Dan spoke about the work that RESULTS and our grassroots campaigners have been doing on:

• Working on securing an IDSC inquiry into disability and development.
• Advocating for DFID to improve and mainstream the work they do on disability and education.
• Upcoming plans for supporting the 2014 replenishment of the Global partnership for Education, the world’s foremost education multilateral

It was my first time meeting the RESULTS team and my first time attending one of their Advocacy Days at Parliament.  The day began with a briefing from Walter Nyika, our honoured guest from Zimbabwe, who spoke to us about his work on permaculture and nutrition in Malawi.  After an inspiring talk, we headed to Parliament to meet with our MPS. My local MP of Cardiff South and Penarth is Stephen Doughty, a leader politician and former head of Oxfam Cyrmu.

After requesting to meet with Stephen at Parliaments central lobby, I was pleased to find out that he was available to meet with me. The meeting couldn’t have gone any better!  Stephen was extremely interested in the work RESULTS are doing and was keen to support their future campaigns. Within a minute he agreed to write the Rt. Hon Justine Greening, calling on her to commit at least 149 million per year, over multiple years, at the ‘Nutrition for Growth’ event to funding financially sound, national nutrition plans and by the end he wanted to give us a shout out in The Chamber. He also kindly agreed to speak at any future RESULTS events and was keen to help build the RESULTS group in Cardiff.

Other grassroots had similarly successful meetings. Reg Davis, leader of the Poole group, met with Robert Simms MP and Tom Maguire, leader of the central London group, met with Caroline Lucas MP, the former leader of the Green Party. Both MPs were extremely interested in the issue of global undernutrition and were keen to bring it to the attention of Justine Greening.

All in all, the advocacy day was an absolutely fantastic start to my time at RESULTS and I am now motivated to do more with the great team.

IF – Religious lobby of parliament 15 May 2013

This event was billed in development circles as ‘The 500 nuns lobby’.  On the 15^th May, 250 religious, priests and associates (Catholic and Anglican) gathered in Methodist Central Hall for a lively service and briefing from various ‘IF’ NGOs. Timothy Radcliffe gave an inspiring talk suggesting that, ‘Starvation is the exclusion of people from the common table of humanity’. There was amazing energy around as we picked up banners, writing the name of our group on the back, paused for a photo call and processed to Westminster.  Someone had had some ‘punning’ fun with the banners – including: ‘Hunger shouldn’t be a habit)!

The Daughters of the Cross (Gillian in green)

81% of the 250 met with our MP or their office staff.  I and four Asian sisters met for 40 minutes with Charles Rowley, my MP’s Parliamentary Secretary. I pressed home the RESULTS ‘asks’ on undernutrition, the IF campaign asks on tax, transparency and nutrition and (at his request) gave him  an update on TB/miners including news of Mr Mkoko – I also sneaked in cheeky asks on committing to the global fund; enshrining 0.7% in law; disability and education, as well as thanking him profusely for commitments on polio vaccine, 0.7%; ‘the hunger summit’ and asked that the government deliver on its pledges. Charles promised that he would pass the information over to Mark Prisk and that they would tell us what they had done.  The sisters from Asia gave great practical stories of the effects of undernutrition from Pakistan, Nepal and India and I told him about how under-nutrition impacts on TB treatment in Cameroun, telling him of the nutrition programme we are using there along with the drug treatment. He was very interested in Walter Nyika’s story of how food availability in Zimbabwe has changed.  I gave Charles an IF wrist band and badge along with the briefing papers.

