Poverty and health

Food security in Africa is likely to be "severely compromised" by climate change, with production expected to halve by 2020, according to climate change experts. The projections in a report by the Intergovernmental Panel on Climate Change (IPCC), said about 25 percent of Africa's population - nearly 200 million people - do not have easy access to water; that figure is expected to jump by another 50 million by 2020 and more than double by the 2050s, according to the report. This year drought-affected parts of southern Africa - Zimbabwe, Swaziland and Lesotho - experienced a 40 percent to 60 percent reduction in maize production, for which global warming was partly to blame, noted the World Meteorological Organisation (WMO). But the IPCC report was more cautious. "The contribution of climate to food insecurity in Africa is still not fully understood, particularly the role of other multiple stresses that enhance impacts of droughts and floods and possible future climate change".

There have been dramatic changes to municipal services such as water and electricity since the end of apartheid in South Africa, with considerable research having gone into the impacts of commercialisation and cost recovery on low-income households. The research has revealed complex and often negative relationships between the marketisation of services and access and affordability for the poor. It has also been shown to have direct and very negative public health implications, most acutely in low-income township and rural areas.Less obvious, and much less researched, have been the impacts of changes in service delivery on the mental health of low-income residents and household members. What, then, might be the links between poverty, mental health and the shift towards market-oriented reforms in basic services? This paper explores the relationship in the South African context with a detailed, ethnographic case study of ten low-income families in Cape Town coping with a serious mental disorder (schizophrenia).

Water-related diseases are widely recognised as a major threat to public health, especially in the developing world. An estimated 19% of all infectious diseases are related to water, sanitation and hygiene risk factors. In South Africa the provision of basic infrastructure such as water and sanitation has been an important part of the social contract between the government and its constituencies. In 2001 the government became a partner in the Water, Sanitation and Hygiene for All (WASH) campaign, which was designed to attract resources to address the situation of millions of people without access to adequate water supply and sanitation. In Johannesburg, a privately managed parastatal was contracted to deliver water and associated services in the city. As part of their water service delivery and improvement of services, the company opted to deliver services using prepaid water meters and yard taps. But do households respond differently to hygiene and handwashing interventions such as WASH depending on which water and payment systems they have? This paper explores that question.

The five-year $362.6 million grant to Lesotho seeks to increase water supplies for industrial and domestic use, to mitigate the devastating affects of poor maternal health, HIV/AIDS, tuberculosis and other diseases by substantially strengthening the country’s health care infrastructure and human resources for health capacity, and to remove barriers to foreign and local private sector investment. Mozambique’s five-year $506.9 million Millennium Challenge Compact aims to reduce poverty levels through increased incomes and employment by improving water, sanitation, roads, land tenure, and agriculture. This program is expected to benefit about five million Mozambicans by 2015.