Africa Keywords:, "Millennium Development Goals", child and maternal mortality, diseases, access to water, global partnership

All the Millennium Development Goals (MDGs) relate to human health, including women and children, to one degree or another, but three of them are specifically devoted to the most acute and urgent problems in this area - reducing child mortality by two - thirds, maternal mortality by three-quarters, etc. over the period 1990-2015. fight against HIV/AIDS, malaria and other infectious diseases.

HOW MANY CHILDREN IN AFRICA DON'T MAKE IT TO THE AGE OF FIVE?

There has been steady progress in reducing child mortality in all countries of the world over the past two decades. Under-five mortality in developing countries has decreased by one-third, from 99 per 1,000 live births in 1990 to 66 in 2009, a significant improvement, although not sufficient to meet the MDG target of reducing child mortality by two-thirds.¹

In all regions, with the exception of Sub-Saharan Africa (SSA), South Asia and Oceania, this indicator decreased by 50% or more. North Africa and East Asia were the most successful, with under-five mortality rates falling by 68% and 58%, respectively ^.2

Child mortality rates continue to be highest in SSA countries, where one in eight or nine children die before the age of five (121 deaths per 1,000 live births), which is twice the average for developing regions and about 18 times higher than the average for developed countries. This region, which is home to only 12.5% of the world's population, accounts for half of all deaths in the world among children of this age group (3.7 million per year), while a significant number of countries in the region do not yet show a downward trend.³ Diseases such as pneumonia, diarrhoea and malaria, as well as chronic malnutrition, are the main causes of death in children under the age of five.

Of the 26 countries with under-five mortality rates exceeding 100 deaths per 1,000 live births, all but Afghanistan and Haiti are located in the sub-Saharan part of the African continent. The highest mortality rate in 2010 was recorded in West and Central Africa, where one in seven children under the age of five died (143 deaths per 1,000 births).⁴. Although the overall under-^five child mortality rate has decreased by 28% in SSA countries since 1990, this reduction is clearly insufficient to meet this MDG5.

At the same time, there are also significant positive developments. According to official data, four of the ten countries where the child mortality rate decreased by more than 50% between 1990 and 2009 are located in sub-Saharan Africa (these are Malawi, Madagascar, Eritrea and Ethiopia). In addition, five of the six countries (Niger, Malawi, Madagascar, Liberia and Sierra Leone) where the death rate decreased by more than 100 deaths per 1,000 births over the same period also belong to the same region. It is a paradoxical fact that child mortality declined most rapidly not in rich and prosperous countries, but, on the contrary, in very poor ones, such as Niger, Malawi, Liberia and Sierra Leone. We can agree with the opinion of one of the participants of the 15th African Union (AU) Summit on maternal and child health in Africa (Kampala, July 2010), an adviser to Save the Children International, Nigerian Ch. Anyan said that "it's not about resources, it's about political will." Access to basic health services, he believes, could prevent many cases of child and maternal mortality on the continent.⁶

In Malawi, for example, according to the United Nations Children's Fund (UNICEF), the under - five mortality rate fell from 222 per 1,000 births in 1990 to 92 in 2010, and infant mortality (under one year of age) fell from ¹³¹ to 58 in the same period7. The country would have been successful-

Ending. For the beginning, see: Asia and Africa today. 2012, N 8, 9.

whether innovative and effective ways of providing primary health care, especially to women and children living in rural areas, have been applied. In a short period of time (only three months), several thousand rural health workers-volunteers from among high school graduates-were trained. As part of the Bike Town Africa project, funded by a Canadian charity, they were provided with bicycles free of charge for access to remote areas, in order to diagnose and vaccinate children, distribute mosquito nets, distribute medicines, etc. This made it possible to immediately increase the coverage of the population by three times.

A successful solution to the problem of reducing child mortality in Africa requires the widespread organization of primary health care, including in remote and hard-to-reach areas, the use of inexpensive but effective means of protecting and preventing diseases, in particular prenatal and postnatal follow-up, increased coverage of immunization and vaccination of children, the use of necessary medicines for prevention and treatment. treatment of children's diseases, etc. For Africa, this is the most effective and promising way to expand health services and bring them closer to the majority of the population, especially the poor. ⁸

MATERNAL MORTALITY RATE

Of all the MDGs, the goal of improving maternal health, which is to reduce maternal mortality rates by three quarters between 1990 and 2015, is the least likely to be achieved by the target date. More than half a million women worldwide die each year from treatable pregnancy and childbirth complications, of which 99% occur in developing countries. The situation in the SSA countries is the most depressing.

