Improving Maternal Health in Africa

December 2014 www.un.org/africarenewal

Improving maternal health in Africa

Sustainable Development Goals promise for Africa

SPECIAL COVERAGE ON EBOLA: How people’s lives are changing Contents December 2014 | Vol. 28 No. 3 10 Special Feature EBOLA Ebola: A wake-up call for leaders

12 Ebola: Fighting a deadly virus 14 Liberians say ‘no’ to hugs and handshakes to keep Ebola at bay Ebola disruption could spark new food crisis 15 Secretary-General Ban Ki-moon attends High-Level 16 Ebola Infographic: Facts & Figures meeting on Ebola at the World Bank. UNMEER 17 Ebola threatens economic gains in affected countries 18 Interview: David Nabarro, UN Special Envoy on Ebola

Also in this issue Editor-in-Chief 5 Improving maternal health in Africa Masimba Tafirenyika

6 Financing Africa’s massive projects Managing Editor 8 West Africa: New railway network to boost inter-regional trade Zipporah Musau 22 AGOA: The US–Africa trade dilemma Staff Writers 24 African leaders laud Climate Summit Kingsley Ighobor 26 Sustainable Development Goals: New targets hold promise for Africa Franck Kuwonu

Research & Media Liaison Departments Pavithra Rao

3 Watch Design & Production 29 Wired Paddy D. Ilos, II 30 Appointments Administration 31 Books Bo Li

Distribution Cover photo: A baby and her mother in Niger. UNICEF/Nyani Quarmyne Atar Markman

Intern Africa Renewal is published in English and French organizations. Articles from this magazine may be Ying Zhao-Hiemann by the Strategic Communications Division of the freely reprinted, with attribution to the author and United Nations Department of Public Information. to “United Nations Africa Renewal,” and a copy Its contents do not necessarily reflect the views of of the reproduced article would be appreciated. Africa Renewal is published by the United the United Nations or the publication’s supporting Copyrighted photos may not be reproduced. Nations, New York, on recycled paper.

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2 AfricaRenewal December 2014 Africa Watch

begin to reach its potential, states the World Bank. Even as it explores new oil sources, the World Bank also advises the Congolese government to invest heavily in infrastructure in order to boost the growth of non-extractive sectors. Overall, the bank believes the country could witness impressive economic growth in the years to come. Stepping up efforts to end violence against women in Africa A gas station in Brazzaville, Republic of Congo. Alamy/MJ Photography By Ying M. Zhao-Hiemann

per day, which is shipped to China, the he International Day for the Encouraging European Union and the United States, TElimination of Violence against according to the Global Trade Atlas, an Women observed on 25 November marks signs for the online organization that provides informa- an important occasion to reflect on the tion on trade statistics. current state of sexual violence in Africa. Republic of Over-reliance on a single commodity Being one of the most severe forms of has its drawbacks, economists warn. gender-based violence, sexual violence, Congo’s economy Already, there is a decline in Congo’s which includes rape, gang rape and sexual maturing oil fields, which will lead to a slavery, is widespread in times of conflict, By Pavithra Rao decrease in production for the short term. post-conflict and displacement. However, the government is moving fast “From Nigeria to Somalia to Mali, espite a recent of history of ethnic to supplement this decrease by issuing we are seeing a heightening of targeted D and political tensions, including a new onshore and offshore exploitation violence against women, girls and their civil war over its highly-prized natural licences. The U.S. Energy Information communities as extremists take control of resources, the Republic of Congo’s Administration states that 10 onshore and territory,” Ms. Phumzile Mlambo-Ngcuka, economy is set for impressive growth, offshore oil blocks are being awarded this Executive Director of UN Women, according to economists. An economic year. The recent drop in the international recently told the UN Security Council. forecast of 7.6% growth over the next price of oil to below $80 per barrel by last In 2014 alone, several such incidents three years will be propelled by abundant November is expected to impact negatively made international headlines. In April, natural resources, including oil, natural on Congo’s oil. 200 school girls from Chibok in northeast gas and diamonds. Congo’s growth is In addition to the volatility in the oil Nigeria were kidnapped by Boko Haram, expected to help dent poverty in the industry, the World Bank says obstacles to a militant Islamist group, and have not country, which the World Bank says Congo’s growth include uneven distribu- been released to date. In November, more is about 70%. tion of resources between infrastructure than 200 women and girls in Tabit, North The Republic of Congo is one of and the social sectors, poor absorptive Darfur in Sudan, were reported to have sub-Saharan Africa’s top five major oil capacity in investment spending and been mass raped, causing a new wave of producers, according to the International a weak expenditure chain. Congo has international concern. The UN Security Monetary Fund. Oil is the country’s also been criticised for earmarking $60 Council called for a thorough investigation dominant income-generating source. In million for the 2015 All Africa Games in into the incident. fact, in 2011, oil accounted for nearly 80% Brazzaville, its capital city, despite its high “It is critical that in the process of of the country’s total revenue. It currently poverty. The country must address these verifying the facts that the safety of produces around 250,000 barrels of crude problems, first and foremost, before it can survivors is of paramount concern,” said

AfricaRenewal December 2014 3 Quotables UN Photo/JC McIlwaine Photo/JC UN

Women in North Darfur, Sudan, march for “16 Days of Activism Against Gender-Based Violence”. Countries like Liberia UN Photo/Albert González Farran need long-term investment to build up our health Zainab Hawa Bangura, the UN Special on Human Rights Day (1 December). The systems to prevent [Ebola] Representative on Sexual Violence women were joined by staff members of outbreaks of this scale from in Conflict. the African Union, UNAMID and govern- ever happening again. We During her earlier mission to South ment officials. owe it to the thousands of Sudan, Ms. Bangura was appalled by the Meanwhile, in East Africa, UN citizens and health workers extent of sexual violence in the country, Women and the Kenya Red Cross are who have so far lost their where it is frequently used as a political jointly implementing a livelihood project lives to be prepared. tool and weapon of war. to help displaced Somali women in the Ellen Johnson Sirleaf, President of the “What I witnessed in Bentiu is the Dadaab Refugee Camp in Kenya, helping Republic of Liberia worst I have seen in my almost 30 years them to earn a living through agriculture of dealing with this issue,” said Ms. and fend for themselves. In addition, UN Bangura, commenting on an incident Women, the UN agency on gender issues, This is the beginning of during which hundreds of civilians were is also supporting a healing project run the liberation of women in massacred in April 2014 and many more by the Somalia Youth Development Kenya. It has started now were raped. Network to train community leaders to and it will not stop. It must The UN has a series of initiatives to conduct healing forums for former rape be respected. We should not help address incidents of sexual violence victims in the Benadir Region. be humiliated. My dress in conflict, post-conflict and displace- UN Women partners with govern- is my choice. ment situations, by increasing women’s ments, UN agencies, civil society organi- Diana Rose Okello, a key protester in the #MyDressMyChoice protests, held political participation and economic zations and other institutions to advocate to challenge an attack on a woman independence, as well as offering them for ending violence, increase awareness of wearing a miniskirt who was stripped victim counselling services. the causes and consequences of violence naked in downtown Nairobi To address the importance of and build capacity of partners to gender perspectives in peace processes, prevent and respond to violence. [Ebola] underscores how UNAMID organized a Global Open The gender agency also important it is to continue to Day in El Fasher on 20 November 2014. supports expanding access push forward until we stamp The forum brought together more than to quality social services to out this disease entirely in 140 women representatives from the survivors covering safety, that region. Until we do, five Darfur states to discuss the role of shelter, health, justice and there are threats of addi- women in peace, urging all parties “to other essential services. tional outbreaks, and given take special measures to protect women Policy guidance helps to step the nature of international and girls from gender-based violence.” up investments in prevention— travel, everybody has some The women later marched to mark “16 the most cost-effective, measure of risk.” Days of Activism against Gender-Based long-term means Barack Obama, President Violence”, an annual campaign that starts to stop violence of the United States on the International Day to End Violence against of America Against Women (25 November) and ends women. UN Photo/Ky Chung

4 AfricaRenewal December 2014 Africa accounting for more than half of both numbers. Improving maternal Poverty fuels maternal mortality, experts say, which explains why death rates are higher in poor countries than health in Africa in rich ones. “For mothers as well as for their infants, the risk of dying during or Despite progress in some countries, many women shortly after birth is 20% to 50% higher and babies still die during childbirth in Africa for the poorest…than for the richest quintile,” states a report by UNICEF, By Kingsley Ighobor the UN Children’s Fund. To put this into perspective, in Chad, just 1% of the poorest pregnant women get antenatal care, compared with 48% of wealthy women. Adolescent girls (ages 15–19) are at high risk of childbirth- and pregnancy-related complications, says WHO. “The probability that a 15-year-old woman will eventually die from a maternal cause is 1 in 3,700 in developed countries versus 1 in 160 in developing countries.” For many women in many countries, no nurses and doctors are available to assist in childbirth.

A woman’s pain Ellen David, 17, of Monrovia, Liberia, did not have money for maternity bills last October when she went into labour late in the night; dfsgfdgdfgdfgfers. Asfsdfsdfsdfsfsd the clinics are not open at night, and the curfew imposed in the wake of the outbreak of the Ebola virus meant she could not have Trainee midwives demonstrating the childbirth process using a birth simulator in Kampala, Uganda. gone to any hospital even if she’d had the

UNFPA/Evelyn Kiapi money. As a result, unskilled neighbours helped her to deliver in a bedroom very n 27 February 2013, four-year-old drew attention and outrage from many early in the morning. But her joy turned Charlotte Mmowa sued Limpopo South Africans. The Limpopo personnel to sorrow when the child died hours later. OProvince health authorities in claimed they had done their best with avail- By noon family members were by its South Africa for 1.1 million rand (about able resources — hinting that they might grave, offering silent prayers as Ms. David $100,000) for mishandling her own birth, have saved the woman’s life if it hadn’t been sobbed uncontrollably. during which her mother died. Months necessary to drive a long distance for blood. “It was a harrowing experience,” said later the court agreed that the nurses and Deddeh Howard, one of Ms. David’s neigh- doctors who treated her mother had been Poverty fuelling deaths bours, in an interview with Africa Renewal. negligent, and awarded Charlotte 547,000 Africa accounts for a big chunk of global “I can only imagine how many babies rand ($50,000) compensation. maternal deaths. In 2013 about 289,000 and mothers we lose in this manner.” Ms. In 2009, 24-year-old Matlou Mmowa women worldwide died during pregnancy Howard herself lost her baby just after delivered Charlotte without also deliv- or childbirth, and of those deaths 62% giving birth in 2011. “It’s an awful pain. You ering the placenta, which is abnormal. The occurred in sub-Saharan Africa, states the look to cuddle your bundle of joy and it dies. placenta connects a foetus to the uterine World Health Organization (WHO), the You want the ground to swallow you up.” wall and allows a baby in utero to feed off UN Population Fund (UNFPA), the World Ms. Howard is the corporate social respon- its mother. Ms. Mmowa bled profusely as Bank, and the UN Population Division in sibility manager for Chevron Corporation doctors unsuccessfully tried to manually their 2014 report, “Trends in Maternal in Liberia, which is assisting Hope for remove her placenta. The Limpopo court Mortality: 1990 to 2013.” The report adds Women, a local health nongovernmental heard that health personnel ordered blood that in 2013, the maternal mortality ratio organization, to provide antenatal care at 4 p.m. and that by 9 p.m., when she died, in developing countries was 230 women for adolescent girls. the blood had not arrived. She was badly per 100,000 births, versus 16 women per The medical director of Hope for treated, claimed Charlotte’s custodian. 100,000 in developed countries. Globally, Women, Dr. Wilhelmina Jallah, says that The bungling of Ms. Mmowa’s child- 3 million newborns die each year and birth, and the novelty of the court case, there are 2.6 million stillbirths, with see page 28

AfricaRenewal December 2014 5 utility, is investing its own revenue and the money it is borrowing from state-owned banks. Economists warn that using private sector finance to pay for the dam could slow Ethiopia’s economic growth in the future. But the government counters that this will be offset by selling electricity to countries in East Africa, a region with improving economic growth. Ethiopia’s recipe for financing the dam from bonds and taxes is being touted as a model for other African countries. This East African country uses a comput- erised system to track and collect taxes, making evasion difficult. The government regularly carries out awareness campaigns to explain taxation and publi- cize what collected taxes are funding such as the dam.

