POVERTY: Nigeria: the reality of medical practice!

I have been practicing in rural Ibarapa district since 1983. Although I am surgeon, we offer preventive services as well in form of immunization for adults and infants and regular health education talks.

In the past two decades, the day at the outpatient clinic starts with a health talk on water-borne diseases among other common diseases like malaria, hypertension, diabetes mellitus, HIV/AIDS and tuberculosis.1 Our usual health talk goes like this:
“Greetings.
“Typhoid fever, cholera, infective hepatitis, gastroenteritis and guinea worm are the common diseases in this environment that are acquired through the drinking of unwholesome water. The water we drink from all sources, except rain water that is harvested, is easily contaminated by faeces deposited in open spaces (which is the usual practice) and washed into these sources by the falling rain.
“Even pipe-borne water is not safe because most pipes are rusty and have burst. So, when Water Corporation is not pumping water, the contaminated pool of water at the leakage points will flow back into the pipes and will be pumped into households when the corporation resumes activity. It is not economical to drink sachet or bottled water routinely. It is meant for social events.
“To make the water from these sources potable, we advise you warm the amount you would need the next day in the evening so that it is cool by the following morning. You need not heat to boiling as all germs that cause these diseases will die as soon as the water is warm to touch.
“Please practice this piece of advice and pass it on to your relations and neighbours as prevention is not only better but cheaper than cure.”
A medical student and I reviewed of mortality at ACE from 1987 to 2001 analyzed at five year intervals, we found that the incidences of typhoid fever, gastroenteritis, infective hepatitis and cholera as causes of mortality dropped by over 80 per cent.2 There has been no cholera outbreak in rural Ibarapa district for over 15 years now even with no improvement in the municipal water supply.
So, while Nigerians are waiting for potable pipe-borne water, warming drinking water before use is a pragmatic option to prevent water-borne diseases.

REFERENCE
Awojobi O A Letter: Pragmatic option for preventing water-borne diseases in Nigeria. Afr Health 2011; 33: 12.

2. Awojobi O A and Olaleye O A Causes and trend of mortality in Ibarapa. Dokita 2003; 29: 53 - 56.

POVERTY: NIGERIA: Never so divided, never so united

LAGOS, 3 February 2012 (IRIN)

 Photo: Ruth McDowall/IRIN
Thousands of city residents nationwide demonstrated, mostly in orderly protest, against a government announcement lifting the subsidy on petrol

A month after an angry public launched protests across Nigeria over skyrocketing fuel prices due to the removal of a government subsidy, a measure of calm has returned and people seem to have settled into accepting a compromise.
The removal of the subsidy on 1 January raised petrol prices from 65 naira to 141 naira (40 to 90 US cents) per litre, and led to sharp increases in food and transport costs.
The public response was swift and widespread. Led by labour unions, professional groups and civil society, different communities across this nation of 167 million people marched through the streets, paralysing businesses and even threatening to shut down the oil industry. A stunned government backed down, settling for a 50 percent rather than a more than 100 percent hike in the fuel price.
"Nigeria has never been this divided since the civil war, and yet the country has never been this united in protest in its history," said Hussaini Abdu, a public policy analyst and director of ActionAid Nigeria.
Many people see cheap fuel as one of the few benefits they get from an otherwise inefficient and corrupt government. The protesters were putting down a marker, say analysts. “Nigerians think that by paying more for fuel, they are only subsidizing corruption,” said Abdu.
The government’s position is that removal of the subsidy would save US$8 billion a year which could then be spent on roads and social projects, and improve citizens’ lives. It says the subsidy only benefits middlemen, not the public, and supporters say the fuel subsidy favours the rich and encourages fuel smuggling to neighbouring countries.
The government believes Nigerians will gain from deregulation of the downstream petroleum sector, and points to the planned or ongoing construction, completion and rehabilitation of railway lines, refineries, highways, hydro-electric stations, information technology and water supply systems.

SURE
These projects, which will benefit the public, are to be executed under a Subsidy Reinvestment and Empowerment Programme (SURE), which also funds short-term social welfare programmes to cushion the impact of the subsidy removal.
The degree to which the public will be convinced is debatable. Analysts say that apart from corruption, people showed unity in the protests out of bitterness at government policies which have left them poor: The minimum monthly wage increased in 2011 from the equivalent of US$46 to $112, but most Nigerians are paid less than this new wage level.
The Centre for the Study of the Economies of Africa (CSEA) says inflation caused by the fuel price rise could lead to poor people spending an even higher proportion of their income on food because they would be paying more for transport. (CSEA says food has the highest weight of 51 percent in Nigerian’s inflation basket; transport has the third highest weight of 7 percent.)
CSEA also says a neutral stance by the Monetary Policy Committee, which sets monetary and credit policy, would help government’s efforts to boost the economy through its SURE programme and its emphasis on job creation. “In the medium term… prices may moderate as efforts are channelled towards addressing the infrastructure deficit in the economy through the SURE programme,” it adds.
The government may have to demonstrate, rather quickly, that it is different from previous ones; that it is accountable; and is attuned to current public sentiment. Otherwise, the show of united public anger against the central government may spill onto the streets again.
Safety consultant Jeff ‘vwede Obahor said the subsidy removal had brought Nigerians to a tipping point, and all they wanted now was good governance. "It's like a champagne effect; too many things have been going down and this is the last straw."
http://www.irinnews.org/report.aspx?reportID=94787

MALARIA: Anti-malarial treatment available to millions of poor Nigerians at a fraction of its normal cost

 January 31, 2012   2 Millions of poor Nigerians will gain access to the most effective combination treatment for malaria at a fraction of its current cost, following the successful conclusion of negotiations between the United Kingdom Department for International Development (DFID) funded Partnership for Transforming Health Systems (PATHS2) and a variety of international and national stakeholders in Nigeria this week.
PATHS2, in collaboration with the Clinton Health Access Initiative (CHAI), will provide life-saving anti-malaria treatments to health facilities based largely in rural communities in the five Nigerian states of Lagos, Kaduna, Jigawa, Enugu and Kano, the latter state recently driven by terrorist bomb attacks.
A course of treatment will be provided for as little as 60 Naira (approximately 25 pence in Sterling), in comparison to previous costs of nearly 20 times as much, making the drugs affordable to even the poorest Nigerians, many of whom still subsist on less than US$1 a day.
The Affordable Medicines Facility for malaria (AMFm) is an innovative financing mechanism to expand access to affordable ACTs—Artemisinin-based Combination Therapies. ACTs are the medicines recommended by the World Health Organisation (WHO) as the most effective malaria treatment.
The AMFm is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), with key financial support provided by UNITAID, DFID and the Bill & Melinda Gates Foundation, and with technical support provided by the Clinton Health Access Initiative (CHAI).
International manufacturers of ACTs receive a subsidy directly through the AMFm initiative almost to the tune of 95% which in turn is passed on by Nigerian pharmaceutical manufacturers, the First Line Buyers of ACTs. Acting as second line buyers, PATHS2 will distribute ACTs through primary health centres in the five Nigerian states in which it currently works, which have a total population of approximately 37 million, representing around 22% of the population of Nigeria as a whole.
Artemisinin-based Combination Therapies were introduced in Nigeria in 2005 for the treatment of uncomplicated malaria due to the increased resistance to chloroquine and sulphadoxine-pyrimethamine – also known as mono-therapies - which were older malaria medicines grown less effective due to the development of resistant strains .
PATHS2 has supported the significant reduction in prices of ACTs by bringing First Line Buyers and PATHS2 states together to discuss their requirement and support the signing of annual contracts between the states and First Line Buyers. The First Line Buyers are pharmaceutical companies in Nigeria who buy directly from WHO certified manufacturers outside the country. In Nigeria, there is currently no domestic manufacturer of AMFm drugs.
The First Line Buyer supported under AMFm will sell Artemisinin/ Lumefantrin (Pack of 24) for just 50 Naira to PATHS2 States health facilities and patients will get it for about 60 Naira, compared to its previous cost, which was as much as 2,000 Naira (£8-00). This pricing makes it the cheapest price available anywhere in the country.
It is estimated that 70% of all disease incidence in Nigeria is related to malaria. The World Malaria Report of 2008 recorded 57,506,430 cases of malaria across Nigeria, causing 225,424 fatalities.
http://www.news-medical.net/news/20120131/Anti-malarial-treatment-available-to-millions-of-poor-Nigerians-at-a-fraction-of-its-normal-cost.aspx