It has the highest maternal mortality rate in the world (640 people for every 100 thousand live births), more than double the figure for all developing countries (290 people).⁹. At the same time, its decline is slower than anywhere else (only by one quarter compared to 1990), and in a significant number of countries (Burkina Faso, Burundi, Central African Republic, Chad, DRC, Mali, Niger, Nigeria, etc.), maternal mortality continues to increase.

More than half of all maternal deaths on the planet occur in the SSA countries, where Somalia, Chad and Guinea-Bissau are the "leaders" in this indicator (more than 1000 people per 100 thousand births) ¹⁰. The most common causes of maternal mortality in African countries are blood loss during childbirth, high blood pressure, as well as malaria, HIV/AIDS and cardiovascular diseases.

Since 1990, the situation has improved somewhat in central and eastern sub-Saharan Africa, but progress has been stalled in the south and west of the continent due to high HIV-related deaths of pregnant women. In South Africa, for example, it even grew by more than half. Overall, the SSA countries have achieved only a 3.3% reduction in maternal mortality since 1990, which is very far from achieving this MDG target. According to UN experts, until African Governments begin to prioritize maternal health in their health agenda, maternal mortality rates in Africa will remain the highest in ^the world11.

With regard to the goal of achieving universal access to reproductive health services by 2015, improvements in this area are being observed in all regions, although at different rates. In SSA, for example, between 1990 and 2009, the number of women who received at least one medical consultation during pregnancy increased from 68% to 78%. At the same time, there is still a gap in this issue depending on the financial situation of a woman (in the city, the quality of medical services is much better than in the countryside), although it has narrowed since 1990.

THE "BIG THREE DISEASES" IN AFRICA

The widespread spread of infectious and parasitic diseases in Africa, along with slow progress in combating them, is a major obstacle to the social and humanitarian development of countries in the region, with serious negative consequences for the physical condition and lives of people. Sub-Saharan Africa is HIV-only/AIDS, malaria and tuberculosis, known as the "big three diseases", claim an estimated 3 million lives each year.

The real disaster for Africa was the AIDS pandemic (the "plague of the 20th century"). It is no exaggeration to describe it as a catastrophe along with floods, droughts and famine. As of 2010, there were about 34 million people in the world. More than two-thirds of them were living in SSA countries. Almost three-quarters of AIDS-related deaths also occurred in this region. Although the high rate of HIV spread/AIDS and the rising death rate from the disease have begun to decline in recent years, and the problem remains greatest in sub-Saharan Africa, where 1.8 million new HIV infections were reported in 2010 (70% of the global total).¹².

It is characteristic that in the region, almost 60% of adults living with HIV are women, while the proportion of women among HIV-infected youth (aged 15-24 years) reaches 72%, which indicates the feminization of the disease. No less acute is the problem of orphaned children due to the death of their parents from AIDS. For example, according to 2010 data, approximately 16.6 million children lost both parents to AIDS, of whom almost 15 million live in SSA countries.¹³

Despite such staggering numbers, thanks to copper-

Chinese developments and their implementation have made positive changes in the fight against AIDS in recent years. These include improvements in prevention programs and the introduction of antiretroviral treatment, which has resulted in a decline in the number of people newly infected with HIV and dying from AIDS. For example, in 22 SSA countries, the incidence of HIV decreased by more than a quarter between 2001 and 2009. In addition, the incidence and mortality of AIDS among children under the age of 15 has significantly decreased: the number of new infections has decreased by 32% and the number of deaths by 26%. In 2010 37% of adults and children with indications for antiretroviral therapy received the necessary treatment, compared with only 2% in the seven years prior. However, there are large differences across countries: 50% or higher in Botswana, Namibia and Uganda, and less than 10% of coverage in Angola, Mozambique, Zimbabwe, Congo and other countries.

