In this study, a cohort of 100 HIV-unexposed, 203 HIV-exposed (HIV negative children born to HIV-infected mothers) and 48 HIV-infected children aged six weeks to one year were recruited from an area of high malaria transmission intensity in rural Uganda and followed until the age of 2.5 years. All children were provided with insecticide-treated bed nets at enrolment and daily trimethoprim-sulphamethoxazole prophylaxis (TS) was prescribed for HIV-exposed breastfeeding and HIV-infected children. Monthly routine assessments, including measurement of height and weight, were conducted at the study clinic. The researchers found overall incidence of malaria was 3.64 cases per person year. Mild stunting and moderate-severe stunting were associated with a similarly increased incidence of malaria compared to non-stunted children. Being mildly underweight and moderate-severe underweight were not associated with a significant difference in the incidence of malaria compared to children who were not underweight. There were no significant interactions between HIV-infected, HIV-exposed children taking TS and the associations between malnutrition and the incidence of malaria. The researchers point out, in conclusion, that they were unable to disentangle the relationship between malnutrition and the incidence of malaria, and their findings do not necessarily indicate any causal connections between malaria and malnutrition.
Poverty and health
The World Bank is preparing a new agriculture action plan to cover 2013-2015. This paper argues that its market liberalisation focus has been criticised, pointing to strongly critical reports on World Bank agriculture projects such as in Peru and Papua New Guinea, and crtique of its lack of gender focus. Critics argue that the Bank is too narrowly focused on private equity investment in agriculture, instead of taking an approach that includes local communities and smallholder farmers. At the same time, the Bank has failed to acknowledge the impact of financial speculation on volatility in food prices, despite many analysts suggesting this is a major contributor to food insecurity. By promoting investor access to land, the authors argue that Bank threaten rather than improve food security and local livelihoods in developing countries.
In 2003 the Comprehensive Africa Agriculture Development Programme (CAADP) was established by the assembly of the African Union (AU) aiming to raise agricultural productivity by at least 6% per year and increasing public investment in agriculture to 10% of national budgets per year. This paper evaluates progress in CAADP negotiations in the Common Market for Eastern and Southern Africa (COMESA) region. There is in general full support in the region for an effectively multidimensional regional CAADP, anchored in ongoing programmes implemented by COMESA. But so far, there has not been enough consultation with relevant non-state stakeholders, like farmers’ organisations, and the authors urge government to include them in the process, as well as to address past failures to communicate effectively and timeously with regional stakeholders about CAADP. They also call for greater integration between regional and national stakeholders and development partners to help mainstream CAADP into ongoing regional programmes and other sectors relevant to food security. More regular dialogue is needed between COMESA, AUC-NPCA and DPs around the implementation of regional CAADP plans. The authors argue that it is very important to ensure coherence between regional policies and investments in food security and in other sectors of regional cooperation.
While all stakeholders acknowledge the importance of regional food security, most agree that introducing the Comprehensive Africa Agriculture Development Programme (CAADP) at the regional level has not been a priority for East African Community (EAC) countries in the past. Institutional capacity and financial resources are argued to have placed limits on the role of the EAC Secretariat in driving the CAADP process. Most external funders have concentrated on national efforts at food security, overlooking the role of regional support and integration. The EAC Secretariat’s relations with development partners is perceived as good, but this has not yet translated into visible improvement in regional agriculture, largely, the authors argue, because implementation remains a challenge. Slow progress in regional trade, infrastructure and other related regional initiatives have impacted negatively on regional food security and agricultural development, and national interests tend to take precedence over regional ones. The authors also call for greater consultation with all stakeholders if CAADP is to succeed.
Countries in the Southern African Development Community (SADC) have never formally launched a regional Comprehensive Africa Agriculture Development Programme (CAADP) process as they are currently developing their own Regional Agricultural Policy (RAP). The authors argue that SADC governments should mainstream CAADP principles into the RAP by, for example, enlarging the range of stakeholders regularly involved in the regional preparations (especially non-state actors like farmers), as well as including accountability mechanisms governing regional food security, and ensuring policy coherence at national and regional levels. So far the major criticism of the RAP process is lack of multi-stakeholder consultation. In addition, SADC development partners are reported as not having adequately supported regional food security measures. The authors argue for more institutional support for the SADC Secretariat, given its key role in the CAADP process.
