An Investor’s Plan to Transplant Private Health Care in Africa (NYT)

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NAIROBI, Kenya — The eyes of the private equity investor lit up as he strode across the empty floor of a recently built hospital here. There was not much to see: a stretch of unfinished concrete, and steel bars pushed into a corner. But Khawar Mann of the Abraaj Group, an investment firm based in Dubai that specializes in developing markets, saw something else. Room for more patients — and a nice return on his investment. “You could squeeze another 50 beds in here, easy,” he said. “That will really improve profits.” Abraaj is trying to do something that hasn’t been tried before: build a global network of hospitals across cultures and in some of the poorest parts of the world — including India, Pakistan, Ethiopia and here in Kenya. Mr. Mann’s new fund has just bought a fast­growing hospital in India and is now trying to export its business model to Africa. Even in rich countries with sophisticated medical markets, it can be tricky, given vastly different regulatory regimes and national quirks, for a hospital to go global.

By Landon Thomas Jr. (NYT)

 

Few have done it. Abraaj, however, is betting that Indians, Nigerians and Pakistanis, who in many cases have annual incomes of no more than $1,000, will dip into their savings to pay for an angioplasty or some other necessary, but not necessarily cheap, procedure. The process is further complicated by cultural differences. The Abraaj­owned hospital chain in Hyderabad, India, for instance, is run by a doctor so revered locally that he approaches “guru” status. Some patients refer to him as a god. As a business model, that might not scale. Still, India, Kenya and other less­developed economies share crucial similarities. Government­run hospitals offer cheap or even free care, but they can be extremely overcrowded and grim. With personal incomes rising, Abraaj thinks an emerging middle class of teachers, small­business owners, call­center workers and others will be eager to pay private doctors for better care. Metropolitan Hospital, located in the rough eastern section of Kenya’s capital, is no Mt. Sinai. The operating theaters are rudimentary. Some rooms, while clean, lack curtains for windows and patients alike. Outside, children play barefoot soccer on a stony field in a suburban sprawl that not long ago displaced the big game that once grazed here. But in a country where the main afflictions are malaria, meningitis and road accidents, the 150­bed hospital has become a destination for people willing to pay for decent medical attention. And then there is the rapid rise of unfamiliar ailments in poorer countries — diabetes, heart disease and obesity. They, too, are a byproduct of booming economies and rising wages, which enable unhealthier diets. “Nairobi is a sweet spot for us,” Mr. Mann said. “There is a big population that is growing. You have emerging middle incomes. And there is a massive need for health care.” He was in town to — he hopes — clinch a deal to buy Metropolitan for the $1 billion health care fund that Abraaj started this year. Mr. Mann is not the only one with this idea: Eight other private equity investors have visited recently, according to Metropolitan’s chief executive.

Abraaj’s fund includes money from the Bill & Melinda Gates Foundation, the medical parts companies Philips Healthcare and Medtronic, as well as other big institutional investors. “There will be some heavy lifting ahead — $1 billion is a lot of money to deploy in these types of markets,” said Maria Kozloski, who oversees private equity investments at the International Finance Corporation, the finance arm of the World Bank, which has also invested in the fund. “The opportunity is compelling, but it’s going to take some time.” The fund’s size also reflects investors’ appetite for new ways to invest in emerging markets — an asset class that represents one­half of the global economy — after four years of so­so returns in publicly traded markets. Abraaj is not well known in the usual private equity circles of New York and London.

But with $10 billion under management, among the most any private equity firm has invested in these markets, its name is well traveled in the Middle East, South Asia and Africa. For years now, its founder, Arif Naqvi, has been pushing the notion that the best way for long­term investors to benefit from core emerging market themes — growing urbanization and consumption — is through long­term private equity investments that target specific business sectors, as opposed to volatile stock and bond market bets. The health care fund, which Mr. Naqvi conceived, is a prime example. Most emerging market investors tend to get their exposure via public stock and bond markets, for instance, by buying shares in Brazilian oil companies or Russian government bonds. But these investments tend to be extremely volatile, shooting up and down in tune with ever shifting risk perceptions in a given country. Abraaj, by contrast, tries to spot investment ideas less likely to be whipsawed by the headlines. In an interview, Mr. Naqvi cited a recent investment in a Turkish dairy company — made at a time when Turks were protesting against their president, Recep Tayyip Erdogan. “Turks will drink milk irrespective of who governs them,” Mr. Naqvi said Selling beer to thirsty Ethiopians or dairy products to Turks is a fairly simple proposition. And it gets at the core thesis of investing in these markets, which is to take advantage of young and growing populations in rapidly developing economies. The trick, of course, is to pick the right companies — because there is no quick and easy way to dump a stake in a private company, as you can with a stock on a public exchange. On the Hunt for Hospitals It is this fundamental challenge — finding the right company, with the right management team — that has kept emerging market private equity funds from growing like their larger peers in more developed markets.

