Monday, December 6, 2010

Will Ivory Coast go the Kenyan and Zim way?

A disputed election. The losing incumbent is quickly sworn in as president. The supposed victor is left out to dry. Riots and violence break out by angry disaffected youth of the undeclared victor.
International mediation teams jet into the country for talks between warring parties.
After several weeks of negotiations, the losing incumbent remains president and the supposed election winner is declared prime minister , with a few loyalists handed some non descript cabinet dockets in an uneasy,fragile settlement. Sounds familiar? Well this is the script that Zimbabwe and Kenya followed after bitterly disputed presidential elections a few years ago.Is this the future of electoral democracy in Africa?
Are African incumbent presidents becoming too cynical about African electoral democracy?
Hold an election which will leave you as president even when you lose it? Quicly swear in as president, close off your border and then let in a friendly mediator usually one who has been in the presidents club at the AU or EU.
In Ivory Coast this is about to play out between the incumbent and the undeclared victor.
Post election settlements are a real threat to the integrity of African elections and threaten to disenfranchise the African voter. Does national peace have to come at the price of a dashed election?

Monday, November 15, 2010

A little German twist of fate

If you told me in high school that I would visit Germany,the country I read about in my modern european history classes at secondary school, four times, I would think you were nuts.
But life throws us many suprises and my association with Germany ,thus far,is a real suprise ,even to me. Well, Forrest Gump warned me a long time ago, 'life is a box of chocolate, you never know what you are gonna get'.
I have now visited Germany four times in the last two years. That's two visits per year, on average.
And yes, I have enjoyed, immensly, all my trips to Germany.
Even as a child in elementary school, I often quizzed my helpless dad about countries and which was richer than the other(which questions my Dad always patiently provided,thanks dad!), I knew that Germany was one of the most advanced countries on the globe. At the time it was up there with the US and Japan. The Asians of course have had something to say about that lately.
But I didn' count Germany among the first countries I would probably visit. There was the language barrier,the stereo types, and thenthe obvious history,which I mastered as a high school history major.
But as I write, I have now visited Germany more times than any other country outside Uganda.
My association with Germany was never delibarately planned. I would say it was fate and Germany came calling each time.
In 2008, I applied and was selected as a German Academic Exchange Service (DAAD)fellow at the University of Oldenburg.

Friday, October 15, 2010

Will the Kings from the east be as benevolent as those from the west?

It is no secret. The global balance of power is shifting from the west to the east. Martin Jaques has an intriguing book title 'When China Rules the world: The end of the western world and the birth of a new global order'. Studies show that the west is undergoing a steady decline especially in economic terms and the in contrast countries such as China and India are on the rise.
And with the loss of economic predominance so too goes global influence and cultural leadership.
But this diatribe is not about the rise of the east and the fall of the east. Its about who would be a more benevolent global leaders, the Chinese or the europeans for instance.
In Uganda, Vice president Gilbert Bukenya recently urged Ugandans to learn chinese.
European values have ruled the world in the last century. With China becoming an economic power one wonder what kind of global leader China will be. What values will it profess to the world.
Bill Gates was in China recently to talk to some Chinese millionaires about donating to global causes. He didnt get many converts.
Some would say that the west gives to poor countries out of guilt of a history of colonialism and imperialism and that China doesnt owe the poor world anything.
Would human rights, democracy, the rule of law, liberty be the dominant ideal in a world led by China?
For all the west's failings, the world in the past two centuries has grown to expect some sense of 'western' justice in the conduct of human affairs. With Asian countries emerging as global power houses will european values still prevail.
As africans we have grown used to western philanthropy,albeit with its strings attached' but will a world ruled by Asia in the next fifty years continue with a western value system?
Can Asia provide a compassionate leadership of the world? Can it guarentee a 'just' world order.
Will international law systems such as the United Nations still play the role they do today? Will diplomacy still be chosen over war?
Can the world depend on Asian global leadership the way the west has done in past centuries?

