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OCHA Policy Brief on Gendered Drivers, Risks and Impacts of Food Insecurity in the Sahel and the Horn of Africa

UN Office for the Coordination of Humanitarian Affairs (2023) CC

It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency. Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls. An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is: A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes). An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa. The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions. Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward. more

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National Guideline For Emergency Nutrition Intervention (May 2022)

Government of Ethiopia (2022) CC

Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a... more

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Outdoor Air Pollution

Our World in Data (2019) CC

Outdoor air pollution is one of the world's largest health and environmental problems. The Global Burden of Disease is a major global study on the causes and risk ... for death. These estimates of the annual number of deaths attributed to a wide range of risk factors are shown here. This chart is shown for the global total but can be explored for any country or region using the "change country or region" toggle. more

Pathogenesis of chronic obstructive pulmonary disease: An African perspective

Allwood, B.; Calligaro, G. South African Medical Journal (SAMJ) (2015) CC2

The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk .... However, in developing countries, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel smoke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa. more

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Influencing food environments for healthy diets

Food and Agriculture Organization of the United Nations FAO (2016) C2

Food environments are usually defined as the settings with all the different types of food made available and accessible to people as they go about their daily lives. That is, the range of food in supermarkets, small retail outlets, wet markets, street food stalls, coffee shops, tea houses, s...chool canteens, restaurants, and all the other venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing, marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems and food environments are challenged in supporting consumer choices that are consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges. more

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Climate Change and Pollen Allergies

Damialis, A.; Traidl-Hoffmann, C.; Treudler, R. (2019) CC

Biodiversity and Health in the Face of Climate Change pp 47–66 This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, par... more

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Delivery of cardiology services in Africa during the COVID-19 pandemic: what should we expect after this pandemic?

Nganou-Gnindjio, C.N.; Temgoua, M.N.; Kuate, L.M. et al. (2021) CC

Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burd... more

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Air pollution and diabetes: it's time to get active!

O'Donovan, G.; Cadena-Gaitán, C. (2018) CC

Cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, and other non-communicable diseases are among the leading causes of morbidity and mortality in low-income, middle-income, and high-income countries, and The Lancet Taskforce recently made the case for investing in non-... more

Situational Analysis of Antimicrobial Use and Resistance in Humans and Animals in Zimbabwe

The Center for Disease Dynamics, Economics & Policy CDDEP (2017) C2

This situation analysis has gathered information about the current state of AMR, contributing factors and antimicrobial use in Zimbabwe from the human, animal, agricultural and environmental sectors. Data has been gathered from different sectors suc... more

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Global Burden of Disease (GBD). The Lancet

(2019) CC

The Global Burden of Disease Study (GBD) is the most comprehensive worldwide observational epidemiological study to date. It describes mortality and morbidity from major diseases, injuries and risk factors... to health at global, national and regional levels. Examining trends from 1990 to the present and making comparisons across populations enables understanding of the changing health challenges facing people across the world in the 21st century. Accessed July 4, 2019 more

Global surveillance, prevention and control of chronic respiratory diseases - a comprehensive approach

Bousquet, J.; Khaltaev, N. (2007) C_WHO

Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease, kill more than four million people every year and affect hundreds of millions more. These diseases erode the health and well-being of the patients and have a... more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Impact of climate change on global malaria distribution

Cyril Caminade, Sari Kovats, Joacim Rocklov et al. PNAS (2014) CC

PNAS | March 4, 2014 | vol. 111 | no. 9 Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate ..., as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution. more

Chronic obstructive pulmonary disease and associated healthcare resource consumption in the Middle East and North Africa: The BREATHE study

Polatli, M.; Kheder, A.B.; Wali, S.; et al. Respiratory Medicine (2012) CC2

The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview of COPD prevalence, associated risk factors... more

Air Pollution - Our overview of indoor and outdoor air pollution

Ritchie, H.; Roser, M. Global Change Data Lab (2024) CC2

The Our World in Data webpage on air pollution provides an extensive overview of the global impact of air pollution on health and the environment. It presents data on sources of pollution, such as industry, vehicles, and domestic energy use, and hig... more

Prioritised research agenda for prevention and control of chronic respiratory diseases

Bousquet, J.; Kiley, J.; Bateman, E.D. European Respiratory Journal (ERJ) (2010) C_WHO

The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highligh... more

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Antimicrobial Resistance (AMR)

Deininger, K. The MEDBOX Team (2023) CC

Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesa... more

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Environmental Determinants of Cardiovascular Disease

Bhatnagar, A. Circulation Research (2018) CC

Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifesty... more

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Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

Schwalm, J.; McKee, M.; Huffman, M. et al. Circulation (2016) CC

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... more

Global Initiatibe for Chronic Obstructive Lung Disease - Pocket Guide 2023

Global Initiative for Chronic Obstructive Lung Disease – GOLD (2023) CC2

Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide and 90% of these deaths occur in low- and middle-income countries (LMICs). More than 3 million people died of COPD in 2012 accounting for 6% of all deaths globally. COPD represents an important public... more