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<p>The World Trade Organisation has cut its global trade growth forecast for this year by more than half to the weakest level in a decade. Joining CNBC Africa for more is Jameel Ahmad, Global Head of Currency Strategy and Market Research at FXTM.</p>


WTO cuts global trade growth forecast to decade low

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<p>News has broken from the Director General of the World Health Organization (WHO) during his trip to the DRC on Wednesday that the Ebola outbreak in the country, which is the second worst in history, is finally, &#8220;on the retreat&#8221;. He went on to warn that the risk was still high and that there was no room for complacency, but is this the sign of relief that the region has been waiting for? Coordinator of UN Emergency Ebola Response, David Gressly joins CNBC Africa for more.</p>


Ebola outbreak 2nd largest since 2014-2016: 2000 lives lost

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<p>Two people cured of Ebola using two experimental treatments have been released from a treatment centre in eastern Democratic Republic of Congo and reunited with their families. Doctor Jean-Jeacque Muyembe and other scientists announced this week that preliminary results from two trials in Congo found two drugs made by Regeneron and the U.S. National Institutes of Health seem to be saving lives. Soraya Aziz Souleymane, Business &#038; Human Rights defender joins CNBC Africa for more.</p>


DRC receives major boost in Ebola fight as two experimental treatments prove effective

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<p>The Ebola outbreak in the Democratic Republic of Congo has hit the one year mark and has seen a rise in cases. Despite this neighbouring Rwanda has been hailed by the World Health Organisation (WHO) for its preparedness, the country has taken a number of measures in an effort to prevent the epidemic from entering its territory. Malik Kayumba, Spokesperson for Ministry of Health Rwanda joins CNBC Africa for more.</p>


Rwanda scales up Ebola prevention measures


<p>GENEVA (Reuters) &#8211; A Congolese woman who may have spread the deadly Ebola virus in Uganda did not go to Rwanda or the Congolese city of Goma while contagious, the World Health Organization said on Friday.</p>



<p>On Thursday, a report written by Uganda’s Health Ministry and published by the WHO’s Africa office had said the woman, a fishmonger, was suspected of going to Goma and Rwanda as well as Uganda before she died.</p>



<p>That raised fears of the outbreak spreading in Rwanda, which has never had a recorded case of Ebola.</p>



<p>But the WHO later withdrew the report and shut down the website where the daily updates were being posted, saying some of the information had not been verified. [nL8N24J2MF]</p>



<p>“We have investigated fully, and there was no travel to anywhere but Uganda,” WHO spokeswoman Margaret Harris said, adding that inaccurate conjecture had unfortunately found its way into the reports.</p>



<p>Healthworkers have mounted a massive campaign of vigilance and vaccination on key routes and borders in the region, and have screened almost 75 million people since the outbreak was declared 11 months ago. It has killed more than 1,700 people.</p>



<p>The 22-year-old woman was thought to have crossed the border between Uganda and Congo at an unmonitored crossing point, the deleted reports said. Harris said there no chance she had also slipped into Rwanda without being spotted.</p>



<p>“We are absolutely certain,” she said. “Our team&#8230; went across and talked to everybody and tracked it day-by-day. Now in her life she may have gone to Rwanda&#8230; but the important thing is she did not spend any time in Rwanda while symptomatic.”</p>



<p>It was extraordinary that a woman with end-stage Ebola had managed to cross the border and sell fish for a day, she added.</p>



<p>A lot of people at potential risk were now being followed up and people were being vaccinated on both sides of the border, Harris said. But it would take several days before it became clear if the woman, who vomited several times at a market, had infected anyone.</p>



<p>Other details in the withdrawn reports were also unverified, including information about a second Congolese Ebola patient travelling to the same market, and about a group of Ugandan healthworkers who may have been exposed to Ebola.</p>



<p>Reporting by Tom Miles; Editing by Mark Heinrich </p>


WHO says investigators conclude that Congolese woman who may have spread the Ebola virus in Uganda did not enter Rwanda