Gillian and the group meet with Charles Rowley, parliamentary assistant to mark Prisk MP

All around Westminster hall there were groups of people gathered round their MPs pressing home their ‘asks’. Ed Miliband, Alan Duncan and Ivan Lewis gave short addresses and the place was a buzz of energy.  Back in Methodist central hall for the final liturgy Sarah Tether told us how motivating it is for her to have committed people like us coming along with strong asks. For many it was the first time lobbying, but afterwards people said how good it was and that they would definitely be lobbying again. It was strange lobbying without the RESULTS gang, and a very different, but positive experience being part of a large lobby – there were even chairs put out for us. We meet again for the IF rally on 8 June  with the strap line –

‘8 leaders.  8 June.  Our chance to stop 1 in 8 people going hungry’

Credit: UNITAID

It has long been known that there is an association between TB and malnutrition, although it is difficult to determine what the nutritional status of individuals with TB was before the onset of the disease. Malnutrition makes people more susceptible to the development of active TB, and  active TB contributes to the development of malnutrition. This vicious circle impacts not only on individuals but can easily transfer to their families and their communities.

Tuberculosis patients have lower Body Mass Index (BMI), muscle mass and subcutaneous stores of fat than control groups. A study in Malawi found that the differences can amount to as much as 20% between healthy individuals and those with active TB. This may be because some participants in the study suffered malnutrition before contracting TB, but the disease also increases demand for energy which contribute to increased weight loss if that demand cannot be met.

In full treatment, TB patients can quickly recover the weight that they have lost, but researchers have consistently found that muscle-mass and protein levels are much slower to recover. Even in patients deemed to be ‘cured’ of TB, these nutrient deficiencies can persist. This is one reason that comprehensive care for TB patients is vital long after the body has been cleared of bacteria.

There is also evidence to suggest that malnutrition, and the consequential weakness in immune function, makes it more likely that exposure to TB bacteria will result in full tuberculosis, rather than development of the latent form of the disease that is found in 2 billion people around the world. Therefore, improvements in nutrition for people who are most at risk of developing TB  should directly decrease the number of TB infections, improve treatment prognoses and save lives.

On 8^th June the UK and CIFF will host a global summit called Nutrition for Growth to raise attention, and funding for long-term nutrition programmes, prioritising at first 20 countries that have a high-burden of undernutrition. RESULTS is calling on the UK to make a pledge of £150million a year, or £750million over five years. A multi-year pledge is important to give stability to developing countries and allow for long-term planning and scaling up of nutrition-specific programming within stronger health systems. An improved global investment in nutrition will not only lead to a reduction in child deaths but will have an important long-term impact in reducing diseases as adults.

Good nutrition won’t definitely stop you getting tuberculosis, but it certainly gives you a better chance of fighting it successfully. If the world truly wants to see a reduction in the burden of global diseases like TB, ensuring good nutrition for all would be an excellent first step.

Note: For a more comprehensive review of evidence linking TB and undernutrition, click here

Guest Speaker: Dan Jones, Campaigns Manager at RESULTS UK

If you would like to join the focus call there are 3 numbers you can call –  0844 762 0762, 0203 398 1398 or 0800 22 90 900. You must then enter the participant code, which is 18718. If you would like advice about which number to call please contact us in the office.

We look forward to you joining us

This week I received a call from Nozipho Mkoko (Musa Mkoko’s wife) informing me that Mr. Mkoko has been hospitalised with tuberculosis. Today, the Mkoko family granted me permission to share this news with you all. As many of you know, Mr. Mkoko is the only surviving miner from the film, They Go to Die. His recent TB infection is an externally acquired infection, not a reinfection of his previous multi-drug resistant TB.  At the end of this message I have listed direct ways to help, as well as how to access an unpublished link to a clip of Mr. Mkoko from the film. I invite you to watch.

Credit: Jonathan Smith

This news is extremely worrisome, and though the facts that he is receiving care in Swaziland and that his TB is treatable mitigates some of the worry, we must also remember that there are intense mental and psychological effects of such a diagnosis. Though the treatment for drug susceptible TB is less intense, it is by no means considered a simple treatment; one’s family would not be ‘relieved’ that they were diagnosed with a different form of cancer. As you can imagine, this news has been mentally and emotionally devastating to not only him, but also his family and community.

