The Presence and Influence of Finnish Education Sector Expertise in International Organisations

The study analyses how Finnish education experts have been positioned within international organisations and have influence on development cooperation in the education sector. In addition, the study identifies the career paths of the experts and explores their views on Finland’s role in global development cooperation in the sector. The analysis concludes that the participating education experts identify Finland as a small player compared to other reference countries involved in development cooperation in the education sector. Consequently, resources, funds and room for influence of these experts are limited. Furthermore, contacts between the Finnish government and education experts placed abroad are described as very limited. Based on the study, experts would benefit from a more active role of Finnish government agencies and ministries. The main recommendations of the study are: active strategic positioning of Finland in the global educational architecture, development of national strategy for development cooperation in the education sector, increased support for international careers and international education expertise as well as increased communication and facilitation of education experts’ networks by the government agencies.This report is commissioned as part of UniPID Development Policy Studies (UniPID DPS), funded by the Ministry for Foreign Affairs of Finland (MFA) and managed by the Finnish University Partnership for International Development (UniPID). UniPID is a network of Finnish universities established to strengthen universities’ global responsibility and collaboration with partners from the Global South, in support of sustainable development. The UniPID DPS instrument strengthens knowledge-based development policy by identifying the most suitable available researchers to respond to the timely knowledge needs of the MFA and by facilitating a framework for dialogue between researchers and ministry officials. The content of this report does not reflect the official opinion of the Ministry for Foreign Affairs of Finland. The responsibility for the information and views expressed in the report lies entirely with the authors

Experience of Research Undertaking among Women Academia at Addis Ababa University: a Qualitative Study

AbstractBackground: As a pioneer University in the Country, Addis Ababa University engages itself in collaborative and local research undertakings along with teaching, community engagements and technology transfer. Despite its long engagement in research, the participation of women academia in research is limited as manifested by their low research productivity in terms of publication in peer-reviewed scientific journals. However, the reasons for their low research participation are less known and needs further exploration. Objective: To explore the experience of research undertakings among women academia at Addis Ababa University. Method: We conducted an exploratory qualitative study using a phenomenological approach among women academia. Eight women who have been working in the University with a rank of a lecturer having at least two years participated in in-depth interviews. We used NVivo10 software to code and categorize the transcripts. Result: Our study revealed that only a few senior informants with more than 10 years of stay at the University had a better experience in applying for national and international research grants. Although all the participants said they had ever undertaken research, their publication track in peer-reviewed journals is limited. Social and economic factors, lack of networking, low salary and family responsibility, limited internet and library access, and lack of research skill among young faculty were raised as impediments to undertake research. Conclusion: This study has indicated that women in academia had limited research engagement in terms of grant application and publication in peer reviewed scientific journals. Balancing work and family life, low salary, lack of access to common University facilities were some of the challenges. While structural change ensures gender equality at a long time, addressing the gender gap in research is the responsibility of AAU. [Ethiop. J. Health Dev. 2021; 35(SI-2):22-29]Keywords: Addis Ababa University, experience of research, women in academi

Female Academic Career Development and Administrative Positions at Addis Ababa University: a Mixed-Method Study

AbstractBackground: In Ethiopia, the number of female in academia in general and in administrative positions and higher university ranks in specific is very small as compared to men. A slight change has been seen in recent years, where a few women have come to male-dominated administrative positions as university presidents, vice presidents, deans and directors with still insignificant increase in the number of full professors. Objective: This study assessed female faculty member's career development and involvement in administrative positions and explored challenges. Method: We used a sequential mixed-method study starting with a cross-sectional quantitative study among 888 faculty members. The quantitate data were analysed using descriptive statistics and regression models to identify independent predictors of administrative involvement using SPSS version 25 software. An exploratory qualitative study was done among eight purposively selected female faculty. NVivo10 data management software was used to code and categorize the transcripts. Result: We found that male faculty members were more likely to involve in administrative positions than their female counterparts [AOR (95%CI) 1.6(1.1, 2.4)]. Those who were provided housing facility by AAU [AOR (95%CI) 2.29 (1.61, 3.23)] and assistant professors and above [AOR (95%CI) 1.495 (1.01, 2.220)] were more likely to involve in an administrative position than their counterparts. The qualitative findings indicated that the low salary faculty earns, lack of networks and family responsibility have deterred females from taking administrative positions. Conclusion: Female faculty involvement in the university administrative position and career development is very low. Both structural and personal factors such as gender roles affected their professional enhancement in academic ranks and hence positions. Creating a conducive platform for female faculty development is recommended to increase their involvement in administrative positions. [Ethiop. J. Health Dev. 2021; 35(SI-2):30-39]Keywords: Addis Ababa University, administrative positions, career development, female academician, female facult

