Alex Leiva, holding his baby girl, uses the water he managed to collect in barrels at 4:00 a.m., the only time the service is provided in Lotificación Praderas, in the canton of Cabañas, on the outskirts of the municipality of Apopa, north of the Salvadoran capital. The families of this region are fighting in defense of water, against an urban development project for wealthy families that threatens the water resources in the area. CREDIT: Edgardo Ayala/IPS
APOPA, El Salvador , Jun 6 2022 (IPS) – Alex Leiva woke up at 4:00 a.m. to perform a key task for his family’s survival in the Salvadoran village where he lives: filling several barrels with the water that falls from the tap only at that early hour every other day.
If he does not collect water between 4:00 and 5:00 AM, he will not have another opportunity to fill the barrels for another two days.
“That’s what I have to do. Sometimes I manage to fill three barrels. The service is provided every other day,” Leiva, 32, a video producer, told IPS.
“It’s difficult to be in a situation like this, where the water supply is so inefficient,” he added.
In El Salvador there are at least 3,000 of these boards, community associations that play an essential role in the supply and management of water resources in rural areas and the peripheries of cities, in the face of the State’s failure to provide these areas with water.
Leiva lives in Lotificación Praderas, in the Cabañas canton, on the outskirts of the municipality of Apopa, north of the country’s capital, San Salvador.
This northern area covering several municipalities has been in conflict in recent years since residents of these communities began to fight against an urban development project by one of the country’s most powerful families, the Dueñas.
The Dueñas clan’s power dates back to the days of the so-called coffee oligarchy, which emerged in the mid-19th century.
Ciudad Valle El Angel is the name of the residential development to be built in this area on 350 hectares, and which will require some 20 million liters of water per day to supply the families that decide to buy one of the 8,000 homes.
The first feasibility permits granted by Anda to the consortium date back to 2015.
The homes are designed for upper middle-class families who decide to leave behind the chaos of San Salvador and to live with all the comforts of modern life, with water 24 hours a day, in the midst of poor communities that lack a steady water supply.
“There are people in my community who manage to fill only one barrel because there isn’t enough water pressure,” said Leiva, the father of a five-year-old boy and a nine-month-old baby girl.
Valle El Angel is an extensive region located on the slopes of the San Salvador volcano, in territories shared by municipalities north of the capital, including Apopa, Nejapa and Opico.
A general view of Parcelación El Ángel, in the Joya Galana canton, in the municipality of Apopa, near San Salvador. The community is fighting to defend the few natural resources that survive in the area, including a stream that originates in the micro-basin of the Chacalapa River. Water in the area is scarce, while Salvadoran authorities endorse an upscale real estate project that will use millions of liters per day. CREDIT: Edgardo Ayala/IPS
Unfair justice
Sociedad Dueñas Limitada, the consortium managing the urban development project, received the definitive green light to begin construction: a thumbs-up from the Constitutional court, which on Apr. 29, 2022 rejected an unconstitutionality lawsuit filed in October 2019 by environmental organizations and communities in northern San Salvador.
The lawsuit was against a dubious agreement signed in 2016 between that company and Anda, which manages water in the country. The deal granted the project 240 liters of water per second – that is, about 20 million liters a day.
The consortium intends to dig eight wells in the area. Water will be extracted from the San Juan Opico aquifer, as well as from shallower groundwater from Apopa and Quezaltepeque.
“These agreements open the door to this type of illegal concessions handed over to private companies…it is a situation that is not being addressed from a comprehensive perspective that meets the needs of the people, but rather from a mercantilist perspective,” lawyer Ariela González told IPS.
González added: “It is our public institutions that legalize this dispossession of environmental assets, through these mechanisms that allow the companies to whitewash the environmental impact studies.”
The organizations and local communities argue that water is a human right, for the benefit of the community, and also insisted in the lawsuit that the aquifers are part of the subsoil, property of the State.
Therefore, if any company was to be granted any benefit from that subsoil, the concession could have to be endorsed by the legislature, which did not happen.
Sara García and Martina Vides are members of an ecofeminist collective that has been fighting for five years to prevent the construction of a large residential project in the area, Ciudad Valle El Ángel, owned by one of the most powerful families in El Salvador. CREDIT: Edgardo Ayala/IPS
The resolution handed down by the Constitutional chamber of the Supreme Court comes at a time when people have lost trust in the Constitutional court in this Central American country of 6.7 million people.
The five Constitutional court magistrates were appointed without following the regular procedure on May 1, 2021, when the new legislature was installed, controlled by lawmakers from President Nayib Bukele’s party, Nuevas Ideas, which holds 56 out of 84 seats.
“This government continues to benefit big capital and destroy local territories,” Sara García, of the ecofeminist group Kawoc Women’s Collective and the Let’s Save the Valle El Ángel movement, which forms part of the Water Forum, told IPS.
García´s fellow activist Martina Vides added: “We want protection for the aquifers and to prevent the felling of trees.”
Both women spoke to IPS on a rainy gray afternoon on the last day of May, in the Parcelación El Ángel, where they live, in the Joya Galana canton, also in the municipality of Apopa, which is in the middle of the impact zone.
A short distance away is the river that provides water to this and other communities, which originates in the micro-watershed of the Chacalapa River. Water is supplied under a community management scheme organized by the local water board.
Vides pays six dollars a month for the water service, although she only receives running water three or four days a week.
According to official figures, in this country 96.3 percent of urban households have access to piped water, but the proportion drops to 78.4 percent in the countryside, where 10.8 percent are supplied by well water and 10.7 percent by other means.
Since the Ciudad Valle El Angel project began to be planned, environmentalists and community representatives have been protesting against it with street demonstrations and activities because it will negatively impact the area’s environment, especially the aquifers.
The struggle for water in El Salvador has been going on for a long time, with activists demanding that it be recognized as a human right, with access for the entire population, because the country is one of the hardest hit by the climate crisis, especially the so-called Dry Corridor.
For more than 10 years, environmental and social collectives have been pushing for a water law, reaching preliminary agreements with past governments. But since the populist Bukele came to power, the progress made in this direction has been undone.
In December 2021, the legislature approved a General Water Resources Law, which excluded the already pre-agreed social proposals, although it recognizes the human right to water and establishes that the water supply will not be privatized. However, this is not enforced in practice, as demonstrated by the Dueñas’ urban development project.
A vendor of a traditional ice cream in El Salvador, made with shaved ice bathed in fruit syrup, waits for customers on one of the streets of Parcelación El Ángel, in the municipality of Apopa, north of the capital. The locality is one of the epicenters where poor families have been organizing to block a residential development project, which will affect the local water supply and worsen the water shortage in the area. CREDIT: Edgardo Ayala/IPS
Not the only one
The residential development project is neither the first nor the only one in the area.
