Ghana’s Public Health Milestone

Here’s the sort of progress that rarely makes the news: Ghana, a country of about 30 million best known for being the first African colony to achieve independence, has now earned another distinction–eliminating one of the nastiest infectious diseases in the world. As The Telegraph reports:

Trachoma, the leading infectious cause of blindness in the world, is spread by flies and human touch, and is linked to poverty and lack of access to clean water and sanitation. It starts as a bacterial infection and, if left untreated, causes the eyelashes to scratch the surface of the eye, causing great pain and, potentially, irreversible blindness.

In 2000, about 2.8 million people in Ghana were estimated to be at risk of the disease but the World Health Organization (WHO) has now officially recognised that the country has eliminated it.

The WHO director-general, Dr Tedros Adhanom Ghebreyesus, hailed the country’s achievement: “Although there’s more work to do elsewhere, the validation of elimination in Ghana allows another previously heavily-endemic country to celebrate significant success.”

Ghana eliminated the disease through a partnership between its ministry of health, the WHO, pharmaceutical companies, and charities. Around 3.3 million doses of an antibiotic effective against trachoma were donated by Pfizer, one of the world’s larges pharmaceutical companies; another 6,000 had surgery to treat more advanced stages of the disease. (Amazing what civil society can accomplish when it comes together.)

Thanks to these efforts,Ghana now joins six other countries where trachoma is endemic — Oman, Morocco, Mexico, Cambodia, Laos, and Nepal — that have eliminated the disease.

Nevertheless, trachoma still remains a significant global problem: over 200 million people across 41 countries (mostly in Africa) are at risk of infection. Ghana and several other nations have shown the way. Here is hoping more health agencies, pharma companies, and charities take note.

Fifty Cents to Avoid a Lifetime of Debilitation

Some weeks ago, I read a piece in The Economist that has stayed with me. It was about the efforts of Sierra Leone, among the world’s poorest countries, to combat “neglected tropical diseases” (NTD), a family of 17 diverse communicable diseases that afflict over 1.5 billion in tropical and subtropical areas worldwide.

It featured one victim named Hannah Taylor, who woke up one day with a fever, followed by her legs swelling up to four times their normal size. The physical damage was irreversible, and the subsequent appearance and putrid smell led to her being ostracized by her community. She was a victim of lymphatic filariasis (a.k.a. elephantiasis), a mosquito-borne infection that could have been treated safely with a pill costing no more than fifty cents before it progressed.

But instead, the microscopic worms infested her body, debilitating her. For years she thought she had been a victim of evil witchcraft and was deeply depressed.

Eventually, Taylor put on a brave face and campaigned to raise awareness about the disease, its causes, and why victims shouldn’t be stigmatized. She passed away some weeks prior to the publishing of the article; she was quoted as expressing  happiness that her children would not suffer the way she would, thanks to Sierra Leone’s remarkable progress in fighting the disease.

Progress or not, it is incredible to think that billions of lives are negatively impacted by something as mundane to most of us as a mosquito bite. It is even more incredible that a mere fifty cents – spare change we’d throw in a tip jar without a thought – is all that stands between someone and a debilitating disease. It is utterly senseless that in a world with so much wealth and resources sloshing around that we have not been able to address this vast disparity in health outcomes and quality of life.

 

When Schizophrenia Isn’t a Mental Illness

Culture may play a huge role in how schizophrenia manifests, according to one study published in a leading British psychiatric journal. It interviewed 60 adults diagnosed with schizophrenia – 20 each from the U.S., Ghana, and India – and found one stark difference between the nationalities: while American subjects were likelier to report violent, sadistic, and hateful voices, most of the subjects from Africa and Asian claimed to hear generally positive voices – which not a single American reported. Continue reading

Another Ebola Outbreak Speaks to the Cruel Randomness of Birth

An Ebola outbreak has reported in the Congo, and may be spreading to larger cities where it will become more virulent. The horrific disease, which is sometimes known as the death of a thousand cuts, is endemic to the region; only a few years ago, a similar outbreak, this time in West Africa, claims tens of thousands of lives in across three of some of the world’s poorest countries.

I cannot help but contemplate the sheer randomness of the human condition. By a mere accident of birth, millions of people are at risk of dying in one of the most awful ways imaginable. Hundreds of millions more find themselves born in places rife with disease, natural disasters, poverty, and/or political repression.  Continue reading

Africa’s Great Green Wall

Africa does not come to mind when one thinks of audacious public works projects. But the continent’s growing wealth and political stability, combined with the pressing challenges of climate change and environmental degradation, is driving its leaders to come together and concentrate their efforts into forging bold new solutions.

Among them is the Great Green Wall, an incredible idea to create a wall of vegetation across the width of the Sahara to stave off rapid desertification and improve agricultural output (which most Africans depend on for survival). It would be around 4,000 kilometers in total, making it the largest “living structure” in the world, three times the size of the Great Barrier Reef. Continue reading

An African Nation Takes Charge in Addressing Hunger

254px-zambia_-_location_map_28201129_-_zmb_-_unocha-svgAfrica rarely comes to mind when one thinks of groundbreaking scientific research, much less the obscure nation of Zambia, located in the south of the continent. Yet in addition to being one of the world’s fastest growing economies, it is home to the Zambia Agricultural Research Institute, a gleaming new government agency that is pioneering solutions to world hunger.