Gender Difference in Research Productivity and its Associated factors in Addis Ababa University: a Cross-Sectional study

AbstractBackground: Gender equity movements have increased the number of women going to higher institutions. However, the number of women participating in research is limited in creating a critical mass. Objective: To assess the gender gap in research and its associated factors determinants among faculty at Addis Ababa University. Method: We conducted a cross-sectional study from October 2018 to March 2019 using a structured self-administered questionnaire. University faculty who was lecturers and above level who served the University for more than a year were invited to participate in the study. Faculty were approached by data collection facilitators with graduate degrees and the secretory of the respective departments. We used descriptive and multivariate statistical methods to analyse the data. Result: Of the 888 study participants, 161 (18.1%) females faculty participated in the study. It was found that three hundred ninety-seven male academics (54.6%) and 50 female academics (31.1%) had ever published articles in peer-reviewed journals (p<0.001). Male faculty were more likely to publish in peer-reviewed journals than their female counterparts [AOR and (95% CI) [2.55 (1.68, 3.86)]. Faculty with a rank of assistant professors and above [AOR (95% CI) 3.47(2.31, 5.21)], those who have a Ph.D. as highest degree [AOR (95% CI) 2.98 (2.11, 4.19) and those who have affiliation with other institutions [AOR (95% CI) 2.59 (1.98, 3.56)], were more likely to publish in peer-reviewed journals than their counterparts. Conclusion: Female faculty were less likely to be involved in research than men counterparts. The University needs to narrow the gender gap in research by designing and implementing an appropriate intervention strategy. [Ethiop. J. Health Dev. 2021; 35(SI-2):15-21]Keywords: Addis Ababa University, female faculty, gender difference, publication, researc

RUTI vaccination enhances inhibition of mycobacterial growth ex vivo and induces a shift of monocyte phenotype in mice

Copyright © 2019 Prabowo, Painter, Zelmer, Smith, Seifert, Amat, Cardona and Fletcher. Tuberculosis (TB) is a major global health problem and there is a dire need for an improved treatment. A strategy to combine vaccination with drug treatment, termed therapeutic vaccination, is expected to provide benefit in shortening treatment duration and augmenting treatment success rate. RUTI candidate vaccine has been specifically developed as a therapeutic vaccine for TB. The vaccine is shown to reduce bacillary load when administered after chemotherapy in murine and Guinea pig models, and is also immunogenic when given to healthy adults and individuals with latent TB. In the absence of a validated correlate of vaccine-induced protection for TB vaccine testing, mycobacterial growth inhibition assay (MGIA) has been developed as a comprehensive tool to evaluate vaccine potency ex vivo. In this study, we investigated the potential of RUTI vaccine to control mycobacterial growth ex vivo and demonstrated the capacity of MGIA to aid the identification of essential immune mechanism. We found an association between the peak response of vaccine-induced growth inhibition and a shift in monocyte phenotype following RUTI vaccination in healthy mice. The vaccination significantly increased the frequency of non-classical Ly6C-monocytes in the spleen after two doses of RUTI. Furthermore, mRNA expressions of Ly6C--related transcripts (Nr4a1, Itgax, Pparg, Bcl2) were upregulated at the peak vaccine response. This is the first time the impact of RUTI has been assessed on monocyte phenotype. Given that non-classical Ly6C- monocytes are considered to play an anti-inflammatory role, our findings in conjunction with previous studies have demonstrated that RUTI could induce a balanced immune response, promoting an effective cell-mediated response whilst at the same time limiting excessive inflammation. On the other hand, the impact of RUTI on non-classical monocytes could also reflect its impact on trained innate immunity which warrants further investigation. In summary, we have demonstrated a novel mechanism of action of the RUTI vaccine, which suggests the importance of a balanced M1/M2 monocyte function in controlling mycobacterial infection. The MGIA could be used as a screening tool for therapeutic TB vaccine candidates and may aid the development of therapeutic vaccination regimens for TB in the near future.EC HORIZON2020 TBVAC2020; Indonesian Endowment Fund for Education (LPDP); UK Medical Research Council (MRC); the UK Department for International Development (DFID

Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses.

BACKGROUND World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with coronavirus disease 2019 (Covid-19). METHODS We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. RESULTS At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P = 0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P = 0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P = 0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P = 0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration. CONCLUSIONS These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ISRCTN83971151; ClinicalTrials.gov number, NCT04315948.)

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95$7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95$43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and$37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere