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Displaced and neglected: Ethiopia's desperate drought victims

Wed, 19 Apr 2017 14:53:42 +0000

Dead camels rot on the outskirts of informal settlements in Ethiopia’s rain-starved Somali region as their owners, once proudly self-sufficient pastoralists, turn to government aid to stay alive. Ethiopia is facing a drought so terrible that nomadic herders, the hardiest of survivors, have been pushed to the brink. The lucky ones receive supplies of food and brackish water, but the majority, who have settled in spontaneous camps in the remotest reaches, must look after themselves. “We call this drought sima,” said 82-year-old Abdu Karim. “It means ‘everyone is affected’. Even when I was a child, no one spoke of a drought like this one.” Across the Horn of Africa, people are struggling after three successive years of failed rains. In Somalia and Yemen, there is real fear of famine. While Ethiopia’s remote southern region has been spared the warfare that has deepened the crisis confronting its neighbours, the drought has been no less brutal. “Having lost most of their livestock, they have also spent out the money they had in reserve to try to keep their last few animals alive,” said Charlie Mason, humanitarian director at Save the Children. “For those who have lost everything, all they can now do is go to a government assistance site for food and water.” Livestock are the backbone of the region’s economy. Pastoralists here are estimated to have lost in excess of $200 million-worth of cattle, sheep, goats, and camels. That is not only a blow to their wealth, but also deprives them of the meat and milk that is the mainstay of the pastoralist life-support system. Last year, more than 10 million people were affected by an El Niño-induced drought. The government spent an unprecedented $700 million, while the international community made up the rest of the $1.8 billion needed to meet their needs. This year, the appeal is for $948 million to help 5.6 million drought-affected people, mainly in the southern and eastern parts of the country. So far, only $23.7 million has been received. “Last year’s response by the government was pretty remarkable,” said World Vision’s Ethiopia director, Edward Brown. “We dodged a bullet. But now the funding gaps are larger on both sides. The UN’s ability is constrained as it looks for big donors – you’ve already got the US talking of slashing foreign aid.” Under strain The government has a well-established safety net programme managed by the World Bank that supports the chronically food insecure, typically with cash-for-work projects. But it doesn’t pick up those affected by sudden shocks like the current drought. They fall under a new and separate programme, which is struggling to register all those in need. There are 58 settlements for the internally displaced in the Somali region currently receiving government aid. But that’s only a fraction of the 222 sites containing nearly 400,000 displaced people identified in a survey by the International Organization for Migration. Forty-four percent of these camps reported no access to food, and only 31 percent had a water source within a 20-minute walk. "People were surviving from what they could forage to eat or sell but now there is nothing left,” said one senior aid worker who visited a settlement 70 kilometres east of the southern town of Dolo Ado, where 650 displaced pastoralist families weren’t receiving any aid at all. The only livestock left alive in the camp was one skinny cow, its rib cage undulating through its skin, and her new-born calf. In some shelters people were reported as too weak to move.  James Jeffrey/IRIN IDPs are falling through the cracks Informal settlements have sprung up wherever the exhausted pastoralists have stopped. The further away from the regional capital, Jijiga, the less likely they are to be supplied by the government. There is also a degree of friction between the federal government and the semi-autonomous regional authority. “There’s a logical reason to limiting the number of temporary[...]