Sunday, September 12, 2010

Witzenhausen: The Tale of a small town

They told us it was a small rural town in the heart of Germany. Well, there was nothing terribly rural about this delightful, albeit,small river town famous for its cherries. Pardon me, I am from Kampala and 'rural' town is a relative term. It took us about two and half hours to get here by taxi from Frankfurt International. It could take marginally less time when you taken the bullet train from Frankfurt.
Witzenhausen, we were told is a university town to a satelite campus of organic agricultural sciences of the University of Kassel. It is a tourist delight(and we came across american and english tourists) with buildings from the middle ages. We visited a cathedral from the times of Martin Luther and the reformation. I was amazed that back then they would bury aristocrats in cathedrals. Middle age paintings are still there for all to see and there are not many places in the world you can still say that about.
We visited a tower north of the town where prisoners would be secluded from society. Above the tower you have an imposing view of the town.
We were to be guests here for fourtneen days. Twenty six people from more than fifteen countries.
I took up residence at the Deula. One of us says we are at' Am sande 2',strasse, the German word for street.
In Witzenhausen, business closes at six pm in the evening and these folk do keep time-almost to a fault. Sunday is a complete shut down, the shops are closed.They need the rest. After all, they have been building this nation for centuries while we did the hunter-gather gig...
There is a delightful tarmarcked foot path along the river in the town that is absolutely gorgeous for nature walks and introspection.
We were to be students in a medieval monastery later turned into a German colonial administration school (the irony was not lost on me) and currently an agricultural school.
Witzenhausen, a small, intimate town in the heart of Germany

Tuesday, August 3, 2010

HIV/AIDS is still a disease of international emergency

Recent trends suggest that international attention on HIV/AIDS is waning and so is the funding. The global commitment to combat HIV/AIDS internationally is in some form of down turn.

An emerging perception is gaining currency that HIV/AIDS is no longer the threat it was in decades past(especially in the west) and that budgets, programmes and efforts lined up globally to respond to it should be down sized (in corporate speak).

International funding for HIV/AIDS in the developing world has been scaled down according to the international press and from the actual providers of HIV/AIDS care such as Dr Peter Mugyenyi, Head of the Joint Clinical Reseatch Centre (JCRC) in Kampala,Uganda.
PEPFAR the most important funder of HIV/AIDS treatment in Sub Saharan Africa is 'flat funding' AIDS programmes in Africa according to the International Treatment Preparedness Coalition (ITPC)2010 report and a Medicine San Frontiers report of 2009. The implication is that AIDS treatment centres in Sub saharan Africa cant enroll new patients because they have no budget lines to support their life-long treatment due to funding 'flat-lining'.

The global financial crisis is the first excuse thrown about to explain the declining funding from western donors for the HIV/AIDS response in countries which cant cope unaided but reports show that political factors in western donor countries are equally at play.

It has been reported in 'The New York Times', 'The Boston Globe' and in the 'Huffington Post' in the US that the Obama administration is intent on scaling down on PEPFAR funding in favour of promoting a proposed new maternal and child health initiative in the developing world. It is understood that Dr Ezekiel Emmanuel has been pushing this line within the Obama administration. Politically speaking,PEPFAR was a Bush administration initiative with enormous success and the Obama administration is in need of a similar international success.

Clearly, maternal and child health too is a continental emergency and the recent July 2010 AU summit in the Ugandan capital was called solely on the subject. However, to cut AIDS treatment funding at the moment and to renege on promises to incrementally scale up funding to treat the increasing number of patients in need of anti retroviral therapy would be nothing short of tragic.

In Uganda, 100,000 new patients are added to list of those in need of AIDS treatment(ART) , in a country where only a half of those eligible for treatment get it(a continental record nevertheless). HIV/AIDS prevalance rates in some Sub Saharan African countries such as Uganda are on the increase and more not less funding is needed from international donors but also from African governments which should do more to shoulder the burden of treatment of their own citizens. The World Health Organization (WHO)issued new guidelines requiring that patients be put on AIDS treatment earlier than initially recommended hence increasing the treatment burden further.

