Enhancing Global Health Security in Sub-Saharan Africa: The case for integrated One Health surveillance against zoonotic diseases and environmental threats.

Facing Global Environmental Change

This study examined the impact of poverty and insecurity on food security in Sub-Saharan Africa (SSA). In spite of the abundance of diverse resources in SSA across the continent, most nations in the SSA are wallowing in abject poverty. Studies have reported a dehumanising poverty rate comprising high inflation, high costs of food prices, and economic hardship with a greater percentage of the populace living far below the poverty line on poverty index indicators. This study employed qualitative research design involving phenomenological approach in investigating the root cause of the contributory factors to food insecurity in SSA, to gain an in-depth understanding of the experiences of citizens as variables of the study. Purposive sampling as convenience sampling technique was employed in collecting data from different categories of citizens through Key Informant Interview on poverty, insecurity and food security issues by direct contacts and Google form circulation on social media platforms among public servants, traders, farmers, transporters, artisans, and food vendors. In all, 67 participants that consented to participate in the study (28 male and 39 female respondents) were enlisted in the study. Findings from the study revealed prevalence of food insecurity, poverty and insecurity as drivers of food insecurity in SSA. It is therefore incumbent on stakeholders to address squarely the issue of poverty and security related issues.

Food security entails having sufficient, safe, and nutritious food to meet dietary needs. The need to optimise nitrogen (N) use for nutrition security while minimising environmental risks in sub-Saharan Africa (SSA) is overdue. Challenges related to managing N use in SSA can be associated with both insufficient use and excessive loss, and thus the continent must address the ‘too little’ and ‘too much’ paradox. Too little N is used in food production (80% of countries have N deficiencies), which has led to chronic food insecurity and malnutrition. Conversely, too much N load in water bodies due mainly to soil erosion, leaching, limited N recovery from wastewater, and atmospheric deposition contributes to eutrophication (152 Gg N year–1 in Lake Victoria, East Africa). Limited research has been conducted to improve N use for food production and adoption remains low, mainly because farming is generally practiced by resource-poor smallholder farmers. In addition, little has been done to effectively address the ‘too much’ issues, as a consequence of limited research capacity. This research gap must be addressed, and supportive policies operationalised, to maximise N benefits, while also minimising pollution. Innovation platforms involving key stakeholders are required to address N use efficiency along the food supply chain in SSA, as well as other world regions with similar challenges.

Governance, morality and food security in sub-Saharan Africa

ISHS IV All Africa Horticultural Congress - AAHC2021: Transformative Innovations in Horticulture Digital agriculture to fulfil the shortage of horticultural data and achieve food security in sub-Saharan Africa

We aim to disseminate field lessons gained from studying zoonotic diseases among children with diarrhea in the Nairobi Urban Health and Demographic Surveillance System. Despite the numerical importance of slums in sub-Saharan Africa, little is known on the practice of health surveillance in those resource-limited areas. Challenges and lessons gained concern sustaining community participation over the years, engaging with gatekeepers, hiring and training local fieldworkers, ensuring safety of employees and material, and offering clinical care to children with diarrhea in their households.

Introduction: Public health security is concerned with infection prevention and control worldwide. These measures are the concern of all and sundry to ensure prevention of any outbreaks of diseases that has epidemic potential. Africa may be uniquely positioned to have the most severe and under-detected outcomes related to COVID-19 infection. This article seeks to highlight such challenges of healthcare delivery systems in the context of the COVID-19 pandemic in sub-Saharan Africa. The communique also suggests possible strategies for improvement in such settings. Method: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them. Results: We identified and exhaustively discussed the main limitations to public health security in sub-Saharan Africa as follows i) Continuing deterioration of the public health infrastructure for disease control, ii) The changing outlooks of contagious diseases, iii) Private sector reforms like the managed care, iv) Relatively weak health care systems, and v) Poor organizational structures. Conclusion: Most Africans are eager to see the desired transformation in our public health systems. Unfortunately, the political will to invest in public health infrastructure is lacking. Also, the system is characterized by human resources shortage and diverted resources, which significantly impacted the provision for emerging COVID-19 pandemic –related care. Interestingly the monumental breakthroughs in research development for bio-therapeutics and vaccines in African countries appear a mirage even with extensive past study experience with such products from China and the Western world. Finally, notwithstanding these challenges in our public health systems as elaborated, the facts are that enormous capacities exist that can be harnessed in African countries for the COVID-19 preparedness and response.

Sub-Saharan Africa has been portrayed as the most vulnerable region to the impacts of global climate change because of its reliance on agriculture which is highly sensitive to weather and climate variables such as temperature, precipitation, and light and extreme events and low capacity for adaptation. This article reviews evidence on the scope and nature of the climate change challenge; and assesses the impact of climate change on agriculture and food security in Sub-Saharan Africa. From the review, it is apparent that the climate in Africa is already exhibiting significant changes, evident by changes in average temperature, change in amount of rainfall and patterns and the prevalence of frequency and intensity of weather extremes. The review also revealed that although uncertainties exist with regards to the magnitude of impacts, climate will negatively affect agricultural production in Sub-Saharan Africa. Specifically, as result of current and expected climate change, the area suitable for agriculture, the length of growing seasons and yield potential, particularly along the margins of semi-arid and arid areas, are expected to decrease. These impacts will affect all components of food security: food availability, food accessibility, food utilisation and food stability and hence increase the risk of hunger in the region. The review thus confirms the general consensus that Sub-Saharan Africa is the most vulnerable region to climate change. It suggests that, policymakers and development agencies should focus on formulating and implementing policies and programmes that promote farm level adaptation strategies currently being practiced by farmers across the region.