Dismantling tax havens Ethiopia’s financing approach, including An artist’s impression of the Grand Ethiopian Renaissance Dam. www.grandmillenniumdam.net taxes, is just one of the emerging ways of funding projects in Africa. Other countries on the continent are working towards similar initiatives. Africa currently collects Financing Africa’s about 27% of its GDP in taxes, which is insufficient to fund infrastructure such as roads, bridges, schools and hospitals. massive projects At the Ninth African Development Forum in Marrakesh, Morocco, last October, Prime Minister José Maria Innovative bankrolling gains popularity and Pereira Neve of Cape Verde explained that raises high hopes among key countries Africa could receive more tax revenues with “good governance and transparency By Kingsley Ighobor and Busani Bafana in the management of public finances.” Many of the 700 delegates at the confer- t is an audacious $4.8 billion project home contributed the first $350 million, ence, which was organized by the UN undertaken by one of the world’s poorest with government workers contrib- Economic Commission for Africa (ECA), Icountries. At the construction site in uting amounts equivalent to a month including some African heads of state, the Benishangul region of Ethiopia near of their salaries. private sector and civil society repre- the Sudanese border, some 8,500 workers Semegnew Bekele, an Ethiopian sentatives, discussed innovative ways of are labouring tirelessly every day to build construction engineer working on the dam, financing Africa’s projects. They urged the gigantic Grand Ethiopian Renaissance told The Guardian, a British newspaper: African governments to laser-focus on tax Dam. When completed in 2017, the dam will “Ordinary people are building an extraor- havens where some multinational compa- generate 6,000 megawatts of electricity for dinary project.” Development experts now nies keep their money. domestic consumption and export. showcase the dam as proof of an inno- Tax havens, which are places where On the surface, the 558 ft tall dam — vative approach to project financing. taxes are markedly low, are a part of the Africa’s biggest hydropower project — belies “Approximately $450 million has been broader problem of illicit financial flows Ethiopia’s financial muscle. The GDP per raised from Ethiopians to help build the (IFFs) from Africa, an issue that has lately capita in Ethiopia is only $475. The late dam and I think the target is probably a drawn scrutiny. In 2013, for instance, Prime Minister Meles Zenawi, who laid billion dollars,” says Zemedeneh Negatu, ActionAid, an international non-govern- the foundation stone in 2011, said the managing partner at Ernst & Young ment organization focusing on poverty, dam would be built without begging for Ethiopia, a financial consulting firm. launched a global campaign to stop money from donors. Since then, construc- Ethiopians, private companies and Barclays, a British bank, from promoting tion has progressed steadily using money even other countries such as Djibouti are tax havens in Africa. By “helping your from local taxes, donations and govern- buying bonds. In addition, the Ethiopian clients set up operations in tax havens like ment bonds. Ethiopians abroad and at Electric Power Corporation, a state-owned Mauritius, you are part of a system that

6 AfricaRenewal December 2014 is draining vital public funds out of the even well known in Africa, according to of economic growth. Even then, only very continent each year,” ActionAid warned the ECA. But in the second quarter of few countries, including South Africa, have the bank. Barclays denied it encourages 2013 alone, 164 firms secured $124 billion pension systems that are broad-based, business set-ups in tax havens. private equity capital, according to Preqin, relatively transparent and protect benefi- a firm that tracks private equity trends. ciary rights. Another problem is that many Magnets for investors The African Development Bank (AfDB) pension funds lack credibility due to poor Africa loses between $50 billion and $148 states that between 2010 and 2011, invest- services to beneficiaries and mismanage- billion annually to IFFs, according to a 2013 ment deals in Africa increased from $890 ment of funds, according to 27four, a South ECA report titled: The State of Governance million to $3 billion. In 2012, institutional African firm that consults on managing in Africa: The Dimension of Illicit Financial investors injected $1.14 billion in Africa- retirement funds. Consequently, not every Flows as a Governance Challenge. Tracking focused private equity funds, according African country can rely on pension and stopping “illicit financial flows is not to African Private Equity and Venture funds for projects. just a moral imperative, it is a good input Capital Association, an organization that for transformative policies,” said Carlos promotes private investments in Africa. Growing investments at home Lopes, ECA’s executive secretary, in an For example, Ethos Private Equity, a South Despite Africa’s socioeconomic chal- interview with Africa Renewal held at the African firm, alone received $900 million lenges, Mr. Lopes remains optimistic. “I conference. IFFs include under-invoicing, from equity funds. am also a realist,” he says, identifying over-pricing, double duties, disguised The AfDB has also jumped on the three megatrends in Africa’s favour. profits and the use of tax havens. private equity bandwagon, launching a “The first is the demographic one. It is In tones that were at times urgent and pan-African facility to support the develop- true the rest of the world is aging and angry, some speakers at the Marrakesh ment of women fund managers. Geraldine Africa is getting younger. The second conference maintained that while Africa Fraser-Moleketi, the bank’s special envoy is the hard commodities in Africa once could still accept aid and encourage foreign on gender, told Africa Renewal that the you take out oil and gas. The third is direct investments, these should not be idea is about looking at “innovative policies Africa’s reservoir of productivity through the main sources of finance. Africa’s vast because current models are not inclusive.” unused arable land.” natural resources such as gold, platinum, Africa’s approximately one billion popula- Cristina Duarte, Cape Verde’s diamonds, chromite, copper, coal, cobalt, tion and a combined consumer spending finance and planning minister, who has iron ore and uranium — 12% of the power that will rise to over $1.3 trillion announced her candidacy for the AfDB’s world’s oil reserves and arable land and by 2020, according to McKinsey, a global presidency, says Africa must keep trying forests — will continue to be magnets for management consulting firm, makes to grow investment at home, adding: “How investors. The rate of return on invest- the continent a tantalizing prospect for can we convince others to invest in our ment in Africa today, even adjusting for private equity funders. continent and in our development if we real and perceived risks, is higher than Pension funds pool money from are not doing the same to the full extent in any other developing region, according workers to be paid upon retirement and of our ability?” Still, the current project to an ECA report. are particularly useful for long-term financing picture in Africa is mixed: investments. During tough financial Ethiopia’s fast-moving dam construc- Private equity firms forage times, pension funds can be handy tion is a success story compared with a Mr. Lopes is optimistic about Africa’s to augment infrastructure expendi- trans-West African highway that is yet private sector investment prospects. ture, financial experts believe. David to be completed 40 years after it was “Africa might have finally found a way to Ashiagbor, a consultant with the AfDB’s conceived. At the Marrakesh Development whet the appetite of private equity inves- “Making Finance Work for Africa” project, Forum, however, the palpable feeling tors,” he says, adding: “The reality is that says Africa’s pension funds currently hold was that Africa is entering a new dawn Africa cannot rely on development aid for $380 billion in assets, thanks to a decade of innovative financing. its transformation agenda, so its appetite is moving towards private investment and domestic resource mobilization.” The Grand Ethiopian Renaissance Dam The message sounds good except that, again, tax loopholes are spanners in the Africa’s biggest hydropower project works. In response, Mr. Lopes is arguing for an African common market to harmo- nize disparate regulatory systems and discourage companies from exploiting both the loopholes and the tax havens. Private equity funding, which is when rich individuals or institutions inject US4.8 85,000 6,000 capital into a company and acquire equity Billion Workers Megawatts ownership, can be lifelines for companies the cost of the dam building the dam power to be generated gasping for cash. Yet, ten years ago, it wasn’t

AfricaRenewal December 2014 7 West Africa: New railway network aims to boost inter-regional trade Rail to link Benin, Burkina Faso, Côte d’Ivoire, Ghana, Niger, Nigeria and Togo By Franck Kuwonu

n the dual carriageway linking the main airport to downtown ONiamey, the capital of Niger, workers are busy digging trenches in the middle of the island separating the lanes, and laying tracks where rows of lampposts once stood. They are racing against the clock to build a thousand-kilometre stretch of a regional network that will connect Niamey to the West African seaport of Cotonou, Benin. The project is expected to be completed by the end of 2015. “We’ve waited so long for the train to arrive,” quipped Nigerien president Mohamadou Issoufou as he ushered his counterparts from Benin and Togo into a brand-new carriage on a muggy day in April 2014. The symbolic ride lasted for only a few minutes. “History is in the making,” said President Issoufou. Building a railroad network along the Workers lay rails at a train station outside Niamey, Niger. Ado Youssouf West African coast from Abidjan in Côte d’Ivoire to Lomé in Togo has been talked that were slowing down traffic and being The projected regional railroad network about for years. The network is expected used to solicit bribes have been removed. is expected to speed up transit times for to boost trade among Benin, Burkina Yet even in those improved conditions, freight and reduce the prices of consumer Faso, Côte d’Ivoire, Niger and Togo. After a private car could take up to 18 hours goods for landlocked Sahelian countries several delays, the project is now firmly to travel the 1,050-km trip from Niamey such as Burkina Faso and Niger because back on track following the decision by to Cotonou. For freight transport, travel most imported goods will be shipped by the exclusively francophone Conseil de times are even longer; drivers could spend train. Those countries are also expecting l’Entente (Council of Accord), the oldest up to three or four days on the road. the regional railroad network to boost West African subregional cooperation A 2011 study of infrastructure their exports of natural resources. forum, to start construction. Niger and within the Economic Community of Benin started working on their stretch West African States (ECOWAS) region Network to speed up transit time of the project in April, to be followed by found that road freight across the West Niger’s mineral resources contribute a Burkina Faso and Togo shortly thereafter. African region moves at an average very small amount to its gross domestic of 9.6 km per hour, almost half the product (GDP), although they repre- Surface transport slow average velocity in southern Africa. sent more than three-quarters of its Landlocked Niger depends on its neigh- The study, which was done by the World total exports. According to Oxfam bours’ seaports and road infrastructure to Bank’s Africa Infrastructure Country International, a UK-based charity, Niger’s move its exports and imports. Much of its Diagnostic (AICD), a project that uranium exports, which constituted 71% international trade is conducted through examines physical infrastructure in of the country’s total exports in 2010, Cotonou and Lomé seaports. Africa, also found surface transport to be contributed a paltry 5.8% to its GDP. Until recently, road transit across the more expensive than in the rest of Africa Over the next decade, however, the region has been unreliable. The situation, and other developing countries. It costs government hopes to quadruple the however, is improving gradually as inter- US$0.08 per kilometre to move one tonne revenue from uranium. Authorities recog- national trade corridors are being reha- of freight, twice the average cost in the nize that reducing production costs is key bilitated and many police checkpoints rest of the developing world. to maximising profits and tax advantages.

8 AfricaRenewal December 2014 This will entail shifting to moving uranium Issoufou has vowed to ride the train to Bolloré Africa Logistics (BAL), the ore to the Cotonou seaport by rail wagons, the events commemorating Nigerien inde- French company that has been awarded the rather than trucking it over the 2,000 km pendence on 18 December. Niger-Benin contract, currently operates from the Northern Agadez region. public service concessions in Côte d’Ivoire A 2013 study by Conseil de l’Entente Exploring innovative financing and Burkina Faso through a subsidiary, projects mineral exports for the entire The new tracks being laid from Niamey the Société Internationale de Transport region will rise from 109,200 tonnes per will connect to an existing sub-network in Africain par Rail. Rail to link Benin, Burkina Faso, Côte d’Ivoire, Ghana, Niger, Nigeria and Togo year over the 2012–2020 period to 3.4 neighbouring Benin. That segment is part of Once the coastal rail line is completed, million tonnes per year over the 2020– a bigger West African rail track project that the whole network will be 3,000 km with 2030 period. Since shipping goods to and will loop back to Abidjan with the addition of 1,200 km of new track, in addition to the receiving them from Niger and Nigeria a coastal rail line running through Cotonou existing 1,800, which are to be rehabilitated. accounts for 90% of the Cotonou seaport’s (Benin), Badagry (Nigeria), Lomé (Togo) Other countries in the region are looking activities, Benin stands to gain from and Accra (Ghana). at similar BOT arrangements. Leaders improved transportation infrastructure. Experts estimate that the Niger-Benin from Benin, Côte d’Ivoire, Ghana, Nigeria, Not everybody in Niamey is convinced section will cost $1.6 billion, a sum that and Togo recently called on both BAL and that building the transport network should has long deterred investors. Governments Pan-African Minerals, a UK-based mining be a priority. Representatives company, to finance the coastal from civil society organiza- rail line linking Côte d’Ivoire tions went on the airwaves in We’ve waited for so long for the to Nigeria. The projected May 2014 to voice their oppo- train to arrive. History is in cost for this rail project is sition to the project, arguing about $58.9 billion. that Niger should spend its the making. Since 2009, ECOWAS has resources on guaranteeing been pushing for interconnec- food security and lifting its people out have now started exploring innovative tion of the rail networks that exist in 11 of its of poverty. The country is ranked last on financing alternatives. Because of the 15 member states. But unlike in Southern the latest UN Development Programme economic potential of these projects and Africa, where intra-regional rail networks Human Development Index. The govern- Africa’s expected growth over the coming are well developed and integrated, in West ment, however, has the support of the years, regional authorities are eager to let Africa the rail systems are mostly frag- coalition of opposition parties. private investors take control of the “stra- mented and operate on three different rail “We are convinced that a rail network tegic infrastructure” for as long as neces- gauges (widths). Most francophone coun- is very important for a landlocked country sary to recoup their initial investments tries’ rails are 1,000 mm wide, but Ghanaian like ours. But rushing it over the first and make profits. They are inviting the and Nigerian rails are 1,067 mm wide, while 140 km…is very surprising,” said Seini private sector to invest under build, operate Guinea and Liberia use the standard 1,435 Oumarou, the leader of the coalition. and transfer (BOT) arrangements. Under mm width. The coastal rail line project Niger’s general elections are sched- such an arrangement, private compa- carries hope for the entire region, in part uled to be held in early 2016. Mr. Oumarou nies build and initially operate the infra- because its completion would demon- suspects authorities of being influenced structure, then hand over operations and strate that once-insurmountable technical by “political expediency,” as President ownership to the government. challenges can be overcome.

