Search

Financial sanctions are often thought of as the “soft alternative” to armed conflict and are widely used in the 21st century. Nonetheless, sanctions are often criticized for being non-specific in their action, and having impact beyond their intended remit. One often-overlooked area affected by sanctions are academic systems of research and education. Sanctions place “invisible barriers” for research in these countries by limiting access to necessary resources and curtailing their effective use. In this paper we present a national survey of Sudanese academics focused on the impact of 20 years of economic sanctions on their work. It identifies key areas of academic research and education that have been impacted by international sanctions. Moreover, these data highlight how the impact of sanctions on academia is likely to persist long after they are formally lifted. The paper concludes by problematising the current interpretation of jus post bellum, or moral behaviour after conflict. It suggests that the responsibility to make reparations in the form of support for academic systems applies to countries who impose economic sanctions. [ABSTRACT FROM AUTHOR]

Ghana has made significant stride towards universal health coverage (UHC) by implementing the National Health Insurance Scheme (NHIS) in 2003. This paper investigates the progress of UHC indicators in Ghana from 1995 to 2015 and makes future predictions up to 2030 to assess the probability of achieving UHC targets. National representative surveys of Ghana were used to assess health service coverage and financial risk protection. The analyses estimated the coverage of 13 prevention and four treatment service indicators at the national level and across wealth quintiles. In addition, we calculated catastrophic health payments and impoverishment to assess financial hardship and used a Bayesian regression model to estimate trends and future projections as well as the probabilities of achieving UHC targets by 2030. Wealth-based inequalities and regional disparities were also assessed. At the national level, 14 out of the 17 health service indicators are projected to reach the target of 80% coverage by 2030. Across wealth quintiles, inequalities were observed amongst most indicators with richer groups obtaining more coverage than their poorer counterparts. Subnational analysis revealed while all regions will achieve the 80% coverage target with high probabilities for the prevention services, the same cannot be applied to the treatment services. In 2015, the proportion of households that suffered catastrophic health payments and impoverishment at a threshold of 25% non-food expenditure were 1.9% (95%CrI: 0.9–3.5) and 0.4% (95%CrI: 0.2–0.8), respectively. These are projected to reduce to 0.4% (95% CrI: 0.1–1.3) and 0.2% (0.0–0.5) respectively by 2030. Inequality measures and subnational assessment revealed that catastrophic expenditure experienced by wealth quintiles and regions are not equal. Significant improvements were seen in both health service coverage and financial risk protection over the years. However, inequalities across wealth quintiles and regions continue to be cause of concerns. Further efforts are needed to narrow these gaps. [ABSTRACT FROM AUTHOR]

This paper responds to Vanessa Watson’s article on the inappropriate urban development plans that are increasingly common in sub-Saharan Africa as governments seek to make their cities “world class”. It describes how the government of Angola has been able to use financing from Chinese credit facilities to build prestige projects that include support for the public-privately developed Kilamba city with 20,000 apartments. The apartments were initially too expensive for most of the population, and the state has had to draw further funds from its housing budget for a subsidized rent-to-purchase scheme to make the units affordable for middle-level civil servants. The author argues that an opportunity is being missed to use today’s income from high-priced natural resources and the current easy access to Chinese credit lines and technical expertise to address the very large backlogs in urban upgrading of basic service infrastructure and housing for the poor. The paper also reflects on a previous post-independence period when a number of African new cities were built, leaving some countries with decades of debt and stagnant development. Can errors from the past offer lessons for future African urban development? [ABSTRACT FROM PUBLISHER]

Background: The Global Forum 2015 panel session dialogue entitled "From evidence to policy - thinking outside the box" was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region.Discussion: The Global Forum 2015 debate attributed African Region's low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organizations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region.Conclusion: The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening NHRS governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of action plans for implementing research recommendations, preferably in the context of the Sustainable Development Goals; and encouragement of competition on NHRS strengthening and research output and uptake among the countries using a barometer or scorecard to review their performance at various regional ministerial forums and taking into account the lessons learned from the MDG period. [ABSTRACT FROM AUTHOR]

