(Formerly called IRIN) Journalism from the heart of crises

  • Breaking the cycle of youth unemployment, poverty

    Youth unemployment and underemployment are among the main barriers to development in West Africa, say experts. Not only does the exclusion of young people from the labour force perpetuate generational cycles of poverty, it also breaks down social cohesion and can be associated with higher levels of crime and violence among idle youth.

    "A decent and productive job [not only] contributes to attaining fundamental individual and family well-being, but also spills over, contributing to society's broader objectives, such as poverty reduction, economy-wide productivity growth and social cohesion," said Diego Rei, the International Labour Organization's (ILO) senior regional adviser on youth employment in Africa.

    Worldwide, an estimated 73 million youths - defined as those between the ages of 15 and 24 - were unable to secure work in 2013, according to the ILO. The rate of underemployment is difficult to measure, but experts say that it is likely that millions more were either working jobs for which they are overqualified or else receiving below-average wages.

    In sub-Saharan Africa, the youth unemployment rate hovers around 12 percent. While this is slightly lower than the global youth unemployment rate of 12.4 percent, the African region has the world's highest rate of working poverty - people who are employed but earning less than US$2 a day. Despite being Africa's most educated generation to emerge from schools and universities, a youth in Africa is twice as likely to be unemployed when he or she becomes an adult, according to the ILO.

    "Here in Africa, we have this idea that if I'm learning, I'm supposed to work in the future," said 22-year-old Mamadou Diene, an English major at Cheikh Anta Diop University in Dakar who wants to become a translator. "But instead. we only have a very small number of them who are employed. It's a real problem."

    A form of social exclusion

    In a late 2013 report on social inclusion, the World Bank considers youth unemployment to be a form of social exclusion, particularly in developing countries: it hinders and degrades the role of young people in society and the development of their countries, and it reduces their personal well-being and future opportunities.

    Not being able to find good, quality work early on is stressful and discouraging for youths, say the World Bank and ILO. When youths do not find work, their risk of unemployment as an adult increases, as does their chance of receiving low wages later in life, according to a 2014 World Bank report on youth employment.

    There is no specific link between unemployment and violence or crime, note World Bank researchers, but unemployed youth are disproportionately more likely to commit crimes when a number of other factors, such as weak support networks, are also present.

    Young women in sub-Saharan Africa are at a particular disadvantage in finding jobs, as they usually have less access to quality education and healthcare compared to their male peers.

    Millions of productive jobs will need to be created to include the estimated 11 million African youths who are expected to join the labour market each year over the next 10 years, says the World Bank in its report.

    Growth versus jobs

    Many African countries have registered high rates of economic growth in recent years, but this has not translated into new jobs.

    This is partly because much of the growth in sub-Saharan African countries over the past decade has been driven by the extractive industries - oil, gas and minerals - says Deon Filmer, a lead economist in the Research Group of the World Bank and co-author of the organization's report. "While these industries generate output and revenues that are reflected in GDP growth, they're not particularly big job creators."

    The number of jobs created in these sectors, relative to outputs and revenues, is much lower than in export-oriented manufacturing, he added.

    Further, the pace of growth for wage-employment cannot keep up with the growing population: Africa has the largest "youth bulge" in the world, and the number of youths is expected to grow by 42.5 million between 2010 and 2020, says the World Bank. Even in countries such as Ghana and Tanzania, where the number of wage jobs has grown by around 10 percent, the increase is not enough to absorb all the new entrants to the workforce.

    And with nearly half of the current African population under the age of 14, the problem is only expected to get worse.

    Agriculture not international relations

    The director of the Economic Policy Analysis Unit for the Economic Community of West African States (ECOWAS) Commission, Felix Fofana N'Zue, told IRIN one of the reasons so many young people are being excluded from the labour market is a mismatch between their skills and the market's demands.

    "Africa has failed to train people for its needs," he said. "Instead, it has been training young Africans to satisfy or meet the needs of other people."

    In Senegal, for example, he explained that the agricultural sector employs nearly 80 percent of the workforce, but that the majority of university graduates study subjects such as economics, the humanities and international relations.

    N'Zue said that, while these fields are important, such degrees leave young people either living in Africa unemployed or underemployed or migrating to places like the US or Europe.

    "Once we start training people with the skills they need for jobs we need to create and fill, that's when young people will become a valuable asset to the workforce," he said.

    Flaubert Mbiekop, the programme officer for social and economic policy at the International Development and Research Centre (IDRC), agreed.

    "With regards to youth unemployment, one of the issues we have been looking at is the apparent mismatch between the qualifications the youth have and the expectations of the employers in the labour market," he said.

    But it will be difficult to convince the small minority of youth who attend university to forgo study in fields thought to lead to more lucrative professions - such as finance, management, law and medicine - in favour of studying farming and agriculture.

    "We see many young people coming from rural areas, hoping they will enjoy a better life, better work in the city, but that is not necessarily the case," Mbiekop said. "So the question is: how can we make the agricultural sector attractive to the youth? How can we get them interested in a sector that is not yet well developed in many African countries, but has so many opportunities?" he asked.

    Students need credit

    "Youth unemployment isn't a one-dimensional problem.We have to look at both the human capital dimension - what young people bring to their work, their abilities, and so on, as well the business environment that's conducive to productive work or not, conducive to competitive firms starting up or not," said Filmer.

    But it is not enough for governments and the private sector to create more jobs geared towards young people - whether in agriculture, manufacturing or the natural resource industries. Access to quality education also needs to improve, alongside a focus on skills-building with apprenticeships and internship opportunities.

    Youth also need more access to credit, he said.

    "If we look at the issue of financial inclusion, there are many [young] workers operating their own business, but access to credit, to be able to purchase inputs, is lacking," Filmer said. "So we need reforms to enable youth to access financial markets."

    Support could come in many forms, from setting up savings groups at the village level to using new financial technologies, like mobile money. Both approaches have engaged young people, pulling them into financial markets and allowing them to start their own businesses.

    Access to work space and land is also important, especially for women, who are often denied land rights.

    "We see that access to land for youth in rural areas, for example, and space to operate a business in urban areas are real constraints, and youth are really shut out of those markets," Filmer said.

    The ILO's Rei said labour market interventions, such as creating incentives for the private sectors to hire young people, providing youth with information about job vacancies and career prospects, and ensuring that recruitment processes are transparent and non-discriminatory, will also go a long way in helping ensure more young people are included in the labour force.

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    Breaking the youth unemployment cycle
  • Crop-eating pests plague southern African farmers

    The rainy season, always welcome in often dry southern Africa, has brought with it favourable breeding conditions for army worms and red locusts. The crop-eating pests are contributing to the woes of subsistence farmers already struggling to recover from setbacks in the last farming cycle. 

    In Zimbabwe, where the World Food Programme (WFP) estimates that 2.2 million people now require food assistance, more than 800 hectares of cereal grain crops and 300 hectares of pasture have been destroyed by outbreaks of army worms.

    Godfrey Chikwenhere, Deputy Director of the Department of Research and Specialist Services in the Ministry of Agriculture, told IRIN that the damage caused by the army worms, which are in fact moth larvae, was significant and would impact the food security of households in the affected areas.

    He said the army worm originated in East Africa and the Horn of Africa. Between October and November, moist winds carried the moths into Zimbabwe and deposited them in northern Zimbabwe’s Mashonaland Central Province, from where they spread across the country. A similar pattern of movement occurred in 2013.

    Zimbabwe

    “Some crops were completely destroyed, forcing some farmers to replant when we are way into the farming season, and this will result in reduced yields,” Chikwenhere said. “The effect will also be felt among livestock producers because of the destruction of pastures, especially in the cattle-producing provinces of Matabeleland North and South.”

    Spraying pesticides to destroy the caterpillars could only be done on crops because the spraying of pastures and game parks could expose animals to toxic chemicals, he noted. As a result, the army worms had been able to reproduce unhindered in some areas. 

    Although his department initially had adequate supplies of carbaryl - the chemical used to contain the pest – Chikwenhere said stocks were running out fast and there was a shortage of vehicles to monitor outbreaks and distribute the pesticide. 

    “Because of the almost daily high rainfall being recorded in many parts of the country, some farmers are having to respray, as the rains dilute the effect of the chemical,” he added.

