The very high levels of adherence to antiretroviral therapy observed in some settings in sub-Saharan Africa appear to be explained by the need to preserve a network of social relationships that people with HIV rely upon to survive, rather than being a consequence of individual motivation, according to a study conducted in Nigeria, Tanzania and Uganda.

Birtukan Mideksa has been sentenced to life in prison. She spends her days and nights in solitary confinement in a two-metre by two-metre cell. She cannot leave it to see daylight or even to receive visitors. Previous inmates say the prison is often unbearably hot. Her crime: refusing to say sorry. The judge, aged 34, is the head of Ethiopia's most popular political party, the only female leader of a main opposition party in Africa.

The new Kenyan National HIV/AIDS Strategic Plan should address rights abuses that make children vulnerable to HIV infection and impede access to care, Human Rights Watch has said in a policy proposal submitted to the government. The organization pointed out that tens of thousands of children in Kenya who need anti-retroviral treatment (ART) are not receiving it. The Kenyan National Aids Control Council (NACC) is currently preparing its new five-year strategic plan.

The death toll from a contaminated baby medicine sold in Nigeria has risen from 34 - recorded in early December - to 84, the health ministry has said. There have been 111 reported cases of children who have fallen ill after being given teething syrup "My Pikin". The poisonous syrup was discovered last November when babies began dying of organ failure across the country.

Countries in Africa should promote maternal, infant and child health and report on progress, in order to curb high death rates on the continent, according to the African Union (AU). "There are continents where women give birth and it is a pleasant experience because they are bringing life," said AU Commissioner for Social Affairs Bience Gawana.

Paul Collier ( November–December 2008) advocates ‘slaying three giants’ to end the food crisis: peasant agriculture, the fear of scientific agriculture, and the myth of biofuels from grain to overcome US oil dependence. His analysis is, however, very much grounded in the agriculture of the last century.

Collier continues to make the 20th century-long argument that increased yields is what can feed the hungry, a point that seems self-evident. But much research now documents that the hungry remain with us, not because of a lack of food but rather because of distribution and the inability of the poor to access food that is available, often only a few miles away. Amartya Sen won the Nobel Prize for Economics (1998) for demonstrating not only the theory, but the empirical reality, of famines occurring in the midst of plenty. Moreover, research on commercial agriculture demonstrates its negative effects on the environment, public health, and farming families (Magdoff et al. 2000; Nestle 2002). Commercial farming is highly dependent upon fossil fuels for production, processing, and transport, and is a major contributor to climate change (IPPC 2007).

Collier is correct to lament the high price of food in 2008, causing food riots in about 80 countries. However, he places blame for ‘the root cause’ on the increasing consumption of the Asian (i.e., Chinese and Indian) middle-classes. The statistics tell a different story. As stated by a senior economist at the International Grains Council, Amy Reynolds, ‘At the start of the decade, a small amount of grain—18 million tons—was used for industrial purposes. This year 100 million tons will go towards biofuels and other industrial purposes. Can anyone really tell me that hasn't had an impact on what we pay for food?’ (Chakrabortty 2008, p. 4).

There is never one root cause, and using grain to feed American cars, instead of people, is just a single factor, but one we can change quickly. We fully agree with Collier that Americans must end their addiction to oil, by refusing to put, as he states, one-third of our grain production into gas-guzzling vehicles. A longer term issue, but relevant to increasing demand, is that more than half the US grain and nearly 40 per cent of world grain is being fed to livestock, rather than being consumed directly by humans (Pimentel 1997).

Other contributing factors include the increasing costs of petroleum-based fertilizers and pesticides and increasing speculation on commodities markets (Stewart and Waldie 2008). These factors demonstrate, contra Collier, that the root causes of the global food crisis are related to the political economy of commercial agriculture itself, and not simply a matter of supply and demand.

We disagree quite strongly with Collier’s derisive depiction of ‘peasant agriculture’. He attacks the populism that ‘Peasants, like pandas, are to be preserved.. This overly general categorisation seems to include the very diversified category of small-scale family farming, a category which comprises the majority of farm operations throughout the world. These smallholders (often female farmers) are highly entrepreneurial and innovative. They are even more efficient than commercial agriculture, if one uses the measure of capital expenditure per bushel or tonne of yield.

Many scientists now provide statistics that ‘Africa can feed itself’ and that ‘organic farming can feed the world’ (Halberg et al 2007; Norstad 2007). Organic food production and localised forms of small-scale food production are among the fastest growing areas in agriculture today as the health and environmental effects of commercial agriculture are increasingly rejected and as people move to more healthful plant-based diets. Small-scale urban agriculture in the form of community gardening is becoming increasingly important in seasonal food supplies and local forms of food security.

