Finding a better way for Africa

Finding a better way for Africa, The South African Star

http://www.thestar.co.za/index.php?fSectionId=225&fArticleId=2638362

July 25, 2005

By Franklin Cudjoe

World leaders gathered in Gleneagles, Scotland, to discuss the great issues of the day and had their deliberations cruelly interrupted. However, Make Poverty History (MPH) campaigners had already cashed in on their much-publicised emotional tirade against what they believe perpetuates poverty in Africa: debts, free trade and insufficient aid.

The US government had already announced that it would scrap cotton subsidies it has long given to the US farmers after the WTO ruled these were illegal. This undoubtedly will boost the economies of sub-Saharan cotton producers but paradoxically, MHP campaigners urge poor nations to erect high tariffs against Western imports.Millions more dollars will be committed to fighting diseases on the continent.

But what matters more is what poor countries can do for themselves. In that regard we can learn much from the mistakes of others.In the 1950s and 1960s, governments of many countries in Africa and Latin America erected trade barriers. The plan was to enable the industries of their countries to grow, "protected" from outside competition. What actually happened was the opposite.Although the industries in these "protected" countries grew for a short period, the lack of competition meant that their industries became inefficient and fell behind the rest of the world.

Also, because imports were very expensive or even unavailable, their costs of production rose as they were stuck using old technologies.Soon these "protected" industries were producing goods that few people wanted, exports fell and, in many cases, the industries - usually run by friends of the president - had to be subsidised by the state in order to keep them afloat.

Governments paid for these subsidies by taxing farmers (either directly or by forcing farmers to sell to marketing boards) and by borrowing - one of the reasons why so many African and Latin American countries have such large debts.Some governments, such as Brazil's, printed money to pay off the debt and this led to hyperinflation, reduced confidence in the economy and caused massive disinvestment.

The lesson we should learn from this is that governments should not try to create national champions by "protecting" them from competition or by subsidising them.This can be applied to wealthy countries, that currently "protect" farmers with tariffs and subsidies, and lower-income countries as well, that are egged on by various Western NGOs to protect infant-industries.Brazil is an interesting case. It had one of the most extreme "import substitution" programmes in the 1950s and 1960s, which lead to a ballooning debt during the 1970s followed by hyperinflation and, finally, massive debt rescheduling.After a bout of good economic governance in the 1990s, it has been growing steadily as a result.But there are some signs of a return to the old days. Brazil's government recently announced that it plans to break patents on Aids drugs. It claims that it wants to reduce the cost of providing drugs to 180 000 people with HIV.But if it wanted to do that, would it not be better to negotiate a price differentiation scheme with the manufacturers, rather than forcing the production of drugs locally? This smacks of a return to the bad old protectionist policies of yesteryear.But there is another, more disturbing aspect to the decision to break patents.
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Brazil currently benefits from the billions of dollars pumped into the development of Aids medicines by the research-based pharmaceutical industry.As the incidence of HIV/Aids in wealthy countries gradually declines, so demand for new drugs in those countries will wane. Yet Aids remains a very serious problem in many poorer countries, including Brazil.

What would happen if all poorer countries chose to break the patents on Aids medicines? I'll tell you: there would be few if any new Aids medicines. Research-based drug firms seem to be taking notice of unfavourable market conditions for Aids medicines created by the governments of Brazil and some other countries.

Fewer and fewer drug companies are engaged in Aids research as they have been characterised as killers of babies in Africa and find little attraction in continuing research.Over the past six years the number of HIV/Aids medicines and vaccines in the pipeline has decreased by over 30%. In 1999 there were 125 drugs and vaccines in the R&D pipeline; today there are fewer than 85.This is worrying because resistance to existing Aids medicines is continuously rising and better new medicines will be needed to keep people alive in the future.Instead of pursuing dubious industrial policies by breaking patents, the governments of middle-income countries should be paying a fair price for the medicines they buy - otherwise there will be no more medicines with which to treat Aids patients in the future.

This is of particular concern to the people of Africa, because more than half of the global number of persons infected with HIV/Aids reside on this continent - and most of them do not have access to drugs. In a discussion with Richard Tren of Africa Fighting Malaria, he revealed that the South African government (and people in the Nepad secretariat) are very keen to increase the amount of generic drugs. Yet simply producing something locally does not mean that it will be cheaper or more accessible than importing it. Supporting more white elephants is not what Africans need, especially when the likelihood is that access to medicines will not improve.

Given the removal of several Indian-produced generic Aids medicines from the WHO pre-qualification list, governments should also be extra vigilant about the quality of the generic drugs; setting up lots of local production units may not guarantee good quality or good prices.In the short term, the unfortunate reality is that the situation in Africa will not change much. Distributing drugs to all of those who would benefit from them is likely to be too costly and difficult. A major problem is that in most African countries, the health infrastructure is simply too poorly developed to be able reliably to deliver Aids medications to great numbers of people.For us in Africa, the real nuts to crack are excessive government regulations, poor education, punitive local taxes on drugs and poor health infrastructure both in terms of personnel and resources.It is significant to note also that most HIV/Aids victims in Africa especially cannot afford decent meals, or clean water to help gulp down antiretrovirals.

