ISSN 1024-0802

M e d i t e r r a n e a n • A f r i c a • A s i a • L a t i n A m e r i c a • E l s e w h e r e

Special INCO issue – July 2005

NoticeNeither the European Commission, nor any person acting on its behalf,may be held responsible for the use to which information contained inthis publication may be put, or for any errors which, despite carefulpreparation and checking, may appear.© European Communities, 2005Non-commercial reproduction authorised, subject to acknowledgementof source.

A magazine providing information on European research, RTD info ispublished in English, French and German by the Information andCommunication Unit of the European Commission’s Research DG.Editor in chief: Michel ClaessensTel. : +32 2 295 9971Fax: +32 2 295 8220E-mail : research@cec.eu.int

84 000 copies of this issue were published.All issues of RTD info can be consulted on-line at the Research DG’s website:europa.eu.int/comm/research

The Union’s policy4 Europe as a partner

in world scienceInterview with Louis Bellemin, Head of theInternational Scientific Co-operation Policy Unit atDG Research until May 2005.

MEDITERRANEAN

Sustainable development8 One sea, three continents

Desertification, drought, depleted soils, disappearingforests… All the regions bordering the Mediterraneanare facing these same crucial issues. The 13 countriesconcerned are now looking at how to tackle themwithin the MedCoastLand project.

Cultural heritage10 A shared heritage

Multidisciplinary Arab and European part-ners working on the Hercomanes projectare taking steps to classify and conservethe early 20th century architectural her-itage in Syria and Egypt.

Epidemiology12 The price of change

Chronic diseases (cancers, cardiovascu-lar disease, etc.) are causing a risingdeath toll in the developing countries. Teams work-ing on the Tahina project are looking at the reasonsfor this epidemiological transition in Algeria andTunisia.

AFRICA

Poverty diseases 16 New ‘clinical partnership’

to fight a triple plagueAids, tuberculosis and malaria cause 6 million deathsa year in Africa. By organising clinical trials in thefield, the European Developing Countries ClinicalTrial Programme is contributing to the fight againstthese diseases.

Animal health19 The ravages of ticks

Over the past eight years the InternationalConsortium on Ticks and Tick-borne Diseases and its150 researchers from all over the world have beengathering data and facilitating the sharing of know-ledge on ticks, the scourge of sub-tropical and trop-ical regions.

Natural resources20 Water management

Home to almost a sixth of the world’spopulation, Africa has just 9% of globalwater resources. Various research projects are nowlooking at management of this vital resource.RTD info puts the spotlight on the Okavango, thethird largest river in southern Africa.

22 The virtues of seaweedThe Seaweed Africa project is compiling avast database of the different species ofAfrican algae – a precious resource in thefields of medicine, food, agriculture andenvironmental monitoring.

ASIA

Health services24 Health report on

Chinese citiesRapid socio-economic developments in China,especially in its towns and cities, have changed itspublic health system. European and Chineseresearchers are studying its fairness and equity inthe port of Nantong and the industrial city of Zibo.

Subsistence economy26 The suburban fields

Peri-urban agriculture and aqua-culture make a major contribution tothe diet and incomes of a whole section of Asia’spopulation. Nevertheless, such practices raiseenvironmental issues that are now being studiedby joint European and Asian teams.

Fisheries28 Integrating traditional know-how

In Asia, and also in Africa, the multidisciplinaryKnowfish project and its 19 partners aim toimprove the management of fishery resources bytaking into account the local practices of the vari-ous fishing communities concerned.

Natural disasters30 Lessons from the Red River

The Red River floods frequently, bring-ing loss of life and damage to prop-erty. Vietnamese, Thai, Chinese andEuropean scientists working on the Flocods pro-ject have developed a decision-support tooldesigned to provide an improved response to ris-ing waters.

LATIN AMERICA

Agronomy32 Maize adapted to the Tropics

The world’s third most cultivated cereal, maize isvery sensitive to the acid soils which are commonin the tropics. Research by the partners on the‘Maize for sustainable cropping systems’ projectare shedding new and promising light on certaincultivars that are resistant to these soils.

34 Combating ‘bean stress’50% of the world’s beans are grown in Central andSouth America. However, various types of abioticstress disturb the production of this highly nutri-tious and very popular leguminous crop.Researchers with the OpUsLi project have been

studying these phenomena with the aim ofselecting seeds that are better suited tothese regions.

Biodiversity36 Forests: a transcontinental inventory

Set up in 1991 by the EU as part ofpreparations for the Rio Convention,the European Tropical Forest ResearchNetwork was charged with improvingour knowledge of the tropical forestsso as to better protect them. RTD info looks at theresults to date, especially in the Brazilian Nordeste.

Environment38 Chemistry cleans river waters

Mercury pollution is poisoning many rivers inLatin America. European and LatinAmerican researchers on the Mercuryproject are tackling the problem byusing technologies based onsupramolecular chemistry.

ELSEWHERE

United States40 Transatlantic Bio-dialogue

For the past 15 years, the EU-US BiotechnologyResearch Task Force has formed a bridge across

the Atlantic. RTD info takes a close lookat a ‘win-win’ partnership that has donemuch in identifying the direction of sci-entific research in this area.

New Independent States42 SOS grey matter

The collapse of the Soviet Uniontriggered a mass exodus of some ofits best brains and the disintegrationof its scientific activities. Set up by the EU in1993, the INTAS association is seeking to helpNIS researchers overcome this major crisis.

Balkans44 The copper stakes

The Balkan Peninsular has majormineral resources, especially the oresused for copper extraction. This is anindustry that can play a major role in the socio-economic recovery of these countries – but onlyfollowing a drastic reduction in its negativeimpact on the environment, which is where theIntreat project comes in.

2 RTD in fo Spec ia l I N CO issue June 2005

THE EUROPEAN UNION’S SCIENTIFICAND TECHNOLOGICAL CO-OPERATIONON-LINE

To find out moreSixth Framework Programme (2002-2006)Europa Site: 00 europa.eu.int/comm/research/iscp/index_en.cfm00 Cordis Site: www.cordis.lu/fp6/inco.htm

INCO programme archives (International co-operation) Fifth Framework Programme (1998-2002)00 www.cordis.lu/inco2/00 www.cordis.lu/inco2/src/res-a-1.htm

Fourth Framework Programme (1994-1998)00 www.cordis.lu/inco/home.html00 europa.eu.int/comm/research/intco1.html

ContactINCO Information Desk00 inco@cec.eu.int

F E AT U R E S

RTD in fo Spec ia l I N CO issue June 2005 3

The sharing of knowledge throughscientific co-operation with theinternational community as awhole has been a feature of the Euro-pean Union’s research policy from theoutset. Over the years, it has assumed atriple dimension. First, there is the scien-tific and technological ‘assistance’granted to the developing world, dic-tated in part by the legacy of responsi-bility for research and higher educationinherited from the colonial past of cer-tain Member States and subsequentlyextended to others. A second key dimension came with the fall of theBerlin Wall and its effects both on Central and Eastern Europe, whichculminated in Union accession, and on the former USSR. Finally, thereis the intensification of research links with various partners in the formof the bilateral co-operation agreements concluded during the 1990s.

The year 2002 brought about a profound change with the launch ofthe Sixth Framework Programme and the emphasis on creating the Euro-pean Research Area (ERA). As an affirmation of the greater role the Unionis determined to give to its scientific and technological capacity in anincreasingly multipolar world, this new emphasis has shifted the focusaway from specific programmes devoted to international co-operationand towards a greater spirit of openness enabling researchers from allover the world to work together without barriers.

This new direction has created many rewards. It means a Europe thatis more welcoming to ‘imported brain power’, thereby increasing itspower of attraction as a universal pole and reference for science.(1) TheERA is also designed to achieve coordination between the international

scientific co-operation policies of each EUMember State. Finally, it supports Euro-pean strategies at global level and in theframework of major international agree-ments – whether UN or otherwise – andespecially in areas of external policy, suchas development aid, world health, theglobal environment, and global water,energy and transport problems.

In addition to the dynamic pursuit ofbilateral agreements, this new approachis based on dialogue – or rather on

any number of specific and differentiated dialogues – with groups ofpartners in various parts of the world to define concrete and targetedactions inspired by a shared vision. The Union’s international scien-tific co-operation is not limited to continuing progress in particularfields, whether it be developing a vaccine, improving a plant, efficientirrigation systems or whatever. Rather, it is rooted in a desire for thepartner countries to develop their own ability to generate knowledge,through training (researcher exchange), education, and the follow-up of research results.

This special issue presents successful co-operation projects, groupedaccording to some of the world’s principal regions. They are exampleswhich illustrate the various facets of the research partnerships to whichthe Union is a party worldwide.

�

(1) With systems of financial aid for foreign teams seeking to participate in European

research and host fellowships and return grants for individual researchers.

The internationalrole of research

Science knows no country,because knowledge belongs tohumanity, and is the torchwhich illuminates the world,”declared Louis Pasteur morethan a century ago. In an ageof the globalisation ofknowledge, together with itsapplications and transmissionthrough the information andcommunication technologies,this message of universalismrings truer than ever.

