975 research outputs found

    Cardiovascular, renal and liver events associated with human immunodeficiency virus type 1 infection and antiretroviral therapy

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    The first 15 years of the human immunodeficiency virus type 1 epidemic was characterized by patients progressing to clinical acquired immunodeficiency syndrome and death. The availability of potent antiretrovirals led to the recognition of unique adverse events associated with select drugs. More recent data suggest that end-organ damage may be associated with ongoing viremia. Further understanding of the potential role different drugs and the virus itself has on various organs can enhance the clinician's ability to manage patients in the clinic

    Overcoming barriers to trust in agricultural biotechnology projects: a case study of Bt cowpea in Nigeria.

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    Background: Nigeria, Africa’s most populous country, has been the world’s largest cowpea importer since 2004. The country is currently in the early phases of confined field trials for two genetically modified crops: Bacillus thuringiensis (Bt) cowpea and nutritionally enhanced cassava (“BioCassava Plus”). Using the bio-safety guidelines process as a backdrop, we evaluate the role of trust in the operation of the Cowpea Productivity Improvement Project, which is an international agricultural biotechnology public-private partnership (PPP) aimed at providing pest-resistant cowpea varieties to Nigerian farmers. Methods: We reviewed the published literature and collected data through direct observations and semistructured, face-to-face interviews. Data were analyzed based on emergent themes to create a comprehensive narrative on how trust is understood and built among the partners and with the community. Results: Our findings highlight the importance of respecting mandates and eliminating conflicts of interest; holding community engagement initiatives early on; having on-going internal discussion and planning; and serving a locally-defined need. These four lessons could prove helpful to other agricultural biotechnology initiatives in which partners may face similar trust-related challenges. Conclusions: Overcoming challenges to building trust requires concerted effort throughout all stages of project implementation. Currently, plans are being made to backcross the cowpea strain into a local variety in Nigeria. The development and adoption of the Bt cowpea seed hinges on the adoption of a National Biosafety Law in Nigeria. For countries that have decided to adopt biotech crops, the Nigerian cowpea experiment can be used as a model for other West African nations, and is actually applied as such in Ghana and Burkina Faso, interested in developing a Bt cowpea

    Trait stacking for biotech crops: an essential consideration for agbiotech development projects for building trust.

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    The development of agricultural biotechnology humanitarian projects for food security in the last five years has been rapid in developing countries and is expected to rise sharply over the coming years. An extremely critical issue in these projects involves building trust with the community and farmers they aim to serve. For the first time, our social audit engagement with one of these initiatives, the Water Efficient Maize for Africa project, has revealed that a critical but unrecognized component of building trust with farmers involves publicly addressing the concerns surrounding stacked trait crops. As a result, we argue in this article that it is critical to actively anticipate the concerns that could be raised over trait stacking by incorporating them into global access plans of such initiatives early in order to facilitate adoption, provide the best value to the small-scale farmer and gain trust with the community whom these projects aim to serve. This perspective, based on an actual international social audit, should be of value to scientists, funders and partners involved in biotech development initiatives for food securit

    "Harnessing genomics to improve health in India" – an executive course to support genomics policy

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    BACKGROUND: The benefits of scientific medicine have eluded millions in developing countries and the genomics revolution threatens to increase health inequities between North and South. India, as a developing yet also industrialized country, is uniquely positioned to pioneer science policy innovations to narrow the genomics divide. Recognizing this, the Indian Council of Medical Research and the University of Toronto Joint Centre for Bioethics conducted a Genomics Policy Executive Course in January 2003 in Kerala, India. The course provided a forum for stakeholders to discuss the relevance of genomics for health in India. This article presents the course findings and recommendations formulated by the participants for genomics policy in India. METHODS: The course goals were to familiarize participants with the implications of genomics for health in India; analyze and debate policy and ethical issues; and develop a multi-sectoral opinion leaders' network to share perspectives. To achieve these goals, the course brought together representatives of academic research centres, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. RESULTS: Seven main recommendations emerged: increase funding for healthcare research with appropriate emphasis on genomics; leverage India's assets such as traditional knowledge and genomic diversity in consultation with knowledge-holders; prioritize strategic entry points for India; improve industry-academic interface with appropriate incentives to improve public health and the nation's wealth; develop independent, accountable, transparent regulatory systems to ensure that ethical, legal and social issues are addressed for a single entry, smart and effective system; engage the public and ensure broad-based input into policy setting; ensure equitable access of poor to genomics products and services; deliver knowledge, products and services for public health. A key outcome of the course was the internet-based opinion leaders' network – the Indian Genome Policy Forum – a multi-stakeholder forum to foster further discussion on policy. CONCLUSION: We expect that the process that has led to this network will serve as a model to establish similar Science and Technology policy networks on regional levels and eventually on a global level

    Building effective partnerships: the role of trust in the Virus Resistant Cassava for Africa project

