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Financial sanctions are often thought of as the “soft alternative” to armed conflict and are widely used in the 21st century. Nonetheless, sanctions are often criticized for being non-specific in their action, and having impact beyond their intended remit. One often-overlooked area affected by sanctions are academic systems of research and education. Sanctions place “invisible barriers” for research in these countries by limiting access to necessary resources and curtailing their effective use. In this paper we present a national survey of Sudanese academics focused on the impact of 20 years of economic sanctions on their work. It identifies key areas of academic research and education that have been impacted by international sanctions. Moreover, these data highlight how the impact of sanctions on academia is likely to persist long after they are formally lifted. The paper concludes by problematising the current interpretation of jus post bellum, or moral behaviour after conflict. It suggests that the responsibility to make reparations in the form of support for academic systems applies to countries who impose economic sanctions. [ABSTRACT FROM AUTHOR]

Africa is a continent with huge resource endowments and prospects for growth. However, the continent battles with myriads of problems such as poverty, food insecurity and dwindling commodity prices among others. This is because Africa's export is dominated by primary products that are majorly climate-dependent and vulnerable to price volatility. This paper therefore examined the economic situations of Africa considering the dwindling commodity prices in the face of the threat posed by climate change. Climate change remains one of the greatest environmental problems with economic, social, health, security and environmental implications. The paper employed a combination of both secondary and historical information obtained from different sources (UNDP, UNECA, NBS, Trade reviews etc). Analytical method used include descriptive statistics such as tables, averages and percentages. Despite the declining Africa's contribution to global market, commodity prices have been plummeting with very devastating impact on the livelihood of households and general wellbeing of the inhabitants of many of these countries. Countries relying on mineral resources such as oil, copper, gold and platinum to mention just a few have been the worst hit. Therefore, African countries' local currencies and trade balance have weakened against the dollar leading to high inflation in the continent. The terms of trade is declining as Africa continues to import commodities it should be producing because of the weak productive base, decaying infrastructure and the worsening climate conditions. This implies that households' welfare in these countries is likely to be compromised because of more job losses emanating from declining profits accruing to the solid mineral sector in the affected countries. The paper recommends increased investment in infrastructure facilities and human capital development for skills enhancement in Africa. Also, climate change adaptation policies should be formulated and implemented by African governments at all tiers and encouragement of value addition in exportable commodities to enhance favourable trade balance. [ABSTRACT FROM AUTHOR]

Ghana has made significant stride towards universal health coverage (UHC) by implementing the National Health Insurance Scheme (NHIS) in 2003. This paper investigates the progress of UHC indicators in Ghana from 1995 to 2015 and makes future predictions up to 2030 to assess the probability of achieving UHC targets. National representative surveys of Ghana were used to assess health service coverage and financial risk protection. The analyses estimated the coverage of 13 prevention and four treatment service indicators at the national level and across wealth quintiles. In addition, we calculated catastrophic health payments and impoverishment to assess financial hardship and used a Bayesian regression model to estimate trends and future projections as well as the probabilities of achieving UHC targets by 2030. Wealth-based inequalities and regional disparities were also assessed. At the national level, 14 out of the 17 health service indicators are projected to reach the target of 80% coverage by 2030. Across wealth quintiles, inequalities were observed amongst most indicators with richer groups obtaining more coverage than their poorer counterparts. Subnational analysis revealed while all regions will achieve the 80% coverage target with high probabilities for the prevention services, the same cannot be applied to the treatment services. In 2015, the proportion of households that suffered catastrophic health payments and impoverishment at a threshold of 25% non-food expenditure were 1.9% (95%CrI: 0.9–3.5) and 0.4% (95%CrI: 0.2–0.8), respectively. These are projected to reduce to 0.4% (95% CrI: 0.1–1.3) and 0.2% (0.0–0.5) respectively by 2030. Inequality measures and subnational assessment revealed that catastrophic expenditure experienced by wealth quintiles and regions are not equal. Significant improvements were seen in both health service coverage and financial risk protection over the years. However, inequalities across wealth quintiles and regions continue to be cause of concerns. Further efforts are needed to narrow these gaps. [ABSTRACT FROM AUTHOR]