“

As the Community’s scientific and technological co-operation is neces-sarily linked to the European Union’s external policy, geopolitical devel-opments in some regions also caused us to diversify our approach. In thedecade following the fall of the Berlin Wall, for example, preparations forthe recent enlargement resulted in the implementation of important pro-grammes to restore the research potential of these Central and Eastern

European countries, which had become can-didate countries, and to include them in theEuropean Research Area. Another example isthe political change in South Africa thatenabled us to enter into a co-operation agree-ment with a country with which we had notpreviously co-operated in this way. On theother hand, events in the Former Yugoslaviacaused us to freeze co-operation in the 1990s.

In terms of figures, in the early 2000s morethan 3 000 projects were launched under theINCO research programme. These involvedaround 8 000 research teams and about40 000 partners, half of them Europeans andthe rest from third countries. Therefore, atthe time of launching the Sixth FrameworkProgramme we had a number of very impor-tant partnerships which provided the basisfor the most recent developments.

� Yet under the Sixth Framework Programme(2002-2006) resources allocated to co-operation seem to have been reduced…

Not at all. A new and much more openapproach has been introduced, in addition tofurther developing the approach pursued todate, that is, the specific actions of projects orsupport measures, defined in accordance with

the particularities of regional groups of countries, which are continuing.The point is that the international dimension is no longer confined to aspecific scientific and technological co-operation programme but is nowinherent in all Community research activities.

For the first time, researchers from any country in the world can partici-pate fully in all the principal research and development activities supportedby the Union. When these are not industrialised countries, the Commis-sion can even support this participation by intervening financially so thattheir scientists can join European consortiums.

The principal criteria for deciding Community intervention of courseremain common interest and scientific excellence. For the Community,

� Could you trace the development of theCommunity’s international scientific co-operation?

Louis Bellemin – Recent years have seen somenotable changes in policy. In the 1980s, ouractivities were concentrated in the developingcountries. This co-operation – which I woulddescribe as “assistance” – was aimed at help-ing them solve their problems in fields such ashealth, the environment and agricultural production. In a way it supple-mented the Community’s development aid.

In the 1990s, scientific and technical co-operation policy acquired anew dimension. It opened up, in terms of objectives and geographically.We started to develop scientific co-operation agreements with the indus-trialised countries and with the ‘emerging economies’ – meaning coun-tries that are developed in some sectors while facing the problems of de-veloping countries in others. Our action changed. We sought to developpartnerships with which to tackle issues of common interest. With theUnited States, Australia and Japan, for example, we developed researchco-operation projects in a number of high-tech sectors – most notablyin the field of materials or with the IMS(1) multilateral industrial initiative,or to tackle global or regional environmental problems.

The EU has been involved in scientific and

technological co-operation for more than two

decades now. During this period, policy has

evolved increasingly towards an opening up of

European programmes to third

country players from all over the

world. Interview with Louis

Bellemin, Head of the International

Scientific Co-operation Policy Unit

at DG Research until May 2005.

Europe as a partner in world science

The international

dimension is no longer

confined to a specific programme

for scientific and technological

co-operation, but is now

inherent in all Community

research activities.

“ “

Louis Bellemin

4 I N T E R V I E WRTD in fo Spec ia l I N CO issue June 2005

(1) Intelligent Manufacturing Systems.

I N T E R V I E W RTD info Special INCO issue June 2005 5

it is a question of linking up our researchers with the best know-how inthe world; for the third countries, it is the opportunity to enrich their cap-acities by co-operating with Union scientists. Common interest andmutual benefits, which can be very diverse, are the two key words in thesepartnerships. Usually they concern problems on such a scale that it is ineveryone’s interest to tackle them together. There are many examples ofthese: climate monitoring, management of major environmental chal-lenges, vast projects such as ITER in the field of thermonuclear fusion orGALILEO for satellite navigation, or the health battle being waged by someregions of the world against Aids, malaria and tuberculosis. The bene-fits are mutual. We too are concerned by the development of respiratoryailments or bird flu in Asia. It is in our interest to tackle these issues withscientists from these countries and to try and help resolve them.

Finally, the other particularity of present policy is to implement anaction plan for international mobility. Our aim is to attract excellent for-eign researchers to Europe who will boost our own scientific and techno-logical capacity and then, when they return home, strengthen relationsbetween the scientific communities in their country and the EU bymaintaining links with the host laboratories in Europe. The developingor emerging countries must not see this as a brain drain but as a learn-ing opportunity for their very best scientists and, in the medium term,as a progressive strengthening of their scientific and technologicalcapacities. What is more, appropriate measures are in place to promotethe return of researchers to these countries.

� How is this common interest defined? How do the partnerships withthese third countries function?

Special forums for political dialogue and debate are set up for this pur-pose, consisting of the regional communities of the third countries andMember States. For the Mediterranean Basin, it was the 1995 BarcelonaSummit that set up an institutional forum – known as MoCo – to defineand monitor scientific and technological co-operation. Over the past twoyears we have adopted a similar approach for the Asian countries, LatinAmerica and the Caribbean and, most recently, the Western Balkans,namely the four former countries of Yugoslavia (Croatia, Bosnia-Herze-govina, Serbia Montenegro and Macedonia) and Albania. For somemajor partners – the United States, Canada, Australia, China, India andRussia – the framework for dialogue consists of joint committees chargedwith monitoring implementation of scientific and technological co-oper-ation agreements. Today, we have such specific agreements with nearlyall the important partners worldwide, in Asia, the Mediterranean, NewlyIndependent States and on the American continent.

� So for the developing countries we have moved away from assis-tance and towards partnership. But what happens if countries haveneeds but nothing to offer in exchange?

The answer is very clear. We have spoken of mutual interests and this prin-ciple also applies to co-operation with the developing countries. Theproblems that concern them are usually in the fields of health, foodsafety, energy, water and the environment. These subjects have always beenof Community concern. But 20 years ago we tackled them by defininghere, in Brussels, what we believed to be right. The big difference todayis that these activities are defined jointly. We are partners. But while theapproach has changed, that does not mean we no longer take into

�

account the problems linked to development, the tackling of which is alsoin the interests of the Community at various levels: political, economic andsocial, for example. So again you see there is this ‘exchange’ between theCommunity and these third countries.

� Is this new policy of opening up European programmes to thirdcountry researchers bringing its rewards?

It is working. At present it may not be at the level we hoped but I am con-vinced that this opening up is excellent for the Community and for ourpartner countries and that in future they can only participate more in ouractivities. But it is an innovative approach and our partners were used tothe mechanisms and instruments of the previous co-operation pro-grammes. These new possibilities to which they were previously deniedaccess are original. It takes a certaintime for the information to get throughand to learn how to use these newinstruments for maximum benefit.

I thus feel that a special effort must bemade to circulate information on thesenew opportunities and the ways of usingthem. If you are in the depths of Chileor South Africa it is important to have theright information in time. That meansbefore it is published in the Official Jour-nal. If it is a call for proposals with a

three-month response deadline, that requires certain preparation. That is whywe started to put into place systems comparable to the national contact pointsthat exist in Europe. These contact points now exist in the North African coun-tries and the Western Balkans. We have also launched an information net-work covering the Russian Federation and the NIS. In other cases – inChina, Australia, Argentina, Chile and South Africa in particular – we are help-ing to put into place joint structures to promote this co-operation.

Actions of this kind are vital and they are showing their worth. Morethan 500 Russian teams participated in the first calls for proposalsunder the Sixth Framework Programme following a vast informationcampaign, for example.

Louis Bellemin:

For the Community, it

is a question of linking

up our researchers with the best

know-how in the world. For the

third countries, it is the

opportunity to enrich their

capacities by co-operating with

the Union’s scientists.

“ “

6 I N T E R V I E WRTD info Special INCO issue June 2005

� A major ambition of the European Research Area is to create more‘25 + 1’ synergies, meaning better coordination of the objectivesand certain strategic activities of the research programmes of indi-vidual EU Member States. Does this dimension also concern scien-tific and technological co-operation policy?

We are developing many synergies of this kind. The Member States arepresent in the frameworks for dialogue that I have just mentioned.These exchanges lead to the defining of action plans for co-operationin which they are closely associated. When it comes to concrete imple-mentation, the actions may be either purely Community (and not nec-essarily uniquely through the Framework Programme) or multilateral andtaken in hand by two or three European countries, or mixed, involvingMember States and the Union.

The Sixth Framework Programme also has the ERA-NET instrument withwhich to strengthen synergies between the individual Member States.It can also be used for international co-operation activities. In this con-text there is co-operation between various Member States and candidatecountries, with the Western Balkans or with Latin America and China.

� What should the Seventh Framework Programme, now being pre-pared, bring in terms of scientific and technological co-operation?

The philosophy should not change. I believe that the principle of open-ing up the programmes should be maintained, as should the partner-ship strategy, based on principles of reciprocal benefits and mutualinterest. This will no doubt be the basis for the new programme thatshould be finalised in the course of the coming months.

