Fiebre amarilla en Africa: su impacto en salud pública y perspectivas para su control en el siglo XXI

In the last two decades, yellow fever re-emerged with vehemence to constitute a major public health problem in Africa. The disease has brought untold hardship and indescribable misery among different populations in Africa. It is one of Africa's stumbling blocks to economic and social development. Despite landmark achievements made in the understanding of the epidemiology of yellow fever disease and the availability of a safe and efficacious vaccine, yellow fever remains a major public health problem in both Africa and America where the disease affects annually an estimated 200,000 persons causing an estimated 30,000 deaths. Africa contributes more than 90% of global yellow fever morbidity and mortality. Apart from the severity in morbidity and mortality, which are grossly under reported, successive outbreaks of yellow fever and control measures have disrupted existing health care delivery services, overstretched scarce internal resources, fatigued donor assistance and resulted in gross wastage of vaccines. Recent epidemics of yellow fever in Africa have affected predominantly children under the age of fifteen years. Yellow fever disease can be easily controlled. Two examples from Africa suffice to illustrate this point. Between 1939 and 1952, yellow fever virtually disappeared in parts of Africa, where a systematic mass vaccination programme was in place. More recently, following the 1978-1979 yellow fever epidemic in the Gambia, a mass yellow fever vaccination programme was carried out, with a 97% coverage of the population over 6 months of age. Subsequently, yellow fever vaccination was added to the EPI Programme. The Gambia has since then maintained a coverage of over 80%, without a reported case of yellow fever, despite being surrounded by Senegal which experienced yellow fever outbreaks in 1995 and 1996. The resurgence of yellow fever in Africa and failure to control the disease has resulted from a combination of several factors, including: 1) collapse of health care delivery systems; 2) lack of appreciation of the full impact of yellow fever disease on the social and economic development of the affected communities; 3) insufficient political commitment to yellow fever control by governments of endemic countries; 4) poor or inadequate disease surveillance; 5) inappropriate disease control measures, and 6) preventable poverty coupled with misplaced priorities in resource allocation. Yellow fever can be controlled in Africa within the next 10 years, if African governments seize the initiative for yellow fever control by declaring an uncompromising resolve to control the disease, the governments back up their resolve with an unrelenting commitment and unwavering political will through adequate budgetary allocations for yellow fever control activities, and international organisations, such as WHO, UNICEF, GAVI, etc., provide support and technical leadership and guidance to yellow fever at risk countries. Over a ten-year period, of stage-bystage mass yellow fever vaccination campaigns, integrated with successful routine immunisation, Africa can bring yellow fever under control. Subsequently, for yellow fever to cease being a public health problem, Africa must maintain at least an annual 80% yellow fever vaccine coverage of children under the age of 1 year, and sustain a reliable disease surveillance system with a responsive disease control programme. This can be achieved at an affordable annual expenditure of less than US$1.00 per person per year, with a reordering of priorities.Durante las últimos dos décadas, la fiebre amarilla ha vuelto a emerger con fuerza hasta constituirse en un grave problema de salud pública en Africa, trayendo indecibles sufrimientos a mucha de su población y convirtiéndose en un obstáculo más para su desarrollo social y económico. A pesar de los destacados logros alcanzados en el conocimiento de la epidemiología de esta enfermedad y de la disponibilidad de una vacuna segura y eficaz, la fiebre amarilla continúa siendo un serio problema de salud pública tanto en Africa como en América en donde anualmente afecta a 200.000 personas, aproximadamente, y causa alrededor de 30.000 muertes. Africa contribuye con más del 90$1,00 por persona al año, lo cual es muy razonable siempre y cuando se reordenen las prioridades presupuestales

