July 22, 2022

USAID Chief Visits Horn of Africa Amid Severe Regional Hunger Crisis

U.S. aid officials are calling on countries in the Horn of Africa to speak out against the Russian government’s blockade of Ukrainian ports, which have held back grain exports needed to feed millions of hungry people in the region. Officials also are pleading with armed groups in Ethiopia, Somalia and South Sudan to allow free passage of foodstuff in areas under their control.

The U.S. government’s top aid officials are on a three-day visit to East Africa, where nearly 20 million people are in a state of severe hunger and food insecurity aggravated by the Russian invasion of Ukraine and cutoff of Ukrainian food exports.

In her first stop in the region, USAID Administrator Samantha Power, speaking in Kenya’s capital Nairobi, said a concerted effort is needed to overcome the regional humanitarian crisis.

Earlier in the week, Power announced $1.2 billion in new money for Ethiopia, Somalia and Kenya and spoke Friday of how the money will be dedicated to meeting the food crisis in Kenya.

“That’s an enormous sum of money and it speaks to the amount of need here, but again we need other donors to step as well,” Power said. “At the same time we try to mobilize those resources we need to be pushing for access to hard-to-reach areas, and no party to the conflict should be impeding the safe passage of humanitarian relief.”

Kenya will receive about $255 million of the latest U.S. contribution. Some 4.1 million people are food insecure in Kenya, up from 3.5 million in March this year.

Kenya’s minister for public service and gender Margaret Kobia said the government has been able to provide humanitarian assistance in the arid and semi-arid areas of the country.

“The government has been giving cash transfers since September last year,” Kobia said. “We feel that even for those who are moving from one location to another, cash transfer remains a mode that can reach them wherever they are so long as they have a telephone.”

The Horn is experiencing a drought that is leaving millions on the brink of starvation.

Humanitarian agencies operating in Ethiopia and Somalia are finding it challenging to access some parts of both countries because of conflict and hundreds of thousands of people have been forced to move to safer areas to get access to food, water and medicine.

The United Nations and Turkey have mediated a deal to free Ukrainian grain exports. But Power said African countries need to pressure Russia to make sure the exports reach their intended destinations.

“This is going to be a challenging period for this region even if the grains can be unlocked, but every voice on the continent and around the world should be crying out in unison to Vladimir Putin, ‘Let the grains go, let the grains go Mr. Putin,’” Power said. “This is a humanitarian catastrophe in the making and anything any one of us can do to alleviate that must be done.”

Somalia gets 90 percent of its wheat from Russia and Ukraine, and even those with money are finding it difficult to afford the food in the markets.

Aid agencies warn eight areas in Somalia are at risk of famine and more than 7 million people are affected by drought, which has wiped out pastures and livestock.

Source: Voice of America

July 22, 2022

Monkeypox Virus Could Become Entrenched as New STD in US

The spread of monkeypox in the U.S. could represent the dawn of a new sexually transmitted disease, though some health officials say the virus that causes pimple-like bumps might yet be contained before it gets firmly established.

Experts don’t agree on the likely path of the disease, with some fearing that it is becoming so widespread that it is on the verge of becoming an entrenched STD — like gonorrhea, herpes and HIV.

But no one’s really sure, and some say testing and vaccines can still stop the outbreak from taking root.

So far, more than 2,400 U.S. cases have been reported as part of an international outbreak that emerged two months ago.

Health officials are not sure how fast the virus has spread. They have only limited information about people who have been diagnosed, and they don’t know how many infected people might be spreading it unknowingly.

They also don’t know how well vaccines and treatments are working. One impediment: Federal health officials do not have the authority to collect and connect data on who has been infected and who has been vaccinated.

With such huge question marks, predictions about how big the U.S. outbreak will get this summer vary widely, from 13,000 to perhaps more than 10 times that number.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said the government’s response is growing stronger every day and vaccine supplies will soon surge.

“I think we still have an opportunity to contain this,” Walensky told The Associated Press.

Monkeypox is endemic in parts of Africa, where people have been infected through bites from rodents or small animals. It does not usually spread easily among people.

