DISEASE AND HEALTH

Priority risks and future trends

From longstanding to emerging hazards, environmental factors are a root cause of a

significant burden of death, disease and disability – particularly in developing countries. The
resulting impacts are estimated to cause about 25% of death and disease globally, reaching nearly
35% in regions such as sub-Saharan Africa (1). This includes environmental hazards in the work,
home and broader community/living environment.

A significant proportion of that overall environmental disease burden can be attributed to

relatively few key areas of risk. These include: poor water quality, availability, and sanitation; vector-
borne diseases; poor ambient and indoor air quality; toxic substances; and global environmental
change. In many cases, simple preventive measures exist to reduce the burden of disease from
such risks, although systematic incorporation of such measures into policy has been more of a
challenge. Below are estimates of deaths globally from the most significant environmentally-related
causes or conditions, and from certain diseases with a strong environmental component:

• Unsafe water, and poor sanitation and hygiene kill an estimated 1.7 million people annually,
particularly as a result of diarrhoeal disease .

• Indoor smoke – primarily from the use of solid fuels in domestic cooking and heating – kills
an estimated 1.6 million people annually due to respiratory diseases.

• Malaria kills over 1.2 million people annually, mostly African children under the age of five .
Poorly designed irrigation and water systems, inadequate housing, poor waste disposal and
water storage, deforestation and loss of biodiversity, all may be contributing factors to the
most common vector-borne diseases, including malaria, dengue and leishmaniasis.

• Urban air pollution generated by vehicles, industries, and energy production kills

approximately 800 000 people annually .

• Road traffic injuries are responsible for 1.2 million deaths annually; low- and middle-income
countries bear 90% of the death and injury toll. Degradation of the built urban and rural
environment, particularly for pedestrians and cyclists, has been cited as a key risk factor .

• Lead exposure kills more than 230 000 people per year and causes cognitive effects in one
third of all children globally; more than 97% of those affected live in the developing world.

• Climate change impacts – including more extreme weather events, changed patterns of

disease and effects on agricultural production – are estimated to cause over 150 000 deaths
annually .

• Unintentional poisonings kill 355 000 people globally each year . In developing countries –
where two-thirds of these deaths occur – such poisonings are associated strongly with
excessive exposure to, and inappropriate use of, toxic chemicals and pesticides present in
occupational and/or domestic environments

Overview of the Healthcare System in the Philippines

Healthcare in the Philippines is considered to be of good quality by international standards.

For instance, the World Health Organization ranks the efficiency of the Filipino healthcare system
60th in the world. Meanwhile, the Bill and Melinda Gates Foundation, using medical access and
quality as their criteria, ranks the Philippines 124th in the world. Regardless of the assessment
criteria, the healthcare system in the Philippines is steadily improving.

Above all, this is thanks to government reforms that are moving the country closer to a
universal system. As such, all Filipino citizens are entitled to free medical care through the
Philippine Health Insurance Corporation, known as PhilHealth. And in early 2019, the country
reached a major milestone with the Universal Healthcare Act. After that, the scope of PhilHealth’s
coverage expanded to include free medical consultations and laboratory tests. Furthermore, going
forward all Filipino citizens will be automatically enrolled in the national program.

How the Healthcare System in the Philippines is Funded

The PhilHealth program was set up in 1995 to provide affordable universal coverage.

PhilHealth is government-controlled and funded. It is financed by local and national government
subsidies, as well as through contributions by employers and employees. Moreover, the program
offers various medical plans depending on income, age, and circumstance.

PhilHealth has six major membership categories. They are:

• Formal Sector: Workers employed by public and private companies.

• Indigents: Impoverished people subsidized by the National Household Targeting System for
Poverty Reduction. As such, this category includes people who have no visible means of
income and whose income is insufficient for subsistence.

• Sponsored Members: People subsidized by their local governments.

• Lifetime Members: Retirees and pensioners who have already paid premiums for at least
120 months and are over 60 years old. These are non-paying members.

• Senior Citizens: A category under a certain set of regulations (RA 10645) that offers free
PhilHealth coverage to those 60 years old. However, this is not the same as lifetime
members.  It applies to seniors not currently covered by any of the existing membership
categories of PhilHealth.

• The Informal Economy: Primarily self-employed people, migrant workers, and those who
do not neatly fit within the Formal Sector category. In other words, it is a favorite among
expats.

