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Background: Infertility affects over 50 million couples worldwide and impacts people's social and emotional wellbeing. In low- and middle-income countries, particularly across Africa, the inclusion of fertility care into reproductive health (RH) policies remains fragmented or non-existent.Objective and Rationale: This review aims to provide a framework for understanding the inclusion (or lack thereof) of fertility care in RH policies in African settings. It synthesizes the barriers and facilitators to such inclusion, with a view to uncovering the positioning of fertility care in broader health systems and on the agendas of key stakeholders such as health policymakers and practitioners.Search Methods: A qualitative evidence synthesis was performed, systematically searching papers and grey literature. Searches were conducted in MEDLINE, EMBASE, CINAHL, Web of Science and Scopus between February and April 2020. No date restrictions were applied. Language was limited to publications written in English and French. Two reviewers independently screened titles and abstracts, and extracted data, applying thematic coding. The quality of the included papers was evaluated using The Joanna Briggs Institute Checklist for Text and Opinion Papers.Outcomes: The search identified 744 papers, of which 20 were included. Findings were organized under four cross-cutting categories, namely: perceived importance of infertility; influence of policy context; resource availability and access; and perceived quality of care. Across these categories, key barriers to the inclusion of fertility care in RH policies were limited political commitment, under-recognition of the burden of infertility and high costs associated with ART. Conversely, facilitators comprised specialized training on infertility for healthcare providers, standard procedures for ART safety and guidelines and North-South/South-South collaborations.Wider Implications: The inclusion of fertility care in African RH policies depends upon factors that include the recognition of infertility as a disease, strong political engagement and proactivity and affordability of ART through opportunities for partnership with the private sector, which ease costs on the public health system. Further qualitative and quantitative research, including context-specific analysis and in-depth comparative approaches across diverse African countries, will help to delineate differential impacts of local and global factors on fertility care to address this neglected RH issue. [ABSTRACT FROM AUTHOR]

Fairness or equity in health financing is critical to ensuring universal health coverage (UHC). While equity in health financing is generally about financing health services according to ability-to-pay, misconceptions exist among policymakers, decision-makers and some researchers about what constitutes financing health services according to ability-to-pay or an equitably financed health system. This commentary characterizes three misconceptions of equitable health financing-(1) the misconception of fair contribution, (2) the pro-poor misconception and (3) the misconception of cross-subsidization. The paper also uses these misconceptions to clearly illustrate what constitutes equity in health financing, highlighting the importance of income distribution. The misconceptions come from the authors' extensive engagements with policymakers and practitioners, especially in Africa. A clear understanding of equity in health financing provides an avenue to significant progress towards UHC and improving a country's income distribution. [ABSTRACT FROM AUTHOR]

Modern humans originated in Africa 300,000 yr ago, and before leaving their continent of origin, they underwent a process of intense diversification involving complex demographic dynamics. Upon exiting Africa, different populations emerged on the four other inhabited continents, shaped by the interplay of various evolutionary processes, such as migrations, founder effects, and natural selection. Within each region, continental populations, in turn, diversified and evolved almost independently for millennia. As a backdrop to this diversification, introgressions from archaic species contributed to establishing different patterns of genetic diversity in different geographic regions, reshaping our understanding of our species' variability. With the increasing availability of genomic data, it has become possible to delineate the subcontinental human population structure precisely. However, the bias toward the genomic research focused on populations from the global North has limited our understanding of the real diversity of our species and the processes and events that guided different human groups throughout their evolutionary history. This perspective is part of a series of articles celebrating 40 yr since our journal, Molecular Biology and Evolution , was founded (Russo et al. 2024). The perspective is accompanied by virtual issues, a selection of papers on human diversification published by Genome Biology and Evolution and Molecular Biology and Evolution. [ABSTRACT FROM AUTHOR]

Water will be a major limitation to food production in the 21st century, and drought issues already prevail in many parts of the world. Finding solutions to ensure that farmers harvest profitable crops, and secure food supplies for families and feed for animals that will provide for them through to the next season are urgent necessities. The Interdrought community has been addressing this issue for almost 30 years in a series of international conferences, characterized by a multi-disciplinary approach across the domains of molecular biology, physiology, genetics, agronomy, breeding, environmental and social sciences, policy, and systems modeling. This special issue presents papers from the 7th edition of the conference, the first to be held in Africa, that paid special attention to drought in a smallholder context, adding a 'system' dimension to the crop focus from the previous Interdrought events (Varshney et al. , 2018 ; Hammer et al. , 2021). [ABSTRACT FROM AUTHOR]

SUMMARY: Earthquake hazard assessment is the first step towards implementing prevention, preparedness and response or faster recovery actions to reduce the risk of seismic disasters. In this paper, we present a comprehensive study on present-day seismicity in terms of the estimated waiting time and conditional probability in Africa by 2022–2072 using four competing distribution models (Brownian passage time (BPT), gamma, lognormal and Weibull). We also investigate how much Coulomb stress change $\ ({\Delta {\rm CFF}})$ induced by previous earthquakes that occurred in neighbouring active sources should revise the probability of occurrence at the location of the next events. We analyse large earthquakes with moment magnitude, ${M}_{\rm w} \ge 6.0$ , collating data from the Global Centroid Moment Tensor and from several published literature that list fault plane solutions of large African earthquakes since 1900. We assume that the data set is stationary and consists of independent events. First, the model's parameters are estimated and the results of the statistical analysis of the interevent times show clear evidence of quasi-periodic recurrence behaviour for large earthquakes ${M}_{\rm w} \ge $ 6.0 in different seismotectonic regions in Africa. Next, a comparison among the distribution models is performed with the aim of selecting the most suitable one. The results in terms of the maximum likelihood criterion and its extension (Akaike Information Criterion) indicate that, in general, the BPT and Weibull models had similar fits to each other, and performed slightly better than gamma and lognormal models. Then, we use Gaussian random distributions to treat parameter uncertainties (e.g. aperiodicity, maximum expected magnitude, slip rate and mean recurrence time) of the distribution models associated with each seismotectonic region. From repeated Monte Carlo draws, we assess uncertainties of the 50-yr conditional probability values for the next earthquake obtained from two distribution models (BPT and BPT + $\Delta {\rm CFF}$) related to the 50th percentile. The results of the BPT distribution indicate very high chances of future earthquakes in the study region where the conditional probability of a large earthquake reaches 99.5, 95.6, 83.1 and 82.2 per cent for the western branch of the East African Rift System (EARS), northwest Africa, the Afar region, and the eastern branch of EARS, respectively. Taking into account the effect of stress change from interacting sources (BPT + $\Delta {\rm CFF}$), these probabilities are slightly modified to 99.8, 98.4, 89.9 and 87.3 per cent for the western branch of EARS, northwest Africa, the Afar region and the eastern branch of EARS, respectively. These marginal increases suggest that the estimated effect of the earthquake interaction introduced by the coseismic slip of previous earthquakes on neighbouring active sources is minor if compared with the uncertainties affecting the renewal models used for the basic time-dependent conditional probability assessment. [ABSTRACT FROM AUTHOR]

