Day: March 24, 2024

Geneva — In marking World Tuberculosis Day, the World Health Organization is calling for action to rid the world of this ancient scourge, which has sickened and killed millions of people throughout the ages.

This year’s theme, “Yes! We can end TB,” is intended to send a message of hope that ending the epidemic, which WHO says each year causes the deaths of some 1.3 million people, is possible.

While the disease is curable and preventable, heads of state at the 2023 U.N. high-level meeting on TB estimated that $13 billion was needed every year for prevention, diagnosis, treatment, and care to end the epidemic by 2030.

The heads of state, who pledged to accelerate progress to end TB and to turn these commitments “into tangible actions,” approved a series of global targets for moving this process forward.

“These include reaching 90% of people in need with TB prevention and care services, using WHO-recommended rapid tests and the first method of diagnosing TB, and providing a health and social benefit package to all people with tuberculosis,” said Dr. Tereza Kasaeva, director of WHO’s Global Tuberculosis Program.

“This is a watershed for the global fight to end tuberculosis. The next five years will be critical for ensuring that the political momentum we have now is translated into concrete action towards reaching global TB targets.”

Tuberculosis is the world’s second leading infectious killer after COVID-19, above HIV and AIDS. WHO reports 1.3 million people died from TB in 2022 and an estimated 10.6 million fell ill with the disease.

This is the highest number of new cases since the agency began monitoring the disease in 1995. WHO says the sharp rise may be linked to “delays in treatment caused by the COVID-19 pandemic.”

TB, an airborne disease, spreads when infected people cough, sneeze, or spit. It is present in all countries and age groups.

“Preventing TB infection and stopping progression from infection to disease are critical for reducing the incidence to the levels envisioned by the anti-TB strategy,” said Saskia Den Boon, technical officer, WHO Global TB Program.

“One of the key health care interventions to achieve this reduction is TB preventive treatment, which WHO recommends for people living with HIV, household contacts of people with TB and other risk groups.

“Strategies to provide preventive treatment are often linked to screening, to find and treat people earlier in the course of their disease and thus help to prevent transmission and improve outcomes,” she said.

In recent years, new tools developed and recommended by WHO are making TB screening more feasible. These include shorter preventive treatments of one or three months and a new antigen-based skin test for TB infection.

“For screening, WHO recommends the use of artificial intelligence or AI for the computer aided protection of tuberculosis abnormalities on chest x-ray among other tests,” said Den Boon.

WHO has released a modeling study that examines the costs and benefits of screening and preventive treatment in four countries — Brazil, Georgia, Kenya, and South Africa.

“The investment case studies showed that in all four countries, many TB episodes can be prevented, and lives saved by investing in TB screening,” Den Boon said.

“The modeling showed that relatively modest investments can achieve significant health and economic benefits in all four countries… From a societal perspective, the intervention package was cost-saving in all four countries. The return on investment varied between countries and was up to $39 gained for every dollar invested,” she said.

WHO scientists agree that early diagnosis is crucial to tackling, curing, and preventing the spread of tuberculosis. By the same token, they agree on the importance of developing new vaccines for prevention and eventual eradication.

Currently, only the BCG TB vaccine for children is available and it is 100 years old.

“Indeed, it is absolutely unacceptable that in the 21st century with a lot of innovations, we still do not have a new effective, TB vaccine,” said Kasaeva.

She said WHO’s director general, Tedros Adhanom Gebreyesus, launched a TB Vaccine Accelerator Council last year to bring attention to this problem and attract investments for research and development.

She said the U.N. high-level meeting is backing WHO’s initiative, adding, “This will make it possible to have new TB vaccines within the next five years.”

“We have more than 16 candidates in the pipeline, some of them in the later stages,” she said, “but we need more attention, more prioritization, more investments.”
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ALONG RIVER RWIZI, Uganda — Along a stretch of bush by a muddy river, laborers dug and slashed in search of bamboo plants buried under dense grass. Here and there a few plants had sprouted tall, but most of the bamboo seedlings planted more than a year ago never grew.

Now, environment protection officers seeking to restore a 3-kilometer stretch of the river’s degraded banks were aiming to plant new bamboo seedlings, clear room for last year’s survivors to grow and look after them better than they did the first time.

A successful bamboo forest by the river Rwizi — the most important in a large part of western Uganda that includes the major city of Mbarara — would create a buffer zone against sand miners, subsistence farmers and others whose activities have long threatened the river. The National Environment Management Authority estimates that the Rwizi has lost 60% of its water catchment area over the decades, and in some areas this winding river runs as narrow as a stream.