This paper highlights the challenges and limitations faced by scholarly presses in South Africa, presenting the business and operational changes required (both individually and collectively) to meet overarching political and competitive pressures. The direct competition of international commercial publishers, a disconnect between national research imperatives and the business model of scholarly presses, and the lack of support for university presses, have perpetuated the knowledge gap between publishing in the 'north' and the 'global south'. Direct engagement with institutions and the state is necessary, as is a robust and confident approach to technology and services, while clarifying and articulating specific needs and aspirations. [ABSTRACT FROM AUTHOR]

The article comments on the book "African External Finance in the 1990s," edited by Ishrat Husain and John Underwood. Thirteen papers, plus comments, summarize a research project initiated by the World Bank to assess the likely availability of external financial resources needed to achieve significant economic growth in sub-Saharan Africa and provide an empirical basis of the long-term financial planning that successful reform and development require.

This paper assesses if legal origin explains domestic, foreign, private and public investments through financial intermediary channels of depth, efficiency, activity and size. The findings show that legal origin matters in the finance-investment nexus, though its ability to explain aggregate investment dynamics only through financial intermediary channels is limited in the cases of private and public investments. [ABSTRACT FROM AUTHOR]

This study utilizes firm-level data from the World Bank's Enterprise Survey Indicator Database, conducted between 2009 and 2018 for 32 countries in Africa, to examine the causal relationship between firm productivity, innovation, and financial development. We show evidence that firm innovation significantly and positively affects firm productivity. We also show the mediating role of well-developed financial markets on productivity. In a well-developed financial market, the impact of firm innovation is significant through the facilitation and financing of innovation activities; and innovative firms to boost productivity and lower production costs. These findings are significant for countries in Africa (and other less-developed countries) who spend less on R&D but can adopt or imitate existing innovative ideas from technology-rich countries for accelerated economic growth and increased productivity. [ABSTRACT FROM AUTHOR]

What are the characteristics of recipient countries that attract more climate finance in mitigating and adapting to climate change? In this study, we address this question by looking at recipients in 43 Sub-Sahara African countries for the period 2006–2017, and implement several panel regression techniques, including system generalized methods of moments estimations to address potential endogeneity concerns. We also performed sensitivity analysis using panel quantile regressions. The findings show that Sub-Sahara African countries with higher population growth rate, higher poverty levels, better ease of doing business profile, weaker governance policies, weaker control of corruption, stronger rule of law enforcement, deepened social inequality, and better ICT usage, have attracted more climate finance. Policy implications of the study are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Review of African Political Economy is the property of Review of Political Economy (ROAPE) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Achieving Universal Health Coverage (UHC) by improving financial protection and effective service coverage is target 3.8 of the Sustainable Development Goals. Little is known, however, about the extent to which paying bribes within healthcare acts as a financial barrier to access and, thus, UHC. Methods: Using survey data in adults from 32 sub-Saharan African countries in 2014–2015, we constructed a multilevel model to evaluate the relationship between paying bribes and reported difficulties of obtaining medical care. We controlled for individual-, region-, and country-level variables. Results: Having paid bribes for medical care significantly increased the odds of reporting difficulties in obtaining care by 4.11 (CI: 3.70–4.57) compared to those who never paid bribes, and more than doubled for those who paid bribes often (OR = 9.52; 95% CI: 7.77–11.67). Respondents with higher levels of education and more lived poverty also had increased odds. Those who lived in rural areas or within walking distance to a health clinic had reduced odds of reporting difficulties. Sex, age, living in a capital region, healthcare expenditures per capita, and country Corruption Perception Index were not significant predictors. Conclusions: We found that bribery in healthcare is a significant barrier to healthcare access, negatively affecting the potential of African countries to make progress toward UHC. Future increases in health expenditures—which are needed in many countries to achieve UHC—should be accompanied by greater efforts to fight corruption in order to avoid wasting money. Measuring and tracking health sector-specific corruption is critical for progress toward UHC. [ABSTRACT FROM AUTHOR]