Lake Chad money, Oxfam-GOAL merger, and serial Syria talks: The Cheat Sheet

Fri, 17 Feb 2017 15:10:25 +0000

Every week, IRIN’s team of editors takes a look at what lies ahead on the humanitarian agenda and curates a selection of some of the best reports, opinion, and journalism you may have missed: What’s coming up? Finding $1.5 billion for Lake Chad The borders of Nigeria, Cameroon, Niger, and Chad meet at Lake Chad. The region is now one of the most critical humanitarian hotspots in the world, with a food security ranking teetering on the edge of full-blown famine in some areas. The UN says it can help about eight million of those in need if it is sufficiently funded.  Attacks by the extremist Boko Haram and counter-insurgency operations against them have uprooted millions and disrupted social services, trade, and agriculture.  Strained relations between Nigerian authorities and the international aid community have also played a part, while formidable logistics and security challenges hamper operations in neighbouring countries.  With South Sudan, Iraq, Yemen, and Syria all clamouring for media clicks and donor dollars, the "Lake Chad Basin" humanitarian situation has to fight for attention even while its capacity to respond faces setbacks. Last night, fresh attacks and clashes were reported in Maiduguri, the forward base for a still-fragile humanitarian operation in northeastern Nigeria.  A conference in Norway on 24 February aims to stimulate donor contributions and diplomatic attention. Thematic sessions will be held on food, protection, access, and education. The one-day event co-hosted by Nigeria, Norway, and the UN, will include ministers from the affected nations and the most important donor countries, leaders of relevant regional organisations, development finance institutions, and UN bodies. And the pledgers better pledge: the UN-led response plans are costed at $1.5 billion. Own GOAL? The Irish NGO GOAL, reeling from a corruption scandal, has started merger talks with Oxfam Ireland, the two agencies announced. Regular IRIN readers will need no reminding of GOAL's problems. A procurement fraud in Turkey lifted the lid on a shocking web of conflicts of interest that has taken the scalp of the CEO and the COO already, and triggered an investigation by the US government that is still ongoing. GOAL's donors got spooked and its income has collapsed. The latest news confirms that the chances of GOAL surviving in its current form are receding by the day. Is it game over for GOAL? Lost in Syria peace talks One round of Syria peace talks is delayed but under way in the capital of Kazakhstan this week and yet another is due to start the following week in Geneva. The Russia- and Turkey-brokered Astana talks began a day late thanks to disagreements over the agenda, and the UN-sponsored negotiations are on shaky ground too: A key Syrian opposition body has said it wants to talk transition with Damascus, which for its part has no interest in engineering President Bashar al-Assad’s exit from power. Nobody knows exactly who will show up in Geneva, or when, or if they’ll actually do much talking at all. But it’s probably safe to bet that Syria’s long-winded UN rep Bashar al-Jaafari will make an appearance, and that there will be further splits among the opposition delegation, which has presented itself as unified. If all this sounds like déjà vu all over again, you’ve clearly been paying attention for the past six years. With talk now of Pentagon plans for US troops on the ground, tune in next week for our update from Aron Lund on the post-Astana pre-Geneva lay of the land, and what it means for the future of Syria. The big Munich meet-up Conferences often mean strange bedfellows, and the Munich Security Conference that kicks off today is no exception. Participants include German Chancellor Angela Merkel, UN Secretary-General Antonio Guterres, US Vice-President Mike Pence and, um, Bono, obviously. Russian Foreign Minister Sergei Lavrov will be in attendance too, as will NATO Secretary-General Jens Stoltenberg. But the weirdest double act of the weekend should come on Sunday when t[...]