Franklin Cudjoe is the Director of Imani: the Centre for Humane Education in Ghana. For more information, visit their website, www.imanighana.org

Wedding dresses and fishing nets arethe best use for mosquito bed nets!

Hi Franklin,

Thank you for your news of your BBC debates. I strongly agree with you that DDT is much better than mosquito nets, of course it gives tremendous results. Wedding dresses and fishing nets are the best use for nets!

I wouldn't like to be trapped inside a net in bed with a hungry female mosquito, equipped with infra-red sensory detection. She will always get her fill of blood in the end and wait patiently until her target is asleep. What man can escape a predatory female?

As an historian I did lots of work from primary sources on the history ofmalaria eradication in Southern Italy: 1943-1955 were the key years. It was all completely eradicated with DDT (before the ban, of course) after thousands of years when millions had suffered and whole cities been abandoned in ancient and medieval centuries, time and time again.

Lots of other Mediterranean countries used DDT to eradicate it too, aroundthe same time and the US too. Do you know Gordon Harrison's book Mosquitoes,Malaria and Man, a History of Hostilities since 1880? I myself had a lot of small mosquitoes in my bedrooms in Italy for 17 years because my wife wouldn't let me use insecticides - not even the benign ones still authorised for sale after the ban. We got stung and stung and couldn't sleep at nights.
When she left, I sprayed and in 20 minutes all the mosquitoes disappeared for ever.

Another factor was the flat roof they bred in rain puddles and these needed to be dispersed. I wonder, could they be breeding in the waterin the troughs of corrugated iron African roofs or is that water too shallow?

DDT was banned because it slightly thins the eggs of birds of prey. But the ban probably caused up to 400 million unnecessary prematuredeaths since the 1950s, in the Third World! That's more deaths than Hitler, Stalin, MaoTse Tung, Idi Amin and all the tyrants and wars of the whole 20th century,all put together. So hypocritical too ? the West only banned it after they'd already cleaned up their malaria! India never accepted the ban.

Oh, and another thing Italian public health authorities did in their 1950sand 1960s economic miracle was they de-wormed all their children. Cheap and effective eradication of intestinal parasites and head lice too. I think HIV immune deficiency in Africa is due in large part to multiple parasite infections (malaria and worms in particular). De-worming would be a much cheaper and more effective means of boosting Africans? immune systems thanall the expensive Aids drugs and campaigns that are so fashionable. Also,it gives people more energy when they are free of parasites, so productivityrises and it is a good economic investment in the labour force. Cheaper and more cost-effective than over-educating all the masses.

Regards

Andrew

Should we ban chemotherapy too?

USAID’s anti-pesticide policies must change, or millions will continue to die

Paul Driessen

Would you take medications that could cause anemia, nausea, diarrhea, hair loss – even increased risk of infection and fetal defects?

Most people with terminal cancer would jump at the chance to take such risks. And if an activist “stakeholder” tried to prevent them from undergoing chemotherapy – because of “ethical” concerns about its “dangers” or a preference for “more appropriate” alternatives like surgery, broccoli or hospice care – their response would be fast and furious.

Africa faces a similar situation. Only instead of cancer, the killer is malaria. Instead of chemotherapy drugs, the interventions are insecticides. And in addition to activists, patients must contend with healthcare agencies that often oppose insecticides and promote largely ineffective alternatives.

Malaria infects up to 500,000,000 people a year – more men, women and children than live in the United States, Canada and Mexico combined! It kills 2,000,000 every year – the population of Houston, Texas.

The vast majority live in sub-Saharan Africa, and nearly 90% are children and pregnant women. In 2002, malaria killed 150,000 Ethiopians, 100,000 Ugandans and 34,000 Kenyan children. Victims become so weak they cannot work for weeks on end. Many are left with permanent brain damage – and immune systems so enfeebled that they die of AIDS, typhus, dysentery or tuberculosis.

Malaria costs impoverished Africa $12 billion in lost productivity every year.However, the World Health Organization, UNICEF, U.S. Agency for International Development, wealthy foundations and environmental activists still insist that African nations rely on inadequate bed net, drug and “integrated vector management” programs – and avoid pesticides, especially DDT. If the United States had rates akin to Africa’s, 100,000,000 Americans would get malaria every year and 250,000 children would die. Its hospitals would be overwhelmed, its economy devastated, and citizens would demand immediate action – using every pesticide and other weapon in existence. But the United States and Europe (over)used DDT to eradicate malaria. They then banned the pesticide and now generally oppose its use. Nevertheless, a few African nations still spray DDT in tiny amounts on the walls and eaves of cinderblock or mud-and-thatch houses. For six months, it repels mosquitoes, kills any that land on walls and irritates the rest, so they don’t bite.

