration statistics.
The country counts itself an important U.S. trading partner, with ties that stretch back to the early 1800s during the Jefferson era. Speaking before Congress last February, Mark Feierstein, USAID assistant administrator for the Bureau for Latin America and the Caribbean, highlighted the connection: “We help each other not only because it is the right thing to do and is an expression of our [American] values, but because our well-being is linked to that of people throughout this vast and diverse hemisphere.”
While undernutrition is widely recognized in other parts of the world, Guatemala’s crisis went relatively unnoticed until international media began to expose the direct connection between the sharp rise in chronic hunger and malnutrition, the world economic crisis, and global climate change. In the case of Guatemala, this means floods and droughts exacerbated by severe deforestation. The international coverage brought the high prevalence of undernutrition to the attention of Guatemala’s opinion leaders, development organizations, and informed citizens.
But to those most affected, chronic malnutrition is just part of life. Among the rural poor, who are mostly indigenous, mothers and fathers and community leaders will tell you: ’We’ve always eaten frijol and tortillas, and drunk coffee. Babies get sick and mothers die in childbirth—it has always been this way.’
“It’s also been elusive to Guatemalan economic and political leaders who are just beginning to understand how the ’other half’ of our nation—rural, indigenous, and marginal urban populations—lives, and that Mayans [Guatemala’s majority indigenous population] are not genetically short in stature,” reflects Dr. Baudilio López, USAID/Guatemala health officer.
For development leaders, chronic malnutrition is usually considered another ingredient in a statistic stew along with natural disasters, rapid population growth, a faltering economy, increased crime, maternal and infant mortality, urbanization, and poverty.
So how did chronic malnutrition come to be invisible? History holds part of the answer: Guatemala is a post-conflict society that emerged from a 36-year civil war in December 1996—a war that shredded the delicate fabric of an already divided society—and a recent democracy that adopted its current constitution in 1985.
It is the land of the ancient Maya who still wear traditional clothing and speak 22 indigenous languages. When the Spanish conquered the Maya 500 years ago, they retreated to the hills and mountains to avoid the injustices of colonization. In the highlands, they built communities with market and political systems that were insulated from central government and mainstream commerce and social life. They followed their ancestors’ slash-and-burn practices to cultivate beans and corn, and they became migrants working on non-native coffee, banana, and sugar plantations.
Basic services, such as electricity, water and sanitation, health and education, and new technologies like agricultural diversity and cultivation practices did not reach the isolated communities. The civil war further severed relations between the disenfranchised rural indigenous and the urban, largely Ladino (non-indigenous and officially recognized as a distinct ethnic group) landowners and government leaders.
Another part of the equation is that chronic malnutrition was never identified as a root cause of other development challenges.

Feeding for a Stable and Secure Future
The average citizen in the United States spends approximately 10 percent of family income on food while the poorest of the world spend over 50 percent. Improving nutrition in developing countries, and particularly during the critical 1,000-day window beginning with a woman’s pregnancy through her child’s second birthday, has long-lasting positive effects and can help break the cycle of poverty. Strong evidence demonstrates that providing better nutrition within that window could save millions of lives and increase a country’s gross domestic product by at least 2 to 3 percent annually.
Guatemala has 14 eco-regions with climate and soils that produce an abundance of food. However, the basic diet among the rural poor, who are mostly indigenous, is beans (frijol), corn in the form of tortillas or broths, and coffee with little use of fruits, vegetables, or sources of animal-based protein. This derives from a history and culture of subsistence farming using slash and burn techniques. Even communities that produce crops such as carrots, onions, strawberries, or squash prefer to sell the produce rather than consume it. They are often not aware that their produce is any more nutritious than that in their regular diet.

Food security
credit: Sonia Dominguez, USAID
A farmer from Sololá shows his snow peas fresh from the vine. Snow peas are a non-traditional export that Guatemala began producing with USAID agriculture value chain alliances.

Food security is composed of three elements: Food access is adequate resources to obtain appropriate foods for a nutritious diet, which depends on income available to the household, the distribution of income within the household, and the price of food. Food utilization is proper biological use of food, requiring a diet providing sufficient energy and essential nutrients, potable water, and adequate sanitation as well as household knowledge of food storage and processing, the basic principles of nutrition, and proper management of childcare and illness. Food availability is having sufficient quantities of food available from household production, other domestic output, commercial imports, or food assistance.
Unlike other countries where malnutrition is largely a problem of availability, the malnutrition situation in Guatemala stems from people, particularly women’s lack of access to the money needed to buy nourishing food, and the improper use of food. In the book, Finding the Ties that Bind: Beyond Headship and Household, the Population Council’s Judith Bruce and Cynthia Lloyd explain how in Guatemala, an additional $11.40 per month in a mother’s hands would achieve the same weight gain in a young child as an additional $166 earned by the father.

