Will Cancun restore faith and confidence in climate change negotiations?

By Ochieng’ Ogodo

[Nairobi] December 6, 2009 was thought of as significant day that was going to grip the attention of world with focus glued to the Bella Center in Copenhagen where the United Nations Climate Change summit was taking place until December 18. The expectations were both high and low.
The roadmap to Copenhagen was mostly on haggling over the reaching of a legally binding agreement on Green House Gas emissions reduction with set targets that becomes effective when the Kyoto Protocol ends in 2012 or a politically binding one.
Denmark hosting the summit had been rooting for politically binding agreement instead of legally binding protocol and wanted a plan to delay any deal to mid-2010.
This came against a backdrop where some of the western countries were reluctant for an agreement that will compel them to meet certain targets on emissions reduction and the United States refusal to ratify the Kyoto Protocol is case in history.
US president, Barack Obama, acknowledged on November 13, 2009 that a legally binding deal was impossible in Copenhagen. Worth noting was the fact that he had to first deal with a reluctant Senate to pass domestic laws to cut greenhouse gas emissions before he could agree to an international deal, a requirement that has stalled the talks.
Obama’s comments were received as serious blow to efforts aimed at getting meaningful agreement by the close of business on December 18 “We do not need a politically binding agreement as it will give room to big GHG emitters like the US and Canada to get away with it,” said Tove Marie Ryding of the Greenpeace
Her argument was that the 2007 report of the Inter-Panel on Climate Change by climate change scientists was clear that if the world does not act now and drastically reduce Green House Gas emissions, there will be serious socio-economic and environmental disaster that includes sea level rise, extreme climatic cycles like prolonged droughts and flooding, upsurge in disease burden, among many others.
According to the then executive secretary of the United Nations Framework Convention on Climate Change (UNFCCC), Yves de Boer, the Copenhagen agreement was to include a set or package of forward looking and “politically accountable” conclusions.
These were to include a list of individual 2020 targets for industrialised countries, what major developing countries will do about growth paths and limiting emissions, what individual countries will commit to in terms of a start up funding, formula on how cost of future adaptation and mitigation will be shared and Conference of Parties decisions on capacity building, mitigation, adaptation, Reducing Emissions from Deforestation and Forest Degradation and a new institutional arrangement where necessary.
GHG Emissions reduction
At this fifteenth edition of the Conferences of Parties aimed a getting consensus and agreement on reduction of GHG said to be causing global warming beyond required level was not just be the burden for the developed word but also what the developing countries can do to mitigate the situation and to adapt to adverse impacts of climate change..
Scientists in 2007 said the developed countries-the major contributors to atmospheric pollution through emission of dangerous gasses like carbon dioxide and methane-must reduce their emissions by 20-40 percent compared to 1990 when climate change movement started by 2020.
But they said thereafter that they underestimated it and that glaciers were now melting at a much faster rate; that the reduction should move up to 80 percent.
“We listen to science and when scientists say that glaciers are melting at a very fast rate; that we are moving to a tipping point where major changes may occur, we realise the urgency of getting legally binding agreement out of Copenhagen summit with clearly set targets,” said Ryding.
She said scientist are also saying that by the end of this century, if it remains business as usual, there could be sea level rise of 2 meters wiping out many small island states.
Climate change scientists and some western political establishments are also arguing that the developing countries where China is fast industrialising and currently ranked the highest polluter in the world must reduce their emissions.
Climate change reductions pundits are proposing a 13-20 percent reduction compared to Business As Usual. “The developing world can emit but not increase and move towards a greener development direction,” Ryding concurred. But the Copenhagen meeting ended up in botched-up discussion that succeeded in having no success for tangible for GHG emissions reduction and only creating huge mistrust among nations of the world, especially the developed against the developing world
Replacing the Kyoto protocol.
As we move to COP 16 in Cancun, Mexico, the search for a new legally binding deal, led by the United Nations though the US argued could not be reached in Copenhagen and that there was need for more time to hammer appropriate agreement hence the need for political binding outcome will be one of the main issues.
Those who argued that a politically binding agreement would be suicidal as it is essentially non- enforceable will be rooting for second commitment off the Kyoto Protocol in Cancun.
They argue that, save for its weak compliance mechanisms, it is the only legal global climate change agreement that has a set of rules to be relied.
“What we need is a complete legally binding agreement and ambitious targets for emissions reduction and finances for adaptation,” Paul Erik Lauridsen of CARE Denmark said. He said the developed countries must accept to reduce their emissions but the developing world must also have their targets.
The African position through the Africa Ministerial Council on Environment is that the Kyoto protocol must not be replaced but strengthened. Much haggling is expected on this at the negotiations.
Adaptation Needs
Another issue expected to dominate the proceedings is the financing of adaptation by the developed north in the global south being pushed by the developing word who have contributed very little to the global warming but are the most vulnerable and worst hit by impacts of climate change.
They argue that the purpose of adaptation financing and availing of appropriate technology to the developing nations by the developed world is not to lift them out poverty but protect the poor against effects of climate change caused by the industrialised countries as they developed over the years.
Green peace’s Ryding says its estimated that adaptation will cost about US$ 150 billion annually but the developing world are demanding an agreement out of Copenhagen for about US$ 200 billion annually for adaptation. China and India that are emerging economies are more for technological transfers from the west for green development to adapt rather than financial assistance.
The developing world position is that the developed world should pay up for global warming since they made their wealth out of industrial pollution.
Twenty percent of global emissions are from destruction of tropical forests and their protection is being considered one of the major solutions to tackling climate change. But forest, because of their life supporting services, has many people depending on them and removing them all over suddenly would lead to serious socio-economic disasters.
The issue is expected to also feature prominently at the conference, especially who shod benefit from the money coming out of forest protection; will it be the central government or the indigenous people who have been living in the forest for centuries.
Massive attendance
The Copenhagen meeting had a massive attendance estimated at over 15,000 delegates that included President Obama of the USA. More than 20,000 NGOs registered for the summit while accreditation for journalists was in excess 5,000. It is not yet clear whether Cancun will draw such a huge crowd but it will definitely be an important summit expected mostly to restore faith and confidence in climate change negotiations

**Ochieng’ Ogodo is a Nairobi journalist and the Sub-Saharan Africa News Editor for Scidev.net .He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.

