Rationing Antiretroviral Therapy for HIV/AIDS in Africa: Efficiency, Equity, and Reality

Background: Rationing of access to antiretroviral therapy already exists in sub-Saharan Africa and will intensify as national treatment programs develop. The number of people who are medically eligible for therapy will far exceed the human, infrastructural, and financial resources available, making rationing of public treatment services inevitable. Methods: We identified 15 criteria by which antiretroviral therapy could be rationed in African countries and analyzed the resulting rationing systems across 5 domains: clinical effectiveness, implementation feasibility, cost, economic efficiency, and social equity. Findings: Rationing can be explicit or implicit. Access to treatment can be explicitly targeted to priority subpopulations such as mothers of newborns, skilled workers, students, or poor people. Explicit conditions can also be set that cause differential access, such as residence in a designated geographic area, co-payment, access to testing, or a demonstrated commitment to adhere to therapy. Implicit rationing on the basis of first-come, first-served or queuing will arise when no explicit system is enforced; implicit systems almost always allow a high degree of queue-jumping by the elite. There is a direct tradeoff between economic efficiency and social equity. Interpretation: Rationing is inevitable in most countries for some period of time. Without deliberate social policy decisions, implicit rationing systems that are neither efficient nor equitable will prevail. Governments that make deliberate choices, and then explain and defend those choices to their constituencies, are more likely to achieve a socially desirable outcome from the large investments now being made than are those that allow queuing and queue-jumping to dominate

Aid Allocation of the Emerging Central and Eastern European Donors

The paper examines the main characteristics of the (re)emerging foreign aid policies of the Visegrád countries (the Czech Republic, Hungary, Poland, Slovakia), concentrating on the allocation of their aid resources. We adopt an econometric approach, similar to the ones used in the literature for analyzing the aid allocation of the OECD DAC donors. Using this approach, we examine the various factors that influence aid allocation of the Visegrád countries, using data for the years between 2001 and 2008. Our most important conclusion is that the amount of aid a partner county gets from the four emerging donors is not influenced by the level of poverty or the previous performance (measured by the level of economic growth or the quality of institutions) of the recipients. The main determining factor seems to be geographic proximity, as countries in the Western-Balkans and the Post-Soviet region receive much more aid from the Visegrád countries than other recipients. Historical ties (pre-1989 development relations) and international obligations in the case of Afghanistan and Iraq are also found to be significant explanatory factors. This allocation is in line with the foreign political and economic interests of these new donors. While there are clear similarities between the four donors, the paper also identifies some individual country characteristics

Temperature and Field Dependence of the Energy Gap of MgB2/Pb planar junction

We have constructed MgB2/Pb planar junctions for both temperature and field dependence studies. Our results show that the small gap is a true bulk property of MgB2 superconductor, not due to surface effects. The temperature dependence of the energy gap manifests a nearly BCS-like behavior. Analysis of the effect of magnetic field on junctions suggests that the energy gap of MgB2 depends non-linearly on the magnetic field. Moreover, MgB2 has an upper critical field of 15 T, in agreement with some reported Hc2 from transport measurements.Comment: 5 pages, 5 figures. Submitted to Phys. Rev.

Intensive HST, RXTE and ASCA Monitoring of NGC 3516: Evidence Against Thermal Reprocessing