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<p>On Wednesday the 17th of July, the World Health Organisation&#8217;s Emergency Committee declared the Ebola outbreak in the Democratic Republic of Congo a &#8220;Public health emergency of international concern&#8221;. Niniola Soleye, Managing Director of DRASA Health Trust joins CNBC Africa for more.</p>


WHO declares DRC Ebola outbreak global health emergency

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<p>The World Health Organisation says Africa alone accounts for 42 per cent of globally detected cases of substandard and fake drugs. Chinedum Chijioke, MD of Sproxil Africa joins CNBC Africa to explore ways technology is helping to solve this problem.</p>


Tackling counterfeit medicine with innovation

<p>South Africa said on Monday producers of cold meat products were to blame for delays in tracing the cause of the world’s worst listeria outbreak, which has killed 180 people in the past year.</p>
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<p class="">As shoppers queued up to return processed meat items and demand refunds, shares in the biggest food firm in Africa’s most industrialised economy, Tiger Brands, tumbled because of its link to the outbreak that has spread since January 2017.</p>
<p class="">The government, which has been criticised for taking too long to find the cause, had on Sunday linked the outbreak to a meat product known as “polony” made by Tiger’s Enterprise Food.</p>
<p class="">It also said it was investigating a plant owned by RCL Foods that makes a similar product, whose shares also slid on Monday before recovering.</p>
<p class="">Both companies, which say they are cooperating with the authorities, suspended processed meat production at their plants after health authorities ordered a recall of cold meats associated with the outbreak from outlets at home and abroad.</p>
<p class="">The U.N. World Health Organization called the outbreak the largest ever recorded globally, after 948 cases were reported since January 2017. Listeria causes flu-like symptoms, nausea, diarrhoea and infection of the blood stream and brain.</p>
<p class="">South Africa’s Health Ministry said the source was found after pre-school children fell ill from eating polony products traced to processed meat producers.</p>
<p class="">“The meat processing industry was not cooperating for months. They did not bring the samples as requested. We had long suspected that listeria can be found in these products,” the ministry’s communications director, Popo Maja, told Reuters.</p>
<p class="">“It is not that we are incompetent, or that we have inadequate resources,” Maja said when asked why it had taken more than a year to find the cause of listeria.</p>
<p class="">He said all firms in the industry were being examined.</p>
<p class="">South Africa’s processed meat market grew about 8 percent in 2017 to a retail value of $412 million, according to Euromonitor International. Tiger Brands has a 35.7 percent market share, followed by Eskort Bacon Co-Operative with 21.8 percent. Rhodes Food, RCL Foods and Astral Foods each have less than 5 percent.</p>
<p class="">Tiger Brands, Eskort, RCL Foods, Rhodes and Astral said they had complied with all requests from the health authorities.</p>
<p class="">Lawrence McDougall, the CEO of Tiger Brands, said there was no direct link between the deaths and its cold meat products. “We are unaware of any direct link,” he told a media briefing.</p>
<p class="">Health Minister Aaron Motsoaledi had said on Sunday the outbreak had been traced to a Tiger Brands factory in the northern city of Polokwane.</p>
<p class="">The authorities are also examining a second Tiger Brands factory and have not said when they could conclude tests on RCL Foods, which has a plant under investigation.</p>
<p class="">Rhodes said it produced processed canned meat, different from the cold processed meat made by rivals. Astral said it produced fresh and frozen chicken, not polonies and items linked to the outbreak. Both those firms said their products were safe.</p>
<p class="">Fast food chain owner Famous Brands said it was recalling ready-to-eat meat products from its retail outlets.</p>
<h3>CLEANING FRENZY</h3>
<p class="">The minister told South Africans not to consume any ready-to-eat processed meat due to the risk of cross-contamination.</p>
<p class="">The announcement prompted a frenzied clearing and cleaning of the shelves by local supermarkets chains Shoprite, Pick n Pay, Spar and Woolworths, which also urged consumers to return the meats for refunds.</p>
<p class="">Neighbouring states acted swiftly. Zambia banned imports of South African processed meat, dairy products, vegetables and fruit. Mozambique and Namibia halted imports of the processed meat items and Botswana said it was recalling them. Malawi stepped up screening of South African food imports.</p>
<p class="">Shares in Tiger Brands sank as much as 13 percent, before recouping some losses to close 7.4 percent lower at 393.38 rand. RCL Foods fell more than 6 percent but later recovered to trade down just 0.5 percent at 17.11 rand.</p>
<p class="">Dozens of customers lined up outside a Tiger Brands outlet with bags of cold meat products and demanding their money back.</p>
<p class="">“I lost trust with Enterprise. I’ll be scared even if they say this problem is solved. I would rather go back to peanut butter and jam,” said call centre agent Tshepo Makhura, 37.</p>
<p class="">Deline Smith, a 57-year-old housewife with three full bags, said: “I hope my grandchildren are going to be okay because we gave them food over the weekend from these parcels.”</p>
<p class="">Analysts said profits at the two firms were unlikely to be hit hard. Standard Bank analyst Sumil Seeraj estimated the recall would cut operating profit at Tiger Brand’s value added foods division by 6 percent at most.</p>
<p class="">“The big hit is going to come with inventory write-offs because they are recalling all these products. That’s most likely where they will lose because the inventory write-off will affect operating profit from that division,” Seeraj said.</p>
<p class="">The Enterprise unit of Tiger Brands had “a very strong brand in meat”, he said, adding: “In the short term consumers will switch to other forms of protein.”</p>


