The COP29 climate meeting in Baku, the capital of Azerbaijan, formally concludes on Friday, November 22, 2024.
As COP meetings come and go, the Baku meeting has been a damp squid. By the time it ends, it will have been attended by nearly 50,000 delegates. That is half the nearly 100,000 who attended COP28, which took place in 2023 in Dubai, United Arab Emirates – the highest number ever.
Some have argued that Azerbaijan was a terrible venue, because it is a petrostate ruled by President Ilham Aliyev, described as leading “an authoritarian regime; elections are not free and fair, political power is concentrated in the hands of Aliyev and his extended family, corruption is rampant, and human rights violations are severe”. The UAE is really not much different; it is only beginning to grow out of being a petrostate, and is less a democracy than Azerbaijan. Sure, Baku is nowhere as shiny as Dubai, and isn’t a great shopping destination, but it has a good view, seated as it is on the coast of the Caspian Sea, the largest inland body of water in the world.
While nearly all United Nations member states sent delegates to Baku, the absence of big power leaders was notable. US President Joe Biden did not attend; China’s President Xi Jinping didn’t show; France’s President Emmanuel Macron didn’t rock up; Germany’s Chancellor Olaf Scholz was absent due to the collapse of his ruling coalition; Brazil’s President Luiz Inácio Lula da Silva cancelled after a head injury; European Commission President Ursula von der Leyen was missing in action, and good old Russian President Vladimir Putin did not go either.
Leading economies
The leaders from several of Africa’s leading economies and most populous nations also didn’t pitch up.
South Africa’s President Cyril Ramaphosa did not attend; Nigeria’s President Bola Tinubu was nowhere to be seen; Egypt’s Abdel Fattah El-Sisi, who hosted COP27 in 2022, and Ethiopian Prime Minister Abiy Ahmed, hadn’t punched the clock as of the time of writing. Kenya’s President William Ruto, who has taken an active stance on climate change issues and has hosted a couple of save-the-planet conferences, did not personally attend. Countries like Morocco, Tunisia, Côte d’Ivoire, Angola, were also represented by vice presidents or ministers.
The short of it is that the leaders of the world’s leading polluters weren’t in Baku to have fingers wagged in their faces. China is by far the largest emitter of CO₂, followed by the US, India, the EU, and Russia. In Africa, the leading polluter countries are South Africa, Nigeria, Egypt, Algeria, Angola and Morocco.
Perhaps it shouldn’t be surprising. The world is in great turmoil. Right wing populist leaders are being swept to power in many parts of the world by voters who are fed up and angry with the “neo-liberal” order that has dominated the world in the last 30 years. These leaders are not tree huggers, and don’t give a hoot about windmills or elephants dying in Africa’s drought-ravaged savannahs.
The horrors of war are everywhere, competing with climate change catastrophe; the Israel-Palestine atrocities; the madness in Sudan; the Sahel is on fire; the highest number ever of refugees and internally displaced persons in the world.
In Africa, southern Africa has been hit by the worst drought in 70 years, and lakes and rivers have run dry, leading to a seizure of hydropower dams. Several regions of Africa have seen their worst floods in generations. Perhaps for some African chiefs, going to Baku to debate the perils of climate change in these circumstances, would be like the hated emperor Nero playing the fiddle as Rome burns.
Africa suffers a great environmental injustice. It contributes significantly less to global greenhouse gas emissions (less than 4 per cent) than other continents, yet it suffers disproportionate impacts from climate change. Africa is warming at about 1.5 times the global average rate.
Historical data shows that Africa has had a 34 per cent decline in agricultural productivity growth since 1961 due to climate variability. The Horn of Africa recently faced its worst drought in 40 years, affecting millions. In 2022, weather, climate, and water-related hazards caused over US$8.5 billion in economic damages in Africa, with more than 110 million people directly affected.
It is projected that crop yields on the continent could fall 2.9 per cent by 2030 and 18 per cent by 2050 under current climate change trajectories. The African Development Bank estimates that climate change could reduce gross domestic product (GDP) growth by up to 3 per cent annually by 2050 in sub-Saharan Africa. Projected damages in major African cities could reach US$65 billion by 2050 for moderate climate change scenarios. And climate change is expected to displace 86 million Africans within their own countries by 2050 due to factors like sea-level rise, drought and flooding.
Battered by some of the harshest repercussions of climate change, Africa urgently needs both global mitigation efforts and robust local adaptation strategies. Hopefully, prayerful leaders like President Ruto who stayed home, did the right thing. At this point, anything helps.
The author is a journalist, writer, and curator of the “Wall of Great Africans”. X(Twitter)@cobbo3
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Inside Tanzania’s Life-Saving Birthcare Model
Tanzania is winning the battle against maternal and newborn deaths, as the latest numbers reveal a significant decline.
“Tanzania is committed to reducing maternal and newborn mortality and ensuring safe deliveries as part of the national development plan. The Safer Births Bundle of Care is one of the key strategies supporting this effort,” said Dr. Benjamin Kamala, the Senior Research Scientist at Haydom Lutheran Hospital and Principal Investigator for the program, leading its implementation across five regions in Tanzania.
A groundbreaking study published in the New England Journal of Medicine shows that the innovative health program in Tanzania – centered on regular, on-the-job training for healthcare workers – reduced maternal deaths by 75% and early newborn deaths by 40%. The three-year study, conducted across 30 high-burden healthcare facilities in Tanzania, tracked approximately 300,000 mother-baby pairs under the Safer Births Bundle of Care (SBBC) programme. The programme focuses on improving care for mothers and babies during the day of birth, the critical time when a woman goes into labor and delivers her baby.
