MIXED BAG OF FORTUNES FOR SADC

The Southern Africa region has continued on a positive economic growth path with significant differences in growth rates among countries in the region. 

Mozambique, Zambia and Angola registered the fastest growth rates, exceeding the 7 percent growth rate target of the Southern African Development Community (SADC), supported by positive performance of the mining sectors and strong public expenditure, according to a recent African Development Bank (AfDB) report.

The report titled “Southern Africa Review Quarterly and Analysis” says that officials in Zimbabwe also predict a significant acceleration of growth (from 3.7 percent in 2013 to 6.1 percent in 2014) premised on the successful implementation of its Zimbabwe Agenda for Sustainable Socio-Economic Transformation (ZIM-ASSET) and the completion of on-going institutional and structural reforms encompassing the mining sector.

“However, there are significant negative pressures to growth in Zimbabwe arising from liquidity constraints, weak aggregate demand and infrastructure bottlenecks,” states the report.

In Malawi, the report says, growth is expected to accelerate to 6 percent in 2014, up from an estimated 5 percent in 2013, benefiting from a good tobacco harvest.

However, the continued suspension of budget support following the exposure of government officials’ misuse of public funds and the suspension of uranium mining activities due to low global ore prices present downward risks for Malawi.

AfDF says the Namibian economy is growing at 5.3 percent, reflecting a mild acceleration of growth relative to the fourth quarter of 2013, driven by increased mining and construction activities.

In Lesotho, the report says the 2014 first quarter growth is expected to be as high as that observed in the last quarter of 2013 (about 5 percent), given accelerated growth in the diamond mining, telecommunications and trade sectors.

Growth in Mauritius is accelerating but remains moderate (3.7 percent in 2014) in tandem with the recovery trend in its major economic partner, Europe.

Growth is decelerating in South Africa, where persistent structural constraints to growth, including the labour unrest and the interest rate hike implemented to ease exchange rate pressures, have dampened growth.

Developments in South Africa, AfDB noted, are expected to negatively affect Swaziland’s growth outlook. Inflation was moderate across the board in the first quarter of 2014, supported by easing exchange rate pressures, moderate external prices and weak domestic demand.

All countries except Malawi reported single-digit inflation, four meeting the SADC convergence target of less than 5 percent and one (Zimbabwe) registering a deflation rate of -0.91 percent in March 2014.

There were price pressures arising from rising fuel prices, increasing public wages and seasonal food shortages in a number of countries including Mauritius and Zambia.

Not all countries have reported first-quarter data on external balance, fiscal balance and debt.

The report says early indications suggest that most countries met the SADC convergence targets in the first quarter of 2014.

“However, a deterioration of the external position was observed in about half of the countries due to large imports of capital equipment and manufactured goods (Mozambique and South Africa), slow growth in the economies of major trading partners and sources of capital (Mauritius) and lower export revenues from mining (Angola, Zambia and Malawi),” says the report.

In Malawi, notes the report, the suspension of budget support also weighed in. Fiscal deficits widened in the majority of countries due to expansionary fiscal policies in Angola, Mauritius, Mozambique and Swaziland, revenue constraints arising from decelerating economic activity in Zimbabwe; and from the suspension of budget support in Malawi.

Nevertheless, the report says, the fiscal position of the Southern African Customs Union (SACU) countries is generally improving as the countries pursue fiscal consolidation (Botswana, Lesotho, and Namibia) and improve domestic resource mobilisation (Swaziland and Namibia) while also benefiting from SACU revenue inflows in the first quarter of 2014.

“Countries stayed within the SADC convergence target on debt, although debt levels are increasing in a number of countries including Angola, Mozambique and Zambia, to fund fiscal deficits.

“This performance has affected the level of international reserves, which decreased in Angola, Mozambique, and Zambia though for Angola stayed within the SADC convergence target of six months of import cover,” say the report.

The report says the region’s 2014 outlook is positive overall. Average growth is expected to rebound to 4.9 percent in 2014, up from the 4.3 percent average growth rate estimated for 2013. Average inflation should drop to about 6 percent, following significant disinflation in Malawi.

At least four countries expect to post a positive current account balance in 2014, compared to only one country at the end of 2013. Seven countries are expected to have increased their international reserves to at least four months of import cover by the end of 2014, compared to four countries in 2013, although the majority will still fall short of the SADC convergence target.  

However, the AFDB report says, growth is partially driven by expansionary fiscal policy measures that will negatively affect the fiscal balance and debt levels in a number of countries.

The region’s economic landscape for 2014 will be affected by a number of factors, including on-going institutional and structural reforms, as well as national elections, in some countries. Elections are expected to worsen the fiscal positions of Mozambique and Malawi, increase inflation risk in Malawi and increase uncertainty with respect to capital and investment inflow in Malawi.

