Urban water services in Sub Saharan Africa: access, private sector involvement and technical paradigm.

The thesis analyses the water supply sector in the Sub Saharan African region, focusing on the challenges experienced by the water utilities to fulfil their mandates, in a context of rapid urbanization. In September 2000, building upon a decade of major United Nations (UN) conferences and summits, world leaders came together at UN Headquarters in New York to adopt the Resolution A/RES/55/2, committing their nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets - with a deadline in 2015 - that have become known as the Millennium Development Goals (MDG). The goal number 7 was \u201cEnsure environmental sustainability\u201d and it included the Target 7.C which is to \u201chalve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation\u201d. The water MDG is dramatically off track in Sub Saharan Africa, with only 64% of the population covered in 2012 instead of the expected 77.5% (WHO and UNICEF 2014). These poor performances are driven by urban areas, where the water supply coverage through household connections declined while the access through other improved sources, like public taps, private hand pumps and protected wells, hardly compensated for that. This calls for a reconsideration of the policies implemented in the sector following the prescriptions of the neoliberal agenda for the sector. In the \u201880s and \u201890s policymakers from International Financial Institutions (IFIs) and donors agencies designed a set of recipes to address poor performances of the urban water services in the developing world. This happened in the context of structural adjustment policies, such as trade liberalization, labor market reforms, financial deregulation and privatization of State Owned Enterprises (SOE). In the water sector, these orientations were translated into decentralization, private sector participation, commercialization and corporatization of water utilities, with the shift of governments from providers to regulators. The thesis studies some of the devices and solutions typically adopted by the reformed utilities and justified by the expectation of positive outcomes for the access to water by the poor The work shows however that some of these devices gained a certain degree of autonomy from access goals and became a priority as such, to be pursued by water utilities regardless their impacts and interaction with key social dimensions. This phenomenon was in some cases favoured by a biased attitude of water sector practitioners, benchmarking regulation and donors. The work highlights that in some cases the reform solutions do not contribute to the achievement of the declared objectives, while their implementation can divert scarce resources and attention from key sector priorities. Cost recovery, Private Sector Participation and household level metering issues are analysed. The work is organized in three parts. The first part proposes a review of the main notions and issues addressed by water economics (chapter 1), with particular attention to developing countries. The second part is divided into three chapters, closely linked together for their arguments but conceived as autonomous papers and characterized by different methodological approaches: the first is quantitative, the second and the third are more qualitative in nature and they include original findings from interviews on the Lilongwe Water Board, a water utility from Malawi. The second chapter focuses on the problems of cost recovery and access to drinking water in Sub Saharan Africa. A model explaining the dynamics in water coverage which accounts for financial performances of utilities is proposed. The data set covers 25 countries in the Sub Saharan region from 1995 to 2012. The results suggest that the access to water depends upon financial results, but this relationship is not linear: with increasing returns for relatively low levels of cost recovery and decreasing returns beyond a certain threshold. The results are consistent with the literature about the risks associated with corporatization and neoliberal reforms in the water sector, and they provide some supporting quantitative evidence and recommendations for sector policies in the region. The third chapter refers to the Light Private Sector Involvement initiatives in the Sub Saharan Africa water supply sector, considering in particular efficiency improvements, aid effectiveness and related policy implications. The study analyses the determinants that can incentivize or discourage the partners of light forms of Private Sector Involvement (PSI) initiatives to achieve the expected results in the water supply sector in the Sub Saharan Africa region. This is done through a review of case studies involving management and service contracts, which are the lightest and lower risk forms of public-private partnership. While five cases are taken from the available literature, the sixth includes contributions from original research on Lilongwe Water Board (Malawi). The chapter considers the incentives to perform for both the private and the public partner, as determined by the contracts and by the wider context. The incentives necessary for both parties to engage in the partnership are also considered, jointly with the costs of creating these preconditions. The study concludes that the allocation of risks and decision making power are among the drivers of poor performances by light PSI initiatives. Moreover, as most partnerships are financed by development projects, the study discusses the policy implications of promoting these PSI initiatives. The fourth chapter analyses the priorities and tools for Water Demand Management in urban Africa, focusing on household level water metering. The study presents an analysis of the issues associated with water metering at household level by utilities in low income areas or informal settlements of Sub Saharan African cities. Metering is considered a key tool for water demand management and recommended as a good practice in the water supply sector but, while its benefits are clearly spelled out by donors and development agencies, its costs and shortcomings are seldom considered. The chapter analyses such challenges, based on the available literature and on an original case study on Lilongwe Water Board (Malawi). It is argued that the technical paradigm of metered household level connection can be in some cases a constraint to the connection of low income households, due to the high cost and complexity of the practices associated to this paradigm, while the benefits in terms of demand management are not straightforward. Some alternatives to universal household level metering are also identified. Finally, in the last part of the work the findings from the studies presented are summarized and some conclusions and recommendations are drawn about the importance of better focusing on the priority of water access, encompassing a wider set of operational solutions

How different aid flows affect different trade flows: Evidence from Africa and its largest donors

