Poverty and health

On seeds: Controlling the first link in the food chain
Tandon N: Pambazuka News 557, 9 November 2011

The Alliance for a Green Revolution in Africa (AGRA) and the Gates Foundation represent the interests of biotechnology companies like Monsanto that are attempting to monopolise Africa’s seed industry, according to the author of this article. With Monsanto among the Foundation's portfolio investments, the author questions the legitimacy of the Foundation’s drive to promote genetically modified (GM) crops produced and patented by Monsanto. The risks to farmers of fully adopting industrial agriculture in general and GM seeds in particular include: transferring their food and farming decisions to global corporations; losing ecological and agricultural diversity as GM crop varieties spread; increased use of pesticide and fertiliser normally required for GM crops; and driving small- and medium-scale family farmers off their land because they cannot afford the expensive inputs that industrial agriculture demands, like patented GM seeds. Instead, the author argues for an approach based on traditional knowledge, with small-scale farmers growing diverse crops for local markets, planting farmer-selected crops from seed saved year-on-year (referred to as heirloom varieties), and, drawing on case studies, argues that integrated farm management based on traditional knowledge – without using pesticides or chemical fertilisers – have proven to yield greater harvests. To address the issues of nutrition security, poverty and health in Africa, farmers and governments should not be coerced into following the Western industrial agricultural model, and the Gates Foundation and AGRA should not be regarded as genuine partners in finding solutions to the food crisis in the continent.

Pathways to progress: Transitioning to country-led service delivery pathways to meet Africa’s water supply and sanitation targets
De Waal D, Hirn M and Mason N: Water and Sanitation Programme, 2011

This report maps progress in water supply and sanitation of 32 countries in Sub-Saharan Africa. According to the report, political stability has heavily influenced progress in improving access to water supply and sanitation services with low-income stable countries outperforming low-income fragile and resource-rich countries, breaking with the common perception that access to sanitation and water increases with gross domestic product (GDP). The good progress of low-income stable countries has been assisted by their receiving three times more aid than low-income fragile countries and two times more aid than resource-rich countries, per unserved person. Low-income stable countries making most progress have capitalised on harmonised and aligned aid modalities to successfully transition to more programmatic, ‘country-led’ forms of service delivery. The authors emphasise that a shift in aid modalities from external funder-driven projects to country-led programmatic approaches can potentially increase access to water and sanitation services for millions of people by 2015. To accelerate progress to meet Millennium Development Goals for water and sanitation, at least an additional US$6 billion a year of domestic and external funding is needed, they add.

Poverty, child sexual abuse and HIV in the Transkei region, South Africa
Banwari M: African Health Sciences 11(Special Issue 1): 8117-8121, August 2011

In this paper, the author argues that poverty robs children of their rights, forcing parents to sell their daughters in exchange for money. The trio of poverty, sexual assaults and HIV are argued to be are complementary to one another. In this paper, five case cases are described, as presented at Sinawe Centre as victims of rape, where money has played a role in the delay in reporting the crime to the police. First, a 13 year old girl was raped by a known person. The cost of settlement was a mere R500 (equivalent to US$70). The second victim was paid R10 or R20 for each sexual act. Third, fourth and fifth cases were young girls who were forced to marry by their parents. The history, physical examination and laboratory investigations are given. Psychosocial and economic aspects are also discussed, such as the cultural practice of lobola (bride price). The author argues that South Africa’s high incidence of HIV and AIDS may be partly linked to the custom of lobola, which is often seen as a monetary transaction, whereby the wife is a bought object and the husband often feels free to acquire mistresses. This increases the possibility of infection, which is turn can be transmitted to the wife. In addition, the author argues that high rates of sexual assault in South Africa run parallel with high levels of HIV prevalence, and mental health problems resulting from rape are seldom treated. Although the South African government Has pledged to provide HIV post-exposure prophylaxis if the survivors of rape present within 72 hours of the event, none of the girls and women in the case studies qualified, as they reported the incidences too late.

