Water quality and access are already huge roadblocks for communities throughout West Africa without competition from investors in the Global North.  This makes the ‘water grab’ trend even more detrimental to African health and life. The most coveted water resource in the region is the Niger River which runs through four countries: Mali, Niger, Guinea and Nigeria. The Niger River sustains the lives of 100 million West Africans through drinking water and irrigation for the temperamental farmlands in the region. In the past couple of years foreign investors have flooded the area buying farmland and taking precious water resources for irrigation, leaving local communities without land, but also dwindling water supplies from their greatest water resource.

An example of this environmental, social, and health problem is Mali’s Office du Niger. This department is responsible for land deals with Western countries and corporations. Land deals fueling the great ‘water grab’ jumped 60% from 2009 to 2010 according to research performed by the London-based International Institute for Environment and Development.

Although there has been publicity and attention concerning the land contracts because of deals with corporations (Nestle) and countries (China and India), the repercussions of these land deals on local communities is absent from the discussion. It was only last week that the National Coordination of Farmer Organizations in Mali met for the International Peasants Conference to fight against the land grabs throughout the Niger River Valley.

Jamie Skinner and Lorenzo Cotula of the International Institute for Environment and Development sum up the situation well: “Allocating water to irrigated agriculture potentially affects a much broader range of users”. As if the global north and former colonial powers haven’t taken enough resources from African countries, now they’re depleting water resources in African countries to irrigate African land for their own ambitions. Unless governments, local organizations throughout West Africa and citizens of the world use their collective resources to stop the land and water grab, the fate of over 100 million West Africans is at stake.

This week saw a number of exciting advances in dealing with health worker shortages as well as building the capacity of developing health systems. Africa now has its own association for public health, schools of medicine are working to meet the need for professional health workers, new state of the art hospital facilities are built in northern Rwanda, young people ask for more information and more sexual education, and African countries still work to meet the need for their health systems to deal with infectious diseases as well as non-communicable diseases.

Africa Federation of Public Health Associations Launched

Public Health is a growing field across the African continent. The WHO Regional Director for Africa, Dr Luis Sambo said the launch of the African Federation of Public Health Associations provides a useful platform to harness complementary capabilities and resources for better public health outcomes in the region. He said it will facilitate exchange of information and experiences among national public health associations and promote inter country cooperation.

Partners in Health completes Butaro District Hospital

With extensive research and architectural design efforts, the Burera District in northern Rwanda now has a state of the art hospital. PIH expanded the existing health center to grow into this pinnacle of treatment since 2007.

Safe Sex – Out of Fashion?

In a study published on World Contraception Day with support from the International Planned Parenthood Foundation (IPPF), young people in 29 different countries said that they needed more sexual health education and information. ”Sexuality is often a politically loaded subject which governments don’t want to burn their fingers on,” says Henk Rolink of Dutch sexual health and rights organisation Rutgers WPF. ”What’s more, health care budgets are often very low. Family Planning gets a low priority. In many other countries sex education mainly concentrates on abstinence. This is often the case in Western countries too, but of course it doesn’t square with reality. Young people do have sex.”

Obesity is Contagious 

This article’s title comes from research that shows individuals with close friends who are obese are more likely to also be overweight. Nigeria’s health system works to address NCDs, particularly obesity, as growing health concerns. At the gathering of health experts during the International Conference Centre in Abuja for the 2nd International Conference of the Federation of African Nutrition Societies (FANUS), the focus was on series of health concerns particularly the growing global obesity epidemic.

Hospital Turns Back Doctors Amid Doctor Shortage

In one of the more developed countries of Africa, there are still significant shortages in health workers and doctors. In scenes that can be replicated in many burdened health systems, one of Ghana’s port cities’ hospitals has closed its doors because there aren’t enough medical doctors. Director of Health Services Dr. Irene Agyepong said that actions had been taken to return the hospital to normal operations.

354 Students Enrolled in Orota School of Medicine

It is no doubt that increasing programs for medical education will be key to meeting the shortage of health workers across Africa as well as building the capacity of health systems. With the increases in enrollment at the Orota School of Medicine, Eritrea has seen the patient burden on the health system decrease from 29,000 people per doctor to 20,000 people per doctor. The school has a goal of school of having a doctor for 6000 every people in the year 2020.

Follow the Polio outbreak in real time with HealthMap

Smallpox has been globally eradicated since 1980, so why is the eradication of Polio so much more difficult? The World Health Organization (WHO) recently released that the Global Polio Eradication Initiative (GPEI) would be conducting a new targeted 15 country effort to vaccinate 72 million children in Africa. The new campaign follows numerous failed efforts of the past and reemerging outbreaks. Why does the African continent remain prone to Polio outbreaks that spread rapidly? Why did the organized campaign to eradicate Smallpox take only 21 years while Polio is going on almost 40 years?

