Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania – challenges in implementation

Background

In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme.

Methods

The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control – 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 – 2004) and implementation phases (2004 – 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs.

Results

The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative.

Conclusion

The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns.     

Salt tolerance in wild Hordeum species is associated with restricted entry of Na+ and Cl- into the shoots

Eight wild Hordeum species: H. bogdanii, H. intercedens, H. jubatum, H. lechleri, H. marinum, H. murinum, H. patagonicum, and H. secalinum, and cultivated barley (H. vulgare) were grown in nutrient solution containing 0.2 (control), 150, 300, or 450 mol m(-3) NaCl. In saline conditions, the wild Hordeum species (except H. murinum) had better Na+ and Cl- 'exclusion', and maintained higher leaf K+, compared with H. vulgare. For example, at 150 mol m(-3) NaCl, the K+:Na+ in the youngest, fully expanded leaf blades of the wild Hordeum species was, on average, 5.2 compared with 0.8 in H. vulgare. In H. marinum grown in 300 mol m(-3) NaCl, K+ contributed 35% to leaf psi(pi), whereas Na+ and Cl- accounted for only 6% and 10%, respectively. By comparison, in H. vulgare grown at 300 mol m(-3) NaCl, K+ accounted for 19% and Na+ and Cl- made up 21% and 25% of leaf psi(pi), respectively. At 300 mol m(-3) NaCl, glycinebetaine and proline together contributed almost 15% to psi(pi) in the expanding leaf blades of H. marinum, compared with 8% in H. vulgare. Decreased tissue water content under saline conditions made a substantial contribution to declines in leaf psi(pi) in the wild Hordeum species, but not in H. vulgare. A number of the wild Hordeum species were markedly more salt tolerant than H. vulgare. H. marinum and H. intercedens, as examples, had relative growth rates 30% higher than H. vulgare in 450 mol m(-3) NaCl. Hordeum vulgare also suffered up to 6-fold more dead leaf material (as a proportion of shoot dry mass) than the wild Hordeum species. Thus, several salt-tolerant wild Hordeum species were identified, and these showed an exceptional capacity to 'exclude' Na+ and Cl- from their shoots.     

Tolerance of combined submergence and salinity in the halophytic stem-succulent Tecticornia pergranulata

Background and Aims

Habitats occupied by many halophytes are not only saline, but are also prone to flooding. Few studies have evaluated submergence tolerance in halophytes.

Methods

Responses to submergence, at a range of salinity levels, were studied for the halophytic stem-succulent Tecticornia pergranulata subsp. pergranulata (syn. Halosarcia pergranulata subsp. pergranulata). Growth and total sugars in succulent stems were assessed as a function of time after submergence. Underwater net photosynthesis, dark respiration, total sugars, glycinebetaine, Na⁺, Cl⁻ and K⁺, in succulent stems, were assessed in a NaCl dose-response experiment.

Key Results

Submerged plants ceased to grow, and tissue sugars declined. Photosynthesis by succulent stems was reduced markedly when underwater, as compared with in air. Capacity for underwater net photosynthesis (P_N) was not affected by 10–400 mm NaCl, but it was reduced by 30 % at 800 mm. Dark respiration, underwater, increased in succulent stems at 200–800 mm NaCl, as compared with those at 10 mm NaCl. On an ethanol-insoluble dry mass basis, K⁺ concentration in succulent stems of submerged plants was equal to that in drained controls, across all NaCl treatments. Na⁺ and Cl⁻ concentrations, however, were elevated in stems of submerged plants, but so was glycinebetaine. Submerged stems increased in succulence, so solutes would have been ‘diluted’ on a tissue-water basis.

Conclusions

Tecticornia pergranulata tolerates complete submergence, even in waters of high salinity. A ‘quiescence response’, i.e. no shoot growth, would conserve carbohydrates, but tissue sugars still declined with time. A low K⁺ : Na⁺ ratio, typical for tissues of succulent halophytes, was tolerated even during prolonged submergence, as evidenced by maintenance of underwater P_N at up to 400 mm NaCl. Underwater P_N provides O₂ and sugars, and thus should enhance survival of submerged plants.Key words: Flooding, halophyte, Halosarcia pergranulata, inundation, inland salt marsh, respiration, Salicornioideae, salt lake, submergence–salinity interaction, tissue solutes, underwater net photosynthesis     

Growth of tomato and an ABA-deficient mutant (sitiens) under saline conditions

To determine whether ABA accumulation inhibits or promotes shoot growth under stress, an ABA-deficient mutant tomato, sitiens, and its wild-type, the cultivar Rheinlands Rhum, were exposed to moderate salinity stress. Plants were grown at 75 m M NaCl for 2 weeks under conditions of moderate or high relative humidity (70% and 95% RH, respectively). At 70% RH, shoot DW and relative growth rate were reduced more in sitiens than in the cultivar, but the major difference between genotypes was in the degree of injury suffered by older leaves. Most leaves of sitiens died after 2 weeks, but those of the cultivar remained alive. When plants were grown at 95% RH, to maximize the leaf water status of both genotypes, there was no significant effect of salt on shoot DW of either genotype. However, there was still considerable leaf death in sitiens whereas no visible injury appeared in the cultivar. Cl^– accumulated to higher levels in leaf tissues than Na⁺, but to similar concentrations in both genotypes, and so could not explain the injury in the sitiens leaves. The results indicate that ABA maintains rather than inhibits new growth under stress, and has a major effect on preservation of older leaves.     