However, while access to antiretroviral therapy and prevention efforts are bearing fruit, the total number of people living with HIV in sub-Saharan Africa remains high at 22.5 million. ¹⁴ So far, two-thirds of Africans living with HIV who are in dire need of treatment do not have access to appropriate treatment. Because of the scale of the AIDS pandemic, the need for treatment far outstrips the availability of antiretroviral drugs. Suffice it to say that for every person who starts a course of appropriate therapy, there are six newly infected people. Africa lacks the medical staff, financial resources, equipment and medicines needed to prevent and treat this terrible disease. We need to combine all efforts at the national and international levels, and actively engage the international community with Governments, the private sector and civil society in African countries.

Of the traditional tropical diseases that are widespread in Africa, malaria is the most dangerous, claiming the life of one child every minute. The World Health Organization (WHO) estimates that 655,000 malaria deaths were reported worldwide in 2010 (up from 985,000 in 2000). However, 90% of all malaria deaths continue to occur in SSA countries, and most victims are children under the age of five years: it is malaria that is considered the main cause of child mortality in the region. With regard to the incidence of malaria, of the 216 million cases reported in 2010, 80% were in SSA countries, of which Nigeria, DRC and Burkina Faso were the most affected. ¹⁵

According to the World Malaria Report 2011, malaria - related deaths have declined by more than 25% globally and 33% in Africa since 2000. At the same time, 11 African countries (Algeria, Botswana, Cape Verde, Eritrea, Madagascar, Namibia, Rwanda, Sao Tome and Principe, South Africa, Swaziland and Zambia) recorded a reduction of more than 50% in the number of malaria cases and deaths ^.16 In all countries, such progress has been linked to the implementation of proactive malaria prevention and control measures over the past decade, including the widespread use of insecticide nets, improved diagnosis, and increased access to effective medicines to treat the disease. Overall, although malaria morbidity and mortality rates have declined over the past decade, they still remain excessively high for a disease that is completely preventable and curable.

More than a century after R. Koch discovered the causative agent of tuberculosis and half a century of using effective drugs, this disease, which has become a thing of the past in industrialized countries, is still a scourge of a huge mass of the population of African countries. Moreover, in recent years, there has been a new surge of this disease in the region. The fact is that HIV/AIDS weakens the immune system of the human body, provokes the spread of tuberculosis and makes it more difficult to treat.

The number of cases of tuberculosis, as well as deaths from it, is decreasing in all regions except sub-Saharan Africa. Nowhere else in the world is the incidence and mortality rate of tuberculosis as high as in this region, and only here does it still tend to increase. Thus, over the past 20 years, the incidence of tuberculosis in the SSA countries has increased from 300 to 490 cases, and the death rate from it - from 32 to 53 per 100 thousand people. (For comparison, in North Africa, TB morbidity and mortality rates are only 27 and 2.4, respectively. ¹⁷) When combined with AIDS, TB causes huge physical and material losses, reducing incomes and impoverishing those affected and their families, which in turn increases poverty and slows economic growth, especially in rural areas. in the countries of South Africa, which became the epicenter of the double epidemic.

In general, despite the increased efforts of the international community and African countries themselves to combat infectious diseases over the past decade, if current trends continue, sub-Saharan Africa will not be able to achieve the global MDG goal of"stopping the spread of infectious diseases by 2015".-

HIV prevention/AIDS, malaria and other major diseases and start a trend towards reducing the incidence."

The burden of infectious diseases in Africa is so high that 72% of deaths in the region, according to WHO estimates, are caused along with complications during pregnancy and childbirth by these diseases, and not by chronic and non-infectious diseases, as is the case in other regions. The problem is not only and not so much the lack of financial resources needed to carry out relevant activities in this area, but rather social conditionality, which is closely related to factors such as malnutrition and hunger, unsanitary conditions, ignorance and poverty, i.e. the living conditions of the poorest segments of the population.

ACCESS TO DRINKING WATER AND SANITATION

To date, about 1.1 billion rubles. People in developing countries do not have adequate access to water, and 2.6 billion people in developing countries do not have adequate access to water. there is no basic sewage system. The reason for this, according to experts of the United Nations Development Program (UNDP), lies not in the physical lack of water, but in the weakness of state power, poverty and inequality. Coverage rates for safe drinking water and sanitation are lowest in sub-Saharan Africa. Thus, according to the UN, more than 40% of the population of this region is deprived of access to clean drinking water, and about 70% do not have the opportunity to use basic sanitary facilities. At the same time, the gap between the urban and rural population in this region is huge (more than 2 times)¹⁸.

