Crossing the Congo Is a Journey Across Hell on Earth

by John Tamny

“Our hearts just broke – they just wanted to get out of their lives,” but “we had to drive off with Charlie and me hanging off the car literally beating the guys away.” Those are the words of Mike Martin about midway through Crossing the Congo: Over Land and Water in a Hard Place, the fascinating book he wrote with Chloe Baker (introduction) and Charlie Hatch-Barnwell (photos) about the trio’s perilous 2013 drive across the Democratic Republic of Congo (DRC), from Kinshasa to South Sudan.

For those who think they know poverty, dysfunction, or basic corruption within government officialdom, they would be wise to pick up this essential book. Odds are they’ll never view – or discuss – the three in the same way again. What the authors of Crossing report from the DRC brings new meaning to all three, and much, much more.

A Hellacious Journey

Journey Congo DRC Kinshasa CrossingMartin and Baker are both Londoners, and in 2013, before life, work, and marriage were set to intrude (Martin and Baker were engaged to be married to one another when the trip began), they drove from London to the African continent, and back. Crossing is the (Hatch-Barnwell joined them in Kinshasa) account of their 60 day, 2,494 mile journey across the DRC.

There’s really no way to adequately retell what the authors witnessed, nor what they endured. Along those lines, it’s safe to say that the authors themselves would probably admit that their recall left much of what might animate their experiences, out of the book. That’s not a knock on the authors, as much as it’s to say that their journey into hell defies literary – or photographic – description.

Needless to say, readers would do best to simply try and imagine beginning a drive from Houston to Dallas only for I-45 to be mostly unpaved, and mostly undrivable due to massive potholes everywhere along the route. The travelers would have to endure regular interruptions in their journey thanks to I-45 intermittently ending; the lulls in what no westerner would describe as an “interstate” littered with massive trees and smaller rivers that need to be cleared or crossed on manmade rafts sturdy enough to carry a four-wheel drive automobile. And that’s the just the beginning.

For the trip from Houston to Dallas to even passably resemble what the authors experienced in the DRC, there would have to be no signs indicating which direction to drive up north, and then if eager to attain guidance, every request would be met with outstretched hands from people loitering on the route, and who also treat the roadway as their personal toilet.

There would be no internet or phone during the drive for GPS or calls for directions, access to mere buckets of water would have to be negotiated, food largely scarce, and then police, if at all helpful were most often drunk and stoned, would erect checkpoints throughout the route from which they’d try to shake down the well-to-do with bribes in return for free passage.

The above is a rather incomplete, G-rated description of what the authors endured over nearly 2,500 miles. While the average first-world driver can complete a 100-mile trip easily within two hours, in the DRC 100-miles traveled represents a very successful day. Figure that the authors’ 710 mile passage from Kinshasa to Kananga alone took place over 15 days. During one 5 mile stretch as they exited Kinshasa, they were stopped by government officials no less than four times.

Poverty Beyond Compare

So while even the cruel wouldn’t wish a drive across the DRC on their worst enemies (the authors did it, by choice, mostly because “people said that it could not be done. That it was impossible.”), to read Crossing is to wish that Paul Krugman would attempt the drive as a way of curing the Princeton professor of his silly belief that government spending powers growth. In truth, governments can only spend – and build paved roads inefficiently – insofar as the private sector is creating wealth. Government spending doesn’t drive economic growth as much as it’s mostly an economy-sapping effect of it.

Applied to the DRC, there are only 700 miles of mostly drivable roads there because the country’s economy is almost wholly non-existent. As Baker puts it in the book’s introduction, “Throughout the DRC there is relentless poverty, and little palpable sense of hope for the future.” Despite abundant natural resources, “the DRC remains 186th of 187 countries in the Human Development Report, with 84 per cent of the population suffering underemployment and up to two-thirds living below the poverty threshold.” Baker describes Congolese poverty as “beyond comparison.”