Since 1796, when cowpox was used to protect humans from Smallpox, eradication efforts have taken place. It wasn’t until the WHO intensified the eradication of smallpox in 1967 that efforts were coordinated around the world. The Smallpox Eradication Program (SEP) was jointly run by the WHO, CDC, and National Ministries of Health in various countries. Doctors and epidemiologists from the US volunteered to help with the efforts. In many instances US volunteers were overbearing and controlling of their local counterparts. A report by Paul Greenough documented the use of intimidation and coercion in the final stages of the SEP. Foreign volunteers were sent to kick down doors (literally), force vaccination of those who refused, and fix the mistakes of local staff members (1995). These coercive tactics evoked resistance from local communities, but the SEP prevailed. The SEP was run in a structured, militant fashion, where individual human rights were overridden for the global public good. Similar issues with resistance have been seen in Polio eradication efforts, but responses to resistance have not been as militant. Could this be why Polio has continued to resurface?

The earliest documented case of Polio in Africa is traced back to 1580 B.C. in Egypt and still the virus continues to spread across the continent. The eradication of Polio relies heavily on National Immunization Days (NIDs), but these events are ineffective because they aren’t comprehensive vaccination efforts, positive cases are missed and some children aren’t vaccinated causing continued Polio outbreaks. Organized Polio eradication efforts began when the World Health Assembly launched the Expanded Programme on Immunization (EPI) in 1974, a program implemented through the NIDs . In 1988, the World Health Assembly said that by the year 2000 Polio would be eradicated and they launched the Global Polio Eradication Initiative (GPEI) to make it happen. Many prominent people and organizations put their support behind the program including Rotary International and Nelson Mandela, who in 1996 launched the “Kick Polio Out of Africa” campaign which vaccinated 420 million children. In the 90s, the UN Secretary General negotiated peace treaties to vaccinate in war-torn Liberia and Sierra Leone. Most recently in 2004, 23 African countries coordinated NIDs focused on Polio vaccination.

After all these efforts, Africa remains the only continent where Polio remains alive and well in multiple countries. A series of studies completed across West Africa showed that due to misconceptions about the vaccine, lack of adequate funding and corruption at the local level, and ineffective immunization campaigns, Polio has persisted on the African continent (Melissa Leach & James Fairhead, 2007). The year 2007 marked an outbreak of 25 cases in Angola which spread to 28 cases in the Democratic Republic of the Congo (DRC). In 2008, after an outbreak in northern Nigeria, where there have been vaccination conspiracy theories, spread to a dozen other countries, the WHO made Polio eradication their “top operational priority.”

Armed with a “more effective” version of the oral vaccine, the new GPEI organized effort across 15 countries hopes to eradicate Polio for good. However, just yesterday the New York Times wrote that the WHO reported 104 deaths and 201 cases of paralysis from Polio in the DRC. Is the renewed GPEI effort, launched Oct. 28, 2010, even working? Is eradication even a desirable goal at all, if past experience with Smallpox Eradication Program requires militancy?

Crossposted from the Americans for Informed Democracy Blog where I am writing as a Global Health Analyst.

This week saw the continued striking of Nigerian doctors as well as  empty promises of stretched health ministries and US food aid. Our blog hosted a bright discussion on HIV/AIDS in South Africa highlighting the issues of Gender Based Violence and the use of pornography to influence health behaviors and education. Please let us know what you think in the comments, we’d love to start a conversation! If you are interested in submitting a guest post – submit here.

Sierra Leone: Unfulfilled Promises of Free Maternal Health Care for Mothers

Marie Musa, 37, is devastated. After the mother of four gave premature birth, her baby boy died a few hours later – because the hospital did not have enough incubators to rescue the infant. In August, the same month that Musa’s baby died in hospital, James Bamie Davies, commissioner of the customs and excise department of Sierra Leone’s National Revenue Authority (NRA), announced in a government gazette an auction of medical appliances, including eight incubators. Only the public outcry that followed the announcement of the auction in the gazette, did the Ministry of Health and Sanitation spring into action and recover the goods.

Uganda: Nine Million Face Hunger

As Uganda joins the word to mark World Food Day today, Isaac Khisa looks at Uganda’s strides in ensuring that every citizen has at least a meal a day Uganda today joins the rest of the world in celebrating World Food Day but with millions of its population still malnourished. According to United Nations Food and Agriculture Organisations, nine million Ugandans are still facing hunger with many affording only one meal a day. Uganda population is now estimated at 31 million, meaning that about 30 per cent of Ugandans can hardly find something to eat.