The Global fund on AIDS,Malaria and TB is finding difficulty raising funds from western donors and is incapacitated in calling successive rounds of funding AIDS treatment in poor countries.
Now is not the time to play politics with human lives in Sub Saharan Africa. For millions of patients who depend on PEPFAR and the Global Fund monies for their drugs,this is a matter of life and death.

PEPFAR may go down as one of the few successes of the Bush administration and failing it inorder to promote a new global health initiative for political expedience is failing humanity needlessly.

Sunday, July 11, 2010

The World Cup and Gross Domestic Product(GDP).

You would wonder what in the world, the FIFA World Cup has to do with Gross Domestic Product(GDP)figures of countries but, come to think of it, it has evertything to do with it.
Consider this: the top three finalists at this 2010 World Cup Finalists are Germany,Netherlands and Spain. Its no coincidence that these countries are countries with some of the highest GDP figures acording to the World Bank.
Many have decried the poor perfomance of African countries at this World Cup and other earlier editions (save for Cameroon in 1990 , Senegal in 2002 and Ghana in this World Cup). The truth is that historically, the best perfoming countries at the World Cup have also been some of the wealthiest. All countries that have won the World Cup have been major industrial powers(save for the Latin American countries). England,Italy,France,West Germany have each won the world cup.
There would seem to be a corelation between GDP and success at the World Cup finals. Can this be pure coincidence?
Many pundits agree that hosting the World Cup on home soil is an advantage. Think here of the French in 1998 or the English in 1966 or even Uruguay in the maiden competition.
Not every country has the economic muscle to host a World Cup. FIFA recently revealed that there were not many countries in Africa which would have been able to host the prized competition even if they wanted. Investing billions of dollars in perfunctory stadiums, many of which will not be used much after the World Cup, is not every country's cup of tea. In Africa, not even Nigeria can afford such hefty investments despite the billions in pay offs that come with hosting such a global show piece. South Africa is reported to bag close to 3 billion dollars as an off-shoot of hosting the World Cup in terms of increased Tourism interest, trade and commerce.
Besides all the economics, it takes money to afford the best training possible for a competing team, hiring the best coaches money can buy, paying competitive player bonusses(many African teams self-destruct on account of unpaid bonusses at competitions).
If African countries want to win the World Cup may be the Holy Bible comes in handy' Seek first the economic kingdom and the rest will follow'.

Sunday, June 6, 2010

Larry King Live Makes 25 years

CNN is marking 25 incredible years of Larry King Live. Donald Trump turned the tables on Larry King in a commemorative interview on CNN fielding questions from a diverse audience of people he has interviewed over the years from Lionel Ritchie to Marlon Brando. Questions regarding his favourite interview, why he favours suspenders, his endurance on the show were all put to the 'King of talk television'. They showed a snippet of an interview he had with Marlon Brando a few days before he died.Marlon Brando had been out of the public eye for ages at the time and we see him give Larry a kiss,presumably for the unique rapport he strikes with his guest.
I first watched Larry in 1992 when CNN broadcasts were pionnered in Uganda. I became an instant fan even when when I was just a teenage secondary school kid.
Larry King is a gifted interviewer and there is no one like him on television. Even years of training would not produce a Larry King. He simply has got it. He is comfortable talking to a rocket scientist as he is talking to Snoop Doggy Dogg. His staying power is truly remarkable.

