Jul 29, 2010

Trade not Aid!

This upcoming Saturday (July 31, 2010), Kenyan Economist James Shikwati will be speaking on Zambia Blog Talk Radio (ZBTR). Shikwati is the founder of Inter Region Economic Network and is founder CEO of The African Executive. The focus of the discussion will be the need for “Trade not Aid” to Africa.

Shikwati echoes a lot of what Dambisa Moyo and Bill Easterly espouse in that aid to Africa not only finances huge bureaucracies that are often corrupt and inefficient, but also stifles the spirit of entreprenism and has entrenched a beggar mentality in us in which a white saviour must swoop in to save us! (How do you like my paraphrasing?)

So, most of this we already know and has been discussed ad nauseam. I’m interested to hear his ideas for developing markets to produce locally the things we consume and revitalising entrepreneurial activities. There is much to be done beyond just turning off the aid tap.

I think I’ll post a summary/review on this discussion.

The programme will air at 7 a.m. PST/10 a.m. EST/3 p.m. GMT/4 p.m. CAT

Here is the link to listen

Jul 28, 2010

Linguistic Hegemony in Music?

As I was streaming Radio Phoenix from Lusaka over the weekend, it dawned on me just how much of the current music being released by Zambian artists is predominantly in Bemba and/or Nyanja. Since I understand and speak both languages I have little problem understanding the lyrics (unless they toss in some very ‘deep’ words mostly spoken ku mushi (in the village).

I appreciate the fact that a lot of the popular artists are either based in Lusaka or the Copperbelt where both languages are widely spoken but this certainly can’t be a true representation of our music culture. Where are the other artists who sing in Tonga, Lozi or Kaonde? Are they not getting the airplay on the major radio stations or are they also singing in Bemba and Nyanja to attract fans? Perhaps I just need to find streams for the lesser known radio stations. 

I will give credit to Obrine Mwaka better known as O.C. who has released some very popular songs sung in Swahili. This has propelled him to prominence not only at home but also in Kenya, Tanzania and Uganda, and displays his remarkable language skills. There a few other artists such as JK and Petersen Zagaze who have performed in Shona and Lozi, respectively in addition to their usual Bemba/Nyanja but they are the few exceptions.

It’s my fervent hope that my musings aren’t a symptom of a larger problem. It may be worthwhile to talk with friends who work in the local music scene to ask their opinions. 

Another AU Summit

I’ve really tried my hardest to ignore the fact that the AU was meeting in Kampala, Uganda this week. But like the scene of a train wreck I can’t stop gawking when I know better! So, just what has been discussed by our fearless leaders?

1.  The welfare of women and safe motherhood are to be placed on the forefront of development agendas this year. According to the summit chairperson, Bingu wa Mutharika, "if we improve the welfare of women, access to food and health care, maternal mortality will significantly reduce." Okay, let’s see how this unfolds.

2.  The twin bombings in Kampala were obviously on the agenda, and were widely condemned. Uganda’s president, Museveni, has called for more support in the peace keeping mission in Somalia; the current mission is dominated by his country and Burundi. Djibouti and Guinea have pledged to send troops though other countries like Zambia have balked, claiming insufficient resources. This is not far from the truth but I think African leaders need to be more open and honest – just what peace is being kept in Somalia, and why should resources be spent supporting a puppet regime that barely controls the capital, Mogadishu, and up until four years ago operated out of a hotel in Nairobi? The only countries that have a vested interest at this time are those that share a border with Somalia and are at risk of seeing the conflict spill across their border as it did on July 11 in Uganda.

The country has been self destructing for 20 years before our eyes and why should 2010 be the year the rest of the continent takes definitive action?  We’ll wait for the Americans or the Europeans to take military action and then grumble about foreign interference in African affairs. Oh boy!

One issue I didn’t see addressed is the self-declared republic of Somaliland. How many discussions are we going to have about security in the horn of Africa without acknowledging the stability that exists in Somaliland and finally give them the due credit as a nation state? They have successfully held presidential elections, have a government, and deserve support. As long as the rest of the continent continues to ignore its existence and thereby denying access to trade, investment, and development the chances of its survival remain miniscule; another black mark in our de-merit column.   

3.   The AU’s champion circus leader, Muammar Gaddafi, yet again made a push for his goal in unifying the continent under a unified banner – “United States of Africa”. Does this man have nothing better to do with his time? Aren’t there any national telecoms he can purchase with his country’s oil money?