Policymakers in Sub-Saharan Africa face several choices to increase levels of access to electricity under severe budget constraints. First, they need to prioritise technologies that can supply electricity at a low cost. Second, they need to design and implement appropriate policies to attract private investment. On the first choice, renewable energy is becoming increasingly competitive with fossil fuels. Moreover, it contributes to energy security and environmental sustainability, while providing access to new sources of (sustainable) finance. On the second choice, developing countries typically face a multitude of constraints to attract investment to their energy sector. It can be daunting and expensive to address them all at once. This paper presents a new methodology to support policymakers to better target policies for the promotion of commercial-scale renewable energy investment. The methodology, which we call “Green Investment Diagnostics” draws upon the Growth Diagnostics framework, extensively used in the field of Development Economics to identify the binding constraints to economic growth. It is operationalised with a decision tree analysis that builds cumulative evidence to prioritise some constraints over others, through the review of indicators and validation through expert interviews. We apply this approach to Kenya and Ghana, finding that Ghana’s key constraints to investment in renewable energy are an unreliable off-taker, macroeconomic imbalances, regulatory uncertainty, pressures to keep prices low, as well as insufficient and costly domestic finance. Kenya instead offers generous returns to investment in renewables but faces a low demand, a lack of networking infrastructure and problems of governance and social acceptance, exacerbated by uncertain land property rights and rent-seeking. [ABSTRACT FROM AUTHOR]

Background: There is an increasing recognition that non communicable diseases impose large economic costs on households, societies and nations. However, not much is known about the magnitude of diabetes expenditure in African countries and to the best of our knowledge no systematic assessment of the literature on diabetes costs in Africa has been conducted. The aim of this paper is to capture the evidence on the cost of diabetes in Africa, review the methods used to calculate costs and identify areas for future research.Methods: A desk search was conducted in Pubmed, Medline, Embase, and Science direct as well as through other databases, namely Google Scholar. The following eligibility criteria were used: peer reviewed English articles published between 2006 and 2016, articles that reported original research findings on the cost of illness in diabetes, and studies that covered at least one African country. Information was extracted using two data extraction sheets and results organized in tables. Costs presented in the studies under review are converted to 2015 international dollars prices (I$).Results: Twenty six articles are included in this review. Annual national direct costs of diabetes differed between countries and ranged from I$3.5 billion to I$4.5 billion per annum. Indirect costs per patient were generally higher than the direct costs per patient of diabetes. Outpatient costs varied by study design, data source, perspective and healthcare cost categories included in the total costs calculation. The most commonly included healthcare items were drug costs, followed by diagnostic costs, medical supply or disposable costs and consultation costs. In studies that reported both drug costs and total costs, drug costs took a significant portion of the total costs per patient. The highest burden due to the costs associated with diabetes was reported in individuals within the low income group.Conclusion: Estimation of the costs associated with diabetes is crucial to make progress towards meeting the targets laid out in Sustainable Development Goal 3 set for 2030. The studies included in this review show that the presence of diabetes leads to elevated costs of treatment which further increase in the presence of complications. The cost of drugs generally contributed the most to total direct costs of treatment. Various methods are used in the estimation of diabetes healthcare costs and the costs estimated between countries differ significantly. There is room to improve transparency and make the methodologies used standard in order to allow for cost comparisons across studies. [ABSTRACT FROM AUTHOR]

Background: The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods: This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results: Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions: There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. [ABSTRACT FROM AUTHOR]

This paper conceptualises ‘global financial crisis’ as primarily political and focuses on the way it impacts on the ability of youth to renegotiate their place and space with patterns of authority and control in Africa, using the instrumentality of new media. Three main arguments are made. First is that, even though the crisis occurredwithinthe economy, non-economic causal factors were key triggers. Second, the intersection between youth protest, the pressures of a global system in crisis and the opportunities being provided by globalised social media has been critical not only to the deepening of resistance, but also to the ability of youth to appropriate the discourses and channel grievance. Third, youth appropriation of protest discourses surrounding the pressures of the recent global crisis has forced a renegotiation of patterns of authority and control and is deepening stability challenges in different ways. This paper concludes by examining how the state has responded to this emerging youth ability to not only demand but also impose discourses within the public space. [ABSTRACT FROM AUTHOR]