Growing Opportunity
There are significant opportunities to simultaneously increase the income and nutritional status of rural households and increase the efficiency of poverty-fighting municipal services.
One of the most promising opportunities is Guatemala’s leader status in non-traditional agriculture, horticulture, and coffee exports in Central America. For example, USAID programs have engaged thousands of small-scale coffee growers in the highlands to develop production and marketing skills and participate in a global market niche for high-quality, specialty coffees. Guatemalan coffee production creates 2 million jobs every year for rural families.
Recognizing the opportunities and challenges, in 2010, USAID realigned its resources to focus on reducing malnutrition as the root cause of poverty—which drives people to seek work in other countries or with the growing drug or human-trafficking trades.
The new presidential initiatives, Feed the Future and Global Health, are timely for Guatemala; they facilitated the design of a multi-year, multi-sector strategy for food security and nutrition in support of the Government of Guatemala’s inclusive country-led food security plan.
The USAID strategy focuses on the poor, food-insecure Western Highlands region. It is embraced by a wide-range of Guatemalan stakeholders including national government officials, municipal authorities, private sector leaders, rural poor community leaders and families, civil society organizations, and other international donors, who have not historically sat around the same planning table.
“The goal,” says David Delgado, senior food security adviser for USAID/Guatemala, “is to sustainably reduce poverty and chronic malnutrition in Guatemala by focusing on agriculture, local governance, and nutrition.”
Horticulture and coffee hold the strongest potential for small-scale farmers and cooperatives where lands are managed and worked collectively and the proceeds are shared. Linking health and nutrition education interventions, particularly with mothers and small children, with agriculture value chains, and incorporating the support of municipal leaders is vital for the sustainability of this ambitious development venture.

The Feed the Future Foundation
Based on USAID best practices, this is how it is expected to work: Feed the Future will strengthen municipal governments’ economic development plans to reduce poverty and chronic malnutrition, improve their capacity to deliver basic services, especially water and sanitation, and support community-based advocacy to ensure that food security is sustainable. USAID will continue support to NGOs that advocate for improved health and nutrition, and is working to ensure that local governments are accountable and responsive to the needs of vulnerable groups.
“Our experience shows that increased income for farmers and job creation for day laborers that comes from the production of high-value crops, complemented by better access to basic health services, nutrition education, potable water, and comprehensive hygiene, improves food security and offers rural families a ticket out of poverty,” says Julia María Asturias, USAID/Guatemala food security officer. Targeted environmental and climate change-mitigation activities will further reduce food insecurity.
The strategy aligns USAID resources and integrates programming with other U.S. Government agencies; leverages investments from other donors, the private sector, and the Government of Guatemala; and includes an active monitoring and evaluation component and a diplomatic strategy to advocate for policy changes that increase the likelihood of sustainable poverty reduction in Guatemala.
“In short,” continues David Delgado, “our strategy takes a wide angle-lens view of what causes chronic malnutrition and concentrates our joint efforts on one geographic area, always in partnership with Guatemalan Government and community leaders. It is strategic to build on synergies between the USAID Feed the Future and Global Health Initiatives so that we can offer the rural poor an integrated set of tested solutions. We will commence work with those people who are most affected and most likely to be change agents: women and small-scale farmers.
“We know that raising income to increase access to food and improving nutrition practices are the best ways to attack chronic malnutrition. To improve nutrition practice, behavior change in rural households is needed—from selection and cooking of nutritious foods to food allocation within the family and care giving. Because these are traditionally women’s responsibility, an active and more empowered role of women—wives, mothers, mothers-in-law, and grandmothers—is essential to reduce chronic malnutrition. Women must learn to increase essential vitamins and minerals in the family diet, they must practice immediate and exclusive breastfeeding of newborns and learn complementary feeding of young children as well as the prevention and early detection and treatment of childhood illnesses.”
The change in women’s role and behavior will be sustainable if it is supported by male community leaders and family members. Local governance is an effective way to engage men in behavior change around nutritional choices and the use of scarce financial resources for nutrition during the first 1,000 days during a woman’s pregnancy and her child’s second birthday.