The Differences Between Private and Public Care

Like most countries, private care in the Philippines means many additional comforts for
patients. Facilities are newer, cleaner, more comfortable, and more private. Wait times are shorter
and the staff is multilingual. However, it is not necessary to visit a private facility to see an English
speaking doctor. Nearly all doctors and nurses speak English. In fact, their language skills are
almost too good to be true. Many medical personnel are recruited to work in English language
countries overseas.

Private services are important to the Filipino healthcare system. About 30% of the population
uses the private system as their primary means of healthcare. A majority of hospitals, approximately
60%, are private as well. Furthermore, medical tourism is a significant part of the economy, which
helps account for the large percentage of private facilities and specialty centers.
 Many public hospitals, especially in large cities, have high standards of care and diagnostic
services. However, that is not universally true of all public facilities. If you are opting for public care,
a local friend or colleague can help advise you on which hospitals and clinics have the highest
standards of care.

Who is Eligible for Healthcare in the Philippines

International citizens who are legally residing in the Philippines are eligible to join PhilHealth.
For most, the Informal Economy membership category is the best fit. The annual costs are usually
under $100. As well, foreigners married to a Philippine national can get coverage as a dependent.

However, short term visitors, like tourists, are not covered by PhilHealth. As such, they
should carry their own travel medical coverage.

Health Options for Expats and Foreigners

Expats looking to sign up for healthcare in the Philippines must first get in touch with
PhilHealth. Happily, there is an online registration process for those in the Formal Sector and
Informal Economy categories. This is a nice change for foreigners who are used to having to visit
government offices in person! In addition to registering with PhilHealth, foreign citizens should also
register ahead of time with a local doctor and a local hospital.

Keep in mind PhilHealth is the public system and you may want to supplement it with a
private global medical plan. As mentioned, the private plan will be easily accessible with significantly
more private hospitals than public hospitals. You will have shorter to no wait times and global
access to care.

Challenges From the “Brain Drain”

“Brain drain”, the emigration of highly trained or intelligent people from a particular country, is
a serious problem in the Philippines for the healthcare system. Many qualified Filipino medical
personnel are recruited to work overseas, leaving the medical industry short-handed. The country
has approximately just one physician per 33,000 residents, which is significantly worse than in other
countries. Furthermore, the problem is not just with doctors. From dentists to midwives, the average
ratio of practitioners to patients is poor and shows few signs of improving. However, recent changes
have made provisions to award grants to medical students to start their career in their home
country. They also mandate that new medics serve in remote areas for three years.

Specialized Care and Addiction Treatment

The war on illegal drugs is brutal. Thousands of suspected drug dealers have been shot on
sight. Additionally, there are lengthy prison terms for those caught using illicit substances. Fear of
death from street violence and police encounters has encouraged many users to voluntarily
surrender. Unfortunately, government-run rehabilitation centers are operating beyond capacity.
They have become places of refuge from police brutality and street justice. Physicians are frustrated
that they can no longer offer services like one-on-one counseling. And activists complain that the
underlying causes of addiction, including hunger and poverty, are not being addressed. In other
words, it is a frustrating and deadly situation. In conclusion, seeking treatment overseas is the
preferred option for expats and Filipinos with financial resources.

Healthcare Item Average Cost in the Philippines

PhilHealth insurance plan ₱2,400 - ₱3,600

One-night hospital stay ₱2,500

Emergency room visit ₱2,500

Doctor’s office visit ₱500

Filipino medical system: Public, private, universal, national, state, single payer - which is it?

The Philippines has a public medical system with the option to either choose free,
government-provided healthcare or purchase private healthcare from your own pocket.

The Filipino state healthcare system

The public healthcare system is delivered through public health and primary healthcare
centres linked to peripheral barangay (local town) health centres. Around 40% of the hospitals in the
Philippines are public. Doctors at public hospitals in the Philippines are well-trained, but there are
still a number that say the technology and equipment used at public hospitals isn’t as good as
private ones. So you’ll have to make sure to ask around from your local contacts to get their opinion
before you choose the hospital that’s right for you.

POVERTY

What Is Poverty?

Poverty is a state or condition in which a person or community lacks the financial resources
and essentials for a minimum standard of living. Poverty means that the income level from
employment is so low that basic human needs can't be met.

In 2015, more than 736 million people lived below the international poverty line. Around 10
per cent of the world population is living in extreme poverty and struggling to fulfil the most basic
needs like health, education, and access to water and sanitation.