During 1998 April 13-16, NGC 3516 was monitored almost continuously with HST for 10.3 hr in the UV and 2.8 d in the optical, and simultaneous RXTE and ASCA monitoring covered the same period. The X-rays were strongly variable with the soft (0.5-2 keV) showing stronger variations (~65% peak-to-peak) than the hard (2-10 keV; ~50% peak-to-peak). The optical continuum showed much smaller but highly significant variations: a slow ~2.5% rise followed by a faster ~3.5% decline. The short UV observation did not show significant variability. The soft and hard X-ray light curves were strongly correlated with no significant lag. Likewise, the optical continuum bands (3590 and 5510 A) were also strongly correlated with no measurable lag above limits of <0.15 d. However no significant correlation or simple relationship could be found for the optical and X-ray light curves. These results appear difficult to reconcile with previous reports of correlations between X-ray and optical variations and of measurable lags within the optical band for some other Seyfert 1s. These results also present serious problems for "reprocessing" models in which the X-ray source heats a stratified accretion disk which then reemits in the optical/ultraviolet: the synchronous variations within the optical would suggest that the emitting region is <0.3 lt-d across, while the lack of correlation between X-ray and optical variations would indicate, in the context of this model, that any reprocessing region must be >1 lt-d in size. It may be possible to resolve this conflict by invoking anisotropic emission or special geometry, but the most natural explanation appears to be that the bulk of the optical luminosity is generated by some other mechanism than reprocessing.Comment: 23 pages including 6 figures, accepted for publication in Ap

Countering Communist and Nasserite Propaganda: the Foreign Office Information Research Department in the Middle East and Africa, 1954-1963

This thesis considers the role of the Information Research Department (IRD) in countering Arab nationalist and Communist propaganda directed at British interests in the Middle East and Africa between 1954 and 1963. It argues that the 1956 Suez Crisis and its fallout was the catalyst that drove a significant expansion of IRD's remit and responsibility. From 1956 the department – which up to this point had had a purely anti-Communist function – was given the responsibility of countering the increasing flow of Arab nationalist propaganda emerging from Egypt. The same year, the Communist powers mounted a renewed and concerted effort to culturally and ideologically penetrate Africa. IRD, who to this point had been excluded from directly operating in Africa, began counter-Communist work in the face of stiff Colonial Office resistance. Analysis of IRD in the Middle East has rarely considered events beyond the immediate aftermath of Suez. IRD's work in Africa is almost wholly unexplored. It is a central contention of this thesis that the two regions cannot be viewed in isolation post-Suez. Egypt's standing was buoyed by the propaganda capital of victory over Suez, and Nasser's position as the figurehead of Arab nationalism was assured. In seeking the removal of colonial influence from the Middle East and Africa, Arab propaganda – particularly the Voice of the Arabs programme of Cairo Radio – ties the regions together. Communist and African nationalist propagandists were drawn to Cairo in the wake of the Suez Crisis. The former, building relationships through aid, sought to leverage Cairo's expanding influence to their own advantage. The latter sought facilities and support for their own propaganda efforts. After Suez, IRD sought to manage Egyptian propaganda whilst avoiding direct confrontation, seeking to normalise relations. In Africa, the department sought to build an infrastructure for information work aimed at influencing future leaders, their efforts constrained by the timetable of British decolonisation. In both regions, through developing relationships with local agencies and the BBC, and from initiatives such as the Transmission 'X' news commentary service, IRD continued to address Arab nationalist and Communist propaganda with a flexibility and responsiveness not recognised in the current literature on IRD

How Intense Policy Demanders Shape Postreform Politics: Evidence from the Affordable Care Act

The implementation of the Affordable Care Act (ACA) has been a politically volatile process. The ACA\u27s institutional design and delayed feedback effects created a window of opportunity for its partisan opponents to launch challenges at both the federal and state level. Yet as recent research suggests, postreform politics depends on more than policy feedback alone; rather, it is shaped by the partisan and interest-group environment. We argue that “intense policy demanders” played an important role in defining the policy alternatives that comprised congressional Republicans\u27 efforts to repeal and replace the ACA. To test this argument, we drew on an original data set of bill introductions in the House of Representatives between 2011 and 2016. Our analysis suggests that business contributions and political ideology affected the likelihood that House Republicans would introduce measures repealing significant portions of the ACA. A secondary analysis shows that intense policy demanders also shaped the vote on House Republicans\u27 initial ACA replacement plan. These findings highlight the role intense policy demanders can play in shaping the postreform political agenda