In this study we compare the impacts of official finance coming from the largest donors of African countries on bilateral trade flows between the donor and the recipient. Applying a gravity model approach, we distinguish between development finance and other official flows. We find that official finance from all the donors stimulates export of goods to Africa, while trade flows in the opposite direction are fostered in the case of China and Europe, but not for the US. Despite some claims in the literature that aid from China aims at securing import of natural resources, we find evidence that countries receiving Chinese aid raise their bilateral export of manufactured goods and not of primary commodities. Finally, while for Europe and the US official flows other than development assistance play a bigger role in shaping trade flows, China primarily uses highly concessional and development oriented flows. (C) 2020 Elsevier B.V. All rights reserved

Free to die: Economic freedoms and influenza mortality

: Seasonal influenzas are annually responsible for hundreds of thousands of deaths worldwide, often because of insufficient care, which may depend on orientations of economic policy. Yet, the empirical evidence on the relations existing between policies based on different degrees of economic liberalism and flu mortality is still scarce. This paper contributes to filling the gap by proposing an empirical investigation into the effects of various dimensions of liberalism, proxied by the different components of the Fraser Index of Economic Freedom, on deaths from seasonal influenzas in a sample of 38 OECD countries observed from 1970 to 2018. A dynamic panel System-GMM estimator is used to alleviate endogeneity concerns, while alternative models, specifications and subsamples check the robustness of findings. Findings show that: a) not every component of economic freedom has an effect on flu mortality; b) more economic freedom not always means less or more deaths from flu. In particular, stronger protection of property rights and smaller government consumption are associated with higher flu mortality, which is instead lower when people and capital are freer to move. Such results give rise to policy considerations and contribute to inform policymakers about actions that can limit the mortality of a globally widespread disease like flu

Direct access to markets by farmers and the role of traders: insights from Kenyan and Tanzanian leafy vegetables markets

The research literature shows that agriculture has potential for development, job creation and structural change if agricultural value chains are considered in their entirety: from inputs, to farm, through processing, until marketing. This is particularly important in the case of Africa, where agriculture contributes in a major way to GDP and employment. However, this focus on value chains does not seem to have been accompanied by attention to the diversity of actors operating along value chains. Based on an extensive literature review on access to markets by farmers and on participatory research with farmers, traders, and sectoral stakeholders of leafy vegetables value chains in Kenya and Tanzania, this study argues that the role played by traders in local fresh produce markets in Africa is poorly understood and supported. It is argued that powerful narratives about the benefits of direct access to market by farmers, which are also present in academic literature, are sometimes overoptimistic, or interpreted beyond their scope and applied regardless of the specific features of actors and produce. The study shows that the leafy vegetables trade provides self-employment for many women, and that it has positive impacts on other groups, notably farmers

Radiation recall dermatitis induced by COVID-19 vaccination in breast cancer patients treated with postoperative radiation therapy

Background: and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case reports describe radiation recall dermatitis in breast cancer patients treated with postoperative radiation therapy following COVID-19 vaccination. In this study we investigated the incidence and severity of radiation recall dermatitis after COVID-19 vaccination in irradiated breast cancer patients. Methods: Patients that received at least one COVID-19 vaccination dose during the year after the end of postoperative breast radiation therapy were included in this observational monocentric study. Local symptoms occurring inside the radiation field after vaccination were patient-reported and scored according to the PRO-CTCAE questionnaire. Descriptive data of radiation recall dermatitis incidence and severity, and potential risk factors were evaluated. Results: A cohort of 361 patients with 756 administered COVID-19 vaccinations was analyzed. Breast symptoms were reported by 7.5% of patients, while radiation recall dermatitis was considered for 5.5%. The incidence of radiation recall dermatitis per single dose of vaccine was 2.6%, with a higher risk for the first dose compared to the second/third (4.4% vs 1%, p = 0.003), especially when administered within the first month after the end of irradiation (12.5% vs 2.2%, p = 0.0004). Local symptoms were generally self-limited and a few cases required anti-inflammatory drugs. Conclusions: Radiation recall dermatitis is an uncommon but not rare phenomenon in breast cancer patients that received COVID-19 vaccination within one year after breast irradiation. However, symptoms severity were generally low/mild and reversible. These findings can be useful for patient counseling

Caracterização fenotípica de suínos crioulos da região Centro-Sul do Paraná, Brasil

