The impact of urbanisation and urban growth on humanity has made megacities an important and burning agenda in contemporary political and development discourse. Megacities, most especially those in the Third World, are fast becoming emerging frontiers for socio-economic growth and development in an increasingly globalised international system. There is no doubt that megacities have become a phenomenon that is worth the attention of academics, politicians, policymakers, the organised private sector and civil society. In 2014, the Ramphal Institute launched its megacities project; a programme conceived and designed to identify best practices and practicable solutions to the problems of governance, service delivery and finance in megacities within the Commonwealth. But what is the importance of a Commonwealth perspective to the discourse on megacities and how will it impact the debate on urbanisation and urban growth?
Urban settlements within the Commonwealth feature prominently among those with exponential increase in their population. Cities like Bombay, Dhaka, Karachi, Lagos and New Delhi are currently home to over 10 million inhabitants each. These cities are now important political and economic centres that shape, in a decisive manner, the fortune and future of their respective countries, regions and population. What transpire in these Commonwealth cities have serious impact on international political and economic relations. It is this stark reality that should make megacities an issue at the front burner of development discourse in the Commonwealth especially among a cross-section of stakeholders within members of the organisation.
The Commonwealth, therefore, cannot afford to take a back seat especially when one considers the fact that over 100 million of its citizens reside in megacities and are confronted with everyday challenges of urbanisation and urban growth. While some benefit from the opportunities these cities present, millions are trapped under the burden of their challenges and contradictions. This makes the involvement of the Commonwealth strategic and important. Being an established international organisation with long standing reputation, the Commonwealth can and should provide a platform through which the exchange of ideas on how best to address the inherent problems in its megacities can flourish. Given the fact that megacities are by nature complex and dynamic societies in terms of demographics, socio-economic outlook and organisational structure, the Commonwealth can help leverage the establishment of functional linkages and interrelationship among the megacities within the group. Such relationships are non-existence at the moment in spite of the spiral effect events in megacities have on each other and the rest of the world.
While the lack of functional linkages among Commonwealth’s megacities is mainly due to their geographical spread, ideological dissimilarities, racial and cultural diversity, and complex governance structure, these issues if well managed can become problem solving opportunities instead of hindrances. They can provide a premise for exploring areas where potential connections can be established among these cities based on common interests, shared values, and similar challenges. This is especially the case with Commonwealth’s megacities in Africa and Asia where neither cross-continental research nor city-level policy assessment of opportunities and challenges has been done. The lack of knowledge at this level is a limitation to the development of effective intervention mechanisms, at the Commonwealth’s level, to reduce the negative effects of urbanization on megacities.
Therefore, given the possibility that inter-city cooperation among Commonwealth’s megacities may play an important role towards securing their future prosperity, there is a need to develop a sound evidence base framework on how the interactions can be established and sustained. There is no organisation better positioned to midwife the establishment of this relationship than the Commonwealth.
By Adesoji Adeniyi, PhD - Ramphal Institute Research Associate
What can we learn from the success of the Commonwealth Games in Glasgow, in July, 2014? At a time when many Commonwealth bodies in Britain have closed – like the Commonwealth Business Council, or the modern club facilities of the Royal Commonwealth Society – and only half of the Commonwealth leaders turned out for the controversial summit in Sri Lanka in 2013, this was a genuine triumph. While the last Scottish Games of 1986 in Edinburgh were boycotted and ended in financial disaster, and the Delhi Games of 2010 were overshadowed by corruption and poor attendances, athletes and spectators alike have hailed the Glasgow Games as a joyful carnival.
The Commonwealth Games are a festival of youth, but they are a little eccentric. Participants include dependent territories like the Cook Islands and Falklands, Jersey and the Isle of Man, which is why there are 18 more teams than sovereign states in the Commonwealth. While world records are always broken the competitors know they don’t have to withstand world-beating athletes from the United States, Russia or Germany, and the top of the medal table sees a quadrennial battle between England and Australia.
But the key elements in the Commonwealth Games are the sense of ownership, so that small countries can walk tall and the regional news around Britain can celebrate local winners, and a recognition that this is something different from the Olympics or a global event for a single sport. It provides a chance for younger sports people, and for those from countries squashed out of international contests by lack of resources. A single language for communication also helps.