Mozambique holds its elections in October while Malawi held its polls in May.

That said, the reports observe, important institutional and structural reforms are on-going in line with the development aspirations of member countries.

In the first quarter of 2014, Angola launched its ambitious electricity sector reform programme.

Malawi registered significant progress in the implementation of the public finance management reforms embedded in the Extraordinary Performance Assessment Framework.

Zambia reformed legislation in an attempt to improve the business climate; while in Zimbabwe, new foreign currencies were added to the multicurrency basket to facilitate trade and investment.

The report says in order to strengthen and sustain the positive growth trend, SADC member countries should pay particular attention to the issues including sustainable management of revenues from extractive industries and economic diversification in resource-rich countries; building resilience to external economic shocks in globally integrated economies, through economic diversification and diversification of target markets.

They further need to enhance capital budget absorption capacities to maximise benefits from expansionary fiscal policies; and public finance management reforms to reduce imbalances in budget allocations, improve domestic resource mobilisation and enhance safeguards.

Southern Times 

PATH ZAMBIA ELIMINATING MALARIA STEP BY STEP IN THE HOT ZONES

Community health workers practicing using rapid diagnostic tests for malaria

Lake Kariba in southern Zambia is absolutely stunning. The world’s largest artificial reservoir is rich with fish, birds, crocodiles, hippos, and islands—and the lake’s shoreline town of Siavonga boasts a thriving tourism business. This beautiful area is also a breeding ground for the mosquitoes that carry malaria and is on the front lines of the Zambian government’s efforts to combat the disease.

When I met with Zambian Minister of Health Dr. Joseph Kasonde, he emphasized that the goal is not a “malaria-free Zambia” but malaria-free Zambians—stopping transmission of the disease by targeting the malaria parasite reservoir in humans. PATH is tackling malaria on many fronts, including improved drugs, diagnostics, vaccines, and systems. Key to this work is building evidence to support broad-scale use of these new innovations.

At Lake Kariba, I met more than 50 community health workers, participants in a PATH-led training session, who are helping to reduce malaria in the country’s Southern Province. These men and women hike—sometimes as far as 12 miles—into hilly regions that are often inaccessible by vehicles to test and treat people and ensure they have preventative measures like insecticide-treated bednets. Such remote areas often are the “hot spots,” the breeding grounds that contribute to the spread of malaria.

“Malaria is a killer disease,” said Marie Antoinette Musanabera, a trainer from the Ministry of Health who attended the workshop. “For us to bring services closer to the community—to bring services to their doorstep—that is how you break the chain of malaria.”

Community health workers are the heroes of global health, and they have been instrumental in making Zambia a malaria success story. Health facilities reported a 66 percent decline in the number of malaria deaths from 2000 to 2009; the drop was especially steep after distribution of 3.6 million long-lasting insecticidal bednets between 2006 and 2008. During this period, parasite prevalence declined 53 percent nationwide. In recognition of the country’s achievements, in 2013 the United Nations awarded Zambia the African Leaders Malaria Alliance Award.

The Zambian government has set a goal of near-zero deaths and five malaria-free districts by 2016, and PATH is playing a lead role in supporting the country’s efforts. Our approach builds on successful methods (such as using bednets, insecticide spraying, strengthening surveillance and data reporting, and testing and treating). We also pilot new tools and strategies, such as proactively providing drugs that halt malaria transmission by killing the parasite even if someone is not showing symptoms and which temporarily prevent people from being reinfected. The lessons learned from PATH’s Malaria Control and Elimination Partnership in Africa (MACEPA) program in Zambia and three other countries (Ethiopia, Kenya, and Senegal) will inform subsequent adaption and adoption of these methods across Africa.

The Siavonga residents shared with me the impact they’ve seen from the collaboration to reduce malaria in Southern Province.

“During the times of peak months (rainy season), we used to have a lot of people in the hospital,” said Florence Namwanza, a mother of six, who described her bouts with the disease and its symptoms of sweating, vomiting, fever, and backache. “Now, there are not so many.”

The district representative emphasized the large-scale implications of this effort. “Once malaria is controlled, the outlook of people’s lives will be better,” said Dr. Phallon Mwaba. “They will be more productive in fishing and farming. It may look today like we are just trying to control malaria but, ultimately, it will affect the economic status of the people.”

Malaria is estimated to cost Africans $12 billion a year, including the cost of health care, days off school and work, decreased productivity, and loss of investment and tourism. The disease kills an estimated 630,000 people a year, most of them African children.

The good news is that increased prevention and control measures have led to a reduction in malaria mortality rates by 42% globally since 2000. During this period, PATH has made tremendous strides in research and development for new tools and in partnering with governments to scale up malaria prevention and control. Across PATH, more than $79 million is committed to malaria activities this year alone, and our portfolio of malaria programs and projects includes more than 125 staff members.