MALNUTRITION: Nigeria: Saving a child could be down to a couple of nutrients

Anna Angbazo : July 10, 2011



Poor diets retard children’s growth and their development, including their cognitive development. Photo: REUTERS

Although the federal government has expressed its commitment to meeting the Millennium Development Goals, especially as relates to health, some experts say investment in quick gains projects such as improved nutrition would be cheap but eventually productive for the nation.
In 2000, for instance, the World Health Organisation (WHO) ranked Nigeria’s health system 187th out of its 191 member states, particularly due to problems such as hunger and malnutrition, which have become increasingly severe over the years.
Jane Miller, the country representative of UK’s Department for International Development (DFID), explains the rationale behind Nigeria’s poor ranking rather succinctly.
“Malnutrition, malaria and communicable diseases such as measles, diarrhoea and pneumonia significantly contribute to maternal and child mortality and morbidity,” Miller says, adding that “one million Nigerian children under the age of five die each year.”
Malnutrition has been a serious concern to the WHO, which insists that it is by far the major factor behind child mortality, with underweight births and inter-uterine growth restrictions causing 2.2 million child deaths every year.
The global health agency says mothers’ neglect of infants’ breast-feeding also causes about 1.4 million deaths, while describing malnutrition as the most serious single threat to public health across the world.
Linus Awute, the permanent secretary of the Federal Ministry of Health, concedes that Nigeria is one of the countries that are mostly affected by deaths of children under the age of five years due to factors such as malnutrition.
He stresses that over two-thirds of malnutrition-related deaths of children usually occur within the first year of their existence, adding that the children’s undernourishment is associated with inappropriate feeding practices.
“Appropriate feeding of infants and young children remains a key factor in promoting health and child survival. However, many mothers have yet to imbibe the required child-feeding attitudes and practices, in spite of many public sensitisation campaigns,” he says.
Going from the general to the specifics, the WHO says malnutrition is also responsible for about 14 percent of infants born with low birth weights in Nigeria and more than 75 percent of children, under the age of five, who are anaemic.
Mr Awute, on his part, stresses that babies who undergo exclusive breast-feeding do well in their first six months of life, adding, however, that such babies subsequently need adequate and appropriate complementary feeding for them not to become malnourished.
He also said malnutrition usually crops up because of deficiencies of macro- and micro-nutrients in the babies’ food, adding that these deficiencies induce ”protein-energy malnutrition, iron-deficiency anaemia, iodine-deficiency disorders and Vitamin A-deficiency.”
Lawan Tahir, a paediatrician, also called on new parents to ensure that infants are given healthy, balanced diets after stopping their breast-feeding.
“To reduce child mortality, mothers should feed their children with balanced diets after they have been weaned,” he says.

Killer of young ones
Mr Tahir, a senior registrar at the National Hospital, Abuja, who said two out of every three child deaths are related to malnutrition, adding that a malnourished child is prone to numerous diseases because of the child’s poor immune system which cannot resist infections.
After breast-feeding, the next thing most mothers do is introducing the babies to cereals, as the infants feed on mainly carbohydrate diets.
“Nevertheless, what the child needs at that point is actually not carbohydrates alone but proteins, fats and oils, as well as micro-nutrients to enable him or her to have a balanced nutrition,” he said. “Unfortunately, most children are not given well-balanced diets, probably due to their parents’ poverty or ignorance.”
Mr Tahir adds that poor diets retard children’s growth and their development, including their cognitive development. The paediatrician explains that malnutrition is a health condition which signifies poor nutrition, as well as an imbalance between the intake of nutrients and what the body actually requires.
Experts say rising cases of malnutrition in Nigeria can be attributed to the lack of food security in the country, poor feeding habits, waning exclusive breast-feeding of newborn babies and poor quality complementary feeding of infants after the age of six months.
Another paediatrician, Azeez Ibrahim says micro-nutrients deficiency is a direct cause of child mortality.
“Micro-nutrients such as iron, iodine, and Vitamin A are necessary for the healthy development of children, while their absence in diets can cause serious disorders,” he said He, however, said malnutrition is not a health problem of children alone, adding that “many adolescents are also having malnutrition problems and these affect their learning processes and productivity.”
Mr Ibrahim, nonetheless, insists that some cases of malnutrition in adolescents are due to increased intake of carbonated drinks (soft drinks), as such drinks only provide “empty calories” that are insufficient to meet the body’s requirements for proper growth.
“Malnutrition in a female adolescent is worse because as the young ladies prepare for marriage, they need a balanced diet for them to attain their potential as women,” he says.

All together on safety
As part of efforts to foster improved nutrition in Nigeria, the Global Alliance for Improved Nutrition (GAIN) is working with the federal government via the National Fortification Alliance (NFA). The NFA comprises government regulatory agencies such as National Agency for Food, Drug Administration and Control (NAFDAC) and the Standards Organisation of Nigeria (SON).
Hauwa Keri, NAFDAC’s director of Establishment Inspection, says the aim of the government policy on fortified foods is to get more nutritious staple foods like wheat and maize flour, vegetable oil and sugar into the markets and homes of vulnerable families whose diets lack the essential micro-nutrients.
“The goal of the effort, which began in March 2007, is to change the lives of the citizens by giving them a chance to eat more balanced diets every day,” she says.
Ms Keri stresses that the Federal Government has been leading a national campaign to add essential micro-nutrients to food products such as wheat and maize flour, refined sugar and vegetable oils since 2002.
Besides, Ms Keri said, a pilot programme is underway to fortify table salt with iron so as to provide the needed micronutrients for the people, adding that table salt is already being fortified with iodine.
“The project is at a pilot stage in three zones and it aims at ascertaining whether fortifying salt with iodine and iron will be acceptable,” she says. “It is also at a research and study stage; the outcome of the investigations will determine whether to adopt the iron fortification scheme or not.”
Larry Umunah, the country representative of GAIN, says Nigeria has been identified as one of the countries that are determined to tackle the menace of malnutrition frontally.
He, however, stresses the need to ensure that mothers and children have proper nutrients so as to curb the rising menace of maternal and child mortality in the country.
Umunah said if Nigeria is able to effectively tackle the issue of malnutrition among mothers and children, the country will definitely be in a better position to achieve the health targets of the UN Millennium Development Goals (MDGs).
“Ensuring that mothers and children have proper nutrients is of paramount importance. If Nigerian mothers and children are able to have improved nutrients, the country will move toward achieving the MDGs,” he said.
Dr Orhii, the director general of NAFDAC, however, stresses the need for regulatory agencies to enforce the full compliance of food industries with the extant regulation regarding the fortification of their products.
Mr Orhii bemoans the inability of the vast majority of the rural people to have access to fortified foods, adding that the prevalence of ”hidden hunger” among the rural populace has been a source of public health concern.
The NAFDAC director says that fortified foods contain all the essential vitamins that prevent diseases, adding that lack of iodine in salt, for instance, can make a child dull.
“Iodine deficiency can also interfere with the reproductive system of girls in future,” he said. “We insist on the fortification of foods with essential vitamins to prevent diseases which usually affect vulnerable groups like pregnant women and children below the age of five.”
http://234next.com/csp/cms/sites/Next/Home/5728780-146/saving_a_child_could_be_down.csp

TUBERCULOSIS: Alternative Methods for Diagnosing TB

7/13 BIRMINGHAM, Ala. (Ivanhoe Newswire) –



(AP Photo)

Two new methods to diagnosing tuberculosis, an endemic infectious disease, can be used in poor countries.
One study suggests that less sputum tests collected the same day of consultation are needed and the other suggests that a faster laboratory test can be used while maintaining the same level of accuracy for diagnosis. Both studies show that alternative, less labor-intensive tests that are more convenient for patients could be effectively used in poorer countries.
The researchers enrolled 6627 patients in Ethiopia, Nepal, Nigeria and Yemen who had had a cough for more than two weeks (a characteristic symptom of tuberculosis).
In the main trial the centers participating in the study were randomly assigned each week for a year to use different methods of sputum collection. The results suggest that a sputum collection scheme in which two samples are collected one hour apart followed by a morning specimen could identify as many smear-positive patients as the standard "spot-morning-spot" scheme in which patients provide an on-the-spot specimen during their initial consultation, a specimen collected at home the next morning, and another on-the-spot specimen when they bring their morning specimen to the clinic. The study also confirmed that examination of the first two specimens alone identifies most smear-positive patients, independently of which scheme is used.
"The identification of the majority of smear-positive patients may require no more than one patient visit, and the scheme presented here has the potential to improve the diagnosis of pulmonary tuberculosis in Low and Middle-Income Countries. A single-visit diagnosis would represent a substantial opportunity to improve the delivery of TB services, particularly to the poor," the authors were quoted as saying.
In the second study, which is a sub-study of the main trial, the researchers examined nearly 2,400 patients to show that a faster laboratory test, a variant form of smear microscopy—light emitting-diode fluorescence microscopy (LED-FM)— could identify more people with tuberculosis than the standard smear microscopy test (in which technicians use a stain called Ziehl Neelsen from a patient's sputum). However LED-FM might also lead to more people without tuberculosis being needlessly treated, as this test picks up more false positives, that is, people who don't have TB but who are incorrectly classified as test-positive for the disease.
"This study has shown that LED-FM can play a key role in reaching the [World Health Organization] targets for TB detection, reducing laboratory workloads, and ensuring poor patients' access to TB diagnosis and prompt treatment," the authors said.