    Recent torrential rains and flooding in several of Zimbabwe’s southern provinces have destroyed crops as well as homes and infrastructure, according to local news reports.

    In its monthly report for January, Chikwenhere’s department predicted that: “Fresh outbreaks emanating from secondary generation army worm are likely to hit most parts of the country up to May 2014, if current weather conditions persist.”

    He said there was a need to train farmers on prevention and early reporting. “A lot of our farmers are well versed on spraying pests… but they need to be trained on how to identify army worm at an early stage, so that intervention mechanisms are implemented before any damage is done.”

    Malawi

    Army worm outbreaks have also been reported in Mozambique, eastern Zambia and Malawi, where 2,600 hectares of crops were affected, over 500 hectares of which were totally destroyed according to reports from the Ministry of Agriculture. 

    Food shortages in Malawi are already afflicting 1.85 million people, according to the Malawi Vulnerability Assessment Committee (MVAC). Now the country is also experiencing outbreaks of red locusts, mainly around Lake Chiuta and Lake Chilwa near the border with Mozambique in the southeast. 

    A January migratory pest report by the International Red Locust Control Organisation for Central and Southern Africa (IRLCO-CSA) notes that the locusts bred in January and their eggs have now produced hoppers. 

    “Hoppers will fledge and adults are expected to appear in March/April,” reads the report. “These swarms, if not controlled, will migrate and threaten food security in most countries in the region.”

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    Pests plague southern African farmers
  • Helping Africa’s urban poor gain from modernization

    Plans to reshape and modernize African cities, in part driven by investment, architecture and construction companies seeking new markets, could deepen existing social inequalities, according to recent research. But these development plans could also benefit the poor if governments are responsive to the needs of their citizens, argue analysts.

    The implementation of these development plans within existing cities is having major exclusionary effects on vulnerable low-income groups through evictions and relocations, states the journal article "African urban fantasies: dreams or nightmares?". This is because some of the informal settlements - where most of Africa’s urban poor live - are on lands attractive to property developers.

    “In the competition for well-located urban land, the poor will inevitably lose out and be pushed to the edge of the cities, far away from jobs and public facilities. Governments will focus public investment on infrastructure for the new projects, and this will drain resources away from providing services to low-income areas,” Vanessa Watson, the author of article, told IRIN.

    “With the majority of urban populations living in deep poverty and with minimal urban services, the most likely outcome of these fantasy plans is a steady worsening of the marginalization and inequalities that already beset these cities,” added Watson, who works with the African Centre for Cities (ACC) programme at the University of Cape Town.

    Indeed, the Humanitarian Policy Group in a recent report cited “development policies and projects and land grabbing as some of the drivers of urban displacement”.

    Pro-poor benefits

    Countries such as Angola, the Democratic Republic of Congo, Ghana, Kenya, Nigeria, Rwanda and Tanzania have partnered with the private sector to develop master plans for their cities.

    In Kenya, there are plans to build Konza and Tatu cities, which will house some 100,000 residents and include business parks and shopping malls. The government is priming the proposed Konza City to be Africa’s Silicon Valley, part of its wider efforts to make Nairobi a regional information technology hub.

    Advocates of Tanzania’s proposed Kigamboni City, near the commercial capital Dar es Salaam, say it will be an ultra-modern urban centre whose facilities will compete with those in Dubai, Hong Kong and Kuala Lumpur.

    Instead of heightening social inequality, the establishment of alternative cities may offer some pro-poor benefits, argues Albert Nyange, an urban planning lecturer at the University of Nairobi. He noted that in Kenya, such developments have spurred government action in transport infrastructure development.

    “Cities that are planned for the majority of the population directly contribute to improved quality of life of the poor.”

    “Investment in an efficient transport system is in itself pro-poor because it means transport becomes affordable. An efficient railway system will ensure the cost of commodities reduces, and [there are] many other benefits that come in housing development, such as jobs,” said Nyange.

    “What is needed is not bashing of these plans but engagement with city authorities to provide incentives to those who can provide products, such as cheap but decent housing targeting the low-income groups.”

    Optimizing population density

    Nyange added that these new cities could provide a “solution to ease the pressure off the old cities” and could, if done right, “provide a sustainable solution to rapid urbanization”.

    Blaming the chaotic nature of African cities such as Nairobi on rapid urbanization and poor planning, he said, “The new development initiatives provide an opportunity to re-plan and reshape African cities to cope with urbanization in some way and create order that is currently lacking.”

    Most of Nairobi’s population lives in the slums. The Kibera slum, which is located just a few kilometres from the city centre, is home to some 500,000 to 700,000 people living at densities of over 2,000 per hectare, according to UN-HABITAT.

    While reshaping cities will enhance the provision of services such as piped water and electricity, vulnerable slum residents and those with disabilities must be taken into consideration, added Tom Odongo, the head of lands, housing and physical planning at the Nairobi County Government.

    Indeed, if care is taken to avoid exacerbating inequalities, “sustainable forms of urban development can deliver economic growth, environmental protection and social inclusion,” stated Rafael Tuts, the coordinator of the urban planning and design section at UN-HABITAT.

    “Cities that are planned for the majority of the population directly contribute to improved quality of life of the poor.”

    According to Tuts, what is key in planning these cities is “optimizing density - not necessarily maximizing it” to ensure that rapidly urbanizing countries are able to meet the needs of their growing urban populations. “But density alone is not the answer. We also need to minimize zoning, take advantage of mixed-land use and invest in our public space.”

    New planning approaches

    To benefit the majority poor in African cities, ACC’s Watson recommended different approaches in planning.

    “The poor will require a different approach to service provision which does not impose major costs. These may include decentralized and community-based service approaches, different levels of service and some subsidization,” she said.

    But Watson argues that while Africa’s large cities have been labelled as the last frontier for property development and are currently being “revisioned in the image of cities such as Dubai, Shanghai and Singapore, the reality in all of these cities stands in stark contrast to the glass-box towers, manicured lawns and water features on developers’ and architects’ websites”.

    David Satterthwaite, a senior fellow with the human settlements group at the International Institute for Environment and Development (IIED), notes, “The plans [Watson talks about] focus government attention and budgets on very expensive high-tech initiatives that, if built, will primarily serve an elite minority”.

    However, some cities have used local political processes to expand the reach of basic services for low-income groups. “These include many city governments that have learnt to work with their local organizations and federations of slum/shack dwellers in Jinja (Uganda), Harare (Zimbabwe) and many urban centres in Namibia and South Africa.”

    What African cities need, said Satterthwaite, are "competent and accountable local governments that respond to the needs and priorities of their citizens.”

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    Modernization versus Africa’s urban poor
  • Mozambique’s small-scale fishermen battle headwinds

    Invasive species, illegal fishing practices and Mozambique’s difficulty in translating its rapid economic growth into jobs are squeezing the country’s small-scale fishing sector - a vital contributor to food security.

    At dawn each day, weather permitting, scores of small craft - up to 10 metres long and crewed by eight - launch from Beira’s Praia Nova (New Beach) to set out and haul in 400-metre gill-nets in a constant cycle of roughly 15 minutes, for the next nine or so hours. Even though a single boat sets and hauls nets with a reduced and illegal size mesh over a distance of around 12km daily, the catch barely pays for the fuel used by the single 15-horsepower outboard motor.

    In July 2013, across the bay from Beira, near the Pungwe river mouth, fishing crews began catching prawns not seen before, known locally as “Rainbow” prawns or “the new species”.

    Praia Nova’s Community Fisheries Council president, Dilip Ramgi, told IRIN: “The capture is high [of Rainbow prawns], but the value is not good. People think they are diseased because they are not used to them. The normal prawns are much more delicious than the Rainbow… [and] the exoskeleton [of the foreign prawn] is much harder.”

    The sales price for Rainbow prawns is only 50 metical ($1.67) per kilogram and a commercial enterprise has been buying them, while local prawns continue to sell at 150 metical ($5) a kilogram. “More are caught of the new species than the local one. They are from Southeast Asia. They are taking over the [prawn] beds,” Ramgi said. “No one knows how they got here.”

    "More are caught of the new species than the local one. They are from Southeast Asia. They are taking over the [prawn] beds"

    There is speculation the Rainbow prawns arrived in the bilges of foreign trawler vessels, or were transported from Asia to local prawn farms and escaped through careless management. The government fisheries department is still determining precisely what type of prawn they are, and trying to establish how they arrived in Mozambican waters.