After all, it can be hard to get a true reading of your business partner in Jakarta, Indonesia, if you are sitting in New York, London or Hong Kong, as is the case with most private equity shops. Abraaj tries to solve that by being based in Dubai and maintaining 20 regional offices, in places like Cairo and Karachi, Pakistan. Its principals also hail from these markets. In addition to Mr. Naqvi, who is from Pakistan, the firm’s senior partners are citizens of Egypt, Ghana, India, Mexico and Turkey. The 48 ­year ­old Mr. Mann is typical in this respect. Born in the dicier precincts of Birmingham, England, to parents who had recently immigrated from Pakistan, Mr. Mann went to Cambridge, won a scholarship to the Wharton School and dropped his plan to become a doctor, switching to law and finance. Today he lives in Dubai and spends at least three weeks a month searching for hospitals and health clinics to buy in places like Ethiopia, Nigeria and Pakistan. He wears the tightfitting suits of a money­center banker, carries a fancy handbag and converses fluently in Urdu and Hindi. Mr. Mann, who works with a large team of bankers and health professionals in managing the fund, cuts a striking figure in Nairobi, pacing the halls of the two hospitals he’s scouting out — Metropolitan and Nairobi Women’s Hospital. Nairobi Women’s is one of the city’s largest private hospitals, originally founded by an ambitious entrepreneur, Dr. Sam Thenya, to provide care to women experiencing domestic abuse. With his slick suit and practiced smile, Dr. Thenya seems more a deal maker than a doctor. Both he and Mr. Mann caused a bit of a stir, rushing up and down the hospital’s spartan hallways and bursting into crowded patient rooms. Mr. Mann brimmed with questions about how to get doctors to see more patients and provide them with more profitable services. In a laboratory where blood samples from patients are analyzed, Mr. Mann asked how long each test took. Between 15 to 30 minutes, he is told. “That’s good,” he replied. “You want to get the tests back as quickly as possible.” Then Mr. Mann poked his head into the room housing the hospital’s single CT scan machine. The room was empty but for a bored­looking attendant hunched over a computer. These machines are a rarity in Kenya, and for hospitals looking to maximize profits, they are crucial pieces of equipment. Mr. Mann asked the doctor how many scans he performed in a day. About seven, came the reply. He shook his head. “You could be making a lot more money out of that machine,” Mr. Mann said. “You could be doing as many as 15 to 20 patients a day. A machine like this can really drive profitability.” ‘Not Mother Teresa Stuff’ Mr. Naqvi, in marketing Abraaj’s health fund, has insisted that its emphasis will be to have a positive social impact first and make money second. He refers to this mix of capitalism and social good — a bit majestically — as “partnership capital.” Nevertheless, both he and Mr. Mann know that any vision of a benevolent health conglomerate will not materialize unless they can find hospitals that are financially sound.

 

Perhaps the greatest tension for Abraaj to resolve is pricing. Few patients in India or Africa have health insurance. In Kenya, 67 percent of health expenditures are paid out of pocket. And in India — the fund’s central focus — that number is 60 percent. This makes for extremely price­sensitive patients. For example, the Hyderabad hospital chain that Abraaj recently bought, Care, has a business model that relies on patients paying $3,000 for a heart bypass operation, even though average income per capita in India is half that amount. (In the United States, similar treatment might cost $40,000, although insurance would help.) “Look, this is not Mother Teresa stuff — we have a responsibility to our investors,” Mr. Mann said. “But in this case, I really think that you can do good and make money.” That has been a driving philosophy behind Care Hospitals, India’s fifth­largest private hospital group. Founded by a team of Hyderabad cardiologists in the 1990s, Care has been a darling of private equity investors for the better part of 10 years. Last year, when Care again hit the market, Abraaj had to beat out a scrum of competing institutions. The Guru Will See You Now When Mr. Naqvi hired Mr. Mann to head the new fund in 2014, their first challenge was to find a country, and a hospital, that would serve as the driving force for the project. Because of India’s 200­million­person middle class and its wealth of doctors and surgeons trained to world standards, it was a logical place to start. Mr. Mann had long been aware of the niche that Care had carved out for itself, with its 16 hospitals serving a wide area in and around Hyderabad and other parts of central India. Mr. Mann knew, too, that to make the dream work across countries and continents, it would not be enough to swoop into Nigeria, buy the best hospital he could find and hope for the best.

Read more at NYT.com

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Doctor uses iPad to conduct remote surgery in Gaza (CNN Africa)

(CNN)In countries ravaged by conflict, providing international medical expertise on the ground can be almost impossible.

By Susie East, for CNN

But a new software, called Proximie, is enabling surgeons to provide help from wherever they are in the world, all through the screen of an iPad.
“I see on my screen the surgical feed that is being captured by the camera in Gaza and I’m able to draw on my screen the incision that needs to be done,” says Dr. Ghassan Abu-Sitta, Head of Plastic Surgery at the American University of Beirut Medical Center.