South Africa blames food firms for world’s worst listeria outbreak

<p><div id="attachment_295801" style="width: 706px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-295801" class="wp-image-295801 size-large" src="http://cnbc.africa/wp-content/uploads/2018/01/Sheraton_Hotel_Addis_Ababa_wikipedia-1110x720.jpg" alt="" width="696" height="451" /><p id="caption-attachment-295801" class="wp-caption-text">Dr Senait&#8217;s story was told at the Sheraton Addis. Picture: Wikipedia</p></div></p>
<p>By Samuel Getachew</p>
<p>It was the dying days of the summer of 2016 and a few weeks away from the Ethiopian New Year’s. Tedros Adhanom (PhD) was Ethiopia’s Foreign Minister, who had recently announced his candidacy to become the next head of the World Health Organization (WHO). There was also a heated presidential election that night between an unorthodox candidate and a former First Lady on the verge of becoming America’s first woman president. That was an interesting topic of discussion for his guests at an Indian restaurant within the compound of Sheraton Addis.</p>
<p>The Minister had tidbits of interesting stories he had acquired travelling the world as Ethiopia’s Foreign and Health Minister. The light of the immaculate restaurant was dim enough to have eye contacts, with beautiful classical Indian music playing in the background for his guests and a young lawyer from Howard University who was shadowing him while speaking imperfect Amharic to be at ease. The charismatic politician with a PhD from the UK’s University of Nottingham was known to invite random people he meets on social media for a conversation.</p>
<p>He was reflective, chatty and excited with what lied ahead for him that night. He had met hundreds of people at a Diaspora forum that summer in Bahir Dar who had promised to help him in his campaign. He wanted to recruit more.</p>
<h4>Delightful Indian cuisine</h4>
<p>By the time, it was time to order dinner; he asked if he could delight his guests with his special order. Within 30 minutes, there was a table full of cuisine of India, from Chicken tikka, Biryani, Tandori chicken and butter chicken. “These are the favorite cuisine of Senait,” he said. “Dr. Senait Fisseha,” he corrected himself.</p>
<p>He was delighted to know his guests knew who she was having witnessed her activities on social media and being recognized for her efforts and most recently in Toronto with the Bikila Award. For the rest of the night, it was not the United States politics that occupied the discussion, but his vision for his unlikely campaign as the head of the WHO, which at that point was a fringe candidacy and his “beloved sister Senait”.</p>
<p>At that point, she was the temporary chair of his campaign and wanted her to be its permanent chair but she was hesitant. She was the one who had encouraged his entry into the competitive campaign. She knew his time was up and she had assembled a tight team, which at the time, included noted Ethiopians, including Mehret Mandefro, a Harvard University medical doctor with connections to the Obama White House, and the young Ethiopian American lawyer from Washington DC by the name Nathan Zewdu who was at the dinner as well as a very bright colleague of Dr. Senait from the University of Michigan, whom along with Nathan had committed to move to Ethiopia.</p>
<p>He was not expected to win as the candidates from France and Pakistan were seen as the early favorites.</p>
<h4>Meeting Dr Senait</h4>
<p>He recalled how he met her officially when she invited him to Michigan University when he was on a visit to Washington DC to receive the Jimmy and Rosalyn Humanitarian Award and how he was taken back with her candor, smarts, and ambition for Ethiopia.</p>