An Uphill Climb
There is far to go before chronic nutrition stops stunting half of Guatemala’s future. But raising public awareness of the problem and making its profound and far-reaching effects visible comes at a strategic time for Guatemala and its neighbors, providing an opportunity for new partners to work in innovative ways toward mutual prosperity, security, and stability.
Felix Mayor, leader of the Utz-Ajticonelá association in Zaragoza, Chimaltenango, reflects on the changes that USAID/Mercy Corps-led agriculture value chains have brought his community: “When our land is healthy, then our people are healthy and can grow up strong like our crops to feed us so that we can work; then we thrive. When we thrive, our youth stay home….
“Now we have a high school so they can work and go to school and stay here with the family. When the technicians first came to offer to help us learn to diversify our crops our land was sick—our strawberries no longer grew as they used to and we suffered—we did not know what to do. The technicians taught us how to take care of our environment, plant new crops, and nourish the soil with rotating these new plants with our strawberries. We learned to recycle our plastic, to build latrines, and to fence in our collective plots.
“Our women now work in the new packing plants. Not only do they have incomes for the first time in our history, they learn hygiene and to use the crops we produce for family meals. We no longer have to sell to the coyotes on the side of the main roads. Now we sell with dignity to buyers who pay us a fair price that we learned how to negotiate. We earn more. So, like the land, with opportunities we can thrive and take better care of our children and our community.”
http://www.usaid.gov/press/frontlines/fl_nov11/FL_nov11_FOOD_GUATEMALA.html

MALNUTRITION: Ethiopia Recruits Health 'Army' to Combat Child Mortality, Malnutrition

2011-12-01T08:34:00.000-05:00

November 11, 2011: Peter Heinlein : Addis Ababa

Photo: VOA - P. Heinlein
Dr. Monica Thallinger treats a severely malnourished child at the Phase Two emergency ward of the Doctors Without Borders health clinic at Hilaweyn refugee camp, Dollo Ado, Ethiopia, (File).

Ethiopia is organizing what it calls a Health Development Army aimed at lowering child mortality rates and improving the quality of care in rural areas where 85 percent of the population lives. The announcement came at an event marking progress in reducing malnutrition, one of the Horn of Africa's biggest child killers.
The 2011 Ethiopian Demographic and Health Survey reports nearly nine percent of the country's children die before their fifth birthday. Minister of State for Health Dr. Keseteberhan Admassu says while that figure is high, it is less than half of what it was 20 years ago.
Speaking Friday at an event to celebrate the drop in child mortality and malnutrition rates, Dr. Keseteberhan said a key factor has been establishment of a network of rural "health extension" posts.
Only a few hundred of these posts existed when the last big drought hit in 2008. Today, there are more than 9,000. The result has been tens of thousands of young lives saved.
Dr. Keseteberhan says the next step will be a military-style mobilization scheme reaching down to the family level.
"The government is setting up what we call the Health Development Army, which is basically organizing the community into small groups and engaging them to further own the programs that are implemented through the Health Extension Program," said Kesteberhan.
The minister told VOA the government hopes to recruit “model families” for the health army, who can help bring about changes in the health habits of rural Ethiopia, where malnutrition and child mortality rates are high.
"We have a very good basis to identify these model families, who can be the leaders in their communities to bring behavioral change and disseminate information," Keseteberhan stated. "So the Health Development Army is basically a way of organizing people, disseminating information and bringing behavioral change across a community."
The 2011 health survey suggests the massive international effort to improve Ethiopia's health is paying off. The number of underweight children has decreased by more than 30 percent over the past decade. During that time, the number of youngsters whose growth was stunted due to malnutrition has dropped from nearly 60 percent to less than 45 percent.
Ted Chaiban, country director of the United Nations children's agency, or UNICEF, called it a "remarkable achievement."
"It is clear that the health system in Ethiopia has established a robust and resilient system that can withstand periodic and cyclical shocks and emergencies without resulting in escalated mortality rates and increased levels of malnutrition," he said.
Friday's event also marked a milestone in achieving full funding for the Ethiopian health initiative. The Canadian government announced a $50 million, five-year donation, narrowing what had been a $95 million funding gap for the $365 million program.
http://www.voanews.com/english/news/africa/Ethiopia-Recruits-Health-Army-to-Combat-Child-Mortality-Malnutrition-133693378.html

POVERTY: MADAGASCAR: Donors deliver despite sanctions

2011-12-01T08:26:00.000-05:00

ANTANANARIVO, 30 November 2011 (IRIN)
Photo: Guy Oliver/IRIN
Donors like UNICEF have stepped in to keep public health services running

After more than two years of political crisis, Madagascar finally appears to be moving towards the restoration of democracy. A new prime minister has been appointed, and elections are planned for 2012. Donors who suspended aid to the impoverished island nation are watching these developments closely.
"I think no one will be coming out of the woodwork unless they see that the Malagasy are serious about their transition," said USAID Country Director Rudolph Thomas, who underscored the need for free, fair and transparent elections.
After Andry Rajoelina's ousting of President Marc Ravalomanana was branded a coup in 2009, many foreign donors suspended all but emergency aid to the country. The European Union (EU) halted programmes and froze all development aid channelled through the government.
The United States followed suit by shelving the African Growth and Opportunities Act (AGOA), its preferential trade agreement with Madagascar, as well as plans to make the country the first beneficiary of its bilateral aid agency, the Millennium Challenge Corporation.
Many aid workers expected the sanctions to be as short-lived as the crisis. "At the beginning, we had to make a clear statement that we don't like coups," Thomas said. "If we did nothing, it would have seemed like an endorsement."
More than two years later, Rajoelina remains in power and the sanctions remain in force. The effects have been disastrous in a country dependent on foreign aid for 70 percent of its national budget. Work on infrastructure and environmental protection has come to a halt, suspension from AGOA has resulted in exports being cut by half, and at least 50,000 people, mainly textile factory workers, have lost their jobs.

