Category: Africa

Source: The Conversation – Africa – By Dileepa Ediriweera, Health Data Scientist, Liverpool School of Tropical Medicine

Not every snakebite injects venom. When venom enters the body, however, it can cause snake envenoming. This is a potentially fatal condition and it mostly affects poor rural communities across tropical and subtropical regions who don’t have easy access to medical care.

As researchers with decades of combined experience in snakebite and tropical disease epidemiology, we came to realise that snake envenoming faces a data crisis. Over half of the countries where venomous snakes pose a threat don’t keep count of how many people are bitten or envenomed.

In rural sub-Saharan Africa and south Asia, many victims live hours away from the nearest clinic, lack transport, or seek care from traditional healers. As a result, their cases are never captured in national health statistics.

To bridge this massive gap, we conducted a study to map the global burden of snake envenoming and related deaths.

We looked at data from 79 countries by reviewing studies published up to 31 March 2025. This allowed us to update the findings from our milestone 2008 global burden study. To fill the remaining data gaps, we built a geostatistical model that combines real-world data with local environmental and socioeconomic factors. This allowed us to estimate envenoming and fatality rates.

We conclude from our findings that snake envenoming is a public health crisis on a far greater scale than official statistics have shown. Our results show that sub-Saharan Africa bears the heaviest toll.

The World Health Organization has set an ambitious target to halve snakebite mortality and disability by 2030. Mapping the problem at the country level is the first crucial step.

Uncovering the hidden burden

To overcome the lack of reliable data, we turned to a model-based geostatistics framework.

To understand how this modelling works, think of it as predicting invisible patterns by combining known data points with environmental signals. Instead of assuming data for every region, this modelling uses statistical probability to calculate a range of likely outcomes based on environmental signals.

We fed our model with data including climate, snake species richness and socioeconomic indicators. The model then calculated the probability of snakebites occurring in specific locations, even where official health records were completely blank.

By comparing different data sources (including hospital-reported data and regional statistics) against ground level community-survey data, our framework allowed us to account for unreported snake envenomings. It produced both a baseline floor and a potential upper ceiling for snake envenomings and fatalities.

Based on this, we estimate that at least 2.1 million people experience snake envenoming each year globally. The true number could be high as 7 million. Using our model, which adjusts for substantial under-reporting, annual deaths may range from 274,000 to 513,000.

The geographic distribution of this burden is uneven. Our research shows that sub-Saharan Africa alone accounts for 45% of all global envenomings and fatalities. That burden has likely been underestimated for decades. People in sub-Saharan Africa experience snake envenoming and death at nearly three times the rate seen in south Asia.

Countries like Nigeria, the Democratic Republic of Congo and Ethiopia face a high burden, driven by dense rural populations and high exposure in agricultural fields.

Why sub-Saharan Africa is hit hardest

The reasons sub-Saharan Africa suffers such disproportionate harm are structural rather than accidental.

Firstly, the continent hosts a rich diversity of medically important venomous species. These include saw-scaled vipers (Echis spp.), puff adders (Bitis arietans), African cobras (Naja spp.) and mambas (Dendroaspis spp.). They are responsible for substantial morbidity and mortality across the continent.

Secondly, millions of rural agricultural workers labour in open fields without protective boots and walk on unlit footpaths at night. When a bite occurs, fragile health systems, long travel distances to regional facilities and the high cost or total absence of effective antivenom mean a treatable medical emergency can quickly become fatal. Similar conditions exist in parts of Asia.

We estimate that over 800,000 survivors are left with long-term physical disabilities each year, including amputations and other permanent impairments. These disabilities can reduce household income, increase healthcare costs and push already vulnerable farming families deeper into poverty.

Going forward

Meeting the World Health Organization’s goal requires moving away from guesswork and using spatial risk data to guide real-world policy.

By identifying high-risk hotspots, governments and global health partners can strategically stockpile antivenom where it is needed most, train primary healthcare workers in high-burden rural zones and improve rapid transport infrastructure.

Snake envenoming has remained hidden for too long. Better data cannot solve the problem, but can help ensure that antivenom, healthcare services and prevention efforts reach the communities that need them most.