the Proposed railroad in West Africa

Cost of network to link Benin, Burkina Faso, Côte d’Ivoire, Ghana, Niger, Nigeria and Togo

$1.6 billion $0 $58.9 billion New tracks Existing tracks Proposed tracks 6 Ghana 1 Côte d’Ivoire Benin 3,000 5 Burkina Faso Kilometres Nigeria Total length of tracks Togo 3 4 2 Niger 1. Ouagadougou 2. Abidjan 3. Lome 4. Cotonou 5. Parakou 6. Niamey

AfricaRenewal December 2014 9 The outbreak of Ebola, one of the most feared diseases in recent times, in Liberia, Guinea and Sierra Leone caught the world completely unprepared. The pandemic has killed thousands of people, with implications far beyond the borders of the affected countries.

EBOLA

Girls in Voinjama, Liberia, look at a poster that displays information on Ebola. UNICEF/Liberia/Jallanzo Ebola: A wake-up call for leaders Disease exposes the weaknesses of neglected healthcare systems By Masimba Tafirenyika

he recent outbreak of the Ebola As fate would have it, the epicenter of they now struggle to provide basic health virus epidemic in Guinea, Liberia the virus is in countries that are among care to citizens. Tand Sierra Leone has exposed the the world’s poorest, although in 2013 Sierra underbelly of many of Africa’s healthcare Leone and Liberia ranked second and A wake-up call systems. They are often poorly funded, sixth among the top 10 countries with the Although the years of conflicts in West severely neglected and in some cases virtu- highest economic growth rates in the world, Africa are still being felt, this does not ally nonexistent. The disease’s virulence according to The Brookings Institution, a solely explain the devastation brought by has overwhelmed health systems that even US think tank. As reported by The New the Ebola virus. Graça Machel, the widow before Ebola lacked basic equipment and York Times, “The disintegration of the of former South African President Nelson facilities, medical staff and supporting health care systems in the affected coun- Mandela, said the Ebola outbreak should infrastructure. tries is already having a profound impact be a wake-up call for African leaders. Ebola has shaken and awakened deci- on the populations’ health beyond Ebola, “Ebola has exposed the extreme weak- sion-makers in a way that malaria, tuber- as clinics close or become overwhelmed or nesses of our institutions as governments, culosis and other epidemic diseases that nonfunctional.” To exacerbate the situation, countries which are affected were found claim millions of lives in Africa each year these health systems, including the general totally unprepared,” she told African have failed to do, with the possible excep- infrastructure, were wrecked by internal business leaders in November 2014 at a tion of HIV/AIDS. conflicts and civil wars to the point where meeting in South Africa.

10 AfricaRenewal December 2014 The prognosis for the affected coun- developed by the Africa Health, Human & an international emergency. Indeed, it was tries, which now include Mali, is even more Social Development Information Services not until August that it declared Ebola an dire. In an editorial in The New England (Afri-Dev.Info), a research coalition, showed emergency, and by that time the disease Journal of Medicine, Dr. Jeremy J. Farrar that by 2010, the top five countries who had was already ravaging the affected areas. of the Wellcome Trust, a charity that funds met the target were Rwanda (23.3%), Malawi “Hindsight is always better,” said Dr. research in health, and Dr. Peter Piot of (18.5%), Zambia (16%), Burkina Faso (15.7) Margaret Chan, the head of WHO. “All the the London School of Hygiene and Tropical and Togo (15.4%). agencies I talked to — including the govern- Medicine, who helped discover the Ebola In 2013, Africa had an estimated deficit ments — all of us underestimated this virus in 1976, write: “West Africa will of 1.8 million health workers. Perhaps not unprecedented, unusual outbreak.” see much more suffering and many more surprising is the state of the health systems To be fair, WHO has suffered from deaths during childbirth and from malaria, in the affected countries. According to severe funding cuts in recent years. Its tuberculosis, HIV/AIDS, enteric and respir- Afri-Dev.Info, in 2014, with a population two-year budget for 2014-2015 is about atory illnesses, diabetes, cancer, cardiovas- of 4.2 million, Liberia had only 51 doctors, $4 billion, having been cut by $1 billion cular disease, and mental health during and 269 pharmacists, 978 nurses and midwives, in 2011, according to reports. This has after the Ebola epidemic.” They warn of “a while Sierra Leone, with 6 million people, crippled its effectiveness in handling global very real danger of a complete breakdown had 136 doctors, 114 pharmacists and 1,017 health emergencies. The New York Times in civic society, as desperate communities nurses and midwives. reported that WHO’s “outbreak and emer- understandably lose faith in the established gency response units have been slashed, systems,” adding that “without a more Slow global response veterans who led previous fights against effective, all-out effort, Ebola could become Regrettably, Ebola struck at countries Ebola and other diseases have left, and endemic in West Africa, which could, in whose health systems were already on their scores of positions have been eliminated turn, become a reservoir for the virus’s knees. This has not stopped analysts from — precisely the kind of people and efforts spread to other parts of Africa and beyond.” acknowledging that the response to the that might have helped blunt the outbreak Back in 2001, African health minis- outbreak was indeed weak. Politico, a US in West Africa before it ballooned into ters signed on to the Abuja Declaration publication, wrote: “The response to the the worst Ebola epidemic ever recorded.” pledging to allocate at least 15% of their Ebola outbreak in West Africa will never Notwithstanding, global health experts say national budgets towards improving be remembered as an example of good that even if WHO had had better funding, it their health systems. According to the leadership. Not by the governments of the is neither an emergency-response network World Health Organization (WHO), a countries involved, not by other nations, nor a direct provider of health care services, decade after the declaration was signed, and not by the international health organi- but a technical agency that provides 27 countries had increased the propor- zation that says it’s there to deal with advice and support. tion of their total government expendi- public health emergencies.” The affected countries too have to tures allocated to health, but only Rwanda True, the world was found wanting in shoulder some of the criticism. They waited and South Africa had achieved the 15% its response to the Ebola epidemic, but it until it was too late to request international target. More depressingly, seven countries has been the World Health Organization, aid. When governments are reluctant to had actually reduced their health budget the main UN health arm, that has borne ask for help, Sophie Delaunay, the executive over the same period, and 12 had not the brunt of the criticism. It was faulted made any progress. A different scorecard for taking too long to declare the outbreak see page 20

Country Country Population Density of *Absolute Density of *Absolute Density of *Absolute Status (Millions)1 Doctors2 No of Nurses & No of Pharmacists2 No of Doctors Midwives2 Nurses & Pharmacists Midwives

Ebola Affected Country Liberia 4,190,000 0.1 51 2.7 978 0.8 269

Comparison Country Croatia 4,307,000 28.4 12,490 58.0 25,485 7.0 2,972

Ebola Affected Country Sierra Leone 5,979,000 0.2 136 1.7 1,017 0.2 114

Comparison Country Denmark 5,598,000 34.2 18,797 160.9 88,335 NA NA

Ebola Affected Country Guinea 11,451,000 NA 940 NA 4,408 NA 190

Comparison Country Cuba 11,271,000 67.2 76,506 90.5 103,014 NA NA

1For roughly equivalent period of data 2(Per 10,000) 2006-2013; *(For latest year absolute figures are available - To provide context only); Figures from UNFPA, WHS 2014, and Global Health Observatory; Table by Afri-Dev.Info 2014

AfricaRenewal December 2014 11 Ebola: Fighting a deadly virus Weak national healthcare systems and few medical staff struggle to cope By Sulaiman Momodu

EBOLA

A volunteer disinfecting the hospital of Tahouay in Conakry, Guinea. Afreecom/Idrissa Soumaré

he sight of an Ebola patient is in Senegal and South Africa, the wealthy According to the WHO, the mortality frightening. Sharon Washington, travelled to Europe or the US where hospi- rate of the current Ebola outbreak is 55% Tan employee of Liberia’s foreign tals are even better equipped. and by early November 2014, more than ministry, got married in January this Because of severe shortages of doctors, 5,000 had died of the virus. Ebola is spread year at a colourful ceremony in the capital nurses, other health workers, medical through human-to-human transmission Monrovia. This writer attended the facilities and equipment, many people in via direct contact (through broken skin or wedding. Later on, Mrs. Washington nursed Africa do not trust their countries’ health mucous membranes) with the blood, secre- her sister who was ill with what started systems. For example, with a populations, organs or other bodily fluids of infected as a mild fever until she got weak and tion of about 4.2 million, Liberia has one people, and with surfaces and materials (e.g. started having severe muscle pain, chronic doctor per 100,000 people, while Sierra bedding, clothing) contaminated with these headache and sore throat. Thereafter, it was Leone, with six million people, has two fluids. The incubation period for the virus vomiting, diarrhoea, rash, impaired kidney doctors per 100,000, according to the World from infection to the onset of symptoms is 2 and liver function, internal and external Health Organization (WHO). to 21 days. Humans are not infectious until bleeding from all openings of the body — the they develop symptoms. Patients can die eyes, mouth, and ears and finally, death. It Africa’s healthcare systems within days or after a few weeks of symptoms. was Ebola. Next, Mrs. Washington tested To put this into perspective, consider In the three countries severely hit by positive for the virus and, tragically, within that Cuba, with a population of about 11 Ebola, masked health workers in biohazard a few days, she too passed away. million, has about 600 doctors per every suits can be seen everywhere. Ambulance Long before the current Ebola virus 100,000 people. The dire constraints sirens blare through the main streets, outbreak, affluent citizens of the three most of Africa’s healthcare systems coupled carrying critically ill Ebola patients; news- affected countries of Sierra Leone, Liberia with crowded urban centres, explain papers carry banner headlines on Ebola and Guinea often sought medical atten- why the Ebola virus disease, which daily; radio and television stations and social tion abroad. While some visited premier first broke out in Guinea’s Guéckédou media focus on the disease. Billboards carry medical facilities in Africa such as the Korle area in March 2014, quickly spread to messages such as “Ebola is real,” “Don’t eat Bu Teaching Hospital in Ghana and others Liberia and Sierra Leone. bush meat,” “Don’t touch the sick,” “Don’t