Its work includes cultivating a form of sorghum (an important staple grain) that is bitter tasting to pests like birds; improving corn, unanother global staple, to be richer in vitamin A (whose deficiency leads to hundreds of thousands of cases of blindness worldwide); and creating disease resistant cassava, a nutritionally-dense and drought-resistant crop that provides a basic diet for over 500 million people.

Moreover, in order to diversify the food supply to better prevent hunger, Zambia gives its farmers electronic vouchers that allow them to buy whatever farm supplies they want. Imagine how much more progress we’ll see as more and more nations get the resources to educate, train, and empower their citizens. (Especially Africa, with its large youth population.)

Source: The Economist

Lessons from Senegal on Regulating Sex Work

When it comes to public health innovations, Senegal rarely come to mind as a role model. But as the The Economist recently reported, the country is an outlier on the continent (and indeed much of the world) in treating sex work as a public health matter. Continue reading

Africa’s Ambitious New Free Trade Agreement

To most outsiders, Africa is a perpetually chaotic and conflict-ridden place, despite the fact that wars on the continent (both civil and inter-state) are at a historic low (albeit from a high base and with some nasty conflicts still brewing).

To take advantage of these improving political circumstances, and its nascent economic potential, most of Africa is coming together to forge the sort of pact typically seen as the pursuit of wealthier states: a united commercial market known as the African Continental Free Trade Area

From The Washington Post (bolding mine):

On Mar. 21, 44 African heads of state and government officials met in Kigali, Rwanda, to sign the framework to establish this initiative of the African Union.

The AfCFTA will come into effect 30 days after ratification by the parliaments of at least 22 countries. Each country has 120 days after signing the framework to ratify.

This will be one of the world’s largest free-trade areas in terms of the number of countries, covering more than 1.2 billion people and over $4 trillion in combined consumer and business spending if all 55 countries join. 

[…]

It creates a single continental market for goods and services as well as a customs union with free movement of capital and business travelers. The African Union agreed in January 2012 to develop the AfCFTA. It took eight rounds of negotiations, beginning in 2015 and lasting until December 2017, to reach agreement.

The A.U. and its member countries hope the AfCFTA will accelerate continental integration and address the overlapping membership of the continent’s regional economic communities (RECs). Many African countries belong to multiple RECs, which tends to limit the efficiency and effectiveness of these organizations.

One of its central goals is to boost African economies by harmonizing trade liberalization across subregions and at the continental level. As a part of the AfCFTA, countries have committed to remove tariffs on 90 percent of goods. According to the U.N. Economic Commission on Africa, intra-African trade is likely to increase by 52.3 percent under the AfCFTA and will double upon the further removal of non-tariff barriers.

In addition to facilitating existing economic activity, it is hoped that ACFTA will help promote Africa’s underdeveloped but fast growing manufacturing sector, diversifying its economies beyond agriculture and resource extraction.

While it remains to be seen how this ambitious effort will play out, it is definitely a step in the right direction, especially for a region that is the youngest and most potentially dynamic in the world.

Africa’s Greatest Success Story

Few people have ever heard of the island nation of Mauritius, located 1,200 miles off the coast of Africa. Perhaps its sole claim to fame, if any, is that it was the only habitat of the extinct dodo. But as op-ed in the Daily Maverick reveals, this tiny country of just 1.3 million is a regional heavyweight in social, economic, and political development:

Mauritius’ average score in the World Bank’s Ease of Doing Business indicators is 77.54, ranking it 25th worldwide, compared to the sub-Saharan average of 50.43, or the score of its Indian Ocean neighbour Madagascar in 162nd position at 47.67. The next highest sub-Saharan African country, Rwanda, is in 41st slot. Kenya is at 80, South Africa 81st, and Botswana 82nd.

On the Ibrahim Index of African Governance, defined as the provision of the political, social and economic public goods, Mauritius again tops the African rankings, scoring 81.4 in 2017. Seychelles is second with 73.4, with Botswana completing the top three with a score of 72.7.

Mauritius’ GDP per capita is $9,630, well above the sub-Saharan African average ($1,464), that of Madagascar ($401), and South Africa and Botswana ($5,284 and $6,924). Only in this key regard does it rank below Seychelles where, with a population of just 95,000, it’s over $15,000. The average life expectancy of Mauritians in 1960 was 58; now it’s 74, whereas sub-Saharan Africa has gone from 40 to 59 over the same period.

Indeed, Mauritius’ economy has enjoyed average annual growth of 5 percent since its independence from the U.K. in 1968. This is a rare distinction both regionally and globally, and speaks to the country’s stable and effective governance despite its humble and unpromising beginnings. Continue reading

Africa’s Art Deco Capital

Asmara, the capital of Eritrea, has just been designated as a World Heritage Site for its unique collection of Art Deco buildings, which UNESCO calls “an exceptional example of early modernist urbanism at the beginning of the 20th century and its application in an African context”. (And for which the city is sometimes called “Africa’s Miami”.)

Asmara’s architecture is a legacy of Italian rule, which stretched from 1889 until the end of the Second World War. Italy’s determination to be a colonial power, like its stronger European rivals, drove it to pioneer new and radical styles far from the constraints of European sensibilities (indeed, many of these structures were heavily criticized at the time). It became known as a paradise for bold Italian architects, and by the 1930s the capital had the nickname of “Little Rome” because half of its residents were Italian.

Unfortunately, Eritrea’s government is among the most repressive and totalitarian in the world, and there is much concern about its capacity to preserve these structures, to say nothing of the treatment of its citizens.

Info and photos courtesy of the New York Times and UNESCO