Commercial agriculture, according to Collier, may increase yields by 10 to 20 per cent. Yet long term analyses from the UN Food and Agriculture Organization (FAO) demonstrate, across the globe, that ‘best practices’ of smallholder agriculture will double yields. ‘Best practices’ include the sharing of seeds (farmers’ rights), research following farmers’ requests, available and affordable credit and yes, agricultural extension. Collier is very wrong in saying that the latter has ‘largely broken down’, for many sources across the African continent document that removing the government from agriculture was a systematic policy of the World Bank (Berg report) and USAID from 1981. If agricultural credit, extension and markets do not work in Africa, the explicit policy of removing ‘government interference’ from agriculture is a major cause.

Another way Collier reveals he is caught in the last century is that he considers ‘scientific’ thinking as coming from those with white coats in elaborate laboratories. The barefoot woman bending over her cultivated genetic treasure is not ‘scientific’, even though such farmers have cultivated genetic biodiversity over thousands of years. These free gifts do not fit into the corporate logic behind commercial agriculture, where only profit can be an incentive, not curiosity nor sharing. Yet indigenous knowledge provides us with all our current food diversity and is the basis for 70 per cent of our current medicines. Americans, for example, need to know that every major food crop we use today was given to us by Native Americans. In contrast, commercial agriculture makes a profit by depleting the gene pool, the result of valuing only very specific traits. As the FAO concluded (1996, p. 13–14), ‘The chief contemporary cause of the loss of genetic diversity has been the spread of modern commercial agriculture.’

A major point which Collier avoids is that genetically modified seeds rely on the patenting of life forms, which most all the world rejects, with the exception of the US government and the global biotechnology industry. Much of the genetically modified research currently involved in the Alliance for a Green Revolution for Africa (AGRA of the Gates and Rockefeller Foundations) relies on freely taking seeds and experimenting them with them in the laboratory; if an innovative trait is produced (e.g., pesticide resistance), the plant is patented, with zero recognition to other breeders of the variety over thousands of years. By adding one gene, the corporation patents the whole plant, and often, the whole specie. Africans call this act ‘biopiracy’, or the theft and privatisation of genetic wealth which had previously been available to all (Mushita and Thompson 2007). We agree with farmers that the sharing of biodiversity is both the past, and the future, of human sustenance.

Food is a human right, not a corporate commodity for speculation. Mother Nature does not operate on a boardroom quarterly profit margin. But food production can be very profitable, sustainable and feed all of us. It is just not capable of feeding the ‘giants’ of Wall Street or the City of London; it is those giants’ interference with food production that needs slaying, because food produced mainly to feed corporate profit will merely lead to more food crises, not fewer.

* William Aal is with the Community Alliance for Global Justice, Seattle. Lucy Jarosz is a professor of geography at the University of Washington. Carol Thompson is a professor of political economy at Northern Arizona University.
* Please send comments to [email protected] or comment online at http://www.pambazuka.org/.

REFERENCES:

Chakrabortty, Aditya. 2008. ‘Fields of gold,’ The Guardian (London), 16 April, p. 4.
Food and Agriculture Organization, United Nations. 1996. Report on the State of the World's Plant Genetic Resources for Food and Agriculture, prepared for the International Technical Conference on Plant Genetic Resources, Leipzig, June17-23, Rome: FAO.
Halberg, N., et. al. 2007. Global Development of Organic Agriculture: Challenges and Prospects. London: CABI Publishing.
Intergovernmental Panel on Climate Change (IPCC), United Nations. 2007. Climate Change 2007. http://www.ipcc.ch/ipccreports/index.htm
Magdoff, Fred, et al., 2000. Hungry for Profit. New York: Monthly Review Press.
Mushita, Andrew and Carol Thompson. 2007. Biopiracy of Biodiversity – International Exchange as Enclosure. Trenton, NJ: Africa World Press.
Nestle, Marion. 2002. Food Politics. Berkeley: University of California Press.
Norstad, Aksel, ed. 2007. Africa Can Feed Itself. Oslo: The Development Fund.
Articles from a June 2007
Pimental, David. 1997. ‘‘U.S. could feed 800 million people with grain that livestock eat,’ Cornell ecologist advises animal scientists.’ Cornell University Science News. http://www.news.cornell.edu/releases/aug97/livestock.hrs.html
Stewart, Sinclair and Paul Waldie. 2008. ‘Who is responsible for the global food crisis?’ Globe and Mail, 31 May.

cc. Over the last two years, the People’s Health Movement (PHM) campaign has advanced significantly in Africa. It now has active, funded campaigns in the DR Congo, Congo-Brazzaville, Benin, Burkina Faso, Togo and Cameroon, with Zimbabwe and South Africa also involved (without receiving PHM funding), as well as advanced negotiations to launch the campaign in Senegal and Djibouti. Elsewhere, new PHM circles have been formed in the last three months in Mali, Kenya, Morocco and Uganda, where representatives will be submitting campaign proposals shortly. The countries that are on the verge of completing the assessment are now eligible for small, additional funding to hold national workshops through which to present the results to their respective governments, along with UN agencies, international and national NGOs and the media.