Priority setting represents an even bigger challenge during public health emergencies than routine times. This is because such emergencies compete with routine programmes for the available health resources, strain health systems and shift health-care attention and resources towards containing the spread of the epidemic and treating those that fall seriously ill. This paper is part of a larger global study, the aim of which is to evaluate the degree to which national COVID-19 preparedness and response plans incorporated priority setting concepts. It provides important insights into what and how priority decisions were made in the context of a pandemic. Specifically, with a focus on a sample of 18 African countries' pandemic plans, the paper aims to: (1) explore the degree to which the documented priority setting processes adhere to established quality indicators of effective priority setting and (2) examine if there is a relationship between the number of quality indicators present in the pandemic plans and the country's economic context, health system and prior experiences with disease outbreaks. All the reviewed plans contained some aspects of expected priority setting processes but none of the national plans addressed all quality parameters. Most of the parameters were mentioned by less than 10 of the 18 country plans reviewed, and several plans identified one or two aspects of fair priority setting processes. Very few plans identified equity as a criterion for priority setting. Since the parameters are relevant to the quality of priority setting that is implemented during public health emergencies and most of the countries have pre-existing pandemic plans; it would be advisable that, for the future (if not already happening), countries consider priority setting as a critical part of their routine health emergency and disease outbreak plans. Such an approach would ensure that priority setting is integral to pandemic planning, response and recovery. [ABSTRACT FROM AUTHOR]

Advances in evolutionary theories (the Extended Synthesis) demonstrate that organisms systematically modify environments in ways that influence their own and other species' evolution. This paper utilises these theories to examine the economic consequences of human dispersal from Africa. Evidence shows that early humans' dispersal affected the adaptability of animal species to human environments and, through this, the extinction of large mammals during Homo sapiens ' out-of-Africa migration. Empirical analyses explore the variation in extinction rates as a source of exogenous pressure for cooperation and innovation among hunter-gatherers and examine the impact of extinction on long-run development. The results indicate that extinction affects economic performance by driving continental differences in biogeography, disease environments and institutions. Eurasia's location along the out-of-Africa migratory path provided human and animal populations with co-evolutionary foundations for domestication and agriculture, which gave Eurasians technological and institutional advantages in comparative development. [ABSTRACT FROM AUTHOR]

The Coronavirus disease (COVID-19) pandemic has revealed the fragility of pre-crisis African health systems, in which too little was invested over the past decades. Yet, development assistance for health (DAH) more than doubled between 2000 and 2020, raising questions about the role and effectiveness of DAH in triggering and sustaining health systems investments. This paper analyses the inter-regional variations and trends of DAH in Africa in relation to some key indicators of health system financing and service delivery performance, examining (1) the trends of DAH in the five regional economic communities of Africa since 2000; (2) the relationship between DAH spending and health system performance indicators and (3) the quantitative and qualitative dimensions of aid substitution for domestic financing, policy-making and accountability. Africa is diverse and the health financing picture has evolved differently in its subregions. DAH represents 10% of total spending in Africa in 2020, but DAH benefitted Southern Africa significantly more than other regions over the past two decades. Results in terms of progress towards universal health coverage (UHC) are slightly associated with DAH. Overall, DAH may also have substituted for public domestic funding and undermined the formation of sustainable UHC financing models. As the COVID-19 crisis hit, DAH did not increase at the country level. We conclude that the current architecture of official development assistance (ODA) is no longer fit for purpose. It requires urgent transformation to place countries at the centre of its use. Domestic financing of public health institutions should be at the core of African social contracts. We call for a deliberate reassessment of ODA modalities, repurposing DAH on what it could sustainably finance. Finally, we call for a new transparent framework to monitor DAH that captures its contribution to building institutions and systems. [ABSTRACT FROM AUTHOR]

This article looks at the role of finance within a traditional form of capitalism. In essence, it was a component of a dynamic process which relied on classical production functions to create value. This contrasts with its more recent role in which financial value creation happens in isolation of production. It tries to tease out the implications for Africa as well as for the future of capitalism. The conclusion reached is that Africa is ripe for that traditional role of finance, but not for its modern variant. Policy choices will determine which options dominate investment decisions. [ABSTRACT FROM AUTHOR]

Diabetes stigma is a pervasive social phenomenon with significant impacts on individuals living with type 2 diabetes mellitus (T2DM). Despite the negative health impact of diabetes stigma, little is known about the experience of this phenomenon in Africa. This review aimed to synthesize existing quantitative and qualitative studies that examine the experiences and outcomes of T2DM stigma in Africa. A mixed studies review methodology was utilized to conduct this research. Relevant articles were identified by searching the Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE and PsycINFO databases. The mixed method appraisal tool was used to assess the quality of included studies. Of 2626 records identified, 10 articles met the inclusion criteria. The prevalence of diabetes stigma was as high as 70%. The results of the review indicate that individuals with T2DM in Africa are labelled as 'having HIV', 'nearing their death' and 'wasting resources'. These experiences were associated with low quality of life, disease concealment and avoidance of self-management behaviours. The findings highlight the urgent need for further stigma-centric studies to fully understand how T2DM stigma is experienced in Africa. The evidence from such studies would inform the development and evaluation of effective interventions to address this social consequence of T2DM. [ABSTRACT FROM AUTHOR]

The article presents the discussion on US-European global COVID-19 response exist due to alarming vaccine hesitancy in Europe and US contexts. Topics include emphasizing the urgent need for leveraging strategic multilateral diplomacy among US-European and ASEAN states combating pandemic; and emphasizing the important need for constructive education and awareness on public health information accepting COVID-19 vaccines in Africa.