“Like being in the room”

Abu-Sitta has already used the Proximie software to lead two operations in the Gaza strip from his base in Beirut. From hundreds of miles away he showed colleagues how to negotiate a blast injury and operate on a congenital anomaly affecting the hand.
The software means that surgeons can demonstrate — in real time — the actions needing to be taken on the front line.
The procedure uses two smart phones or tablets connected to the internet which show a live camera feed of the operation. The surgeon sees this, and then marks on their device where to make incisions.
“That drawing shows up on my colleague’s screen in Gaza and he follows my drawings by making the incisions where they appear on the screen,” says Dr. Abu-Sitta, “It really is the equivalent of being there in the room with them.”
With two thirds of the world’s population lacking access to safe surgery, the time is ripe to develop new techniques to reach more remote areas.
How 3D printing is changing the world of surgery

A helping hand

Being able to watch surgery in progress could also make it a useful training aid.
“We want to be the platform for medical students to really engage in surgery,” says Proximie co-founder Prof. Nadine Hachach-Haram. “Historically the old viewing galleries that happened in surgery where students could come in and learn and watch, they don’t exist anymore.
“Surgery is very visual. You can read it in a book if you want but it’s not the same as watching it live, so this is where our platform really fits in.”
According to Peter Kim, Vice President of the Sheikh Zayed Institute for Pediatric Surgical Innovation, Proximie could be a positive addition to the range of other products using cameras and video for real-time sharing.
“I think the need and effort to share best practice and dissipate very siloed experiences in medicine should be supported,” says Kim. “Those involved should be applauded for their effort but if it is a product with cost attached to it, the value must be clearly articulated.”
Previously, Abu-Sitta and his staff were trying to help overseas surgeons by sending them audio recordings, photos and X-rays using the online messenger WhatsApp. But the new software is far more interactive, providing detailed images and patient information throughout the surgery.
“We wanted to push the idea that with only the minimum hardware, and minimum infrastructure you can still pull it off,” says Abu-Sitta, “With just two tablets, iPad to iPad, we’re able to perform this surgery.”
Whether it’s used for education or to conduct delicate surgeries in conflict zones, internet enabled software such as Proximie could be the future of surgery.

(Al Jazeera) Somalia executes al-Shabab journalist

| Politics, Africa

Hanafi said he confessed to the killing of journalists following torture by authorities in Mogadishu [AP]

Hanafi said he confessed to the killing of journalists following torture by authorities in Mogadishu [AP]

Somalia has executed a journalist accused of helping members of al-Shabab kill at least five journalists in the capital.

Hassan Hanafi, who was captured in neighbouring Kenya in 2014, was executed on Monday morning by a firing squad in Mogadishu after his appeal at a military court failed.

Hanafi was accused of helping fighters from the al-Qaeda-linked group identify possible targets in the journalism community between 2007 and 2011.

From 2009 to 2011 he worked for Radio Andalus, al-Shabab’s official mouthpiece.

In an interview aired on Somalia state TV in February, Hanafi admitted ordering the murder of several journalists.

But in an audio recording of a phone call leaked last month Hanafi appeared to claim he made the confessions after being tortured.

According to the Committee to Protect Journalists more than 25 journalists have been killed in the Horn of Africa country since 2007.

Al-Shabab, which is seeking to overthrow the country’s Western-backed government, was pushed out of Mogadishu in 2011 by government troops backed by an African Union force.

It continues to carry out suicide attacks and targeted assassinations in south and central parts of the country, and it has also conducted major attacks in Kenya, Djibouti and Uganda, which all contribute troops to the African Union effort.

The article was published in Al Jazeera.

Mobile technology proven to address challenges around healthcare (IT News Africa)

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ViiV Healthcare, a global specialist HIV company, announced jointly with its global partners, Vodafone Foundation, the Elton John AIDS Foundation, ELMA Philanthropies and the United States Government through the United States Agency for International Development (USAID), the launch of the Mobilising HIV Identification and Treatment (MHIT) programme in Lesotho.

By Staff Writer (IT News Africa)

Mobile technology proven to address challenges around healthcare. (Image Source: dogtownmedia.com)

The MHIT programme is a multi-million dollar three-year commitment led by the Vodafone Foundation through the Vodacom Lesotho Foundation, with financial contributions from the private and public sectors, including funding and community mobilisation expertise from ViiV Healthcare, as well as support from Elton John AIDS Foundation to Baylor College of Medicine Children’s Foundation—Lesotho, ELMA Philanthropies and USAID.

The goal of the MHIT programme is to double the number of children in Lesotho in care and on treatment within three years, thereby ensuring that their health and futures are not compromised or cut short through lack of access to HIV services. It also aims to improve uptake of services that address mother-to-child transmission of HIV to prevent more children from being born with the virus.