Ethiopia survives its great drought, but a way of life may not

Mon, 13 Jun 2016 10:32:17 +0000

Sitting on parched ground pummelled by the sun, a camel looks on majestically as pastoralists mill around it in a whirl of activity. Loaded onto its back are sacks of grains and pulses, yellow jerry cans, bottles of cooking oil, bits of fabric and plastic to make rough bivouac structures, and more. After a final check of ropes, a woman makes a loud purring noise while gesturing upwards. The camel jerkily stands up, emitting a loud groan. Leading it by a rope, the family rejoins other pastoralists trekking through the Awdal Region abutting Somaliland’s northwestern border with Ethiopia: home for those on the move. Faced with desiccated pastures in Ethiopia’s Somali Region last November, these pastoralists and many others responded to rumours of rains and good pasture hundreds of kilometres away on the coast of Somaliland, an internationally unrecognised but de facto sovereign nation separate from Somalia. But, when they got there, there wasn’t enough rain or pasture for the numbers that descended. Thousands of goats, sheep, cows, and even drought-hardy camels died, buried in mass graves to prevent disease spreading (it still broke out, killing further livestock). Now, the pastoralists are returning to Ethiopia, or trying to do so. Only one of Abdulahi Amir’s three camels has survived this far, but it might not last long either. “We’re stuck here. My sick camel can’t carry anything,” the 70-year-old tells IRIN, his possessions strewn all around him on the ground. Amir has four family members with him. Five others stayed behind in Sitti, (one of the nine zones in Ethiopia’s Somali Region), where he is trying to get back to. What’s the plan now? “We will wait,” he says. James Jeffrey/IRIN Bad – but it could be worse Ethiopia’s current drought is the worst the country has seen in 50 years, according to many estimates. The tribulations of the pastoralists notwithstanding, there are no scenes reminiscent of 1984, when drought contributed to more than one million Ethiopians dying. Crop production in Ethiopia’s northern Tigray and Afar regions has dropped by between 50 and 90 percent in some parts, and failed completely in others. In the country’s Somali region, more than half a million livestock are estimated to have died and a joint government and humanitarian partners' report estimates 1.5 million people – 27 percent of the region’s population – need food assistance. “I’ve never come across anything like this,” says 65-year-old Eltise Muse Bah in the remote village of Fedeto, in the Sitti Zone. “We’ve named this drought ‘mulia’, which means, ‘that which erases everything on the ground’.” The severity of the drought stems from the ocean warming El Niño effect that has disrupted weather patterns around the globe. Ethiopia has about 10.2 million people needing food aid, out of a population of around 100 million, according to the UN. In the north of neighbouring Somalia, an estimated 4.6 million people – nearly 40 percent of the population – need humanitarian assistance. Initially, the government tried to manage the situation itself, using an extensive food security network developed over the decades since images of the 1984 famine came to stigmatise Ethiopia. The Productive Safety Net Programme is a welfare-for-work initiative enabling about seven million people to work on public infrastructure projects in return for food or cash. There is also a national food reserve and early warning systems based on the woredas, the administrative districts. Ethiopia even managed to open early a new railway line to bring food supplies from the port at Djibouti on the Horn of Africa coast. Ethiopia’s political commitment to an effective emergency response appears for now to have prevented disaster. Outside help unavoidable  But Ethiopia hasn’t tackled this drought alone. It’s a fact the government conceded in October 2015, when the estimated numbers of those affected shot up, resul[...]

For Eritreans, Egypt is the new route to Europe

Mon, 06 Jun 2016 16:27:37 +0000

Like much of Cairo, the sprawling low-income neighbourhood of Ard el-Lewa comes alive in the evening, once the sun has gone down. On warm summer nights, children chase cats along streets too narrow for cars. Tuk-tuks weave between the shisha smokers and newspaper readers spilling onto the road as the cafés fill up. But it’s not just Egyptians out enjoying themselves. Large numbers of young Eritrean men also cluster on street corners, or gather outside the newly opened Eritrean restaurant in one of the concrete tenements, exchanging news in their Tigrinya language. “There are so many new Eritreans now in Ard el-Lewa,” Filmon*, an Eritrean community activist, told IRIN. “It all changed at the end of last summer. So many started arriving that now there is a shortage of flats to rent and the landlords have increased the prices.” Cairo has long been home to a small community of Eritrean refugees fleeing war, oppression and traffickers, but local activists say the number of new arrivals has soared over the last year.   In the past, most Eritreans who came to Egypt registered asylum claims with the UN’s refugee agency, UNHCR, and waited years for a shot at resettlement to Europe or the United States. But these recent arrivals don’t intend on staying that long. Filmon said most have come to Egypt with the intention of finding a boat to Europe as soon as possible from ports near Alexandria. “They are all just waiting for the smugglers to tell them their boat is ready,” he said. “Ard el-Lewa has become a big waiting room.” ‘Good smugglers and bad smugglers’ The newcomers are part of a surge of refugees fleeing Eritrea that began in 2014. UNHCR recorded a sharp increase in Eritreans seeking asylum in the EU that year. In 2015, the numbers increased again, with more Eritreans arriving in Italy via the Mediterranean than any other national group.  The refugees are fleeing a notoriously repressive state where political opposition is banned; freedom of movement, expression and religion are curtailed; and young people are forced to perform open-ended military service, which can last for decades. Tekle, a 27-year-old Pentecostal Christian from Asmara, said he fled because he faced religious persecution. “We have to pray in secret,” he said. “The risk of jail, especially for the prayer leaders, is very great. Hundreds of Pentecostals are in prison due to their beliefs.” Tekle arrived in Egypt last autumn, guided by a series of smugglers across the Eritrean border into eastern Sudan, then by jeep to Khartoum, across the desert to Aswan, and by train to Cairo. He is now awaiting a call from a local simsar, or broker, who connects migrants in Ard el-Lewa with smugglers on the coast. “I am waiting for my turn,” he told IRIN. “I don’t know where I will leave from. They will call me when they know the way is safe, and then we will go to the north coast to wait for the boat.” Tekle is aware of the risks, but trusts his agent. “I know the good simsars. I only paid $2,000 for my trip – although some others pay much more – and I know he will find me a good boat.” As Tekle hinted, the journey for many others is much harder. Rahwa, a skinny 16-year-old, travelled alone from her small village in the Eritrean highlands and is still suffering from the effects of a lingering parasitic infection picked up from drinking the dirty water given to her by her smugglers. Sarah, an older Eritrean woman who is caring for her, says Rahwa was sexually abused by her smugglers during the journey. “Ninety percent of the ladies who have come this route suffer wounds in their hearts,” said Sarah. “The way is so dangerous… you don’t know if you can even trust the people beside you.” Filmon agrees that the journey is hardest for women. “There are good smugglers and there are bad smugglers. If you know who to choose and you are with a man, you can be safe. But travelling alone is very dangerous.” Egypt route picks up[...]

