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Archive for May 26th, 2011

Kenyan problem: Activists say underlying causes of displacement remain unresolved

Posted by African Press International on May 26, 2011

Analysis: IDPs as political pawns in Kenya

Activists say underlying causes of displacement remain unresolved (file photo)

NAIROBI/NAKURU, 26 May 2011  – Belonging to the “wrong” ethnic group in Kenya’s Rift Valley Province cost Milka Wanjiru her home, her farm and her shop. After elections in 1992, the mother of 11 lost it all to looters and arsonists.

“It is now 20 years since I became displaced, I have known no peace since then,” Wanjiru told IRIN in Nakuru, the main town in Rift Valley, where the family lives in a rented house. “Two years after we were displaced, we tried to return to our home to rebuild our lives but we were shocked to find a note on the charred kitchen door saying ‘We have already burnt everything, now we want your husband’s head’. We left and have never gone back.”

To survive, Wanjiru and her children turned to casual labour in farms at Mutukanio, Nakuru North District. Her family is one of 2,700 grouped under the Greater Subukia Zone internally displaced persons (IDPs), who were uprooted from their homes in the Rift Valley during the 1992 and 1997 election years.

Thousands of families such as Wanjiru’s find themselves uncertain of ever resettling as political, policy and technical difficulties persist in the country’s handling of IDPs.

The Kenya Human Rights Commission (KHRC), an NGO, has a caseload of 50,000 IDPs, whose displacement predates the post-election violence of 2008, often by two decades.

Across the country, there are now between 200,000 and 250,000 conflict-related IDPs in Kenya, according to the Internal Displacement Monitoring Centre (IDMC), a project of the Norwegian Refugee Council.


Muthoni Wanyeki, KHRC executive director, told IRIN not enough attention had been paid to those displaced before the 2007 elections, when disputed results unleashed violence that pushed some 600,000 people to flee their homes.

“The KHRC is only one organization. Reports have been produced on the clashes that led to displacement in 1997 and in 1992, yet none of these reports has been acted on,” she said. 

“Fundamentally, the underlying reasons for displacement remain. The Ministry of Lands should initiate discussion on ways and means of dealing with the various [competing] claims to land in the Rift Valley and Coast,” she said.

Wanyeki also took issue with a 2008 government resettlement plan, dubbed Operation Rudi Nyumbani (“Return Home” in Kiswahili) saying this failed to acknowledge the socio-economic variety among those displaced that year, treating them all as “as if they were smallholder farmers who had land of their own”.

“We have IDPs who lived in urban and peri-urban areas and who were renting houses; there were those who had homes and land and those who did not have land,” Wanyeki said. “There was no planning for these IDPs in the implementation of the resettlement programme.

“Secondly, resettlement was beset by corruption at local levels – district levels – regarding payment of compensation for IDPs who lost property. Thirdly, there was large-scale corruption with regard to buying land and building houses for the IDPs.” 

Nuur Mohamud Sheekh, IDMC’s Horn of Africa analyst, said Kenya had several categories of IDPs whose situation remained dire.

“We have those historically displaced during the colonial days from their land in Central and Rift Valley provinces; those displaced as a result of human rights violations like the case of Wagalla massacre and lately in Mount Elgon [western Kenya]; those displaced as a result of politically instigated violence in 1992 and 1997; the 2007-2008 post-election displaced; the Mau evictees; those displaced by natural disasters; those displaced as a result of violation of Kenya’s territories and; finally, those who are regularly displaced as a result of conflict over water and pasture resources.”

Political interference

Unfortunately, Sheekh said, the IDP situation had become politicized. “You find that politicians always invoke IDPs but rarely deal with the situation in a comprehensive manner,” he said. “The political elites are so pre-occupied with the 2012 elections that the welfare of IDPs has been put on the back burner for the time being. Political priority has become the ICC [International Criminal Court, where proceedings against six prominent Kenyans have been initiated over their involvement in the 2007-2008 violence], and the 2012 elections.

“To be fair to the government, positive steps have been taken to find durable solutions for IDPs,” Sheekh said. “Durable solutions include return, resettlement in another part of the country and local integration. However, these steps were not undertaken in the spirit of the UN Guiding Principles or the African Union Convention for the Protection and Assistance to IDPs.

“Most importantly [in 2008] the government mostly attended to Kikuyu IDPs and ignored the needs of other sections of the IDP population, such as pastoralist Somalis, Turkanas, etc,” he said.

Sheekh added that Operation Rudi Nyumbani violated IDPs’ right, enshrined in the Guiding Principles, not to be forcibly returned to areas of high risk to their lives, safety and liberty. “The government rushed the programme through and settled IDPs in transit camps despite protests from sections of the IDP population.

