HIPC relief: Too late, too little? Perspectives from a new qualifier, Tanzania

In 1970 the external debt of Tanzania, a least developed country, was 16.8 per cent of GDP and 58.6 per cent of exports. The ratio of per capita debt to per capita income was 14.4 per cent. By 2001 the debt had reached just over 100 per cent of GDP and over 11 times the value of exports, with a per capita debt to per capita income ratio of 102 per cent. By any wisdom this is a terrifying story. Efforts to address the debt burden have involved own initiatives and global initiatives, the latest being the enhanced HIPC Initiative. What are the new prospects? This paper attempts to assess the potency of the HIPC Initiative in addressing the key agenda items in Tanzania: poverty reduction/eradication and resolving the external debt burden. The assessment involves analysing long-term trends in debt build-up and debt servicing obligations as well as Tanzania’s efforts in order to become eligible for the enhanced initiative, though still attempting to achieve the completion point at over 16 months after reaching the decision point. The main conclusions are that relief comes too late to address adverse impacts and is too little to meet poverty targets. This calls on Tanzania to concentrate on complementary measures and the HIPC Initiative to undergo refinements like addressing the time lag between decision and completion points, and incorporating ratio of recurrent expenditure as a threshold level. – HIPC ; debt ; Tanzani

Live Recombinant Salmonella Typhi Vaccines Constructed to Investigate the Role of rpoS in Eliciting Immunity to a Heterologous Antigen

We hypothesized that the immunogenicity of live Salmonella enterica serovar Typhi vaccines expressing heterologous antigens depends, at least in part, on its rpoS status. As part of our project to develop a recombinant attenuated S. Typhi vaccine (RASTyV) to prevent pneumococcal diseases in infants and children, we constructed three RASTyV strains synthesizing the Streptococcus pneumoniae surface protein PspA to test this hypothesis. Each vector strain carried ten engineered mutations designed to optimize safety and immunogenicity. Two S. Typhi vector strains (χ9639 and χ9640) were derived from the rpoS mutant strain Ty2 and one (χ9633) from the RpoS+ strain ISP1820. In χ9640, the nonfunctional rpoS gene was replaced with the functional rpoS gene from ISP1820. Plasmid pYA4088, encoding a secreted form of PspA, was moved into the three vector strains. The resulting RASTyV strains were evaluated for safety in vitro and for immunogenicity in mice. All three RASTyV strains were similar to the live attenuated typhoid vaccine Ty21a in their ability to survive in human blood and human monocytes. They were more sensitive to complement and were less able to survive and persist in sewage and surface water than their wild-type counterparts. Adult mice intranasally immunized with any of the RASTyV strains developed immune responses against PspA and Salmonella antigens. The RpoS+ vaccines induced a balanced Th1/Th2 immune response while the RpoS− strain χ9639(pYA4088) induced a strong Th2 immune response. Immunization with any RASTyV provided protection against S. pneumoniae challenge; the RpoS+ strain χ9640(pYA4088) provided significantly greater protection than the ISP1820 derivative, χ9633(pYA4088). In the pre-clinical setting, these strains exhibited a desirable balance between safety and immunogenicity and are currently being evaluated in a Phase 1 clinical trial to determine which of the three RASTyVs has the optimal safety and immunogenicity profile in human hosts

A comparison of HIV prevalence and incidence estimates between the private security sector and the general public of South Africa

Presentation published as a abstract in Abstracts for XVII International Conference on AIDS, Mexico City, Mexico, 3-8 Augus

Knowledge, attitudes, beliefs and practices related to HIV/AIDS among employees in the private security industry in South Africa

Paper presented at the AIDS Conference, Mexico City, 3-8 AugustThe aim of the study was to critically assess HIV/AIDS related knowledge, attitudes, beliefs and practices among employees in the private security industry in three provinces in South Africa. A second-generation surveillance approach was used where 15 private security companies participated. Fieldworkers approached participants at selected companies and asked them permission to complete a questionnaire and to provide a dry blood spots (DBS) specimen for HIV testing. A total of 2787 employees participated and 2224 agreed to be interviewed and to give a blood specimen for an HIV test. The participants showed high levels of knowledge about HIV/AIDS and positive attitudes towards PLWHA. Most of the participants (86.7%0 had one regular partner while 14.6% of the participants had two or more sexual partners (17.6% males vs. 5.6% females). A tenth of the participants (10.7%) had had sex with someone 10 years younger than themselves. Participants under 24 years old reported high condom use (62.4% males & 53.6% females) compared to their above 50 year old counterparts (16.4% males & 9.1% females). Participants with two or more partners reported high condom use (63.9% males & 44.8% females) compared to those with one partner (37% males and 31% females). The majority of participants knew where to get VCT services (88.1%) but only 53.2% reported to have ever tested for HIV. HIV/AIDS education programmes should promote safer sex practices among older employees. The 'know your status' campaign needs to be strengthened so that employees can know their status

The impact of and responses to HIV/AIDS in the private security and legal services industry in South Africa

The generalised nature of the HIV/AIDS epidemic in South Africa means that it impacts unevenly on businesses. Companies respond in varied ways, and with varied means, to the challenges posed by the epidemic. Assessment of the impacts of HIV/AIDS, and of the responses of companies to it, are critical to help mitigate the impact of the epidemic on productivity, labour costs, and the supply of skills. This report documents the first study of its kind to be conducted in the private security and legal services industries, and provides clarity on the current status of both industries in terms of the prevalence and incidence rates of HIV, the impact of the epidemic on businesses in the sectors, and their responses to HIV/AIDS thus far. The findings represent a first step in the continued monitoring and evaluation of the impacts of the epidemic in both sectors, and the recommendations offer a starting point for refining HIV/AIDS management strategies at a sector and company level.

Knowledge, atttiudes, beliefs and practices related to HIV/AIDS among employees in the private security sector in South Africa

Presentation published as a abstract in Abstracts for XVII International Conference on AIDS, Mexico City, Mexico, 3-8 Augus

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. The precise role of bacterial infection in the course and pathogenesis of COPD has been a source of controversy for decades. Chronic bacterial colonization of the lower airways contributes to airway inflammation; more research is needed to test the hypothesis that this bacterial colonization accelerates the progressive decline in lung function seen in COPD (the vicious circle hypothesis). The course of COPD is characterized by intermittent exacerbations of the disease. Studies of samples obtained by bronchoscopy with the protected specimen brush, analysis of the human immune response with appropriate immunoassays, and antibiotic trials reveal that approximately half of exacerbations are caused by bacteria. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae are the most common causes of exacerbations, while Chlamydia pneumoniae causes a small proportion. The role of Haemophilus parainfluenzae and gram-negative bacilli remains to be established. Recent progress in studies of the molecular mechanisms of pathogenesis of infection in the human respiratory tract and in vaccine development guided by such studies promises to lead to novel ways to treat and prevent bacterial infections in COPD