Category Archives: Agriculture

Creating malaria … and drug shortages

Malaria control rests heavily on support from or activities of other development sectors besides health.  Power supply and agriculture provide two current examples.

Yewhalaw and colleagues explore the ramifications of dam construction for electricity supply in Ethiopia and see how human activity can increase mosquito breeding and the spread of malaria. Their work concludes –

This study indicates that children living in close proximity to a man-made reservoir in Ethiopia are at higher risk of malaria compared to those living farther away. It is recommended that sound prevention and control programme be designed and implemented around the reservoir to reduce the prevalence of malaria. In this respect, in localities near large dams, health impact assessment through periodic survey of potential vectors and periodic medical screening is warranted. Moreover, strategies to mitigate predicted negative health outcomes should be integral parts in the preparation, construction and operational phases of future water resource development and management projects.

At the same time Médecins Sans Frontières (MSF) has issued a warning about how agricultural market dynamics may have negative bearing on artemisinin supplies in the very near future. MSF explain that –

Current best estimates, based on available stocks and current planting efforts, demonstrate that there will be a shortfall of about 40 tons of artesiminin starting material in 2010 to produce the expected 240 million treatments needed. Taking into account that it takes about 14 months from the planting of Artemisia annua to the availability of the finished product, the availability in 2010 depends on what is being planted by farmers in the next weeks and months. We believe that market forces will not resolve the short-term artemisinin supply problem. Because it is extracted from plants, the supply of artemisinin is impacted by the highly volatile market of food crops which affect farmers’ decisions of whether or not to plant Artemisia annua.

These are two examples of how human actions exacerbate the scourge of malaria.  Such human influences are common throughout the history of malaria control. Intersectoral planning and surveillance is needed since malaria is not just a health affair.

urban hunger –> urban agriculture –> urban malaria

The growing problem of urban hunger and urban food insecurity was featured in the Wall Street Journal today. In Monrovia, Liberia, “The cost of a cup of rice has risen to nearly 50 cents from 20 cents, a huge leap for many families who live on less than $1 per day.” The result: “Escalating hunger in African cities is forcing aid agencies accustomed to tackling food shortages in rural areas to scramble for strategies to address the more complex hunger problems in sprawling slums.”

One of these strategies, according to IDRC is urban agriculture:

Urban agriculture (UA) is wrongly considered an oxymoron. Despite its critical role in producing food for city dwellers around the world, urban food production has largely been ignored by scholars and agricultural planners; government officials and policymakers at best dismiss the activity as peripheral and at worst burn crops and evict farmers, claiming that urban farms are not only unsightly but also promote pollution and illness. Contradicting this image, recent studies document the commercial value of food produced in the urban area while underscoring the importance of urban farming as a survival strategy among the urban poor, especially women heads of households.

Urban farming requires water. The International Water Management Institute reports that, “Manual water fetching with watering cans is most common.” They often get water from “polluted streams or they do farming along storm water drains and gutters.” This sometimes leads to “wastewater irrigation.”

Of course malaria vectors need water. In urban Accra, Ghana, Klinkenberg and collaegues found that Anopheles and Culex “outdoor biting rates were respectively three and four times higher in areas around agricultural sites (UA) than in areas far from agriculture.”

The solution to the problem of urban malaria is not to stop urban agriculture, but to intensify integrated vector management interventions.  We certainly don’t want to protect people from malaria and then have then suffer from food insecurity.

Population -> Deforestation -> Climate Change -> Malaria

Malaria “vectorial capacity was estimated to be 77.7% higher in the deforested site than in the forested site” in western Kenya according to a new study by Afrane and colleagues. Deforestation created micro-climates and micro-habitats. They concluded that “deforestation in the western Kenyan highlands could potentially increase malaria risk,” and unfortunately, “In African highlands where temperature is an important driving factor for malaria and the human population generally has little functional immunity.”

Generally, “Kenya’s forests are rapidly declining due to pressure from increased population and other land uses,” as explained by the World Rainforest Movement (WFM). The process has been long standing from including early establishment of large agricultural plantations in the last Century to continued agricultural expansion based on population growth and logging. WFM advocates for community involvement in forest conservation.

kfwg.gifKenya is making progress on reducing malaria deaths through successful LLIN and treatment efforts, but this may be offset if communities do not see the connection between malaria and their environment.  Intersectoral collaboration in malaria control is crucial so that gains in malaria intervention coverage are not counteracted through expanding endemic areas.

IRS vs Organic Farmers in Uganda

Nine companies engaged in organic farming in Lango sub-region’s districts of Oyam, Apac and Lira are suing the government of Uganda over the use of DDT for indoor residual spraying according to the Monitor. The Monitor reports the case as filed states that, “The decision by the government to introduce DDT in the districts is illegal as it contravenes the provisions of the Stockholm Convention on persistent organic pollutants of 2001.” WHO does clarify that the Convention says DDT can be used for public health purposes, but the question is, who defines the public’s health?