Agriculture: Need for paradigm shift in Africa

By Ochieng’ Ogodo

[Nairobi] Application of knowledge and appropriate technology is critical for increased agricultural productivity for the rural poor in the developing world, especially Africa, Emanuel Tambi, Economist, Senior Policy Officer, Rural Economy Division at the African Union Commission in Addis Ababa has said.

This should be the new paradigm shift in agricultural growth in the developing world, especially in Africa, where majority of the rural poor depend on it as source livelihood and somewhat economic empowerment.

“In order to successfully meet challenges of globalization, developing countries, in general, and Africa, in particular, must place science and technology at the heart of their development policy,” he said.

He, however, recognized that, as continent with countries having primarily agriculture economies, Africa is confronted with limited human and material resources in scientific and technological fields, and therefore has problem incorporating science and technology into its development policies.

It is for this that his department is currently working with Regional Economic Communities, members states, research institutes such as International Livestock Research Institute and IFPRI, civil society organisations as well as development partners to move forward the agenda for research and technology.

Professor Kwadwo Asenso-Okyere, IFPRI’s director for International Service for National Agricultural Research Division said in many parts of the developing world, mostly Africa, agriculture plays an important role in national development in terms of employment and national wealth creation.

The pervasive poverty in many parts of these countries cannot be tackled sufficiently without paying attention to production and market development for agricultural products.

To cope with the demand factors and emerging global issues, actors in the food and agriculture value chain need to innovate to meet the challenges of the 21^st century.

“The good news is that there has been steady progress in African agriculture over the last few years with growth rates increasing from 2 percent per annum in the 1990s to about 5 percent in the 2000s,” he told the forum.

But to sustain this, Okyere stated, there is need for extraction of economic, ecosystem and social value from knowledge which involves putting ideas, knowledge and technology to work in a manner that brings about a significant improvement in performance.

A lot of knowledge, he explained, already exist and can be used to improve the livelihoods of the smallholder farmer in the rural settings where more than 50 percent depend on agriculture.

But there are no proper linkages for knowledge mobility from institutions of learning, research and different actors to get innovation to work to advance food and agriculture and this call for new approaches to capacity building.

The first stage of capacity building development, he pointed out, should be at the universities or institutions of higher learning to make them innovate and become efficient.

“It has been demonstrated that students retain 90 percent of concept or method if they teach others, 75 percent if they practice by doing, 50 percent if they are involved in a discussion but only five percent through lectures,” he said.

Scientists and students should talk to farmers and see how best they could infuse their [farmers] indigenous knowledge with those in formal educational systems and pass it on for accelerated agricultural production in the developing world.

The next level of capacity building is that of farmers to make them adopt new knowledge and technologies as well as improve on the existing ethnic agricultural knowledge to step up agricultural growth for food and poverty reduction.

Okyere also said for knowledge to be generated and used effectively for innovation in agricultural development there must be innovators in organizations, institutions, technologies and policies that are involved in the process.

Joachim Von Braun, Director of IFPRI challenged Africa and the rest of the developing world to develop their basic science, build practical technical education programmes on agriculture at higher institutions of learning and tap into existing indigenous knowledge to improve agricultural production for food security and wealth creation for the rural poor.

“Agriculture is a major source of employment in the developing world and also a vital source of food for majority of rural populations,” said Braun

Yet agricultural education and research is not being felt on the ground because of lack direct connection between scientists, students and the smallholder farmer who needs knowledge to adopt innovative methods of farming for increased yields.

Most agriculture students, he explained, do have practical experience and thus the big gap between knowledge and innovation and reality on the ground in the end. Africa, he told meting should make agriculture part of its higher education technical programme as one of the means in innovatively addressing food insecurity and poverty reduction in rural settings.

It should be part of the learning process right from secondary education level and Africa should also build up its basic science and not keep knocking on the doors of the western institutions for solutions.

“Africa and the developing world must build their own biological, physical and chemistry sciences and use that knowledge at all levels of food and agricultural systems,” said Braun.

**Ochieng’ Ogodo is a Nairobi journalist and the Sub-Saharan Africa News Editor for Scidev.net .He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.

Water and sanitation provision still a huge challenge for Africa

By Ochieng’ Ogodo
Journalist-Kenya
In the small hours of the morning, Caren Adhiambo gathered herself out of bed and wiped her face with the back of her right hand before picking a 20 litre jerican and venturing into the night.
Her mission this early was one; getting water. In Nairobi’s Kibera slum where she lives water is a scarce commodity. “I have lived here for five years and each passing day is a struggle for water,” she resignedly said.
Often they have to do about five kilometers to fetch water from boreholes in other neighborhoods like Dagoreti corner where a 20 liter jerrican of water retails for KSh. 3 at the minimum.
Houses with tap water are very few in this habitat estimated to house more than 300,000 people. Apart from private water taps they also get water from tankers hovering around, some marked “clean soft water.” They buy it without seeking to know source.
In Adhiambo’s household of seven, they use six jerricans a day and washing clothes is once a week. “Here there are no Nairobi City Council public water taps thus leaving us at the mercy of private water tap owners and tankers,” she pointed out adding they do not get rather cheap water.
The price ranges from KSh.3 to KSh.10 per twenty liter jerrican. “We have to queue for long hours to get water and we buy it expensively.”
Milka Achieng’ is lucky to have piped water in her house but she has to share a pit latrine with several other families exposing them to great danger incase of an outbreak of a contagious disease related to ecological sanitation.
The mother of three said most people use “flying toilets”-polythene paper bags where they defecate and then thrown out through the windows into the open neighbourhood.
“Most plots here do not have pit latrines or toilets and people use paper bags to defecate and throw them out into the open. You have to be careful when walking on the paths here lest you step on faeces,” she said.
There are few public toilets constructed by the government recently to improve sanitation but the demand far outstrip them according to Achieng’
There are many people without water taps or toilets in Kibera. “We are suffering greatly when it comes to toilets and faecal matter is all over,” she explained.