It is easy to assume that ‘care’ equals ‘cure.’ We are fortunate that the Swaziland Health Minister Benedict Xaba has greatly improved care and that access to medication is no longer a hurdle. But given his physical state – weak, emaciated – and that his TB is complicated by HIV, a favourable outcome is neither guaranteed nor probable. This all too seriously highlights the continued battle that high-risk individuals have for contracting TB. Mr. Mkoko’s family will fight tooth and nail to ensure his well-being, just as they did during his last battle, and just as they would if they faced one hundred battles more, but he is weaker, older, and his lungs are lacerated from spending decades in the dusty mineshafts where he once worked.

If you are like me, you empathize with Mr. Mkoko and have the urge to want to ‘do something.’ But we should remember our version of the TB epidemic is not the same as Mr. Mkokos, however our epidemic is equally as challenging. As the family of Mr. Mkoko fights their own battles, we must realize that our fight is not in the dim lit homes of a Swazi house. Our role is not to change the wet sheets of a shivering father who has perspired through them, or in navigating public transport for a full day to secure a blister pack of pills. Our fight is to ensure that those fighting these battles have the tools they need to win; that the Global Fund is funded, that the research and innovation we need comes to fruition, that TB REACH is expanded, that the mines lower risk, and that data-driven policies that support patient centered care are rolled out. In continuing to fight the battles we face in our epidemic, we can ensure that future patients avoid illness and physical and mental distress. Though being behind a lab bench or keyboard can often times seem distant, it is equally as important as being in the field.

The TB epidemic will not be overcome in a single broad, sweeping gesture – rather success will manifest itself in sustaining the countless individual efforts fought daily around the globe. It is up to us to define our own fight.

I ask that you keep Mr. Mkoko in your thoughts and prayers. He is one case out of the 8.7 million cases of TB in the world at present, but he represents the positive side of fighting an epidemic – that people can overcome incredible obstacles. He and his family are a representation of why we all fight to overcome TB.

If you would like to help the Mkoko family, you can do so in the following ways:

1) Email the family a message of hope and compassion. We have set up Mrs. Mkoko with a Gmail account that she can check periodically. Click here to email the Mkoko Family.

2) Donate to directly support Mr. Mkoko’s care. We have created a special fund for the Mkoko Family. We are not soliciting funds per se, but this is indeed a tangible way we can help; sometimes defining our fight is as simple as sustaining the efforts of others. Click here to donate

3) If you haven’t yet done so, download our letter and email your MP demanding that the UK fully fund the Global Fund to Fight AIDS, TB and Malaria and TB REACH. You can find your MP’s details at www.theyworkforyou.com

4) To access the clip, click here and use the password ‘mkoko.’ I will leave this up for about two weeks.

Onward,

Jonathan Smith

Potato Curry and Chappati

A formula indeed; one that Tom and I have both followed on blogs about the challenge. And there’s nothing wrong with a blog like that; but this is the fifth time I have done that challenge, and well, I’m getting pretty good at it. I don’t have the same feelings of tiredness, hunger and grumpiness……all in I’m just not finding it difficult. I am craving caffeine in the mornings but I’m living with that…..I mean humans evolved without drinking a flat white every day; anyway I have around 72 ‘tea’ bags that I bought from Sainsbury’s. It’s cheap but it does the job.

As a result, I have had a little bit more time to think clearly about the challenge and the campaign more broadly, and so I think I’ll share my thoughts on those.

As the total raised through Live Below the Line for the year pushes past the £650,000 mark and thousands of people converge around the IF campaign and its hunger and food related asks, I wonder, did the GPP have the foresight to know that this was an issue that’s time had come? Do they own a crystal ball into which they gaze of an evening?

To answer that question, I think, no, the GPP don’t have the power to see the future. I do however think that they have captured a moment by making hunger and food the central theme of their campaign. Leaving aside the catchiness of the campaign and the way it has started to permeate the public’s imagination, the issue at its heart, hunger and poverty are so central to everything we do that it seems inconceivable that while they have been at the core of everything we do, they have also somehow managed to slip off our radar. Allow me to elaborate.

