sub-Saharan Research Articles

Temporal Dynamics of Scout Release-Behavior of Termitophagous Ponerine ant, Megaponera Analis

AbstractMegaponera analis is an obligate termitophagous species endemic to sub-Saharan Africa. The species forages by sending out scouts to search for termites. Once termites are located, the scouts return to the nest and recruit nest mates. Scouts face unpredictable environmental conditions, including sudden flooding, temperature changes, high winds and predation by natural enemies. We observed 519 scouting trips from 18 different colonies over three years to determine how long it takes for the colony to replace a scout that has likely died while on scouting duty or is lost due to environmental perturbations. Study areas were at Maremani, Musina, Masebe and D’nyala Nature Reserves in the Limpopo Province of South Africa. We introduced definitions of scouting turnover, scouting trip, and scouting session. Scouting turnover is the time it takes a successive scout to leave the nest for a trip, whereas a scouting trip is the journey a scout takes from the nest in search of food. Since M. analis shows bimodal foraging behavior, the morning observations were recorded as the first scouting session, while the subsequent session, which starts in the afternoon, was recorded as the second scouting session. The mean scouting turnover for all 519 trips was 9.36 ± 0.64 (SD) minutes. When turnover was divided into sessions, the first scouting session lasted a mean of 7.77 ± 12.17 (SD) minutes, while the second had 10.34 ± 18.32 (SD) minutes. The minimum turnover was zero minutes, and the maximum was 124 minutes.

Prevalence of chronic kidney disease among young people living with HIV in Sub Saharan Africa: A systematic review and meta-analysis.

Globally, the prevalence of chronic kidney disease (CKD) is increasing among young people living with HIV (YPLHIV), with inconsistent estimates. Aggregated data on the prevalence of CKD are needed in sub-Saharan Africa (SSA) to inform strategies for early diagnosis and management. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of CKD among YPLHIV in SSA. We searched Medline/PubMed, EMBASE, African Index Medicus, and African Journals Online for articles reporting the prevalence of CKD among YPLHIV in SSA using predefined search strategies up to 15th January 2024. The reference lists of identified articles were checked for additional eligible studies. The eligibility criteria were studies among YPLHIV aged 10-24 years reporting CKD prevalence defined by either glomerular filtration rate (GFR), albumin-to-creatinine ratio (ACR) or proteinuria. We used a narrative synthesis to report differences between the included studies. The DerSimonian-Laird random effects model was used to pool the CKD prevalence, and heterogeneity was assessed using the Cochrane Q-test and I-squared values. We assessed the risk of bias in each article using the Joanna Briggs Institute checklist and publication bias in a funnel plot and Egger's test. Of 802 retrieved articles, 15 fulfilled the eligibility criteria and were included in the meta-analysis. Of these, 12 (80%) were cross-sectional studies that used estimated GFR to diagnose CKD. Only one study followed the standard definition of CKD. The pooled CKD prevalence from 15 studies was 12% (95% CI 6.0-19.5%), ranging from 0.8% to 53.1% according to the definition used, with a high degree of heterogeneity (I2 = 97.7%, p<0.001). The included studies were of moderate quality, with no evidence of publication bias. Sensitivity analysis showed that the findings were robust to the methodological and analytic approach. CKD prevalence among YPLHIV is moderately high and highly heterogeneous across SSA. The standard definition of CKD should be used to enable estimation of CKD prevalence in different studies and settings. HIV programs enrolling YPLHIV should routinely screen for CKD to ensure early diagnosis and management. PROSPERO registration number: CRD42022347588.

Developing digital twins of urban low-income communities in Sub-Saharan Africa: a case study in Ghana, West Africa

