Providing Probiotics to Sub-Saharan Africa: Ethical Principles to Consider

The United Nations Food and Agriculture Organization and World Health Organization in 2001, made a clarion call for efforts to be made to make probiotic products more widely available, especially for relief work and populations at high risk of morbidity and mortality. This strong and direct request to governments, funding agencies, corporate pharmaceutical and food industries has so far not had any impact in sub-Saharan Africa, where people are mired in poverty and stricken with gastro-intestinal and an escalating epidemic of sexually transmitted diseases including HIV/AIDS. The ability of certain probiotic strains to prevent and treat some gut and urogenital conditions, and the relative low cost and practical means by which this can be achieved, provides a potential addition to the armamentarium of methods to lower the impact of disease and enhance the quality of life of people in this part of the world. Companies selling reliable probiotic products have not yet entered sub-Saharan Africa, perhaps due to logistical reasons and low pricing. Nevertheless, in order to make a significant impact on the health and wellbeing of this large population, ways must be found to provide access to this technology. A community kitchen project in Tanzania, initiated by our group, is one way of taking the concept to the grass roots