Based on lessons learned from examining the relationship between several international organizations and African higher education, this paper unveils the subtleties and complexities of power dynamics in negotiations, provides illustrative cases to enhance such understanding, discusses the implications of power dynamics in negotiations over higher education policy, and provides a glimpse at the necessary ingredients to build sustainable and healthy international partnerships. Based in a conceptual framework of power dynamics, the paper hinges on international regimes for its theoretical foundation, and on the intersection of conflicting agendas for a transformative higher education in Africa, as advocated by the Association of African Universities (AAU) and the General Agreement on Trade in Services (GATS), for its historical framework. An understanding of the subtleties and complexities of power dynamics in international negotiations is critical for Africa at this crossroads of her relationship with BRIC countries, particularly amidst the competition between China and other superpowers and their respective organizations over Africa as a market arena. This understanding will also be important for examining newly claimed 'reformed' policies originating from the historically dominant Western countries because (a) the dimensions of this relationship are still being negotiated/established, thus a good time to address power dynamics; (b) Africa is engaged in a quest for development through partnerships; and, (c) African scholars are often confronted with the idea of a higher education system by African design. With a focus on Africa that simultaneously highlights the problem of developing nations more generally, this paper discusses four categories of power - hermeneutical, informational, manipulative, and monetary -- that must be taken seriously into account in international negotiations as they have dire consequences for the developing world. [ABSTRACT FROM AUTHOR]

Information Technology (IT) is now globally recognized as a very strong tool for economic development and is being used by many countries to spur economic growth and to create jobs. In an attempt to objectively measure the progress of Africa in IT development over the last decade, this paper critically analyzes the Global IT Reports of three specific years during the last decade - 2009, 2012 and 2015. This is done by getting the lowest common denominators of indicators present in all the three (3) years and making an analysis on the basis of these common indicators for the countries of the world. When countries are grouped into their continents and a comparison is made of the averages of the NRI indicators for different continents, the results can be used to show how well Africa is doing with respect to other continents and what African countries need to do in order to use ICT to enhance the economic development of their countries. [ABSTRACT FROM AUTHOR]

This paper offers a first comprehensive account of popular voting intentions in Africa's new electoral democracies. With reference to aggregate and survey data from 16 countries, this paper shows that competitive elections in Africa are more than mere ethnic censuses or simple economic referenda. Instead, Africans engage in both ethnic and economic voting. Not surprisingly, people who belong to the ethnic group in power intend to support the ruling party, in contrast to those who feel a sense of discrimination against their cultural group. But, to an even greater extent, would-be voters in Africa consider policy performance, especially the government's perceived handling of unemployment, inflation, and income distribution. Moreover, a full account of the intended vote choice in Africa also requires recognition that citizens are motivated – sincerely or strategically – by partisan considerations; they vote for established ruling parties because they expect that incumbents will win. This paper shows that voters attempt to associate themselves with prospective winners because they wish to gain access to material benefits and to avoid retribution after the election. These dynamics are most evident in African countries where dominant parties restrict the range of electoral choice. [ABSTRACT FROM PUBLISHER]