The Commission’s proposals, which are now being studied, would havethe effect of adapting and improving the set of implementing instrumentsfor Community research and technological development activities –instruments that should also remain open to third country researchers.Actions to encourage researcher mobility should also continue to beaccompanied by specific financial measures enabling researchers whocome to Europe to return to their country of origin. It would also be desir-able to be able to adapt the support for bilateral national co-operationprogrammes by developing access to ERA-NET-type solutions.

It would also be a good thing to encourage the ability to respond in theface of scientific demands that could arise very suddenly. At the time ofthe SARS crisis, the severe acute respiratory syndrome of bird origin, theChinese invoked their agreement with the Union to propose jointresearch activities. We were able to respond rapidly to this request, andare quite proud of the fact, but it would have been made much easierif we could have had access to a budget provided specifically to exploitthe possibilities offered by scientific co-operation agreements.

Personally, I am quite convinced that everybody today recognises theimportance of international scientific and technological co-oper-ation at a time when Europe wants to move faster than evertowards a knowledge society, a development that compels usto work with all the other countries in the world. I am there-fore convinced that the Seventh Framework Programme will

naturally include the necessary internationaldimension.

�

To find out more00 INCO programme

http://europa.eu.int/comm/research/fp6/inco/index_en.html

The problems of

concern to the

developing countries

are usually in the fields of

health, food safety, energy,

water and the environment.

Twenty years ago our

approach was to decide in

Brussels what we believed

needed to be done. The big

difference today is

that we now decide

this together.

“

“

© EC

Mediterranean

8 M E D I T E R R A N E A N - S U S TA I N A B L E D E V E L O P M E N TRTD in fo Spec ia l I N CO issue June 2005

T he Mediterranean coastline is vast, stretching some 46 000 km,19 000 of which is island coastline. Europe, Asia and Africa sharea Mediterranean area of about 1.5 million km2 that is home to 430million inhabitants, more than half of them (286 million) in North Africaand the Middle East. Over the past 30 years, the population of theMediterranean Basin as a whole has increased by around 50%, especiallyin its southern zones. Although it is here that the problem of desertifica-tion is most serious – with just 5% arable land – the Mediterraneanregion as a whole is facing identical problems with the same growing senseof urgency: desertification and shrinking water resources, land degrad-ation and soil impoverishment, pollution, salinisation, deforestation, for-est fires, and unbridled urban development. There is also the addedimpact of tourism that, while bringing undeniable economic benefits, also

causes worrying ecological imbalances. In terms ofagriculture, in many regions this degradation ofland is resulting in a very worrying loss of product-ivity and the development of genuinely ‘devastated’zones.

Knowledge mix

Throughout the Mediterranean Basin, attempts arebeing made to tackle various aspects of the prob-lem through research projects, information gather-ing, experience in the field, exercises in rational man-

agement, and analyses of the chemical and physical processes at work.However, these often very fruitful activities are usually pursued rather ran-domly and without any connection with the local communities or deci-sion-makers. This is why the MedCoastLand project was set up in 2002for a four-year period. It is being coordinated by the Agronomic Mediter-ranean Institute of Bari (AMIB), Italy.(1)

But is this just another project? “Not at all,” explains project managerPandi Zdruli. “The aim is not to contribute to additional research but to

For centuries, the Mediterranean served as a civilising linkbetween Europe, North Africa and the Middle East. For many

years now, the regions that border it have been facing aproblem of growing concern: desertification. The soils are

becoming poorer, water is deficient and the forests aredisappearing. The MedCoastLand project, involving

13 countries bordering the Mediterranean Sea aims to sharethe knowledge acquired in the sustainable development of

coastal regions and encourage links between decision-makers, farmers and scientists.

(1) The Bari AIM is a member of the Centre international des hautes études agronomiques

méditerranéennes (CIHEAM), which proposes training, research and co-operation actions.

Artiplex – These bushes, which provide foodfor small ruminants, are used for replantingarid zones. Here they are shown growing nearMarrakech (Morocco). Inset: reforestation inthe coastal region of Adana (Turkey).

1133

One sea, three continents

disseminate the knowledge that has accumu-lated over many years, the results of which areoften still not generally known.” To do so, theMedCoastLand project has set up a network of36 bodies from 13 countries.(2) “These countriesare facing comparable problems –mainly thelack of water and drying up of soils – but theyare posed in different terms depending on thesocio-economic conditions. The context is notthe same in Europe as it is in North Africa or theMiddle East.”

MedCoastLand is distinctive for the number ofdifferent players involved, including policy-makers, researchers and farmers. “To permitdialogue between these different persons, theymust find a common language and listen to oneanother. For that the policy-makers and scien-tists must leave their desks and get out andabout in the field. That is what is starting to hap-pen. Our network is based on notions of theexchange of ideas and mutual respect for opin-ions. Theory and action are complementaryand can be mutually enriching.”

The real and the virtual

Meetings are held regularly, in the form ofseminars, as well as visits to the field and to datefive workshops. The first, held in Adana (Turkey)in June 2003, looked at how to carry out anecosystem-based assessment of soil degradationto facilitate effective action by land users. In2004, a meeting was held in Marrakech(Morocco) on the subject of the profitable

management of soil conservation and anotherin Alexandria (Egypt) on the impact of partici-patory management. The contributions of par-ticipants are collected for publication and canbe found on the Internet.

As these are coastal areas, the informationconcerns the sea as well as the land. “Somepeople do not always understand that thesetwo elements are fundamentally linked andwarrant equal attention. It is impossible toseparate them.”

Finally, by collecting data in this way it is pos-sible to avoid duplication of information as wellas to fill any gaps. The duplication of researchis in fact a very real problem. “One of the waysof combating it is by speeding up the dissem-ination of this knowledge base and the resultsof previous projects. But these results are notalways accessible, as the scientific institutions arenot always interested in seeing them dissemi-nated. Our view is that, while scrupulouslyrespecting intellectual ownership, the free dis-tribution – through publications or more par-ticularly the Internet – of thisresearch and its results can onlybe beneficial, for the authors aswell as society.”

As regards the gaps, in certain fieldsthere is a distinct lack of indicatorsand statistics. “We try to identifyany areas where information andknowledge bases are lacking, but at

the same time are commit-ted to arriving at concreteresults. That means de-veloping an approach thatcombines productivity,remuneration for the play-ers and soil conservation.To achieve this, you haveto be able to propose long-term sustainable develop-ment projects to the deci-sion-makers in thesecountries and regions. Thattoo is one of the MedCoastLand aims.”

�

RTD in fo Spec ia l I N CO issue June 2005 9S U S T A I N A B L E D E V E L O P M E N T

(2) Algeria, Morocco, Tunisia, Lebanon, Egypt, Syria,

Malta, Turkey, Jordan, Palestinian Authority, Spain,

France, Italy.

To find out more00 Medcoastland

http://medcoastland.iamb.it

00 Istituto Agronomico Mediterraneo di Bariwww.iamb.it

00 Ciheamwww.ciheam.org/

Contact00 medcoastland@iamb.it

The MedCoastLand structureThe project consists of seven working

groups, or ‘work packages’, which are closely

linked and continually active.

� WP1 is the heart of the project. Thisgathers and disseminates information on

the internet and operates an internet

forum and genuine ‘virtual campus’ for

the retrieval and exchange of knowledge.

� WP2 concentrates on the environmen-tal factors that lead to soil degradation

and the indicators with which to evalu-

ate and monitor it. The ultimate object-

ive is to develop an eco-system as an aid

to land management and conservation.

� WP3 studies management and conserva-tion experiences of a nature enabling

economic and sustainable solutions.

� WP4 promotes the participative man-agement of soil resources.

� WP5 analyses the policies of the partnercountries with a view to identifying

proposals favourable to sustainable

development applicable at regional or

national level.

� WP6 is working on a draft agreementbetween the Southern Mediterranean

countries on the sharing of information

and long-term co-operation. The aim is

to promote the management and conser-

vation of land at the ‘regional’ level in

the broadest sense.

� WP7 operates a document search servicefor the benefit of all the project players.

Harvest hopes in dry regions.

H ercomanes stands for Heritage Conservation and Managementin Egypt and Syria. That much is clear. But let there be no mis-take: the focus is on late 19th and early 20th century buildings,witnesses to a mingling of cultures that illustrates the links between thenorth and south of the Mediterranean. The project aims to improve themanagement systems implemented in restoring and conserving theurban fabric and architecture of the period, in Cairo and in Aleppo.

Neighbourhood, street and building: a triple analysis

“The interest in this heritage began to emerge in the early 1990s,”explains Galila El Kadi, an architect and town planner at the IRD (Institutde Recherche pour le Développement) and project coordinator. “In Egypt,it was following the terrible 1992 earthquake that increased nationalawareness led to a recognition of the architectural value of buildings of thiskind. While in Syria it was rapid urbanisation coupled with land and prop-erty speculation that posed the threat to the legacies of the 19th and 20thcenturies. Faced with the danger of losing the memory of the city, the intel-lectuals decided to act. The movement they initiated had a positiveimpact that took shape through the desire to improve the legislation, docu-mentation and conservation relating to these periods in their past.”