12 AfricaRenewal December 2014 touch the dead.” Nobody trusts anybody. No Lack of basic information about the greater international aid, including US$1 more handshakes, hugs or kisses — even on virus and prevention methods contributed billion to limit its spread. While WHO esti- the cheek. People are now getting accustomed to its spread. From the outset, Guineans mates that the outbreak could potentially to the ritual of hand washing in chlorine- doubted that the virus existed and even infect more than 20,000 people, the US treated water. Most offices use thermome- attacked Médecins Sans Frontières (MSF) Centers for Disease Control and Prevention ters to check workers’ and customers’ body workers, accusing the humanitarian health warned of a nightmare scenario that could temperatures for fever. And fever these days aid organization of bringing a strange result in up to 1.4 million infections by — any fever — is considered Ebola-related. disease to their country. In September, January 2015. “This is an epidemic that is Guineans killed eight journalists and aid not just a threat to regional security, it’s Why it spread so fast workers in a village school near Nzérékoré, a potential threat to global security,” said “The health systems in our countries are south-eastern Guinea, and dumped their US President Barack Obama. very weak,” admitted Tolbert G. Nyenswah, bodies in a septic tank. Liberia’s Assistant Minister for Preventive In Liberia, angry youths looted an How Nigeria tamed the virus Services, in an interview with Africa Ebola centre in August in Monrovia’s West Nevertheless, there have been some victo- Renewal. Mr. Nyenswah chairs the National Point, carting away items including blood- ries in the Ebola battle. Nigeria and Senegal Ebola Incident Management System, estab- stained mattresses. With the virus breaking have contained the virus. The Washington lished by the government to tackle the in Kailahun, in eastern Sierra Leone that Post, a US newspaper, referred to Nigeria’s disease. Across the border in Sierra Leone, is also an opposition stronghold, Sierra efforts as “an example of hope.” things are the same. Leoneans initially accused the ruling party How did Nigeria do it? Once Patrick Ebola exposed the inadequacies of of attempting to decimate the opposition. Sawyer, a visiting Liberian-American the region’s health systems. Medical Also, fear of stigmatization dissuades many diplomat, was confirmed as having the services in Sierra Leone and Liberia lack from going to hospitals and they are also Ebola virus in Lagos, Nigeria’s city of 17 good laboratory facilities and cannot afraid they might contract the virus there. million people, the diagnosing doctor kept detect some medical conditions in their him in the hospital despite his protests early stages. Often times, diagnosis is and that of his government. Officials done when it is too late for treatment, say tracked the 281 persons with whom he medical authorities. “This dreadful virus 4.2mn population might have had contact. has overtasked our public health facilities Liberia has one doctor per The diagnosing doctor, Ameyo and capabilities,” said Liberian President Adadevoh, later died of the disease herself. Ellen Johnson Sirleaf. Good Governance 100,000 people Airport staff was unprepared and the Initiative, an NGO headed by former government had not set up any hospital British Prime Minister Tony Blair, isolation unit, so he was able to infect reported in November that 12 persons were While previous outbreaks in the several people, including health workers dying from the disease every day in the Democratic Republic of the Congo and in the hospital where he was taken, some affected countries. Uganda were in rural areas, the current of whom had to restrain him to keep him Sierra Leone and Liberia fought outbreak in West Africa found its way into there. Even when the virus found its way brutal civil wars, which ended in 2002 populated urban communities. Traditional to the oil hub of Port Harcourt in the and 2003 respectively, while Guinea has practices such as burial rituals and caring southeast, authorities were able to quickly struggled with security issues, including for the sick at home contributed to its spread. contain it, an example WHO said others military coups. The wars and insecuri- should be able to follow. ties decimated social infrastructure in Stemming the outbreak Health authorities in Nigeria saturated these countries. Sierra Leonean Minister For their part, the three most stricken coun- the media with information on Ebola. of Health Abubakarr Fofana acknowl- tries are making frantic efforts to contain The country employed a ‘whole commu- edges that the region’s health systems need the virus. They have declared states of nity approach,’ in which everyone, from total rehabilitation. emergency, quarantined towns and villages military personnel to church leaders — who Acute shortage of personal protec- and imposed curfews. “Anything and every- had received detailed briefing from health tive equipment and little or no incen- thing is being done to halt the spread of the officials — educated grassroots Nigerians tives for frontline health workers did not virus,” says Liberia’s Information Minister on the virus. Nigerians also actively used help matters initially. Dozens of health Lewis Brown. Sierra Leone’s President social media to disseminate Ebola-related workers died after contracting the virus Ernest Bai Koroma adds, “These are extra- messages. Another key strategy was that while treating patients. Some infected ordinary times, and extraordinary times authorities and citizens celebrated the foreign doctors and other humanitarian require extraordinary measures.” doctors, nurses and others who gave their workers were flown back to their coun- International response has also been lives to the struggle tries for better treatment. Government gaining strength. The UN established an As the Ebola virus continues to spark took a few missteps such as quarantining Ebola Emergency Response Mission based fears globally, the world is hoping for a the densely populated West Point neigh- Accra, Ghana, in late September – the first vaccine and for aggressive, concerted bourhood in Monrovia, a move protested such for any disease by the global body. efforts to contain the virus’ spread, as well by angry residents. WHO director Margaret Chan appealed for as improved health systems in Africa.

AfricaRenewal December 2014 13 Yambuku, the Sudan ebolavirus spread across Liberians say ‘no’ to big hugs and four towns – Nzara and Maridi, which saw the most cases, and Tembura and Juba. handshakes to keep Ebola at bay A 1978 report by the World Health Organisation (WHO) states that the 1976 Zaire ebolavirus, in which 318 people were infected and 280 died, began at the Yakubu Mission Hospital after a patient was treated for what was then thought to be malaria. Eleven out of the 17 hospital staff died in that outbreak. Though the Ebola virus strains in the DRC and Sudan are the most common, there are three others: Reston virus (which is not infectious to humans), Taï Forest virus and Bundibugyo virus. The Zaire strain, which has up to 90% fatality rate, is the one currently ravaging Guinea, Liberia and Sierra Leone, where more than 6,000 people have died, as of December 2014. In November, there was another unrelated Ebola outbreak in the DRC, where a pregnant EBOLA woman was infected after eating bush meat. About 67 cases and 49 deaths were reported Liberia’s President Ellen Johnson Sirleaf, right, and U.S. Ambassador to the United Nations Samantha in the DRC as of November 2014. The death Power give each other the ‘Ebola handshake’ at a news conference in Monrovia. AP/Abbas Dulleh toll in the DRC from all prior outbreaks combined stands at more than 1,590. By Franck Kuwonu and Lisa White* hands and avoiding physical contact with bodily fluids from the sick or dead bodies. t the entrances to private and public Traditional family care practices and SARS: Lessons Abuildings in Monrovia, Liberia’s burial rituals that involve close contact with capital, a new custom has emerged since an infected body have contributed to the from another the outbreak of the Ebola virus: visitors rapid spread of the disease. Customarily, wash their hands upon entering and Liberians wash, clean and dress the remains deadly virus exiting. Tap buckets conveniently placed in of their loved ones before interment. hallways dispense a mixture of water and People have also been warned against By Bo Li chlorine or bleach from which people eating game meat, what Liberians call wash their hands. bush meat. In rural areas, bush meat is an he first case of the Severe Acute Gone are some of Liberians’ endearing important source of protein and income for TRespiratory Syndrome was reported in social rituals such as a kiss on the cheek, hunters. Communities are being compelled mid-December 2002 in Foshan, Guangdong friendly hugs or handshakes, or warm to change their diets. Experts believe fruit Province. At the time, the World Health embraces between parents and children. bats are the carriers of the virus. Organization described it as the first severe Since the Ebola outbreak, authorities Ebola has changed the way people relate transmissible disease of the 21st century have been advising the public to be more to each other at home and at work. and its origin, symptoms, effects and treat- hygienic, including frequent washing of *Lisa White works for the UN Mission in Liberia. ment were hardly understood. Within a short period, SARS spread rapidly to densely populated areas in mainland China, Hong Kong, Hanoi in Vietnam, Singapore Congo (DRC), by Dr. Peter Piot, a Belgian and Toronto, Canada. Various strains microbiologist, who currently heads the Initially, there was a perception that London School of Hygiene and Tropical China was unprepared to cope with a of Ebola virus Medicine, and a team of infectious disease serious public health threat such as SARS. experts. The outbreak occurred near the Ebola The virus was being spread from person to By Yemisi Akinbobola River, earning the virus its name. person, primarily from respiratory droplets A second outbreak, called Sudan ebola- produced when an infected person coughs he first case of Ebola was reported in virus, occurred in Sudan between June and or sneezes. As a result, schools, shops, TAugust 1976 in the Yambuku District of November 1976. While the spread of the earlier restaurants and other public places Zaire, now the Democratic Republic of the virus was contained within a 70km radius of were closed.

14 AfricaRenewal December 2014 China’s handling of the SARS outbreak holds lessons for the Ebola epidemic in Africa. After some initial problems in handling the disease, China’s health ministry later made fighting SARS a priority. The government instituted a centralized emergency response system led by the Beijing municipal government. The unified system significantly improved efficiency of data collection and communication among hospitals. Provincial governments were requested to ensure accuracy of information reported and timely imple- mentation of detection, isolation, contact tracing and surveillance measures. Some hospitals were designated exclusive centres for treating SARS patients. Other hospitals had isolated areas for suspected patients. Once a case was detected, quarantine and contact tracing were immediately instituted. EBOLA Hospitals were directed not to turn away any SARS patients. Top Chinese scien- Women harvesting rice in Carysburg, Liberia. Panos/Aubrey Wade tists, epidemiologists and clinicians were recruited to study and treat the disease and to design educational materials for the general public. Ebola disruption could The public had unrestricted access to SARS-related information, which helped reduce panic. SARS was categorized as a spark fresh food crisis reportable disease, meaning that all provinces were obligated to report new infec- Food prices skyrocket as farmers abandon farms tions and deaths with “no delay, cover-up or missing cases.” Health officials released By Franck Kuwonu timely and accurate information during televised press conferences. The govern- s Guinea, Liberia and Sierra Leone areas have been abandoned,” IFAD ment, medical experts and the media battle the deadly Ebola virus President Kanayo F. Nwanze told Africa joined forces to educate the public on the Aoutbreak and the world mobilizes Renewal. In Guinea, similar disrup- symptoms of SARS, its preventive methods to contain it, high food prices have been tions in population movements have had and reporting channels. Eventually, the reported as farmers abandon their fields in “devastating effects on food production battle against SARS was won. the affected countries. and exports”. In the Fouta Jalon region The International Fund for Agriculture of Guinea, for example, Mr. Nwanze Development (IFAD), a UN body that pointed out that potato exports to Senegal finances agriculture in poor countries, has dropped to 22 tonnes from 250 tonnes SARS was warned that this could lead to a food crisis if the previous year. categorized as adequate measures are not taken quickly to As a result of these disruptions, a reportable safeguard agricultural production. including restrictions of movements in As early as September 2014, the Liberian food production areas, wholesale prices disease, meaning government reported that large parts of on distribution markets have plummeted that all provinces the rice crop could not be harvested in the while retail prices have skyrocketed on local were obligated central, northern and western parts of the markets. “In August, the wholesale price of country because of shortages of labour. a kilogramme of potatoes fell from 3,500 to to report new Yet, local communities were not allowing 200 Guinean francs,” Mr. Nwanze said. infections and farm workers to be hired from outside In Liberia, wholesale food prices started deaths with no the country for fear they would bring falling in mid-September in major markets the Ebola virus. in the capital Monrovia, according to the delay, cover-up or “In Sierra Leone, we have information missing cases. that up to 40% of farms in the hardest-hit see page 21

AfricaRenewal December 2014 15 Ebola: facts & Figures Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a death rate of up to 90%. The illness affects humans and nonhuman primates (monkeys, gorillas, and chimpanzees). Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of the Congo, and the other in a remote area of Sudan. The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence.

2,164 17,145* Mali 1,327 8 | 6 is the number of reported 1 confirmed, probable and Guinea suspected cases of the Ebola 20 | 8 virus disease.

7,312 7,635 66 | 49 Other Countries 1,583 These countries have been 3,146 Sierra Leone declared Ebola-free Liberia Congo Deaths Cases Nigeria 6,070 Senegal Deaths 35.4% * Data as of 3 December 2014 including data from the United States

symptoms How It Spreads Fever, weakness, muscle pain, headache, and sore throat; followed by vomiting, diarrhoea, and bleeding Direct physical contact with body fluids of an infected person (including dead bodies) o - most infectious: blood, 30 C 100.4OF faeces, vomit

How to Prevent Ebola is Not Airborne Isolate yourself and get medical care Unlike influenza or tuberculosis, Who? Ebola does not spread through If you have been in an affected country the air + have had contact with a sick person + People can you began to have symptoms Survive Ebola

Wash your hands with soap and water Although Ebola is a severe, frequently often fatal illness, getting medical care early can Handrub with alcohol-based hand sanitizer increase the chance of survival