The non-dipolar magnetic fields of accreting T Tauri stars

Models of magnetospheric accretion on to classical T Tauri stars often assume that stellar magnetic fields are simple dipoles. Recently published surface magnetograms of BP Tau and V2129 Oph have shown, however, that their fields are more complex. The magnetic field of V2129 Oph was found to be predominantly octupolar. For BP Tau the magnetic energy was shared mainly between the dipole and octupole field components, with the dipole component being almost four times as strong as that of V2129 Oph. From the published surface maps of the photospheric magnetic fields we extrapolate the coronal fields of both stars, and compare the resulting field structures with that of a dipole. We consider different models where the disc is truncated at, or well-within, the Keplerian corotation radius. We find that although the structure of the surface magnetic field is particularly complex for both stars, the geometry of the larger scale field, along which accretion is occurring, is somewhat simpler. However, the larger scale field is distorted close to the star by the stronger field regions, with the net effect being that the fractional open flux through the stellar surface is less than would be expected with a dipole magnetic field model. Finally, we estimate the disc truncation radius, assuming that this occurs where the magnetic torque from the stellar magnetosphere is comparable to the viscous torque in the disc.Comment: 14 pages, 8 figures. Figures are reduced resolutio

Paedophiles in the community: inter-agency conflict, news leaks and the local press

This article explores the leaking of confidential information about secret Home Office plans to house convicted paedophiles within a local community (albeit inside a prison). It argues that a politics of paedophilia has emerged in which inter-agency consensus on the issue of ‘what to do’ with high-profile sex offenders has broken down. Accordingly, the article situates newspaper ‘outing’ of paedophiles in the community in relation to vigilante journalism and leaked information from official agencies. The article then presents research findings from a case study of news events set in train following a whistle-blowing reaction by Prison Officers’ Association officials to Home Office plans. Drawing from a corpus of 10 interviews with journalists and key protagonists in the story, the article discusses both the dynamics of whistle blowing about paedophiles and also what happens after the whistle has blown

WALLABY Early Science - I. The NGC 7162 Galaxy Group

We present Widefield ASKAP L-band Legacy All-sky Blind Survey (WALLABY) early science results from the Australian Square Kilometre Array Pathfinder (ASKAP) observations of the NGC 7162 galaxy group. We use archival HIPASS and Australia Telescope Compact Array (ATCA) observations of this group to validate the new ASKAP data and the data reduction pipeline ASKAPsoft. We detect six galaxies in the neutral hydrogen (HI) 21-cm line, expanding the NGC 7162 group membership from four to seven galaxies. Two of the new detections are also the first HI detections of the dwarf galaxies, AM 2159-434 and GALEXASC J220338.65-431128.7, for which we have measured velocities of $cz=2558$ and $cz=2727$ km s$^{-1}$, respectively. We confirm that there is extended HI emission around NGC 7162 possibly due to past interactions in the group as indicated by the $40^{\circ}$ offset between the kinematic and morphological major axes for NGC 7162A, and its HI richness. Taking advantage of the increased resolution (factor of $\sim1.5$) of the ASKAP data over archival ATCA observations, we fit a tilted ring model and use envelope tracing to determine the galaxies' rotation curves. Using these we estimate the dynamical masses and find, as expected, high dark matter fractions of $f_{\mathrm{DM}}\sim0.81-0.95$ for all group members. The ASKAP data are publicly available.Comment: 20 pages, 11 figures, accepted for publication in MNRA

The environmental security debate and its significance for climate change

Policymakers, military strategists and academics all increasingly hail climate change as a security issue. This article revisits the (comparatively) long-standing “environmental security debate” and asks what lessons that earlier debate holds for the push towards making climate change a security issue. Two important claims are made. First, the emerging climate security debate is in many ways a re-run of the earlier dispute. It features many of the same proponents and many of the same disagreements. These disagreements concern, amongst other things, the nature of the threat, the referent object of security and the appropriate policy responses. Second, given its many different interpretations, from an environmentalist perspective, securitisation of the climate is not necessarily a positive development