Background Accurate estimation of diarrhea incidence from facility-based surveillance requires estimating the population at risk and accounting for case patients who do not seek care. The Enterics for Global Health (EFGH) Shigella surveillance study will characterize population denominators and healthcare-seeking behavior proportions to calculate incidence rates of Shigella diarrhea in children aged 6–35 months across 7 sites in Africa, Asia, and Latin America. Methods The Enterics for Global Health (EFGH) Shigella surveillance study will use a hybrid surveillance design, supplementing facility-based surveillance with population-based surveys to estimate population size and the proportion of children with diarrhea brought for care at EFGH health facilities. Continuous data collection over a 24 month period captures seasonality and ensures representative sampling of the population at risk during the period of facility-based enrollments. Study catchment areas are broken into randomized clusters, each sized to be feasibly enumerated by individual field teams. Conclusions The methods presented herein aim to minimize the challenges associated with hybrid surveillance, such as poor parity between survey area coverage and facility coverage, population fluctuations, seasonal variability, and adjustments to care-seeking behavior. [ABSTRACT FROM AUTHOR]

There have been few reports from Africa on the use and health effects of emollient therapy for newborn infants. We aimed to describe neonatal skin care practices in Africa, and to illuminate opportunities to introduce evidence-based interventions to improve these practices. We conducted a scoping review of the quantitative and qualitative published peer-reviewed and grey literature in English on emollient use in Africa. Outcomes of interest included neonatal skin care practices, with a focus on the application of oils and other products to infant skin, including in association with bathing and massage. We screened 5257 articles and summarised findings from 23 studies—13 qualitative, nine quantitative and one mixed methods—that met our study criteria. Seven studies reported the use of emollients for perceived benefits, including thermal care, treatment for illness, promotion of growth and development, infection reduction, skin condition improvement, spirituality and lubrication to aid massage. Four studies reported the quantitative health impact of skin care product applications, including improvements in skin condition, neurodevelopment and bone growth, as well as a reduction in nosocomial infections. This review highlights opportunities for skin care intervention and future research on neonatal skin care practices in Africa. [ABSTRACT FROM AUTHOR]

Background Computer-aided detection (CAD) may be a useful screening tool for tuberculosis (TB). However, there are limited data about its utility in active case finding (ACF) in a community-based setting, and particularly in an HIV-endemic setting where performance may be compromised. Methods We performed a systematic review and evaluated articles published between January 2012 and February 2023 that included CAD as a screening tool to detect pulmonary TB against a microbiological reference standard (sputum culture and/or nucleic acid amplification test [NAAT]). We collected and summarized data on study characteristics and diagnostic accuracy measures. Two reviewers independently extracted data and assessed methodological quality against Quality Assessment of Diagnostic Accuracy Studies–2 criteria. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines were followed. Results Of 1748 articles reviewed, 5 met with the eligibility criteria and were included in this review. A meta-analysis revealed pooled sensitivity of 0.87 (95% CI, 0.78–0.96) and specificity of 0.74 (95% CI, 0.55–0.93), just below the World Health Organization (WHO)–recommended target product profile (TPP) for a screening test (sensitivity ≥0.90 and specificity ≥0.70). We found a high risk of bias and applicability concerns across all studies. Subgroup analyses, including the impact of HIV and previous TB, were not possible due to the nature of the reporting within the included studies. Conclusions This review provides evidence, specifically in the context of ACF, for CAD as a potentially useful and cost-effective screening tool for TB in a resource-poor HIV-endemic African setting. However, given methodological concerns, caution is required with regards to applicability and generalizability. [ABSTRACT FROM AUTHOR]

The sharing of health data is an essential component in the provision of healthcare, in medical research, and disease surveillance. Health data sharing is subject to regulatory frameworks that vary across jurisdictions. In Africa, numerous factors complicate the regulation of health data sharing, including technological, motivational, economic, and political barriers, as well as ethical and legal challenges. This comparative study examines the regulation of health data sharing in Africa by comparing and contrasting the legal and policy frameworks of five African countries. The study identifies gaps and inconsistencies in the current regulatory regimes and provides recommendations for improving the regulation of health data sharing in Africa. [ABSTRACT FROM AUTHOR]

Online interviews can be powerful tools in global health research. In this article, we review the literature on the use of and challenges associated with online interviews in health research in Africa and make recommendations for future online qualitative studies. The scoping review methodology was used. We searched on Medline and Embase in March 2022 for qualitative articles that used internet-based interviews as a data collection method. Following full-text reviews, we included nine articles. We found that online interviews were typically conducted via Microsoft Teams, Zoom, Skype, WhatsApp, Facebook Messaging and E-mail chats. Online interviews were used in Africa because of the restrictions imposed by the coronavirus disease 2019 pandemic and the need to sample participants across multiple countries or communities. Recruitment for online interviews occurred online, interviews were characterised by inaudible sounds, the inability to use video options and the challenges of including people with low income and education. We recommend that researchers critically evaluate the feasibility of online interviews within a particular African locality before fully implementing this data collection approach. Researchers may also collaborate with community-based organisations to help recruit a more socioeconomically diverse sample because of the potential of excluding participants with limited internet access. [ABSTRACT FROM AUTHOR]