SOURCE: PLoS, published online July 12, 2011
http://www.cbs42.com/content/health/story/Alternative-Methods-for-Diagnosing-TB/_HsVL1rQjEGr8Fuk289xrg.cspx

GLOBAL FUND: Nigeria: grants frozen

A major foreign financier of AIDS, Tuberculosis and Malaria activities in Nigeria, The Global Fund has temporarily frozen grants to one of its principal recipients in the country, Yakubu Gowon Centre for alleged misappropriation of funds, Daily Trust reports
In a report filed before the Independent Corrupt Practices and other Related Offences Commission by the Global Fund, the Yakubu Gowon Centre is alleged to have illegally transferred funds outside the country amounting to $15.5million, incurred extra budgetary expenditures of $5.2million and has undocumented fund amounting to $3million.The centre which was established to honour former Head of State General Yakubu Gowon has been in existence since 1992, embarking on programmes to reduce poverty and fight diseases....

http://allafrica.com/stories/201106300692.html

POVERTY: SENEGAL: Poorly-trained midwives pose danger

DAKAR, 30 June 2011 (IRIN)

 Photo: Tiggy Ridley/IRIN
Midwives need better training on how to cope when things go wrong (file photo)

 Poorly-regulated, privately-run training schools in Senegal are churning out midwives who do not have a solid grasp of birthing or ante- and post-natal care, causing women and babies to die needlessly, according to the UN Population Fund (UNFPA).
Other basic competencies, as defined by the World Health Organization, include referral in high-risk pregnancies or births; addressing miscarriages; and family planning.
Most women who die during labour in Senegal do so because of post-partum haemorrhaging, according to UNFPA’s joint Senegal director, Edwige Adekambi.
“We know the causes of maternal mortality; we know that if a haemorrhaging woman does not get care within two hours she is likely to die, but many private training schools don’t even include this care in their curriculum,” she told IRIN.
Some 401 women died per 100,000 live births in Senegal, according to the latest government health survey in 2005, ranking 144 out of 181 countries studied; and only 52 percent of births in 2005 were accompanied by a qualified birth attendant, though for the poorest 20 percent of women this drops to 20 percent. While performing better on maternal mortality than most of its West African neighbours, Senegal still has a lot of work to do to reach the Millennium Development Goal on maternal mortality, according to UNFPA.
These and other issues were discussed at the Senegal launch of UNFPA’s State of the World’s Midwives report on 29 June.

Unregulated
Senegal has dozens of private midwife training schools which are in theory, regulated, but with just two government inspectors to do this, many get away with low standards, said Adekambi.
Bigoué Ba, vice-president of the National Association of Midwives, told IRIN “Anyone can open a school in Senegal. There’s no monitoring.”
While there is a national test that all midwives must pass to be recruited into a public hospital or clinic - and generally those who pass have been trained in public institutions, according to UNFPA - many who fail the exam can still obtain a diploma and find a job in a private clinic, said Adekambi.
The government has tried to improve regulation of schools, but cannot be expected to do it all, Health Minister Modou Diagne Fada told journalists at the report launch. “We are committed to improving maternal mortality rates and addressing the midwife problem, but partners have to help with this too,” he said.
UNFPA is working with the government, the National Association of Midwives, and aid groups to improve the national curriculum; it calls on the government to impose stricter regulation across the sector.
The current curriculum, while thorough, excludes vital aspects of birthing support, including how to administer antibiotics, to give oxytocin to stimulate uterine contractions; and using ventouse (a vacuum device) during birth to ease delivery. UNFPA teaches these techniques in “post-training” for midwives in several regions including Kolda and Tambacounda in central Senegal.

Rural shortage
As well as better training, more midwives are needed across the country: Senegal has just two midwives per 1,000 population, which is one-third of the recommended international norm, according to WHO.
Density of midwives, nurses and doctors per 1,000 population : Mali 0.3; Niger 0.2; Nigeria 2.0;
Liberia 0.3; Senegal 0.5; Sierra Leone 0.2

Shortages are particularly acute in rural areas: Matam, on the eastern border, has just 14 state-trained midwives and requires 389; Tambacounda has 38 (only one of whom is trained in family planning) and requires 515; while Dakar has 445 but requires a further 1,566, according to 2008 statistics from the Ministry of Health and Prevention’s human resource unit.
There is no gynaecologist or obstetrician at all in Kolda, so for complicated births women have to travel to Tambacounda, which takes more than the precious two-hour window, if something goes wrong.
To reach Millennium Development Goals four and five to improve child and women’s mortality and health, Senegal needs to recruit 250 additional midwives per year, according to UNFPA.

Recruitment drive
In 2010 the government did a countrywide recruitment push, hiring hundreds of additional midwives to work in rural areas.
While partially successful, half of all midwives recruited to rural areas “found a reason why they had to return to Dakar within the year,” said Health Minister Fada.
He puts the onus on them to stay. “It is their duty if they accepted this profession, to work where the needs are,” he told journalists at the report launch in Dakar, and he also called on the Midwives’ Association to encourage midwives to stay.
But the government also needs to think of more creative ways to encourage midwives to work in rural areas, said Ba of the National Midwives Association. Incentives have been discussed but few yet put into practice. These include providing midwives with lodging, a vehicle, health insurance for their families, or career development training.
The Health Ministry should also consider training up the hundreds of traditional birthing attendants, known as “matrones”, who work in villages throughout the country, said Ba.
More also needs to be done to make midwifery an “attractive” career, according to Ba. Midwives are paid on average US$200-300 per month at first but, given that there is very little career development, this could rise by just $100 over two decades of work. Career development training would also incentivize women to commit over the long term, she said.
All recognized the progress the Health Ministry has made since 2010: trying to regulate training more carefully; requiring the minimum of a baccalaureate certificate to enter midwife training; and delegating more medical tasks to midwives.
Most significantly, the government made all births, including Caesarean sections, free of charge in all regions of the country, except Dakar.
Further improvements will cost more than recent additions to the health budget will allow, said Fada. New income sources for the health sector, such as additional taxes on cigarettes and other goods, are being considered.
http://www.irinnews.org/report.aspx?reportID=93111

POVERTY: Community Transportation System to Save Maternal Lives

Bill Brieger : 27 Jun 2011

Guest contribution from: Ahmed Mohammed Ahmed, Community Mobilization Specialist, Targeted States High Impact Project (TSHIP), Bauchi State, Nigeria

TSHIP aims to improve maternal and child health in Nigeria by strengthening health services and enhancing community participation. An example of the latter follows.

Five Ward Development Committees [WDCs] in Pali and Kungibar Districts of Alkaleri Local Government Area in Bauchi State have initiated a community approach to emergency transportation for pregnant women and children. This is at the background to recent 2OO8 NDHS survey which showed high rates of maternal and child mortalities in the North-East part of Nigeria.



The initiative which saw a strong commitment on the parts of different community and ward structures like the National Union of Road Transport Workers [NURTW], Okada Riders Association (motorcycle taxi drivers), Health Providers, Traditional and Religious leaders, was witnessed by other stakeholders such as Alkaleri LGA whose Chairman was represented at the occasion by the Director PHC.

The event was marked with a short drama presentation highlighting the objective of the Emergency Transport Team [ETT], which is to provide free transport service to pregnant women and children under 5 from all the communities within the five wards. Mobile phone numbers of the executive committee members and that of other drivers and motorcycle drivers in the scheme were provided at the inauguration for ease of contact. (see transportation committee members at left)

In his brief speech at the occasion, the visiting Chairman of Bara WDC in Kirfi, Malam Haruna Katukan Bara, says ‘I am here to learn about this unique experience and also help my ward in replicating it.’ He also urge community members to support the good works of the WDCs towards the development of humanity.