In this article, the influence of conflict on the economies of neighbouring countries is discussed. The results from previous papers show a strong negative effect for an entire area around a country suffering from conflict, but this paper reaches a different conclusion, by using more recent data and adjusting the methodology previously employed. Additionally, a new type of contiguity matrix is constructed and used in the actual analysis. The final analysis consists of a large number of regressions and concludes that conflict actually has two opposing effects. First, like conflict countries themselves, directly contiguous countries actually suffer from the negative effects of proximate conflict. Secondly, however, there is also a positive spillover of conflict, which affects non-contiguous countries and this effect is larger for countries that are closer to the conflict country. The results from the paper predominantly hold for the most violent kind of conflict. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to investigate the presence of currency substitution in eight African countries. Design/methodology/approach - This study investigates the presence of currency substitution in eight African countries - Egypt, Morocco, Nigeria, Ghana, Kenya, South Africa, Tunisia and Zambia - for the period 1976 to 2005 using both regional and US dollar as anchor currencies. Findings - The paper finds that currency substitution is prevalent in Ghana and Nigeria when CFA franc is used as an anchor currency. However, when US dollar is used as an anchor currency there is no evidence of currency substitution in Ghana, but the presence of currency substitution in Nigeria is still observed. The paper also finds the presence of currency substitution in South Africa, but not in Egypt when the US dollar is the anchor currency. For Kenya, Tunisia and Zambia there is no evidence of currency substitution irrespective of the anchor currencies considered. In the case of Morocco, no evidence of currency substitution is observed when the Egyptian pound is used as anchor currency, but there is weak evidence of currency substitution when the US dollar is considered. Originality/value - This paper provides useful information on the presence of currency substitution in African countries. [ABSTRACT FROM AUTHOR]

The question of how to build science and technology (S&T) capacity in Africa has been on and off the agenda for decades, as has the issue of how to use partnerships to accelerate capacity building. Recent policy proposals have focused on expanding S&T capacity but have emphasized less the need for a rigorous rethink about how science, technology and innovation can be better organized for development. This paper aims to assess, using evidence from recent cases, the importance of new theories and practices based on the role of innovation and knowledge systems. The paper argues that lessons can be learned from transformations in research policy and from practices that better integrate new ideas from innovation, knowledge and development. It focuses on the changes required for science, technology and innovation to be accepted as key for the alleviation of poverty. [ABSTRACT FROM AUTHOR]

A major concern in the development of African economies is the impact of corruption on economic growth and while there is general agreement on its detrimental effects, there is considerable debate over its nature and importance. In particular there is little work on the interaction between corruption, government expenditures and how this influences economic growth in countries in the region. This paper takes an endogenous growth model, extends it to include different categories of government spending and then introduces the possibility of corruption, which is allowed to have different effects on each of the categories. The results confirm the negative effect of corruption and military spending, but also show that corruption interacts with military burden, through indirect and complementary effects, to further increase its negative effect. The policy implications are that the effects of corruption on economic growth are worse than was thought in countries which have high military burdens. [ABSTRACT FROM AUTHOR]

Summary Marginality refers to a position at the margins of social, political, economic, ecological, and biophysical systems. The paper applies this concept to the case of Ethiopia. Marginality hotspots are mapped by overlaying seven different indicators using Geographic Information System software. Results show that people in the South-West and in the North are most marginalized. Overlaying marginality hotspots with a map of agro-ecological belts shows that a large share of marginality hotspots is located in areas with low agricultural potential. Marginality is not bound to specific ethnic groups but ethnic fractionalization is significantly lower in marginality hotspots than in other areas. [ABSTRACT FROM AUTHOR]

This paper presents empirical evidence on how telecommunications infrastructure is related to economic growth in a panel dataset covering 44 African countries for the period from 1990 to 2010. A dynamic panel data approach model is employed, which suggests that telecommunications contribute in a major way to the economic development of the continent, after controlling for a number of other factors. Furthermore, the findings also show that investment in telecommunications is subject to increasing returns, demonstrating that an increase in telecommunications investment produces further growth. Therefore, telecommunications investment and services should be encouraged in the region. [ABSTRACT FROM AUTHOR]

This paper aims to examine the role of individual resources in explaining African political participation. If political participation is costly and requires inputs in terms of individual resources, and citizens in young developing country democracies face comparatively high participation costs and have more limited individual resource endowments than citizens in more established democracies, a resource approach to political participation should be particularly relevant in the African setting. On the contrary, however, empirical findings drawing on recent data for more than 27,000 respondents in 20 emerging African democracies suggest weak explanatory power of the resource perspective. Often, the relatively resource poor actually participate to a greater extent than the more resource rich. The results are encouraging in that they suggest fairly broad-based political participation, but also call attention to the need to evaluate the motivational forces behind the decision to take part. [Copyright &y& Elsevier]