Zimbabwe: Diarrhea claims 4000 yearly

About 4 000 children die from diarrhoea in Zimbabwe each year due to poor hygiene and unsafe drinking water, a United Nations senior official said last week. In a speech read on his behalf at the annual commemorations of the Global Hand-Washing Day held in Mutoko last week, Unicef country representative Dr Peter Salama said hand-washing is the single most effective and inexpensive way to prevent diarrhoea.

Benin: Disease Spreads as Floods Continue

Two-thirds of the African nation of Benin is underwater, with at least 43 people killed and nearly 100,000 made homeless. Heavy rain began falling at the start of October, and the Rivers Oueme and Mono soon overflowed. Thousands of hectares of land, mostly used for growing rice and other vegetables are now underwater. “Here, the water isn’t going away. We have it up to our knees and now it’s as high as our thighs,” said one resident. “The water, it’s everywhere, and it’s very difficult for people to escape.

South Africa: The Real Health Deal

Health minister Dr Aaron Motsoaledi will today sign the “real deal” with nine provincial health MECs and eight ministers, giving South Africans a shot at “a long and healthy life”. The Negotiated Service Delivery Agreement (NSDA) gives a frank, but brutal assessment of South Africa’s healthcare system and at the same time commits “not to keep doing things as usual” in finding solutions.

This week comes with controversy and numerous calls for the eradication of various diseases by the WHO. Health workers in go on strike in another African country after South Africa’s months long strike. Liberian doctors said they would only treat “critical” patients. Tuberculosis is becoming more resistant among young people and HIV positive individuals, but more effort is being put into research.

WHO sees end to TB

Last week TB was discussed as a “forgotten disease for forgotten people,” but now it seems that the WHO has released a plan that identifies gaps in research to create faster treatment regimes. “There is an urgent need to scale up action against TB – 10 million people, including 4 million women and children, will lose their lives unnecessarily between now and 2015 if we fail,” Dr. Margaret Chan, the WHO director-general, said.

Its Time to End the Double-Standard of Food Aid

Tido von Schoen-Angerer, Executive Director of Doctors Without Border’s “Access to Essential Medicines Campaign” wrote on Huffington Post about how the US government continues to send sub-standard food supplies to areas in need. The United States, the world’s biggest food aid donor, continues to send the corn-soy flours that do not address childhood malnutrition. You would be hard pressed to find these foods in American grocery stores, because it’s food we would never feed our own children.

More: Can the story on US food aid get any worse from Aid Watch posting Financial Times

“Paradigm” Shift Needed in Health Care, Experts Say

In Africa there needs to be a greater focus on prevention and treatment of noncommunicable diseases like diabetes and hypertension and not just infectious diseases like HIV/AIDS, health experts told the 2010 U.S.-Africa Private Sector Health Conference October 6. “Health is as critical as institutions, infrastructure and education for Africa’s economic competitiveness and growth. It is a prerequisite for human energy, entrepreneurship, dynamic markets and a productive society,” said Haskell Ward, vice-president of Seacom Corporation and chairman of the Global Health Strategic and Advisory Committee of the American Cancer Society.

Ending Africa’s Hunger Means Listening to Farmers

Africa is hungry – 240 million people are undernourished. Now, for the first-time, small African farmers have been properly consulted on how to solve the problem of feeding sub-Saharan Africa. Their answers appear to directly repudiate a massive international effort to launch an African Green Revolution funded in large part by the Bill and Melinda Gates Foundation. “Food and agriculture policy and research tend to ignore the values, needs, knowledge and concerns of the very people who provide the food we all eat – and often serve instead powerful commercial interests such as multinational seed and food retailing companies,” said Michel Pimbert of the International Institute for Environment and Development (IIED), a non-profit research institute based in London.

African cholera outbreak kills 2000

A preventable disease that is linked to the need for clean water sources has continued to kill people in a number of countries. WHO officials report that, as of October 3, there have been 40,468 reported cases of cholera and 1,879 reported cholera deaths in four countries, including Cameroon, Chad, Niger and Nigeria. The outbreaks started a few months ago, officials said.

Obesity: an underestimated “silent killer”

There is a new “silent killer” in town. It joins the ranks of malnutrition, malaria, hypertension, diabetes, HIV/AIDS, etc. It is obesity. “We are eating our way to the grave’’ and “obesity is rising in rural areas.’’ Adults are overweight or obese, while children are malnourished – a paradox. In the men still look at a potbelly as a badge of pride and success.” The World Health Organization reports that more than one-third of African women and a quarter of African men are estimated to be overweight, and predicted that it will rise to 41 percent and 30 percent respectively in by 2016. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

As the United Nations Summit on the Millennium Development Goals (a set of eight goals aimed at eradicating poverty) comes to a close, one thing is apparent. The health-related development goals are in the most danger of not being met by the 2015 deadline.