But this year more than 15,000 cases have been reported in countries that historically don’t see the disease. In the U.S. and Europe, the vast majority of infections have happened in men who have sex with men, though health officials have stressed that anyone can catch the virus.

It spreads mainly through skin-to-skin contact, but it can also be transmitted through linens used by someone with monkeypox. Although it’s been moving through the population like a sexually transmitted disease, officials have been watching for other types of spread that could expand the outbreak.

Symptoms include fever, body aches, chills, fatigue and bumps on parts of the body. The illness has been relatively mild in many men, and no one has died in the U.S. But people can be contagious for weeks, and the lesions can be extremely painful.

When monkeypox emerged, there was reason to believe that public health officials could control it.

The tell-tale bumps should have made infections easy to identify. And because the virus spreads through close personal contact, officials thought they could reliably trace its spread by interviewing infected people and asking who they had been intimate with.

It didn’t turn out to be that easy.

With monkeypox so rare in the U.S., many infected men — and their doctors — may have attributed their rashes to some other cause.

Contact tracing was often stymied by infected men who said they did not know the names of all the people they had sex with. Some reported having multiple sexual interactions with strangers.

It didn’t help that local health departments, already burdened with COVID-19 and scores of other diseases, now had to find the resources to do intensive contact-tracing work on monkeypox, too.

Indeed, some local health officials have given up expecting much from contact tracing.

There was another reason to be optimistic: The U.S. government already had a vaccine. The two-dose regimen called Jynneos was licensed in the U.S. in 2019 and recommended last year as a tool against monkeypox.

When the outbreak was first identified in May, U.S. officials had only about 2,000 doses available. The government distributed them but limited the shots to people who were identified through public health investigations as being recently exposed to the virus.

Late last month, as more doses became available, the CDC began recommending that shots be offered to those who realize on their own that they could have been infected.

Demand has exceeded supply, with clinics in some cities rapidly running out of vaccine doses and health officials across the country saying said they don’t have enough.

That’s changing, Walensky said. As of this week, the government has distributed more than 191,000 doses, and it has 160,000 more ready to send. As many as 780,000 doses will become available as early as next week.

Once current demand is satisfied, the government will look at expanding vaccination efforts.

The CDC believes that 1.5 million U.S. men are considered at high risk for the infection.

Testing has also expanded. More than 70,000 people can be tested each week, far more than current demand, Walensky said. The government has also embarked on a campaign to educate doctors and gay and bisexual men about the disease, she added.

Donal Bisanzio, a researcher at RTI International, believes U.S. health officials will be able to contain the outbreak before it becomes endemic.

But he also said that won’t be the end of it. New bursts of cases will probably emerge as Americans become infected by people in other countries where monkeypox keeps circulating.

Walensky agrees that such a scenario is likely. “If it’s not contained all over the world, we are always at risk of having flare-ups” from travelers, she said.

Shawn Kiernan, of the Fairfax County Health Department in Virginia, said there is reason to be tentatively optimistic because so far the outbreak is concentrated in one group of people — men who have sex with men.

Spread of the virus into heterosexual people would be a “tipping point” that may occur before it’s widely recognized, said Kiernan, chief of the department’s communicable disease section.

Spillover into heterosexuals is just a matter of time, said Dr. Edward Hook III, emeritus professor of infectious diseases at the University of Alabama at Birmingham.

If monkeypox becomes an endemic sexually transmitted disease, it will be yet another challenge for health departments and doctors already struggling to keep up with existing STDs.

Such work has long been underfunded and understaffed, and a lot of it was simply put on hold during the pandemic. Kiernan said HIV and syphilis were prioritized, but work on common infections like chlamydia and gonorrhea amounted to “counting cases and that’s about it.”

For years, gonorrhea, chlamydia and syphilis cases have been rising.

“By and large,” Hook said, doctors “do a crummy job of taking sexual histories, of inquiring about and acknowledging their patients are sexual beings.”

Source: Voice of America

July 22, 2022

Explainer: What’s Behind the Rising Conflict in Eastern DRC?

