The African Union, the Transformation and Challenges of a Continent

The establishment of the African Union was noteworthy in the way it undermined the authoritarian theory and practice of its predecessor, the Organization of African Unity. The justification was based on the right of peaceful co-existence of member states and—as a consequence—the right of member states to request intervention from the Union in order to restore peace and security. The African Union’s Constitutive Act introduced an array of responsibilities, powers, and rules that challenged the premises of Africa’s earlier leaders. The Act established how the Union would carry out its business through a network of organs, agencies, government ministries, and NGOs, which this paper examines in some detail. While the organizational structure attempted to balance national and continental concerns, it also revealed an obvious weakness in the power of its three principal parliamentary, administrative and legal bodies. Although AU has made great strides in building an institution committed to human security and development, there is need to sharpen its focus, and bring about more specificity in organizational goals. The dual missions of a movement championing the independence of sovereign African states and simultaneously creating a homeland for all of African descent were, if not contradictory, at least so divergent as to strain the ability of its leaders to ensure a lasting consensus. While the initial vision was a powerful one and attracted a group of true believers, the complexities of a modern global economy have demanded an array of new developmental strategies to meet this challenge. The challenges include but not limited to good governance in Africa, alleviation of poverty and hunger, as well as hindrances to citizen participation, especially women, in civic and state affairs. Keywords: AU, OAU, African Transformation, African Challenge

Dietary mineral supplies in Malawi: spatial and socioeconomic assessment

Background Dietary mineral deficiencies are widespread globally causing a large disease burden. However, estimates of deficiency prevalence are often only available at national scales or for small population sub-groups with limited relevance for policy makers. Methods This study combines food supply data from the Third Integrated Household Survey of Malawi with locally-generated food crop composition data to derive estimates of dietary mineral supplies and prevalence of inadequate intakes in Malawi. Results We estimate that >50 % of households in Malawi are at risk of energy, calcium (Ca), selenium (Se) and/or zinc (Zn) deficiencies due to inadequate dietary supplies, but supplies of iron (Fe), copper (Cu) and magnesium (Mg) are adequate for >80 % of households. Adequacy of iodine (I) is contingent on the use of iodised salt with 80 % of rural households living on low-pH soils had inadequate dietary Se supplies compared to 55 % on calcareous soils; concurrent inadequate supplies of Ca, Se and Zn were observed in >80 % of the poorest rural households living in areas with non-calcareous soils. Prevalence of inadequate dietary supplies was greater in rural than urban households for all nutrients except Fe. Interventions to address dietary mineral deficiencies were assessed. For example, an agronomic biofortification strategy could reduce the prevalence of inadequate dietary Se supplies from 82 to 14 % of households living in areas with low-pH soils, including from 95 to 21 % for the poorest subset of those households. If currently-used fertiliser alone were enriched with Se then the prevalence of inadequate supplies would fall from 82 to 57 % with a cost per alleviated case of dietary Se deficiency of ~ US$ 0.36 year−1. Conclusions Household surveys can provide useful insights into the prevalence and underlying causes of dietary mineral deficiencies, allowing disaggregation by spatial and socioeconomic criteria. Furthermore, impacts of potential interventions can be modelled

Conflict and human security in the North Rift and North Eastern Kenya

Purpose – Within the theoretical context of human security, this United Nations (UN) three-year research project examines the causes and effects of conflicts in the arid and semi-arid lands of Northern Kenya. The purpose of this paper is to address the human security concerns arising out of conflict, displacement, migration and poverty. The people who live in the area are mainly nomadic pastoralists. Design/methodology/approach – A review of previous empirical research and ongoing field studies are used to examine four problem areas: cattle rustling, proliferation of small arms, competition over scarce resources and conflict between refugees and local communities. Findings – Seeking access to water and green pastures, the nomads generally follow their cattle across the region, and their movement is not confined to Kenya alone. They cross and re-cross international boundaries to and from Ethiopia, Sudan, Somalia and Uganda resulting in conflicts over water and pasture. Resource competition in a fragile economy has had grave consequences for the economic security of families and internally displaced people. Originality/value – The North Rift and North Eastern regions of Kenya are the most underdeveloped area of the country and suffer from a high level of human insecurity, with more than three-quarters of the population living below the poverty line. This UN project seeks an empirical understanding of the causes of conflict and ways to build the capacity of a vulnerable population to gain both freedom from fear and freedom from want.Africa, Conflict, Kenya, Natural resources, Poverty

Monitoring and Management of Proteinuria Is Often Ignored in Patients Receiving mTOR Therapy Following Orthotopic Liver Transplantation

