The national park idea was developed in the late 19th century in North America and was exported and applied to natural landscapes of Africa by the colonists. History reminds us that ideas and the institutions that they spawn become outmoded and inconsistent with contemporary realities. Crisis and senescence are not too strong words to use to describe the plight of national park and reserve systems in East Africa.
It is nearly 100 years since the national park and reserve system was introduced in East Africa to save beast from man. But today, the national park system, just like the biodiversity conservations goals that it seeks to promote, faces profound and hitherto unanticipated challenges. The notion of national parks as exclusive and pristine ecosystem assemblages, managed for posterity, is under intense challenge by recent advances in ecosystems ecology and systems resilience.
The cutting-edge ecological understanding and management policies of the 1900s are no longer tenable. Ecological understanding has moved on but park centric conservation practice is standing still. I know few ecologist who still believe that in the absence it human disturbance, natural ecological processes will lead inevitably to ecological balance. Anthropogenic climate change and habitat loss through fragmentation as well as land degradation have profoundly modified the rules that govern ecosystems response characteristics.
A study by Ogutu and others published in the Journal of Zoology in 2008 showed that abundance of six major ungulates in the Maasai Mara National Reserves declined markedly and persistently between 1989 and 2003. Ecologists believe that these declines in wildlife populations are attributable to habitat deterioration owing to recurrent droughts, increasing human population and changing land use in pastoral lands contiguous to the reserve.
Similar patterns of decline have been reported by Kenya Wildlife Services in Amboseli National Park. In 2007, there were an estimated 10,000 zebras. Early this year, only 982 Zebra were counted. Similarly in 2007, there were 7,100 wildebeests compared to 143 recorded in 2010. This massive die-off left lions without prey. In response to this unprecedented decimation of large ungulates, Kenya Wildlife Service relocated 7,000 Zebra and Wildebeest to Amboseli National Park in an attempt restore the predator–prey balance. This relocation was estimated to $1.3 million dollars.
But despite growing evidence that the concept and practice of parks and reserves is problematic, national conservation agencies are still stuck with the doctrine of preservation. For instance, the Kenya Wildlife Service states that it is “responsible for preserving ecosystems and biodiversity and ensuring that these resources remain in optimum condition for the multiple activities the government and local people demand of them”.
According to the Tanzania National Parks Policy, the purpose of national parks is to “preserve areas possessing exceptional value or quality illustrating natural resources to ensure that they retain a high degree of integrity as true, natural and unspoiled examples of a resource”. But many of Tanzania’s national parks and reserves, especially in the north, are becoming increasingly insulated due to human settlement, agricultural cultivation, and the active elimination of wildlife on lands adjacent to the parks. Recent studies have shown that insularization of the national parks and reserves has been an important contributory factor in large mammals extinctions in six northern Tanzania parks over the last 35-83 years.
Uganda’s species conservation and management objective is to promote and maintain viable and representative wildlife populations both within and outside protected areas. According to figures published in the Uganda Wildlife Policy of 1999, between 1960 and 1998, Uganda lost 97% of its Elephants, 85% of its Impala, 57% of its Buffalo and 57% of its very own Uganda Kob.
The evidence that national parks and reserves are no longer an effective means for maintenance of viable populations of wildlife is compelling. But why is the attitude of preservation of wildlife and unimpaired nature through national parks and reserves so entrenched in the mission of wildlife and conservation authorities in East Africa?
At the time of their establishment by the colonists, parks were seen as primarily as “vignettes of primitive Africa”. The traditional mission of national parks and reserves–“to preserve wildness, and as much as possible of the rich biological and cultural heritage of this planet, in a manner that will allow for the sustained, respectful, and non-consumptive enjoyment of these resources by the present and future generations”–is problematic and largely unattainable in the context of contemporary in East Africa.
The mission of the present-day park and reserve systems is a “dinosaur” that faces imminent extinction. This extinction is driven largely by the destabilizing change in landscapes and ecosystems as a result of the complex, uncertain and nonlinear dynamics of human population growth patterns around parks and reserves, habitat degradation, habitat fragmentation and climate change. To preserve wildness as much as possible has become mission impossible.
I propose a new approach for the management of parks and reserves in East Africa. In this approach, the mission of parks and reserves in the 21st century would be to perpetuate as much of the remnant landscapes and wildlife as possible. Key to achieving this mission will be the concept of resilience. The goal would be to manage for parks and reserves for resilience. In this context, resilience is defined as the capacity of a system (park or reserve) to absorb disturbance (drought, habitat loss, biodiversity loss, human perturbation) and re-organize while undergoing change, so as to retain essentially the same function, structure and identity.
