Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa.
Poverty and health
This collection of articles includes an article on food security in Kenya. Since 2006, the rains in Kenya’s Central Highlands have become less reliable. The March and April rains regularly arrive late, and the season is much shorter. In 2008, there were only four days of rain. The seasonal rivers that provide water for irrigation, livestock and domestic uses have mostly dried up, leading to water and food shortages. These burgeoning problems are pointing in one direction – poverty, malnutrition and health problems for the nation’s poor. Declining production, and the limited access and affordability of imported food, mean food security has declined, with many impacts. The government should store grain during bumper harvests to provide food in poor seasons; processing this surplus can also add value and avoid wastage.
Since April 2011, the humanitarian community has been gearing up to deploy a new mechanism aimed at combining expertise on food aid and agricultural assistance to boost food security and make food insecure communities hit by a disaster more resilient. The tool, which is deployed by aid workers in emergency responses, is the "cluster approach", first implemented in 2005. A "cluster" consists of groupings of UN agencies, NGOs and other international organisations around a sector or service provided during a humanitarian crisis. The cluster approach currently encompasses 11 clusters or sectors such as logistics, water and sanitation, early recovery and nutrition. Agriculture as a separate cluster will cease to exist under the new scheme. The new cluster is led jointly by the UN Food and Agriculture Organization (FAO) and the World Food Programme (WFP). The tool is aimed at implementing a proper `early recovery' approach by introducing recovery and development aspects into relief work as early as possible and strengthening transition.
In South Africa lone mothers of working age are only entitled to social assistance for themselves if they are disabled. A means-tested Child Support Grant is payable on behalf of their children but, though important, it is small in amount and is not intended to contribute to the caregiver's living expenses. In the context of South Africa’s Constitution which declares that ‘everyone has the right to have their dignity respected and protected’ and that access to social security is to be progressively realised, this project explored the meaning of dignity in lone mothers' lives and the extent to which social security protects or erodes their dignity. The themed reports of the project cover the definition of lone motherhood in South Africa, the impact of poverty and inequality on lone mothers in South Africa and social security and the dignity of lone mothers in South Africa.
Poverty reduction is a central feature of the international development agenda and contemporary poverty reduction strategies increasingly focus on ‘targeting the poor’, yet poverty and inequality remain intractable foes. This paper argues that this problem exists because many current approaches to reducing poverty and inequality fail to consider key institutional, policy and political dimensions that may be both causes of poverty and inequality, and obstacles to their reduction. Moreover, when a substantial proportion of a country’s population is poor, it makes little sense to detach poverty from the dynamics of development. For countries that have been successful in increasing the well-being of the majority of their populations over relatively short periods of time, the report shows, progress has occurred principally through state-directed strategies that combine economic development objectives with active social policies and forms of politics that elevate the interests of the poor in public policy. The report is structured around three main issues, which, it argues, are the critical elements of a sustainable and inclusive development strategy: patterns of growth and structural change that generate and sustain jobs that are adequately remunerated and accessible to all, regardless of income or class status, gender, ethnicity or location; comprehensive social policies that are grounded in universal rights and that are supportive of structural change, social cohesion and democratic politics; and protection of civic rights, activism and political arrangements that ensure states are responsive to the needs of citizens and the poor have influence in how policies are made.
This report seeks to explain why people are poor and why inequalities exist, as well as what can be done to rectify these injustices. It explores the causes, dynamics and persistence of poverty; examines what works and what has gone wrong in international policy thinking and practice; and lays out a range of policies and institutional measures that countries can adopt to alleviate poverty. It notes that current approaches to reducing poverty and inequality fail to consider key institutional, policy and political dimensions that may be both causes of poverty and inequality, and obstacles to their reduction. Moreover, when a substantial proportion of a country’s population is poor, it makes little sense to detach poverty from the dynamics of development. For countries that have been successful in increasing the well-being of most of their populations over relatively short periods of time, the report shows, progress has occurred principally through State-directed strategies that combine economic development objectives with active social policies and forms of politics that elevate the interests of the poor in public policy. The report is structured around three main issues, which, it argues, are the critical elements of a sustainable and inclusive development strategy: patterns of growth and structural change (whether in the agricultural, industrial or service sectors) that generate and sustain adequately paid jobs; comprehensive social policies that are grounded in universal rights and that support structural change, social cohesion and democratic politics; and protection of civic rights, activism and political arrangements that ensure that States are responsive to the needs of citizens and that the poor have some influence in how policies are made.
COMESA's goal is the establishment of a free trade area, a customs union, a common market and ultimately an economic union. COMESA is home to 10 of the poorest countries in the world - Angola, Burundi, Ethiopia, Malawi, Mozambique, Rwanda, Somalia, Sudan, Zaire and Zambia. This paper examines the impact of COMESA on the poor. The report finds that while COMESA has liberalised trade in goods and services generally, there is now an urgent need to liberalise intra-regional trade in services and improve relations among its members. Conflicts in COMESA are unsustainable and strong
implementation mechanisms are needed to address non-tariff barriers and other trade restrictions within the region, with decisions on how transfer of sovereignty in some areas of trade policy to regional institutions is done in relation to SADC and COMESA.
Medicins Sans Frontiers comment on limitations in the Millenium Challenge Corporation funding of poverty reduction programmes. They note that the allocation of funding almost entirely to capital costs with no resources for recurrent costs, such as salaries, will constrain implementation in low income countries.
In this article, Global Health Watch provides an analysis of WHO’s ‘Draft implementation plan on maternal infant and young child nutrition’ (shown also in this section of the newsletter) . While it welcomes the evidence-based approach adopted in the draft, it argues that the plan fails to deal with the intersection of trade relations and nutrition, and steers clear of the challenges to be faced in building a regulatory framework to regulate transnational agribusiness and food corporations at global and country level. This is especially problematic at the moment, as new provisions are being inserted into preferential trade agreements to provide transnational corporations with powerful new defences against regulation at both the national and international levels. Global Health Watch argues that that nutrition needs to be understood in the context of food security (and insecurity). Food security in Africa is jeopardised by speculation in food commodities, which was the main contributor to a 50% rise in food prices in 2008, as well as the diversion of land growing food to growing biofuels. Global Health Watch argue that WHO cannot address the issues of trade and the regulation of transnational industry alone but it can take a pro-active stance in working with other competent intergovernmental bodies.
This communication lays out a new policy framework for European Union humanitarian action to strengthen efforts to tackle food insecurity in humanitarian crises. In it, the he European Commission reports its intention to strengthen four pillars of food security in general and emergency settings by increasing availability of food, improving access to food, improving quality and ensuring people eat nutritious food, and boosting the effectiveness of crisis prevention and management. Key points include the benefits of involving beneficiaries in operations and incorporating gender, livelihood and protection considerations in assessing needs and designing and delivering responses. The Commission draws attention to the needs of nutritionally vulnerable groups, including children under-two and pregnant women, while urging for integration of programmes so that needs are addressed holistically, and underlining the importance of linking relief with rehabilitation and development. The framework on food security spells out the need to support agriculture in poor countries to help them reach the UN Millennium Development Goal of halving hunger and poverty by 2015.