Zambia, six other meet the Abuja Declaration

ZAMBIA has met its goal in the Abuja Declaration to allocate at least 15 per cent of their annual budgets to healthcare by 2015.
Twelve years African governments pledged in the Abuja Declaration to allocate at least 15 per cent of their annual budgets to healthcare by 2015.
Zambia and five other African countries have met this goal. The other countries are Liberia, Madagascar, Malawi, Rwanda and Togo
The six African countries have met the target, and five other countries are spending at least 13 per cent of their annual budgets on health, according to data compiled by the UN World Health Organization (WHO).
While on aggregate spending on health has increased - up to 10.6 per cent from 8.8 - about a quarter of African Union (AU) member-states have regressed and are now spending less on health than they were in 2001, adds the WHO data.
Recently, the AU held another special summit on HIV/AIDS, tuberculosis (TB) and malaria in Abuja, Nigeria, dubbed Abuja +12, which provided an opportunity for African governments and other stakeholders to review progress made and to discuss what should be done to ensure health funding targets are met before 2015.
“A renewed and bold commitment here in Abuja is essential as, drawing from experiences in the AIDS response, we know that smart investments will save lives, create jobs, reinvigorate communities and further boost economic growth in Africa,” said Michel Sidibé, the executive director of UNAIDS, in a press statement.
At present, funding for healthcare remains short of requirements and is very unevenly spread across countries. According to UNAIDS, an additional US$31 billion per year will be needed to meet the continent’s 15 per cent health funding targets.
As of 2011, at least 69 per cent of the world’s 34 million people estimated to be living with HIV/AIDS were in sub-Saharan Africa.
But there are encouraging signs. The number of new HIV infections fell by 25 per cent in 2011 compared to a decade earlier.
“The main challenge in the fight against HIV and AIDS globally is how to ensure universal access to prevention, treatment, care and support, and… ensuring zero transmission of new HIV infections in children,” wrote Ghanaian President John Dramani Mahama in a blog article in May.
Among 21 priority countries in Africa, the number of children newly infected with HIV has fallen by 38 per cent since 2009, according to a joint AU-UNAIDS report launched at Abuja +12.
Africa is also lagging behind in reducing cases of - and deaths from - TB and malaria.
Globally, Africa is the only region not on track towards halving TB deaths by 2015, and it accounts for almost a quarter of the global caseload, according to WHO.
Inadequate TB detection and drug-resistant strains of the disease, which can be 100 times more expensive to treat, pose significant challenges in Africa. About 40 per cent of TB cases in Africa go undetected, adds WHO.
Malaria is also a serious health problem. Eighty per cent of the world’s cases and 90 per cent of malaria-related deaths occur in Africa.
“We are at a turning point for making historical gains in Liberia's health sector - where no child dies of malaria and every mother living with HIV can give birth to HIV-negative children while living healthy lives themselves,” wrote Liberian President Ellen Johnson-Sirleaf, in a statement to the Global Fund.
Liberia allocates 18.9 per cent of its annual budget to healthcare, the second highest proportion in Africa; Rwanda spends 23.7 per cent.
According to the AU/UNAIDS Abuja +12 report, there is an economic case to be made for further investment in healthcare: For every year that life expectancy rises across the continent, it argues, GDP will increase by 4 per cent. The average life expectancy in Africa is 54.4 years, the lowest globally.
“A sick population cannot generate the productivity needed to maintain the acceleration of our economy,” said Ghana’s President Mahama.
More funding for health could also mean more jobs within the health sector. In 2012 for example, the AU approved a business plan to increase the output of the local pharmaceutical industry.
“Focusing on three things that Africa needs to do urgently - decrease dependency by growing African investments, deliver quality-assured drugs sooner to the people who need them, and leadership - the blueprint will help African countries to build long-term and sustainable solutions,” stated Mustapha Sidiki Kaloko, the AU Commissioner of Social Affairs, in a statement, ahead of the Abuja +12 summit. “Africa’s health and our prosperity are inextricably linked.”