Caution reigns
When the UN Special Rapporteur on the Right to Food, Olivier de Schutter, visited Madagascar in July 2011, he declared that "all food security indicators are in the red", with food insecurity affecting at least half the population. One of the highest levels of child malnutrition in the world made him urge the international community to reconsider the sanctions.
However, donors remain cautious. Some programmes have been allowed to run their course but few have been renewed. The Swiss Development Cooperation (SDC), for example, decided to cut Madagascar as one of its partner countries in 2010. Although some reduced programme funding will continue, its rural development programme, SAHA (Sahan'Asa Hampandrosoana ny eny Ambanivohitra), will end in 2012.
"In any programme there is a moment when the donor thinks it's been enough. Programme SAHA has basically reached its goal, although the development process... is not finished, of course. Follow-up and up-scaling work will now continue through a partnership of NGOs," said Nicolette Matthijsen of Helvetas Swiss Intercooperation, a Swiss NGO specializing in agricultural development and good governance, that implements SAHA.
Aid to the government remains suspended, but many NGOs report that they have increased their budgets in response to the worsening humanitarian situation in Madagascar. USAID's spending increased from US$57 million in 2008 to over $80 million in 2010. "We're doing more than before the crisis and have emerged as the biggest bilateral donor," Thomas said.

Independent fundraising
The Netherlands-based Inter-church Organization for Development (ICCO), which supports the national land reform programme, one of the projects expected to benefit from the US Millennium Challenge Corporation, has also expanded its programme.
"We do our own fundraising, so while we receive less money from the Dutch government, we managed to double our budget here in Madagascar," said the ICCO's Peter Egging.
He noted that the Millennium Challenge withdrawal had "taken the wind out of the sails" of the national land reform programme, sections of which had to be closed down, but that several organizations, including the ICCO, had increased their support and the land reform programme was now working in 30 municipalities.
As public expenditures on health and education nosedived during the crisis, aid organizations stepped in to keep social services functioning. When the budget for education dropped from $82 to a little over $14 million, for example, UNICEF jumped in with $37 million to pay teachers’ salaries and fund schools. The agency provided similar support to the public health sector after 214 health centres closed at the beginning of 2011, mostly due to lack of personnel.
“As a result of the crisis, development aid has been frozen and funding lost,” commented UNICEF Country Representative, Bruno Maes. "However, UNICEF succeeded in securing significant funding, in order to save, for example, primary school children from the negative impact of the crisis."
The sanctions mean aid organizations have had to walk a fine line when working with the authorities. "In general, the collaboration with ministries at technical level is accepted by donor organizations. On the other hand, an institution such as the EU isn't allowed to finance development projects in communes with a government-appointed PDS [Président de la Délégation Spéciale - regional leader], if the work dictates that the implementing organization has to work with him," said Egging.

Finding extra money
Some aid agencies have seen their budgets increase because of ongoing international programmes. At USAID, for example, budget increases are mainly linked to the President's Malaria Initiative, of which Madagascar is one of 15 participating countries in Africa. Similarly, the Humanitarian Aid department of the European Commission has provided funding through its international programme for disaster preparedness.
NGOs are also trying to tap into the private sector for extra funding or assistance. Telecommunication companies, for instance, provide free helplines to UNICEF, while cement factories have donated building materials. In return, UNICEF helps them develop child-friendly business practices.
"There are all kinds of ways to find extra money. We have a fund from a Swiss commune, which we use to aid a project for street children. If you have a good plan, you'll find money," said Matthijsen.
Some organizations have circumvented the sanctions by channelling their funding directly into projects. Maes said that UNICEF had managed to uphold basic education services during the crisis "by targeting the beneficiaries directly".
Although this approach is often successful, it may not be sustainable in the long term. "You need to work with the authorities, as you want your projects to upscale," Matthijsen said.
A SAHA programme to promote the cultivation of yams, a nutritious food regarded by Malagasy as being for the very poor, took off only after the national nutrition organization spread the word about the value of growing yams, and farmers start planting and eating them.
As Matthijsen pointed out, "A government can say: 'We want everyone to do this.' As a project, you can't do that."
http://www.irinnews.org/report.aspx?reportID=94351