Background: Podoconiosis, also known as mossy foot or endemic non-filarial elephantiasis, is a preventable form of lower-leg lymphoedema caused by prolonged (typically barefoot) exposure to soil derived from volcanic rocks. Acute adenolymphangitis (also called ‘acute attack’) is a serious complication of podoconiosis resulting in significant symptoms and worsening disability. Despite the well-known morbidity associated with podoconiosis, to date there have been no studies looking at the impact, or burden, of podoconiosis on caregivers. This study explored the experiences and impact of acute attacks on the caregivers of those with podoconiosis in one endemic district of Ethiopia. Methods/Principal findings: This qualitative study was based in Wayu Tuka woreda (district), Oromia, Western Ethiopia. 27 semi-structured interviews of those with podoconiosis and their caregivers were conducted in June 2018. Here we report the findings from the caregiver’s interviews. Data were analysed using NVivo 12. Directed content analysis, a qualitative approach related to thematic analysis, was used to analyse the results. This study highlights a previously unreported impact of acute attacks on the caregivers of those affected by podoconiosis. The findings demonstrate the significant social and financial pressures placed on podoconiosis-affected families which are exacerbated during acute attacks. This study also highlighted the emotional burden experienced by caregivers, the range of care activities placed on them and the limited support available. Conclusions: This study found a significant impact on the caregivers of those with podoconiosis, especially during acute attacks, in in Wayu Tuka woreda. It also highlighted the limited support available to caregivers. Further research is needed to understand whether this impact applies to podoconiosis caregivers across Ethiopia, and beyond, and to establish if there are wider implications of this important consequence of podoconiosis, for example on the economy and caregivers’ mental and physical health. [ABSTRACT FROM AUTHOR]

Introduction: In 2016, for the very first time, the Ministry of Health in Zambia implemented a reactive outbreak response to control the spread of cholera and vaccinated at-risk populations with a single dose of Shancol—an oral cholera vaccine (OCV). This study aimed to assess the costs of cholera illness and determine the cost-effectiveness of the 2016 vaccination campaign. Methodology: From April to June 2017, we conducted a retrospective cost and cost-effectiveness analysis in three peri-urban areas of Lusaka. To estimate costs of illness from a household perspective, a systematic random sample of 189 in-patients confirmed with V. cholera were identified from Cholera Treatment Centre registers and interviewed for out-of-pocket costs. Vaccine delivery and health systems costs were extracted from financial records at the District Health Office and health facilities. The cost of cholera treatment was derived by multiplying the subsidized cost of drugs by the quantity administered to patients during hospitalisation. The cost-effectiveness analysis measured incremental cost-effectiveness ratio—cost per case averted, cost per life saved and cost per DALY averted—for a single dose OCV. Results: The mean cost per administered vaccine was US$1.72. Treatment costs per hospitalized episode were US$14.49–US$18.03 for patients ≤15 years old and US$17.66–US$35.16 for older patients. Whereas households incurred costs on non-medical items such as communication, beverages, food and transport during illness, a large proportion of medical costs were borne by the health system. Assuming vaccine effectiveness of 88.9% and 63%, a life expectancy of 62 years and Gross Domestic Product (GDP) per capita of US$1,500, the costs per case averted were estimated US$369–US$532. Costs per life year saved ranged from US$18,515–US$27,976. The total cost per DALY averted was estimated between US$698–US$1,006 for patients ≤15 years old and US$666–US$1,000 for older patients. Conclusion: Our study determined that reactive vaccination campaign with a single dose of Shancol for cholera control in densely populated areas of Lusaka was cost-effective. [ABSTRACT FROM AUTHOR]