When the ancestors of modern Eurasians migrated out of Africa and interbred with Eurasian archaic hominins, namely, Neanderthals and Denisovans, DNA of archaic ancestry integrated into the genomes of anatomically modern humans. This process potentially accelerated adaptation to Eurasian environmental factors, including reduced ultraviolet radiation and increased variation in seasonal dynamics. However, whether these groups differed substantially in circadian biology and whether archaic introgression adaptively contributed to human chronotypes remain unknown. Here, we traced the evolution of chronotype based on genomes from archaic hominins and present-day humans. First, we inferred differences in circadian gene sequences, splicing, and regulation between archaic hominins and modern humans. We identified 28 circadian genes containing variants with potential to alter splicing in archaics (e.g. CLOCK , PER2 , RORB , and RORC) and 16 circadian genes likely divergently regulated between present-day humans and archaic hominins, including RORA. These differences suggest the potential for introgression to modify circadian gene expression. Testing this hypothesis, we found that introgressed variants are enriched among expression quantitative trait loci for circadian genes. Supporting the functional relevance of these regulatory effects, we found that many introgressed alleles have associations with chronotype. Strikingly, the strongest introgressed effects on chronotype increase morningness, consistent with adaptations to high latitude in other species. Finally, we identified several circadian loci with evidence of adaptive introgression or latitudinal clines in allele frequency. These findings identify differences in circadian gene regulation between modern humans and archaic hominins and support the contribution of introgression via coordinated effects on variation in human chronotype. [ABSTRACT FROM AUTHOR]

Recently, various state-space implementations of surplus production models (SPMs) have been developed for data-limited stocks. Often, catches and fishing effort are underestimated and discards are ignored. This results in biased estimates of stock status and reference points. Therefore, we conduct a sensitivity analysis for different under-reporting scenarios (due to non-declared landings, by-catch, and discards) on model estimates and thus advice for the black hake species in northwest Africa. Two modelling frameworks were used, namely a stochastic SPM in continuous time (SPiCT) and Just Another Bayesian Biomass Assessment (JABBA). A common set of diagnostics was developed to allow comparison across modelling frameworks. Scenarios correspond to hypotheses about misreporting and assumptions and priors that were kept consistent. The ratio of current fishing mortality over the fishing pressure that gives the maximum sustainable yield, F/FMSY , is most affected by under-reporting. Results are sensitive to the prior assumed for the initial depletion level, B0/K , and research is needed. If the misreporting is changing over time, relative quantities (e.g. F/FMSY) and trends are biased, while if misreporting (or at least a part of misreporting) is constant, relative quantities are unbiased. Therefore, the nature of any trend in misreporting should be investigated. [ABSTRACT FROM AUTHOR]

Dormant seeds of the root parasitic plant Striga hermonthica sense strigolactones from host plants as environmental cues for germination. This process is mediated by a diversified member of the strigolactone receptors encoded by HYPOSENSITIVE TO LIGHT/KARRIKIN INSENSITIVE2 genes. It is known that warm and moist treatment during seed conditioning gradually makes dormant Striga seeds competent to respond to strigolactones, although the mechanism behind it is poorly understood. In this report, we show that plant hormone gibberellins increase strigolactone competence by up-regulating mRNA expression of the major strigolactone receptors during the conditioning period. This idea was supported by a poor germination phenotype in which gibberellin biosynthesis was depleted by paclobutrazol during conditioning. Moreover, live imaging with a fluorogenic strigolactone mimic, yoshimulactone green W, revealed that paclobutrazol treatment during conditioning caused aberrant dynamics of strigolactone perception after germination. These observations revealed an indirect role of gibberellins in seed germination in Striga , which contrasts with their roles as dominant germination-stimulating hormones in non-parasitic plants. We propose a model of how the role of gibberellins became indirect during the evolution of parasitism in plants. Our work also highlights the potential role for gibberellins in field applications, for instance, in elevating the sensitivity of seeds toward strigolactones in the current suicidal germination approach to alleviate the agricultural threats caused by this parasite in Africa. [ABSTRACT FROM AUTHOR]

Seismic tomography models reveal differences in the geographic distribution and magnitude of P - and S -wave velocity variations (VP and VS , respectively) below ∼2200 km depth in the Earth's mantle. In particular, large low shear velocity provinces (LLSVPs) beneath the Pacific and Africa exhibit a distinct low velocity population in the distribution of VS that does not stand out in VP models, carrying important implications for the origin of these features. However, it is possible that the absence of a distinct low velocity feature in VP models is an artefact of VP models having lower resolution compared to VS models owing to differences in coverage. Here, we use 'tomographic filters' computed from the singular value decomposition of the sensitivity matrices for a pair of VP and VS models in order to test whether such low velocity features are suppressed in VP models. Our 'cross-filtered' results show that resolution alone cannot explain the absence of a corresponding low VP population. We additionally apply the joint VP and VS tomographic filter technique to thermochemical mantle convection models to show that cases with distinct phase and/or composition may be differentiated from cases where only temperature varies. We then develop a new proxy for exploring uncorrelated VP and VS more broadly using the difference between the observed VP model and the filtered VS model input. Our results show that 'large uncorrelated modulus provinces' (LUMPs) extend beyond the boundaries of LLSVPs, and exhibit anomalies in both fast and slow regions. [ABSTRACT FROM AUTHOR]

Background Numerous groups of plants have adapted to CO2 limitations by independently evolving C4 photosynthesis. This trait relies on concerted changes in anatomy and biochemistry to concentrate CO2 within the leaf and thereby boost productivity in tropical conditions. The ecological and economic importance of C4 photosynthesis has motivated intense research, often relying on comparisons between distantly related C4 and non-C4 plants. The photosynthetic type is fixed in most species, with the notable exception of the grass Alloteropsis semialata. This species includes populations exhibiting the ancestral C3 state in southern Africa, intermediate populations in the Zambezian region and C4 populations spread around the palaeotropics. Scope We compile here the knowledge on the distribution and evolutionary history of the Alloteropsis genus as a whole and discuss how this has furthered our understanding of C4 evolution. We then present a chromosome-level reference genome for a C3 individual and compare the genomic architecture with that of a C4 accession of A. semialata. Conclusions Alloteropsis semialata is one of the best systems in which to investigate the evolution of C4 photosynthesis because the genetic and phenotypic variation provides a fertile ground for comparative and population-level studies. Preliminary comparative genomic investigations show that the C3 and C4 genomes are highly syntenic and have undergone a modest amount of gene duplication and translocation since the different photosynthetic groups diverged. The background knowledge and publicly available genomic resources make A. semialata a great model for further comparative analyses of photosynthetic diversification. [ABSTRACT FROM AUTHOR]