 

Why palliative care is ultimate gift for Lunga

Emily Kasaso smoothing Betty

By DOREEN NAWA
THE death of a child is an inexplicable sorrow. No matter the circumstances, it is a life-altering experience.
Emily Kabaso, 69, has watched two of her grandchildren die, and a third, Betty, aged one and half years, is dying if no assistance is given.
As a volunteer in her community in Lunga, Mrs Kabaso has cared for terminally-ill people including children, with many of them dying because she could not meet their medical needs and professional care.
“I made up my mind to give these children a home. I decided to be the mom. Everybody needs one,” she says.
When it’s clear that one of her grandchildren is dying, Mrs Kabaso sets out to make the child as comfortable as possible.
“For the two that passed on, I made sure they died under my care. The same love I gave to their mother is the same I afforded my grandchildren.
“But doing it alone is very, very difficult. The children died in my own hands, on my lap, not in hospital, because we just only have a building without medical staff, “mrs kabaso said
When Betty was born, she showed no signs of dying at an early age. And because her mother did not undergo an HIV test to determine her status, Betty was breastfed.
Despite Betty’s mother’s health deteriorating, she did not seek medical attention but instead concluded that it was black magic.
“One day Betty’s mother was brought to my home in a critical condition. Luckily, that day we had nuns from the local Catholic Church who had come to offer medical services and they did a test on her, which came out positive,” said Mrs Kabaso.
Before she could get accustomed to the anti-retroviral drugs, her condition worsened. she died, leaving Betty with her grandmother.
Betty is not the only child with such a condition, there are many others, but because of lack of palliative care, some of them end up dying before they reach their fifth birthday.
According to the World Health Organisation, palliative care is an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illnesses, through the prevention and relief of suffering by means of early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Such care is essential for people living with HIV/AIDS because of the variety of symptoms they can experience such as pain, diarrhoea, cough, and shortness of breath, nausea, weakness, fatigue, fever, and confusion. This helps relieve symptoms that result in undue suffering and frequent visits to the hospital or clinic.
Lack of care results in untreated symptoms that hamper an individual’s ability to continue his or her daily activities at the community level and it places an unnecessary burden on homes.
Local Government Minister Emerine Kabanshi, who is also Lunga member of Parliament, hopes that soon, a clinic or hospice will be established to alleviate the suffering of the people in the area, which does not have a hospital, clinic or hospice.
“As a mother, I feel for these people, soon something will be done to change their way of life and the suffering of my people here,” said Ms Kabanshi.
Getting the nearest health centre or hospice takes over eight hours through the waters of Lake Bangweulu and Luapula River, the nearest one being in Samfya.
Senior Chief Kalima Nkonde of the Unga-speaking people said: “We have lost children to HIV/AIDS who would have added value to the development of our area. I would like to appeal to Government to help us build a health post and send medical personnel. Patients want to die with dignity and have time with their families to convey their last words but here in Lunga, the situation is different.
More often, you will find patients and their families are grateful for such care, whether the treatment is successful or not. Palliative care is the ultimate gift.

ICTs: helping farmers make the most of their produce

By DOREEN NAWA

THE use of information and communication technologies (ICTs) has expanded opportunities for small scale farmers aiming to extend their agri-businesses into viable and sustainable ones.

The ICTs are addressing the need to better the way small-scale farmers access the market.

Failure to access market has been one of the greatest challenges that Zambia’s small scale farmers have been facing. But with the use of ICTs in accessing market places and prices, the plight of these farmers could soon be history.

Failure to access the market and market information has often made small-scale farmers vulnerable to exploitative briefcase businessmen.

Until the Short Message Service (SMS) system was put in place, farmers had very little knowledge about market prices and had to sell their crop to intermediary buyers at prices often well below market rates.

The SMS trading system was introduced by the Zambia National Farmers (ZNFU). It is called the ZNFU4455.

According to ZNFU media liaison officer Calvin Kaleyi, the SMS system, which was launched in August 2006, is very simple to use.

“The service allows smallholder farmers to compare current prices in their district, province or nationwide and to make the best decision on where to sell their produce, thus giving them commercial power that they did not have previously.

With support from corporate sponsors, we intend to introduce new commodities and services to the system,” Mr Kaleyi said.

“The system is very accessible for small farmers because mobile phone technology is cheap,” he said.

In addition, says Mr Kaleyi, the service spurs competition among traders and processors, who keep a close eye to see how their competitors' prices are moving.

The service allows smallholder farmers to compare current prices in their district, province or nationwide and to make the best decision on where to sell their output, thus giving them commercial power that they did not have previously. 

Commodities that are part of the market information service include maize, beans, groundnuts, soybeans, sunflower, sorghum, cassava, beef, sheep, pigs, goats and wheat.

