Alternatives International

High and Dry

Jason Leung — 2011-08-02T17:26:37Z

In the past few months, a vicious drought has plagued East Africa. Regarded as the worst drought in sixty years, the region is witnessing a natural disaster that has destroyed livelihoods, brought famine upon its populations, and driven millions from their homes.

The United States Agency for International Development (USAID) referred to the drought as “the most severe food security emergency in the world today.” Beyond the devastating impacts locally, this humanitarian crisis is ultimately threatening the stability of the entire region. It poses an immense challenge for East African governments, international agencies, and humanitarian organizations which must address both the short-term practical needs of the people, and consider the long-term well-being of the Horn of Africa.

Droughts and dry seasons are normal, cyclical and annual occurrences in East Africa, but the scale of the recent drought has by far exceeded any other drought in the last half-decade. Rajiv Shah of USAID stated that “eleven and a half million people are at real risk of malnutrition and famine.” This drought is the fifth in the region in the last seven years. The severe dry spells, continually increasing in intensity and frequency, have rendered farmland useless, stunted crops, and devastated livestock; leading to a dramatic inflation of food prices. In northern parts of Kenya, the price of maize has increased by 57% over the past year.

This has created a troubling situation since millions of people have become completely reliant on the extensive aid pouring in from international aid organizations. Furthermore, the actual drought is not predicted to end until October. Food security, access to potable water, and shelter are the most immediate concerns. Until such needs are attended to, millions of people will continue to be forced off their arid lands and move towards places and regions that have been less affected by the drought. Oxfam has reported a 23% rate of “severe malnutrition;” humanitarian emergencies in the past have usually only reported 4%.

Many experts are viewing this crisis as the climax reached due to many different factors, the primary of which is the failure of the government to provide adequate social infrastructure. Poor accessibility of basic transport, resource infrastructure, and health infrastructure worsens the food and water security in the region. Resultantly, the effects of the reduced rainfall are intensified. These aspects have greatly increased the severity of this dry season relative to any other, as “high food prices, fluctuating rainfall, a rising population, and ever dwindling natural resources have created the perfect storm,” says Leigh Daynes, the Director of Communications, of Plan UK.

Humanitarian organizations such as Oxfam are scrambling to mobilize resources to support the millions of thirsty and starving victims of the crisis. This response unfortunately comes in midst of declining aid, due to something Manoj Juneja of the Food and Agriculture Organization calls “donor fatigue.” This phenomenon has most recently manifested with the drought crisis. Of the $US 500 million requested in aid during the beginning of sparse rainfall for countries such as Djibouti and Kenya, only 30% was actually offered by donor countries. These governments have tightened their aid contributions after giving substantial aid to other crises in recent years, such as Pakistan, Japan, and Haiti.

Funding for projects dedicated to providing sanitary water for the developing world have experienced shortfalls long before these recent disasters. Using data collected by the Organization of Economic Cooperation & Development (OECD), WaterAid published reports stating that over the last decade aid allocated to the accessibility of potable water shrank from 8% to 5%. “It shows how far water and sanitation have slipped down the list of donor priorities,” observed John Garrett, the senior policy analyst at WaterAid. While a 3% decrease does not seem significant, the impact of investing in clean water and sanitation projects is immense when you consider the developmental byproducts of this investment. The World Bank estimates that a lack of sanitation reduces the GDP of developing countries by 6%. Sanitation issues are also linked to negative social impacts, such as lowered school attendance for young girls.

With global contribution to water sanitation projects shrinking, the lack of infrastructure to provide this basic necessity has intensified the catastrophe. The World Bank's water chief, Julia Bucknall has estimated about 2.6 billion people “die of diarrhea caused by dirty water or inadequate sewage systems,” and that figure will only increase in such dire situations as that in East Africa. The reality remains that more investment is needed into preventative projects and programmes. As Camilla Knox-Peebles, a food security specialist with Oxfam, says:“It is hard to get funding to tackle deeper-seated problems until there is an emergency.” Global organizations and donor countries need to recognize the importance of investing in projects that help to ensure proper access to clean water. To safeguard against dry seasons or droughts transforming into full-blown humanitarian emergencies, a preventative approach, rather than a latent reactive one, is needed.

What will make the effort to formulate long-term strategic solutions difficult are some of the unique challenges facing the countries affected. In Kenya, for example, 3.5 million people are in need of assistance. Kenya's population is experiencing a serious land-grabbing problem at the hand of the government—the appropriation of land is driving Kenyans from their homes and further worsening food security. Water-rich areas such as the Tana Delta have been parceled off by the Kenyan government to western multinational corporations, such as Bedford Biofuels (CAN) and G4 Industries Ltd (UK), to grow water-intense crops and biofuels, including sugarcane and jatropha. These plots of land, rather than being used to aid the millions of malnourished citizens, are being used to fuel western needs. These acts of government negligence and greed play a significant role in the food and water crisis.

The severe drought in East Africa is ravaging lives in the region. International response is slowly mounting the gravity of the situation. However, the severity of this crisis is a function of more deeply rooted factors, such as lack of aid towards infrastructure, which have built up and placed the region in a state of emergency. Jeffrey Sachs, a leading development expert, calls for a sustained investment in the dry lands to help eradicate the poverty that has caused the catastrophe that is unfolding before the world's eyes - one that will affect and dictate the trajectory of the region, and more importantly, the affected lives that hang in the balance. It will not be enough to just respond accordingly to this humanitarian crisis by feeding the millions suffering from the famine. Rather, it is of paramount importance to address the many determinants of the drought to prevent the region from being victimized by unavoidable natural circumstances, and dependent on foreign emergency aid.

