In this cross-sectional study, researchers screened 131 adults with or without pulmonary tuberculosis (TB) for HIV, wasting and disease severity using the 13-item validated clinical TB score and 24-hour dietary intake recall. Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following were low among patients with severe TB: energy, protein, total fat, carbohydrate, calcium, vitamin A and folate. Patients with moderate-to-severe clinical TB score had lower average energy intake than patients with mild TB scores (6.11 vs. 9.27 megajoules [MJ], respectively). The average 24-hour nutrient intakes of wasted and non-wasted TB patients were comparable. Nutrient intake among men was higher when compared to women regardless of wasting and severity of TB. Among those with wasting, men had higher average energy intake than women (8.87 vs. 5.81 MJ, respectively). Among patients with mild disease, men had higher average energy intake than women with mild disease (12.83 vs. 7.49 kcal, respectively). These findings suggest that severity of pulmonary TB and female gender were associated with reduced nutrient intake. Early diagnosis and nutritional support may be important in management of patients.
Poverty and health
Neoliberal sanitation experts visiting Durban, South Africa for the Toilet Summit in early December 2012 may argue that South Africa should embrace low-water toilets, yet community critics regularly report that Durban’s water-less ‘Ventilated Improved Pitlatrine’ (VIP) and ‘Urinary Diversion’ (UD) strategies are failing. The author argues that middle- and upper-class South Africans could easily cross-subsidise their low-income fellow residents by paying more for the privileges of filling swimming pools and bathtubs, watering gardens and running washing machines, and that government can at the same time adjust tariffs downwards for poor people. If such reforms were made to water and sanitation prices, then better health and gender equity would result, and more funds could be raised for installing decent toilets in South African cities, as well as to repair sewage pipes whose cracks infect rivers and harbours. The construction capability and subsidised funding for projects is available in South Africa so that 'toilet apartheid' is argued to relate more to political choices in how these resources are used.
Four country case studies undertaken for this report provide examples of innovations in policy design and implementation that have improved the investment climate for smallholders, such as decentralisation of land management responsibilities in Tanzania. Implementation of progressive policies in the face of major power imbalances between beneficiaries and vested interests seeking to maintain the status quo remains a major challenge. There are six inter-related sets of conclusions from the study. 1. Policy is currently biased against smallholders. 2. The investment climates that support smallholder investment and corporate investments in agriculture, while having elements in common, are not the same. 3. Policies must respond to the diversity of rural societies. 4. Policy innovations in inclusive investment do exist and should be copied. 5. Effective implementation is vital. 6. Politics matter: Vested interests undermine socially optimal outcomes, yet without a political analysis there is a risk of assuming that politicians choose policy in a socially optimal way and of constructing a normative analysis that focuses on technical solutions to the challenges of economic liberalisation.
As the International Year of Cooperatives is being observed in 2012, the Food and Agriculture Organisation (FAO) has said that one of the only chances small-scale food producers have to gain competitive access to local and global markets is by banding together in cooperatives. According to FAO chief, Graziano da Silva, cooperatives follow core values and principles that are critical to doing business in an equitable manner, that empower and benefit members and the local community. This is especially relevant in poor rural communities and in promoting sustainable local development. He said that the cooperative business model helps small- and medium-scale farmers add value to their production and access markets. Small scale food producers are also able to take part in policy discussions through co-operatives. Co-operatives help to generate employment, boost national economies, reduce poverty and improve food security. The FAO has pledged to foster the growth of agricultural cooperatives, including through their promotion by special ambassadors for cooperatives and by developing approaches, guidelines, methodologies and training tools for supporting policy on and organisational development of co-operatives.
Increased agricultural development in Zambia will compromise the country’s food security if peasant farmers continue to be driven off customary land to pave the way for large-scale local and foreign agribusiness, according to the University of Zambia’s Dean of the School of agriculture, Mickey Mwala. He argued that smallholder farmers are responsible for food security in Zambia. Land grabs and forced evictions of local farmers by both foreign and local investors are common, according to the Zambia Land Alliance, a land rights advocacy organisation. The Alliance blames the eviction of farmers on the cumbersome procedures involved in obtaining title deeds and “archaic” laws, which do not recognise customary rights as a form of land ownership. Under Zambian law, title deeds are the only legal proof of ownership of land. To get a title deed takes between two months and 10 years and is discouragingly complicated for illiterate applicants who cannot afford legal assistance.