Women farmers feed the world
Hillstrom C: Yes Magazine, October 2011

As African farmers experience escalating anxiety over the appropriation and control of land, seeds and farming techniques by foreign governments and corporations, the multi-million dollar Alliance for a Green Revolution in Africa – a Gates Foundation-funded initiative – promises to increase food production and defeat poverty in Africa by implementing vigorous Western-style agricultural techniques and genetically modified crops. Modelled on the previous Green Revolutions of Latin America and the Indian sub-continent, the African Green Revolution should heed the environmental devastation these previous experiments in agriculture have wrought, the author of this article cautions, such as seriously depleted water tables and impoverished soil. Although new seeds and tools may bring higher production in the short term, some Africans are concerned about the consolidated control that foreign corporations will exercise over food supply, as well as the precarious dependence on large amounts of water and energy inputs, and the environmental toll such methods may eventually take. A growing movement of local farmers – largely led by women – argues that the surest path to food security is ensuring food sovereignty. The article points to a number of international organisations and alliances, like Via Campesina and Groundswell International, which advocate for community-level control over food production. These organisations target primarily women farmers who, according to the article, are responsible for up to 70% of food production in the developing world. The author asserts that supporting small-scale women farmers is crucial to ensuring food sovereignty in poor countries.

Agricultural success from Africa: the case of fertiliser tree systems in southern Africa (Malawi, Tanzania, Mozambique, Zambia and Zimbabwe)
Ajayi OC, Place F, Akinnifesi FK and Sileshi GW: International Journal of Agricultural Sustainability February 2011: 129-136, 1 February 2011

In response to declining soil fertility in southern Africa and the negative effects that this leads to, such as food insecurity, fertiliser tree systems (FTS) were developed as technological innovation to help smallholder farmers to build soil organic matter and fertility in a sustainable manner. In this paper, the authors trace the historical background of FTS and highlight the developmental phases and outcomes of the technology. The synthesis shows that FTS are inexpensive technologies that significantly raise crop yields, reduce food insecurity and enhance environmental services and resilience of agro-ecologies. Many of the achievements recorded with FTS can be traced to some key factors: the availability of a suite of technological options that are appropriate in a range of different household and ecological circumstances, partnership between multiple institutions and disciplines in the development of the technology, active encouragement of farmer innovations in the adaptation process, and proactive engagement of several consortia of partner institutions to scale up the technology in farming communities. It is recommended that smallholder farmers would benefit if rural development planners emphasise the merits of different fertility replenishment approaches and take advantage of the synergy between FTS and mineral fertilisers rather than focusing on `organic vs. inorganic' debates.

Brazil calls for pact on social factors to improve health
Bulletin of the World Health Organisation 89(10): 714-715, October 2011

In this interview with the World Health Organisation, Brazilian Minister of Health Alexandre Padilha calls on other countries around the world to develop a pact to eradicate poverty and hunger. Padhila calls for the launch of a proactive and rational agenda that encompasses the food, pharmaceutical, arms, tobacco and alcohol industries, as well as action to develop and increase the wealth of peoples, setting goals for environmental sustainability and the end of extreme poverty. The last two United Nations meetings on health – on polio and HIV and AIDS – point to the same direction in solving both challenges: equity in the access to prevention measures and treatment, he notes. The Brazilian Ministry of Health has carried out a broad public consultation to prepare a plan to address non-communicable diseases. The prevention and control of these diseases will be the subject of a set of political and governmental policies.

