Alex de Waal

Human resources for health: overcoming the crisis

In this analysis of the global workforce, the Joint Learning Initiative-a consortium of more than 100 health leaders-proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the worlds poorest countries and for building sustainable health systems in all countries. Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base. Especially in the poorest countries, the workforce is under assault by HIV/AIDS, out-migration, and inadequate investment. Effective country strategies should be backed by international reinforcement. Ultimately, the crisis in human resources is a shared problem requiring shared responsibility for cooperative action. Alliances for action are recommended to strengthen the performance of all existing actors while expanding space and energy for fresh actors.

New variant famine: AIDS and food crisis in Southern Africa.

Southern Africa is undergoing a food crisis of surprising scale and novelty. The familiar culprits of drought and mismanagement of national strategies are implicated. However, this crisis is distinct from conventional drought-induced food shortages with respect to those vulnerable to starvation, and the course of impoverishment and recovery. We propose that these new aspects to the food crisis can be attributed largely to the HIV/AIDS epidemic in the region. We present evidence that we are facing a new variant famine. We have used frameworks drawn from famine theory to examine the implications. HIV/AIDS has created a new category of highly vulnerable households--namely, those with ill adults or those whose adults have died. The general burden of care in both AIDS-affected and non-AIDS-affected households has reduced the viability of farming livelihoods. The sensitivity of rural communities to external shocks such as drought has increased, and their resilience has declined. The prospects for a sharp decline into severe famine are increased, and possibilities for recovery reduced.

What's New in the 'New Partnership for Africa's Development'?

This article provides an overview of the New Partnership for Africa’s Development (NEPAD) in the context of Africa’s current economic and governance crises, the attempt to establish an Africa Union, and the interest in Africa displayed by the G8 leadership and in particular by the UK’s prime minister Tony Blair. NEPAD has to be seen simultaneously as a ‘big idea’, a new way of doing business, and a comprehensive development framework. The ‘big idea’ is to put Africa’s concerns on the table of the G8 and seek a much better deal for Africa in terms of international aid, debt relief and access to markets. The new way of doing business is a new form of ‘enhanced’ development partnership that makes both donor and recipient mutually accountable for development outcomes. The development framework is a long—and expanding—list of programmes and projects, akin to those that have been tried before. The heart of NEPAD is a commitment to good governance, operationalized through a radical plan for ‘peer review’ of governance performance. This promises a radical new approach to development partnership, but it also faces political hazards. The governance component is also analysed in the context of the pan–Africa institutions envisaged by the African Union. There is a need for coordinating and rationalizing peace and security initiatives. NEPAD may unlock additional financing for development, but it should not be seen as a cash cow. The challenges for NEPAD include opening up the process to make it more participatory, including greater focus on HIV/AIDS. NEPAD faces the real danger of being over–sold and of raising unrealistic expectations among Africans. It is, nevertheless, an outstanding opportunity for Africa’s development.

African roles in the Libyan conflict of 2011

Libyas relationship with sub-Saharan Africa has been complex, troubled and misunderstood, both during the rule of the late Libyan leader Muammar Gaddafi and the conflict that culminated in his overthrow and death. The Libyan conflict of 2011 divided Africa, but nonetheless the African Union (AU) was able to agree on a political strategy aimed at achieving a negotiated settlement and power transition. The AUs peace initiative was launched in March 2011 and, contrary to widespread perception that the AU sought to prop up Gaddafi, it offered a credible and balanced option of a negotiated solution. United Nations Security Council resolution 1973 expressed support for the initiative, but in the event France, Britain and the United States blocked its chances of success. This article draws on evidence and analysis provided by the AU officials involved. It details the process whereby the AU adopted and implemented its decisions, and describes the AUs diplomatic engagement with Gaddafi and the National Transitional Council. The article also draws on information provided by Sudanese military and intelligence officials, providing an account, hitherto untold, of how the Sudanese government supported the Libyan opposition with military supplies, training and intelligence, in tacit cooperation with NATO countries. The article concludes with reflections on how the Libyan conflict has had an impact on the doctrine of the ‘responsibility to protect’, on the AU, and on Libyas relations with Africa.

