Early Warning Indicators for HIV Drug Resistance in Cameroon during the Year 2010

BACKGROUND: Rapid scale-up of antiretroviral therapy (ART) in resource-limited settings is accompanied with an increasing risk of HIV drug resistance (HIVDR), which in turn could compromise the performance of national ART rollout programme. In order to sustain the effectiveness of ART in a resource-limited country like Cameroon, HIVDR early warning indicators (EWI) may provide relevant corrective measures to support the control and therapeutic management of AIDS. METHODS: A retrospective study was conducted in 2010 among 40 ART sites (12 Approved Treatment Centers and 28 Management Units) distributed over the 10 regions of Cameroon. Five standardized EWIs were selected for the evaluation using data from January through December, among which: (1) Good ARV prescribing practices: target = 100%; (2) Patient lost to follow-up: target ≤ 20%; (3) Patient retention on first line ART: target ≥ 70%; (4) On-time drug pick-up: target ≥ 90%; (5) ARV drug supply continuity: target = 100%. Analysis was performed using a Data Quality Assessment tool, following WHO protocol. RESULTS: THE NUMBER OF SITES ATTAINING THE REQUIRED PERFORMANCE ARE: 90% (36/40) for EWI(1), 20% (8/40) for EWI(2); 20% (8/40) for EWI(3); 0% (0/37) for EWI(4); and 45% (17/38) for EWI 5. ARV prescribing practices were in conformity with the national guidelines in almost all the sites, whereas patient adherence to ART (EWI(2), EWI(3), and EWI(4)) was very low. A high rate of patients was lost-to-follow-up and others failing first line ART before 12 months of initiation. Discontinuity in drug supply observed in about half of the sites may negatively impact ARV prescription and patient adherence. These poor ART performances may also be due to low number of trained staff and community disengagement. CONCLUSIONS: The poor performance of the national ART programme, due to patient non-adherence and drug stock outs, requires corrective measures to limit risks of HIVDR emergence in Cameroon

Imperfect information and financial liberalization in LDCs

This thesis examines the interest rate, market entry and credit decisions which banks are expected to make following financial liberalization. It uses analytic tools from information economics and industrial organization theory to consider the policy implications of behaviour which responds to the constraints of imperfect information. The financial markets of the Caribbean Commonwealth supply the stylized facts which inform the analysis. Chapter 1 introduces the topics treated. The financial liberalization hypothesis is based on the 1973 works of McKinnon and Shaw. Chapter 2 describes their characterization of market fundamentals and behaviour in LDCs. It discusses the descriptions of equilibrium, and the welfare implications of these equilibria, in models which analyze economies with similar fundamentals. Chapter 3 derives stylized facts from the descriptions of the economic institutions and financial systems of the four Caribbean countries whose banking behaviour we model. Chapter 4 analyzes deposit rate determination by banks in the long-run equilibrium of a search market. It posits that in long-run equilibrium depositors find it costly to switch banks because doing so requires that they forego improved service at their current banks. The inelastic deposit supply which results from these switching costs implies that monopsonistic deposit rates are a noncooperative equilibrium. It is argued that this facilitates tacit collusion among banks and that a deposit rate floor is the appropriate policy corrective. Chapter 5 argues that the enhancement of intermediation service responsible for depositor switching costs reflects the information banks acquire about customers and their ability to offer suitably tailored service. Chapter 6 considers bank entry into a market where established customers of certain value have switching costs. Entering banks attract new customers of lower expected value. If new banks are therefore unable to generate sufficient revenue to cover their fixed costs, they exit. This chapter argues that liberal entry policy is not sufficient to ensure competition. Chapter 7 develops a simple model of bank screening by loan size in one sector of an economy. It finds a sequential equilibrium in which low-risk borrowers , self-select by the choice of contracts with a loan size below that they demand at the interest rate for their risk class. In Chapter 8 the partial equilibrium model of Chapter 7 is embedded in a general equilibrium framework to demonstrate that the market equilibrium is not constrained Pareto efficient. It argues that subsidizing the highest interest rates will improve loan allocation while maintaining the separation induced by private contracts. Chapter 9 summarizes the main results and conclusions of the thesis

Libération des acides gras par autolyse enzymatique des triglycérides des graines oléoprotéagineuses

National audienc

Bank Consolidation, Internationalization and Conglomeration

This paper documents global trends in bank activity, consolidation, internationalization, and financial firm conglomeration, and explores the extent to which financial firm risk and systemic risk potential in banking are related to consolidation and conglomeration. We find that while there is a substantial upward trend in conglomeration globally, consolidation and internationalization exhibit uneven patterns across world regions. Trends in consolidation and conglomeration indicate increased risk profiles for large, conglomerate financial firms, and higher levels of systemic risk potential for more concentrated banking systems. We outline research directions aimed at explaining why bank consolidation and conglomeration do not necessarily yield either safer financial firms or more resilient banking systems.Financial risk;Banking;Banking systems;financial institutions, deposit money, banking system, banking industry, deposit money banks, foreign asset, financial services, bank assets, bank mergers, banking crises, bank consolidation, equity capital, financial system, return on assets, bank activity, bank risk, bank holding, moral hazard, bank for international settlements, banking markets, bank holding companies, banking system concentration, financial sector, bank ownership, deposit insurance, deposit growth, international financial statistics, assets of deposit money banks, banking distress, assets of deposit money, bank policy, financial systems, financial assets, derivative, banking assets, bank acquisitions, bank of england, financial markets, bank diversification, derivative instruments, banking institutions, banking industries, banking ? crises, banking firm, bank financing, retail banking, banking regulation, international capital, banking ? distress, bank loan, bank holding company, bank intermediation, banking crisis, financial intermediation, bank funding, banking system asset, equity market, stock market, bank deposits, banking system assets, financial deregulation, bank recapitalizations, currency crises, banks with assets, international finance, bank entry, financial conglomerates, banker, holding company, bank subsidiaries, interbank market, bank profitability, financial stability

Diversified composition of sunflower (Helianthus annuus L.) seeds within cultural practices and genotypes (hybrids and populations)

International audienc

Débouchés actuels et futurs du tournesol produit en France - Critères de qualité

National audienceThis article reviews the use of sunflower produced in France (seeds, oil, cake) in both food and nonfood areas and outlines the prospects for the coming decades. This production meets quality criteria that are controlled, monitored and improved upon by professionals of French oleaginous industry. The results obtained in the determination of parameters influencing the oil content, the balance between oleic and linoleic acids are presented.Cet article fait un bilan des domaines d’utilisation du tournesol produit en France (graines, huile, tourteaux) aussi bien dans les domaines alimentaires que non alimentaires et fait état des perspectives pour les prochaines décennies. Cette production répond à des critères de qualité qui sont contrôlés, suivis et améliorés par les professionnels de la filière oléagineuse française. Les résultats obtenus lors la détermination des paramètres influençant le taux en huile, l’équilibre entre les acides oléiques et linoléiques est présenté

Staff/Patient ratio in the overall study population.

<p>Staff/Patient ratio in the overall study population.</p

Overall national ART performance for each EWI.

<p>Overall national ART performance for each EWI.</p