In a planet increasingly under assault from human transformation, the role of conservation of biodiversity is critical as insurance to enable resilient ecosystems through sustained flow of ecosystems goods and services to society. But parks and reserves in their current configuration are unlikely allies in a management for resilience paradigm. Under a resilience paradigm, wildlife authorities would have to migrate mentally, from a mindset of static, invariant wilderness in which everything must be saved and embrace uncertainty, complexity and the fact that disturbance, natural or anthropogenic, is inevitable.
I argue here that there is need for a paradigm shift toward networks of dynamic ecosystems in the design and management of parks and reserves. This shift is fundamental if the goal of long-term conservation of biodiversity in a rapidly changing world is to be achieved. I propose the development of a network of interconnected parks and reserves to be used in sustainable management of and biodiversity at the landscape level.
Connecting the parks and reserves of northern Tanzania with the parks and reserves of south eastern Kenya would be an excellent place to start. The objective of the network of parks and reserves is to maintain optimum diversity and ecological within and among functional groups to secure biodiversity as well as enable re-organization and adaptive learning after disturbance.
Can the “dinosaur” mission of national parks and reserves evolve successfully in a world where nearly all of their founding scientific assumptions have been proven wrong? The answer to this question will be found in the ability of conservation practitioners to embrace the concept of resilience while at the same time convincing the public and preservation lobbyists that managing parks and reserves for resilience has long-term socio-ecological value.
Creative Commons
Sunday, May 23, 2010
Sunday, May 16, 2010
Ethnic Polarization Enables Corrupt and Totalitarian Regimes to Thrive in Africa
I have been wondering lately why Africans are stuck with atrocious governments. I am mystified by the level of acceptance and tolerance Africans have for incompetent public servants and despicable public service.
Why isn’t there public outrage and street protests over something as basic as lack of reliable water supply when citizens actually pay a public company to deliver water? Why aren’t African parents outraged by the fact that the public school system is broken and that it fails too many kids? Why for instance does the Kenyan public continue to travel by “Matatus” when this inappropriate mode of transportation kills and maims thousands of people through road accidents every year?
I recall the so-called freedom struggles that led Africa’s liberation from the yoke of colonialism. These struggles were galvanized by a collective aspiration and conviction that colonial rule was a purveyor socio-economic injustice. Africans wanted self-determination. Africans wanted a more equitable society. For instance Africans wanted a greater expansion of economic opportunities through unfettered participation in commerce. African parents were agitating for better education opportunities for their children. Africans wanted access to land and rights to grow cash crops.
The problems Africans face today–lack of political voice and inequitable access to services and opportunities–are fundamentally similar to the grievances that inspired our forbearers to deploy a virulent and bloody liberation struggle. I wonder why there is no popular uprising against the injustice and misrule perpetrated by contemporary African rulers. What is disconcerting about the African governance and socio-economic crises is that a majority of the obnoxious African leaders acquired power through political competition. And they won by impressive majorities. Omar Bashir, Robert Mugabe, Yoweri Museveni, Meles Zenawi are good examples. In 2007 Kenyans, stuck with a choice between two corrupt leaders, were thrown into a vicious ethnic conflagration. And today Kenya has a legally constituted coalition government, presided over by ethnic lords.
My sense is that the mobilization against colonial rule was motivated by racial rather than political grievances. This is has parallels in independent African states. The only notable uprisings in post independence Africa have been motivated by ethnic rather political grievances. I recall the united opposition against Kenya’s president Moi with the advent of multiparty politics in Kenya. There was a determined ethnic coalition against the Moi regime led by the Mr. Matiba, the late Odinga and the so-called young Turks. But Moi was just way smarter. He mastered and skillfully applied the cardinal imperatives of Kenyan politics, self-interest and ethnicity.
Similarly, the people of southern Sudan executed a brutal civil war against the Muslim north for over five decades. Today, the government of Southern Sudan, under the leadership of Sudan Peoples Liberation Movement (SPLM), is pursuing retrogressive policies and is engaged in blatant corruption but this is yet to incite any mass protests. So was the civil war just about Sharia law and domination by the Muslim north?