“Monitoring and analysis of this programme has shown that very little consultation was carried out and the programme was implemented in the absence of proper reconciliation between communities,” Sheekh said.

Photo: Manoocher Deghati/IRIN
Resettlement of IDPs was beset by corruption (file photo)

Unresolved tensions

David Tebelewa fled his home in the Rift Valley’s Njoro district in 1998 after an attack by a rival community, which left his mother and two brothers dead. He had a 0.8 hectare potato farm before he was forced to flee and is now a casual labourer around Nakuru.

“Those of us who were displaced were allocated land in [another] district but the land was also allocated to people who bribed government officials. In the end, only those close to power got land while were remain landless and suffering.”

Patrick Githinji, the chairman of the National Network of IDPs, an NGO, said: “People at grassroots have yet to achieve peace; they [different communities] only co-exist with a lot of mistrust and suspicion.”

Of the IDPs displaced before the 2007 polls, Githinji said, the largest single group consisted of tens of thousands of families, displaced between 1992 and 2006, who have since integrated into local communities around Nakuru.

“This group forms a large number of hawkers, informal sector workers, prostitutes and street families in Nakuru town,” he added.

Githinji said there was a need to sensitize IDPs against manipulation by politicians seeking votes. He said he feared IDPs may not be resettled this year so politicians can use them during their campaigns for the 2012 elections.

Efforts by IRIN to obtain comment from the Ministry of State for Special Programmes, which is in charge of the IDP resettlement, were unsuccessful.

Sheekh of the IMDC told IRIN: “For Kenya to find a durable solution to the perennial IDP problem, it is important that she adopts the Draft National IDP Policy which is still lying at the Ministry of State for Special Programmes. It is also important that the government ratifies the African Union IDP Convention.

“These instruments provide a framework for IDP protection. That said, the implementation of the new constitution is likely to address issues that have been causing grievances and will hopefully redress these grievances.”

js-rk/am/mw source

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Cheaper drugs

Posted by African Press International on May 26, 2011

HIV/AIDS: Drug price cuts secured amid growing funding fears

Cheaper drugs

JOHANNESBURG, 19 May 2011 (PlusNews) – Three international organizations have negotiated reductions on key first- and second-line, and paediatric antiretrovirals (ARVs) that will help countries save at least US$600 million over the next three years.

The Clinton Health Access Initiative (CHAI), the international drug purchasing facility UNITAID and the UK Department for International Development (DFID) made the announcement on 18 May.

The deal expected to affect most of the 70 countries comprising CHAI’s Procurement Consortium, features notable reductions in the prices of tenofovir (TDF), efavirenz, and the second-line ritonavir-boosted atazanavir (ATV/r) used in HIV patients who have failed initial, or “first-line”, regimens.

As part of the deal, the three bodies set price ceilings for more than 40 adult and paediatric ARVs with eight pharmaceutical manufacturers and suppliers, including Cipla Ltd, Matrix Laboratories and Autobindo Pharma.

Together these eight companies account for most ARVs sold in countries with access to generic drugs, according to David Ripin, scientific director of CHAI’s Drug Access Programme.

As a result, the cost of ATV/r is down by two-thirds from just three years ago. Meanwhile, a once-a-day fixed-dose combination (FDC) pill containing TDF and efavirenz will now cost countries less than US$159 per patient per year. In 2008, low-income countries paid about $400 per patient per year for the same pill.

How did they do it?

According to UNITAID and CHAI, this success is a product of increased demand for these drugs and more efficient manufacturing of the active ingredients, which are estimated to account for as much as 75 percent of generic ARV costs.

“When you make an active ingredient, you use a multistep chemical process,” Ripin told IRIN/PlusNews. “To reduce costs, you can look for a less expensive source of raw materials of which there are a few examples, including TDF … or you can tinker with the chemical process used to make the product to make them more efficient.”

But Ripin added that doing either comes at a cost for pharmaceutical companies, for whom a change in raw material suppliers or manufacturing processes means re-applying for approval of the drug with regulatory bodies.

“Any time you change anything with the way you make a drug, you need to get regulatory approval,” he said. “You have to do a fair amount of work to prove that your product works just as well now as it did before.

“The pharmaceutical companies and generic manufacturers are fantastic at making these types of improvements… [but] they have a limited set of research and development resources available to them,” Ripin said. “They often need to make a decision where they are going to get a higher return on that research and development, and typically that comes from the introduction of new products on the market.”

According to Ripin, the key is providing companies with data on the large and growing markets for ARVs.

“We help companies evaluate for themselves whether it’s a worthwhile business opportunity,” he said. “The second key factor they have to consider is the competitive marketplace for their drugs, where there is an incentive for lower [production] costs and lower-priced products as they want to maintain their market share.” 