Finally, one of the community’s traditional birth attendants (right) thanked the committee for taking action to save the lives of pregnant women in the wards.

http://www.malariafreefuture.org/blog/?p=1228

MALNUTRITION: Rice is king, but at a price

LONDON, 2 June 2011 (IRIN)
 Photo: Kate Holt/IRIN
Nigerian rice farmers have tripled their yields, but can’t compete with Asian producers

Most of us, when we worry about food prices, think short term - the price today compared with yesterday; the chance that the price will have gone up again tomorrow. But Oxfam this week risked some long term predictions, and came up with alarming results. They foresaw the steepest rise of all in the price of rice, with rice in China, for instance, becoming 80 percent more expensive by 2020, and 180 percent dearer by 2030.
The price of rice is obviously of huge concern in China, India and the rest of Asia, where it has always been the basis of the diet - just as the Middle East has traditionally depended on bread, Italy on pasta, northern Europe on potatoes and Africa on maize, cassava and root crops like yams.
But tastes in food are changing, driven by urban lifestyles and global communications. Consumers, no longer limited to what they can grow in their own area, look for foods which are easy to prepare and eat. The losers have been staples which need lengthy preparation - soaking, peeling and pounding. The winners have been pasta, noodles, and above all, rice, making the price of rice a matter of pressing concern far beyond the traditional rice-eating countries.
Nigeria has a rich tradition of foods based on local crops, amala (yam skin porridge) and eba (made from cassava), ogi (fermented cereal) and pounded yam. Rice used to be a party food, noodles practically unheard of. Now rice and noodle dishes are the staple of roadside food stalls, and every night in TV advertisements, smiling housewives feed their perfect families on instant noodles and jollof rice.
Forty years ago Nigerians ate an average of three kilograms of rice a year; now it is 35kg and rising. Nigeria is one of the world’s biggest rice importers, lying third (behind the Philippines and Iran) in 2008, the last year for which International Rice Research Institute figures are available.
Forty years ago Nigerians ate an average of three kilograms of rice a year; now it is 35kg and rising
It should add up to big profits for the international rice traders, and it does, but they are acutely aware of the vulnerability of the system. A senior executive from one of the world’s biggest global dealers in agricultural produce said this week he was really concerned about threats to, and the sustainability of the supply chain.
“Look at Africa,” Chris Brett, senior vice-president and global supply chain manager for Olam International, told an audience at the UK’s Institute of Development Studies. “It’s absolutely amazing how much food is imported. We know that the food security agenda is very important.”

Vulnerable to price fluctuations
Of all the world’s food commodities, rice is perhaps the must vulnerable to sudden shocks. The world may produce a huge amount of the grain, but nearly all of it is eaten in the countries where it is produced - only somewhere in the region of 5-7 percent is traded on the international markets. So there is a disproportionately large effect on the price when in a major producing country has a bad harvest, or stops exporting, as India did in 2008. The supply is not limitless. 1.3 million tons is the most rice Olam has traded on the international market in a year, but that has now fallen back a little to 1.1 million. Brett told his audience: “We seem to have hit a ceiling.”
The hunger for security of supply has led Olam into production and processing, and it is now working with 12,000 rice farmers and operating two mills in Nigeria, the country where it first started as a produce buying company more than 20 years ago. “We have decided that rice is a good business for us to be getting into. Nigeria imports 2.4 million tons of rice a year; it’s not rocket science to think that if you can produce it, there’s a market.”
Production has flourished. With help from US Agency for International Development’s (USAID) MARKETS scheme, an agribusiness initiative, the farmers’ associations have received loans for inputs and improved seed, and raised their yields from 1.5 to 4.4 tons a hectare. The once-derelict mills are turning out smartly packaged sacks of “Lobi” brand rice.
It is a secure source of supply within Nigeria and insulated from currency shocks, but Olam’s problem is that Lobi at the moment cannot compete with the popular imported brands from East Asia, either on quality or on price.

Poor quality
Among Nigerian customers, local rice has a poor reputation, often well deserved. Ola Bassey, a young professional woman from Lagos, told IRIN she never bought Nigerian-produced rice. “Some people buy it, it’s cheaper, but it’s just too much stress. You have all the bother of picking the sand and stones out of it - they get the kids to do it for punishment. People would rather pay extra and not have the hassle.”
Olam’s rice mills can deal with the sand and stones, but Brett admitted to IRIN that the quality of the Lobi rice itself was still not as good as that of Mama Gold, Olam’s premium brand of imported rice, just because of the varieties of rice used by the farmers.
Growing rice in Nigeria is also more expensive than growing it in Thailand, the Philippines or China. It is dry upland rice, produced without irrigation, and only one crop a year is possible. Farmers in East Asia cultivate wet paddy rice and can have three harvests a year.
At the moment Olam can sell Lobi more cheaply than the imported varieties because of the duty that has to be paid on imported rice. That duty has already been suspended once, for six months, in 2008. Brett’s nightmare is that a new rise in global food prices will lead to the removal of protection.
“The threat is that I wake up one morning and find the Federal Government has decided to cut import duty on imported rice. Nigerian farmers are never going to be as productive, and at the moment we don’t have the tonnage. But give us another two years, and we should see a stronger commercial viability.”
Currently Nigerian farmers produce only 10 percent of the rice sold on the local market, according to a USAID survey, while Thailand supplies 74 percent of the rice Nigerians buy.

http://www.irinnews.org/report.aspx?reportid=92873

MALARIA: Africa

*Kenya: Chase for Profit Hampers Malaria Drugs Subsidy *
On the streets of Nairobi, James Odhiambo goes from one pharmacy to he next in search of anti-malarial drugs marked with the Global Fund's logo of a green leaf. He is looking for this specific brand because he understands that it is more than 10 times cheaper than the same drug produced by different manufacturers.
http://allafrica.com/stories/201105250668.html

* Nigeria: Edo Govt Tasks Women on Malaria Scourge *
Edo State Government has advised women in the state to utilise the insecticide treated mosquito nets that had been freely provided by the government to fight the malaria scourge.
http://allafrica.com/stories/201105250268.html

* Nigeria: Malaria - Yobe to Distribute 1,300 Mosquitoe Nets *
In its bid to control malaria, Yobe State Government is to distribute more than 1,300 Mosquito Nets to the 17 local governments in the state next month.
http://allafrica.com/stories/201105240930.html

* Tanzania: Malaria Test Success Drives Up Antibiotic Use *
Antibiotic misuse has soared in an African capital as an unforeseen consequence of improving the diagnosis of malaria, according to a study.
http://allafrica.com/stories/201105231019.html

* Tanzania: Anti-Malarial Therapy Not to Sell Above Tsh 1000 *
The Government has subsidized the costs for the combine therapy anti-malarial drugs by more than 93 percent. Now its full dose will only cost Tsh 1000.
http://allafrica.com/stories/201105241334.html

* Ghana: Join War On Malaria - Minister Tells Sports Personalities *
The Minister for Youth and Sports, Hon. Clement Kofi Humado, has called on all sporting associations in the country to join the war on malaria to make the quest towards achieving the Roll Back Malaria
(RBM) of near zero death by 2015 a success.
http://allafrica.com/stories/201105241291.html

* Nigeria: Govt to Ban Mono-Therapy Malaria Drugs *
The Federal Government has hinted that in the nearest future, it would ban all mono-therapy drugs used in malaria treatment in Nigeria as they are no longer effective following resistance of the drugs by Nigerians.
http://allafrica.com/stories/201105240732.html

* Kenya: Marginal Profits Hamper Malaria Drug Subsidy *
On the streets of Nairobi, James Odhiambo goes from one pharmacy to the next in search of anti-malarial drugs marked with the Global Fund's logo of a green leaf. He is looking for this specific brand because he understands that it is more than ten times cheaper than the same drug produced by different manufacturers.
http://allafrica.com/stories/201105210027.html

* Angola: Tomboco Registers Over 5000 Cases of Malaria *
About 5,575 cases of malaria, registered from January to March this year, were notified by the health authorities in Tomboco District, northern Zaire Province.
http://allafrica.com/stories/201105231182.html

* Angola: New Malaria Fight Strategy Reduces Death *
The health services in central Huambo province recorded a drop in the rate of death caused by malaria in the first quarter of this year from 222 in 2010 to 58, as a result of new strategies in the fight against the disease.
http://allafrica.com/stories/201105191040.html

* Angola: Technicians Finish Training on Rapid Malaria Test *
About sixteen laboratory technicians from the northern Uige Province finished on Thursday, in this city, a training programme on handling new equipment for testing malaria, ANGOP has learnt.
http://allafrica.com/stories/201105200574.html

* Nigeria: Demystify Malaria Diagnosis And Treatment, Local Experts Urged *
Nigerian medical experts have been urged to demystify the diagnosis and treatment of malaria as part of strategies to reduce the burden of the disease in the country.
http://allafrica.com/stories/201105180136.html

* Kenya: Pneumonia And Malaria Rated Top Killers Last Year *
Preventable malaria defied sustained government efforts meant to keep it at bay to kill the highest number of people last year.
http://allafrica.com/stories/201105180003.html

* Nigeria: Lasg, NGOs Walk Against Malaria *
As part of activities to mark this year's World Malaria Day, the Lagos State Ministry of Health in collaboration with health related NGOs held a walk and free malaria screening/awareness creation exercise
which took off from Maryland and culminated at Kosofe Local Government Area Headquarters.
http://allafrica.com/stories/201105170743.html

* East Africa: Official Calls for Harmonisation of Policies on Malaria *
Member states of the East African Community are urged to harmonise policies to ensure elimination of malaria in the region.
http://allafrica.com/stories/201105160291.html

MALARIA: Nigeria: predictable misuse of some nets

Bill Brieger : 21 May 2011

During a recent community mobilization and supervisory visit to Abat community Onna Local Government Area (LGA) in Akwa Ibom State, Nigeria, colleagues saw nets from last year’s mass distribution being used to protect vegetable gardens. Bright Orji commented that, “When we spoke with community about the mis-use, they claimed that those were torn nets. We did not believe them, and also told them that torn nets could be amended.”



The team took four pictures of different nets in several places, Orji said that, “Mis-use is on the rise, and we need to counter this urgently.” Before they had nets community members used a small shade built of palm fronds to protect the plants, but apparently the nets are seen as a better deal as they also keep off some animals and insects. Ironically if community members think nets will keep off insects are fooling themselves as sun exposure will destroy the pesticide.



The team had heard complaints about nets before - sleeping under a net is too hot; nets are difficult to hang. Because of such complaints, Orji noted, “In our focal communities we are teaching community health workers to hang nets using net hangers provided by the State Ministry of Health (SMOH).”

We wondered whether people are using the nets that adults would have used, or are they taking away from children and pregnant women? Orji explained that, “Most households in our LGAs have more than two. Some nets had been given to pregnant women before the State placed two nets per household. So, men can take new ones from State to use while women continue to use the ones obtained from us or vice visa.”

Orji added that, “It is very important for a formative research to investigate net use, reasons for non use and mis-use. We will develop a proposal to the SMOH for this.”

Apparently the local health authorities were unaware of this problem until Orji “shared the photos at one of our partners’ meetings.” An SMOH staff member on the mobilization/supervision team told Orji that, “We only do monitoring when an NGO invites us, or go out whenever the National Malaria Control Program visits.”


This net mis-use highlighted some of the gender dynamics in the community. In terms of growing these vegetables, and farming in general, it is women’s responsibility. Orji explained that, “One of the villlage chiefs informed us that women are the ones farming all their lands. In Onna the tradition is that men stay at home to drink while women go to farm.”
Therefore the women most likely put up the nets over the vegetables. Orji somewhat joking added that, “Perhaps when the man got drunk, the woman decided to punish him by exposing him to mosquitos through the removal of his net.”

What we have learned from this experience is two-fold. Follow-up education and assistance is needed to ensure that nets given out freely are actually used for the intended purpose. Secondly, this effort will be aided by formative research on how people perceive and value the nets. Otherwise all we will achieve is universal coverage of vegetable gardens! We should also find the agriculture extension agents in the area to help the people find better ways to protect their gardens from pests, otherwise nets will remain an attractive option.



http://www.malariafreefuture.org/blog/?p=1208

POVERTY: Nigeria: Can President Jonathan Reduce Poverty?

11 May 2011 : Omolaraeni Borisade [University of Ibadan Dept. of Communication and Language Arts]

Following his success at the Presidential election, it is pertinent to begin to examine President Goodluck Jonathan's ability to reduce the overwhelming poverty in the country. Without doubt, this is a country that is so much endowed with all imaginable resources, but lacks the ability to make her citizens happy. Consequently, millions of Nigerians wallow in abject poverty in the midst of plenty.
It is on record that successive governments since independence in 1960 have been making efforts to alleviate poverty and stimulate development. But it appears that past poverty alleviation programmes have not yielded the much desired results as millions of Nigerians could still not boast of three square meals a day.
It is sad that the United Nations human poverty index has ranked Nigeria as the 25th poorest nation in the world despite getting $300 billion in oil and gas revenues and development aid. Certainly, the causes of this unenviable profile cannot be divorced from corruption, bad governance, debt overhang among others.
The question is this? How we are going to continue under President Goodluck Jonathan government beginning from May 29? Can we expect a radical departure from the status quo? Does President Jonathan have a magic wand to reduce poverty in Nigeria?
In the past, we have had operation Feed the Nation (OFN), the Green Revolution, establishment of Directorate of Food Roads and Rural Infrastructure (DFFRI), Directorate of Employment (NDE) among others-all tailored towards reducing national poverty, but did we succeed? Not really!
Now, is President Jonathan going to rehash all these past efforts or his he going to come up with fresh thinking on how poverty should be reduced? It must be noted that poverty precipitates crimes in the society. It is poverty that drives young ladies into prostitution and armed robbery. It is poverty that forces people into rituals and corruption.
I shall therefore be glad if President Jonathan makes pragmatic efforts towards reducing poverty. Development communication course in my discipline has taught me that poverty can be reduced if the programmes are rural-driven rather than top-down approach.
http://allafrica.com/stories/201105120441.html

MALARIA: Africa: Cheap Malaria Drugs to Flood Africa Soon

Yinka Shokunbi : 30 April 2011
With the renewed determination of the international community to sweep out malaria out of Africa, a new initiative to put affordable and effective anti-malaria drugs within the reach of people in often remote communities in Africa is making rapid progress.
In four implementing countries - Ghana, Kenya, Madagascar and Nigeria - life-saving malaria treatment can now be bought in private stores and pharmacies for as little as 50 U.S. cents as against previous cost which was up to 20 times as much.
The Affordable Medicines Facility - malaria (AMFm) gets key financial support from UNITAD, the United Kingdom and the Bill & Melinda Gates Foundation, technical support from members of the Roll Back Malaria (RBM) Partnership and it is hosted by the Global Fund.
The initiative, which began last year, is being piloted in eight countries - Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania (including Zanzibar), Uganda and Cambodia - to enable lessons to be learnt before a potential global rollout.
AMFm aims to make anti-malarial drugs, known as artemisinin-based combination therapies (ACTs), available as widely and cheaply as possible. About 225 million people fall ill with malaria every year and 780,000 die from the disease.
Although the World Health Organisation (WHO) specifically recommends ACTs as first-line treatment for Plasmodium falciparum malaria, the most deadly form of the disease, the drug accounts for only about one in five of all treatments taken for malaria and until recently, it has only been available for free or at low cost in public health facilities.
Most people buy anti-malaria treatments in private shops and pharmacies where ACTs were not available at an affordable price before the launch of AMFm. These shops sell older, cheap medicines such as chloroquine and sulfadoxine-pyrimethamine, which are no longer effective because the Plasmodium falciparum is increasingly resistant to them.
The objective of the AMFm programme is to drive out these ineffective therapies by bringing down ACT treatment costs drastically and making the drugs more accessible to millions of people.
According to the executive director of the Global Fund, Prof. Michel Kazatchkine, "We are making further progress in fighting malaria in Africa by providing affordable treatment to millions of people through the Affordable Medicines Facility for malaria," said executive director of the Global Fund.
"The Affordable Medicines Facility - malaria is a major step forward. It uses innovative financing methods to save lives by providing affordable and effective medicines to more people in need through the public, NGO and private sectors."
For the innovation to work, the Global Fund first negotiates a discounted price for ACTs with drug manufacturers and then pays most of the reduced price on behalf of importers from the private, NGO and public sectors, leading to an average sales price of less than 10 cents.
The reduced prices allow private wholesalers to sell the ACTs to retailers at a profit. Pharmacies and stores in turn sell the drugs to patients and caregivers with an additional mark-up, while keeping the retail price affordable.
The AMFm was introduced in the country in March 2011, ACTs that are not co-paid by the AMFm cost about 1,000 - 1,500 Naira (US$ 6.70 - 9.50) per adult treatment.
The Society for Family Health (SFH), a not-for-profit NGO started distribution of AMFm co-paid ACTs in Nigeria in March 2011.
Under AMFm, SFH will sell a full course of treatment for children aged under-five years in private health facilities and outlets at US$ 0.20. The adult course of treatment is expected to sell for US$ 0.80.
In the eight countries where the AMFm is being implemented, governments are supporting the initiative with public awareness campaigns and training for ACT providers.
http://allafrica.com/stories/201105021732.html