Hunger was the issue which kick started the western rush to aid the Global South in response to the famines that swept Sub Saharan Africa in the 70’s and 80’s; and whilst they have long been seen as key indicators of progress and the focus of some campaigning, hunger and undernutrition have gradually slipped down the international agenda. In 2012 less than 0.3% of global aid assistance went directly on nutrition; as a result the number of undernourished people in developing countries has actually risen in absolute terms, climbing from 824 million in 1990 to 925 million in 2010. This despite the fact that ‘we have the means; we have the capacity to eliminate hunger from the face of the Earth in our lifetimes. We only need the will’ JFK, 1963

It was this fact that inspired Sam Daley-Harris to go on and found RESULTS in the USA in the USA1970s. This fact: we have the means, resources, infrastructure and understanding to eliminate hunger. It is up to us to generate the will to make it happen.

And that’s what we have to do and that, I think, is the strength of Live Below the Line and the IF Campaign….they represent that push, that clamouring of spirit that is needed to generate the will to end hunger. RESULTS believes in that vision and is firm in stating that we all posses the agency to call for change.

Whether David Cameron, Justine Greening and the rest hear that call is one thing, but to push them to exercise that will………..well, that’s something we can –and must- all do.

Now here is an extract from a more ‘traditional’ Live Below the Line blog:

My shopping list:

1kg potatoes- 50p

Carrots 750g- 24p

5 X bananas- 64p

Three large onions- 40p

Can of spaghetti- 16p

350g Red lentils -50p

750g flour- 22p

4X canned tomatoes- £1.24

1X can of kidney beans- 21p

8X value sausages – 56p

Value tea bags- 12p

Assorted spices- 11p

TOTAL £4.90

Meals

Breakfast: banana every day

Lunch: Sausages and potatoes/potato curry

Dinner: Potato curry/Dhaal/chappatis

Potato curry and chappati

Not much variety but the food is tasty, contains protein and has some spices. I love that filthy tea. As a big fan of curry and dhall I relish getting to eat lots of those. From Monday-Wednesday I ate banana for brekkie and then had either curry or sausages for lunch. On Weds I added my can of spaghetti to the sausages and made a meal I can only describe as delicious.

Tonight I’ll eat some more curry and cook the dhal which includes the kidney beans. Tomorrow and Saturday are banana for breakfast then dhal/curry for lunch and dinner. Two days of delicious Indian food!

Our guest on the call was Kat Pittore, RESULTS’s own nutrition advocacy officer. The call was a great opportunity to hear about the issue of undernutrition and the major campaigning opportunities we have over the coming month to make a big impact and turn the tables on hunger.

Click here for the call.

So what happened? The Grameen Bank was granted institutional status in 1983 by the enactment of a special law: the Grameen Bank Ordinance. The Ordinance enabled the creation of a legal entity that would “provide credit… to landless persons for all types of economic activities”, and outlined the relationship that the Bank would have with government and its clients.

Three decades have passed since then, and the Grameen Bank has made loans totalling more than $9bn to millions of poor people. These clients are mostly women, over 5.5 million of whom own shares in the Bank purchased with funds from their Grameen savings accounts. Since 1987 these borrower-shareholders have also sent representatives to occupy nine out of twelve seats on Grameen’s Board of Directors, and this representation gives the poor shareholders significant input into the strategic direction of the Bank. The system was designed to ensure that the Bank retained its original focus on alleviating poverty, as well as its commitment to addressing the needs of its clients.

Grameen’s methodology has been emulated all over the world, but at home in Bangladesh the Bank has recently been under threat following a public clash with the governing Awami League party. Almost two years have passed since the government forced the resignation of the Bank’s founder, Prof Muhammad Yunus, amidst public protests from Grameen employees and clients. And a Commission of government appointees is currently investigating the legal status of the Bank, as well as the rights of shareholders and other issues. The Commission is simply the latest development in the fraught relationship between Grameen and the Awami League government, but the tone of its preliminary findings is particularly troubling.

In an interim report published recently, the Commission raised a number of disquieting points about the legal status of the Bank and its shareholders. The document supports the government’s position that Grameen is ultimately an organ of the state under the terms of the Ordinance, citing as evidence the fact that the Ordinance does not explicitly give ownership of the Bank to its shareholders. Indeed, the Commission notes that the statute does not properly define the rights of the people it describes as ‘member-borrowers’ or ‘shareholders’ at all.