The use of mobile technology has proven a successful tool to address some of the challenges around access to healthcare services, such as access to transport, in rural regions of sub-Saharan Africa.(1) In Lesotho, the Vodafone Foundation is building on this success by deploying mobile clinics to rural areas to reach children – including adolescents – and mothers in hard to reach communities, providing primary care services (including antenatal checks and immunisation) and searching for individuals living with HIV to provide them with better access to treatment, using mobile money-based transport vouchers so they can reach clinics or hospitals. For many children and mothers, this could be the first time that primary healthcare services have been accessible to them. In addition, the use of mobile technology enables the management, coordination of services and communications to support the implementation of the programme.

Dr Dominique Limet, CEO ViiV Healthcare, commented: “Through our Positive Action programmes, we have a successful track record in mobilising communities and supporting capacity building at grassroots level to address the challenges of the HIV epidemic. By working with the right partners, we can deliver practical solutions to make a true difference to the lives of children in Lesotho and help future generations live longer and more fulfilling lives.”

Rishaad Tayob, Managing Director, Vodacom Lesotho said: “Vodacom Lesotho Foundation and Vodafone Foundation are bringing money, marketing, management and mobile technology to challenge paediatric HIV.  Partnership is critical and by working with private funders and the Government of Lesotho and USAID, we aim to double the number of children on treatment and in care. We are already saving lives.  We are privileged to also have the full support of His Majesty the King.”

Lesotho has one of the world’s highest rates of HIV/AIDS with 23% of the two million population living with HIV.(2, 3) Antiretroviral treatments (ARTs), which suppress the HIV virus and stop its progression, are available, however, only a third of the estimated 19,000 children in Lesotho living with the virus are receiving ARTs.(3, 4, 5) Lesotho is made up mostly of highlands where many of the villages can be reached only on horseback, by foot or light aircraft. This means that resources are scarce and difficult to access by mothers and their children.

Read more at IT News Africa 

New dengue vaccine shows promise (CNN)

(CNN)A new type of dengue vaccine called TV003 seems to protect people against at least one type of the virus, according to a small study. If further research can bear out its effectiveness, the new vaccine could eventually represent a big advance in controlling the most common mosquito-transmitted virus worldwide.

Although another dengue vaccine recently became available in Mexico, Brazil, the Philippines and El Salvador, it may not be appropriate to use in countries such as the United States.

By Carina Storrs, Special to CNN

That licensed vaccine, called Dengvaxia, has been found to reduce the rates of severe dengue cases in adults and older children in Asia and Latin America, but many of them had probably already had a dengue infection in their lives. In contrast, Dengvaxia could increase the risk of dengue disease among young children who have not been exposed to dengue virus before — a group that is similar to the U.S. population. (In countries where the vaccine is available, it is only given to children age 9 and older.)

So researchers at several institutions in the United States set out to develop a new vaccine that would give people — including those who have not been infected — strong protection against all four types of dengue virus.

“Control of dengue has certainly been a public health priority for many years. But getting there has not been easy,” Stephen S. Whitehead, a researcher at the National Institutes of Health who designed the new vaccine, said at a news teleconference on Tuesday. Whitehead is one of the authors of the study that tested TV003, which was published on Wednesday in Science Translational Medicine.

The researchers decided to take a different tack in testing the vaccine. Normally the efficacy of a new vaccine is tested in large studies in areas affected by the disease, but those kinds of studies can take up to 10 years and cost millions of dollars. Although that research will still need to be done, “we really wanted to have an early clue that the (vaccine) would work,” Whitehead said.

A different way to test vaccines

Instead, the researchers used a “human challenge model.” They gave TV003 to 24 adult volunteers in Maryland and Vermont, while another 24 adults got a placebo as a control. After one injection of TV003, 92% of participants in the vaccine group developed antibodies to all four types of dengue virus. The only side effect associated with the vaccine was a rash around the injection site, which typically went away in five to 10 days.

But the biggest question is whether the new vaccine can prevent dengue infections. In the “human challenge” part of the study, the participants were artificially infected — using a needle, instead of a mosquito — six months after receiving TV003 with a highly weakened version of dengue virus Type 2.Previous studies have suggested that Dengvaxia does not protect as well against Type 2 as Types 1, 3 and 4.

None of the vaccinated adults got infected, whereas 80% of the individuals in the control group developed a rash and all of them had detectable dengue virus in their blood.

This type of experiment could be “totally unethical,” but in this case, the researchers got consent from healthy adults and used a form of the virus designed to be very weak, said Dr. Sarah George, an associate professor of infectious diseases at St. Louis University. George was not involved in the current study.

As the researchers discussed in the teleconference, this type of approach has been used to develop vaccines for a number of diseases, including malaria, flu and cholera.

