The CFA franc was initially pegged to the French franc and has been linked to the euro for about two decades.

Benin, Burkina Faso, Guinea-Bissau, Ivory Coast, Mali, Niger, Senegal, and Togo currently use the currency. All the countries are former French colonies with the exception of Guinea-Bissau.

The announcement was made Saturday during a visit by French President Emmanuel Macron to Ivory Coast, the world’s top cocoa producer and France’s former main colony in West Africa.

Ivory Coast President Alassane Ouattara, speaking in the country’s economic capital Abidjan, announced “three major changes”.

These included “a change of name” of the currency, he said, adding that the others would be “stopping holding 50 percent of the reserves in the French Treasury” and the “withdrawal of French governance” in any aspect related to the currency.

Macron hailed it as a “historic reform”, adding: “The Eco will see the light of day in 2020.”

The deal took six months in the making, a French source said.

The CFA franc’s value was moored to the euro after its introduction two decades ago, at a fixed rate of 655.96 CFA francs to one euro.

The Bank of France holds half of the currency’s total reserves, but France does not make money on its deposits stewardship, annually paying a ceiling interest rate of 0.75 percent to member states.

The arrangement guarantees unlimited convertibility of CFA francs into euros and facilitates inter-zone transfers.

CFA notes and coins are printed and minted at a Bank of France facility in the southern town of Chamalieres.

The CFA franc, created in 1945, was seen by many as a sign of French interference in its former African colonies even after the countries became independent.

The Economic Community of West African States regional bloc, known as ECOWAS, earlier Saturday urged members to push on with efforts to establish a common currency, optimistically slated to launch next year.

The bloc insists it is aiming to have the Eco in place in 2020, but almost none of the 15 countries in the group currently meet criteria to join.

Stumbling Blocks

ECOWAS “urges member states to continue efforts to meet the convergence criteria”, commission chief Jean-Claude Kassi Brou said after a summit of regional leaders in the Nigerian capital Abuja.

The key demands for entry are to have a deficit of less than 3 percent of gross domestic product, inflation of 10 percent or under and debts worth less than 70 percent of GDP.

Economists say they understand the thinking behind the currency plan but believe it is unrealistic and could even be dangerous for the region’s economies which are dominated by one single country, Nigeria, which accounts for two-thirds of the region’s economic output.

Nigeria’s Finance Minister Zainab Ahmed told AFP “there’s still more work that we need to do individually to meet the convergence criteria”.

ECOWAS was set up in 1975 and comprises Benin, Burkina Faso, Cape Verde, Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo — representing a total population of around 385 million.

Eight of them currently use the CFA franc, moored to the single European currency and gathered in an organisation called the West African Monetary Union, or WAMU.

But the seven other ECOWAS countries have their own currencies, none of them freely convertible.

AFP

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In MSF’s briefing paper “Waiting isn’t Option: Preventing and Surviving Advanced HIV[2]” , data from MSF-supported hospitals presented at the International AIDS Society (IAS) Conference on HIV Science in Paris today, highlights that in MSF-run and MSF-supported hospitals in Democratic Republic of Congo (DRC), Guinea, Kenya and Malawi, people arrive with such severe immune failure that overall mortality for patients presenting with AIDS is between 30-40%. Almost one-third of those deaths occur within 48 hours.

The main causes of illness and death are due to treatment failure or interruption and late diagnosis leading to delayed treatment. Unlike in the early 2000s, when little treatment was available, more than 50% of AIDS admissions at referral hospitals supported by MSF had already started antiretroviral therapy (ART), with many showing clinical signs of treatment failure. “Despite extensive access to antiretrovirals, there has not been the expected drop in late-stage presentations of HIV in developing countries. What’s different is that among people admitted to hospitals, the majority are already diagnosed and many have been on treatment for several years. In Kenya, in Homa-Bay, where antiretrovirals have been available for years, half of the patients hospitalised AIDS cases show signs of treatment failure. We’re pushing to switch these patients to second-line antiretrovirals more rapidly,” says David Maman, MSF Epicentre epidemiologist.

At community level, MSF population surveys also show that a proportion of people living with AIDS in communities in southern and eastern Africa remain untested and untreated. Around 10% of people living with HIV in districts of Malawi, Kenya and South Africa had AIDS, of which 47% had never received testing or treatment. “People are still being diagnosed late. We need new ways to detect those left out, early on, before they arrive at hospital in often fatal condition or die at home without ever receiving care. Stigma and lack of information still remain high, leading to delayed treatment or no testing and treatment at all. This illustrates the need to complement increased antiretroviral coverage at community level with improved care for those on treatment for years,” says Gilles van Cutsem, MSF HIV Advisor.

