COVID-19 economic vulnerability and resilience indexes: Global evidence.

This study complements the extant literature by constructing COVID-19 economic vulnerability and resilience indexes using a global sample of 150 countries categorised into four principal regions: Africa, Asia-Pacific and the Middle East, America, and Europe. Seven variables are used for the vulnerability index and nine for the resilience index. Both regions and sampled countries are classified in terms of the two proposed and computed indexes. The classification of countries is also provided in terms of four scenarios pertaining to vulnerability and resilience characteristics: low vulnerability-low resilience, high vulnerability-low resilience, high vulnerability-high resilience, and low vulnerability-high resilience to illustrate sensitive, severe, asymptomatic, and best cases, respectively. The findings are relevant to policy makers, especially as they pertain to decision-making in resource allocation in the fight against the global pandemic.

Experimenting with co-development: A qualitative study of gene drive research for malaria control in Mali.

We investigate how technology 'co-development' (between researchers, stakeholders and local communities) is framed in practice by those developing gene drive mosquitos for malaria eradication. Our case study focuses on UK and Mali-based researchers planning to undertake the first field trials in Mali of gene drive mosquitos for malaria control. While they and the wider gene drive research community are explicitly committed to the principle of co-development, how this is framed and practiced is not clear. Through qualitative analysis of 34 interviews complemented by observation and documentary research conducted in 2018, we identify and compare ten framings of co-development mobilised by UK and Malian researchers and stakeholders. For Malians, co-development reflected Mali's broader socio-political context and a desire for African scientific independence and leadership. It was mobilised to secure community and stakeholder support for gene drive mosquito field trials, through outreach, building local scientific capacity and developing those institutions (e.g. regulatory) necessary for field trials to go ahead. For UK participants, co-development was also concerned with scientific capacity-building, knowledge exchange between researchers, and stakeholder and community outreach to secure consent for field trials. Overall, our findings suggest co-development is opening up previously expert-dominated spaces as researchers attempt to take responsibility for the societal implications of their work. However, its main function is as a project management tool to enable and instrumentally support technological development, field trials and eventual deployment. This function extends into areas which are traditionally the responsibility of the state, such as regulatory development, facilitated by Mali's fragile political and economic situation. Paradoxically, co-development simultaneously depoliticises gene drive, masking power relations and closing down substantive debate and agency. Characterised by extreme poverty, conflict and weak institutions, Mali may become a site for technological experimentation where there is little interrogation of gene drive or its governance.

"There is no free here, you have to pay": actual and perceived costs as barriers to intermittent preventive treatment of malaria in pregnancy in Mali.

BACKGROUND: "There is no free here," the words of a Malian husband, illustrate how perceptions of cost can deter uptake of intermittent preventive treatment of malaria in pregnancy (IPTp). The Malian Ministry of Health (MOH) recommends a minimum of three doses of IPTp at monthly intervals. However, despite a national policy that IPTp be provided free of charge, only 35% of pregnant women receive at least one dose and less than 20% receive two or more doses. METHODS: This study explored perceptions and experiences of IPTp cost in Mali and their impact on uptake, using qualitative interviews and focus groups with pregnant women, husbands and mothers-in-law. Study team members also interviewed and observed health workers at four health centres, two in Sikasso Region and two in Koulikoro. RESULTS: Despite national-level policies, actual IPTp costs varied widely at study sites-between facilities, and visits. Pregnant women may pay for IPTp, receive it free, or both at different times. Health centres often charge a lump sum for antenatal care (ANC) visits that includes both free and fee-based drugs and services. This makes it difficult for women and families to distinguish between free services and those requiring payment. As a result, some forego free care that, because it is bundled with other fee-based services and medications, appears not to be free. Varying costs also complicate household budgeting for health care, particularly as women often rely on their husbands for money. Finally, while health facilities operating under the cost-recovery model strive to provide free IPTp, their own financial constraints often make this impossible. CONCLUSIONS: Both actual and perceived costs are currently barriers to IPTp uptake. Given the confusion around cost of services in the two study regions, more detailed national-level studies of both perceived and actual costs could help inform policy and programme decisions promoting IPTp. These studies should evaluate both quantitatively and qualitatively the cost information provided to and understood by pregnant women and their families. Meanwhile, unbundling free and fee-based services, making clear that IPTp is free, and ensuring that it is provided at no cost could help increase uptake. Free community-based distribution might be another route to increased uptake and adherence.

Participation of African social scientists in malaria control: identifying enabling and constraining factors.

OBJECTIVE: To examine the enabling and constraining factors that influence African social scientists involvement in malaria control. METHODS: Convenience and snowball sampling was used to identify participants. Data collection was conducted in two phases: a mailed survey was followed by in-depth phone interviews with selected individuals chosen from the survey. FINDINGS: Most participants did not necessarily seek malaria as a career path. Having a mentor who provided research and training opportunities, and developing strong technical skills in malaria control and grant or proposal writing facilitated career opportunities in malaria. A paucity of jobs and funding and inadequate technical skills in malaria limited the type and number of opportunities available to social scientists in malaria control. CONCLUSION: Understanding the factors that influence job satisfaction, recruitment and retention in malaria control is necessary for better integration of social scientists into malaria control. However, given the wide array of skills that social scientists have and the variety of deadly diseases competing for attention in Sub Saharan Africa, it might be more cost effective to employ social scientists to work broadly on issues common to communicable diseases in general rather than solely on malaria.