<p>She had met him for the first time 15 years ago when she was doing her OB-GYN residency and he was the head of the Health Bureau of the Tigray Regional State.</p>
<p>By that point, she has had an extraordinary career that has taken her to high places since she received her JD (Juris Doctor) and Medical Doctorate simultaneously in 1999 from the Southern Illinois University. Reproductive endocrinologist and infertility specialist in the United States, her interest lied in her native Ethiopia. She convinced the university to commence a global initiative to help Ethiopia’s broken healthcare system. That was few years before her appointment as the Director of International Programmes at the Buffet Foundation, a liberal well-funded group that has had influence in the healthcare of emerging nations around the world.</p>
<h4>Collaborating on Ethiopian issues</h4>
<p>The duo had collaborated before when it came to the issues of Ethiopia more specifically in her as her role as an Ethiopian Diaspora bringing faculty at the University of Michigan to volunteer. His visit was to be an official visit to cement, expand and institutionalize the partnership that was growing.</p>
<p>There was a partnership to be found and funding to be acquired for what at some point seemed an impossible gesture. With the financial support of the New Medical Education Initiative and with St. Paul Hospital Millennium Medical College (SPHMMC) in the capital, in 2012, the initiative began. Her effort had netted St. Paul its first batch of OB-GYNs, radiologists, surgeons, internists and a renal transplant program.</p>
<p>The new program offered needed training and faculty retention program, in a nation whose locally educated doctors reside in the United States much more than they are residing in Ethiopia. She was awarded USD 1.5 million as seed money from a still unknown doctor and a five-year grant from the Centers for Disease Control and Prevention and the American International Health Alliance and emulated such a program that was happening in Ghana.</p>
<h4>Achievements at University of Michigan</h4>
<p>At the University of Michigan, where she was recently honored with the Bicentennial Alumni Award, she served as the chief of Division of Reproductive Endocrinology &amp; Infertility and the Medical Director of the Center for Reproductive Medicine. With a USD 25 million grant, she also established and was the founding director of the University of Michigan Center for International Reproductive Health Training.</p>
<p>She understood. The friend who she had encouraged to enter the world’s sacred institution is a busy man. She had stood by him at difficult times, as a candidate and as the director general. Even at his challenging, even controversial times, but no one knows his capability better, his gift and potential than her. Whether bringing diversity or gender parity that has known little change in its leadership, WHO is now an institution where it demands attention and respect because of the dream of Senait.</p>
<p>At the ceremony where she was hailed and celebrated at the University of Michigan earlier this month, Tedros could not attend but sent a video message that is posted on the University’s website. In a recorded message, Tedros said, “It is very difficult to summarize my respect for Senait. Her contributions to Ethiopia, to global health, and to me are really immense”.</p>
<p>He added that “Senait is the definition of selfless” and he has “never met anyone so willing to put others ahead of themselves. No task is too big or too small for her. She is one of the most remarkable colleagues I have ever worked with”. The mother of four remains the chief advisor for Tedros and continues to work on advancing sexual and reproductive health and rights around the world.</p>