Sudan and Eritrea crackdown on migrants amid reports of EU incentives

Wed, 25 May 2016 16:32:28 +0000

Authorities in Sudan have launched a crackdown on Eritrean migrants - arresting those living in the capital, Khartoum, and intercepting hundreds travelling north through the country towards Libya, the launching point for smugglers’ boats heading for Europe. Reports that 900 Eritreans were rounded up in Khartoum on Monday and that a further 400 arrested en route to Libya have been deported to Eritrea, come amid recent revelations in the British and German media that the EU is planning to deepen its cooperation with a number of African countries, including Sudan and Eritrea, to stem migration towards Europe. Kibrom*, a 16-year-old Eritrean refugee who used the route through Sudan and Libya to reach Europe in 2015, told IRIN that his twin sister was among a group of 130 Eritreans captured by Sudanese soldiers in the town of Dongola, about halfway between Khartoum and the Libyan border, earlier this month. “I passed the same way. When we were travelling, we had to bribe the police. My sister used the same smuggler, but when he tried to bribe the police, it didn’t work,” he said. Kibrom’s sister, along with the rest of the group, were taken to a prison in Khartoum where they spent three days. Kibron said he tried to alert the UN’s refugee agency, UNHCR, but failed to make contact. “Only the Eritrean Embassy was informed. They took them in an open truck at night time to the Eritrean border,” he said. “From there they were taken to a prison located in my city – Teseney.” Leaving Eritrea without permission is a criminal offense and Kibrom is extremely concerned about his sister, who was trying to evade military conscription, as well as his mother and two younger brothers who are still living in Teseney. “My mother can’t even try to see my sister or she will be arrested as well,” he told IRIN over the phone from Sweden where he has applied for asylum. “I’m so worried what’s going to happen to them.” A spokesperson with UNHCR’s office in Khartoum confirmed that a number of migrants, including Eritreans, had been intercepted in northern Sudan heading towards the Libyan border. Of those being held at the Aliens Detention Centre in Khartoum, UNHCR had only identified six individuals who had previously sought asylum and been recognized as refugees. None of those six had been deported and the spokesperson did not comment on the other deportations but said: “If an individual does not apply for asylum through the channels provided and subsequently does not express a wish to seek asylum, Sudan may be within its legal right to pursue deportation of irregular migrants from its territory. “For UNHCR, the principle prohibiting forcible returns or non-refoulement only takes centre stage when the affected individuals are persons of concern to UNHCR, which does not appear to be the case in this particular instance.” It is unclear whether UNHCR had access to all of the Eritreans detained in Khartoum prior to their deportation. Meron Estefanos, an Eritrean activist based in Sweden who has been in touch with the relatives of some of the deportees, told IRIN that another group of around 300 Eritreans arrested while making their way to Libya were deported last Friday. Sudan has a prior record of deporting Eritreans without allowing them access to asylum procedures, a practice that UNHCR has condemned in the past as amounting to refoulement. Increased border controls In addition to the arrests of migrants in Sudan, Estefanos said there has also been a noticeable increase in controls on the Eritrean side of the Sudan-Eritrea border in the last two months. “Leaving Eritrea to Sudan is becoming hard now,” she told IRIN. “People are being intercepted and sent back.” Last year, a UN inquiry found evidence that Eritrea is a totalitarian state responsible for “systemic, widespread and gross human rights violations” including a system of indefinite national service that amounts to forced lab[...]