According to the Asian Development Bank, the major causes of poverty include:

1. low economic growth

2. a weak agricultural sector

3. increased population rates, and

4. a high volume of inequality.

Economic policies to reduce poverty:

1. Sustainable economic growth

Sustainable economic growth means a rate of growth which can be maintained without
creating other significant economic problems, especially for future generations.

Promoting economic growth increases total income in society, creating more jobs and
income which could be redistributed.

2. Reduce unemployment

Unemployment occurs when a person who is actively searching for employment is unable to
find work.

Unemployment can be reduced through both supply-side policies, such as free training
schemes for those who are structurally unemployed

3. Progressive taxes

Progressive tax is based on the taxpayer's ability to pay. It imposes a lower tax rate on low-
income earners than on those with a higher income. This is usually achieved by creating tax
brackets that group taxpayers by income ranges.

4. Increasing benefits to the poor

Means-tested benefits involve increasing welfare benefits to those on low incomes. For
example, child benefit and housing benefit.

5. National minimum wage

A minimum wage is the lowest level of pay that is legally allowable. It is set as an hourly rate,
given that setting a weekly or monthly rate would be impossible as not everyone works the same
number of hours in a week or a month.

This is an effective way of increasing the incomes of the low paid and therefore reducing
wage inequality.

6. Benefits in kind

These are important public services which are provided free at the point of use (or
subsidized). They mainly involve education and health care. Free education enables those from
low-income families to gain skills and qualifications which can help lead to better jobs and higher
incomes in the future.

7. Universal basic income

Universal basic income (UBI) is a government program in which every adult citizen receives
a set amount of money on a regular basis.

The goals of a basic income system are to alleviate poverty and replace other need-based
social programs that potentially require greater bureaucratic involvement.
 EDUCATION

Education is one of the most powerful instruments for reducing poverty and inequality and
for laying the basis for sustainable growth. It has strong links not just to productivity growth but to
improved health, to the ability to understand the need to care for the natural environment, and even
to population stabilization.

A lack of education can be defined as a state where people have a below-average level of
common knowledge about basic things that they would urgently need in their daily life.For instance,
this could include basic knowledge in math, writing, spelling, etc. Especially in poor developing
countries, educational inequality is quite prevalent.

The following are some of the issues developing countries have in education:

1.Children often have to work from an early age. People living in poverty in developing countries
cannot afford to send their children to school. Hence, children are forced to work instead to support
their family.

2.There are no schools in many areas. Despite the desire to go to school, there are areas that do
not have a nearby school. Some cannot go to school because of the distance and they do not have
enough money for getting an apartment. These places are usually in the countryside wherein
houses are like miles away from each other.

3.Families do not have access to books or computers. Disadvantaged families are having a
hard time earning for food so they no longer think of getting a book. For this reason, children cannot
even get a chance to read books or navigate computer.

4. Literacy rates are often low. People in developing countries cannot read and write well because
of the lack of schools and teachers. Aside from that, their priority is not education but earning a
living. As mentioned above, people have to work early. As long as they are working and earning
enough just to get by, getting educated is not important for them.

To solve the problems, developed countries play a major role in improving the education
worldwide. Here are some ideas that could be implemented:

1. Developed countries could help developing nations by providing money. The main issue
among developing countries is the budget for education. Developed countries can financially help
these struggling countries to improve the literacy rates.

2. Developed countries could invest in schools and technology. They could supply the funds to
build schools and pay for teachers. Since one of the issues is absence of schools in some areas,
money is badly needed in putting up schools in far flung areas. This way, even the children who live
in the mountains will get the chance to attend school. Technology is also important. People from
developing countries have to be knowledgeable on the equipment being used today.

3.Children need to have access to free schooling. It is true that education nowadays is
expensive. What children need today is free education. This will lessen the burden of parents and
will prevent children from working early.

4.Computer equipment could be donated. These computers do not have to be most advanced
ones, as long as it can allow people to learn the basic skills. The Internet can expose students to a
world of knowledge and information.
5. Governments should make education compulsory for all children. If education is required by
law, then people will comply to avoid punishment. They should encourage parents to send their
children to school.

6. Governments of developed and developing countries must work together. Collaboration is

vital in solving education issues in developing countries. This can give insight to developed
countries on the real situation and can provide some approaches for the improvement developing
countries.