What also requires mention is that it wasn’t always this way. Though it’s easily one of Africa’s poorest countries today, Baker reports that the “DRC was the second most industrialized country in Africa at independence,” and Martin adds that the “DRC had been at its most ‘advanced’ state just before the Belgians left.”

The once-developed country even had paved roads, including the route that the authors took when they crossed the country. Alas, no more. As Martin pithily explains it, “The Congo was now free, but it was f***ed.”

Why the tragic decline? Readers doubtless know why. It’s government. Always government. Reading a book like Crossing caused this reviewer to wonder about before/after when it came to the authors’ political/economic views. What they witnessed had to have profoundly altered their views of government.

Economic Ruins

On a personal level, Martin acknowledges that by trip’s end the trio was “shattered.” While it’s possible that the proverbial (or literal) journey into the heart of darkness merely brought forward what was inevitable, Martin ended his engagement to Baker fairly early on.

Martin and Baker admit that this most maddening of ‘holidays’ understandably brought out the worst in them; particularly the mercurial Martin. He doesn’t suffer fools well, and government is often a magnet for society’s fools who crave power and wealth of the coercive and thieving variety, as opposed to the earned kind that springs from removing unease from the lives of others.

Martin writes that “The Democratic Republic of Congo really is one of the most bureaucratic, officious and corrupt countries in the world.” He quotes a guidebook which says ‘They [the Congolese] are the most corrupt people on earth.’

Interesting there is that, at least before independence, what was the Belgian Congo was, as previously mentioned, relatively prosperous. Indeed, at varying times Martin refers to the “archaeological” aspects of the country whereby a tour of it reveals what once was, including legible road signs, government offices and buildings, and other effects of normal economic activity.

Nowadays it’s mostly gone. As opposed to bustling businesses, the “economy” in the DRC amounts to the various NGOs naively working to fix what is broken. Gombe is the relatively upmarket part of Kinshasa where the city’s “industrialists” (think NGO workers) live and work, but after at least a decade of international intervention, Martin describes what is relatively prosperous as rather primitive.

He indicates that the area’s police “did not even have proper electricity, any computers or appropriate offices.” It’s safe to say this will be the norm so long as the NGOs remain. Their very existence in the DRC parodoxically ensures that the DRC will remain devastated.

Known Corruption

What’s important about all of the above is that the DRC’s civilian population is well aware of what’s going on, as is Martin. The people know the DRC’s leaders use international aid to “accumulate further wealth at the expense of the people,” while Martin describes western aid programs as “a lot more stupid than they looked…” Well, of course they are.

Crossing the Congo DRC Martin Baker Hatch-BarnwellHard as it is for do-gooders to acknowledge, countries never fail due to a lack of money or resources. They implode because the investors whose intrepid capital commitments power real economic activity choose to direct their funds elsewhere; nearly always thanks to corrupt governments scaring them off.

Getting right to the point, non-corrupt countries lightly run by leaders beholden to the rule of law don’t need foreign aid. That the DRC is a foreign-aid recipient is all the evidence one would need that the country’s leadership is pocketing what’s flowing in. If they weren’t, as in if they weren’t corrupt, return-obsessed investors would populate Gombe rather than its NGO industry that is anything but. So yes, the problem in the DRC is appalling government. It goes back to what is a mostly false version of independence, and its horrid aftermath.

At the risk of being repetitive, the former Belgian Congo was relatively well-to-do. It reached its economic apex only for Joseph-Desire Mobutu to destroy it at independence. Mobutu foisted on the country “Zairianisation,” which “saw the expropriation of all small business, farms and factories that belonged to the remaining foreigners in the country.”

Those who took what was not theirs predictably oversaw collapse of those same assets in concert with an outflow of the people who actually knew how to run the businesses taken from them by force.

With the economy in freefall, Mobutu partially ripped a page from Krugman’s book and encouraged his impoverished subjects to “steal cleverly, little by little.” It sounds like taxes; the only difference being that the force is explicit. Readers can doubtless imagine how things unfolded.