The migrants taking on a warzone

Tue, 10 May 2016 11:41:53 +0000

Newcomers don’t want to stay long in Obock. In the summer, 50°C temperatures and ferocious sandstorms sear this dusty port in Djibouti’s underdeveloped north. And yet this small town has become a haven for two very different groups. Travelling south are refugees fleeing the war in Yemen, 25 kilometres away across the Bab-el-Mandeb strait. Heading in the opposite direction: Ethiopian migrants taking smugglers’ vessels towards the very same conflict. Nearly 35,000 people have made the journey southwards across the strait (which translates as ‘Gate of Tears’) to the tiny authoritarian state of Djibouti since March 2015, when Houthi Shia rebels overthrew the Yemeni government and Saudi Arabia responded with a relentless bombing campaign. Just over half are Yemeni. According to the Regional Mixed Migration Secretariat, which monitors movements between the Horn of Africa and Yemen, the rest are Somali refugees, Djiboutian returnees and other nationalities. The Somalis and a small number of Eritreans are transferred to two camps in the south of the country and most of the Yemenis move on to Djibouti City, the capital. But not all have the resources to do so. Many of the 3,000 refugees stuck at Markazi camp, a few miles outside Obock, have already endured one summer of the hot, dusty winds known locally as the khamsin. The winds are so strong they can uproot tents and the refugees are dreading their arrival again this summer. “We are scared [of] staying for another one, [but] what can we do about it?” asks Fawaz, who worked for an oil company in Aden before moving his wife and their four young children to Yemen’s capital Sana’a and then to Djibouti as the civil war spread. His tone is injured, close to anger. “We cannot move. So we have to suffer again.” Rachel Savage/IRIN Abdullah and his family have been at Markazi camp since last September The well-educated Fawaz, who teaches English to 55 students in the makeshift secondary school, is something of an oddity in the camp. Most of Markazi’s residents are from poor, fishing villages on Yemen’s Red Sea coast. Abdullah, a 50-year-old father of six, thought he and his family would only be in Djibouti for a few days when they boarded his boat in September 2015 to avoid the Saudi bombs raining down on the village of Bab-el-Mandeb. “Prison in Saudi Arabia is better than this place,” he says dryly, sparking knowing laughter amongst the other refugees sheltering from the burning sun in a tent furnished with thin sleeping mats. Heading into war More than 500 Yemenis have decided war is preferable to the bleak desert camp and have headed home in their boats, ignoring warnings from the UN’s refugee agency, UNHCR, that the security situation is still volatile. Miranda Grant/IRIN Among the few hundred returnees heading back across the strait to Yemen are smugglers’ boats carrying migrants from Ethiopia, as well as a smattering of Somalis. More than 92,000 migrants, almost 90 percent of them Ethiopian, arrived on Yemen’s Red and Arabian Sea coasts in 2015, according to RMMS data. The pace has continued in 2016, with more than 10,000 migrants landing in Yemen in March (another 65 didn’t survive the crossing). Mostly men from Ethiopia’s Oromo ethnic group, they continue to make use of this centuries-old trade route, to escape oppression and discrimination back home, and in pursuit of jobs as taxi drivers and plantation labourers in Saudi Arabia and the Gulf states. Bram Frouws, a coordinator at RMMS, says that most know about the conflict in Yemen, which has killed at least 6,400 Yemeni people and displaced 2.8 million others from their homes, but view it as a necessary way station en route to Saudi Arabia in search of a better life. He speculates that the chaos of war may even mean that “they think it’s ea[...]