A general inventory and the beginnings of a classification began – in1993 in Egypt, and from 2000 in Syria – to save the buildings of thisperiod from demolition or uncontrolled transformations. In Aleppoand its surroundings, 39 buildings were selected and in Cairo 74. “Wesought a better definition of the methodological framework for this inven-tory by making a study at neighbourhood, street and individual build-ing level. This stage-by-stage approach makes it possible to evaluate inter-esting urban forms, to take into account the architectural and stylisticcharacteristics of groups of buildings, and then to analyse the buildingsindividually, in terms of structure, construction techniques, materials,deformation, etc.”

Aleppo is believed to be one of the oldest cities in the world while Cairo’sMuslim quarter is listed by Unesco as a world heritage site. What is

more, these two cities have remained the home of a rich architecturethroughout the centuries while more recent buildings, from the

late 19th and early 20th centuries, are today being listed, studiedand restored. It is this activity which gave rise to the

Hercomanes project, carried out – with EU support – byArab teams from Egypt and Syria and European teams

from France and Italy.

Cairo – The Misr Bank – This oldest of thefinancial institutions in the ‘city’ of Cairowas built in 1927 by the Italian architectAntonio Lasciac.

Aleppo – The Kassis hospital inthe Azizeya district. Built in1916 by an Italian architect andlater converted into a hospital,

the villa was verycarefully renovatedand modernised in1987, whileretaining its medicalfunction.

M E D I T E R R A N E A N - C U L T U R A L H E R I T A G E

A shared heritage

10 RTD in fo Spec ia l I N CO issue June 2005

11RTD in fo Spec ia l I N CO issue June 2005C U L T U R A L H E R I T A G E

Quality of life and aesthetics

In Aleppo, researchers studied the Azizeya dis-trict that forms part of the modern town. TheKassis hospital – originally a villa built by anItalian architect in 1916 – was renovated veryintelligently in 1987, conserving its medicalfunction and modernising the care facilities.“This example showed that it is possible torenovate without disfiguring, and many build-ing owners followed this example. It is also for-bidden now to demolish the listed buildings.”

In Cairo, the project focused in particular onEmad El Dine street and the immediate vicinity.This street runs for 2.5 km through the city andis home to many cinemas and theatres. It is inits southern section, known as Mohamed Farid,that the Egyptian capital’s financial centre islocated. The oldest of the institutions is the MisrBank, built in 1927 by the architect AntonioLasciac. Public and private partners were veryclosely involved in renovating this district, suc-cessfully conserving urban housing, modernisinginfrastructure, cleaning façades and convertingsome areas into pedestrian zones.

The social science researchers on the Herco-manes project also interviewed residents andshopkeepers to find out what they thoughtabout it all. “We wanted to assess how theyviewed the site, before and after restoration, andgauge the importance and meaning they gaveto it. In some cases we also wanted to know ifthey would be willing to contribute financiallyto other operations. Many of them stressedthe improvements to the quality of life in theirneighbourhood and the aesthetic value of theresults.” The historians, meanwhile, made an in-depth study of these neighbourhoods’ pasts andtheir symbolic value – information that could be

used in generating greater awareness with aview to their preservation.

“One of the results of the Hercomanes projectis also to have brought about a change in con-cepts. The notion of a shared Mediterraneanheritage – or even of a cosmopolitan or eclec-tic heritage – is increasingly replacing the notionof a Western, exogenous or colonial heritage.(1)

This shared heritage is linked to a commoncivilisation that covers both sides of the Mediter-ranean – just like the Greco-Roman civilisationthat is very evident in these regions and recog-nised as a source of wealth that is not limitedby borders.”

�

(1) This concept was studied in greater depth at theIsmarmed (International Seminar on theManagement or the Shared Mediterranean Heritage)meeting, supported by the EU and Unesco, whichwas held in Alexandria from 29 to 31 March 2005.The meeting was coordinated by the IRD, theprincipal Hercomanes partner. www.ismarmed.com

To find outmore00 www.hercomanes.com

Contact00 Galila El Kadi

elkadiga@link.net

Partners

� IRD (Research Institute forDevelopment), Paris, France

� Centre of Architectural and EngineeringDesign Support, Cairo, Egypt

� University of Aleppo, Syria

� Istituto Universitario di Architettura diVenezia, Italy

� Université Lyon 2 Lumière, France

Cairo – The Diplomats Club.

Cairo – The Omar Effendidepartment store.

12

C hronic diseases (cancer, cardiovasculardisease, diabetes, obesity), which accountfor 88% of deaths in industrialised coun-tries, are now also responsible for 40% of deathsin the emerging countries. The World HealthOrganisation (WHO) reports that 63% of dia-betics live in the developing countries (wherethey were rare just 20 years ago), a figure that isexpected to rise to 75% in 2025. Cancer and car-diovascular disease are now the primary cause ofdeath in China and, since the 1980s, they havekilled twice as many people as infectious dis-eases in Mexico. Many other examples could begiven, all illustrating the same pattern.

“All over the world, the epidemiological transitionhas been sparked by two major phenomena:socio-economic development and progress inmedicine, leading to a decline in the traditional causes of death,” explainsHabiba Ben Romdhane of the National Public Health Institute in Tunis,scientific coordinator of the Tahina project (Epidemiological Transition andHealth Impact in North Africa). French, Tunisian, Algerian and Belgianresearchers are all contributing to Tahina's multidisciplinary approach byepidemiologists, nutritional experts, economists, sociologists and anthro-pologists to the study of both the medical situation and the socio-economic and cultural context. The aim is to strengthen the capacity ofNorth African health sectors to manage the epidemiological transition andimplement a health policy that takes changing lifestyles into account.

Fewer and different deaths

In Tunisia, chronic diseases today account for more than 60% of deaths.This trend should not, however, be stigmatised as a 'negative' price paidfor modernity. It is rather a reflection of the fact that, since 1970, an effect-ive health and population policy has brought a sharp fall in mortality –infant mortality in particular – and that life expectancy rose from 52 yearsin the late sixties to 72 in the year 2000. At the same time, the birth rate

fell from 7.2 children per woman in the early 1960s to 2.1 in 1999.Tunisian women are marrying later in life and 63% of them use contra-ceptives, a pattern found throughout the country.

“But it is true that new problems are appearing. The epidemiological situ-ation for cancers is at an intermediary stage between that found in thedeveloped and in the developing countries. We know that lifestyle, andespecially diet, play an important role as a risk factor for these patholo-gies, and that the latter in particular has changed. Although cereals remaina basic foodstuff in Tunisia, the level of consumption is falling progres-sively, while consumption of meat and poultry is increasing,” points outHabiba Ben Romdhane.

The same trend is apparent in Algeria. “Communicable diseases, previ-ously the principal cause of morbidity and death, are now giving wayto non-communicable diseases, chronic and/or caused by lifestyles, ofa kind that are typical of the industrialised countries,” believesDr Abdelkrim Ouchfoun, a specialist in epidemiology and preventive medi-cine and the Algerian partner in the Tahina project.

M E D I T E R R A N E A N - E P I D E M I O L O G YRTD in fo Spec ia l I N CO issue June 2005

Economic change affects everything: lifestyles, demography, relationships betweentown and country, culture and education. It also has an impact on health, bringingchanging patterns of sickness and mortality. Over recent years, the developingcountries – like the industrial regions before them – have experienced what is knownas 'epidemiological transition'.The Tahina project isendeavouring to analyse thesechanges in Tunisia and Algeria,where they affect principallyurban populations.

The PRICE of change

13

Refining the statistics

During the first two years of the project,which was launched in 2002, researcherssought to better describe the mortality andits causes, as well as hospital morbidity. Inboth Algeria and Tunisia this involved revis-ing procedures for recording the medicalcauses of deaths by making the issuing ofa death certificate standard practice – as rec-ommended by the WHO – and by trainingpersonnel responsible for the collecting,medical coding and analysis of certificates.“This aroused a certain interest and verypositive co-operation between the partici-pants and the health authorities in question,thereby helping to achieve the objectives,”

believes Bernard Maire, administrative coordinator withthe Tahina project.

The first results relate to 44 033 deaths recorded inTunisia in 2002-2003 and 13 817 recorded in Algeria in2002. To assess the level of epidemiological transition, theanalysts consider the relative importance of the major cat-egories of cause of death: trauma and accidents; infec-tious diseases and prenatal affections; transmissible andperinatal diseases; and the group of non-communicablediseases. The latter group includes all the chronic diseasesthat affect mainly adults, some of which are linked tolifestyles (diet, sedentariness, smoking or consumption ofalcohol, etc.).

Cardiovascular disease comes top

The first global results give 83% for the group of non-communicable diseases in Tunisia and between 58% and67% in Algeria.(1) Cardiovascular disease easily tops the

list, accounting for about a quarter of deaths.