Op-Ed: From local impact to global influence – Ethiopia’s Senait Fisseha

<p><em>Griffins Manguro | Ghent University</em></p>
<p>The World Health Organisation (WHO) has clear markers on the road to controlling the global HIV/AIDS pandemic. By 2020, about nine out of every ten people should know their HIV status. Nine out of ten HIV positive people should be on antiretroviral treatment (ARVs) and the virus should not be detectable in their blood.</p>
<p><div id="attachment_91118" style="width: 1034px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-91118" class="wp-image-91118 size-full" src="http://cnbc.africa/wp-content/uploads/2017/03/Drugs-Wikimedia.jpg" alt="" width="1024" height="761" /><p id="caption-attachment-91118" class="wp-caption-text">Photo: Wikimedia.</p></div></p>
<p>And by 2030, the WHO says, there should be no new infections, no AIDS-related deaths and no stigma or discrimination related to the virus.</p>
<p>These are all good goals and important ways to measure how countries are progressing. In Kenya, where I live and conduct my research, there has been some progress, but more must be done. We see progress in reducing new infections among adults, providing preventive medication and providing oral self-testing for HIV.</p>
<p>But more must be done to reduce new infections among adolescent girls and young women, female sex workers and men who have sex with men.</p>
<h2>Fewer new infections, more people on treatment</h2>
<p>Kenya’s latest HIV progress report shows that new infections are dropping.</p>
<p>There were 40% more people on antiretroviral treatment in 2017 than there were four years ago. Antiretroviral treatment prevents the virus from multiplying and prolongs the lives of HIV positive people. It also lowers the risk of transmission from HIV positive to HIV negative people.</p>
<p>Currently, 66% of the 1.5 million people living with HIV in Kenya are on antiretroviral treatment. The goal is to have at least 90% on treatment by 2020.</p>
<p>This strategy is based on WHO recommendations, which call for a person to start treatment immediately after testing positive. Previously it was recommended that people start ARVs only after their CD4 cells (blood cells which fight infection) dropped below 500 cells per cubic millimetre of blood.</p>
<h2>HIV self-testing strategy</h2>
<p>One of the biggest changes in Kenya’s strategy this year was the introduction of guidelines for oral HIV self-testing.</p>
<p>People can test themselves for HIV using their saliva. In most African countries, self-testing is mostly used for research. Kenya is the first country to introduce a plan to make it available nationally. The aim is to increase the number of people getting tested and link those who are HIV positive to care and treatment.</p>
<p>The self-testing kits became available in public and private health facilities and in some pharmacies countrywide from July and could be bought at subsidised prices. They will help fill a gap in HIV testing. The number of Kenyan adults who have ever tested for HIV has grown between 2008 and 2016, from roughly a quarter of adults to more than half.</p>
<p>But certain populations, such as men who have sex with men, sex workers and adolescents, have low testing rates. This is mostly because they may experience stigma and discrimination when seeking routine HIV services.</p>
<p>Self-testing is a way to avoid stigma and discrimination and boost people’s links to care.</p>
<p>But the process has some problems, including the absence of counselling before and after testing. Without good counselling, people who test positive may not seek treatment and care. This can be solved by community health volunteers following up at people’s homes. They already support family planning, maternal health and child health and can help people who use the kit and test positive.</p>
<h2>Preventive medicine</h2>
<p>Kenya also launched guidelines on the use of pre-exposure prophylaxis (PrEP). This comes in several forms, including vaginal rings and gels. The most common is a tablet taken daily.</p>
<p>PrEP is given to people in high-risk groups who are HIV negative to prevent them from contracting the virus. They may be in relationships where one partner is infected with HIV and the other is not. Others at high risk are male and female sex workers.</p>
<p>Kenya and South Africa are the only countries in Africa that offer this type of treatment as part of a national HIV prevention strategy.</p>
<h2>On alert for infections among youth</h2>
<p>Kenya also started paying more attention to young people. More than half of the world’s new HIV infections are in the group aged between 15 and 24.</p>
<p>In Kenya, too, 51% of new adult HIV infections were in this age group by 2016 – a steep increase from 29% in 2013. It is also the only age group in Kenya that has recorded an increase in new infections. This is because young people tend to have little knowledge about the virus and the behaviours that increase their chances of infection.</p>
<p>People in this age group often have sex while under the influence of alcohol, which can result in poor decisions. Girls in this age group also have transactional sex with older men.</p>
<h2>Looking ahead</h2>
<p>Kenya has made great strides against HIV and in providing care to all HIV infected people. But more work is needed.<img loading="lazy" decoding="async" src="https://counter.theconversation.com/content/88850/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" />The country must step up its efforts to get more men tested. It will also be important to get more adolescents and young girls to adopt HIV prevention methods, and to reduce stigma and discrimination among sex workers and men who have sex with men.</p>
<p>This article was originally published on The Conversation.</p>