The researchers are now testing whether the TV003 vaccine can protect people from the three other types of dengue virus. They are currently challenging study participants with Type 3 and hope to have results by late spring or summer.

ar, the results with TV003 have helped inform dengue vaccine studies about which vaccine formula to use, Dr. Anna P. Durbin, associate professor at Johns Hopkins Bloomberg School of Public Health, said at the teleconference. “We are very happy to say that the first phase 3 efficacy trial of the vaccine started last month,” said Durbin, who led the current study on TV003. The trial is working to enroll 17,000 people between the ages of 2 and 59 around Brazil and address whether the new vaccine can help reduce dengue disease.

“Who knows what will happen (in future studies) — dengue is full of surprises,” George said. However, she added that it is unlikely that TV003 would increase the severity of disease among people who have not previously been infected with dengue, as Dengvaxia seems to do.

The difference comes down to how the two vaccines are designed. Dengvaxia contains hybrid viruses that are made up mostly of yellow fever virus and have just two molecules from dengue virus. On the other hand, the new vaccine contains the entire virus for all four types, except they all contain mutations that make them much less potent in people.

Because the immune system will “see” more dengue virus molecules with the new vaccine, it could develop a stronger protective response to the four virus types, said George, who has received funding from Takeda Pharmaceuticals to study the immune responses to a dengue vaccine the company is developing.

Read More at CNN.com

Kenyans Reacquire an Old Taste: Eating Healthier (NYT)

In the 1950s and ’60s, governments in Africa and Asia started subsidizing the production of staple crops like rice and corn because it was the fastest way to fill bellies and reduce starvation in those regions. Today, needs have changed: The problem is no longer chronic hunger but malnutrition, and the solution is not more calories, but better calories.

A field of maize in Malawi.Credit Mike Hutchings/Reuters

It’s a crucial difference. A diet of corn or rice may keep a person alive, but can result in myriad health issues from night-blindness to severe anemia. For decades, however, governments, agriculture companies and development organizations have focused so heavily on staple crop production that Africa and South Asia are now growing too much corn (or maize, as it’s widely known abroad) and rice, says Prabhu Pingali, director of the Tata-Cornell Agriculture and Nutrition Initiative at Cornell University. Most of the surpluses are used for animal feed, in some cases to drive the growth of industrial animal production.

These starchy foods are not only insufficient to combat malnutrition; they have also displaced crops that are more nutrient-rich but harder to produce. And while governments have undertaken significant efforts, particularly since the global food crisis of 2008, to control prices for staple crops, they have made little effort to support the production or affordability of more nutritious foods, says Pingali. (See his critique of food policies as published in a June 2015 report in the journal Food Security. At the site, click on “Look Inside.”)

Consider lentils, or dal, in India, a legume that is rich in protein, fiber and key nutrients. “For decades, dal prices were rising relative to rice prices, but nobody said anything about it,” said Pingali. “It’s only now that people are saying: ‘Wait a minute. We need dal as much as we need rice. Where’s our dal strategy?’”

Governments around the world have long failed to promote the production or availability of a wide range of legumes, vegetables or fruits; in fact, just about every food other than corn, wheat or rice has been neglected. “Like in many other countries, when you talk about food security, Kenyans are talking about how many bags of maize we have,” said Mary Abukutsa-Onyango, a horticultural researcher at the Jomo Kenyatta University of Agriculture and Technology near Nairobi. She has a story to tell about how to start turning things around.

Ten years ago, vegetables that had been introduced during colonial times, mainly cabbage, collard greens and kale (sukuma wiki in Swahili), were standard fare in many parts of Kenya, particularly urban areas. Indigenous greens like African nightshade, jute mallow and spider plant had become associated with poverty, and many Kenyans chose not to eat them despite their greater nutritional value.

Abukutsa has published more than a dozen studies documenting the robust health benefits of the traditional vegetables, which are high in vitamin A, iron, zinc and other micronutrients often lacking in local diets. Moreover, she began working to encourage restaurants and supermarkets to serve or carry these vegetables; she and her students took field trips to help farmers grow them; and she helped to develop and publish recipes to make them more appealing and approachable, since preparation for some of the greens can be rather involved, and some traditional cooking knowledge had become less widespread as the vegetables’ popularity declined. Then she circulated her findings to other researchers, to get them interested in these nutritional powerhouses.

Today, restaurants throughout Nairobi serve greens like African nightshade to packed lunch crowds and supermarkets sell out of them while kale wilts on the shelf, a sign that the traditional vegetables have been taking over the exotic varieties. More farmers are growing the indigenous greens, and in the most convincing sign of increasing commercial interest, seed companies are breeding them.