– Snakebites are a far bigger problem than we knew: new study maps the hidden dangers
– https://theconversation.com/snakebites-are-a-far-bigger-problem-than-we-knew-new-study-maps-the-hidden-dangers-292524

Source: The Conversation – Africa – By Lydia Namatende-Sakwa, Associate Research Scientist, African Population and Health Research Center

“Me who is a poor person, do I have the luxury to have depression? No, it is only you who is rich that has the luxury to have depression.”

This statement, shared by a research participant in Kampala, the Ugandan capital, captures a persistent misconception: that depression belongs to wealthy people or those whose lives are comfortable enough to permit emotional vulnerability.

It is an example of how socio-cultural beliefs can become a barrier to recognising mental health problems and seeking support.

In 2025, Uganda’s Ministry of Education and Sports issued a set of mental health and psychosocial support policy guidelines and resources for schools. These included a training manual, teachers’ handbook and wellbeing guide. They provide practical information on recognising distress, psychosocial support, referral and wellbeing in education settings.

The next challenge is to put the guidelines into practice.

Our team of researchers at the African Health and Population Research Center did a study to provide evidence that would help schools in Uganda follow the guidelines. We looked at what people understand by mental health, what learners and staff need, school capacity and what needs to happen first to put the guidelines into action.

The study engaged 200 learners, teachers, parents, community representatives, policy actors and development partners across four districts: Kampala, Jinja, Gulu and Mbarara. Kampala is the capital city; Jinja is a mixed rural-urban context. Gulu is an area affected by conflict and displacement. Mbarara is an education and economic hub with urban and rural schools.

We found socio-cultural and gender norms strongly influenced whose distress was recognised, how it was explained and whether seeking help was considered acceptable. Mental health at school was linked to issues like literacy, spirituality, poverty, family instability, displacement, disability and trauma.

Learner distress reflected overlapping academic, family, economic, social and institutional pressures. The responses at school must take all these into account. School mental health programmes must address both emotional wellbeing and structural pressures such as poverty, stigma and exclusion.

Listening to Ugandans

Our four study sites were chosen to reflect a range of environments, with different resources and socio-cultural influences.

We held dialogues at each site with learners aged 13-18, parents, teachers, government representatives, youth-led organisations, religious and community leaders, NGOs and researchers. Special interest groups (including refugees, LGBTQ organisations and people with disabilities) were also included.

The dialogues explored understandings of mental health, learner and staff needs, school capacity and future priorities.

What’s influencing mental health

The study participants described student mental health as a growing concern. They mentioned depression, anxiety, stress, low self-esteem, fear, social withdrawal, substance use, bullying-related distress, trauma, anger, academic pressure and poor emotional regulation.

Participants described these as interconnected problems.

The drivers of distress among students were identified as:

• academic pressure

• family and home background, including absent parents, domestic violence and neglect

• poverty that resulted in lower self-esteem and greater exclusion from peer groups

• bullying, teasing, humiliation and harsh discipline

• substance use and addiction, especially among boys and urban learners.

Boys and girls were seen as vulnerable to different pressures.

Barriers to getting help

Participants in all sites said mental illness carried a stigma. It was seen as morally wrong, caused by supernatural forces, or “a disease for the rich”.

Another perception was that boys and men couldn’t seek help for fear of looking weak.

Learners also felt they could not trust adults with their problems. They feared that teachers might judge them or reveal their personal stories publicly. Learners experiencing anxiety or distress thought they might be labelled lazy or badly behaved, or accused of “faking it” or “seeking attention”.

The danger is that withdrawal, poor concentration, anger or declining performance might then be treated as deliberate disobedience.

Mental health difficulties were sometimes attributed to witchcraft, curses or demonic possession. Religious and cultural systems can offer hope, belonging and support, but problems arise when they become the only explanation for distress. As one Kampala teacher warned,

Some people will pray until somebody dies.

Learners reported being told, “You have to be strong … a guy who does not cry.” Such expectations encourage boys to hide stress and may lead to withdrawal, anger or risky behaviour rather than seeking support.

Girls face pressures linked to harassment, poverty, reproductive-health stigma and social judgment, often while being expected to remain silent. Female educators also face gendered scrutiny, including questions such as, “Where are their husbands and why are they not interested in staying with them?”

Counselling can itself carry stigma. People reported fear and shame associated with getting professional help.