A survey has also been started to investigate the importance of these non-communicable diseases in Tunisia's principal public hospitals. The resultsconcern all cases of hospitalisation, grouped according to medical spe-ciality and considering the average length of stay, treatment administered,discharge figures and hospitalisation costs. An analysis was also carriedout per hospital, per governorship and per region. Data on more than150 000 hospital admissions were gathered but only those relating tocardiovascular disease have been the subject of an in-depth study to date,including a comparison between the 1992 and 2002 figures (see box).

Trends in cardiopathiesCardiopathies take various forms. Comparisons were made betweenthose recorded in Tunisian hospitals in 1992 and in 2002. In 1992,rheumatic cardiopathies (type of cardiac disease associated withpoverty, poor nutritional condition, late take-up by care systemsand linked to infection with staphylococcus) accounted for 12%of cardiopathies in men and 25% in women; ischaemic car-diopathies (cardiac infections linked to a modern, sedentarylifestyle, with a calorie-rich unbalanced diet) accounted for 39%of hospitalisations among men and 16% among women; finally,illnesses linked to high blood pressure represented 6% and 10% ofmale and female patients respectively.

In 2002, rheumatic cardiopathies represented just 7% of hospital-isations (5% among men, 12% among women), ischaemic car-diopathies increasing to 46% (54% among men, 31% amongwomen) and high blood pressure accounted for 9% of hospital-

isations. “In the space ofjust ten years, we haveseen marked change inthe causes of hospital-isation. This fully con-firms the rapid progressof epidemiological transi-tion,” concludes HabibaBen Romdhane.

Trends in cardiopathies (% in specialised service)

Men Men Women Women1992 2002 1992 2002

Lifestyle, and diet inparticular, plays animportant role in therisk factors for ‘new’pathologies. InNorth Africa,vegetables and fishare excellent sourcesof health. But theirconsumption isdecreasing, togetherwith that of cereals,to be replacedmainly by meat andpoultry.

RTD in fo Spec ia l I N CO issue June 2005E P I D E M I O L O G Y

60

50

40

30

20

10

Rheumatoid Ischaemic cardiopathies cardiopathies

(1) If the uncertainties linked to ill-defined causes and the sampling are taken intoaccount. These results also show major regional variations in the two countries(for example, between 66.8% and 87.9% for non-communicable diseases inTunisia).

In Algeria, the study lasted twoweeks,(2) and was carried out on arepresentative sample of hospitals ineach Wilaya (administrative region).During this very short period, 21 560hospitalisations (including 3 887births) were studied. The results area useful supplement to national stat-istics on global morbidity. “Excludingbirths, traumatisms and accidentsaccounted for about 10% of hospi-talisations during this period. Non-communicable diseases accountedfor over 50% – including 28% fordisorders of the digestive system,13% for respiratory diseases and 12%for cardiovascular disease,” explainsDr Atek of the Algiers Institute ofPublic Health.

Rapid transition

“In Tunisia, our surveys have pro-vided solid confirmation of the leveland rate of epidemiological transi-tion. In Algeria, where we knew lessabout the situation, the results alsoshow that this transition is well underway and developing fast. The initialpicture provided by these indica-tions will be further completed byindividual data on morbidity (nutri-tional state, state of health, risk fac-tors) and lifestyle (physical activity,diet, occupation, level of education,etc.). This information will soon becollected on representative samplesat national level,” explains the pro-ject coordinator.

A study is also in progress on thehealth systems in these two coun-tries, as well as on the way they areor should be changing. It will bebased on an analysis of steps taken to prevent and treat chronic non-com-municable diseases elsewhere in the world. The research must serve asa basis for discussions with health system specialists and decision-mak-ers with a view to setting new health policy strategies.

Prevention requires knowledge. One of the project's tasks, therefore, isto identify, measure and understand the various factors that lie behindthese changes, such as tobacco smoking (especially among young peo-ple), obesity, dietary changes, conditions of urban and rural life, etc. To

develop a realistic health policy it is necessary to define the cost ofthese 'new' diseases (for which treatment is expensive), assess all the ben-efits of prevention, study the possi-ble lessons that can be learned fromthe experiences of industrialisedcountries, and involve the actorsand the population. “Combatstrategies that are adapted to whatis possible economically for thecountry in question and to thesocio-cultural needs of the popula-tion must be developed and madeavailable to doctors,” believes DrOuchfoun. “The medical profession and health managers must alsoplay a leadership role in regard to other sectors and associations involvedin the protection or promotion of public health.”

�

(2) The difference in the situation, and above all the size of the country, and thus inthe survey costs, did not permit a study of the same kind as in Tunisia.

14 E P I D E M I O L O G YRTD in fo Spec ia l I N CO issue June 2005

Partners

� National Public HealthInstitute (INSP), Tunis

� IRD (Research Institute forDevelopment), Paris

� National Public HealthInstitute (INSP), Algiers

� Prince Leopold Institute ofTropical Medicine,Antwerp (BE)

� Mediterranean AgronomicInstitute of Montpellier(FR)

� National Institute ofNutrition and DietaryTechnology (INNTA), Tunis

� University of Oran, Facultyof Medicine, Algeria

Contacts00 habiba.benromdhane@rns.tn00 Bernard.Maire@mpl.ird.fr

To find out more 00 www.mpl.ird.fr/tahina/index.htm

Invitation to a modern diet in North Africa.

Africa

© EC

A century ago, tuberculosiswas one of the biggestkillers in Europe andmalaria was present in many of itssouthern regions. Vaccination andthe invention of antibiotics in theformer case and clean water in thelatter changed all that. Thus, Aids,tuberculosis and malaria are notplagues in the face of which medi-cine is powerless. In Africa, how-ever, treatments are often unsuitedto the context in which these threediseases occur – and are continu-ing to put a brake on developmentand to pose a threat to the future.

Deciding priorities

Approved unanimously by the European Coun-cil and Parliament in 2003, and officiallylaunched this year by the Commission on 22February 2004 in Dakar (Senegal), the EDCTPinitiative is the fruit of a lucid analysis of the situ-ation. While fundamental research to developfuture vaccines against Aids or malaria is mostcertainly a necessity, given the terrible toll

exacted by current pandemic diseases the firsttarget must be effective treatment. Yet progressin this field often struggles to get beyond thestage of organising clinical trials for potentialmedicines or vaccines.

To ensure that any conclusions drawn have asound scientific basis, clinical trials must respectvery systematic procedures that require consid-erable resources and a medical scientific infra-structure of a very high standard. How manypromising potential treatments against Aids,

tuberculosis or malaria havefailed to be explored in the con-text of African living conditionsdue to a lack of the necessaryfinancing or organisation? Whatis more, international co-oper-ation in this field too often pro-duces “the construction of infra-structures showing no regardfor local needs, thus bringingno public health benefits, theover-dependence of Africancountries on developed coun-tries and the brain drain,” saysDicky Akanmori of the University

of Ghana, President of the EDCTP’s DevelopingCountries Coordinating Committee.

The main problem currently facing the fightagainst diseases of poverty is therefore the frag-mentation of the research effort and the enor-mous financial and technical difficulties oforganising clinical trials in Africa. This is essen-tially the analysis that led to the creation of theEDCTP and which forms the basis of its actionand its organisation. Its philosophy can besummed up in one word: partnership.

16 A F R I C A – P O V E R T Y D I S E A S E SRTD in fo Spec ia l I N CO issue June 2005

New ‘clinicalpartnership’

to fight a triple plagueSix million deaths – that is the terrible toll

suffered by Africans every year due to the ravagesof Aids, tuberculosis and malaria. Yet most

terrible of all is that this is an avoidable disaster,if only clinical research could develop treatmentpolicies that are appropriate to the precarious

living conditions of Africa’s populations. Throughthe European and Developing Countries ClinicalTrials Partnership (EDCTP), allocated funding of

€600 million over five years, Europe is making animportant and original contribution to combating

these poverty diseases.

The main problem facing the fightagainst poverty diseases is the

fragmentation of the research effortand the enormous financial andtechnical difficulties involved in

organising clinical trials in Africa.

17

Targeting real needs

First there is the partnership between African and European countries(14 EU states plus Norway). Far from adopting an approach of pater-nalistic assistance, the EDCTP has opted for co-management by Africans,with their irreplaceable knowledge of local situations, and Europeans.The Partnership Board is a symbol of this parity and openness, and func-tions as a type of scientific board responsible for settingthe EDCTP priorities. It is made up of four African scien-tists, four European scientists and four internationalexperts. The mission of this North-South partnership isto finance – on the dual basis of calls for proposals andproject piloting –development of the medical and scien-tific bases necessary to carry out clinical trials in Africa.Staff training, study grants for African scientists, and themodernisation of medical centres are examples of actionsbeing implemented.