    At Praia Nova’s market, where fishing boats return in the late afternoon to sell their catch to traders, the disparity between the availability of local and Rainbow prawns is stark. Trader Maria Albert, 19, who has four children, displays four local prawns next to small mound of Rainbow prawns and a dozen or so small fish. She makes $3 to $6 a day profit. “There are not much local prawns, they are rare now. Poor people buy the rainbows, but not often,” she told IRIN.

    The alien species has expanded its habitat by about 10km from the Pungwe river mouth and analysts say it would be all but impossible to eradicate. The invasion is putting additional pressure on local prawn stocks, which have been suffering the adverse effects of the of the country’s dam system.

    Mozambique’s prawns are “internationally renowned and play a major part in the national revenues,” said a report called Damned By Dams, by International Rivers, an NGO advocating the protection and preservation of riverine systems.

    “The regulated flow [by the Cahora Bassa dam] on the Zambezi River in conjunction with the loss of nutrient-rich sediment has had a devastating effect on prawn populations and catches. An estimated $10 to $30 million a year is being lost due to decreased catch rates,” the report noted.

    Prawns lay eggs in the sea, and the hatched larvae are forced into river mouths and mangrove forests during the dry season by ocean currents when river flows are weak. They are then pushed back into the sea as juveniles during the rainy season, when river water flows are stronger.

    More than a quarter of million Mozambicans rely on fishing - both freshwater and maritime - for their livelihoods, and their activities support downstream enterprises from traders to transport businesses, as well as contributing to food security.

    Fewer fish

    A report by the South African Institute of International Affairs in August 2013, Small-Scale Fisheries in a Modernising Economy: Mozambique, noted: “The pressures on Africa’s fish stocks [which create employment for 95 percent of fishers and account for more than 90 percent of the fish consumed in Africa] are likely to grow in coming years, driven both by domestic and international demand. About 75 percent of Africa’s fish stocks are either over- or fully exploited.”

    Mozambique’s nearly 2,700km Indian Ocean coast is home to about 60 percent of the country’s 24 million people, with about 75 percent engaging in subsistence agriculture. The skewed settlement is attributed to nearly two decades of civil war, when people fled the hinterland for the coastal regions, where agricultural land is generally less suitable for food production.

    “Every year the size of fish is getting smaller… It’s the reason why the net size is being reduced,” Ramgi said. The minimum mesh size of beach seine nets (used from the shore) was 38mm, which was too big, so 25mm mesh has been adopted, even though it is “not legal”. Likewise, gill net mesh sizes have been reduced from 50mm to 38mm.

    There are more than 1,200 fishermen operating from Praia Nova - the country’s largest launching site - with 292 registered gill nets, a sharp decrease from the 370 nets in 2012, and the 414 nets in 2007. “People are not necessarily giving up fishing, some are just moving northwards. But there is no money in fishing anymore. In the past I had ten fishing boats, now I have only three,” Ramgi said.

    Fishermen told IRIN that three years ago an eight man crew could expect to return from a day’s gill-netting of pelagic fish with between 90kg and 150kg - now, a 90kg haul is seen as a good catch.

    The reasons are disputed among fishermen, with blame attributed to the increasing number of people driven to the sector as a last resort, the destruction of coastal mangrove forests for use in construction and as fuel, the use of illegal chicocota nets – made from mosquito nets – and because their equipment restricts them to just under five kilometres from the shore.

    Chicocota nets

    Illegal chicocota nets are made in plain sight on Beira’s beaches, with mosquito nets sewn onto a frame of old trawler net ropes to form a large funnel. The fine mosquito net mesh means that nothing – not even larvae – escape. About 80 percent of the catch is usually dumped as unsuitable for consumption.

    Antonio Remedio Augusto, of the government’s small-scale fisheries department in Sofala province, told IRIN there were “maybe more than a 1,000 chicocota nets” in use around Beira, and despite awareness campaigns the practice was very difficult to stop. “They tell us, ‘Okay, give us money to buy a good net’. People know the damage [these nets cause to the marine environment], but [fishing with] chicocota nets provides good money.”

    About 600 community fisheries councils form a central plank in a community-government partnership in small-scale fishery operations and are used as a conduit for everything from government communications and assistance to conservation awareness and providing financing.

    In 2010 the government gave the Beira council a boat by to patrol the coastal waters and rip out chicocota nets. But little has been achieved because “there is no money for fuel”, Ramgi said.

    Praia Nova’s council office uses mangrove poles as supports for its building and the illegally harvested wood is sold openly in the adjacent sprawling market, where the hundreds of stalls are constructed from mangrove timber.

    About 40km north of Beira, the 1,400 fishermen in the village of Ndjalane have experienced first-hand the impact of denuded mangrove swamps on their livelihoods. “When the mangroves were cut down, everything disappeared - the fish, crabs, prawns, everything,” Ndjalane’s community fisheries council president, Antonio Maximo, told IRIN.

    Mangroves

    A three-year-old joint donor-government replanting programme has seen the mangrove forests begin to recover, and the local council has strict controls on harvesting the trees. Anyone from the community needing wood “has to ask the council first”, Maximo said. “People can only remove plants where the density is high. If people are caught removing plants… the wood is confiscated and they… [have] to plant 500 new plants.”

    However, the rejuvenated areas remain vulnerable to outsiders plundering the wood for sale in Beira.

    Some fishermen believe changing climate conditions also account for reduced catches. “The rains are coming later. Normally they came during the November/December months, now it’s January/February. Bad weather [which prevents them from fishing] is more frequent, and the tides [are] much higher than in the past,” fisherman Chiringa Boaze Munchacha, 32, told IRIN.

    Jaime Tangune, president of a Beira-based transport association, told IRIN that fish were being dried for only one day to retain water - making it heavier so as to fetch higher prices - instead of two days as before, reducing the shelf-life of the fish from more than a year to just a few months.

    The 2008 global economic slowdown did not dampen the country’s growth rates – in part driven by a resource boom – but it has not translated into employment as there has not been “any significant structural change, limiting its capacity to sustainably reduce poverty and foster human development, still one of the lowest in the world,” a 2012 report by African Economic Outlook said.

    The sustainability of the small-scale fishing sector lies on the land, Augusto noted. “If people have jobs, they will stop fishing.”

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    Net fishing in Mozambique
  • Life-saving hepatitis C drug approved, but cost is high

    Following approvals in the US and Europe this month of a new drug to treat hepatitis C, activists are pushing for the medication to be made available in poor countries, a development reminiscent of the activism that forced down HIV/AIDS drug prices a decade ago in Brazil, South Africa and Thailand.

    The World Health Organization (WHO) estimates that as many as 185 million people are infected with hepatitis C, which is often called a “viral time bomb” because it can exist, undiagnosed, in a person’s body for many years without causing symptoms. 

    According to the Open Society Foundations (OSF), more than 350,000 people die every year from liver disease related to the virus, and every year an estimated three to four million more people are infected.

    Many of these people are co-infected with HIV; the illnesses are both blood-borne and have shared routes of transmission, particularly injecting drug use.

    Unlike HIV, hepatitis C can be cured. But current treatment options have serious side effects, do not always work and are unaffordable for most people. The existing treatment, pegylated interferon, which is manufactured by Roche and Merck, can cost as much as US$18,000 for a 48-week course.

    Interferon, which must be injected, can, in combination with the drug ribavirin, cure 40-70 percent of patients who use it. But its high cost has kept it out of reach for most patients, except in Egypt and Thailand, where the governments were able to negotiate significant price reductions with drug manufacturers.

    “How have we got to a global system where new drugs being developed are out of reach of most of the population?”

    The new drug, sofosbuvir, released by pharmaceutical giant Gilead, promises a leap forward in the hepatitis C treatment. It is orally administered, reduces treatment time to 12 weeks, has fewer side effects, and, if used in combination with other drugs, can achieve a 90 percent cure rate. The hitch? The price tag.

    In the US, which has some of the highest drug prices in the world, Gilead is expected to charge $80,000 for one course of treatment - more than four times the cost of interferon. While the cost of the drug is likely to be lower elsewhere, healthcare advocates fear the price will remain beyond the reach of poor people.

