Publications

Considerable effort has been made to estimate the global resource requirements of scaling-up HIV/AIDS and tuberculosis (TB) interventions. There are currently several medium- and long-term global estimates available. Comprehensive country specific estimates are now urgently needed to ensure the successful scaling-up of these services. This paper reviews evidence on the global resource requirements of scaling-up HIV/AIDS and TB interventions. The purpose of this review is to summarise and critically appraise the methods used in the global estimates and to identify remaining knowledge gaps, particularly those relevant to country level estimation.

The growing strength of the women’s movement in the 1960s and 1970s challenged the ‘medicalization’ of women’s bodies and the medical construction of woman’s health needs as distinct from women’s own experiences and priorities (Boston Women’s Health Book Collective 1992). The women’s movement questioned the fallacy that males, as doctors or partners, knew better or more about women’s bodies than women did. Women articulated felt experiences of mental, physical, reproductive and sexual health needs. Analysing their experiences with reference to the social, political and economic forces that shaped health, women explored the connections between race, class and gender based oppression as they affected the health of women.

Since the early 1990s, several studies have looked at the impact of HIV/AIDS and household responses, mainly in East and Southern African countries where HIV infection has reached rates in excess of 30% of adult populations (Kwaramba, 1998; Rugalema, 1999; Luzobe, Muheewa, Olaunah, Wandui, & Kalenzi, 2001; Shah, Osborne, Mbilizi & Vilili, 2002; Muwanga, 2002; Booyens & Arntz, 2003; SADC-FANR, 2003; Yamano and Jayne, 2004). These studies concluded that AIDS has a disproportionate impact on the morbidity and mortality of the most productive age groups. Its impact on households is characterised by a sharp reduction in the available time, labour and other resources of individuals and households, even leading to loss of assets. Because the disease has both a long incubation period and is accompanied by a lengthy period of illness, the socio-economic as well as
psychological impact will be felt over a prolonged period. In addition to the suffering this causes, the increase in AIDS prevalence adversely affects individual lives as well as state development and efforts to alleviate poverty. In West Africa, the HIV/AIDS epidemic developed at a slower pace but infection rates are rising fast. Because countries have their own unique contexts, it cannot be assumed that the findings of East and Southern African studies on the impact of the epidemic can be extrapolated and used in a straightforward way to develop policy in other region

A motivated and qualified workforce is crucial to increase the productivity and quality of health services in order to contribute to achieving health services targets. Priority programmes have a stake in a skilled and motivated workforce, as they are implemented primarily by a health facility’s existing health staff. Motivation in the work context is defined as “an individual’s degree of willingness to exert and maintain an effort towards organisational goals”. The challenge for managers is how to create this kind of motivation. Research has shown that workers and their managers often perceive motivation differently. In addition, little is known about the motivational factors that are important for health workers in resource-poor settings.

The devastating impact of AIDS in the world – especially in sub‐Saharan Africa ‐ has led to an unprecedented global effort to ensure access to antiretroviral (ARV) medicines to treat the disease in every country where HIV is a threat. While the World Health Organization (WHO) goal of ensuring access to antiretroviral treatment (ART) for 3 million people by end‐2005 was not achieved, an estimated 1.3 million people who would not otherwise have been treated now have access to ART. This book is a
testament to the early treatment successes and the hidden challenges of antiretroviral therapy (ART) in resource‐poor settings. It is also a wake‐up call to the risk of treatment failure and the development of widespread ARV resistance unless all patients are given the continuing support they need to achieve full adherence to ARVs. AIDS is particularly challenging because of the need to achieve very high (at least 95%) levels of adherence to prevent treatment failure and the generation of ARV‐resistant virus.

Around 1.5 million people die every year of malaria; every 30 seconds a child dies due to this preventable and curable disease. Over 90 % of malaria cases and the great majority of malaria deaths occur in sub-Saharan Africa. Most of the affordable antimalaria drugs have become ineffective because Plasmodium falciparum – the malarial parasite responsible for the most severe malaria cases and deaths – has developed resistance to them.