Low-income urban and rural communities in Sub-Saharan Africa are habitats for more than 556 million profoundly poor people, and the United Nations and the African Union are pessimistic that sustainable development goals will be met. The number of people falling into poverty is increasing, and policy initiatives to reduce poverty have been confounded by various economic, political, social, structural, and environmental issues. Despite a wealth of natural and human assets, there is no systematic approach to sustainable development for poverty alleviation in Sub-Saharan Africa. This case study of an urban community in Ghana, West Africa, investigates the potential role of digital twins in a systematic approach to sustainable development for poverty alleviation. Aerial and community surveys of the built environment and social and economic surveys of businesses and households were compiled to inform a virtual representation of the study area. A small e-commerce business intervention was introduced, and data was recorded for studies on the impact of the intervention. A 3D interactive view, extensive video, and fixed images provided a comprehensive view of the built environment. A limited view of the social and economic environment was obtained from a small population sample. It was observed that online transactions increased in the businesses receiving the e-commerce intervention, demonstrating a willingness of businesses and their customers to engage in e-commerce when incentives are provided. A single successful community-centric initiative has little value unless it can be generalized across the broader society. This limited case study focused on developing and testing virtual and physical constructs to enhance a deeper understanding of the community, community engagement, and pathways to sustainability. The scale of the intervention was too small to conclude generalizability. Future research will focus on improving the data collection processes, fidelity of virtual representations, visualization methods, and methodologies for constructing viable virtual interventions.

Critical Perspectives on the Adoption of Circular Design Strategies in the Built Environment for Sustainable Development in Sub-Saharan Africa

Adopting circular design strategies (CDS) in building development presents a transformative approach toward sustainability by promoting resource efficiency and reducing environmental impacts. This paper examined the current landscape of CDS adoption, focusing on barriers, enablers, benefits, and critical success factors within the built environment (BE) in Sub-Saharan Africa. Drawing on a comprehensive review of global contexts literature, the study identifies and categorizes 185 factors, subsequently pruning them to 121 pertinent to the design stage. Barriers such as low awareness, regulatory gaps, and economic constraints are explored alongside enablers like leadership commitment, technological innovation, and supportive policies. The paper underscores the pivotal role of these factors in shaping sustainable building practices, emphasizing the need for tailored strategies to overcome local socio-cultural, economic, and technological challenges in the BE of Sub-Saharan Africa. This research contributes a nuanced understanding of how CDS can be effectively integrated into the BE, offering practical implications for policymakers, industry stakeholders, and researchers striving to embrace sustainable practices.

Risk of transfusion-associated malaria in sub-Saharan Africa: The case of Mali.

Malaria is a health threat in sub-Saharan Africa, where Plasmodium is not tested in blood bags. Our objective was to determine the prevalence of plasmodial carriage in blood bags and the associated factors, and the involvement of these bags in the occurrence of malaria in recipients. From 1st April to 30th November, 2020, we conducted a prospective cross-sectional study of 348 blood bags stored at 4°C in Bamako. Using SPSS 21.0 software, statistical analyses were performed using a binary logistic regression model with a significance threshold of p < 0.05 and the odds ratio (OR) framed by its 95% confidence interval (CI). During this period, 348 blood bags were transfused into 108/152 hospitalised patients, generating a transfusion frequency of 71.1%, with a prevalence of plasmodial carriage of 22%. Among the 54 initially malaria-negative recipients, all 20 (37%) who received malaria-positive blood bags and slept under long-acting insecticide-treated nets (LLINs) developed malaria. We recorded 33.3% deaths. Donor age ≤ 34 years (p = 0.011; OR = 2.55[CI.95% = 1.25-5.23]), replacement donation (p = 0.000; OR = 0.04[CI.95% = 0.0-0.19]) and not regular use of LLINs by donors (p = 0.048; OR = 0.53[CI.95% = 0.29-1]) were factors associated with plasmodial carriage of blood bags. CD4 count<200 cells/mm3 (p = 0.002; OR = 0.2[CI.95% = 0.10-0.52]), severe anaemia (p = 0.034; OR = 0.26[CI.95% = 0.10-0.90]) and decompensated anaemia (p = 0.034; OR = 3.88[CI.95% = 1.11-13.56]) were factors independently associated with recipient death. The prevalence of plasmodial carriage among blood donors is increasing in Mali. Transfusion malaria is a reality to be feared, with the risk increasing with the level of malaria endemicity of the blood donor.

