"The composition of world poverty has changed noticeably. Numbers of poor have fallen in Asia, but risen elsewhere. The share of the world’s poor living in Africa has risen dramatically. Not only has Africa emerged in the 1990s as the region with the highest incidence of poverty, the depth of poverty is also markedly higher than that found in other regions - suggesting that without lower inequality economic growth in Africa will have a harder time reducing poverty in the future than elsewhere. Looking forward, if the rates of progress against poverty that we have found for the last two decades of the twentieth century are maintained then we expect that the poverty rate for the developing world as a whole will fall to 15% by 2015, just short of the Millennium Development Goal of halving the 1990 poverty rate."
Poverty and health
Transforming Our World, the 2030 Agenda for Sustainable Development, which is likely to be adopted by UN Member States, contains astonishingly bold and ambitious aspirations for transforming global health. The Agenda includes a series of “zero targets” to be achieved by 2030, including to “end preventable deaths of newborns and children under 5 years of age” and to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.” The author argues that such targets are simply unattainable unless there’s a massive scale-up in research and development (R&D) for conditions that disproportionately affect poor communities in low- and middle-income countries (LMICs). Unfortunately, the SDGs as currently written say way too little on the essential role of scientific innovation in achieving SDG 3 (the health goal) and they say nothing at all about the crucial importance of monitoring progress in global health R&D. A compelling August 2015 report by Policy Cures, an independent research group, made the case that the SDG 3 targets “will not be achieved without R&D to develop new health technologies—such as new and improved drugs, vaccines, diagnostics, and other critical innovations—and to improve our understanding of how to best target the tools we already have.” The author argues that the SDG health targets are a fairytale without a renewed global commitment to meet the R&D needs—and rights—of the world’s poor people.
Wealthy states are currently purchasing millions of hectares of land in poor states throughout Africa. This is a problem for many reasons, including increasing rural poverty and driving millions of people off land that they have been farming for generations. These land purchases also have environmental effects and are resulting in food shortages and food insecurity across Africa. In this paper, the author discusses this controversial practice and concludes that these land purchases should be considered land grabs. He focuses on the environmental effects that such land grabs have and also discusses the social effects of these land grabs on the communities in which they are taking place. The author concludes that African states must immediately recognise that these deals have environmental repercussions that harm not only the natural resources, but their citizens as well; and should thus put measures in place to curb the incidences and conclusion of these deals. African governments should instead sell such land to African entities, or at the very least, entities that will be required to keep a portion of all grown food in the host state to feed the populace. They must also reform land tenure and land registration laws to ensure that their citizens are not forced off land that they have farmed for generations. Only when African states control their land can they ensure that their citizens do not go hungry.
Four country case studies undertaken for this report provide examples of innovations in policy design and implementation that have improved the investment climate for smallholders, such as decentralisation of land management responsibilities in Tanzania. Implementation of progressive policies in the face of major power imbalances between beneficiaries and vested interests seeking to maintain the status quo remains a major challenge. There are six inter-related sets of conclusions from the study. 1. Policy is currently biased against smallholders. 2. The investment climates that support smallholder investment and corporate investments in agriculture, while having elements in common, are not the same. 3. Policies must respond to the diversity of rural societies. 4. Policy innovations in inclusive investment do exist and should be copied. 5. Effective implementation is vital. 6. Politics matter: Vested interests undermine socially optimal outcomes, yet without a political analysis there is a risk of assuming that politicians choose policy in a socially optimal way and of constructing a normative analysis that focuses on technical solutions to the challenges of economic liberalisation.
The World Health Organization promotes salt reduction as a best-buy strategy to reduce chronic diseases, and Member States have agreed to a 30% reduction target in mean population salt intake by 2025. Whilst the UK has made the most progress on salt reduction, South Africa was the first country to pass legislation for salt levels in a range of processed foods. This paper compares the process of developing salt reduction strategies in both countries and highlights lessons for other countries. Like the UK, the benefits of salt reduction were being debated in South Africa long before it became a policy priority. Whilst salt reduction was gaining a higher profile internationally, undoubtedly, local research to produce context-specific, domestic costs and outcome indicators for South Africa was crucial in influencing the decision to legislate. In the UK, strong government leadership and extensive advocacy activities initiated in the early 2000s have helped drive the voluntary uptake of salt targets by the food industry. It is too early to say which strategy will be most effective regarding reductions in population-level blood pressure. Robust monitoring and transparent mechanisms for holding the industry accountable will be key to continued progress in each of the countries.