Most people in rural Kenya grapple with a huge problem of access to water and sanitation. Photo: Ochieng Ogodo
In Kibera, there are no storm water drainage systems and people wade through dirt when it pours. “On water born diseases God is there for us.” Achieng’ said. This overcrowded dwelling has liter-biodegradable and non-biodegradable-strewn all over. Kibera is a microcosm of what goes on in slums in most African urban centers and clearly exemplifies the sorry state in provision of clean water and sanitation to many people in Africa, be it in urban or rural settings.
Unmet fundamental human rights
Provision of clean water and adequate sanitation is not only a fundamental human right but among measures of a country’s healthy living. However, inadequate provision of the two is still a huge problem in rural and urban Africa, especially in slums.
Dr. Catherine Kyobutungi of the Africa Population and Health Research Center (APHRC) said the problem is more acute in African slum areas compared to rural dwellings. But even in rural areas, she hastened to add, there is a huge problem of access to water and sanitation.
“In Africa 70 percent of the urban population live in slums under extremely difficult conditions when it comes to water and sanitation provision,” she said.
“Water, both in quality and quantity, is an important aspect of life irrespective of one’s social status. On average a person needs 20 liters a day,” she explained.
But whereas it is recognised that diseases associated with water are mostly water washed and water borne, not much is being done and this is a clear indication of a continent still unable to meet basic needs of its people.
“In many cases scarcity and quality go hand in hand and the poor bear the brunt of water washed and waterborne diseases,” Kyobutungi explained
While the need for safe water to be healthy and prevent diseases, especially from water borne diseases cannot be gainsaid those in slums suffer both. “In public heath terms you need both quality and quantity,” she said.
Sanitation and diseases has tight link
According to Kibyotungu, an associate research scientist at the Nairobi based APHRC, there is a tight link between sanitation and diseases. The first thing is a toilet but there is much more to this like having Ventilated Improved Pits.
Waste disposal, the drainage system and general environmental cleanliness influences diseases like malaria and cholera.
“Sanitation and supply of affordable clean water can influence the transmission of water diseases. But waste disposal is also important,” said her.
For Kenya, 20 percent of the country is urbanised but not much has been done to uplift these places out of the situation according to the researcher.
In Nairobi, for instance, public taps are only available to 3 percent of slum dwellers while in the entire city it is only to 15 percent of the inhabitants. Other urban areas have only 35 percent of the people accessing tap water and in the whole country only 11 percent have access for a population of over 36 million people.
“For the entire country, on average, only 34 percent have access to public tap or water right into their residences,” clarified Kyobutungi. Thirty-one percent nationally get their water from wells and springs and other sources. In Kenya rural areas most people do not have access to water.
In Nairobi those who live in slums pay more for water compared to other city residents as they buy 20 liter container between Ksh 2-10.
“This is eight times what other city residents pay and it happens irrespective of the fact that quality of water is questionable,” said Kyobutungi.
Slums are fertile grounds for exploitation by those who move around with water tankers and small containers in handcarts. Sources of their water and cleanliness are always questionable.
On sanitation only 7 percent of slum dwellers have flush toilets while for the whole of Nairobi it’s available to 56 percent of the over three million city dwellers. Kenya as a whole has only 12 percent with access to flush toilets according to Kyobutungi. In slums VIPs are only accessed by 6 percent while in rural areas those who have what can be called decent pit latrines is only six percent with entire country having only seven percent.
The whole of Nairobi has only 13 percent with VIP toilets. Flush toilets plus VIPs in Nairobi is accessed by 69 percent. For slums combined it is 12 percent.
For traditional pit latrines it is 73 percent for slums in Nairobi while Kenya as a whole only 66 percent access them. In slums 10 percent are without any such facilities while in the entire country 15 percent have no access to sanitation services at all.
“Visiting toilets in slum areas is not free and one has to part with between KSh.2-5 per visit and children are forced to ease themselves in their houses and throw these away in paper bags or just do so around their ramshackles,” Kyobutungi observed. Availability of the facility does not mean usage. It depends on their pockets.
“This,” said Kyobutungi “means it is a dire situation given it’s a basic need but has not been met.” And the consequences are many. Children both in rural and slum areas are vulnerable but with the latter being more exposed.