When the gunshots rang out, Dansira Karikumutima jumped to her feet.

“I ran away with my family,” she said of the March day that M23 rebels arrived in Cheya, her village in eastern Democratic Republic of Congo’s North Kivu province. “We scattered, each running in a different direction out of fear.”

Months later, the 52-year-old, her husband and their 11 children have regrouped in an informal camp in Rutshuru town, where they’re spending nights in a schoolhouse and scavenging for food by day.

They’re among the latest victims of rising volatility in the eastern DRC. If unchecked, the unrest “risks reigniting interstate conflict in the Great Lakes region,” as the Africa Center for Strategic Studies warned in a late June report on the worsening security situation.

M23 is among more than 100 armed groups operating in the eastern DRC, an unsettled region where conflict has raged for decades but is escalating, especially in recent months. Nearly 8,000 people have died violently since 2017, according to the Kivu Security Tracker, which monitors conflict and human rights violations. More than 5.5 million people have been displaced — 700,000 just this year, according to the United Nations.

The Norwegian Refugee Council identified the DRC as the world’s most overlooked, under-addressed refugee crisis in 2021, a sorry distinction it also held in 2020 and 2017.

Fueling the insecurity: a complicated brew of geopolitics, ethnic and national rivalries and competition for control of eastern DRC’s abundant natural resources.

The fighting has ramped up tensions between the DRC and neighboring Rwanda, some of which linger from the 1994 genocide in Rwanda, where ethnic Hutus killed roughly 800,000 Tutsis and moderate Hutus. Competition for resources and influence in DRC also has sharpened longstanding rivalries between Rwanda and Uganda.

How does M23 fit in?

The DRC and its president, Felix Tshisekedi, accuse Rwanda of supporting M23, the main rebel group battling the Congolese army in eastern DRC. M23’s leaders include some ethnic Tutsis.

M23, short for the March 23 Movement, takes its name from a failed 2009 peace deal between the Congolese government and a now-defunct rebel group that had split off from the Congolese army and seized control of North Kivu’s provincial capital, Goma, in 2012. The group was pushed back the next year by the Congolese army and special forces of the U.N. Stabilization Mission in the Democratic Republic of the Congo (MONUSCO).

Rwanda and its president, Paul Kagame, accuse the DRC and its army of backing the Democratic Forces for the Liberation of Rwanda (FDLR), a Congo-based mainly Hutu rebel group that includes some fighters who were involved in the genocide.

What sparked the resurgent crisis?

Last November, M23 rebels struck at several Congolese army positions in North Kivu, near the borders with Uganda and Rwanda. The rebels have made advances that include the overrunning of a Congolese military base in May and taking control of Bunagana, a trading town near the border with Uganda, in June.

Bintou Keita, who as head of MONUSCO is the top U.N. official in the DRC warned in June that M23 posed a growing threat to civilians and soon might overpower the mission’s 16,000 troops and police.

M23’s renewed attacks aim “to pressure the Congolese government to answer their demands,” said Jason Stearns, head of the Congo Research Group at New York University, in a June briefing with the Center for Strategic and International Studies (CSIS).

The rebels want implementation of a 2013 pact known as the Nairobi agreement, signed with the DRC government, that would grant them amnesty and reintegrate them into the Congolese army or civilian life.

How is Uganda involved?

“The longstanding rivalry between Uganda and Rwanda in the DRC and the Great Lakes region is a key driver of the current crisis,” the Africa Center observed in its report. It cited a “profound level of mistrust at all levels — between the DRC and its neighbors, particularly Rwanda, Uganda and Burundi, as well as between all of these neighbors.”

Late last November, Uganda and the DRC began a joint military operation in North Kivu to hunt down the Allied Democratic Forces (ADF), an armed group of Ugandan rebels affiliated with the Islamic State and designated by the U.S. government as a terrorist organization. Uganda’s President Yoweri Museveni has blamed ADF for suicide attacks in Kampala last October and November.

