Wednesday, March 31, 2010

Human Rights Are Not Just for the Rich World

According to Dr Marcos Espinal of the Stop TB Partnership, "TB is not a medical problem. It is a development issue. It is an economic problem. It's a human rights situation." And I applaud him for saying this. If developing countries are not allowed to develop (and I would argue that developed countries are doing all in their power to stop them from developing), diseases like TB will not successfully be treated by drugs alone. People in developing countries are poor, they suffer bad health, they receive little or no education, they live in terrible conditions and their human rights are being denied. It is no wonder that TB and many other diseases are rife and increasing.

I would add that HIV, also, is not just a medical problem, nor is it just a matter of sexual behaviour. Parallel arguments could be used to show that, so far, both HIV and TB programmes have failed to prevent the spread of the diseases and will continue to do so. If you don't deal with the conditions that result in diseases spreading, all diseases, you will not eradicate the diseases. After using little more than expensive pharmaceutical products to treat TB for many years, an estimated 440,000 people are now resistant to commonly used TB drugs. I have not been able to find estimates for the number of people with HIV strains that are resistant to first line drugs commonly used in developing countries, but resistance is a very serious threat.

There's an interesting article on the website of the United Nations Development Programme (UNDP). They have been publishing the Human Development Report for many years now and they are about to reveal some of the main trends over the past four decades. The Human Development Report measures development by criteria other than just economic, such as health, gender, education and other things. This article notes that there has been significant progress in development, but this has come from improvements in education and health, not economics.

It also notes that these improvements have little or nothing to do with globalization. Rather, they have been achieved by expansion of "educational and health systems, coupled by initiatives of the international community to enable access to vaccines and antibiotics." In other words, state intervention.

The research finds that there is no correlation between economic growth and changes in non-income components of human development. It concludes that "the oft-repeated dictum that growth is a necessary condition for increasing human development is simply not true."

So the approach to development and human rights related problem, such as HIV or TB, is to improve education, health, economic circumstances, gender imbalances, employment, infrastructure and many other things. The approach should not be to set up well financed vertical programmes that target single diseases or narrow issues at the expense of other, broader issues.

Throwing eye watering sums of money at a problem, such as HIV or TB, will not even solve the problems of HIV or TB. Especially if most of the money is spent on technologies that are produced in rich countries. That's just taking money out of one pocket and slipping most of it into another. It's time for new thinking on development. Development is not just one thing, it's many things. And if you don't know enough about any of them, just read the Universal Declaration of Human Rights and consider how many of those rights people in developing countries are currently being denied.


Tuesday, March 30, 2010

More Good News for Big Pharma: Resistant Gonorrhoea

Yesterday, I blogged about the fact that TB is on the rise worldwide. Funding for TB prevention, and even for treatment, are not commensurate with the threat to global health that this epidemic poses. And the rise of TB is often blamed on the current HIV pandemic. I would suggest that there is a TB epidemic of a level that can not wholly be explained by the HIV pandemic and that, like almost every disease and health issue aside from HIV, TB is being ignored.

Those heavily involved in the HIV industry, such as Michel Sidibe, the head of UNAIDS and Michel Kazatchkine, head of the UN Global Fund for HIV, TB and Malaria, deny that high levels of HIV funding have starved other diseases of cash. Kazatchkine claims that 'over a third of of overall funding of the Global Fund is actually going to strengthening health systems'. I don't know how he came up with this estimate but it seems to me that there are only certain aspects of health systems that are benefitting from HIV cash, and those aspects relate to HIV.

Kazatchkine says the money is not just going on condoms and drugs. I sometimes wonder if the money is even going on condoms, along with the logistics of ensuring that people use condoms all the time and properly. Even the claim that a lot of money is being spent on drugs can seem hollow when people supposed to be taking them often cannot do so because of lack of food. And 20% of the new HIV cases in Kenya every year come from vertical infection, from mothers transmitting HIV to their babies.

Treatment of people with HIV may well have exceeded expectations. And I would like to see every HIV positive person who needs treatment receiving the drugs and support they need. But since the recent expansion of HIV treatment, millions more have become infected. Prevention has been forgotten about. People like Kazatchkine and Sidibe like to argue that distinguishing between treatment and prevention is a false dichotomy, but this is not so. If treatment played such a huge role in preventing further infection, transmission rates would be much lower than they are. In fact, the majority of people in Kenya who are HIV positive do not know their status. Perhaps there shouldn't be a dichotomy between treatment and prevention, but there is.

And if you think the programmes to teach people about safe sex and to persuade them to use condoms have been successful, consider the figures for preventable and treatable sexually transmitted infections (STI). There are an estimated 340 million new cases of curable STIs every year. This is after over 20 years of preaching about safe sex in every country in the world. If people were practicing safe sex, transmission of most STIs would also be reduced. Prevention involves taking steps to ensure the infection is not transmitted. In the case of STIs, that could involve the correct use of condoms, minimally.

HIV treatment and care has received much of the money available for the disease. Kenya's official strategy papers make this quite clear. Prevention has received very little money and has been pretty unsuccessful, with 5 new infections for every two put on HIV treatment, globally. And HIV has been treated as if it's just an easy matter to round up people and give them some drugs. As a result, there is growing resistance to the few HIV drugs available in developing countries. This can be compared to TB, where it has long been recognised that you can't just send people away with some drugs and expect them to take them religiously for 9 months and never see them again.

If health solely involves treating sick people, how will you ensure the continuing health of those who are not (yet) sick? In the field of sexually transmitted diseases, gonorrhoea is now also developing resistance to the most commonly available drugs. There has been little recent research into alternative treatments for gonorrhoea (or TB) because, I would suggest, most of the money has been spent on other 'priorities' (Oh, and big pharma are waiting for public funding for their research, a very important component for these (private) companies). One of those priorities is HIV and despite ploughing a lot of money into condoms and safe sex campaigns, prevention has not received the level of funding it needs.

Yet more evidence of the lack of success of HIV prevention work is the level of pregnancies among women receiving HIV treatment. Women with untreated HIV have far lower fertility levels, so treatment should increase fertility. But women on HIV treatment should also be receiving advice about having unprotected sex and about unplanned pregnancies. I don't believe that all these HIV positive women are choosing to have more children, though some of them may be. Because other research has shown that the vast majority of pregnancies among women who are HIV positive were not planned.

Sidibe even seems to think that the global recession and climate change are distractions to the industry's fight against Aids. I would be hard pressed to find an attitude to which I am more opposed. He even has the cheek to suggest that HIV funding has not led to the neglect of other diseases because it has increased attention for TB, the two diseases being 'integrated', and that HIV prevention should take on a 'holistic approach'. Damn right, but I don't think his use of 'holistic' is the same as mine. But when is all this HIV money going to be spent on the many health issues that I and many others would claim have been ignored? Apparently, Sidibe and Kazatchkine think that's already taking place, and Sidibe feels that support from the big pharmaceutical companies is essential. Very funny.


Monday, March 29, 2010

TB on the Rise: Big Pharma Delighted

Although TB is often mentioned along with HIV, it doesn't get nearly as much attention, certainly not as much attention as it deserves. And it gets a fraction of the funding. It happens to be in the news now because World TB Day was just last week. Unlike HIV, TB is easier to catch but also easier to prevent. It's also curable. But like HIV, TB spreads rapidly in populations which face serious and long term economic challenges, have poor and inaccessible health systems, low educational standards and an inadequate infrastructure.

Like HIV, TB will not be eradicated until the determinants of health are tackled. Like HIV, you can spend as much as you like on the disease but as long as people live in terrible living conditions without even basic water supply and sanitation, suffer from poor health and nutrition and face many other stresses that allow any diseases going to spread rapidly, neither will be eradicated. The huge amounts of money spent on HIV over the last three decades has done little to reduce its spread and the far smaller amounts spent on TB have been equally unsuccessful.

