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Friday, 8 August 2008

Malawi records increase in tobacco earnings

Blantyre, Malawi - Earnings from Malawi's main foreign exchange earner - tobacco - are expect to rise by 88 per cent this year, the Tobacco Control Commission (TCC) has said.

TCC General Manager Godfrey Chapola told PANA Friday Malawi would realise about US$ 348 million this year, up from US$ 185 million last year.

"These are record sales considering that we had adverse weather in the last growing season," Chapola said, adding "The bottomline is that we had improved prices for our tobacco."

A total of 143,000 metric tonnes of tobacco was auctioned by the end of July, going at an average of US$ 3 per kilogramme.

Tobacco accounts for over 75 per cent of Malawi's foreign exchange earnings. Over 80 per cent of Malawians are employed directly or indirectly in the tobacco in d ustry which also contributes to 23 per cent of Malawi's entire tax collections.

Tobacco sales will close in september.

Achieving Universal Treatment Access: The Experience in Rural Malawi

Universal access to antiretroviral (ARV) therapy is feasible even in the most rural areas of in low- and middle-income countries by using a simple and standardized approach to care, according to a report out of the rural Thyolo district of Malawi reviewed at the XVII International AIDS Conference by Moses Massaquoi, MD, of Medecins Sans Frontieres. However, a second presentation at the conference by researchers associated with a University or North Carolina (UNC) research project in Lilongwe, Malawi, indicates that high-level drug resistance is a major concern among patients no longer responding to their first ARV regimen and may greatly impede their ability to benefit from subsequent regimens.

HIV prevalence is high in Malawi, a republic of nearly 13 million in southeast Africa. One in five adults is infected with the virus, and there are more than 90,000 AIDS-related deaths each year.

In urban centers of low- and middle-income countries, HIV-positive people tend to have greater access to care—and treatment—because there is usually a greater number of hospital, clinics and trained health care providers. Care and treatment can be harder to come by in rural areas, where a sizeable percentage of the world’s HIV-positive people reside, due to a shortage of trained medical staff, clinics and other resources.

In the Thyolo district, with its population of about 600,000, nearly 1 in 10 adults and children are infected with HIV. Fifteen to 20 percent of those are in immediate need of ARV therapy.

Simple, standard protocols have been put into place to achieve universal access to care and treatment in Malawi, including its rural districts. These include initiating universal HIV testing, using cheap and readily available single first-line ARV regimen for all HIV-positive people in need of treatment (Triomune, a generic tablet containing nevirapine, stavudine and lamivudine), and monitoring patients every three months.

ARV therapy is also decentralized, meaning that treatment is made available in rural clinics—not just urban hospitals—thereby preventing the need to travel long distances on a regular basis to procure medications.

Finally, there is the novel concept of task-shifting—assigning non-medical and nurses the responsibility of distributing ARVs, and educating patients about their safe and effective use, notably in areas where HIV-trained physicians are not available. Mossaquoi explained that, in 2004, physicians were primarily response for the distribution of ARVs. However, there are fewer than 100 HIV-trained physicians in Malawi—a country where at least 400 are needed to effectively care for the 170,000 patients in immediate need of ARVs.

Thus, In 2007, based on a successful tuberculosis treatment model, the task of distributing medications in rural areas, and educating patients about their safe and effective use, is being supplemented with the help of non-medical and nursing members of rural communities.

These standardized and simplified approaches to HIV treatment have proved successful in the Thyolo district, underscoring what is possible in all regions of low- and middle-income countries. By 2007, the universal access target of providing treatment to those who need it was met. Of the 13,702 patients in Thyolo who have received treatment since April 2003, 77 percent remain in care. Only 11 percent have died and 12 percent have experienced problems with treatment adherence. Less than 1 percent have discontinued their treatment program altogether.

According to Dr. Massaquoi, task-shifting essentially quadrupled the number of individuals initiating ARV therapy since 2004.

The cost of universal access in Thyolo has been estimated at $2.75 million per 10,000 patients—about $4.50 per resident per year.

A major challenge to universal ARV access is the evolution of drug-resistant HIV. In the United States and other industrialized nations, viral load testing is employed regularly to determine if a patient is no longer responding effectively to treatment, characterized by a rebound in viral load. In Malawi and other poor countries, viral load testing—and often CD4 cell count testing—is not routinely available, thus many patients remain on a treatment regimen that is no longer keeping viral load undetectable and, thus, accumulating additional genetic mutations and, ultimately, high-level drug-resistance.

This was the case in the presentation by UNC’s Mina Hosseinipour, MD. According to a study conducted on blood samples collected from Malawian HIV-positive patients receiving HIV treatment, 94 samples from 96 patients failing Triomune showed high rates of drug resistance. Resistance to lamivudine was present in 81 percent. High-level resistance to both of the first-generation non-nucleoside reverse transcriptase inhibitors available in Malawi—nevirapine and efavirenz—was documented in 93 percent. And 17 percent of patients had high-levels of nucleoside reverse transcriptase inhibitor cross resistance.