Lack of water and widespread use of unsafe sources, along with the lack of basic sanitation, are the main reasons for the mass spread of infectious diseases, primarily gastrointestinal and parasitic, often leading to disability and high mortality, especially in children. Every year around the world, about 2 million children die due to polluted water and lack of sanitation, and this figure dwarfs the number of victims of violent acts (wars, terrorism, etc.). As noted in the Human Development Report 2006, denial of access to water, like hunger, is silent the crisis facing the poor and condemning them to greater poverty, inequality and vulnerability ¹⁹.

Despite the global nature of the problem of water supply and sanitation, it does not occupy any prominent place on the international agenda, unlike, for example, the strong response of the world community to the HIV pandemic/AIDS or the issue of "Education for all". Nevertheless, it is one of the MDG targets, which aims to halve the proportion of people who do not have permanent access to clean drinking water and basic sanitation by 2015. At the current rate of development, sub-Saharan Africa is projected to meet its water targets only by ²⁰⁴⁰, and its sanitation targets by 2076.2 A very different picture is being observed in North Africa, which reached the target of providing safe drinking water and sanitation facilities in 2010.

In terms of improving the lives of slum dwellers in developing countries, the proportion of the urban population living in slums has fallen from 46% to 33% over the past 20 years. The highest prevalence of urban slums among developing regions is found in SSA countries (62% in 2010), although it has declined since 1990 (70%). The situation is particularly difficult in conflict-affected countries in Africa , where the proportion of the urban population living in slums increased from 64% to 77% between 1990 and 2010.21 Improving the living conditions of the poorest, whose numbers continue to grow in all cities in the developing world, requires the development of a long-term and more realistic program that goes beyond this MDG target, and serious efforts on the part of the State.

GLOBAL PARTNERSHIP FOR DEVELOPMENT: PROMISES AND REALITY

The last, eighth MDG is to build a global partnership for development. In fact, this is not a goal (unlike the first seven), but a tool for achieving the MDGs, since these goals cannot be achieved without the assistance of developed countries by strengthening global partnerships within the framework of international cooperation. While the main burden of responsibility for achieving the MDGs lies with developing countries, international support and assistance from developed countries is crucial, especially for the poorest countries. Specific tasks under the glo goal-

The goals of the global partnership include increased official development assistance (ODA), access to developed country markets, and debt relief.

According to Russian researcher G. E. Roshchin, ODA is the most important component of financial resources coming to sub-Saharan Africa from abroad. ²² In 2010, net ODA to all developing countries reached the highest level ever - almost $130 billion, or 0.32% of gross national income (GNI) developed countries*²³. However, aid levels are lagging behind commitments made in 2005 at the Group of Eight Summit (Gleneagles) to increase aid by 2010. ODA of $50 billion, including $25 billion for Africa. As of 2010, the total deficit was $21 billion, which affected, first of all, aid to African countries, which did not receive $18 billion. It is assumed that the region as a whole will be able to receive no more than $11 billion. of the additional $25 billion pledged at Gleneagles. There is a clear failure to meet the full obligations of some donor countries, most of whose aid was intended for African countries. If these commitments were met, aid to African countries would now amount to almost $64 billion. instead of $46 billion. (in current prices)²⁴.

As for the least developed countries (LDCs), they receive about one third of the total amount of aid from donor countries. According to the latest data, in 2009, the Organization for Economic Cooperation and Development (OECD) member countries provided $37.6 billion in ODA to LDCs, which is 0.1% of their total GNI, and this is much lower than the UN target of 0.15-0.20% set for these countries. In absolute terms, the deficit is between $21 billion and $40 billion.²⁵

Overall, ODA remains concentrated in a very limited number of countries. The top 10 recipients of aid received through the OECD Development Assistance Committee (DAC) account for about a quarter of its total volume, while the top 20 account for 38%. At the same time, many countries do not receive it even in the minimum required amount. The largest recipients of ODA in sub-Saharan Africa are Ethiopia, Tanzania,Côte d'Ivoire, DRC, Sudan, Mozambique, Uganda, Kenya, Nigeria, Ghana and Zambia. ²⁶

The prospects for ODA are also worrisome. Thus, according to a recent OECD survey, financial constraints imposed in a number of donor countries are expected to sharply slow the growth rate of ODA to developing countries, including Africa, to 1% per year in 2011-2013, compared with 13% growth in the previous three years.²⁷ It is not yet clear how this fits in with the promises made at the last UN MDG Summit (September 2010) to raise aid levels to the UN target of 0.7% of GNI by 2015.