The farmers have logical fear that if DDT spraying inside houses is not done with proper precautions, their crops and livelihoods as organic farmers could be imperiled. Those pressing the suit claim that the agency contracted to do the work is in fact not following precautions and thus opening the potential to contaminate their crops. Let’s look at what is at stake.

In an overview of organic farming in Uganda, the International Trade Center explains that, “Uganda has the most developed sector of certified organic production in Africa. About 33,900 farmers manage 122,000 hectares of land using organic methods, an area that accounts for 1% of Uganda’s arable land (IFOAM & FiBL, 2006). Although still small and far below the increasing global demand, the country’s export of organic agricultural produce has been growing substantially in recent years. In Uganda, which has one of the lowest agro-chemical usages in Africa, the majority of farmers practice de facto organic agriculture without being certified yet (ACODE, 2006). Since no significant domestic market exists, certified organic agriculture targets mainly export markets in Europe and North America.”

In fact, the Monitor reported in 2007 that, “Organic farming has become a means of generating income for farmers and consequently fighting poverty.” Furthermore, “On the world market, Uganda’s export share of organic products has increased considerably and is the highest in Africa. The coordinator of Nogamu, Mr Moses Muwanga says 38 percent of organic agricultural production in Africa is from Uganda, with over 50,000 certified organic farmers. This makes Uganda one of the countries with the highest comparative advantage for organic production in Africa.” takes us to an organic farm in Tororo District and with pictures and text concludes that a Tororo farmer could, “teach farmers in Europe or America a thing or two. His type of farming — sustainable and organic — produces lots of food and lots of varieties of food. And it doesn’t need huge tractors, diesel fuel, artificial fertilisers and chemical poisons. As I said earlier, nothing is wasted.”


The Kulika Charitable Trust Uganda “has set up a sh800 million agricultural training institute at Lutisi, 37km on the Kampala-Hoima highway,” ( In short, there have been major investments in capacity building for organic farming in Uganda. “The core of Kulika’s Community Development Programme is training of farmers in sustainable organic agriculture which focuses on experiential learning, practical work, on-farm experimentation and demonstrations to improve the skills of farmers (see photo from Kulika).”

The economic issue here may be confusing – a chicken and egg debate. Does malaria control promote economic development or does economic development strengthen societies to control malaria. Assuming it is the latter scenario, we need to think twice about interventions that will affect the livelihoods of thousands of Ugandan farmers, specially when alternative control measures are available.

WHO recognizes that, “When implementing IRS, it is critical to ensure that adequate regulatory control is in place to prevent unauthorized and un-recommended use of public health pesticides in agriculture, and thus contamination of agricultural products. Pesticide contamination can have serious ramifications for trade and commerce for countries exporting agricultural products.” The organic farmers in Uganda question whether adequate control is possible.

Insecticide Treated Cows

Some malaria carrying mosquitoes are also attracted to cattle that may be sleeping outside the door of a dwelling. Studies have even shown that “cattle treated with pyrethroid in the control of malaria and reduction of vector density.” While we have seen malaria advocates calling for every house to have insecticide treated nets, we have yet to hear from the proponents of an ITCs (insecticide treated cows) for every home.

fulani-child1a.jpgActually there are a number of ways to fool a mosquito – not just on April 1st – and as the research mentioned above points out, the field of integrated vector management is wide.  There may be a number of issues to explore that are appropriate – culturally and technologically – for communities to control their mosquito populations. These need to be explored and promoted for long term sustainability of malaria control efforts.

In the meantime there are donor organizations that provide families in developing countries with cows and other livestock, just maybe not insecticide treated ones.  Maybe this is an opportunity for better integration of agriculture and malaria control.

Malaria and Agriculture

The World Development Report 2008: Agriculture for Development. points out starkly that agriculture has been neglected. Evidence exists that rural poverty has actually increased in Sub-Saharan Africa and South Asia, two areas of high malaria endemicity. Therefore the World Bank calls for greater investment in agriculture in developing countries. According to

Jaques Diouf in the International Herald Tribune, rising agricultural commodity prices, climate related disasters, and population increase are among factors threatening food security in the developing world. “World Bank studies show that a 1 percent price rise for staple food products leads to a drop of around 0.5 percent in calorie intake for the world’s poorest.” At the same time Diouf sees opportunities for African agricultural development if past neglect cited in the World Development Report is addressed. One needs to throw malaria into this equation.

dscn1030sm.JPG The World Development Report identifies several ways in which malaria affects agriculture and agriculture affects malaria. Production systems, particularly irrigation and micro dams facilitate mosquito breeding. Generally the siting of villages and farms near water sources increases the likelihood of malaria, and malaria in turn is a major drain on agricultural production. The neglect of agriculture and the farming population over the years has rendered them less able to purchase or access malaria prevention and treatment services.

On the other hand some practices like keeping livestock near the house may deflect mosquitoes from humans. Even better, the Report identified that improved income from agricultural investments actually makes it possible for people to buy ITNs and obtain treatment in a timely manner. The key lesson from the report is that rural development – both in terms of health and agriculture – must be planned together for optimal benefits.