LONG-TERM WORLDWIDE DECLINE IN ABORTIONS HAS STALLED

Press Release from Guttmacher

After a period of substantial decline, the global abortion rate has stalled, according to new research from the Guttmacher Institute and the World Health Organization (WHO). Between 1995 and 2003, the overall number of abortions per 1,000 women of childbearing age (15–44 years) dropped from 35 to 29; according to the new study, the global abortion rate in 2008 was virtually unchanged, at 28 per 1,000. 

This plateau coincides with a slowdown, documented by the United Nations, in contraceptive uptake, which has been especially marked in developing countries. The researchers also found that nearly half of all abortions worldwide are unsafe, and almost all unsafe abortions occur in the developing world. The study, Induced Abortion: Incidence and Trends Worldwide from 1995 to 2008, by Gilda Sedgh et al., was published online today by The Lancet.

In the developing world, the abortion rate was 29 per 1,000 in both 2003 and 2008, after falling from 34 per 1,000 between 1995 and 2003. The situation was somewhat different in the developed world, excluding Eastern Europe, where the abortion rate was much lower, at 17 per 1,000 in 2008, having declined slightly from a rate of 20 in 1995.

“The declining abortion trend we had seen globally has stalled, and we are also seeing a growing proportion of abortions occurring in developing countries, where the procedure is often clandestine and unsafe. This is cause for concern,” says Gilda Sedgh, lead author of the study and a senior researcher at the Guttmacher Institute.

 “This plateau coincides with a slowdown in contraceptive uptake. Without greater investment in quality family planning services, we can expect this trend to persist.”

Research from WHO shows that complications due to unsafe abortion continued to account for an estimated 13% of all maternal deaths worldwide in 2008; almost all of these deaths occurred in developing countries.

Globally, unsafe abortion accounted for 220 deaths per 100,000 procedures in 2008, 350 times the rate associated with legal induced abortions in the United States (0.6 per 100,000). Unsafe abortion is also a significant cause of ill-health: Each year approximately 8.5 million women in developing countries experience abortion complications serious enough to require medical attention, and three million of them do not receive the needed care.

“Deaths and disability related to unsafe abortion are entirely preventable, and some progress has been made in developing regions. Africa is the exception, accounting for 17% of the developing world's population of women of childbearing age but half of all unsafe abortion–related deaths," notes Iqbal H. Shah, of the WHO and a coauthor of the study.  

“Within developing countries, risks are greatest for the poorest women. They have the least access to family planning services and are the most likely to suffer the negative consequences of an unsafe procedure. Poor women also have the least access to postabortion care, when they need treatment for complications.”

The findings provide further evidence that restrictive abortion laws are not associated with lower rates of abortion. For example, the 2008 abortion rate was 29 per 1,000 women of childbearing age in Africa and 32 per 1,000 in Latin America, regions where abortion is highly restricted in almost all countries. In contrast,  in Western Europe, where abortion is generally permitted on broad grounds, the rate is 12.
The Southern Africa subregion, where close to 90% of women live under South Africa’s liberal abortion law, has the lowest abortion rate in Africa, at 15 per 1,000 women. Other very low subregional rates are found in Western Europe (12) and Northern Europe (17), where both abortion and contraception are widely available either for free or at very low cost.

Eastern Europe presents a very different situation, with an abortion rate that is nearly four times that of Western Europe. This discrepancy corresponds with Eastern Europe’s relatively low levels of modern contraceptive use and low prevalence of highly effective methods such as the pill and the IUD. After a striking decline in the abortion rate between 1995 and 2003, from 90 to 44 per 1,000 women, Eastern Europe experienced virtually no change in the rate between 2003 and 2008.

"These latest figures are deeply disturbing. The progress made in the 1990s is now in reverse. Promoting and implementing policies to reduce the number of abortions is now an urgent priority for all countries and for global health agencies, such as WHO,” says Richard Horton, editor of The Lancet. “Condemning, stigmatizing, and criminalizing abortion are cruel and failed strategies. It's time for a public health approach that emphasizes reducing harm - and that means more liberal abortion laws."

The full article and related materials can be found online @ http://www.guttmacher.org

Price monitoring tool for maize

By Esther Nakkazi

A price-monitoring tool that will make available monthly updates of staple food prices is to be developed for east and central Africa countries.

The software-monitoring tool will seek to increase competition and resilience to price volatility and kicks off early this year with the monitoring of maize prices, the major staple food of this region.

“We will be giving monthly updates of food prices and balances. We will also be trying out a forecasting model so that we can be more prepared, but this may take some time to adapt adequately,” said Dr. Michael Waithaka the Policy Analysis and Advocacy programme (PAAP) manager at the Association for Strengthening Agricultural Research in East and Central Africa (ASARECA).

