RE: [ujeni] Just a thought
- I too appreciated your thoughts Scott. I will have to say, however,
that I still think that monies would be better spent on improving
nutrition and sanitation (such as clean water sources) rather than
expensive chemotherapeutic interventions for HIV/AIDS. For example,
for the cost of one year of therapy for one person receiving ARVs in
Zambia's program over one hundred people could receive insecticide
treated mosquito nets. There are some studies showing that increases
in life expectancy that have been seen in the developed world have
been due to improvements in sanitation and nutrition, not to
chemotherapeutic interventions (much to my chagrin, I have to admit
since I also think that advancements in drug therapies are also very
exciting). I would like to see a study that compares the efficacy of
antiretrovirals verses improved nutrition and preventing malaria in
extending and improving the lives of AIDS patients. That having been
said, I also do recognize that while from a public health perspective
this focusing of resources on malnutrition and malaria may seem
logical, on a case by case basis, it is difficult to deny someone
needed medications that their counterparts in more developed nations
can access easily. However, I do think that AIDS has much more
glamour in the media than malnutrition and I do think that peoples�
obsession with getting AIDS meds to Africa with little concern and
press for much more basic problems such as childhood mortality from
malnutrition is a little like placing a Tiffany's stained glass door
on a house that doesn't have any walls or roof. After all, when was
the last time you heard Katie Couric talk about stunting and wasting,
diarrhea, or the killer common cold? And, the only time that malaria
makes major headlines is when our troops enter malaria endemic
As far as malaria goes, what I have read about the malaria projects in
place such as Roll Back Malaria (RBM), GFATM (The Global Fund to Fight
AIDS, TB, and Malaria), MVI (The Malaria Vaccine Project�created by
the Bill and Melinda Gates Foundation), is that they are incredibly
segmented and operate in a piecemeal fashion. Wouldn't it make more
sense to pool funding from all agencies and governments and come up
with one plan of how to distribute nets internationally? How to best
to distribute them and get people to comply is obviously a region-
specific issue, but since the evidence suggests that they work and at
a very low per capita cost, why aren�t we focusing more resources in a
widespread effort that could actually have an international impact.
Why are health care workers not distributing nets that they have
available to them as Scott suggests, and is that an answer that such
programs do not work, or is it simply that the healthcare workers have
not been educated as to their efficacy and importance? Perhaps this
too is due to the fact that a fancy and expensive pill is much sexier
than a net. Shouldn�t health care workers practice �evidence-based�
interventions? It bothers me that Bush has chosen to put so much
money into an expensive tertiary intervention when many primary
interventions have not been successfully funded or implemented. I
think that often the simplest interventions are the most effective,
and are often overlooked for more complex and complicated
interventions. Lastly, I think that it is important to comment that
while funding for malaria vaccine efforts has increased in the last
decade, funding available for a malaria vaccine is only one tenth the
amount of funding that vaccine development efforts for HIV/AIDS
- 'Voting doesn't fill the belly'
12 December 2004 23:59
Mozambique's ruling party, Frelimo, surged ahead last week in unofficial results from the country's recent election, puzzling analysts who had expected a neck-and-neck finish with the opposition Renamo. At the same time, evidence of ballot-stuffing in some remote districts cast a shadow over the clean bill of health that international observers gave the elections.
Projections suggest that Frelimo's presidential candidate, Armando Guebuza, will get 60% of the vote, as compared with 35% for Renamo's Afonso Dhlakama, who in 1999 collected nearly 48% of the vote. These projections are based on results posted by individual polling stations and collected by Radio Mozambique correspondents around the country.
The sharp drop in Renamo support was accompanied by an equally dramatic fall in voter turnout, with numbers expected to be between three million and 3,5-million: less than half of the eligible voters. Turnout in the 1994 and 1999 general elections was 5,4-million and 4,9-million respectively.
Analysts agreed that abstention had been highest among Renamo's traditional supporters in the largely agricultural centre and north of the country, who felt that the government had let them down, and the opposition had failed to provide a viable alternative.
"People chose to stay in the fields -- voting doesn't fill the belly," said independent journalist Marcelo Mosse.
"In the cities, the absence might have been a criticism not only of [outgoing president Joaquim] Chissano, but also of Guebuza -- he is not someone who inspires support."
The political weekly Savana described the low turnout as "a red card to the political class", which it accused of being out of touch with voters' interests.
Reports of irregularities were concentrated in Tete province in western Mozambique.
"In Tete there was clearly fraud, though not enough to affect the final result," said Luís de Brito of the Electoral Institute of Southern Africa (Eisa).
He said two voting stations in the province's Changara district had reported turnout of close to 100%, with most of these votes going to Frelimo. De Brito said the high turnout for the province as a whole gave reason for suspicion.
"In Tete, we have an average of 400 voters turning out at each voting table, compared with fewer than 300 per table in all the other provinces."
De Brito said Renamo activists had been forced to leave certain areas of Tete province early in the election campaign, which had prevented them from sending monitors to polling in those areas. Elsewhere in the country, the presence of party representatives during voting and counting was hailed as Mozambique's best safeguards against fraud.
