Disease Surveillance Networks Initiative Africa: Final Evaluation

The overall objective of the Foundation's Disease Surveillance Networks (DSN) Initiative is to strengthen technical capacity at the country level for disease surveillance and to bolster response to outbreaks through the sharing of technical information and expertise. It supports formalizing collaboration, information sharing and best practices among established networks as well as trans-national, interdisciplinary and multi-sectoral efforts, and is experienced in developing and fostering innovative partnerships. In order to more effectively address disease threats, the DSN has four key outcome areas:(1) forming and sustaining trans-boundary DSN;(2) strengthening and applying technical and communication skills by local experts and institutions;(3) increasing access and use of improved tools and methods on information sharing, reporting and monitoring; and(4) emphasizing One Health and transdisciplinary approaches to policy and practice at global, regional and local levels

Health-industry linkages for local health: reframing policies for African health system strengthening

The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013–15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a ‘local health’ policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health–industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with ‘global health’ frameworks but poses a challenge to some of its underlying assumptions

Why are IPTp Coverage Targets so Elusive in Sub-Saharan Africa? A Systematic Review of Health System Barriers.

Use of intermittent preventive treatment (IPTp) is a proven cost-effective intervention for preventing malaria in pregnancy. However, despite the roll-out of IPTp policies across Africa more than ten years ago, utilization levels remain low. This review sought to consolidate scattered evidence as to the health system barriers for IPTp coverage in the continent.Methods and findings: Relevant literature from Africa was systematically searched, reviewed and synthesized. Only studies containing primary data were considered. Studies reveal that: (i) poor leadership and governance contribute to slow decentralization of programme management, lack of harmonized guidelines, poor accountability mechanisms, such as robust monitoring and evaluation systems; (ii) low budgetary allocation towards policy implementation slows scale-up, while out-of-pocket expenditure deters women from seeking antenatal services that include IPTp; (iii) there are rampant human resource challenges including low staff motivation levels attributed to such factors as incorrect knowledge of IPTp recommendations and inadequate staffing; (iv) implementation of IPTp policies is hampered by prevailing service delivery barriers, such as long waiting time, long distances to health facilities and poor service provider/client relations; and (v) drug stock-outs and poor management of information and supply chains impair sustained availability of drugs for IPTp. For successful IPTp policy implementation, it is imperative that malaria control programmes target health system barriers that result in low coverage and hence programme ineffectiveness

Food safety in food security and food trade:

CONTENTS: Overview / Laurian J. Unnevehr; Food Safety as a Public Health Issue for Developing Countries / Fritz K. K�ferstein; Mycotoxin Food Safety Risk in Developing Countries / Ramesh V. Bhat and Siruguri Vasanthi; Trends in Food Safety Standards and Regulation: Implications for Developing Countries / Julie A. Caswell; Food Safety Issues in International Trade / Spencer Henson; Balancing Risk Reduction and Benefits from Trade in Setting Standards / John Wilson and Tsunehiro Otsuki; Case Study: Guatemalan Raspberries and Cyclospora / Linda Calvin, Luis Flores, and William Foster; Case Study: Kenyan Fish Exports / Richard O. Abila; Case Study:The Shrimp Export Industry in Bangladesh / James C. Cato and S. Subasinge; Case Study: Reducing Pesticide Residues on Horticultural Crops / George W. Norton, Guillermo E. Sanchez, Dionne Clarke-Harris, and Halimatou Koné Traoré; Case Study: India Responds to International Food Safety Requirements / Shashi Sareen; Case Study: Supermarkets and Quality and Safety Standards for Produce in Latin America / Julio A. Berdegué, Fernando Balsevich, Luis Flores, Denise Mainville, and Thomas Reardon; Case Study: Beef industry in China / Colin G. Brown and Scott A.Waldron; Case Study:The Poultry Industry in Colombia / Miguel I. Gómez, Diego M. Sierra, and Daisy Rodriguez; Case Study: Reducing Mycotoxins in Brazilian Crops / Elisabete Salay; Food Safety and GM Crops: Implications for Developing-Country Research / Joel I. Cohen, Hector Quemada, and Robert Frederick; Food Safety Policy Issues for Developing Countries / Laurian J. Unnevehr, Lawrence Haddad, and Christopher Delgado.food security, Food safety, trade, health,

Biotechnology and the African Farmer

Research and Development/Tech Change/Emerging Technologies,

Rockefeller Foundation - 1999 Annual Report

Contains statement of mission and vision, president's message, program information, grants list, financial statements, and list of board members and staff

Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya

Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya.MethodsA micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel®, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated.ResultsIn Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain functions rather than dollar value. Further work is needed to develop extrapolative costing models that can be applied at country level without extensive micro-costing exercises. This will allow other countries to generate more accurate estimates in the future

Report on the evaluation of surveillance systems relevant to zoonotic diseases in Kenya, 2015: A basis for design of an integrated human–livestock surveillance system

The Zoonoses in Livestock in Kenya (ZooLinK) is a project that seeks to enable Kenya develop an effective surveillance programme for zoonotic diseases (infectious diseases transmissible between animals and human beings). The surveillance programme will be integrated across both human and animal health sectors. To achieve this goal the project will work in close collaboration with Kenyan government departments in responsible for animal and human health. As a prelude to the start of the project, an evaluation of the existing surveillance systems for human and animal health was carried out. The evaluation focused on the national surveillance system and the systems at the western part of Kenya (Busia county, Kakamega county and Bungoma county) where the initial programme will be developed. In conducting the evaluation the investigators used key informant interviews, focused group discussion participant questionnaires, audio recordings and observation for data collection. Data analysis for the qualitative data focused on generating themes or theory around the responses obtained in the key informants interviews and focused group discussions. Univariate analysis was performed by use of simple proportions in calculation for surveillance system attributes like sensitivity, completeness, PVP and Timeliness for the human health surveillance systems. The findings of the evaluation revealed that there was poor linkage between animal health surveillance and the human health surveillance systems. None of the systems had surveillance structures dedicated to zoonotic diseases. Most practitioners used clinical signs for diagnosis of diseases with little reference to acceptable case definitions. Laboratory diagnosis in animal health services focused more on suspected notifiable diseases as opposed to being a standard operating procedure for diagnosis. In Human health services the health care facilities that had laboratory within the facility conducted laboratory diagnosis for cases referred by the clinicians. However, some clinicians preferred using clinical signs for diagnosis to avoid the wait or turn-around time in the laboratory. For effective surveillance of zoonoses to be realized it would be advisable to establish surveillance structures specific to zoonoses and the necessary resources allocated to the surveillance activities. In addition, an integrated approach that incorporated both human and animal disease surveillance should be employed in the surveillance of zoonoses