Residential complexes of this type have already been built in that area for the upper middle class, thanks to investments made by other wealthy families in the country, such as the Poma family.
And the same type of agreements have been reached with these other companies, in which the consortiums receive an endorsement to obtain water for their projects, said González.
The same thing has happened in the surroundings of the Cordillera del Bálsamo, south of the capital, where residential projects have been developed around municipalities such as Zaragoza, close to the beaches of the Pacific Ocean.
In Valle El Ángel there is also at least one company whose main raw material is water. This is Industrias La Constancia, which owns the Coca Cola brand in the country and other brands of juices and energy drinks, located in the municipality of Nejapa.
González, the Fespad lawyer, said that there should be a moratorium in the country in order to stop, for a time, this type of investment that threatens the country’s environmental assets, especially water.
But until that happens, if it ever does, and until the water supply improves, Alex Leiva will continue to get up at 4 a.m. every other day to fill his three barrels.
Tuberculosis (TB) is an infectious disease, which remains a major public health problem globally. In the year 2020, the estimated number of people who died from tuberculosis is 1.3 million among HIV-negative people and 214,000 among HIV-positive.1 Current pharmacotherapy of tuberculosis involves a combination of at least four drugs. Rifamycins are key components of pharmacotherapy for both active and latent TB.
Rifamycins are a class of antibiotics isolated from Amycolatopsis in 1957. Four distinct semi-synthetic rifamycin analogs (rifampicin, rifabutin, rifapentine, and rifaximin) are approved for clinical use. Rifampicin, rifabutin, and rifapentine are used for the treatment of TB and chronic staphylococcal infections.2 Rifapentine given once weekly for 12 weeks with isoniazid is effective and well tolerated in the treatment of latent TB.3 Rifaximin is poorly absorbed from the gastrointestinal tract and is indicated for the treatment of traveler’s diarrhea, functional bloating, irritable bowel syndrome, and small bowel bacterial overgrowth.4
Variable exposure to anti-TB drugs may be associated with unfavorable treatment outcomes.5 Factors associated with drug exposure variability of anti-TB drugs, such as age, gender nutritional status, human immune-deficiency virus, diabetes, and genetic polymorphism, were described in various previous studies.6–9 There has been a notable development in recent years on how genetic variations in drug-metabolizing enzymes and transporters contribute to variation in exposure and response to the drugs.10,11 As the local and systemic concentrations of anti-TB drugs are affected by genetic variations in drug-metabolizing enzymes and transporters, pharmacokinetic and pharmacogenetic studies are increasingly performed to optimize TB treatments.12,13
Rifamycins are thought to be metabolized by microsomal hepatic carboxylesterases (CES), and serine esterase arylacetamide deacetylase (AADAC) to 25-deacetylrifamycins.14,15 The uptake, distribution, and excretion of rifampicin are mediated by membrane drug transporters. There are two transporters superfamilies; the solute carrier (SLC) transporters and the adenosine triphosphate (ATP)-binding cassette (ABC) transporters.16 SLC superfamily consists of more than 400 membrane-bound family proteins. Multiple studies revealed that the SLCO1B1 sinusoidal influx transporter influences rifampicin influx,17,18 and the SLCO1B1 *15 haplotype is associated with rifampin-induced liver injury.19 Most ABC transporters in eukaryotic cells mediate the efflux of the substrate from the cells. ABC transporters influence the hepatocellular concentration of rifampicin.20–23 Rifamycins are substrates of P glycoprotein (P-gp), coded for by the polymorphic ABCB1 gene.24 Rifampicin also induces ABCB1 gene expression.25 Although SLCO1B1 and ABCB1 gene products have been reported to influence rifamycins pharmacokinetics, there is no candidate gene identified so far for therapeutic drug monitoring.
Recently, advances in technology and scientific discoveries in the medical arena have enabled the practitioner to individualize drug therapy. The keen interest to personalize TB treatment has been a point of discussion over the last decade.26–29 The use of pharmacokinetics and pharmacogenetics of anti-tubercular drugs as tools for TB treatment optimization has been discussed previously.13,18 However, there is a scarcity of comprehensive data on the pharmacogenetics of rifamycins. This systematic review was, therefore, designed to evaluate the influence of genetic polymorphism in rifamycins metabolizing enzymes and transporters on their pharmacokinetics.
Methods
This systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements (Table S1). The protocol has been registered at PROSPERO with registration number CRD42020206029.
Search Strategy
Relevant studies were identified through a search of PubMed, Web of Science, Embase, and Scopus databases. The following combination of words was used: pharmacokinetics OR concentration OR “drug concentration” AND rifamycins OR rifampin OR rifampicin OR rifabutin OR rifapentine OR rifaximin AND SLCO1B1 OR ABCB1 OR carboxylesterase OR CES OR Arylacetamide deacetylase OR AADAC AND “Genetic polymorphism” OR pharmacogenetics OR pharmacogenomics OR “single nucleotide polymorphisms” OR SNP. Further, a hand-search was done from reference lists of studies included to identify eligible studies. There was no limitation on the dates of publication or publication status. Publications available only in the English language were included. The search was refined to studies of human participants.
Eligibility Criteria
The following were the eligibility criteria for the inclusion of studies: 1. Human participant studies; 2. Studies that reported on pharmacokinetic parameters of rifamycins; 3. Studies in which study participants were genotyped for rifamycins metabolizing enzyme or transporters gene; and 4. Studies that reported on the pharmacokinetic parameters of rifamycins and the effect of genetic variation on pharmacokinetics.
Quality Assessment
Validated tools exist for genetic association studies methodological quality assessment. We used the quality of genetic association studies (Q-Genie)30 tool to assess the quality of included studies. Using the checklist adopted (Table S2) from Q-Genie TS assessed the quality of selected studies.
Data Extraction
Two (TS and GM) independently extracted data from all included publications using a pre-prepared data extraction format which included items as follows: first author, publication year, study drug, sample size, type of pharmacokinetic parameters assessed, a country in which the study was conducted, participant characteristics, genetic polymorphism investigated, pharmacokinetic parameter results and its association with genetic polymorphism. The disparity between the two reviewers during data extraction was resolved through discussion.
No contact with the authors was done for missing data and the data presented in this review were extracted from the articles.