The official Commonwealth may look weak, but underlying people-to-people links remain strong. The Glasgow organisers showed what can be done in the Commonwealth’s name when you bring together proper professionalism, with enough sponsorship, media and civic support, and a winning volunteer ethos. It is for governments and all those interested in revaluing what is a powerful living resource to replicate this at the next Heads of Government meeting in Malta, next year. Effective commitment to development, and to the right to a full life for all Commonwealth citizens, should be the aims in Valletta.
Written by Richard Bourne
Poland is not a member of the Commonwealth, but a recent analysis of Polish migration to and settlement in the United Kingdom highlights the current significance of historic and cultural links in international migration. This was a theme argued powerfully by the Ramphal Commission on Migration and Development, 2011, and especially in the commission’s first report prepared by Alan Gamlen ( see this website ) which was looking at migration patterns in today’s Commonwealth.
Notoriously, the United Kingdom government forecast that only 13,000 Poles would come to the UK after Poland joined the European Union in 2004. But by 2011 the number resident in the UK had risen to 597,000, although some had already returned to take advantage of rising living standards after EU accession.
The scale of this influx should have been no surprise. A quarter of a million Poles had chosen to stay in the UK in 1945, rather than return to a communist Poland, and indeed the reason that the UK had gone to war was because Nazi Germany had invaded that country. The British parliament in 1947, grateful for their wartime help in spite of some xenophobia even then, passed the Polish Resettlement Act which offered British citizenship to Polish troops and airmen and their families.
From 1947 until 1989, when the Berlin Wall fell, significant Polish communities and clubs survived in London, Leeds and other cities. While intermarriage and assimilation took place, many families retained contact through the Iron Curtain. Historic friendships were not forgotten. It was therefore inevitable that, when it was possible for Poles to move freely across Europe, so many would chose to bring their skills and energy to a country seen as a land of asylum and opportunity – especially since the UK was one of only three EU states which lifted barriers at once.
Recent would-be Commonwealth migrants to the UK from the Caribbean and South Asia have not been so lucky. They face increasing obstacles compared with their predecessors who arrived in the 1950s and 1960s, as nationality acts and migration rules have tightened up. But the Polish case should remind planners throughout the Commonwealth of the power and value of cultural, family and historic links when they consider issues of migration, as well as movements for higher education.
Destination states – which include states like South Africa and Singapore, as well as states like Canada and the UK – have to be sensitive to the underlying links of family, friendship and mutual respect, so easily upset by bureaucratic regulation. Xenophobia is a zero sum game if everyone plays it.
Written by Richard Bourne
In 2010, the year when Haiti faced a deadly earthquake, the Jamaican economist Norman Girvan, who has just died, analysed a series of peer-reviewed studies suggesting a link between higher sea surface temperature and storm frequency in the North Atlantic Ocean. What he sought to explain is the difficulty for an economist to simply analyze data without using a broader perspective.
Let’s take the case of Jamaica. It has signed about 19 environmental treaties and protocols since 1991, and will participate in the 4th Small Islands Developing States ( SIDS ) Conference, September 2014, in Samoa. In preparation for this event, an inter-sessional meeting has just started this week (April 21-24th) to address key issues of particular relevance to the SIDS. These include the need for finance and technology, so that islands can make a smooth transition to the Green Economy; the need for sustainable agriculture; and how to address the burden of debt, especially important for states like Jamaica.
Evaluation is long overdue. States like Jamaica which signed the Barbados Programme of Action for the Sustainable Development of Small Island Developing States (BPOA), need to assess what action has taken place. The Samoa conference can be a turning point in terms of making serious decisions and agreeing strategies which require a regional approach. For Jamaica and the Caribbean states this will need leadership at the CARICOM ( Caribbean Community ) level.
The most recent assessment report (AR5) from the International Panel on Climate Change confirms a high confidence that climate change will lead to extreme high sea level impact; however, the chapter focused on SIDS demonstrates how difficult it is to draw a direct connection with climate change for these islands. This topic will be the subject of our next blog dealing with the case of two small Commonwealth islands, based on the latest data from this report.