The Mozambican Political Process Bulletin -- an independent newsletter with a wide network of correspondents -- also cited evidence of ballot-stuffing in Tsangano district of Tete province, as well as in Chicono in northern Niassa province. In the latter, 996 out of 1 000 voters registered at one station appeared to have voted, with Guebuza gaining more than 900 of the votes.
Such reports contradicted the positive assessment of international observation teams, who praised Mozambique's strong legal framework for elections, the professionalism of polling station staff, and balanced coverage both in state and private media. Asked why the international teams had not picked up the incidents of fraud cited by Eisa, De Brito said these incidents had occurred mostly at remote and inaccessible polling stations.
The international teams, including Southern African Development Community parliamentarians and representatives of the Commonwealth, the Carter Center and the European Union, were however concerned at the low electoral turnout. Several of the observer teams also mentioned the mistrust that had been created by the party-political structure of the National Electoral Commission, where Frelimo is able to force through decisions by majority vote.
Elderly pay the price for raising Aids orphans
14 December 2004 08:21
Until a week ago, elderly Hannah Dube and her five grandchildren living in the dusty village of Kezi in soutwestern Zimbabwe had been surviving on small portions of dried white melon.
Then Zimbabwe's social services stepped in, handing the 75-year-old Dube emergency aid of the staple corn grain to feed her family, caught in the grip of an HIV/Aids pandemic and a crippling drought.
Her face worn by grief and stress, the aging grandmother's plight in this remote and rural corner of Zimbabwe tells the story of the burden of many other pensioners in this southern African country where HIV/Aids has turned a million children into orphans.
The UN children's organisation Unicef estimates that more than one in five children will be orphaned in Zimbabwe by 2010, with more than 80% of those orphaned by HIV/Aids, which kills about 3 000 people per week on average.
Nine of her grandchildren are orphaned -- she is looking after five children between the ages of five and 13.
Three successive years of drought in this naturally dry region some 600km southwest of the capital, characterised by unproductive soils, and a political and economic crisis have exacerbated food shortages.
"We only eat one meal a day," said Dube, who lives in a hut next to a dusty road, where her cooking fire has long since gone out.
"We are used to it now and there is nothing unusual about it," she said.
While food is available in the shops, people like Dube and her family, who have no source of income whatsoever, cannot even dream of buying any.
Driving up to Dube's home along a narrow dust road, hundreds of people, dangling empty sacks, were seen walking back home, looking tired, hungry and dejected.
They are coming from the local business centre where they had gone to register their names for food aid to be handed out three days later.
"We were told [by an international aid organisation] to come and register our names for food coming next week. But now they say only those on the old list will be given food," Dube said.
The Zimbabwean government this year turned away foreign food aid, saying the country produced enough to feed its people.
But Harare has recently allowed the United Nations World Food Programme to undertake a one-off free food distribution to get rid of its stock left over from April when the government stopped general food aid.
Volunteer workers confirm the hunger in the area.
"It is depressing to go out there visiting the sick, handing out a few bars of soap, diapers, some antiseptic solutions -- but seeing that what is urgently needed is food," said volunteer Georgina Tshabalala.
Dube is not only struggling to provide food for her orphaned grandchildren, but also shelter.
She cleans up grass that fell while she was thatching the roof of her new mud and pole hut in this remote rural area of Zimbabwe.
With nobody to help her build or maintain their home, Dube has to risk climbing onto the roof to patch it up before the rains bring it down.
Inside, the fire has gone out.
Dube said besides the fact that their one meal has already been cooked, she could not afford to keep the fire going because she does not have the energy to regularly go to the bush to cut down firewood.
The elderly woman -- old and weak enough to be a dependent herself -- said she had no choice but to look after her some of her grandchildren.
Those who are not under her wing are probably involved in illegal gold mining, rife in the area.
"I don't really know how they are surviving, but no one helps me with anything. The chickens and the goats you see outside I sell to send these children to school," she said.
Despite the difficult living conditions and lack of food, one of her grandchildren, Dan, (7), passed his year-end school examinations with A grades. - Sapa-AFP
Improved Zim inflation still world's highest
14 December 2004 15:15
Zimbabwe's official inflation rate dropped to 149,3% last month, down from 209% in October, the state Central Statistical Office said on Tuesday. The new rate still leaves Zimbabwe with the highest inflation in the world.
The troubled Southern African country is in the midst of its worst economic crisis since independence from Britain in 1980, with inflation peaking at more than 600% last year.
With the local currency plummeting, sending a Christmas card to Europe by air mail now costs Z$40 000 (about R41) -- twice as much as a one-bedroom apartment did shortly after independence.
A dollar was equivalent to Z$2 at the time, compared with the current official rate of Z$5 600, or Z$8 000 on the black market.
The Reserve Bank attributes the recent drop to tighter fiscal policies aimed at reining in rampant profiteering and a lucrative black market in scarce commodities and hard currency.
However, the official inflation rate excludes prices on a wide range of services and imports that have continued to soar throughout the year.
The cost of medicines, vehicle repairs and health, agriculture and mining equipment has risen by more than 600%. The state telephone and postal companies have increased their fees by 1 000%.
The agriculture-based economy has collapsed in the four years since the government began seizing thousands of white-owned commercial farms for redistribution to black Zimbabweans.
The country routinely faces acute shortages of food, gasoline, hard currency and other imports. -- Sapa-AP