Climate and political effects on agriculture: Empirical evidence from SSA

AbstractThe most of Sub‐Saharan African (SSA) countries have been affected by climate change and food insecurity problems due to the reduction of production and productivity of cereal crops in the continent. The purpose of this research was to examine the short‐run and long‐run effects of climate change on agricultural productivity in 24 selected SSA countries. In the study, a systematic Generalized Method of Moments (GMM) Model was used with recent data from 24 SSA countries from 2001 to 2020. The panel regression result revealed that temperature and precipitation showed positive significant effects whereas carbon dioxide emission had negatively influenced the cereal crop productivity in the region. Specifically, the empirical result indicates that a one percent increase in precipitation increases cereal crop productivity by 0.27%. The empirical result of the GMM model revealed that political stability, temperature, GDP per capita, trade openness, carbon dioxide emission, fertilizer consumption, and precipitation have both short‐run and long‐run effects, while precipitation has only a short‐run effect on agricultural productivity in the study area. A key implication of this work is the realization of the lagging effects of climate change in determining cereal crop production and productivity. This study was unable to include all SSA countries because the excluded countries did not have sufficient data on the selected variables in the study. Hence, adopting high‐temperature and drought‐resistant types of enhanced cereal crops is advised to combat the negative effects of climate change in the study area.

Viral rebound on antiretroviral therapy in France according to region of origin, sex, and HIV acquisition group. Results from the French Hospital Database on HIV (ANRS CO4-FHDH).

Assessing the potential increased risk of viral rebound (VR) in migrants requires adequate control for sex and acquisition risk groups. People living with HIV1, enrolled in the ANRS CO4-French Hospital Database on HIV, who achieved virological suppression with antiretroviral therapy (ART) initiated between 2006 and 2016 were included. We first compared the risk of VR, with loss to follow-up and death considered as competing events, across origin among the HIV acquisition groups, then across acquisition groups among the different origins, and finally across modality of a variable combining sex, acquisition group, and origin. Models were adjusted for clinical and biological confounding factors. We included 21 571 French natives (FRA), 10 148 migrants from sub-Saharan Africa (SSA), 1137 migrants from the non-French West Indies (NFWI), and 4205 other migrants (OTHER). The 5-year probability of VR was 19% (95% confidence interval [CI] 19-20) overall, 15% in FRA, 21% in OTHER, 26% in SSA, and 34% in NFWI (p < 0.0001). It was 14% in men who have sex with men (MSM), 23% in heterosexual men, and 23% in women (p < 0.0001). After adjustment, all acquisition groups had a higher risk of VR than MSM from FRA, with men and women from NFWI having the highest risk (adjusted hazard ratio [aHR] 2.46; 95% CI 2.12-2.86 and aHR 2.59; 95% CI 2.20-3.04, respectively). Within each acquisition group, all groups of origin had a higher risk of VR than FRA. Within each region of origin, except the NFWI, heterosexual men had a higher risk of VR than MSM. After accounting for sex and acquisition group, migration, especially from NFWI, remains prognostic of VR.

Violence Against Women and Girls in Zimbabwe: A Review of a Decade of the Empirical Literature.

Violence against women and girls (VAWG) is a complex social problem affecting many women globally. In Zimbabwe, intimate partner violence (IPV) and child marriages remain persistent public health problems with detrimental effects on the health and well-being of women and girls. Statistics show that Zimbabwe has one of the highest rates of IPV and child marriage in sub-Saharan Africa. Given this background, this paper systematically reviewed published research on VAWG in Zimbabwe from 2012 to 2022 to identify research gaps. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we systematically searched for literature across five electronic databases: Web of Science, Medline, Psych-Info via EBSCO-Host, and Google Scholar. Our initial search yielded 261 articles, of which only 45 met our inclusion criteria. We summarized these studies using thematic analysis and performed a quality assessment using the Mixed Methods Appraisal Tool. The findings revealed several gaps, including a limited focus on relational and perpetrator perspectives, insufficient attention to other forms of VAWG such as non-partner sexual violence, rape, and trafficking, and a lack of studies on marginalized groups such as people with disabilities, sex workers, and same-sex couples. In addition, there were no longitudinal studies examining trends and dynamics of VAWG over extended periods or comparing different geographical regions. Few studies also focused on the evaluation of interventions. Although significant progress has been made in addressing VAWG, this review underscores the need for more research to fill these gaps for effective and evidence-based policymaking and response strategies.