By Clara Rachel Casseus, Ramphal Istitute Research Associate
Girvan, Norman (2010) Are Caribbean Countries Facing Existential Threat?
IPCC (2013) Summary for Policymakers. In: Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Stocker, T.F., D. Qin, G.-K. Plattner, M. Tignor, S.K. Allen, J. Boschung, A. Nauels, Y. Xia, V. Bex and P.M. Midgley (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA.
Moore, W.R. (2010) “The impact of climate change on Caribbean tourism demand”, Current Issues in Tourism, 13(5), pp.495-505.
Witter, Michael (2013) Jamaica: Achievements since Barbados, 1994, and new Challenges for Samoa, 2014 – Synthesis Document for the SIDS National Preparatory Process, UNDP/ Jamaican Government, 53p.
Africans are paying a “super tax” to send remittances home, because of the high charges imposed by two of the world’s leading money transfer operators –Western Union and MoneyGram. This is the conclusion drawn by the Overseas Development Institute, a London based think-tank, which carried out an extensive study of the cost of remittances paid by diaspora communities from developing countries.
Remittances from diaspora communities play an increasingly important role in supporting the welfare of communities left behind, and they have become a key source of external resource flows for developing countries. According to the latest issue of the World Bank’s Migration and Development Brief, these funds now exceed official development assistance and are more stable than private debt and portfolio equity flows. But a major development institute in London has warned that the benefits of remittance transfers to Africa are lost as a result of the high charges imposed by two of the leading money transfer operators –MoneyGram and Western Union.
This year, remittances to developing countries are expected to top $436 billion and by 2016, are projected to rise to $516 billion. India receives the highest level of remittances, with $70 billion in 2013, while Nigeria is also a large recipient, receiving $21 billion. These funds support education, health, education, food security and productive investment in agriculture and in many developing countries, they surpass earnings from major exports.
In a report issued to coincide with the World Bank’s Brief, the Overseas Development Institute stated that the African diaspora now pay 12% to send $200 – almost double the global average. The report states that “ in effect, Africans are paying a remittance ‘super tax’. Reducing charges to world average levels and to the 5% target would increase transfers by $1.8 billion annually. That figure would pay for the education of some 14 million primary school age children in sub-Saharan Africa –half of the out-of-school total; improved education for 8 million people or clean water for 21 million.
Sources: www.odi.org/remittances-africa & http://blogs.worldbank.org/peoplemove/
Written by Patsy Robertson, Ramphal Institute, Chair
The paper describes issues relating to migration, brain drain and diasporas in Commonwealth countries, drawing on work undertaken for the Ramphal Commission on Migration and Development, 2009-2011. It concludes that the official Commonwealth, managed by the Commonwealth Secretariat, finds it hard to promote key development strategies due to shortage of personnel and funds, disagreements among its members, and a plethora of demands.
Presented by Richard Bourne
The east, central and southern regions of Africa have some of the highest incidence rates of cervical cancer in the world, making the area the epicentre of the disease. It is the most common cancer among sub-Saharan African women. Worldwide three quarters of cervical cancer cases occur in developing nations where programmes for screening and treatment are seriously deficient. Screening and early treatment are crucial in the prevention of the disease. Vaccination programmes are beginning to be implemented in a number of countries, offering hope for the younger generation that this preventable disease can be tackled in a significant way and end the suffering which it causes.
Health systems in developing countries can lack the capacity and infrastructure to provide proper treatment, while screening of patients is often carried out at a late stage. Such issues are compounded by patients not having the capability to access treatment services which do exist. This can be due to a range of factors including affordability and geographic constraints. A recent report from the only public cancer treatment centre in Kenya indicates that almost half the women being treated “disappeared” from their programmes.
Vaccinating girls against the Human Papilloma Virus (HPV) has become a vital intervention in many countries. HPV is the main cause of cervical cancer. It is spread through sexual contact, it is therefore important that girls are vaccinated before they become sexually active.