      Colonel Gaddafi, please stop pursuing YOUR dream and pursue that of Africa’s citizens. Our dreams include some of the following –

Peace and security in all 53 countries
Access to land, housing, and clean water
Quality healthcare in facilities with adequate equipment, drugs and medical staff
The eradication of preventable diseases such as malaria, HIV/AIDS, cholera and dysentery, polio, measles, yellow fever
Access to quality education from nursery school through university/technical college
Employment opportunities that offer living wages in a safe and respectable environment
Rule of law.

Take your pick on any of these issues and a whole host of others I haven’t included. If not take a seat and prepare your next rant for the UN general meeting until such a time that you’re prepared to talk seriously about the issues that genuinely affect us.

4.  Sudan’s Al-Bashir was yet again defended by his counterparts. According to the chairman of the AU, the indictments against Al-Bashir by the International Criminal Court (ICC) are “an abuse of African sovereignty for a non-African entity to seek trial of a sitting president from the continent”. They have demanded a 12-month suspension of the arrest warrants pending a review by the AU. Excuse me while I choke back my laughter…may we just say case closed?

Exactly, how is the AU going to investigate the allegations against Al-Bashir? Have they even admitted that there have been acts of genocide in southern Sudan? Shall we send the ineffectual Thabo Mbeki or Kofi Annan as chief investigators? Oh, and let me guess the investigation will be funded by EU money! Just what is the point of this organisation?

Jul 27, 2010

Conflict Minerals

For the last few months I've been following the discussion of the Conflict Minerals Act. The legislation was recently signed into law, and is intended to "develop the means to ensure that the multimillion dollar trade in minerals from eastern Congo stops financing the world’s deadliest conflict since World War II. It will also help raise awareness about the issue to both the public and policy makers". The law demands greater transparency and accountability from companies whose products contain these mineral ores or their derivatives.

Laura Seay has an article in the Christian Science Monitor that offers some compelling arguments for why this legislation may not work. Do we have any examples of legislation passed in the U.S. or  Europe that have made an impact in Africa in trouble areas? I can only think of the economic and political pressure applied to apartheid South Africa in which banks and investment firms withdrew from the country, and many western nations severed diplomatic ties.

Below is a video recently released by the Enough project that draws attention to the issue of conflict minerals.


Jul 25, 2010

Arizona; the New South?

I am little late to the party, but I think it’s still worthwhile to bring something to the table. Arizona’s controversial anti-immigration is back in the news this week since the Obama administration and civil rights groups have brought challenges to the courts. Another piece of legislation signed by Governor Jan Brewer that has been overshadowed by the broader immigration arguments is HB2281, banning ethnic studies programs in Arizona schools.

The new law bars classes that "promote the overthrow of the U.S. government, promote resentment of a particular race or class of people, are designed primarily for students of a particular ethnic group or advocate ethnic solidarity instead of the treatment of pupils as individuals". Arizona state school superintendent, Tom Horne, has condemned ethnic studies as “ethnic chauvinism” and “high treason”. Really?

I am not exactly sure what the so-called radicals in Arizona have been teaching in those classes but I am disinclined to buy the rhetoric. I’ve taken classes focused on African, African-American and Native-American studies and I don’t remember receiving the ethnic chauvinism alluded to by Horne and his league of fear mongers. 

What I do remember was learning about the history of the people, cultures, their contributions to the greater human experience, and so forth. There was value in these courses because I feel they presented a side to a story that would otherwise by a paragraph or footnote in a general history or anthropology textbook. Until, that is changed, there will be a need for such targeted courses.

I hate to break it to Mr Thorne and others, ethnic studies isn’t about selling the story of oppression and segregation, and making people angry. It is about recognising and understanding the different narratives of the country’s people. The spirit of these classes is to serve as a bridge and to foster a greater appreciation of the cultural diversity that exists in our modern world. 

Making a Vibrant Zambian Brand

"Why is it that Zambia has no outstanding brands that can compete favorably and fair well within the continent of Africa or even within the country itself?" 

The above is from an article by Wesley Ngwenya. Coming right off the heels of a discussion on Zambia Blog Talk Radio last week along the same lines it's obvious this is something that many of us are thinking about. That's step one. Step two should be brain storming, followed by implementation. How many of us are moving to step two and beyond? 