Results
Included and Excluded Study
A total of 115 articles related to genetic polymorphism of drug-metabolizing enzymes and drug transporters with the pharmacokinetics of rifamycins were retrieved from PubMed, Web of Science, Scopus, and Embase databases. Hand search identified two additional articles which were not obtained during the database search. As shown in the PRISMA flowchart (Figure 1) 51 duplicates were removed. The remaining 66 articles were screened by title and abstract for predefined criteria, and 47 were excluded. The reasons for exclusion of studies from titles and abstracts were (1) review articles (N=3); (2) studies focusing on drugs other than rifamycins (N=26); (3) studies that did not have information on the pharmacokinetics of rifamycins but only genetic information reported (N=8); and (4) studies in which only pharmacokinetics data were reported without genetic information (N=10). Furthermore, four articles were excluded after reading them fully. Of the four articles excluded; one article did not contain rifamycins data, one study was done on healthy participants and the other two articles did not contain pharmacokinetic parameters.
Figure 1 PRISMA flow diagram showing the literature search for studies that investigated the effect of genetic variations in drug metabolizing enzymes and drug transporters on the pharmacokinetics of rifamycins.
Notes: PRISMA figure adapted from Liberati A, Altman D, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology. 2009;62(10). Creative Commons.
Characteristics of Included Studies
Of the 15 articles selected for qualitative data synthesis, most of the studies (N=14) focused on SLCO1B1 gene polymorphism association with the pharmacokinetics of rifamycins (Table S3). Specifically, seven studies evaluated the association of SLCO1B1 gene polymorphism and pharmacokinetics,31–37 three studies SLCO1B1 and ABCB1 gene polymorphism with pharmacokinetics,38–40 one study SLCO1B1 and AADAC gene polymorphism with pharmacokinetics,41 one study SLCO1B1, and CES gene polymorphism with pharmacokinetics,42 and two studies SLCO1B1, AADAC, and CES gene polymorphism with pharmacokinetics.43,44 Only one study investigated the association between CES gene polymorphism with pharmacokinetics.45 The most studied rifamycins are rifampicin (thirteen studies) and rifapentine (two studies). No study is available that reported the pharmacokinetic-pharmacogenetic association for rifabutin and rifaximin.
There was variation among studies in sample size, the type of study participants, and the pharmacokinetics parameter compared with gene polymorphism. The smallest sample size was 34,39 while the largest was 256.34 The study participants were TB patients from 13 different countries and races. The majority of the studies were done on adults, but one study data were obtained from children.42 In some studies, participants were TB-HIV co-infected patients. The pharmacokinetics parameters commonly compared with gene polymorphism were maximum concentration (Cmax), AUC (area under the curve), and clearance. However, methods for blood sample collection and pharmacokinetic parameter determination varied among studies.
Association Between Drug Transporter and Rifamycins Pharmacokinetics
Association Between Polymorphism of SLCO1B1 and Rifamycins Pharmacokinetics
SLCO1B1 gene encodes for an Organic Anion Transport Proteins 1B1 (OATP1B1). It is located on chromosome 12. OATP1B1 is a transmembrane protein involved in the uptake of various drugs including rifamycins from the blood into the hepatocyte.46 Currently, 191 clinical variants have been reported. SLCO1B1c.521T>C (rs4149056), where the valine amino acid changed to alanine at position 174, was reported to affect drug response.47 Eight studies assessed the effect of rs4149056 SNPs on rifamycin pharmacokinetic parameters. Among these studies, only Huerta-García et al reported increased AUC among heterozygous CT for SLCO1B1 521T>C than the other genotypes. However, the observed increase in AUC was not statistically significant.39 A summary of specific transporters influence on pharmacokinetics is presented in Table 1.
Table 1 Summary of the Studies Reported the Drug Transporter (SLCO11 and ABC1B) Gene Polymorphisms Association with Rifamycins Pharmacokinetics Variation
SLCO1B1 g.38664C>T (rs4149032) was reported in twelve studies. rs4149032 is an intronic SNP most common in the African population.48,49 Gengiah et al reported high frequency in the SLCO1B1 (rs4149032) gene polymorphism and its association with low median rifampicin C2.5hr in the heterozygous and homozygous variant carriers.32 Similarly, Chigutsa et al reported high allelic frequency of the SLCO1B1 rs4149032 polymorphism and 28% reductions in the bioavailability of rifampin for homozygous variants.40 No statistically significant increase in the rifampicin exposure for the homozygous TT of g.38664 C > T (rs4149032) was observed in the study of Kim et al.37 However, the large number of studies reviewed here did not report any observed significant effect of SLCO1B1 rs4149032 SNP polymorphism with rifamycin pharmacokinetic variation.
SLCO1B1 c.388A>G (rs2306283) is another SNP in the SLCO1B1 gene. This SNP causes a change of asparagine amino acid to aspartic at 130, but the effect of this change on the transporter function is not clear yet. Huerta-García et al reported the AG genotype derived from SNP SLCO1B1 c.388A>G was associated with lower rifampicin AUC0–24 h values compared to those with AA genotype.39 In post hoc analysis, Dompreh et al observed that the SLCO1B1 c.388AA genotype was associated with low rifampin concentrations compared to those with c.388GG.42 The five remaining studies did not report any association between rs2306283 SNP and rifamycin pharmacokinetics. The SNP SLCO1B1 c.463 C>A (rs11045819) is another variant allele of the SLCO1B1 gene reported to affect rifamycin pharmacokinetics. According to Weiner et al, patients with SLCO1B1c.463C>A variant allele had 42% lower rifampin exposure, 34% lower peak concentration levels, and 63% greater apparent oral clearance compared with SLCO1B1 c.463CC.36 However, the remaining five studies did not report any association between rs11045819 SNPs and rifamycin pharmacokinetics.
Association Between Polymorphism of ABCB1 and Pharmacokinetics
ABCB1 (ATP-binding cassette sub-family B member 1) genes encode for P-gp also known as multidrug resistance protein 1 (MDR1). P-gp is a transmembrane protein, which acts as an energy-dependent drug efflux pump. It decreases intracellular drug accumulation, thereby decreasing the effectiveness of many drugs.50 The ABCB1c.3435 C>T (rs1045642), ABCB1c.G2677 T/A (rs2032582) and ABCB1c.1236C>T (rs1128503) SNPs are the most common nonsynonymous and synonymous SNPs studied.51 Rifamycins are a substrate and inducer of the ABCB1 gene.52 The decrease in rifampicin exposure with the time of treatment is partly explained by the induction of the ABCB1 gene. Three studies assessed the effect of four ABCB1, rs1045642 rs2032582, rs1128503, and rs3842 (ABCB1c.4036A>G) SNPs. Huerta-García et al demonstrated that the rs1045642 TT genotype is a predictor that explains 34.8% of the variability in rifampicin Cmax and 48.5% of the variability in AUC0–24 h.39 However, the other two studies did not replicate this observed result of Huerta-García et al.38,40
Association Between Drug-Metabolizing Enzyme and Pharmacokinetics
Rifamycins are metabolized by esterase enzymes. The esterase enzymes implicated in the metabolism of rifamycins are hepatic carboxylesterases (CES), and serine esterase arylacetamide deacetylase (AADAC). Two carboxylesterases, CES1 and CES2, are recognized to play major roles in drug metabolism. These enzymes metabolize rifamycins to their respective deacetylrifamycins.14,15,53 Polymorphism of the CES1 and CES2 genes have been shown to influence the metabolism of several drugs.54 However, few studies investigated the effect of CES1 and CES2 gene variants on rifamycin metabolism (Table 2).