Ten years after the International Conference on Population and Development (ICPD), it is relevant and necessary to review and reflect on progressmade in implementing a more holistic and comprehensive view of reproductive health care, as called for in the ICPD Programme of Action. In
1994, the international health community agreed on the need to integrate sexual and reproductive health care services to meet the needs of women,
men and adolescents throughout the life-cycle. Integration was seen to provide the best hope and means for quality, comprehensive and cost-effective service delivery. Since that time, however, efforts to integrate services have produced mixed results, and there is now a need to take stock of accomplishments and to suggest where further efforts are needed if countries are to provide quality, comprehensive sexual and reproductive
health care.

Agriculture and rural development are – at least partly – back on the international development agenda. Investments in agricultural and rural development are important ingredients in policies for fostering broad-based and pro-poor economic development in countries where more than half – and often close to 75 per cent – of the population still mainly depend on agriculture for their livelihoods. Rural areas harbour 75 per cent of the poor, who are desperately seeking ways to improve their living conditions and income

The Operational Guide aims to be helpful to people working in the development sector, whether they find themselves in government, international development organisations, NGOs or community organisations. It specifically targets those working in the field of HIV/AIDS, but it also hopes to be of use to development programmers and practitioners in a more general sense

Agri-food systems in developing and transitional countries are restructuring rapidly. Increasingly supermarkets have emerged in developing countries as important retailers, particularly for the high-value products meeting specific consumer demands related to production process and quality (Orden et al., 2004). In Latin America, supermarkets buy 2.5 times more produce from local farmers than the region exports to the rest of the world (Reardon and Berdegue, 2002). Supermarkets have also become a strong growth retail segment in Asia (Hu et al., 2004; Zhang, 2001) and Africa (Neven and Reardon, 2004; Weatherspoon and Reardon, 2003) and Central and Eastern Europe (Dries et al., 2004). The determinants, dynamics and outcomes of retail restructuring in developing and transitional countries are being discussed in detail in the first issue of the Global Issue Paper series of the Regoverning Markets Project (Vorley and Fox, 2004).

Renewed attention exists for agricultural development in SSA as the engine for rural development. This results in part from the drive for reaching the Millennium Development Goals (MDGs) by 2015 and in particular MDG 1: a 50% reduction of (predominantly rural) poverty in SSA. It is realized that in order to achieve the MDGs, a more effective approach to innovation for agricultural development is needed. The opportunities presented through the World Trade Agreements have led to changing roles of the three main groups of actors (i.e. public, private and civil society), in agricultural service delivery. At the same time, urgent demands for technological innovation have led to important organizational and institutional innovations in the local Agricultural Knowledge and Information Systems (AKISs). Decentralization of public administration and deconcentration of service delivery have encouraged empowerment of FGs and farmer organizations in agricultural innovation. Slowly the local innovation system is shifting from a linear ‘Transfer of Technology’ (TOT) process (from research to extension to farmers) to a more systemic partnership-based co-innovation process. FGs and farmer organizations are to play a stronger role at different levels in the national and local innovation systems with a formalized farmer representative role at national and meso-levels.

Leprosy is feared because of the deformities and disability that it may cause. Successful leprosy treatment should prevent or heal deformities and disabilities. Most of these are secondary complications of impaired of nerve function, often caused by immunological reactions against M. leprae antigens. Unfortunately, people remain at risk of neuropathy resulting from such reactions during and even after successful anti-leprosy treatment

La décentralisation est effective au Bénin depuis les élections communales suivi par l’installation des maires en 2003. Les attentes exprimées concernant cette réforme institutionnelle sont considérables et vont bien au-delà d’une simple réorganisation administrative du territoire. La décentralisation vise la promotion de la démocratie locale, son renforcement et son approfondissement. La participation des citoyens à la gestion des affaires publiques devrait favoriser le développement à la base et son adaptation aux réalités du terrain. Enfin, la décentralisation offre la possibilité de répondre au profond besoin de la population en matière de justice sociale et d’équité et de réduire la pauvreté par le partage des fruits de la croissance.