But their role hasn’t been defined for close the thirty years; yet successive governments, central bank governors, finance ministers and government-appointed Grameen Board Chairmen have been satisfied with the de facto ownership exercised by the shareholders. The Commission actually specifically notes in their report that “No clarification about the usage of these terms seems to have been sought by anyone”, presumably because all parties were satisfied with the status quo where the Bank maintained its operational independence and the shareholders dominated the board. Here, members’ status embodies the spirit in which Grameen was created.

The Grameen Bank functions best as an institution that serves the needs of its clients, but at the moment the Awami League government is trying to make it an institution that is run by the State. And that is worrying.

Past experiences in Bangladesh and elsewhere indicate that governments are not always good at operating development finance institutions. For example, previous experiments in state-run microfinance have sadly been used as a conduit for patronage, vote-buying, and associated corruption. In many cases these institutions eventually collapse under the weight of their own mismanagement, leaving a legacy of wasted resources and institutionalised corruption.

If this were to happen to the Grameen Bank it would be a travesty. After three decades of demonstrating the potential for inclusive financial services to change the lives of disadvantaged people for the better, the Bank must be allowed to retain its independence. If the de facto status of the members on the Board of Directors is not properly defined in the Ordinance, then the law should be altered to normalise the situation. Any discrepancies cannot and should not be used as an excuse for the government to deprive Grameen’s members of the rights they have exercised for more than thirty years, and everyone who cares about the work of the Grameen Bank has a responsibility to stop that from happening.

Credit: These O Duke

Evidence shows that investing in nutrition is tremendous value for money in the fight against child mortality.  The example of malaria prevention shows that integrating nutrition programs into other development initiatives delivers even greater benefits.

The most underweight children have the highest risk of dying from malaria but if children are deficient in essential micronutrients, such as zinc, Vitamin A, iron and folate, they face dying from malaria even if they are not underweight. Large numbers of children less than five years old suffer and die from malaria due to lack of protein energy, zinc, vitamin A and other micronutrients.

Unlike many causes of death and disability, with appropriate nutritional support these deaths are entirely preventable. With the advances in nets and other simple malaria technologies there is massive potential to bring down child deaths through increased investment in these simple solutions.

Studies have demonstrated that malaria-control programs will have limited success if they do not also address undernutrition.^[1]  Nutritional counseling and education of mothers followed by feeding programs have to specifically focus on improving the health of the malnourished. This, alongside malaria-control measures, could reduce deaths from malaria on a large scale if built into a long term programme.

Medicins San Frontiers (MSF) is one of the organisations in the field that is addressing both malnutrition and malaria as public health problems and integrating their prevention and treatment into the set of basic health measures aimed at all young children.  They are currently employing this approach in Niger^[2]

“The effort being made to treat malnutrition in Niger is tremendous, and this needs to be supported,” says José Antonio Bastos, president of MSF in Spain. “The problem in 2012 was that a massive plan for treating malnutrition was prepared and implemented, but it excluded other health needs, in particular malaria prevention and immunisations. It failed to take account of the fact that even if you provide children with appropriate nutrition, you can still lose them to malaria or a respiratory infection. There is a need for an integrated response, rather than for pushing one response to the exclusion of others.”

So measures to improve nutrition, if sustained over a number of years, increase the success of other development interventions.  In the UK there is an opportunity to promote this lesson on 8^th June, when the Prime Minister is hosting a second ‘Hunger Summit’, co-hosted by the Childrens Investment Fund Foundation (CIFF).  The UK government can take the lead by giving a significant pledge, of £150 million per year, for the next five years. This has been calculated as the UKs ‘fair share’ of the funding gap, according to World Bank figures, and will encourage other donor countries and leverage major contributions from private foundations.

[2] http://www.doctorswithoutborders.org/press/release.cfm?id=6739&cat=press-release