Table 2 Summary of the Studies Reported the Drug-Metabolizing Enzyme (AADAC and CES) Gene Polymorphisms Association with Rifamycins Pharmacokinetics Variation
Sloan et al investigated CES1 rs12149368 SNP effect on rifampicin pharmacokinetics in Malawian tuberculosis patients. The rs12149368 variant does not affect the plasma rifampicin concentration43 (Table 2). Song et al identified 10 variations in CES2 in Korean TB patients. Among the ten variants three closely linked SNPs, c.-2263A>G (rs3759994, g.738A>G), c.269–965A>G (rs4783745, g.4629A>G), and c.1612+136G>A (g.10748G > A), may alter the metabolism of rifampicin by affecting the efficiency of transcription of the gene. In particular, the CES2 c.-2263A>G variant, which is found in the promoter region is associated with increased plasma concentrations of rifampicin.45
Shimazu et al reported that microsomes from a liver sample genotyped as AADAC*3/AADAC*3 showed decreased enzyme activities, compared with others. However, the allelic frequency is low, 1.3% European American, and 2.0% African American. The AADAC*2 (rs1803155) allele, which has a higher frequency has also shown reduced enzyme activity. The recent report of Francis et al and Weiner et al revealed that rs1803155 SNP has a significant effect on rifapentine exposure in tuberculosis patients. The mean AUC-24 of rifapentine decreased by 10.2% in black tuberculosis patient carriers of AADAC rs1803155 G versus A allele.44 The odds increase for GG allele carriers. A similar result was reported by Francis et al. Patients carrying the AA variant of AADAC rs1803155 were found to have a 10.4% lower clearance of rifapentine.41 However, another study from Malawi showed that AADAC rs1803155 SNP did not affect rifampicin pharmacokinetics.43
Discussion
This systematic review provides current updates on the impact of genetic polymorphisms of drug transporters and drug-metabolizing enzymes on the pharmacokinetics of rifamycins. The overall finding suggests that the polymorphism in the drug transporter SLCO1B1 rs4149032, rs2306283, rs11045819, and ABCB1 rs1045642 and metabolizing enzyme AADACrs1803155 and CES2 c.-22263A>G (g.738A>G) of rifamycins partly contributes to the variability of pharmacokinetic parameters in tuberculosis patients.
The SLCO1B1 gene is located on chromosome 12. Fifteen exons and many variants have been identified in the SLCO1B1 gene. The missense mutation of rs4149056 (c.521T>C) where the wild type T is substituted with variant C causes a change in amino acid of OATP1B1 protein from valine to alanine at 174 positions. This change has been implicated in reduced OATP1B1 protein function and is associated with an increased risk for statin-induced muscle toxicity.55 However, an increase in the exposure to rifamycins was not reported in seven studies, and the one study, which reported an increase in AUC for the heterogeneous variant is also statistically non-significant. Lower frequency of rs4149056 CC variant in African populations56 where the majority of studies were done and small sample size may contribute to no difference in the pharmacokinetics. rs2306283 (388A>G) SNP causes a change of asparagine amino acid to aspartic at 130 positions. The consequence of this change on the transporter function is not well elucidated. The patients who were homozygous wild type (AA)42 and heterozygous (AG)39 were reported to have lower rifampicin exposure. Similarly, no myopathy was observed with rs2306283 polymorphism which was observed in other SLCO1B1 genes in patients taking statins suggesting no effect or increased activity of the mutant variant.57
rs11045819, which is located on exon 4, is another missense variant known in SLCO1B1gene. Of the four studies that assessed the impact of rs11045819 SNPs on rifampicin pharmacokinetics, only Weiner et al reported lower rifampicin exposure, lower peak concentration levels and greater apparent oral clearance with the SLCO1B1 rs11045819 variant allele (CA) compared to the wild-type allele (CC).36 This is consistent with a previous report that rs11045819 polymorphism increases OATP1B1 transporter activity and decreases systemic exposure of the OATP1B1 substrate.58,59
The well-studied SLCO1B1 gene SNPs believed to affect rifamycin pharmacokinetics is rs4149032. The rs4149032 is an intron-located SNP and is reported to have a high allelic frequency. The effect of SLCO1B1 rs4149032 on gene expression and OATP1B1 protein transporter function is not clear yet. Nevertheless, SLCO1B1 rs4149032 polymorphism was found to be associated with lower rifampicin exposures. Emmanuel et al and Gengiah et al reported that patients who are homozygous mutant and heterozygous for rs4149032 polymorphism have lower bioavailability and Cmax respectively of rifampicin.32,40 In addition, Kim et al observed lower oral clearance and higher rifampicin exposure for rs4149032 homozygous wild type (TT).37
Rifampicin significantly increases gene expression, protein levels, and efflux activity of ABCB1.25,60 It is also a substrate for P-glycoprotein.61 Huerta-García et al demonstrated that the rs1045642 SNPs, which is a silent mutation, is associated with rifampicin pharmacokinetics. Patients with CC or CT genotypes showed lower values of Cmax and AUC 24 compared to those with a TT genotype.39 Although the rs1045642 SNPs is a silent mutation, previous studies have shown that rs1045642 affects the P-gp protein either by being in linkage disequilibrium with other functional SNPs or by allele-specific differences in the codon usage affecting the protein folding and function.62,63 The observed change in the rifampicin pharmacokinetics with rs1045642 SNPs may be attributed to the above explanation.
Rifamycins are metabolized by the esterase enzyme family; microsomal hepatic carboxylesterases (CES), and serine esterase arylacetamide deacetylase (AADAC) to 25-deacetylrifamycins.14 Three esterase enzymes AADAC, CES1, and CES2 have been reported as enzymes responsible for rifamycin deacetylation. Several genetic polymorphisms of the CES1 and CES2 genes have been shown to affect drug metabolism. For example, variations of the CES1 gene have been reported to affect the metabolism of dabigatran oseltamivir, imidapril, and clopidogrel. Similarly, CES2 gene polymorphisms have been found to affect aspirin and irinotecan.54 Few studies are available that report the association of CES1 and CES2 variants and rifamycin pharmacokinetics. Song et al evaluated 10 SNPs of CES2 and found increased plasma rifampicin concentrations with the CES2 c.-22263A>G (g.738A>G) variants.45 Although Dompreh et al did not report similar results,42 the higher frequency of this variant allele warrants further investigation.