Notable about Krugman is that he’s historically been a free trade advocate while seemingly forgetting that imports are the reward for the production that he thinks should be endlessly taxed. This rates mentioning because, quite unlike the developed world in which workers are showered with goods and services in return for their toil, imports into the DRC are near non-existent, reflecting the almost total lack of remunerative work in the country, along with regular theft of what makes it in.

For those who decry imports and open trade, they would be wise to read about Martin’s four-day nightmare in pursuit of something as prosaic as a steering box for the Land Rover that transported them across the Congo. Those who decry imports have plainly never lived where they’re non-existent, nor witnessed the end result of excessive government power.

The problem is that no book, and no review of a book, can adequately describe just how awful life is in countries defined by absolute government corruption. Still, Martin, Baker and Hatch-Barnwell do a great job of giving the reader a sense.

Daring to Dream

At this review’s beginning, reference was made to Martin and Hatch-Barnwell “literally beating the guys away.” What Martin described as heartbreaking took place as the trio left Lomela in order to continue their drive across the DRC. Having paid some locals to help them move trees so that they could continue their trek (for some compensated “it was their first ever pay day”), some of the workers held onto the westerners’ Land Rover because they hoped for more pay days, and even better, eventual passage into Europe.

Indeed, as Baker puts it early on, “The people we met all shared the same dream, a dream of reaching Europe, where they felt hard work would translate into a safe and secure future for their families.” As Martin later explains, those who live in the hell that is the DRC view the West as “a paradise with endless luxuries and wealth.” For American commentators prone to mocking slow-growth Europe, realities in Africa reveal their haughty critiques as the droolings of people who are both unwise and spoiled.

And for the Americans who proclaimed loudly that the U.S. was on the verge of being a “Banana Republic” if either Hillary Clinton or Donald Trump were elected president, Crossing the Congo exposes them as truly mindless, and similarly spoiled.

The truth is that we younger people in the West, whether in Europe or the U.S., have no real sense of suffering. A read of this essential book will open many eyes, and perhaps foster a greater desire among us all to open our doors to the world’s strivers who are presently having their talents suffocated in the cruelest of ways.

Reprinted from Real Clear Markets.

John Tamny Congo DRC

John Tamny is a Forbes contributor, editor of RealClearMarkets, a senior fellow in economics at Reason, and a senior economic adviser to Toreador Research & Trading. He’s the author of the 2016 book Who Needs the Fed? (Encounter), along with Popular Economics (Regnery Publishing, 2015).

This article was originally published on FEE.org. Read the original article.

S&T could raise Africa’s agricultural productivity

By Paul Boateng

For Africa to achieve increased agricultural productivity, there is a need to invest in S&T, writes Paul Boateng.

On my way straight from Kenya’s Jomo Kenyatta International Airport in Nairobi to a meeting and stuck in one of the city’s endless car jams, my taxi driver began a conversation about the lack of rain.

A veteran of countless conversations with his counterparts in London, which normally end up with a rant against the government of the day, I was wary. This one, however, was different. It was wide-ranging, comprising a discourse from him on the merits of drought-resistant maize seed and the challenges of accessing it, interspersed with my own reminiscences of farm life as a boy on the other side of the continent in Ghana and the challenges of smallholder farmers’ access to global markets.

Every family connected to agriculture

This exchange reminded me of one of Africa’s great realities: no matter where you are or what you do, every family is in some way connected to the land. Agriculture remains a vast still largely untapped resource for the continent awaiting the long overdue green revolution.

Fortunately, there are increasing signs for optimism regarding agricultural development in Africa. According to the 2016 African Agriculture Status Report, after decades of stagnation, Africa’s farms have registered sustained agricultural productivity growth since 2005.

“If we are to ensure that agriculture can play its true role as a catalyst in achieving sustainable development in Africa, we must take decisive action.”

Paul Boateng

International organisations are also prioritising agriculture. For instance, the African Development Bank’s annual meeting to be held next week (22-26 May) in India, which I will be attending, has the banner “Transforming Agriculture for Wealth Creation in Africa”.