Dr. Kibyotungu

A third of children living in slums in Kenya must have been affected by diaorrhea at least in two weeks and 32 percent before the age of five shall have had diaorrhea episodes and this compares to 18 percent in the entire Nairobi and 21 percent for the whole country.
“This is already bad enough. Dehydration kills many children in slum areas and the more the episodes the more the chances that that the children will die,” she said. But even sadder is their mothers do not know what to do and health facilities are unavailable. Where there are medical facilities costs will deter many from visiting.
At night the problem is compounded with insecurity with muggers on the prowl and people even get fatally beaten. With diaorrhea children disease like pneumonia sets in and it becomes a vicious circle only stopped by death.
“It has a both mid and ultimate consequence, which is death” For children below 5 years 151 out of 1000 will die before their first birthday. For Nairobi it is 98 out of 1000. Most children in the slum areas die because of diarrhea and account for 20 percent of deaths there.
Little investment and thought have been given to this area. “Slums are illegal and the government cannot put infrastructure but again it has both legal and political connotations,” said Kyobutungi. There are about 80 slums in Nairobi alone with most of them over 40 years in existence.
Millennium Development Goals
According to A Snapshots of Drinking Water and Sanitation in Africa by the United Nations Children's Fund (UNICEF) and World Health Organisation (WHO) the number of people without access to sanitation increased by 153 million from 430 million in 1990 to 583 million in 2006.
“The rate at which Africans gained access to sanitation, 153 million people since 1990, is insufficient to meet the MDG sanitation target,” the report says. Even more shocking is that 38 African countries in Africa have less than 50 percent sanitation coverage.
Whereas 605 million people had access to improved drinking water in 2006, thus a coverage increase of 56 percent in 1990 to 64 percent in 2008, those without access increased by 61 million from 280 million people in 1990 to 341 in 2006. This falls far short of the required number to meet MDG on drinking water by 2015.
MDG target 7c calls on countries to “Halve by 2015, the proportion of people without sustainable access to safe drinking water and basics sanitation.” Africa is steel in lack of clean water and decent sanitation for majority of its population. This makes it indeed one of the big and urgent challenges for the content in the 21st century.
**Ochieng’ Ogodo, a Nairobi journalist, is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting and the chairman of the Kenya Environment and Science Journalist Association [KENSJA]. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com

Africa needs effective health service delivery systems and research

By Ochieng’ Ogodo

One of the desirable key drivers of Africa’s social and economic development, which can be best realised through the vehicle of regional integration, is the reduction of the burden of disease.
But Africa still faces huge challenges in her efforts to provide affordable, quality and accessible health care to the people.
It is for this reason that Juma Mwapachu, Secretary General of the East African Community (EAC), says putting effective health service delivery systems and health research is at the heart of regional cooperation and integration.
“It is generally recognised that one of the key drivers of Africa’s social and economic development, which is indeed best realised through the vehicle of regional integration, is the reduction of the burden of disease,” he told the Fifth European and Developing Countries Clinical Trials Partnership (EDCTP) Forum in Arusha, Tanzania 12TH – 14TH October 2009.
He said that amongst the four basic types of investment required to enable the poor world escape from poverty, is health, “including control of the main killers-infection, nutritional deficiencies, and unsafe child birth through the provision of preventative and curative health services”
“In its Africa Health Strategy 2007-2015,” he said, “policy document adopted by the African Ministers of health in Johannesburg in April, 2007, the African Union equally recognises this linkage. Whilst Africa’s population is 10 percent of the world population, Africa bears 25 percent of the global disease burden. Yet Africa has only 3 percent of the global health workforce.”
Africa’s health care provision, Mwapachu said, has been wanting and whereas commitments have been made in the past, such proclamations have not been accompanied by practical follow ups at policy levels.
“It is difficult to doubt or question this state of affairs when many Sub-Saharan African countries remain stuck in dependency syndromes with at least 40 percent of their recurrent budgets, on average, being paid for by development partners,” he said.
The funding deficit for better health care for all, he said, troubles many right thinking people in Africa due to the new wave of a disease burden emerging. Mwapachu also observed the serious issue of counterfeit drugs that has hit East Africa hard.
“It estimated that in the East African Community region as much as 70 percent of the generic drugs sold in the drug stores and pharmacies are counterfeit,” he told the gathering.
On health research or research for health, he said, the picture in so far as Africa’s commitment to health research is concerned is not any different from that of health care generally.
He said there is no African-wide health research as such and the African Union has merely called for multi-country collaboration in health research which is to be undertaken through the Regional Economic Communities (RECs) such as the EAC.
But most of the RECs, except the EAC one and a few others have no policy framework for promoting such collaboration and their policy focus and priorities differ.
The EAC, he said, has mainstreamed Annual Health Scientific Conferences which brings together policy makers and top researchers focusing on selected key health research projects in its calendar of activities.
“At the EAC, we have seen the importance of developing an institutional health research framework and capacity.”
With multilateral support mainly from Canadian and Swedish Governments, the EAC is now at an advanced stage of enacting a law, through the EAC Legislative Assembly, for constitution of a fully fledged EAC Health Research Commission.
Explaining further, Mwapachu said the AU is engaged in advancing the translation of health research into policy and action and has evidence informed policy network (EVIPNet-Africa) that will, among others, form a strong basis for health research collaboration and exchange of health research outputs.
But the challenge is on how the programme would be funded given that Africa is yet to reflect serious commitment to allocating adequate resources to fund health and other scientific research.
“The African Union has set a benchmark of 2 percent of national recurrent budget expenditure and 5 percent of health development budget for health research at national levels,” he pointed out.
Only few African countries, he said, have been able to fulfil such benchmark with Tanzania that recently scaled up state investment in research and development from 0.3 percent to 1.0 percent of Gross Domestic Product.
“Africa’s commitment to health and research would be of little meaning if research is not translated to productive use. Africa faces a huge challenge in so far as its infrastructure is concerned for commercialisation of health research findings,” he summed up.

**Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world including Africa, the US and Europe. He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.