CHAI also provides countries with data on best market prices for drugs to help inform national procurement, as was the case with South Africa’s recent ARV tender. Although South Africa is not expected to benefit from the new price cuts, the country has the largest ARV tender in the world, and could secure the drugs at competitive prices. In terms of the CHAI agreement, lower prices are available to members of the Procurement Consortium but are dependant on volumes ordered.

How low can we go?

TDF has become an important drug for many countries, including South Africa, hoping to implement the 2009 World Health Organization (WHO) HIV treatment guidelines, which recommend starting HIV patients on treatment sooner but also a shift away from more toxic ARVs to TDF.

However, the high cost of earlier treatment and better drugs has prohibited many countries from fully implementing the WHO recommendations. According to a recent report released by Médecins Sans Frontières (MSF), both Malawi and Zimbabwe reversed their move to WHO guidelines due to financial constraints.

While new price reductions bring TDF’s price closer to that of the long-time and widely adopted first-line ARV Zidovudine, further drops in TDF’s price will have to be logged to ensure widespread uptake, said Brenda Waning, coordinator of market dynamics for UNITAID.

For Waning and others like MSF, the issue of sustainable funding for the HIV response looms large ahead of the June UN meeting on HIV/AIDS in New York, rumoured to be the last for years to come, according to MSF’s report.

“There has been a lot of attention on commodities and not at other major drivers of cost,” she told IRIN/PlusNews. “We have to look at other places in the health system where we can capture cost-effectiveness.”

In particular, Waning pointed to the potential savings associated with the roll-out of new point-of-care diagnostics, which, although not high on the global agenda, will help countries task shift such testing away from scarce doctors. 

Although the cost remains high, introducting FDC would help governments save on ARV shipping, transportation and storage, while improving adherence and patient outcomes.

llg/kn/mw source

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A colonial-era coconut plantation is being revived in southern Mozambique

Posted by African Press International on May 26, 2011

MOZAMBIQUE: Coconut, cashew projects offer hope for small farmers

Cashew nuts

MAXIXE, 23 May 2011 (IRIN) – A colonial-era coconut plantation is being revived in southern Mozambique to provide small incomes to a largely cashless rural community, and is being viewed as a pilot project that could be rolled out across poor isolated communities to generate work for hundreds if not thousands of people.

A year after winning independence from Portugal in 1975 the country descended into a 16-year-long civil war, and emerged from the conflict as one of the world’s poorest.

Some colonial-era plantations have survived charcoal burners or other methods of destruction, but remain under-utilized through a lack of investment or the handicaps of poor road and transport infrastructure.

South African farmer Graham Ford has teamed-up with US NGO TechnoServe, with the consent of the Inhambane provincial government – as all land in Mozambique is owned by the state – to revive an abandoned coconut plantation, about 10km from Maxixe.

A small processing factory in the community extracts the meat and oil from coconuts collected by local people and is then transported to the highway by 4WD vehicles where it is loaded onto trucks bound for South Africa.

Coconut products have a ready market in the food and healthcare sectors.

The factory accepts two sacks of coconuts – stripped of their husks – from one person a week, which translates into a monthly income of about 1,000 meticais (US$33.50)

“Until now the local people have not really availed [themselves of] the natural resources around them on a commercial level because they had to take them all the way to the highway [about 10km away]. Here they were only given small sums of money by men who took the coconuts to Maputo,” TechnoServe agricultural consultant Rizwan Khan told IRIN.

He said the key to replicating such an initiative, so the poor derived greater commercial benefit, was to situate factories in or near communities.

Khan said the long-term plan was to support the establishment of similar factories across Inhambane Province that would mirror the Maxixe pilot programme – such is the international demand for coconut oil.

A 2002-2003 government survey identified Inhambane as the poorest of the country’s 11 provinces, with about 80 percent of the population living below the poverty line. However, a survey conducted in 2008-2009 found poverty levels had decreased to 60 percent in the province which was rated as the seventh poorest.

Cashew nuts

Mozambique’s cashew nut industry was severely affected by the civil war and outbreaks of fungal infections among its ageing cashew tree population led to a decline in both quality and quantity.

NGO CARE International is attempting to revive the cashew trade in Inhambane Province through its SEED (Sustainable Effective Economic Development) programme.

CARE’s acting project manager based in the Inhambane coastal town of Vilankulos, Michaela Cosijan, told IRIN cashew nut production was one of the focus sectors, as the resource was being under-utilized.

In partnership with the provincial authorities, a campaign has been launched to plant a new generation of cashew trees across the province, and an insecticide programme introduced to protect the remaining productive trees.

The NGO is also organizing cooperatives for farmers to achieve greater value for their products.

