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Africa

AIDS: translating scientific discoveries into sustainable, affordable programs

David Wilson's picture

Red ribbon for World AIDS Day, Thailand (credit: Trinn Suwannapha).

We’re entering a phase where AIDS is moving from emergency crisis financing to sustainable development financing—which is a major challenge, but one that we’re continuing to tackle, with the goal of stronger national ownership and responsibility.

 

One of the Bank’s international mandates is to support countries to develop better national health plans and budgets. Today, the Bank released an important study, The Fiscal Dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda, which is a part of this mandate. The study helps countries do the long-range planning that we so desperately need in HIV programs.

 

The Bank has a long-established partnership with ministries of finance and planning, and we understand country systems. We stand ready to help countries integrate HIV into their programs and plan for it in a sustainable way.

 

We’ve seen extraordinary progress in AIDS. Today, we have more antiretroviral drugs to treat HIV than every other virus in history combined. We’ve reduced treatment costs from tens of thousands of dollars to as little as $100. And we’ve expanded our understanding of effective HIV prevention, including the role of male circumcision and the important role that treatment can play in prevention under the right circumstances.

 

Many of us involved in HIV remember the days when 70% of beds in health facilities in Africa were occupied by people with AIDS. Our successes in treatment and prevention have removed this specter and have allowed health systems to focus on other important health priorities.

Wanjiku’s Story: One Woman, a Common Experience

Asa Torkelsson's picture

One Sunday, I was invited for a late lunch at the house of Dorcas Wanjiku Njoroge in Thika. Deeply seated in armchairs in the living room, we enjoyed sukuma wiki, ugali and a bit of cooked meat while she told me the story of her life.

Today is International Women’s Day, and the empowerment of rural women is the theme of the ongoing 56th session of the Commission on the Status of Women. At the World Bank, it is a day to “think equal and to act equal.”

It is in this context that I share the life of Wanjiku, as told by her.

Wanjiku was born on in 1933 at a tea farm in Kiambu where her parents worked. As she grew up, she took care of the many children at the farm and was not taken to school, as her father did not see the use of education to a girl.

Enabling a Population, One Woman at a Time: Gender Reforms in Kenya

Yasmin Bin-Humam's picture

Imagine things are looking up for you. You are running your own business transporting and selling charcoal to retailers in the area, your husband has a steady job, and together you own real estate which you rent out. Then, your husband dies – your in-laws and your husband’s kinsmen take all of the assets and are entitled to do so under law. You are left with nothing to rebuild your life and provide for your child.  This is what happened to Anna in Kenya.  Her story is not uncommon. Women’s rights groups in Kenya have been pushing for change and finally, with the institution of a new Constitution in August of 2010, their rights will be protected. This Constitution, the main purpose of which was to limit the powers of the executive, has risen from the ashes of ethnic violence following elections in 2007 in which over 1,100 people are believed to have been killed. 

In terms of broad legal principles relating to women’s rights, Kenya’s new Constitution has Legal reforms in Kenya are making things better for Kenyan women.two reforms. The first, is that customary law, still recognized in Kenya alongside codified law and common law, is no longer exempt from constitutional provisions prohibiting discrimination based on gender. As a result, discriminatory inheritance practices such as those that disinherited Anna will come under increased legal scrutiny. The second, is that in addition to gender being a prohibited ground for discrimination, protections were strengthened with a clause mandating equality based on gender, and a clause providing that parties to a marriage are entitled to equal rights at the time of marriage, during marriage and at the dissolution of marriage. In addition, Kenya has instituted specific provisions, so that Kenyan women can now pass citizenship to their spouses and children on equal footing with Kenyan men. The latter, a huge achievement as it empowers the other half of the population with the same right, is something many countries still continue to prohibit wives and mothers to do.

2012 Social Media as a Tool for Citizen Feedback

Victoire Ngounoue's picture

More often than not, “we” criticize the “system” for being corrupt; yet it is simply a reflection of what we make of it. For example, what would happen if “we” decided never to collect bribes from users in our health service system? Or if we implemented and respected the rule of ‘first come, first served’ instead of paying or collecting bribes for faster service delivery? What would happen when it is brought to our knowledge that there are irregular practices operating within our health centers?

2012 Social Media as a Tool for Citizen Feedback

Victoire Ngounoue's picture

Un Forum I-Social pour la Promotion de la Santé et la Bonne Gouvernance au Cameroun.More often than not, “we” criticize the “system” for being corrupt; yet it is simply a reflection of what we make of it. For example, what would happen if “we” decided never to collect bribes from users in our health service system? Or if we implemented and respected the rule of ‘first come, first served’ instead of paying or collecting bribes for faster service delivery? What would happen when it is brought to our knowledge that there are irregular practices operating within our health centers?