Responding to the growing level of morbidity associated with cervical cancer, Kenya has initiated a HPV vaccination programme for all girls of primary school age. Demand for the vaccination has exceeded supply and the £30 per dose cost is prohibitive for many families. The Global Alliance for Vaccinations and Immunisation (GAVI) have assisted the Kenyan health service in distribution of the vaccine on a national scale. They argue there is a vital need to reduce costs so the vaccine is available for everybody.
Similar programmes have begun emerge across a variety of developing Commonwealth countries in the region. In Rwanda cervical cancer is the most common cause of cancer among women. In response the small nation became the first low-income African county to achieve nationwide access to the vaccine. Such a programme has been facilitated by the immense progress made by the health sector in Rwanda which has strategically positioned itself to tackle preventable diseases.
In South Africa, where the disease is the second biggest killer of women in the country, the government has announced that all girls in public primary schools will be vaccinated to prevent the disease. Any child who goes through Grade 4 will receive the vaccine, offering hopes for a new generation of women protected from the cancer.
The African Centre of Excellence for Women's Cancer Control reports the incidence rates of cervical cancer in Zambia as the second highest in the world. To address the heavy burden of the cancer in the country the Cervical Cancer Prevention Program in Zambia (CCPPZ) was established. This has aimed to offer girls at selected primary schools the vaccine with a view to expanding the programme nationwide. Further, the CCPPZ also aims to educate families and communities on the potential benefits of the vaccine so more girls can be reached. It also looks to tackle any stigma associated with invasive treatments for those diagnosed with the disease.
Overcoming cultural barriers and reluctance is a major concern for programmes across the continent. In Kenya women have been noted to ignore symptoms and seek traditional medical practitioners. Such actions delay diagnosis and prolong treatment, allowing the cancer to develop and become more difficult to treat.
As with a range of other conditions, vaccinations provide a crucial means with which to combat the burden of preventable diseases on developing nations. It is imperative that struggles in implementing national vaccination programmes are overcome. With continuing investment, global advocacy and assistance the problems which face vaccination programmes, be they due to poverty, remoteness or a failing health system can be challenged. Similarly cervical cancer remains one of the biggest killers of women in the developing world. However, the programmes highlighted in Rwanda, Zambia, Kenya and South Africa offer hopes for an alternative future. Strengthening of health system capacities and continued international support are key to achieving reductions which may one day see the threat of this preventable cancer diminished.
Written by Michael Cavanagh
Nigeria, the biggest Commonwealth country in Africa with a population of nearly 190 million, was never going to achieve the goal of a basic education for all children by next year, 2015. Rough estimates suggest that as many as 10.5 million are not in school. But what is worse is that, due to the insurgency in the Northeast, the statistics are now in retreat.
Almost every day the Boko Haram sect, which combines radical Islam with an exploitation of poverty and unemployment among young men, commits atrocities. “Boko Haram,” literally, means “western education is forbidden.” President Goodluck Jonathan has declared a state of emergency in three Northern states – Borno, Yobe and Adamawa – but raids have taken place elsewhere in the North. Last year, for example, there was an attempt on the life of the octogenarian Emir of Kano, in which a number of his bodyguards were killed. The British Council was forced to close its beautiful office and theatre in Kano, decorated in traditional Hausa style, and cut its staff there from over 30 to four.
Boko Haram, which has demanded that President Jonathan convert to Islam, has declared war on modernity, traditional rulers, western education and particularly girls’ education. An attack in February on a Federal Government College in Yobe led to the deaths of 29 secondary students. These “unity schools” are the prestige institutions of public education, and five colleges were closed after the assault, affecting 10,000 students.
Not surprisingly, this is having a woeful impact on educational standards in the Muslim North, which have long lagged behind those in the largely Christian South. National Bureau of Statistics figures for 2012 show that while the national attendance rate for primary schools was 71 per cent, an increase of 10 per cent on 2008, the figures for the Northeast were only 42 per cent, and for the Northwest 47.8 per cent. It is likely that these will have declined since. The impact of the insurgency on literacy rates for women aged 15 to 24 is serious. The rate for these Nigerian women as a whole has fallen to 66 per cent in 2012, down about 14 per cent on 2008. In the Northeast states the comparable literacy rate is only 30.1 per cent.
