Real exchange rate misalignment and macroeconomic implications: Recent evidence from Ghana

We evaluate the degree of real exchange rate (REER)  misalignment and its macroeconomic implications for the  Ghanaian economy using quarterly data (2000Q1-2015Q3). Our results uncovered a clear misalignment of the actual REER from its equilibrium level throughout the sample period, although the REER was close to its equilibrium level at the end of 2012. The study also revealed a weak positive undervaluation-economic growth nexus for Ghana. Overvaluation was observed to exert disinflationary pressures, while undervaluation tends to increase inflationary pressures in Ghana. The study thus suggests that the use of REER undervaluation as a deliberate industrial policy instrument for sustained economic growth may be  counterproductive in the context of Ghana, as such policy may potentially undermine price stability objective of the central bank.Keywords: Equilibrium Exchange Rate; Misalignment;Ghana

Exchange Rate and External Trade Flows: Empirical Evidence of J-Curve Effect in Ghana

Ghana’s external trade has remained in perpetual deficits over the three decades alongside depreciating domestic currency. This paper therefore examines the effect of real exchange rate (RER) movements on Ghana’s external trade performance, using a battery of times series models. The study particularly assesses the validity of Marshall-Lerner Condition, the J-Curve and Kulkarni Hypotheses in the case of Ghana. The empirical analysis reveals inelastic responses of both export and import demand to changes in RER. We found a steady long run link between RER movements and Ghana’s trade balance. However, the impact of RER on Ghana’s trade balance was found to be asymmetric. Periods of minimal real depreciation (a “tranquil” regime) lend support to Marshall-Lerner Condition (MLC), the J-Curve theory and Kulkarni Hypothesis in the context of Ghana. In contrast, we found less visible evidence of J-curve for periods of excessive real depreciation (an “intemperate” regime). It is therefore critical to sustain macroeconomic stability in order to engender low and stable inflation and stable foreign exchange rates. This however requires the adoption of appropriate and coordinated monetary and fiscal policies

Exchange Rate and External Trade Flows: Empirical Evidence of J-Curve Effect in Ghana

Ghana’s external trade has remained in perpetual deficits over the three decades alongside depreciating domestic currency. This paper therefore examines the effect of real exchange rate (RER) movements on Ghana’s external trade performance, using a battery of times series models. The study particularly assesses the validity of Marshall-Lerner Condition, the J-Curve and Kulkarni Hypotheses in the case of Ghana. The empirical analysis reveals inelastic responses of both export and import demand to changes in RER. We found a steady long run link between RER movements and Ghana’s trade balance. However, the impact of RER on Ghana’s trade balance was found to be asymmetric. Periods of minimal real depreciation (a “tranquil” regime) lend support to Marshall-Lerner Condition (MLC), the J-Curve theory and Kulkarni Hypothesis in the context of Ghana. In contrast, we found less visible evidence of J-curve for periods of excessive real depreciation (an “intemperate” regime). It is therefore critical to sustain macroeconomic stability in order to engender low and stable inflation and stable foreign exchange rates. This however requires the adoption of appropriate and coordinated monetary and fiscal policies

Insecticide resistance status of Aedes aegypti in Southern and Northern Ghana

Background: Outbreaks of Aedes-borne arboviral diseases are becoming rampant in Africa. In Ghana, there is no organized arboviral control programme with interventions restricted to mitigate outbreaks. Insecticide application is a crucial part of outbreak responses and future preventative control measures. Thus, knowledge of the resistance status and underlying mechanisms of Aedes populations is required to ensure optimal insecticide choices. The present study assessed the insecticide resistance status of Aedes aegypti populations from southern Ghana (Accra, Tema and Ada Foah) and northern Ghana (Navrongo) respectively. Methods: Phenotypic resistance was determined with WHO susceptibility tests using Ae. aegypti collected as larvae and reared into adults. Knockdown resistance (kdr) mutations were detected using allele-specific PCR. Synergist assays were performed with piperonyl butoxide (PBO) to investigate the possible involvement of metabolic mechanisms in resistance phenotypes. Results: Resistance to DDT was moderate to high across sites (11.3% to 75.8%) and for the pyrethroids, deltamethrin and permethrin, moderate resistance was detected (62.5% to 88.8%). The 1534C kdr and 1016I kdr alleles were common in all sites (0.65 to 1) and may be on a trajectory toward fixation. In addition, a third kdr mutant, V410L, was detected at lower frequencies (0.03 to 0.31). Pre-exposure to PBO significantly increased the susceptibility of Ae. aegypti to deltamethrin and permethrin (P<0.001). This indicates that in addition to kdr mutants, metabolic enzymes (monooxygenases) may be involved in the resistance phenotypes observed in the Ae. aegypti populations in these sites. Conclusion: Insecticide resistance underpinned by multiple mechanisms in Ae. aegypti indicates the need for surveillance to assist in developing appropriate vector control strategies for arboviral disease control in Ghana. Keywords: insecticide resistance, target-site mutations, Aedes aegypti, Piperonyl butoxide Synergist, knockdown resistance, Ghana

Short-Term Aggressive Disease Management Programs for Heart Failure: Effect on Drug Utilization, Clinical Outcomes, and Costs

Cardiovascular disease is the leading cause of death in developed countries. It is estimated that about 15 million people worldwide die every year from heart disease, with a substantial proportion of these deaths occurring in developing nations. Congestive heart failure (CHF) is a condition that develops as a late complication from a variety of heart disease states. CHF remains a devastating disease. It exacts a high toll in terms of mortality and morbidity and carries a high price burden. As the population ages and treatments for conditions such as acute coronary syndrome and hypertension improve, the prevalence of heart failure can be expected to increase, because survivors of hypertension and myocardial infarction live long enough to develop complications such as congestive heart failure. Recent advances have clearly shown that treatment strategies including ACE inhibitors, beta-adrenoceptor antagonists, and aldosterone inhibitors improve morbidity and survival. However, even among patients treated with recommended therapy at recommended doses, mortality remains high. Opportunities exist for further improvement of prognosis beyond current guidelines for heart failure. As new evidence emerges, it is evident that survival can be further improved by using other strategies such as angiotensin receptor antagonists as alternative or add-on therapy and ventricular resynchronization for qualifying candidates. The management of heart failure patients in the community presents unique challenges. Patients who are managed in community hospitals are often elderly and/or very ill, with several comorbidities and clinical characteristics that may be different from patients who qualify for clinical trials. Furthermore, there appears to be a delay in incorporating scientific evidence into practice and studies continue to show that many heart failure patients do not receive recommended medications at adequate doses. Disease management programs have evolved as a way of improving heart failure care. Different models have been established and some institutions have published the results of their specific programs. The consistent findings include reductions in hospitalization rates, improvements in quality of life, and reductions in cost. However, to date, such studies have not compared different models and until large prospective trials are available, the true benefits of these programs will continue to be debated.Disease-management-programmes, Drug-utilisation, Heart-failure, Pharmacoeconomics