Kenyan government has failed on right to food
Kibugu J: Pambazuka News 548, 22 September 2011

Despite guarantees to the right to adequate food in its current Constitution and ratification of several international covenants that expressly recognise this right, the Kenyan government has failed its people in this regard, writes the author of this article. The current food crisis is marred by reports of surplus crops rotting in granaries due to lack of markets or means of transportation to ready markets, while there have been allegations of theft of relief food by government officials. The government has admitted that it does not have sufficient infrastructure to distribute relief food and is relying on local and international relief agencies to do the job. Poor distribution of relief food has been exacerbated by government’s failure to map the drought zones properly, the author argues. Controversy has also raged regarding the safety of genetically modified maize being imported into the country, with the public bio-safety regulatory authority admitting incapacity to conduct the required tests. It is on record that the government ignored the adverse weather forecast from the Kenya Meteorological Department and the local chapter of the International Committee for the Red Cross, failing to plan ahead. Poor government policies that fail to incentivise maize production - the country’s staple food - have also been blamed for declining maize yields, year on year. The author calls on government for effective measures to end the cycle of famines.

Land and power: The growing scandal surrounding the new wave of investments in land
Zagema B: Oxfam Briefing Paper 151, 22 September 2011

The new wave of land deals in agriculture has had a negative impact on the poor in developing countries, according to this paper by Oxfam. Oxfam’s research has revealed that residents regularly lose out to local elites and domestic or foreign investors because they lack the power to claim their rights effectively and to defend and advance their interests. Oxfam makes a number of key recommendations. First, the rights of the communities affected by these deals must be respected and their grievances addressed, and those who are profiting from the international deals must help to ensure this happens. Second, the balance of power must be shifted in favour of local rights-holders and communities. Governments should adopt strong, internationally applicable standards on good governance relating to land tenure and management of natural resources. Third, host governments should respect and protect all existing land use rights, and ensure that the principle of free, prior and informed consent is followed and that women have equal rights to access and control over land. Fourth, investors should respect all existing land use rights. Fifth, financiers and buyers should accept full supply-chain responsibility. Sixth, home country governments should require companies investing overseas to fully disclose their activities, and ensure that standards and safeguards are implemented to protect small-scale food producers and local populations.

Leprosy on the increase in Madagascar
IRIN News: 26 September 2011

According to IRIN News, new cases of leprosy have been reported from clinics in Antalaha, a remote area of Madagascar. The driving force behind the outbreak of the disease is increased malnutrition, the article reports, caused by dramatic increases in the price of rice. And while people are becoming poorer and more susceptible to illness, the public healthcare system is receiving less money from the government. According to the United Nations Children's Fund (UNICEF), government spending for health dropped to US$2 a person in 2010, compared to $5 in 2009 and $8 in 2008. Clinics in remote places like Antalaha are the most likely to suffer from shortages of drugs and medical supplies. Six to 12 months of treatment with multidrug therapy - a combination of two antibiotics and an anti-inflammatory (medicines that the World Health Organisation distributes for free) - stops the disease from spreading, but there are other obstacles to overcome. The main one, according to medical workers, is that the Malagasy authorities declared that leprosy had been eradicated from the country in 2010. Medical workers are reported to be afraid to report new cases to the authorities as this will contradict the official position on the disease. Diagnosing the illness can also be tricky in a tropical climate that causes many dermatological problems, and basic items like bandages – which are needed to dress the wounds – are usually lacking in health centres.

Social grants may be discontinued in Swaziland
IRIN News: 17 October 2011

Swaziland's parliamentarians recently debated the social safety net covering children, the elderly and the disabled. Recipients often depend on these small grants and pensions for survival. The debate on the future of social services was prompted by submissions from the Deputy Prime Minister, Themba Masuku, on the suspension of grants to the elderly. A number of Members of Parliament (MPs) supported the call for a constitutional amendment to abolish these government grants when government had no money to pay for them. The article reports that many pensions were suspended in the first quarter of 2011. In June 2011 only 6,480 pensions were reported to be paid, while at least 40,000 pensioners without bank accounts were reported to have received no benefits, so that OVC grants could be paid instead. The Deputy Prime Minister did not respond to parliamentary questions as to when regular pension payments would resume. The non-payment of social grants is expected to have a knock-on effect on health of the country’s population, particularly those living in extreme poverty.

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