Cost of clinical trials worries donors

Wed, 23 May 2012 23:00:00 +0000

The more medical successes there are, the more it costs to find the next one, prompting donors to demand more from researchers carrying out large-scale trials of drugs, vaccines and global health impacts. “As a funder, I hate clinical trial applications,” said Jimmy Whitworth, head of international activities at the science funding division of UK-based Wellcome Trust, which finances health research. Clinical trial costs have spiralled in recent years - one recent report estimated a 70 percent cost rise per patient between 2008 and 2011 - but without sound evidence of beneficial medicinal effect, regulatory agencies will not approve. A clinical drug trial can take up to 12 years, enrol thousands of participants across continents, and cost from as much as US$1.3 billion to nearly $12 billion for each new drug before it is approved for public use. And the costs keep climbing. “We need other ways of funding that are more flexible, quicker,” said Geoff Garnett, deputy director of the HIV Department at the US-based Bill & Melinda Gates Foundation. “I think a lot of what we should be doing is public health trials rather than clinical trials,” Garnett commented. “If we bog down our public health trials with clinical trial requirements, then we miss out on some of the important behavioural and organizational interventions that make clinical care and prevention work much better.” Why so costly? A greater number of participants must be tested in more settings, including those living where reports of a particular disease are falling, to determine whether improvements are the result of the proposed intervention or are being produced by existing ones. Bloated trials mean more researchers, institutes and funders, which in turn increases regulatory requirements. “The reality is, trials are getting steadily larger and more expensive… regulation is becoming ever more complicated,” said Chris Witty, research director at the UK Department for International Development (DFID). “We’re paying more and more for less and less.” Too ambitious As researchers compete for dwindling research and development dollars, donors criticize overly ambitious proposals. “The timetables are often extremely optimistic, so there is a real problem in that funding may run out before the research question is actually answered, said the Wellcome Trust’s Whitworth. “Frankly, very often clinical trials don’t look great value for money.” HIV research has tended to carry out trials in the most expensive way, Witty said, noting that researchers often make poor correlations between cost and the potential impact of a study. Donors and researchers are looking at partnerships and other ways to bring down costs, including “adaptive testing”, which uses real-time data to modify an ongoing trial. New funding In 2010, the Bill & Melinda Gates Foundation pledged $10 billion to research and develop vaccines for some of the world’s poorest countries and its grants database shows more than $70 million going to clinical trials since 2004. In the UK, the Wellcome Trust, the Medical Research Council (MRC) and DFID have committed $57 million to fund late-stage trials of interventions in cash-strapped countries. “Give us the evidence,” said Wendy Ewart, deputy chief executive and director of strategy at MRC. “Make the case for future funding.” oja/pt/he 95507 200709057.jpg Feature Health Cost of clinical trials worries donors IRIN LONDON Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon Comoros Cape Verde Djibouti Algeria Egypt Eritrea Ethiopia Gabon Georgia Ghana Great L[...]