POPULATION

Population is defined as a group of individuals of the same species living and interbreeding
within a given area.

The world population now stands at 7.8 billion inhabitants, having reached the 7 billion
milestone in 2011.Demographers expect the 8 billion milestone in 2023, with global population
projected to reach 9 billion by 2037 and 10 billion by 2056. The rate of population growth and the
number of people living on earth have both increased.

 Countries now suffering from overpopulation are being forced to spend a great deal of
money and and attention on fertility control.

 The growth of population has been greatest in countries that are both poorest and least able
to invest in social and educational services.

 Many people consider rapid population growth in the Third World to be a major obstacle to
development, yet there are many ways in which population growth may be a stimulus to
progress.

Demand for Education

Education is widely accepted to be a fundamental resource, both for individuals and

societies. It is the central to the construction of genuinely democratic societies.

Demand for education can be classified in to two types.

1.Individual demand or private demand

2.Social demand

For instance Psacharopoulos and Woodhall ( 1985) have defined the individual demand as
the enrolment of individuals in an educational system. On the other hand,,If we aggregate the
individual demand, we get the social demand. Thus the social demand is the total number
ofpersons enrolled in an educational system.

One of the most powerful tools in stemming population growth will be education, says Mark
Montgomery. “We’ve seen some astonishing transitions, especially in the 1970s in what were then
poor countries where fertility rates fell when levels of education went up.”

 Countries in which women are better educated typically have smaller families and lower
rates of population growth.
  Education leads to lower birth rates and slows population growth.This makes it easier for
countries to develop. A more-educated workforce also makes poverty eradication and
economic growth easier to achieve.
 Researchers have suggested that more-educated communities value smaller, higher-quality
families.

CHILD LABOR

In the world’s poorest countries, slightly more than 1 in 4 children are engaged in child
labour.

Children around the world are routinely engaged in paid and unpaid forms of work that are
not harmful to them. However, they are classified as child labourers when they are either too young
to work or are involved in hazardous activities that may compromise their physical, mental, social or
educational development. In the least developed countries, slightly more than one in four children
(ages 5 to 17) are engaged in labour that is considered detrimental to their health and development.

The issue of child labour is guided by three main international conventions: the International
Labour Organization (ILO) Convention No. 138 concerning minimum age for admission to
employment and Recommendation No. 146 (1973); ILO Convention No. 182 concerning the
prohibition and immediate action for the elimination of the worst forms of child labour and
Recommendation No. 190 (1999); and the United Nations Convention on the Rights of the Child.
These conventions frame the concept of child labour and form the basis for child labour legislation
enacted by countries that are signatories.

Prevalence of child labour

Sub-Saharan Africa has the largest proportion of child labourers (29 per cent of children
aged 5 to 17 years). This is in stark comparison to the Middle East and North Africa, where 5 per
cent of children in this age group are performing potentially harmful work.

In the world's poorest countries, slightly more than one in four children are engaged in work
that is potentially harmful to their health
Gender disparities

In all regions, boys and girls are equally likely to be involved in child labour. However,
gender disparities are often observed in the types of activities carried out, with girls far more likely to
be involved in unpaid household services.

In all regions, girls are as likely as boys to be engaged in child labour

Fertility

What is Fertility?

 The human female is generally fertile from early teens to about mid-forties.
 The human male generally remains fertile throughout adulthood.
  The larger the fraction of the population who are in fertile age range the more rapid will be
the population growth;
 Influence the average age of the population structure towards the younger end of the
spectrum.

According to Population Division of the Department of International Economic and Social

Affairs of the UN Secretariat (1980)

 Fertility should decline more rapidly in the countries where it is currently lowest since the age
structure appears to favor such a course.
 Among twenty one centuries the mean number of the children ever born ranged widely.
 In the developed world, there is a tendency of global for family sizes on average to be
smaller than the replacement level.

The “replacement level of fertility” is the number that causes a country’s population to slow
down and eventually stabilize.

 Fertility is usually expressed using the proxy measure of birth rate either crude or
standardized for age and sex.
 The higher the birth rate the more markedly the birthrate is depressed by the age structure.
 Fertility should decline more rapidly in the countries where it is currently lowest since the age
structure appears to favor such a course.

Total Fertility Rate (TFR) / population Rate

 Is the total number of live birth per 1000 of a population in a year.