POVERTY: Nigeria: Poverty Eradication through Agriculture and Enterprise Revolution

May 1st, 2011 : Peter Osalor

The story of Nigerian agriculture is best read between the lines of its political history. Africa’s most populous nation had an overwhelmingly agricultural economy during the hundred years spent under British colonial rule since 1860, and well into the first decade after its independence.
In the 1960s Nigeria was the world’s second largest producer of cocoa, the largest exporter of palm oil and a principal producer and exporter of cotton, rubber and groundnut. Working traditional tools and practices, Nigerian peasants contributed 70% of export revenue and 60% of GDP in the same period. The total food requirement was met almost entirely by local produce and agricultural imports were to the bare minimum.
Circumstances changed radically with the oil boom of the 1970s, as the discovery of vast oil and gas reserves in the strategically significant sub-Saharan nation turned its fortunes overnight.
The windfall transformed Nigeria’s agricultural landscape into a gigantic oil field criss-crossed by more than 7,000 km of pipelines connecting 6,000 oil wells, two refineries, innumerable flow stations and export terminals. The colossal investments in the sector paid off, with unofficial estimates suggesting Nigeria raked in more than $600 billion in petrodollars in the last decade alone.
Unfortunately, the obsession with non-renewables over all other sectors of the economy eventually turned Nigeria’s boon into a bane. New found wealth spawned political instability and massive corruption in government circles, and the country was rent asunder by decades of violent civil war and successive military coups.
Agriculture was one of the first casualties of the oil regime, and by the 1990s, cultivation accounted for just 5% of GDP. Farming modernisation and support continued to remain low on the list of national priorities as vast stretches of rural Nigeria gradually plunged into poverty and food scarcity. Deforestation, soil erosion and industrial pollution further hastened the down-spiral of agriculture to the point where it ended up as a subsistence activity.
The fall of Nigerian agriculture coincided with the collapse of its macroeconomic and human development indicators. With income distribution concentrated on a few urban pockets, the majority of rural Nigeria was left reeling under massive poverty, unemployment and food shortages. A widening urban-rural divide sparked social unrest and mass migration into towns and cities.
Organised urban crime became as real a security threat as militancy in the Niger-Delta region. Nigeria plummeted to the bottom in world economic rankings and Africa’s most populous nation acquired the unhappy distinction of having more than half (54%) of its 148 million people living in abject poverty. The World Bank coined the term “Nigerian Paradox” specifically to describe the unique condition of extreme underdevelopment and poverty in a country brimming with resources and potential.
The country was ranked 80th in a 2007 UNDP poverty survey covering 108 countries.
The transition to democratic civilian rule at the end of the last century paved the way for an enthusiastic programme of economic reform and restructuring. Nigeria’s urgency for inclusive growth was much in evidence in the adoption of an ambitious blueprint designed to reverse trends and jump-start a stagnating economy.
The Vision 20-2020 document adopted under former president Olusegun Obasanjo lays out broad parameters for sustainable development with the specific goal of instating Nigeria as a global economic superpower in a time_bound manner.
The 2020 goals are in addition to Nigeria’s commitment to the UN Millennial Declaration of 2000 that proposes universal basic human rights by 2015.
The realisation of these allied and intertwined objectives depends entirely on Nigeria’s ability to bring about inclusive growth by means of an entrepreneurial revolution, while simultaneously correcting massive infrastructural shortages and administrative anomalies.
Economies usually begin expanding with an initial agricultural revolution: The case of Nigeria however calls for agriculture to be part of a larger enterprise revolution that efficiently leverages the nation’s extensive resources and human capital.
http://www.thenigeriandaily.com/2011/05/01/poverty-eradication-in-nigeria-through-agriculture-and-enterprise-revolution-part-1/

MALARIA: Nigeria research provides insights on bednet use—and misuse

Marcy Erskine, International Federation of Red Cross and Red Crescent Societies; Toju Maleghemi, WHO Cross River State; Iyam Ugot, Special Advisor to the Governor of Cross River State, Community Health
Nigeria’s Cross River State Roll Back Malaria team is tasked with “finding” 500,000 previously distributed bednets to determine how many are still being used and why.
In Nigeria, the Cross River State Government has been a leader in public health, providing free primary health care to pregnant women and children under five* and working to improve health indicators and protect its residents from malaria-related illness and death. In 2008, the State Government, with support from the Canadian Red Cross and USAID, distributed over half a million nets—enough for each child under five attending a vaccination site during an integrated measles campaign.
In 2010, Nigeria’s Cross River State Roll Back Malaria (RBM) team was tasked with “finding” these previously distributed long-lasting insecticide-treated nets (LLINs) to determine how many were still “good” and how many new nets were needed in the next distribution cycle. A “good” net was defined by age: a net distributed in 2008 or later was considered good, while older nets were considered non-viable. The physical condition of the LLIN was not taken into account given the subjective nature of assessing hole size and viability of the net. Given that the estimated lifespan of the distributed nets is three years, it was expected that the majority of the nets distributed in 2008 would still be in use. However, the results of the household census undertaken by Nigeria Red Cross volunteers throughout the State to assess household LLIN needs “found” only 52 percent of the LLINs distributed during the campaign. Similar results have been seen in Senegal, where the National Malaria Control Program (NMCP) is leading a rolling distribution of a similar nature with support from NetWorks.
In Cross River State, the results of the household registration led the State project team to question why such a low number of nets was found and, subsequently, the Nigeria evidence-based health information system (NEHSI) staff were contacted. NEHSI, supported by the International Federation of Red Cross and Red Crescent Societies (IFRC) and the World Health Organization (WHO), conducted a qualitative study to find out what had happened to the previously distributed nets.
The results of the study were of immediate relevance to the net distribution and hanging program currently being rolled out. It was assumed that some people would not be honest about receiving or owning nets from the previous distribution, including ones not yet hung and used, and the survey found that this was actually the case in a number of surveyed households. Another interesting discovery was that more than two-thirds of people surveyed would only sleep under the bednets for about 6–12 months, at which point the nets were considered to be expired or no longer “good” and were either burned or used for another purpose, such as covering a kiosk or screening a window. About half of the survey respondents also believed that once a net had been washed more than twice, it was no longer effective, and nearly one-third of respondents believed that washing the net in cold water would destroy the insecticide and reduce its effectiveness.
This study was relatively inexpensive and easy to implement, and it provided new critical information that is already being used to inform Cross River State’s next phase of mosquito net distributions. It will also be useful to other countries trying to account for nets that are still “good” in households. The study raised concerns about not only the validity of planning net replenishment campaigns based on the age of the net alone, but also the potential difficulties with quantifying net needs when moving from low or moderate to high LLIN coverage based on assumptions of “existing” nets.
In Cross River State, targeted messaging is being developed to encourage residents to use their mosquito nets for the full three years (or longer) and to repair them when they are torn or damaged. A net awareness campaign is being considered to improve knowledge and practice regarding LLIN use, maintenance, and repair. An end process monitoring exercise is currently taking place to ensure that universal coverage has actually been achieved where distribution has taken place. The campaign used a house-to-house distribution and hanging method, with volunteers equipped with hammers, nails, and string in addition to LLINs. The effectiveness of this approach for ensuring LLIN utilization will be assessed later in the year.
In Nigeria as a whole, the progress to date is staggering. The country bears approximately 25 percent of the malaria burden in Africa among its population of 153 million. Under the leadership of the Government and the Federal Ministry of Health, and with support from partners, the country has distributed close to 30 million LLINs and plans to distribute another 28 million this year. Nigeria’s success is reflective of strong leadership, effective partnership, and an excellent coordinating mechanism. In addition to the strong role of the NMCP, State ownership is crucial. Cross River State’s Government has played a key role in the coordination of the current campaign to move from targeted to universal coverage. This qualitative study to “find” previously distributed nets was one of the first of its kind, and provides critical information for Nigeria and other countries seeking to undertake similar activities. The study also demonstrates the importance of regular quantitative and qualitative data collection and analysis to modify project planning.