The authors of this paper argue that Tanzania has the potential to substantially increase its maize exports to other countries, if global maize production falls due to supply shocks in major exporting regions. Tanzania may be able to export more maize at higher prices, even if it also experiences below-trend productivity. Future climate predictions suggest that some of Tanzania’s trading partners will experience severe dry conditions that may reduce agricultural production in years when Tanzania is only mildly affected. Tanzania could thus export grain to countries as climate change increases the likelihood of severe precipitation deficits in other countries while simultaneously decreasing the likelihood of severe precipitation deficits in Tanzania. Trade restrictions, like export bans, prevent Tanzania from taking advantage of these opportunities, foregoing significant economic benefits.
As the drought in the Horn of Africa, deepens, Oxfam has extended its famine relief programmes in Somaliland, Ethiopia and Kenya with a mixture of emergency aid, long-term development and prevention, and advocacy to address the root causes of chronic drought. Nearly five million Ethiopians are affected by the crisis. Oxfam is scaling up its response in Ethiopia to reach 700,000 people by helping communities look for more sustainable sources of water, drilling boreholes, developing motorised water schemes and improving traditional water harvesting systems. In the driest and worst affected areas Oxfam has been trucking in emergency water supplies to over 69,000 people, which is treated and used for drinking, cooking, washing and keeping animals alive. Community health workers are also conducting public campaigns to help stop the spread of water-borne diseases such as diarrhoea. In Kenya, 4.3 million people are affected by the crisis – mainly in the southern agricultural areas and the northern pastoralist regions, such as Turkana and Wajir. People in these areas rely on their livestock as their main source of income and nutrition, but the drought has left the animals weak, dying and hard to sell. Oxfam’s “de-stocking” programme buys up some of the weakest goats and, sheep and slaughters the animals to provide meat to the community. About 900,000 vulnerable animals – belonging to 18,000 families – are also benefiting from Oxfam’s veterinarian and de-worming programmes.
European Commissioner for Humanitarian Affairs, Kristalina Georgieva, has endorsed the Charter to End Extreme Hunger, launched by leading agencies to make deadly food crises like the one gripping East Africa a thing of the past, saying “We need to pre-empt crises, rather than reacting when the disaster hits.” The first leader to sign this charter was Kenyan Prime Minister Raila Odinga, and later other leaders including UK Development Minister Andrew Mitchell endorsed it. Georgieva’s public engagement came as part of a debate, held by aid groups Caritas Europa, Oxfam, Polish Humanitarian Action (PAH) and ONE, which took place in December 2011 in Warsaw, Poland. The event organisers are calling on the European Union (EU) as a whole, including the European Commission and EU member states, to take action on three fronts. 1. Launch a pan-European initiative for the Horn Africa, involving all EU member states, that mobilises substantial funds for recovery and longer-term assistance to ensure families can feed themselves now and rebuild their futures. 2. Invest more in building people’s resilience by supporting local food production. Supporting local, small-scale farmers and pastoralists is argued to be one of the best ways to mitigate the effects of climate change and soaring food prices. To do so, the authors observe that the EU must boost these investments within the next seven-year EU budget. 3. Launch a new flexible tool that ensures there is no money gap between emergency aid and long-term assistance when a humanitarian crisis strikes.
Malawi's maize-growing central and southern regions have not had good rains, prompting concerns about possible shortages of the staple in the coming months. With maize plants still in the early stages of growth, there is concern the crop might not be ready for harvest at the usual time in April-May. Maize meal prices climbed by more than 60% in the last four months of 2011 due to fuel and foreign currency shortages. An input subsidy programme in recent years had helped Malawi become self-sufficient in maize, with 40% funded externally. The government has tried to control the maize price increase by increasing the price of maize sold through the state grain marketer, ADMARC, and to set a controlled price to discourage traders from buying through ADMARC and reselling. United Nations agencies are reported as saying however that ADMARC itself has played a role in price increases.
Endowed with 80 million hectares of arable land (of which only 10% is used), diverse climatic conditions, and abundant water resources, the Democratic Republic of Congo (DRC) has the potential to become the breadbasket of the entire African continent, according to this paper. Instead, the country is one of the most affected by malnutrition. The DRC has the highest number of undernourished persons in Africa and the highest prevalence of malnutrition in the world. As a result, child stunting and infant mortality rates in the DRC are also among the highest in the world. Overall, at least 50% of the population is deficient in vitamin B12, calories, riboflavin, iron, vitamin E, folate, and zinc. In rural areas, strategies to improve nutrition will need to use instruments that attack malnutrition directly rather than relying simply on rising incomes. Overall, the results highlight the paradox of the DRC - a country with huge potential for agricultural development but incapable of feeding itself in terms of both quantity and quality of nutrients.