AADAC is primarily expressed in the liver and metabolizes clinically important drugs including rifamycins. Three, namely, AADAC*1 (wild-type), AADAC*2, and AADAC*3, where the latter two have decreased enzymatic activity, were reported so far.14,15 Recently, Francis et al and Weiner et al reported AADAC rs1803155 SNPs to have a significant effect on rifapentine metabolism. Shortly, a mutant variant of rs1803155 (AA) has decreased activity and decreased clearance of rifapentine. On the other hand, patients who have the wild type (GG) have shown decreased rifapentine exposure.41,44 Furthermore, Gabriele et al discovered the presence and inter-individual variation of AADAC in the human lung.64 These findings suggest the important role of AADAC pharmacogenetics in tuberculosis drug therapy.
Exposure to rifamycins in particular rifampicin is a crucial variable for successful tuberculosis treatment outcomes. The high inter-individual variability in rifamycins pharmacokinetics have been associated with various factors such as diabetes mellitus65 and partly HIV co-infection.66,67 The majority of studies included in this review included patients with co-morbid conditions. The sample size is also inadequate for some studies.
In conclusion, the genetic polymorphism of drug transporters and drug-metabolizing enzymes has an impact on rifamycin pharmacokinetics. However, based on the available data, it is difficult to identify candidate SNPs in the drug transporters SLCO1B1 and ABCB1 for therapeutic drug monitoring. On the other hand, the effect of drug-metabolizing enzyme SNPs on the rifamycin pharmacokinetics is promising but needs more studies. In general, further controlled clinical studies with adequate sample size are required to characterize the genetic variation influence on the pharmacokinetics of rifamycins for tuberculosis chemotherapy optimization.
Funding
A study reported in this publication was supported by the Fogarty International Center and National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number D43 TW009127 and by the Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or CDT-Africa, Addis Ababa University.
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An African American man has sparked outrage on social media after posting photos of all thirty-three of his children with various baby mamas.
The man took to Facebook to share photos of his adorable children, referring to himself as the “Legend.”
He thanked his children’s mothers for being present, lending support, and staying to care for their children. He mentioned the names of his baby mamas to express his gratitude for their love and efforts, while also revealing that nine of his children were missing from the family photo.
He captioned, “The LEGEND The LEGACY WILL LIVE FOREVER 💕💕💙💙💪🏾💪🏾😍😍😍 I want to thank my kid’s mothers for helping me make dis day possible I want thank Rushelle Leonard &Emmalee Ja’Shay Carraway Mecie Okra& UncleBilly Jackson Nana@ Tammy LaNell Miles alsoKortlyn Nycole for staying & helping with my kid’s thanks Nykedra Kedrapooh Haggerty for our photoshoot & being understanding with 9 missing it still turned out good I’m truly blessed 😘😘🤞🏾🤞🏾”.
About 4.6 million, or one in 10, Black people living in American are immigrants, according to a January report from Pew Research Center.
Although they are only 7% of the non-citizen population, Black immigrants make up 20% of deportations on criminal grounds, according to a 2018 Black Alliance for Just Immigration report.
When the Lyoya family arrived in the United States in 2014 after facing years of war and persecution in the Democratic Republic of Congo, the refugees thought they had finally made it.
They were living in Malawi when they won asylum to live in the U.S., part of a growing number of refugees from Congo in Michigan.
“They told us that in America, there’s peace, there’s safety, you’re not going to see killing anymore, that it was basically a safe haven,” Dorcas Lyoya said in Congolese during an interview with the Detroit Free Press, part of the USA TODAY Network, through a translator.
Lyoya’s death and others like it can rattle the sense of security of Black immigrants and refugees who came to the U.S. to escape violence only to find themselves vulnerable to the same brutality and racism African Americans encounter from police as well as the additional specter of federal immigration authorities, immigration advocates told USA TODAY.
“It’s shocking to Black migrants who have this vision of the United States as the land of the free and the home of the brave,” said Nana Gyamfi, executive director of the Black Alliance for Just Immigration. “There’s a notion that police here are going to be different.”
Patrick Lyoya’s death brings fear in growing Black immigrant community
Although refugee admissions hit a record low in 2021, over the past two fiscal years people from the Congo became the the largest group of refugees to settle in Michigan, according to data from the U.S. State Department.
Grand Rapids is home to the largest Congolese refugee population in the state thanks to employment opportunities as well as family and social connections like churches, saidChris Cavanaugh, director of Samaritas’ New American Resettlement program in West Michigan.
Samaritas helps refugees meet many of their immediate needs and offers a cultural orientation on what it means to live life in America, he said. But they didn’t talk much about the racial implications of being Black in America until George Floyd’s murder sparked a nationwide racial justice protest movement in 2020, which Cavanaugh said a number of Congolese refugees joined.
In the wake of Lyoya’s death, Cavanaugh said Samaritas is hoping to support refugee communities by providing resources to help them access services in their native language including during interactions with law enforcement.
“Certainly the Congolese community is feeling some fear, kind of scared over what happened and I would say rightfully so,” Cavanaugh said. “Those maybe who have much less English skills are just more apprehensive about getting pulled over or how they’re supposed to respond in certain situations.”
A history of violence, from Amadou Diallo in 1999 to Botham Jean in 2018
Many Black immigrants and refugees are surprised when they encounter violence from both police and immigration officials, Gyamfi said.
“We have to deal with the violence that police inflict on us because we’re Black,” Gyamfi said. “And then the additional violence that then often is inflicted on us by ICE in this immigration enforcement system because of our migrant status.”
But Black migrants have long been subjected to the same racism and brutality that disproportionately affects Black Americans.
Protests broke out for several weeks in 1999 after Guinean immigrant Amadou Diallo was killed by four white police officers in New York City who said they thought his wallet was a gun. All four officers were acquitted of second-degree murder charges. That same year, Patrick Dorismond, a 26-year-old Haitian American, was killed by police sparking another wave of protests in New York.
‘Double-barreled racism’ embedded in immigration laws, law enforcement
Black immigrants are also disproportionately detained and deported by Immigration and Customs Enforcement, said Bill Ong Hing, a law and migration studies professor at the University of San Francisco.
“Embedded in the immigration laws are these anti-Black aspects beginning with the visa system,” Hing said. “They face this double-barreled racism when it comes to law enforcement.”
“The way that most Black migrants end up getting deported is through contact with the police,” Gyamfi said. “There is an awareness that this can happen and there is a lot of anxiety around any type of police contact.”