MALARIA: Jhpiego and Johns Hopkins

2011-12-01T08:19:00.000-05:00

Malaria Resources Available Jhpiego provides technical assistance to test innovative concepts for malaria in pregnancy programs and apply proven practices to help countries scale-up life-saving services.
Malaria in Pregnancy Resource Package
The resource package contains a variety of tools designed to assist policymakers, public health professionals and health managers in implementing programs that will reduce the incidence of malaria in pregnancy and provide effective treatment for pregnant women with malaria.
Scaling Up Malaria in Pregnancy Programs: What It Takes!—The Jhpiego Experience
Read about our approach in this strategy paper:
Malaria Implementation Guide
This practical guide is intended to help African countries implement and scale up programs to prevent and treat malaria in pregnancy.

Malaria, an infectious disease transmitted by mosquitoes, is one of the most serious public health problems globally. Every year, there are 247 million cases of malaria worldwide and nearly 800,000 deaths; 90% of these cases occur in Africa.1
Pregnant women and their newborn children are particularly vulnerable to the disease. Eighty-five percent of all deaths from malaria are among children under five 2. In Africa, around 10,000 pregnant women and up to 200,000 infants die as a result of malaria infection during pregnancy.3
Yet malaria is 100% preventable and treatable.
Many countries have made significant strides in combatting malaria but none have reached the Roll Back Malaria (RBM) targets of covering 80% of affected populations with life-saving malaria prevention and treatment measures by 2010.

What Jhpiego Is Doing
Jhpiego stands as a committed partner of the RBM Partnership to fight malaria worldwide and achieve Millennium Development Goal 6—reduce malaria morbidity and mortality by half. For over a decade, Jhpiego has led and supported efforts to tackle malaria, working at global, regional and country levels. Jhpiego is a recognized leader in the prevention and control of malaria in pregnancy (MIP) and supports efforts worldwide to ensure that pregnant women and their unborn babies are safe from the harmful impact of malaria. Jhpiego’s approach has been to address malaria prevention and control comprehensively across the health “continuum of care,” from the community to health facility to national level on a maternal, neonatal and child health (MNCH) platform of care. Jhpiego also leads and supports efforts in multiple countries to ensure that young children and adults, in addition to pregnant women, are receiving prevention and treatment options for malaria.

Highlights from Jhpiego’s portfolio
Through participation in strategic partnerships, Jhpiego has extended its ability to make an impact on malaria globally.As a technical representative in the RBM MIP Working Group, Jhpiego has contributed to efforts that have reprioritized MIP as a core component of MNCH programming. Through participation in the RBM Harmonization Working Group, Jhpiego has contributed to raising awareness among stakeholders and disseminating best practices in malaria prevention and control.
Jhpiego works closely with the RBM regional African networks to support malaria prevention and control efforts in member countries. Jhpiego has supported program reviews in African 18 countries, focusing on malaria comprehensively and MIP, and is expanding reviews to malaria-affected countries in the Near East and Asia.

Jhpiego currently supports malaria programs in 14 countries, such as:

Burkina Faso: Through MCHIP, Jhpiego supports the National Malaria Control Program in upgrading health workers’ skills in malaria diagnosis, case management, promotion of insecticide-treated bed nets (ITNs), monitoring and evaluation, and MIP control through in-service training, improved supervision, communication messaging and pre-service education.

Ghana:Jhpiego is partnering with the private sector to improve malaria diagnostics, treatment and prevention messaging as well as to increase community engagement.

India: Jhpiego isconducting a malaria review of India’s successes in malaria prevention and control and existing challenges, including how these challenges are being addressed. It is expected that this review will inform ways to accelerate malaria prevention and control in India on an MNCH platform.

Mozambique: Through MCHIP, Jhpiego has supported the development and roll out of new malaria case management protocols as part an Integrated Services Packages for MNCH and sexual and reproductive health/family planning.