Abukutsa has also worked to include the study and breeding of indigenous vegetables in university curriculums, because she knows that horticulture students often go on to become agriculture extension officers, the key source of farming advice for farmers around the country. Five universities now include the cultivation of indigenous fruits and vegetables in their syllabuses, she said. While the obvious goal was to ensure that knowledge about indigenous crops trickled down to farmers, there has also been a potentially more powerful result: The insights that drive these efforts have been trickling up as well, and are making their way into national policy.

Historically, Kenya’s ministries of health and agriculture have operated in isolation from one another, but in 2012, they decided to collaborate on a new agricultural policy that emphasizes more diverse, underutilized and nutrient-dense crops, Abukutsa explained. “The policy we had before had been focusing more on commercial crops for export and staples,” she said. “We needed a policy specifically addressing nutrition — not just talking about production.”

The government’s policy proposal has not been published yet because the draft text is not yet in final shape. But when it is, Abukutsa expects that it, like policy declarations before it, will affect the type of training available to farmers through the government’s extension program and perhaps the types of crops for which research is funded.

“The new policy will ensure that when we talk about food security, we are not just talking about maize — that we are talking about all that is available,” she said. The resurgence in popularity of indigenous vegetables is too recent to show an impact on national health statistics, but Abukutsa is confident it will lead to improvement, especially in relation to malnutrition and degenerative diseases. She’ll be tracking the results.

Other groups too are working to breed and improve the quality of indigenous crops in Kenya and around the globe. The Nairobi-based World Agroforestry Center has been leading a campaign to breed and conserve threatened varieties of indigenous fruits such as baobab, bush mango and African plum. It has a team working with small-scale farmers in Cameroon and other parts of Africa to domesticate fruit trees that have always grown in the wild. Largely because of deforestation, the fate of these trees in the wild is uncertain, so domestication may not only preserve them, it may also lead to the development of varieties of trees that will be more nutritious and resilient.

Elsewhere, the Taiwan-based World Vegetable Center has been breeding varieties of indigenous vegetables around the world, although its communications director, Maureen Mecozzi, said the work remains an uphill battle. “Although many countries now recognize the need to encourage production of a more diverse set of crops, developing the policies, funding the research, and building the infrastructure to support that diversity is a big challenge,” she said.

So far, there has been no research from which to quantify the changes in Kenyans’ consumption of indigenous fruits and vegetables, the impact of those crops on the nutritional status and overall health of populations. But researchers who work globally, like Pingali, and locally, like Abukutsa, are confident that the only path that makes sense is focusing more on vegetables and other nonstaple crops, whether they are indigenous or not.

“I’m now of the view that we’ve sort of beat the calorie problem,” said Pingali. “Even if you think towards 2050 horizons, we’ve got the tools and the mechanisms to support the demand for staple grains. Now, a lot of people will argue me on that. But I believe the same people who say we need to double the amount of rice, et cetera, should also be asked: Well, what about tomatoes? What about green beans?”

“As you think to the future and the demands for food in the future,” he said, “only focusing on staples puts us in this really funny situation of creating increased imbalance in our diets.”

Rachel Cernansky is a freelance journalist in Denver. She writes about agriculture, health, and the environment.

Read More at the NY Times.com

Technology is a key driver to overcome healthcare challenges in Africa (IT News Africa)

Healthcare in Africa differs widely, depending on the country and also the region—those living in urban areas are more likely to receive better health care services than those in rural or remote regions.  Many communities lack clean water and proper sanitation facilities, particularly in rural areas.  This means that illnesses caused by poor hygiene, such as cholera and diarrhoea, are common in some countries.

By Staff Writer: IT News Africa

Mobile technology can address some of the biggest health challenges in Africa.

Heavy demands on health care systems
Diseases such as malaria, tuberculosis and HIV/AIDS as well as diseases found mostly in African countries such as elephantiasis, leprosy, polio, helminthiasis and trachoma are rife. Furthermore, there are not enough health workers, hospitals and clinics in Africa. Some African countries lack basic equipment and have inadequate supplies of medicines. Half of Africans do not have access to essential drugs and disruption to daily life and damage to facilities caused by conflict, mean health clinics have an even greater struggle to offer services to local populations.  Diseases then take an even greater toll. Demands on health care systems are also increasing as non-communicable diseases, such as cancer, hypertension, diabetes and heart disease are on the rise.

At a 2001 African Union (AU) meeting in Abuja, Nigeria, African countries agreed to allocate 15% of their budgets to healthcare.  To date, only six countries have met this commitment.  Health experts now believe that even if the target is reached, 15% of a small budget is not sufficient to make major inroads into poor health.  Four of the six countries allocating 15% of their budget still spend only 14USD per capita on health.

Technology—a key driver to overcome healthcare challenges
Vuyani Jarana at Vodacom Business says that mobile technology can address some of the biggest health challenges in Africa. “We have developed a range of healthcare solutions using mobile technology specifically to bridge the gap,” he says. To achieve this and leapfrog the global health care systems, it is critical for technology and innovative solutions to be implemented across the continent.