Non-communicable diseases: a time bomb about to explode

By Ochieng’ Ogodo
In a long time, certain diseases have been thought of as only afflicting those wallowing in material comfort. But that is now misplaced given non-communicable diseases such as diabetes and Cardio Vascular Diseases (CVDs] like high blood pressure have become common among lowlifes in places like Korogocho and Kibera slums.
And without clear cut policies and funding for most common non-communicable diseases [NCDs], Kenya could be sitting on a time bomb. Jane Nyambura Hiuko is one such lowlife citizen whose life became miserably from diabetes which took her long to discover. “I did not know I was suffering from diabetes. I always thought it was malaria or typhoid but with unending body weaknesses and knee aches,” she recollected.
In mid 2000s she used to visit a dispensary in Nairobi ’s Kariobangi estate where diagnosis and treatment was mostly for malaria and typhoid with no respite. “It was an agony in which my body behaved like it was being pricked by needles from every side. This was accompanied with extreme heat in the night and I bathed about four times before sunrise.”
From 75 kilograms, the 52 year old mother of six rapidly lost weight at an average of three kilograms a week. “I though I was suffering from TB.” It was not until October 2008 when she attended a free outreach clinic run by Africa Population and Health Research Center [APHRC] in Korogocho that she discovered her diabetic status.
Her sugar level was 32.6 millimals per litre and the doctor instantly put her on treatment through injections. She was also put on diet and after two weeks it dropped to 5.9.
Harry Ndara Waruinge, also of Korogocho, is attending the same clinic that offers medical services for no penny because of being diabetic high blood pressure patient. In 1996 he discovered he was diabetic and last year his situation got compounded by another diagnosis that revealed he was also suffering from high blood pressure.
Emphasis has been on most common communicable diseases in Kenya and Africa at large, among others, malaria, Tuberculosis [TB], HIV/Aids, measles, acute lower respiratory tract infections, diarrhea diseases and dysentery.
They are frequent because most African countries’ tropical climate that supports infection-causing agents to thrive and the growth of vectors that carry some of these diseases such as the mosquito that transmits malaria.
Weak health systems that do not fully offer preventive services like high immunization coverage for measles that can be easily contained is also a factor.

Dr. Kyobutungi

Non-communicable diseases on the rise
“But CVDs are on the rise because of change in lifestyles and exposure to environmental factors,” according to Dr. Catherine Kyobutungi, Associate Research Scientist with APHRC.

Kyobutungi says there are very high levels of alcohol consumption, most of which is cheap liquor with high alcoholic content. Other than interfering with the functions of various body systems and organs that culminates in NCDs, alcohol may have a direct effect on the pancreas which is responsible for insulin secretion. Insulin is one of the hormones that regulate the metabolism of glucose in the body and so if its secretion is interfered with, one may easily get diabetes.
“There are high levels of tobacco consumption mostly through smoking. Prolonged exposure to products of tobacco smoke results in damage to blood vessels which can ultimately result in a cardiovascular disease”.
Besides, some products of tobacco smoke are carcinogenic [cancer-causing] and high tobacco consumption is associated with many types of cancer especially cancer of the lungs.
Because of resource deprivation in slum areas like lack of land for cultivation, majority depend on cheap food resources with high starch levels. Economic factors also dictate that healthy foods such as fruits, foods with high fiber content, “healthy” fats are not affordable.
The poor are more concerned with having a meal rather than the quality of it. CVDs among the poor are also associated with prolonged stress.
Environment pollution around slum areas by toxins like smoke from factories, heavy traffic as well as indoors cooking (indoor air pollution) may also damage blood vessels and parts of the respiratory system leading to chronic obstructive diseases of the respiratory system, cardiovascular diseases and even cancers.
“Stress,” says Kyobutungi “has been long associated with conditions like high blood pressure which in most cases is a precursor of NCD of the heart, kidney, brain and other organs. The poor, especially those in slum settlements are constantly stressed due to the constant struggle to earn a basic living, insecurity and lack of social networks.”
According to Beryl Akinyi of the Counseling and Advocacy for Kidney Disease [CAFKID] most people do not know about the kidney disease while the mortality rate is 6000 annually.
“Those suffering from diabetes and high blood pressure are most vulnerable to kidney disease yet many do not about these NCDs,” she stated
Experts say CVDs will double up from 1990 to 2020 because of factors like urbanization and modernization. Many people are migrating from rural to urban area, changing their eating habits and live in polluted neighborhoods, which are some of the risk factors for the anticipated rise.
Unhealthy diet a major cause
The World Health Organisation [WHO] says the most important causes of heart disease and stroke are unhealthy diet [low in fruits and vegetables, high in sugar, high in salt, high in fat], physical inactivity, tobacco use and alcohol consumption. These are called 'modifiable risk factors'.
Effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity; referred to as 'intermediate risk factors'.
The major modifiable risk factors are responsible for about 80 percent of coronary heart disease manifesting as heart attacks and cerebrovascular disease known as stroke.
There are also a number of underlying determinants of chronic diseases. They reflect the major forces driving social, economic and cultural change–globalization, urbanization, and population ageing. Other determinants of CVDs are poverty and stress.
In 1998 alone, WHO puts it, non-communicable diseases killed 31.7 million people world wide. It is projected this will be 36.5 million by 2020 with middle and developing countries bearing the brunt. The burden in low-income countries will also increase greatly over the same period.
Kyobutungi says there is need for universal early diagnosis, especially the poor. “Early detection and management of intermediate risk factors will lead to fewer complications and less probability of dying from these diseases. Most of them suffer for a long time without knowing it and by the time they do, they have already developed complications which are more difficult to manage.”
Early diagnosis, she explained, can be easily done even at the lowest level of health care in the country. Widespread prevention programs that encourage healthy lifestyles such as proper eating habits, less consumption of alcohol and tobacco and more physical activity are also necessary. “We need affordable medical services that are accessible to the urban poor.”
Not taken seriously in AfricaThe problem, she states, has not been taken serious in Africa and the focus of many ministries of health in Sub-Saharan Africa [SSA] has been on communicable diseases like HIV/AIDS, TB and malaria.
“Many SSA governments have therefore not invested much in health services to tackle the non-communicable diseases,” said Kyobutungi.
In addition, popular perception is that CVD are diseases of the affluent who can afford the high cost of diagnosis and treatment. Most people are diagnosed when they present with symptoms and yet screening could be easily integrated in primary health care services.
The average cost of screening diabetes is Kshs. 200 in a local pharmacy. These diseases are not treatable but are manageable. The cost of buying 1 vial of insulin that will last for two weeks is about Kshs.1500 from a local chemist and Kshs 500 from government hospitals.
The average cost for drugs to control high blood pressure is about KSh.1000 per month based on the drug combination and type of drugs used. It could be much higher.
Policies for non-communicable diseases in most countries are very weak or non-existent. For instance the current Kenya National Health Sector Strategic Plan II 2006-2010 says very little about non-communicable diseases and is mentioned only twice in the whole document..
Kyobutungi hopes that the new HSSP coming into effect in 2011 will have more substantive focus on non-communicable diseases. But the government can increase access to screening and treatment services at public health facilities, it can formulate and enforce national policies that reduce exposure to tobacco products [directly or indirectly], programs that educate the public about the dangers of high alcohol consumption and also encourage healthy eating.
“The beginning of any good policy is good data, so government should also invest in generating data that shows the true magnitude of the problem at the population level rather than relying on hospital generated data when it is clear that most people do not use these hospitals when they are sick,” she pointed out.
Currently, according to Elizabeth Kahurani, APHRC’s communication officer, their organization and the City Council of Nairobi’s Department of Health are involved in intervention in slum areas with the main objective of generating research that informs policy formulation, decision making and other development efforts in addressing health and population challenges among the urban poor.
**Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world including Africa, the US and Europe. He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.