Statistics suggest that Nigeria has been making progress on other MDGs. For example, maternal mortality has fallen from 800 per 100,000 in 2004 to only 350 per 100,000 in 2012. There is, however, an unmet need for family planning, with only 17.3 per cent of women aged 15-49 using any type of child spacing, and almost none ( 3.3 per cent ) in the poorest households.
There has been criticism of the Nigerian government’s security and negotiation responses to Boko Haram, which has bases in neighbouring countries also. The UN, whose office in Abuja has been attacked, has been slow to define it as an international terrorist organisation. But it is absolutely clear that, without an end to this insurgency, Nigerians in the North of the country will not enjoy the fruits of the MDGs.
Richard Bourne, Secretary of the Ramphal Institute, has been visiting Nigeria for research purposes.
Millennium Development Goal 4 (MDG4) aims to reduce child mortality from its 1990 level by two thirds by 2015. Globally the child mortality rate has been reduced significantly. However, at a national level success in achieving the MDG 4 targets have been highly variable. Disparities have been found both within and between regions. While child mortality rates remain stubbornly high for some countries, three of the least developed countries in the Commonwealth have made impressive gains, achieving their MDG 4 targets. Despite facing similar health issues and socio-economic concerns as their neighbours, these countries have witnessed considerable success. According to UNICEF progress can be made “when concerted action, sound strategies, adequate resources and strong political will are harnessed in support of child survival”. Reversing these trends requires action on multiple fronts – reducing poverty, decreasing maternal mortality, boosting education and gender equality and environmental sustainability. With this in mind we will consider the case of Malawi, which has met its MDG 4 target, seeing the fastest rate of reduction for child mortality in Africa.
In 1990 Malawi's under-five mortality rate stood at 244 deaths per 1000 live births, placing it firmly in the top ten countries globally with the highest rate of child mortality. Since then the country has made huge progress. Of all low-income, high mortality countries, Malawi is second only to Bangladesh in achieving the highest annual rate of reduction, with a score of 5.6%. It now registers a lower level of child mortality than its neighbours Zambia, Zimbabwe and Mozambique. The provision of healthcare has been a central theme in the Presidency of Joyce Banda – who rose to prominence as a relentless women's rights advocate. Through numerous initiatives for maternal healthcare and engagement with traditional leaders she continues to promote gender equality in largely male dominated society. UNICEF indicates that during President Banda's administration there has been a dramatic decline in the rate of under-five mortality
Public health experts attribute the continuing decline to increased use of key health interventions. These include immunisations, the use of insecticide treated bed nets to prevent malaria, rehydration tablets, improved sanitation and Vitamin A supplements. Innovative technologies have also contributed to the reduction. Fast delivery of HIV test results through mobile phones has allowed for quicker treatment. Further, the “baby bubble” - an adaptation of western respiratory devices - has been used to help babies in respiratory distress due to acute infections such as pneumonia. The device uses air pressure to keep babies' airways open and has been designed to work on its own as hospitals may not have wall mounted air supplies.
Despite these gains, the health system, as in many developing countries, is weak. This has affected the availability, access, utilisation and quality of health services. Supply chain management is poor and there is a shortfall of qualified staff. Meeting the needs of the population outside urban centres has proved particularly difficult. In 2002 Malawi adopted the Essential Health Package (EHP) which aims to reduce poverty and improve equity of access to health services. It addressees the major causes of disease and death: vaccine-preventable diseases, malnutrition, infections and common injuries.
Currently pneumonia is the most prominent cause of death among under-fives, accounting for 14% of deaths. This is followed by premature birth and HIV/AIDS which stand at 13%. Birth asphyxia and diarrhoea are also responsible for a significant number of deaths. Of particular concern is the relationship between acute malnutrition and HIV/AIDS, with up to 50% of identified acute malnutrition is associated with HIV/AIDS.
Malawi has made rapid progress in reducing its child mortality levels. Further gains will require ongoing investment, targeted responses and the continued support of a strong leadership. Current efforts need to be sustained and scaled up in order to continue recent positive trends.