Why is this theme significant? Africa harbours immense agricultural potential, which can help power its socioeconomic transformation. With some 200 million hectares, Sub-Saharan Africa boasts half of the world’s arable land that can be used for agricultural production. The sector also remains the backbone of Africa’s economy, accounting for 24 per cent of Gross Domestic Product (GDP) — the total value of goods produced and services provided annually — across the region and employing just over 60 per cent of local labour forces. Agriculture’s role in the continent’s future economic development is only set to grow, with its food and beverage markets predicted to reach US$1 trillion by 2030.

For the most part, however, the continent’s agricultural promise remains unfulfilled. The sector’s productivity lags behind other developing regions, which affects Africa’s food security and imperils future economic growth. The continent’s farmlands and rangelands are increasingly degraded, resulting in lower crop yields for farmers. In addition, 95 per cent of agriculture in African countries is rain-fed, and the continent’s reliance on its agricultural sector and low levels of irrigation make it particularly vulnerable to changes in climate patterns. Infrastructural problems and a lack of appropriate financing further hamper the sector’s growth.

Why ST&I is essential

If we are to ensure that agriculture can play its true role as a catalyst in achieving sustainable development in Africa, we must take decisive action. I believe that investing in scientific and technological innovation is essential to boosting agricultural productivity and alleviating poverty.

Scientific research can create the higher-yielding, resilient food crops needed to boost agricultural growth, and improve our citizens’ well-being. For example, before the introduction of drought-resistant maize in South Africa in 2002, average yields in South Africa were around 2.4 tonnes per hectare. According to agricultural economist, Wandile Sihlobo, these actually increased to around 5.3 tonnes per hectare in 2013/2014, the highest average commercial yield on the African continent. These GM maize crops have also proven to be more tolerant against armyworm, an invasive pest causing havoc in Uganda, as well as other African countries, than conventional crop varieties.

I was also impressed to learn about the development of the orange-fleshed sweet potato (OFSP) on the continent which the World Food Prize called “the single most successful example of micronutrient and vitamin biofortification”.

At a recent event held by the Planet Earth Institute, we heard from Robert Mwanga, a member of the team from the International Potato Center (CIP) that developed this innovation. Mwanga and his colleagues, Maria Andrade and Jan Low, developed disease-resistant, drought-tolerant, high-yielding OFSP varieties that can flourish in the diversity of soils and climates in Sub-Saharan Africa.

What makes this innovation especially valuable is that the scientists have bred vitamin A and other crucial nutrients into these staple crops, which can reduce hidden hunger for millions. Since 2009, the successes of the CIP’s work have been shared throughout the region, with nine countries including Ethiopia, Kenya, Mozambique and Uganda releasing 56 new superior varieties, 40 of which are orange-fleshed.

“Scientific research can create the higher-yielding, resilient food crops needed to boost agricultural growth, and improve our citizens’ well-being.”

Paul Boateng

These products can play a vital role in enhancing food security on the continent and combatting vitamin A deficiency, which affects more than 43 million children on the continent.

An increasing number of African countries have also found that investment in space science and technology can provide essential data for decision-making in agriculture. Nigeria’s first orbiting satellite, NigeriaSat-1, for instance, provides data and imagery to help monitor conditions that may affect the country’s farmers who make up 70 per cent of its workers. The satellite was also used to create the first detailed map of the country, allowing the government and policymakers to determine where farming takes place, and provide better support for its large rural communities.

Financing key to agricultural sector

Finally, according to the African Development Bank, low levels of special financing are one of the major constraints in boosting the agricultural sector in African countries. The latest technologies can help enhance access to finance for the continent’s smallholder farmers who comprise 80 per cent of local agricultural workers.