“Our needs lie mainly in the acquisition of new skills. Manycare staff have no idea how to carry out a clinical trial inaccordance with the criteria required by the international scientific com-munity. We are more than 850 kilometres from the capital here and haveto count on our local teams,” says Doctor Leonard Maboko of theMbeya Medical Centre (Tanzania). Allocated two-thirds of the €600 mil-lion available over five years (€200 million from the Union, €200 mil-lion from the partner states, and €200 million from other sources, pri-vate or international), the development of the material and humaninfrastructure needed for clinical trials in Africa will absorb the lion’s shareof the EDCTP’s provisional budget

Multiple partnerships

In addition to the North-South partnership, there is alsothe partnership between southern countries. Insufficientmeans of communication mean that promising experi-

ences in certain parts of Africa – in preventing HIV infection in Uganda,for example, or treating opportunistic infections among Aids suffererson the Ivory Coast – fail to receive the attention they deserve. TheEDCTP is therefore working on setting up a network of African clinicalresearch centres, operating through regular meetings, joint seminars andsatellite connection systems.

The northern countries have also entered into a partnership among them-selves, so as to avoid unnecessary duplication and regrettable compe-tition between teams pursuing similar projects. One of the EDCTP’sfirst tasks was to compile a register listing all the clinical trials in Africa

that deal with Aids, tuberculosis andmalaria as a basis for harmonisingtrial procedures.

Finally, there are the public-privatepartnerships. The pharmaceuticalindustry is often accused of ignoringpoverty diseases because they lackprofit potential. No doubt there isan element of truth in this criticism,but in a market economy it is difficultto ask companies to work at a loss.Hence, the EDCTP proposes to getround the problem by suggestingthe co-financing of trials, to whichcompanies could contribute eitherby providing the molecules testedfree of charge or by granting prefer-ential licences on some of theirpatents.

This list of partnerships would notbe complete without mention of theclose relations the EDCTP plans toestablish with organisations pursu-ing similar aims (especially the UnitedNations Global Fund, the World

P O V E R T Y D I S E A S E S RTD in fo Spec ia l I N CO issue June 2005

How many promising potentialtreatments against Aids,

tuberculosis or malaria havefailed to be explored in the

context of Africans’ livingconditions due to a lack of the

necessary financing ororganisation?

Information meetingon Aids and Aids

prevention in SouthAfrica. Examples ofgood practice are

often little known inother regions of the

continent. ©CE/Guy Stubbs

�

Health Organisation, and the Bill and Melinda Gates Foundation) –proof that there can be no question of rivalry on such a serious subject.

Efficiency and ethics

It is too soon to assess the results of an initiative that has only just startedup and whose action will extend over a decade. Nonetheless, nine pro-jects have already been approved for financing, and Pascoal Mocumbi,high representative of the EDCTP, was recently able to welcome the pub-lication of the results of a promising trial in the medical journal TheLancet. Carried out by an international team of several Africanresearchers, this clinical trial involved the vaccination of Mozambicanchildren against malaria and seemed to confirm that the right strategyhad been chosen. “This study shows that obtaining a vaccine againstmalaria is an objective within our reach and has caused us to step upour efforts,” he stated.

Such a complex administrative machinery as that of the EDCTP is alwaysgoing to suffer from some initial teething problems, especially when seek-ing to work in partnership with scientists from several dozen countrieson two continents. Also, the regrettable and repeated controversiesover the ethics of clinical trials in developing countries during the 1990shave not been without their consequences, certain scientists beingaccused of running trials under conditions that would be judged un-acceptable in the industrialised world. The lessons of these controversialissues have now been learned and the EDCTP programme will notfinance any project that has not been evaluated in ethical terms and autho-rised by the health authorities in the countries in question.

“The EDCTP attaches great import-ance to ethical considerations.Countries without them need to beencouraged to acquire ethical com-mittees, develop the training ofresearchers, and provide them withon-line access to the necessarydocumentation,” explains Souley-mane Mboup of the Le Dantec Hos-pital in Dakar (Senegal), member ofthe EDCTP Partnership Board. In

thus affirming the universal nature of medical ethics and working forresearch on disease and poverty to be undertaken by and for Africans,the European contribution through the EDCTP marks a major and notedchange of tone in the fight against diseases of poverty.

�

18

A legal innovationThe creation of the EDCTP was made possible by virtue of Art-icle 169 of the Treaty of Amsterdam. This article stipulates that“in implementing the multiannual Framework Programme, theCommunity may make provision, with the agreement of theMember States concerned, for participation in research anddevelopment programmes undertaken by several Member States,including participation in the structures created for the execu-tion of those programmes”. This article had not been applied pre-viously. The launch of the EDCTP is thereforean important step towards the construction ofthe European Research Area. With the legalform of European economic interest groupingunder Dutch law, the EDCTP is a flexiblestructure that is open to private partners and able to evolve inline with the new needs in combating poverty diseases that willcertainly be felt in the course of the coming years.

P O V E R T Y D I S E A S E SRTD in fo Spec ia l I N CO issue June 2005

To find out more 00 www.edctp.org

The EDCTP is a partnership co-managed by Africans, with theirirreplaceable knowledge of local

situations, and Europeans.

A F R I C A – A N I M A L H E A L T H RTD in fo Spec ia l I N CO issue June 2005 19

M inute parasites when they settle on the skin of mammals,ticks subsequently swell up as they absorb their victim’s bloodand can be the carriers of sometimes fatal diseases. Particu-larly vigorous and prolific, they exist in many forms and at every latitude.Anyone who takes a walk in the countryside, especially with a dog as acompanion, must surely be aware of them. But the damage caused innorthern countries – even if they can have serious consequences forhumans, in particular as the source of infection with Lyme disease – bearsno comparison to the disasters they can cause in developing countrieswhere they can decimate livestock herds.

The first problem these ‘bloodsuckers’ cause cattle, sheep and other smallruminants is anaemia, resulting in weight loss and thus loss of earningsfor the rearers. Their skin is also damaged by the bites and loses its value.In addition to this ‘direct’ damage, these parasites also transmit diseasessuch as anaplasmosis, cowdriosis, dermatopholosis, theilerois and babesio-sis that cause losses among livestock in tropical and subtropical countriesthat are estimated to cost billions of euros a year.

Variety of weapons

“The problem is all the more crucial as, in the southern hemisphere, about870 species of tick have been identified as having the potential to trans-mit disease. What is more, a large number of these species can be pre-sent in the same region. This means that even when a response is foundfor one type of parasite, such as a vaccine against a disease carried byone species, additional methods, such as acaricides, must continue to beused to combat the other types of tick. That is why we are seeking poly-valent methods,” explains Frans Jongejan of Utrecht University’s Facultyof Veterinary Medicine (NL), coordinator of the action since it waslaunched in 1996.

The ICTTD already received Union support under the Fourth FrameworkProgramme and has just received its ‘third mandate’ under the SixthFramework Programme with financial aid of €1 842 000 over a 48-month period. From the outset, this long-term effort has concentratedon a triple strategy.

First of all, on the prevention frontresearchers are working on new multi-component vaccines that target boththe parasites themselves and the dis-eases they transmit. This aspect is allthe more important as the ticks havea tendency to develop a growingresistance to the chemical substancesdesigned to destroy them. The massive use of these acaricides alsoposes serious problems from an environmental point of view.

Other network laboratories are concentrating on perfecting screening tests,in particular diagnostic tests that can be applied simultaneously to dif-ferent pathogenic agents. Finally, epidemiological studies are being car-ried out to assess the socio-economic impact of tick-borne diseases.

Cross-referencing

Over the coming years, the ICTTD will organise its activ-ities into working groups. The Database working groupis compiling a huge database (THP base) of availableinformation on three elements: the ticks, their victims (Hfor ‘host’) and the pathogenic agents. This knowledgeshould make it possible to arrive at an improved diag-nosis of the various diseases by comparing medical datawith ecological or climatic data so as to be able todefine the geographical distribution of tick species andof diseases in subtropical regions. The four avenues ofresearch – Biosystematics Forum, Molecular DiagnosticNetwork, Genomic and Vaccine Design Group and StudyGroup on Tick-Host-Pathogen Interactions – are aimed primarily atimproving biological knowledge of a nature to bring further progressin combating this plague. It is particularly important to understand theinteraction between the ticks, their hosts and the diseases caused as wellas to establish the genomic and proteomic data that could be used inlaunching new vaccines.

�

Attack by Rhipicephalusappendiculatus (Zambia). Inthe southern hemispherealone, around 870 species oftick are potential carriers ofdisease, and many differentvarieties can be found in thesame region.

On the left,Amblyommavariegatum(female tick) and on the right,Rhipicephalus humeralis – (male tick).

Some 50 European, African and Latin American institutions are participating, with Union support, inthe third ICTTD (International Consortium on Ticks and Tick-borne Diseases) initiative. For the pasteight years, this network has harnessed the efforts of more than 150 researchers who have resolvedto combat, by different and complementary means, the damage caused by these particularly vigorous

arachnids which wreak such havoc on livestock herds.