For example, there are mobile applications to:
– Capture patient information making service records more accurate and easily accessible
– Remind patients when they are due back at a clinic for an immunisation visit
– Remind the clinic management to submit an update on stock levels, expiry dates, wastage and stock received.

Jarana believes that technology will be a key driver in helping the continent to overcome some of its biggest healthcare challenges.

Innovative funding mechanisms can provide much needed revenue
Funding remains a monumental problem. Under these difficult circumstances, it is imperative to create new and innovative sources of funding like innovative financing for development, to address the socio-economic development needs of the population, of which health is clearly an urgent priority. According to McKinsey & Company, “innovative” refers to finance mechanisms that might mobilise, govern, or distribute funds beyond traditional donor-country official development assistance (ODA).  New revenue streams will have to be identified to implement or scale up already-existing programmes to address the current health challenges.

The Group contribution
Innovative financing for development has the capability of generating significant amounts of revenue that could either replace or complement existing traditional methods of funding. For instance, innovative funding mechanisms implemented with the assistance of a revenue-assurance expert like Global Voice Group has generated an estimated USD 1.5 billion over the last 10 years, through micro-levies on international telecommunications services.  These revenue-generating opportunities empower African countries to take charge of their own socio-economic development, using their own resources and through the smart integration of ICTs.

Innovative Financing—a game changer for sustainable development
Several developing or emerging countries are already capitalising on innovative financing for development.  For instance, in Haiti, education is being funded through micro-charges on international telephone calls.  By June 2015, more than US$16 million had been generated, allowing the government to provide free quality education to 1.4 million Haitian children.

It is no exaggeration, then, to say that innovative financing for development is a real game changer for sustainable development.  The leveraging of international incoming calls as an innovative funding mechanism has become an important part of the economies of many African countries. However, to make this funding mechanism effective international incoming telecoms traffic must be accurately measured and a revenue-assurance solution put in place to prevent fraud.  GVG’s cutting edge telecommunications governance solutions have assisted many African countries to optimise the revenue generated by international incoming telephone traffic so as to ensure that both the local operators and the government receive their fair share of the revenue.

These revenues can be used to finance social projects like health and education and meet the respective countries’ specific development goals.  This paves the way to more sustainable models of society on the African continent.

Read More at IT News Africa

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(AFK Insider) Gates Foundation Pays For Contraceptive Delivery By Drone To African Women

Ghana health care. Photo Credit: gooverseas.com

Ghana health care.
Photo Credit: gooverseas.com

By Dana Sanchez

Published: January 29, 2016, 3:26 pm 

Drones are delivering contraceptives to hard-to-reach Ghanaian villages in a program jointly funded by the U.N. and the Bill & Melinda Gates Foundation, and it’s so successful that other countries want it too, HuffingtonPost reported.

Deliveries to rural Ghana that once took two days now take 30 minutes by drone, and each flight costs only $15, according to Kanyanta Sunkutu, a South African public health specialist with the U.N. Population Fund.

Sunkutu said he expected the pilot program in Ghana to encounter resistance, and worried people would associate the drones with war. So the U.N., in its program materials, referred to the drones only as “unmanned aerial vehicles” — not drones.

“We don’t want that link between war and what we are doing,” Sunkutu told The Huffington Post in an interview. “But the resistance we thought we would get has not been there.”

Less than than 20 percent of women in sub-Saharan Africa use modern contraceptives. In rural Africa, a flood can shut down roads for days and cut off medical supplies, making access to birth control a massive problem.

An estimated 225 million women in developing countries around the world want to delay or stop childbearing, but don’t have reliable birth control, according to the World Health Organization. This prevents women and girls from finishing school or getting jobs. About 47,000 women die of complications from unsafe abortions each year.

“We are particularly committed to exploring how our family planning efforts can meet the needs of young women and girls,” Bill and Melinda Gates said, according to their foundation website.

The idea to use drones for delivering birth control came from a program in the Amazon, Sunkutu said.

The drone operator packs a five-foot-wide drone with contraceptives and medical supplies from an urban warehouse and sends it over to places hard to reach by car. There, a local health worker meets the drone and picks up the supplies.

Project Last Mile has been flying birth control, condoms and other medical supplies to rural areas of Ghana for several months.

Now it’s expanding to six other African countries. The goal is to revolutionize women’s health and family planning in Africa. Tanzania, Rwanda, Zambia, Ethiopia and Mozambique have expressed an interest.

Using drones to improve reproductive health isn’t exactly a new idea — it’s just new in Africa, according to Huffington Post. In June, a Dutch organization called Women on Waves used a drone to fly abortion pills to Poland, trying to raise awareness of Poland’s restrictive abortion laws.

Project Last Mile says it is the first to develop a long-term, sustainable program for delivering contraceptives by drone.

Sunkutu hopes that eventually drones will revolutionize other areas of rural African life., starting with family planning.

