South-South Collaboration Research Articles

Forest Carbon Monitoring and Reporting for REDD+: What Future for Africa?

A climate change mitigation mechanism for emissions reduction from reduced deforestation and forest degradation, plus forest conservation, sustainable management of forest, and enhancement of carbon stocks (REDD+), has received an international political support in the climate change negotiations. The mechanism will require, among others, an unprecedented technical capacity for monitoring, reporting and verification of carbon emissions from the forest sector. A functional monitoring, reporting and verification requires inventories of forest area, carbon stock and changes, both for the construction of forest reference emissions level and compiling the report on the actual emissions, which are essentially lacking in developing countries, particularly in Africa. The purpose of this essay is to contribute to a better understanding of the state and prospects of forest monitoring and reporting in the context of REDD+ in Africa. We argue that monitoring and reporting capacities in Africa fall short of the stringent requirements of the methodological guidance for monitoring, reporting and verification for REDD+, and this may weaken the prospects for successfully implementing REDD+ in the continent. We presented the challenges and prospects in the national forest inventory, remote sensing and reporting infrastructures. A North-South, South-South collaboration as well as governments own investments in monitoring, reporting and verification system could help Africa leapfrog in monitoring and reporting. These could be delivered through negotiations for the transfer of technology, technical capacities, and experiences that exist among developed countries that traditionally compile forest carbon reports in the context of the Kyoto protocol.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa.

A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d'Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative's model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d'Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South-South collaboration has been central to the initiative's accomplishments: Guinea's clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up.

International research collaboration: the key to combating pulmonary vascular diseases in the developing world.

International research collaboration: the key to combating pulmonary vascular diseases in the developing world.

Palliative care education and training workshop for caregivers of patients with cancer in Ghana

organizations and several new grants and awards. Each of these linkages have contributed to improving and increasing training, and locally relevant research. Drawing on PRIME-K’s experience, there are four key lessons from these MEPI-enabled partnerships: establishing strong foundations can lead to new collaborations; infusing existing partnerships with resources enables innovative and sustainable solutions to long term problems; connecting new partners with different strengths can expand their scope of impact; and providing opportunities to search for local solutions within Kenya and SubSahran Africa strengthens South-South collaborations. Going Forward: Partnerships have been integral to meeting the goals of MEPI in Kenya by enhancing quality of trainings and expanding medical education and research opportunities. The lessons learned from PRIME-K’s partnerships are important to future large scale collaborative interventions addressing health system needs in low resource settings. Funding: This program was supported by NIH grants 1R24 TW008889 Abstract #: 01ETC034

Transforming health professions' education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative.

BackgroundAfrican medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.MethodsSemi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These interviews were recorded, transcribed and coded to identify common themes.ResultsAll of the consortia have prioritized efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilize limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalization of collaborative activities.ConclusionsThe consortia described in this paper demonstrate a paradigm shift in the relationship between medical schools in four African countries. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding that was leveraged to form in-country partnerships has created a culture of collaboration, overriding the history of competition. The positive impact on the quality and efficiency of health workforce training suggests that future funding for global health education should prioritize such south-south collaborations.

Making Agricultural Innovation Systems (AIS) Work for Development in Tropical Countries

Agricultural innovation in low-income tropical countries contributes to a more effective and sustainable use of natural resources and reduces hunger and poverty through economic development in rural areas. Yet, despite numerous recent public and private initiatives to develop capacities for agricultural innovation, such initiatives are often not well aligned with national efforts to revive existing Agricultural Innovation Systems (AIS). In an effort to improve coordination and responsiveness of Capacity Development (CD) initiatives, the G20 Agriculture Ministers requested the Food and Agriculture Organization of the United Nations (FAO) to lead the development of a Tropical Agricultural Platform (TAP), which is designed to improve coherence and coordination of CD for agricultural innovation in the tropics. This paper presents a summary of the results obtained from three regional needs assessments undertaken by TAP and its partners. The surveyed tropical regions were Southeast Asia, Sub-Saharan Africa and Central America. The findings reveal a mismatch in all three regions between the external supply of primarily individual CD and the actual demand for institutional CD. The misalignment might be addressed by strengthening south-south and triangular collaboration and by improving the institutional capacities that would render national AIS more demand-oriented and responsive to the needs of smallholders in domestic agriculture.

A Culture of Solidarity?