To find out more00 www.icttd.nl/

Contact00 Frans Jongejan

f.jongejan@vet.uu.nl

Partners45 institutions in 30 countries

The RAVAGESof TICKS

T he Okavango has its source in Angola,crosses Namibia and never reaches thesea. In Botswana’s semi-arid KalahariDesert it disappears into a huge delta of lakes,lagoons and islands. “It is a miracle of nature,”says Lars Ramberg, Director of the Harry Open-heimer Okavango Research Centre (HOORC,Botswana), as he describes the luxuriance of themarshlands that attract almost 650 species ofbirds. “But this extremely sensitive ecosystemcould be upset by brutal intervention.” TheWerrd (Water and ecosystem resources inregional development) research project, ofwhich the HOORC is scientific coordinator, isseeking to preserve this ecological balance.Launched three years ago with EU support, sci-

entists from Africa (Botswana, Namibia, SouthAfrica) and Europe (Sweden, Netherlands,United Kingdom) are working together on thisproject that is the latest in a number of researchprogrammes to win international support. Thisis because Okavango is a very coveted resourceand its delta is still threatened despite a Com-mission (Okacom) set up jointly by Angola,Namibia and Botswana in 1994 to manage it.

Under threat

Suffering serious effects from drought, in 1996Namibia considered diverting the Okavangoto its capital, for example. Average annual rain-fall in Namibia is no more than 250 mm, just2% of which feeds its transient rivers. Fortu-

nately, the

return of the rains caused the authorities toreconsider. The idea nevertheless remains anoption for the future, as does that of buildinga hydroelectric dam upstream of Botswana. Atone time, Botswana itself planned to dam oneof the arms of the delta – before abandoningthe idea following a recommendation from theIUCN (International Union for the Conservationof Nature). For its part, Angola has drawn upa number of plans for reservoirs.

All these initiatives pose a threat to the river flowand the extraordinary fauna of its delta, aswell as to the existence of fishermen, livestockfarmers and those whose livelihood is tourism.As Lars Ramberg (BE) explains, “we can onlyfear the scale of the consequences of projectsof this kind”.

20 A F R I C A – N A T U R A L R E S O U R C E SRTD in fo Spec ia l I N CO issue June 2005

The Okavango, in Botswana, is drying up. ©CE/F.Jacobs

Public healthIn sub-Saharan Africa, with its crucial lack ofsanitary installations, water is a frequent car-rier of disease. In most of the large towns,fewer than 10% of houses are connected tothe sewers and only between 10% and 30%of inhabitants are served by a refuge collec-tion system. The fear is that plague, which hasalready made an appearance in a number ofrural areas (in Mozambique and Tanzania in particular), could spreadto urban areas.

This is the question that interests researchers on the Ratzooman pro-ject. With €1 450 000 in EU funding, the project includes fourAfrican partners (Mozambique, Zimbabwe, Tanzania, South Africa)and four European partners (United Kingdom, Belgium, theNetherlands, Denmark).

“Many Africans are totally ignorant of the many diseases trans-mitted by rats. We want to alert them to the risks and informthem about how to avoid them,” explains Steven Belmain ofthe Natural Resources Institute (UK), the project coordinator.

The scientists’ first task was to take blood samples in the field fromhumans, rodents and pets to estimate the prevalence of three diseasesof concern: plague, leptospirosis and toxoplasmosis. They alsoassessed their socio-economic impact and identified the ecological(water management, land use), sociological (behaviour, hygienestandards) and epidemiological factors that increase risk of transmis-sion. Finally, they set up a risk forecasting model that should enablethe local authorities to take adequate measures. As an incentive, a con-gress will be held in South Africa to present the Ratzooman resultssome time before project completion, in 2005 or 2006.

www.nri.org/ratzooman/

With a population of 864 million,Africa is home to almost a sixth ofthe world’s population, but to just

9% of its water resources. Themany African states share some

80 river basins and lakes, theimportance of which is easy to

understand. Various researchprojects are currently looking at

ways of providing integratedmanagement of this vital

resource, with a special focus onthe Okavango, southern Africa’s

third largest river.

WATER MANAGEMENT

Mastomys natalensis,the rat that carriesdiseases including

plague, leptospirosisand toxoplasmosis.

N A T U R A L R E S O U R C E S RTD in fo Spec ia l I N CO issue June 2005 21

Werrd has drawn up a number of scenarios forthe possible effects on the delta of the variousland use or upstream dam constructionschemes. This has not only provided Okacom– which recently decided to set up a permanentsecretariat – with a richer basis for its deliber-ations, but can also lend legitimacy to the manyinitiatives of villagers living in the river basin whoalso want their voices to be heard.

By strengthening contacts between the variousplayers concerned by the future of the Oka-vango, Werrd has built up a body of knowledgeon the river’s hydrology, the ecology of itsdelta and the socio-economic impact of thevarious possible or present management poli-cies. The results can be consulted on an inter-net site on which comments can be posted. Toalert public opinion and to ensure that infor-mation has a sound scientific basis, researchershave also distributed an explanatory poster,in English and Portuguese, to schools andtourist infrastructures. A manual for teachers hasalso been produced.

Better wetland management

Covering nearly 7 million hectares, today thewetlands of the Okavango are the largest siteprotected by the Ramsar Convention.(1) InAfrica, as elsewhere, these zones were longseen as wastelands that needed to be drainedbefore they could be put to good use. Inanother part of Africa, in Kenya and Tanzania,Lake Victoria provides a clear illustration of theissues at stake. A source of revenue, food andemployment for 30 million people, it has lostmuch of its biological diversity. It is now thesubject of research by the Ecotools project pur-sued by European (Italy, Unitad Kingdom, Ire-land, the Netherlands) and African partners(Uganda and Kenya). “We are studying thevital functions of wetlands, in terms of nutrientrecycling, carbon storage, and as areas for thedevelopment of fish stocks and reed growing,etc.,” explains Claudio Rossi of Sienna Univer-sity, the Ecotools coordinator.

During a previous EU-backed project on wetlandsin Argentina, pilot projects carried out by histeam alerted public opinion and policy-makers– especially in the field of agriculture and forestry– to the need to take into account all componentsof an ecosystem if its integrity is to be conserved.

Ecotools hopes to achievethe same results inUganda and Kenya byinvolving governmentinstitutions. By modellingthe impact of pressureon the life of the lake –including that of a build-up of urban waste – andon its fish stocks inparticular, the project hasrevealed the existence ofregional as well as localeffects. These are all fac-tors that pose a threat towetlands.

�

In most of Africa’s large towns fewer than 10%of houses are connected to the sewage system

and only between 10% and 30% of homesbenefit from a refuge collection service. The

photograph shows Lagos in Nigeria.©CE/O.Lehner

To find out more 00 Werrd project

www.okavangochallenge.comhttp://irn.org/programs/okavango/Participants: Sweden (University ofLinköping/coordinator) - Botswana,Namibia, Netherlands, UnitedKingdom, South Africa

00 Aquapol projectwww.fen.bris.ac.uk/engmgt/swg/research/aquapol/index.htmlParticipants: United Kingdom (Bristol University), Kenya,Zimbabwe, Ireland, Italy

00 Ecotools projectwww.unisi.it/ecotools/Participants: Italy (University ofSienna/coordinator), Uganda, Kenya,the Netherlands, United Kingdom,Ireland

Conserving water quality“Even when someone goes to fetch clean water at a supply point, itcan be contaminated very quickly due to the way it is transported andstocked,” points out Stephen Gundry, a researcher at Bristol University(UK), coordinator of the Aquapol project. With three partners inEurope (United Kingdom, Ireland, Italy) and three in Africa (Kenya,Zimbabwe, South Africa), this project receives around €900 000 inEU assistance.

Researchers first made an inventory of present water-related policiesin the three African countries in question. They then selected 120 rurallodgings in each of them. To allow for seasonal changes, the micro-biological water quality was measured on two occasions at variouspoints from the source to the home, with details of storage, hygienemeasures and sanitary installations also recorded. “The populationwas very much involved in the project,” continues Stephen Gundry,“We asked mothers, for example, to keep a record of their family’shealth, especially of any outbreaks of dysentery.”

In South Africa and Zimbabwe researchers tested ceramic filters thatwere fitted to the water tanks in about 60 homes. This very simplepractice made it possible to reduce intestinal complaints in youngchildren by between 70 and 80%.

www.fen.bris.ac.uk/engmgt/swg/research/aquapol/index.html

(1) Adopted in 1971, in the Iranian town to which itowes its name, the Ramsar Convention is an inter-governmental treaty that provides a framework fornational and international actions for the conserva-tion and rational use of wetlands.

The sources arepure, but after that?Water courses atreacherous pathand by the time it iscollected (shownhere in a canal) ithas often lost itsessential qualities.

22 A F R I C A – N A T U R A L R E S O U R C E SRTD in fo Spec ia l I N CO issue June 2005

I t was back in 1996 that the Martin Ryan Institute (National Univer-sity of Ireland), which specialises in marine sciences, launched Algae-Base. “The aim was to create, on the internet, a database devoted toalgae. At first, the information was limited to species found in the BritishIsles,” explains Michael Guiry, one of the scientists who initiated the pro-ject. “But data on North-West Europe, then the North-West Atlantic andthe Mediterranean were soon added.” This was followed by informationon the freshwater cousins of these marine plants, resulting in an Algae-Base of approximately 35 000 species that are described in detail, com-plete with classification (phylum, class, order, genus, family, species, etc.)and distribution as well as supporting drawings and photographs andreferences to leading articles published in renowned scientific journals.

