Report on Norwegian assistance to Grameen Bank

Date:   December 7 2010

Norad (The Norwegian Agency for Development Cooperation) submitted its report today on Norwegian support to Grameen Bank in Bangladesh in the 1980s and 1990s.

Minister of the Environment and International Development Erik Solheim requested Norad to prepare the report after the Norwegian television series “Brennpunkt” raised the question of where the Norwegian aid money had gone.

Norad’s report shows that Grameen Bank transferred a total of NOK 608.5 million to its sister company Grameen Kalyan in 1996. Norway’s share of this amount is estimated to be approximately NOK 170 million. The Norwegian Embassy in Dhaka reacted immediately when it discovered the transfer in 1997. In the embassy’s view, the transfer was not in accordance with the agreement. The matter was raised with Grameen Bank. Following negotiations, it was agreed in May 1998 that NOK 170 million was to be transferred back from Grameen Kalyan to Grameen Bank.

“According to the report, there is no indication that Norwegian funds have been used for unintended purposes, or that Grameen Bank has engaged in corrupt practices or embezzled funds. The matter was concluded when the agreement concerning reimbursement of the funds was entered into in May 1998 under the government in office at the time,” said Mr Solheim.

The report will be made available in English at http://www.mfa.no<http://www.mfa.no> as soon as possible.

By Press contact: Christian Grotnes Halvorsen, mobile tel.: +47 48 153 748
Minister of Foreign Affairs

AFRICA: RESEARCH ON AGRO FUELS NEEDED.

By Thomas Ochieng

In the pursuit of green and clean energy as an alternative for the conventional source of power, the promotion of agro fuel also known as bio diesel has gained momentum in the recent past. One such agro crop that has been promoted vigorously is the oil seed bush known as jatropha curcas this plant is said to have the potential of turning the marginalized land in Africa into very productive land.
The promoters of this plant often say that this crop that is ideal for the marginalized eras that are often dry, and with low nutrients has not been put to test. study conducted by Berkley university in the united states on the plant jatropha curcas found that the said crop yield vary greatly depending on soil fertility and water, but importantly the research found that any claim of low nutrients, low water, low labor, the non-existence of competition with food production and the ability of the plant to tolerate pest and diseases are not true.

Fuel from agriculture in commercial technology FACT an agro crop information center based in Netherlands goes as far as warning of large-scale plantation of jatropha  pending conclusive research on the plant to prevent what the call bad investment. The institution also stresses the importance of distinction between real promises and dangerous exploitation as concern the jatropha business. In its final report, the institution concludes that to the contrary to the issue of use of marginal and unproductive land,  rainfall of between 1000 to 1500 mm per hectare of water, which cannot be considered
marginal land is required.

It can be rightly stated that many indigenous group, who have lived in the forests for centuries, are worried that their right are being overlooked. They know from experience that governments and corporations can be unsympathetic dismissing indigenous people as underdeveloped and opposing their claims for land rights and special status. This is often because they may present an obstacle to the so-called development projects. This is against principle of prior informed consent that should apply, which is a way of ensuring that forest activities do not take place without their permission.

In their report of 2007 on agro fuel in Africa, under the title Impact on land food and forest in Africa, the Africa Biodiversity Network (ABN) found that arable land was being taken away from communities in rural African areas by private entities under the guise of bio diesel production, only to be converted to other use. This can only be termed as neo colonialism by the multi nationals whom are being lured by a very elaborate campaigns by acquisition firms like the Emergent Asset Management in the United Kingdom whom have set up what is known as African Agricultural land Fund that empowers potential investors to participate in another scramble for Africa under the pretext of utilizing marginalized land in Africa.

It’s worth to note that ounce these so-called investors control these vast lands they may decide to turn the eras into other use like mining, logging or even tourism a case n point is in Kenya where an Italian company is trying to get hold of a land in the coastal area very popular with Italian tourists, under the guise of introducing jatropha plant.

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Second-line drugs often cost up to four times more than first-line drugs

UGANDA: Striving to provide first-, second- and third-line ARVs

Photo: Kate Holt/IRIN

KAMPALA, 1 December 2010 (PlusNews) –  Life-prolonging antiretroviral (ARV) medication is reaching more HIV-positive Ugandans than ever before, but health workers are concerned about how they will deal with the inevitable rise in drug resistance.