Does Current Account Balance Affect Economic Growth? Evidence from Sub-Saharan Africa

This study aimed to provide an econometric analysis of the impact of current account balances on economic growth in various subregions of Africa. It utilized the cross-sectional autoregressive distributive lags (CS-ARDL) technique and analyzed data from 1994 to 2022. The result showed that inflation has had an adverse effect on the Gross Domestic Product (GDP) in three specific regions. While the short-run influence of inflation on GDP may not be statistically significant, its long-term impact is notably negative. Foreign Direct Investment (FDI) has a negative effect on GDP in the short run; however, this effect is not statistically significant across the different economies. Over time, Foreign Direct Investment (FDI) has a negligible effect on the GDP in North Africa, but it has a negative and statistically significant influence in Central Africa. These findings emphasize the different regional dynamics in Africa and illustrate the intricate interplay between current account balances and economic growth. In conclusion this study affirmed the necessity for targeted economic strategies to combat inflation and utilize FDI for long-term growth.

Periodontal diseases in Africa.

Periodontal diseases, a group of complex conditions marked by an excessive immune response and periodontal tissue destruction, are a global health concern. Since 1990, the incidence of these diseases has doubled, with Western sub-Saharan Africa experiencing the highest burden. Accurate diagnosis and case identification are crucial for understanding the etiology, features of disease, research, treatment and prevention. Modern perspectives on periodontal disease classification are based on commonality among those affected. However, current literature is often plagued by methodological inconsistencies and focused on disease mechanisms in European populations. Health inequalities in low- and middle-income countries (LMICs) are exacerbated by these challenges, with sub-Saharan Africa, and Nigeria specifically, facing unique difficulties such as clinical personnel shortages and limited research infrastructure. This review explored disparities in periodontal disease research, care and outcomes in African populations. We highlighted these disparities and identified the factors contributing to inequities in periodontal health outcomes. We further demonstrated the critical need for inclusive and equitable healthcare and research practices tailored to the unique challenges faced by diverse populations and regions with limited resources. Addressing these disparities is essential for ensuring that advancements in healthcare are accessible to all, thereby improving global oral health and general health.

The Effect of Education on Economic Growth in Sub-Saharan African Countries: Do Institutions Matter?

This paper investigates the moderating role of institutional quality on the relationship between education and economic growth in Sub-Saharan Africa (SSA). The study applies the panel ARDL model to data from 18 SSA countries spanning 2000–2020 for its main analysis, along with a battery of diagnostics test to ensure the robustness of the results. The results reveal that the long-term effect of education on economic growth is statistically insignificant, attributing this finding to high rates of education exclusion and low-quality education. Remarkably, the research emphasizes the moderating role of institutional quality, showing the positive effects of education on economic growth when countries demonstrate robust corruption control and political stability. The study contributes to the existing literature by highlighting specific institutional factors influencing the effectiveness of education in driving economic growth, emphasizing the need for a strong institutional framework alongside educational efforts for sustainable development. The findings highlight that robust institutions form a crucial infrastructure that enhances the effectiveness of education in driving productivity and fostering economic growth.

Analysis of Iron Status in Sickle Cell Disease Patients During Steady State at the Center de Recherche et de Lutte contre la Drépanocytose (CRLD) Bamako.

Sickle cell disease (SCD) is a prevalent inherited blood disorder arising from a single point mutation that results in substitution of valine with glutamic acid in the Beta hemoglobin chain, making red blood cells assume a banana shape under low oxygen state. It is most prevalent in sub-Saharan Africa, affecting approximately 2% of the population in Mali. This study aimed to evaluate the iron status and associated hematological parameters in SCD patients at steady state in an environment with a high prevalence of iron deficiency. A cross-sectional study was conducted at the Center de Recherche et de Lutte contre la Drépanocytose (CRLD) in Bamako, Mali, involving 757 SCD patients aged 10 to 29 years. Iron deficiency was defined as serum ferritin < 20 ng/mL, while iron overload was associated with serum ferritin > 500 ng/mL. The study population consisted of 171 (22.6%) hemolytic phenotypes (SS and Sβ0) and 586 (77.4%) viscous phenotypes (SC and Sβ+). Iron deficiency was found in 19 SCD patients (2.5%), with a higher prevalence in the SC phenotype (68.4%). All iron-deficient subjects exhibited microcytosis (MCV < 80 fL) and hypochromia (MCH < 26 pg). Hemoglobin levels < 12 g/dL were observed only in homozygous SCD patients. Low reticulocyte counts were noted in iron-deficient subjects with SC and Sβ+ phenotypes, but not in iron-deficient SS subjects. Serum C-reactive protein (CRP) was normal (< 10 mg/L) in all iron-deficient subjects, excluding iron deficiency due to chronic inflammation. Iron deficiency was observed among 2.5% of the study population, with a predominant occurrence among those with SC phenotype. All iron deficient subjects had microcytosis and hypochromia. Hemoglobin levels below 12 g/dL were only found in homozygous SCD patients. Additionally, low reticulocyte counts were noted in iron deficient patients with SC and Sβ+ phenotypes, though not in those with the SS phenotype. These findings contribute to the understanding of iron status in SCD patients in an African context and highlights the importance of monitoring iron levels in these population to prevent complications associated with iron deficiency or overload.