The rainforests are the great green heart of Africa, and present a unique combination of ecological, climatic and human interactions. In this synthesis paper, we review the past and present state processes of change in African rainforests, and explore the challenges and opportunities for maintaining a viable future for these biomes. We draw in particular on the insights and new analyses emerging from the Theme Issue on 'African rainforests: past, present and future' of Philosophical Transactions of the Royal Society B.A combination of features characterize the African rainforest biome, including a history of climate variation; forest expansion and retreat; a long history of human interaction with the biome; a relatively low plant species diversity but large tree biomass; a historically exceptionally high animal biomass that is now being severely hunted down; the dominance of selective logging; small-scale farming and bush meat hunting as the major forms of direct human pressure; and, in Central Africa, the particular context of mineral- and oil-driven economies that have resulted in unusually low rates of deforestation and agricultural activity. We conclude by discussing how this combination of factors influences the prospects for African forests in the twenty-first century. [ABSTRACT FROM AUTHOR]

A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Dans la santé, une franchise sociale est un réseau de praticiens privés à but lucratif tenus par contrat d'assurer des services socialement bénéfiques sous une même marque. Au début du XXIe siècle, les donateurs ont encouragé avec beaucoup d'enthousiasme les franchises sociales pour les services de santé génésique. Se fondant sur un recueil d'informations descriptives relatives à 45 franchises sociales cliniques, situées dans 27 pays d'Afrique, d'Asie et d'Amérique latine, cet article examine leur contribution à l'accès universel à des services globaux de santé génésique. Il révèle que ces franchises n'ont pas élargi l'éventail de services de santé génésique, mais se sont principalement centrées sur la contraception et, dans une moindre mesure, les soins maternels et l'avortement. Dans de nombreux cas, la couverture n'avait pas été étendue à de nouvelles zones. Les mesures prises pour garantir la viabilité vont à l'encontre de l'objectif d'accès des groupes à faible revenu. Dans près des deux tiers des franchises, le coût total de l'ensemble des services devait être payé par les patients et était inabordable pour les femmes à faible revenu. Les normes et les protocoles d'assurance qualité étaient en place dans toutes les franchises, mais on dispose de données limitées sur leur observance. Des entretiens informels avec des patients ont indiqué qu'ils étaient satisfaits des services. Néanmoins, les difficultés pour recruter des franchisés et une certaine usure, l'incapacité des franchisés de suivre des programmes de formation, l'utilisation d'agents de santé profanes pour assurer des services sans soutien ni supervision et des problèmes logistiques pour appliquer les outils d'assurance qualité sont autant de facteurs préoccupants. La contribution des franchises sociales à l'accès universel aux services de santé génésique paraît incertaine. Il ne semble pas justifié de continuer d'investir en leur faveur pour la prestation de services de santé génésique, à moins que de nouvelles données ne prouvent leur utilité. Una franquicia social en salud es una red de profesionales de la salud particulares con fines de lucro, vinculados mediante contratos para ofrecer servicios de beneficio social bajo una marca en común. A principios del siglo XXI se ha visto un considerable entusiasmo por parte de donantes para promover las franquicias sociales para la prestación de servicios de salud reproductiva. Basado en un compendio de información descriptiva sobre 45 franquicias sociales clínicas, situadas en 27 países de Ãfrica, Asia y Latinoamérica, este artículo examina su contribución al acceso universal a los servicios integrales de salud reproductiva. Se encontró que estas franquicias no han ampliado la gama de servicios de salud reproductiva, sino que se han centrado principalmente en servicios de anticoncepción y, a menor grado, en servicios de salud materna y de aborto. En muchos casos, no se había extendido la cobertura a nuevas áreas. Las medidas tomadas para garantizar sostenibilidad eran contrarias al objetivo de acceso para grupos de bajos ingresos. En casi dos terceras partes de las franquicias, las pacientes tuvieron que pagar el costo total de todos los servicios, inasequible para mujeres de bajos ingresos. Aunque todas las franquicias habían establecido normas y protocolos para garantizar la calidad, había limitada evidencia de su cumplimiento. Las entrevistas informales con pacientes indicaron satisfacción con los servicios. No obstante, preocupan factores como las dificultades en reclutar franquiciados y una considerable amortización de puestos de trabajo, la imposibilidad de los franquiciados de asistir a programas de capacitación, el uso de trabajadores de la salud laicos para proporcionar servicios sin apoyo o supervisión, y los problemas logísticos aplicando las herramientas de garantía de la calidad. La contribución de franquicias sociales al acceso universal a los servicios de salud reproductiva parece ser incierta. A menos que surja más evidencia de su valor, no se justifica continuar invirtiendo en ellas para la prestación de servicios de salud reproductiva. [ABSTRACT FROM AUTHOR]

