Forum for Development Studies
Volume 41, Issue 2, 2014
http://www.tandfonline.com/toc/sfds20/current

On the Fractured, Fragmented and Disrupted Landscapes of Conservation
Rune Flikkea*
DOI: 10.1080/08039410.2014.918759
pages 173-182
Published online: 17 Jun 2014
Abstract
Since Agenda 21, drawn up after the UN Conference on Environment and Development held in Rio de Janeiro in 1992, the merger of environmentalism and development has been pitched as a ‘win–win’ scenario often coined as ‘conservation-as-development’. By integrating local populations in the environmental projects ‘conservation-as-development’ claim to overcome negative aspects of the nature–culture divide. Using the arguments forwarded by Cortes-Vazquez, Turner, Semedi and Howell in this issue, the article critically discusses the development of these environmentalist efforts, exemplified by the UNESCO Biosphere reserves and the UN-REDD, to suggest that the natureculture divide keep cropping up in new constellations despite the official rhetoric. It is suggested that a solution is to be found in a serious, ethnographic approach that pays attention to the new social networks and material flows that tie local and global worlds together through these forms of environmentalist practices.

When Are Health Systems Ready for New Vaccines? The Introduction of Pneumococcal Vaccine in Malawi
Lot Jata Nyirendaa*, Kristin Ingstad Sandberga & Judith Justiceb
DOI: 10.1080/08039410.2014.894936
pages 317-336
Published online: 31 Mar 2014
Abstract
Increasing coverage of routine immunisation and new vaccines is key to reaching Millennium Development Goal number four (MDG 4) on reducing child mortality. Malawi, despite a weak health system, is on track to achieve MDG 4, partly because of its high-performing immunisation programme. Among the early adopters of new vaccines, with major support from Global Alliance for Vaccines and Immunisation, Malawi introduced pneumococcal vaccine in 2011 during a time of severe political and economic crisis. This exploratory case study (part of a larger research project on explaining differential immunisation coverage, conducted in 2010 and 2011, using primarily qualitative methods including in-depth interviewing) looks at the decision-making and policy process for vaccine introduction within the broader political–economic context. Based on a framework of benchmarks on preparedness of immunisation systems and assessments of integration with health systems, the study findings suggest that pneumococcal vaccine introduction was more integrated with key health system functions the closer it got to the point of service delivery. Furthermore, although the vaccine introduction succeeded in relation to immunisation targets and prevention of disease, it may have had substantial indirect costs to other targeted health interventions and broader health systems functions at times when basic amenities are in short supply or unavailable. For a donor-dependent country such as Malawi, policy choices are limited to what is on offer – and new vaccines were on offer; other crucial necessities were not. Further research could establish with more certainty the conditions under which vaccine introduction strengthens health systems that are already weak, and when they push systems further into crisis.