The reason Mugabe has stayed at the helm in Zimbabwe is because he projected the “imperialist British” as the archenemy of the Zimbabwean people. Mugabe then polarized the Zimbabwean public, casting the leading opposition parties as pro white imperialism. Thus Mugabe cut himself a blank cheque for misrule and got a majority of his citizens to sign it off.
I am inclined to believe that ethnic polarization and petty self-interests are the greatest obstacles to structured social mobilization for political and economic transformation in Africa. However, African societies can mobilize virulent violence when their collective racial or ethnic interests are threatened.
Why isn’t there public outrage and street protests over something as basic as lack of reliable water supply when citizens actually pay a public company to deliver water? Why aren’t African parents outraged by the fact that the public school system is broken and that it fails too many kids? Why for instance does the Kenyan public continue to travel by “Matatus” when this inappropriate mode of transportation kills and maims thousands of people through road accidents every year?
I recall the so-called freedom struggles that led Africa’s liberation from the yoke of colonialism. These struggles were galvanized by a collective aspiration and conviction that colonial rule was a purveyor socio-economic injustice. Africans wanted self-determination. Africans wanted a more equitable society. For instance Africans wanted a greater expansion of economic opportunities through unfettered participation in commerce. African parents were agitating for better education opportunities for their children. Africans wanted access to land and rights to grow cash crops.
The problems Africans face today–lack of political voice and inequitable access to services and opportunities–are fundamentally similar to the grievances that inspired our forbearers to deploy a virulent and bloody liberation struggle. I wonder why there is no popular uprising against the injustice and misrule perpetrated by contemporary African rulers. What is disconcerting about the African governance and socio-economic crises is that a majority of the obnoxious African leaders acquired power through political competition. And they won by impressive majorities. Omar Bashir, Robert Mugabe, Yoweri Museveni, Meles Zenawi are good examples. In 2007 Kenyans, stuck with a choice between two corrupt leaders, were thrown into a vicious ethnic conflagration. And today Kenya has a legally constituted coalition government, presided over by ethnic lords.
My sense is that the mobilization against colonial rule was motivated by racial rather than political grievances. This is has parallels in independent African states. The only notable uprisings in post independence Africa have been motivated by ethnic rather political grievances. I recall the united opposition against Kenya’s president Moi with the advent of multiparty politics in Kenya. There was a determined ethnic coalition against the Moi regime led by the Mr. Matiba, the late Odinga and the so-called young Turks. But Moi was just way smarter. He mastered and skillfully applied the cardinal imperatives of Kenyan politics, self-interest and ethnicity.
Similarly, the people of southern Sudan executed a brutal civil war against the Muslim north for over five decades. Today, the government of Southern Sudan, under the leadership of Sudan Peoples Liberation Movement (SPLM), is pursuing retrogressive policies and is engaged in blatant corruption but this is yet to incite any mass protests. So was the civil war just about Sharia law and domination by the Muslim north?
The reason Mugabe has stayed at the helm in Zimbabwe is because he projected the “imperialist British” as the archenemy of the Zimbabwean people. Mugabe then polarized the Zimbabwean public, casting the leading opposition parties as pro white imperialism. Thus Mugabe cut himself a blank cheque for misrule and got a majority of his citizens to sign it off.
I am inclined to believe that ethnic polarization and petty self-interests are the greatest obstacles to structured social mobilization for political and economic transformation in Africa. However, African societies can mobilize virulent violence when their collective racial or ethnic interests are threatened.
Thursday, May 13, 2010
Kenya's Eduction Culture Needs Radical Transformation
The exam-centric education system we inherited from the British colonists has created a workforce more adept at imitation than innovation. A radical change in Kenya’s education culture is needed to foster the human capital necessary for innovation- led social and economic transformation.
High scores in Kenyan Certificate of Primary Education (KCPE) determine the quality of secondary school a student will be admitted to. Private primary schools are notoriously famous for these super-high scores. A majority of students who ace the KCPE examinations, most of who are from well-to-do urban families, gain admission to top-flight public high schools. An inordinate proportion of students from these high-test score secondary schools eventually get admission into engineering, law and medical schools in public universities.
Teachers in both primary and secondary schools, under pressure to maintain their schools’ scoring record, teach to the test and organize extra classes for exam drills. Most public high schools in Nairobi that were historically day have been converted to boarding schools, ostensibly to sequester and then drill any form of imagination and playful inquiry out of young learners.