These questions are for everyone, particularly for authorities in health centers. These kinds of questions are being answered by winners of the Cameroon 2011 Development Marketplace competition. Nowadays, advances in ICT tools and social media channels provide us with various ways to monitor and expose corrupt practices. When I first visited the website of I Paid a Bribe by the Janaagraha Centre for Citizenship and Democracy, I was amazed by the innovation, frightened by testimonies, and thankful to those who had the courage to report irregular practices. My next move while browsing the website was to check if Cameroon was amongst those countries participating on this platform. Unfortunately not!

Taking the pulse: The evolving health public-private partnership in Lesotho

Patricio V. Marquez's picture

Jean J. De St Antoine and Kanako Yamashita-Allen are co-authors of this post.

During a recent visit to Maseru, we met with staff at the 425-bed Queen ’Mamohato Memorial Hospital which opened in October 2011 and at one of three primary care clinics that have been running since 2010 as part of a Ministry of Health (MOH)--led public private partnership (PPP).  The PPP aims to facilitate access to quality health services in a poor country.   

Misadventures in Photographing Impact

David McKenzie's picture

One of my favorite papers to present is my paper on improving management in India, in part because we have wonderful photos to illustrate what bad management looks like and what improved practices look like (see the appendix to the paper for some of these).  Photographing impact isn’t only useful for presentations and glossy summaries, but may potentially offer a new form of data. However, this is easier said than done, and today I thought I’d share some misadventures in trying to photograph impacts on small firms.

Beginners: High Energy in Cote d'Ivoire

Mission to Côte d'Ivoire scheduled to take place between February 13 and 17. Time to prepare for my first trip with the Bank: call for tickets and hotel, visit the travel clinic, request UNLP and visa, read security recommendations, exchange money etc. Ah, of course, prepare all the background documents and coordinate the elaboration of our meeting schedule. Simple activities that tend to become uninteresting for those who have done it several times before are rather exciting for a beginner.

Sights from the start of a long engagement with Cote d'Ivoire: Football Fever!I landed in Cote d’Ivoire just in time for the big final of the Africa’s Nations Cup: Cote d’Ivoire, the favorites to win, facing the surprising Zambia. Everyone’s eyes were on the game and the scenario was set for a week of celebrations. Football (soccer), however, is tricky and Cote d’Ivoire ended as the runner up. That did not change the plans in the country: Monday the 13th had been declared a national holiday for the people to welcome the players and so it was. A slight unexpected issue for us, as most of our meetings scheduled for that day were cancelled. An anti-climax for a beginning.

Educational technology and innovation at the edges

Michael Trucano's picture

the business of tomorrow, today?As part of my duties at the World Bank, I talk with lots (and lots!) of people and groups.  Mostly, I talk to people within the World Bank and in other development institutions (this is part of my official responsibilities, to support the work of such people as a 'subject expert'); to our counterparts in governments around the world (we say 'clients' but I am not a big fan of this formulation); and with lots of consultants and practitioners*.

(*Some of you may quickly identify a pretty important group that is missing here: 'users', or beneficiaries.  This is a pretty big, if not fundamental, omission, in my view. Talking with practitioners is a sort of proxy for talking with end users and beneficiaries ... I guess ... but certainly an insufficient and inadequate one. Mistaking those who pay for, and those who implement, development programs with those who actual 'use' or benefit from them is a recipe for potential disaster ... perhaps a topic for a future blog post.)

I also speak with lots of companies.  Sometimes I am obliged to do this, because (to be blunt, and honest) the company is 'important' and politically well connected.  Sometimes I really want to do this, because the company is doing something quite new and/or cool, or is doing something quite well.  (I should note that these things aren't necessarily mutually exclusive, of course.) I frequently talk with companies at the request of colleagues or counterparts in government ("these guys are telling us x and y ... should we believe them?"). I also do it to better understand what is happening in various markets; I often find that firms (as with NGOs) have a better sense of what is happening in government schools related to the use of technology than do ministries of education.

Occasionally I speak not to individual companies, but to large industry groups.  Because presentations to these types of groups often occur behind 'closed doors' of various sorts, I thought I'd share here some of what I tell them, in case it might be of any interest.  (One of the reasons that this blog exists is to try to open up certain conversations that typically occur behind closed doors to wider audiences.)

Somali Remittance Freeze: What Can Be Done About It?

The remittance freeze is impacting Somali families that rely on relatives in America (photo credit: Trocaire, Flickr)Minneapolis has the largest Somali population in the US. Sending remittances to Somalia was put at risk late December when the Sunrise Community Bank in Minneapolis announced that it was going to close the accounts of all Somali remittance companies on December 30th 2011.To our knowledge, the Sunrise Community Bank was the last bank that was serving Somali remittance companies in Minneapolis. Closure of accounts meant no operation for remittance companies. This in turn meant no money for remittance-dependent Somalis, who had no other options since remittance service providers such as Western Union and MoneyGram didn’t operate in Somalia. Aid groups lobbied to challenge the closure, and their petition reached all the way up to President Obama.


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