Aid ThoughtsMasimba Tafirenyika describes how dire the food security situation in Malawi has become:
Once again Malawi finds itself in a tight spot. A food crisis set off by erratic rains, rising food prices and economic hardships is slowly unfolding. For the first time in several years, the country's ability to feed its citizens is at risk. Sadly and unexpectedly, Malawi has lost its hard-earned status as an agricultural success story — it used to produce enough maize for its people to eat and still provide a surplus to neighbours. Many are now wondering what went wrong and whether there could be lessons for other African countries.
More than 1.63 million people, or 11 per cent of the population, are facing severe food shortages, according to the World Food Programme, a UN relief agency. Malawi needed $30 million to the end of 2012 to cover the shortfall.
As Tafirenyika hints, this stands in stark contrast to reporting on Malawi over the past few years, where it was heralded as a shining example of how to tackle food security. Five years, ago Celia Dugger wrote in the NYT how the country's president, Bingu wa Mutharika, despite the protests of many, "ignored the experts" and subsequently dealt with the country's hunger problems by drastically scaling up its fertiliser subsidy programme. Malawi subsequently enjoyed a spate of bumper harvests and many were quick to tout the large-scale subsidisation as being both a success and worth of replication in other countries. Most notable was the support of Jeffrey Sachs, who's incessant belief that the fertiliser subsidisation was a policy holy grail led him to write an oddly-appreciative obituary for Mutharika, who died at the end of a thuggish, repressive and disastrous second term in office.
Meanwhile, hunger returns to Malawi, but we have not yet established a convincing narrative. Many economists (including a few on this blog) have pointed out, time and time again, that the fertiliser subsidy programme was fraught with pitfalls, both political and practical. While the recent crisis is probably too complex to fully substantiate these concerns, now would be an appropriate time for the fertiliser advocates to turn their attention to the food situation in Malawi, and begin to ask why. Otherwise, we risk touting a policy that might actually have been a complete failure, or at the very least lacked the sort of robustness that anti-hunger policies desperately need.
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Thursday, January 17, 2013
Fwd: How policies end: not with a bang, but a whimper
Somewhat less neglected tropical diseases
What progress has been made, a year on from Big Pharma's promise to help eliminate neglected tropical diseases?
A year ago, the leaders of some of the world's biggest pharmaceutical companies arrived for a meeting in London, at Bill Gates's behest, and announced they would all do their bit towards fighting neglected tropical diseases (NTDs).
On Wednesday, two reports give some idea of what has been achieved since, and it looks like a positive story. The companies have delivered 1.2bn treatments for diseases where treatments exist, which is an increase of 150m treatments on what they were delivering before. More to the point, perhaps, is that they delivered on every order made by a developing country. According to a report released by organisations including pharma, Gates and NGOs who were involved in the London meeting, 29 countries began receiving albendazole or mebendazole to treat or prevent soil-transmitted helminthiasis, increasing treatments provided with those drugs to 238m last year from 46m in 2011.
A scorecard has now been developed by the partners to track progress on the diseases towards goals for 2020, which include elimination of guinea worm – Jimmy Carter's crusade and one neglected disease that is likely to disappear. Others among the 10 neglected tropical diseases targeted by the London declaration will be much harder to shift.
The second report is from the World Health Organisation, which charts progress over not one year but the past two and makes clear that increased effort was under way before the London meeting. In 2010 alone, it says, 711 million people received single-dose preventive medicines for at least one of four diseases – lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), schistosomiasis and soil-transmitted helminthiasis.
But director general Margaret Chan hails the "new momentum":
With this new phase in the control of these diseases, we are moving ahead towards achieving universal health coverage with essential interventions. The challenge now is to strengthen capacity of national disease programmes in endemic countries and streamline supply chains to get the drugs to the people who need them, when they need them.
Money, of course, will be an issue. The UK put in a substantial sum last year, increasing its investment from $24.7m (£39.5m) in 2011 to $42.5m last year, while the US steadily increased its funding to $89m in 2012. But it won't be enough. Preliminary analyses, says the report, suggest an annual funding gap of approximately $300m until 2020 for the implementation of programmes, which would prevent the scale-up of critical initiatives and endanger hundreds of millions of people.
Caroline Harper, chair of the UK Coalition against Neglected Tropical Diseases and chief executive of member NGO Sightsavers, hailed the collaborative working from all the partners involved and the launch of the scorecard but warned that more was needed than drug donation programmes:
This shift in the way we are working as a community gives me hope for the future. However, it is essential that this continues, for example, with partners across different sectors including health, education, water and sanitation working together. Only by pooling expertise, resources and research can NTD elimination become a reality.
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