Background: Community-based health insurance (CBHI) scheme is an emerging strategy for providing financial protection against health-related poverty. It is being piloted in the Sheko district, but community satisfaction with the scheme has not yet studied. Therefore, this study aimed to assess the level of household’s satisfaction to CBHI scheme and associated factors in a piloted Sheko district; southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in Sheko district from March to April 2018. Data was collected on 528 households by using simple random sampling method. Trained data collectors gathered the data using a pre-tested and structured questionnaire. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. To determine the independent predictors of household’s satisfaction to CBHI, a cut point of p values < 0.05 were used. Results: This study showed that more than half (54.7%) of the households were satisfied with the CBHI scheme. Satisfaction to CBHI was positively associated with adequate knowledge of CBHI benefit packages (AOR = 2.29, 95% CI = 1.55–3.38), type of health facility visit (AOR = 1.93, 95% CI = 1.09–3.39), laboratory service provision (AOR = 2.07, 95% CI = 1.15–373) and length of enrollment (AOR = 1.53, 95% CI = 1.01–2.32). Conclusions: Household’s satisfaction to CBHI scheme was moderate. Modifiable factors, including adequate knowledge of CBHI benefit packages, type of health facility visit, laboratory service provision, and length of enrollment were independent determinants of satisfaction. In order to augment enrollee’s satisfaction to CBHI, efforts should be given to improving their knowledge of CBHI benefit packages through education and information campaigns. Furthermore, due consideration should also be given to improving the quality of health services. [ABSTRACT FROM AUTHOR]

Background: The Maternal Mortality Ratio in Mozambique has stagnated at 405 deaths per 100,000 live births with virtually no progress over the last 15 years. Low Institutional Birth Rates (IBRs) levelling around 50% in many rural areas constitute one of the contributing reasons. Demand-side financing has successfully increased usage of maternal health services in other countries, but little information exists on in-kind incentives in rural Africa. The objective was to test the impact on Institutional Birth Rates of giving a USD 5.50 baby package incentive to every woman who came to give birth in a health centre in a rural, poor district of Cabo Delgado, Mozambique. Methods and findings: The intervention was implemented in one district in 2010 with the remaining 15 districts serving as controls. The total population in the 16 districts in 2006 was just under 1.5 million people. IBRs were observed from 2006 to 2013 (53 months before and 55 months after the intervention began). The non-intervention districts showed a slight increase, from a mean IBR of 0.39 (SD = 0.10) in 2006 to 0.67 (SD = 0.13) in 2014. The intervention district had a dramatic increase in IBRs within six months of the start of the intervention in 2010, which was sustained until the end of the study. Adjusting for the background increase and for confounders, including health facilities and health personnel per district, and taking clustering in districts into account, the estimated rate ratio of institutional births in the intervention district was 1.80 (95% CI 1.72, 1.89 p<0.001). Conclusion: Women were almost twice as likely to have an institutional birth following the introduction of the baby package. [ABSTRACT FROM AUTHOR]

Despite the removal of user fees on public primary healthcare in Zambia, prior studies suggest that out-of-pocket payments are still significant. However, we have little understanding of the extent to which out-of-pocket payments lead patients to hardship methods of financing out-of-pocket costs. This study analyses the prevalence and determinants of hardship financing arising from out-of-pocket payments in healthcare, using data from a nationally-representative household health expenditure survey conducted in 2014. We employ a sequential logistic regression model to examine the factors associated with the risk of hardship financing conditional on reporting an illness and an out-of-pocket expenditure. The results show that up to 11% of households who reported an illness had borrowed money, or sold items or asked a friend for help, or displaced other household consumption in order to pay for health care. The risk of hardship financing was higher among the poorest households, female headed-households and households who reside further from health facilities. Improvements in physical access and quality of public health services have the potential to reduce the incidence of hardship financing especially among the poorest. [ABSTRACT FROM AUTHOR]