Time Trends in the Burden of Environmental Heat and Cold Exposure Among Children and Adolescents

Environmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally. To report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019. This repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024. EHCE in children and adolescents from January 1990 to December 2019. The primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly. From 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age. In this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.

Forecasting Africa’s fertility decline by female education groups

While female education has long been recognized as a key driver of fertility decline during the process of demographic transition and most population projection models consider it implicitly or explicitly in their forecasts of overall fertility, there still is need for a method to forecast education-specific fertility trends directly. Here we propose a method for projecting education-specific fertility declines for cohorts of women in Sub-Saharan Africa based on all available demographic and health surveys data for African countries (including 1.03Mio cases). We study at different levels of aggregation (sample clusters, strata, and national) the associations between ideal family size and completed cohort fertility for education groups, on the one hand, and the average level of education in those units, on the other. The consistently very strong empirical associations suggest a plausible narrative by which a higher prevalence of educated women in a spatial unit influences the fertility levels of women in all specific education categories. Empirical associations between education-specific cohort fertility trends at the national level and newly available quality-adjusted human capital data for these cohorts are then operationalized to produce education-specific population projections as they are needed for-among other uses-the shared socioeconomic pathways scenarios that are widely used in the climate change research community. Sensitivity analyses including out-of-sample projections support the validity of the proposed method which is then applied to 37 African countries.

Investigating the housing and transportation burden in a Ghanaian city

ABSTRACT Although there is a strong relationship between housing and transportation (H+T) spending, traditional housing affordability estimates from sub-Saharan Africa exclude transportation costs. Also, the H+T literature has few case studies from small cities and developing countries. This dearth of research makes it difficult to understand the housing burden and provide workable solutions. This paper measures H+T affordability in Koforidua, Ghana, based on rental and transportation costs. A household survey comprising 600 renting households was conducted and analyzed using group comparisons and Ordinary Least Square regressions. The results showed that H+T consumes approximately 56% of household income. This is a huge household burden considering the high unemployment rates in developing countries. Household income and size are significantly associated with H+T spending. Interestingly, smaller households have a marginal propensity to spend on H+T than larger households due to dependency ratio and housing choices. We recommend transport and housing subsidies, and affordable housing to ameliorate the H+T burden. Other policy recommendations and actions have been discussed to guide policymakers.

Adaptation of the G-NORM (Gender norms scale) in Uganda: An examination of how gender norms are associated with reproductive health decision-making.

Restrictive gender norms exacerbate health inequalities all over the world. More specifically, they prevent women from seeking preventive health services, constrain women's economic empowerment, and are associated with reproductive health decision making. Gender norms, a subset of social norms, are dynamic and change over time. However, we lack data on how they are changing and how these changes affect health outcomes because current measures do not adequately capture the complex concept of gender norms. We originally developed and validated a gender norms scale, the G-NORM, in India. In this study, using cross-sectional data, we adapted the G-NORM from Southeast Asia (India and Nepal) to sub-Saharan Africa (Uganda) in four steps: 1. Formulation of new scale items (via qualitative analysis) 2. Cognitive Interviewing 3. Questionnaire Administration (n = 2422 women of reproductive age) and 4. Psychometric analysis (Confirmatory Factor Analysis). Like the original scale, descriptive norms and injunctive norms comprised two unique sub scales with high Cronbach's alphas (.80 & .92). Average scores differed depending on the type of norm suggesting that some gender norms are changing faster than others. Specifically, more equitable injunctive norms were associated with lower odds of partner-dominated contraceptive decision making but descriptive norms were not. Gender norms serve as a multi-faceted determinant of health and wellbeing and require measurement tools which account for their conceptual complexity. Validating the G-NORM in Uganda expands measurement options for researchers in the sub-Saharan African region working to change norms to reduce health inequalities or to understand the gender normative context before beginning a study.