Kenya ranks 13th in the 22 high burden TB countries and fifth in Africa, although it is notable that they are only rank 9th for HIV. There were 132,000 new cases last year. It is estimated that there were 2000 multiple drug resistant cases but only 4.1% of these were diagnosed. And only 48% of new TB patients were coinfected with HIV. New cases of TB are declining but the number requiring retreatment, those who either weren't treated successfully or who didn't finish their treatment, is increasing.

I think it is important to note that just over half of the new TB cases were not people who also have HIV. TB is an epidemic in its own right. While high HIV prevalence will increase the spread, TB is spreading independently of HIV too. And why wouldn't it? Most people in Kenya live in the sort of conditions where all diseases spread rapidly. Just as HIV has been treated as if it is exceptional and as if it is possible to eradicate a disease without also dealing with the determinants of health, TB is being treated as if people's living conditions don't matter. But they do matter, very much.

Jeffrey Sachs points out that if Africa had better health systems, HIV would have been identified a decade earlier. This is quite true, the symptoms that were later recognised as those of Aids were not recognised as being out of the ordinary. They were consistent with very poor health, poverty and malnutrition. It was only when people in more developed countries started to be infected that HIV and Aids were identified. By then, it was too late to avert a massive epidemic. Then, as now, the conditions in which people lived were appalling. 

Nigeria has an even more serious TB epidemic, third in the world, with 100,000 new cases last year, although they only rank 21st in the world for HIV (despite being estimated to have the second highest number of people living with HIV, after South Africa). Rwanda and Malawi have the highest rates of TB in the world but Rwanda, at number 14 and Malawi, at number 8, certainly don't have the highest rates of HIV. The point I'm trying to make is that in developing countries, conditions are poor and declining but also, are not being remedied by the pouring of funds into programmes that merely treat sick people (ok, a small amount goes into prevention, but not much).

Aside from neglecting the determinants of health in general, programmes for TB and HIV are mainly targeted at people who are already sick. Most of the money goes to treating people who are already infected. Preventing both HIV and TB has a lot in common, indeed, preventing all diseases has a lot in common. People need good living conditions, water and sanitation, education, health, employment, economic well being, good nutrition, food security and many other things. Instead, most of the aid money going into these diseases is spent on drugs and other technologies.

PRWeb has a cringe-making release about a report on TB theraputics (which costs $3450, in case you are interested. This release enthuses about the "excellent commercial opportunity for existing as well as new companies in this marketplace." The "marketplace" is certainly growing, because if the only solution to TB is to wait until people become infected and then treat them with drugs, resistance is only a matter of sitting back and waiting. People in developing countries with TB are given the drugs and sent home to continue spreading it in their inadequte housing and with their poor nutrition and lack of education and water and sanitation.

These pharmaceutical companies have been humming and hawing because public funding hasn't been forthcoming but now that it looks like that will be made available, they can start raking in the cash. Remember, that's public funding, because the profits certainly won't be public.

All the conditions for the rapid spread of TB are in place and many of them are the same conditions for the spread of HIV. Little has been done to alleviate these conditions and in countries like Kenya, they have been steadily disimproving for several decades. It may be popular to blame the HIV epidemic, for TB and just about everything else that's happened since the 1980s, but this excuse won't wash. Winding down public services and public spending started before HIV was even identified. TB was around before HIV was identified. The opportunity to eradicate TB is still there, but throwing a lot of drugs and money at it will continue to fail.

Developing countries need to be enabled to develop. Diseases are not just inconvenient pathogens that can be eradicated with some extremely expensive drugs. They require an appropriate environment and suitably weakened hosts. Current and past approaches to TB and HIV ignore the existence of appropriate environments and weakened hosts aplenty. That's why HIV and TB are spreading, despite the billions spent on them.


Saturday, March 27, 2010

Stop These 24 Crimes Against Humanity

Perhaps people in rich countries like to believe that some of their country’s wealth supports people in developing countries. They may think too much money or too little money goes to developing countries and they may approve of development aid or they may disapprove. But they are less likely to realise that rich countries extract exponentially larger amounts of wealth from developing countries than they give in aid.

So instead of arguing for more aid money or less aid money or different ways of distributing it, people who feel strongly about development could lobby their governments to consider how rich countries could reduce the extent to which they impoverish poor countries. Below, I’ve compiled a list of 24 ways this could be done. This is what I call ‘development by omission’ and it will be noticed that every item in this list represents highly unethical behaviour, perhaps even criminal behaviour.

  1. Stop grabbing land in developing countries for food, resources, biofuels, etc, and return the huge tracts of land that have been grabbed during previous imperialist regimes.
  2. Stop growing biofuels, which only benefit rich countries (if they benefit anyone at all) and effectively steal water, land and other resources from developing countries. Biofuels mainly use food crops, so this also drives up the prices that people in developing countries have to pay for vital goods.
  3. Stop using developing countries as sources of raw materials and natural resources. Monocultures such as coffee, tea, cotton, sisal, cocoa and others keep people in developing countries in penury. They also waste land that should be used for food production.
  4. Stop trying to palm off genetically modified (GM) crops on developing countries, especially under the pretext that this will make them more food secure and will solve food shortages. GM crops represent higher costs and lower profits for farmers, even in the rich countries for which they were originally developed. They also make farmers less self reliant and more vulnerable to various hazards, natural and otherwise.
  5. Stop using developing countries as sources of cheap labour, especially in the growing of monoculture crops, non-food crops and crops intended for export. Export Processing Zones (EPZ) have been set up so that foreign companies can avoid meeting even minimum labour regulations, as well as avoiding paying tax.
  6. Stop allowing foreign companies tax holidays and other benefits that are not available to people in the developing country in question. Tanzanian companies that wish to exploit the country's rich reserves of gold, for example, cannot compete with foreign companies.
  7. Stop dumping cheap, subsidised goods, such as sugar and cotton, on developing country markets. Rich countries need to remove subsidies and allow developing countries to compete.
  8. Reverse unfair trade agreements, especially bilateral agreements, that allow rich countries to extract goods and services from developing countries so cheaply that the developing countries lose out.
  9. Stop aggressively recruiting skilled employees, such as doctors and nurses, which are in very short supply. Compensate adequately the countries who have lost most of their skilled employees over the years.
  10. Repeal the various structural adjustment policies and similar World Bank and IMF (International Monetary Fund) strictures that reduce developing countries' ability to develop. Get rid of conditional aid, especially where those conditions are purely for the benefit of rich countries and are harmful to developing countries.
  11. Change the terms and conditions for loans so that repayment does not mean that the borrowers are barely able to service the debt each year and will not be free of debt for the foreseeable future.
  12. Get rid of ghost aid in its various forms. Much aid never reaches developing countries, some is a de facto subsidy for rich country products and services and some is debt cancellation or some other kind of expedient that makes it look as if aid is much higher than it really is. Get rid of purely supply led aid and interventions that are designed to benefit wealthy companies and NGOs.
  13. Stop huge capital projects, such as hydroelectric dams, which cause more damage than good and usually only benefit some western companies who build the structures.
  14. Where foreign companies are operating in developing countries, ensure that they pay proper wages and develop good working conditions. Also, ensure that they pay tax, at least at levels paid by people and companies from that company.
  15. Stop aid programmes that simply increase dependency and do nothing to improve conditions. Also, aid that destroys local markets, such as food aid that consists of donations in kind from rich countries.
  16. Stop selling unnecessary weaponry and other technologies, especially out of date technologies that are no longer of any use. Far from protecting developing countries from this kind of exploitation, many Western governments have been party to the exploitation. Also see
  17. Stop setting up and supporting puppet regimes and undemocratic, corrupt governments. Stop interfering in the running of countries purely for the benefit of rich countries.
  18. Stop encouraging developing countries to privatise public services and public utilities, especially where that involves those services and utilities being taken over by foreign companies.
  19. Stop exporting pollution by producing the most polluting products in developing countries, for example, force growing fruit and vegetables in Kenya and flying them to Europe.
  20. Stop dumping toxic waste and any other kind of wastes in developing countries, where they are unlikely to be treated responsibly. Stop dumping computers and other used goods where there is no demand for them and no capacity for processing the resulting waste.
  21. Stop stealing indigenous knowledge and indigenous crops, genes and plants. Stop putting patents on things that have been stolen from developing countries.
  22. Stop using developing countries as military and geopolitical pawns and pretending that this is a form of development.
  23. Stop using developing countries as markets for products that are difficult or impossible to sell elsewhere. Stop forcing products on people who can't afford the consequences, such as GM crops, baby milk formula, etc.
  24. Stop rich 'philanthropists' from using developing countries and their people for their experiments and their expansionist aspirations.