Tobacco use among people living with HIV results in excess morbidity and mortality. However, very little is known about the extent of tobacco use among people living with HIV in low-income and middle-income countries (LMICs). The authors assessed the prevalence of tobacco use among people living with HIV in LMICs. The authors used Demographic and Health Survey data collected between 2003 and 2014 from 28 LMICs where both tobacco use and HIV test data were made publicly available. They estimated the country-specific, regional, and overall prevalence of current tobacco use (smoked, smokeless, and any tobacco use) among 6729 HIV-positive men from 27 LMICs (aged 15–59 years) and 11 495 HIV-positive women from 28 LMICs (aged 15–49 years), and compared them with those in 193 763 HIV-negative men and 222 808 HIV-negative women, respectively. The authors estimated prevalence separately for males and females as a proportion, and the analysis accounted for sampling weights, clustering, and stratification in the sampling design. They computed pooled regional and overall prevalence estimates through meta-analysis with the application of a random-effects model. They computed country, regional, and overall relative prevalence ratios for tobacco smoking, smokeless tobacco use, and any tobacco use separately for males and females to study differences in prevalence rates between HIV-positive and HIV-negative individuals. The overall prevalence among HIV-positive men was 24·4% for tobacco smoking, 3·4% for smokeless tobacco use, and 27·1% for any tobacco use. The authors found a higher prevalence in HIV-positive men of any tobacco use (risk ratio [RR] 1·41 and tobacco smoking than in HIV-negative men (both p<0·0001). The difference in smokeless tobacco use prevalence between HIV-positive and HIV-negative men was not significant. The overall prevalence among HIV-positive women was 1·3% for tobacco smoking, 2·1% for smokeless tobacco use, and 3·6% for any tobacco use. The authors found a higher prevalence in HIV-positive women of any tobacco use, tobacco smoking and smokeless tobacco use than in HIV-negative women. The high prevalence of tobacco use in people living with HIV in LMICs mandates targeted policy, practice, and research action to promote tobacco cessation and to improve the health outcomes in this population.
Several major initiatives in the past few years have brought renewed attention and commitment to economic development and food and nutrition security in Africa. The recent economic recovery and the new commitment to change among African leaders and development partners indicate for the first time after decades that Africa is poised to achieve real progress toward food and nutrition security. Sustaining and accelerating growth to reach the poverty reduction and nutrition Millennium Development Goals will require clear strategies to guide future policy and investment decisions. Furthermore, these goals seek to only halve the number of poor and malnourished in the next 10 years, something a number of African countries will fail to do. Progress toward food and nutrition security in Africa, therefore, calls for more than growth and requires a greater focus on human welfare improvement supported by adequate investments in health and nutrition safety nets to protect vulnerable segments of the population.
Pimbert’s book covers a range of topics related to food sovereignty. He looks at local food systems, livelihoods and environments, and the ecological basis of food systems before explaining how the current multiple crises in food, agriculture and environment arose, in terms of the social and environmental costs of modern food systems. The book concludes with the author’s vision of a way forward: He presents food sovereignty as an alternative paradigm for food and agriculture and discusses how to promote national policies and legislation and global multilateralism and policies that promote food sovereignty.
The Human City Project is a community-driven media, architecture, urban planning and human rights movement in Port Harcourt, Nigeria. It is a collaboration between local and international community organisers, filmmakers, broadcasters, urban planners, architects, designers, university researchers and ordinary people from across Port Harcourt’s informal settlements. Those involved share skills and technologies for communities to record their experiences, tell their stories and change their lives. They are moved by the conviction that democratic design principles can make cities more creative and just. Based on community mapping of needs and priorities, a community radio station was started – Chicoco Radio – formally owned by Chicoco Community Media Initiative, an incorporated board of trustees drawn from communities across the city. With a campaign of 'the people live here' communities in the informal settlements in Port Harcourt have resisted eviction, and are carrying out activities to map and make visible their conditions and needs, develop their voice and capacity to participate meaningfully in the shaping of their city, including to change the way the city is imagined and inhabited on principles of social justice and equity. With the means to tell their stories on film, on air and in court, charting their reality on maps and describing their visions in urban action plans, these communities are changing their lives and shaping their city.
This paper produced for a conference at the Overseas Development Institute (ODI) reflects on the experiences of women and girls with poor accessibility to services and markets, and inadequate transport in rural sub-Saharan Africa. It uses examples from field research to look at the impact of these factors on girl’s education before going to examine access to health services.