 The rate of births in population calculated in several ways. Live births from Universal
Registration System for births, deaths and marriages.
 Population counts from a census and estimation through specialized demographic
techniques.
 The birth rate along with Mortality Rate and Migration Rate are used calculate Population
Growth.
 Another term interchangeably with birth rate (fertility rate) is Natality. When the crude death
rate is subtracted from crude birth rate the result is the Rate of Natural increase Mooney.

Total Fertility Rate (TFR) decline from about 6 at the beginning of the 1960’s to 40 by the
middle of 1990’s. These trends in fertility reduction are slow by East and Southeast Asian
standards.

 John May noted that the countries sub-Saharan region in Africa has the highest fertility rate
in the world. It has a rate of 5.1 children per women, and the rate of modern contraceptive
use overall is 23 percent.
 The countries of sub-Saharan region, with a collective population of 920 million, are on track
to reach 2.1billion people by 2050.

Mortality rates declined rapidly after the war but slowed down starting the 1960s as the gains
from technological advance were exhausted and further reduction depended more on
socioeconomics development (Herrin 1998)

 This is clearly depicted in the movement of the infant mortality rate (IMR)
  In terms of Socioeconomic Development John Bongaarts explained that “raises the cost and
decreases the benefits of having children and it reduces mortality, especially children. These
changes often lead parents to want smaller families.

Consequences of Fertility Trends

According to Cleland with reference to former chief economist at the World Bank, Francois
Bourguignon when a country reduces its fertility rate and the wage-earning component of its
population becomes larger in comparison to the nonworking, dependent component (often referred
to as a change in age structured).

Factors to incorporate in calculating a hypothetical change in total fertility rate (TFR) by

Casterlined (2015)

Nuptiality – adult years spent in or out of marital union

Preference Composition – in union years spent not wanting another child (versus wanting a child)

Wanted Rates – Rate of child bearing among those wanting another child (conditional wanted rate)

Unwanted Rates – Rate of child bearing among those not wanting another child (conditional
unwanted rate)

What is Gender Gap?

The gender gap is the difference between women and men as reflected in Social, Political,
Intellectual, Cultural, or Economic Attainments or Attitudes.

The Global Gender Gap Index aims to measure this gap in four key areas;

 Health
 Education
 Economics
 Politics

Example: The gap in economics is the difference between men and women when it comes to
salaries, number of leaders and participations in the workplace.

Countries need to pay attention to the gender gap not only because such inequality is
inherently unfair. Numerous studies suggest that greater gender equality leads to better economic
performance.

At the current rate of progress the overall global gender gap will take a hundred years to
close, while the gap in the workplace will now not be closed for 217 years (WEF GGGI).

It is a gap the world can’t afford to ignore.

AGRICULTURE

Agriculture is the cultivation and breeding of animals, plants and fungi for food, fiber,
biofuel, medicinal plants and other products used to sustain and enhance human life. Agriculture
plays a crucial role in the economy of developing countries, and provides the main source of food,
income and employment to their rural populations.
 Despite the important role of agriculture in developing countries, it is one of the major
problems faced by the third world countries. More than half the population of all the developing
nations in the world depends on Agriculture or farming for survival and for at least two meals a day,
that is almost 75 percent of the world’s poorest people, approximately 1.4 billion women, children
and men based on __Nikhil Ghimer_. However, the even more intriguing fact is that 50 percent of
hungry people are farming families. A lot of internationally acclaimed projects are carried out every
year in order to train and empower these people from such countries to at least to help them learn
to live off Agriculture.

The developing countries are currently facing different problems especially in the sector of
agriculture. These are some of the problems we think that need an urgent solution.

Small and fragmented land holdings:

The major reason for this problem is the inheritance law. The land belonging to father is
distributed equally among his sons. This distribution of land does not entail a collection or
consolidated one, but its nature is fragmented.

Different tracts have different levels of fertility and are to be distributed accordingly. If there
are four tracts which are to be distributed between two sons, both the sons will get smaller plots of
each land tract. In this way the holdings become smaller and more fragmented with each passing
generation.

• A lot of time, labour is wasted in moving seeds, manure ,implements and cattle from one
piece of land to another

• Irrigation becomes difficult on such small and fragmented fields.

• A lot of fertile land is wasted in forming boundaries.

• The solution to this problem is cooperative farming in which farmers pool their resources and
share the profit.

Seeds:

• Good quality seeds are out of reach of the majority of farmers, especially small and marginal
farmers mainly because of high prices of better seeds.

