| [Afrique du Sud: défis et succès du confinement liés au COVID-19]

At the beginning of March 2020, South Africa (59 million inhabitants) was hit by the pandemic of COVID-19 and soon became the most affected country in Africa by the SARS-CoV-2 virus. From one single case on March 5th, the number of cases increased rapidly, forcing the South-African Government to swiftly react and place the country under strict lockdown for six weeks. The strategy of the South African Government bore fruits with a contained spread of the virus. If the number of positive cases at the end of the lockdown reached 5647, the number of fatal casualties was limited to 103 deaths. The lockdown was overall well respected, even if serious problems of food supply soon occurred in informal settlements, leading to riots and confrontation with security forces. Indeed, populations were obedient, but not being able to practice sport or outdoors activities appeared heavy

Electricity portfolio innovation for energy security: the case of carbon constrained China

China’s energy sector is under pressure to achieve secure and affordable supply and a clear decarbonisation path. We examine the longitudinal trajectory of the Chinese electricity supply security and model the near future supply security based on the 12th 5 year plan. Our deterministic approach combines Shannon-Wiener, Herfindahl-Hirschman and electricity import dependence indices for supply security appraisal. We find that electricity portfolio innovation allows China to provide secure energy supply despite increasing import dependence. It is argued that long-term aggressive deployment of renewable energy will unblock China’s coal-biased technological lock-in and increase supply security in all fronts. However, reduced supply diversity in China during the 1990s will not recover until after 2020s due to the long-term coal lock-in that can threaten to hold China’s back from realising its full potential

Environmental impact assessments of the Three Gorges Project in China: issues and interventions

The paper takes China's authoritative Environmental Impact Statement for the Yangzi (Yangtze) Three Gorges Project (TGP) in 1992 as a benchmark against which to evaluate emerging major environmental outcomes since the initial impoundment of the Three Gorges reservoir in 2003. The paper particularly examines five crucial environmental aspects and associated causal factors. The five domains include human resettlement and the carrying capacity of local environments (especially land), water quality, reservoir sedimentation and downstream riverbed erosion, soil erosion, and seismic activity and geological hazards. Lessons from the environmental impact assessments of the TGP are: (1) hydro project planning needs to take place at a broader scale, and a strategic environmental assessment at a broader scale is necessary in advance of individual environmental impact assessments; (2) national policy and planning adjustments need to react quickly to the impact changes of large projects; (3) long-term environmental monitoring systems and joint operations with other large projects in the upstream areas of a river basin should be established, and the cross-impacts of climate change on projects and possible impacts of projects on regional or local climate considered. © 2013 Elsevier B.V.Xibao Xu, Yan Tan, Guishan Yan

Expenditures for the care of HIV-infected patients in rural areas in China's antiretroviral therapy programs

<p>Abstract</p> <p>Background</p> <p>The Chinese government has provided health services to those infected by the human immunodeficiency virus (HIV) under the acquired immunodeficiency syndrome (AIDS) care policy since 2003. Detailed research on the actual expenditures and costs for providing care to patients with AIDS is needed for future financial planning of AIDS health care services and possible reform of HIV/AIDS-related policy. The purpose of the current study was to determine the actual expenditures and factors influencing costs for untreated AIDS patients in a rural area of China after initiating highly active antiretroviral therapy (HAART) under the national Free Care Program (China CARES).</p> <p>Methods</p> <p>A retrospective cohort study was conducted in Yunnan and Shanxi Provinces, where HAART and all medical care are provided free to HIV-positive patients. Health expenditures and costs in the first treatment year were collected from medical records and prescriptions at local hospitals between January and June 2007. Multivariate linear regression was used to determine the factors associated with the actual expenditures in the first antiretroviral (ARV) treatment year.</p> <p>Results</p> <p>Five ARV regimens are commonly used in China CARES: zidovudine (AZT) + lamivudine (3TC) + nevirapine (NVP), stavudine (D4T) + 3TC + efavirenz (EFV), D4T + 3TC + NVP, didanosine (DDI) + 3TC + NVP and combivir + EFV. The mean annual expenditure per person for ARV medications was US$2,242 (US$1 = 7 Chinese Yuan (CNY)) among 276 participants. The total costs for treating all adverse drug events (ADEs) and opportunistic infections (OIs) were US$29,703 and US$23,031, respectively. The expenses for treatment of peripheral neuritis and cytomegalovirus (CMV) infections were the highest among those patients with ADEs and OIs, respectively. On the basis of multivariate linear regression, CD4 cell counts (100-199 cells/μL versus <100 cells/μL, <it>P </it>= 0.02; and ≥200 cells/μL versus <100 cells/μL, <it>P </it>< 0.004), residence in Mangshi County (<it>P </it>< 0.0001), ADEs (<it>P </it>= 0.04) and OIs (<it>P </it>= 0.02) were significantly associated with total expenditures in the first ARV treatment year.</p> <p>Conclusions</p> <p>This is the first study to determine the actual costs of HIV treatment in rural areas of China. Costs for ARV drugs represented the major portion of HIV medical expenditures. Initiating HAART in patients with higher CD4 cell count levels is likely to reduce treatment expenses for ADEs and OIs in patients with AIDS.</p