Balancing conservation with national development: a socio-economic case study of the alternatives to the Serengeti Road

Developing countries often have rich natural resources but poor infrastructure to capitalize on them, which leads to significant challenges in terms of balancing poverty alleviation with conservation. The underlying premise in development strategies is to increase the socio-economic welfare of the people while simultaneously ensuring environmental sustainability, however these objectives are often in direct conflict. National progress is dependent on developing infrastructure such as effective transportation networks, however roads can be ecologically catastrophic in terms of disrupting habitat connectivity and facilitating illegal activity. How can national development and conservation be balanced? The proposed Serengeti road epitomizes the conflict between poverty alleviation on one hand, and the conservation of a critical ecosystem on the other. We use the Serengeti as an exemplar case-study in which the relative economic and social benefits of a road can be assessed against the ecological impacts. Specifically, we compare three possible transportation routes and ask which route maximizes the socio-economic returns for the people while minimizing the ecological costs. The findings suggest that one route in particular that circumnavigates the Serengeti links the greatest number of small and medium sized entrepreneurial businesses to the largest labour force in the region. Furthermore, this route connects the most children to schools, provisions the greatest access to hospitals, and opens the most fertile crop and livestock production areas, and does not compromise the ecology and tourism revenue of the Serengeti. This route would improve Tanzania’s food security and self-reliance and would facilitate future infrastructure development which would not be possible if the road were to pass through the Serengeti. This case study provides a compelling example of how a detailed spatial analysis can balance the national objectives of poverty alleviation while maintaining ecological integrity

Reflections on Norheim (2018), Disease Control Priorities Third Edition Is Published; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

The publication of Disease Control Priorities, 3rd edition (DCP3) is a major milestone in the global health world. DCP3 reviews and summarizes high quality health intervention effectiveness and cost-effectiveness evidence relevant to low- and middle-income countries and is freely available to users. This Commentary summarizes Norheim’s (2018) assessment of DCP3’s role in country health priority-setting and offers reflections on what DCP3 can continue to offer countries seeking to improve their purchasing of health

PI external reviews : summary of report; Ecosystem Approaches to Human Health (EcoHealth) - report to IDRC Board of Governors, March 2004

French version available in IDRC Digital Library: Résumé du rapport de l'examen externe de l'initiative de programme Écosystèmes et santé humaine (ÉCOSANTÉ) présenté au Conseil des gouverneurs du CRDI en mars 200

Résumé du rapport de l'examen externe de l'initiative de programme Écosystèmes et santé humaine (ÉCOSANTÉ) présenté au Conseil des gouverneurs du CRDI en mars 2004

Version anglaise disponible dans la Bibliothèque numérique du CRDI: PI external reviews : summary of report; Ecosystem Approaches to Human Health (EcoHealth) - report to IDRC Board of Governors, March 200

External review : Non Communicable Disease Prevention (NCDP) Program, IDRC

NCDP was a new program replacing the previous tobacco control focused program (1994-2011) that was merged with IDRC’s Ecosystems and Human Health program in 2014. The NCDP’s portfolio included a total of 82 projects; seventy-four were considered to be within the scope of the evaluation. The quality of research ranged from acceptable to very good; examples of the best research prove to be outstanding. The NCDP program was productive, including examples of influential research that involved local researchers that appeared in international peer reviewed journals. The program’s research outputs demonstrate an intention to influence policy, with clear successes in many countries as well as globally

The consequences of tobacco tax on household health and fi nances in rich and poor smokers in China: an extended cost-eff ectiveness analysis