Jul 21, 2010

Wisdom of Whores by Elizabeth Pisani: A Review


If you’ve watched or listened to Elizabeth Pisani’s TED Talks on HIV, Sex and Drugs you’ll know that she’s a very forthright and engaging speaker. She’s a little racy, and could make a room of full of people squirm uncomfortably as she talks about transgender prostitutes in Indonesia or drug use in prisons with dirty needles.

Her 2008 book, Wisdom of Whores, is simply the boldest and most riveting book I’ve read to date about the business of AIDS – how it’s spread in various communities, the way in which politicians, scientists, and NGOs have responded, the impact of cultural and religious attitudes, etc. Her writings mainly draw from the work she has done in the last 20 years in Southeast Asia and eastern Africa. This personal experience adds a rich texture to the book and makes for a good and easy to understand read.

Given the amount of time she has spent in places like Indonesia and Thailand, this is where a lot of the focus lies. She writes very candidly (and sometimes graphically) of her conversations with prostitutes and brothel owners about their economics of their trade as well as the societal structure that fosters a system in which both men and women buy and sell sex. She also goes into great detail about intravenous drug use and the sharing of dirty needles that generally fuels the spread of HIV in this part of the world.

Pisani raises the point that many health authorities and donors have seemingly turned a blind eye to the spread of HIV through the sharing of dirty needles because it’s not a subject that taxpayers would be keen to have their tax money spent on. We are more drawn to the pitiful stories of innocent wives and mothers unsuspectingly infected by their husbands and partners.

This portion of the book was a bit overlong, but provided some very useful insights given that I was working under some very inaccurate assumptions. So, I am happy to have new information!

She also touches on sub-Saharan Africa, home to the highest prevalence rates. No earth shattering news in this section, but I do like how she talks about things many African leaders and the rest of us aren’t too keen to talk about openly about why HIV/AIDS remains a problem – inter-generational relationships (sugar daddies sleeping with young girls) and multiple concurrent relationships (both men and women).

Other issues tackled in the book are political and religious ideologies that have shaped the fight against HIV/AIDS; the former Bush administration features prominently with its misplaced emphasis on abstinence education at the cost of preventative measures such as condom provision. Muslim clerics and the Catholic Church do not escape unscathed either, and rightfully so.

I could ramble further, but I’ll leave you with this. I thoroughly enjoyed this book. I learned a lot, had some myths debunked and reassessed some of my own beliefs and misgivings about HIV. I also appreciated the various insights from an “insider” about how funding is sought, given and spent. The business of AIDS is intriguing... 

Jul 20, 2010

Development in half measures

As Zambians we have fully embraced the mantra that economic development will be achieved by lowering trade barriers, encouraging foreign direct investment (FDI), removing protectionist practices, etc. This is all well and good, but is there anyone looking at things strategically and not just going out guns blazing with no clear plan?

Mining activities have been ramping up in the last few years with estimated $3 billion annual copper sales. Now, how much of that will be captured as tax revenue and allocated for infrastructure development in the areas that have seen the increased economic activity?

The people are crying out for improvements in the basic necessities – water and sanitation, fully staffed and well equipped health facilities, adequate school facilities for their children, paved roads with drainage that works. The mining companies won’t provide these goods and services nor should they be expected to; they are in the business of mineral extraction. It’s up to us, as a people, to demand that the government lives up to its responsibilities to the citizenry. In the same vein, the mining companies will not voluntarily clean up waste, and minimise the environmental impacts if they can get away with it. Let’s get real! We can only make them accountable by having strong oversight and enforcement that makes it non-negotiable to be good stewards of our natural resources.

However, with the government’s inability to wake up and plan well, people are now asking questions of the investors. If they are making money from mineral extraction why can’t they build or improve roads given the fact their heavy usage or even provide housing for the workers who have migrated in search of work in the mines given the pittance they pay in taxes? These are not unreasonable questions nor can we fault people for asking them. Just what are we going to do? Or will the pleas continue to fall on deaf ears? 

Jul 19, 2010

Survivorship

Is anyone doing any work on AIDS survivorship? What do I mean by survivorship?  I am talking about the people whose lives have been impacted by the disease through loved ones, co-workers, friends, etc.