UN Secretary General Ban Ki-Moon stressed the importance of the revamped push towards maternal health and reduction of child mortality rates. Throughout the summit, UN officials, world leaders and other speakers emphasized the progress made since the Millennium Declaration in 2000, rather than the shortcomings. Out of the eight Millennium Development Goals (MDGs), improving maternal health and reducing child mortality rates are the two goals lagging behind (and account for two out of the three health-related MDGs.)[1]

Ban Ki-Moon declared the start of a $40 Billion Global Strategy for Women’s and Children’s Health on the the last day of the summit. The project will involve several international health agencies and expects to reach 15 million women and children. Ki-Moon explained the importance of women’s and children’s health saying, “Investing in women’s and children’s health has a multiplier effect across the millennium development goals.” Queen Rania of Jordan emphasized that the shortcoming are an institutional problem, not an individual problem. The influential queen said, “These women are working hard…But their time is not efficient.” According to the U.N., improvement of women’s and children’s health is possible by 2015. [2]

The multi-billion dollar global strategy includes projects throughout the world in countries like Afghanistan and several African countries. The Nigerian, Liberian and Rwandan governments have pledged to spend more money on women’s health by increasing training of midwives. In Afghanistan, the government plans to increase access to contraceptives for women in need. In addition, Planned Parenthood will redouble their efforts in 173 different countries.

Although these efforts are admirable and additional attention to health related MDGs have proven necessary, is it possible to achieve thus far unmet needs by the 2015 deadline? And why are women’s and children’s health the most neglected of the MDGs? The United Nations has already been criticized for making too lofty a program without effective strategy. Only time will tell whether the United Nations, and the rest of the international community will actually make the effort to give more for women’s and children’s health.

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[1] Oloruntoba, Bunmi. “Women and Children the Focus of Achieving the MDGs.” AllAfrica.com. 24 September 2010.

[2] Ward, Olivia. “$40 Billion promised at UN for maternal, child health.” TheStar.com. 22 September 2010.

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Olivia is the new Communications Intern who will be managing the blog and working with social media outreach. Apply to write a guest post or join the blog team [Learn more]

Army Takes Over, Access to HIV Treatment Halted by Strikes in South Africa

As South Africa’s health system is crippled by strikes the Government warns health workers of contributing to murder. HIV/AIDS treatment access has also been halted as the health system ceases to function. Strikers are demanding increased pay due to their insubstantial compensation. Should they be paid more?

Army Medical Teams Move into Strike-Bound Hospitals

Health Minister Warns of Murder as Staff Strike at Hospitals

Strike Jeopardizes HIV Treatment

Government Threatens Action Against Health, Security Strikers

National Public Sector Strike Hits HIV Treatment

Nation Becomes a Victim of its ARV Treatment Success

Public Health Strained by Nurses Strike

Botswana: Acquiring a Taste for Recycled Water

The Water Utilities Corporation in Botswana is breaking ground on a facility to treat waste water in order to supply a water source for the country. Many citizens have expressed disgust at the thought of drinking waste water, but the program holds great potential as water scarcity increases across the continent and around the world.

Hillary’s “new approach” to Global Health

David Rieff takes on the US Secretary of State’s approach to global health and development calling it naive, contradictory and muddled.

Donor Fatigue New Threat to HIV/AIDS Fight

Doctors Without Borders has raised the alarm that this is, “No time to quit! The HIV crisis is far from over.” As economic recession hits, many countries around the world  are decreasing their aid funding for HIV/AIDS treatments. The Obama Administration has come under fire for their cuts to HIV/ AIDS and PEPFAR funding.

• Is Obama Failing on AIDS?
• Optimism as U.S.  HIV Program Lifts Funding Caps

Mozambique: Maputo Central Hospital Bans Use of U.S. Dollars

Patients in Mozambique will no longer be forced to use U.S. Dollars to pay for treatments. This is an important move to increase access to health care in the country.

Cholera Outbreak Grips Nigeria

The need for clean water is demonstrated as cholera rapidly spreads across Nigeria and neighboring countries. As a common disease and treatable disease, the recent cholera outbreak calls for greater access to clean water sources for impoverished communities.

Cholera claims 352 lives

Cholera Outbreak Highlights Vulnerability of Children, Mothers

Cholera Outbreak – FG Moves Drugs, Officials to Bauchi, Borno

Cholera, Measles claim more lives

Cholera Outbreak hits 3,000 in Three Nations