Lost In Africa
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FAO estimates from 2011 suggest that as much as 37 percent of food produced in Sub-Saharan Africa is lost between production and consumption. Estimates for cereals are 20.5 percent. For post-harvest handling and storage loss only, the FAO estimate is 8 percent, and the African Post-harvest Losses Information System (APHLIS) estimate is 10-12 percent.
South Africa is one of the countries most severely affected by HIV/AIDS. At the peak of the epidemic, the government, going against consensus scientific opinion, argued that HIV was not the cause of AIDS and that antiretroviral (ARV) drugs were not useful for patients and declined to accept freely donated nevirapine and grants from the Global Fund. Using modeling, we compared the number of persons who received ARVs for treatment and prevention of mother-to-child HIV transmission between 2000 and 2005 with an alternative of what was reasonably feasible in the country during that period. More than 330,000 lives or approximately 2.2 million person-years were lost because a feasible and timely ARV treatment program was not implemented in South Africa. Thirty-five thousand babies were born with HIV resulting in 1.6 million person-years lost by not implementing a mother-to-child transmission prophylaxis program using nevirapine. The total lost benefits of ARVs are at least 3.8 million person-years for the period 2000-2005.
Does a great treasure of the Serengeti need a highway around it, never-mind through it Does the Selous need uranium mining operations when almost 90% of its elephants have been lost due to poaching Does a massive port in Lamu on the Indian Ocean really benefit the marine eco-system there It is all done in the name of globalization and it is a desecration. It is not a question of not telling Africans what they should or should not do. It is a question of survival for the ecology of the planet. Without an environment there is no viable economy.
Many studies have attributed the loss of learning from Covid explicitly to the lost teaching time from closure of schools. In Malawi, however, students have not only lost learning from the lack of physical schooling time due to school closures, but also suffered a one-off loss in foundational knowledge on concepts which they had previously mastered. Adjusting our estimates to account for the difference in time between the last pre-Covid assessment, the reopening of schools, and our post-Covid assessments, we have estimated the share of learning loss observed that stems from each dimension of lost learning.
In Figure 1 the blue line shows how learning would have progressed if the pre-Covid learning trajectory had continued. The red line shows the actual learning trajectory post-Covid. The gap between the blue and red lines at the far left shows the one-off impact of the closure of schools (the gap between the red and green lines shows the explained difference in learning (14 points) as a result of the physical time lost from closure of schools. The gap between the green and blue lines on the y-axis shows the unexplained drop in learning (26 points) that may reflect students losing previous mastery over foundation concepts). The green line shows the learning trajectory post-Covid, adjusted for the 14-point expected loss of learning from the closure.
The lost output or human capital approach was used to evaluate the years of life lost due to premature deaths from NTDs among 10 high/upper-middle-income (Group 1), 17 middle-income (Group 2) and 27 low-income (Group 3) countries in Africa. The future losses were discounted to their present values at a 3% discount rate. The model was re-analysed using 5% and 10% discount rates to assess the impact on the estimated total value of human lives lost.
Globally, a number of studies have been conducted on the economic burden of a single NTD [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31] in one or a few countries [32, 33]. To date, no study has attempted to measure the value of human lives lost due to NTDs in all or the majority of countries in continental Africa. Therefore, the study reported in this paper was an attempt to contribute to bridging this knowledge gap.
The paper answers the question: What is the value of human lives lost due to NTDs in continental Africa More specifically, the objective was to estimate the monetary value of human lives lost due to NTDs in Africa in 2015.
The late Professor Gavin Mooney [34] outlined three types of approaches used in deriving monetary values for human life: (a) the implied values (or revealed preferences) approach, which is based on values implied by past healthcare decisions; (b) the HCA or lost output approach, which equates the value of human life with the value of livelihood; and (c) the willingness-to-pay (or contingent valuation) approach, which is based on how much individuals are prepared to pay to reduce the risk of morbidity or death. The strengths and weaknesses of each approach have been exhaustively discussed in Linnerooth [35], Mooney [36] and Jones-Lee [37].
