Innovative spending in health: what should money be spent on to make global health innovations more effective in developing countries?

Background Delivering effective healthcare to people in developing countries is a perennial challenge, hence the unending search for, and implementation of creative or innovative ways of spending money and other resources that are available for health. Objectives This paper presents and discusses some innovations in health-spending from South Africa and Zimbabwe. The presentation will also ask a number of inter-related theory, policy and practice questions, among others, how such innovations get embedded in health systems, how they can be/are cushioned from internal and external shocks, whether there are any back-up mechanisms, and who is liable when such innovations fail? Methods This paper is based on an on-going three-year project and is drawing on evidence emerging from interviews with key stakeholders located at various points within and around health systems in South Africa and Zimbabwe, observations and document reviews. Result From creation of policy and practice space for medical facilities run separately or collectively by public, private and civil society stakeholders; generation, consolidation and use of disease surveillance data at district, provincial and national levels; to empowering rural communities in shaping health delivery options, there is abundant evidence in the two countries of innovative efforts to do more with less. Conclusion This paper confirms the need for agile and innovative approaches to ensuring that the health needs of marginalised populations are met. In addition to reflecting on the utility and effectiveness of some approaches already in use, the paper also brings to the fore some hitherto unreported innovations in health spending in South Africa and Zimbabwe

Socio-economic impact of GMOs on African consumers

The debate surrounding genetically modified organisms (GMOs) remains an important one for consumers and consumer organisations the world over, and is characterized by strong views for, and against the technology. The debate is of particular interest to Africa, where the countries are yet to embrace the new technology and where food security challenges tend to amplify the dilemma faced by decision-makers. Consumers, represented through the work of consumer organizations, are a very active and vocal constituency in this debate, as it unfolds in Africa.The objective of this paper is to inform the reader on how the consumer movement has contributed to the GMO debate in Africa in the past few years and to highlight the potential socio-economic impacts on African consumers. Firstly, the paper summarises the consumer movement and its work with the Joint Advocacy Project on GMOs; and secondly looks at the potential social, ethical and cultural impacts. Economic and environmental impacts are also discussed. The Socio-Economic Impact Assessment tool is highlighted as one of several tools to guide bio-safety decision-making policy. A few recommendations and policy implications are given at the end of the paper

Societal beliefs, scientific technologies and HIV/AIDS in Africa: facing the challenge of integrating local communities in Kenya and Zimbabwe

Of the many challenges that Africa is facing, the HIV/AIDS pandemic ranks amongst the most threatening. This article draws attention to local community settings and focuses on village set-ups, probing into the nature of the approaches to combat the pandemic. Given the issues surrounding the spread of the virus, including, for example, stigmatisation/discrimination, sexuality, modes of transmission, cultural beliefs and practices, trauma, health-care services, aid organisations as well as governance issues, we raise questions that cut across the societal belief terrains on the one hand, and scientific/technological advancements on the other. The article explores questions relating to: the extent to which cultural practices are part of the unbreakable barriers in the effort to combat the pandemic; the extent to which cultural contexts of local communities are understood or misunderstood; how focus on participatory approaches and not diagnostic measures can help; and how best a sustainable integration of scientific and social aspects can be achieved in the search for solutions. To address these and other related questions, the argument will be informed by examples from Kenya and Zimbabwe, looking at how particular 'scientific' and 'local' communities have strived to integrate their efforts to combat HIV/AIDS