Sources: World Health Organization (WHO), The Economist

16 AfricaRenewal December 2014 EBOLA

Vendors struggle with plummeting sales and rising cost of transporting goods to the market in West Point in Monrovia, Liberia, after the Ebola outbreak and quarantine took effect in the country. UNDP/ Morgana Wingard Ebola threatens economic gains in affected countries Foreign workers return home, citing contagion fears By Kingsley Ighobor

he economic impact of the Ebola is contained by early 2015, cases stay around Currently, there are food shortages even as virus outbreak in the most affected 20,000 and economic activity gradually the local currency, the leone, is depreciating T countries — Guinea, Liberia and increases; the second scenario is “High at a fast pace. Sierra Leone — is still unravelling. Figures Ebola” — when the disease is contained In Liberia, the price for a bag of rice, are being collected and it is still unclear more slowly, cases reach up to 200,000 the staple food, increased from $28 to $35 when the deadly virus will be contained. people and the outbreak worsens signifi- since the epidemic began. The price of fish Even the most optimistic projections cantly into 2015. The bank observes that also increased following the government’s paint an uncertain economic future for in the “High Ebola” scenario, West Africa’s warning against eating “bush meat”, a local those countries. gross domestic product (GDP) could suffer a favourite. Sanitary products such as plastic Even before the Ebola outbreak, $32 billion loss by 2015; in the “Low Ebola” buckets and chlorine are now more expen- these three West African countries were scenario, GDP loss for the region could be sive than before the Ebola outbreak. among the world’s poorest. The 2014 about $4 billion. Foreign investors are withdrawing UN Development Programme’s Human In a “Low Ebola,” Guinea’s GDP would in droves from worst-hit countries. Development Index, which ranks countries contract to 2.4% from 4.5%; Liberia to 2.5% ArcelorMittal, the world’s leading steel- based on income, life expectancy, educa- from 5.9%; and Sierra Leone to 8% from maker, recently moved its expatriate staff tion and quality of life, placed Sierra Leone 11.3%. Clearly, the wheels are coming off out of Liberia. London Mining, a British 183 out of 187 countries, Guinea at 179 and these economies. “The Sierra Leonean company, also removed staff from Sierra Liberia at 175. The fear is that Ebola could economy has been deflated by 30% because Leone. Without iron ore, Sierra Leone’s eat away at the slim improvements that new of Ebola,” Joseph Sesay, the country’s agri- growth output, which was 20% in 2013, will investments have produced. culture minister, told the BBC. fall to 5.5%, according to the International A World Bank study on the economic A UNDP report, “The Economic and Monetary Fund (IMF), stressing how impact of the Ebola epidemic in 2014 iden- Social Impact of Ebola Virus Disease in critical the iron ore sector is to the country’s tified two possible scenarios. The first Sierra Leone”, warns that Ebola could wipe scenario is “Low Ebola” — when the disease out post-war economic gains in the country. see page 20

AfricaRenewal December 2014 17 Interview EBOLA: This catastrophe must never be allowed to happen again — David Nabarro

ollowing the Ebola virus outbreak, the United Nations set up its first-ever public health mission — the UN Mission for Ebola Emergency F Response (UNMEER) — to deal with the pandemic. In this interview with Newton Kanhema for Africa Renewal, David Nabarro, the UN Secretary-General’s Special Envoy on Ebola, discusses the UN’s efforts to bring the virus under control.

we expected: as the response intensifies we begin to see improvements in some areas.

How far do you think we are from seeing the end of this pandemic? I can see a light at the end of the tunnel, but it’s quite a long way away. I’m not sure what lies between now and the end of the tunnel. The difficulty with an outbreak like this is that it is unpredictable and can take a sudden turn for the worse at any time. There can be new chains of transmission and we might find that fatalities have shot up more than two or three weeks ago. I’m really wary about making predictions, either how long it’s going to take or how bad it will be before we get it under control. If I put a date EBOLA on it, then I will almost certainly end up being wrong. David Nabarro, Special Envoy of the UN Secretary-General on Ebola. UN Photo/Eskinder Debebe Africa Renewal: Can you tell us the the beginning of January 2015. There is still Is the current virus strain in West status of the UN response to the Ebola a long way to go in terms of people coming Africa more virulent than the strain we outbreak? under treatment, but the burials are safer have seen in Central Africa? David Nabarro: The outbreak is a and more dignified and in some parts of the There are no differences in the spread completely unprecedented situation. We region the outbreak curve is beginning to pattern. What really matters here is that have had outbreaks of Ebola over the last 40 bend. But I want to stress that we are still everybody should know that if people come years, but we’ve never had one on this scale. a long way from the outbreak being under under treatment early, then there’s a good That’s why the global community decided to control and ending. chance that they’re going to survive. mount an extraordinary response. The UN is supporting the efforts of governments, We have seen more than 5,000 fatalities About $1 billion is needed to control the non-governmental partners and other inter- in the three most-affected countries of spread of the disease. How far have we national donors. We are bringing together Liberia, Sierra Leone and Guinea. Is the gone towards that target? all the different parts of the UN under situation stabilizing? In September 2014 the UN appealed for UNMEER. We anticipate that 70% of people Well, the situation is varied across the nearly $1 billion. As of now, we have received infected with Ebola will be under treatment affected countries. In some counties in nearly $800 million. However, because by the end of November and that at least Liberia, there are reports that the accel- the disease has spread further since the 70% of all burials will be safe and dignified. eration rate is slowing down. In other areas, appeal, we have revised it upward to $1.5 We also anticipate that the disease particularly some of the urban communities billion so as to attend to the 70% of the cases spread would begin to diminish in the speed and particularly in parts of Sierra Leone, it’s under treatment and 70% safe burials up to it was accelerating and that the outbreak still expanding at a rapid rate. We don’t March 2015. There may be a need for more curve would start bending downwards by have the full data. It is uneven but it’s what resources after the end of March.

18 AfricaRenewal December 2014 There have been complaints that concerned about this outbreak and are Do you think this outbreak could have some countries are giving less than doing their share. been avoided? what is expected of them. How would My role is to focus on where we are you characterize the international We also hear some pledges have not now. I’m sure that at some point there response so far? been met. Is this true? will be a need to do a historical analysis – Well, in general, governments, the Most of the countries that pledged have what we call in medicine a “post-mortem.” wider public, and businesses have been actually remitted or committed their funds That is not for me to do; it is not my area incredibly generous. What has happened extremely quickly. I know of no country of expertise. is that sometimes they’ve gone back to or organization that pledged and has not national treasuries and asked them to made the funds available. If there are any When SARS hit Asia, you were playing re-examine the amounts they were putting issues, they may be the normal administra- the same role as now. Can you tell us up and to perhaps come up with further tive bottlenecks that sometimes occur with what is different this time round? contributions. One country has had four this kind of assistance. This outbreak is in a part of the world tranches of assistance. where health systems are not the strongest. Several other countries have provided In that case, the $800 million pledged It’s also a virus with high death rates. It further bursts of assistance, hence I am not has been delivered? requires very close contact tracing. We keen to criticise any country. We’ve also Not all the money is in bank accounts, have seen that countries that are able seen incredible generosity from founda- but there’s a term called “commitment,” to act fast can get it under control, espe- tions. For example, the Paul G. Allen Family which has legal value because it means that cially when they are prepared: Nigeria Foundation put in $100 million, the Bill & the money will come, and we can afford, and Senegal are examples, Mali is also Melinda Gates Foundation gave $50 million, therefore, to spend against that money. It is reacting quickly. We’ve also seen that in and the Children’s Investment Fund only a pledge that must be received before certain counties and districts in the Foundation gave $20 million. Individual being spent. The $800 million reflects affected countries where the response has members of the public are putting commitments. It’s been a very extraordi- been robust and intense, the virus’ accel- money into charity appeals. Business nary response. eration has been reduced. So you need a people from all over the world have also high degree of organization and discipline. been generous. What is the UN doing to avoid delays, This means preparedness. if there are any, in terms of the money What is your assessment of contribu- coming in? Going forward, what have we learnt? tions by African countries? What I have been doing, for example, on Three words: preparedness, vigilance and I’ve talked a lot with African leaders, the trust fund that the Secretary-General solidarity. Being ready, being alert and with the African Union, ECOWAS has set up and I am responsible for, is to working together, because diseases don’t [Economic Community of West African establish a system so that we have a seven- respect borders. We must remember what States], the East African Community, day cycle. When the money comes in, we get this disease has done and put up defences and also with African business people proposals of how that money will be spent so that this kind of suffering and misery and civil society. Africans are extremely within those seven days. doesn’t happen again.

Fighting Ebola

is needed to control the spread of the Ebola disease by March 2015. The United Nations $1.5 billion made an initial appeal for $1 billion in September 2014 and later revised it to $1.5 billion.

The worst-hit countries that have cases of Ebola (rate of deaths as a percentage of the number of cases)

Liberia Sierra Leone Guinea 70% 54%

• the percentage of people the percentage of the infected with Ebola that the UN amount received. This equals aims to put under treatment. to $800 million in commit- • The percentage of safer and ments as of November 2014. 41.2% 21.6% 61.3% dignified burials by March 2015 7,635 cases 7,312 cases 2,164 cases Data as of 3 December 2014

AfricaRenewal December 2014 19 Ebola threatens economic gains highly anticipated World Bank-funded the country’s tourism minister. And in from page 17 road project linking Liberia and Guinea Senegal, with fewer tourists, its GDP could was suspended and the contractor, China contract by 1%, notes the World Bank. Henan International Cooperation Group, Economists may be ringing the alarm economy. Fearing for staff safety, a number pulled out its workers. bells, but many development experts say of international non-governmental organi- In addition, with border closures and there’s no need to press the panic button. zations in Liberia have also closed their travel bans around the region, intra-sub- The World Bank is calling for a swift national operations. regional trade, already at an abysmal 12%, and international response to mitigate There is no confirmed Ebola case in is likely to get worse. “We used to import Ebola’s economic impact. Already, the IMF Ghana but that hasn’t stopped mining goods from Nigeria to sell here [Sierra is providing $130 million emergency relief firms from evacuating foreign staff and Leone], now we cannot do that because to Ebola-hit countries even as the US wants slowing down their operations. Business there are no flights,” says Chris Eyen, a the fund to augment that amount with a Day, a Ghanaian publication, reports that Freetown-based businessman. In addition $100 million debt relief. top hotels in Accra, the capital city, which to flight cancellations, most shipping lines At the last G20 meeting in Brisbane, are usually almost full, now have just a are no longer berthing in Liberia. Australia, held in mid-November 2014, 30% occupancy rate. Ghana and Côte Other countries in the region are leaders of the world’s leading econo- d’Ivoire produce 60% of the world’s cocoa, experiencing a ripple effect. The Gambia, mies backed the IMF relief fund. Donors a sector also threatened by Ebola. There which derives 16% of its GDP from tourism, are scaling up their support, says World are fears that Ebola could spread into is seeing up to a 65% decline in tourism Bank President Jim Yong Kim. The UN these countries. “Any threat of that virus receipts, according to Benjamin Thomas, initially appealed for one billion dollars disrupting the flow of harvested cocoa to fight Ebola of which $800 million had beans out of the producing regions could been received by mid-November, according threaten to increase cocoa prices once to David Nabarro, the UN system coordi- again,” says research analyst Nitesh Shah nator for Ebola virus disease (See page 18). of ETF Securities, a London-based invest- 60% Dr. Nabarro said that up to $1.5 billion was ment firm. By mid-October 2014, due to a of the world’s cocoa is produced now needed. There is a sense of urgency drop in production caused by Ebola, inter- by Ghana and Côte d’Ivoire, in global efforts to contain the virus, national cocoa prices had surged by 18.5%. which is threatened by Ebola but there is also an understanding that The Ebola virus has also affected revamping economies devastated by Ebola infrastructure projects. For example, a could prove challenging.

Ebola: A wake-up call for Leaders lumping all African countries together to one of the reasons there has been no cure yet from page 11 avoid hurting the economies of non-Ebola for Ebola. “A profit-driven industry does not countries. “If you scare away investors by invest in products for markets that cannot lumping the continent into one big mass, pay,” she told delegates at a conference in director of Doctors Without Borders, told what good does it do? It will take another Cotonou, Benin. Testing on healthy volun- Politico, “they become responsible when decade to recover.” teers in the US and some African coun- the situation deteriorates.” There are, Politicians around the world have tries has started on experimental vaccines however, reasons why countries are not sounded the same warning, worried that and results are expected during the quick to request help or try to suppress bad Ebola was creating a contagion effect on first quarter of 2015. news. In many cases these have to do with African economies. “We have to isolate the The time will come when the deci- national pride and the fear of scaring away disease, not the countries affected,” said UN sion-makers will take stock of the state of tourists and investors. And these fears are Secretary-General Ban Ki-moon. healthcare systems in many African coun- not unfounded. African tourism has borne tries, how the outbreak unravelled and the brunt of the Ebola fear factor. Francisco Vaccines and profits the effectiveness of the global response. Ferreira, the World Bank’s chief econo- The absence of any drugs or vaccines against Nevertheless, even as the epidemic is stabi- mist for Africa, said the Ebola “fear factor” the scourge of Ebola has been the main lizing in some parts of the affected coun- prevents tourists from visiting even coun- source of fear among the public. According tries, it’s spreading in others, especially tries such as Kenya and South Africa where to Time, a US weekly magazine, the scarcity Sierra Leone, and to a lesser extent Mali. there had been no cases of the virus. of drugs and vaccines is not due to a lack of “Now is no time to let down our guard,” innovation. “Drugs have been in develop- warned the UN Secretary-General. “A Stigmatization ment for years, but since pharmaceutical gap anywhere in the response leaves In addition to the economic, social and companies have had no financial incentive space for the virus to spread disease, kill political impact of Ebola is the stigma to fund them, researchers have hit walls.” people, destroy families and threaten the attached to it. Nigeria’s finance minister, Dr. Chan makes the same point, adding world…We must keep fighting the fire until Ngozi Okonjo-Iweala, cautioned against that the drug industry’s drive for profit was the last ember is out.”

