Joint statement for the ECOSOC side event on “Innovation Systems for Family Farming”

CGIAR, FAO, GFAR and IFAD, by convening this side event on “Innovation Systems for Family Farming” during the High-Level Segment of the ECOSOC Substantive Session 2013, wish to draw the attention of the ECOSOC members to the crucial importance of innovation in family farming and of agricultural innovation systems

Catalogue of touristic products responsible with biodiversity in Central America and Dominican Republic

[Español] Se presentan algunas de las ofertas turísticas de la República Dominicana y Honduras que muestran una especial atención a la protección y al respecto hacia la biodiversidad. Los productos fueron desarrollados en el marco del proyecto «Negocios y Diversidad Biológica en Centroamérica y República Dominicana: Contribución del Sector Turístico a la Restauración y Protección de la Biodiversidad» de la Unión Europea, la Agencia de Cooperación Internacional Alemana de (GIZ), entre otros socios. Global Nature Fund quiere asegurarse de que estas ofertas sean solicitadas por los y las turistas europeos y de que el mayor número posible de ellas, regresen de sus vacaciones, llevándose consigo impresiones sobre la naturaleza del país además de sus recuerdos de sol y playa. Los tours proporcionan a los y las turistas experiencias inolvidables en la naturaleza y promueven la sensibilización de los huéspedes sobre este tema. Los hoteles han llevado a cabo un análisis de sus impactos sobre la biodiversidad y están aplicando medidas concretas para proteger la biodiversidad. Todas las ofertas cumplen con los requisitos mínimos para la preservación de la biodiversidad y, por lo tanto, constituyen una oferta sólida incluso para los y las visitantes más exigentes.[English] This document presents tourist offers in the Dominican Republic and Honduras which have a special relation to biological diversity. These offers were developed within the framework of the project, Business and Biological Diversity in Central America and the Dominican Republic: Contribution of the Tourism Sector to the Restoration and Protection of Biological Diversity of the European Union, the German Society for Economic Cooperation GIZ and other partners. The Global Nature Fund promotes these offers to ensure that European tourists may take home some information about nature and people from their countries of destination, in addition to their memories of beach and sun. The tours offered will lead tourists in the destination countries to very special experiences in nature and will promote the sensitization of the guests to this topic. The hotels introduced here, have carried out a Biodiversity Check and are implementing concrete measures to promote biological diversity. Here, too, special experiences are guaranteed! All offers fulfil important requirements for the preservation of biological diversity and thus form a credible offer even for discerning visitors

Listado de productores de agricultura orgánica de la República Dominicana

La publicación de este directorio tiene como objetivo apoyar a las empresas turísticas de la República Dominicana -hoteles y restaurantes - para que ofrezcan productos agrícolas más sostenibles y amigables con la biodiversidad. También quiere ayudar a los intermediarios del sector turístico a identificar a los productores y productoras locales, para que puedan ampliar su oferta y prepararse para una creciente demanda del mercado hacia productos orgánicos. Este listado fue elaborado en colaboración con el Ministerio de Agricultura y el Departamento de Agricultura Orgánica, quienes facilitaron la información de fondo, así como los contactos de los productores orgánicos de la República Dominicana. 55 agricultores confirmaron su interés en ser incluidos en este catálogo

Optimizing Investments in Georgia’s HIV Response

Georgia has a concentrated but growing HIV epidemic. Over the past decade, HIV prevalence has increased among all population groups, particularly among men who have sex with men (MSM). If current conditions (behaviors and service coverage) are sustained up to 2030, the epidemic is expected to stabilize among female sex workers (FSWs). At the same time, HIV prevalence among people who inject drugs (PWID) and the clients of female sex workers (FSW) may increase, but at a slower rate than in the past. MSM account for the largest proportion of new infections and experience the highest prevalence levels of HIV (13 percent in 2012). However, prevention programs that specifically target MSM currently account for approximately only 3 percent of HIV spending. The HIV epidemic in the general population is expected to increase due largely to the increasing HIV prevalence among MSM and existing prevalence among PWID. The HIV epidemic among PWID in Georgia has stabilized due to significant and prolonged efforts to target this population. Testing key populations and their sexual partners is the most cost-effective strategy to identify those who require antiretroviral therapy (ART). Testing key populations and their sexual partners is the most cost-effective strategy to identify those who require antiretroviral therapy (ART). Opportunities exist to further optimize investments. Improvements in technical efficiency may provide additional gains.The health and economic burden of HIV in Georgia is growing. In the long term, the model predicts that HIV resource needs will increase with rising incidence and prevalence. However, the analysis estimates that optimizing current allocations by increasing spending on ART provision while sustaining investment in key populations could save approximately 224,635 dollars annually. The results also show that optimizing the allocation of current spending would lower annual spending commitments for newly infected PLHIV by approximately 15 percent. Current annual spending will not be enough to achieve National HIV Strategic Plan and international targets

