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By William Smith and Wendy Turnbull, RH Reality Check. Posted April 1, 2008.

Earlier this month, Population Action International (PAI) and the Sexuality Information and Education Council of the United States (SIECUS) teamed up to conduct a joint policy research trip to Zambia. Zambia is one of the 15 focus countries prioritized to receive global U.S. HIV/AIDS assistance. Zambia was also one of the first countries where PAI documented, in 2003, the destructive impact of the Global Gag Rule (also known as the Mexico City policy) on family planning and reproductive health care services.

Other criteria, however, also made Zambia an ideal country through which to answer many questions about the effects of U.S. policy and funding. Long before PEPFAR’s arrival, a conservative religious environment defined Zambian society, within which the promotion of abstinence and marriage were already strong currents in everyday life.

First, what would the effect be after four years of the U.S. putting nearly $577 million into the country under policies that disproportionately emphasize these strategies over a more comprehensive HIV- prevention approach that included condom education and distribution?

Second, how are PEPFAR policies interpreted and implemented in this environment? And have they exacerbated the dire sexual and reproductive health and rights situation in Zambia, where rural family planning and reproductive health outreach collapsed after the country’s leading SRHR provider refused the terms of the Global Gag Rule?

Third, has U.S. assistance harmonized with other donors and what has the Zambian government’s role been in the midst of this? And finally, and perhaps most importantly, what are the needs of the health care workers on the ground and the Zambian people themselves in attempting to stem the generalized HIV epidemic in the country?

Having returned from the research trip to Zambia, PAI and SIECUS will be answering these key questions over the next several weeks and reporting on our findings and educating Members of Congress and their staff about how U.S. policy and assistance really plays out in the field. We’ll also be collaborating with and supporting Zambian NGO colleagues to increase SRHR advocacy with their own policymakers.

Immediately, however, we wanted to share some disturbing observations from our research interviews that both advocates and lawmakers should consider long and hard during Congressional recess and in preparation for floor consideration of PEPFAR reauthorization in a few weeks.

1) By all appearances, reproductive health seems to have vanished from Zambia both conceptually and as a health service. At the policy level, there is no official framework for SRHR. At the program level, sexual and reproductive health (SRH) services are thin and fall far short of demand. Rates of maternal death, unplanned pregnancy and unsafe abortion — especially among young women — are persistently high. Contraceptive stockouts have become more frequent and community-based SRH outreach throughout rural Zambia is non-existent, thanks to the Global Gag Rule. While the U.S. is one of a handful of donors providing FP/RH assistance and donated contraceptives to Zambia (about $6 million in FY07, compared with $216 million in PEPFAR funding), this small amount of U.S. assistance is hamstrung by Global Gag Rule restrictions and consequently is narrowly focused on providing technical assistance to the public sector.

2) While we observed and documented some impressive prevention programming funded with PEPFAR, it is as far from a comprehensive approach as one can imagine. Higher risk groups, such as sex workers, seem mostly neglected by PEPFAR and rarely talked about in a country with major trucking routes and new copper mines drawing migrant workers from the region. Condoms, as well, are not as actively promoted or distributed as they were pre-PEPFAR in Zambia — where prevalence is around 17 percent and rises to 30 percent or more in some parts of the country. And based on our conversations with Zambian and U.S. NGO staff, there is a lot of confusion about what you can and can’t say about condoms under PEPFAR. The notion that other donors — miniscule in comparison to PEPFAR — will step in to meet needs specifically jettisoned by PEPFAR in practice has not been borne out in Zambia.