If rich countries stopped doing all or even some of the above, developing countries would be a lot better off. The paltry amounts of money spent on ‘aid’ would probably no longer be necessary. The number of people who live in poverty, suffer disease and other harm and who die unnecessarily as a result of rich countries’ practices of extracting wealth from developing countries could even seem like genocide. The list is by no means exhaustive.


Friday, March 26, 2010

Do Those Who Pay Lobbyists Get What They Pay For?

The International Policy Network (IPN) is almost beyond belief. The head of the organisation, Julian Morris, has an article on India's recent decision to place a moratorium on the growing of genetically modified (GM) brinjal (aubergine, egg-plant). Morris puts this decision down to their use of the 'precautionary principle', which Morris doesn't approve of. He refers to India's high rates of poverty and malnutrition, implying that their decision to reject GM brinjal (for the moment) will contribute to these problems.

For several reasons well known to Indian farmers, GM crops do not reduce poverty, far from it. For a start, GM seeds and other inputs are much more expensive than conventional ones. Secondly, the usage of these inputs goes up, steadily, the longer the crops are grown in the same place, so profits go down. Thirdly, yields go down, reducing profits even further. Fourthly, none of the other promised advantages of GM crops have materialised. GM has been an expensive waste of money, of land and of people's lives.

As for malnutrition, the previous points make it clear that GM crops are not going to have much positive impact on this. We have been promised crops with higher nutritional value but, in addition to getting less food from GM varieties, there is no nutritional benefit. According to Wikipedia, the precautionary principle "states that if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is not harmful, the burden of proof that it is not harmful falls on those who advocate taking the action".

What could Morris have against such a principle in relation to GM? There is more than a suspected risk of harm, of several kinds, to the public and the environment; there is little or no scientific consensus but nor has there been much scientific research; the burden of proof should lie with the proponents of GM, but they have consistently failed to do any research that could allay fears. Morris says his disagreement is that you can't prove a negative. But proponents are not being asked to prove a negative, they are being asked to carry out adequate research to show that GM crops are safe to humans, animals and the environment, economically viable, politically viable, ethical and many other things. The risks of not doing this research are too great.

The Indian minister in question, Jairam Ramesh, did not simply grab whatever expedient he found handy and place a moratorium on GM brinjal. He held a lengthy and comprehensive consultation. This is something an industry paid lobbyist who runs an institution that pretends to be an educational think tank, such as Morris, would have little understanding of. People who voted for Ramesh were asked their opinion and they said 'no', overwhelmingly. If Morris had his way, Ramesh would have paid large consultancy fees to Morris and his ilk and done what they advised, regardless of what Indian farmers and consumers wanted.

Morris goes on to fault the use of the precautionary principle by the EU to ban animal growth hormones. He sees this decision as flawed (really, read the article!). But his grasp of basic logic is as poor as his knowledge about GM organisms. He argues that water and oxygen would be banned under the EU's interpretation of the precautionary principle 'if they were classified as pesticides'. That's like saying that pedestrians would have to obey speed limits if they were classified as vehicles.

Like many interested parties who have their snouts in the GM gravy train, Morris sees any opposition to GM or any other dangerous technology as anti-science, anti-technology, rather than sensible criticism and protest against health and safety issues being decided purely on the basis of profits for multinationals. He seems to have little time for anything remotely like a scientific argument. He's not too astute politically, either. The "small but politically savvy band of opponents" in India that he refers to are none other than the Indian electorate, people who will be most directly affected by decisions about further exposures to GM risks.

The IPN website claims to have 'ideas for a free society' and to be 'bringing down barriers to enterprise and trade'. It would be more accurate to say 'this is as free as it gets, put up with it'. If I thought Morris was trying to clarify moot points, to analyse certain alternative interpretations of data, to shed light on difficult issues, I would at least defend his right to do that, even if I didn't agree with him. But there is no sense, science, logic, even political clout, behind what Morris writes. He seems to be writing utter nonsence because that's what he gets paid to do. But if the quality of his arguments are anything to go by, he doesn't get paid very much.


Thursday, March 25, 2010

Viva La Via Campesina

Today I received an email from La Via Campesina, an " international movement of peasants, small and medium-sized producers, landless, rural women, indigenous people, rural youth and agricultural workers". This communication declares that La Via Campesina characterizes this current moment as "one of arrogance and authoritarianism on the part of the United States, the European Union and transnational corporations". It goes on to state that:

The increase of military presence and military bases in various parts of the world, “humanitarian” invasions and occupations which indicate war, the occupation of markets and territories, and the military presence to control energy resources, water, and natural biodiversity are all tactics derived from civilization’s crisis of capitalism and the logics of exploitation, racism, and patriarchy. These tactics also work to disguise the climate crisis in illegitimate negotiations.

Mtandao wa Vikundi vya Wakulima Tanzania (MVIWATA, the Tanzanian Network of Farmers' Groups) is a member of La Via Campesina, so I hope they attend the movement's 'Assembly of Social Movements' in Bolivia in April. Perhaps they will also represent their neighbours, such as Kenya, Uganda and others. Only a handful of African countries are presently represented. Kenya is not. But they need to be.

It's hard to think of any strategy that could be worse for Tanzania and other developing countries than a concerted move towards large scale farming. Yet most members of a group of several hundred 'researchers' recently agreed that "the domination of the agricultural sector by small scale farmers is a serious problem".

A serious problem for whom? For wealthy politicians, who own much of the country's best land? For the multinationals, who want to control the country's ability to feed itself? For those who want to see more African land dedicated to the production of biofuels that will allow people in wealthy countries to continue their wasteful lifestyles? For those who see Tanzanian land and people as 'assets', to be bought up to enable them to produce food for people in wealthy countries?

These 'researchers', who must spend their time reading tabloid newspapers and the outputs of right-wing, imperialist think-tanks, rightly point out that small-scale farmers lack capital and skills. But they conclude that they should therefore become the de facto slaves for those unscrupulous enough to take over much of the country's land, natural resources and productive capacity.

If people lack skills, and it's not just Tanzanian small farmers who lack skills, this is because of the continuing failure of the education system. Many people don't attend school at all, many attend for a few years and many leave with very little practical knowledge of any kind. But this is not a reason to send in the large scale commercial farmers, ready to "inject capital and technology". People need better education, whether they are small scale farmers or from any other walk of life.

If the infrastructure is failing people, the infrastructure needs to be improved. Foreign land grabbers and multinationals are not going to do that. But in order to market goods even to Tanzanians, the country needs proper transport networks, reliable and widespread electricity supplies, communication networks and the like.

If, as these people suggest, Tanzanian agriculture is scaled up, what will happen to the subsistence farmers? They probably make up the largest economic group in Tanzania. The researchers' answer is the 'outgrower' system. Farmers become 'outgrowers' for some factory or exporter, producing a crop, usually a monoculture, usually not a food crop, to be exported. The farmer gets a very small price, they middle person gets a large price and the destination country converts the primary good into some high value product, often sold back to Tanzania at extortionate prices.

