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

Community land formalization and company land acquisition procedures: A review of 33 procedures in 15 countries

Indigenous and community lands, crucial for rural livelihoods, are typically held under informal customary tenure arrangements. This can leave the land vulnerable to outside commercial interests, so communities may seek to formalize their land rights in a government registry and obtain an official land document. But this process can be time-consuming and complex, and in contrast, companies can acquire land relatively quickly and find shortcuts around regulatory burdens. This article reviews and maps 19 community land formalization and 14 company land acquisition procedures is 15 countries in Africa, Asia and Latin America. Comparing community and company procedures identifies multiple sources of inequity

The co-operative reform process in Tanzania and Sri Lanka

This article reports on findings from a three year study of co-operatives in Sri Lanka and Tanzania. The article asks three questions: why do co-operative sectors need reforming; what is the co-operative reform process; and why has reform succeeded in some countries but not others? It provides a short history of co-operatives in three phases: the colonial period, the post-colonial nationalist period and the period of market liberalisation. It shows that the control exercised by colonial governments was deepened under nationalist governments, with co-operatives becoming parastatals. Liberalisation brought a sustained attempt by international agencies to reassert the distinctive nature of co-operatives as member-owned businesses. However, co-ops were ill-prepared to adjust to a competitive market and the lifting of government regulation; many failed, some were corrupted, while a few became truly member-controlled. The article draws on documentary analysis and key informant interviews to provide accounts of the reform process in Tanzania and Sri Lanka. It finds that the process is incomplete and often contested