Environmental Policies in International Markets

La hipòtesi estableix que a la llum de l'escàndol d'emissions de Volkswagen, una creença comuna que s'ha format és que la captura regulatòria en el control i establiment d'estàndards d'emissions ha portat a una menor reducció de la contaminació i una menor innovació ambiental en els motors de combustió de gasolina i dièsel. Els resultats indiquen que sota un monopoli multiproducte, la captura regulatòria només condueix a més emissions i menys esforç d'innovació. El contrari és cert en la competència d'oligopolis. Per tant, el que estableix la hipòtesi és fals. El segon assaig estudia el poder de mercat en el mercat de l'aigua de Califòrnia. Els resultats d'aquest estudi indiquen que sota els supòsits de el model de Cournot, el poder de mercat en aquest mercat d'aigües poc profundes és limitat. Les proves de robustesa demostren el mateix resultat. El tercer i últim assaig de la tesi ofereix una comparació de dos instruments de política, com els estàndards d'emissió i els impostos a l'adquisició, en presència d'empreses d'oligopoli multiproducte per al mercat de l'automòbil. Els resultats indiquen que els estàndards d'emissió ofereixen més incentius a la innovació que els impostos a les adquisicions. Els consumidors estan millor amb les normes d'emissió si no es distribueixen els ingressos fiscals. Altrament, preferirien els impostos sobre l'adquisició. A més, els fabricants estarien millor amb l'impost a les adquisicions.Esta disertación comprende tres ensayos relacionados con las políticas ambientales en los mercados internacionales. Dos ensayos consisten en el análisis de modelos teóricos (específicamente para las políticas ambientales en la industria automotriz), y uno en el análisis de modelos teóricos y empíricos (específicamente para el mercado del agua). industria del automóvil. La hipótesis establece que a la luz del escándalo de emisiones de Volkswagen, una creencia común que se ha formado es que la captura regulatoria en el control y establecimiento de estándares de emisiones ha llevado a una menor reducción de la contaminación y una menor innovación ambiental en los motores de combustión de gasolina y diésel. Los resultados indican que bajo un monopolio multiproducto, la captura regulatoria solo conduce a más emisiones y menos esfuerzo de innovación. Lo contrario es cierto en la competencia de oligopolios. Por tanto, lo que establece la hipótesis es falso. El segundo ensayo estudia el poder de mercado en el mercado del agua de California. Los resultados de este estudio indican que bajo los supuestos del modelo de Cournot, el poder de mercado en este mercado de aguas poco profundas es limitado. Las pruebas de robustez demuestran el mismo resultado. El tercer y último ensayo de la tesis ofrece una comparación de dos instrumentos de política, como los estándares de emisión y los impuestos a la adquisición, en presencia de empresas de oligopolio multiproducto para el mercado del automóvil. Los resultados indican que los estándares de emisión ofrecen mayores incentivos a la innovación que los impuestos a las adquisiciones. Los consumidores están mejor bajo los estándares de emisiones si los ingresos fiscales no se redistribuyen. De lo contrario, preferirían un impuesto a las adquisiciones. Además, los fabricantes estarían mejor con los impuestos a las adquisiciones.This dissertation comprises three essays related to environmental policies in the international markets. Two essays consist of the analysis of theoretical models (specifically for the environmental policies in the automobile industry), and one in the analysis of both theoretical and empirical models, (specifically for the water market). automobile industry. The hypothesis states that in the light of the Volkswagen emissions scandal, a common belief that has formed is that regulatory capture in the control and setting of emission standards has led to lower pollution abatement and less environmental innovation in gasoline and diesel combustion engines. The results indicate that under a multiproduct monopoly regulatory capture only leads to more emissions and less innovation effort. The opposite is true under oligopoly competition. Thus, what hypothesis states is false. The second essay studies the market power in Californian's water market. The results of this study indicate that under the assumptions of the Cournot model, market power in this thin water market is limited. The robustness tests prove the same result. The third and final essay of the thesis provides a comparison of two policy instruments such as emission standards and acquisition taxes in the presence of Counot model with with n firms and vertically differentiated products for the automobile market. The results indicate that emission standards offer greater innovation incentives than do acquisition taxes. Consumers are better off under emission standards if tax revenues are not redistributed. Otherwise, they prefer an acquisition tax. Also, manufacturers are better off under acquisition taxes