Manures, fertilizers and biocides:

• Indian soils have been used to grow crops over thousands of years without caring much for
replenishing. This has led to depletion and exhaustion of soils resulting in their low
productivity.

• The average yields of almost all the crops are amongst the lowest in the world.

• This could be solved by using good quality and ecofriendly manures and fertilizers.

Irrigation:

• Many farmers are still dependent on monsoon. More area need to brought under assured
irrigation.
 • Safeguards must be taken against ill effects of over irrigation. Large tracts in Punjab and
Haryana have been rendered useless (areas affected by salinity, alkalinity and water-
logging), due to faulty irrigation

Lack of mechanisation and proper technology:

• Most of the agricultural operations in larger parts are carried by human hand using simple
and conventional tools and implements like wooden plough, sickle, etc.

• Little or no use of machines is made in ploughing, sowing, irrigating, thinning and pruning,
weeding, harvesting threshing and transporting the crops.

• It results in huge wastage of human labour and in low yields per capita labour force.

Soil Erosion

• Large tracts of fertile land suffer from soil erosion by wind and water.

• This area must be properly treated and restored to its original fertility

Agricultural marketing

• In the absence of proper marketing facilities, the farmers have to depend upon local traders
and middlemen for the disposal of their farm produce which is sold at throw-away price.

• In most cases, these farmers are forced, under socio-economic conditions, to carry on
distress sale of their produce.

• In most of small villages, the farmers sell their produce to the money lender from whom they
usually borrow money.

Inadequate storage facilities

• Lack of storage facility forces the farmers to sell the produce immediately after the harvest at
prevailing market prices which are bound to be low.

• Thus, farmers are deprived of their legitimate income.

• Post -harvest losses could be reduced by providing proper storage facilities to the farmers.

These are few key solutions in addressing problems in agriculture:

1. Develop high-yield crops

• Increased research into plant breeding, which takes into account the unique soil types of
Africa, is a major requirement. A dollar invested in such research by the CGIAR consortium
of agricultural research centres is estimated to yield six dollars in benefits.

2. Boost irrigation

• With the growing effects of climate change on weather patterns, more irrigation will be
needed. Average yields in irrigated farms are 90% higher than those of nearby rain-fed
farms.

3. Increase the use of fertilizers

• As soil fertility deteriorates, fertilizer use must increase. Governments need to ensure the
right type of fertilizers are available at the right price, and at the right times. Fertilizer
 education lessens the environmental impact and an analysis of such training programs in
East Africa found they boosted average incomes by 61%.

4. Improve market access, regulations, and governance

• Improving rural infrastructure such as roads is crucial to raising productivity through

reductions in shipping costs and the loss of perishable produce. Meanwhile, providing better
incentives to farmers, including reductions in food subsidies, could raise agricultural output
by nearly 5%.

5. Make better use of information technology

• Information technology can support better crop, fertilizer and pesticide selection. It also
improves land and water management, provides access to weather information, and
connects farmers to sources of credit. Simply giving farmers information about crop prices in
different markets has increased their bargaining power. Esoko, a provider of a mobile crop
information services, estimates they can boost incomes by 10-30%.

6. Adopt genetically modified (GM) crops

• The adoption of GM crops in Africa remains limited. Resistance from overseas customers,
particularly in Europe, has been a hindrance. But with Africa’s rapid population growth, high-
yield GM crops that are resistant to weather shocks provide an opportunity for Africa to
address food insecurity. An analysis of more than one hundred studies found that GM crops
reduced pesticide use by 37%, increased yields by 22%, and farmer profits by 68%.

7. Reform land ownership with productivity and inclusiveness in mind

• Africa has the highest area of arable uncultivated land in the world (202 million hectares) yet
most farms occupy less than 2 hectares. This results from poor land governance and
ownership. Land reform has had mixed results on the African continent but changes that
clearly define property rights, ensure the security of land tenure, and enable land to be used
as collateral will be necessary if many African nations are to realise potential productivity
gains.

8. Step up integration into Agricultural Value Chains (AVCs)

• Driven partly by the growth of international supermarket chains, African economies have
progressively diversified from traditional cash crops into fruits, vegetables, fish, and flowers.
However, lack of access to finance and poor infrastructure have slowed progress.
Government support, crucial to coordinate the integration of smallholder farmers into larger
cooperatives and groups, may be needed in other areas that aid integration with wider
markets