Globally, there is growing interest in finding new tools and approaches to reduce the burden of malaria and to accelerate progress towards the goal of eradication. Because of its remarkable progress, Southern Province offers a good test case for elimination. Once methods are proven successful there, they can be scaled up to the rest of the country. If successful in its quest, Zambia would be the first country in sub-Saharan Africa to achieve this transformation.

Some of the men and women I met at Lake Kariba have been doing this work for decades—and their hard work and commitment is paying off. Seeing their dedication and that of the government representatives renewed my conviction that that, together, we can turn the tide.

One of the trainers summed it up like this: “The major reason we are here is to actively detect malaria parasites in people and treat them, to ensure that we have cleared them, in the hope and belief that one day we will be free of malaria.”

PATH 

LIBERIA 'FACES HUGE EBOLA SURGE'

Ebola is spreading exponentially in Liberia, with thousands of new cases expected in the next three weeks, the World Health Organization (WHO) says.

Conventional methods to control the outbreak were "not having an adequate impact", the UN's health agency added.

At least 2,100 people infected with Ebola have died so far in the West African states of Guinea, Liberia, Sierra Leone and Nigeria this year.

The WHO says 79 health workers have been killed by the virus.

Organisations combating the outbreak needed to scale-up efforts "three-to-four fold", the WHO said.

It highlighted Liberia's Montserrado county, where 1,000 beds were needed for infected Ebola patients but only 240 were available, leading to people being turned away from treatment centres.

Transmission of the virus in Liberia was "already intense", and taxis being used to transport infected patients appeared to be "a hot source of potential virus transmission", the WHO said.

When a treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload," it added.

"When patients are turned away... they have no choice but to return to their communities and homes, where they inevitably infect others."

Three countries - Guinea, Sierra Leone and Liberia - are at the heart of the Ebola outbreak, but Liberia is suffering the most by far. Why this is the case is not completely understood. Finding the answer will be a critical part of tackling the outbreak.

Variations in burial practice - which can include touching the body and eating a meal near it - are being investigated.

There are also questions about trust in the authorities and how the risk of Ebola is being communicated. Riots erupted in the West Point slum, with some reports suggesting protesters believed Ebola was a hoax.

Another aspect is the state of the healthcare system, which was left in ruin by the civil war. Liberia had one doctor per 100,000 people before Ebola killed several staff.

The response has also been lacking. In the capital Monrovia there are 240 beds, but experts say they need more than 1,000. Patients without a bed have no choice but to go back home, where they may spread the virus.

The Ebola disease spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments.

Conventional means of controlling the outbreak, which include avoiding close physical contact with those infected and wearing personal protective equipment, were not working well in Liberia, the WHO said.

Local communities, especially those in rural areas, had been able to slow the transmission when they put in place their own protective measures, the WHO statement said.

Also on Monday, the African Union urged its member states to lift travel bans imposed to contain the virus, saying that the bans could hurt the region's economy.

"We must be careful not to introduce measures that may have more... social and economic impact than the disease itself," commission chief Nkosazana Dlamini-Zuma said in quotes carried by AFP news agency.

The current outbreak has mortality rate of about 55%.

Liberia has the highest number of reported cases and deaths, with more than 1,000 casualties so far.

Hundreds have also died of the virus in Guinea and Sierra Leone.

There have been at least eight deaths in Nigeria. One case has also been confirmed in Senegal but there have been no deaths so far.

JONGLEI HEALTH MINISTRY CONFIRMS KALA-AZAR DISEASE OUTBREAK

The health ministry in South Sudan’s Jonglei state has reported an outbreak of Kala-azar in its remote Akobo and Nyirol counties.

A south Sudanese man recovers from the kala azar disease

"We have heard of the upsurge of the disease in Langkien where a big number of people are affected. Other cases were reported in Akobo, but our health team [have’] not gained access to those locations,” a doctor at Bor civil hospital told Sudan Tribune on Sunday.

Kala-azar is a chronic and potentially fatal parasitic disease of the the internal organs, particularly the liver, spleen, bone marrow and lymph nodes transmitted by sandfly bites.

The disease is reportedly common in parts of Asia, Africa and South America, and causes an estimated half million cases per year.

Jonglei’s health minister, Angok Kuol confirmed the outbreak of the disease, saying medicines were dispatched the two affected counties.

"Recently there were reports of increasing cases of Kala-zar in Nyirol and Akobo counties. So we have sent in medicines, training materials and a consultant has even gone to help health personnel on the ground", said Kuol.

Jonglei ministry of health now relies on its partners to deliver health services in the areas controlled by rebels fighting against government.

"We have allowed all our partners who are operating in the counties under rebel to continue delivering health services,” said the minister.

ST