    Pricing

    Médicins Sans Frontières’ director of policy and analysis, Rohit Malpani, says the drug has been priced so high because it cost the company $11 billion to acquire Pharmasset, the original maker of the drug.

    According to one analyst, Gilead has to make $4 billion on the drug annually, to justify the high cost of the buyout. 

    This is not a reflection of the research and development costs; it is an assessment of how much the company can get for it, Malpani adds. “Companies will engage in extensive studies to determine what the market will bear, but that is not the way that life-saving commodities should be priced.”

    Access strategy

    MSF’s Access Campaign, which lobbies for affordable medicines for resource-strapped communities, is waiting for Gilead to finalize its “access strategy” for poor countries after having received input from a range of organizations.

    A Gilead spokesperson told IRIN that it would announce the details of its access programme early next year. The company says it is “committed to making its medicines available to patients, regardless of where they live or their ability to pay”, and that it is “working very closely with advocates in communities that are affected by hepatitis C to develop an appropriate access and pricing strategy”.

    The spokesperson said Gilead wanted to “help ensure access to Sovaldi [the brand name for sofosbuvir] in resource-limited countries, especially countries that have a high hepatitis C burden”.

    However, Malpani is not optimistic that the reduced price will be low enough to make the drug widely accessible. Furthermore, MSF believes Gilead is likely to offer “middle-income” countries - like China, Iran and Ukraine - a higher pricing strategy than that given to poor countries.

    Ironically, 75 percent of the world’s poor reside in middle-income countries, Malpani said. “Our concern with Gilead’s access strategy is that it is likely to be unaffordable and punitive to the countries in that category,” he said.

    MSF would like to set a target price for the drug of less than $500. However, according to an OSF report, "Unfortunately, past experience with HIV suggests that drug companies are unlikely to voluntarily extend significant discounts to middle-income countries, even if they may be open to reducing the price for the world's poorest."

    According to one study, a 12-week course of sofosbovir could cost as little as $62-$134 to produce.

    Asked why the drug was so expensive in the US, the Gilead spokesperson said: “We believe that the price of Sovaldi in the United States is fair, based on the value it represents to a larger number of patients.” A special programme for those unable to afford it would be available, he added.

    “But the starting point is so outrageous, not even halving it would make it accessible,” says Els Torreele, director of OSF’s Access to Essential Medicines Initiative.

    “How have we got to a global system where new drugs being developed are out of reach of most of the population? It’s totally normal today to price drugs at $100,000. Something is wrong with a system where drugs that so many people need are costing so much. This is not sustainable for anyone,” she said.

    Daniel Wolfe, director of the International Harm Reduction Development Program at OSF, said that because of its association with HIV and drug use, hepatitis C is still highly stigmatized. “The experience of HIV has shown us that the combination of expensive medication and social stigma is deadly,” he said.

    He added that companies are pricing their drugs for profit rather than public health concerns. “When governments are confronted by high prices for a stigmatized population affected, they tend to look the other way,” Wolfe said.

    Patent worries

    In India a “patent opposition” has been filed by the Initiative for Medicines Access and Knowledge (I-MAK) to stop Gilead from obtaining a patent on the drug there, which would clear the way for low-cost generics to be manufactured.

    India has long been at the forefront of manufacturing generic life-saving drugs. Under its Patent Act, medications that are not new do not qualify for patent protection; I-Mak argues that sofosbuvir is “old science” stemming from a long line of antiretroviral drugs.

    The World Trade Organization’s 1995 Trade-related Aspects of Intellectual Property Rights (TRIPS) agreement laid down minimum standards for patent laws. There is, however, “some flexibility for countries to determine what is meant under the criteria of patentability”, says Torreele, citing I-MAK’s case against Gilead’s sofosbuvir patent.

    Since social activism helped force down the cost of AIDS drugs with generic alternatives over a decade ago, “the world has changed,” says Torreele. “The solutions to making HIV drugs affordable are not there anymore.”

    While TRIPS makes allowances for governments to override patent laws to protect public health, “there is lots of pressure by the pharmaceutical industry on them to avoid these measures”.

    And negotiations, spearheaded by the US, are currently taking place with 11 other countries to finalize the Transpacific Partnership Agreement, a trade deal that some worry could undermine the flexibility allowed by TRIPS.

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    Cost fears over new hepatitis drug
  • Is Africa ready for GM?

    Even as food insecurity continues to afflict impoverished and disaster-affected populations around the continent, African policymakers and consumers remain deeply divided over the potential harms and benefits of genetically modified (GM) foods, which advocates say could greatly improve yields and nutrition.

    A recent study published in the journal Food Policy, titled Status of development, regulation and adoption of GM agriculture in Africa, shows that heated debates over safety concerns continue to plague efforts to use GM crop technology to tackle food security problems and poverty.

    Yet results from the four African countries that have implemented commercial GM agriculture - Burkina Faso, Egypt, South Africa and Sudan - suggest an improvement in productivity. In South Africa, a 2008 study showed an 11 percent grain yield advantage when using GM maize, and in Burkina Faso, the technology has led to a 15 percent increase in cotton.

    “Compared to conventional plant breeding methods, GM technology is less time-consuming and more accurate in acquiring the desired objectives,” said Carl M.F. Mbofung, a professor at the University of Ngaoundere, Cameroon, said at a 2010 conference on agriculture in Africa.

    A 2011 report by the Melinda and Bill Gates Foundation, which strongly supports the use of GM technologies, noted that the average yield of cereal per acre was seven times greater in the US, where GM crops are widely used, than it was in sub-Saharan Africa. While better infrastructure can account for some of this difference, the report argues that a failure to invest in GM crops is partly responsible.

    Still, there remain significant challenges across the continent regarding the need to build robust regulatory frameworks and to bridge the knowledge gap between scientists, policymakers and the public to allow for informed decisions.

    Regulating GM

    The Food Policy report suggests that when effective biosafety regulatory frameworks are in place, GM is more likely to be widely adopted and accepted.

    The authors interviewed 305 respondents from Egypt, Ghana, Kenya, Nigeria, South Africa and Tunisia - countries that are already cultivating GM crops or have large research and development programs devoted to it.

    Only South Africa had European-style risk assessment frameworks, according to the report, and of the six countries, stakeholders there expressed the most support for GM technologies and said that GM crops had a high level of adoption.

    By contrast, a US Department of Agriculture 2012 Agricultural Biotechnology report noted that, “Tunisia still has no legal framework dealing with the introduction, use and marketing of agricultural biotechnology.”

    “In view of the challenges identified in developing and regulating GMOs [genetically modified organisms] in Africa, there is an urgent need for all countries to establish a regulatory framework that will lead to a comprehensive and balanced evaluation of GM products,” said the Food Policy report.

    The Food Policy also study suggested that following the European Union’s (EU) European Food Safety Authority (EFSA) risk assessment model is one possible way to reduce the perceived risks associated with GM crop cultivation. Having a centralized continent-wide agency would reduce the individual cost of each country creating a separate regulatory risk assessment board.

    “Aside from this, I do not see the advantage of copying or adopting the EU model of the EFSA as it has not enhanced the adoption of the GE [genetically engineered] crops in the EU. We are more concerned [with] meeting our food and nutrition insecurity needs in Africa, which are non-issue[s] with the Europeans,” Diran Makinde, director of the African Biosafety Network of Expertise, part of the New Partnership for Africa's Development (NEPAD), told IRIN.

    Issues of political will could also threaten to undermine a continent-wide regulatory project, according to the report.

    Bridging the knowledge gap

    In recent months Kenya has stepped up campaigns on biotechnology education and awareness.

    At a seminar organized by the Open Forum on Agricultural Biotechnology in Africa, Governor Benjamin Cheboi of Kenya’s Baringo County released a statement saying the technology holds great promise for the holistic economic development of a nation.

    “It has become crucial for sustainable development in every biological sector including agriculture, forestry, medicine and environment, yet lack of information undermines its adoption in the country,” his remarks stated.

    Makinde agreed that there are not enough avenues for farmers to get information about GM crops and biotechnology. “Africa needs to put regulations on information resources, training and education that will involve short- and long-term trainings in biosafety, tailor-made workshops, internships and study tours - as seeing is believing - linkages and networking,” he said.