Written by Michael Cavanagh
It is estimated that in 2012 approximately 6.6 million children, 18,000 children per day, died before reaching their fifth birthday. This represents a reduction of almost half the number of under-fives who died in 1990, when more than 12 million children died. The average annual rate of reduction in under-five mortality accelerated from 1.2% a year for the period 1990-1995 to 3.9% for 2005-2012. While significant, this remains insufficient to reach MDG 4 which aims to reduce the under-five mortality rate by two thirds between 1990 and 2015. As the region with the highest child mortality rates in the world, sub-Saharan Africa faces huge challenges. A rate of 98 deaths per 1000 live births has meant that a child born in the region faces more than 16 times the risk of dying before their fifth birthday than a child born in a high income country.
Of the 2012 figures, close to 75% of the deaths are attributable to just six conditions: pneumonia, diarrhoea, neonatal infection, measles, malaria and HIV/AIDS. These conditions are all preventable or manageable with adequate treatment. Malnutrition and a lack of safe water and sanitation contribute to half of these deaths. The impact of poor living standards upon health can be profound. For those living in poverty such issues are exacerbated by a lack of access to affordable and good quality healthcare.
Global support and continued investments are essential to strengthen health systems in developing nations so that all children are able to receive the care they need. Developing health systems are however faced with a variety of issues which must be challenged and overcome if effective and equitable services for children are to emerge. Expanding the scale and scope of health interventions is crucial, as is tackling barriers which may hinder advances.
A lack of funding at a macro-level and low heath system capacity can constrain positive developments. Critically many developing countries are facing a health worker crisis. It is estimated that sub-Saharan Africa will require an additional 860,000 workers to scale up its healthcare provision to meet the health related MDG targets. Efforts are already under-way to promote and increase the number of community health workers who operate at a local level, improving the scale and distribution of coverage.
Access to healthcare remains a key issue. Proven cost-effective interventions for deadly diseases such as malaria, diarrhoea and measles exist but can fail to reach vulnerable groups. Weak health services at a district level can create inequalities between regions. Strengthening district health services can contribute to the delivery of primary care services to marginalised children and families at a community level.
The chart below indicates under-five mortality rates from 1990-2012 set against MDG 4 targets for all African countries in the Commonwealth, it also includes Pakistan, India and Bangladesh.
Developing Commonwealth countries have seen variable degrees of success in reducing child mortality. India and Nigeria, who together account for more than a third of all under-five deaths, have seen significant reductions, though neither has reached its MDG target. Nigeria has not yet halved its child mortality rate from 1990 while India is also unlikely to reach its target despite a greater level of reduction. Sierra Leone, long considered one of the worst countries in the world for child mortality is yet to reduce its 1990 rate by a third. A combination of chronic underinvestment in health programmes, malnutrition and harmful cultural practices in a post-conflict setting have acted to keep mortality rates high. Scaling existing programmes up has been noted as a particular area of difficulty. Botswana, Lesotho and Swaziland have all witnessed a small increase in child mortality for the period 1990-2012. Poor sanitation, dirty drinking water, malnutrition and the HIV/AIDS epidemic have been indicated as key factors for the increases. By contrast Malawi, Tanzania and Bangladesh have taken huge strides in reducing their child mortality rates. All three countries have met their MDG 4 target.
The need to prevent and treat the conditions which contribute to child mortality has been accepted as a global imperative. Regular immunisations, vitamin A supplements, rehydration for children suffering from severe diarrhoea and use of bed-nets by women and children to protect them from malarial mosquitoes have all been proven to be simple and effective ways of keeping children alive. Ensuring access to these life-saving interventions is crucial.
As the 2015 MDG deadline approaches numerous initiatives have emerged to tackle these issues. The Global Vaccine Action Plan is working towards universal access to immunisation by 2020. A strong immunisation programme is an integral part of a well functioning health system. The WHO and UNICEF have joined other partners in establishing a new Global Action Plan for Pneumonia and Diarrhoea which aims to have proven preventative and treatment measures in place for all children by 2025. Such a focus is encouraging. It is vital that these developments are matched by a strengthening in the capacity of emerging national healthcare systems, so that they can provide access and quality care for all citizens.
Written by Michael Cavanagh