No other pesticide, at any price, is this effective, and even mosquitoes resistant to DDT’s killer talents succumb to its repellent properties. Used this way, virtually no DDT gets into the environment. Most important, it’s safe for humans. Hundreds of millions of people – American GIs, Holocaust survivors, and parents and children all over the USA, Europe and Asia – were sprayed with DDT, with no significant ill effects.

Indeed, the worst thing Greenpeace and other activists can say is that “measurable quantities” of DDT and its DDE metabolite are “present” in human fatty tissue, blood and mother’s breast milk. Some researchers, they claim, “think” DDE “could” be inhibiting lactation and “may” therefore be “contributing” to “lactation failure” around the world. In fact, lactation failure results mostly from malnutrition and disease. The problem is minor compared to the effects of chemotherapy – and irrelevant compared to the risk of losing more children to malaria. “African mothers would be overjoyed if DDT in our bodies was their biggest worry,” says Ugandan farmer and businesswoman Fiona Kobusingye. They’d be thrilled if Greenpeace and others would show greater concern for the lives of African mothers and children, by supporting insecticide use.

South Africa’s DDT household spraying program cut malaria rates by 80% in 18 months. The country was then able to treat a much smaller number of seriously ill patients with new artemisinin-based drugs, and slash malaria rates by over 90% in just three years! Mozambique trains a few people in each community, and sends them out to spray every house twice a year, in a successful and inexpensive program. Zambia has a similar program. However, when Uganda announced earlier this year that it was going to use DDT to control malaria, the EU warned that it might ban all agricultural exports from the country, if even a trace of DDT was found on them!

Last year, USAID spent $80 million “on malaria.” But 85 percent of this went to consultants, and 5 percent to promoting the use of insecticide-treated nets. It spent nothing on actually buying nets, drugs or pesticides. Too often, USAID, WHO and UNICEF emphasize ultra precaution about alleged risks from pesticides – at the expense of millions of deaths from diseases that pesticides could prevent. They proclaim insecticide-treated bed nets a success for reducing malaria rates by 20% – but say DDT was a failure because it did not completely eradicate the disease. Worst, until just a year ago, they were providing Africans with anti-malarial drugs that they had known for years fail 50 to 80% of the time.

No wonder malaria rates have risen 10% in the seven years since their Roll Back Malaria campaign promised to cut rates in half by 2010. DDT will never control malaria by itself. However, it is a vital weapon against a disease carried by different parasites and many species of mosquitoes, some of which can breed in hoof prints during the rainy season.

Decisions about which weapons to use, where and when, should be made by health ministers in countries with malaria problems – not by anti-pesticide activists and bureaucrats in air-conditioned, malaria-free offices in Washington, Geneva or Brussels. These health ministers need a precautionary principle that safeguards families from real, immediate, life-threatening risks – instead of condemning them to poverty, disease and premature death, to prevent minor, conjectural risks from pesticides.

Most important, African and other malaria-endemic countries need progress NOW – not 20 or 50 years from now, when (hopefully) a vaccine has finally been developed, sufficient artemisinin drugs are available for every victim, mosquito breeding areas are controlled, and communities have modern homes and hospitals (with electricity, window screens and running water). Access to life-saving pesticides is a basic human right.

We wouldn’t ban chemotherapy because those potent drugs present risks, or prohibit Florida and New York from using insecticides to protect people, horses and birds against West Nile virus. We must stop preventing African nations from using DDT and other insecticides to control diseases that kill millions of their citizens annually.

President Bush and many members of Congress support major funding increases to combat malaria and break Africa’s perpetual cycle of disease, famine and poverty. However, this money will do little to reduce disease if it is spent on more consultants, conferences, reports and bed nets – and only insignificant amounts are directed to pesticide and other programs that actually work. The President and Congress need to ensure that health agencies’ financial practices are open to scrutiny, their misguided policies and priorities are corrected, and they are held accountable for the success or failure of their programs. They need to ensure that insecticides and household spraying with DDT are restored to the world’s arsenal for combating malaria. Otherwise millions will continue to die on the altar of politically correct ideologies.
____________
Paul Driessen is senior policy advisor for the Congress of Racial Equality and Committee For A Constructive Tomorrow (CFACT), and author of Eco-Imperialism: Green power ∙ Black death (www.Eco-Imperialism.com). © 2005 Paul K. Driessen

Let Africa fight its own devils

Let Africa fight its own devils

By Franklin Cudjoe

written in response to "Blair in Africa" (The Times, 8 October 2004)

Sir, in recent weeks, my continent has attracted much media attention in the West thanks to the likes of Tony Blair, Gordon Brown and Bob Geodolf. Their aim is to rally international action for what to them has become “a scar on the conscience” of the world. In that vein, your editorial of October 8, 2004 titled, “Blair in Africa” sought to give support to their cause.