If you have seen firsthand the devastation this scourge has caused, you are never the same. Something inside of you shifts, and evidence of this may not be revealed right away; it could take months or years to manifest. Where is the support to deal with this?

AIDS is not a staid ailment that only claims a few hundred lives each year. I’m 28; I have never known a world without this disease. Life expectancy in Zambia is pegged at 38 (down from 40 but up from 33). If such statistics are to believed I have ten more years to beat the odds. Do I even want to calculate what a 14.3 percent adult prevalence would translate to for me, and the people I know?

A lot of focus has been rightly placed on prevention and treatment, but what about the psychological effects wrought on people who are not HIV negative but have felt the impacts in one way or another? How do you cope with what has been done to the psyche? This would encompass restoring trust in relationships, and in human condition. And how do you avoid fatalism from setting in and taking over? It’s hard to imagine that this not only affects us personally but collectively as a nation. Just how do you heal?

Jul 13, 2010

Vision for the Future

In order to achieve something, one must first have a vision. Align this vision with goals – what steps must you take to accomplish said vision. Along the way hurdles will be thrown up in the form of self doubt, naysayers, logistical hang-ups, etc. But how do you keep going? In the face of defeat or failure where do you find it within oneself to draw on that last ounce of willpower to take one more step towards success?

It is from the optimism and confidence that dwells in each of us. Even the most jaded can look to tomorrow and say, “It will get better. It can get better”. It is only when you lose sight of this that you start accepting defeat and wallow in it.

As I look at the daily newspapers and news aggregators from Zambia, I see how we’ve accepted defeat in many ways. Instead of looking ahead to next year’s presidential and general elections with a renewed sense of optimism and elation, we’ve allowed doom and gloom to be the message of the day.

The opposition continuously paints a bleak picture in which President Rupiah Banda is setting the wheels in motion to steal votes and intimidate opposition supporters, and the ruling party will use their generous financial resources to distribute maize and beer to constituents to secure more votes. It would be naïve and disingenuous to discount these concerns but I refuse to adopt their defeatist attitudes.

Instead of demoralising the voters, they need to craft a new message. How can you inspire people to vote for your party, when you’ve created a perception that there is no hope in the electoral process? Isn’t that just a recipe to create and entrench voter apathy? Tell us that change is possible, and that it is within our powers to deliver this change. We will use the election process to send a new mandate even in the face of intimidation.

There are so many opportunities for the opposition to make headway. They need to mobilise people to register as voters and to show up on Election Day to VOTE. Instead of whining about the lack of coverage on national television and in the state-run newspapers use the other resources available that the government doesn’t have a chokehold on – rural and urban radio, blogtalk radio, community gatherings, SMS, social media like Facebook and Twitter, word of mouth – take your pick!

The people of Zambia need to hear that all is not lost and that we will not be citizens of another failed African state. Though the road ahead may be tough, through hard work, sacrifice and sheer determination we can turn things around, each and every one of us. We’re tired of the name calling, and childish antics. We need change, and who is going to help deliver it?

If the opposition do not have a clear vision on how to not only unite Zambians during election time but beyond as we restore our country to respectability and prosperity perhaps they are the wrong people to lead our country, and we would in fact be worse off a 5-10 years from now. “Better the devil we know” and have in office right now.

The President and his party have an eroding popularity, but in the face of a disorganised opposition incapable of setting aside personal agendas they stand a very real chance of winning the presidency and a majority of seats in parliament. If and when this happens, I will have no patience for those crying foul when in fact they failed to capitalise on the opportunities presented to them. And then where will we be as a nation?

We are a resilient people and we can overcome the seemingly insurmountable odds we face! Others have, why can’t we? We deserve better, and it’s about time we started demanding it from those in leadership and the aspirants. 

Jul 12, 2010

What a month!

World Cup 2010 has wrapped. We have a new champion of world football – España. Once the parties are over, hangovers have been nursed, and the vuvuzelas begin to accumulate dust what will be the lasting legacy of the tournament? 

The South Africans did a commendable job. I think Sepp Blatter can give himself a pat on the back for doggedly backing SA’s bid against the odds. They defied the sceptics who were sounding warning bells about the lack of safety for American and European fans (nothing about the African fans, thoughJ). Reported crimes were miniscule and barely showed up on the radar.

