Risk-sensitive urban development is required to reduce accumulated risk and to better consider risk when planning new developments. To deliver a sustainable city for all requires a more frank and comprehensive focus on procedure: On who makes decisions, under which frameworks, based upon what kind of data or knowledge, and with what degree and direction of accountability? Acting on these procedural questions is the promise of transformative urban development. This paper explores the status of risk sensitive and transformative urban development and the scope for transition towards these components of sustainability in urban sub-Saharan Africa through the lens of diverse city cases: Karonga (Malawi), Ibadan (Nigeria), Niamey (Niger) and Nairobi (Kenya). The paper draws from a 3-year research and capacity building programme called Urban Africa: Risk Knowledge that aims to address gaps in data, understandings and capacity to break cycles of risk accumulation. A common analytical framework is presented to help identify blockages and opportunities for transition towards a risk-sensitive and transformative urban development. This framework is then illustrated through each city in turn and a concluding discussion reflects on city observations to draw out recommendations for city level and wider action and research partnerships.
Urban development in the last four decades has brought a complete change to the urban image of Gaborone. Its original savannah landscape and surrounding green complexion has changed by cumulative impacts of numerous factors involved in creation of a contemporary settlement, from a small village to the capital city of Botswana. The concept of a "garden city" was introduced immediately after the country gained its independence from the British in 1966. Building on the legacy of "garden city", it was assumed that the "new town" will continue to shape and gain recognition as an urban oasis. However, this was not the case and Gaborone became the fastest growing urban laboratory in Sub-Saharan Africa, portraying intensive diffusion and adoption of imported urban models (WARD, 1999). The spectacular population increase from only 7,000 people in 1966 to almost 200,000 in 2001, and urban sprawling were inevitable. This enlargement was fuelled by rural-urban migration owing to the administrative and economic status of Botswana's new capital, as well as, due to intensive urbanization, industrialization and transportation based on individual car use. Even in the latest city development plan (GoB, 2001) less attention has been paid to the role of green networks and areas, and their contribution to many ecological and societal values. Today, Gaborone is facing the challenge of the typical problems of mega-cities, such as environmental degradation, urban sprawl. The research project DIMSUD is dedicated to identify ways toward sustainable urban development, starting with an analysis of challenges, and continuing with the tasks for urban planning and opportunities for sustainable urban development.
RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.
Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.