Hing, founder of the Immigrant Legal Resource Center, said more immigration advocacy organizations began paying attention to this issue in the wake of Floyd’s death. Personal experiences of racism and high-profile cases like Lyoya’s have also started to shift the way Black migrants view themselves.
“They may start out seeing themselves as different from African Americans, but realize that the mainstream, including the police, treat them like any other Black person which is not good,” he said.
Contributing: The Associated Press
Contact Breaking News Reporter N’dea Yancey-Bragg at nyanceybra@gannett.com or follow her on Twitter @NdeaYanceyBragg
The AU was established with a vision to achieve “an integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in global arena.” Hence, the birth of the AU marked a shift in the focus of Africa’s foremost pan-African institution away from mainly the support of anti-colonial and anti-apartheid (liberation) movements to the task of greater integration for expedited development.
I am happy that the Thabo Mbeki Foundation has chosen, as its focus for 2022, the history and evaluation of the African Union, which was officially launched twenty years ago in South Africa.
The African Union (AU), Africa’s foremost continental organisation, has come of age. Some twenty years ago, in July of 2002, this prestigious African institution came into being in continuance of the Pan-African vision of an independent, united and prosperous Africa shared by the continent’s independent leadership, for which they set up its parent institution, the Organisation of African Unity (OAU). This occasion of the commemoration of the African Union’s twentieth anniversary provides an opportunity for all of Africa to come together and listen to each other as a way of determining how well the continental organisation has fared in achieving the goals for which it was set up; what challenges have limited its success; how to surmount these challenges; and what opportunities there are in a fully operational continental organisation in today’s global geopolitics.
The establishment of the OAU on May 25, 1963 marked the culmination of diverse and far-reaching political trends, on and off the continent. Its ideological basis can be found in the late nineteenth century Pan-Africanist movement, which had its origins amongst Black American intellectuals — Martin Delany and Alexander Crummel — in the United States of America (USA). Canvassing for a Black nation independent of the U.S.A as the only means to ensuring the prosperity of Black peoples, their ideas caught on and were further developed by W. E. B Du Bois and Marcus Garvey, who urged a return to the continent. The Pan-African idea was picked up and advanced on the continent by several prominent intellectuals and heads of state, including Kwame Nkrumah of Ghana, Julius Nyerere of Tanzania, Kenneth Kaunda of Zambia, and Sekou Toure of Guinea. These individuals provided practical expressions of Pan-African ideals in Africa, applying them to the African reality of colonial subjugation and other forms of foreign oppression.
Therefore, when the Heads of Africa’s thirty-two independent states gathered in Addis Ababa, Ethiopia, to sign the OAU Charter in 1963, it was with a common belief that for Africa to achieve its potential and aspirations, it must be free from external control, and its peoples must rise above racial, ethnic, and national differences and work together cooperatively in the spirit of brotherhood and solidarity. As a result, Article II of the OAU’s founding Charter included an agenda to promote African unity and solidarity; coordinate and intensify their cooperation and efforts to achieve a better life for Africa’s people; protect their sovereignty, territorial integrity, and independence; obliterate all forms of colonialism in Africa; and encourage international cooperation, with due regard for the Charter of the United Nations and the Universal Declaration of Human Rights.
Armed with a pledge of cooperation in all aspects of social endeavour, politics, economics, education, health, science, and defence by member states, the OAU immediately embarked upon what was then the foremost obstacle to its agenda of a united and prosperous Africa — the struggle for the independence of all African states under colonialism and other forms of foreign oppression (apartheid). In this regard, the OAU Coordinating Committee for the Liberation of Africa swung into action, organising diplomatic, financial, and logistical support for liberation movements wherever they existed in Africa. The organisation was involved in the independence agitation of Guinea Bissau, Angola, Mozambique, Central African Republic, Namibia (former South West Africa) and the struggle against the apartheid regime in South Africa. It was also active in defending its member nations’ integrity and sovereignty, and resolving border disputes. This impact was especially observed in the Congo, where strategic raw materials have always been a source of unrest, in Nigeria during a civil war that threatened the unity of the Federal Republic, and in Egypt during the 1967 Israeli occupation.
In pursuance of its mandate, the AU has recorded reasonable successes through direct contributions and international community collaborations. It has been active in minimising and settling conflicts in conflict-prone areas like Somalia and Sudan; it has successfully arbitrated post-election violent conflicts in Kenya, Comoros and Cote de’ Ivoire; and it has intervened in coup situations by ensuring a return back to civilian rule.
Another landmark achievement of the OAU was the ambition to create an economically integrated Africa. In this instance, it was instrumental to the establishment of Regional Economic Communities (RECS), notably the Economic Community of West African States (ECOWAS), the East African Community (EAC), the Common Market for Eastern and Southern Africa (COMMESA), the South African Development Coordinating Commission (SADCC), and the Arab Maghreb Union. In addition, it established the African Economic Community (AEC) in 1991, which was expected to expand into a common market, a customs union, and an African monetary union.
Notwithstanding the OAU’s commendable achievements, its membership identified a need to refocus the organisation’s attention away from its decolonisation agenda and more towards promoting peace and stability as a prerequisite to an eventual political and economic integration that will ensure African interests in an increasingly geopolitically quartered world. To that effect, the Heads of Government of the OAU came to a consensus and issued the Sirte Declaration of September 1999, calling for the establishment of an African Union that would accelerate the process of integration on the continent to enable her to compete favourably in a changing global economy and address any social and political challenges arising from globalisation. Thus, the African Union (AU) came into existence in 2002.
The AU was established with a vision to achieve “an integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in global arena.” Hence, the birth of the AU marked a shift in the focus of Africa’s foremost pan-African institution away from mainly the support of anti-colonial and anti-apartheid (liberation) movements to the task of greater integration for expedited development. Among the AU’s stated goals are: Achieving greater unity and solidarity among African countries and peoples; defending the territorial integrity and independence of its member states; accelerating the continent’s political and socio-economic integration; promoting common positions on issues of concern to the continent and its peoples; promoting sustainable economic, political, and cultural development; fostering cooperation in all fields of human endeavour to raise African peoples’ living standards; protecting and promoting human and people’s rights in accordance with the African Charter on Human and People’s Rights; and promoting peace, security, and stability on the continent.