In this article, based on interviews, ethnographic data, and documentary evidence, I examine the case of a Bolivian-Iranian hospital in the context of south-south scientific and economic collaboration. This hospital provides a lens through which we can understand the tensions between local and global processes. Medicine, in particular, has become a site where such alignments are made visible and tangible: the term ‘biogeopolitics’ helps to describe this process. I use the hospital as a way to illustrate what theory from the south might look like ethnographically, and conclude with a discussion of the contradictions and promises of theory from the south within south-south collaborations.

Cooperation in Health: Mapping Collaborative Networks on the Web

ObjectiveTo map and investigate the relationships established on the web between leading health-research institutions around the world.MethodsSample selection was based on the World Health Organization (WHO) Collaborating Centres (CCs). Data on the 768 active CCs in 89 countries were retrieved from the WHO's database. The final sample consisted of 190 institutions devoted to health sciences in 42 countries. Data on each institution's website were retrieved using webometric techniques (interlinking), and an asymmetric matrix was generated for social network analysis.FindingsThe results showed that American and European institutions, such as the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the National Institute of Health and Medical Research (INSERM), are the most highly connected on the web and have a higher capacity to attract hyperlinks. The Karolinska Institute (KI-SE) in Sweden is well placed as an articulation point between several integrants of the network and the component's core but lacks general recognition on the web by hyperlinks. Regarding the north-south divide, Mexico and Brazil appear to be key southern players on the web. The results showed that the hyperlinks exchanged between northern and southern countries present an abysmal gap: 99.49% of the hyperlinks provided by the North are directed toward the North itself, in contrast to 0.51% that are directed toward the South. Regarding the South, its institutions are more connected to its northern partners, with 98.46% of its hyperlinks directed toward the North, and mainly toward the United States, compared with 1.54% toward southern neighbors.ConclusionIt is advisable to strengthen integration policies on the web and to increase web networking through hyperlink exchange. In this way, the web could actually reflect international cooperation in health and help to legitimize and enhance the visibility of the many existing south-south collaboration networks.

Research Priorities for Medical Toxicology in Low and Middle Income Countries

In the editorial by Dr. Reza Afshari “What is the best research for low income countries” (1), some important issues have been raised, highly relevant to developing countries. In most developing countries including India, emergency medicine is not well established and clinical toxicology is even further a low priority in view of both research and clinical management. The number of poison control and treatment centers is few and if they exist, they are mainly in metro cities. Moreover, we are faced with lack of required resources for such research. Dr. Afshari’s suggestion about the need for epidemiological studies should be regarded as highly important (1). These studies should be prospective and community-based rather than hospital or poison centre based. Unless we know the pattern of poisonings, it will not be possible to formulate the guidelines for treatment and research as poisonings vary in different countries and in different areas of a country (2). Depending on pattern, the treatment and research guidelines can be devised and scarce resources can be allocated. The acute poisonings in developing countries are very often due to toxic chemicals. This is because there is a lack of control on availability of chemicals as laws do exist but implementation is lacking (2). Although specific antidote is available for majority of them, mortality remains high because treatment is often delayed due to non-availability of proper centres and lack of antidotes. Therefore, it is necessary to train health care professionals and to provide better awareness in general public regarding risks of poisonings. Furthermore, not only resources are lacking, western textbooks or literature is only available for management of poisonings and local guidelines are limited. In high income countries, both knowledge and money are available but poisoned patients are in limited number while in developing countries it is other way round. We must pay the most careful attention to the role of gastric lavage which due to legal reasons in some countries such as India, it is mandatory (3). It is also crucial to carefully investigate the venomous snakes where more species are required to be identified and antivenoms should be developed. There is a great need to develop low-priced diagnostic kits and cheaper analytic methods for poisons. More access to information in developing world and South-South collaboration is a highly welcomed idea. We need a standardized format to record, uniform protocols to manage poisonings and low cost healthcare technologies such as self-inflating bag in saving patients with respiratory arrest following snakebite or OPC poisoning or where short term ventilation is required.