Kenya’s HIV progress report: good progress, but also big gaps

<p data-reactid="32">GENEVA (Reuters) &#8211; Zimbabwean President Robert Mugabe has been removed as a WHO goodwill ambassador, the World Health Organization (WHO) said on Sunday following an outrage among donors and rights groups at his appointment.</p>
<p data-reactid="32"><strong>READ:</strong> <a href="http://cnbc.africa/news/southern-africa/2017/10/21/critics-urge-reverse-mugabe-appointment/">Critics urge WHO to reverse Mugabe’s appointment</a></p>
<p>WHO Director-General Tedros Adhanom Ghebreyesus, who made the appointment at a high-level meeting on non-communicable diseases (NCDs) in Uruguay on Wednesday, said in a statement that he had listened to those expressing concerns.</p>
<p data-reactid="41">“Over the last few days, I have reflected on my appointment of H.E. President Robert Mugabe as WHO Goodwill Ambassador for NCDs in Africa. As a result I have decided to rescind the appointment,” Tedros said in a statement posted on his Twitter account @DrTedros.</p>
<div class="Attribution_attribution_o4ojT" data-reactid="42">
<p class="Attribution_content_27_rw" data-reactid="43">Reporting by Stephanie Nebehay; Editing by Toby Chopra</p>
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Zim’s President Mugabe removed as WHO goodwill ambassador

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<p>Nigeria&#8217;s Minster of Health, Isaac Adewole, announced that three cases of the monkeypox virus have been confirmed from the WHO regional laboratory in Senegal.</p>


Nigeria confirms three cases of monkeypox

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<p>According to the World Health Organization, motorcyclists make up 23 per cent of all road traffic deaths. One start up in Rwanda had this particular statistic as its selling point when entering the Rwandan market. Joining CNBC Africa or a breakdown on uptake of the business and market segmentation is the CEO Barrett Nash.</p>