Considerable outside funding will be required to overcome the financial shortfalls faced by most of Africa’s protected areas. Given limited levels of external support, it will be essential to allocate these funds wisely. While most recent studies on conservation triage have recommended prioritizing reserves with the highest remaining conservation value (the “last best places”), such investments are complicated by the fact that these same reserves often attract the greatest revenues from ecotourism and thus the most attention from corrupt local governments. Alternatively, philanthropic organizations might achieve greater returns from investing in the management of neglected areas with lower current conservation value but with less financial leakage from corruption. We outline here how high levels of corruption could favor a strategy that shifts investments away from the last best places. [ABSTRACT FROM AUTHOR]

We organise a field experiment with smallholder farmers in Rwanda to measure the impact of financial literacy training on financial knowledge and behaviour. The training increased financial literacy of participants, changed their savings and borrowing behaviour and had a positive effect on the new business start-up. However, it failed to have a significant (short-term) impact on income. Using a two-stage regression framework, we identify enhanced financial literacy as one of the important factors explaining behavioural changes. We also test whether financial knowledge spillovers from trained farmers to their peers in local village banks but find no evidence for that. [ABSTRACT FROM AUTHOR]

Background: The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Over the last decade, the African Region has realised improvements in health outcomes as a result of interventions implemented by both governments and development partners. However, alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination.Method: Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research.Results: GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that basically, earmarking and donor conditions drive funding allocations regardless of countries' priorities. Although studies cite the lack of harmonisation of GHI priorities with national strategies, evidence shows improvements in that area over time. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers to include groups such as civil society organisations (CSOs), with both positive and negative implications. GHI strategies such as co-financing by countries as a condition for support have been positive in achieving sustainability of interventions.Conclusions: GHI approaches have not changed substantially over the years but there has been evolution in terms of donor funding and conditions. GHIs still largely operate in a vertical manner, bypassing country systems; they compete for the limited human resources; they influence country policies; and they are not always harmonised with other donors. To maximise returns on GHI support, there is need to ensure that their approaches are more comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries' changing epidemiologic profiles; and to strengthen their involvement of CSOs. [ABSTRACT FROM AUTHOR]

Background There is a growing recognition of China?s role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China?s engagement as a donor with that of more traditional global health donors. Methods Using newly released data from AidData on China?s development finance activities in Africa, developed to track under reported resource flows, we identified 255 health, population, water, and sanitation (HPWS) projects from 2000?2012, which we descriptively analyze by activity sector, recipient country, project type, and planned activity. We compare China?s activities to projects from traditional donors using data from the OECD?s Development Assistance Committee (DAC) Creditor Reporting System. Results Since 2000, China increased the number of HPWS projects it supported in Africa and health has increased as a development priority for China. China?s contributions are large, ranking it among the top 10 bilateral global health donors to Africa. Over 50% of the HPWS projects target infrastructure, 40% target human resource development, and the provision of equipment and drugs is also common. Malaria is an important disease priority but HIV is not. We find little evidence that China targets health aid preferentially to natural resource rich countries. Conclusions China is an important global health donor to Africa but contrasts with traditional DAC donors through China?s focus on health system inputs and on malaria. Although better data are needed, particularly through more transparent aid data reporting across ministries and agencies, China?s approach to South-South cooperation represents an important and distinct source of financial assistance for health in Africa. [ABSTRACT FROM AUTHOR]

