Publications

According to the World Health Organization, human African trypanosomiasis (HAT) (sleeping sickness) caused the loss of ≈1.5 million disability-adjusted life years (DALYs) in 2002. We describe the effect of HAT during 2000–2002 in Buma, a rural community near Kinshasa in the Democratic Republic of Congo. We used retrospective questionnaire surveys to estimate HAT-related household costs and DALYs. The HAT outbreak in Buma involved 57 patients and affected 47 (21%) households. The cost to each household was equivalent to 5 months’ income for that household. The total number of HAT-related DALYs was 2,145, and interventions to control HAT averted 1,408 DALYs. The cost per DALY averted was US $17. Because HAT has a serious economic effect on households and control interventions are cost-effective, considering only global burden of disease rankings for resource allocation could lead to misguided priority setting if applied without caution in HAT-affected countries.

Au Mali, les indicateurs de santé restent préoccupants. Une meilleure performance du secteur public dans la fourniture de services de base est une nécessité absolue pour la réduction de la pauvreté. Le défi posé aux divers acteurs en matière de santé communale est de travailler ensemble de façon effective au profit d’une santé publique appropriée aux besoins locaux, y compris à ceux des groupes les plus vulnérables.

Although agricultural research and development (R&D) in West Africa aim at improving the livelihoods of resource-poor farmers, the intended beneficiaries are often too poorly organised and consequently have limited political clout to influence the R&D agenda. The authors are not aware of farmers in West Africa funding agricultural R&D projects; this in contrast to farmers in Northern America and Europe

Since the early 1990s, several studies have looked at the impact of HIV/AIDS and household responses, mainly in East and Southern African countries where HIV infection has reached rates in excess of 30% of adult populations (Kwaramba, 1998; Rugalema, 1999; Luzobe, Muheewa, Olaunah, Wandui, & Kalenzi, 2001; Shah, Osborne, Mbilizi & Vilili, 2002; Muwanga, 2002; Booyens & Arntz, 2003; SADC-FANR, 2003; Yamano and Jayne, 2004). These studies concluded that AIDS has a disproportionate impact on the morbidity and mortality of the most productive age groups. Its impact on households is characterised by a sharp reduction in the available time, labour and other resources of individuals and households, even leading to loss of assets. Because the disease has both a long incubation period and is accompanied by a lengthy period of illness, the socio-economic as well as
psychological impact will be felt over a prolonged period. In addition to the suffering this causes, the increase in AIDS prevalence adversely affects individual lives as well as state development and efforts to alleviate poverty. In West Africa, the HIV/AIDS epidemic developed at a slower pace but infection rates are rising fast. Because countries have their own unique contexts, it cannot be assumed that the findings of East and Southern African studies on the impact of the epidemic can be extrapolated and used in a straightforward way to develop policy in other region