Parents ferry children as young as primary six to school on the weekend for extra tuition. In most urban schools, and some rural primary schools too, classes begin at 7 am and end after dusk. In both public and private schools holiday tuition is mandatory. Amidst pressure from long school days and onerous homework, the Kenyan student’s most intellectually demanding work is memorizing mind–numbing facts for regurgitation.
And it gets even better. On a designated day, just before the start of the national exams, parents and teachers pack churches and school assembly halls with bended knees and beseeching hearts to pray for divine wisdom.
The product of this educational culture is deficient in the inquiry, investigation, and analytical skills needed for scientific and technological innovation. My experience while teaching 3rd year undergraduate engineering students at a local university was uninspiring. While their motivation and effort was impressively high, these “A” students were atrociously weak at seeing connections, synthesizing information, extrapolating ideas or generating hypotheses. This may suggest that the Kenyan education does not nurture problem-solving and analytical skills required for innovation.
The education system we inherited and nurtured faithfully over the last five decades was designed to give Africans basic education and not tools and skills that enable critical thinking and problem solving. The goal was to mass-produce literate but unthinking underlings to serve the colonial administration as manual labourers and career civil servants. And I think it has achieved it goal. My sense is that Kenyan students, graduates, and I dare say educators, are adept at absorbing existing knowledge and imitating existing technology.
It is not possible to deliver a critical mass of analytical minds and leaders of innovative solutions needed to realize the much-hyped vision 2030 through the current education system. A robust transformation of the educational culture must happen before homegrown Kenyan innovation, not imitation, can challenge scientific and technological dominance of the west and increasingly, of the east.
However, the larger tragedy of the failure of our education system plays out in research, both in universities and public research institutions. Kenyan¬–based scientists, without Western collaborators, seldom publish in high impact factor peer reviewed journals. But to be fair to Kenya, it is helpful to note that no African country (except South Africa) or Asian country is represented among the top 20 journals, ranked by the average number of citations in every published paper.
Kenya has for a long time recognized that a critical mass of entrepreneurial researchers is required to sustain research and encourage innovation. Since the famous “air-lifts” of the late 1950s and 1960s, Kenya has sent and continues to send some of the best students to North America and Europe for training in science and technology. Those who return, especially to public universities and research institutions, are seldom valued for their initiative and creativity. Instead they are sucked into the bureaucracy, often to managerial positions that demand nothing of their high education and specialized training.
Education reform needed nurture a new generation of characteristics and abilities among young learners. I believe students, at all levels, should be taught using problem-based and inquiry–based learning. This approach will develop their powers of investigation and critical thinking. Student grades should depend on active contribution during group-based learning and problem-solving sessions, to change the focus from competitive examination to collaborative learning.
The fundamental goal of radical transformation of the education culture must be to be to situate learning in the life of the student in a manner that enables critical thinking, promotes problem solving and deepens opportunity for innovation. Ultimately, the key to reform in education is a curriculum that emancipates the Kenyan children, liberates them to play, explore, experiment, discover, reflect and doubt. Hence, unleashing the full complement of human ingenuity and creative abilities of every sort, which must be the source of our collective resilience.
High scores in Kenyan Certificate of Primary Education (KCPE) determine the quality of secondary school a student will be admitted to. Private primary schools are notoriously famous for these super-high scores. A majority of students who ace the KCPE examinations, most of who are from well-to-do urban families, gain admission to top-flight public high schools. An inordinate proportion of students from these high-test score secondary schools eventually get admission into engineering, law and medical schools in public universities.
Teachers in both primary and secondary schools, under pressure to maintain their schools’ scoring record, teach to the test and organize extra classes for exam drills. Most public high schools in Nairobi that were historically day have been converted to boarding schools, ostensibly to sequester and then drill any form of imagination and playful inquiry out of young learners.
Parents ferry children as young as primary six to school on the weekend for extra tuition. In most urban schools, and some rural primary schools too, classes begin at 7 am and end after dusk. In both public and private schools holiday tuition is mandatory. Amidst pressure from long school days and onerous homework, the Kenyan student’s most intellectually demanding work is memorizing mind–numbing facts for regurgitation.
And it gets even better. On a designated day, just before the start of the national exams, parents and teachers pack churches and school assembly halls with bended knees and beseeching hearts to pray for divine wisdom.
The product of this educational culture is deficient in the inquiry, investigation, and analytical skills needed for scientific and technological innovation. My experience while teaching 3rd year undergraduate engineering students at a local university was uninspiring. While their motivation and effort was impressively high, these “A” students were atrociously weak at seeing connections, synthesizing information, extrapolating ideas or generating hypotheses. This may suggest that the Kenyan education does not nurture problem-solving and analytical skills required for innovation.