Knowledge, Not Funding is the Most Important Research Resource

In the last issue of the Asia Pacific Journal of Medical Toxicology, Dr. Reza Afshari raised the question of what are the best scientific areas of focus of toxicology for “low income countries and how such research might be achieved (1). South-south collaboration, in which developing countries share resources, was one of the proposed solutions. Rather than limit discussion to “low income” countries, the issue of research agenda might be better framed within the perspective of “developed” and “developing” countries. Two of the largest Asia Pacific Association of Medical Toxicology member countries, Iran and India lay almost within visual distance of the United Arab Emirates. Despite its wealth, the United Arab Emirates has a general lack of high-quality medical research, and toxicology research is virtually non-existent. In contrast, Iran and India, with far less economic strength, have a vast network of highly trained and expert clinicians in medical toxicology and most other medical specialties. This is helpful to consider, and to understand that high income does not equal quality in research. Outstanding medical research, applicable to both developing and developed countries, may be conducted in resource-poor settings. An example of collaborative research that comes to mind is the World Health Organization (WHO) Pediatric Hydrocarbon Study Group clinical decision rule for young children with possible hydrocarbon aspiration (2). The results of this research, that was supported by the WHO, conducted in Egypt, and led by an American toxicologist, have clinical applicability and utility in developing and developed countries. Conducting this study in a developed country, such as the USA, would have been extraordinarily difficult or impossible. In addition to South-South collaborations, tapping research expertise of other countries, developed or developing, is another key factor for facilitating relevant and translatable research in countries that historically lack such. Finding mutually relevant research questions that are shared by developed and developing countries can also avail research opportunities. Lastly, developing a culture of research led by clinicians and persons with expertise in biostatistics and epidemiology, who may be based in clinical sciences or academia, is an important key to having a sustained productive research effort in any country. This letter can be easily summarized: “The most important resource for quality research is not funding, it is knowledge”.

COMPARE Forum: The idea of North-South and South-South collaboration

The idea of having a Compare Forum focusing on the above title was first discussed with one of the Editors of Compare during a PhD defence in Oslo in 2011. The PhD dissertation itself was linked to...

Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

BackgroundAlthough information systems (IS) have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries.MethodsAdapting a context-mechanism-outcome case study design, we analyze our team’s own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological) characteristics and mechanisms affecting outcomes at micro, meso and macro levels.ResultsTechnological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings) and North–south imbalances (common to all international interactions). Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration.ConclusionsThere is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve outcomes of interest to all parties. Issues specific to IS development, including technological support and software licensing models, can also affect outcome and sustainability – especially in the North–south context. Careful attention must be given to power relations between the various stakeholders at macro, meso and micro levels when implementing IS. North–South-South collaborations should be encouraged. Governance as well as technological issues are crucial determinants of IS application, and ultimately whether the system is seen as a tool, weapon, or white elephant by the various involved parties."You may call me a fool, But was there a rule The weapon should be turned into a tool? And what do we see? The first tool I step on Turned into a weapon. - Robert Frost""White (albino) elephants were regarded as holy in ancient times in Thailand and other Asian countries. Keeping a white elephant was a very expensive undertaking, since the owner had to provide the elephant with special food and provide access for people who wanted to worship it. If a Thai King became dissatisfied with a subordinate, he would give him a white elephant. The gift would, in most cases, ruin the recipient. - The Phrase Finder"

Capacity building in environmental and occupational health in Sri Lanka

Although environmental and occupational health (EOH) research and services in Sri Lanka have a long history, policies related to EOH are outdated. We review the International Training and Research in Environmental and Occupational Health (ITREOH) program in Sri Lanka that commenced in 2006 as a collaboration between the University of Alabama at Birmingham and the Faculty of Medicine of the University of Kelaniya, Sri Lanka. The program has trained over 20 scientists in conducting EOH research. New pioneering research in EOH was initiated. The program was instrumental in furthering the training and research in EOH by initiating a MPH degree program, the first in the country. The program has established North-South, South-South and in-country collaborations between institutions and scientists, increasing the visibility of EOH in the future.

Modern Biotechnology—Potential Contribution and Challenges for Sustainable Food Production in Sub-Saharan Africa

Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs), can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or through strong policies. This leaves the determination of research and development priorities in the hands of international funding agencies. Whereas funding from the United States is generally supportive of GM technology, the opposite is true of funding from European sources. African countries are thus pulled in two different directions. One alternative to this dilemma might be for countries in the sub-Saharan Africa region to develop stronger South-South collaborations, but these need to be supported with adequate funding. African governments as well as external funding agencies are urged to consider the important role that biotechnology, including GM technology, can play in contributing to sustainable development in Africa, and to provide adequate support to the development of capacity to research, develop and commercialize GMOs in the region.