“They can deliver ballots after elections, or exams for school,” he said. It becomes a logistics management solution for hard-to-reach areas. We’re going to use family planning as an entry and make it sustainable.”

The article was published in AFKInsider.

 

(UN News) Half the population of Central African Republic faces hunger, UN warns

Two and a half million people in the Central African Republic (CAR) are facing hunger. Photo: WFP/Bruno Djoye

20 January 2016 – An emergency food security assessment by the United Nations World Food Programme (WFP) and its partners has revealed that half the population of the Central African Republic (CAR) – nearly 2.5 million people – faces hunger.

This marks a doubling in the number of hungry people in a one-year period, as conflict and insecurity have led to limited access to and availability of food.

“Three years of crisis have taken a huge toll on the people of CAR,” said Guy Adoua, WFP Deputy Country Director in the country, in a press release.

“Families have been forced so often to sell what they own, pull their kids out of school, even resort to begging, that they have reached the end of their rope. This is not the usual run-of-the-mill emergency. People are left with nothing,” he added.

According to the assessment, one in six women, men and children struggles with severe or extreme food insecurity, while more than one in three is moderately food insecure, not knowing where their next meal is coming from.

“WFP is extremely concerned by this alarming level of hunger. People not only lack enough food but are also forced to consume low-cost, low-nutrient food that does not meet their nutritional needs,” added Mr. Adoua.

The report shows that the 2014-2015 harvest was poor and that food prices remain high as farmers have not tended their fields due to insecurity, and hundreds of thousands have been forced to flee their homes and abandon their land and livelihoods.

Further clashes erupted in late September as much of the food security data for the assessment was being collected. That violence fuelled more displacement as people were slowly returning home. Nearly 1 million people are still displaced inside CAR or seeking refuge in neighbouring countries.

The report recommends continued emergency food assistance to displaced families and returnees; food and technical assistance to farmers to recover; creating safety nets through programmes such as the school meals programme; and providing support to rehabilitate the infrastructure through food-for-assets activities.

Meanwhile, WFP is providing emergency food and nutritional support to those most vulnerable and plays a crucial role in supporting recovery efforts. The agency’s programmes focused on cash-based transfers and local food purchases going into school meals for thousands of children boost the local economy and people’s livelihoods.

“We must help the most vulnerable, who need emergency food assistance to survive, yet we also need to focus on people across CAR so they can recover and rebuild,” stressed Mr. Adoua.

In December 2015, WFP provided food for nearly 400,000 people through general food distributions, cash-based transfers, nutrition support and school meals, as well as food-for-assets activities, but $41 million is required so that it can respond to urgent needs through to the end of June. To date, WFP’s operation is only 45 per cent funded.

This article was published in the United Nations News Centre.

(Seychelle News Agency) Comoros-Seychelles to Sign Agreement in Drug Fight, Prisoner Exchanges

Victoria, Seychelles | December 29, 2015, Tuesday @ 18:00 in National » DIPLOMACY | By: Rassin Vannier et Betymie Bonnelame | Views: 594
Comoros-Seychelles to sign agreement in drug fight, prisoner exchanges
Ambassador Caabi Elyachroutu Mohamed congratulated president Michel on his re-election (Patrick Joubert Seychelles News Agency)

(Seychelles News Agency) – Seychelles and the Comoros are working on a judicial agreement to address the drug trade and future exchanges of prisoners, government officials from the two countries said Tuesday.

The agreement will allow prisoners to serve time in their respective countries’ prisons.

The Comoros already have such an agreement with neighbouring island nation Madagascar and Tanzania in East Africa.

The subject is timely. Eighteen Comorian fishermen were arrested by the Seychelles Coast Guard in Seychelles’ waters in November. Officials say the fishermen were fishing without authorisation in the lagoon of the Aldabra Atoll, a nature reserve.

Tuesday’s announcement came after a meeting between Seychelles President James Michel and Comoros Ambassador Caabi Elyachroutu Mohamed. During his meeting with Michel, Mohamed congratulated the Seychelles head of state on his December re-election on behalf of Comorian President Dr. Ikililou Dhoinine.

One of the boats caught by the Seychelles coast guards ( SIF) Photo License: CC-BY

During his trip to Seychelles, Mohamed met with the 18 fishermen in total who were arrested. Three Comorian skippers were charged last week with illegal fishing.

“I wish that the court proceedings will be done in the best possible conditions,” he said.

Mohamed is on a working visit to the Seychelles archipelago in the western Indian Ocean. The two countries enjoy bilateral co-operation in many fields given that both are small island states.

The Comorian ambassador has expressed his interest in the having the Seychelles national airline making Coromos one of its destinations.

“The Seychelles is becoming the hub of the region, this is interesting for us. We wish that Air Seychelles will be interested in flying to our island,” said the Madagascar-based Mohamed.