The United Nations Millennium Declaration (2000) calls for an "open, fair, regulated, predictable and non-discriminatory multilateral trading and financial system".²⁸. The Doha Round of negotiations of the World Trade Organization (WTO), which was launched in 2001 mainly to achieve this goal, is currently stalled due to serious disagreements on a number of positions and, according to UN analysts, is on the verge of collapse, which calls into question the commitment of the world community to the ideas of the multilateral system.

Overall, the international trade situation, especially with regard to developing countries 'access to developed countries' markets, is as follows. Currently, a significant proportion of exports from developing countries (about 80%) are imported by developed countries on a duty-free basis, reflecting the overall liberalization of world trade. However, since 20% of exports are still subject to duties and tariffs on developing-country exports have barely been reduced since 2005, serious obstacles remain in the way of these exports. In addition, for LDCs, most of which are located in Africa, the export situation has not improved since 2004, with the exception of some agricultural commodities.²⁹

Tariffs on goods of strategic importance to developing countries, such as textiles and agricultural products, continue to be high, while developed countries provide huge subsidies to their rural producers. Rich countries spend three times as much on subsidizing their agriculture as on ODA to all developing countries (according to the latest data, the volume of agricultural subsidies of OECD member countries in 2010 was $366 billion, or 0.85% of their total GDP).³⁰. What kind of fair and non-discriminatory multilateral trade can we talk about in such an environment? Indeed, agricultural subsidies to local producers in developed countries have a very negative impact on production and trade in developing countries, including LDCs, limiting their access to world markets, depriving local farmers of income and reducing their production, which ultimately affects the food security of these countries. Achieving the MDG target of market access in developed countries and the successful conclusion of the WTO Doha Round requires removing all barriers to exports from developing countries, including reducing customs duties and reducing subsidies to agricultural producers in developed countries, and this requires, above all, political will.

The external debt burden reduces the State's ability to pay, hinders its economic growth, and hinders efforts to reduce poverty. As the experience of the 2000s has shown, improved debt management, trade development, and a significant increase in the number of foreign direct investment projects.-

* Recall that the UN target for ODA is set at 0.7% of the GNI of developed countries. To date, only five donor countries have reached or exceeded this level: Denmark, Luxembourg, the Netherlands, Norway and Sweden.

Large-scale external debt write-offs, especially for the poorest countries, have helped to reduce the burden of regular external debt repayments.

The key indicator of debt sustainability set as the MDG target for the global partnership is the ratio of external debt service payments to export earnings. According to the latest estimates, in 2010 this ratio decreased to the pre-crisis level almost everywhere, which was largely due to the overall improvement in the export situation. For example, in SSA countries, the debt service ratio declined from 9.4% in 2000 to less than ³% in 2010.3 The situation is worse in LDCs and small island developing States, where this indicator has either increased or decreased slightly.

So far, of the 40 countries eligible for debt relief under the Heavily Indebted Poor Countries Initiative (HIPC), 36 countries have reached the decision point, and their future external debt payments have been reduced by $59 billion. 32 of these 36 countries (including 26 African countries)* that have reached the end of the process have received an additional $30 billion in debt relief. as part of the Multilateral Debt Relief Initiative (MDRI). Four SSA countries (Chad, Comoros, Côte d'Ivoire and Guinea) are in the interim phase between decision-making and completion, while three more (Somalia, Sudan and Eritrea) are in the pre - HIPC phase. Both initiatives are aimed at channeling the funds released to meet the urgent challenges of the MDGs, in particular the fight against poverty, hunger and unemployment, the development of social infrastructure, etc. ³²

Debt relief has already allowed some countries to increase spending on health, education and other social services. For example, the Ministry of Health of Burundi increased its budget 4-fold between 2005 and 2007, successfully using the funds that became available as a result of HIPC debt cancellation, and in Zambia, free medical care was introduced for rural residents ⁱⁿ 200633.