All defendants before the International Criminal Court (ICC) to date have been African, with their alleged crimes having been committed, at least partly, on African soil. When turning to national laws to resolve issues of interpretation in these cases, should the ICC see whether it can use laws of the African state in which the crime occurred? This article argues that it should, but observes – from a dataset of 16,192 citations containing over 200 citations to national laws – that it rarely does. Instead, it turns much more often to Western European and US laws. This phenomenon, the article suggests, troublingly reflects and perpetuates the marginalization of African and other global South laws from what constitutes international law. The article also argues that the Rome Statute requires the ICC to at least examine for appropriateness the laws of a subset of these neglected systems ('the national laws of States that would normally exercise jurisdiction over the crime') when identifying general principles of law. There are several compelling reasons to extend this examination requirement to African and other global South country laws more broadly, and even when not dealing with general principles of law, and few reasons not to. [ABSTRACT FROM AUTHOR]

Background and Aims The Lythraceae are a mainly subtropical to tropical family of the order Myrtales with 28 currently accepted genera and approximately 600 species. There is currently no well-supported phylogenetic and biogeographical hypothesis of the Lythraceae incorporating all currently accepted genera, which we sought to provide. Methods Plastomes of representative species of 18 distinct Lythraceae genera were sequenced and annotated. Together with existing sequences, plastomes of all 28 currently accepted genera in the Lythraceae were brought together for the first time. The plastomes were aligned and a Bayesian phylogenetic hypothesis was produced. We then conducted a time-calibrated Bayesian analysis and a biogeographical analysis. Key Results Plastome-based Bayesian and maximum-likelihood phylogenetic trees are generally congruent with recent nuclear phylogenomic data and resolve two deeply branching major clades in the Lythraceae. One major clade concentrates shrubby and arboreal South American and African genera that inhabit seasonally dry environments, with larger, often winged seeds, adapted to dispersal by the wind. The second major clade concentrates North American, Asian, African and several near-cosmopolitan herbaceous, shrubby and arboreal genera, often inhabiting humid or aquatic environments, with smaller seeds possessing structures that facilitate dispersal by water. Conclusions We hypothesize that the Lythraceae dispersed early in the Late Cretaceous from South American to North American continents, with subsequent expansion in the Late Cretaceous of a North American lineage through Laurasia to Africa via a boreotropical route. Two later expansions of South American clades to Africa in the Palaeocene and Eocene, respectively, are also hypothesized. Transoceanic dispersal in the family is possibly facilitated by adaptations to aquatic environments that are common to many extant genera of the Lythraceae, where long-distance dispersal and vicariance may be invoked to explain several remarkable disjunct distributions in Lythraceae clades. [ABSTRACT FROM AUTHOR]

Because of potentially strong eco-evolutionary interactions with their hosts, parasites may initiate or enhance host diversification. The adaptive radiation of cichlid fish in Lake Victoria provides a good system to study the role of parasites at different stages of host speciation. We analyzed the macroparasite infection of four replicates of sympatric blue and red Pundamilia species pairs that vary in their age and extent of differentiation. Sympatric host species differed in parasite community composition and in the infection levels of some of these parasite taxa. Most infection differences were consistent between sampling years, indicating temporal consistency in parasite-mediated divergent selection between species. Infection differentiation increased linearly with genetic differentiation. However, significant infection differences between sympatric species were only found in the oldest, most strongly differentiated Pundamilia species pair. This is inconsistent with parasite-driven speciation. Next, we identified five distinct species of Cichlidogyrus , a genus of highly specific gill parasites that has radiated elsewhere in Africa. Infection profiles of species of Cichlidogyrus differed between sympatric cichlid species only in the oldest and most differentiated pair, again inconsistent with parasite-mediated speciation. To conclude, parasites may contribute to host differentiation after speciation, but do not initiate host speciation. [ABSTRACT FROM AUTHOR]

Background Utilization of adequate and quality prenatal healthcare services confers critical benefits to women and their unborn children. However, utilization rates remain low in many countries in Africa. Several studies have attempted to understand the primary drivers behind these low statistics. This article contributes to this discourse by examining the associations between birth interval and timing and number/frequency of antenatal care visits in Africa. Methods We pooled data from the publicly available Demographic and Health Surveys conducted in the last decade (2010–2020) for 32 African countries. Data were analysed using descriptive proportions and mixed effect binary logistic regression. Results The results illustrate moderate significant associations between spacing on the most recent birth by ≥36 months and early (first trimester) first antenatal care contact in both our bivariate (odds ratio [OR] 1.18, p<0.001) and multivariate (OR 1.106, p<0.001) analyses. The benefits on optimal antenatal contacts predicted on spacing are also noticed with birth intervals of 24–35 months (OR 1.08, p<0.001) and ≥36 months (OR 1.48, p<0.001). Conclusions Optimal birth spacing is beneficial for ANC utilization in terms of timing and total number of contacts. Post-partum family planning/contraceptive use can be an effective pathway to prolonging birth intervals. We argue that maternal and child health programmes strengthen prioritizing contraceptive use between births. [ABSTRACT FROM AUTHOR]

