Knowledge in development aid and healthcare: a comparative analysis

Effective delivery in the fields of development aid and healthcare relies on knowledge and its communication. Institutions, practitioners and the end-users are examined in these two fields as key actors in the production and communication of knowledge. Similarities and differences, and strengths and weaknesses of their approaches to knowledge are compared. Knowledge is shown to be an intrinsically political process in which institutions and practitioners play a critical role in its communication. Establishing a common background is essential to communicate knowledge effectively. The World Bank’s notion that knowledge is a simple commodity should be challenged

Knowledge for development? : reflections from consultants and advisors in Bolivia

Knowledge has been a central part of development discourses in the last 40 years. Development organisations have been concerned with its production and dissemination across developing countries with the purpose of eradicating poverty. This thesis focuses on the processes of knowledge production and dissemination for development in the work of consultants and advisors in two organisations in Bolivia. In particular, it examines and analyses the perceptions and reflections of consultants, advisors, and, to some extent, beneficiaries/clients; how they are framed by institutional and organisational discourses; and the apparent limits to reflexivity within the development assistance field. The thesis uses qualitative methods and draws on interview and documentary data collected in the east and central part of Bolivia. It examines the activities of consultants and advisors in two organisations: a Bolivian based development consultancy company Centro de Estudios y Proyectos (CEP) and a Dutch development agency (SNV). Using, as a conceptual framework, the notions of knowledge/power and discourse developed by Michel Foucault and aspects of Jürgen Habermas’s theory of communicative action, the thesis finds that knowledge engagements are heavily framed by dominant development discourses although they are potentially more productive when the different actors share meanings about the world. This, however, is not usually the case, and the engagements are marked by fundamental differences between the actors. The thesis also finds that consultants, advisors and beneficiaries/clients reflect, learn and hence produce rich knowledge individually but this is not openly shared with their organisational hierarchies because it can potentially challenge the development discourses that frame what the organisations do. The thesis concludes that, in order to overcome constraints imposed by dominant development discourses, it is necessary to build shared meanings between the actors where these do not exist, while recognising that their differences are also the source of new knowledge

The Malawian co-operative movement: insights for resilience

Heavy government interference, lack or leadership and low levels of skills are some the factors that have for decades weakened and in some cases caused the failure of co-operatives in Africa. However, in the recent past, African co-operatives have experienced a remarkable renaissance. We examine whether these co-operatives are resilient forms of organisation, and if so, what are the key factors that are conducive to resilience. We examine the Malawian co-operative movement from which very little is known. We explore four of the biggest co-operative Unions in the country. Our analysis is guided by a framework compounded by five key factors conducive to co-operative resilience. Our results suggest that women’s inclusion, business income diversification, collective skills, and strategic partnerships with external agents are factors conducive to resilience. We also conclude that these factors need to be grounded on reflexive behaviour amongst leaders and cooperative members

Innovation priorities for UK bioenergy: technological expectations within path dependence

UK bioenergy innovation pathways have been locked into current energy infrastructure through technological expectations, especially the reciprocal requirements of state bodies and industry. Over the past decade UK policy has given bioenergy an increasingly important role for decarbonising the energy system; technoscientific innovation has been expected to expand the range of biomass that can be sustainably converted to energy. Needing industry investment to fulfil its policy aims, the UK government has faced requirements to provide long-term support measures. Innovation priorities have been shaped by policy arrangements closely involving industry with state bodies. Their expectations for future benefits have mobilised resources for bioenergy innovation mainly as input-substitutes within current energy infrastructural patterns; novel path creation lies within a path dependence. Although technical progress has encountered diffi culties and long delays, expectations for economic and environmental benefits have built support, while confl ating national benefi ts with private-sector interests. Through such expectations, innovation priorities wishfully enact some desired futures from among those which had been advocated in policy documents

Global vaccine safety blueprint: the landscape analysis (survey of regulators)

The perspectives of regulatory licensing authorities were assessed in countries that produce, procure, and both produce and procure vaccines. A web-based survey was developed to explore regulators’ knowledge, attitudes and practices concerning their national vaccine safety system. Additionally, their opinions about what would be needed to ensure future capacity and capabilities for a global vaccine safety system were probed, along with models of collaboration for regulatory authorities and the private sector that address public safety issues

H3Africa and the African life sciences ecosystem: building sustainable innovation

Interest in genomics research in African populations is experiencing exponential growth. This enthusiasm stems in part from the recognition that the genomic diversity of African populations is a window of opportunity for innovations in postgenomics medicine, ecology, and evolutionary biology. The recently launched H3Africa initiative, for example, captures the energy and momentum of this interest. This interdisciplinary socio-technical analysis highlights the challenges that have beset previous genomics research activities in Africa, and looking ahead, suggests constructive ways H3Africa and similar large scale science efforts could usefully chart a new era of genomics and life sciences research in Africa that is locally productive and globally competitive. As independent African scholars and social scientists, we propose that any serious global omics science effort, including H3Africa, aiming to build genomics research capacity and capability in Africa, needs to fund the establishment of biobanks and the genomic analyses platforms within Africa. Equally they need to prioritize community engagement and bioinformatics capability an d the training of African scientists on these platform s. Historically , the financial, technological, and skills imbalance between Africa and developed countries has created exploitative frameworks of collaboration where African researchers have become merely facilitators of Western funded and conceived research agendas involving offshore expatriation of samples. Not surprisingly, very little funding was allocated to infrastructure and human capital development in the past. Moving forward, capacity building should materialize throughout the entire knowledge co-production trajectory: idea generation (e.g., brainstorming workshops for innovative hypotheses development by African scientists), data generation (e.g., genome sequencing), an d high-through put data analysis an d contextualization . Additionally, building skills for political science scholarship that questions the unchecked assumptions of the innovation performers be they funders, scientists, and social scientists, would enable collective innovation that is truly sustainable, ethical, and robust

Twenty-first century vaccinomics innovation systems: capacity building in the global South and the role of Product Development Partnerships (PDPs)

The availability of sequence information from publicly available complete genomes and data intensive sciences, together with next-generation sequencing technologies offer substantial promise for innovation in vaccinology and global public health in the beginning of the 21st century. This article presents an innovation analysis for the nascent field of vaccinomics by describing one of the major challenges in this endeavor: the need for capacities in “vaccinomics innovation systems” to support the developing countries involved in the creation and testing of new vaccines. In particular, we discuss the need for understanding how institutional frameworks can enhance capacities as intrinsic to a systems approach to health technology development. We focus our attention on the global South, meaning the technically less advanced and developing nations in Africa, Asia, and Latin America. This focus is timely and appropriate because the challenge for innovation in postgenomics medicine is markedly much greater in these regions where basic infrastructures are often underresourced and new or the anticipated institutional relationships can be fragile. Importantly, we examine the role of Product Development Partnerships (PDPs) as a 21st century organizational innovation that contributes to strengthening fragile institutions and capacity building. For vaccinomics innovation systems to stand the test of time in a context of global public health, local communities, knowledge, and cultures need to be collectively taken into account at all stages in programs for vaccinomics-guided vaccine development and delivery in the global South where the public health needs for rational vaccine development are urgent

An appeal to the global health community for a tripartite innovation: an ‘‘Essential Diagnostics List,’’ ‘‘Health in All Policies,’’ and ‘‘See-Through 21st Century Science and Ethics"

Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an ‘‘Essential Diagnostics List.’’ Additionally, we explain the ways in which adopting a vision for ‘‘Health in All Policies’’ could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, ‘‘see through’’ taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20th century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public–private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London