Background In China, there are more than 300 million male smokers. Tobacco taxation reduces smoking-related premature deaths and increases government revenues, but has been criticised for disproportionately aff ecting poorer people. We assess the distributional consequences (across diff erent wealth quintiles) of a specifi c excise tax on cigarettes in China in terms of both fi nancial and health outcomes. Methods We use extended cost-eff ectiveness analysis methods to estimate, across income quintiles, the health benefi ts (years of life gained), the additional tax revenues raised, the net fi nancial consequences for households, and the fi nancial risk protection provided to households, that would be caused by a 50% increase in tobacco price through excise tax fully passed onto tobacco consumers. For our modelling analysis, we used plausible values for key parameters, including an average price elasticity of demand for tobacco of –0·38, which is assumed to vary from –0·64 in the poorest quintile to –0·12 in the richest, and we considered only the male population, which constitutes the overwhelming majority of smokers in China. Findings Our modelling analysis showed that a 50% increase in tobacco price through excise tax would lead to 231 million years of life gained (95% uncertainty range 194–268 million) over 50 years (a third of which would be gained in the lowest income quintile), a gain of US$703 billion ($616–781 billion) of additional tax revenues from the excise tax (14% of which would come from the lowest income quintile, compared with 24% from the highest income quintile). The excise tax would increase overall household expenditures on tobacco by $376 billion ($232–505 billion), but decrease these expenditures by $21 billion (–$83 to $5 billion) in the lowest income quintile, and would reduce expenditures on tobacco-related disease by$24·0 billion ($17·3–26·3 billion, 28 income quintile). Finally, it would provide fi nancial risk protection worth$1·8 billion ($1·2–2·3 billion), mainly concentrated (74%) in the lowest income quintile. Interpretation Increased tobacco taxation can be a pro-poor policy instrument that brings substantial health and fi nancial benefi ts to households in China

Is the early identification and referral of suspected head and neck cancers by community pharmacists feasible?:A qualitative interview study exploring the views of patients in North East England

INTRODUCTION Head and neck cancer (HNC) is the eighth most common cancer in the United Kingdom. Survival rates improve when the cancer is diagnosed at an early stage, highlighting a key need to identify at-risk patients. This study aimed to explore opportunistic HNC identification and referral by community pharmacists (CPs) using a symptom-based risk assessment calculator, from the perspective of patients with a diagnosis of HNC. METHODS Purposive sampling was used to recruit patients from the HNC pathway in three large teaching hospitals in Northern England. Qualitative methodology was used to collect data through an iterative series of semistructured telephone interviews. Framework analysis was utilised to identify key themes. RESULTS Four main themes were constructed through the analytic process: (1) HNC presentation and seeking help; (2) the role of the CP; (3) public perception of HNC and (4) the role of a symptom-based risk calculator. Participants agreed that CPs could play a role in the identification and referral of suspected HNCs, but there were concerns about access as patients frequently only encounter the medicine counter assistant when they visit the pharmacy. HNC symptoms are frequently attributed to common or minor conditions initially and therefore considered not urgent, leading to delays in seeking help. While there is public promotion for some cancers, there is little known about HNC. Early presentation of HNC can be quite variable, therefore raising awareness would help. The use of a symptom-based risk calculator was considered beneficial if it enabled earlier referral and diagnosis. Participants suggested that it would also be useful if the public were made aware of it and could self-assess their symptoms. CONCLUSION In principle, CPs could play a role in the identification and referral of HNC, but there was uncertainty as to how the intervention would work. Future research is needed to develop an intervention that would facilitate earlier identification and referral of HNC while not disrupting CP work and that would promote HNC and the risk calculator more widely. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement and engagement (PPIE) was integrated throughout the project. Initially, the proposal was discussed during a Cancer Head and Neck Group Experience (CHANGE) PPIE meeting. CHANGE was set up to support HNC research in 2018. The group is composed of seven members (four female, three male) with an age range of 50-71 years, who were diagnosed at Sunderland Royal Hospital. A patient representative from the University of Sunderland PPIE group and a trustee of the Northern HNC Charity were recruited as co-applicants. They attended project management group meetings and reviewed patient-facing documentation

Global susceptibility and response to noncommunicable diseases.

Globalization and human interdependence have created immeasurable value for humanity. These forces, however, also provide channels for health risks to spread throughout the world. Global functions for health, such as international partnerships or research and development, are a rational response to global health risks like pandemics or globalized supply chains. Self-interest compels governments – or donors – to provide global functions even though their benefits are widely shared the world over