The genes of the major histocompatibility complex (MHC) are among the most polymorphic genes in vertebrates and crucial for their adaptive immune response. These genes frequently show inconsistencies between allelic genealogies and species phylogenies. This phenomenon is thought to be the result of parasite-mediated balancing selection maintaining ancient alleles through speciation events (trans-species polymorphism [TSP]). However, allele similarities may also arise from postspeciation mechanisms, such as convergence or introgression. Here, we investigated the evolution of MHC class IIB diversity in the cichlid fish radiations across Africa and the Neotropics by a comprehensive review of available MHC IIB DNA sequence information. We explored what mechanism explains the MHC allele similarities found among cichlid radiations. Our results showed extensive allele similarity among cichlid fish across continents, likely due to TSP. Functionality at MHC was also shared among species of the different continents. The maintenance of MHC alleles for long evolutionary times and their shared functionality may imply that certain MHC variants are essential in immune adaptation, even in species that diverged millions of years ago and occupy different environments. [ABSTRACT FROM AUTHOR]

Landscape, climate, and culture can all structure human populations, but few existing methods are designed to simultaneously disentangle among a large number of variables in explaining genetic patterns. We developed a machine learning method for identifying the variables which best explain migration rates, as measured by the coalescent-based program MAPS that uses shared identical by descent tracts to infer spatial migration across a region of interest. We applied our method to 30 human populations in eastern Africa with high-density single nucleotide polymorphism array data. The remarkable diversity of ethnicities, languages, and environments in this region offers a unique opportunity to explore the variables that shape migration and genetic structure. We explored more than 20 spatial variables relating to landscape, climate, and presence of tsetse flies. The full model explained ∼40% of the variance in migration rate over the past 56 generations. Precipitation, minimum temperature of the coldest month, and elevation were the variables with the highest impact. Among the three groups of tsetse flies, the most impactful was fusca which transmits livestock trypanosomiasis. We also tested for adaptation to high elevation among Ethiopian populations. We did not identify well-known genes related to high elevation, but we did find signatures of positive selection related to metabolism and disease. We conclude that the environment has influenced the migration and adaptation of human populations in eastern Africa; the remaining variance in structure is likely due in part to cultural or other factors not captured in our model. [ABSTRACT FROM AUTHOR]

Food and agriculture accounts for around one-third of global emissions reflecting the effects of consumption in high-income countries on production and land use around the world. These effects include those transmitted through international trade such as in the constituents of animal feed for meat. African countries face a dual challenge of adapting to the growing effects of climate change in the shape of extreme weather, and increasing agriculture and food production as part of developing their economies. At the same time, there is increasing concentration in the production and trading of agriculture and food products, globally and within Africa. This article considers the interaction of concentration and responses to climate change in food markets through a focus on meat and animal feed, and the developments in maize and soybeans in East and Southern Africa. The possible role for competition policy as part of a wider reform agenda is proposed. [ABSTRACT FROM AUTHOR]

This article presents data and analyzes the structure of employment in 13 African economies at the administrative unit level, with a focus on the role of services. We provide two novel pieces of evidence. First, we present a descriptive snapshot of changes in the composition of employment over time and across geographies. This reveals evidence of structural transformation toward services and service-related occupations at subnational level and provides a fine-grained overview of who works in services and where and how this has changed over time. Second, we provide correlations between services and economic development, using per capita nightlight luminosity as a proxy. We document (1) a strong positive association between high skills services and economic development; (2) substantial heterogeneity across industries within services; and (3) a mediating role of market conditions and technology in the relation between services and economic development. Overall, our work highlights an important role of services activities for employment, skills, and economic development in Africa. [ABSTRACT FROM AUTHOR]

A novel injectable pre-exposure prophylaxis, cabotegravir, has greater efficacy and acceptability than oral tenofovir/emtricitabine for prevention of HIV infection. Cabotegravir is currently priced at $22 200 per year, >185 times higher than the $60–$119 estimated cost-effectiveness threshold for middle-income countries (MICs). Following civil society pressure, ViiV provided access to generic versions in 90 countries with the Medicines Patent Pool (MPP), including all African nations. However, several MICs outside Africa have rapidly growing HIV epidemics. We analyzed the ViiV-MPP deal to assess population covered and gross domestic product (GDP) per capita. There were 38 countries excluded from the ViiV-MPP deal despite having a GDP per capita lower than the highest-earning African country. These countries include 2.4 billion people (30% global population), with an incidence of 122 000 (8%). For cabotegravir to have a significant impact on HIV infections, millions will need to be treated at affordable prices in a wide range of countries. [ABSTRACT FROM AUTHOR]

Following the World Health Organization (WHO) guidance on strategic purchasing in 2000, low- and middle-income countries (LMICs) are trying to shift from passive purchasing (using fixed budgets) to strategic purchasing of healthcare which ties reimbursement to outcomes. However, there is limited evidence on strategic purchasing in Africa. We conducted a scoping literature review aimed at summarizing the roles played by governments, purchasers and providers in relation to citizens/population in strategic purchasing in Africa. The review searched for scientific journal articles that contained data on strategic purchasing collected from Africa. The literature search identified 957 articles of which 80 matched the inclusion criteria and were included in the review. The study revealed that in some countries strategic purchasing has been used as a tool for healthcare reforms or for strengthening systems that were not functional under fixed budgets. However, there was some evidence of a lack of government commitment in taking leading roles and funding strategic purchasing. Further, in some countries the laws need to be revised to accommodate new arrangements that were not part of fixed budgets. The review also established that there were some obstacles within the public health systems that deterred purchasers from promoting efficiency among providers and that prevented providers from having full autonomy in decision making. As African countries strive to shift from passive to strategic purchasing of healthcare, there is need for full government commitment on strategic purchasing. There is need to further revise appropriate legal frameworks to support strategic purchasing, conduct assessments of the healthcare systems before designing strategic purchasing schemes and to sensitize the providers and citizens on their roles and entitlements respectively. [ABSTRACT FROM AUTHOR]