Poverty and inequality issues in Albania: trends and determinants

Poverty and inequality are complex and widespread phenomena. Poverty is an indicator and the main factor of inequality, so reduction of poverty is one of the biggest challenges for economic and social consolidation of a country. There are different concepts of poverty, in this paper we are focused on the concept of absolute poverty. The main objective of this paper is to conduct an analysis on the trends of poverty and inequality indicators, as well as an analysis on the reduction of poverty in Albania between 2002 and 2008

Global lessons for strengthening breastfeeding as a key pillar of food security

Breastfeeding is identified as a central pillar of food security by the World Health Organization, however globally significant challenges remain in achieving breastfeeding targets for early initiation, exclusive breastfeeding for 6 months, and continued breastfeeding for 2 years and beyond. Inadequate support in health systems, poor maternity protections and workplace policies, and insufficient regulation of commercial milk formulas, among other barriers, continue to undermine this key pillar across nations. This paper highlights the central importance of breastfeeding for food security across diverse global settings by examining three case studies: Honduras, Pakistan and the USA. The cases highlight the complex layering and intersections of key challenges that threaten breastfeeding in the era of pandemics, the climate crisis, conflict and global inequality. Lessons drawn from these case studies, combined with additional insights, reinforce the importance of multisectorial collaboration to scale up investment in creating equitable, enabling environments for breastfeeding. These structural and systems approaches can successfully strengthen the breastfeeding ecosystem to ensure greater first food system resilience in the face of global crises, which compound maternal and infant vulnerabilities. Additionally, the cases add urgency for greater attention to prioritizing breastfeeding and incorporating IYCF-E protocols into disaster preparedness and management into the policy agenda, as well as ensuring that first food security is considered in energy policy. An integrated approach to policy change is necessary to recognize and strengthen breastfeeding as a pivotal part of ensuring food security across the globe

Formation of iminium ions during the processing of metal halide perovskites †

Ammonium ions are a key component of many organic–inorganic metal halide materials. We show that the hexagonal perovskite (Me2NH2)PbI3 is rapidly transformed to iminium-based perovskites (Me2C 00000000 00000000 00000000 00000000 11111111 00000000 11111111 00000000 00000000 00000000 NMeR)PbI3 (R = Me, Et), simply by stirring the material in the respective ketone at room temperature, triggering clear changes in the materials’ photophysical properties

Contested moral landscapes: Negotiating breastfeeding stigma in breastmilk sharing, nighttime breastfeeding, and long-term breastfeeding in the U.S. and the U.K

Recent public health breastfeeding promotion efforts have galvanized media debates about breastfeeding in wealthy, Euro-American settings. A growing body of research demonstrates that while breastfeeding is increasingly viewed as important for health, mothers continue to face significant structural and cultural barriers. Concerns have been raised about the moralizing aspects of breastfeeding promotion and its detrimental effects on those who do not breastfeed. Far less, however, is known about the moral experiences of those who pursue breastfeeding. This study draws together research on breastmilk sharing (2012–2016) and nighttime breastfeeding from the U.S. (2006–2009), and long-term breastfeeding from the U.K. (2008–2009) from three ethnographic projects to address this gap. Comparative analysis of these cases reveals that while breastfeeding is considered ideal infant nutrition, aspects of its practice continue to evoke physical and moral danger, even when these practices are implemented to facilitate breastfeeding. Breastmilk sharing to maintain exclusive breastmilk feeding, nighttime breastfeeding and bedsharing to facilitate breastfeeding, and breastfeeding beyond the accepted duration are considered unnecessary, unhealthy, harmful or even deadly. The sexual connotations of breastfeeding enhance the morally threatening qualities of these practices. The cessation of these “problematic” breastfeeding practices and their replacement with formula-feeding or other foods is viewed as a way to restore the normative social and moral order. Mothers manage the stigmatization of these breastfeeding practices through secrecy and avoidance of health professionals and others who might judge them, often leading to social isolation. Our findings highlight the divide between perceptions of the ideal of breastfeeding and its actual practice and point to the contested moral status of breastfeeding in the U.S. and the U.K. Further comparative ethnographic research is needed to illuminate the lived social and moral experiences of breastfeeding, and inform initiatives to normalize and support its practice without stigmatizing parents who do not breastfeed