The country's Prime Minister Pinda uses the examples of tea, sugar and sisal to demonstrate how successful the outgrower system has been. Perhaps Pinda doesn't go out much but I think he will find that the majority of tea, sugar and sisal workers and outgrowers earn a pittance. And these crops are not essential food crops. People need to feed themselves and their dependents and they need to produce enough food to ensure the country's food sovereignty, the right of peoples "to define their own food, agriculture, livestock and fisheries systems, in contrast to having food largely subject to international market forces".

To avoid being tricked out of what's left of their natural resources and land, Tanzanians need to be aware of philosophies such as that of La Via Campesina. Most Tanzanians fit into one or other of the movement's categories. Because those Tanzanians who don't belong to any of those categories, rich businesspeople, politicians and the like, are ready to sell everything to the highest bidder. And, as usual, the money won't 'trickle down'.

La Via Campesina's objectives include the preservation of land (currently threatened by massive levels of land grabbing), water (threatened by all agricultural production for export, but especially biofuel and non-food crops), seeds (threatented by the attempts by genetically modified organism producers to control seed supplies) and other natural resources (threatened by natural resource exploitation which is almost entirely controlled by foreign multinationals). Other objectives include food sovereignty and sustainable agricultural production based on small and medium sized producers.

If Pinda and his colleagues are concerned about the country's low agricultural output, there are many initiatives that can be employed. As mentioned, improved education and infrastructure. But also, an improvement in the economic circumstances of the majority of people. The country is relatively rich in resources, but they are being effectively stolen by foreigners. There's (so far) no shortage of wealth in the country, distribution is the serious problem.

Most Tanzanians are just about getting by, right now. If agriculture is scaled up, by whatever means, the majority will lose the little access they have to food and other vital goods. Tanzanians need to feed Tanzanians. They don't need to be exploited by commercial and political interests. And the same applies to Kenyans and other Africans.

The final word must go to La Via Campesina:

The current industrialized agribusiness model has been deliberately planned for the complete vertical integration and to dominate all agriculture activities. This model exploits workers and concentrates economic and political power. La Via Campesina advocates a decentralized model where production, processing, distribution and consumption are controlled by the people the communities themselves and not by transnational corporations.


Wednesday, March 24, 2010

Deliberate GM Contamination of Kenya's Maize?

India's notorious genetically modified (GM) cotton plantations, which even Monsanto now admits are a failure, were not established after consultation or adequate research. The GM seed was introduced surreptitiously and spread far and wide and was eventually accepted on the grounds that it was too late to avoid it. Monsanto have profited considerably from this 'accident', having upped the prices for their seeds and other inputs many times over the years. One of the many failures of these GM seeds is that fertilizers and pesticides need to be used in ever increasing quantities.

Now, the pests have developed resistance, no amount of pesticide will control the problem. Yet Monsanto's solution to this is to roll out a new version of their GM cotton seed, with a new set of inputs and even higher prices. The seed has contaminated much of India's cotton growing areas and much of the country's arable land. But no amount of destruction is enough for Monsanto. They want to control what India does with its cotton and, eventually, all its other agricultural products.

I have argued elsewhere that what happened to India could also happen to other countries and whole continents. Well, it seems like someone is already trying to contaminate Kenya's staple crop, maize, with GM maize. 40,000 tonnes of GM maize was imported from South Africa earlier this year, at a time when the country had a surplus of the crop. A Kenyan company called Louis Dreyfus Ltd imported the stuff. It is sitting in Mombasa Port right now.

Questions are being raised about how this could happen and worries are being expressed about some of the possible effects of GM contamination. It is possible that some Kenyans are confused about the dangers that GM contamination poses. If this consignment were distributed and used as seed, farms directly affected would also contaminate farms around them. Maize is the most commonly grown crop here and it's grown for Kenyan consumption.

But other crops, grown for export, could also become contaminated. One of Kenya's top exports is fruit and vegetables and much of it goes to Europe. Europe has fairly strict laws about allowing the importation of GM contaminated foods. Kenya could end up exporting very little. Tea and coffee are also among its top exports but they too could end up being compromised by GM contamination. Anyone who thinks that opposition to GM foods is just anti-scientific, luddite or in any way mistaken should do some reading up on the subject.

One wonders who is behind allowing GM products to enter the country, who could profit from such a move? Has it happened before and is Kenya's maize already contaminated? And will this consignment of contaminated maize be allowed to be distributed or will it be sent back to South Africa, who have already fallen for the GM trick? I don't feel very confident about the future for some of Kenya's most important exports.


Tuesday, March 23, 2010

Education is Not a Prophylactic, it's a Human Right

When a school girl becomes pregnant here, she is usually excluded from school. Ostensibly, she is allowed to return to school once she has delivered but, in practice, most never return to school. She is excluded on the grounds that she is a 'bad example' to her peers. The boy or man responsible for her pregnancy, apparently, does not set such a bad example. School boys who make school girls pregnant, if identified, are not excluded. Adults who make school girls pregnant can't be excluded, but they are rarely punished. Sometimes the adults who make school girls pregnant are their teachers.

So I was surprised to hear that seven teachers, one of whom is a principal, have been interdicted for such an offence in Bomet and Chepalungu districts, Kenya. In Bomet, 37 girls have become pregnant and have dropped out of school. Whether any of the girls are underage or not is less important than the fact that the teachers have behaved inappropriately for people in their position. It is hard to believe that they have not taken advantage of their position, in addition to breaching the trust of both their pupils and the parents of the pupils.

An official in the district referred to the teachers as 'amorous', which doesn't seem to be the most appropriate term and seems to miss the seriousness of the offences. Amorousness is not a crime but sexual assault and sexual assault on a minor are. Teachers are supposed to educate their pupils to enable them to avoid things like underage sex, sexually transmitted diseases and unplanned pregnancy. The schools may be willing to allow the girls to return to school later but the damage has been done. Some may return, but they will be at a serious disadvantage as a result of their experience.

Another article suggests that education is 'crucial to lowering [HIV] prevalence' because HIV prevalence in Tanzania has dropped among those with secondary education whereas it has remained static among those with little or no education. I object to the suggestion that education is good just because it reduces the risk of HIV. Education is a human right. It is an intrinsic good, not just an instrumental good that reduces HIV prevalence.

However, the article's conclusions must be difficult to establish because primary and secondary students who become pregnant, the ones who were least likely to be using condoms (and therefore at most risk of contracting HIV and other sexually transmitted infections), are excluded from school. They are no longer in the demographic in question. But they can not be excluded from the 'little or no education' demographic. This may skew the figures, somewhat. (I don't have access to the full paper, so the authors may have allowed for this possibility).

I'm glad to hear that education officials are realising that when a girl gets pregnant, a male is involved, either a man or a boy. They are also starting to admit that some teachers are involved and are punishing the perpetrators, rather than just the victims. But education, and education for girls, in particular, still appears to be seen as something less important than education for boys. And it also appears to be seen as a way of reducing HIV prevalence, rather than a human right. Well educated boys and girls, men and women, will be able to ensure their own health and welfare, that's why it is a human right.


Monday, March 22, 2010

The Gates/GM Progeny

Some of the most deceitful and unscrupulous people in the business world want to exploit Africa and one of the richest people in the world is spending huge amounts of money trying to help them. This person, Bill Gates, considers himself to be a philanthropist. Yet he is party to efforts to tie farmers into agreements that will commit them to expensive farm inputs, such as seeds, fertilizers and pesticides, will probably reduce yields, will have significant health consequences, will increase dependence and food insecurity and will generally make things worse than they already are.