3) Sexuality education is the missing foundation for effective prevention of the sexual transmission of HIV/AIDS. In one classroom, we observed a group of students being told that certain body fluids can transmit HIV. The students looked utterly bewildered and the skilled educators realized that it was because these students had a deficit in the basics of how their bodies work. The educators stepped in to describe what these body fluids were, but no patchwork quilt of HIV/AIDS prevention is going to maintain a long-term curbing of the epidemic if the education system does not play its part and begin providing comprehensive sexuality education as a foundation for other efforts.4) PEPFAR in Zambia operates largely in isolation. This has been observed in other PEPFAR focus countries and is endemic to the U.S. approach to foreign policy in other settings. This has profound implications for harmonizing with the Zambian government and its priorities for tackling the epidemic, as well as for coordinating with other donors to minimize duplication and maximize comparative advantages. For example, while it is true that the Zambian government works with the PEPFAR team there to develop an annual “country operational plan,” it is a bit akin to a borrower setting the entirety of the terms for a bank loan — it just doesn’t work that way. Zambian providers and advocates repeatedly told us that U.S. political priorities drive PEPFAR planning and programming, not the reality of HIV/AIDS on the ground.

5) Again, as seen in other focus countries, PEPFAR has created a discernible break between local NGOs and international and U.S.-based groups working in the country. The experience of many Zambian NGOs is that PEPFAR has not benefited from the development and capacity building of indigenous groups doing this work, but rather has led to the growth of U.S.-based NGOs, especially faith-based groups, who are the major recipients of PEPFAR’s largesse. That said, international and U.S. NGOs are clearly doing impressive work in the areas of treatment and care under PEPFAR, but at present the relatively tiny investment in home-grown, Zambian NGO efforts on the prevention side speaks to concerns about the sustainability of current activities and the development of Zambian professionals to lead this work in the future.

Reauthorization of PEPFAR’s prevention components needs to move beyond the persistence of the destructive political and ideological shenanigans of the bill’s first iteration. To this end, our field research in Zambia highlights key areas that must be addressed if PEPFAR’s promise is to be truly realized, and new infections averted.

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William Smith is Vice President for Public Policy at the Sexuality Information and Education Council of the United States (SIECUS).Wendy Turnbull is the Senior Policy Research Analyst at Population Action International (PAI).

Source: AlterNet.org

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UN warns on food price inflation

Pakistani women at subsidised food store 03.03.08

Governments are urged to take action to help ease rising prices

The head of the UN World Food Programme has warned that the rise in basic food costs could continue until 2010.Josette Sheeran blamed soaring energy and grain prices, the effects of climate change and demand for biofuels.

Miss Sheeran has already warned that the WFP is considering plans to ration food aid due to a shortage of funds.

Some food prices rose 40% last year, and the WFP fears the world’s poorest will buy less food, less nutritious food or be forced to rely on aid.

Speaking after briefing the European Parliament, Miss Sheeran said the agency needed an extra $375m (244m euros; £187m) for food projects this year and $125m (81m euros; £93m) to transport it.

This is not a short-term bubble and will definitely continue
Josette Sheeran
WFP

She said she saw no quick solution to high food and fuel costs.

“The assessment is that we are facing high food prices at least for the next couple of years,” she said.

Miss Sheeran said global food reserves were at their lowest level in 30 years – with enough to cover the need for emergency deliveries for 53 days, compared with 169 days in 2007.

Biofuel prices

Among the contributing factors to high food prices is biofuel production.

Miss Sheeran says demand for crops to produce biofuels is increasing prices for food stuffs such as palm oil.

Miss Sheeran said governments needed “to look more carefully at the link between the acceleration in biofuels and food supply and give more thought to it”.

The WFP says countries where price rises are expected to have a most direct impact include Zimbabwe, Eritrea, Haiti, Djibouti, the Gambia, Tajikistan, Togo, Chad, Benin, Burma, Cameroon, Niger, Senegal, Yemen and Cuba.

Areas where the WFP is already seeing an impact include:

  • Afghanistan: 2.5 million people in Afghanistan cannot afford the price of wheat, which rose more than 60% in 2007
  • Bangladesh: The price of rice has risen 25% to 30% over the last three months. In 2007, the price rose about 70%.
  • El Salvador: Rural communities are buying 50% less food than they did 18 months ago with the same amount of money. This means their nutritional intake, on an already poor diet, is cut by half.
  • Anger over rising food prices have already led to riots in Burkina Faso, Cameroon, Senegal and Morocco.

