BACKGROUND: For HIV-exposed infants in Malawi, there are missed opportunities at each step of the testing and treatment cascade. OBJECTIVE: This study assessed factors associated with HIV positivity among infants in Malawi and turn-around times for infant HIV testing. METHODS: HIV testing data for infants aged 0-18 months from 2012 to 2015 were extracted from the Malawi HIV laboratory information management system and analysed using logistic regression. Turn-around time was defined as time between collection of samples to results dispatch from the laboratory. RESULTS: A total of 106 997 tests were included in the analyses. A subset of 76 006 observations with complete dates were included in the turn-around time analysis. Overall positivity was 4.2%. Factors associated with positivity were increasing age (infants aged 3-6 months: adjusted odds ratio [aOR] = 2.24; infants aged 6-9 months: aOR = 3.42; infants aged > 9 months: aOR = 4.24), female sex (aOR = 1.08) and whether the mother was alive and not on antiretroviral therapy at time of the infant's test (aOR = 1.57). Provision of HIV prophylaxis to the infant after birth (aOR = 0.38) was found to be protective against HIV positivity. The median turn-around time was 24 days (increased from 19 to 34 days between 2012 and 2015. CONCLUSION: Infant HIV positivity has decreased in Malawi, whereas turn-around time has increased. Factors associated with positivity include increasing age, female sex, and whether the mother was alive and not on antiretroviral therapy at the time of the infant's test.

The Pampa de Jones fossil site, a stratigraphically isolated roadcut near the northeastern shore of Nahuel Huapi Lake in Neuquén Province, Argentina, holds a rich fossil biota including a macroflora, a microflora, insects, and most famously, an ontogenetic series of pipid frogs. The site exposes tuffaceous mudstone and sandstone beds of probable lacustrine origin, considered to belong to the volcanic Huitrera Formation. However, there have been no reliable age constraints for the fossil assemblage. We undertook laser fusion analyses of sanidine and biotite crystals occurring in a tuff layer found 4.4 m above the main fossil horizon. Twentyeight sanidine crystals yielded an 40Ar/39Ar age of 54.24 ± 0.45 Ma that is preferred over our biotite age of 53.64 ± 0.35 Ma. Pampa de Jones is thus the oldest well-dated Eocene fossil site in Patagonia, predating two other recently 40Ar/39Ar-dated sites: Laguna del Hunco (51.91 ± 0.22 Ma) and Río Pichileufú (47.46 ± 0.05 Ma). The improved age control makes possible a finer scale of evolutionary hypothesis testing and turnover analysis in the region. The age is concordant with the site's placement in the Huitrera Formation and a depositional origin related to Early Paleogene arc volcanism, and it correlates to an interval of significant climate fluctuations following the Paleocene-Eocene boundary.

La localidad de Pampa de Jones es un afloramiento estratigráficamente aislado, cercano a la costa noreste del Lago Nahuel Huapi en la Provincia del Neuquén, Argentina. Contiene una rica biota fósil que incluye macroflora, microflora, insectos y una reconocida serie ontogenética de pípidos. La secuencia estratigráfica consiste de fangolitas y areniscas tufáceas de probable origen lacustre, asignada a la Formación Huitrera. La ausencia de datos geocronológicos directos ha impedido la estimación de edades confiables para esta paleobiota. En este trabajo se analizan por fusión láser los cristales de sanidina y biotita presentes en un nivel de toba ubicado a 4.4 m por encima del principal horizonte fosilífero. Veintiocho cristales de sanidina arrojaron una edad 40Ar/39Ar de 54.24 ± 0.45 Ma, la cual se prefiere a la edad de 53.64 ± 0.35 Ma estimada a partir de la biotita. La biota de Pampa de Jones es la más antigua del Eoceno de Patagonia datada radiométricamente, y precede a las dos localidades Eocenas datadas en la región: Laguna del Hunco (51.91 ± 0.22 Ma) y Río Pichileufú (47.46 ± 0.05 Ma). El control cronológico ajustado permitirá evaluar hipótesis evolutivas y analizar recambios en la región con una mayor resolución temporal. La edad obtenida concuerda con la ubicación de la secuencia dentro de la Formación Huitrera y con el origen de los depósitos asociados al volcanismo de arco del Paleógeno temprano, y se correlaciona con un lapso de significativas fluctuaciones climáticas ocurridas con posterioridad al pasaje Paleoceno-Eoceno.