Someone who really wanted to benefit people in developing countries with a lot of money at their disposal could do many things. In agriculture, they could develop indigenous crops that are selectively bred to resist drought, flooding, increased salinity and other adverse conditions. In infrastructure, they could provide people with clean water and give them access to better and more sustainable forms of energy and fuel. This would also confer great health benefits. There are numerous things that could be done to improve people's economic conditions, their education and their skills.

But Gates prefers technical solutions, mostly ones that will make his foundation, along with some people connected with it, rich. Never mind that these 'solutions' will worsen the situation in developing countries, that doesn't seem to be a worry for this 'philantrocapitalist'. Perhaps he's just an old style capitalist in disguise. Genetically modified (GM) crops have been a disaster in developed and developing countries alike. His efforts to tackle a handful of diseases while ignoring the conditions that allow those diseases to spread will have few long term benefits. Just because he is rich, he shouldn't have the right to interfere with the welfare of so many vulnerable people, especially at the same time as claiming to be doing good.

Another article sees Gates as propping up a form of neo-colonialism. GM crops are an inappropriate, imported technology, designed for large scale industrial farming like that predominant in the US. Most African farmers are small farmers and they are the ones likely to suffer if they are pushed out of farming by GM. It's not the big farmers and landowners who can afford industrial scale farming that are suffering from food shortages. And those who are suffering from food shortages will quickly find that GM will not feed them, either. They are short of food because they are poor, GM foods will only increase the prices and reduce access further.

It's time that people realised that GM does not have any advantages for poor people, or even for relatively well off people. It is designed to make money for the handful of multinationals that develop the technology. And anyone who claims to be doing good by imposing GM on poor farmers in developing countries is a liar and an opportunist.


Sunday, March 21, 2010

Development is Not All About Money

It's basic science that if you insulate a hot cooking pot properly, the food inside will continue cooking even after you remove the heat source. But however basic, probably most people in the world cook with a continuous heat source, gas, electricity, parafin, wood, charcoal, whatever.

So it comes as a surprise to some people, people who would recognise the basic science, that you don't need to keep the food over a continuous heat source. You can bring things to the boil and then transfer them to a heat box, hay box, cooking basket, fireless cooker, whatever you want to call it. This insulated container will allow the food to continue cooking. Even if it's something slow to cook, like beans, it will eventually cook completely.

And when people don't even have ready access to the basic science, seeing food cook without any obvious heat source seems like magic. Of course, there is an obvious heat source, but when the food is removed and put in a stone cold container, it still cooks. Using this method you can save a lot of money on fuel. I don't think I need to rehearse the benefits of cutting fuel use or cutting costs of any kind.

The technology goes way back but interest in it seems to wax and wane. I've heard it was popular during and after the second world war, when there were shortages of food and fuel. And not only is the technology widely known and cheap, it can even be totally free to make one of these devices. Then it saves you money and you can use it to cook, keep things hot, even keep water hot all night so you can use it to wash with in the morning.

Here in Nakuru, working with Ribbon of Hope Self Help Group, I'm hoping that most people will be interested in making and using this neat trick. Most of them use charcoal or wood. These are expensive and trees are in short supply. It also requires a lot of work to search for fuel. Any way of cutting fuel use and costs would be welcome as most people in and around Nakuru are poor. And using cooking baskets even reduces smoke inhalation, water use and degradation of the nutritional value of the food because it cooks at low temperatures. And washing up is easier!

You can buy cooking baskets, marketed as fireless cookers, in the supermarkets. They are fine looking and work very well. But they are expensive. Not many people would shell out the equivalent of a whole week's salary, perhaps even two week's salary, for one of these. But the good news is that they are easy to make and they can be made using locally available materials.

On Friday we went to Athinai, a place totally dominated by sisal plantations and some factories that use the raw material for very basic products, such as ropes. The best of it is exported as a raw material, earning the company less than it should and earning locals even less. Especially considering the factory's habit of not bothering to pay people for months and even years.

Anyhow, the factory has some by-products, some of which are dumped, some of which are sold for good money and some of which are sold for very little money. The dry fibres, even the ones that are not fit to be sold, make perfect padding for cooking baskets. People in Athinai can get it in large supplies, free of charge. If they can't get enough, or if the factory starts to charge for it, they can use rolled up newspapers, dry banana leaves, hay, straw or anything dry and light that is a good insulator.

Instead of weaving expensive baskets and using other materials that go into the beautiful cooking baskets you see in supermarkets, I got a couple of used sacks in the market, one small and one large. People can get sacks free of charge if they know where to look or who to ask. Then all they have to do is stuff the large bag, make a little nest for the samll bag, which will hold the pot. A piece of material of some kind, stuffed with the stuffing and tied off or sewn, will do as the lid. Then tie off the big sack to make it all snug and you're cooking.

In front of the people who turned up for the demonstration, we stuffed a pile of sisal waste, something people there are so familiar with, into the sack as described. A pot of rice was brought to the boil and transferred to the cooking basket. And 40 minutes later people were shown the cooked rice. Not only were they astounded, but they were invited to take the whole thing apart so they could be sure there was no trick involved, which they did.

Cooking just for myself, I spend about ten shillings a day on charcoal but people with families can easily spend twice or three times that amount. It is estimated that you can cut charcoal (or wood) use by half by employing a cooking basket. So the amount saved is considerable. If someone earns 150 shillings a day working in the fields and they spend 600 shillings a month on charcoal, it's like getting an extra two day's wages without having to do the work. 24 extra days a year!

Rather than just concentrating on income generating activities, Ribbon of Hope is also looking at ways of cutting expenditure. These cooking baskets are perfect because they need not cost anything and they start saving you money straight away. Coupled with solar cookers, the amount of money people could save throughout the year begins to look like an excellent bonus. If you only use the solar cooker on 100 days of the year, that's another 6 day's wages to add to make a cool extra one and a half months. And as we don't have to give people this estimated 4,500 shillings a year, we think it's a pretty sustainable way of helping people with their finances.


Sunday, March 14, 2010

Genetically Modified Cotton Has Failed, Says Monsanto

Thanks for telling us after so many people have wasted their time and money and many people have even lost their lives as a result of this failure. Scientists who have not been bought off by the biotech industry have been warning against the use of these crops for years. They have been calling for proper research into what their true consequences are before imposing them on an unprepared world. But now it's too late.

What about all the people who have destroyed their land because of the industry's lies? What about the farmers who have run into such huge debts that they have found no way out but to commit suicide? If anyone knew that these crops were designed to fail, it was Monsanto and the rest of the industry. In some cases they have failed to do proper research, in other cases they have supressed the results of their research. Instead of doing the groundwork necessary, they have simply paid off powerful people to do their dirty work. Who needs salespeople when 'democratically elected' leaders will do the work at a far lower cost?

The president of the European Parliament, Jerzy Buzek, may have been bought off by Monsanto or the industry as a whole. Or maybe he's just brain dead. He has said that he is against GMO (Genetically Modified Organisms) but that they are inevitable. What could he mean by this? That the GM industry is going to do what it wants, regardless of what we insignificant members of the electorate want? That all the people who could possibly prevent GMO from being imposed on us have been bought off?

We can only speculate. Buzek goes on to say that because we can't win the battle, he is not going to fight it. He also said that Europe would lose out on 'competitivity' if we don't accept GMOs. There's a bit of overdetermination here; does he feel that we shouldn't fight something that is advantageous to us or does he feel that we shouldn't fight a battle we cannot win? He only needs to argue for one of these, not both. They could both be true but we don't know which one sways this foolish man. If you object to my calling Buzek foolish, just read the rubbish he comes out with about only genetically modified rice being able to grow in Bangladesh.

Given the evidence for Buzek's small brain, he probably has a short memory and a limited capacity for research and comprehension. But GM cotton was released in India because it had already been passed around unofficially and had already contaminated a large proportion of the cotton sector. It wasn't released after careful consideration and proper consultation (don't be silly!). I'm sure this was not as a result of anything the GM industry did, no doubt it was just an accident. But that is no reason for Europe or any other continent to make the same mistakes.

