In vitro efficacy of artemisinin-based treatments against SARS-CoV-2

Effective and affordable treatments for patients suffering from coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are needed. We report in vitro efficacy of Artemisia annua extracts as well as artemisinin, artesunate, and artemether against SARS-CoV-2. The latter two are approved active pharmaceutical ingredients of anti-malarial drugs. Concentration–response antiviral treatment assays, based on immunostaining of SARS-CoV-2 spike glycoprotein, revealed that treatment with all studied extracts and compounds inhibited SARS-CoV-2 infection of VeroE6 cells, human hepatoma Huh7.5 cells and human lung cancer A549-hACE2 cells, without obvious influence of the cell type on antiviral efficacy. In treatment assays, artesunate proved most potent (range of 50% effective concentrations (EC50) in different cell types: 7–12 µg/mL), followed by artemether (53–98 µg/mL), A. annua extracts (83–260 µg/mL) and artemisinin (151 to at least 208 µg/mL). The selectivity indices (SI), calculated based on treatment and cell viability assays, were mostly below 10 (range 2 to 54), suggesting a small therapeutic window. Time-of-addition experiments in A549-hACE2 cells revealed that artesunate targeted SARS-CoV-2 at the post-entry level. Peak plasma concentrations of artesunate exceeding EC50 values can be achieved. Clinical studies are required to further evaluate the utility of these compounds as COVID-19 treatment

[Introduction] The making and unmaking of precarious, ideal subjects – migration brokerage in the Global South

The migration literature is often underpinned by the idea that migrants are either completely ‘free’ agents, individually choosing how best to achieve returns on their human capital and resources (Sjaastad 1962) or ‘agents of development’ for their home countries and regions (Turner and Kleist 2013). Conversely they are viewed as exploited slaves, being pushed into low-paid occupations and controlled by middlemen and employers. Unsurprisingly, in many close-knit societies a process as expensive and life-defining as migration is rarely undertaken as an individual act and is shaped by complex social interactions within kinship networks and beyond (Lindquist 2012). Brokerage is ever-present in migrant labour markets around the world, variously interpreted as occupying the ‘middle space’ between migrants and the state, helping migrants navigate complex immigration regimes (Lindquist, Xiang, and Yeoh 2012; McKeown 2012; Schapendonk 2017), acting as an extension of the state seeking to outsource border controls (Goh, Wee, and Yeoh 2017) and colluding with employers to cheapen and commoditise migrant labour (Guérin 2013; McCollum and Findlay 2018). It is increasingly recognised that an understanding of contemporary migration is not complete without an understanding of the mediating practices that facilitate and constrain it (Coe and Jordhus-Lier 2011; Cranston, Schapendonk, and Spaan 2018). This special issue investigates the role that migration brokers play in the subjectivation and precarisation of migrant men and women from marginalised classes and ethnicities in the Global South. It shows how these processes are critical for them to become a part of contemporary economic and political systems of international and internal labour circulation. It responds to the call of labour geographers for a deeper understanding of the ways in which diverse economic and social contexts result in complex forms of precarity (McDowell 2015) and adds to the evidence on the role of actors beyond the workplace in co-creating precarity (Buckley, McPhee, and Rogaly 2017)

Transformations in network governance: the case of migration intermediaries

types: Article"This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Ethnic and Migration Studies on 3 February 2015 available online: http://wwww.tandfonline.com/10.1080/1369183X.2014.1003803Market liberalisation has fundamentally changed state interventions in the supply of services and supportive infrastructure across a range of public services. While this trend has been relatively well documented, there has been a dearth of research into the changing nature of state interventions in migration and mobility. Indeed the increasing presence of migration intermediaries to service the many and varied needs of migrant workers, particularly skilled migrants, remains significantly under-researched both theoretically and empirically. In providing an analysis of the location, role and changing nature of migration intermediaries, we highlight the implications of commercially-driven governance structures. In particular we suggest that the shift from government to network governance has important implications for skilled migration including: inequities in access to information regarding the process of migration and labour market integration; and, greater dependence on (largely unregulated) private intermediaries. Accordingly, we present empirical examples of migration intermediaries to illustrate their role and the relationship with and implications of their exchange with migrants