An estimated 400 accredited facilities are providing about 218,000 Ugandans with ARVs, and more than 300,000 have enrolled on HIV treatment, but many patients have died and some have simply abandoned treatment.

Although studies show that ARV adherence is generally high, frequent drug stock-outs as a result of funding shortages and supply-chain problems as well as food insecurity mean that patients have experienced interruptions in their treatment regimens, predisposing them to resistance.

“The … drug resistance problem is in evolution and we need to be prepared to handle it,” said Dr Ivan Mambule Kiggundu, study coordinator of the Europe-Africa Research Network for Evaluation of Second-line Therapy (EARNEST) trial which is trying to determine the best option for resource-limited settings at the Infectious Disease Institute (IDI), part of the Mulago Hospital Complex in the capital, Kampala.

Currently, about 3 percent of adults and 4.6 percent of children on ARVs are taking second-line drugs. According to the previous UN World Health Organization (WHO) CD-4 count (which measures immune strength) cut-off of 200, the Ministry of Health has estimated that 379,551 would people require ARVs.

However, Uganda has adopted WHO’s new CD-4 cut-off of 350, so the number of people needing treatment will go up significantly – and because more people will be on ARVs for longer, the number of people developing resistance is also likely to rise.

Second-line treatment

Second-line drugs often cost up to four times more than first-line drugs, but so far most patients who need the medicines have access to them. The AIDS Support Organization (TASO) a Ugandan NGO, one of the biggest providers of ARVs in the country, has 32,990 HIV-positive clients, of which 600 are on second line drugs.

The international NGO, Médecins Sans Frontières, has pointed out that the most affordable second-line regimen recommended by WHO costs more than three times the most affordable of the improved first-line regimens recommended by WHO.

Jackie Nankya*, a patient at TASO, developed resistance about five years after starting ARV therapy. “I was adhering to the drugs so well but suddenly the sickness reoccurred with intensity in spite of the drugs,” she said.

Nankya suffered from lipodistrophy – the uneven distribution of fats on the body – a common sign of drug resistance. She developed a buffalo hump and a large abdomen and lost fat in her legs. Since starting on second-line treatment she is slowly regaining her old shape, but worries about what would happen if she became resistant to the second-line drugs.

This [lack of funding to ensure sufficient, steady ARV supplies] will result in big numbers of patients failing on the simpler and low-cost first-line drugs and needing more expensive and more sophisticated second-line therapy

TASO checks the CD4 count and viral load of its clients every 6 months. “When the CD4 count is stagnant and the viral cells are neither decreasing nor reducing then we know they are resistant to the drugs they are taking, if they are adhering,” said Carol Asiimwe Mutabazi, a laboratory technician at TASO Kanyanya, on the outskirts of the capital, Kampala.

“Clinically we can also tell that the patients are becoming resistant when in spite of taking ART [antiretroviral treatment] they start getting opportunistic infections like tuberculosis and meningitis.”

Third-line treatment

But even organizations as large as TASO do not have the capacity to treat patients who become resistant to second-line drugs. “When a client becomes resistant to the second-line drugs we refer them to the Joint Clinical Research Centre (JCRC),” said Dr Isaiah Kalanzi, TASO’s medical programme officer for the central and south-western regions.

JCRC, Uganda’s oldest treatment centre, offers limited access to third-line ARVs. “We have them at JCRC but we do not give them to everybody; we are only giving them to people participating in our research,” said Peter Mugyenyi, executive director and founder of JCRC.

The Centre is testing the efficacy of the drugs and drawing up a distribution strategy in a resource- limited setting like Uganda. “We have found that these drugs work very well – they are very important because they will be needed in future,” he noted.

Mugyenyi said the need for third-line drugs in Uganda was still small – between 300 and 400 patients nationally – but few of those who could not access the drugs at JCRC would be able to pay the roughly US$3,200 per year for third-line drugs.

Earlier this year, he addressed the US Congress, warning that unless sufficient funding was found for Uganda’s ARV programme, treatment interruptions would be inevitable.

In September 2010, the US government stepped in to bridge gaps in Uganda’s ARV supply, but significant funding is still required, especially in light of WHO’s new treatment guidelines.