And just in case Buzek is worried about the silly rumour that the Vatican was pro-GM, that was just bunkum. The GM obsessed cardinal who was so keen on compromising the health and welfare of so many people has been replaced with what must be one of the few Catholic leaders who has a grain of sense. Cardinal Peter Turkson realises that GM crops could be used as "weapons of hunger and poverty". Not only does he realise this, but he actually considers this to be an undesirable outcome. He realises that GM will lead to the greater dependence of the weak and poor on the strong and rich, environmental degradation, higher costs and an increase in the number of food insecure and starving people in the world. Already, the number of starving people has increased steadily as the percentage of GM crops has increased.

Some commentators have wondered about why Monsanto might want to claim publicly that GM cotton has failed. They have pointed out that Monsanto has now produced a new generation of GM cotton. Monsanto knew long ago that the first generation had failed and they now want people to change to the new generation, which employs a second modified gene and requires an enlarged set of inputs in terms of pesticides and artificial fertilizers. It also requires greater expenditure on those wonderful pieces of intellectual property we used to call seeds, those things we used to be able to collect for free at the end of the growing season.

No, you don't have to back out of GM cotton just because the whole live experiment has failed, and you probably can't, anyhow. You just have to buy more expensive seeds and invest in more expensive pesticides and fertilizer. After all, you are part of this experiment. If it goes down the pan, so do you.


Saturday, March 13, 2010

Solar Cookers: Free or Just Cheap?

I want to find community development projects that either make money or reduce costs that are themselves free or almost free. I've started with a simple solar cooker, made by Solar Cookers International (SCI), in Nairobi. But they cost 500 Kenyan shillings (around £4.50), which would also buy you about 12 kilos of the staple food, ground maize meal. That's food for quite a few people, and I wouldn't blame people for saying 'it's a great idea but I can't afford it now'. Especially when you can buy a charcoal burning stove for about 150 shillings.

Of course, charcoal is a significant expense and people with families can use 15 or more shillings a day worth of it. True, you could point out how much less charcoal you would use if you invested in a solar cooker. But the word 'invest' is the big problem. Many people wouldn't have the amount of money they need to invest all at once. And even if they had the money, they still might use it for something else, such as a solar powered light or a battery powered torch. People use their money as they see fit and make their spending decisions based on their own criteria.

I love SCI's cookers, I use them myself. I have the luxury of being able to afford several, which is ideal on a sunny day. They are also great for demonstrating the concept because they fold up and I can easily carry three or four, along with the other paraphernalia needed to show people how to use them. They are resilient and so simple, I'd recommend them to anyone. They are cheap, but not free.

However, when the money available is a hundred or two hundred shillings a day, perhaps less, these cookers are not going to fly off the shelves. I have tried suggesting to people that they could make their own, given that they are simple and require cheap materials. I've said I would come and help them to make cookers so they would have them for a maximum of about 50 shillings. This has been met with some enthusiasm, but not much. I'm not terribly sure why this is, but I'll be looking out for the explanation.

Anyhow, when you demonstrate the use of solar cookers, people are excited, inspired, even stunned. They start off by dismissing the possibility of cooking with a piece of shiny cardboard, regardless of whether you paint the pots black or any other colour. But when they see their everyday foods cooked they are speechless. Even ugali, the tasteless and almost nutrition-free (it's pure starch) staple, boiled maize meal, cooks far more easily than it does on a charcoal stove. At least some people are interested. But there's still the problem of cost.

So after demonstrating their use in Salgaa, half an hour West of Nakuru, I said I'd come back and help people to make them. They make all sorts of things themselves, so cutting out a shape in cardboard and sticking on shiny paper shouldn't be a problem. The cardboard can come from large boxes and the shiny paper could be aluminium foil. These are cheap. Compared to the manufactured solar cooker, it's really cheap, almost free. But that doesn't impress people. They have to pay for cardboard boxes, they are very useful. And aluminium foil is not cheap enough for some people, though the amount you'd need for a solar cooker is small.

Well, it's possible to get large amounts of cardboard very cheaply, perhaps free, if you look in the right places. And it's possible to get very good reflective paper, very durable, much better than aluminium foil. I wandered the streets looking for products that use this material and discovered that new vehicle wheels are wrapped in this untearable material, which is almost shiny enough to see your face in. Also, supermarket products, such as chocolate, sweets, tea and various other things are wrapped in similar materials.

I knew I would be met with more objections, we don't have a car, we don't eat chocolate, etc. But neither do I have a car nor do I eat most of these products. The thing is, someone does. They are not stacked in the supermarkets for no reason. And when people have finished with things, they throw them away. Over the fence, in a ditch, anywhere. Occasionally, they throw things in a bin and they end up in a dump. But still, this means that this great reflective material is available, you just have to look.

I looked and enquired and asked whoever I could think of. I was met with complete incomprehension when I said I didn't want to buy vehicle tires. But when it was realised that I placed a value on the material they were wrapped in, availability suddenly dropped. It was clear that I would have to pay money if I wanted this stuff, being white, and therefore incalculably rich. But the people who were going to make the solar cookers, they wouldn't have to pay money. Not much, anyhow. And people here are good at finding things they need or getting them very cheaply. So I left it up to them to collect the materials.

This hasn't worked so well. On the appointed day, I turned up to find 40 people, 2 cardboard boxes, one too small to be of much use, and three wrappers, around half a square meter of reflective material altogether. But I had brought glue and glue brushes and most of the materials were there to make a start. I said what had to be done and sat down and told people to go ahead. Eventually one person volunteered and a few others joined in. They couldn't complete the cooker, but I think it was clear to everyone there how easy it is to make the cooker. I'm just hoping that they will also see that they have to collect the materials needed, because I can't do that.

Of course, for less than £200 I could buy every person there a solar cooker. For about £50, I could supply them with all the materials to make their own. But how sustainable is that, for a start? And how many people would use the solar cooker if I presented them with it for free? This would not be sustainable, not at all. And I have given people with plenty of education and free time presents of solar cookers. Not one of them has used it. I know solar cooking is a hard sell, in terms of people actually using the technology. And I also know that you can't just thrust it on people.

It's going to take more time. There are community leaders in Salgaa who are very keen. Slowly, we will push the issue and hope that even a handful of people will start to find some way of including the solar cooker in their day to day lives. Who knows what the result will be. Solar cookers are not the only example of free or almost free community development projects, but this is the first time that I have tried one of them with the aim of establishing 'free or almost free' as a development model (or micro model). It's early days and I'll report back in due course.


Wednesday, March 10, 2010

Cut Corruption, Don't Cut Aid

I arrived in Nakuru in September of last year expecting to work for an organisation called ICROSS (International Community for Relief of Starvation and Suffering), supposedly to work on a HIV related project. However, in my first week in Nakuru I realised they didn't have any active projects. Officially, they were waiting for funding. But as I was led from one 'site' to another, I realised there was something not quite right about ICROSS. It was hard to put a finger on, but the first thing I found strange was that only a couple of people had ever even met the guy who headed ICROSS, Mike Meegan (also known as Mike Elmore-Meegan, Dr Meegan, Fr Meegan, Br Meegan and probably a few other names not worth repeating). Some had heard of him but most didn't even recognise the name.

Well, it quickly turned out that none of the 'sites', these community based organisations and support groups that I was being taken to see, had any real connection with ICROSS. ICROSS would just collect up organisations and include them in their proposals when they were looking for funding, which was all the time. The only function the organisation seemed to serve was to find funding. Anything worthwhile that was achieved was done by a handful of volunteers, along with some of these organisations that had been 'absorbed' by ICROSS. Of course, ICROSS would always take the credit.