Africa: Low technology level and lack of information hindering climate change adaptation

By Ochieng’ Ogodo

As climate change intensifies through increased temperatures and precipitation, most smallholder [SH] farmers in Africa , majority living in rural areas, are not adapting to global warming.
Low levels of technology and scarcity of information on climate change are some of the major obstacles for the vast majority of African farmers in adapting to global warming.
Claudia Ringler, a senior research fellow at the International Food Policy Research Institute [FPRI], says global change, including increased population, urbanization, international trade and climate change will have significant effect on food and water security in the coming decades on Africa .
Speaking at How can African agriculture adapt to climate change? Results and Conclusions for Ethiopia and beyond meeting December 11-14, 2009 in Nazareth Ethiopia , Ringler said rural areas in developing countries, especially Africa , will be least able to adapt to these changes, in particular climate change, as incomes and employment in rural areas are largely dependent on agriculture.
“Ethiopians will find it particularly difficult to adapt because of high dependence on rainfed agriculture, very low incomes, widespread poverty and food insecurity, low levels of human and physical capital and poor infrastructure,” she cited.
No adaptation to changing circumstances.
Whereas most households have perceived increase in temperature and decline in rainfall according to a study tabled at the meeting, many have done nothing to adapt to changing circumstances.
The study conducted by IFPRI under Food and Water Security Under Global Change: Developing Adaptive Capacity with a Focus on Rural Africa, in the Nile Basin of Ethiopia and Limpopo Basin in South Africa is the first detailed one on factors affecting adaptation to climate change among house hold farmers.
Approximately 1000 Ethiopian cereal crop farmers in the survey identified shortage of land as the biggest single constraint to adapting to climate change. Next was lack of information and credit lines.
Done in collaboration with the Center for Environmental Economics and Policy in Africa, the Ethiopian Development Research Institute, the Ethiopian Economics Association and the University of Hamburg, Germany the study shows that about half the farmers surveyed did not adapt at all to changes in temperature and rainfall,
Ringler, who was the project leader, said African countries are particularly vulnerable because of limited ability to adapt to dependence on rainfed agriculture, the low level of human and physical capital, poor infrastructure, and already high temperatures.
Ethiopia’s vulnerability, the study states, is intertwined with poverty, although some regions of the country are more vulnerable than the others like Afar, Somali, Oromia and Tigray.
Mahmud Yesuf from Addis Ababa University , the study’s co-author, argued that weak institutional and informal networks, little access to technology and a shortage of information is hampering farmers' ability to adapt to global warming.
“The majority of farmers do not have information on what to do but even where they do, there are no resources required for technologies like building stone and sand bunds,'' said Yesuf.
He warned that some technologies being given as one fix-it-all will not work. “There has been failure to take cognizance of the fact that a technology appropriate for one region may absolutely be unsuitable for another.”
There is also the insecure land tenure, and coupled with undeveloped labour market in agriculture, the future looks bleak without immediate interventions.
Yesuf said 42 percent of household farmers in the region of study did not adapt to climate change despite apparent knowledge of its existence.
Information on climate change is vital
The study on cereal crop farmers suggests that information about climate change and better access to institutions strongly improves farming households’ ability to adapt to global warming.
It found that households with good access to formal agricultural extension assistance, credit and farmer-to-farmer networks were among those most likely to initiate climate change adaptation measures on their farms.
About half the farmers surveyed said they did not adapt at all to changes in temperature and rainfall, blaming the lack of information, followed by shortages of labour, land and money.
Households led by older and more experienced farmers, and households led by literate farmers, were more likely to adopt climate change adaption strategies. Large households were also more likely to respond to climate change, suggesting that the availability of labour is a key issue.
Apart from changing their planting and harvesting periods, the IFPRI report said, farmers also changed crop varieties, were conserving soil and water, intensified water harvesting and planting trees. Five percent of the farmers surveyed said they responded by migration or shifting from crops to livestock herding.
African farmers find it relatively easy to alter planting schedules or using different tillage methods but need to do much more, such as using seed varieties designed to survive climate change, warned Kidane Georgis of the Ethiopian Institute of Agriculture.
Georgis also said that national and regional climate change research institutions were guilty of poor linkages, which affected the speed and quality of information-sharing. Weak agriculture department extension systems hampered the farmers' uptake of new technologies.
Small holder farmers narrated how weather variability has brought great suffering and altered their lifestyles. “We have over the years seen great increase in temperatures and severe change in rainfall patterns,” Tukies Barusha, a small holder farmer from Adami Tuli district said