In pursuance of its mandate, the AU has recorded reasonable successes through direct contributions and international community collaborations. It has been active in minimising and settling conflicts in conflict-prone areas like Somalia and Sudan; it has successfully arbitrated post-election violent conflicts in Kenya, Comoros and Cote de’ Ivoire; and it has intervened in coup situations by ensuring a return back to civilian rule. Unrestricted by the OAU’s ‘non-interference’ concept, the AU has reserved the authority, through its Peace and Security Council, to intervene in the domestic affairs of member nations to promote peace and safeguard democracy, even employing military action in circumstances of genocide and crimes against humanity. Through its voluntary ‘Peer Review Mechanism’, whereby individual member states concede to be assessed by a group of experts collected from other member states, the AU has been able to encourage democracy and good governance on the continent. The AU has also established a practice of sending election monitoring teams (Observer Missions) to all member states to guarantee that the terms of the African Charter on Democracy, Elections, and Governance (2007) are followed.
Many untapped opportunities can be gained from an objective, independent, and people-oriented continental union. Without some of the AU’s encumbrances — vested interests and constitutional limitations — the continental organisation can do much more to ensure good governance, peace, stability and economic prosperity through extensive collaborative networks that transcend any cultural, national, and regional divide.
The AU has demonstrated strategic leadership on the continent. Africa has presented a common front on several issues that have shaped global debates and decisions through its activities. It had some impact on the terms of engagement between the UN and regional organisations. By achieving an African consensus, it has been able to drum support for African candidates vying for positions in international organisations, such as Nigeria’s Okonjo Iweala as director-general of the World Trade Organisation, Ethiopia’s Tedros Adhanom Ghebreyesus as secretary-general of the World Health Organisation, and Rwanda’s Louise Mushikiwabo as secretary-general of the Organisation Internationale de la Francophonie. The AU has also demonstrated commendable leadership and served as an advisor to governments and intergovernmental agencies.
In pursuit of its agenda of African prosperity, the AU put necessary declarations and institutions in place that promote economic integration among its fifty-four member states. It has established development organisations such as the African Union Development Agency-NEPAD and progressive frameworks such as the African Continental Free Trade Area (AfCFTA) and Agenda 2063. There have been proposals for an African Monetary Union and an African Central Bank, even though these have not seen a political will by member states to bring them to fruition. The AU also made considerable efforts to ensure that the COVID-19 vaccines are available to its member states.
Financial dependence, poorly governed states and a constant push for reforms have been identified as some of the impediments to the AU’s progress. Other factors identified include the development of the ‘cult of personality, concentration of power in the office of the chairperson of the commission and the shrinking spaces for popular participation in decision making.’ The AU exhibited some flaws in its decision-making when it relocated its July 2012 bi-annual summit from Lilongwe, Malawi, to Addis Ababa, for the former’s refusal to invite Omar al-Bashar because he had been charged with war crimes by the International Criminal Court (ICC). Also reprehensible is its practice of appointing leaders with questionable democratic credentials as chairpersons. Other issues that cast aspersion on the AU’s image and performance include its inability to find a lasting solution to Africa’s teeming educated and unemployed youths, the recent resurgence of coups and violent conflicts, and its romance with China, which has seen the latter gain increasing and unbalanced concessions on the continent.
Many untapped opportunities can be gained from an objective, independent, and people-oriented continental union. Without some of the AU’s encumbrances — vested interests and constitutional limitations — the continental organisation can do much more to ensure good governance, peace, stability and economic prosperity through extensive collaborative networks that transcend any cultural, national, and regional divide. To achieve this, the AU must be seen to uphold the highest standards and be more people-oriented.
Toyin Falola, a professor of History, University Distinguished Teaching Professor, and Jacob and Frances Sanger Mossiker Chair in the Humanities at The University of Texas at Austin, is the Bobapitan of Ibadanland.
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The AU was established with a vision to achieve “an integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in global arena.” Hence, the birth of the AU marked a shift in the focus of Africa’s foremost pan-African institution away from mainly the support of anti-colonial and anti-apartheid (liberation) movements to the task of greater integration for expedited development.
I am happy that the Thabo Mbeki Foundation has chosen, as its focus for 2022, the history and evaluation of the African Union, which was officially launched twenty years ago in South Africa.
The African Union (AU), Africa’s foremost continental organisation, has come of age. Some twenty years ago, in July of 2002, this prestigious African institution came into being in continuance of the Pan-African vision of an independent, united and prosperous Africa shared by the continent’s independent leadership, for which they set up its parent institution, the Organisation of African Unity (OAU). This occasion of the commemoration of the African Union’s twentieth anniversary provides an opportunity for all of Africa to come together and listen to each other as a way of determining how well the continental organisation has fared in achieving the goals for which it was set up; what challenges have limited its success; how to surmount these challenges; and what opportunities there are in a fully operational continental organisation in today’s global geopolitics.
The establishment of the OAU on May 25, 1963 marked the culmination of diverse and far-reaching political trends, on and off the continent. Its ideological basis can be found in the late nineteenth century Pan-Africanist movement, which had its origins amongst Black American intellectuals — Martin Delany and Alexander Crummel — in the United States of America (USA). Canvassing for a Black nation independent of the U.S.A as the only means to ensuring the prosperity of Black peoples, their ideas caught on and were further developed by W. E. B Du Bois and Marcus Garvey, who urged a return to the continent. The Pan-African idea was picked up and advanced on the continent by several prominent intellectuals and heads of state, including Kwame Nkrumah of Ghana, Julius Nyerere of Tanzania, Kenneth Kaunda of Zambia, and Sekou Toure of Guinea. These individuals provided practical expressions of Pan-African ideals in Africa, applying them to the African reality of colonial subjugation and other forms of foreign oppression.
Therefore, when the Heads of Africa’s thirty-two independent states gathered in Addis Ababa, Ethiopia, to sign the OAU Charter in 1963, it was with a common belief that for Africa to achieve its potential and aspirations, it must be free from external control, and its peoples must rise above racial, ethnic, and national differences and work together cooperatively in the spirit of brotherhood and solidarity. As a result, Article II of the OAU’s founding Charter included an agenda to promote African unity and solidarity; coordinate and intensify their cooperation and efforts to achieve a better life for Africa’s people; protect their sovereignty, territorial integrity, and independence; obliterate all forms of colonialism in Africa; and encourage international cooperation, with due regard for the Charter of the United Nations and the Universal Declaration of Human Rights.
Armed with a pledge of cooperation in all aspects of social endeavour, politics, economics, education, health, science, and defence by member states, the OAU immediately embarked upon what was then the foremost obstacle to its agenda of a united and prosperous Africa — the struggle for the independence of all African states under colonialism and other forms of foreign oppression (apartheid). In this regard, the OAU Coordinating Committee for the Liberation of Africa swung into action, organising diplomatic, financial, and logistical support for liberation movements wherever they existed in Africa. The organisation was involved in the independence agitation of Guinea Bissau, Angola, Mozambique, Central African Republic, Namibia (former South West Africa) and the struggle against the apartheid regime in South Africa. It was also active in defending its member nations’ integrity and sovereignty, and resolving border disputes. This impact was especially observed in the Congo, where strategic raw materials have always been a source of unrest, in Nigeria during a civil war that threatened the unity of the Federal Republic, and in Egypt during the 1967 Israeli occupation.