According to Dr. Hosseinipour’s report, between 22 and 50 percent of patients had no fully active drugs in the recommended second-line NRTI backbone.

These troublesome data, Dr. Hosseinipour commented, underscore the need to not only maintain universal access to ARVs, but to greatly improve upon the monitoring of patients on therapy to reduce the risk of treatment-limiting drug resistance.

Malawi embarks on 2009 fresh voters' registration

Malawi has a tough mission ahead of 2009 general election, to register afresh seven million people on to its new voter's roll.

Registration for elections, which is expected to take three and half months, starting from 18 August and close on 29 November will cover the country's 28 districts, Fegus Lipenga, spokesperson for Malawi Electoral Commission (MEC) reported.

He said MEC is to spend US$ 50 million for the whole electoral process as well as equipment that will successfully assist in the registration exercise, saying since equipment to be used for registration was very expensive and the body could not afford to place for all centres, registration would be staggered.

He further said that new voters' electoral roll is being launched in a bid to avoid a repeat of a fiasco in 2004 elections, in which the number of registered voters dropped because of a High Court order for reinspection of lists.

MEC has already launched a media campaign to attract eligible voters out of 13 million population to register and all stakeholders have been urged to persuade more people to register in order to vote in 2009, Lipenga said.

Apart from traditional donors and UN development programme, Malawi has also received a pledge of US$ 8 million from former colonial power, Britain, for the 19 May, 2009 election.

Current president Bingu wa Mutharika will face a strong challenge from his predecessor, Bakili Muluzi, who is seeking a fresh extended term at Malawi's state house.

Mr Muluzi took over power from dictator Kamuzu Banda in Malawi's first democratic polls in 1994, stepping down in 2004 and handing over to current president Bingu wa Mutharika, as his chosen successor. The two subsequently fell out, even prompting incumbent president to form his new party and cross the floor with government.

Since coming to power, Mr Mutharika has adopted an anti-corruption policy that has seen former head of state and other high Malawi officials in and out of courtrooms on corruption charges.

In May, Mr Muluzi was arrested for allegedly plotting to overthrow government, having made amongst others, comments such that he will unseat president Mutharika.

Ten Questions: Linda McDonald

Linda McDonald, 48, from Gyle, is founder of Malawi Underprivileged Mothers and Edinburgh's Citizen of the Year 2008.

1 What is your earliest memory of Edinburgh? Coming to Edinburgh to start my nursing training in 1978 to live in the nurses accommodation we had to stay in for the first 18 months.

2 What are your memories of school?

The first school I attended was Park School, Glasgow, which was a very regimented private girls school, so I couldn't wait to move on to Charing Cross secondary and be introduced to some boys.

3 Where is your favourite place in Edinburgh and why? I still absolutely love Princes Street, no matter what people say about some of the shops there. The Gardens and the view of the Castle means it will always be special.

4 What are the best things about Edinburgh? The history and the beauty of the place. I'm also tempted to say the people of Edinburgh, but most of the people I know aren't born-and-bred, they've come in from elsewhere and seen how beautiful it is.

5 What would you change about the city? The traffic and all of the roadworks. I know these things have to be done but you can't get moving. I'd also change the shops on Princes Street. Some of them are rubbish! It's been eclipsed by George Street, despite Princes Street being more iconic.

6 Describe a perfect Edinburgh day/night out. Getting a bus to George Street, meeting friends and having a nice lunch and a drink and watching the world go by.

7 Which sports interest you? I do Pilates. After spending 30 years as a nurse I have a lot of back problems so it helps me align my central core.

8 What was your most embarrassing moment? Being a midwife I'm always chatting to pregnant women and asking them when they're due, but a couple of times I've been told they weren't expecting. They were just fat!

9 What is your greatest achievement? Apart from bringing up my lovely children and finding true love, it has to be setting up MUMs and producing a charity concert at the Usher Hall. Seeing all people like Tom Farmer turn up and knowing they're all there because of me was a wonderful thrill.

10 Sum up Edinburgh in three words. Historic. Beautiful. Home.

Malawi to Hold Presidential, Parliamentary Elections on May 19

Malawi will hold presidential and parliamentary elections on May 19 and plans to register 7 million voters, the Malawi Electoral Commission said.

The southern African nation will budget $50 million for the vote, Fegus Lipenga, a spokesman for the commission, said in a telephone interview today from Lilongwe, the capital. Voter registration will take place between Aug. 18 and Nov. 29.

The ballot will be the third in Malawi since the end of one-party rule under Hastings Kamuzu Banda 15 years ago.

