The campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) was launched at Osindisweni Hospital in Ethekwini District, KwaZulu-Natal Province on 4 May 2012. CARMMA aims to accelerate the implementation of activities to stem maternal and child mortality and meet Africa’s targets for Millennium Development Goals four and five - to reduce by three quarters the maternal mortality rate and to reduce by two thirds the child mortality rate between 1990 and 2015. South Africa has a rising maternal mortality rate, yet it is one of the last countries in southern Africa to implement the campaign since it was started in 2009. In many of the countries, the national champions of CARMMA or the national authorities have committed to follow-up activities to intensify the reduction of maternal mortality in their countries, including Malawi, Zambia, Rwanda and Swaziland.
Poverty and health
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.
Before his death in April 2012, Malawi's former president Bingu wa Mutharika resisted calls by the International Monetary Fund (IMF) to devalue the Malawian kwacha as a way to boost exports, arguing that poor people would be negatively impacted. His decision alienated external funders, who withdrew support. Malawi's new president, Joyce Banda, has moved quickly to restore relations with funders, in part by meeting the IMF's conditions for a support package. On 7 May 2012, she devalued the kwacha by nearly 50% and untied the currency from the dollar. External funders have started responding, with the World Bank reportedly working on a package to help poor Malawians cope with the effects of devaluation and the United Kingdom (UK) agreeing to unlock aid frozen in 2011. The UK's International Department for International Development (DFID) are reported to have pledged to release an initial £30 million (US$47.3 million) tranche of urgent funding, of which £10 million ($15.8 million) will be used to support Malawi's healthcare system, and £20 million will go to towards stabilising the economy. The implications for household poverty of the measures funded are as yet not reported.
In this study, researchers aimed to determine short- and long-term trends in child malnutrition in Eastern and Southern Africa and how these are affected by drought and HIV. An analysis was conducted of data from national surveys, generally from the mid-1990s to the mid-2000s. Results indicated that overall trends in child nutrition are improving as national averages; the improvement is slowed but not stopped by the effects of intermittent droughts. In Southern Africa, the prevalence rates of underweight showed signs of recovery from the 2001–03 crisis. As expected, food production and price indicators were related (although weakly) to changes in malnutrition prevalence; the association was strongest between changes in food production and price indicators and changes in malnutrition prevalence in the following year. Despite severe intermittent droughts and the HIV and AIDS epidemic (now declining but still with very high prevalence rates), underlying trends in child underweight are improving when drought is absent. Preventing effects of drought and HIV could release potential for improvement and, when supported by national nutrition programmes, help to accelerate the rates of improvement, now generally averaging around 0.3% per year, to those needed to meet Millennium Development Goals (0.4 to 0.9% per year).
Malaria is commonly considered a disease of the poor, but there is very little evidence of a possible two-way causality in the association between malaria and poverty. This study aimed to address this gap. In the study, results show that households with a child who tested positive for malaria at the time of the survey had a wealth index that was, on average, 1.9 units lower. If malaria is indeed a cause of poverty, as the findings of this study suggest, then malaria control activities, and particularly the current efforts to eliminate/eradicate malaria, are much more than just a public health policy, but also a poverty alleviation strategy, the authors argue.
According to this draft comprehensive implementation plan, the World Health Organisation acknowledges that nutrition challenges are multi-faceted, effective nutrition actions exist but are not expanded sufficiently and new initiatives have been launched to address nutrition, such as the Scaling Up nutrition movement. The plan sets five global targets and a time frame. The plan aims to alleviate the double burden of malnutrition in children, starting from the earliest stages in development. It contains five key actions. 1. To create a supportive environment for the implementation of comprehensive food and nutrition policies. 2. To include all required effective health interventions with an impact on nutrition in national nutrition pans. 3. To stimulate development policies and programmes outside the health sector that recognise and include nutrition. 4. To provide sufficient financial resources and staff for the implementation of nutrition interventions, 5. To monitor and evaluate the implementation of policies and programmes.
This report by the Commission on Sustainable Agriculture and Climate Change contains its recommendations to policy makers on how to achieve food security in the face of climate change. The Commission’s recommendations are designed to be implemented concurrently by a constellation of governments, international institutions, investors, agricultural producers, consumers, food companies and researchers. They call for changes in policy, finance, agriculture, development aid, diet choices and food waste as well as revitalised investment in the knowledge systems to support these changes. The Commission recommends significantly raising the level of global investment in sustainable agriculture and food systems in the next decade; sustainably intensifying agricultural production on the existing land base while reducing greenhouse gas emissions; and reducing losses and waste in the food system. The Commission urges governments attending the Rio+20 Earth Summit in June 2012 to make financial commitments for regionally-based research, implementation, capacity building and monitoring to improve agriculture and food systems.
Brazil has agreed to assist South Africa on social development issues, particularly in fighting against poverty and hunger. Brazil is aiming to help 16.2 million Brazilians out of extreme poverty with its comprehensive national poverty alleviation plan, ‘Brasil Sem Misera’. The plan includes cash transfer initiatives, and increased access to education, health, welfare and sanitation. South Africa has expressed a desire to learn about Brazil’s national alleviation plan and its successful Zero Hunger programme.
In this report, the authors argue that food security in Southern Africa needs to be "mainstreamed" into the migration and development agenda and migration needs to be "mainstreamed" into the food security agenda. They set out to promote a conversation between the food security and migration agendas in the African context, focusing on the connections in an urban context. Four main issues are singled out for attention: the relationship between internal migration and urban food security; the relationship between international migration and urban food security; the difference in food security between migrant and non-migrant urban households; and the role of rural-urban food transfers in urban food security. Findings indicate that most poor households in Southern African cities either consist entirely of migrants or a mix of migrants and non-migrants. Rapid urbanisation, increased circulation and growing cross-border migration have all meant that the number of migrants and migrant households in the city has grown exponentially. This is likely to continue for several more decades as urbanisation continues. Policymakers cannot simply assume that all poor urban households are alike. While levels of food insecurity are unacceptably high amongst all of them, migrant households do have a greater chance of being food insecure with all of its attendant health and nutritional problems.
Many African countries and regions have programmes to boost their agricultural productivity to ensure food security, with the pan-African Comprehensive Africa Agriculture Development Programme (CAADP) being the most comprehensive. On 5 March 2012 members of the CAADP Development Partners Task Team met in Brussels to discuss and explore how to facilitate and support greater involvement of regional stakeholders that are important for CAADP implementation at the regional level. Participants discussed how to achieve faster progress on implementing the programme and stressed the need to identify concrete regional actions for faster progress. They also emphasised the importance of deciding on roles and responsibilities of different regional actors, and of improving coordination among development partners, and between development partners and Regional Economic Communities. Although these ideas do not represent formal positions, they could be used to guide discussion between development partners, Regional Economic Communities and other actors during the Eighth CAADP Partnership Platform meeting, due to be held 3-4 May 2012.