A Systematic Review of the Trends, Effects, and Deterrents of Collective Marketing Participation Among Smallholder Farmers in Sub-Saharan Africa

Smallholder farmers’ participation in collective marketing is essential for the growth of smallholder farming businesses and the sustainability of their livelihoods. Collective marketing provides smallholder farmers with increased opportunities to scale up market access and participation. Given the challenges that the majority of smallholder farmers still face regarding market access and participation, this review was conducted to explore the trends and effects of collective marketing participation, as well as the barriers to participation among smallholder farmers in Sub-Saharan Africa (SSA). The results show that collective marketing has a high potential to give smallholder farmers access to both formal and informal market participation, as well as recognition by public and private support structures. To improve collective marketing participation among SSA countries, more focused and content-specific strategies and interventions are needed to address the complex socio-economic and structural barriers that limit smallholder farmers’ ability to fully benefit from collective marketing initiatives across the region.

Understanding Natural Immunity against Malaria: Mechanisms, Implications, and Future Directions

Malaria remains a significant global health challenge, particularly in sub-Saharan Africa, where it contributes to high morbidity and mortality rates. Natural immunity to malaria, acquired through repeated exposure to Plasmodium parasites, provides partial protection against severe disease but does not prevent infection. This review explores the mechanisms underlying natural immunity, including the roles of innate and adaptive immune responses, and the impact of factors such as age, genetics, and repeated exposure. It also examines the implications of natural immunity for malaria control strategies, particularly in endemic regions where partial immunity helps reduce the disease burden. The review highlights recent advances in immunological research, including the identification of immune markers and biomarkers that correlate with malaria resistance. Additionally, it discusses how natural immunity can inform the development of more effective vaccines and therapies. The review concludes by identifying key gaps in current research and suggesting future directions, including enhancing natural immunity through vaccines and immunotherapies, and the importance of global collaboration in advancing malaria control efforts. Keywords: Malaria, Natural immunity, Innate immunity, Adaptive immunity, Plasmodium parasites, Vaccine development.

Prevention and Treatment of HIV/AIDS: The Gates Foundation’s Role in Reducing Incidence and Extending Lives

HIV/AIDS remains a critical global health challenge, with profound social and economic impacts exacerbating existing inequalities and straining healthcare systems. Since its inception, the Bill &amp; Melinda Gates Foundation has been at the forefront of combating this epidemic through its comprehensive and strategic approach. This review examines the foundation’s role in reducing HIV incidence and extending lives by focusing on prevention and treatment strategies. The foundation’s key initiatives include advancing scientific research and innovation, expanding access to antiretroviral therapy (ART), supporting pre-exposure prophylaxis (PrEP), and integrating HIV care with other health services. The foundation also emphasizes policy advocacy and global leadership, collaborating with international organizations to shape health strategies and reduce stigma. The review highlights the impact of these efforts in high-burden regions, particularly sub-Saharan Africa, and explores emerging challenges such as drug resistance and health inequities. Future directions include embracing innovative solutions, expanding access to advanced prevention methods, and ensuring the sustainability of HIV/AIDS programs in resource-limited settings. The Gates Foundation’s multifaceted approach serves as a model for global health initiatives, demonstrating how strategic investment and collaboration can drive significant progress in the fight against HIV/AIDS. Keywords: HIV/AIDS, prevention strategies, treatment programs, antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP).

The price of mistrust: the impact of a medical ethics scandal on scientific capacity in Sub-Saharan Africa

ABSTRACT This study investigates how negative news alleging ethical misconduct in clinical trials can hinder scientific development in emerging economies. We examine a 2000 exposé surrounding a clinical trial conducted in Northern Nigeria, leading to decades of community mistrust in foreign pharmaceutical companies. By comparing scientific output of researchers in affected and less affected regions, we find a significant decline in publication growth, particularly for medical researchers. An exploration of the mechanisms suggests that eroded community support and participation in research and reduced international collaboration contributed to this slowdown. This study highlights the importance of the science-community relationship in fostering scientific development. Our findings imply that a ’social li- cense to operate’ grounded in community trust is essential for scientific progress, and that future research on the determinants of scientific capacity in developing countries should consider community attitudes and involvement.