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The highlands of East Africa have a high agricultural potential and have historically supported kingdoms with stratified social structures. Today, traditional fertility practices cannot be maintained under conditions of mounting population growth and land scarcity. Land degradation is now threatening the very basis of the farming communities. This paper discusses land degradation in East Africa in the context of soil conservation. It describes technical and institutional responses to land degradation including regional cooperation and concludes that degradation is not yet irreversible. Relatively low-cost technologies exist that have the potential, given supportive institutions and incentives, to achieve widespread adoption among smallholders.