Can estimates of antimalarial efficacy from field studies be improved?
Monitoring therapeutic efficacy of antimalarial drugs is important because treatment failure rates are the primary basis for changing antimalarial treatment policy. An important aspect of efficacy studies is the use of PCR genotyping to distinguish recrudescent from new infections. The conclusions reached using this technique might be misleading if there is insufficient parasite diversity or a non-uniform haplotype frequency distribution in the study area. Statistical techniques can be used to overcome this problem, but only when data describing the haplotype frequency distribution are available. Therefore, assessing haplotype frequency and distribution should form an integral part of all studies investigating the therapeutic efficacy of antimalarial treatment regimes.
Summary Government action during food crises in southern Africa frequently exacerbates the problems, driving food staple prices well beyond import parity. We argue that an inability to make credible commitments, due largely to a lack of trust between public and private sectors, contributes to this dynamic. Empirical policy analysis can facilitate resolution only within a consultative process involving a broad range of stakeholders. The policies emerging from such a process are not likely to approximate first best recommendations. Yet the precise policies may be less important than the fact that they exist and that main stakeholders find them credible.