MALARIA: Vac-4-All and MRTC

2011-12-01T08:14:00.000-05:00

Vac-4-All and MRTC : Launch multi-centre Malaria Vaccine Efficacy Trial in Mali
Vac-4-All, a new vaccine development initiative, and the Malaria Research and Training Centre (MRTC), a public research and training facility of the University of Bamako in the Republic of Mali, have completed the immunizations of Malian children with MSP3, a malaria vaccine prototype which recently produced promising results in a small scale trial in Burkina Faso 1.
Malaria is one of the most prominent public health problem affecting children and pregnant women in developing countries, with nearly 2.5 Billion individuals exposed, a few hundred Millions infected, and close to 1 Million deaths per year.
The trial capitalizes on the knowledge of host-parasite immune interactions and the clinical expertise accumulated by the two groups. The partnership forged between the groups intends to develop affordable vaccines against malaria and this trial is the first of a series of trials being planned to investigate several novel malaria vaccine candidates.
800 children aged 12 – 42 months are enrolled in the multi-centre double-blind, randomised, controlled Phase IIb efficacy trial. It is designed to provide a clear-cut demonstration of the efficacy of the target antigen, MSP3, in preventing clinical malaria episodes, and the underlying immunological mechanism. With an average incidence of 3 malaria attacks per person per year in the study areas, 2,400 malaria episodes are expected in the study population each year. The children are distributed across 8 villages, which are located in 2 regions which differ by their exposure to malaria, one with seasonal transmission and the other with perennial transmission, both at very high level.
Cases will be actively followed-up over 2 years post-vaccination by a large Medical team, headed by M.Sissoko and I.Sagara, with staff stationed in dispensaries in each hamlet. Particular attention has been given to the conditions of community-based and individual informed consent and participation2, to the design and organisation of the trial, to the definition criteria for clinical malaria, and to the identification of surrogate markers of protection.
About Vac4All: Vac-4-All is a private venture dedicated to malaria vaccine development, created in 2010 by P. Druilhe, formerly Head of the Malaria Vaccine Development Laboratory at the Institut Pasteur in Paris. Its mission is address urgent public health needs by developing vaccines that can be produced in a straightforward manner and that will be affordable to the populations in under-developed countries that need it most. The Vac-4-All approach follows a rationale that capatilizes on the analysis of immunological interactions between P.falciparum (the microbe that causes Malaria) and human beings which has led to the identification of several vaccine candidate molecules, explore potential surrogate markers of protection identified by clinical investigations in humans, and uses state-of–the–art research tools to analyse results from clinical trials to rationally guide product development.
About MRTC: the Malaria Research and Training Center, at the University of Bamako, in the Republic of Mali, is one of the widest malaria research facilities on the African continent and one with long-standing experience in conducting malaria clinical trials. Headed by Professor Ogobara Doumbo, its mission is to train and promote promising Malian and African doctors and scientists to work on state-of-the-art human malaria research projects and to conduct GCP/ICH-standard clinical trials with promising prophylactic and therapeutic novel compounds which could contribute to solving the problem of malaria in Africa. It is a partnership initiative, created by the MoE and MoH of Mali with technical and funding support from diverse partners including the US NIAID/NIH, TDR/WHO, the Rockfeller Foundation, and different universities (France, Italy, USA). MRTC works in close collaboration with Mali’s National Malaria Control Program and other national public institutions and with a large number of research groups over the world. Its past contributions in this field have gained international recognition.

Further information-----------------------------------------------------------------------------------------------------------------------------------
Prof. Ogobara Doumbo, Malaria Research and Training Center (MRTC), University of Bamako, BP 1805, Point G, Bamako, Republic of Mali. Mail : okd@icermali.org Phone : +223-222-8109 Fax: +223-222-8109

POVERTY: PAPUA NEW GUINEA: Tackling maternal health "crisis"

2011-12-01T08:08:00.000-05:00

GOROKA, 30 November 2011 (IRIN)
Photo: Marianne Kearney/IRIN
Lisa Micheals, 27, is pictured with two of her five children she started having at age 16. She decided to have a tubal ligation after her most recent one

Decades of neglect, a failing health system and remote mountainous topography have created a "crisis in maternal health", according to a government taskforce in Papua New Guinea.
While progress has been made since the taskforce released its recommendations in 2009, some 250 women are still dying for every 100,000 live births, according to a 2008 inter-agency estimate.
Maternal mortality rates in PNG doubled from 1996-2006, states the government's most recent national health survey, which prompted the government-appointed taskforce to find ways to make pregnancy less deadly.
Inaccessible and ill-equipped health centres, early pregnancies, poor care and ineffective communication are among the reasons health and aid workers cite for the still-high level of maternal deaths.

Access
In PNG, the nearest health clinic might be hours by boat, foot, or in the luckiest of circumstances, local transport, from the village, says Miriam Lovai, former head of the national midwife association.
"On the Sepik River [the country's longest river] and other rivers they [women] are floated down on rafters consisting of tied banana trees or other logs," said Lovai.
At least four out of 10 people in parts of PNG cannot access healthcare due to distance or lack of roads, according to the taskforce.
Even when a woman can access trained medical care, there is still little understanding of when to seek care during childbirth, said Grace Kariwiga from the UN Children's Fund (UNICEF) office in the capital, Port Moresby. "The woman, the family or the husband, often delay seeking care, because they don't recognize the danger signals."
"Most give birth at home, because there is a lack of money, and [transport] infrastructure, so it is difficult for them to come in," said George Manapel from the national Department of Health in Goroka, the capital of East Highlands Province, one of 21 provinces.
Nationwide, 53 percent of women gave birth with a skilled birth attendant in 2006, but access to healthcare in some provinces is worse than others, noted the government taskforce.
To make it easier for pregnant women to seek care, it recommended transport subsidies.
It also suggested expanding local solutions such as a "red card" system in the remote Trobiand Islands of Milne Bay Province where women in labour can display a red card on the side of the road, which obliges any car to take her to the nearest health centre.