“Once bamboo is established, it is almost like a net,” said Jeconious Musingwire, an environment officer who was the project’s technical adviser. “The roots trap everything, including the surface runoff, and stabilize the weaknesses of the banks.”

Uganda is seeing growing interest in bamboo, a perennial plant cultivated in many parts of the world. It can be burned for fuel in rural communities, taking pressure off dwindling forest reserves of eucalyptus and other natural resources. It’s a hardy plant that can grow almost anywhere. And businesses can turn it into products ranging from furniture to toothpicks.

Some of the bamboo species grown in Uganda are imported from Asia, but many — like one whose shoots are smoked and then boiled to make a popular traditional meal in eastern Uganda — grow wild.

The Ugandan government has set a 10-year policy that calls for planting 300,000 hectares of bamboo, most of it on private land, by 2029 as part of wider reforestation efforts.

That’s an ambitious target. The Uganda Bamboo Association, the largest such group with 340 members, has planted only 500 hectares. Even with growing interest in bamboo farming, authorities will have to encourage more farmers in rural parts of Uganda to plant vast tracts of land with bamboo.

But signs are promising.

Not far from the scene where laborers were tending bamboo plants sits a large commercial farm that includes seven acres of bamboo. The plants at Kitara Farm were well-tended, and a stockpile of 10,000 bamboo poles sat waiting to be sold.

Caretaker Joseph Katumba said the property has become something of a demonstration farm for people who want to learn more about bamboo. He recalled that when they first began planting bamboo in 2017, some people asked why they were “wasting land” by planting bamboo when it grows wild in the bush.

Katumba said that’s changed, with skeptics now interested in planting bamboo “because they have studied it and they love it.” Unlike eucalyptus — a tall flowering plant widely planted here for its timber — “there is no bamboo season. The more you look after it well, weeding around it, the more and more years you will earn from bamboo.”

Bamboo grows faster than eucalyptus and regenerates like a weed. It also can thrive in poor soil. Kitara Farm stopped planting new eucalyptus lots while its bamboo acreage continues to expand, he said.

“We have so many eucalyptus forests. But we realized that once you cut the eucalyptus trees, eventually they get finished, and once they are finished there is no more money,” he said. “But with bamboo, we investigated and found out that when you plant it … the grandkids and their grandkids and their grandkids will earn from bamboo.”

A single bamboo pole brings a little less than a dollar, so farmers need to grow a lot to earn enough. Bamboo promoters are urging them to see a bamboo plantation as the same kind of cash crop as coffee or tea estates. Banks are offering bamboo “plantation capital” to clients, loans that promise ownership of substantial acres of bamboo.

“Each person should actually plant bamboo, and a lot of it,” said Taga Nuwagaba, a bamboo farmer and businessman who owns a bamboo furniture factory near the Ugandan capital of Kampala. He touts the plant as a a renewable resource that sequesters carbon, too.

“You cut one, five will grow,” he said.

Bamboo plants are normally ready for harvesting in three to five years, and a well-maintained plantation can be useful for at least 50 years, said Jacob Ogola, an agronomist who is working as a consultant at Kitara Farm. He said bamboo is easy to manage, and typically doesn’t need spraying for pests.

Bamboo seedlings are now more widely available via private nursery beds.

Steve Tusiime, a self-described bamboo collector, owns one such nursery in Mbarara. Tusiime said he’s been fascinated by the plant since seeing one as a boy. Before he got into growing, he recalls traveling to a farm in central Uganda to “hug” bamboo plants, and in 2018 spending his own money to attend a bamboo convention in China, where he got his first bamboo seeds.

Standing on another stretch of land by the river Rwizi where he and his partners have created a bamboo park in a recreation resort still to be commissioned, he waxed lyrical about how bamboo “energizes” him.

“Each bamboo you see here has a story. It has where it comes from and it has different use and it has a different name,” he said. “When you come here the story is bamboo. You learn about different species, different uses. You see different features of bamboo.”

Still, Uganda’s bamboo plantations aren’t growing fast enough to build an industry around the plant. Tusiime’s nursery has sold fewer than 10,000 seedlings in the past two years, confounding his own assessment of bamboo as an important cash crop which also happens to benefit the environment.