Early uptake of HIV counseling and testing among pregnant women at different levels of health facilities - experiences from a community-based study in Northern Vietnam

<p>Abstract</p> <p>Background</p> <p>HIV counselling and testing for pregnant women is a key factor for successful prevention of mother to child transmission of HIV. Women's access to testing can be improved by scaling up the distribution of this service at all levels of health facilities. However, this strategy will only be effective if pregnant women are tested early and provided enough counselling.</p> <p>Objective</p> <p>To assess early uptake of HIV testing and the provision of HIV counselling among pregnant women who attend antenatal care at primary and higher level health facilities.</p> <p>Methods</p> <p>A community based study was conducted among 1108 nursing mothers. Data was collected during interviews using a structured questionnaire focused on socio-economic background, reproductive history, experience with antenatal HIV counselling and testing as well as types of health facility providing the services.</p> <p>Results</p> <p>In all 91.0% of the women interviewed had attended antenatal care and 90.3% had been tested for HIV during their most recent pregnancy. Women who had their first antenatal checkup at primary health facilities were significantly more likely to be tested before 34 weeks of gestation (OR = 43.2, CI: 18.9-98.1). The reported HIV counselling provision was also higher at primary health facilities, where women in comparison with women attending higher level health facilities were nearly three or and four times more likely to receive pre-test (OR = 2.7; CI:2.1-3.5) and post-test counseling (OR = 4.0; CI: 2.3-6.8).</p> <p>Conclusions</p> <p>The results suggest that antenatal HIV counseling and testing can be scaled up to primary heath facilities and that such scaling up may enhance early uptake of testing and provision of counseling.</p

Breastfeeding and infant care as ‘sexed’ care work: reconsideration of the three Rs to enable women’s rights, economic empowerment, nutrition and health

Women’s1 lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women’s reproductive biology is closely linked to their social roles and situation, including regarding economic disadvantage and disproportionate unpaid work. Recognizing, as well as reducing and redistributing women’s care and domestic work (known as the ‘Three Rs’), is an established framework for addressing women’s inequitable unpaid care work. However, the care work of breastfeeding presents a dilemma, and is even a divisive issue, for advocates of women’s empowerment, because reducing breastfeeding and replacing it with commercial milk formula risks harming women’s and children’s health. It is therefore necessary for the interaction between women’s reproductive biology and infant care role to be recognized in order to support women’s human rights and enable governments to implement economic, employment and other policies to empower women. In this paper, we argue that breastfeeding–like childbirth–is reproductive work that should not be reduced and cannot sensibly be directly redistributed to fathers or others. Rather, we contend that the Three Rs agenda should be reconceptualized to isolate breastfeeding as ‘sexed’ care work that should be supported rather than reduced with action taken to avoid undermining breastfeeding. This means that initiatives toward gender equality should be assessed against their impact on women’s ability to breastfeed. With this reconceptualization, adjustments are also needed to key global economic institutions and national statistical systems to appropriately recognize the value of this work. Additional structural supports such as maternity protection and childcare are needed to ensure that childbearing and breastfeeding do not disadvantage women amidst efforts to reduce gender pay gaps and gender economic inequality. Distinct policy interventions are also required to facilitate fathers’ engagement in enabling and supporting breastfeeding through sharing the other unpaid care work associated with parents’ time-consuming care responsibilities, for both infants and young children and related household work

The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

<p>Abstract</p> <p>Background</p> <p>Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices.</p> <p>Methods</p> <p>This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users.</p> <p>Results</p> <p>The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals.</p> <p>Conclusion</p> <p>HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.</p