Information search

Little is known about algae and their uses despite the fact that, if care-fully selected and used, they can change the fortunes of coastal popu-lations. Although Ireland is modest compared with the Asian market giants,the 45 000 tonnes of algae it harvests every year make a considerablesocio-economic impact on the country’s west coast. As the African con-tinent is surrounded by oceans and the cold water currents render its west-ern coasts ideal for algae culture, it seemed logical to study its underwaterplant life and to list and disseminate the data gathered. That is the aimof the SeaweedAfrica project launched in 2001. With a budget of around€999 000 and EU support, seven partners are contributing to its work(see facing page), with the Martin Ryan Institute as coordinator.

“AlgaeBase provides the principal data on speciesnames and their distribution,” explains Irishresearcher Roisin Nash. “The existing base there-fore served as a launching pad. It was a questionof developing it for the coasts of Africa, thenadding information on the ecology, present orpotential uses, growing and harvesting

methods, etc.” Each partner is responsible for identifying a number ofspecies and supplying the database with information on them. Researchersmeet regularly to report on progress and set priorities. “These meetings

have improved communication, especially between the African partners,by creating genuine links between them,” says Robert Anderson ofCape Town University. They provide the opportunity to take stock of activ-ities to date.

Aquatic plants are useful plants

“We have shown that the use of seaweed in medicine and pharmacy isfast expanding,” notes John J. Bolton, of the University of the WesternCape. “For example, we are testing one seaweed-based product for thetreatment of immune deficiency caused by the Aids virus.” Algae are usedin more than 200 different forms in health, agriculture, animal aquacul-ture, nutrition, thalassotherapy, environmental monitoring, cosmetics,etc. “This shows the importance of making this information available freeof charge,” concludes John Bolton. An Internet site was launched in April2003 with a country search function. For those without internet access,CD-ROM versions of the database will be distributed in those African coun-tries bordering the Atlantic and Indian Oceans.

�

Although surprisingly little is known aboutseaweed, there is no doubting its value in fields asvaried as medicine, agriculture, nutrition andenvironmental monitoring. Taking the IrishAlgaeBase scientific initiative as its inspiration, theSeaweed Africa project is currently compiling avast databank centered on Africa. For a continentsurrounded by oceans, this will provide a valuabletool for improved identification and use of thisnatural resource which is in plentiful supply.

Partners

� Martin Ryan Marine Science Institute,National University of Ireland, Galway(Ireland) - coordinator

� University of Cape Town, in co-oper-ation with the Marine and CoastalManagement (South Africa)

� University of the Western Cape andInternational Ocean Institute (SouthAfrica)

� University of Namibia� International Ocean Institute - East

Africa (Kenya)

� University of Stockholm (Sweden)� CIIMAR (Centro Interdisciplinar de

Investigação Marinha e Ambiental),University of Porto (Portugal)

To find out more00 Seaweed Africa

www.seaweedafrica.org00 AlgaeBase

www.algaebase.org

Gathering algae in Namibia.

Asia

I t all began in the late 1990s when the Chinese Government announcedthat it was awarding top priority to reforming the urban health caresystem, judged to be in a pitiful state. A senior official at the HealthMinistry, Cai Renhua, today Director of the Chinese Health EconomicsInstitute, enlisted the expertise of the Institute of Development Studies(IDS) at Sussex University (Brighton, UK) and of the Faculty of Medicinein Shanghai, both of which had already participated in studies of thehealth care system in rural China. The task was to assess the equity andefficiency of health services in Chinese towns and to submit recommen-dations to health officials.

A research consortium was set up and organised into two groups. TheIDS, as study coordinator, teamed up with the Shanghai Faculty ofMedicine (which later became the University of Fudan) and sociologistsfrom the University of Hamburg (DE) to study equity of access to healthservices, while Shandong University’s Institute of Social Medicine andHealth Policy worked with the Stockholm School of Economics (SE) onthe efficiency of the health system. With co-financing assured from the

EU (INCO programme), the British Government and the Ford Founda-tion, the researchers were able to begin their mission by defining theirmethod. As it is impossible to try and obtain a comprehensive picturein a country as vast as China, they decided to focus on a case study.

Spotlight on Nantong and Zibo

Two cities in eastern China were selected: the port of Nantong (popu-lation 2.5 million) which lies on the banks of the Yangtze in JiangsuProvince, and the industrial city of Zibo (population 1.4 million) inShandong Province. There were also scientific reasons for the choice. “Oneof the greatest difficulties facing social science research in China is therate of change. It was to get round this difficulty that we decided to carryout studies that were both very local and very detailed and which wouldbe able to reveal the dynamic of the change in progress,” explain pro-gramme coordinators Gerald Bloom (ISD) and Tang Shenglan, formerlya researcher at Fudan University and now at the Liverpool School of Trop-ical Medicine (UK).

24 A S I A – H E A L T H S E R V I C E SRTD in fo Spec ia l I N CO issue June 2005

Epidemiological transition is well under way inurban China. This trend, which accompaniesdevelopment, is marked by a decline ininfectious diseases and an increase in chronicdiseases similar to those found in theindustrialised countries.

Dramatic changes are sweeping across China, of which economic reform and an expandingprivate sector, a massive rural exodus, the overturning of social structures, and an ageing

population are just some of the most striking examples. How are these changes affecting theefficiency of health services and what are the consequences for access to treatment? These

are the two questions being posed by a team of European and Chinese experts in theframework of a study co-financed by the INCO programme.

Health report on Chinese cities

H E A L T H S E R V I C E S RTD in fo Spec ia l I N CO issue June 2005 25

The authorities in both Nantong and Zibo were enthusiastic participantsin the study. They provided medical statistics compiled by the healthcentres (number of patients, types of pathology, etc.) as well as variouseconomic and social data that are essential to any analysis of a healthcare system. In addition to collecting these statistics, the researchers alsocarried out their own in-depth studies in the field. They set up a panelof several thousand families representing the different social classes, issu-ing each family with a book in which to record, during two weeks, detailsof any visit to a health care establishment. The researchers also conductedface-to-face interviews with inhabitants, government officials, businessmanagers and hospital directors.

New illnesses, new patients

What lessons can de learned from this three-year study that combinedan economic and sociological analysis with a quantitative and qualita-tive approach? As space does not permit the presentation of the collecteddata in any detail – it runs to 250 pages of a book containing about 30publications in both English and Chinese(1) – we will highlight the mostnotable findings.

First of all, the study provides a very precise picture of the health situ-ation of the populations of these two towns. This shows that the six mostcommon causes of mortality are at present chronic diseases of the kindthat are found in Western societies (cancers, cardiovascular disease,etc.). Infectious diseases rank seventh, although they remain an import-ant public health issue, especially with the resurgence of tuberculosis andthe spread of Aids. The researchers see this as proof that epidemiolog-ical transition is well under way in urban China, marked by a decline ininfectious diseases and an increase in the chronic diseases that accom-pany development.

The second lesson is that access to hospital care is not dependent on sexbut on economic status. Employees of public administrations and of prof-itable state-owned enterprises attend medical centres much more oftenthan employees of loss-making enterprises, private companies or, mostnotably, the unemployed. There is a simple explanation for this inequal-ity: those who seek most health care are those who benefit from ahealth insurance policy paid for by their employer. Such systems are veryrare. If they do not have sufficient insurance cover, those who suffer froma chronic disease spend a large part of their wages on their treatment.As to the poorest sections of the population, whose situation is often pre-carious, they find it difficult to meet the cost of health care.

A mixed picture

Although not egalitarian, are China’s health servicesefficient? The study offers a mixed response onthis point. There was a notable drive for modern-isation between the early and late 1990s, when suchhigh-tech devices as medical imaging became gen-erally available, for example. The hospitals tookon a lot more staff and the standard of careimproved during this period. Unfortunately, therewas a down side to this progress. Patients with the

means to do so abandoned the clinics and health centres in favour ofthe modern hospitals, even when their condition did not really requireit. The costs of a consultation tripled between 1990 and 1999 (includ-ing an adjustment for inflation), while the daily cost of hospitalisationincreased fourfold. There also seems to be a certain wastage and bed occu-pancy fell from over 80% in the early 1990s to around 60% today.

The study therefore provides a mixed picture of the Chinese healthcare system. On the one hand, the quantity and quality of care serviceshave improved, and the drive for modernisation has brought consider-able progress in public health. But on the other, health services providea less than perfect response to a considerable and largely unsatisfieddemand. Millions of Chinese citizens are unable to receive the treatmentthey need while more and more hospital beds are remaining empty. Theseobservations were presented first at a round table attended by officialsfrom Nantong and Zibo, and then at the Ministry of Health in Beijingat the end of 2001. These meetings were the occasion to present someof the possible areas for public action suggested by the researche