“Bamboo can be a future tree for Uganda or for even Africa. For example, you’ve heard people talking about charcoal and firewood and this and that. Bamboo is a better solution,” he said. “You can produce the briquette, you can use it directly as firewood. Bamboo is going to be a game changer in Africa. You can eat bamboo, you can use it to build, you can create an industry for bamboo, you can feed it to your animals, and it can take care of your land.”
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BENGALURU, India — Abinaya Tamilarasu said her four cows are part of the family. She has a degree in commerce from a local college, but prefers being home milking cows and tending to her family’s land.

“Our family cannot let farming go, it’s a way of life for us,” said the 28-year-old, who lives on her family farm in India’s southern Tamil Nadu state. Even when she could be making more money elsewhere, she said she’s “still happy we have our cows.”

India is the world’s largest milk producer, and is home to 80 million dairy farmers who made 231 million tons of milk last year. Many farmers, like Tamilarasu, only have a few cows, but the industry as a whole has 303 million bovine cattle like cows and buffalo, making it the largest contributor to planet-warming methane emissions in the country. The federal government has made some positive steps to reduce methane, but wants to focus emissions cuts elsewhere, like by moving to renewable energy, saying most methane emissions are a fact of life. But experts say the industry can and should make more reductions that can quickly limit warming.

India is the third-largest emitter of methane in the world, according to figures published earlier this month by the International Energy Agency, and livestock are responsible for about 48% of all methane emissions in India, the vast majority from cattle. Methane is a potent planet-warming gas that can trap more than 80 times more heat in the atmosphere in the short term than carbon dioxide.

The Indian government has not joined any global pledges to cut methane emissions, which many see as low-hanging fruit for climate solutions, as methane emissions only last in the atmosphere for about a dozen years, compared to CO2 that can linger for a couple of hundred years.

But there’s some work on methane reduction in agriculture on the national level: The government’s National Dairy Development Board, which works with more than 17 million farmers across the country, is looking into genetic improvement programs to provide more nutritious feed to livestock which would make cows more productive, meaning each farmer would need fewer cows to produce the same amount of milk. Studies by the NDDB show that emissions are reduced by as much as 15% when a balanced diet is provided to the animals.

The board is also looking into reducing crop burning, a high-emitting practice that some farmers use to clear their lands, by feeding those crops to cows.

“Climate-smart dairying is the need of the hour,” said Meenesh Shah, the board’s chairman.

Vineet Kumar, from the New Delhi-based Centre for Science and Environment, agreed that good quality feed can help lower emissions. He also said encouraging more local breeds that emit less can help. “These solutions can be a win-win for everyone,” he said.

But Thanammal Ravichandran, a veterinarian based in the southern Indian city of Coimbatore, noted that there’s currently a shortage of feed in India, so farmers give their cattle whatever they can, which is mostly lower quality and higher emitting.

“Farmers are also not able to invest in better quality feed for their cattle,” she said. To get better, and more affordable feed, dairy farmers need more government support, she said.

Whatever measures are taken to reduce methane emissions, experts note that it should have minimal impact on farmers’ livelihoods, and should account for the ways people raise their livestock.

“Livestock have been closely integrated within the Indian farming system,” said Kumar, meaning any drastic changes to farming methods would have severe effects on farmers. He added that efforts to reduce emissions shouldn’t reduce the use of cow manure as fertilizer on India’s farms, as chemical fertilizers emit nitrous oxide, an even more potent greenhouse gas.

But looking at India’s methane emissions as a whole could provide some more obvious solutions to slashing the gas, said Bandish Patel, an energy analyst at the climate thinktank Ember. Focusing on the energy sector is an easy win for targeted reduction of methane emissions, he said.

“You look at agriculture, those emissions are very dispersed in nature, whereas, with oil, gas and coal mining, there are very pointed sources from which you can basically reduce methane going forward,” he said.

Shah from the NDDB added that India’s high agricultural emissions must be considered in the context of the country being home to the world’s largest cattle population, the largest producer of milk, and the largest rice exporter, as rice production also produces significant methane emissions.

“In this light, India’s agriculture sector emissions must be considered significantly low,” Shah said. Because of its large population, India’s per capita emissions are well below average.

For dairy farmers like Tamilarasu, better welfare for her cows and programs for farmers to have better practices are welcome, but she won’t be leaving her cows for the climate any time soon. She plans to continue dairy farming for the foreseeable future.

“The way we see it, our cows and us support each other. If we can make their lives better, they will make ours better too,” she said. 
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