Www.tarsc.org; R Loewenson, Training and Research Support Centre, EQUINET Bringing local evidence.

www.tarsc.org; www.equinetafrica.org

R Loewenson, Training and Research Support Centre, EQUINET

Bringing local evidence to global processes for strengthening African

voice in GHD

Programme on globalisation and womens health with

S Wamala, Karolinska, Sweden

Case studies withM Nyamongo AIHD, KenyaJ Kanyamurwa Makerere, Uganda P Kamuzora TARSC Tanzania

Rates of childhood stunting 1995-2005

Source WHO 2003 de Onis et al 2003, 2004

MALAWI: >70% of population facing food shortages;

MOCAMBIQUE: severe floods 2000 and 2001: drought 2002:

ZAMBIA: second year of crop failure: few food stocks:

LESOTHO: second year of food shortages: maize prices high;

ZIMBABWE: food shortages:

Food crises in southern Africa 2002

Chopra 2004

Highest food insecurity ->

Global dimensions to the food crisis in Africa

• Climate change and water stress- 1990 twelve countries in stress; 2025 trends predict 22 countries in stress

• TNC control of agrochemicals, patents, grain distribution, retail sales

• Rising trade in/ consumption of fast foods • Trade and food prices – 67% increase in FPI

March 2009 to March 2011• Trade rules- Unresolved market access issues• New pattern of large scale land acquisitions for

export production, biofuels, bioengineering

Sources: Loewenson et al 2010, GRAIN 2010, Shrecker 2011, UN ECA 2009

Literature review of Globalisation, womens occupational roles and nutritional outcomes

• 199 peer reviewed, cross national, large scale studies, official sources, review 1990-2009

• Positive (12 papers): Improved technology, information, normative commitments, investment in low income producers, urban employment

• Negative (58 papers): Falling national/local food self sufficiency, livelihood, nutritional losses, inequalities, insecure access to production inputs, local foods and heath care

• Time, labour, resource burdens amenable to public policy with nutritional benefits – diplomacy for a green revolution or a gender revolution in agriculture Africa?

Source: Loewenson et al 2010 SJPH 38(Supp 4)6-17

Source: Udry et al in Chopra 2004; IDRC Ecohealth 2011

Equalising production inputs between men and women in Burkina Faso

Improving soil fertility and nutrition through legume production in Malawi

Analysis of MDG panel database

• 2000-2006 data including 48 African countries• Analysis of associations in MDG1 (poverty,

underweight, diet), MDG3 (gender equality in literacy, education, employment, parliament) MDG8 (global partnership- duty free imports; tariffs, ODA to trade capacity)

• MDG database cannot measure trade impacts on womens health – trade disaggregations not to country level; inadequate gender disaggregation.

• Evidence needed from other sources to support negotiations

Source: Wamala et al 2010 SJPH 38(Supp 4)18-21

What contribution from African research?

• Body of relevant evidence – not linked to global policies or made accessible to global negotiators

AREAS FOR A RESEARCH AGENDA

• Bringing local, national, regional evidence and analysis to global policy development and global financing

• Highlighting and explaining gaps between global policy commitments and goals and local realities

• Asking and exploring ‘what if’ questions to examine and inform alternatives based on African realities and interests

Source: Loewenson 2011, AIHD, TARSC Karolinska 2011

Challenges to research supporting GHD

• Understanding global policy, complex attribution, linking paradigms across disciplines

• Lack of data specific to globalisation and health; limits to information access, especially from TNC and global processes

• Design issues• Funding and resourcing research • Accessing and engaging communities and

policy personnel on globalisation and health issues

Source:AIHD, TARSC Karolinska 2011

Options and innovations

• Involving policy personnel and multiple disciplines and countries, investment in training and problem formulation

• Systematic reviews on policy relevant questions; monitoring and evaluation; multicountry work; community based evidence on ‘what if’ questions

• Drawing on wider disciplines and regions: Case studies; scenario building; policy analysis

• Integrate evaluation / evidence into global programmes

• Develop and engage partnerships early in the process, across sectors and integrating in existing networks

Source:AIHD, TARSC Karolinska 2011

Partnerships and links in ESA

Regional training programmes – eg UWC SoPH, U Nairobi, SA Inst Diplomacy, IPHU, web courses

Regional transdisciplnary research networks - EQUINET, Ecohealth, CODESRIA, INDEPTH

Regional policy and advocacy forums – SADC, EAC, COMESA; Civil society, economic/social justice networks, PHM; parliament associations

Supporting Strategic Leadership in Global Health Diplomacy in East, Central and Southern Africa ECSA Health Community, MoPHS Kenya, Uni Nairobi, SA Dept of Int Relns and Coopn, EQUINET (TARSC, SEATINI)