So, to those who are worried about how this work will be affected by the demise of ICROSS Ireland? For a start, it's only ICROSS Ireland that has closed. ICROSS Kenya continues its 'operations'. But even if that were to close, very little would happen on the ground in Nakuru. ICROSS simply didn't do very much here, aside from pay visits when they wanted to show potential funders or publicists around. They would take a few photos, maybe hand out something small that they had acquired from some donor or other, then head back to the Nairobi office (where none of the projects were based).

The many small organisations that ICROSS claims (incorrectly) to have founded just continue as they did before ICROSS arrived. Some will be better off, some will be a small bit worse off, but most will continue as if nothing had happened. Because nothing has happened to most of them. Some of them will continue to welcome anyone from ICROSS because there is a slight chance of a handout, a few may collapse because they only got together to pick up anything being given out by organisations like ICROSS, but for most, ICROSS will be a faint memory.

As to what happened to all the money ICROSS has raised over the years, these newspaper articles are silent. In addition to the one above, there is another in the Sunday Times, one in the Irish Mail on Sunday and one in the Irish Examiner. These can be added to the collection of articles on the organisation's suspect activities, going back years. For the moment, we can only guess at what the money was used for.

The numerous scientific papers that have Meegan's name on them may seem suspect now, too. But judging from what I've heard, he is unlikely to have had anything to do with the data, at any level. None of the people involved in one of these projects in particular had ever met the man and he never visited the sites where the participants lived, where data was produced and collected. Let's hope that's the case, because many would not wish to rely on data that could be seriously flawed.

But I wouldn't want people to think that no harm has been done, that no one has been depending on all the money donated to ICROSS over the years. After spending a few weeks finding out that ICROSS wasn't doing anything effective in Nakuru, I asked Meegan to make some money available, urgently, as people were sick and in need of help. He and I disagreed on this matter and I finished working with ICROSS before I had even started. Some of the sick people who were in dire need died and many will continue to suffer and die. Meegan likes to boast about how many people he knows have died of Aids here in Kenya. But some of them are dying because aid money is not getting to them.

On a broader scale, also, it matters very much that money intended for poor people, sick people and starving people is not getting to them, regardless of whether it is diverted to repressive regimes, rich foreign contractors, greedy governments or where ever else it may go. If charities, aid organisations, governments, consultancies, commercial organisations or other parties are corrupt, that needs to be remedied. But there are too many people who would like to see aid cut or stopped altogether. Why punish the people who are already suffering because of the conduct of those who are supposed to be accountable, who are from wealthy countries, who are well off themselves? Aid is not the problem, corruption is.

It is extraordinary that Meegan seems to have surrounded himself with so many prominent people. The few people I know who have met him find him utterly unconvincing and I agree with them. But he seems to have been able to fool a lot of people for a long time. Audits and investigations have been carried out over the years and both he and his organisation have been found wanting. Yet ICROSS continued their fundraising and somebody continued, presumably, spending the money. Just not in Nakuru. Hopefully this time will be different.


Monday, March 8, 2010

Lucky Those British Choppers Happened to be in Kenya

Apparently some tourists were rescued by helicopter when there was flash flooding in the Samburu area. The British Army and Airforce helicopters just happened to be in the area because they 'train' there. It's lucky they were able to rescue the people in the tourist areas. None of the tourists were reported as having any injuries. An elephant research centre was not so lucky. The BBC article doesn't mention if there were any non-Britons or non-tourists involved.

In other areas, six people are reported to have been drowned and five others are missing. The article doesn't say if there happened to be any British helicopters there. Livestock, homes and properties have been destroyed in many areas, including Samburu. Many people have been displaced. Interestingly, Kenyan helicopters were also involved in the airlifting of tourists in Samburu. Perhaps it's easier to spot white faces against the muddy background.

One of the deaths was in Mogotio, where flooding a couple of months ago displaced several hundred, many of whom are still living in tents. Another person died and one is missing just outside Nakuru town, in Kaptembwa. Three people were killed by flooding further North. While many have already been displaced in Western province, many more are threatened with flooding as rivers are close to bursting their banks. Exact figures are unclear but the number is said to be 'below 2000'. But thankfully the 600 tourists (although this number includes tourist lodge staff) said to be affected are all OK, having lost only their luggage.

Many areas are being warned to prepare for more flooding and other hazards that come with the very wet conditions, such as cholera, malaria and other water related diseases. Farmers have been holding off sowing crops in many areas because the rain has been too heavy and those who have planted are in danger of losing their crops. Maize seeds are being distributed in some areas, although this is unlikely to benefit many people for some time. Let's hope those British helicopters and emergency services will still be available if and when disaster strikes.


Saturday, March 6, 2010

Political and Religious Leaders Overseeing the Spread of HIV

There's an interesting article on about how Ugandans who think they may be HIV positive are less likely to refer other family members for HIV testing. In a survey, people were asked before testing if they thought they were likely to be HIV positive. A majority said they thought they were likely to be. Of course, only some of them were. But most of those who are HIV positive in the country do not know their status. This doesn't bode well for a country that is said to have been so successful and progressive in its fight against the disease.

The very people who are most likely to be HIV positive are least likely to go for testing. So you would think that the Ugandan government would aim to target these people, make it easier for them to get tested, increase access to HIV facilities, reduce discrimination and stigma. Instead, the government is going in the opposite direction, trying to whip up anti gay feelings and making such strong threats against people even suspected of being gay that most people will be less willing to find out their HIV status, whatever their circumstances.

The Bahati Bill will make a lot of people avoid even discussing HIV or sexuality because if someone is found to be gay, HIV positive and sexually active, they will face the death sentence. In order to cover up their sexuality, many gay people are said to have heterosexual relationships, even to marry a heterosexual partner. Their partner will even face a lengthy prison sentence for not reporting that they were married to a gay person. Currently, only an estimated one quarter of HIV positive people know their status. If this bill becomes law, that figure should go down even further.

Some leading American Christians are said to be behind Bahati's bill. But the Catholic church is equally adamant that condoms shouldn't be used to prevent unplanned pregnancy, HIV or other sexually transmitted infections. They even lie about the effectiveness of condoms, which would seem to be in breach of the ninth commandment. But as far as they are concerned, it is 'artificial contraception', and therefore immoral. The use of condoms is currently being debated in The Philippines, where HIV prevalence is low, but rising.

You would think that political and church leaders would aim to reduce transmission of HIV and to stamp out stigma and discrimination. But, on the contrary, they seem to be against any measures that target some of the most significant channels to HIV infection. We must look beyond political and religious leadership if we are to have any hope of making progress in the fight against HIV.


Thursday, March 4, 2010

Women Are Not Mere Instruments in the Fight Against Aids

One of the recurring themes on this blog is my claim that HIV transmission is not just about sex. In fact, sexual transmission of HIV is not just about sex. What I mean is that there are circumstances surrounding sexual behaviour that determine whether the risk of HIV transmission is higher or lower. And if those circumstances are ignored by the many so called HIV prevention programmes, those programmes will fail.

So far, most HIV prevention programmes have been designed with the assumption that reducing HIV transmission is all about influencing sexual behaviour. This is sometimes referred to as the 'behavioural paradigm'. And most HIV prevention programmes have failed. UNAIDS emphasizes the fact that HIV is now the leading cause of death in women of reproductive age. Considering current rates of maternal illness and death from non Aids related causes in developing countries, this is truly shocking.

But here is the more shocking bit: "up to 70% of women worldwide have been forced to have unprotected sex". If women are subjected to violence to this extent, this is the real outrage. That women do not have the right to choose when to have sex, whether to have sex, with whom to have sex or any of the other circumstances is horrifying. These are the sorts of circumstances surrounding sexual behaviour that I am talking about.