Ground wētā in vines of the Awatere Valley,Marlborough: biology,density and distribution

The endemic New Zealand ground wētā (Hemiandrus sp. ‘promontorius’) has a Naturally Uncommon conservation status. This is because of the paucity of information on its density and distribution. Here, the biology, density and distribution of a population of this wētā found in and around vineyards in the Awatere Valley, Marlborough was studied. Wētā density was assessed in vineyards, paddocks and shrublands in this valley. Soil moisture, penetration resistance, pH and organic matter were recorded at locations with and without wētā. Wētā density in vineyards was significantly higher than in either paddocks or shrub habitats. In vineyards, the density of this insect was significantly higher under-vines than in the inter-rows. Higher numbers of this wētā were found in moist soils that required lower force to burrow. Females laid an average of 55 eggs between March and April, which hatched in September. These findings highlight the intersection between agriculture and conservation.     

The Tau/A152T mutation,a risk factor for frontotemporal‐spectrum disorders,leads to NR2B receptor‐mediated excitotoxicity

We report on a novel transgenic mouse model expressing human full‐length Tau with the Tau mutation A152T (hTau^AT), a risk factor for FTD‐spectrum disorders including PSP and CBD. Brain neurons reveal pathological Tau conformation, hyperphosphorylation, mis‐sorting, aggregation, neuronal degeneration, and progressive loss, most prominently in area CA3 of the hippocampus. The mossy fiber pathway shows enhanced basal synaptic transmission without changes in short‐ or long‐term plasticity. In organotypic hippocampal slices, extracellular glutamate increases early above control levels, followed by a rise in neurotoxicity. These changes are normalized by inhibiting neurotransmitter release or by blocking voltage‐gated sodium channels. CA3 neurons show elevated intracellular calcium during rest and after activity induction which is sensitive to NR2B antagonizing drugs, demonstrating a pivotal role of extrasynaptic NMDA receptors. Slices show pronounced epileptiform activity and axonal sprouting of mossy fibers. Excitotoxic neuronal death is ameliorated by ceftriaxone, which stimulates astrocytic glutamate uptake via the transporter EAAT2/GLT1. In summary, hTau^AT causes excitotoxicity mediated by NR2B‐containing NMDA receptors due to enhanced extracellular glutamate.     

Tolerance of Hordeum marinum accessions to O2 deficiency, salinity and these stresses combined

Background and Aims

When root-zone O₂ deficiency occurs together with salinity, regulation of shoot ion concentrations is compromised even more than under salinity alone. Tolerance was evaluated amongst 34 accessions of Hordeum marinum, a wild species in the Triticeae, to combined salinity and root-zone O₂ deficiency. Interest in H. marinum arises from the potential to use it as a donor for abiotic stress tolerance into wheat.

Methods

Two batches of 17 H. marinum accessions, from (1) the Nordic Gene Bank and (2) the wheat belt of Western Australia, were exposed to 0·2 or 200 mol m⁻³ NaCl in aerated or stagnant nutrient solution for 28–29 d. Wheat (Triticum aestivum) was included as a sensitive check species. Growth, root porosity, root radial O₂ loss (ROL) and leaf ion (Na⁺, K⁺, Cl⁻) concentrations were determined.

Key Results

Owing to space constraints, this report is focused mainly on the accessions from the Nordic Gene Bank. The 17 accessions varied in tolerance; relative growth rate was reduced by 2–38 % in stagnant solution, by 8–42 % in saline solution (aerated) and by 39–71 % in stagnant plus saline treatment. When in stagnant solution, porosity of adventitious roots was 24–33 %; salinity decreased the root porosity in some accessions, but had no effect in others. Roots grown in stagnant solution formed a barrier to ROL, but variation existed amongst accessions in apparent barrier ‘strength’. Leaf Na⁺ concentration was 142–692 µmol g⁻¹ d. wt for plants in saline solution (aerated), and only increased to 247–748 µmol g⁻¹ d. wt in the stagnant plus saline treatment. Leaf Cl⁻ also showed only small effects of stagnant plus saline treatment, compared with saline alone. In comparison with H. marinum, wheat was more adversely affected by each stress alone, and particularly when combined; growth reductions were greater, adventitious root porosity was 21 %, it lacked a barrier to ROL, leaf K⁺ declined to lower levels, and leaf Na⁺ and Cl⁻ concentrations were 3·1–9-fold and 2·8–6-fold higher, respectively, in wheat.

Conclusions

Stagnant treatment plus salinity reduced growth more than salinity alone, or stagnant alone, but some accessions of H. marinum were still relatively tolerant of these combined stresses, maintaining Na⁺ and Cl⁻ ‘exclusion’ even in an O₂-deficient, saline rooting medium.Key words: Aerenchyma, combined salinity and waterlogging, leaf Cl⁻, leaf K⁺, leaf Na⁺, radial O₂ loss, salt tolerance, salinity–waterlogging interaction, sea barleygrass, waterlogging tolerance, wheat, wild Triticeae