In Kenya, the Syngenta Foundation for Sustainable Agriculture, UAP Insurance, and telecoms giant, Safaricom, partnered to create Kilimo Salama (‘Safe Agriculture’), an insurance product for Kenyan farmers. Using the MPESA gateway, a widely used mobile phone-based money transfer, financing and microfinancing service, the product will offer smallholder farmers insurance policies to protect them from significant financial losses incurred during drought or excessive rainfalls. Given that such programmes can truly enhance farmers’ productivity, I would encourage the continent’s private sector companies to explore similarly impactful activities that can generate a competitive financial return.

As Makhtar Diop, the World Bank’s vice-president for Africa, writes, “A vibrant, sustainable and resilient agricultural sector is vital for Sub-Saharan Africa’s economic future”.

I hope that, moving forward, we will see new partnerships developing in which the private sector works with universities to take advantage of the new enabling environment that central bank governors and ministers of finance and agriculture are creating on the ground in Africa.

This is the surest pathway to move from “striving to thriving” in agriculture, with science and innovation as its foundation.

Paul Boateng is a former chief secretary to the UK Treasury and is chair of the Planet Earth Institute and the Nairobi-based Africa Enterprise Challenge Fund. He can be contacted at [email protected].

 

References

[1] New Report Finds Ten Years On, African Countries That Embraced Agriculture Saw Food Production, GDP and Nutrition All Improve (Alliance for a Green Revolution in Africa, 6 September 2016)

[2] African Development Bank Annual Meetings, Ahmedabad May 22-26 (African Development Bank, 2017)

[3] Makhtar Diop Foresight Africa 2016: Banking on agriculture for Africa’s future (Brookings Institution, 22 January 2016)

[4] International Fund for Agricultural Development Rural Development Report 2016: Fostering inclusive rural transformation (International Fund for Agricultural Development, 2016)

[5] World Bank Africa’s agriculture and agribusiness markets set to top US$ One Trillion in 2030 (World Bank, 4 March 2013)

[6] Jennifer Mbabazi, Moyo El-hadj M. Bah, Audrey Verdier-Chouchane Chapter 2.1Transforming Africa’s agriculture to improve competitiveness (World Economic Forum, 2015)

[7] The special challenge for sub-Saharan Africa (Food and Agricultural Organisation,2009)

[8] Wandile Sihlobo Africa Needs To Adapt To The Changing Climate (Huffington Post,6 March 2017)

[9] Elsa Buchanan Uganda declares armyworm outbreak as pest spreads in the region (International Business Times, 24 March 2017)

[10] 2016 – Andrade, Mwanga, Low and Bouis (World Food Prize, 2016)

[11] Planet Earth Institute PEI Spotlight Seminar: The Future of Agriculture in Africa (Planet Earth Institute, 2017)

[12] Kevin Perkins and Sheila Huggins-Rao Fighting vitamin A deficiency with a new kind of sweet potato, radio, and people power (Huffington Post, 18 October 2016)

[13] African Development Bank Feed Africa: Nourrir l’Afrique (African Development Bank, 2016)

[14] Steve Wiggins and Sharada Keats Leaping and learning: linking smallholders to markets (Overseas Development Institute, 2013)

[15] Kilimo Salama (Kilimo Salama, 2017)

[16] Makhtar Diop Foresight Africa 2016: Banking on agriculture for Africa’s future (Brookings Institution, 22 January 2016)

 

This article was originally published on SciDev.Net. Read the original article.

Universities need to work with tech companies

Martin Hall, University of Cape Town

The world of higher and professional education is changing rapidly. Digitally-enabled learning, in all its forms, is here to stay. Over the last five years, massive open online courses (MOOCs) have enabled universities to share their expertise with millions across the world. This shows how rapidly developing digital technologies can make learning accessible. The Conversation

These new technologies are shaking up traditional classrooms, too. And as the nature of work changes professionals are turning to high level, online courses to keep pace with new demands.

universities tech companies private sector MOOCs
Shutterstock

 

But much of this new technology is the preserve of private sector companies. This means that universities have to work with them. Yet partnerships with for-profit companies still don’t feel right for many in the higher education sphere. Knowledge has long been seen as a public good, and education as a basic right. Many of today’s universities were shaped by the principles of public funding.