Rainy season used to run from January through to Septembers but these days it has become unpredictable. Maize has been a staple food crop here but planting time has shifted much with low yield from long dry spells.
Sometimes severe floods destroy crops in the field, devastates infrastructure and kills animals and human beings according to Barusha.
“When I was a boy we were not using fertilizers but today we have to use chemical fertilizers if we have to realise some little yield. Even the amount of maize we get from a hectare of land is down considerably,” Barusha, 47, a father to 15 said.
“We also keep cattle but the changes have been severe with prolonged dry spells and there is not enough grass and water for the animals. My father, at any given time, kept around 100 heads of cattle but today I am forced have only fifteen,” said Fitala Lemu, a middle aged man from Dagada district in Oromia region.
Diseases like Malaria and typhoid are on the increase in the region according to the two farmers. In an area where people have families averaging ten, the pressure on ecological resources like water and forests is enormous and sometimes resulting into tension among communities.
Rethinking water storage strategies
Sub-Saharan Africa [SSA] countries must rethink and adopt water storage strategies for mitigation and adaptation, said Fitsum Hagos, a social scientist with the International Water Management Institute [IWMI].
SSA, he said, is one of the places that will be hit harder by severe water shortage as the region is already under severe water stress.
Most countries here enjoy good rains which could be harvested but it turns into waste run-offs. Citing Kenya , Hagos said it is among SSA countries with poor water storage infrastructure and urgently needs improved management as a mitigation and adaptation measure.
“We need to rethink water storage for climate change adaptation in Kenya and the rest of Sub-Saharan Africa,” Hagos said against a population of 32 million people Kenya had water storage of only 4 cubic meters per person.
“That is very low and the country needs to do something substantial about its water storage infrastructure for both human use and agricultural production, especially in the face of climate change,” he said.
He blamed the low water storage infrastructure in Africa on the lack of political will, dwindling donor funding and trans-boundary issues that make certain usage of water bodies like river Nile shared by several countries difficult.
Ethiopia, he pointed out, had irrigation potential of 3.7 million hectares that could be developed but currently only 200,000 hectares are under irrigation. “The total run-off during the peak season especially June through to Septembers is huge with the rest of the year a long dry spell,” he said. “If we store water we could use it for irrigation and domestic consumption.
The issue of water is critical in SSA since majority, especially in rural settings housing majority of the national populations, depend on fragile rainfed agriculture economies but climate change is not factored in development plans despite extreme weather variability.
“Water stress will affect agriculture, people’s health, among many others. We need to understand priority storage areas from infield to large scale schemes,” he said.
Promotion of water storage system depending on local circumstances and potentials-from farm and communal levels to large scale projects like dams at the basin level for hydroelectric powers stations for local consummation and export-is urgent.
Hagos said for rivers like Nile that passes through several countries it is imperative upstream activities takes care of the needs of those downstream. “We must take into perspective what happens at all stages whenever we are developing projects like a dam. We need an integrated water resource management,’ he pointed out.
Concurring, Ringler called for private investment on on-farm irrigation as a short term priority and a large scale public investment in water storage as one the ways for long term answers to the water problem in SSA.
Clean Development Mechanism
The Clean Development Mechanism, Ringler argued, should be expanded to compensate technologies that replace wood fuel in Africa .
A large percentage of the people in Africa were using firewood and charcoal which should be considered dirty energy. “In Ethiopia for instance,” she said, “92 percent of the people were using wood fuel and the forest cover had declined over the years from 40 to 4 percent.” . Ethiopia has a population of 73 million people.
“Replacing firewood with other clean energy sources like solar power should be accommodated under CDM as one of the ways of fighting global warming and Sub-Saharan Africa could play a big role in this,” she said at a meeting. “If a project replaces firewood then CDM funds should be made available to it,” she added.
Araya Asfaw, Director, Horn of Africa-Regional Environment Center, said Africa must prepare and talk with one voice in Copenhagen next year when a new agreement replacing the Kyoto Protocol is expected to be concluded.
“Africa did not benefit from the Kyoto protocol because it made it difficult for her to access the CDM fund yet it needs funds to mitigate and adapt to global warming,” he said.
He said most technologies recommended for CDM currently like solar power are not accessible to Africa because of lack of funds. Even countries protecting forests should be compensated.
In the past, he said, Africa has not been effective in global negotiations and African Union and her member states should this time round come up with a strong voice to ensure it benefits from the next agreement since it’s more affected by climate change and has very little mechanism for coping up.

**Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world, including Africa, the US and Europe . He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.

