Understanding the System Context of Alternative Food Supply Chains

This paper focuses upon the case of alternative food supply chains (AFSCs) as a "laboratory" for the implementation of sustainability concepts on a larger scale. To realize this type of upscaling, two important conditions should be fulfilled: the initiatives have to combine a performing internal organisation with the ability to understand and interact with the larger food system. To explore these concepts, the theory of hybrid organisations and the system innovation policy approach are discussed. Theory and empirical evidence learns that both concepts are complementary, as they both stress the importance of networking with actors that can be situated within or outside the supply chain.Agribusiness, Industrial Organization,

Coordination of collective action in the agro-food sector

Collaboration between stakeholders in the agro-food sector is nowadays a common phenomenon. Despite the huge diversity observed, this paper argues that collective action always results in the establishment of a collective organization (whether formally organized or not), which is characterized by the presence of a coordination centre. This organism represents all partners united in the collective and performs tasks by order of the individual members and the group. From a theoretical point of view, all collective organizations qualify as hybrid organizations, which can be studied through the lens of Transaction Costs Economics. Hybrids governance structures are a large set of arrangements that are situated between markets and hierarchies. When organizing transactions, hybrids do not purely rely on the price mechanism or authority, but rather on an interplay of four coordination mechanisms. These coordination mechanisms are the central element of this paper and we hypothesize that their degree of formalization is positively correlated with the complexity of the tasks faced by the coordination centre. To test this hypothesis, a survey was designed and information was gathered on some general and organizational characteristics of 65 collective initiatives in the Flemish agro-food sector. Information on the coordination mechanism could thereby be directly gathered, but the complexity of the tasks was approximated by the collective organization’s objectives, the characteristics of the specifications in force and the entry rules for members. The analysis proves that there is indeed a positive relationship between the degree of formalization of the coordination mechanisms on the hand and the complexity of coordination centre’s tasks. Information devices occurs in combination with informal cooperation in small groups, contracts are adopted by groups of 5 to 14 members to realize medium complex objectives and formal coordination (extern regulation and new governance bodies) is finally linked to quality differentiation, which requires considerable efforts in the definition and enforcement of product and/or process specifications.Collective action, coordination mechanisms, hybrid governance structures, Agribusiness,

CHALLENGES FOR THE FLEMISH AGRICULTURAL RESEARCH INSTITUTES TO SUPPORT AN INNOVATIVE AND COMPETITIVE AGRICULTURAL SECTOR

Agriculture is faced by permanent evolution and it is expected that this trend will continue in the next decennium. The question is what challenges lie ahead and which types of agricultural research can support the sector in order to retain its competitive power by the year 2020. To address this issue, a multi-stakeholder and multi-disciplinary process was initiated in Flanders. The process outcomes learn that two types of action are needed. Firstly, there is need for a focused knowledge production in 5 thematic fields. Central issues hereby are an efficient agriculture, the broadening of the value creation model of agriculture and the increasing sustainability of production. Secondly, efforts should be made to improve the organisation of research with emphasis on participation, anticipation, meta-coordination and validation of research outcomes.Research organisation, Knowledge networks, Innovation, Agribusiness, Agricultural and Food Policy, Community/Rural/Urban Development, Teaching/Communication/Extension/Profession,

Linking the agricultural knowledge and innovation system’s subsystems: the case of the Flemish ornamental plant production

Knowledge and innovation are keywords in a context of resource scarcity and sustainable intensification of agriculture. But in order to fully use the knowledge potential and to transform research results into innovative practices, there is a need for an adequate configuration of the agricultural knowledge and innovation system (AKIS). This configuration should be considered in relation to its own specific context and history. This paper focuses on the particular situation of ornamental plant production in Vlaanderen (Flanders), Belgium. In practice, we see that innovations in this sector are not limited to individual companies, but that new collective structures are put in place. The sector’s geographical clustering within the province of Oost-Vlaanderen is hereby an important facilitating factor. The new AKIS constructions have their own logic and objectives, but illustrate the need for further development of interlinkages between AKIS subsystems. The four examples of networking initiatives focus upon the production practices of ornamental plant production companies (VMS), alignment of research (Technopool Sierteelt), knowledge transfer and interaction between research and primary production (Sietinet) and, finally, co-creation of new varieties between research and the growers (BEST-select and Azanova). The results show that such initiatives can indeed contribute positively to the functioning of the AKIS. A partial approach, which looks at specific interactions instead of the AKIS as a whole, is thereby a more practical starting point than an integrated or overarching strategy

A System Approach on Organizational Innovations in the Agro-Food Sector: The Case of AFSCs in Flanders