African wild suids consist of several endemic species that represent ancient members of the family Suidae and have colonized diverse habitats on the African continent. However, limited genomic resources for African wild suids hinder our understanding of their evolution and genetic diversity. In this study, we assembled high-quality genomes of a common warthog (Phacochoerus africanus), a red river hog (Potamochoerus porcus), as well as an East Asian Diannan small-ear pig (Sus scrofa). Phylogenetic analysis showed that common warthog and red river hog diverged from their common ancestor around the Miocene/Pliocene boundary, putatively predating their entry into Africa. We detected species-specific selective signals associated with sensory perception and interferon signaling pathways in common warthog and red river hog, respectively, which contributed to their local adaptation to savannah and tropical rainforest environments, respectively. The structural variation and evolving signals in genes involved in T-cell immunity, viral infection, and lymphoid development were identified in their ancestral lineage. Our results provide new insights into the evolutionary histories and divergent genetic adaptations of African suids. [ABSTRACT FROM AUTHOR]

Background The implementation of publicly funded health insurance schemes (PFHIS) is the major strategy to drive progress and achievement of universal health coverage (UHC) by 2030. We appraised evidence on the equity of insurance schemes across Africa. Methods We conducted a systematic review of published studies that assessed equity in health insurance schemes implemented under the UHC agenda in Africa. Seven databases, Web of Science, Medline, CINAHL, Scopus, Cochrane Library, EMBASE and World Bank eLibrary, were searched; we operationalized the PROGRESS-Plus (p lace of r esidence; r ace/ethnicity/culture/language; o ccupation; g ender/sex r eligion; e ducation; s ocioeconomic status; s ocial capital) equity framework to assess equity areas. Results Forty-five studies met the inclusion criteria and were included in the study, in which 90% assessed equity by socioeconomic status. Evidence showed that rural residents, those self-employed or working in the informal sector, men, those with lower educational attainment, and the poor were less likely to be covered by health insurance schemes. Broadly, the insurance schemes, especially, community-based health insurance (CBI) schemes improved utilization by disadvantaged groups, however, the same groups were less likely to benefit from health services. Conclusions Evidence on equity of PFHIS is mixed, however, CBI schemes seem to offer more equitable coverage and utilization of essential health services in Africa. [ABSTRACT FROM AUTHOR]

Galectin‐3 is a member of the lectin family encoded by the LGALS3 gene on chromosome 14. It is secreted by a wide range of immune cells and mammary tumor cells. Through its activity on the tumor microenvironment, in particular on tumor‐infiltrating leukocytes, galectin‐3 improves the proliferation, survival, and colonizing ability of mammary neoplastic cells. Consequently, galectin‐3 expression in the tumor microenvironment could worsen therapeutic outcomes of breast neoplasms and become a biomarker and a therapeutic target in combined immunotherapy in breast neoplasms. There is a limited amount of information that is available on galectin‐3 in breast cancer in Africa. In this review, we analyze how galectin‐3 influences the tumor microenvironment and its potential as a biomarker and therapeutic target in breast neoplasms. We aim to emphasize the significance of investigating galectin‐3 in breast neoplasms in Africa based on the results of studies conducted elsewhere. [ABSTRACT FROM AUTHOR]

Acknowledgements We thank the national NTD programmes, regional and district health staff and community health workers for their tireless determination and efforts towards the control and elimination of neglected tropical diseases. Neglected tropical disease elimination is a relay race - let's not drop the baton How has the Ascend programme contributed to strengthening health systems for sustainable country-driven neglected tropical disease programming? Keywords: behaviour change; COVID response; elimination; health systems; neglected tropical diseases; supply chains; West and Central Africa EN behaviour change COVID response elimination health systems neglected tropical diseases supply chains West and Central Africa ii1 ii6 6 10/14/22 20220902 NES 220902 Background The timelines for eliminating neglected tropical diseases (NTDs) are relatively short in comparison to the millennia that these diseases have plagued communities, yet within our lifetime, several countries have successfully eliminated diseases through focused and concerted public health campaigns. [Extracted from the article]

Living in an increasingly interconnected world, epidemics and pandemics are increasingly likely to be a vista for the future. This, coupled with the likely devastating effects of climate change, means that humanitarian crises are likely to increase. Now, more than ever before, is the time to scale up investment in prevention and preparedness strategies, and to review our current approaches to delivering health services, including those that address neglected tropical diseases. The Ascend West and Central Africa programme has illustrated the importance of innovation, multisector partnerships, resilience and the opportunity for change. [ABSTRACT FROM AUTHOR]

Innovation plays a critical role in progress towards achievement of the World Health Organization's road map for neglected tropical diseases 2021–2030. As disease prevalence decreases, the cost to identify and treat remaining cases goes up. Additionally, as programmes move to the surveillance phase, diagnostic tests need to be highly sensitive and affordable. Until the early end to the Ascend West and Central Africa programme, the Ascend Learning and Innovation Fund supported five projects from 2019 to 2021. Designed for innovation, the fund encompassed a range of activities, including operational research, product development and social behavioural change. This flexibility allowed innovation to bridge the gap between strategic policy and practical implementation, piloting and proving business models to respond to information found through Ascend. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus (GDM) complicates pregnancies in Africa. Addressing the burden is contingent on early detection and management practices. This review aimed at identifying the barriers to diagnosing and managing GDM in Africa. We searched PUBMED, Web of Science, WHOLIS, Google Scholar, CINAHL and PsycINFO databases in May 2020 for studies that reported barriers to diagnosis and management of hyperglycaemia in pregnancy. We used a mixed method quality appraisal tool to assess the quality and risk of bias of the included studies. We adopted an integrated and narrative synthesis approach in the analysis and reporting. Of 548 articles identified, 14 met the eligibility criteria. Health system-related barriers to GDM management were the shortage of healthcare providers, relevant logistics, inadequate knowledge and skills, as well as limited opportunities for in-service training. Patient-related barriers were insufficient knowledge about GDM, limited support from families and health providers and acceptability of the diagnostic tests. Societal level barriers were concomitant use of consulting traditional healers, customs and taboos on food and body image perception. It was concluded that constraints to GDM detection and management are multidimensional. Targeted interventions must address these barriers from broader, systemic and social perspectives. [ABSTRACT FROM AUTHOR]