This world was changing well before the disruptive impact of digital technologies, with tuition fees rising above the rate of inflation and the emergence of private universities as part of the higher education landscape. But there’s still unease about technology and its role. The reality, though, is that higher education institutions will have to get over their queasiness if they’re to survive in this brave new world.

Universities may not have the know how or the money to match the innovations coming onto the market through private tech companies. The decision by Nasdaq-listed technology education (edtech) company 2U to acquire Cape Town based startup GetSmarter for R1,4bn ($103million) is the largest price tag yet for a South African company working in digital education.

This is an indication of what it would cost a university to set up a full online division. Few institutions will have this money, or the ability to raise it. The alternative is to reconsider the advantages of public-private partnerships, taking care to retain authority over quality. For many universities this could be the only way of keeping pace with the changing world of education.

The story of a start up

The story of how GetSmarter got off the ground is a text book case of how a simple idea, combined with guts and luck, can reap huge rewards.

GetSmarter was launched in 2008 with a tiny budget and offered just one online course, in wine evaluation. By 2016 its annual revenues had grown to about R227 million. The foundation for this expansion has been a wide range of courses developed and offered in partnership with the University of Cape Town and, more recently, the University of the Witwatersrand and Stellenbosch University.

GetSmarter’s key breakthrough into the international realm came with professional programmes in association with the Massachusetts Institute of Technology (MIT) and Cambridge University. GetSmarter’s first course with HarvardX will soon be presented.

After its acquisition was announced I talked to the company’s CEO, Sam Paddock, co-founded with brother Rob. We discussed the lessons for other small digital companies – and for universities that are mulling the value of digital learning.

The Paddock brothers leveraged the cash flow from their father’s niche law firm to launch their first online course. They then used upfront payments for that course and the courses that followed to keep financing their next offerings. In the nine years that followed, edtech has become a crowded and complex field.

GetSmarter’s purchase price has garnered a lot of media attention: it’s high, in US dollar terms, and is a vote of confidence in the company. The price represents a valuation of a company’s assets, intellectual property and know-how, and strategic positioning for the future.

But what does it say about the kinds of investments and partnerships that conventional universities will have to make as they adapt to the full disruption from new digital technologies? The key aspect of GetSmarter’s success is how its partnership with universities has played out. As Paddock points out:

We are starting to realise the potential of public-private partnerships, where the credibility and resources of great universities can be combined with the skills of nimble private operators.

Good news for the digital economy

This acquisition is also good news for South Africa’s digital economy. Paddock says GetSmarter will employ more South African graduates and give them international experience and expertise.

And, he says, ecosystems often develop from one significant investment in an individual company. “This was how Silicon Valley started, as well as London’s ”silicon roundabout“. Cape Town, GetSmarter’s home city, has been trumpeted as South Africa’s own Silicon Valley: ”Silicon Cape“.

The opportunity to lead in digital innovation and application has been widely recognised, for example through the work of Accelerate Cape Town. The Cape Innovation and Technology Initiative (CiTi) has a range of initiatives underway, including a three year partnership with Telkom intended to build the digital workforce.

Last year, cellphone giant Vodacom announced an investment of R600m to assist in developing South Africa’s digital skills.

GetSmarter’s big win is good news and proof – if universities needed it – that such initiatives can bolster higher education’s offering in a rapidly changing world. Universities in Africa know that they need to keep up with the relentless march of digitally enabled learning. GetSmarter’s journey from bootstrapped startup to a billion rand enterprise is a case study, worthy of attention.

Martin Hall, Emeritus Professor, MTN Solution Space Graduate School of Business, University of Cape Town

This article was originally published on The Conversation. Read the original article.

Does Mozambique suffer from a very high suicide rate?

Bradley Wagenaar, University of Washington

Three years ago the World Health Organisation launched the first ever world suicide report and claimed that Mozambique had the highest suicide rate in Africa at 27.4 per 100,000 people. The Conversation Africa’s Samantha Spooner asked Dr. Brad Wagenaar about his research which sought to fill the knowledge gap on Mozambique’s suicide attempts and deaths. The Conversation

How severe is Mozambique’s suicide crisis?