    Gradual adoption

    The Food Policy report notes that some countries, such as Ghana and Kenya, are likely to use a three-step approach - known as Fiber-Feed-Food, or F3 - to adopt GM crops.

    Through this method, Bt cotton will be adopted first, followed by livestock feed, before producing GM foods for human consumption. This allows time for the necessary risk assessments to be carried out.

    “Farmers and consumers need to experience the benefits of the technology in terms of the economic benefits to farmers, and quality of food for human/animals, and environmental benefits with the decrease use of pesticides,” said Makinde.

    He added that so far benefits have been realized from insect-resistant cotton, insect-resistant and herbicide-tolerant maize/soybean for livestock, insect-resistant maize, and nutrient-enriched food commodities like cassava, cowpea, banana, rice and sweet potato for humans.

    “The approach is essentially designed to familiarize farmers and [the] public with the new technology and to allay concerns about potential risks of GMOs,” said the report.

    U-turns on policy

    But it is clear that the adoption of GM crops is still highly contentious. Kenya, under former president Mwai Kibaki, in November 2012, ordered a ban on GM food until the government is able to certify that there have been no negative health effects.

    “The ban will remain in effect until there is sufficient information, data and knowledge demonstrating that GMO foods are not a danger to public health,” said a statement by Kibaki’s cabinet.

    “ In view of the challenges identified in developing and
    regulating GMOs [genetically modified organisms] in Africa, there is an urgent
    need for all countries to establish a regulatory framework that will lead to a
    comprehensive and balanced evaluation of GM products ”

    The ban followed a controversial study linking cancer in rats to GM food consumption; the study’s methodology was criticized as flawed by independent scientists.

    According to the lead agency dealing with the regulation of GMOs in Kenya, the National Biosafety Authority, the ban is only for food and does not include experiments within laboratories or in confined field trials.

    The ban carries fines of up to 20 million Kenya shillings (about US$230,000) and a 10-year jail term for traders failing to comply, and also requires that all GM-derived products be labelled from production to marketing.

    The African Biotechnology Stakeholders Forum (ABSF) maintains that the Kenyan government has put in place structures to ensure GMOs are used safely.

    “The Kenyan government has taken a forward-looking stance in providing an enabling environment for the safe and responsible application of modern biotechnology,” the ABSF report said.

    Mixed perceptions

    In Uganda, too, legislators have been hesitant to pass laws supporting the development of GM technologies. The 2012 National Biotechnology and Biosafety bill, which aims to provide a regulatory framework for the safe development, research and general release of GMOs, was deferred by legislators in February 2013.

    “The whole concept of GMOs has been riddled with fears and misconceptions,” Michael Lulume Bayigga, Uganda’s shadow health minister, told IRIN. “The owners of these GMOs are whites in the US, Europe and China who are looking for market[s] in Africa. They are creating markets and empowering themselves. These GMOs are tools of imperialism.”

    He added: “I will cautiously support GMOs as long as they have been developed, modified and tested by our own [African] scientists. But this engineering is worrisome.”

    “We are going to look at their concerns and have further discussions on it so that [the] bill is re-tabled for debate,” Connie Acayo, the public relations officer at the Ministry of Agriculture, Animal Industry and Fisheries, told IRIN. “We want the bill in order to enable us to regulate the development and application of GMOs. At the moment, we don’t have control over GMOs that enter into the country.”

    The bill, which would set the legal stage for farmers to buy GM seeds and plants and to export GM produce, has been in approval limbo since 2003.

    Uganda is currently carrying out a series of GMO trials at the country’s National Agricultural Research Organization (NARO) centers. These plants are engineered to be resistant to wilt disease, cassava brown streak virus disease and other common bugs.

    Ongoing trials include a vitamin A-enriched banana, disease-resistant cotton, GM cassava plants and drought-resistant maize meant for semi-arid northeastern Uganda, commonly known as Karamoja. These crops take into consideration increasing climate change and global warming.

    “GMOs are not contradictory to food safety. All the commodities being worked on by NARO go through all tests for stability, cost effectiveness and safety,” Emily K. Twinamasiko, director general of NARO, told IRIN. “No doubt people naturally worry about the new and the unknown, but the regulatory framework provided for in the [Biotechnology and Biosafety] bill will take care of all this.”

    Sustainable development

    But the Food Policy report also noted that in South Africa, GM crops had not benefited subsistence farmers, who were not using them because of the cost of the seeds and because of delays in obtaining regulatory approval. “This constraint still represents a significant challenge in developing local GM traits for subsistence farmers,” the report said.

    Some NGOs argue that there are methods to improve agricultural outputs without relying on GM technology.

    The Food Policy report’s authors spoke to a Greenpeace campaign director in Africa, who said the risks of GM were too high for uneducated farmers, and that “ecological farming and traditional knowledge methods should form the basis of promoting sustainable development.”

    She said improving infrastructure and increasing access to regional markets will likely result in greatly increased productivity and enhanced food security on the continent. She further said that empowering women with more efficient methods of farming - provided it is done in a targeted way that accounts for socio-economic context - can also be transformative.

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    Is Africa ready for GM?
  • Gorongosa residents reminded of Mozambique’s bad times

    The central Mozambique town of Gorongosa is living on the edge of bad memories. The threats by the Resistência Nacional Moçambicana (Renamo) to revive a civil war that killed up to a million people and displaced five million others is causing fear and suspicion among its residents.

    Deminers, based in the Sofala province town bordering the high-end international tourism destination of Gorongosa National Park, are a reminder that two decades after the civil war ended its legacy has yet to be erased.

    Buildings under construction as well as completed, such as the new fresh produce market, are indicators the town is emerging from its post-conflict malaise - but it is a confidence questioned since the decision by Renamo leader Afonso Dhlakama to withdraw from the peace accords signed with the ruling Frente de Libertação de Moçambique (Frelimo) government in 1992.

    The recently resurfaced 70km road north to Gorongosa from Inchope – which lies on the east-west axis of the strategically important Beira Corridor connecting landlocked Zimbabwe to the Mozambican port city – is now dotted with army patrols.

    Assault rifles spill over the side of trucks packed with soldiers crouched low in the soft-skinned vehicles, and the odd heavy goods lorry that barrels along the road through the sparsely populated area.

    “There is very little traffic anymore [on the Inchope-Gorongosa road],” Gorongosa resident Mario Padrito, 20, told IRIN. “You can travel five to 10 kilometres without seeing a car – before, you saw one [vehicle] at least every kilometre.”

    In the town the route to the Nhandari river – where women do washing, soldiers bathe and children play – is now a few hundred metres longer since the shortest route was deemed militarily strategic and blocked by a rudimentary bamboo barrier, preventing access to an army post.

    The Gorongosa area is the spiritual home of Renamo. It is where Renamo launched the 1977 civil war and where Dhlakama recently announced the withdrawal from the peace accords, after the government reacted to several alleged attacks by Renamo forces in the province by routing Dhlakama from his bush stronghold in the Gorongosa mountains.

    Since Dhlakama and his soldiers – estimated to number from a few hundred to more than a thousand – returned to the bush, hit-and-run attacks by suspected Renamo gunmen in the province have reportedly killed several government soldiers.

    "The last [civil] war started like this. It was a small war at first and then it just got bigger"

    “The last [civil] war started like this. It was a small war at first and then it just got bigger,” Domingos Francisco, 35, a community leader in the village of Nhamissongoro, about 7km south of Gorongosa, told IRIN.

    “When they [Dhlakama and President Armando Guebuza] speak, it will finish. If they don’t speak, it will go on forever. When the rains begin [usually in November], the grass beside the road will grow tall and Renamo will be able to shoot [Frelimo soldiers] unseen from right next to the road,” he said.

    A deminer, who declined to be identified and moves from one town to another for his work every three months or so, told IRIN: “Everyone in Gorongosa is suspicious of each other. You can sit down and have a beer and a smoke with someone, but you cannot trust anyone,” he said. “There are Renamo in the town and outside of it.”

    Renamo support

    A Frelimo election organizer in Gorongosa, who declined to be named, acknowledged to IRIN that Renamo – created and sponsored by the then white minority-ruled Rhodesia to destabilize newly independent Mozambique, and afterwards by apartheid South Africa when Zimbabwe achieved independence from Britain in 1980 - “does have support”.

    “That is why Dhlakama [who has disappeared since withdrawing Renamo from the peace agreement] has not been found, as he is probably moving with the population,” he said.