Friday, May 21, 2010

The East African Com mon Currency and the Greek Cautionary Tale

Greek tragedies are eminent in world literature and now, they seem instructive for common currencies around the world. Advocates of an East African Common currency (who now include the IMF)should take pointers from Greece and the european union.
Greece's national debt is threatening to bring down the eurozone (and the rest of the global economy)analysts have already written eulogies for the euro. Harvards' Niall Ferguson has penned an article in he has entitled 'The End of the Euro'. Greece is reportedly in debt by as much as 15% of GDP.
It would seem that the British have, for now, been vindicated for passing up the euro in favour of the pound. The fear is that if of one of the common currency countries has a messy fiscal and economic policy then the economic impact will spread to other members like a cancer. That when in a common currency, its not enough to worry about your own books but your neighbour because he could unwittingly bring you down.
Greece has already accepted a billion-dollar IMF loan and a German-led rescue loan to save it from financial catastrophe which even its severly austere measures have not been able to cure in the short term.
For East Africans, its time to look at the downside of a common currency given the Greek lesson and to be cautious in fast tracking the East African common currency. All East African member countries have to be prudent economic policy managers and fiscal disciplinarians otherwise the sins of own will be borne by all. If Burundi, for instance, is grappling with a huge national deficit then this will impact on other East African common currency countries.
The Greek tragedy is a cautionary tale for East Africa's planned common currency.

Tuesday, April 27, 2010

Scaling down International AIDS Funding is Tragic.

The International Treatment Preparedness Coalition (ITPC) has released an April 2010 report that shows that internation funding for AIDS treatment has been scaled down or 'flat-lined' by the most important global funders who include the Global Fund and the PEPFAR(US President's'Emergency Fund for AIDS relief.
But national governments in Africa too are to blame for not meeting their own Health Spending targets set in Abuja in 2001 for funding health funding commitments of at least 15% of their annual budgets.
Dr John Mugyenyi of the JCRC(Joint Clinical Research Council) of Uganda has reported that many AIDS treatment providers across Africa are not enrolling any new patients on anti retroviral treatment programmes(despite the increase in demand for treatment). He also reports that rationing of ARVs is already in effect by some ART providers which compromises treatment and drug adherence and therefore raises fears of drug resistance. Millions of lives are at risk unless funding is matched with the incremental need for AIDS treatment.
Drug resistance is an even graver threat because it calls for second-line drugs that are much more costly and are not as readily available in developing countries, even commercially.
Cut backs in funding from international donors due to cited 'global credit crunch' and a lack of political will in African countries risks the lives of millions which may result in needless deaths.

Wednesday, March 17, 2010

A National Treasure Goes Up in Flames.An Obituary for Kasubi Tombs

Kasubi Tombs, the burial site for ancient Buganda kings,the Kampala-based UNESCO heritage site has gone up in flames. It was reduced to ashes before my very eyes on live television Tuesday evening. The tombs were said to be 200 years old and the resting places of four kings of the ancient Buganda Kingdom. Reportedly set up in 1910 by the then King Mutesa I, the tombs have been a source of pride not only for enthnic Baganda but all Ugandans alike and I like to believe they were a national treasure which sadly we could afford to pass on to the next generations of Ugandans.
I watched as hundreds of youths cried helplessly infront of the raging flames as an ancient treasure of many years went up in smoke.
One was only left to wonder how the tombs which are only a few kilometres from the city centre couldnt be reached within minutes by the Kampala City fire Brigade. Was this just another case of the widespread public services incompetence and negliegence? Why should we be hard on critics who brand our nations failed states? Wasnt this just another illustration of a dysfunctional state?
The Kasubi tombs were a tourist site and a fixture for every foreign visitor to Kampala. They also offered spin-off employment to many as well as the traditional minders who lived on the premises.
I visited the Kasubi tombs as a child and I was in awe of all the traditional regalia that lay for all to see in the tombs and the extravagantly rich Buganda traditional on elegant display.
Many think that Africans have no achitectural heritage and Kasubi Tombs was always there to prove the doubters wrong. Now it is gone for good although an inspiring Facebook group is rallying wellwishers for a rebuilding effort.
The Kasubi Tombs fire is a sad commentary on the state of affairs in our Banana republic and puts to question whether we have a functional state in Uganda. Where was the police in all this?
And was screaming in agony the best the onlookers could do to save the tombs? Why do we spend billions of shillings arranging to host the Queen of England when we cant even afford to keep the country's jewels for the next generation of Ugandans?