The education system we inherited and nurtured faithfully over the last five decades was designed to give Africans basic education and not tools and skills that enable critical thinking and problem solving. The goal was to mass-produce literate but unthinking underlings to serve the colonial administration as manual labourers and career civil servants. And I think it has achieved it goal. My sense is that Kenyan students, graduates, and I dare say educators, are adept at absorbing existing knowledge and imitating existing technology.
It is not possible to deliver a critical mass of analytical minds and leaders of innovative solutions needed to realize the much-hyped vision 2030 through the current education system. A robust transformation of the educational culture must happen before homegrown Kenyan innovation, not imitation, can challenge scientific and technological dominance of the west and increasingly, of the east.
However, the larger tragedy of the failure of our education system plays out in research, both in universities and public research institutions. Kenyan¬–based scientists, without Western collaborators, seldom publish in high impact factor peer reviewed journals. But to be fair to Kenya, it is helpful to note that no African country (except South Africa) or Asian country is represented among the top 20 journals, ranked by the average number of citations in every published paper.
Kenya has for a long time recognized that a critical mass of entrepreneurial researchers is required to sustain research and encourage innovation. Since the famous “air-lifts” of the late 1950s and 1960s, Kenya has sent and continues to send some of the best students to North America and Europe for training in science and technology. Those who return, especially to public universities and research institutions, are seldom valued for their initiative and creativity. Instead they are sucked into the bureaucracy, often to managerial positions that demand nothing of their high education and specialized training.
Education reform needed nurture a new generation of characteristics and abilities among young learners. I believe students, at all levels, should be taught using problem-based and inquiry–based learning. This approach will develop their powers of investigation and critical thinking. Student grades should depend on active contribution during group-based learning and problem-solving sessions, to change the focus from competitive examination to collaborative learning.
The fundamental goal of radical transformation of the education culture must be to be to situate learning in the life of the student in a manner that enables critical thinking, promotes problem solving and deepens opportunity for innovation. Ultimately, the key to reform in education is a curriculum that emancipates the Kenyan children, liberates them to play, explore, experiment, discover, reflect and doubt. Hence, unleashing the full complement of human ingenuity and creative abilities of every sort, which must be the source of our collective resilience.
Monday, May 3, 2010
A New Approach to Foreign Aid
Aid continues to draw controversy and debate amongst academics, recipients and development agencies. The anti aid campaigners in Africa argue that aid underwrites public sector incompetence and fuels corruption. Proponents of aid point to gains in delivery of health and education services to the most needy and underserved populations.
A new book by Nancy Birdsall and William Savedoff of the Centre for Global Development is the latest, compelling addition to the aid conversation. The central thesis of the Birdsall and Savedoff’s book, Cash on Delivery: A New Approach to Forign Aid is that aid money for poor countries should be given for outcomes, not input. They argue that aid money should not be used to cover expenses but instead be paid out if a country achieved certain development goals. They call this Cash on Delivery Aid (COD Aid).
COD Aid is meant to be robust approach to altering funder-recipient relationships, providing basis to ensure accountability and achieve shared goals. The key features of COD Aid include: i) payment for outcomes not inputs; ii) hands-off donors, responsible recipients; iii) ownership of process and institution building; and iv) transparency through public dissemination.
These features are inevitably amenable to local accountability, local ownership of process and most importantly, learning by doing on the part of recipients (no expats).
Although it proposes a fundamental shift in the aid business, the authors point that COD Aid is intended to supplant all other forms of foreign assistance. They see COD Aid as complementing existing aid programs. I find this concession rather problematic, especially in the face of an abundance of evidence on the critical flaws of the current practice of aid programmes.
Birdsell and Savedoff contend that when COD Aid’s mechanisms for measuring progress, providing incentives, and clarifying responsibilities become established, it will help funders and recipients make much more efficient use of existing resources across a spectrum of aid programs.
The authors provide some interesting examples of hoe COD Aid would work. For instance, instead of using aid money to pay to build schools, or to train teachers, aid could be used to reward a country for getting more kids to complete school–without sacrificing education quality, as measured in test performance.