    The BBC is planning a special day of coverage of this issue on Tuesday 11 March, online, on radio and on TV.
  • Choose Your Language Of Preference Below 

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    Ladies and Gentlemen:

    I am glad to inform our audience and patrons that we have finally broken the supersonic speed of language barriers here at the Zambian Chronicle. You can now read your favorite blog in seven (7) different languages from around the world. 

    It is believed that every single human being alive who is literate enough to both read and excogitate can understand one of these languages or at least a dialect of the same. We were prompted to add this feature due to increased traffic and the kind of inquires were receiving from those who have visited our site. Our blog stat info was outstanding … 

    For instance, when we posted the Zambia Leads The World – Least Expensive/Fastest Adoption Programs article, we received referrals from all over the world as people were interested in knowing and learning about Adoption Programs the Zambian Enterprise offered. When we posted Just Who Is Carlos Slim – The World’s Richest Man? we received inquires from all over the world, I guess people of all faiths, languages, economic status, styles and backgrounds were interested in knowing who the new kid on the block was.

    We don’t receive many comments but on that day a Spanish commentator left one in Spanish. A Weekend With Bill Clinton just brought in even more inquires and so did Hidden Secrets Of Lumwana – World’s Largest Undeveloped Deposits (Copper, Gold, Cobalt & Uranium) and then we had visitors going back A Crush On Obama … America Votes’08 to the day we had the largest number of hits exceeding hundreds of readership was when we posted Best Ever US Ambassador To Zambia – Carmen M Martinez . 

    Of course that record (Ambassador Martinez) was broken today when we first published the translated French Version of the Zambian Chronicle; we are very sensitive to the needs of our audience therefore the decision to add more versions.  

    We, at the Zambian Chronicle are committed to serving the entire world in letting every one know about the good tidings concerning our country. We are also committed to changing and helping shape the world view of the Zambian Enterprise and what better ways to do that than using our abilities coupled with synergies technology has to offer, welcome aboard … thanks a trillion.

    Brainwave R Mumba, Sr.

    CEO & President – Zambian Chronicle

    Copyrights © 2007 Zambian Chronicle. All rights reserved. Zambian Chronicle content may not be stored except for personal, non-commercial use. Republication and redissemination of Zambian Chronicle content is expressly prohibited without the prior written consent of Zambian Chronicle. Zambian Chronicle shall not be liable for any errors, omissions, interruptions or delays in connection with the Zambian Chronicle content or from any damages arising therefrom.

    Zambian Chronicle is a wholly owned subsidiary of Microplus Holdings International, Inc.

    Copyrights © 2007 Microplus Holdings Int., Inc. 

    Zambian International Adoption

    The Zambian Enterprise leads the world with the least expensive as well as fastest adoption programs currently available. In fact, the International Adoption Agency lists Zambia on behalf of the whole continent as br-01-2.jpgthe best place for adoption. 

    This is actually a great blessing in disguise as local entrepreneurs could engage in a little more charity enterprising by providing philanthropic shelter as they work with this agency in preparing adoptions thereby alleviating prevalent the street kids quandary. 

    The American families are in a hurry to adopt but in most countries the legal framework is not only cost prohibitive but also laborious dragging on for years, in some cases. Zambia is the first African country under the auspices of the International Adoption Agency to be open for both married and single adopting parents in the US; Homeland Security (INS) approved families could be traveling as early as this summer (2007) … thanks a trillion.

    Brainwave R Mumba, Sr. 

    CEO & President – Zambian Chronicle 

    Copyrights © 2007 Zambian Chronicle.  All rights reserved. Zambian Chronicle content may not be stored except for personal, non-commercial use. Republication and redissemination of Zambian Chronicle content is expressly prohibited without the prior written consent of Zambian Chronicle. Zambian Chronicle shall not be liable for any errors, omissions, interruptions or delays in connection with the Zambian Chronicle content or from any damages arising therefrom.

    Zambian Chronicle is a wholly owned subsidiary of Microplus Holdings International, Inc. 

    Copyrights © 2007 Microplus Holdings Int., Inc.