Health Research Governance In Africa

The globalisation of research has resulted in the increased location of research involving humans in developing countries. Countries in Africa, along with China and India, have seen research grow significantly. With emerging infectious diseases, such as Ebola and Zika, emphasising the risk of public health crises throughout the world, a further increase in health research, including clinical research in developing countries, which are often the sites of these diseases, becomes inevitable. This growth raises questions about domestic regulation and the governance of health research. This book presents a comprehensive and systemic view of the regulation of research involving humans in African countries. It employs case studies from four countries in which research activities continue to rise, and which have taken steps to regulate health research activity: South Africa, Nigeria, Kenya, and Egypt. The book examines the historical and political contexts of these governance efforts. It describes the research context, some of the research taking place, and the current challenges. It also looks at the governance mechanisms, ranging from domestic ethical guidelines to legal frameworks, the strengthening of existing regulatory agencies to the role of professional regulatory bodies. The book analyses the adequacy of current governance arrangements within African countries, and puts forward recommendations to improve the emerging governance systems for health research in African and other developing countries. It book will be a valuable resource for academics, researchers, practitioners and policy-makers working in the areas of health research, biomedical ethics, health law and regulation in developing countries.

Drawing on various disciplinary perspectives, this book re-focuses the debate on what makes a good health system, with a view to clarifying the uses of social science research in thinking about health care issues in Africa. The explosion of the HIV/AIDS pandemic, the persistence of malaria as a major killer, and the resurgence of diseases like tuberculosis which were previously under control, have brought about changes in the health system, with implications for its governance, especially in view of the diminished capacity of the public health facilities to cope with a complex range of expanded needs. Government responsibilities and objectives in the health sector have been redefined, with private sector entities (both for profit and not-for profit) playing an increasingly visible role in health care provisions. The reasons for collaborative patterns vary, but chronic under-funding of publicly financed health services is often an important factor. Processes of decentralisation and health sector reforms have had mixed effects on health care system performance; while private health insurance markets and private clinics are pointers to a growing stratification of the health market, in line with the intensified income and social differentiation that has occurred over the last two decades.These developments call for health sector reforms.

Today’s era of intense globalization has unleashed dynamic movements of people, pathogens, and pests that overwhelm the static territorial jurisdictions on which the governance provided by sovereign states and their formal intergovernmental institutions is based. This world of movement calls for new ideas and institutions to govern people’s health, above all in Africa, where the movements and health challenges are the most acute. This book insightfully explores these challenges in ways that put the perspectives of Africans themselves at centre stage. It begins with the long central and still compelling African health challenge of combating the pandemic of HIV/AIDS. It then examines the global governance responses by the major multilateral organizations of the World Bank and the World Trade Organization and the newer informal flexible democratically oriented ones of the Group of Eight. It also addresses the compounding health challenge created by climate change to assess both its intensifying impact on Africa and how all international institutions have largely failed to link climate and health in their governance response. It concludes with several recommendations about the innovative ideas and institutions that offer a way to closing the great global governance gaps and thus improving Africans’ health and that of citizens beyond.

This volume addresses the ideational and policy-oriented challenges of Africa’s health governance due to voluntary and involuntary cross-border migration of people and diseases in a growing 'mobile Africa'. The collected set of specialized contributions in this volume examines how national and regional policy innovation can address the competing conception of sovereignty in dealing with Africa’s emerging healthcare problems in a fast-paced, interconnect world.

A timely inquiry into how domestic politics and global health governance interact in Africa. Global health campaigns, development aid programs, and disaster relief groups have been criticized for falling into colonialist patterns, running roughshod over the local structure and authority of the countries in which they work. Far from powerless, however, African states play complex roles in health policy design and implementation. In Africa and Global Health Governance, Amy S. Patterson focuses on AIDS, the 2014–2015 Ebola outbreak, and noncommunicable diseases to demonstrate why and how African states accept, challenge, or remain ambivalent toward global health policies, structures, and norms. Employing in-depth analysis of media reports and global health data, Patterson also relies on interviews and focus-group discussions to give voice to the various agents operating within African health care systems, including donor representatives, state officials, NGOs, community-based groups, health activists, and patients. Showing the variety within broader patterns, this clearly written book demonstrates that Africa's role in global health governance is dynamic and not without agency. Patterson shows how, for example, African leaders engage with international groups, attempting to maintain their own leadership while securing the aid their people need. Her findings will benefit health and development practitioners, scholars, and students of global health governance and African politics.

This book reveals the necessary steps required by researchers from both developing and industrialised areas to conduct biomedical research in resource poor communities. This book goes beyond the ethical consideration and concentrates on issues considered minor by many researchers during planning of their research conduct. The communities considered are diverse both culturally and geographically. The communities are exposed by the authors with several years' experience working in the area on hierarchy, beliefs and fears, the economical and social aspects. Probably the education levels and how this is developing, impacting on research have been discussed. The boundaries and religions that make each community as an important aspect demarcating Africa into the social structures. Planning and preparing to undertake biomedical research in resource poor communities of Africa goes even deeper than the normal ethical considerations.

In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and "albeit sometimes counterintuitively - trust for their people. The state has morphed into the para-state " not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the global health paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional.

Integrating information and communication technologies (ICTs) into governance processes can greatly enhance the delivery of public services to all citizens. ICT integration will not only improve the performance of governance systems, it will also transform relationships amongst stakeholders, thereby influencing policymaking processes and regulatory frameworks. In the developing world, however, the potential of ICTs for effective governance remains largely unexplored and unexploited. This book presents the context, theory, and current thinking on the interaction between ICTs and local governance, particularly in Africa. It discusses the shift from OC governmentOCO to OC e-governance, OCO describes the role of local-level authorities, and presents the benefits and limitations of introducing ICTs in government operations. Case studies from Ghana, Senegal, South Africa, and Uganda describe local governance/ICTs projects executed by civil society organizations, academic institutions, and government authorities. Drawing from the findings in these case studies and from the introductory research and original conceptual framework, the book presents a series of conclusions and recommendation on the future of effective ICTs use for better governance and improved economic development at the local level. This book will be of interest to professionals, practitioners, and policy advisors at local and national government levels in developing countries (particularly in Africa); international organizations staff, bilateral aid agencies, international financial institutions, civil society organizations, and private sector; researchers, academics, students, and professors of public administration and governance in Africa and throughout the world."