Rwanda start-up looks to make riding in Africa safer

<p><strong><em>Dr Leanne Mandim | Life Healthcare </em></strong></p>
<p>For many, wellness in the workplace has moved from a <em>nice to have</em> to a <em>must have</em>.</p>
<p>“The increasing demands of today’s fast-paced business environment means employees need more personal health, wellness and lifestyle support than ever before. It’s well documented that happy, healthy employees are more efficient and more productive,” says Dr Leanne Mandim, Head: Employee Health and Wellness Solutions for Life Employee Health Solutions.</p>
<p><em>While the physical health of employees is always a key focus of wellness programmes, Mandim believes that an integrated programme which also highlights mental health is key. </em></p>
<p>“The mental health and wellbeing of employees in the organisation is critical for maintaining sustainable levels of employee engagement, resilience in the face of organisational change, motivation, and innovation. Through an integrated employee wellness approach employers can benefit through the positive impact on productivity and business performance,” she says.</p>
<p>A recent World Health Organization study has shown that depression and anxiety account for the most frequent occurrences in occupational disability, according to the study, depression and/or anxiety is expected to account for 15% of the global disease burden by 2020<sup>1</sup>. It is estimated that between 3% &#8211; 10% of GDP is lost annually as a result of stress related sick leave<sup>2</sup>.</p>
<p>“A well-managed comprehensive and holistic wellness programme can have definite benefits in positively managing risks surrounding depression and anxiety,” says Mandim.</p>
<p>A growing body of evidence suggests that employers can reduce costs by investing in the health and well-being of their employees. This includes both the direct costs of providing healthcare and indirect costs, such as absenteeism and reduced productivity.</p>
<p>Many employers have recognised the wider potential benefits of investing in wellness and have used it to promote the achievement of other important company objectives. Investing in wellness can lead to:</p>
<ul>
<li>Improving employee engagement and building individual resilience.</li>
<li>Strengthening the employer value proposition to attract and retain the best talent.</li>
<li>Reducing safety risk through behavioural change solutions.</li>
<li>Enhancing the value and sustainability of the organisation’s most critical resource – people – and demonstrating this to stakeholders.</li>
<li>Achieving the organisation’s wider purpose and improving the lives of people.</li>
<li>Building the organisation’s reputation and brand.</li>
</ul>
<p>&nbsp;</p>
<p>As productivity remains a core concern for most organisations, the demand for sustainable employee wellness initiatives has shifted from a purely HR driven strategy to a business imperative. With South Africa’s increasing disease burden, companies are starting to feel the pressure to play a more active role in employee wellness.</p>