    The sense of insecurity in and around Gorongosa has prompted population movement from the town as well as into it, but the numbers are difficult to gauge as both security chiefs and the district governor, Paulo Majacunene, declined to speak with IRIN.

    Antonio Blonde, 58, a farmer in Mucosa, about 12km from Gorongosa, told IRIN that six neighbouring families had left the village to stay with relatives in Gorongosa, and the nearby village of Vunduzi had emptied. This could not be independently verified as the road to Vunduzi has been closed.

    Blonde, whose wife was killed during the civil war, has a farm with about 300 litchi trees, 200 orange trees, 100 avocado trees and 350 banana plants. He said he would not leave Mucosa although he was “scared” the war could resume.

    “Every time I come to Gorongosa I have to spend money. In Mucosa I don’t have to spend money, I’m just living off my farm.” He was concerned that if the security situation deteriorated, traders from Gorongosa would not come to the farm to buy his produce and he did not have the means to transport his goods to market.

    In Nhamissongoro village, community leader Francisco said, “Every night about 10 families come from Gorongosa to sleep at my homestead, as there is talk that Renamo is going to attack the town. Even… I am getting scared. No one sleeps inside their houses anymore [in Nhamissongoro]. Everyone is sleeping outside so they can see or hear if someone is coming in the night.”

    Mineral wealth

    Renamo has been the official opposition since the first multi-party elections in 1994, but analysts say the former rebel movement never successfully transformed itself into a political party and the void is being filled by Daviz Simango, the mayor of Beira, capital of Sofala province, and his Mozambique Democratic Movement (MDM), founded in 2009.

    The MDM has eight parliamentary seats, Renamo 51, and Frelimo 191. Renamo boycotted the local elections on 20 November 2013. Presidential and legislative polls are planned for October 2014.

    Opposition to Frelimo rule is strongest in the central and northern provinces – the MDM also hold the mayoral seat of Quelimane, the administrative capital of Zambezia province.

    About 50 percent of Mozambique’s national budget is donor-funded, but an emerging boom in the resource sector is expected to alter this equation. The exploitation of huge gas fields off Cabo Delgado and Inhambane provinces, along the country’s Indian ocean coastline of about 2,700km, and coal deposits in Tete Province’s Moatize Basin, all in the central and northern regions, could bring enviable wealth.

    Even among Frelimo supporters in Gorongosa there are grumblings that all the revenue from the hydrocarbons industries is being funnelled to Maputo, the national capital located in the south, and “all the mining companies’ head offices” are there too. “Beira has a port and an airport, just like Maputo, so why can’t they [mining companies] work from there,” a man campaigning for Frelimo said to IRIN.

    Some analysts have speculated that Renamo’s return to the bush is more a consequence of being excluded from the country’s burgeoning mineral wealth.

    According to an August 2013 report by the South African Institute of International Affairs, A Boom for Whom? Mozambique’s Natural Gas and the New Development Opportunity, the anticipated mineral bonanza could be in its infancy.

    "Renamo [soldiers] will use one bullet and one is dead. Frelimo [soldiers] will shoot all the leaves off a tree"

    “In addition to rich deposits of coal and natural gas, Mozambique has significant deposits of heavy mineral sands, limestone, bauxite, rare earths, graphite, gold and base minerals, among others,” the report said. “Depending on how they are managed, such natural resources could lift Mozambique into middle-income status.”

    There have been no reported attacks by Renamo on mining concerns or their employees, but such operations are seen as vulnerable.

    The heavy security presence is failing to put people at ease and there is a belief that although Renamo soldiers maybe ageing, they have “experience of war” and are seen as more proficient soldiers with an intimate knowledge of the region, while “Frelimo soldiers come from Maputo, Beira and Nampula [capital of Nampula province]. They don’t know Gorongosa,” Francisco said.

    “Renamo [soldiers] will use one bullet and one is dead. Frelimo [soldiers] will shoot all the leaves off a tree,” he said. “We need peace. If they [Frelimo and Renamo] want to fight, they should just fight in the office – not in the bush with guns.”

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    Fear of war in Gorongosa
  • Senegal on the frontline of the battle with Big Tobacco

    Djité Sekou, 32, smokes as he passes his nights guarding one of the many high-rise apartment buildings in Dakar, Senegal. It has been eight years since his first cigarette - a Monte Carlo from Morocco - and when money is available he goes through 20 to 30 per day. It is an addiction that can cost him up to a quarter of his monthly income.

    Like most smokers in Senegal, he rarely buys a full packet, preferring to purchase cigarettes individually - a sales strategy tobacco companies employ to ensure that even those with limited means are able to afford their daily nicotine.

    “If my pocket is heavy, I buy the full packet,” explained Sekou. “If my pocket is empty, I buy four Excellence [cigarettes] at 100 [CFA] francs [US$0.20].”

    Sekou is one of a growing number of smokers across Africa. While reliable, up-to-date figures are unavailable, the 2007 Global Youth Tobacco Survey estimated that up to 20 percent of Senegalese boys and 10 percent of girls aged 13 to 15 used tobacco products - a number believed to be much higher today.

    Oumar Ndao, Senegal’s focal point for tobacco control at the Ministry of Health, says, “This is due to extremely weak legislation that, apart from prohibiting television advertising, demands no restrictions.”

    Tih Ntiabang, Africa coordinator of the civil society Framework Convention Alliance, based in Yaounde, Cameroon, says advertising focuses “on two groups of people - the youth and women. For the youth, they portray smoking as cool. For women, if you smoke you are emancipated.”

    In Senegal, there are almost no restrictions on smoking in public places, and warning labels on packets are small.

    The exception is the holy city of Touba, where smoking has been banned for religious reasons since 1980 (15 years before the US State of California enacted its ban on smoking in enclosed workplaces).

    Yet with Senegal’s parliament due to vote on new anti-smoking legislation, the rest of the country may soon follow suit.

    If passed, the law would ban all tobacco advertising, restrict smoking in public places, and demand health warnings that cover 30 percent of all cigarette packaging.

    Ndao believes that, even if the law could be strengthened further, this would be a “major step forward” and “endow Senegal with one of the strongest [such] laws in the region.”

    Weak tobacco control continent-wide

    With the largest proportion of young non-smokers and the weakest tobacco controls of any other continent, according to the World Health Organization (WHO), Africa is a lucrative market for cigarette marketers.

    Just five African countries have comprehensively banned smoking in public places, according to WHO, while nine - Chad, Eritrea, Ghana, Guinea, Kenya, Madagascar, Mauritius, Niger and Togo - ban all tobacco advertising. Only four African countries - Madagascar, Mauritius, Niger and the Seychelles - meet WHO recommendations for health warnings on packaging.

    “In a number of places, there is no legislation at all,” said Ntiabang. “What is really driving this is the tobacco industry strategy to recruit new smokers.”

    Yet even where laws do exist, enforcement is a major problem. Senegal’s Ministry of Health has banned smoking in all health centres, but according to the government’s own report to WHO, this has had “no practical impact in reality.”

    WHO estimates that, globally, tobacco kills six million people per year, a figure that, without action, could rise to eight million by 2030, with 80 percent of deaths occurring in low- and middle-income countries.

    Taking on the tobacco industry

    Many health advocates believe the tide is turning, however, with Kenya, Mauritius, Seychelles and South Africa all having introduced tighter tobacco control laws in recent years. Ntiabang believes these are symptoms of “a changing trend” - but one under threat by the tobacco industry.

    The 2013 WHO global report on tobacco use accuses the industry of trying to influence public health policy, exaggerating its economic importance, manipulating public opinion, fabricating support from “front groups”, undermining proven science and intimidating governments with litigation.

    “Tobacco industry interference is the number one problem we have in Africa, especially in countries that are in the process of elaborating legislation,” Ntiabang adds. “The tobacco industry interferes in every single stage of this process.”

    A WHO official IRIN interviewed agreed: “Every single country in Africa where there is proposed legislation, you find them there.”

    According to Article 5.3 of the WHO’s Framework Convention on Tobacco Control, tobacco companies are not supposed to be involved in shaping health policy. But the official said many countries have been swayed by “information given by the industry claiming that they are critical to the economy, and yet the reality is they are just profiteers and are not contributing that much to the economy.”