* This is the overall health policy in Nigeria, but is not yet implemented by all states.
http://www.macepalearningcommunity.org/newsletter_nigeriabednet.htm

POVERTY: Nigerian biosafety bill may fail, say scientists

Emeka Johnkingsley : 27 April 2011
 Flickr/World Bank Photo Collection
Farmers have not been listened to, say campaigners against the biosafety bill

[ABUJA] Supporters of genetically modified (GM) crop technology fear that their four-year effort to get a biosafety bill enacted in Nigeria may have been in vain if the country's upper house fails to pass it before its tenure ends next month (29 May).
The 2007 bill, passed by the country's lower chamber last July, is with the Senate. It is one of more than 400 bills introduced to the National Assembly between 2007 and 2010 that were highlighted by the Nigerian Bar Association last December as needing passage before 29 May.
Stakeholders are concerned that, since Nigeria — which is in the midst of elections — has a poor culture of continuity between governments, they may have to start again, delaying plans to move from confined trials of biotechnology products to commercialisation.
National biosafety bills provide a framework to ensure that the development, and use, of GM organisms and products do not negatively affect plant, animal and human health; agricultural systems; or the environment.
With these standards in place, multinational biotechnology companies could do business in Nigeria, said Bamidele Solomon, director-general of the National Biotechnology Development Agency, a promoter of the bill.
"Research and development grants and opportunities, which in the past had been inaccessible because of a lack of enabling facilities, would be easily available," he said.
Mohammed Ishiyaku, a researcher at the Institute of Agricultural Research involved in a cowpea biotechnology project, said that if the bill failed to pass it would demoralise many scientists.
His project uses GM cowpeas to fight insect damage and, it is hoped, increase farmers' yields by 40 per cent.
"All of us are enthusiastically looking forward to this bill," he told SciDev.Net. "We will then be able to conclude the steps required before the cowpea can proceed to farmers."
Daniel Aba, a sorghum breeder at Ahmadu Bello University is trying to develop a variety that contains vitamin A, iron and zinc. "If the biosafety bill is not in place, it means that the research will remain within research centres," he said.
Ibrahim Abubakar, president of the Agricultural Society of Nigeria, said: "We cannot make any significant progress without the enabling law, especially now that there is some pessimism about the use of biotechnology."
But Environmental Rights Action (ERA), a Nigerian advocacy group, said the urgency to pass the bill may stem from other motives.
"Nigerians are yet to understand and adequately contribute to the bill," an ERA spokesperson said. "We suggest it is stopped in its tracks.
"The eagerness to get the bill passed is coming from biotech industry allies in this country.
"ERA is not against biotechnology as a whole but against a system unequivocal in its conviction to foist alien and unverified technologies on our farmers, and the nation as a whole, without checks."
He said the public hearing on the bill, organised by the Joint Committee on Science and Technology and Agriculture of the House of Representatives in 2009, allocated little time for protesters to voice their opinions — compared with the time offered to proponents.
http://www.scidev.net/en/news/nigerian-biosafety-bill-may-fail-say-scientists.html

POVERTY: Nigeria: Election Violence Or Farewell to Poverty

Issa Aremu : 25 April 2011
Mni — In place of post election development agenda (which ordinarily is inclusive of security of lives and properties), Nigerian voters are being weighed down with post election violence of an unprecedented scale and proportions.
As many as 200 had been reportedly killed with hundreds of thousands displaced! With specific reference to Kaduna, in place of clear cut all inclusive electoral campaign issues such water, light and food, urban renewal, revival of collapsed factories prior to rescheduled gubernatorial election next Thursday, we have taken a decade plunge backward to the dark days of mutually destructive primordial issues of ethnicity and "religion" amidst feverish curfew.
Pray, what has election in particular and democracy in general got to do with killings and curfews? Within the two days of seemingly orchestrated violence on all sides of the partisan divides, the gains of reconciliation and conflict resolutions of the last ten years in Kaduna had been brutally eroded as peoples hitherto peacefully coexisting are being thrown to violent identity crisis. In the orgy of violence from Kaduna to Katsina, Kano to Bauchi, poor voters had turned on poor voters leaving in their trails mass destruction of lives and lives. And of course, properties that were never there in the first instance.
Whatever the causes (and obviously election related), the motivation for the latest crisis and mayhem especially in the Northern part of the country, the emerging pattern is that of voters (read; masses) on voters' violence. It was reminiscent of black on black violence of the discredited apartheid South Africa. We are again back to Nigeria's persistent crisis of governance in which the poorest of the poor have become cannon folders in the game of the political elite for political power. It is unfortunate that a decade after the sectarian crisis after which enormous resources had been deployed in peace building and conflict resolution, Kaduna could degenerate to the blind abyss of mutually assured crisis of destruction we have just witnessed. Every aspect of the latest crisis points to a national crisis of governance such that that if care is not taken this singular uncontrolled crisis may engulf the whole nation. Kaduna and indeed the Northern crisis should be seen as a metaphor for deep national crisis. It is commendable the crisis is being put under control. But why should it have been allowed to happen and made to be out of control in the first place? Security challenges have been identified as part of the critical success factors of 2011 serial elections. The buzz word before the election was "crowd control". We were impressed with "show of force" which turned out not be show of security! Why then should the chief security officers of the states be caught napping in the wake of spontaneous reactions to elections results that were expected to legitimately generate so much legitimate passion? The point cannot be over stated; most incumbent governors are too deep in partisanship either seeking for re-election or looking for refuge in the senate. The post election deaths and mayhems are manifestations of the singular fact that many governors are no more on duty to protect lives and properties. On the contrary, what we have witnessed in recent weeks are gross distortions of governance on the altar of excessive executive partisanship. In recent weeks, we have not seen authoritative allocation of resources for the protection, uplift and advancement of the citizens but misapplication of state scarce resources (money and time) on part of most incumbent governors. But all said assuming the governors had been on duty to proactively protect the citizens, what are the fundamentals that led to the mass uprising of the electorate against the electorate? What could make the citizens who had hitherto two days before diligently joined the queues to break all rules of engagement in mass bloody protests? Why would a promising democracy destination turned to dens of deaths on account of elections? Recent crisis points to the fact that Nigeria has serious deterioration of human development index caused mainly by unemployment, factory closures and mass poverty and the growing gap between the rich and the poor. The rich certainly cry and fight. It is also a truism that the poor also fight and cry as we have seen the poor of the Arab countries confronting their ancient unaccountable sit-tight regimes. But only the poorest of the poor can serially engage in self destructions as we are seeing in Nigeria. In fact in Egypt, despite the desperation of Mubarak dictatorship, both Christians and Muslim protesters of Cairo in solidarity confronted injustices.
They did mutually engage in wars of attrition as in Nigeria. Therefore beyond the post election violence and its proactive and reactive management, we must urgent move to uplift our people and economy more than empty growth figures. We must create mass decent employment for our unemployed. There must be minimum social floor below which people must not fall before they appreciate the sanctity of lives. It must task our imagination that thousands could be readily mobilized on working days for mass protests of destructive proportions. Most cities in protests were once functioning industrial cities. We must get these huge potential productive forces engaged otherwise they all become destructive forces as we have witnessed in recent. We must say farewell to poverty and bring back development agenda in Nigeria. Paradoxically elections are supposed to be about development and poverty eradication.
Sadly in the ongoing contestations, it is more about persons rather than programmes. It is a sad commentary that spate of factory closures had not formed the basis of electoral contestation. Voters hardly know what they are voting for. In fact there are no electoral issues as such! It is never late to put development issues on the political agenda otherwise we will all be consumed with personal primordial issues which in turn will push us deeper into underdevelopment. There cannot be sustainable democracy without sustainable development just as there cannot be sustainable development without sustainable democracy.
http://allafrica.com/stories/201104250572.html