Abstract: Current debates and market based interventions in international public health seek to bring about explicit improvements in the quality of care offered by informal providers. In this paper we examine how informal providers are framed as problematic and question assumptions about what constitutes appropriate knowledge and expectations of how economic actors in the medical marketplace will behave. We argue that existing portraits of informal providers tend to establish clear cut distinctions between different kinds of practitioner; ‘dis-embed’ biomedical transactions from the broader relationships within which they take place; freeze or anatomise what are dynamic economic relationships between stakeholders, and obscure or ignore the position of informal providers in a global pharmaceutical supply chain. [Copyright &y& Elsevier]

Africa is most vulnerable to climate change, although it makes the least contribution to factors that result in global and regional climatic changes. High levels of vulnerability and low adaptive capacity across the continent have been linked to, among other things, poverty. This paper discusses and analyses the relationship between climate change and poverty in Africa. It investigates the relationship between climate change and poverty patterns in Africa, analyses the resultant impact, and discusses potential adaptation policies for moderating the consequences of climatic changes on poverty in the region. The record shows that climate change is happening. What is not discussed or is little researched is the potential devastating impact of climate change on socio-economic development in Africa and the policy measures available to the continent for adaptation. [ABSTRACT FROM AUTHOR]

The assumption that 'There Is No Alternative' (TINA) to capitalism as practiced in the United States of America and Western Europe has been the bane of aids effectiveness in assisting to solve the underdevelopment problem in Africa. This paper attempts to show that except there is a fundamental reorientation in the conceptualization of capitalism-free market and democracy-the underdevelopment problem would only be further complicated with aids. [ABSTRACT FROM AUTHOR]

Medicines are integral of any healthcare system, and limited access to medicines undermines health systems’ objectives of equity, efficiency and health development. In African countries, where it is estimated that 50–60% of the populace lack “access” to essential medicines, health problems associated with limited drug benefits are more damaging. However, there is no single solution to medicine access problem given its multiple dimensions: availability, acceptability, affordability and accessibility. This paper explores affordability dimension of medicine access and concentrates solely on price regulatory policies and institutional structures that national and international policy makers may consider in making prices of essential drugs compatible to the purchasing power of African households. The main theme is the application of the concept of bilateral dependence in creating price-sensitive purchasers to exert countervailing market power on drug price setting in African healthcare systems. [Copyright &y& Elsevier]

The long-standing disagreement between the international community and African leaders over an appropriate development strategy has been settled by the World Bank’s Comprehensive Development Framework (CDF) and African leaders’ New Partnership for Africa’s Development (NEPAD). Both documents support neoliberalism and see increased global integration as the key to Africa’s development. This paper traces Africa’s journey from the dependency/neoliberalism debate in the early 1980s to the current endorsement of neoliberalism. It is argued that the overwhelming global attention and support enjoyed by NEPAD derives from its embrace of Western development ideas as well as changes in the global political economy that have made reformist ideas more acceptable. NEPAD’s success will, however, depend on how African leaders and the international community respond to the initiative. [Copyright &y& Elsevier]

Background: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. Objective: This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. Methods: The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Results: Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. Conclusions: The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives. [ABSTRACT FROM PUBLISHER]