The dependency on rainfed agriculture and weak adaptability of the agricultural sector to climate change threaten food security in Sub-Saharan Africa (SSA). Biochar has widely been touted as a relatively easy means of increasing the soil water storage capacity of soils and thereby improving or maintaining crop yields. In this study we simulated the effect of biochar amendment on sorghum aboveground biomass and grain yield at a site in South Sudan. We used the model AquaCrop parameterized using site, soil, and cropping management data from a field experiment carried out at the site in 2011 and 2012, which were both wet years. Changes in soil hydraulic properties due to biochar were based on a published meta-analysis study. In order to investigate whether the response to biochar differed in dry years, simulations were also carried out for 1990, which was the driest year during the period 1979–2014. Measured and modelled biomass and yields with and without biochar for 2011 and 2012 were compared. Simulated and measured yields depended on growing season rainfall and distribution. The simulations showed that biochar amendment had an effect on rooting zone soil water content and sorghum biomass and grain yield in 1990, but not in 2011 and 2012. In view of expected climate change, the results have important implications for sorghum production and the potential use of biochar in SSA. Given the limited response of grain yield to biochar shown in our simulations, careful selection of sorghum variety and cultivar and consideration of planting date may be a more effective means of improving yields than applying biochar.

Understanding the impacts of climate variability on crop yields is critical for food security, particularly in Sub-Saharan Africa, where rainfed agriculture dominates and is highly sensitive to climatic changes. While process-based crop models are commonly used with long-term climate scenarios to inform transformative adaptation, integrating long-range seasonal forecasts offers an opportunity to inform short-term, responsive adaptation strategies. This study uses the LPJmL process-based hydrology-crop model with SEAS5 seasonal hindcasts as climatic inputs (temperature, precipitation, and radiation) to evaluate the skill of seasonal forecasts in predicting crop yields at lead times of one to seven months for major crops in three countries in Sub-Saharan Africa: Ghana (West Africa), Kenya (East Africa), and Zimbabwe (Southern Africa). We validate the results against the WFDE5 dataset and observed weather station data from national meteorological agencies. We calibrate LPJmL with sub-national yield data to ensure local relevance and accuracy. We use performance metrics, including cumulative probability distributions and Ranked Probability Skill Scores, to evaluate forecast reliability. By capturing interannual and intraseasonal variability, this seasonal yield forecasting can serve as an early warning system to support a range of short-term response strategies, such as agricultural measures (adjusting sowing dates, early harvest due to extreme weather events, and fertilizer application) and broader strategies that include market interventions, cash transfers, food reserve management, and food assistance programs. This study advances the integration of seasonal forecasts into process-based crop models and the use of yield forecasts for responsive adaptation strategies for food security in Sub-Saharan Africa.

Background and methodsThe prevention and control of breast cancer in sub-Saharan Africa (SSA) is an increasingly critical public health issue. Breast cancer is the most frequent female cancer in SSA and mortality rates from this disease are the highest globally. Breast cancer has traditionally been considered a disease of high-income countries, and programs for early detection have been developed and implemented in these settings. However, screening programs for breast cancer in SSA have been less effective than in high-income countries. This article reviews the literature on breast cancer in SSA, focusing on early detection practices. It then examines the case for and against mammography and other early detection approaches for breast cancer in SSA.ResultsWomen with breast cancer in SSA are younger compared with high-income countries. Most women present with advanced disease and because treatment options are limited, have poor prognoses. Delay between symptom onset and healthcare seeking is common. Engagement with early detection practices such as mammography and breast examination is low and contributes to late stage at diagnosis.DiscussionWhile early detection of breast cancer through screening has contributed to important reductions in mortality in many high-income countries, most countries in SSA have not been able to implement and sustain screening programs due to financial, logistical and sociocultural constraints. Mammography is widely used in high-income countries but has several limitations in SSA and is likely to have a higher harm-to-benefit ratio. Breast self-examination and clinical breast examination are alternative early detection methods which are more widely used by women in SSA compared with mammography, and are less resource intensive. An alternative approach to breast cancer screening programs for SSA is clinical downstaging, where the focus is on detecting breast cancer earlier in symptomatic women. Evidence demonstrates effectiveness of clinical downstaging among women presenting with late stage disease.ConclusionsApproaches for early detection of breast cancer in SSA need to be context-specific. While screening programs with mammography have been effective in high-income countries, evidence suggests that other strategies might be equally important in reducing mortality from breast cancer, particularly in low-resource settings. There is a strong argument for further research into the feasability and acceptability of clinical downstaging for the control of breast cancer in SSA.

Creating a framework towards integrated health syndromic surveillance and response in Africa

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security.

Food-energy-water security in sub-Saharan Africa: Quantitative and spatial assessments using an indicator-based approach

The rising burden of non-communicable diseases in sub-Saharan Africa