POVERTY: Nigeria: Breaking the poverty cycle through entrepreneurial revolution

April 18, 2011
Nigeria is a country of absurd economic realities. The 12th largest crude oil producer in the world and the second largest economy in Africa earn an estimated $2.2 million a day in oil revenue. Yet, its GDP per capita, at just over $1,400, is among the lowest for the continent and 54% of its 148 million people live on less than $1 per day.
The figures are especially shocking because of the abundance of natural resources primarily oil and natural gas, and massive agricultural potential based on its climate and significant rural population.
Human development data for Nigeria has remained persistently bleak despite a considerable upturn in the country’s economic fortunes since 2000.
The UNDP ranked the country 80th in a poverty survey of 108 developing nations that focussed on severe deprivation . The agency gave Nigeria a Human Poverty Index of 37.3, placing it below more impoverished African neighbours with far smaller economies like Rwanda and Malawi. Significantly, the study looked not just at income destitution, but also at secondary aspects including education, access to health care, standard of living and life_expectancy. More than 67 million Nigerians are docketed as poor according to standard definitions, while 35% of the total population live in extreme poverty.
These recent trends are especially worrying because they parallel a significant but contradictory improvement in Nigeria’s macro_economic performance. Before the current global financial crisis set in, Abuja had been successful in wielding substantial positive change in its overall balance sheets through a process of re_prioritisation and economic reform since 1999. A slew of measures, including privatisation of several steel, petrochemical, mining and port entities helped develop the non_oil sector, bring down inflation and boost international currency reserves. Nigeria also successfully negotiated with the London and Paris clubs to do away with a large part of its foreign debt.
However, World Bank research confirms that even during periods of relative prosperity, poverty levels remained unabated in the broadest sense, and actually worsened during successive positive growth periods.
Between 1972 and 1980, for instance, the Nigerian per capita income shot up from $1,300 to $2,900 based on rapidly escalating oil prices.
A subsequent decline in global oil revenues dragged down per capita income, consumption and expenditure to critical levels. However, Nigeria neglected investment in human development projects and continued to pump borrowed finances into capital_intensive enterprises. The fallout was that the dramatic rise in national fortunes bypassed the majority of Nigerians, as evident from the negligible rise in per capita consumption figures for the same period.
The differential effect on poverty levels in rural and urban areas for the coinciding period is equally startling. Because of a simultaneous worsening of income distribution, rural poverty declined slightly while the number of urban poor gained. However, the worst_off were also the worst losers, as the population living in extreme poverty across Nigeria swelled up from 10 million to 14 million. The obvious explanation behind this is that policy makers sorely failed to share the increase in wealth equitably.
Till 1985, a variety of local factors (political turmoil and social unrest) and foreign influences (falling oil prices and mismanagement of state assets) was responsible for increasing poverty and a widening disparity between rural and urban incomes. Even by 1995, per capita income and consumption remained lower than at the beginning of the oil boom in the ’70s.
It was only towards the end of the 20th century that Nigeria began to press forward a concerted though gradual effort at reform and regulation, made possible by relative political stability and the establishment of a democratically elected government.
The advent of more inclusive policies truly began with the adoption of a proactive manifesto that sought to wean away Nigeria’s exclusive dependence on non_renewable resources and promote micro and macro level entrepreneurship as the only viable means to durable economic prosperity.
This change of stance pertinently describes the entrepreneurial spirit in general: the insistence on unique and creatively challenging business models for rapidly sustainable wealth creation. Entrepreneurship is the core ideal of all developed nations that have successfully capitalized on their human and natural resources to drive economic progress.
Since the Thatcher_Regan era of the 1980s, most developed and developing nations the world over have wholeheartedly embraced entrepreneurship as the key to economic and market superiority.
http://www.vanguardngr.com/2011/04/breaking-the-nigerian-poverty-cycle-through-entrepreneurial-revolution-part-1/

MALNUTRITION: Cash boost should help bring fortified rice and cassava to market

Anjali Nayar : 14 April 2011 : Nature

Golden rice (right) provides more vitamin A than normal rice.International Rice Research Institute

Nearly US$20 million in new grants from the Bill & Melinda Gates Foundation will be spent on getting nutritionally enhanced rice and cassava to market and decreasing malnourishment in Asia and Africa.
The grants will help in the development, testing and marketing of Golden Rice, which is fortified with vitamin A, in the Philippines and Bangladesh, and BioCassava Plus, a tuber fortified with vitamin A, iron and protein in Kenya and Nigeria.
In rich countries, people generally have access to a diverse diet and to foods that have been fortified with various essential nutrients, but these items are often unaffordable or unobtainable in the developing world.
People in poor nations, especially farmers, often only have access to what they grow. In parts of Asia, people rely on rice for 50–80% of their daily calories, and around 70 million Africans rely on cassava. It's no surprise then, that vitamin and mineral deficiencies affect more than two billion people worldwide, and contribute to around 7% of deaths and 10% of the disease burden in low-income countries, according to Juan Pablo Pena-Rosas, coordinator of the Micronutrients Unit at the World Health Organization in Geneva, Switzerland.
Biofortified, or nutritionally enhanced, staple crops could thus greatly reduce the death and disease burden related to nutritional deficiencies, according to Lawrence Kent, head of agricultural development at the Bill & Melinda Gates Foundation in Seattle, Washington. Several research groups are working on fortified varieties of bean, rice, maize, sweet potato, cowpea, peanut, wheat, pumpkin and banana.
"I'm optimistic that biofortification can help to improve people's health and lives because we are using sustainable foods that people already grow," Kent says.

Lab or field?
Plants can be fortified either through conventional plant breeding or using biotechnology to alter its genome and increase its nutritional yield, explains Pena-Rosas.
The firm HarvestPlus in Washington DC, which released orange sweet potato containing 50% of the daily vitamin A requirement in Uganda and Mozambique in 2007, uses traditional breeding techniques. Both Golden Rice and BioCassava Plus are genetically modified organisms (GMOs), and have attracted their fair share of negative attention from the anti-GMO lobby. "Anything that involves biotechnology involves a level of controversy," explains Kent. "But we need to be open and data-focused."
The Gates Foundation grants will help to generate the data needed for Golden Rice and BioCassava Plus to meet food safety and environmental regulations. "These crops will not be used by farmers or consumers until they pass tests for biosafety in each country," says Gerard Barry, who coordinates the Golden Rice Network at the International Rice Research Institute in Los Baños in the Philippines.
Golden Rice is expected to receive regulatory approval in the Philippines in 2013 and in Bangladesh in 2015, according to Ingo Potrykus, a retired geneticist at the Institute of Plant Sciences in Zurich, Switzerland, and one of the rice's inventors. BioCassava Plus should follow a few years later — the team hopes to obtain approvals by 2017, according to Martin Fregene, a plant geneticist and the director of the BioCassava Plus Program, based in St Louis, Missouri.
"As long as we can show that [these products] add value and are safe, there is no mother who would not want to use them to increase the health of her kids," says Fregene.
http://www.nature.com/news/2011/110414/full/news.2011.233.html

MALNUTRITION: Donald Danforth Plant Science Center receives grant from the Bill & Melinda Gates Foundation to work on cassava in Nigeria and Kenya

 April 14, 2011,
 Donald Danforth Plant Science Center

The Donald Danforth Plant Science Center said late Wednesday that it has received an $8.3 million grant from the Bill & Melinda Gates Foundation to advance its work on the cassava plant in Nigeria and Kenya.
Funds will be used to support Phase II of BioCassava Plus, a project that aims to reduce malnutrition by increasing the nutritional value of cassava, a staple crop consumed by more than 250 million sub-Saharan Africans and nearly 700 million people worldwide. Martin Fregene will serve as the lead investigator.
Those who depend on cassava for food often suffer from chronic malnutrition, or insufficient intake of essential nutrients and vitamins including pro-vitamin A, iron and protein. According to the World Health Organization, this malnutrition often leads to blindness and other illnesses, disability and death for an estimated 250,000 to 500,000 children each year.
“Beta-carotene, the precursor to vitamin A, and iron are contained in various foods today, but those foods are scarce, unavailable, or too expensive for many people in Nigeria and Kenya,” Fregene said. “Increasing nutrients in local cassava varieties will make it both accessible and affordable for communities to improve their own nutrition.”
In Phase I of the project, researchers were able to develop cassava plants that have 30 times as much beta-carotene, four times as much iron and four times as much protein as traditional cassava. These increased levels reflect what is needed to provide the minimum daily dietary requirements for a child.
The enhanced cassava created by the BioCassava Plus project will be available to farmers in the same way it is being offered today and will have no royalty fees. This means farmers will be able to freely multiply, save and share their planting materials, Danforth officials said.
http://www.bizjournals.com/stlouis/news/2011/04/14/danforth-center-gets-8m-from-gates.html