Understanding the burden of suicide deaths in Mozambique, other similar Sub-Saharan African countries and in low-and middle-income countries is very challenging. This is primarily due to a lack of readily available measurements from death certificates related to suicide deaths.

suicide Mozambique Africa

In sub Saharan Africa causes of death, such as suicide, have been neglected.
Rafiq Sarlie/Flickr

 

In 2014 the World Health Organisation estimated that only 7% of deaths in Mozambique were reported by cause-of-death. Other analyses between 1980-2012 showed that Mozambique failed to make significant progress on the overall quality and completeness of cause of death reporting.

So currently the only way in which researchers can try and work out what’s happening is by creating exceptionally complicated statistical models to estimate death rates from samples of available cause-of-death data. Sometimes this means developing estimates from similar countries or creating estimates for death rates in a country that has not a single data measurement.

This approach has led to controversial estimates of death rates, including deaths due to suicide. For example, the WHO estimated that there were 4,360 suicide deaths in Mozambique in 2012, whereas the Institute for Health Metrics and Evaluation estimated that a year later there were only 1,744 such deaths.

All this adds up to is the suggestion that Mozambique has a high suicide rate compared to other countries. But we need sustained investments in public sector health data systems that can accurately maintain and analyse cause-of-death data to confirm this.

Added to this is the fact that when it comes to suicide deaths generally, few studies have been done to accurately measure the potential burden of suicide in sub-Saharan African countries. None have ever been done in Mozambique.

Given high rates of infectious diseases in sub-Saharan Africa – such as tuberculosis, HIV and malaria – the global community has historically neglected causes of death such as suicide. I believe this thinking will change over the next few years as non-communicable diseases become leading causes of death across sub-Saharan Africa.

If we want to promote population health effectively we need to invest in understanding these important non-infectious causes of death, as well as associated disability related to mental illness. Globally, mental illness is the leading cause of disability, yet the vast majority of individuals with mental illness don’t receive treatment.

What part of the population is most affected? Did you notice any trends with this?

Our study took place in Sofala, Mozambique. We abstracted all available death and emergency room records to look at patterns in suicide attempts and deaths.

While a novel study, it’s limited in that it reflects only individuals who came to the clinic. Our findings might therefore not be representative of individuals who live in very rural areas, or those who didn’t make it to a clinic.

When it comes to suicide deaths we found that 48% were under 26 years of age, and 16% were under 18. We also found that there were two male suicide deaths for each female.

But we found the opposite gender patterns when we looked at suicide attempts, with 2.2 females for each male suicide attempt registered in the emergency room.

This is a pattern seen across most countries in the world. Females tend to attempt suicide more frequently than males, but tend to use less deadly methods such as ingestion of pills. Males tend to attempt suicide less frequently, but tend to use more violent methods such as hanging.

What methods were most common and why do you think this was?

Mozambique suicideThe most common method of suicide attempt (66%) was rat poison.

Over 54% of suicide deaths used poisoning, with the most common individual poisoning method being rat poison. Hanging was used in 43% of cases. Males were significantly more likely to die by hanging, whereas women were significantly more likely to use poisoning by a toxic substance.

This could explain the gender differences observed whereby women attempt more often, but paradoxically tend to make up a lower proportion of suicide deaths. This can at least be partially explained by our finding that in Mozambique, women tended to use less lethal methods such as poisoning, whereas men appear to attempt less often but use more lethal methods such as hanging.

Why do you think the country has such a high suicide rate?

We really don’t know and don’t have definitive data to ensure that the statistical models estimating high suicide rates across Mozambique are accurate.

Suicide rates vary dramatically across the world. Known risk factors for higher suicide rates include; difficulties in accessing health care – especially mental health care, easy availability of the means of suicide (such as access to rat poison), inappropriate media reporting that tends to sensationalise suicide, and the stigma against people who seek help for suicidal behaviour or mental health and substance use problems.