Sure the lines to get to and from the stadiums were sometimes hideously long but that’s to be expected when you’re trying to cram 60,000< fans into one location at the same time!

Tournament favourites (Argentina, Brazil and Italy), the perennially over-rated English, and others were humbled by unlikely foes. Some would say it was the Jabulani ball, others would say it was the officiating but whatever it was, this tournament proved yet again that football is the great equaliser! Reputations are made and shredded on that pitch over the course of 90 minutes. 

Officiating was yet again a hot button issue. Disallowed goals, yellow cards that should have been straight reds, penalties not given – you name it, we had it! Is it time for FIFA® to implement goal line technology and replays?

I’ll take the goal line technology as it is currently used in tennis; to determine whether or not the ball crossed the line. On the matter of replays, let’s keep that in the NFL. World football is a fast moving game would only be mired down with petty calls for replays and would likely be abused as a delay tactic.

I don’t know if the heartbreak of loss was felt more keenly than it was for African fans. Only one team, Ghana, progressed of the group stages. On their young shoulders they carried the hopes of an entire continent, knocking out the U.S. team unceremoniously (yet again) only to be stopped by the hand of Suarez and their own inability to convert penalties and other opportunities into goals.

The finger pointing is ongoing. Who is to blame? Is it the overpaid and underwhelming foreign coaches? Or is it Africa’s own poor domestic leagues that unable to harness top quality talent coupled with European leagues who poach the young African talent?

Time and money need to be invested locally into sports academies, youth and adult leagues. We cannot continue to be deluded about the quality of African football without taking these steps. We need to match our passion for the game with real investment in the development of our game.

Overall, I enjoyed the last month of football. Thank you South Africa for hosting a memorable tournament. There are many lessons to be learned by FIFA® and future organising committees. See my previous post for some suggestions. 

Jul 8, 2010

The unfair hand of God

One of my sisters sent this cartoon to me earlier, and I thought to share! If you’re offended or don’t get it...

cartoon credit: zapiro
Find this cartoon and others on their website.

United under the Black Stars

Ranil Dissanayake of AidThoughts has a very interesting post about the mood that enraptured many us when Ghana’s Black Stars played Uruguay in last week’s quarter final match at the World Cup. It’s a well written firsthand account of the atmosphere in the stadium and around Cape Town, and cleverly ties in a history lesson about Pan-Africanism. 

Jul 7, 2010

Through different eyes

Over the weekend, I sat down with a friend to discuss culture. She’s currently taking a summer course, and one of her project assignments is to interview someone from a culture different from her own and discuss similarities and differences. Fun stuff! It was like lunch time in the cafeteria during my first year of uni all over again. No, not really, this was serious stuff. I couldn’t pretend to be non-English speaking orphan being sponsored by American missionaries. J

Anyway getting back on track, Amanda raised an interesting point when we were done talking. She was struck by the fact that I didn’t use our time as an opportunity to gripe and point out all the negative things about American culture but instead struck a balance. Now the cynics will probably say I’ve assimilated into the American culture and have lost part of my African-ness. But I look at it differently, bear with me.

There are still parts of American culture that continue to baffle me, and this is due in part to where and how I was raised, my life experiences thus far, and my own personal code of conduct. I just can’t get away from that.

I think my objectivity is driven by my personal situation. I’m a foreigner, yes, but I am not a tourist. I willingly live and work here (for the time being), and as a consequence encounter the good and bad of living here. That’s just life. 

If I were merely “visiting” as a tourist or short-term missionary working with inner-city youth or the homeless, my impressions would likely be very different. Does this differ from the young American and European youngsters we dread to see traipsing around Zambia with their Birkenstocks and backpacks? We know many of them aren’t there are tourists or as long term residents; many are there on short stints to build orphanages and churches, hand out clothes to street kids, etc. Is it any wonder they go back home with tales of misery and woe? “I saw so much poverty. Those poor Africans have so little.

So, how do we change these perceptions? I don’t deny the truth as it exists – yes, there is poverty and suffering, but it’s not the entire story. How do I get someone that just left Zambia to talk about the wonderful time he/she had sipping Mosi while watching the sun set in Siavonga or the vivid beauty of the Umutomboko ceremony?

I’ll probably learn from a friend who recently introduced a study abroad course at the university with which she is affiliated. These students get to learn about Zambia (specifically about media) in the classroom and in the field when they travel to the country. What better way to show a different side to our country and introduce a different narrative?