It is not clear in my mind how one would do this. How for instance would a school district enroll, retain and graduate more children, let alone achieve some lofty quality standard when the fundamental problem is lack of schoolhouses and quality teachers. I am not sure that that the pay-off per child retained and graduating with an agreed level of competence can provide enough resources to invest in education expansion. I have doubts about the scalability of COD Aid.
I must say that Cash on Delivery: A New Approach to Forign Aid is an audacious, fresh and thoughtful addition to the aid debate. It is a must read for academics, funders and recipients of aid.
A new book by Nancy Birdsall and William Savedoff of the Centre for Global Development is the latest, compelling addition to the aid conversation. The central thesis of the Birdsall and Savedoff’s book, Cash on Delivery: A New Approach to Forign Aid is that aid money for poor countries should be given for outcomes, not input. They argue that aid money should not be used to cover expenses but instead be paid out if a country achieved certain development goals. They call this Cash on Delivery Aid (COD Aid).
COD Aid is meant to be robust approach to altering funder-recipient relationships, providing basis to ensure accountability and achieve shared goals. The key features of COD Aid include: i) payment for outcomes not inputs; ii) hands-off donors, responsible recipients; iii) ownership of process and institution building; and iv) transparency through public dissemination.
These features are inevitably amenable to local accountability, local ownership of process and most importantly, learning by doing on the part of recipients (no expats).
Although it proposes a fundamental shift in the aid business, the authors point that COD Aid is intended to supplant all other forms of foreign assistance. They see COD Aid as complementing existing aid programs. I find this concession rather problematic, especially in the face of an abundance of evidence on the critical flaws of the current practice of aid programmes.
Birdsell and Savedoff contend that when COD Aid’s mechanisms for measuring progress, providing incentives, and clarifying responsibilities become established, it will help funders and recipients make much more efficient use of existing resources across a spectrum of aid programs.
The authors provide some interesting examples of hoe COD Aid would work. For instance, instead of using aid money to pay to build schools, or to train teachers, aid could be used to reward a country for getting more kids to complete school–without sacrificing education quality, as measured in test performance.
It is not clear in my mind how one would do this. How for instance would a school district enroll, retain and graduate more children, let alone achieve some lofty quality standard when the fundamental problem is lack of schoolhouses and quality teachers. I am not sure that that the pay-off per child retained and graduating with an agreed level of competence can provide enough resources to invest in education expansion. I have doubts about the scalability of COD Aid.
I must say that Cash on Delivery: A New Approach to Forign Aid is an audacious, fresh and thoughtful addition to the aid debate. It is a must read for academics, funders and recipients of aid.
Sunday, May 2, 2010
Food Security and HIV/AIDS Therapy
A study conducted in Mbarara and Kampala in Uganda shows that limited or uncertain access to adequate food interrupts or postpones initiation of antiretroviral (ARV) treatment among individuals infected with HIV/AIDS.
According to the study, five mechanisms appear to contribute to ARV non-adherence and treatment interruptions or to postponing ARV initiation:
i) ARVs intensified appetite and led to intolerable hunger in the absence of adequate food;
ii) Side effects of ARVs were aggravated in the absence of adequate food;
iii) Infected individuals believed they should skip doses or not start on ARVs at all if they did not have access to food.
The study concludes that addressing food insecurity as part of emerging ARV treatment programs is critical for their long-term success. There is concern that recent gains in HIV/AIDS treatment not sustainable in the presence of widespread poverty and food insecurity exacerbated by climate change.
I think there is an opportunity here for an innovative convergence in policy formulation for both health and agriculture.
See full article
http://feedproxy.google.com/~r/plosone/PLoSONE/~3/48Ur5E-l2Tw/info:doi/10.1371/journal.pone.0010340
According to the study, five mechanisms appear to contribute to ARV non-adherence and treatment interruptions or to postponing ARV initiation:
i) ARVs intensified appetite and led to intolerable hunger in the absence of adequate food;
ii) Side effects of ARVs were aggravated in the absence of adequate food;
iii) Infected individuals believed they should skip doses or not start on ARVs at all if they did not have access to food.
The study concludes that addressing food insecurity as part of emerging ARV treatment programs is critical for their long-term success. There is concern that recent gains in HIV/AIDS treatment not sustainable in the presence of widespread poverty and food insecurity exacerbated by climate change.
I think there is an opportunity here for an innovative convergence in policy formulation for both health and agriculture.
See full article
http://feedproxy.google.com/~r/plosone/PLoSONE/~3/48Ur5E-l2Tw/info:doi/10.1371/journal.pone.0010340
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