All of these risk factors may be acting in Mozambique’s increased suicide rates.

Do you know of anything that’s being done to tackle this?

The Ministry of Health in Mozambique has recently developed a national suicide prevention plan that focuses on:

  • Investments in the collection of data on suicide
  • Training of health professionals in the recognition of suicide risk factors and the management of cases of suicidal thoughts and attempted suicide
  • Raising awareness among the community to decrease stigma related to mental health problems and suicidal behaviour.

In addition, Mozambique is one of the only countries in sub-Saharan Africa, and one of the only low and middle-income countries globally, to have already scaled-up mental health care delivered by psychiatric technicians. These technicians receive two years of training specifically in treating mental disorders, and are placed at district level primary care clinics. They serve as a key component of suicide prevention and intervention.

But very few studies have been done around suicide prevention and intervention across sub-Saharan Africa. We need sustained investments in the developing and testing of suicide prevention interventions in this region to avoid unnecessary suffering and death.

Bradley Wagenaar, Acting Instructor, Department of Global Health, University of Washington

This article was originally published on The Conversation. Read the original article.

Antimalarial candidate holds promise as a single dose

By Laura Owings

[CAPE TOWN] A new antimalarial candidate could pave the way for a single-dose treatment that boots malaria eradication when used in combination with other preventative measures.

In an article published last month (26 April) in the journal of Science Translational Medicine, researchers indicated that the compound MMV390048 could block all life cycle stages of the malaria parasite. It was also shown to be effective against resistant strains, prevent infection and block transmission.

“This drug profile reveals the potential to be part of a single-dose cure, benefitting people who are infected with malaria, and working as a preventative measure,” says Kelly Chibale, a corresponding author of the article and founding director of the University of Cape Town (UCT) Drug Discovery and Development Centre, H3D.

“This drug profile reveals the potential to be part of a single-dose cure, benefitting people who are infected with malaria.”

Kelly Chibale, University of Cape Town (UCT)

An estimated 212 million cases of malaria were identified worldwide in 2015, according to the WHO. Over 90 per cent of those were in Africa.

MMV390048 is a derivative small molecule belonging to the aminopyridine class. It was first announced as a preclinical development candidate in 2012, and in 2014, it was the first new anti-malarial candidate to enter phase I human studies in Africa when clinical trials began at the UCT Clinical Research Centre. Those clinical trials ended in 2015, but the data has not yet been published, Chibale explains.

This article provides preclinical data demonstrating the potential for the compound for the treatment, prophylaxis and cure of malaria in mice and monkey models. The trials involved administering MMV390048 to mice and monkeys before and after infection.

Done as a precursor to clinical studies, Chibale says this research provided a guideline for therapeutic dosage levels that would apply to human models, and gave confidence that the drug could indeed work in humans.

The article shows the drug’s efficacy across the three stages of the parasite’s life cycle: liver, blood and transmission. According to Chibale, this means the drug could kill the parasite in infected individuals before symptoms present, but could also be used when patients are visibly ill, and help block further mosquito transmission.

The drug is set to enter phase IIa clinical trials in 2017 in Ethiopia. If the outcomes of these are successful and funding is available, Chibale says the drug could be on the market in six to eight years.

Maureen Coetzee, director of the Wits Research Institute for Malaria at the University of the Witwatersrand in South Africa, tells SciDev.Net that should the drug become available on the market, it would be a noteworthy advance but adds that measures to control mosquitoes are also needed.

“Finding and treating those people [carrying the parasite] is an immense task, and as long as the malaria vector — mosquitoes — are around, they will feed on those people and transmit the parasites to new hosts,” she says.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

 

References

Tanya Paquet and others Malaria antimalarial efficacy of MMV390048, an inhibitor of Plasmodium phosphatidylinositol 4-kinase (Science Translational Medicine, 26 April 2017)

 

This article was originally published on SciDev.Net. Read the original article.