So far, over 1,000 hits per week have been recorded on the system. It is estimated that more than 15 per cent of SMS messages directly lead to farmers selling their produce, and over 130 traders update their prices on the system weekly.

How it works

To obtain the best prices for a commodity, farmers simply send an SMS message containing the first four letters of the commodity name to 4455.

Within seconds, they receive a text message with prices by buyer using abbreviated buyers' codes. If a farmer wishes to get specific prices in a specific district or province, he or she simply includes the province and district code after the commodity code.

After selecting the buyer that best suits their needs, farmers can send a second SMS message with the abbreviated buyer's code again to 4455.

Currently, the ZNFU works with mobile phone company Airtel, which provides market information data in the regions it covers.

The ZNFU is looking to continue the scheme, with the support of a corporate sponsor, and intends to introduce new commodities and services to the system.

A text message is sent back with the contact name and phone number of the buyer, the full name and address of the company and simple directions for reaching both.

Farmers are then able to phone the contact and start trading. Each SMS message costs approximately less than K1. The system is also supported by a website, for those who have Internet access.

With the new system, they can request the latest market price being sent via SMS for any given commodity. Within seconds they receive information on best prices and the best buyers in a specified province or district.

The SMS service, which costs K0.80 ngwee for each message, enables farmers to compare prices and selected buyers to start trading.

The ZNFU is collecting prices for the commodities on a weekly basis. The livestock commodities offered are: beef, goats, pigs and sheep.  The crop commodities offered are: beans, cassava, ground nuts, honey, maize, rice, sorghum, soybeans, sunflower and wheat.

Such a technology could be the first step towards creating a mobile phone commodity market for the whole of Africa and link up previously isolated small scale farmers.

 “As small scale farmers, we face too many challenges like insufficient quantities to meet demands of large buyers, lack of bargaining power and skills, lack of information about the true value of produce, and we travel long distances in the uncertainty of finding a market for the produce,” says Kenny Siatwinda, a small scale farmer in Chibombo.

“But with the coming of the use of ICTs in finding the market, I believe things will change,” Mr Siatwinda said.

The uncertainty of income and repeated failures in selling the produce at a profit can cause the unavailability of capital to buy farm inputs such as fertilizer, pesticides, and improved technologies leading to a decrease in production and product quality.

Small-scale farmer thus enter poverty cycles as a consequence of poor market access.

ICTs have proven efficient in improving market access for small scale farmers and others to facilitate traceability of agricultural produce.

In Zambia, the agriculture sector has been identified as the main employer in the country with the greatest potential to reduce poverty.

Its contribution to the Gross Domestic Product (GDP) has remained below 20 per cent and the sector has recorded marginal growth in recent years.

“One of the reasons why agriculture seems not to contribute enough to the GDP is challenges we face in marketing the produce.

Some of the farmers end up losing out after investing so much money in inputs and after harvesting, their produce do not find market. But with such an in,” says Janet Mwiinde, a small scale farmer in Chibombo district.

Lack of access to reliable and up-to-date market price information is a serious problem for smallholder farmers across Africa.

Without market information, the farmers are vulnerable to unscrupulous traders giving them prices at below-market rates.

Furthermore, the small scale farmers are reluctant to diversify into different cash crops for fear of not finding a profitable market for their produce.

The success of the initiative has attracted international attention with the World Bank now using the Zambian formula price model as the benchmark for Africa.

 

TEDx Talk: A small change to aid, a big impact on urban poverty

Report By Doreen Nawa

One small change to how donors provide development aid could unlock the power of poor people in urban centres to address their own problems, says Dr David Satterthwaite, senior fellow in the International Institute for Environment and Development’s Human Settlements Group.

In a new TEDx Talk, which he gave last month in Germany, Satterthwaite tells the story of two innovative funds that have enabled low-income communities in more than 200 African and Asian cities to build and upgrade houses and improve water, sanitation and other important services.

They are exceptional cases of success, which could be replicated and scale-up massively if donors changed the way they operate.

 

Today, aid agencies and international development banks provideUS$125 billion a year in aid to national governments in Africa, Asia and Latin America.

But as Satterthwaite explains, while donors justify their aid with images of poor communities, they rarely consult to those communities about the aid they will provide. Nor are the projects they fund accountable to the urban poor. The result is often bad projects that fail to meet local needs.

The other problem is that aid agencies were not set up to work at the local scale at which problems exist. To save staff costs, donors prefer to fund fewer large-scale projects than many smaller ones.