Thursday, February 18, 2010


‘The drugs are now expiring in our stores across the country because we seem to be pushing to have them but don’t have the expertise to clinically dispense them to the multitude who need them’ a medical doctor in the busy national referral hospital of Mulago in the Ugandan capital, Kampala tells this reporter as he struggles to clear a seemingly endless queue in front of his office in the biting Kampala sun.
Due to increasing international partner funding, anti retroviral drugs are increasingly becoming available in the developing world. International funding such as that from the Global Fund on HIV/AIDS,TB and malaria , the billion-dollar United States President Emergency Fund of AIDS relief programme and access initiatives such as those supported by the Clinton Foundation have made anti retroviral drugs widely available albeit at mostly urban health centres in the developing world.
In Uganda, despite reaching 42% of the population in need of Anti Retroviral Therapy in 2005, the number of those in need of Anti Retroviral Therapy continues to grow each year. It is estimated that there were 270,000 HIV-infected people eligible for anti retroviral therapy in 2007; this number is projected to reach 332,000 in 2012 . The most current figures as of September 2008, from the Ugandan Health Ministry are: 1.1 million infected; 357,000 in need; 43% on active treatment.
But in countries such as Uganda, questions remain regarding the capacity of the health care systems to scale up access to anti retroviral drugs. A few years ago it was reported in East African newspaper that $ 700,000 worth of drugs had expired in Uganda’s National Medical Stores and similar reports, more recently have run in the government-owned daily ’The New Vision’ with reports that some government drug stores across the country were reporting expiry of stocked anti retroviral drugs when thousands of clinically –eligible patients in Uganda are still waiting their turn to access these life-prolonging drugs.

Several recent studies in academic journals suggest that fiscal funding for AIDS treatment is no longer the most important barrier to access to antiretroviral drugs and that health systems in developing countries are the gravest impediment to accessing anti-AIDS drugs to the millions who need them. The notion that financial resources alone will not bring about accelerated access to AIDS treatment in resource-limited settings was emphasized further in a survey conducted in July of 2008 in six countries including Uganda by the International Treatment Preparedness Coalition (ITPC).
Some observers contend that even if these drugs were suddenly sufficiently available, there wouldn’t be sufficient capacity to absorb them and dispense them to those who need them as concluded in a study led by Dr Konde- Lule a renowned Ugandan AIDS researcher based at Makerere University

Analysts suggests that there are two conflicting schools of thought with one suggesting that scaling up access to ARVs is possible like has happened in Brazil while the other school argues that health care systems in developing countries don’t have the capacity to mount ambitious national AIDS treatment programmes due to institutional resource constraints. It is shown for example that there is a severe deficit in the health workers available to manage Anti Retroviral Therapy in developing countries which has compounded an already existing shortage of medical workers owing to many factors which include brain drain and uncompetitive reward systems.
It has been estimated that while Africa has 25% of the world’s disease burden, it has only 1.3% of the world’s health work force.

The absence of national laboratory networks to manage disease diagnosis-the first step of AIDS treatment, as well as unavailable CD 4 count machines all pose questions as to the feasibility of implementing ambitious AIDS treatment regimes in the developing world .An ART adherence study conducted in Botswana and Tanzania led by University of Amsterdam’s Dr Anita Hardon found a lack of laboratory facilities to conduct CD4 counts at the study sites visited . There was a lack of prescribing capacity in several health centres since they didn’t have diagnostic equipment .The study found that patients had to wait two weeks before they could be put on therapy owing to delays in diagnostic tests.

Interviews with regular clinicians at the fore front of treating AIDS in Uganda suggest the need to question the institutional assumptions underlying contemporary international AIDS treatment funding priorities. Should ARV drugs themselves be the current focus of drugs access initiatives or should the institutional resource base for administering them be the prerogative? A question whose answer would be critical to international bodies such as WHO,UNAIDS,UNICEF,PEPFAR,The Global Fund, The World Bank etc. As well as national governments in AIDS- ravaged countries,NGOs,HIV/AIDS advocacy networks and of course the millions living with HIV/AIDS .In the race to treat global AIDS, are we putting the cart before the horse? Drugs or health systems which should come first?