Paulo Johaui Murrouibe, a cashew nut farmer in the Inhambane village of Tsumbo, which has about 3,500 residents, told IRIN: “Previously we sold things as individuals at a low price, and had no ability to negotiate a better deal with the buyers. But now, with CARE’s help, we have become organized as a community, negotiating better sales prices and using better farming techniques.”

Filomena Maiopue, director of the Mozambican Cashew Institute, told local media recently: “Over the last five years, the average amount of cashew nuts marketed has fluctuated between 70,000 and 90,000 tons. But this year’s figure of 112,000 tons is a great victory for the country, since it is the highest figure attained since independence.”

bc/go/cb source

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Many turn to pharmacies to meet drug needs

Posted by African Press International on May 26, 2011

PAKISTAN: Women’s secret drug-taking hurting families

A woman buys drugs at a local pharmacy in Lahore, Pakistan. Many turn to pharmacies to meet drug needs

LAHORE, 23 May 2011 (IRIN) – Late each night, Rizwana Bibi* opens the metal box she keeps under her bed to check on her stash of drugs and pops a pill so she can catch some sleep.

“I began soon after I was married, because I was so unhappy,” she said. “My husband is violent. I keep the drug use a secret from him and our three children, though my nine-year-old son sometimes goes to the pharmacy to buy the `medicines’ I ask him to get.

“I tell him they are to help my headaches,” Rizwana told IRIN in Lahore, Pakistan’s second largest city and capital of Punjab Province.

The 30-year-old mother has been using benzodiazepines (a class of compounds used as tranquillizers) and narcotics for the last 10 years. Like her, thousands of married Pakistanis of reproductive age are addicted to drugs, a problem that has taken a serious toll on families, according to Uzma Ahmed, a health visitor who offers advice to women in a community on the outskirts of Lahore.

“There are women I know who use drugs,” Ahmed said. “Often they are terrified their husbands will beat them if they find out. The drug use has a highly negative impact on families, especially the children who sometimes see their mothers smoke, or swallow pills and fall asleep for hours. Some want to give up, but where do they go for help?”

A study by the UN Office on Drugs and Crime (UNODC) of 4,632 female drug users in 13 cities in Pakistan’s four provinces in 2010 found that drug use among women was discreet, hidden and more of an individual activity than among male users. While the number of users was fairly large in cosmopolitan cities like Karachi and Lahore, it also existed in other areas of the country.

The study found that nearly three-quarters of users were aged 21-40, and were illiterate. However, in Peshawar city, nearly half of the users had some education. Overall, more than half were married and mostly lived with their husbands. Most used hashish, but some used hard addictive drugs including synthetics that were available over the counter.

Low self-esteem

“Many female drug users suffer from low self-esteem, loneliness, depression, a sense of isolation and often feel powerless,” the study found. “In an attempt to minimize the stigma, [they] do not seek assistance, and do not utilize services available for them which further complicate the situation.”

Pakistan’s drug problem is documented. In 2006, an assessment by the government found about 628,000 opiate users in the country, of whom around 482,000 (77 percent) were heroin users. The assessment report estimated the number of injecting drug users at about 125,000, double the estimate for 2000.

In March, a joint UNODC and World Health Organization (WHO) mission to Pakistan said improved drug treatment programmes were needed given the scale of the problem. Such programmes, it noted, were often a “low priority on the political agenda” in many countries with a drug problem.

Locals in Lahore said treatment for addiction was hard to come by. “My son, Bilal, 25, is addicted to heroin,” Imdad Asad, 60, said. “We have paid out over Rs. 500,000 [US$5,882] over the last year at various `treatment’ clinics, but he just reverts to the habit after leaving them. These centres are just out to make profits by fleecing desperate families.”

Easy to buy

At the same time, drugs were relatively easy to buy. “I have regular customers, both men and women, who come in to buy injectible narcotics or other drugs like `xanax’ [a benzodiazepine]. I know I should not be selling these without prescription – but then they will just go to another shop,” a pharmacist in Lahore who preferred anonymity told IRIN.

A user, Samina Bibi* 22, said: “It is not hard at all to obtain drugs. I use some blue pills to help me sleep. I do not know what they are. I also smoke hash. A drug dealer who lives close to my house comes and supplies them at my doorstep.”

Treatment is harder for female users because of stigma and the covert nature of use, according to UNODC. While male users are easily seen in public places, women users tend to be hidden far more deeply in the shadows of society.

“Any effective treatment plan for drug addiction can work only if there is effective control on the sale of prescription drugs,” Khalid Bukhari, WHO country adviser on medicine, said. “Right now, psychotropic drugs, narcotics and other substances can be bought freely.

“We need a triple prescription system, where one copy is kept by the doctor, one given to the pharmacy and one to the patient.”

*Not a real name

kh/eo/cb source

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