    Senegal has been no exception, says Ndao: “The industry managed to infiltrate the process with strong lobbying of decision-makers.”

    In Senegal, industry officials lobbied to soften the total ban on advertising to allow communications at the point of sale, but the government has not ceded. They also pressed to ensure health warnings need not be in picture form, said Ndao, which has been more successful. But the [Senegalese] authorities are trying to resist industry pressure and are “aligned strongly with the WHO Convention” he told IRIN.

    A spokesperson for Philip Morris, which controls over 40 percent of the tobacco market in Senegal and owns a cigarette factory in Dakar, confirmed that the company has “proactively and transparently” been communicating its opinions to government, “like any other industry”.

    "The [tobacco] industry is losing major markets in Europe and North America, and is seeking refuge in Africa"

    While the company “welcomes the proposal for the implementation of a tobacco-control law in Senegal”, it continues to seek amendments to “a few elements” including “the lack of a transition period, the ban on trade incentives for wholesalers and retailers, and the total ban on advertising.”

    To Ndao, the incentive is clear: “The industry is losing major markets in Europe and North America, and is seeking refuge in Africa, which explains their strong presence in Senegal.”

    Health impact

    Ahmadou Dem, surgical oncologist at Joliot Curie Cancer Institute at the Dantec hospital in Dakar, is already seeing the consequences of smoking. He has noted an increase in cancers of the lung, larynx, pharynx, bladder and pancreas.

    If nothing is done, the future could be more worrying still, he said. “It will be a catastrophe for our country’s health and economy, because our human and financial resources are limited and cancer care is costly.”

    Dem adds that while facilities to treat cancer do exist - offering surgery, radiation therapy and chemo therapy - they remain “largely inaccessible for the majority of patients, who are poor”.

    Any efforts to reduce smoking rates in Senegal must include an “ongoing anti-smoking campaign at schools, in businesses, and in the media,” he told IRIN.

    Weakening the law

    Ndao recognizes that, despite the huge public health improvements the law will bring, there is a lot more work to do.

    Unless amended by members of the National Assembly, smoking areas will still be permitted in restaurants, bars and hotels, and pictures warnings - considered essential in a country where half of the adult population is illiterate - will be voluntary. Ndao believes parliamentarians will strengthen these areas of the law before it passes.

    And the law will not undertake what is commonly regarded as the most effective way of reducing smoking - raising the price of cigarettes. Such a measure has to be dealt with separately through the tax system.

    At just $0.80 a packet for an economy brand, and $1.20 for a premium brand, cigarette prices in Senegal are almost 10 times cheaper than in the UK and among the cheapest in the world.

    Senegal has chosen not to follow the Economic Community Of West African States guidelines allowing countries to tax cigarettes up to 150 percent, instead abiding by the West Africa Economic and Monetary Union rules limiting taxes to just 45 percent.

    According to WHO, a 10 percent price increase for tobacco products reduces consumption by 8 percent in low- and middle-income countries.

    Two years ago, Phillip Morris created a national scandal in Senegal by reducing the price of its Marlboros by one-third. Black market cigarettes from neighbouring countries such as Gambia and Guinea-Bissau also push prices down.

    Sekou believes that both a stronger law and higher taxes are “necessary,” especially for smokers like himself. “Senegal has the right to do it. Everyone wants to quit. The more they smoke, the less they eat,” he said.

    “For me, someone who struggles to get 1,000 CFA [$2.00] per day, if the price went up - and my wife is next to me, my son is next to me - I wouldn’t do it,” he continued. “Even today paying $1.20 [for a packet] is a problem.

    “As of today, I have decided to quit. I got myself into it, and I’ll get myself out of it too.”

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    Senegal takes on Big Tobacco
  • Behind China’s aid structure

    China’s role as an aid donor has been met with wariness, both from aid experts and recipients. Confusion over the nature of China’s aid arises because the country uses multiple ministries and agencies to give money, has different strategic priorities than traditional Western donors, and does not release detailed reports about how much aid it provides.

    "China has at least nine kinds of aid," Deborah Bräutigam, a leading scholar on Chinese aid to Africa and a professor at the Johns Hopkins School of Advanced International Studies, notes in her book, The Dragon’s Gift. "Medical teams, training and scholarships, humanitarian aid, youth volunteers, debt relief, budget support, turn-key or ‘complete plant’ projects [infrastructure, factories], aid-in-kind and technical assistance."

    Most of these aid forms have existed since China became an international donor. The country gives money through three mechanisms: interest-free loans; grants; and preferential interest loans or tied loans, according to Xue Lei, a research fellow of Shanghai's Institutes for International Studies. "Most of the foreign aid is provided in the form of project aid," he told IRIN.

    This is a key difference between the way China provides aid and way that the US, UK or other Western powers approach assistance. While the US Agency for International Development (USAID) and the UK’s Department for International Development (DFID) provide large amounts of funding to support government budgets in areas such as education, China prefers to instead to work on a single project, such as building a school, or provide scholarships to students to study in China.

    "Both are very attractive, but there's no doubt that China's is much more... visible than putting money into the budget," Kenneth King, professor emeritus at the University of Edinburgh told IRIN.

    Lessons from China’s development

    There are also changes in the way China looks at the links between aid, development and business.

    "In many contemporary accounts of Western aid and capacity-building in Africa, there would not be a close connection between aid and trade," King writes in his book. China by contrast, sees a very important link between private business and aid. Indeed, this is a core element of China's official view to development.

    "China's job, our responsibility, is to try and help Africa compete with us," said Ambassador Zhong Jianhua, China's special representative on African affairs, in an interview with the African Research Institute, published in August.

    This may be a reflection of the fact that China has been a recipient nation of aid. "Influenced mainly by their own experience of development and by the requests of recipient countries, the Chinese aid and economic cooperation programmes emphasized infrastructure, production and university scholarships at a time when traditional donors downplayed these," wrote Bräutigam.

    "China feels that infrastructure is essential to development. There is a huge call for that, and the West hasn't responded. These same companies that are building roads in Africa, they've also built roads in China," said Ward Warmerdam, a researcher at the International Institute of Social Studies in The Hague and an economic researcher at the think tank Profundo. "Gradually, Africa is becoming a much more stable continent. A lot of the Western donors don’t really understand that."

    Agency overlap

    There are three main organs controlling Chinese aid: the Ministry of Commerce, the Ministry of Foreign Affairs and China's Eximbank. The State Council - China's cabinet - has oversight, and approves the annual budget, grants and aid projects over a certain amount, as well as aid to politically sensitive countries. The Ministry of Finance is also responsible for giving aid to multilateral organizations, such as UN agencies.

    The Ministry of Commerce (MOFCOM) is the principal institution for Chinese aid, and houses the Department of Aid. It is in charge of distributing all zero-interest loans and grants. The Ministry of Foreign Affairs coordinates with MOFCOM to decide aid allocations, and is the on-the-ground diplomatic point of contact for Chinese firms and interests in Africa. But the relationship between the two ministries is often tense, and, as experts have argued, conflicting interests between the multiple agencies sometimes hurts Chinese aid policy.

    In addition, over 23 other government ministries and commissions play some role in providing foreign aid. For example, the Ministry of Education has been responsible for scholarships provided to African students to study in China, and the Ministry of Health runs and funds overseas medical programmes.

    “I do think that in the medium term they will likely set up a separate agency,” Bräutigam told IRIN. “There has been a lot of discussion about this in China.”

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    Behind China’s aid structure
  • Untangling China's aid to Africa

    This year, the two most powerful men on the globe, presidents Barack Obama and Xi Jinping, both embarked on Africa tours, pledging to increase aid and investment and work with the continent to improve development.

    While this was Barack Obama's first extended tour of Africa since taking office (he made a one-day stop in 2009 in Ghana), Chinese leaders have been visiting the continent regularly for decades, quietly working on joint development, trade, foreign direct investment and assistance projects.

    "China is the largest developing country in the world, and Africa is the continent with the largest number of developing countries," Jiang Zemin, then-president of China, said in his opening remarks at the first Forum on China-Africa Cooperation (FOCAC) in 2000.

    Since 2000, China has ramped up its aid to Africa, leading to significant interest in and speculation over its motives for doing so. With each FOCAC meeting, China has doubled its pledge to Africa, promising US$5 billion in 2006, $10 billion in 2009 and, at the 2012 summit, $20 billion.