Together with the evolution from the agro-industrial model to the sustainable rural development model (Roep and Wiskerke 2004), a part of the agro-food market has evolved from an anonymous, mass food market to a quality-food market. This shift is driven by factors, such as the changing relations between supply chain actors due to concentration in retail and processing, the growing importance of quality standards, considerable changes in consumer habits and preferences, the increasing attention for the multifunctional dimensions of agriculture and the establishment of new markets for public goods and services (Kirwan, Slee et al. 2003; Jahn, Zerger et al. 2007). As a consequence, the contemporary agro-food markets are more and more characterised by coordination between the actors in food supply chains. Collective action is not only adopted to improve supply chain logistics, but can also be used as a strategic instrument to realise market differentiation, to increase market share, or to obtain niche protection (Hobbs, Fearne et al. 2002; Vuylsteke, Collet et al. 2003; Ménard and Klein 2004). Moreover, new forms of dynamism and innovative forms of cooperation, such as alternative food supply chains, are emerging (Marsden, Banks et al. 2000)...

Sustainability of programs to reach high risk and marginalized populations living with HIV in resource limited settings: implications for HIV treatment and prevention

The experiences of the past 10 years have shown that it is feasible to treat HIV infected patients with ART even in severely resource constrained settings. Achieving the levels of antiretroviral coverage necessary to impact the course of the HIV epidemic remains a challenge and antiretroviral therapy coverage in most nations remains short of even current recommendations. Though treatment as prevention and seek, test, treat and retain strategies are attractive, realization of the benefits of these strategies will require the ability to successfully engage key hard to reach populations such as sex workers. The successes engaging these populations in research settings as seen in the article by Huet et al are encouraging, however key questions remain regarding the sustainability of these efforts as patients are transitioned back to national HIV control programs, many of which are struggling even to maintain the current panels in care in the face declining external funding for HIV care. To achieve the critical goals of increasing treatment uptake and retention and thereby curtail the epidemic of HIV, advocacy from both medicine and public health providers will be critical to generate the support and political will necessary to sustain and enhance the necessary HIV care programs worldwide

High prevalence of HIV and sexually transmitted infections among male sex workers in Abidjan, Côte d'Ivoire: need for services tailored to their needs

Objectives: To assess condom use and prevalence of sexually transmitted infections (STI) and HIV among male sex workers (MSW) in Abidjan, Cote d'Ivoire.MethodsA cross-sectional survey was conducted between October 2007 and January 2008 among MSW attending a sex worker clinic in Abidjan. A short questionnaire was administered in a face-to-face interview, and the participants were asked to provide a urine sample for STI testing and to self-collect transudate of the gingival mucosa for anonymous HIV testing, using a rapid test. A rectal swab for STI testing was taken by a physician. Molecular amplification assays were performed for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis.Results96 MSW participated in the survey, their median age was 27 years and the median duration of sex work was 5 years. Consistent condom use with clients during the last working day was 86.0%, and consistent condom use with the regular partner during the last week was 81.6%. HIV infection was detected in 50.0% of the participants. The prevalence of N gonorrhoeae was 12.8%, chlamydia infection was present in 3.2% and T vaginalis in 2.1% of the study participants.ConclusionsHIV and STI rates found in this study confirm the high risk and vulnerability status of MSW in Cote d'Ivoire. There is a definite need for studies exploring risk and risk perceptions among MSW in more depth and for services tailored to their needs, including developing and validating simple algorithms for the diagnosis of STI in MSW and men who have sex with men

HIV and STI Prevalence among Female Sex Workers in Côte d'Ivoire: Why Targeted Prevention Programs Should Be Continued and Strengthened

Objective: To assess condom use and prevalence of STIs and HIV among female sex workers (FSWs), as part of a comprehensive monitoring and evaluation plan of a nationwide sex worker prevention project in Côte d’Ivoire. Design and Methods: Cross sectional surveys were conducted among FSWs attending five project clinics in Abidjan and San Pedro (2007), and in Yamoussoukro and Gagnoa (2009). A standardized questionnaire was administered in a face-toface interview, which included questions on socio-demographic characteristics, sexual behaviour and condom use. After the interview, the participants were asked to provide samples for STI and HIV testing. Results: A total of 1110 FSWs participated in the surveys. There were large differences in socio-demographic and behavioural characteristics between FSW coming for the first time as compared to FSW coming on a routine visit. The prevalence of N. gonorrhoeae or C.trachomatis was 9.1%, 11.8 % among first vs. 6.9 % routine attendees (p = 0.004). The overall HIV prevalence was 26.6%, it was lower among first time attendees (17.5 % as compared to 33.9 % for routine attendees, p,0.001). The HIV prevalence among first attendees was also lower than the proportion of HIV positive tests from routine testing and counselling services in the same clinics. Conclusions: The results show a relatively high STI and HIV prevalence among FSWs in different cities in Côte d’Ivoire. In th

Paclitaxel plus Eftilagimod Alpha, a Soluble LAG-3 Protein, in Metastatic, HR⁺ Breast Cancer:Results from AIPAC, a Randomized, Placebo Controlled Phase IIb Trial

Purpose: Eftilagimod alpha (efti), a soluble lymphocyte activation gene (LAG-3) protein and MHC class II agonist, enhances innate and adaptive immunity. Active Immunotherapy PAClitaxel (AIPAC) evaluated safety and efficacy of efti plus paclitaxel in patients with predominantly endocrine-resistant, hormone receptor–positive, HER2-negative metastatic breast cancer (ET-resistant HR+ HER2– MBC). Patients and Methods: Women with HR+ HER2– MBC were randomized 1:1 to weekly intravenous paclitaxel (80 mg/m2) and subcutaneous efti (30 mg) or placebo every 2 weeks for six 4-week cycles, then monthly subcutaneous efti (30 mg) or placebo maintenance. Primary endpoint was progression-free survival (PFS) by blinded independent central review. Secondary endpoints included overall survival (OS), safety/tolerability, pharmacokinetics/pharmacodynamics, and quality of life. Exploratory endpoints included cellular biomarkers. Results: 114 patients received efti and 112 patients received placebo. Median age was 60 years (91.6% visceral disease, 84.1% ET-resistant, 44.2% with previous CDK4/6 inhibitor treatment). Median PFS at 7.3 months was similar for efti and placebo. Median OS was not significantly improved for efti (20.4 vs. 17.5 months; HR, 0.88; P = 0.197) but became significant for predefined exploratory subgroups. EORTC QLQC30-B23 global health status was sustained for efti but deteriorated for placebo. Efti increased absolute lymphocyte, monocyte and secondary target cell (CD4, CD8) counts, plasma IFNg and CXCL10 levels. Conclusions: Although the primary endpoint, PFS, was not met, AIPAC confirmed expected pharmacodynamic effects and demonstrated excellent safety profile for efti. OS was not significantly improved globally (2.9-month difference), but was significantly improved in exploratory biomarker subgroups, warranting further studies to clarify efti’s role in patients with ET-resistant HER2– MBC.</p

Paclitaxel plus Eftilagimod Alpha, a Soluble LAG-3 Protein, in Metastatic, HR⁺ Breast Cancer:Results from AIPAC, a Randomized, Placebo Controlled Phase IIb Trial

Purpose: Eftilagimod alpha (efti), a soluble lymphocyte activation gene (LAG-3) protein and MHC class II agonist, enhances innate and adaptive immunity. Active Immunotherapy PAClitaxel (AIPAC) evaluated safety and efficacy of efti plus paclitaxel in patients with predominantly endocrine-resistant, hormone receptor–positive, HER2-negative metastatic breast cancer (ET-resistant HR+ HER2– MBC). Patients and Methods: Women with HR+ HER2– MBC were randomized 1:1 to weekly intravenous paclitaxel (80 mg/m2) and subcutaneous efti (30 mg) or placebo every 2 weeks for six 4-week cycles, then monthly subcutaneous efti (30 mg) or placebo maintenance. Primary endpoint was progression-free survival (PFS) by blinded independent central review. Secondary endpoints included overall survival (OS), safety/tolerability, pharmacokinetics/pharmacodynamics, and quality of life. Exploratory endpoints included cellular biomarkers. Results: 114 patients received efti and 112 patients received placebo. Median age was 60 years (91.6% visceral disease, 84.1% ET-resistant, 44.2% with previous CDK4/6 inhibitor treatment). Median PFS at 7.3 months was similar for efti and placebo. Median OS was not significantly improved for efti (20.4 vs. 17.5 months; HR, 0.88; P = 0.197) but became significant for predefined exploratory subgroups. EORTC QLQC30-B23 global health status was sustained for efti but deteriorated for placebo. Efti increased absolute lymphocyte, monocyte and secondary target cell (CD4, CD8) counts, plasma IFNg and CXCL10 levels. Conclusions: Although the primary endpoint, PFS, was not met, AIPAC confirmed expected pharmacodynamic effects and demonstrated excellent safety profile for efti. OS was not significantly improved globally (2.9-month difference), but was significantly improved in exploratory biomarker subgroups, warranting further studies to clarify efti’s role in patients with ET-resistant HER2– MBC.</p