There is skepticism and resistance to innovations associated with agro-biotechnology projects in the developing world, leading to the possibility of failure. The source of the skepticism is complex, but partly traceable to how local communities view genetically engineered crops, public perception on the technology's implications, and views on the role of the private sector in public health and agriculture, especially in the developing world. We posit that a governance and management model in which ethical, social, cultural, and commercialization issues are accounted for and addressed is important in mitigating the risk of project failure and improving the appropriate adoption of agro-biotechnology in sub-Saharan Africa. We introduce a social audit model, which we term Ethical, Social, Cultural and Commercialization (ESC² ) auditing, and that we developed based on feedback from a number of stakeholders. We lay the foundation for its importance in agro-biotechnology development projects and show how the model can be applied to projects run by Public Private Partnerships. We argue that the implementation of the audit model can help build public trust through facilitating project accountability and transparency. The model also provides evidence on how ESC² issues are perceived by various stakeholders, which enables project managers to effectively monitor and improve project performance. Although this model was specifically designed for agro-biotechnology initiatives, we show how it can also be applied to other development projects.

The growing health disparities between the developing and the developed world call for urgent action from the scientific community. Science and technology have in the past played a vital role in improving public health. Today, with the tremendous potential of genomics and other advances in the life sciences, the contribution of science to improve public health and reduce global health disparities is more pertinent than ever before. Yet the benefits of modern medicine still have not reached millions of people in developing countries. It is crucial to recognize that science and technology can be used very effectively in partnership with public health practices in developing countries and can enhance their efficacy. The fight to improve global health needs, in addition to effective public health measures, requires rapid and efficient diagnostic tools; new vaccines and drugs, efficient delivery methods and novel approaches to therapeutics; and low-cost restoration of water, soil and other natural resources. In 2002, the University of Toronto published a report on the "Top 10 Biotechnologies for Improving Health in Developing Countries". Here we review these new and emerging biotechnologies and explore how they can be used to support the goals of developing countries in improving health.

Genomics, the comprehensive examination of an organism's entire set of genes and their interactions, will have a major impact on the way disease is diagnosed, prevented and treated in the new millennium. Despite the tremendous potential it holds for improving global health, genomics challenges policy-makers to ensure that its benefits are harnessed equitably across populations and nations. The classification of genomics as a global public good and the inequity encountered in the development and application of genomics knowledge are outlined in this paper. We examine the effect of the current patent system on the distribution of costs and benefits relating to genomics knowledge between countries of different economic strength. The global public goods concept provides a normative economic rationale for the modification of certain aspects of the current patent system and for the creation of complementary mechanisms to respond to the health needs of low-income and middle-income countries.

La genómica, el estudio pormenorizado del conjunto de los genes de un organismo y de sus interacciones, repercutirá enormemente en la manera de diagnosticar, prevenir y tratar las enfermedades en el nuevo milenio. Aunque encierra un extraordinario potencial para mejorar la salud mundial, la genómica desafía a los formuladores de políticas a encontrar la manera de asegurar que sus beneficios sean aprovechados equitativamente en todas las poblaciones y las naciones. En este artículo se describen a grandes rasgos la clasificación de la genómica como bien público mundial y las desigualdades surgidas en el desarrollo y aplicación de la información genómica. Examinamos el efecto del actual sistema de patentes en la distribución de los costos y beneficios relacionados con la información genómica entre países de distinta potencia económica. El concepto de bienes públicos mundiales proporciona una justificación económica normativa para modificar algunos aspectos del actual sistema de patentes y para crear mecanismos complementarios que respondan a las necesidades de salud de los países de ingresos bajos y de ingresos medianos.