This research aimed to phenotypically characterize 55 pigs from traditional communities, called Faxinal With each pig, 24 variables were measured: 8 qualitative morphological, 16 quantitative / zoometric and 5 zoometric indices were determined. According to the frequency tables of the qualitative variables, it was observed that most pigs showed similarities to the morphological patterns observed in the Brazilian breeds Moura, Piau and Canastra. For the data of the zoometric variables and the zoometric indices, descriptive statistical analysis and variance analysis were applied using two different sources of variation: sex and Faxinal. There was a great morphological variability of the studied creole pigs, with the highest values of the variation coefficients observed for croup length and width, live weight and snout length. According to the averages obtained, the pigs were classified as elliptical, mesocephalic, longilinous, concavilinous. Significant differences between Faxinal were observed for croup width, body length, snout and croup, croup height and interorbital distance and cephalic, facial and pelvic indices. Significant differences between sexes were observed for withers height, snout length, shin girth and interorbital distance. There was significant between Faxinal *sex interaction for some zoometric variables, but not for the indexes. For body measurements, the correlations were high and significant, with the thoracic perimeter, abdominal perimeter and body length being the characteristics that best correlated with live weight. Cranial measurements (lengths of snout, ear and head and interorbital distance) were moderate to low.  To infer the population structure, a statistical model was applied based on a bayesian approach according to the Structure Harvest software. It was possible to identify three phenotypic groupings, corroborating the results of qualitative variables. Genetic characterization studies should be carried out in these populations to serve as a basis for defining strategic actions for conservation and sustainable use of these genetic resources.Para caracterizar fenotípicamente a 55 cerdos de las comunidades tradicionales Faxinal, se midieron 24 variables: 8 morfológicas cualitativas, 16 cuantitativas / zoométricas y se determinaron 5 índices zoométricos. En la mayoría de los cerdos mostraron similitudes con los patrones morfológicos observados en las razas brasileñas Moura, Piau y Canastra. Para los datos de las variables zoométricas y los índices zoométricos se aplicó análisis descriptivo y estadístico de varianza. Hubo gran variabilidad morfológica de los cerdos criollos estudiados, observándose los valores más altos de los coeficientes de variación para largo y ancho de rabadilla, peso vivo y largo de hocico. De los promedios obtenidos, los cerdos se clasificaron en elipométricos, mesocefálicos, alargados, concavilinos. Se observaron diferencias significativas entre Faxinal para el ancho de la rabadilla, la longitud del cuerpo, el hocico y la rabadilla, la altura de la rabadilla y la distancia interorbital, y para los índices cefálico, facial y pélvico. Se observaron diferencias significativas entre sexos para la altura a la cruz, la longitud del hocico, el perímetro de la espinilla y la distancia interorbital. Hubo una interacción significativa del sexo Faxinal * para algunas variables zoométricas. Para las medidas corporales, las correlaciones fueron altas y significativas, siendo el perímetro torácico, el perímetro abdominal y la longitud corporal los que mejor se correlacionaron con el peso vivo. Las medidas craneales (longitud del hocico, oreja y cabeza y distancia interorbital) fueron de moderadas a bajas. Para inferir la estructura de la población se aplicó un modelo estadístico basado en un enfoque bayesiano según el software Structure Harvester. Fue posible identificar tres grupos fenotípicos, corroborando los resultados de las variables cualitativas. Se deben realizar estudios de caracterización genética en estas poblaciones que sirvan de base para definir acciones estratégicas para programas de conservación y uso sostenible de estos recursos genéticos.Esta pesquisa teve como objetivo caracterizar fenotipicamente 55 suínos provenientes de comunidades tradicionais, chamadas de Faxinal. Em cada suíno foram mensuradas 24 variáveis: 8 morfológicas qualitativas, 16 quantitativa / zoométrica e determinado 5 índices zoométricos.  De acordo com as tabelas de frequência das variáveis qualitativas, observou-se que a maioria dos suínos apresentaram semelhanças aos padrões morfológicos observados nas raças brasileiras Moura, Piau e Canastra.   Para os dados das variáveis zoométricas e os índices zoométricos foram aplicados a análise estatística descritiva e a de variância. Verificou-se grande variabilidade morfológica dos suínos crioulos estudados, sendo os maiores valores dos coeficientes de variação observados para comprimento e largura da garupa, peso vivo e comprimento de focinho.  Através das médias obtidas os suínos foram classificados como elipométricos, mesocefálicos, longilíneos, concavilíneos. Foram observadas diferenças significativas entre Faxinal para largura de garupa, comprimento do corpo, focinho e garupa, altura da garupa e distância interorbital, e dos índices cefálico, facial e pélvico.   As diferenças significativas entre sexo foram observadas para altura da cernelha, comprimento do focinho, perímetro da canela e distância interorbital. Verificou-se interação significativa de Faxinal*sexo para algumas variáveis zoométricas.  Para as medidas corporais as correlações foram altas e significativas, sendo o perímetro torácico, o perímetro abdominal e o comprimento do corpo as que melhor se correlacionaram com o peso vivo. Já as medidas cranianas (comprimento do focinho, orelha e cabeça e a distância interorbital) foram de moderadas a baixas. Para inferir a estrutura populacional foi aplicado um modelo estatístico baseado em uma abordagem bayesiana de acordo com o software Structure Harvester. Foi possível identificar três agrupamentos fenotípicos, corroborando com os resultados das variáveis qualitativas.  Estudos de caracterização genética deverão ser realizados nestas populações para que sirvam de base na definição de ações estratégicas para programas de conservação e uso sustentável desses recursos genéticos

Current status of MEDSCOPE CS-Tools

Presentación realizada en: 13º Mediterranean Climate Outlook Forum (MedCOF) celebrado de forma online entre el 15 de octubre y el 26 de noviembre de 2019