Child mortality
In a recent index of health workers' impact by the NGO Save the Children, PNG ranked in the bottom 20 of 161 surveyed countries.
Children in those countries, which all fall below the World Health Organization (WHO) minimum threshold of just over two health workers per 1,000 people, are five times more likely to die, noted the index.
PNG had one health worker (including doctors, midwives, nurses and community health workers) for every 1,000 residents in 2008, according to WHO.

Photo: Arthur Chapman
Mountainous terrain stands between health centres and women in some parts of the country

Even when health workers are available to serve a population growing at 2.7 percent annually, according to the most recent census in 2000, local health centres lack resources, said Lovai.
In one case Lovai tried to travel by boat to a woman five hours away who was bleeding excessively following a home birth. But the clinic did not have enough fuel, and by the time Lovai purchased some, the woman had died.

Health system
Decentralization of the health system in the 1980s, which put regional governments in charge of health budgets, has worsened access for women seeking maternal healthcare, noted the taskforce.
"The vast majority of women live in rural areas, but the rural health service is not there and is not functioning for various reasons," said Caroline Ninnes from local NGO Susu Mamas, which means Breastfeeding Mums in Pidgin, one of PNG's official languages.
"There is no support and no equipment... and supporting rural health services when access is by boat, foot, road, or even inaccessible is difficult."
Almost nine out of 10 people nationwide lived in rural areas at the time of the 2000 census, but the number of health staff in rural facilities declined by 25 percent between 1987 and 2000.

Communication
Ninnes said illiteracy made it difficult to educate women about the importance of giving birth with the assistance of a trained health worker - or waiting longer to have children.
With 800 different languages across PNG, outreach is not easy. "Languages even vary a lot between villages," said Ninnes.
Susu Mamas is calling on provincial health departments to recruit nurses from underserved communities who speak local languages in addition to the official national languages of Pidgin, Motu and English.
Almost 7 percent of women had given birth before the age of 20 in 2006, which can elevate the risk of pregnancy-related complications, according to the UN Population Fund (UNFPA).
After 27-year-old Lisa Micheals had given birth to her fifth child, she needed little persuasion to end her child-bearing days, which began at 16.
"I saw so many women die in the village, giving birth. So I got them [fallopian tubes] tied," she said.

Initiatives
The Health Ministry and regional health offices are trying to implement the taskforce's recommendations with support from Susu Mamas, as well as UNFPA, WHO and UNICEF, said Ninnes.
For example, the Health Ministry is trying to educate Papuans that husbands and communities should ensure safe pregnancies and deliveries.
Traditionally, pregnancy and birth have been considered a woman's domain in most of Papua's tribal societies where men and women live in separate houses. This has led to many men not understanding the dangers women face giving birth, said Lahui Geita, a government maternal health adviser.
"Pregnancy is everyone's business. It is not an issue that the mother should have to deal with alone," he said.
http://www.irinnews.org/report.aspx?reportid=94352

POVERTY: MALAWI: The rush to rationalize

2011-12-01T08:01:00.000-05:00

JOHANNESBURG, 1 December 2011 (PlusNews) -

Photo: Laura Lopez Gonzalez/IRIN
With less money available, smarter investments in effective HIV programmes are crucial (file photo)