20 AfricaRenewal December 2014 in late 2014 and to Liberia and Guinea in early 2015. Agency unveils early Known as Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), the technology allows enzymes to be added detection kit for Ebola to blood samples in order to convert the blood’s ribonucleic acid (RNA) into deox- Current testing methods take days to produce results yribonucleic acid (DNA), according to US-based Newsweek magazine. After this By Pavithra Rao is done, a primer, which can identify unique strings of genetic code that relate to the Ebola virus, is added. Finally, the mixture of blood samples, enzymes and primer is run through PCR equipment, in which the strand of Ebola genetic code is copied several times. A patient tests positive for Ebola if a reaction occurs at this stage. If there is no reaction, it indicates that the patient has tested negative for the virus. The disease incubates in the human body from two to 21 days after which infectious symptoms such as fever, muscle pain, diarrhoea and internal and external bleeding begin to show. Doctors have stressed that early detection of the virus is key to containing the epidemic. Currently, standard methods of detec- A pharmacist checking boxes containing the Ebola vaccine. Inset: Early detection kit tion (through analysing cell cultures)

WHO/Mathilde Missioneiro take several days to produce results. “Early diagnosis of EVD (Ebola Virus he International Atomic Energy 2014 that Liberia, Guinea and Sierra Disease), if combined with appropriate Agency (IAEA) has thrown a Leone, the countries most affected by medical care, increases the victims’ T lifeline to contain the Ebola Ebola, will each receive a nuclear-derived chance of survival and helps curtail epidemic that has killed more than 6,000 technology that can detect the deadly the spread of the disease by making it persons in West Africa. Director General virus within a few hours. The IAEA will possible to isolate and treat the patients Yukiya Amano announced in November hand over the device to Sierra Leone earlier,” said Mr. Amano.

Ebola disruption could spark crisis commodities such as cassava by (150%); and 40% of the gross domestic product from page 15 palm oil (53%), gari (obtained from grated of the affected countries, according to cassava) (100%), fresh pepper (133%) Mr. Nwanze. The IFAD head is calling for contingency measures such as building agriculture ministry, because farmers food stockpiles in the affected coun- were concerned about produce spoilages tries or at the regional level “to be able to from produce delays at checkpoints along provide massive food assistance where and the road to the city. 40% when needed.” If possible, he said, coun- At the same time, the Food and tries should intensify food production in Agricultural Organization (FAO) reported of farms in the hardest-hit non-affected areas. that initial results from quick assessments areas of Sierra Leone have About $30 million would be showed prices of commodities, including been abandoned needed to respond to those in need, food, increased on average from 30% to including food relief for about 90,000 75% just over one month in Lofa County, households in the three countries, says the the most affected rural county in Liberia. FAO. A Regional Response Programme Empirical observation at the Red and plantains (66%) over a period of two for West Africa, to be implemented by Light Market, one of the biggest market weeks in August 2014. the FAO in Guinea, Liberia and Sierra places in Monrovia, also revealed huge Agriculture, including small-scale Leone, will aim to boost income and increases in the price of staple food and farming, contributes to between 20% agricultural production.

AfricaRenewal December 2014 21 The Shining Century Textile company in Maseru, Lesotho. World Bank/John Hogg AGOA: The US–Africa trade dilemma Has the Africa Growth and Opportunity Act run its course? By John Njiraini

t may seem counter-intuitive to imagine that Africa analysts, the US is now in a sprint to catch up to others could make contractual demands on the United exploiting Africa’s economic potential. With China IStates. Yet, there is evidence that in recent times deeply entrenched in the continent, Europe trying to Africa has become more assertive with a newfound safeguard its interests and India and Japan making confidence. In fact, it appears the continent is at a point major inroads, the US stands to be an outsider in a in history where it no longer needs the begging bowl continent poised to become one of the leaders in global whenever its leaders visit Western capitals. economic growth in the coming years. Already Africa is This sense of confidence was on full display when home to most of the world’s fastest growing economies. $7bn Africa’s leaders converged on Washington DC for the “Africa offers immense opportunities in terms of amount US-Africa Leaders’ Summit in August 2014. Kenya’s abundant natural resources, new technologies, invest- committed President Uhuru Kenyatta, representing the views of ments, access to potential markets, and new types the 50 African leaders, clearly projected the new face of of consumers. Although the US has been relatively by the US Africa’s diplomatic acumen by asserting that “it is good slow to react to these dynamics, hosting the summit government in to see the US is waking up to the realities of the poten- was a sign that it can no longer stay on the sidelines,” new financing tials of Africa just as China did a long time ago.” said Emmanuel Nnadozie, the Executive Secretary to promote Unlike in the past when such a summit would have of the African Capacity Building Foundation based trade and provided a forum for lectures to Africa on democracy in Harare, Zimbabwe. investment with and human rights, this time around it was about mutual One way the US is seeking to deepen its interests in partnerships, deals, trade and investments. “We want to Africa is by encouraging its multi-billion dollar compa- Africa. build genuine partnerships that create jobs and oppor- nies to invest in the continent. Indeed, during the tunities for all our peoples and that unleash the next era summit, new deals worth $14 billion in areas like clean of African growth,” President Barack Obama said. energy, aviation, banking and construction were signed For the US, creating “genuine partnerships” with between various African nations and US multinationals. Africa is coming rather late. In fact, according to The US government also committed to providing $7

22 AfricaRenewal December 2014 have been minimal. Apart from oil, textiles, takes at least two years for investors in manufacturing and artifacts, very few other the textile industry to get returns. That sectors have benefited from the treaty that is why we need the AGOA extended for at allows duty-free entry into the US market least 15 years,” he said, adding that failure for some 6,000 products. by the US Congress to extend the treaty Worse still, just a handful of countries could be catastrophic to the continent in dominate trade under AGOA. In 2011, for terms of job losses. New Wide, which has instance, all exports from Africa to the US operations in Lesotho and Kenya, employs totalled $79 billion. Notably, almost 80% about 13,000 people. came from just three countries – Nigeria In 2012, apparel accounted for 17% of (47%), Angola (19%) and South Africa (13%). non-oil AGOA exports. It is also the most US exports were similarly concentrated, diversified sector in terms of the number with those same three countries receiving of beneficiary countries. In Kenya alone, 68% of the $20.3 billion that came into the the garment and apparel industry within continent in 2011. “The utilization of AGOA the export processing zones employs about privileges has been sub-optimal, with only 40,000 people. seven out of 39 African countries being While extending the treaty will safe- able to meaningfully take advantage of the guard these jobs and create many more, opportunity availed by the treaty,” noted there is a feeling in the continent that Erastus Mwencha, deputy chairperson of AGOA requires significant changes to the African Union Commission. open up the US market to more non-oil and US Trade Representative Michael non-apparel exports. Froman admitted that the discrepancies One sector that is in desperate need of have not sufficiently projected US commit- new markets is the food and agriculture ment to a trade partnership with Africa. sector. But accessing the US agriculture billion in new financing to promote trade “Despite the concrete benefits that AGOA market under AGOA is extremely difficult. and investment with the continent. has brought to both of our continents, it is Apart from the issue of standards, the US is The American deals, however, offer clear that more can and must be done,” Mr. determined to protect its farmers through little cheer to a continent that seeks Froman observed. For instance, the insig- subsidies. Currently, the value of agricul- immediate impact in job creation, poverty nificant non-oil AGOA trade that increased tural exports to the US stands at $520.8 eradication, markets for its produce and marginally from $1.4 billion in 2001 to $5 million. According to Mr. Mwencha, the direct contribution to the economy. This billion in 2013 is a justification that the US can help Africa’s agricultural sector is because it will take years for the benefits treaty requires structural adjustments. by allowing duty-free access of produce of the deals to be felt. On this basis, some “While we are seeing countries starting currently excluded from AGOA, such as African leaders contend that the Africa to branch out and use AGOA for more sugar, tobacco and cotton. Growth and Opportunity Act (AGOA — products, there is still much room to grow a US law enacted in 2000 under which in non-oil, manufactured and value-added Africa can export certain goods to the US products,” he added. By the numbers duty-free) is the best option in deepening For this to happen, President Obama trade between the continent and the US. and the US Congress must be willing to bite the bullet. First, the US government has $53.8bn America Promise few options but to extend the AGOA treaty amount of non-oil exports from Africa The problem, however, is that Africa when it expires in September 2015. More to US over 10 years abhors the uncertainties of the treaty, importantly, African leaders are calling and its limiting structures. “We want to for a long-term extension to eliminate the deepen our engagement with AGOA but uncertainties that shroud the treaty. They 80% this can only be achieved if we elimi- argue that it is only by extending the treaty percentage of all exports from Africa nate the uncertainties and if it is broad- by a minimum of 15 years that investors to the US in 2011 that came from just ened,” observed Kenya’s Industrialisation will feel comfortable investing in the conti- three countries - Nigeria, Angola and Cabinet Secretary Adan Mohammed. nent because they will have ample time to South Africa The need to eliminate uncertainties recoup their investments. and enhance the treaty was one of the key demands African leaders tabled at the The AGOA Dilemma 7 countries summit. Though AGOA has been described According to Heman Boodia, vice presi- the number of African countries out of as the cornerstone of US trade policy with dent of New Wide Garments Ethiopia, the 39 that have been able to meaningfully Africa — increasing non-oil exports from kneejerk extension of AGOA for only five take advantage of AGOA since it was Africa to $53.8 billion from US $8.1 billion years has made it nearly impossible for unveiled over 10 years — its impact and benefits investors to plan for the long term. “It

AfricaRenewal December 2014 23 African leaders laud Climate Summit New initiatives to address agriculture and renewable energy agreed upon By Daniel Shepard

frican leaders have welcomed consequences of a situation it did not the Climate Summit held at the create, they were committed to taking A United Nations in New York action that will set the continent on a in September 2014, and say it increases sustainable course. But they stressed the likelihood that a meaningful global that greater international cooperation is climate agreement will be reached in necessary, including more financing and Paris in 2015. The summit was hosted technology sharing. by UN Secretary-General Ban Ki-moon to mobilize support for a strong climate Significant announcements agreement and to catalyse climate action. Most importantly, the summit was the Announced at the summit were a platform for a number of significant new range of new initiatives regarding agri- announcements, including the introduc- culture, renewable energy, forests, and tion of the Africa Clean Energy Corridor South-South cooperation in Africa. The (ACEC), a regional initiative to trans- spokesperson for the African Group nego- form Africa’s energy mix through the tiators who represent African countries at development of renewable resources the UN, Seyni Nafo, said the summit sent and the creation of a clean 5,000-mile a strong political message — that a global electricity transmission grid from Egypt climate agreement was needed. It allowed to South Africa.

Low-carbon economic development powered by renewable energy can help meet the challenge that climate change presents while improving the livelihoods and economic well-being of people all over Africa. leaders to come together to express their The aim is to support the sustainable commitment to an agreement in Paris. growth of Africa’s energy needs. Endorsed A woman drawing water from a man-made pond in drought-stricken Somalia. UNDP Somalia “This is very important to us. The by the countries of the Eastern Africa last time world leaders came together to Power Pool and the Southern African emphasizes the development of its discuss climate change was in 2009 in Power Pool, the ACEC will accelerate the vast renewable energy resources,” said Copenhagen, which did not produce the expansion of renewable energy by using a Nkosazana Dlamini-Zuma, the chair- best souvenir,” said Mr. Nafo. coordinated, regional approach to energy person of the African Union. “Low-carbon Tanzanian President Jakaya Mrisho planning and development. economic development powered by Kikwete, speaking for the African Group, Cooperation on renewable energy renewable energy can help meet the chal- said the summit “afforded us with a deployment in the region could reduce lenge that climate change presents while unique opportunity to put our minds generation costs by 4% and nearly triple improving the livelihoods and economic together and deliberate on the way to save electricity supply, transforming the well-being of people all over Africa.” this planet from disaster and advance on current energy mix of a large portion of About 80% of all electricity in Eastern green pathways. It was very opportune.” the African continent. and Southern Africa is currently gener- Many African leaders emphasized “Africa’s surging economic growth ated from fossil fuels like gas, oil and that while Africa is suffering from the can be fuelled by an energy mix that coal. Regional demand for electricity

24 AfricaRenewal December 2014 These countries represent millions of farmers, at least a quarter of the world’s cereal production, 43 million undernour- ished people and 16% of total agricultural greenhouse gas emissions. At the summit, China announced that it would contribute US$6 million for South-South cooperation on climate action.