In pursuance of its mandate, the AU has recorded reasonable successes through direct contributions and international community collaborations. It has been active in minimising and settling conflicts in conflict-prone areas like Somalia and Sudan; it has successfully arbitrated post-election violent conflicts in Kenya, Comoros and Cote de’ Ivoire; and it has intervened in coup situations by ensuring a return back to civilian rule.
Another landmark achievement of the OAU was the ambition to create an economically integrated Africa. In this instance, it was instrumental to the establishment of Regional Economic Communities (RECS), notably the Economic Community of West African States (ECOWAS), the East African Community (EAC), the Common Market for Eastern and Southern Africa (COMMESA), the South African Development Coordinating Commission (SADCC), and the Arab Maghreb Union. In addition, it established the African Economic Community (AEC) in 1991, which was expected to expand into a common market, a customs union, and an African monetary union.
Notwithstanding the OAU’s commendable achievements, its membership identified a need to refocus the organisation’s attention away from its decolonisation agenda and more towards promoting peace and stability as a prerequisite to an eventual political and economic integration that will ensure African interests in an increasingly geopolitically quartered world. To that effect, the Heads of Government of the OAU came to a consensus and issued the Sirte Declaration of September 1999, calling for the establishment of an African Union that would accelerate the process of integration on the continent to enable her to compete favourably in a changing global economy and address any social and political challenges arising from globalisation. Thus, the African Union (AU) came into existence in 2002.
The AU was established with a vision to achieve “an integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in global arena.” Hence, the birth of the AU marked a shift in the focus of Africa’s foremost pan-African institution away from mainly the support of anti-colonial and anti-apartheid (liberation) movements to the task of greater integration for expedited development. Among the AU’s stated goals are: Achieving greater unity and solidarity among African countries and peoples; defending the territorial integrity and independence of its member states; accelerating the continent’s political and socio-economic integration; promoting common positions on issues of concern to the continent and its peoples; promoting sustainable economic, political, and cultural development; fostering cooperation in all fields of human endeavour to raise African peoples’ living standards; protecting and promoting human and people’s rights in accordance with the African Charter on Human and People’s Rights; and promoting peace, security, and stability on the continent.
In pursuance of its mandate, the AU has recorded reasonable successes through direct contributions and international community collaborations. It has been active in minimising and settling conflicts in conflict-prone areas like Somalia and Sudan; it has successfully arbitrated post-election violent conflicts in Kenya, Comoros and Cote de’ Ivoire; and it has intervened in coup situations by ensuring a return back to civilian rule. Unrestricted by the OAU’s ‘non-interference’ concept, the AU has reserved the authority, through its Peace and Security Council, to intervene in the domestic affairs of member nations to promote peace and safeguard democracy, even employing military action in circumstances of genocide and crimes against humanity. Through its voluntary ‘Peer Review Mechanism’, whereby individual member states concede to be assessed by a group of experts collected from other member states, the AU has been able to encourage democracy and good governance on the continent. The AU has also established a practice of sending election monitoring teams (Observer Missions) to all member states to guarantee that the terms of the African Charter on Democracy, Elections, and Governance (2007) are followed.
Many untapped opportunities can be gained from an objective, independent, and people-oriented continental union. Without some of the AU’s encumbrances — vested interests and constitutional limitations — the continental organisation can do much more to ensure good governance, peace, stability and economic prosperity through extensive collaborative networks that transcend any cultural, national, and regional divide.
The AU has demonstrated strategic leadership on the continent. Africa has presented a common front on several issues that have shaped global debates and decisions through its activities. It had some impact on the terms of engagement between the UN and regional organisations. By achieving an African consensus, it has been able to drum support for African candidates vying for positions in international organisations, such as Nigeria’s Okonjo Iweala as director-general of the World Trade Organisation, Ethiopia’s Tedros Adhanom Ghebreyesus as secretary-general of the World Health Organisation, and Rwanda’s Louise Mushikiwabo as secretary-general of the Organisation Internationale de la Francophonie. The AU has also demonstrated commendable leadership and served as an advisor to governments and intergovernmental agencies.
In pursuit of its agenda of African prosperity, the AU put necessary declarations and institutions in place that promote economic integration among its fifty-four member states. It has established development organisations such as the African Union Development Agency-NEPAD and progressive frameworks such as the African Continental Free Trade Area (AfCFTA) and Agenda 2063. There have been proposals for an African Monetary Union and an African Central Bank, even though these have not seen a political will by member states to bring them to fruition. The AU also made considerable efforts to ensure that the COVID-19 vaccines are available to its member states.
Financial dependence, poorly governed states and a constant push for reforms have been identified as some of the impediments to the AU’s progress. Other factors identified include the development of the ‘cult of personality, concentration of power in the office of the chairperson of the commission and the shrinking spaces for popular participation in decision making.’ The AU exhibited some flaws in its decision-making when it relocated its July 2012 bi-annual summit from Lilongwe, Malawi, to Addis Ababa, for the former’s refusal to invite Omar al-Bashar because he had been charged with war crimes by the International Criminal Court (ICC). Also reprehensible is its practice of appointing leaders with questionable democratic credentials as chairpersons. Other issues that cast aspersion on the AU’s image and performance include its inability to find a lasting solution to Africa’s teeming educated and unemployed youths, the recent resurgence of coups and violent conflicts, and its romance with China, which has seen the latter gain increasing and unbalanced concessions on the continent.
Many untapped opportunities can be gained from an objective, independent, and people-oriented continental union. Without some of the AU’s encumbrances — vested interests and constitutional limitations — the continental organisation can do much more to ensure good governance, peace, stability and economic prosperity through extensive collaborative networks that transcend any cultural, national, and regional divide. To achieve this, the AU must be seen to uphold the highest standards and be more people-oriented.
Toyin Falola, a professor of History, University Distinguished Teaching Professor, and Jacob and Frances Sanger Mossiker Chair in the Humanities at The University of Texas at Austin, is the Bobapitan of Ibadanland.
WATCH: Governor Yahaya Bello’s Roadmap to Hope 2023
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Support PREMIUM TIMES’ journalism of integrity and credibility
Good journalism costs a lot of money. Yet only good journalism can ensure the possibility of a good society, an accountable democracy, and a transparent government.
For continued free access to the best investigative journalism in the country we ask you to consider making a modest support to this noble endeavour.
By contributing to PREMIUM TIMES, you are helping to sustain a journalism of relevance and ensuring it remains free and available to all.