Nouveau médicament contre le paludisme

Mon, 25 Apr 2011 23:00:00 +0000

l’Organisation mondiale de la santé (OMS) vient de recommander un changement dans le traitement de première ligne du paludisme qui pourrait permettre de sauver près de 200 000 vies par année. Les activistes de la santé en Afrique se préparent cependant à une longue bataille pour faire appliquer les nouvelles directives. La plupart des cas de paludisme sont peu complexes et non mortels, en particulier lorsque les patients ont été exposés au parasite et qu’ils ont développé une réponse immunitaire. Chaque année toutefois, environ 8 millions de personnes contractent un paludisme « sévère ». En 2009 seulement, 781 000 personnes en sont décédées, dont 90 pour cent en Afrique, où la maladie est la principale cause de mortalité chez les enfants. Depuis des années, la quinine est le médicament de choix pour traiter les cas graves de paludisme, mais elle est difficile à administrer et peut avoir des effets secondaires dangereux. « Il faut faire beaucoup de calculs », a dit Véronique de Clerk, coordinatrice médicale de l’organisation non gouvernementale (ONG) internationale Médecins Sans Frontières (MSF) dans le district de Kaabong, dans le nord de l’Ouganda. « Il faut la diluer pour préparer les injections et administrer celles-ci par intraveineuse pendant quatre heures [toutes les huit heures]. Et pour surveiller la procédure, il faut disposer de personnel qualifié ». En Afrique rurale, où on constate une pénurie de travailleurs de la santé, les patients reçoivent souvent trop peu ou trop de quinine, ce qui peut se révéler mortel, a ajouté Mme De Clerk. « Récemment, des études réalisées en Ouganda ont révélé qu’une administration de quinine sur quatre n’était pas faite correctement ». Si l’OMS recommande déjà depuis 2006 l’utilisation de l’artésunate pour traiter les adultes atteints de paludisme sévère, dernièrement , l’organisation a revu ses directives et décidé de recommander également le traitement par artésunate pour les enfants. Cette décision se fonde sur les résultats d’un essai clinique réalisé dans neuf pays africains en 2010 et qui conclut que sur 41 enfants traités avec de l’artésunate plutôt qu’avec de la quinine, une vie supplémentaire est sauvée. « Il est très rare qu’un médicament présente un avantage aussi évident par rapport à un autre, en particulier pour les maladies négligées comme le paludisme », a indiqué Nathan Ford, coordinateur médical pour la campagne de MSF pour l’accès aux médicaments essentiels. Au cours des dix dernières années, plusieurs essais cliniques importants ont démontré que l’artésunate était plus sûr, plus facile à utiliser et plus efficace que la quinine. L’artésunate doit être administrée pendant trois jours par perfusion intraveineuse ou par injection intramusculaire quotidienne. Il est dès lors possible de former du personnel non médical pour l’administrer et d’ainsi permettre aux communautés rurales et isolées de profiter d’un traitement efficace.  Dans son nouveau rapport intitulé « Making the Switch », MSF répertorie les avantages du traitement par artésunate et les défis que suppose ce changement dans la politique et la pratique. Le principal obstacle demeure le prix : l’artésunate coûte en effet deux à trois fois plus cher que la quinine – soit environ 3,30 dollars par enfant traité contre 1,30 dollar pour la quinine – et l’adoption du traitement suppose des frais supplémentaires pour la formation des travailleurs de la santé. « Tout changement dans le protocole entraînant une augmentation des coûts risque de représenter un défi dans les pays où les budgets de la santé sont très serrés », a dit à IRIN M. Ford. MSF estime à 31 millions de dollars par an le coût supp[...]

Where to watch prices

Sun, 24 Apr 2011 23:00:00 +0000

Against a global background of steadily climbing food prices, IRIN lists a selection of websites that offer some useful insights into how, why and where food is becoming more expensive. • UN Food and Agriculture Organization (FAO) food price index This monthly price list consults private sector as well as government sources for prices and export orders. It is officially accepted by countries and used by governments, policy-makers, humanitarian agencies and financial institutions. In its April edition the index showed that food prices had declined but this was a temporary dip reflecting the crises in North Africa and Japan in March, which delayed cereal purchases. The FAO food price index includes an average of the trading prices of five essential commodities - cereals, cooking oil, dairy products, meat and sugar. The average value of the export share of each of these commodities between 2000 and 2004 forms the base for making comparisons. The month-to-month changes in the prices of each of these commodities is shown in graphs based on detailed information on the prices of a broad range of commodities, including 11 kinds of oils, various varieties of rice and kinds of meat. • FAO Global Food Price Monitor If you need more details on how global cereal prices are affecting individual countries then consult the FAO Global Food Price Monitor. Information from markets and FAO offices around the world feed into this information service, which has also created a food price tool. With a few clicks you can access the price of a particular food commodity in any country. • The World Food Programme (WFP) Market Monitor If you are a policy maker or a humanitarian aid worker and need to find out how food prices are affecting the purchasing power of people in 63 vulnerable countries, then consult this quarterly bulletin.  The April edition, covering the first quarter of 2011, reported that in 44 of the 63 countries monitored, the overall basic food basket had increased more than 10 percent above the 5-year average. Read more  EASTERN AFRICA: Consumers, traders feel the burn as prices skyrocket UGANDA: As food prices bite, HIV-positive people turn to kitchen gardens VIETNAM: Struggling to cope with rising prices AFGHANISTAN: Government stockpiling wheat ahead of expected drought Biofuels make a comeback as prices rise In 16 of the countries the cost of the food basket had increased more than 10 percent since the last quarter of 2010, and by more than 20 percent in Ghana, Somalia, Afghanistan, Georgia, and El Salvador. The market monitor uses information collected by WFP field offices and in the April edition it also examined the impact of fuel prices on essential food commodities. It noted that the highest increases in fuel prices occurred in Ethiopia and Haiti, where fuel subsidies have been scaled back, and in Malawi and Uganda. • World Bank Food Price Watch The World Bank has begun producing regular food prices bulletins, using its own food price index based on information drawn from its offices across the world, the FAO food price index, and the US Department of Agriculture, which also regularly produces updates on global supplies of food commodities. The information is detailed and often contains useful analyses not found on other websites. The current update looks at the projected impact of continued food price increases on poverty. jk/he 92568 2008070416.jpg News Food Health Where to watch prices IRIN JOHANNESBURG Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon Como[...]