Another way would be to organise a tour group. What’s to stop any of one of us from organising such a trip? We can’t wait for the tourism board to come up with such ideas. And besides I hear changes are coming to the Zambian embassy in DC, so the visa process should be less cumbersome. J

Jul 6, 2010

Untrustworthy Africans

Let’s be honest; living in Africa, or being African, gives you a certain unwelcome aroma in the eyes of global corporations. Frankly, we’re just not trustworthy.
This is part of an interesting post by White African about what he terms “Africa’s trust problem”. I think many of us can share stories about extra scrutiny at customs counters, flagged online activity by banks and other vendors, and other insulting acts.

I remember planning my last trip to Zambia and my experience using the British Airways online booking system – it doesn’t exist! As soon as I found the flight I wanted, and tried to make the ticket purchase the system rejected my credit card, and directed me to contact a booking agent.  And it was during my phone conversation with the booking agent, I was informed that because my destination was Zambia there was no way for BA to verify the validity of my credit card...since everyone knows that Zambia is riddled with online scammers...NOT!

After a few deep breaths, I put aside the mad, black woman and asked to complete the transaction. Alas, the polite agent could only reserve my seat and would not accept my payment information; I would have to do that through a third party travel agent. At the end of the day my credit card was only legitimate enough to use with a local travel agency with a $45 convenience fee tacked on to the ticket price and not online. I guess BA was hoping the agency would eat the cost if (when) my bank reneged!

And just to be contrary, before I left the country I informed my bank that any card activity in Zambia should be flagged as suspicious and to have it shut down because you can’t trust those Africans! The bank teller didn’t even blink...

Jul 3, 2010

Greener Pastures

With the recent graduation of medical doctors from the University of Zambia, there has been a spate of editorials re-emphasising the chronic shortage of medical personnel in the country, accompanied by the usual admonishments to the new graduates to be patriotic by serving their country and not leaving for proverbial “greener pastures”.

As a developing country it is obviously critical that we retain the best and brightest in all fields, but why the guilt trip? Contrary to conventional wisdom, leaving home is not always an easy decision made at the spur of the moment. It is often a gut-retching decision in which a person has to consider the fact that he/she will have to leave family members behind sometimes even children, to seek work that pays fair wages in a foreign land where they may face discrimination or prejudice for the chance to make a life that consists of more than just surviving! 

Life in the west or the east isn’t a walk in the park either because it often entails establishing oneself at the bottom and working your way up the ladder. But consider this; there is a scalable ladder as opposed to an environment where often times the ladder has been yanked away and disincentives are rife.

The balance between self-interest and national interest is not an easy road. And who are we to pass judgement?

So, instead of labelling others as unpatriotic for looking out for their wellbeing and that of their families, how do we create an environment in which economic benefits, remuneration levels and working conditions are conducive to progress? 

Doctors, nurses, surgeons, and other medical personnel are critical in any country no “ifs”, “ands” or “buts” about it. But what can be done to reverse the ill-effects of medical migration? Finding a solution will involve partnership between the developed and developing world.

Developed countries obviously have a need for skilled medical professionals with their aging populations and insufficient local talent available. The U.S. in particular has a system that unfairly discourages many from entering medical school with the high cost of attendance, and the pervasive elitist emphasis placed on more specialised areas of medicine such as surgery and not general practice. This in turn drives up the demand for nurses and general practitioners that can readily be found in developing countries.

If they were to increase medical attendance and train more general practitioners that could effectively reduce the cost through competition and deal with the supply issue. I am sure the same could be said for EU nations that face similar shortages.

Another area to look at would be reimbursing countries for the investment lost when their health professionals leave for developed countries. Their education is a costly endeavour and is often provided at subsidised levels. The reimbursements could be used to develop or improve existing health facilities making for a safer work and healing environment.

Health sector spending obviously needs to be increased but is often hampered by budget ceilings that are driven by microeconomic policies. The inadequate spending often results in hiring and salary freezes and continues the vicious cycle of an incapacitated system. Countries that spend more on health and education should not be penalised by the World Bank, IMF, and other donors for breaking their spending caps.

And finally, our governments need to understand and appreciate the economic benefits of investing in health and maintaining an adequate workforce in local and rural areas.