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    Background: Virus Resistant Cassava for Africa (VIRCA) is an agricultural biotechnology public-private partnership (PPP) comprising the Donald Danforth Plant Sciences Center (DDPSC), National Agricultural Research Organization (NARO) of Uganda and Kenya Agricultural Research Institute (KARI). The project seeks to develop virus-resistant cassava for farmers in Kenya and Uganda. Yet, there is much public skepticism about the use of genetically modified (GM) crops and private sector involvement in Africa. This case study sought to understand the role of trust in the VIRCA partnership. Methods: We conducted semi-structured, face-to-face interviews to obtain stakeholders’ views on the challenges to, and practices for, building trust in the VIRCA partnership. Interviewee responses, together with relevant documents and articles, were analyzed to generate descriptions of how trust is operationalized in this evolving agbiotech PPP. Data were analyzed based on recurring and emergent themes from the interviewee responses. Results: Various factors undermine and build trust in agbiotech PPPs. Individual and institutional enthusiasm and detailed collaborative agreements stipulating partner roles and responsibilities are likely to enhance trust among partners. On the other hand, negative perceptions propagated by international partners about the capacities of African institutions and scientists, coupled with slow regulatory processes in Africa, are likely to be impediments to trust building. Conclusions: Based on the findings of this study, we have derived four key lessons. First, differences in the capacity of the partner institutions and individuals should be respected. Second, technical and infrastructural capacity support for regulatory processes in Africa must be built. Third, detailed agreements and open and transparent partner practices during project implementation are necessary to dispel perceptions of inequality among partners. Fourth, institutional and individual commitment to succeed is important in initiation of the project. These lessons can be used by other agbiotech PPPs as a guide for building trust among partners and with the community

    Strengthening the Role of Genomics in Global Health

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    How genomics and related health biotechnologies can improve the health of the poor and contribute towards meeting the Millenium Development Goal

    Strategies for building trust with farmers: the case of Bt maize in South Africa

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    <p>Abstract</p> <p>Background</p> <p>In 1999, South Africa became the first African country to approve commercial production of subsistence genetically modified (GM) maize. The introduction of GM crop technology is often met with skepticism by stakeholders including farmers. The involvement of the private sector in this process can further breed mistrust or misperceptions. To examine these issues more closely, the objective of this case study was to understand the role of trust in the public-private partnership (PPP) arrangement involved in the development of <it>Bacillus thuringiensis</it> (Bt) maize in South Africa.</p> <p>Methods</p> <p>We conducted semi-structured, face-to-face interviews to obtain stakeholders’ understanding of <it>trust</it> in general as well as in the context of agricultural biotechnology (agbiotech) PPPs. A thematic analysis of the interview transcripts, documents, reports and research articles was conducted to generate insights into the challenges to, and practices for, building trust among the partners and with the public.</p> <p>Results</p> <p>The findings of this study are organized into four main lessons on trust building. First, as the end users of GM technology, farmers must be engaged from the start of the project through field demonstrations and educational activities. Second, an effective technology (i.e., the seed) is key to the success of an agbiotech PPP. Third, open communication and full disclosure between private sector companies and government regulatory bodies will build trust and facilitate the regulatory processes. Fourth, enforcing good agronomic practices, including appropriate management of the refuge areas, will serve the interests of both the farmers and the seed companies.</p> <p>Conclusions</p> <p>Trust has proven to be a critical factor determining the success of the Bt maize project in South Africa. Distrust of the private sector and of GM technology were cited as major barriers to building trust. The trust-building practices described in this case study have often served to overcome these barriers; however, erosion of trust was also present. The success of the project has been, and will continue to be, dependent upon the concerted effort of the farmers, government, and private sector players in the establishment and maintenance of trust.</p

    The value of trust in biotech crop development: a case study of Bt cotton in Burkina Faso

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    Background: Agricultural biotechnology public-private partnerships (PPPs) have been recognized as having great potential in improving agricultural productivity and increasing food production in sub-Saharan Africa. However, there is much public skepticism about the use of GM (genetically modified) crops and suspicion about private sector involvement in agbiotech projects. This case study sought to understand the role of trust in the Bacillus thuringiensis (Bt) cotton in Burkina Faso project by exploring practices and challenges associated with trust-building, and determining what makes these practices effective from the perspective of multiple stakeholders. Methods: We conducted semi-structured, face-to-face interviews to obtain stakeholders’ understanding of trust in general as well as in the context of agbiotech PPPs. Relevant documents and articles were analyzed to generate descriptions of how trust was operationalized in this evolving agbiotech PPP. Data was analyzed based on emergent themes to create a comprehensive narrative on how trust is understood and built among the partners and with the community. Results: We derived four key lessons from our findings. First, strong collaboration between research, industry and farmers greatly contributes to both the success of, and fostering of trust in, the partnership. Second, this case study also revealed the important, though often unrecognized, role of researchers as players in the communication strategy of the project. Third, effective and comprehensive communication takes into account issues such as illiteracy and diversity. Fourth, follow-up at the field level and the need for a multifaceted communications strategy is important for helping push the project forward. Conclusions: Burkina Faso’s well-established and effective cotton selling system laid the foundation for the implementation of the Bt cotton project – particularly, the strong dialogue and the receptivity to collaboration. Interviewees reported that establishing and maintaining trust among partners, researchers and the community in Burkina Faso greatly contributed to the success of the PPP. By addressing challenges to building trust and engaging in trust-building practices early on, improvements in the effectiveness of agbiotech PPPs are likely
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