However, while progress has been made in implementing debt relief programmes, most of the existing debt relief initiatives are already coming to an end, and a number of low-and lower-middle-income countries are still in or at risk of a debt crisis. According to the latest IMF estimates, there were 19 such countries at the beginning of 2012, including 12 HIPC countries. African countries include Burkina Faso, Burundi, the Democratic Republic of the Congo, Comoros, Cote d'Ivoire, Djibouti, Gambia, Guinea, Sudan, and Zimbabwe. ³⁴ In order to seriously address the debt problem of developing countries, UN experts propose extending the duration of initiatives, defining more flexible debt cancellation conditions, and creating a new mechanism for debt relief. timely action on each individual debt-

Overall, the global community still has a lot to do in the remaining three years to 2015. Achieving the MDGs by this deadline will require donors to urgently implement their aid commitments, increase market access and ease the debt burden of developing countries. According to UN Secretary-General Ban Ki-moon, "in the period up to 2015, we must ensure that these promises are fulfilled. Otherwise, it is fraught with grave consequences that will result in death, illness, unfulfilled hopes, wasted suffering and lost opportunities for many millions of people. " ³⁵

¹ The Millennium Development Goals Report 2011. UN, N.Y., 2011, p. 24.

² Ibid., p. 24 - 25.

³ The situation of children in the world 2012. Children in an urbanized world. UNICEF. New York, 2012, pp. 88-90.

⁴ Ibid., p. 91.

⁵ Overview of Economic and Social Conditions in Africa, 2011. UN, N.Y., 2011, p. 16.

⁶ www.thelancet.com. Vol. 376. September 18, 2011, p. 943.

⁷ The situation of children in the world 2012.., p. 89.

^{Grishina N. V.} 8 Healthcare in Tropical Africa (social aspects). Moscow, IAfr RAS Publ., 2010.

⁹ The Millennium Development Goals Report.., p. 28.

¹⁰ The situation of children in the world 2012.., pp. 116-118.

¹¹ Overview of Economic and Social Conditions in Africa.., 2011, p. 16.

¹² The Millennium Development Goals Report 2011... p. 36 - 37.

¹³ Report on the Global Aids Epidemic 2010. UNAIDS. Geneva, 2010, p. 186.

¹⁴ Ibid., p. 180.

¹⁵ World Malaria Report 2011. WHO. Geneva, 2011, p. viii.

¹⁶ Ibid., p. 74; The Millennium Development Goals Report.., p. 42.

¹⁷ The Millennium Development Goals Report 2010. UN. N.Y., 2010, p. 51; The Millennium Development Goals Report 2011.., p. 46.

^{Abramova I. O., Fituni L. L.} 18 The price of "blue gold": the problem of water resources in the modern socio-economic development of Africa // Asia and Africa Today, 2008, N 12; The Millennium Development Goals Report 2010.., p. 58, 61.

¹⁹ Human Development Report 2006. UNDP. N.Y., 2006, p. 1.

²⁰ Ibid., p. 7.

²¹ The Millennium Development Goals Report 2011... p. 57.

^{Roshchin G. E.} 22 Afrika i mezhdunarodnaya pomoshch [Africa and International Aid].

²³ The Millennium Development Goals Report 2011.., p. 58.

²⁴ Ibid., p. 59; Global Partnership for Development: Time to deliver on promises. UN. New York, 2011, p. 15.

²⁵ Ibid., p. 15. ²⁶ Ibid., p. 25.

²⁷ The Millennium Development Goals Report 2011.., p. 60.

²⁸ United Nations Millennium Declaration. UN. New York, 2000, p. 5.

²⁹ Global Partnership for Development, p. xv.

³⁰ Ibid., p. 45.

³¹ Ibid., pp. 53-54.

³² Там же; Report on the Progress in Achieving the Millennium Development Goals (MDGs) in Africa, 2011. ECA. Addis Ababa, 2011, p. 10.

³³ World Health Report, 2008. Primary health care. WHO. Geneva, 2008, p. 118.

³⁴ Global Partnership for Development, p. 57.

³⁵ The Millennium Development Goals Report 2011...

* Benin, Burkina Faso, Burundi, Cameroon, DRC, Gambia, Ghana, Guinea-Bissau, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Niger, Republic of the Congo, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Tanzania, Togo, Uganda, Zambia, Ethiopia.

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