    A long history of aid

    As Chinese officials are at pains to point out, China has a long history on the continent. Its first major project was the 1,860km Tazara rail line. The five-year scheme, completed in 1975, linked landlocked Zambia to the Tanzanian port of Dar es Salaam, ending Lusaka’s dependence on minority-ruled Rhodesia and South Africa.

    "China historically had a robust ideological engagement with Africa, reflecting the revolutionary spirit of its foreign policy under Mao, but it didn't have any substantial economic interests in the continent," Daniel Large, professor at the Budapest-based Central European University (CEU) and a leading expert on China-Sudan relations, told IRIN.

    What is different today is that it now has economic interests, in addition to being an aid donor.

    Experts say China's role in Africa is often misunderstood.

    "Given some of the more inflated claims about the impact of China in Africa, often contained within arguments about a 'new scramble' or 'new imperialism', there is a marked gap between the perceptions and exaggerated projections of an inexorable Chinese rise in Africa and knowledge of how this is actually playing out," wrote Large.

    Some of the confusion, especially relating to aid, may be because China does not release many statistics about how much aid it gives and has a number of agencies responsible for distributing foreign aid to Africa. The structure of China's economy - where many private firms are fully or partly state-owned - and China's approach to assistance also blur the line between investment and aid.

    So how much aid is there?

    Quantifying the China-Africa relationship is a difficult undertaking because China does not break down its statistics or release detailed reports about how much assistance it gives to Africa, and it has a different definition from the Organization for Economic Cooperation and Development (OECD) of what exactly is meant by "aid". For example, China includes military aid in its definition, while the OECD does not, but China does not consider scholarships to students from developing countries as foreign aid when calculating statistics.

    As a result, estimates by experts on just how much China gives to Africa differ widely, ranging from $580 million to $18 billion a year.

    The Chinese government argues that it does not have the capability to make the data available.

    "There is an assumption in some of the Western media - and to a lesser extent the African media - that the Chinese government has lots of data that it refuses to make public. It is important to ask the question - how accurate is the data we have?" said Ambassador Zhong Jianhua, China's special representative on African affairs, in an interview with the African Research Institute, published in August. "The government's statistical capacity is that of a developing country."

    In 2011, the government did, however, publish a white paper that broke down the data by region: 45.7 percent of aid went to Africa in 2009, and between 1950 and 2009 it spent slightly over $41 billion.

    In 2012 and 2013, China AidData, in partnership with the Centre for Global Development, came up with a database to measure how much aid was being dispersed, using media-based sources. It classified Chinese-funded development projects into "official finance", which includes projects in four categories: those similar to Official Development Assistance (ODA), those similar to Other Official Finance (OOF) - both of which OECD indexes use - Official Investment (made up of foreign direct investment and joint ventures), and Military Aid without Development Intent.

    Their database includes 1,673 non-investment projects to 50 recipient countries from 2000-2011, which they classified as ODA- or OOF-like. Over the course of these 11 years, they found these projects totalled $75.4 billion.

    "Chinese development finance was dispersed really widely," Austin Strange, research associate at AidData, told IRIN. "The only outliers are countries that diplomatically recognize Taiwan."

    “In terms of the number of projects, sectors like education and healthcare were at the top of the list," he added. Infrastructure, transport and energy were also areas where China had a very large presence.

    While most academics believe that transparency on Chinese aid is improving, it still falls far short of the OECD, which releases detailed reports.

    "There's still some secrecy in the official statistics," said Xue Lei, a research fellow of Shanghai's Institutes for International Studies, noting that transparency and reform is something being discussed by academics domestically, too. "Maybe we need one structure, and more transparency on the statistical side. I think in the next few years China will release the actual number."

    Those favouring reform point to the need to set up a single agency with responsibility for aid programmes. For inspiration, many look to China's Asian neighbours, arguing that taking a model from Japan, South Korea or India could be successful.

    Non-interference - really?

    As China gets more involved in Africa, non-conditional aid is becoming a hugely important form of soft power for the country. But many are unsure whether China will be able to maintain its principle of non-interference in another state’s affairs should it need to protect its citizens in volatile areas on the continent; it is estimated that there are between 500,000 and 800,000 Chinese migrants residing on the continent.

    Xue believes that the principle of non-interference will not change, and that China's approach will be a long-term, stability-through-development approach. "We want to try to stabilize the fragile states, to maybe prevent the crisis or conflict from happening," he said, while acknowledging that this would not always be possible.

    "This whole mantra of non-interference and mutual cooperation is not unique to China. It is part of a broader south-south cooperation agenda and rhetoric," said Warderdam. Reconciling this in crisis situations, he believes, will be very difficult.
     

    Underpinning much of the criticism of China's role in Africa is the claim that they are only interested in extractive industries and are plundering the continent's vast resources. They've attracted prominent critics, notably Nigerian Central Bank Governor Lamido Sanusi and South African President Jacob Zuma.

    "Africa is now willingly opening itself up to a new form of imperialism," Sanusi wrote. "China is no longer a fellow under-developed economy - it is the world's second-biggest, capable of the same forms of exploitation as the west. It is a significant contributor to Africa's deindustrialization and underdevelopment."

    Hong Kong University professor Adams Bodomo disagrees with Sanusi, believing that his colonial comparison is flawed. "We are in a world where everybody has their competitive advantages… We have minerals, they have manufactured goods," he told IRIN. "In fact, the presence of Chinese manufactured goods in Africa is an opportunity for African manufacturers to up the ante, to compete. We need competition; we can't talk about free market and then not like competition."

    Kenneth King, professor emeritus at the University of Edinburgh who, for his new book, China's Aid and Soft Power in Africa, travelled across Africa with his wife and interviewed more than 200 people on the continent, also dismisses claims that Africans consider the Chinese to be neo-colonialists. "There are differences in perceptions, but they are remarkably positive," he said, claiming that they had not noticed much antagonism towards China from people on the ground.

    But there is no denying that, at the local level, tensions sometimes run high.

    In 2010, when Chinese managers shot at coal miners in Zambia after a labour dispute, the incident sparked outrage across the country, and Michael Sata, then the opposition leader, used anti-Chinese sentiment to rally support for his presidential campaign. Similarly, in Lesotho, protests and resentment for Chinese migrants have occurred.

    Earlier this year, tensions between China and Ghana increased over allegations about illegal mining, leading to the Ghanaian government deporting more than 4,500 Chinese gold miners.

    "The miners in Ghana - this is very bad for China, and the Chinese government is very upset about this," said Ward Warmerdam, a researcher at the International Institute of Social Studies in The Hague and an economic researcher at the think tank Profundo. He explained that while the government tries to influence the business practices of private Chinese firms in Africa through a series of directives on foreign direct investment, they are unable to influence companies that are not at least in part state-owned or reliant on funding from the government, nor individuals who migrate to Africa on their own.

    "These are companies and actors that it doesn't have an influence over, and this is going to be a big problem for China," he added.

    CEU's Large cautioned that it is necessary to disaggregate core principles of mutual cooperation and non-interference, to see how they meaningfully impact more than just the elites in recipient states. "On win-win and mutual benefit, these should be taken seriously, as constitutive of genuine convictions,” he told IRIN, “but at the same time seen as liable to more instrumental uses.”

    The real question to ask is whether Chinese aid and development policies benefit the population at large, not just leaders. “Just as OECD DAC [Development Assistance Committee] principles or human rights can be subject to all sorts of uses, the same is true of China's principles," he said.

    According to Xue, there is much that China can learn from the West: "Building a tall building is relatively easier compared with more in-depth knowledge of the country and their needs. We can learn from Western experiences in this," he said.

    He believes that China has the opportunity to build a stronger network of NGOs and grassroots projects in Africa that may have more impact on everyday people, something that they have thus far steered away from in favour of larger state-to-state projects: "We are gradually increasing aid provided to other institutions, but a large part of the aid is still provided in bilateral aid."

    But, he said, "China's aid policy is still gradually evolving."

    Warmerdam agrees, but believes that in that process of evolution, it is crucial for African leaders and states to have a greater stake in the decision-making. "The cogs aren't in place, and the dynamics of this relationship aren't set yet," he said. "It's good for African leaders to be careful."

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    Untangling China's aid to Africa

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