Climate change a major threat to health

By Ochieng' Ogodo

Climate change has mostly been associated with melting ice caps, rising sea levels that threatens coastal cities and nations, extreme weather changes that includes prolonged droughts and heavy flooding including unexpected flash floods.
But health experts are now saying there are pathogens that could spread to new regions as a result of climate change, with potential impacts to both human and wildlife health and the global economy according to a report The Deadly Dozen: Wildlife Diseases in the Age of Climate Change.
“There are a number of diseases that could spread fast into new regions as a result of climate change with prospective impacts on both human and wildlife health,” Dr. William Karesh, Vice President and Director of the Wildlife Conservation Society [WCS] Global Health Programmes says.
In East Africa , he points out malaria could escalate due to climate change causing more harm to health problems than now. They believe monitoring wildlife health holds key to knowing what is lurking around us and giving an opportunity to come up with measures for mitigation.
Africa will be hard hit
The report points out that Africa is one of the places that will be hit hard by deadly human-wildlife diseases that have become a major threat in the age of climate change according to the health experts.
WCS’s Assistant Director, Global Health Programme, Kristine Smith says the region was more vulnerable because majority of the people live in rural areas and interact with the wildlife that could carry some of these deadly pathogens.
She says there will be increase in diseases like diarrhoea, cholera, malaria and resurgence of others like sleeping sickness because of changes in temperatures and the environment.
“The rift valley fever, malaria and rinderpest are increasingly becoming both human and wildlife health problems in East Africa due to changes caused by global warming, and leading to extreme weather circumstances and great environmental changes,” she told the Sunday Express.
As new diseases attack wild animals, she says, it increases chances of an epidemic in surrounding communities. In areas where people mostly depend on bush meat, the chances are even higher as climate change negatively impacts on wildlife health.
Dr. Stevens E. Sanderson, President and the CEO of the WCS, speaking on their report says there are deadly diseases that threaten human and animals.
The deadly dozen include such diseases as avian influenza, ebola, cholera and tuberculosis but these are only illustrative of abroad range of infectious diseases. The experts said in addition to the health threats the diseases pose to human and wildlife population, the pathogens that originate or move through wildlife populations have destabilised trade and caused economic damage.
Several livestock disease that emerged in mid 1990s, avian influenza included, caused an estimated loss of US$100 billion to global economy.
“Emerging infectious diseases are a major threat to the health and economic stability of the world,” says Rosa DeLauro, a congresswoman and a champion for The Global Avian Influenza Network for Surveillance [GAIN] programme created in 1996.
According to the experts many wildlife pathogens have been the focus of monitoring but there is very little data on how these diseases will spread because of climate change. The dozen pathogens that may spread as a result of climate change, they stated, are avian influenza, babesiosis, cholera, Ebola, intestinal and external parasites, Lyme disease, plague, red tides, rift valley fever, sleeping sickness, tuberculosis and yellow fever.
Early warning systems
One of the ways for the region and the rest of the world to deal with these increased threats of disease crossing from wild animals to humans, which will be further fuelled by climate change, is the need for early warning systems
"Building warning systems and doing disease surveillance in places like the Congo basin would be cheaper than building expensive machines to control an outbreak," says Karesh.
According to the expert, early warning systems include monitoring disease patterns in wild animals, environmental changes and how they affect the wild animals and the pathogens behaviour because of the changing temperatures and precipitation caused by climate change.
Continuous testing of the wildlife for pathogens could also be an invaluable part of this monitoring system. “Wild animals are more susceptible to new diseases than domesticated animals and are good indicators of an impending outbreak,” he says.
These, he says, does not only offer fertile grounds for building early warning systems but also areas that could be researched on.
He states there are many wildlife pathogens, like Ebola in the Congo area that may be spread as a result of the changing temperatures and precipitation caused by climate change.
For Karesh African governments and the international community should, among others, train local people on how to detect signs of such diseases when they are about to occur by monitoring the behaviour of and wildlife and the seasonality changes.
Sanderson said the health of wild animals is tightly linked t the ecosystem in which they live and influenced by the environment surrounding them.
“Even minor disturbances can have reaching consequences on what diseases they might encounters and transmit as climate changes,” he says. Monitoring wildlife health can, therefore, enable people predict where the trouble spots will occur and set in motion measures to counter.
“The monitoring of wildlife health provides us with a sensitive and quantitative means of detecting changes in the environment. Wildlife monitoring provides a new lens to see what is changing around us and will help governments, agencies and communities detect and mitigate threats before they become disasters, says Karesh
“What we have learnt from the WCS and the GAINS programme is that monitoring of wildlife populations for potential health threats is essential in our preparedness and prevention strategy and expanding monitoring beyond bird flu to other deadly diseases must be our immediate next step,” states DeLauro
Indigenious knowledge
Michael Kocke, also a veterinarian of the WCS, calls for the tapping of indigenous knowledge to deal with these diseases. “Indigenous knowledge can reveal past occurrence of some of these diseases and how they were dealt with including herbs used then to treat them. Scientist can then do research using conventional scientific technology and methods on how to deal with them,” he says.
He says in Africa most people, especially in rural areas, have interacted closely with wildlife and there could be a wealth of information out there that needs researching on.
Indigenious knowledge, Kock says, is vital and should be combined with conventional research for results. Karesh concurred saying that indigenous knowledge can add context to what is going on in the laboratories
Smith believes that building warning systems will also help design adaptation measures like when people should eat what foods and what to avoid when. For instance, this will help people to know when some of the wildlife people consume their meat could be on the verge of infection and they should, therefore, be avoided. This will also help earmark the disease and what needs to be done.
According to Kock climate will complicate the problem of HIV/Aids as those suffering from virus related ailments have their immunity compromised and low nutrition levels may worsen with this. “Climate change is a big issue both the developing and the developed world. The vector range is expanding because of it and more people are getting exposed,” says Kock.
The best defence, according to the experts, is a good offence in the form of wildlife monitoring to detect how diseases are moving so health professionals can learn and prepare to mitigate their impact.
**Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world including Africa, the US and Europe. He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.