Friday, May 18, 2018

Recombinants harsh to HIV vaccine development

By Esther Nakkazi

Today is World HIV vaccine day. As we celebrate the day, we have a lot of hope this time around more than ever.

For the first time in many years, four efficacy vaccine concepts are in phase III and could give us an HIV vaccine. But even if they do not it is a still a great leap forward.

“If they do not give us a vaccine they will at least give us information about how it works,” said Dr. Francis Kiweewa, the head of research and scientific affairs at Makerere University Walter Reeds Project (MUWRP).

Kiweewa said we shall get to know this important information just two to three years from today in either 2020 and 2021 and that is not far off. He was speaking to journalists at their monthly science cafe organized by Health Journalists Network in Uganda, HEJNU.

But that withstanding you could ask do we still need an HIV vaccine anyway? In some circles, the debate is could HIV be the first epidemic to be eliminated without a vaccine.

I guess you have heard of all the interventions these days, the condom, the antiretroviral therapy for both treatment and prevention, the vaginal ring that showed promising results and more to it scientists are busy in their laboratories cooking up new HIV prevention and therapeutic tools every day.

Dr. Kiweewa says despite these efforts we still need an HIV vaccine. "The numbers of new infections remain incredibly high," he says. For instance in Uganda 500 youth get infected with HIV every week. In South Africa, 5000 young women are infected with HIV every week.

Also, the high cost of treatment is unsustainable and ultimately a vaccine would be cheaper, reach many more people and let us not forget that ‘prevention is better than cure’.

Even if we get the HIV vaccine in the next two to three years, there is a possibility that it might not be suitable for us. And here is why an HIV vaccine might work elsewhere and not for Uganda or East Africans.

HIV has many sub-types, the East African region has two predominant subtypes A and D while southern Africa mostly has subtype C. The Uganda Virus Research Institute (UVRI) scientists did a research, sequencing the virus and found that 50% of the HIV virus in Uganda are recombinants of subtype A and D.

This means 50% of the estimated 1.3 million people who are infected with HIV in Uganda have a combination of subtype A and D or AD/DA. While it may not necessarily be more virulent scientists say it progresses faster.

“A vaccine has that challenge,” says Prof Pontiano Kaleebu, the director of MRC/UVRI and the London School of Tropical Medicine (LSHTM). It is for that reason and many others that the renowned professor thinks we are a forgotten lot. 

“They are forgetting us here where we have recombinants in east Africa,” said Kaleebu. In other words, the spread of recombinant forms of HIV could have implications for vaccines developed to guard against only certain sub-types and not others.

Not enough research is being done in the region, your governments are not investing enough money so that the scientists develop that vaccine that is suitable for you.  So keep the optimism but also be mindful of the future that we could walk away empty handed here where the HIV burden is highest.

Thursday, May 3, 2018

WhatsApp groups with journalists and their sources should stop

By Esther Nakkazi

As we celebrate this years' World Press Freedom day, I say WhatsApp groups with journalists and their sources should stop.

In the current era, WhatsApp groups are formed pretty much after every engagement and for any cause to exchange information, debate issues, network or even fundraise.

Some are just timely, they run for a short while and for a worthy cause. I particularly like the baby shower WhatsApp groups. We discuss everything from the sex of the baby to its gifts. On the D-day, we ‘surprise’ the mother.

After the baby shower is over, happy moments in pictures are shared, the group is deleted and we move on. It is interesting that some people forget about the whole issue and probably check on mother and born baby a year later!

While the exchange of ideas and debating issues via WhatsApp is very good and has changed the way audiences consume news, giving feedback and wider visibility through more eyeballs, I am afraid that WhatsApps groups with journalists and especially the people supposed to give them information is outright wrong.

Ethically it has never been a good idea for journalists to cozy up to the people they cover. I thought journalists are supposed to keep some professional distance? But now the opportunist and savvy public relations officers have mastered their WhatsApp game. Don't also forget that journalists can be lazy.

They set up their own groups, send minute to minute updates - these can even be a voice WhatsApp and by the end of the day all radio stations will be singing their story with the same voice quote like a song.

If the groups only kept the conversations to news discussions maybe it would make sense but the reality is that they move beyond that and engage in ‘lugambo’ and getting daily compliments or updating each on a minute by minute basis, because that is what WhatsApp almost does to us!

The defenders of these groups were journalists are bedding with their sources say these keep the journalists and the people who give them information in constant touch in this era of fast news and they are so much alike press conferences but only in virtual space.

I have been on WhatsApp groups where posts deepen not only to family issues but also to uncomfortable topics where the public relations or communications person will blame the journalist for bad publicity - however truthful the story may be and even pressurise the journalists to apologise or retract because their ‘bosses are angry’ and job security has been threatened. 

I guess it is okay to send a personal WhatsApp to the source but manipulation of a whole group to cover what they want and the way they want it is demeaning good journalism.

Until we understand that the two groups have completely different roles, only then will journalists stop bedding with public relations or communication officers in the same WhatsApp group.

Malawi’s six-year maize export ban increased consumption but made farmers poorer

By Esther Nakkazi

Malawi’s six-year maize export ban increased consumption by 6 percent, achieving its objective of increased food security, measured narrowly in terms of availability of maize at lower prices, according to a study by Karl Pauw et al.

But these gains come at a cost to the rural farm sector, which suffered a 0.2 percent decline in agricultural value-added and lower disposable income levels, especially among poor farmers. Malawi imposed an uninterrupted maize export ban from 2011/12 until the end of 2017.

The ban was instituted through the government regulation of international trade of so-called “strategic crops” through its Control of Goods Act (2015). In there, commodities listed in the act, such as maize, require an export license. So export bans are enforced by withholding licenses, which in practice means formal exports through recognized border posts are affected.

Our results show that policy-induced distortions in the form of export bans or export levies on agricultural commodities create disincentives for farmers to produce, rendering these policies self-defeating and unsustainable in the long run. Moreover, export restrictions can be welfare-reducing and welfare losses tend to be biased against poorer farm households says the study.

It says when short-term political motivations outweigh longer-term socio-economic considerations, adverse effects may be conveniently overlooked by policymakers.

"Our results also highlight a more general concern about uncertain and incoherent agricultural policy environments that prevail in so many Sub-Saharan African countries, namely that they perpetuate a subsistence farming culture rather than encouraging commercial crop cultivation," says the study.

"This has negative consequences for the supply of marketed foods and intermediate inputs required by agro-processing sectors. Ultimately this is inconsistent with the stated economic transformation ambitions of so many African countries, articulated in the case of Malawi in its second Malawi Growth and Development Strategy (MGDS II) as shifting its economy from being a “predominantly importing and consuming economy to a predominantly producing and exporting economy”

In the past decade, more than 30 countries, including virtually all the world’s top grain producers and several southern and eastern African countries have imposed grain export restrictions.

Given the political and socioeconomic importance of maize in Malawi, the export ban has always been a highly sensitive topic, and any advocacy on the matter was done discreetly.

More about this study can be found at