As international HIV funding declines, nations are bracing for a future with less money and tougher choices. In countries like donor-dependent Malawi, a new UNAIDS tool is already beginning to shape how to rationalize their HIV responses to cope with the altered circumstances.
Malawi seems to have read the writing on the wall and is in the early phases of costing its HIV programming to see what it will take to make the national response sustainable.
It is also receiving UN agency support to evaluate national HIV programme in light of the investment framework recently released by UNAIDS, which is guiding the choices as national programmes bend to the pressures to rationalise expenditure.
The framework, published in a June 2011 edition of The Lancet medical journal, advocates that countries spend money on a basic set of six activities in HIV care and treatment, including prevention of mother-to-child transmission, medical male circumcision, and increasing access to antiretroviral (ARV) treatment.
Modelling suggests that, if implemented, the framework could avert about 12 million new HIV infections and almost 8 million AIDS-related deaths by 2020.
Dr Mary Shawa, Principle Secretary for HIV/AIDS in the Office of the Presidency, said Malawi will look to non-traditional donors like China to shore up HIV programming, and may also explore innovative financing measures. However, the UNAIDS Country Coordinator in Malawi, Patrick Brenny, says there's no denying the impact that reduced funding will have on HIV programmes.
"More countries are going through these formal exercises because the fat days are over, the funds aren't enough to go around or go as far," Brenny told IRIN/PlusNews. "In the past, when there was a lot of money to go around, you could afford to do all kinds of things. As resources become scarcer, we have to ask, 'What are the smartest investments?'"
With an 11 percent HIV prevalence rate, Malawi has already made painful choices in its programming. The country still relies heavily on the Global Fund, which provides as much as much as 70 percent of the HIV and TB response. Yet UNAIDS notes that in 2011 the government is funding only 1 percent of the HIV/AIDS response.
According to international humanitarian medical agency Médecins Sans Frontières (MSF), Malawi's Round 10 funding application to the Global Fund was denied largely because it was deemed too ambitious. The country had to forgo increasing HIV viral load monitoring, improving early infant HIV diagnosis, and scaling up medical male circumcision, MSF said in a recent statement.

Prevention priorities
The alleged refusal of funders to finance overly ambitious proposals may be a sign of the pressure being put on countries to rationalise HIV and development funding, against the backdrop of the global economic downturn, as Brenny pointed out.
This may also be embodied in what UNAIDS describes as a shift away from "needs-based" programming.
"Countries are also feeling the pinch of the global economic meltdown, and are pulling back and tightening their belts, and look at new areas for more investments - HIV is no exception," said Henry Damisoni of UNAIDS in Johannesburg, South Africa.
"Over the years, a lot of money [has been invested] but if we can't demonstrate meaningful results out of those investments, there is no justification for us to ask for more money," he said.
"Demonstrating a need for a particular programme is no longer sufficient. We're going to have to generate concrete evidence to demonstrate the sustainable gains we're going to make [from the money]."
In Malawi, where 305,000 HIV patients are on ARVs, investment will likely focus on prevention, said Robert Ngaiyaye, executive director of the Malawi Interfaith AIDS Association, who also sits on the national body responsible for coordinating Global Fund grants, known as the country coordinating mechanism.
About 70,000 Malawians are newly infected with HIV every year, according to UNAIDS.
"That's a huge future mortgage of people who will need treatment... for the rest of their lives," Brenny noted. "How do we ensure that... [the number of new infections] becomes less? Because if we're not doing that, then we are mortgaging the future."
Malawi may have difficulty in adopting the investment framework's focus on most-at-risk populations because same-sex relationships are still criminalised.
http://www.plusnews.org/report.aspx?reportID=94357

POVERTY: SOMALIA: Yemen returnee numbers soar

2011-12-01T07:55:00.000-05:00

HARGEISA, 1 December 2011 (IRIN)

Photo: UNHCR/J.Björgvinsson
Hundreds of families have returned from Yemen in the past two months, officials said (file photo)

Continuing unrest and xenophobia in Yemen have prompted an upsurge in the number of migrants and refugees returning to Somalia, with up to 6,000 reported to have travelled back across the Red Sea since the beginning of October.
"About 400 Somaliland families and 600 Somali families have returned to Somaliland in the last two months,” said Abdillahi Hussein Egeh, director-general of the Interior Ministry in Somaliland, which unilaterally declared its independence from the rest of Somalia in 1991.
“Somalilanders stay in this country, while the Somalis continue their journey to Somalia," he said.
Despite the unrest in there, thousands of Africans continue to make the perilous crossing, in the other direction, to Yemen, many of them fleeing not only conflict but a widespread food crisis in south-central Somalia.
"Most of those fleeing [Yemen] are afraid of being the target of the two sides, due to their concern that [both] have accused Somalis of supporting their rival," said Mohamed Ahmed, a father of three who arrived in Hargeisa, Somalia, in late October.
"I have been captured twice, once by the government forces and again by the opposition. Electricity, water and other basic services are erratic due to the crisis,” he said. The final straw that had pushed him to return to Somalia was the bombing of the university in Yemen, where he used to live.
“My wife and children are still in Yemen, because I was unable able to pay for their transport,” he said, explaining that boat fares have risen significantly.

Livestock trade affected
Somaliland used to export about 15,000 head of livestock every month to Yemen but now only exports a third of that figure, according to local businessmen.
"This is because the livestock can't reach the remote places of Yemen," said Abdi Said, a livestock exporter in Somaliland.
"Our income has decreased. For example, one person used to send 500 head of cattle per month,” he said. “This has gone down to 100 per month.”
http://www.irinnews.org/report.aspx?reportID=94358