The monitoring tool will use food price indexes generated by each of the countries’ bureau of statistics every month. The information will then be analyzed and distributed to all countries to create price awareness.

One of the envisaged solutions the tool will offer to local markets is the flow of food from surplus to deficit areas and from markets where the prices are low to where prices are high reducing food shortages.

But this would only work if the regions’ markets were integrated so that food security is improved from a country to a regional level. The high price volatility in the region is associated with the weak integration of the food markets.

High food prices also have a negative effect on trade for Africa, a net food importer, which spends about $20 billion annually on food imports. For instance, 45 percent of rice and 85 percent of wheat consumed in Africa is imported, according to statistics from United Nation’s Food and Agricultural Organisation (FAO).

Dr. Waithaka warned that the monitoring tool would not be the sole solution for the volatile prices since the causes vary a lot but each country would be considered individually to determine the impacts and then they will propose a basket of options.

Since 2010, the east and central African region suffered volatile food prices due to a combination of global causes and region specific factors.

Domestic food prices within this region increased to unprecedented levels in tandem with global food prices, which reached the highest level on record in February 2011, the highest since the inception of the FAO food price index (FPI) in 1990 to suggest a food price crisis.

In east Africa specifically, prices escalated due to recurrent droughts, high input prices in the agricultural sector, which also has low investment and a rapidly expanding population that has created a high demand for food with no corresponding supply.

As food prices escalated, countries in the region imposed trade policy measures like import tariff reductions as well as export taxes and bans to protect their populations from starving.

Export bans were the most famous trade policy measure in the region which unfortunately was a missed opportunity as a ‘crisis is a terrible thing to waste’ said Joseph Karugia, the coordinator Regional Strategic Analysis and Knowledge Support System for Eastern and Central Africa (ReSAKSS-ECA).

“In the 70’s and 80’s we complained about low prices but now that they are high we continue to complain. A regional response would be an opportunity to address the food price crisis,” said Karugia.

Karugia said high food prices would prompt exploitation of regional diversity and facilitate regional trade with priority actions including removal of export bans, elimination of non-tariff barriers and upgrading infrastructure of main regional trade corridors.

Country responses to high food prices;

But all this happened in the reverse, food exports were banned in Kenya, Tanzania and Rwanda. As food security got further threatened, Kenya slapped a temporary ban on export of seeds.

Tanzania followed suit, banning exports of cereals until the food security was analyzed and further refused to lift the ban even when it reported a surplus. Uganda did not limit export of food partly to maintain the export-oriented nature of Uganda’s agriculture sector, which is almost entirely engaged in food production.

President Yoweri Museveni explained the situation and argued farmers to take advantage of the high prices and traders to invest more in agriculture but the public would not believe him. He was booed at the youth gathering in Arua.

The International Monetary Fund (IMF) later applauded Uganda for adhering to a market-oriented approach and keeping true to its title of a ‘food basket’ in the region and not imposing a food ban.

While in Rwanda, the price of maize the main staple crop, almost doubled and food security was threatened with hardly anything to export. In effect, Uganda was the country in the region that responded with a level head to take advantage of the volatile prices in 2010/2011.

Scientists believe that with the monitoring tool that will avail food prices in an integrated market, the east and central African region would partly be rid of price volatility, not entirely but to a decent level.


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Chinese-made TB vaccine comes soon

By Esther Nakkazi

Tuberculosis vaccines may become affordable and readily available to the developing world, as China’s expanding role as a vaccine manufacturer becomes visible in global health.

According to World Health Organisation (WHO) about 2 billion people live with latent TB and globally it is responsible for the death of 1.4 million people annually. Vaccines are the most cost-effective biomedical intervention in medical history.

But as much as tuberculosis has created a public health crisis in the developing world, it is also a major public health priority in China, where there are more than one million new TB cases every year.

Last week, January 10th, Aeras the leading non-profit developer of TB vaccine candidates and China National Biotec Group (CNBG) the largest biotechnology corporation in China signed an agreement to develop new TB vaccines.

"The synergy created by bringing together our scientific and manufacturing expertise could have a substantial impact on efforts to advance innovative candidates in TB vaccine development," said Jim Connolly, President and CEO of Aeras.

Aeras will provide financial support and technical expertise - licensing its recombinant BCG platform - which aims to improve upon the current TB vaccine - and other technologies to CNBG.

While multiple research institutes in China operating under the umbrella of CNBG will be engaged in the development, manufacturing and distribution of affordable new TB vaccines for use globally.

The team will engineer a variety of candidate booster vaccines to match the new constructs with a goal to create more efficacious and longer-lasting protection against TB disease.

China expanding role as a vaccine manufacturer;

But in a bigger picture, the move shows the growing trend of collaborations between Chinese vaccine manufacturers and multinational players. Chinese vaccines are hitting the world market rapidly and its manufacturing capacity is improving.