Purpose: Use ofmTOR inhibitors, such as Everolimus(EVL), in liver transplant (LT) patients continues to rise as the side effect profile becomes more evident. Calcineurin inhibitors, suchas Tacrolimus, have an increased incidence of nephrotoxicity whereas EVLremainsaviableoptiontodecreasethelikelihood of renal dysfunction. In renal transplant patients, standardof care involves regular monitoring urine protein levels. however no such consensus exists amongst LT patients. We analyzed renal function by assessing proteinuria in LT patients started on EVL. Methods: All patients receivingaLTbetween2011 and 2014 treated withEVLwere evaluated. Background infonnation included age, gender and race. Assessment of urine protein to creatinine (UP/C) ratios was done prior to starting EVL. Follow up UP/C ratios were analyzed after starting EVL at 3 months and anytime past 6 months. Nephrotic range was defined as spot urine protein to creatinine ratio greater than 1 gram (g). Statistics were calculated using ANOVA, T-test and Chi-squared tests. Results: 75 LT patients composed primarily of males (76%) with an average age of 60.9years were analyzed. There were 58 Caucasians (77%) and 11 African Americans (14.7%). Out of 75 total patients, 84% of patients had a UP/C ratio measured before starting EVL. After starting EVL, 30.7% had a follow up UP/C ratio measured at any given time. 11 patients had a UP/C ratio measured at 3 months and 17 patients at any time after 6 months. Before starting EVL the mean UP/C ratio was 0.17g. At the 3 monthfollow-up, mean UP/C ratio was 1.30g (p=0.112). At any point past 6 months from the time EVL therapy was started, mean UP/C ratio was 1.45g (p=0.504). 56.5% of patients that had their UP/C ratio checked, EVL was discontinued. The meannumber of months was 17.2 at which EVL was stopped from time ofinitiation. Conclusions: EVL appears to lead to a significant increase in proteinuria in LT patients with the progression of time. There is a potential for worsening renal func-tion, however regular follow up is lacking. It remains imperative that substantial proteinuria shouldlead to the discontinuation of EVL to prevent further renal toxicity

Monitoring and Management of Proteinuria Is Often Ignored in Patients Receiving mTOR Therapy Following Orthotopic Liver Transplantation

Purpose: Use of mTOR inhibitors, such as Everolimus (EVL), in liver transplant (LT) patients continues to rise as the side effect profile becomes more evident. Calcineurin inhibitors, suchas Tacrolimus, have an increased incidence of nephrotoxicity whereas EVL remains a viable option to decrease the likelihood of renal dysfunction. In renal transplant patients, standard of care involves regular monitoring urine protein levels. however no such consensus exists amongst LT patients. We analyzed renal function by assessing proteinuria in LT patients started on EVL. Methods: All patients receiving a LT between 2011 and 2014 treated with EVL were evaluated. Background infonnation included age, gender and race. Assessment of urine protein to creatinine (UP/C) ratios was done prior to starting EVL. Follow up UP/C ratios were analyzed after starting EVL at 3 months and anytime past 6 months. Nephrotic range was defined as spot urine protein to creatinine ratio greater than 1 gram (g). Statistics were calculated using ANOVA, T-test and Chi-squared tests. Results: 75 LT patients composed primarily of males (76%) with an average age of 60.9 years were analyzed. There were 58 Caucasians (77%) and 11 African Americans (14.7%). Out of 75 total patients, 84% of patients had a UP/C ratio measured before starting EVL. After starting EVL, 30.7% had a follow up UP/C ratio measured at any given time. 11 patients had a UP/C ratio measured at 3 months and 17 patients at any time after 6 months. Before starting EVL the mean UP/C ratio was 0.17g. At the 3 month follow-up, mean UP/C ratio was 1.30g (p=0.112). At any point past 6 months from the time EVL therapy was started, mean UP/C ratio was 1.45g (p=0.504). 56.5% of patients that had their UP/C ratio checked, EVL was discontinued. The mean number of months was 17.2 at which EVL was stopped from time of initiation. Conclusions: EVL appears to lead to a significant increase in proteinuria in LT patients with the progression of time. There is a potential for worsening renal function, however regular follow up is lacking. It remains imperative that substantial proteinuria should lead to the discontinuation of EVL to prevent further renal toxicity

Selenium deficiency risks in sub-Saharan African food systems and their geospatial linkages

Selenium (Se) is an essential element for human health. However, our knowledge of the prevalence of Se deficiency is less than for other micronutrients of public health concern such as iodine, iron and zinc, especially in sub-Saharan Africa (SSA). Studies of food systems in SSA, in particular in Malawi, have revealed that human Se deficiency risks are widespread and influenced strongly by geography. Direct evidence of Se deficiency risks includes nationally representative data of Se concentrations in blood plasma and urine as population biomarkers of Se status. Long-range geospatial variation in Se deficiency risks has been linked to soil characteristics and their effects on the Se concentration of food crops. Selenium deficiency risks are also linked to socio-economic status including access to animal source foods. This review highlights the need for geospatially-resolved data on the movement of Se and other micronutrients in food systems which span agriculture–nutrition–health disciplinary domains (defined as a GeoNutrition approach). Given that similar drivers of deficiency risks for Se, and other micronutrients, are likely to occur in other countries in SSA and elsewhere, micronutrient surveillance programmes should be designed accordingly