Rosa Chimbindi, pregnant with her first child, recently went Parirenyatwa hospital, one of Zimbabwe's largest referral facilities, located in Harare, the capital, to have her baby. Instead, staff at the maternity wing told her the hospital was closed because of the health worker boycott. Her doctor had recommended that her baby be delivered by Caesarean section because she was HIV positive and had previously suffered a hip injury.

Priscilla Bosibori, now 17, was 14 when an aunt fetched her from her school in Kisii, western Kenya, on the pretext of taking her to an important family function. Once they had left the school grounds, her aunt said her family had found a way of protecting her from HIV. Bosibori arrived home to a welcome of songs and dances by female members of her family before being placed in a room with other girls her age.

For many women, pregnancy is a time of anticipation and celebration, but for those living positively it can be frustrating when their status – and not their pregnancy – takes centre stage. Being pregnant and positive often comes with its own brand of stigma. In a study among HIV-positive women in the United States, released at the international AIDS conference in Mexico in 2008, about half the respondents thought HIV-positive women could have children if they received appropriate care.

The small, dusty village of Mayange lies 20 kilometres from Rwanda’s capital, Kigali. Its health centre has fewer than 40 beds but serves an estimated 35,000 people. In most ways, the Mayange centre is like thousands of other health facilities across the continent which struggle to meet patients’ needs with very few resources and staff. Thanks to an innovative partnership involving the government, non-governmental organizations and private companies, the Mayange centre now uses mobile telephones to provide better treatment.

Caritas is launching a US$4.1 million appeal to help the people of Kenya after warnings that children have already started to die from hunger-related illnesses. Up to 10 million people could be hit by acute food shortages. A combination of drought, crop failures, high food prices and last year's post election violence means shortages are widespread. The crisis is affecting not only vulnerable groups such as women, children and pastoralists, but also households previously thought to have reliable food sources.

The findings that malaria caseload in many parts of African countries is reducing faster than ever before is good news. But attempts by different players to take credit of the reducing numbers of malaria cases seems not go down well with others. Those who manufacture and distribute Insecticide Treated Nets (ITN) that prevent mosquito that cause malaria from transmitting the virus, claim over 60 percent of the success is attributable to the use of these nets.

Buoyed by what is happening with preventing malaria and unnecessary deaths using less costly and simple methods, health experts want similar strategies be applied on other diseases. Recent studies indicate the use cost-effective preventive strategies such as mosquito nets has reduced hospital admission due to malaria by close to 50 percent, cutting down the number of deaths by thousands and medical bills spend on treating the disease.

Last November, North Eastern Province was hit by floods that cut off the region. Two months later, the green scenery has turned tinder dry. Surface temperatures oscillate between 35 and 40 degrees, says the Kenya Meteorological Department. Residents tread on a thin line between life and death as the food shortage bites. Water sources — pans, dams, and boreholes — have turned into murky poodles. Also facing food shortage are neighbouring districts of Tana River and Kyuso. Fafi and Lagdera, that were carved out of Garissa last year, are also in a bad state.

The government estimates that nearly 180,000 people in Togo are HIV-positive as of 2008 – about 3.2 percent of the population. Some 60 percent are women, and almost 13,000 are children under 14. In December 2008, one month after the government made life-saving antiretroviral medication (ARV) free, IRIN met with some people living with HIV in the capital Lomé.

At least 35 people have died in a meningitis epidemic that has hit several districts in western and north-western Uganda over the past two weeks, a health ministry official said. "Cumulatively we have recorded 47 cases of meningitis with 13 dead in Hoima District," Paul Kaggwa, a spokesman for the ministry, said. "Another 150 cases have been reported in Arua, with 18 dead, and 14 in Masindi, with four deaths."

Makueni District Hospital in eastern Kenya has recorded a significant drop in the weight of several of its HIV-positive patients in the past three months, which nutritionists ascribe to severe food shortages across much of the country. "We have a large number of patients with a BMI [body mass index, a measure of nutritional status] below the healthy cut-off of 18.5," Fransiscah Yula, a nutritionist at the hospital, told IRIN/PlusNews.

In Liberia unemployed women who are HIV-positive face three hurdles to job security: a tough post-war economy, gender discrimination and demands at home aggravated by HIV, say social service providers and some HIV-positive women. While up to half of the estimated 100,000 HIV-positive people in Liberia are women, “little is known about how HIV is affecting vulnerable populations [women, youth, rural residents, orphans and children]”, according to a 2008 government report.

There is an increase of food crises and hunger emergencies in Eastern and Southern Africa, caused by a combination of climate change, conflicts and political factors. The complexity of today’s hunger in Africa means there is no simple answer for how to eradicate it. This paper focuses on these two regions and tries to illustrate some of the factors that contribute to food insecurity.