Saving forests A number of African countries, including Liberia, the Democratic Republic of the Congo, Ethiopia and Uganda, signed on to the New York Declaration on Forests, which calls for slashing the rate of natural forest loss by half by 2020, and totally eliminating it by 2030. More than 105 major companies also joined the initiative, promising to sustainably source products from forest regions. Liberian foreign affairs minister Augustine Kpehe Ngafaun said the summit elicited “concrete commitments from the global community on reducing greenhouse gas emissions and other measures aimed at achieving sustainable development.”

By the numbers

80% of all electricity in Eastern and Southern Africa is currently generated from fossil fuels like gas, oil and coal

25mn farming households across Africa will practice climate-smart agriculture A woman drawing water from a man-made pond in drought-stricken Somalia. UNDP Somalia by 2025

is expected to at least double over the Oxfam, CARE International, Concern next 25 years. Worldwide and Catholic Relief Services), 500mn the alliance demonstrates how govern- farmers will be protected from the New climate-smart agriculture ments and civil society can work together effects of climate change through Another initiative launched at the towards a common goal. the Africa Climate-Smart Agriculture summit, the Africa Climate-Smart The initiative is part of a larger global Alliance initiative Agriculture Alliance, will help about effort to protect 500 million farmers 25 million farming households across from the effects of climate change, while Africa to practice climate-smart agri- increasing agricultural productivity. $6mn culture by 2025. Set up by the African More than 20 governments and over 30 would be contributed by China for Union, the New Partnership for Africa’s organizations and companies announced the South-South cooperation on Development (NEPAD) and five nongov- they would join the newly launched Global climate action ernmental organizations (World Vision, Alliance for Climate-Smart Agriculture.

AfricaRenewal December 2014 25 Sustainable Development Goals: New targets hold promise for Africa MDGs come to an end in 2015 as the new goals come into effect By Tim Wall

on the post-2015 development agenda’. The CAP was the consensus of African leaders, civil society and the private sector. The congruence between African recommen- dations for the post-MDGs era and the framework accepted by the UN General Assembly as the basis for 2015 negotiations on the final shape of the SDGs may be an indication that the rest of the world, especially other developing countries, shares the same concerns as Africa. It may also mean influence. With a population of more than a billion and a new venue as a sought-after investment destination with economic growth rates rivaling those of any other continent, Africa may be moving from a familiar position of receiving advice to one of dispensing it. Speaking in New York in October, the head of the New Partnership for African Development (NEPAD), Ibrahim Mayaki, checked off some of the features Young female student in Monrovia, Liberia. UNMIL/Christopher Herwig of the CAP that also appear in the draft SDGs and on which Africa will need to rely: capacity develop- he first draft of the world’s new development ment enhanced; gender issues tackled, including agenda – the Sustainable Development Goals empowering the small-scale farmers who are women 15% T – takes into account Africa’s interests, but to ensure food security; jobs and a sense of social not in the same way as the expiring Millennium ownership found for youth; greater investment in percentage of Development Goals (MDGs) once did. research and technology. decrease in The Sustainable Development Goals (SDGs) are “We should think about the private sector, including expected to shape the global agenda on economic, small and medium-size firms, where innovation is official bilateral social and environmental development for the next taking place,” Dr. Mayaki said. aid to Africa in 15 years. They are to replace the MDGs, which reach 2012 and 2013 their deadline in 2015. Based on comparison with a key Africa’s common position African Union position paper, Africa is getting what it In early 2014, around the time the CAP was drawn asked for from the UN General Assembly document up, a working group of the UN General Assembly was MDGs that proposes the new set of global goals. starting on a draft to fulfill objectives set at the 2012 Africa’s ‘special needs’ were addressed in the year Rio+20 summit on sustainable development. 1 5 2000 Millennium Declaration, from which the MDGs The Rio text advocated for a continuation of the were drawn. Even though the eight MDGs do not MDGs, to sustain progress on living standards and mention Africa, their emphasis on eliminating extreme to catch up where achievements had fallen short. 2 6 poverty rates, reducing child mortality, promoting But given the ‘sustainable development’ mantra of gender equality, halting the spread of HIV/AIDS, the goals and deep concern about eco-systems and malaria and other diseases, and providing universal climate change, it was certain that environment 3 7 primary education by 2015 means that they target the would figure more prominently in the SDGs. Concerns world’s poorest – many of whom are in Africa. over climate, drought and land use feature promi- In their current form, the SDGs are more focused nently in Africa’s position paper as well. What stands 4 8 on building productive capacity and give more weight out in both the African position and the General to economic and environmental factors, which are also Assembly working group is the emphasis on the key features of the ‘Common African Position (CAP) economy and empowerment.

26 AfricaRenewal December 2014 “The CAP provides important input for Peace, security and governance official bilateral aid to Africa fell by 10 % in the next stage of the intergovernmental Another feature of the plan for the SDGs real terms in 2012, and by about 5% in 2013, process,” as the UN seeks to finalize the as distinct from the MDGs is the grouping despite an increase in ODA to all developing SDGs by September 2015, UN Under- of peace and security issues under the countries for an all-time-high in the latter Secretary-General for Economic and development banner. The reasoning is year. In Africa, incoming foreign direct Social Affairs Wu Hongbo said in an inter- that conflict impacts whether countries investment now surpasses ODA. view with Africa Renewal. advance in their development or not. For A simple substitution of private Both the SDGs and MDGs place Africa, putting peace and security into resources for public funds may not be the poverty eradication at the top of the the SDGs directs attention to conflict- best way to characterize African options. agenda. This was considered by Africa preventing factors such as equity, inclu- The Common African Position takes and the developing world in general to siveness and rule of law. into account a blend of finance sources. be a bedrock requirement, at least These include improving traditionally low in part to ensure that the strength- Finance matters domestic tax collection rates, staunching ening of environmental considera- As opposed to the North-to-South direc- the flow of illicit flight capital and recov- tions does not signal a retreat from tion of the global partnership laid out in the ering stolen assets, tapping global finan- poverty eradication. MDGs, the SDGs will apply equally to all cial markets, stepping up intra-African In fact, Mr. Wu says, the balanced SDG countries. One question is whether Africa, trade, South-South cooperation and public- package is effective in that it addresses which has long been an area of concentra- private partnerships. poverty in terms of vulnerability of the tion for official development assistance As the debate over the post-2015 devel- poor to environmental degradation and (ODA), will see less incoming aid. opment agenda continues, further prepar- through inclusiveness and social justice, But Africa’s position as privileged atory work on implementing the SDGs as well as through economic advance. “I beneficiary of aid may already be slipping. will be held in July 2015 in Addis Ababa, would say the African countries especially According to the Organization for Economic Ethiopia, at the third international confer- will benefit,” he added. Co-operation and Development (OECD), ence on financing for development.

Proposed Sustainable Development Goals (SDGs)

1 End poverty in all its forms everywhere 8 Promote sustained, inclusive and 14 Conserve and sustainably use the sustainable economic growth, full and oceans, seas and marine resources 2 End hunger, achieve food security productive employment and decent for sustainable development and improved nutrition, and promote work for all sustainable agriculture 15 9 Build resilient infrastructure, promote Protect, restore and promote sustain- 3 Ensure healthy lives and promote inclusive and sustainable industrializa- able use of terrestrial ecosystems, well-being for all at all ages tion and foster innovation sustainably manage forests, combat desertification, halt and reverse land 4 Ensure inclusive and equitable quality 10 Reduce inequality within and among degradation and halt biodiversity loss education and promote life-long countries learning opportunities for all 16 Promote peaceful and inclusive 11 5 Achieve gender equality and empower Make cities and human settlements societies for sustainable development, all women and girls inclusive, safe, resilient and sustainable provide access to justice for all and build effective, accountable and 6 Ensure availability and sustainable inclusive institutions at all levels management of water and sanitation 12 Ensure sustainable consumption and for all production patterns 17 Strengthen the means of implementa- 7 Ensure access to affordable, reliable, 13 Take urgent action to address climate tion and revitalize the global partner- sustainable, and modern energy for all change and its impacts ship for sustainable development

Common African Position pillars

1 3 5 Structural economic transformation People-centred development Peace and security and inclusive growth 4 Environmental sustainability, natural 2 resources management and disaster 6 Science, technology and innovation Finance and partnerships risk management

AfricaRenewal December 2014 27 Improving maternal health women surveyed by UNICEF said they had adds a report by the UN Population Fund from page 5 no influence over such decisions. In general, (UNFPA), 95% of married girls under the age of 19 in sub-Saharan Africa “have no say over whether to access or use contraceptives.” Chevron’s support is significant but hardly Maternal Mortality enough. “Many, many young girls try to Progress is being made deliver at home; some of them may require Preventing maternal deaths is not compli- Caesarean operations and it gets really cated, some experts say. “All women need complicated for them,” she told Africa access to antenatal care during pregnancy, Renewal in an interview. 75% skilled care during childbirth, and care and Target Reduction support after childbirth,” states UNICEF. Babies giving birth to babies That may sound simple, but it’s not. For With 225 adolescents in every 1,000 cases of example, due to distance, poverty and pregnancy, the Democratic Republic of the a lack of information, women in remote Congo has the world’s highest rate, followed parts of Africa have no access to health by Liberia (221) and Niger (204). In fact, care. A study by Jose Luis Alvarez, Ruth Countries that have made progress 75% of girls in Niger are married before the Gil, Valentine Hernandez and Angel Gil and those that have not. age of 18, the world’s highest percentage. for BMC Public Health, an online health Dr. Geeta Rao Gupta, UNICEF’s deputy Country PMDR* journal, found that illiteracy, poverty and executive director, warned that, “A 15-year- weak health care systems hamper progress old girl living in sub-Saharan Africa faces Equatorial 81% in maternal health. about a 1 in 40 risk of dying during preg- Guinea To be fair, African leaders have placed nancy and childbirth during her lifetime,” maternal health on the front burner. They Cape Verde 77% whereas in Europe the ratio is 1 in 3,300. are committed to Millennium Development “Babies giving birth to babies,” was how Eritrea 77% Goal (MDG) 5, which envisions a 75% Ms. Howard described the adolescent preg- reduction in maternal mortality by 2015. nancy phenomenon in Liberia. Rwanda 76% A recent report by UNFPA shows some Also, younger girls are at high risk of Ethiopia 69% progress, though hardly enough for a developing obstetric fistula, a potentially victory lap. Equatorial Guinea has achieved Angola 68% serious medical condition in which a hole MDG 5, having reduced maternal deaths Mozambique 64% by 81%. With an annual average reduction of 6.2%, Eritrea has met the goal with a Namibia 58% 77% reduction in maternal deaths. Ethiopia 289,000 Sierra Leone 54% has achieved 69% reduction, Rwanda 76%, Angola 68%, Mozambique 64% and Women died in 2013 during Botswana 52% Cape Verde 77%. Twenty-six of the 46 sub- pregnancy or childbirth Zambia 51% Saharan African countries are at the 40% Swaziland 44% mark, and that includes Nigeria, which accounts for 14% of global maternal deaths. develops between the vagina and rectum or Chad 41% African First Ladies are spear- the urinary bladder. Tens of young fistula heading advocacy efforts on maternal patients are hospitalised in Liberia. Burundi 41% policy and investments in the sector. According to WHO, the main causes of At the UN General Assembly debate last maternal deaths are severe bleeding after of the 46 sub- September, the First Ladies said they were birth, post-childbirth infections, high blood 26 Saharan African 40% “alarmed” at child wives, early pregnancy, pressure during pregnancy, unsafe abortion countries are at unsafe abortions and the risk of HIV. and diseases such as malaria and HIV/ “The current situation [of Ebola] in West AIDS. “Many hospitals in my country don’t Congo 39% Africa shows that we cannot shorthand even have incubators for premature babies progress on health,” admonished Ban Soon- Somalia 34% or doses of oxytocin to stop bleeding,” says taek, wife of UN Secretary-General Ban Ms. Howard. In 2013, of the 7,500 AIDS- Lesotho 32% Ki-moon, at a forum attended by the First related maternal deaths worldwide, 6,800 CAR 27% Ladies. “We have a long way to go post- (91%) were in sub-Saharan Africa. South 2015, so we need each other…[to] deliver for Africa alone accounted for 41.4% of global Zimbabwe 10% women and girls in Africa,” added Roman HIV-related maternal deaths, states WHO. South Africa 9% Tesfaye, Ethiopia’s First Lady. In other It gets complicated when women cannot words, women needn’t die or lose their *Percentage in Maternity Death Reduction even make decisions about their own health. babies in childbirth. The hard work is to Source: UN Population Fund (UNFPA) In Mali, Burkina Faso and Nigeria, 70% of make this dream a reality.