Ugandan officials have accused Rwanda of using M23 to thwart its efforts against ADF, the Africa Center report noted, adding that the U.N. also “has implicated Uganda with aiding M23.” U.N. investigators a decade earlier had claimed credible evidence of Rwandan involvement.

Stearns, of the Congo Research Group, said the joint Ugandan-DRC military operation created “geopolitical ripple effects in the region,” with Rwanda essentially complaining that Uganda’s intervention “encroaches” on its sphere of interest in eastern Congo.

What economic factors are at play?

Some of the fighting is over control of eastern DRC’s vast natural resources, including diamonds, gold, copper and timber. The country has other minerals — cobalt and coltan — needed for batteries to power cellphones, other electronics and aircraft.

“The DRC produces more than 70% of the world’s cobalt” and “holds 60% of the planet’s coltan reserves,” the industry website Mining Technology reported in February, speculating that the DRC “could become the Saudi Arabia of the electric vehicle age.”

The Africa Center report noted there is “ample evidence to suggest that Ugandan- and Rwandan-backed rebel factions — including M23 — control strategic but informal supply chains running from mines in the Kivus into the two countries.” It said the groups use the proceeds from trafficked goods “to buy weapons, recruit and control artisanal miners, and pay corrupt Congolese customs and border officials as well as soldiers and police.”

Access also has value. In late 2019, a three-way deal was signed to extend Tanzania’s standard gauge railway through Burundi to DRC, giving the latter two countries access to Tanzania’s Indian Ocean seaport at Dar es Salaam.

And in June 2021, DRC’s Tshisekedi and Uganda’s Museveni presided over groundbreaking of the first of three roads linking the countries. The project is expected to increase the two countries’ trade volume and cross-border transparency, and to strengthen relations through “infrastructure diplomacy,” The East African reported. The project includes a road connecting Goma’s port on Lake Kivu with the border town of Bunagana.

“Rwanda, in between Uganda and Burundi, sees all this happening and feels that it’s being sidelined, feels that it’s being marginalized,” Stearns said in the CSIS briefing.

Rwanda has had its own deals with the DRC — including flying RwandAir routes and processing gold mined in Congo —but the Congolese government suspended all trade agreements in mid-June.

What can be done to address the crisis?

The DRC, accepted this spring into the East African Community regional bloc, agreed to the community’s call in June for a Kenya-led regional security force to protect civilians and forcibly disarm combatants who do not willingly put down their weapons.

No date has been set for the force’s deployment.

The 59-year-old Tshisekedi, who is up for re-election in 2023, has said Rwanda cannot be part of the security force.

Rwandan President Paul Kagame, 64, told the Rwanda Broadcasting Agency he has “no problem” with that.

The two leaders, at a July 6 meeting in Angola’s capital, agreed to a “de-escalation process” over fighting in the DRC. The diplomatic roadmap called for ceasing hostilities and for M23’s immediate withdrawal.

But fighting broke out the next day between M23 and the Congolese army in North Kivu’s Rutshuru territory.

Speaking for the M23 rebels, Major Willy Ngoma told VOA’s Swahili Service that his group did not recognize the pact.

“We signed an agreement with President Tshisekedi and Congo government,” Ngoma said, referring to the 2013 pact, “and we are ready to talk with the government. Whatever they are saying — that we stop fighting and we leave eastern DRC — where do you want us to go? We are Congolese. We cannot go into exile again. … We are fighting for our rights as Congolese.”

Congo’s government says it wants M23 out of the DRC before peace talks resume.

Paul Nantulya, an Africa Center research associate who contributed to its analysis, predicted it would “take time to resolve the long-running tensions between Rwanda and the DRC.”

In written observations shared with VOA by email, he called for “a verifiable and enforceable conflict reduction initiative between Congo and its neighbors — starting with Rwanda” and “an inclusive democratization process in Congo.”

Rwanda’s ambassador to the DRC, Vincent Karega, warned in a June interview with the VOA’s Central Africa Service that hate speech is fanning the conflict. Citing past genocides, he urged “that the whole world points a finger toward it and makes sure that it is stopped before the worst comes to the worst.”

Source: Voice of America