Changing systems to change norms

Teachers should recognise that a child’s behaviour may arise from bullying, poverty, bereavement or family conflict. Schools should ask not only “What is wrong?” but also “What may have happened?”

School mental health programmes should respect cultural beliefs without delaying appropriate help.

Girls should be protected from harassment and enabled to report problems confidentially. Schools should promote a broader understanding of masculinity in which recognising emotions and seeking help are seen as responsible behaviours.

Schools need private support spaces, clear confidentiality procedures and counselling that is normalised. Learners must be able to seek help before problems escalate.

Socio-cultural and gender norms are reinforced through everyday practices and cannot be changed through awareness messages alone. Uganda’s response must combine norm change with system change. Schools need culturally grounded mental health literacy, safe environments, respectful discipline, confidential support, gender-transformative programming, trained staff and links to health and community services.

The key question is whether schools can recognise distress without judgment and respond with dignity, protection and appropriate care.

– ‘Lazy, weak, bewitched’ – how stigma stops Uganda’s children from getting help, and what schools can do about it
– https://theconversation.com/lazy-weak-bewitched-how-stigma-stops-ugandas-children-from-getting-help-and-what-schools-can-do-about-it-292539

Source: The Conversation – Africa – By Lyal White, Director of the Porter Institute Africa Hub, Gordon Institute of Business Science, University of Pretoria

Economic reform is usually judged by its numbers: inflation, deficits, growth. Less attention goes to the beliefs and habits that decide whether people will accept those numbers, and for how long.

Based on my research on comparative political economy and strategy in Africa, Asia and Latin America, there’s an argument to be made that Argentina under President Javier Milei offers an unusually clear view of that psychology at work as well as useful insights into South Africa’s economic path.

Javier Milei took office in December 2023, promising a set of libertarian policies. Libertarian doctrine holds that individual freedom and free markets work best when government is kept to a minimal role, largely limited to protecting property, contracts, personal safety and free market forces.

Milei was true to his promise. His policies included spending cuts, removing a raft of business rules and restrictions, making the peso officially worth less against the dollar, and stopping the central bank from printing new money to cover the government’s budget gaps.

Together, these steps were meant to end the habit of overspending and money-printing that fuelled runaway inflation, even though they caused short-term hardship for many households.

Milei delivered Argentina’s first fiscal surplus in over a decade and brought monthly inflation down, though at the cost of recession, higher poverty in the early period, and falling real wages and pensions. Later gains included a partial economic rebound and easing of currency controls.

A closer look into Milei’s programme reads less as a test of libertarian doctrine than an experiment shaped by Argentina’s long history of inflation, default and dependence on the state. That history helped make radical reform possible. Yet by August 2026, more Argentines disapproved of the Milei government than approved. So why might support weaken even as headline indicators improve? Inflation has fallen sharply and the budget is back in surplus.

Central to the Argentine story, and to the role of the state, is how citizens come to rely on – but fail to trust – those at the helm. The concept of “state dependency” captures it. This is a society in which large numbers of people organise their lives around income, jobs and support from the state. Their dependence creates powerful resistance to cuts. Argentina built this over decades.

South Africa and Argentina make a revealing pair. Both are middle-income democracies under fiscal pressure, where frustration with corruption and failing public services sits alongside heavy reliance on the state. But the roots differ.

Libertarianism with Argentine characteristics

In 1943 Colonel Juan Perón introduced social measures to help the country’s growing class of urban industrial workers. His set of policies became known as Peronism. It fused union power, protectionism and redistribution.

In 2001 the country suffered an economic collapse. More than half the population was pushed into poverty. Subsidies, price controls and welfare became central to everyday survival. By the end of 2023, roughly 40% of households received a state transfer, and inflation exceeded 200%.

Yet Argentines also learned to distrust the state. The country has defaulted on or restructured its debts at least nine times, and repeated currency collapses wiped out savings. People came to feel losses sharply, to favour spending today over trusting tomorrow, and to meet every stabilisation plan with suspicion. Hoarding dollars and working informally were rational responses.

Decades of crisis produced these defensive habits among citizens. Milei, as a political actor, set out to redirect them.