Reframing governance, security and conflict in the light of HIV/AIDS: A synthesis of findings from the AIDS, security and conflict initiative☆

This paper draws upon the findings of the AIDS, Security and Conflict Initiative (ASCI) to reach conclusions about the relationship between HIV/AIDS, security, conflict and governance, in the areas of HIV/AIDS and state fragility, the reciprocal interactions between armed conflicts (including post-conflict transitions) and HIV/AIDS, and the impact of HIV/AIDS on uniformed services and their operational effectiveness. Gender issues cut across all elements of the research agenda. ASCI commissioned 29 research projects across regions, disciplines and communities of practice. Over the last decade, approaches to HIV/AIDS as a security threat have altered dramatically, from the early anticipation that the epidemic posed a threat to the basic functioning of states and security institutions, to a more sanguine assessment that the impacts will be less severe than feared. ASCI finds that governance outcomes have been shaped as much by the perception of HIV/AIDS as a security threat, as the actual impacts of the epidemic. ASCI research found that the current indices of fragility at country level did not demonstrate any significant association with HIV, calling into question the models used for asserting such linkages. However at local government level, appreciable impacts can be seen. Evidence from ASCI and elsewhere indicates that conventional indicators of conflict, including the definition of when it ends, fail to capture the social traumas associated with violent disruption and their implications for HIV. Policy frameworks adopted for political and security reasons translate poorly into social and public health policies. Fears of much-elevated HIV rates among soldiers with disastrous impacts on armies as institutions, have been overstated. In mature epidemics, rates of infection among the military resemble those of the peer groups within the general population. Military HIV/AIDS control policies follow a different and parallel paradigm to national (civilian) policies, in which armies prioritize command responsibility and operational effectiveness over individual rights. Law enforcement practices regarding criminalized and stigmatized activities, such as injecting drug use and commercial sex work, are an important factor in shaping the trajectory of HIV epidemics.

The epidemiology of lethal violence in Darfur: using micro-data to explore complex patterns of ongoing armed conflict

This article describes and analyzes patterns of lethal violence in Darfur, Sudan, during 2008-09, drawing upon a uniquely detailed dataset generated by the United Nations-African Union hybrid operation in Darfur (UNAMID), combined with data generated through aggregation of reports from open-source venues. These data enable detailed analysis of patterns of perpetrator/victim and belligerent groups over time, and show how violence changed over the four years following the height of armed conflict in 2003-05. During the reference period, violent incidents were sporadic and diverse and included: battles between the major combatants; battles among subgroups of combatant coalitions that were ostensibly allied; inter-tribal conflict; incidents of one-sided violence against civilians by different parties; and incidents of banditry. The conflict as a whole defies easy categorization. The exercise illustrates the limits of existing frameworks for categorizing armed violence and underlines the importance of rigorous microlevel data collection and improved models for understanding the dynamics of collective violence. By analogy with the use of the epidemiological data for infectious diseases to help design emergency health interventions, we argue for improved use of data on lethal violence in the design and implementation of peacekeeping, humanitarian and conflict resolution interventions.

Revisiting new variant famine: the case of Swaziland

The ‘new variant famine’ hypothesis posits links between HIV/AIDS and new patterns of impoverishment, food insecurity and hunger, in southern and eastern Africa. This paper explores the relevance of the NVF hypothesis to understanding Swaziland’s recurrent food crises and high HIV prevalence. Evidence exists that all four markers of NVF are present in Swaziland. The national government and the international community will have to contend with this phenomenon in future planning for the wellbeing of Swazi citizens.

Hybrid social movements in Africa

Abstract This essay identifies patterns in the organisation and character of social movements in Africa, drawing upon examples from sub-Saharan Africa and finding connections with the 2011 ‘Arab Spring’ uprisings. It pays attention to historicising social movements, global linkages and the problem of sustaining change. Rather than defining social movements in an a priori manner, or generalising from definitions derived from the western societies, it explores their concrete meanings in Africa. Thus it aims to avoid both the ‘false negative’ of overlooking genuine African social movements and the ‘false positive’ of labelling movements in a misleading manner. It identifies constraints upon collective action in Africa, exploring the political dynamics which undermine the formation of durable and organised movements and limit their capacity to represent popular concerns.

Democratizing the aid encounter in Africa

The record of aid to Africa, in actual achievements in the improved well-being of its recipients, is not a good one. This article contends that this does not mean that aid slhould be abandoned, but that reform is necessary in the way it is given and managed. The author points out that aid programmes founded on a strong local base and pursued through local agencies have a much better success rate than those imposedfrom outside. He is critical of the tendency among aid donors to avoid proper engagement with the question of political power and argues for a democratization of the aid encounter which would put decisions on the use of aid in the hands of the recipients and ensure the accountability of those administering it.

Case Closed: A Prosecutor Without Borders

Case Closed: A Prosecutor Without Borders Julie Flint and Alex de Waal Eleven years ago, celebrating the creation of the world’s first permanent International Criminal Court, UN Secretary General Kofi Annan spoke of “a gift of hope to future generations, and a giant step forward in the march towards universal human rights and the rule of law.” Reflecting on the birth of the United Nations amidst the struggle against genocide, war crimes, and aggression half a century earlier, Annan noted how the idea of a world criminal court had been stillborn, strangled by the superpower rivalry of the Cold War. Only with the triumph of Western liberalism, and the horrors in former Yugoslavia and Rwanda, had this changed. The International Criminal Court (ICC), Annan said, “is an achievement which, only a few years ago, nobody would have thought possible.”