Well-constrained earthquake depth estimations are important for seismic hazard determination. As local networks of the East-African Rift are usually too sparse for reliable depth estimations, we used detections of pP and sP phase arrivals (the so-called depth phases) at teleseismic distance to constrain earthquake depths in this region. We rely on a fully automatic Cepstral analysis approach, first validated at the global scale using the ISC-EHB catalogue, then applied on the East-African seismicity. We investigated 9575 earthquakes from magnitude 2 since 2005 which allows us to constrain the depth estimation of 584 events with magnitude mainly above 3.5, complemented by 139 reliable depth estimations from previous studies based on teleseismic data as well. To ensure a final catalogue as complete as possible, we also identified from regional catalogues 113 earthquakes assumed to be well constrained, based on network geometry empirical criteria. Thanks to this study, we finally propose new earthquake depth distributions for the seismic source zonation defined by Poggi et al. in order to estimate the seismic hazard of the East African Rift region. Including those new distributions in the source models leads to significant changes of seismic hazard assessments results. [ABSTRACT FROM AUTHOR]

Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) is an important pest on maize, and it can cause large yield losses. As S. frugiperda has invaded many developing countries in Africa and Asia in recent years, it could impact food security. Pesticides remain the main method to control S. frugiperda in the field, and this pest has developed resistance to some pesticides. In this study, we used second-generation sequencing technology to detect the gene expression change of S. frugiperda after treatment by LC20 of three pesticides, lufenuron, spinetoram, and tetrachloroamide, which have different modes of actions. The sequence data were first assembled into a 60,236 unigenes database, and then the differential expression unigenes (DEUs) after pesticide treatment were identified. The DEU numbers, Gene Ontology catalog, and Kyoto Encyclopedia of Genes and Genomes pathway catalog were analyzed. Finally, 11 types of unigenes related to detoxification and DEUs after pesticide treatment were listed, and Cytochrome P450, Glutathione S-transferase, and ATP-binding cassette transporter were analyzed. This study provides a foundation for molecular research on S. frugiperda pesticide detoxification. [ABSTRACT FROM AUTHOR]

Despite its structural flaws and excesses, its regularly prophesized demise and foretold death, capitalism has remained predominant worldwide because under the appropriate institutional framework it offers the most viable path for optimal industrial upgrading, structural transformation, and economic development. In this article, I discuss a particular vulnerability of capitalism, that is, its high propensity to produce major risks, which exacerbates inequality and social tensions. I analyse the differential set of risk-coping options between poor households and non-poor. I then focus on African versions of capitalism, which reflect the peculiar historicity of the continent, marked by centuries of foreign domination, pervasive violence, randomness in economic policy-making, and power struggles not arbitrated by constitutional or legal means. I highlight the root causes of the distorted, extraverted, and largely ineffective forms of capitalism in vogue in Africa and suggest a policy framework for resurrecting capitalism. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the leading malignancy in African females. This study aims to examine the breast cancer burden in Africa using recently released GLOBOCAN 2018 estimates. Methods The incidence and mortality estimates of age- and country-wise burden of breast cancer in 54 African countries were obtained from GLOBOCAN 2018. Results In Africa, breast cancer caused 74 072 deaths, and 168 690 cases were estimated to have occurred in 2018. The age-standardized incidence rate stood at 37.9/100 000 in Africa, varying from 6.9/100 000 in the Gambia to 69.6/100 000 in Mauritius. The age-standardized mortality rate stood at 17.2/100 000 in 2018, ranging from 4/100 000 in the Gambia to 29.1/100 000 in Somalia in 2018. Nigeria was the leading country in terms of absolute burden with 26 310 cases and 11 564 deaths, followed by Egypt with 23 081 new cases and 9254 deaths. The mortality-to-incidence ratio for Africa stood at 0.44, varying from 0.24 in Libya to 0.68 in the Central African Republic. Conclusion To tackle breast cancer burden in Africa, the main challenges are late-stage disease presentation, lack of screening and therapeutic infrastructure, lack of awareness and limited resources. [ABSTRACT FROM AUTHOR]

The repetitive part of the genome (the repeatome) contains a wealth of often overlooked information that can be used to resolve phylogenetic relationships and test evolutionary hypotheses for clades of related plant species such as Pelargonium. We have generated genome skimming data for 18 accessions of Pelargonium section Ciconium and one outgroup. We analyzed repeat abundancy and repeat similarity in order to construct repeat profiles and then used these for phylogenetic analyses. We found that phylogenetic trees based on read similarity were largely congruent with previous work based on morphological and chloroplast sequence data. For example, results agreed in identifying a "Core Ciconium " group which evolved after the split with P. elongatum. We found that this group was characterized by a unique set of repeats, which confirmed currently accepted phylogenetic hypotheses. We also found four species groups within P. sect. Ciconium that reinforce previous plastome-based reconstructions. A second repeat expansion was identified in a subclade which contained species that are considered to have dispersed from Southern Africa into Eastern Africa and the Arabian Peninsula. We speculate that the Core Ciconium repeat set correlates with a possible WGD event leading to this branch. [ABSTRACT FROM AUTHOR]

We conducted and analyzed several internet surveys in order to understand the profile of global research integrity and ethical awareness, encompassing global population distribution. These were (1) the global distribution of Committee of Publishing Ethics (COPE) membership; (2) the global distribution of "Integrity" or "Ethics" journals; (3) the level of academic integrity awareness in European higher education institutions and (4) awareness of academic integrity in the top universities of Asia and Africa. The results of this survey series highlight seriously imbalanced awareness of research integrity and publishing ethics across the world, especially in developing areas with the highest population density. We therefore propose a new index, the "Academic Integrity Awareness Index" for future discussions across the linked spheres of publishing and research. [ABSTRACT FROM AUTHOR]

The Ascend West and Central Africa programme, a UK aid-funded programme, was implemented across 12 countries. The programme focused on strengthening national health systems for sustainable neglected tropical disease (NTD) control and elimination. This commentary presents how Ascend's approach contributed to developing country-driven sustainable systems for NTDs and offers learnings to inform future sustainable NTD programming. [ABSTRACT FROM AUTHOR]