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The dominance of the human capital approach in vocational skills development has been increasingly questioned for being de-humanised and de-contextualised. Contrary to this trend, the discourse in health professional skills development has shown increasing enthusiasm for consolidating this existing paradigm. To debate whether professional skills development should indeed be insulated from such scepticism, this paper examines one strategy adopted by the health professions. Called "task shifting," this strategy involves re-delegating professional tasks to nonprofessional cadres according to a skills-based toolkit. Challenging the context-free approach to using this toolkit, this paper presents ethnographic evidence derived from a case study of pharmacy workforce issues in Malawi. It was found that task shifting was inhibited by a perception barrier about the moral and intellectual superiority of the pharmacists. Pharmacy technicians were judged to be unfit for a professional task because of a perceived lack of professional status, power and ethics. On tracing the origin of the inherent professional prowess assigned to the pharmacists, it was found that professionalism was an ideology borrowed from external sources, "inter alia," colonial legacies and global health governance. This study exposes our hidden assumption about an axiomatic transferability of Anglo-American skills development models to a postcolonial, aid-dependent context. This paper therefore suggests redefining this toolkit by bridging health research into dialogue with non-health disciplinary concerns such as postcolonialism and aid-dependence. In conclusion, it argues that professional skills development is context-laden; and in need of a human-centred approach that involves true indigenous participation-challenges not unlike those faced by the vocational skills discourse.

In July 2005, President Mbeki announced the launch of the Accelerated and Shared Growth Initiative for South Africa (AsgiSA), a new development strategy designed to help the South African state meet the ANC's 2004 election pledges, namely: (1) halve unemployment; (2) halve poverty; (3) accelerate employment equity; and (4) improve broad-based black economic empowerment. AsgiSA outlines a very different development path from the current orthodoxy of the Millennium Development Goals and Poverty Reduction Strategy Papers in spite of the common commitment to halving poverty. This difference in approach encompasses the education and skills sector, where post-basic provision is given considerable attention. This paper seeks to explore why South Africa has taken this different approach, especially in education and skills development. It examines what the current evidence tells us about the strategy's likely success. Finally, it briefly considers the implications this case might have for the dominant model of African education and development.

The US opioid crisis came in three waves -- prescription opioids, heroin, and illicitly manufactured fentanyls -- Centers for Disease Control and Prevention Centers for Disease Control and Prevention resulting in the deaths of nearly 500,000 people from 1996 to 2019. In 2009, drug overdose deaths exceeded those involving automobiles. Opioid overdose deaths contributed to the decrease in life expectancy for Americans from 78.8 to 78.5 during 2014 to 2017. The overprescribing of a schedule II prescription opioid was escalated by pharmaceutical companies promoting a growing belief that pain was an undertreated condition. In 2012, the number of opioid prescriptions peaked at 255 million and deaths exceeded 11,000 per year. The typical prescription opioid abuser was white, male, and 45--55 years of age. The hardest-hit states were in Appalachia and the Northeast. When an abuse-resistant formulation was introduced for OxyContin, the most prevalent prescription opioid, users turned to heroin. From the early 1980s, a new pizza delivery style of Mexican trafficking in black tar heroin infiltrated many of the same states hit hardest by prescription opioids. Heroin overdose deaths reached 14,495 in 2017. As heroin abuse increased in states supplied with black tar heroin, fentanyl-contaminated white powder heroin began to appear in the Northeast. Fentanyl was quickly followed by fentanyl analogs. While heroin deaths continued to escalate through 2017, they were soon overshadowed by fentanyl overdose deaths. Finally, prescription opioid and heroin overdose deaths started to decline in 2017, though fentanyl deaths continued to increase. In late 2019, it appeared that restrictions on transportation and travel due to the COVID-19 pandemic had resulted in decreased availability of illicit drugs, but by 2020 drug abuse had escalated in many countries. Globally, heroin was the primary opioid of abuse and only a few countries -- including Canada, Germany, Austria, and Belgium -- have experienced a significant increase in prescription opioids. However, illicitly manufactured fentanyls are a growing problem in North America, Europe, Australia, and Asia. [ABSTRACT FROM AUTHOR]