I have some comments regarding your analysis. You state: “The solutions to Africa’s problems have been well rehearsed over the years. Developed nations must grant more aid and write off debt. The US and the EU must cut agricultural subsidies and open their markets. Pharmaceutical companies must make anti-retroviral drugs cheaper and more readily available.”

Your first recommendation, like many in recent times, smacks of a misplaced idea of Western guilt for the poverty of the third world and in particular Africa. Before the Brandt Commission on Africa in the 1970s suggested this lame duck approach, post independent African leaders such as Kwame Nkrumah of Ghana and Julius Nyerere of Tanzania, virtually coerced Western leaders into assuming responsibility for all the ills on the continent. Perhaps for ideological reasons Western leaders went for the bait with billions of dollars ‘invested’ and it has since become big business. Alas, it is an unprofitable one with losses in the form of the politicisation of life on the continent and many failed states. Much of Western aid money went on financing the killing machines of African governments while some was stashed away in Swiss banks. The World Bank itself agrees that over US$200 billion poured into the continent in the last three decades has returned negative results.

The Millennium Development Goals set by the UN will not be achieved, not because I’m a cynic, but because history tells me that no amount of foreign aid has ever solved the ‘bedlam’ in Africa. Ethiopia is in the news today because foreign aid robbed that country off its ability to feed itself and perhaps the rest of Africa. People are so emotive about Ethiopia that they tend to forget that over 60 % of that country is fertile yet only 10 per cent has been cultivated. The reason is that when socialism replaced feudalism in 1975, state land redistribution coerced everyone in to subsistence production with marketing boards doing their worst with price controls. Farmers had no incentive to grow food and famine resulted. Tons of food aid never got to the famished people. Mengistu’s thugs sold the food and purchased arms to kill and maim his own people, yet the aid continued. Somalia was the largest recipient of foreign aid in sub-Saharan Africa until it imploded in 1990, yet it was also the food basket of the region. Zimbabwe has, since independence in 1980, received billions of dollars to finance its land redistribution programme but today more that 60 people die there daily due to hunger, yet before it was the food basket of Southern Africa.

There are many examples.Do you forgive debt and increase aid when over 70 percent of it would be used to finance budget deficits perpetuating a vicious circle of unmanageable debt? This approach has left many African countries with debts greater that 100 percent of their incomes. Who bears the burden of repayments? Not the governing elite, but the poor producers of export crops such as cocoa, coffee, peanuts, palm oil, and in some cases local labor employed in oil and other mineral extracting industries.

You have my full marks for your second solution. The EU and the US must not only cut export subsidies, they should remove all agricultural barriers that prevent African agricultural products from entering their markets. While this is a legitimate demand, you shouldn’t be surprised to learn that there are many more trade barriers between African countries than exist with the US or EU. As the World Trade Organisation’s 2001 statistics show, Africa’s share of intra and inter regional trade flows to Western Europe alone was 51.8 %, while it was a paltry 7.8% within Africa.

On pharmaceuticals and anti-retroviral drugs, I think the desire has always been there to reach as many patients as possible. But there is a need to incentivise innovators in the pharmaceutical world so they are able to maximise output and reduce prices in the long run. One effective way is to recognise their intellectual property rights to the drugs.

Unfortunately, many in the NGO world see this as a means to make profit at the expense of the poor with total disregard for where the investment capital is to come from. Finally you say: “But Africa's only truly continental challenge is its Aids pandemic, and yet another layer of foreign governmental oversight is unlikely to speed the delivery of drugs to patients.” Try including the devastating effects of other diseases like Malaria and TB and then ask yourself what the underlying cause really is. I can but attribute all that to poverty even though some leaders on the continent have failed to acknowledge this.

Africa’s real devils are the continent’s own creatures who are busily harvesting the proceeds of the toiling entrepreneurial masses and burdening them with obstacles that defy economic rationality.

Most of these obstacles range from complex, obnoxious and unpredictable laws, the absence of secured property rights, the rule of law and free markets. A functionally corrupt leadership and civil service is enough to entrench bureaucracy and fatten government at the expense of the citizens. In my mind, significant institutional reforms are needed. It is the only way innovation and entrepreneurship can be encouraged since they empower ordinary people economically.

As economies grow and develop, people will be able to afford better technologies, clean water, superior energy sources, better healthcare, and insurance. This is what gives a fair chance to everyone to succeed, not aid.

Franklin Cudjoe,

franklin@imanighana.org

Director

Imani: The Centre for Humane Education, Ghana.

P.O.Box AT 411Achimota-AccraGhana