“This [lack of funding to ensure sufficient, steady ARV supplies] will result in big numbers of patients failing on the simpler and low-cost first-line drugs, and needing more expensive and more sophisticated second-line therapy,” Mugyenyi said. “It would not take long before an increasing number started requiring the ultra-modern, highly expensive third-line drugs – which virtually do not exist in Africa.”

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source. http://www.irinnews.org

What might mobile phones do for healthcare?

AFRICA: Mobile phones for health

Photo: Digital Opportunity Channel

What might mobile phones do for healthcare?

ACCRA/NAIROBI, 3 December 2010 (PlusNews) – Some 80 health professionals and telecom operators are meeting in the Ghanaian capital Accra to explore ways to use mobile phones for better healthcare delivery.

“What we are trying to do here is to find out what mobile technology applications will help us fix some of Africa’s health problems,” said Fiemu Nwariaku, professor of surgery in Ghana and a moderator at the 2-3 December Mobile Health Africa Summit. The efforts are aimed particularly at improving healthcare for underserved populations.

An estimated 450 million people in Africa use mobile phones for everyday personal and business communications, but the technology is becoming increasingly useful for overburdened health workers struggling to reach large numbers of patients with few resources.

IRIN has compiled a list of ways in which mobile phones can be used to improve the continent’s health:

• Health check-up by text message – In a pilot programme, community health workers in Kenya are using mobile phone text messages to check on people living with HIV as a substitute for home visits, which take more time and cost more, as many health workers use motorcycles to visit patients who can live many kilometres away from each other.

A recent study published in the British medical journal, The Lancet, noted that Kenyan patients who received weekly text message check-ups were 12 percent more likely than a control group to have an undetectable level of HIV virus a year after starting life-prolonging antiretroviral (ARV) treatment.

In the south-central Ghanaian village of Bonsaaso, using mobile phones to contact health workers has lowered the maternal death rate. A pilot project in Cape Town, South Africa, used text messages to improve adherence to tuberculosis regimens.

• Health information – On Valentine’s Day 2008, a Dutch NGO started an eight-week campaign in Uganda’s southwestern district of Mbarara with the slogan, “Don’t guess the answers, learn the truth about HIV”. The campaign led to a 100 percent increase in visits to the voluntary counselling and testing centre run by the NGO’s health partner. This year, the same NGO used a text message quiz to test malaria knowledge in a fishing village in eastern Uganda.

In Ethiopia, people can call a confidential hotline anonymously with HIV-related queries. On a 24-hour toll-free medical hotline in the Republic of Congo, set up by the government, the UN Children’s Fund (UNICEF) and a mobile telephone network operator, health professionals respond to queries about paediatric emergencies.

• Monitoring distribution – Keeping track of medicines and other health supplies is extremely difficult in Africa, where systems – especially in rural areas – are often not fully computerized, but data on how many health centres have been equipped with how many doses of medicines, vaccines and so on can now be sent by mobile phone.

In Nigeria, UNICEF is using text messages to track the distribution of some 63 million mosquito nets.

Civil society activists in several African countries came together in 2009 to run the “Stop Stock-outs” campaign, designed to track stock-outs of essential medicines like those for treating malaria and HIV in government-run health centres. Teams use text messages to report stock-outs of various drugs before presenting their findings to the national authorities.

• Research – The convenience and relatively low cost of mobile phone use has also contributed to medical research. A 2009 South African study found that mobile phones were a feasible method of data collection and recommended further exploration.

The government of Ghana is using mobile phones to collect data to assess whether the poor are benefiting from the country’s National Health Insurance Scheme. In Uganda, personal digital assistants (PDAs) are being used to transmit disease surveillance data, among other things.

• The future – Researchers are looking into new and more efficient ways of harnessing this mobile phone technology to improve the continent’s health.

A project led by the University of London is developing self-test devices that can immediately identify sexually transmitted infections. The kit will include a computer chip that can be plugged into a mobile phone or computer, and software on the phone would then analyse a urine or saliva sample placed on the chip and provide a diagnosis.

As more healthcare providers, governments and donors incorporate mobile phones into their health service delivery packages, the gadgets seem set to become an integral part of life in Africa.

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source. http://www.irinnews.org