Satterthwaite shows that another way is possible. He describes howUrban Poor Fund International and the Asian Coalition for Community Action were set up to support slum or shack dwellers to drive their own development, with the funding and its use accountable to them.

The Urban Poor Fund International is managed by Slum/Shack Dwellers International,  a network of more than 30 national slum/shack dweller federations. It has supported over 200,000 households to build or improve their homes and to get tenure of their house plot and hundreds of other initiatives. The Asian Coalition for Community Action (ACCA) has funded more than 1,000 community initiatives in 168 cities.

Both funds are affecting the way city governments work, empowering low-income communities to raise more funds and work in partnership with authorities to develop their settlements and improve living standards. There are now over 100 formal memorandums of understanding between federations and local governments. Thanks to ACCA there are now a hundred city-based funds that groups of savers from informal settlement co-manage with municipal governments.

Satterthwaite points out that the funds have achieved all of this with just US$35 million, a tiny sum when shared across so many countries, cities and communities.

“Imagine if just one per cent of aid — US$1 billion — was spent this way,” he says. “We would truly transform our cities.”

Global Health Corps announces fifth class of fellows

Global health corps has launched its fifth class of fellows today, during the opening of its annual Training Institute at Yale University. The 106 fellows hail from 16 countries and will serve with 44 health organizations in Burundi, Malawi, Rwanda, Uganda, Zambia and select cities in the United States. The newest fellowship class was selected from a pool of almost 4,000 applicants and highlights GHC's continued growth. GHC began with 22 fellows in 2009 and last year placed 90 fellows with 34 organizations. Since 2009, Global Health Corps has grown over 450% and placed 322 fellows in positions to partner with non-profit organizations and government agencies focused on healthcare delivery. 

The organization engages and empowers a new generation of leaders who want to markedly shift the inequity in healthcare access around the world.

"It is critical to elevate these outstanding youth voices within the global health field," said CEO and co-founder Barbara Bush. "At GHC, we invest in young leaders through ongoing mentorship, professional development and leadership training to ensure that the Global Health Corps fellowship becomes a launching point for our fellows, allowing them to become changemakers and innovators in their careers."

GHC recruits, trains and places young professionals with skill-sets that are often viewed as outside of the traditional health workforce, including financial managers, communications specialists, architects, computer scientists and supply chain analysts. It is a model based on partnership where these professionals apply their expertise to strengthening health systems by bringing fresh thinking and new solutions to the work already being done on the ground.

"In this fourth year of partnering with GHC, we are proud to host six more fellows in three of our country programs – Malawi, Uganda, and Zambia," said Adaku Ejiogu, Senior Technical Officer for Partnerships at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). "This program offers young professionals a unique opportunity to develop new skills, experiences and relationships that will make a positive impact on our efforts to eliminate pediatric HIV/AIDS worldwide."

Fellows confront issues including, but not limited to, HIV/AIDS, maternal and child health, hunger and malnutrition and health access. During the fellowship year, the fellows take on projects which in the past have ranged from organizing a flashmob around condom distribution in Burundi, to counseling homeless youth in New Jersey, to constructing a world-class hospital in rural Rwanda. Fellows apply for and carry out a specific job throughout the fellowship year and are expected to engage in the larger health dialogue on a local, national and international level in order to effect broader change.

"My experience as a Global Health Corps fellow has helped me fine-tune my career path and acquire the knowledge and skills that will shape my work for years to come," said Rémy Pacifique Ntirenganya, who served as a Pharmacy Supply Chain Analyst with Partners In Health (PIH), Rwanda. "By working with professionals from diverse backgrounds and participating in numerous capacity building programs on related topics, I've grown personally and increased my ability to make an impact as a global health professional."

Over the next two weeks, the new class of fellows will participate in the Training Institute at Yale University before departing for their in-country assignments. 

Global Health Corps mobilizes a global community of emerging leaders to build the movement for health equity. GHC believes young people are the future to solving global health challenges. We place recent college graduates and young professionals from diverse professional backgrounds in health non-profits and government offices in the US, East Africa and Southern Africa for a year of service in order to strengthen and learn from the organizations. Fellows focus on creating solutions for a variety of current health issues like HIV, maternal child health, and healthcare access. Through additional training, community building, leadership development and mentorship these young people complete their fellowship with skills to be changemakers and paradigm-shifters in the global health field throughout their careers. Since its founding in 2009, GHC has deployed 322 fellows to work in 7 countries.