A society that experiences the status quo as a guaranteed loss is more willing to gamble on radical change. Milei’s campaign against la casta, the political class he cast as living off “productive Argentines”, changed the yardstick by which people judged reform.

Milei presented cuts as a moral clean-up targeting insiders and middlemen, even as retrenchment imposed costs on vulnerable households. This helps explain why his libertarianism took the form of a crusade rather than technocratic market reform. This is designed and implemented by technocrats.

The reforms came in phases. A front-loaded fiscal shock, while his mandate was new, turned a deficit into a small primary surplus within a year and cut ministries from 18 to eight. A dedicated deregulation ministry scrapped rent controls and hundreds of rules. Ending central bank financing of the Treasury worked as a shock to expectations. In a front-loaded fiscal shock, government makes its biggest and most painful budget cuts and tax or spending changes at the very start of a reform, rather than spreading them out over time.

Annual inflation has since dropped from a peak of nearly 300% when Milei was voted in to around 33% in 2025.

Greater predictability reduces panic buying and dollar hoarding, making longer-term planning and formal saving more attractive.

It was never pure libertarianism. Free marketeering has not been implemented in local and international trade practices. Universal child allowances and basic pensions survived. Welfare was restructured, with payments made directly to recipients rather than through political brokers. Rule by decree gave way to deals with Congress.

The result is libertarianism with Argentine characteristics.

Real, but provisional, gains

The gains are real but provisional. A post-drought harvest helped, unusually high earlier inflation flattered annual comparisons, and the social costs were substantial. Real public spending fell by roughly 30%, energy and transport subsidies were slashed, and tens of thousands of public jobs were eliminated.

Industrial policy was largely abandoned, and deep cuts to science, education and social protection raise questions around the institutional capacity needed for lasting development.

The central question is whether an early shock can become lasting credibility. Reforms endure only if households, businesses and investors believe they will not be reversed.

As the memory of crisis fades, people judge the government against their wages, jobs and the prosperity they were promised, not against 2023 when Milei was elected. Argentine surveys increasingly point to concern about wages and employment. And because his appeal rested on a moral break with a corrupt elite, corruption allegations reaching the Milei government strike at the story that made hardship bearable.

Falling approval does not mean the experiment has failed. It underlines how hard it is to turn a mandate for disruption into lasting support.

Is Milei’s shock therapy transferable?

South Africa’s defining trauma is not inflation, which its Reserve Bank has kept in check, but mass unemployment and deeply racialised inequality. More than 26.5 million South Africans receive social grants, which are widely understood as a pillar of post-apartheid redress.

South Africans expect the state to tackle these problems, not retreat from them. Coalition politics, strong unions, active courts, powerful big business and constitutionally protected socio-economic rights make shock therapy far harder. Cuts to social protection would be read through the lens of racial injustice.

Where Milei treats the state as the constraint to be cut back, Operation Vulindlela, run by the South African Presidency and National Treasury since 2020, treats weak coordination in basic infrastructure as a problem to fix.

Credibility can be earned by demonstrating state capability, not only by shrinking the state.

Argentina offers lessons, not a blueprint. Credibility and expectations matter as much as policy design. Confronting patronage works when reform separates the intermediaries who exploit support from the vulnerable people who depend on it. Business and investors can sustain momentum when politics is fragile. And reform needs a story that citizens recognise.

For South Africa, a libertarian route risks eroding the institutions that inclusive growth depends on. The more promising path is a hybrid: a capable developmental state that borrows Argentina’s lessons on credibility and patronage while strengthening the state.

Whether Milei’s experiment proves a turning point or a temporary rupture remains open. What it already shows is that reform depends less on ideological purity than on institutions, credibility and behavioural context.

This article draws on Argentina’s experiment in libertarianism and behavioural political economy: Lessons for South Africa, South Afican Journal of International Affairs (2026), available open access.

Annabel Dennison contributed to this article. She is a Master’s candidate in Economics and Psychology at Paris 1 Panthéon-Sorbonne and an intern with the Porter Institute’s Africa Hub at the Gordon Institute of Business Science in South Africa.

– Radical economic policies in Argentina offer lessons – but not a blueprint – for South Africa
– https://theconversation.com/radical-economic-policies-in-argentina-offer-lessons-but-not-a-blueprint-for-south-africa-292915