Rethinking health sector procurement as developmental linkages in East Africa

Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012–15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa

Prices and availability of locally produced and imported medicines in Ethiopia and Tanzania

Background: To assess the effect of policies supporting local medicine production to improve access to medicines. Methods: We adapted the WHO/HAI instruments measuring medicines availability and prices to differentiate local from imported products, then pilot tested in Ethiopia and Tanzania. In each outlet, prices were recorded for all products in stock for medicines on a country-specific list. Government procurement prices were also collected. Prices were compared to an international reference and expressed as median price ratios (MPR). Results: The Ethiopian government paid more for local products (median MPR = 1.20) than for imports (median MPR = 0.84). Eight of nine medicines procured as both local and imported products were cheaper when imported. Availability was better for local products compared to imports, in the public (48% vs. 19%, respectively) and private (54% vs. 35%, respectively) sectors. Patient prices were lower for imports in the public sector (median MPR = 1.18[imported] vs. 1.44[local]) and higher in the private sector (median MPR = 5.42[imported] vs. 1.85[local]). In the public sector, patients paid 17% and 53% more than the government procurement price for local and imported products, respectively. The Tanzanian government paid less for local products (median MPR = 0.69) than imports (median MPR = 1.34). In the public sector, availability of local and imported products was 21% and 32% respectively, with patients paying slightly more for local products (median MPR = 1.35[imported] vs. 1.44[local]). In the private sector, local products were less available (21%) than imports (70%) but prices were similar (median MPR = 2.29[imported] vs. 2.27[local]). In the public sector, patients paid 135% and 65% more than the government procurement price for local and imported products, respectively. Conclusions: Our results show how local production can affect availability and prices, and how it can be influenced by preferential purchasing and mark-ups in the public sector. Governments need to evaluate the impact of local production policies, and adjust policies to protect patients from paying more for local products.Scopu

The utilisation of health research in policy-making: Concepts, examples and methods of assessment

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies

Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks

Introduction: Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods: We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion: The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions: Current indicator frameworks cannot adequately assess the social outcomes of HIV interventions. This limits knowledge about social drivers and inhibits the institutionalization of social approaches within the HIV/AIDS response. We conclude that indicator frameworks should expand to offer a more comprehensive range of social indicators for monitoring and evaluation and to include indicators of organizational capacity to tackle social drivers. While such expansion poses challenges for standardization and coordination, we argue that the complexity of interventions producing social outcomes necessitates capacity for flexibility and local tailoring in monitoring and evaluation

An assessment of the malaria-related knowledge and practices of Tanzania's drug retailers: exploring the impact of drug store accreditation.

BACKGROUND: Since 2003 Tanzania has upgraded its approximately 7000 drug stores to Accredited Drug Dispensing Outlets (ADDOs), involving dispenser training, introduction of record keeping and enhanced regulation. Prior to accreditation, drug stores could officially stock over-the-counter medicines only, though many stocked prescription-only antimalarials. ADDOs are permitted to stock 49 prescription-only medicines, including artemisinin combination therapies and one form of quinine injectable. Oral artemisinin monotherapies and other injectables were not permitted at any time. By late 2011 conversion was complete in 14 of 21 regions. We explored variation in malaria-related knowledge and practices of drug retailers in ADDO and non-ADDO regions. METHODS: Data were collected as part of the Independent Evaluation of the Affordable Medicines Facility - malaria (AMFm), involving a nationally representative survey of antimalarial retailers in October-December 2011. We randomly selected 49 wards and interviewed all drug stores stocking antimalarials. We compare ADDO and non-ADDO regions, excluding the largest city, Dar es Salaam, due to the unique characteristics of its market. RESULTS: Interviews were conducted in 133 drug stores in ADDO regions and 119 in non-ADDO regions. Staff qualifications were very similar in both areas. There was no significant difference in the availability of the first line antimalarial (68.9% in ADDO regions and 65.2% in non-ADDO regions); both areas had over 98% availability of non-artemisinin therapies and below 3.0% of artemisinin monotherapies. Staff in ADDO regions had better knowledge of the first line antimalarial than non-ADDO regions (99.5% and 91.5%, p = 0.001). There was weak evidence of a lower price and higher market share of the first line antimalarial in ADDO regions. Drug stores in ADDO regions were more likely to stock ADDO-certified injectables than those in non-ADDO regions (23.0% and 3.9%, p = 0.005). CONCLUSIONS: ADDO conversion is frequently cited as a model for improving retail sector drug provision. Drug stores in ADDO regions performed better on some indicators, possibly indicating some small benefits from ADDO conversion, but also weaknesses in ADDO regulation and high staff turnover. More evidence is needed on the value-added and value for money of the ADDO roll out to inform retail policy in Tanzania and elsewhere