Bulletin of the World Health Organization

Can a new UN emergency fund help southern Africa?

The United Nations is set to overhaul its humanitarian response system, but will this be enough to tackle complex emergencies such as the evolving crisis in southern Africa?

A 14-month-old with HIV/AIDS being fed by his grandmother.
AP Photo/O. Zilwa
A 14-month-old with HIV/AIDS being fed by his grandmother.

A new Humanitarian Emergency Fund, which received initial pledges of US$ 175 million towards a US$ 500 million target at the Millennium Summit in September, is due to be operational by early next year, subject to final approval by the UN General Assembly.

The fund should speed up delivery of relief supplies in the event of natural disasters, like the tsunami, and allow for more timely interventions in crises such as those in Niger and the Darfur region of Sudan. But with its launch planned for next year, the fund may be in place too late to alleviate the situation in the southern African nations of Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe.

Under-Secretary General for Humanitarian Affairs Jan Egeland said he regretted that the fund was not already operational as this would have allowed the UN to jump-start its aid operations in southern Africa, where an estimated 12 million people face malnutrition.

The UN launched a flash appeal in August for US$ 88 million to provide food aid, seeds and fertilizers for the hardest-hit country, Malawi, where up to 5 million of the 12 million population are at risk following failure of the all-important maize crop. But responses trickled in too late to buy agricultural inputs for the October planting season, which would have reduced Malawi’s dependency on emergency relief next year.

“Some win and some lose, and Malawi is now losing,” Egeland said at a recent press conference. “It drowned in the drama of so many other things,” he said in reference to disasters, such as the hurricanes in the Americas.

With an average four-month time lag before aid pledges actually reach recipients, the World Food Programme (WFP) has warned of a race against time in raising funds to avert starvation. Villagers in worst affected areas have already started eating water lily roots, which lack nutritional value but are one of the few sources of food available.

“My children have all suffered from diarrhoea as a result of eating the water lilies. But I have no choice but to dive for them because there’s nothing else [to eat],” said Dona Kijani, a mother of three young children in the village of Chigayeni in southern Malawi. Her husband died last year, leaving her to cope on her own.

Malawi’s Ministry of Health in the capital Lilongwe was due to conduct a nutrition assessment in October in the most vulnerable regions of the country. But even before the latest crisis, some 48% of children aged under five were classed as stunted — an indication of long-term chronic malnutrition — and 5% suffered from wasting as a result of acute malnutrition.

More than 1000 acutely malnourished children were admitted to nutrition rehabilitation units (NRUs) in August, compared to 775 children in the same month last year.

The Saint Montfort NRU in the southern district of Chikwawa, for instance, admitted 23 children in August, a rise of 130% over during the same period in 2004. Nursing officer Gertrude Mkwapu said admissions rose further in September and were expected to climb in the looming “lean season” ahead of harvest next March.

Malawi’s high rate of HIV infections — an estimated 14.2% of adults aged 15 to 49 live with the virus — has intensified the crisis. Mkwapu said almost half the acutely malnourished children in her wards were HIV positive. She and other health professionals said that complications due to malaria were likely to surge in the November rainy season.

The village of Napasha in southern Malawi provided a snapshot of the crisis. Around 48 of the 400 households contained AIDS orphans dependent on humanitarian aid and a further eight households had chronically sick people. Local government officials said the pandemic was depriving Malawi’s rural community of the necessary manpower to tend the fields, which were in any case barren because of the drought.

Some people living in Napasha were in despair. Monica Kasitomu said she had to look after her three grandchildren since their mother and father died last year and was totally dependent on WFP distributions of maize and oil handed out to the most vulnerable families in the village.

“I’m getting older and older and soon I won’t be able to take care of them,” she fretted. “There’s not enough food and there’s no money to buy clothes so they can go to school.”

Dr Emilienne Anikpo, Senior Adviser for WHO’s Department of Health Action in Crises, said the “triple threat” of the deteriorating HIV/AIDS situation, food insecurity and the eroding institutional capacity to deliver basic social services in Malawi and neighbouring countries — partly because of the lack of human resources — was reversing southern Africa’s development gains and leaving it more vulnerable to disasters.

After the severe drought of 1992, short-term humanitarian interventions helped the region back onto the road of development. In comparison, after the large-scale interventions in 2002, some 5 million people remained extremely vulnerable and unable to provide their own food needs. The current drought can only increase this vulnerability, warned Anikpo. “There is a need for a combination of short-term response and long-term prevention measures,” Anikpo said.

The proposed UN humanitarian emergency fund should at least smooth the way for short-term response by allowing for a greater degree of predictability. It is intended to replace the existing Central Emergency Response Fund, whose loan facility of US$ 50 million, was shown to be woefully inadequate to cope with the urgent demands of the Asian tsunami of December 2004 and a crisis like the one in Darfur in Sudan.

Although details are still to be finalized, Egeland said most of the fund would be in the form of grants which could be released within three to four days of a request.

Clare Nullis Kapp, Lilongwe.

“My children have all suffered from diarrhoea as a result of eating the water lillies. But I have no choice but to dive for them because there’s nothing else.”
Dona Kijani, a mother in southern Malawi.

“Some win and some lose and Malawi is now losing … It drowned in the drama of so many other things.”
UN Under-Secretary General for Humanitarian Affairs Jan Egeland.