Science-based health innovation in Tanzania: bednets and a base for invention

BackgroundTanzania is East Africa’s largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania’s status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania’s science-based health innovation system, and highlights areas which can be strengthened.MethodsQualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007.Results and discussionTanzania has a rich but complex S&T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year.ConclusionsTo have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing, formulation and standardization, and related areas important to moving from basic research to applications. The private sector can be encouraged to innovate through improved access to financing, and incentives for R&D. The diaspora community represents an untapped source for partnerships and access to other developing world markets and technology. The government may wish to set up mechanisms to encourage south-south collaborations, and to bring the public and private sector together around specific projects to help realize the country’s innovation potential.

Science-based health innovation in Uganda: creative strategies for applying research to development

BackgroundUganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed.MethodsQualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives.ResultsUganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation.ConclusionsScience-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the development of STI in Uganda, demonstrated through personal initiatives of the President and the government’s willingness to invest heavily for the long term in support of STI through the Millennium Science Initiative. Activities to support technology transfer and private-public collaboration have been put in motion; these need to be monitored, coordinated, and learned from. In the private sector, there are examples of incremental innovation to address neglected diseases driven by entrepreneurial individuals and South-South collaboration. Lessons can be learned from their experience that will help support Ugandan health innovation.

Erratum: South-South entrepreneurial collaboration in health biotech

Nat. Biotechnol. 28, 407–416 (2010); published online 7 May 2010; corrected after print 7 December 2010 In the version of this article initially published, a line was missing connecting India and China in Figure 3. The error has been corrected in the HTML and PDF versions of the article.

Widening equity and retaining efficiency: Considerations from the IBSA southern coalface

Access to higher education is a key challenge of the 21st century state. The link between higher education and personal and socio-economic development has intensified the need for ensuring that greater numbers of citizens have expanded access to and have been provided with quality higher education. The article seeks to explore how initiatives for increased access to higher education are experienced in India, Brazil and South Africa. As signatories to the IBSA declaration in the spirit of South–South cooperation, the three countries have publicly declared their commitment to enhance equity by, for example, widening access to higher education. We review the way in which the three countries have implemented key equity initiatives and draw lessons from their practice. Notions of ‘effectiveness’ and ‘efficiency’ are used to understand the extent to which each of the individual systems is responsive to the equity agenda. We find that while there have been notable attempts to implement the equity agenda in the quest for making their systems more ‘socially effective’. This is countervailed by a more pervasive ‘efficiency’ doctrine, underpinned by a market-driven economic paradigm. It is concluded that the innovative practices in each of the countries suggest important strides in the equity agenda but also that much still remains to be done. While the article represents a starting point for the much-vaunted South-South collaboration, tentative findings suggest that a more deliberately articulated policy framework characterized by greater inclusion of those previously excluded is necessary in each of the countries if significant and sustainable development is to be achieved.

South-South entrepreneurial collaboration in health biotech

A survey of entrepreneurial collaborations among health biotech firms in developing countries reveals a surprisingly high level of collaboration but a lack of emphasis on new or improved health biotech products and processes.

Brazil’s 'Biofuels Diplomacy' in Africa: A Model for South-South Collaboration?

Brazil has been and continues to be one of the global leaders in biofuel production. Half of Brazil’s sugar-cane feedstock production goes towards ethanol production. This paper focuses on the evolving diplomatic relations between Brazil and various African countries to promote the development of biofuels technology as an alternative and renewable source of energy. A cursory search on the Internet for 'Brazil Africa biofuels' provides an immense amount of information on the biofuel-related activities taking place across the Atlantic. Brazil’s foreign relations with Africa have been getting stronger, especially since Brazilian Labor Party President Lula da Silva came into power in 2003 In addition to the biofuels market, Brazil has also been active in organizing capacity building workshops about biofuels amongst African regional political organizations at the highest level. Africa leaders think that the South-South partnership such as the one Brazil is pursuing in Africa is a way of maximizing African interests. Like China, Brazil is being used by African governments to counter the traditional colonial and neo-colonial economic domination by Europe of its key infrastructures. The diversification of development partners is something that is desirable. However, African policy makers must be prepared to cope with unintended consequences of the rush to embrace a new technology. To minimize those adverse side effects, biofuels strategies should incorporate adequate environmental and societal impact assessments including protection of farmers from being removed from their land and the protection of ecosystems from loss of biodiversity in the face of putting land into biofuels production.