La génomique, c'est-à-dire l'examen complet de l'ensemble des gènes d'un organisme et de leurs interactions, est appelée à avoir un impact majeur sur la façon dont les maladies seront diagnostiquées, évitées et traitées au cours de ce millénaire. Malgré son énorme potentiel d'amélioration de la santé à l'échelle mondiale, elle constitue un défi pour les décideurs qui devront assurer que les bénéfices en sont exploités équitablement par les populations et les pays. Le présent article décrit le classement de la génomique parmi les biens publics et les inégalités rencontrées au cours du développement et de l'application des connaissances en la matière. Nous examinons l'effet du système actuel de brevets sur la répartition des coûts et bénéfices relatifs aux connaissances en génomique entre pays de puissance économique inégale. Le concept de biens publics mondiaux fournit une justification économique normative en vue de la modification de certains aspects du système actuel de brevets et de la création de mécanismes complémentaires pour répondre aux besoins sanitaires des pays à faible revenu et à revenu intermédiaire.

The new and rapidly advancing field of genomics and related biotechnologies has the ability to either improve or worsen global health inequities. In general, developing countries are left behind in the development of new technologies and advances in genomic medicine. In this view, the University of Toronto Joint Centre for Bioethics (JCB) through the Canadian Program on Genomics and Global Health has developed 25 research projects on capacity enhancement for developing countries for improving global health equity, including public health via genomics and related biotechnologies. One project with a great impact was the “Top Ten Biotechnologies for Improving Health in Developing Countries” for its influence in the “Grand Challenges in Global Health Initiative” foster by the Melinda Gates Foundation. Additionally, the UN Millennium Development Project has asked JCB to become the genomics working group for improving global health through genomics biotechnology and JCB has started by studying applications of genomics/biotechnologies in seven developing countries: Brazil, China, Cuba, Egypt, India, South Africa and South Korea, which may set examples for other developing nations

El nuevo campo de la genómica y sus biotecnologías relacionadas, de rápido desarrollo, tiene la habilidad tanto de mejorar como de empeorar las desigualdades globales en salud. En general, los países en desarrollo quedan atrás en el desarrollo de nuevas tecnologías y avances en la medicina genómica. En vista de esta situación, el Centro Asociado de Bioética de la Universidad de Toronto (JCB) a través del Programa Canadiense sobre Genómica y Salud Global ha desarrollado 25 proyectos de investigación sobre desarrollo de capacidades en países en desarrollo para mejorar la equidad en salud global, incluyendo la salud pública a través de la genómica y sus biotecnologías relacionadas. Entre estos, un proyecto de gran impacto fue “Diez Biotecnologías de Mayor Importancia para Mejorar la Salud en Países en Desarrollo” por su influencia en la “Iniciativa sobre los Grandes Desafíos en Salud Global” presentada por la Fundación Bill and Melinda Gates. Además, el proyecto de las Naciones Unidas “Desarrollos del Milenio” pidió a JCB ser el grupo de trabajo de genómica para la mejora de la salud global a través de la biotecnología genómica, y JCB ha comenzado estudiando aplicaciones de genómica y biotecnología en siete países en desarrollo: Brasil, China, Cuba, Egipto, India, Sudáfrica y Sur Corea, que pueden servir de ejemplo para otras naciones en desarrollo

O novo campo da genómica e suas biotecnologías relacionadas, de rápido desenvolvimento, tem a habilidade tanto de melhorar como de piorar as desigualdades globais em saúde. Em geral, os países em desenvolvimento ficam atrás no desenvolvimento de novas tecnologias e avanços na medicina genómica. Em vista desta situação, o Centro Associado de Bioética da Universidade de Toronto (JCB) através do Programa Canadense sobre Genómica e Saúde Global desenvolveu 25 projetos de pesquisa sobre desenvolvimento de capacitações em países em desenvolvimento para melhorar a equidade em saúde global, incluindo a saúde pública através da genómica e suas biotecnologias relacionadas. Entre estes, um projeto de grande impacto foi “Dez Biotecnologías Mais Importantes para Melhorar a Saúde em Países em Desenvolvimento” por sua influência na “Iniciativa sobre os Grandes Desafios em Saúde Global” apresentada pela Fundação Bill and Melinda Gates. Alem disso, o projeto das Nações Unidas “Desenvolvimentos do Milênio” pediu para que o JCB fosse o grupo de trabalho de genómica para a melhora da saúde global através da biotecnologia genómica, e o JCB começou estudando aplicações de genómica e biotecnologia em sete países em desenvolvimento: Brasil, China, Egito, Índia, África do Sul e Coréia do Sul, que podem servir de exemplo para outra nações em desenvolvimento