Maternal health is a key focus of the United Nations Sustainable Development Goals (SDGs), specifically Target 3.1, which aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.
Tanzania’s program combines continuous, simulation-based training for frontline healthcare workers alongside innovative clinical tools to improve labour monitoring (fetal heart rate monitoring) and newborn resuscitation.It also uses data to drive ongoing improvements, ensuring that healthcare workers have the skills, confidence, and competence to manage birth-related complications for both mothers and newborns.
“We work closely with healthcare workers, equipping them with the necessary tools to improve the quality of care, ensuring they can effectively manage both mothers and babies during and after childbirth,” Dr. Kamala said, which helps them build on over a decade of innovative research and collaboration to improve care during childbirth.
“To give you a sense of the scale of the burden of maternal and newborn mortality in Tanzania when the Safer Births Bundles of Care program was in early development in 2015/16, there were around 556 maternal deaths per 100,000 live births and 25 neonatal deaths per 1,000 live births,” he said.
The published study demonstrates the “transformative impact” of the Safer Births Bundle of Care program conducted across 30 hospitals in five high-burden regions of Tanzania, where there were about 300,000 mother-baby pairs.
Maternal deaths at the start of the program were recorded at 240 per 100,000 live births, with postpartum hemorrhage and hypertensive disorders being the leading causes of death, he said. Over the 24-month study period, this number dropped to approximately 60 per 100,000 live births, representing a 75% reduction. The number of newborn deaths – which are primarily due to breathing difficulties and complications related to prematurity – declined by 40% – from 7 deaths per 1,000 live births to 4 deaths per 1,000 live births.
“These results are remarkable,” Dr. Kamala said.
According to Dr. Kamala, the 75% reduction in maternal deaths was not expected, and a key lesson was the important role of the in-situ team simulations – including for postpartum bleeding – with reflective debriefings that trained facilitators led.
“This seems to be a major part of the success of the program,” he said. “We are delighted by these results and hope that other countries adopt and scale the Safer Births Bundle of Care program… Beyond the numbers, the Safer Births Bundle of Care program has fostered a dramatic culture shift in our healthcare system,” he said. “Healthcare workers are now more confident and better equipped to handle birth-related complications for both mothers and babies.”
Maternal death drop
Dr. Kamala attributed the 60-70% reduction in newborn deaths in Geita and Manyara to several factors.
“Firstly, Manyara was the first site for implementation, giving the region more time to adapt and experience the impact of the program. Most importantly, both regions had a high burden of stillbirths and neonatal deaths, making them ideal targets for focused intervention. As a result, newborn deaths decreased by 60-70%, showcasing a clear positive impact on newborn survival,” he said.
Dr. Kamala said another possible explanation is the differences in the culture of practices, where some health facilities reported inaccurate data due to the fear of blame and shame. However, with the project’s implementation, reporting became more accurate after mplementation. Some regions, such as Tabora, reported an increase in the number of referrals to the study hospitals from other care centers after the program was implemented. These were more likely to be late admissions, which increase the likelihood of poor health outcomes, he said.
After the implementation of the program, there was a 40% decrease in newborn deaths within the first 24 hours after birth, according to the study.
Dr. Kamala said Tanzania’s remarkable progress in reducing maternal mortality by 80% is driven by strategic investments and innovative programs focused on improving maternal and child survival rates.
“Over 2,000 new healthcare facilities have been developed, free health services are being provided to expectant mothers and children under the age of five, and emergency obstetric care – including better transport to hospitals in rural areas are helping to ensure timely, life-saving interventions.
“Most importantly, the Ministry of Health works in collaboration with healthcare workers, hospitals, and development partners to strengthen the skills of frontline healthcare workers, which has been a key factor in driving this progress.
“Political leadership, alongside strategic partnerships and financing, has been crucial in driving progress in maternal and newborn health,” he said.
The program was made possible by the support of the Global Financing Facility for Women, Children, and Adolescents, Norad, UNICEF, and Laerdal Global Health, as well as the Ministry of Health and Haydom Lutheran Hospital. Their partnership and investment enabled the scaling of the Safer Births Bundle of Care to 30 hospitals and supported the research. “The government has now scaled the program to over 150 sites, and there are plans for further expansion to three regions this year and then nationally,” he said.
Dr. Kamala outlined key policy recommendations for other governments can adopt to prioritize maternal health.
“Firstly, it focuses on cost-effective and relatively simple interventions that are essential to preventing maternal and newborn deaths. For example, stronger primary healthcare that is delivered in the community and a well-trained healthcare workforce are also critical. Additionally, working in close collaboration with national, regional, and local health authorities is key.”
He said Tanzania’s approach, where the Safer Births Bundle of Care program was successfully scaled and sustained by aligning the initiative with national guidelines for obstetrical and newborn care. In addition, the creation of mentorship programs and regular supervision has helped to sustain the results.
Looking ahead
Tanzania now plans to expand to three new regions in 2025, followed by a nationwide rollout.
The success of the program has attracted interest from other countries, with Botswana, Ethiopia, Lesotho, and Namibia expressing interest in adapting the program to their healthcare system. In Nigeria, the program has already been launched in two states, Gombe and Borno, marking a significant step in its scaling.
Source: allafrica.com
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