M'nM...Marianne in Malawi: Queasy Contentment

Oh dear, oh dear, how my stomach turns and churns when it comes to goodbyes. Today is my last day at the office. Though my flight doesn't leave until 1:40 pm tomorrow, I will be heading to Blantyre at 5 am tomorrow morning since there is another team flying out, and we want to cut down on mileage costs. So I've got less than 24 hours left here in the "city" of Zomba...which technically is now a city, though perhaps the smallest one I've ever seen!

Tonight there will be a farewell for all of us leaving at the Jones' house. My Bible study group had a nice farewell dinner on Wednesday evening as well, where I had to say goodbye to Helen, since she is at a meeting in Lilongwe, the capital. Mary also gave me 8 metres of gitengi material on behalf of the whole group. She said it's for me and my Mom - that we can get something made to wear and feel close to each other. I couldn't help but joke about calling Mom up in the morning, "Hey Mom, wear your African outfit today so that we can match inter-provincially!" I am so touched by the thoughtfulness - especially the care that this group has shown in praying and asking about my parents.

Anyone here knows that something that has brought me so much joy is getting to know the watchmen and their families from the house I lived at in June. I have been so blessed from their friendship, and have been praying for them constantly. I was so surprised and touched by their effort and time to come and bid me farewell. Just yesterday, Mr. Bitton and his wife Mary walked from Chinamwali to give me a hand-written letter, hand-made doilies, and a bag full of food. Things like this make you pause and reflect on poverty, richness in spirit, and love. I told Mr. Bitton that I am so humbled because I feel that they have given me so much more than I have given them. It is sad to have to part ways.


The middle month of my stay here was very difficult emotionally for me. I felt the oh so familiar feeling that I have known for the last few years of my nodamic life of figurative homelessness. I found myself thinking that I could never feel at home here in Malawi, because no matter how much Chichewa I learned, to the locals I would always be "other". And yet, as I was sitting in church last Sunday, it occured to me that, with some more time and God's help, I could feel at home here. God has surely used these three months to strenghten me and teach me many things - about Jesus, and about myself. I feel like I know myself better for having come here. I only hope that it is a secondary benefit - to the work I came to do!

There were so many more blog posts floating around my head. Like transportation - mini-buses that aren't full when you think they are, and 99% of the cars being Japanese, and the others German. Like clashes in English - not being able to understand each other because "pants" here means underwear (so speak carefully!). Like people - those who have touched my life during my stay.

As I prepare to leave, my heart is heavy, and yet there is peace - knowing that the Lord is in this place, and that He will be with me in my place. And that as He wills, I will be re-united once again with those that have become tucked in my heart.

This is my last blog post from Malawi. To all who have read, I hope you have enjoyed your stay. To all who have prayed, I thank you from the bottom of my heart. To all who have shown their love and care here at Emmanuel International, I pray with utmost fervor that God would continue to indwell your work, so that others would continue to be blessed even more than you have blessed me. And to my parents - thank you for having enough faith to see me through this journey.

Five Groups Honoured With Prize For AIDS Activism

Five community groups honoured with UN-backed prize for AIDS activism

7 August 2008 - Five community organizations from Ghana, India, Iran, Malawi and Mexico have received special recognition as winners of the Red Ribbon Award, a United Nations initiative that honours outstanding local leadership and action in responding to the HIV/AIDS epidemic.

Of the more than 550 organizations from 147 countries that were nominated, 25 were awarded $5,000 and were invited to participate in the XVII International AIDS Conference (AIDS 2008), which is taking place in Mexico City this week.
The winners of the Award - which is presented every two years - were announced in June by the UN Development Programme (UNDP) and the Joint UN Programme on HIV/AIDS (UNAIDS), and were honoured at an awards ceremony last night in Mexico City.

Five of the 25 winners received special recognition in the following categories: providing access to treatment, support and care; supporting children orphaned by AIDS; promoting human rights; empowering women and girls; and providing HIV prevention programmes and services.

They are Centre for Popular Education and Human Rights, Ghana; Sanghamitra, A Women's Collective, India; Consol Homes, Malawi; Fortalecidendo la Diversidad, Mexico; and Hamyaran Mosbat - The Mashhad Positive Club, Iran. They will each receive an additional $15,000.

"These are extraordinary organizations helping to meet the needs of their own communities in often very difficult circumstances," Rebecca Grynspan, Director of UNDP's Regional Bureau for Latin America and the Caribbean, said during the awards ceremony. "In doing so they have shown extraordinary creativity, courage and leadership in responding to the epidemic and achieving tangible results with limited resources."

"All the Red Ribbon participants at this conference are winners," said As Sy, Director of Partnerships and External Relations at UNAIDS. "We hope that the knowledge and resources gained from AIDS 2008 will help inspire you in your own communities in taking your work to the next level. I know all of us have learned from you and your experiences. This knowledge is truly what the Red Ribbon Awards are about."

The 25 winning organizations are also participating in AIDS 2008, where they are hosting the Community Tequio in the heart of the Global Village, a space for participants share their experiences and best practices on HIV/AIDS issues.