28 AfricaRenewal December 2014 Africa Wired Africa embraces mobile app health revolution By Ying M. Zhao-Hiemann

he application of mobile by UNICEF Innovation Labs Ttechnologies in Africa’s and Nyuruka - a Rwandan healthcare system, popu- software firm. mHero (Mobile larly known as mHealth, has Health Worker Ebola Response gained momentum in recent and Outreach), one of the apps months. Nigeria, the region’s most on RapidPro, is currently being populous country, for example, used in Liberia in support of local managed to contain the deadly efforts to combat Ebola. The app Ebola virus in October 2014 partly reports on new cases, broadcasts due to the application of mHealth. messages about care and preven- Nigerian health officials attribute tion and shares training informa- the success to fast communication, thereby allowing real-time tion and instant tracking made coordination between the health possible by the proactive use of ministry and frontline health mobile phone technology. workers. “Emerging technologies can How did Nigeria do it? facilitate early warning systems, Health workers deployed mHealth outbreak response, and commu- app-loaded mobile phones nication between healthcare provided by eHealth & Information providers, wildlife veterinarians and Systems Nigeria, a non-profit other animal health professionals, research company with operations local and national health authorities, in Nigeria and the United States. and international health agencies,” The app helped to significantly wrote Rashid Ansumana, Jesse reduce reporting time of Ebola cases Bonwitt, David A. Stenger and from 12 hours to six hours initially, Kathryn H. Jacobsen, four Sierra and eventually reports were made Leone-based researchers in the in real time, according to Daniel medical journal The Lancet. Tom-Aba, the senior data manager While the application of mobile at the Ebola Emergency Operation technologies in Ebola response is Centre in Lagos. currently in the spotlight, mHeath Nigerian contact tracers also apps could also potentially address used mobile phones equipped other important public health with GPS tracking, which allowed issues, such as HIV/AIDS, tubercu- authorities to verify the tracers’ losis, malaria and maternal health, locations while they visited indi- according to a study by the World viduals suspected of being exposed Health Organization. to the virus. These tracers visited In Zambia, for instance, 18,500 homes across the country U-Report, another UNICEF mHealth Young Zambians can now receive and share information on HIV/AIDS and during the Ebola campaign. The tool, uses simple text messages and other STIs through their mobile phones. UNICEF Zambia/2013/Maseko same mHealth tools are also basic mobile phones to link people being applied in the Ebola fight in to the resources of the National have been referred to anonymous The private sector in Africa is other countries. AIDS Council. UNICEF and the counselling services, and voluntary also getting involved in mHealth. In September 2014, UNICEF health ministry rely on the SMS testing among U-reporters has As a follow-up to its Pan African launched RapidPro, which is a free, tool to spread messages about reached 40%, which is significantly mHealth Initiative, GSMA, an open-source platform hosting HIV/AIDS. Since its initial launch in higher than the 24% national association of mobile phone multiple apps developed jointly 2012, over 50,000 young people average, according to UNICEF. operators and related companies,

AfricaRenewal December 2014 29 introduced the ambitious mHealth across sub-Saharan Africa, for a MTN, Omega Diagnostics tuberculosis and malaria, along Ecosystem Partnership in June potential annual market of 15.5 and Samsung. with approved symptom checkers 2014, which aims to link mobile million users. Currently, the new The partnership rolled out for each disease. Mobilium, Smart phone and healthcare industries partnership consists of eight services in Côte d’Ivoire, Ghana, Health’s developer, confirmed that to jointly deliver mHealth services companies: Gemalto, Hello Doctor, Nigeria, Rwanda, South Africa, the next versions of the app will to pregnant women and mothers Lifesaver, Mobenzi, Mobilium, Uganda and Zambia in September include information on nutrition 2014. Using discounted Samsung as well as prenatal and postnatal smartphones and tablet devices, mother and newborn care. According to Devex, a social enterprise for the global develop- Emerging technologies ment community, there will be an can facilitate early estimated one billion mobile phone warning systems, accounts in Africa by the end of outbreak response. 2015 – one for nearly every person on the continent. In the meantime, in the consumers in these countries can past year alone, more and more now gain free access to health low-cost smartphones, such as content, health registration and data the US$45 Steppa from MTN collection via the pre-embedded and the US$50 Smart Kicka from Smart Health app. Vodacom, are becoming afford- Smart Health is a free, Africa- able. Both in terms of hardware specific app that provides accurate, and software, Africa is ready to real-time information on HIV/AIDS, embrace the mHealth revolution.

Appointments

Amadu Kamara of the United States has been Cristina Gallach of Spain has been appointed appointed as the Ebola Crisis Manager for as the UN’s new under-secretary-general for Sierra Leone. The Ebola crisis managers will communications and public information. Ms. work with their host governments and key Gallach brings to the position a wealth of stakeholders in ensuring a rapid and effective experience in communication, information,

UN Photo/Silke Brockhausen Photo/Silke UN international response to the Ebola crisis. Ediciones El País public diplomacy, international affairs and Mr. Kamara has served the UN in various senior management security policy. Since July 2010, she has been the head of the public functions and brings with him a diverse portfolio spanning the relations unit in the Council of the European Union, Directorate African continent in international affairs. General for Information and Communication based in Brussels.

Peter Jan Graaff of the Netherlands has United Nations Secretary-General Ban been appointed the Ebola Crisis Manager Ki-moon has appointed David Nabarro as for Liberia. He will work with the Liberian the Senior UN System Coordinator for the government and other key stakeholders in Ebola virus disease. He will be responsible for ensuring a rapid and effective international ensuring that the UN makes an effective and UN Photo/Mark Garten Photo/Mark UN UNMEER/Simon Ruf response to the Ebola crisis. Mr. Graaff has coordinated contribution to the global effort to served extensively with the World Health Organization (WHO) control the outbreak of Ebola. Dr. Nabarro will also continue to serve and the United Nations Assistance Mission in Afghanistan as the UN Special Representative for Food Security and Nutrition and (UNAMA). as Co-ordinator of the Movement for Scaling Up Nutrition.

Abdou Dieng of Senegal has been appointed Ismail Ould Cheikh Ahmed of Mauritania as the Ebola Crisis Manager for Guinea, as has been appointed as the UN Special part of the United Nations Mission for Ebola Representative and Head of the UN Mission Emergency response. In his role, Mr. Dieng for Ebola Emergency Response. He has more will succeed the late Mr. Marcel Rudasingwa than 28 years of development and humani- UNMEER of Rwanda. Mr. Dieng most recently served UNSMIL tarian assistance experience with the UN in as Senior Humanitarian Coordinator in the Central African Republic Africa, the Middle East and Eastern Europe. Among others assign- from December 2013 until May 2014. He also worked with the ments, he was the Deputy Special Representative of the Secretary- World Food Programme (WFP). General and Deputy Head of the UN Support Mission in Libya.

30 AfricaRenewal December 2014 Africa BOOKS BOOK REVIEW Ebola: The Natural and Human History of a Deadly Virus Africa’s World Trade: Informal Economies by David Quammen and Globalization from Below (Africa Now) W. W. Norton & Company, New York, NY, USA, 2014; 128 pp; pb $11.15 by Margaret C. Lee (Zed Books, London, UK; 192pp; pb $34.95) lmost as if from nowhere, the Ebola AIDS, Politics, and Music in South Africa (The International African Library) by Fraser A virus outbreak has become one of the G. McNeill (Cambridge University Press, New most-talked about diseases in recent times. York City, USA; 208pp; pb $29.99) The current outbreak has so far led to more Contemporary Africa: Challenges and than 5,500 deaths, according to the World Opportunities (African Histories and Health Organization. Modernities) by Toyin Falola and Emmanuel Statistics provided by the US Centers M. Mbah (Palgrave Macmillan, Hampshire, UK; 280pp; hb $100) for Disease Control and Prevention show that the situation may become more disas- Diasporas, Development and Peace-making in the Horn of Africa (Africa Now) by Petri trous in the coming months – a worst case Hautaniemi and Liisa Laakso (Zed Books, scenario could see more than 1.4 million London, UK; 240pp; pb $34.95) people affected by early 2015. Ethnic Diversity and Economic Instability Author and science writer David in Africa: Interdisciplinary Perspectives by Quammen explores the epidemic and the Hiroyuki Hino, John Lonsdale, Gustav Ranis new fears that have arisen around the virus and Frances Stewart (Cambridge University Press, New York City, USA; 354pp; pb $36.99) in his latest book, Ebola: The Natural and Human History of a Deadly Virus. With a From Apartheid to Democracy: jittery global audience watching the precar- Deliberating Truth and Reconciliation in South Africa (Rhetoric and Democratic ious story unfold in the three most-affected Deliberation) by Katherine Elizabeth Mack West African countries of Liberia, Sierra (Penn State University Press, Abington, USA; Leone and Guinea, panic levels 160pp; hb $64.95) are rising. Making Modern Girls: A History of Mr. Quammen traces the story of the how such a lethal disease is so volatile Girlhood, Labour, and Social Development categorically zoonotic disease. Zoonotic and elusive. in Colonial Lagos (New African Histories) by Abosede A. George (Ohio University Press, disease, he explains, is an animal infection Many medically oriented books are Athens, USA; 296pp; pb $32.95) that can be transmitted to humans. He often difficult to read because of the Race, Nation, and Citizenship in Post- sheds light on how the virus emerged close heavy use of jargon. But Mr. Quammen’s Colonial Africa: The Case of Tanzania to 50 years ago in the forests of Congo and 128-page book stands out for its easy-to- (Cambridge Studies in Contentious Politics) how it has affected, is affecting and could read tone. It also has a gripping presenta- by Ronald Aminzade (Cambridge University affect the world at large. tion of the mysteries behind the virus which Press, New York City, USA; 446pp; pb $32.99) The book provides answers to ques- the author calls ‘hellaciously destructive’ Reach Out Africa: Studies in Community tions such as what brings about a myste- and the reasons it is causing so much panic Empowerment, Sustainable Development, and Cross-Cultural Engagement by Dorothy rious pandemic such as Ebola after years of on a global scale. H. Ettling and Kevin B. Vichcales (Archway dormancy in a mere matter of months and — Pavithra Rao Publishing, Bloomington, USA; 343pp; pb $21.99) Zambia: Building Prosperity from Resource Historical Archaeology in South Africa: The African Union’s Africa: New Wealth (Africa: Policies for Prosperity) by Material Culture of the Dutch East India Pan-African Initiatives in Global Christopher Adam, Paul Collier and Michael Company at the Cape by Carmel Schrire (Left Governance (Ruth Simms Hamilton African Gondwe (OUP Oxford, Oxford, UK; 448 pp; Coast Press, Walnut Creek, USA; 288 pp; hb Diaspora) by Rita Kiki Edozie and Keith $110.00) $89.00) Gottschalk (Michigan State University Press, East Lansing, USA; 314pp; pb $29.95) Africa39: New Writing from Africa south Professional Social Work in East Africa. of the Sahara by Ellah Wakatama Allfrey and Towards Social Development, Poverty Sovereignty and Struggle: Africa and Wole Soyinka (Bloomsbury, New York City, Reduction and Gender Equality by Helmut Africans in the Era of the Cold War, 1945- USA; 384 pp; pb $17.00) Spitzer, Janestic M. Twikirize and Gidraph 1994 (African World Histories) by Jonathan G. Wairire (Fountain Publishers, Kampala, T. Reynolds (Oxford University Press, New Incentives and Agriculture in East Africa by Uganda; 418 pp; pb $39.95) York City, USA; 152 pp; pb $16.95) Mats Lundahl (Routledge, London, UK; 238pp; hb $130.00) Routledge Library Editions: The Economy The Emerging Middle Class in Africa by of the Middle East: North Africa Mthuli Ncube and Charles Leyeka Lufumpa Building Colonialism: Archaeology and (RLE Economy of the Middle East): (Routeledge, New York, USA; 240; pb $50.95) Urban Space in East Africa (Debates Contemporary Politics and Economic in Archaeology) by Daniel T. Rhodes Development by Allan Findlay and Richard I The History of Africa: The Quest for Eternal (Bloomsbury Academic, New York City, USA; Lawless (Routledge, New York City, USA; 302 Harmony by Molefi Kete Asante (Routledge, 192 pp; hb $78.00) pp; hb $120.00) New York City, USA, 418 pp; pb $49.95)

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