But these rights are not just about sex. If a woman doesn't have these rights, you can be sure there are many other rights she doesn't have. The problem here is that the rights of a huge proportion of women are being denied. Women do not have rights just so that they don't contract HIV or any other sexually transmitted infection. And if a woman does have these rights, the issue of whether she does or doesn't have a say in the circumstances surrounding sexual intercourse will not arise. Not everyone will make the best decisions, of course. But the problem is that at present, some parties are being denied this right.

Michel Sidibe, the executive director of UNAIDS, is wrong on several counts. 'Gender issues' do not need to be addressed because this is a way of reducing transmission of HIV. Gender issues need to be addressed because they have so long been ignored. Ensuring rights for women is not just a useful way of ensuring that the Millennium Development Goals are realised. Women are not mere instruments in the fight against Aids.

In Africa, 60% of the people living with Aids are women. Women are far more vulnerable to being infected than men. Yet so much HIV programming ignores the circumstances in which people live and work. The recent emphasis on mass male circumcision is a good example of an intervention that falls for this behavioural paradigm. It also purports to protect men, to some extent, from HIV. The extent to which it protects women is very unclear.

But most HIV prevention programming uses the same paradigm and has done ever since HIV was found to be mainly a sexually transmitted infection. Women's rights have been mentioned, often in this instrumental way that UNAIDS seems to favour. Even economic, health and educational inequalities have been mentioned. Well these are the issues that need to be targeted, not just mentioned. But most of the big money goes into the tired old finger wagging about what people should and shouldn't do in bed.

The issue of violence against women does not need to be 'integrated into HIV prevention programmes'. This is completely the wrong way around. The issue of HIV prevention needs to be integrated into programming that addresses gender inequalities in social intercourse, marriage, work, education and health. HIV is not bigger than all these and until these are successfully targeted, HIV will continue to elude our best efforts.


Wednesday, March 3, 2010

It's OK, Apparently Journalists Are Supposed to Lie

In an article about the Polish journalist and writer, Ryszard Kapuscinski, Neal Ascherson claims that "there is no floodlit wire frontier between literature and reporting". This is interesting because he feels that being a "great story teller" does not make someone a liar. Which is true, except when they are supposed to be writing an article that people assume is 'reportage'.

I don't know about Kapuscinski but if there is no frontier between literature and reporting then why would anyone bother to read the daily tripe? Journalists churn out a lot of rubbish concerning things they know precious little about, but people read papers and listen to radios and TVs every day to find out what is happening in the world. When they read some jumped up hack going on about how there couldn't be global warming because it's very cold today, they think that the whole issue about climate change has been trumped up.

So when it comes to genetically modified organisms (GMO), consumers of journalistic bullshit (the majority of mainstream reporting) think of Frankenstein foods, or whatever crap the 'profession' has dreamed up to ensure that the last thing people do is think or become informed in any way. Neal Ascherson may write for The Guardian, a 'moderate' paper, but lying and reporting are not the same thing and if a journalist lies, he or she is a liar.

What I'm saying about GMOs will probably be of no interest to journalists because I am not opposed to them just because they may be dangerous to humans, animals, plants, water supplies, in general, the whole global ecosystem. Although, I admit it, the fact that no one knows exactly what effect long term consumption of GMOs has on those who consume them (because no credible research has been done), does seem like a glaring omission. I am opposed to the fact that a few multinationals want to control the whole of humanity's ability to provide enough food for itself. Not only do they want this but they already control a massive proportion of global food production. To cap it all, many of the most powerful idiots in the world are in favour of this, with the support of...big media owners.

Ok, I've skipped past the journalists because they are just doing a job and they are paid for by some revolting Murdoch-like character who is trying to do for global media what Monsanto is trying to do for food production. But Ascherson makes a good point, don't bother reading what journalists have to say, unless you like a good read. As for science reporting in the mainstream media, forget it.

Domination of global food production by a few multinationals should be bad enough but approval of GM potatoes or any other GMO in Europe (or anywhere else) will also be a disaster because such crops will contaminate other crops around them. We know that they will because the evidence is clear from every field trial of GMOs. We know that there are other dangerous drawbacks to GM crops and also that none of the promised advantages of these crops have materialised. So what they hell are we growing them for?

I wouldn't wish to blame lying journalists for doing any more than following orders, or whatever it is they do, but if they want to brown-nose the bosses of companies like Monsanto, the least they could do is declare their interest. Because every time they throw in a straw man argument like 'Frankenstein foods', they are scoring a goal for the GMO industry. Monsanto can just claim to be using the crops for animal feed or biofuels. But then the problem doesn't go away. Once GMOs are used, the damage is done.

There are enough arguments against the use of GMOs, aside from the dangers to human health. But these arguments are much more difficult to answer. So rather than get the biotech industry to answer them, they are presented with arguments that they have a ready prepared response to. A response that has been well sold by journalists. And have you noticed the way articles often point out how widespread GMO contamination already is, as if to say it's only a matter of time before there is no longer any point in protesting? That's how they got GM cotton into India. Thanks journalists.


Tuesday, March 2, 2010

Mass Male Circumcision: Science or Politics?

Following the claim that a drive to test Kenyans for HIV resulted in 1.5 million people being tested in three weeks, another paper claims that 36,000 (male) circumcisions were performed in two months. I have serious doubts about the first claim and I have serious worries about the future health of the 36,000. In 2004, Kenya had 16 doctors for every 100,000 people and per capita spending on health was $9.10. There were 72 hospitals in Nyanza and 30.3 beds per 100,000 people.

Most of the circumcisions were performed in Nyanza because it's the only province with relatively low rates of male circumcision. In fact, it's only the part of Nyanza where the Luo tribe predominates that circumcision rates are low, standing at about 48%. HIV prevalence is high in Nyanza and especially high among the Luo. It's around double the national rate of over 7%. While this is said to be because of low rates of circumcision, it is not clear whether there are other factors that may result in high HIV prevalence among this tribe.

The scientific papers claiming that mass male circumcision can significantly reduce HIV transmission are notable for the frequency with which they are cited rather than for their great number. And perhaps the evidence is overwhelming, from a scientific point of view. Perhaps this is the one big breakthrough that the world has been waiting for. But some of the areas where circumcision rates already stand at almost 100% in Kenya also have high and increasing rates of HIV transmission. For example, prevalence is rising in Coast province and it is higher than the national average, even though circumcision rates are nearly 100%.

So what awaits Luos who have been circumcised? Some people I have met who are already circumcised believe that they don't need to use condoms and that seems to be a common view. Some even believe that condoms 'don't work' if you are circumcised. Apparently people who are queuing up to be circumcised now are also being given advice about using condoms once they are able to have sex again. I suspect people are getting circumcised because they think they will no longer need condoms. They may well be getting advice that says they still need to practice safe sex, but if they are heeding this advice then they could just skip the circumcision.

The scientific evidence claims that being circumcised reduces the risk of HIV transmission by 60%, regardless of sexual practices, for example, whether a condom was used, whether one has multiple partners, etc. Still, I just don't see what people think they can gain from being circumcised unless they think they can dispense with the need to use a condom. And maybe a 60% reduction in transmission will make some think the risks of unsafe sex to be small enough to be worthwhile.

Kenya's intention to spend $56 million on a small percentage of the population to prevent a handful of sexually transmitted diseases, given how little is spent on health per capita, seems strange. But spending this kind of money on an intervention that may not have anywhere near the effect it is expected to have is rash. Why, in a country that has so many health priorities, is so much being spent on this handful of diseases and targeting this small demographic (adult male Luos)? Yet the main funding sources, PEPFAR, the Gates Foundation and the Global Fund are all behind the initiative.

I hope this mass male circumcision campaign is worth it and HIV transmission rates drop significantly in the Luo population. But I just wonder if people who have swallowed the hype know that they will only be well protected from sexual transmission of HIV (and some other sexually transmitted infections) if they always use a condom, properly. Because if there are any other factors behind high rates of HIV among the Luo, aside from those relating to sexual transmission, it could be some time before they are given any consideration.