In this paper the author proposes policy options to ensure that poor Zambian families do not lose their land rights in the face of trade policies. The proposals focus on addressing the obstacles that poor families face in accessing and obtaining legal title to land. Strengthening national land policy, the legal framework and investment guidelines would help to protect the land rights of poor families. A comprehensive pro-poor land policy needs to be developed to guide the review of legislation for land administration. For these proposals to work, local communities need to register as legal entities or trusts to legally own land.
In this report, IFPRI describes the evidence on land, water, and energy scarcity in developing countries and offers two visions of a future global food system: an unsustainable scenario in which current trends in resource use continue, and a sustainable scenario in which access to food, modern energy, and clean water improves significantly and ecosystem degradation is halted or reversed. The report provides on-the-ground perspectives on the issues of land tenure and title as well as the impacts of scarce land, water, and energy on poor people in Sierra Leone and Tanzania and describes the work of their organisations in helping to alleviate these impacts.
This new book by UNICEF details how the economic crisis continues to inflict devastating social consequences worldwide. In it, the authors note how access to public goods and services is also increasingly being challenged in the worldwide drive toward austerity measure in terms of reduced social spending. While the average gross domestic product of developing countries is contracting at nearly double the rate as their developed counterparts, combined price, income and service delivery shocks in these nations have potentially severe and irreversible consequences, especially for children, the authors argue. Among these include increased hunger and malnutrition, worsening health outcomes, lower school attendance, higher rates of child labour and domestic violence, rising vulnerability to future shocks and widespread social unrest. Even when faced with shrinking budgets, governments can expand their fiscal space without incurring immense cost, the authors argue. This can be achieved by: re-allocating public expenditures; increasing tax revenues; lobbying for increased aid and transfers; tapping into fiscal and foreign exchange reserves; borrowing and restructuring existing debt; and/or adopting a more accommodating macroeconomic framework.
To keep its mostly maize-growing small farms productive through cycles of drought, Malawi spends 60% of its agricultural budget subsidizing fertilisers. But the findings of this 12-year study suggest farmers in Malawi and elsewhere could increase yields consistently without applying fertilisers, using instead 'fertiliser trees'. To thrive, maize requires phosphorus and nitrogen, large quantities of which have been depleted from African soils. The 'fertiliser tree' or gliricidia, a leguminous tree, has the ability to draw nitrogen from the air and fix it into soil, changing it into a form that plants can use. The trees also restore some amount of phosphorus to the soil, according to the study. In addition, the leaves shed by gliricidia return organic matter to the soil, increasing its structural stability, erosion resistance and capacity to store water. Three consecutive experiments, begun in 1991 in Malawi and Zambia, showed that when gliricidia was planted in rows between maize plants, maize yields were good year after year.
In this background paper, the author argues that the concept of the right to food is an invaluable in development policy as it recognises the links between food security, culture and resource rights, and as a legal principle, it requires a state to ensure that its people are free from hunger. In recent years, the right to food among Kenya’s indigenous peoples has been challenged by climate change and state interventions that have resulted in land loss and resettlement. Past policies aimed at pastoral development - such as the Maasai Group Ranches - have failed in light of their lack of economic, social and cultural viability. Ultimately, the effectiveness of right to food is not only predicated on claimants’ ability to make demands on the state, but also on the state’s compliance with international law, the author argues. In terms of policy, she points out that Kenya is bound by the International Covenant on Economic, Social and Cultural Rights (ICESCR) of 1976, which stipulates the right to food, as well as its new constitution, signed in August 2010, which includes a provision related to the right to food. This provision is a significant step at the national level in regards to addressing food security. The next step ultimately involves the development of legislation, policies and programs to ensure the principles of the right to food are realised at the local level.