Stillbirths "absent from global health agenda"

Wed, 13 Apr 2011 23:00:00 +0000

The annual number of stillbirths around the world is more than double the number of people who die from HIV-related causes, according to a new report that says this widely overlooked epidemic could be dramatically mitigated with better antenatal care. Some 2.64 million foetuses die after the 28th week of pregnancy, most of them in low- and middle-income countries, according the report published by The Lancet. While the number of stillbirths globally has fallen from an estimated three million in 1995, the decline lags behind progress in reducing deaths in children under the age of five. The series authors say the lack of recognition of the issue at a global health level means not enough is being done to prevent more babies from dying. "Parental groups must join with professional organizations to bring a unified message to UN agencies regarding the need to include stillbirths in global health policy." The authors report that grieving mothers are often disenfranchised from their communities; stillbirths can also affect future parenting and lead to divorce. In many countries, bereavement counselling is not widely available for families dealing with depression after a stillbirth. "Behind the statistics are individual stories of families devastated by the loss of their precious child," Janet Scott, research manager at Sands, a British stillbirths and neonatal death charity, said in The Lancet. "A baby who dies before he or she is born is no less loved and cherished, the grief and pain for the parents no less agonizing and enduring, and the guilt at not being able to protect that child no less intense." According to the UN World Health Organization, the five main causes of stillbirth are childbirth complications, maternal infections in pregnancy, maternal disorders such as hypertension and diabetes, foetal growth restriction and congenital abnormalities. A baby who dies before he or she is born is no less loved and cherished, the grief and pain of the parents no less agonizing and enduringHealth facilities overwhelmed At Madiany Hospital in Rarieda District in western Kenya's Nyanza Province, doctors and midwives deal with stillbirths on a daily basis; health workers are overwhelmed by expectant mothers from the entire district, even though the number of women who seek antenatal care is a mere fraction of what it should be. "We are just one hospital serving a whole district with a huge population. To reduce cases of irregular antenatal visits among pregnant mothers - one of the biggest contributing factors to stillbirths - we need to build the capacity of lower level health centres to provide antenatal care," Sylvia Warom, in charge of the hospital's maternity ward, told IRIN. "Many women come to the hospital when they realize they are pregnant and you never see them again until they are ready to deliver; it is unfortunate because many come to deliver already dead children," she added. In rural Nyanza, health centres are few and far between, and many women lose their babies on the long journey from home to the hospital, while others lose babies by choosing to deliver at home. More than half of all Kenyan women deliver their babies without the benefit of skilled medical professionals. According to The Lancet series, an estimated 1.2 million of all stillbirths happen during labour and delivery, highlighting the need to increase the number of women delivering babies with skilled birth attendants present. Better healthcare, better data "In Uganda only 42 percent of women receive skilled attended delivery," said Robina Biteyi, national coordinator of the Uganda chapter of The White Ribbon Alliance, an international maternal health NGO. "It is estimated that 15 percent of all pregnancies are likely to develop life-threatening com[...]