Clinicians, including from MSF, have increasingly voiced concern over the lack of attention and means going towards the prevention and treatment of AIDS across Africa. The World Health Organisation (WHO) yesterday issued its first ever guidelines for the treatment of AIDS in low-resource settings. While this is a positive step forward, MSF calls for the urgent implementation of the guidelines with additional measures to address potential drug resistance and treatment failure.

Key interventions urgently needed to prevent and treat AIDS include the rapid rollout of ‘test and start’, CD4 baseline testing at ART initiation, routine viral load testing, point of care diagnostics for tuberculosis, improved treatment for cryptococcal meningitis, rapid switch to second-line ART for failing and advanced patients, and swift, effective and accessible treatment for opportunistic infections. MSF is also calling for models of care geared towards prevention, treatment and support for patients with AIDS, and free specialised hospital-based care free of charge for patients[3].

MSF is also concerned that the situation will only be exacerbated as funding for the global HIV response continues to stagnate. Anticipated cuts in US funding to the Global Fund (17%) and PEPFAR (11%) from 2018 onwards will see many countries facing further grant restrictions. Shrinking funding envelopes and the need to preserve ART purchases will imperil community responses, including targeted testing and improved treatment literacy and adherence, while starving essential investments needed for health workers, laboratory and diagnostics.

“Each patient presenting with AIDS is a terrible testimony to the challenges to get timely access to test & treatment and to continue their ART uninterrupted. With global political will and funding for HIV on the decline, not only is the broader fight against the virus at risk go into reverse but specifically these patients arriving at hospitals sick with AIDS will have any hope of reprieve snatched away,” says Mit Philips, MSF Health Policy Advisor.

[1] Acquired Immune Deficiency Syndrome (AIDS) is defined as a CD4 count of less than 200 or WHO clinical stage 3 or 4.

[2] Advanced HIV is synonymous with Acquired Immune Deficiency Syndrome (AIDS).

[3] MSF’s report ‘Les Négligés de L’infection au VIH’  also released at IAS, shows the lack of referral-based hospital care for treating AIDS in Kinshasa

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The study, published in the journal PLOS Neglected Tropical Diseases, uses statistical modelling to measure the impact of Red Cross safe and dignified burial (SDB) teams during the Ebola outbreak. It found that the practice of safe and dignified burials potentially averted as many as 10,450 Ebola cases, decreasing the scale of the outbreak by over a third (36.5 per cent).

Red Cross teams in Liberia, Sierra Leone and Guinea took on the complex task of burying people who had died of Ebola, a crucial yet dangerous task given how infectious dead bodies were. The work of the Red Cross SDB teams was further complicated by deeply valued traditional burial practices of washing and touching the dead, which contributed in the early stages of the outbreak to increased infection rates.

“To respond effectively, we had to change our entire approach to dealing with people who had died and their families,” said Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC). “We stopped talking about ‘dead body management’ and instead started talking about “safe and dignified burials’. We talked to communities and did our best to understand their beliefs and priorities. Ultimately, we earned their trust, and this was critical to success.”

In all, Red Cross teams managed over 47,000 safe burials, accounting for over 50 per cent of all burials conducted during the outbreak. The teams were made up entirely of local volunteers, who spoke local languages and who understood cultural norms and community dynamics. Around 1,500 trained volunteers were involved in this work. As a result of their efforts, many of them were stigmatized and threatened.

“This study reveals the vital role of communities and community-based organizations in the Ebola response,” said Dr Julie Hall, Chief of Staff and Special Advisor on Health at the IFRC. “The success of the SDB programme can be largely attributed to the Red Cross teams who were there before, during and after the outbreak. It was they who provided the basis for a response to the crisis that was both acceptable to local communities, and sustainable.”

IFRC is repeating its call for greater investment in strengthening local and community-level health capacity, including by investing in National Red Cross and Red Crescent Societies.

“The 2017 Ebola outbreak in the Democratic Republic of the Congo reminds us of how precarious global health is,” said Mr Sy. “International partners need to better harness and invest in local capacities, building on homegrown knowledge and skills, that will help communities respond, protect themselves and put an end to future health crises.

“The price tag on this investment is far less than the alternative: outbreaks that are deadlier and more expensive.”

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