The HCA or lost output approach was first applied by Petty [38]. However, its theoretical and practical underpinnings have been refined and enhanced by Fein [39], Mushkin and Collings [40], Weisbrod [41], and Landefeld and Seskin [42]. The approach has been widely applied in Asia-Pacific countries [43,44,45,46,47,48,49,50,51,52,53], North America [54,55,56,57,58,59,60] and Europe [61,62,63,64,65,66]. It has been applied in Africa to estimate the economic burdens of cholera [67], malaria [68, 69], HIV/AIDS [70, 71] and diabetes mellitus [72]. The specific approach used in the current study is similar to that developed and applied in estimating the indirect costs of child mortality [73], Ebola virus disease [74], tuberculosis [75] and maternal mortality [76] in the African region.
The choice of the HCA or lost output approach to place monetary values on years of human lives lost due to NTDs was based on successful past applications in estimating indirect costs of a number of health conditions in the region [73,74,75,76]; and availability of data on GDPs and total health expenditure per capita for all countries (except one) in Africa.
The GDP is a monetary measure of the market value of all final goods and services produced within a country in a specific period, e.g. yearly in our case [77, 78]. The NTD premature mortality impacts negatively on all the components of the GDP, including consumption expenditure, investment, government expenditure and net exports, i.e. exports less imports. We used per-capita GDP data to value the years of life lost (YLLs) to premature mortality from NTDs. The per-capita GDP is obtained by dividing the total GDP of a country by its population. The WHO [79] and Chisholm et al. [80] advise that when the focus of an economic burden of a disease study is on overall productivity losses, the quantity of interest should be the effect on the pooled output of remunerated and unremunerated labour as measured by non-health GDP.
Fourth, even though NTDs are not a major cause of death, every year they lead to a substantive loss of disability-adjusted life years (DALYs) in Africa. For example, the WHO estimated that in 2015, the African continent lost 10.3 million DALYs due to neglected parasitic diseases and intestinal nematodes [104].
There are seven broad limitations of the current study. First, some costs were omitted. For example, direct costs of NTD prevention programmes, and diagnosis and treatment services were not taken into account because the current study focused on years of life lost due to premature mortality. The study also excluded the indirect costs of productive labour time lost due to morbidity, including cost of time spent seeking treatment, reduced level of performance of activities/functions of daily living, and time expended by caregivers (family and friends) and those accompanying the sick to sources of care, e.g. health facilities, private pharmaceutical shops, traditional healers. The intangible/psychological costs related to stigmatisation, discrimination, pain, anxiety and bereavement were also omitted.
Third, there is no agreement in literature about whether mortality occurring at different age groups should be weighted differently. In our study, we assumed all life to be intrinsically valuable and thus a year lost in an age group was considered to be of equal value [116]. This is why the current study used per-capita GDP to value YLLs at any age group.
Fifth, a number of weaknesses characterise the lost output approach or HCA: (a) It assumes that the objective of health care is getting sick people back to productive employment. However, there are other objectives, such as preventing morbidity and death so that people can enjoy life (flourish), enjoy leisure and perform non-economic societal functions, etc. (b) In its pure form, the HCA would value the lives of pensioners (elderly), full-time homemakers and non-working children at zero. In this study, we value all lives using per-capita GDP prevailing in each country. (c) The HCA does not capture intangible psychological costs of NTDs, e.G. stigma, pain, bereavement, anxiety and suffering [122, 123].
Sixth, the values of life loss estimates reported in this paper are not a guide to setting priorities in the research, prevention and treatment of NTDs [124, 125]. The estimated value of human lives lost due to NTDs are only meant for use in raising public awareness and advocacy with ministries of finance in African countries on the magnitudes of potential economic losses arising from mortality associated with NTDs. Therefore, we are cognisant of the fact that setting priorities in NTD research, prevention and treatment must be guided by economic evaluation evidence on costs and consequences of competing research, prevention and treatment strategies [81, 82].
When Neandertals mated with modern humans, they shared more than an intimate moment and their own DNA. They also gave back thousands of ancient African gene variants that Eurasians had lost when their ancestors swept out of Africa in small bands, perhaps 60,000 to 80,000 years ago. Restored to their lineage, this diversity may have been a genetic gift to Eurasian ancestors as they spread around the world. Today, however, some of these African variants are a burden: They seem to boost the risk of becoming addicted to nicotine and having wider waistlines. 59ce067264
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