Photo: Matt and Kim Rudge (flickr)

Jason Leung is an International Development Studies and Biomedical Science student at McGill University, with a keen interest in global health and social policy.

Hope for an HIV/AIDS Vaccine

Jason Leung — 2011-07-01T14:22:19Z

Around the world, HIV/AIDS is a pandemic that is identified as having a devastating effect on all aspects of life, from entire populations to individuals. June 2011 marks the thirtieth anniversary of the first published cases of AIDS as well as recognizes the thirty million lives that have been lost in the span of that time. Since then, there have been countless efforts to develop cures and vaccines for the disease.

It is true that HIV/AIDS has had a tumultuous history of biomedical research in hopes of treatment and prevention. While the development of drugs which treat the pandemic, such as antiretroviral drugs, has been quite successful, vaccine development has been marred by shortfalls. Vaccine research has been largely characterized by hopeful vaccine candidates and their failed translation into drugs for human application. The promise of a successful HIV/AIDS vaccine is certainly nothing new.

However, in May, another glimmer of hope has emerged. Studies were published reporting that another breakthrough may have been discovered. A team of researchers at the Oregon Health & Science University conducted a ten-year study with macaque monkeys by giving a cytomegalovirus vaccine (CMV) to twenty-four test subjects for the simian immuno-deficiency virus (SIV), the primate viral agent that HIV evolved from. CMV is part of the herpesviridae family of viruses, the very same that causes the herpes simplex virus.

The optimism of the results of the CMV tests stems from some unprecedented outcomes. Upon exposure to SIV, thirteen of the monkeys had protection against the virus. Twelve of those monkeys were able to retain this immunity a year after the vaccine was administered. The vaccine was able to eliminate all traces of SIV from the monkeys. The Chief Operating Officer of the International AIDS Vaccine Initiative (IAVI), David Cook, characterized the findings to yield “the most profound protection we've seen in an experimental vaccine.”

The drug differs from other vaccines based on the vector that the team employed, CMV, to stimulate an immuno-response. The lead researcher on the Oregon team, Dr. Louis Picker, attributes the success of the vaccine in the macaques to the nature of the vector: “it fools the body into thinking it's always under threat, and keeps the soldiers ready at the point where…the [SIV] virus comes into the body.” By cutting off the SIV's access to the host monkey's cell machinery to replicate through early recognition, the vaccine was able to eradicate the SIV before it progressed to disease.

The largest problem with this breakthrough: it is for a different virus. While HIV is a strain derived from SIV, the fact remains that their research targeted a dissimilar virus. Lawrence Corey, a medical virologist, recognizes that while the success is promising “there is little corollary between animal and human models for HIV; killing the virus in a laboratory or animal host does not guarantee success in humans.” Another large issue with tackling HIV is its ability to high mutability and its ability to evade a host's immuno-defense until it infects cells and replicates. In past vaccine attempts, the vector used in the vaccine was unable to account for this adaptability and evasiveness of the virus and therefore proved ineffective in fostering herd immunity among populations.

A great deal more laboratory work needs to be conducted by the team in order to research how to take what they have achieved in simians and adapt it to humans. It will be critical that this design of a HIV-CMV vaccine include intensive studies on numerous factors and variables, including the drug's effectiveness over time and in different contexts, the drug's safety with respect to the vector, its side effects, and interaction with other drugs and diseases. Despite this, a deeper understanding of the virus from further research and experimentation with CMV may ultimately serve as an important component to an actual vaccine.
The severity of the prevalence of AIDS renders any breakthrough in vaccine research a significant one, especially considering the vulnerability of African populations to the virus . The greatest concern about CMV as a vector is the troubling epidemiology among vulnerable populations, such as children, pregnant women, and immuno-compromised individuals. It is estimated by researchers that over ninety-eight percent of the population in Africa is infected by a dormant CMV virus. While this agent is endemic and can stay benign for many years (such as the related herpes virus), it has been known to be fatal to these vulnerable groups, especially the immuno-compromised, like HIV-infected patients. CMV has been known to be the root of immuno-surpression over the human life-course, andis additionally recognized as one of the biggest causes of birth defects in the developing world. If CMV is the vector that is used to deliver the vaccine, mutations or simply failures of the drug in these populations will not only negate drug action, but will also induce the pathogenesis of CMV. These issues are the challenges that researchers will have to overcome during the continuing research for an HIV vaccine.

While the recent reports of the effectiveness of CMV-based vaccine in preventing SIV are encouraging given the impressive medical outcomes through research, it is important to temper expectations and optimism in the face of this news. Countless reports and studies have been published in favor of a spectrum of vaccine candidates – yet none have emerged to be an appropriate antidote. Furthermore, adapting this CMV vaccine to HIV in humans will require another intensive research process. Given the complexity of the viral agent and the nature of the mechanism by which it causes disease in humans, this phase of drug development will not be short or simple. Will the studies done with CMV on macaques ultimately lead to a successful HIV vaccine or will it simply serve as a stepping stone for further research by broadening our understanding of HIV and its relatives? Only time will tell as the quest towards a cure marches on.

Photos: US Mission Geneva, SimplyAvoir (flickr)