The cost of mental illness in the workplace

<p><strong><span class="fn author-name">Kanyiva Muindi and Blessing Mberu | African Population and Health Research Center</span></strong></p>
<p>Air pollution is a visible problem in Kenya’s capital, Nairobi. The city’s poor air quality is evident in its congested streets where passenger vehicles, trucks and motorcycle taxis jostle for space while belching clouds of black smoke.</p>
<p>Nairobi’s construction boom and practices like the burning of garbageonly add to the levels of outdoor air pollutants. The World Health Organisation (WHO) reports that the level of fine particulate matter in the city’s outdoor air is 17 micrograms per cubic meter (µg/m3). This is 70% above the recommended maximum level.</p>
<p>This figure could even be higher given the absence of a robust monitoring system. Outdoor (ambient) air pollution causes more than 3 million premature deaths globally each year and increases the risk of respiratory diseases and cardiovascular conditions.</p>
<p>What’s less discussed is the problem of indoor air pollution – the presence of air pollutants in homes, offices and classrooms. These could be gases like carbon monoxide and can come from various sources, such as fuels used for cooking and lighting.</p>
<p>Indoor air pollution is not so visible, even though it’s estimated to cause 4.3 million premature deaths globally each year. Estimates of indoor air pollution levels in Nairobi’s households are hard to come by. This is partly due to the complexities of setting up monitoring devices in people’s houses.</p>
<p>The invisibility of the problem is exacerbated by the fact that it’s seen as a private problem because it happens in a household setting. But it’s an important environmental risk factor for our health given that we spend a large amount of our time indoors.</p>
<p>We have been conducting research to understand the levels and burden of household air pollution in Nairobi’s informal settlements. Our research in Korogocho and Viwandani indicates that average levels of fine particulate matter within households are approximately 76 µg/m3. ThisThis is over three times more than the WHO recommendedmaximum level of 25µg/m3.</p>
<h2>An urban problem</h2>
<p>Household air pollution is primarily driven by fuels that are burnt for cooking and lighting. While it’s been associated with rural communities, household air pollution is also an urban issue. Residents of informal settlements have little access to electricity or liquefied petroleum gas. They primarily burn firewood, charcoal and kerosene.</p>
<p>Some households even resort to burning plastic bags and containers when they can’t buy charcoal or kerosene. Burning these fuels releases pollutants such as carbon monoxide, sulphur dioxide, nitrogen dioxide, poly-aromatic hydrocarbons as well as particulate matter of varying sizes.</p>
<p>Wood smoke has been shown to have similar pollutants as cigarette smoke, but at higher concentrations. This has health implications for firewood users. Poor ventilation in homes because of concerns about security or outdoor air pollution adds to the levels of pollution. The pollutants are associated with respiratory diseases, cancers and adverse maternal and child outcomes.</p>
<p>Women are more exposed because they are primarily involved in cooking and household work. A cross-sectional survey in Nairobi’s slums indicates that females form 37% of the slum population, with those aged 20-29 years forming the highest proportion.</p>
<p>In the search for low cost and innovative solutions to the problem of indoor air pollution in poor urban households, three workshops were convened last year in Nairobi.</p>
<p>These involved policymakers, academics, researchers and NGO representatives. Also present were residents of Korogocho and Viwandani – two informal settlements in Nairobi. Together they developed a basket of potential policy interventions which were modelled in different scenarios.</p>
<p>The first involved changing the fuel mix used in cooking and lighting by increasing the price of kerosene and lowering prices for gas and clean cook stoves. This showed a marginal reduction in levels of household air pollutants.</p>
<p>In the second scenario, the price control measures were combined with stronger enforcement of pollution regulations. This resulted in a tripling of the reduction effect in comparison to the previous scenario.</p>
<p>The third scenario added increased health impact assessments and air quality monitoring to scenario two. This led to an even further drop in air pollutant levels.</p>
<p>The final scenario combined all the policy measures mentioned above with a reduction in outdoor air pollution and improved ventilation. This led to the greatest decrease in indoor air pollutant levels.</p>
<h2>What the modelling tells us</h2>
<p>The modelling showed that while price controls may be effective initially, sustaining gains in air quality and health outcomes will require a combination of different measures. The results also show that only targeting household air pollution isn’t enough.</p>
<p>Because indoor and outdoor air pollutants constantly interact with each other as air moves in and out of people’s homes, the greatest gains will only be realised when outdoor air pollution is addressed effectively.</p>
<p>But it’s easy to focus on ambient air pollution which is more visible and ignore the problem within households. That’s why policymakers need to ensure that both challenges are monitored and addressed. Reducing exposure to both indoor and outdoor air pollution is critical to improving health outcomes for vulnerable populations in the informal settlements in Africa’s cities.</p>
<p><em>Chege Mwangi, the policy engagement manager at APHRC, also contributed to this article</em></p>


Invisible and ignored: air pollution inside the homes of Nairobi’s residents

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<p>Sustainable health financing has long been recognised as an essential part of Universal Health Coverage and an important plank in achieving the aims of the Sustainable Development Goals. In recent years the concept has led to numerous health reforms.</p>


Focus on Africa’s healthcare

<p><span class="articleLocation">Tom Miles | GENEVA</span></p>
<p>Tedros Adhanom Ghebreyesus, a former health minister and foreign minister of Ethiopia, won an election on Tuesday to head the World Health Organisation (WHO), the first African to do so, edging out a veteran insider from Britain.<span id="midArticle_byline"></span></p>
<p>A jubiliant Ethiopian official emerged from the closed-door meeting in Geneva, to shout after the secret ballot where Britain&#8217;s candidate David Nabarro came second: &#8220;We did it, we did it!&#8221;.</p>
<blockquote><p>&#8220;It&#8217;s a victory day for Ethiopia and for Africa,&#8221; Ethiopia&#8217;s ambassador Negash Kebret Botora told Reuters.</p></blockquote>
<p>Known universally as Tedros, he garnered 133 votes from the 185 WHO member states who officials said were eligible to cast ballots in the vote to succeed Margaret Chan, who has been at the helm of the Geneva-based U.N. agency since Nov. 2006.</p>
<p>(Reporting by Tom Miles; writing by Stephanie Nebehay; Editing by Gareth Jones)</p>
<p>&nbsp;</p>


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