Scientists claim Chinese-made vaccines will become more widely available to the global market within five years. Today, China’s 40 domestic vaccine manufacturers produce 49 types of vaccines that protect against 27 diseases, according to the National Bureau of Asian Research (NBR).

The industry’s massive annual output totals nearly 1 billion doses, the world’s highest yield in terms of a single national economy’s vaccine output.

“Lots of Chinese labs, buildings, hardware, and equipment are as good as those of multinationals, if not better,” said Kewen Jin, the General Manager, Aura Partners at the Pacific Health Summit.

WHO is closely working with Chinese vaccine manufacturers- providing training for inspectors and auditors- and also approved China’s State Food and Drug Administration (SFDA) in March 2011 as a functional regulatory authority for vaccines.

Chinese-made vaccines approved by the SFDA thus ultimately match international quality standards.
But specifically, China’s entry into the world vaccine market could result in two particularly game-changing turning points: lowering global procurement prices and reducing supply shortages.

Universally, China is known for its low-priced products that may go for Chinese-made vaccines too and has the potential to bring more vaccines to more countries and people.

Markets guaranteed to be impacted include the GAVI-eligible countries-including all east African countries- as GAVI is likely to be a high-volume purchaser of prequalified Chinese- made vaccines, confirmed NBR.

However, as acknowledged by Pacific Health Summit participants in Seattle last year, the traditionally low price points of Chinese-made products have contributed to low public confidence and perceptions of poorer product quality.



The world’s perception of ‘China price’ of Chinese-made vaccines may be inaccurate with its long experience producing traditional vaccines and big volumes of manufacturing levels, said Jack Zhang the director China Program, PATH.

But certainly, China’s entry in the global market means an overall average price drop for vaccines, which could make a difference for the world to meet the Millennium Development Goals and in this Aeras and CNBG collaboration for Tuberculosis.

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Ugandans sleepless over Americans access to their airwaves

By Esther Nakkazi

American Tower Corporation has taken over all MTN Uganda towers in Uganda but this is having a backlash on the deal as Ugandan consumers think this could be a ploy by Americans to access their ‘airwaves’ and hijack their base stations.

Early December, the American Tower Corporation, a leading owner and operator of wireless and broadcast communication sites in North America, and MTN Group Limited entered into a definitive agreement to establish a new joint venture tower company in Uganda.

ATC Uganda, formed out of this joint venture, has acquired all MTN Uganda’s existing 1,000 tower sites, for $175 million, a statement from Boston said. The company also owns Essar Telecom Infrastructure, which it acquired last year.

To Ugandans, the acquisition is significant because it will spur outsourcing among telecoms, which has only started with tower sharing. But to others, in a combination of ignorance and fear, the Americans will be monitoring Uganda’s ‘airwaves’, infringing on their privacy and hasten insecurity.

“It makes sense for telecoms to divest the business of handling masts to third party companies, through outsourcing but I feel we do not need an American company to do it, Ugandan companies have been doing it,” said Fred Bbale, a systems administrator working with the Government.

The debate has been going back and fourth on an IT professionals knowledge sharing online forum, I-network about how it would now be an easy walk for Americans to access and monitor all MTN Ugandans subscribers financial details. Through mobile money? Maybe.

“It will be easier for Americans to monitor their interests in the Uganda economy if they get direct control on MTN Towers. Our personal details with MTN cannot be safe with Americans. Generally it is a threat!” wrote Hadadi Kigozi on the I-Network Dgroup.

Another young University law student also a subscriber with MTN said he knows that even with just using the blackberry or iphone, the Americans can easily know his location and know what he is communicating and with whom. So acquisition to the MTN towers would just give them more access to him and he hates it.

However, there is a difference of opinion at least by a few who think it has no effect. “There is no personal details of yours on tower sites unless you had your name, address and phone number etched into the metal of the towers,” commented Noah Sematimba of Warid Telecoms.

“The Americans do not even need access to the towers to monitor the 'waves' being talking about. Anybody can do that. There are a lot of cheap tools available for GSM hacking and base station hijacking available and with some little extra effort, anybody could replicate what they think the Americans can do without going to the towers,” said James Wire Lunghabo an IT consultant and managing director of Linux Solutions.

ATC Uganda will be managed by American Tower, which will hold a 51percent stake and pay $89 million for this stake while MTN Group will hold a 49 percent stake. American Tower also expects that ATC Uganda will build approximately 280 tower sites for MTN Uganda over the next three years. The transaction is expected to close in the first half of 2012, upon which, ATC Uganda will be the largest owner and operator of tower sites in Uganda.

“Even Wikipedia would tell you that they do not need ATC Uganda-the newly created company- to do what they need to do,” commented Paul Bagyenda a computer scientist. But the dread of ‘Americans are coming’, the IT gurus still is worrisome to some Ugandans.

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