Background Principal Recipients (PRs) receive money from the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) to manage and implement programs. However, little research has gone into understanding their opinions and experiences. This survey set out to describe these, thereby providing a baseline against which changes in PR opinions and experiences can be assessed as the recently introduced new funding model is rolled out. Methodology An internet based questionnaire was administered to 315 PRs. A total of 115 responded from 69 countries in Africa, Asia, Eastern Europe and Latin America. The study was conducted between September and December 2012. Findings Three quarters of PRs thought the progress update and disbursement request (PU/DR) system was a useful method of reporting grant progress. However, most felt that the grant negotiation processes were complicated, and that the grant rating system did not reflect performance. While nearly all PRs were happy with the work being done by sub-Recipients (92%) and Fund Portfolio Managers (86%), fewer were happy with the Office of the Inspector General (OIG). Non-government PRs were generally less happy with the OIG's work compared to government PRs. Most PRs thought the Global Fund's Voluntary Pooled Procurement system made procurement easier. However, only 29% said the system should be made compulsory. When asked which aspects of the Global Fund's operations needed improvement, most PRs said that the Fund should re-define and clarify the roles of different actors, minimize staff turnover at its Secretariat, and shorten the grant application and approval processes. All these are currently being addressed, either directly or indirectly, under a new funding model. Vigorous assessments should nonetheless follow the roll-out of the new model to ensure the areas that are most likely to affect PR performance realize sustained improvement. Conclusions Opinions and experiences with the Global Fund were varied, with PRs having good communication with Fund Portfolio Managers and sub-Recipients, but being unhappy with the grant negotiation and grant rating systems. Recommendations included simplifying grant processes, finding performance assessment methods that look beyond numbers, and employing Local Fund Agents who understand public health aspects of programs. [ABSTRACT FROM AUTHOR]

Why do governments and the International Monetary Fund (IMF) enter into agreements? Conventional wisdom holds that governments turn to the Fund for a straightforward reason: they need an IMF loan. An alternative argument is that governments want IMF conditions to be imposed to help push through unpopular economic reforms. To illustrate how the desire for IMF conditions can play a role in the decision to enter into an agreement, this article considers two analytically significant cases. Drawing upon a data set of 7011 country-year observations of 199 countries from 1952 (or year of independence) to 2000, two outliers are selected: the country observed with the least need for an IMF loan participating in an IMF program (Uruguay in 1990) and the country with the strongest need for an IMF loan not participating in an IMF program (Tanzania in 1983). [ABSTRACT FROM AUTHOR]

The article focuses on the convalescence of the U.S. foreign aid program, which is recovering gradually from multiple sclerosis. Previously, support for European recovery, for investment and technical assistance in Asia and Africa, for economic co-operation with Latin-American neighbors, even for the exchange of students and artists, had to be justified by reference to a new all embracing criterion, expressed in the word "security." Now it is "mutual security" rather than "economic co-operation." The foreign aid agency in its successive reincarnations was progressively weakened by internal disorders. The U.S. foreign aid effort is still too timid, too spasmodic in its financing, too rigid and centralized in its administration. However, the last year or so have seen evidence of real progress in controlling the symptoms. The most acute symptoms are disappearing now, and convalescence has begun. The program's leadership is no longer totally preoccupied with presidential ambitions or even with Ohio politics. The people and their Congress are impressed with the Soviet Union and seem to have decided that there must be something good about the U.S. foreign aid after all.

The article focuses on investment in tropical Africa while emphasizing economic, social and political aspects of opportunities for development and obstacles to change. Although by Western standards tropical Africa is poverty-stricken, per capita incomes averaging $50-150 per year, it has progressed rapidly, especially since World War II, and it gives every promise of continued and even accelerated growth rates. No one who has visited these lands, even if only for a short visit, can fail to detect the atmosphere of hope and progress, of peoples on the move emerging into the twentieth century, although still wrapped in the cocoon of a tribal world. The years since the end of the second World War have seen a marked quickening in the tempo of political evolution in the area. The first great change, however, did not come until 1957 when Ghana (then the Gold Coast) became a self-governing Dominion within the British Commonwealth. Africa needs the capital, the skills, and the know-how that only Western firms can offer. It realizes that the goals of rapid development, which usually includes industrialization, cannot be achieved in any other way. In return, the foreigner should show his sympathy, especially by employing and upgrading his African staff as quickly as is feasible.

The editor discusses the challenges of high education programs for college students in South Africa. The editor addresses the factors of finance for higher education of students, the public debates on free education services for citizens and the impacts of the country's economic performance. The editor also cites the impacts of decolonisation and racial discrimination against Black people of South Africa on higher education program.

A correction to the editorial "Highway to Health" in volume 520 of the journal is presented that discusses the costs of hiring staff for the African Centres for Disease Control and Prevention.