The General Agreement on Trade in Services (GATS) is a set of multilateral, legally enforceable rules governing international trade in services. These rules are aimed at enhancing international trade in services including through promotion of progressive liberalization, free competition among service providers, and open access to national markets with out any prejudice or any pre-conditionality. The agreement regulates the cross-border flow of trade and investment in services and provides important opportunities and threats for developing countries especially in higher education field. However, the potential impact of GATS is still unknown as it is a new agreement yet to be implemented fully. With out examining the purpose, motivations, content, thrust and tone of GATS and specific threats and promises it holds for the economy, society and cultural enfoldments of signatories, they would be grouping into dark. Instead of being positive impacted, negative fallout may be in store for them. Considering the role and importance of higher education for sustainable social, political and economic development in Pakistan it is imperative for the appropriate quarters to investigate pros and cons attached to this new set of globalization process. To better understand this ongoing process the research explores the viability of options for our own institutions to avail the opportunities being offered by foreign market like Middle East, Central Asia, and South Asia etc for performing an efficient role as educational providers across border and vise versa. The research is based on the belief that insightful evaluation of consequence of opening education at various levels of GATS is essential for the formulation of rational, prudential and internationally acceptable policy and response mechanism on the part of Pakistan. Therefore, the dissertation aims to furnish helpful inputs to the authorities managing higher education in Pakistan so as to enable them to articulate realistic proposals, preempt the impact of negative effects attached with the agreement, execute necessary safeguards and reap benefits if any at appropriate stage. The resultant awareness is likely to smoothen higher education system in Pakistan compatible with the dictates of ongoing iiiglobalization and to withstand the competitive environment shaped by the developed world. Depending on the sagacity of policy and organizational intervention the intended expansion in trade and promotion of development can be realized and perils of disposed trade rise by foreign owned and controlled academic institutions can be avoided. Research endeavours to highlight the stakes and the pearls of intended participation of the third world in the forthcoming round of negotiations of GATS and the future of competitiveness of Pakistan’s higher education system hinges upon the reduction of prospective risks and maximization of our competencies.
مسٹر گارنر، جن کی وفات کی خبر حال میں شایع ہوئی ہے، ایک مشہور سیاح تھے، جنھوں نے سالہا سال افریقہ کے جنگلوں کی خاک چھانی تھی، آج سے تقریباً تیس سال قبل انھوں نے اس دعویٰ کا اعلان کیا تھا کہ بندروں میں بھی باہم ایک طریقہ کی گفتگو ہوتی ہے۔ ۱۸۹۲ء میں وہ مقام گیبون میں مقیم ہوئے، جہاں بندروں کی سب سے زیادہ ترقی یافتہ صنف گوریلا کی بکثرت آبادی ہے، یہاں کئی مہینہ تک انھوں نے اپنے تئیں ایک بڑے قفس آہنی میں ایک چمپانزی کے ساتھ مقید رکھا، اور اس کے ذریعے سے بندروں کی باہمی ’’گفتگو‘‘ سنتے رہے، لیکن ان کے اس دعویٰ کو سائنٹفک حلقوں میں زیادہ مقبولیت نہ حاصل ہوئی، اور جمہور محققین کا فیصلہ اس وقت یہ ہے کہ نطق و گویائی کی قوت انسان کے لیے مخصوص ہے، جس میں بندر وغیرہ کوئی صنف حیوانات اس کی شریک نہیں۔
Emergence of biomedical research and innovation with an unprecedented speed has created number of opportunities and challenges for policy makers. On the one hand, it is now possible to introduce tailor-made personal medication regime for an ailing patient to offer state of the art treatments. On the other hand, several ethical and legal issues have been raised due to the complex nature of emerging technologies. Policy makers all over the world are constantly addressing these challenges by continuously upgrading their respective professional and regulatory frameworks. This article is an attempt to highlight Shariah maxims which have contemporary application in medical field. Lately, there has been a lot of interest in the debate of Shariah maxims and many scholars have used maxims-based analytical frameworks to show the dynamic application of Islamic law. This article builds upon those works by focusing on issues related to the medical field.
Objective: To characterize antiretroviral drug resistance mutations among drug naïve patients in two referral hospitals in Kenya
Background: Acquired immunodeficiency syndrome (AIDS) caused by Human immunodeficiency virus (HIV) was first described in 1982. Since then the virus has spread globally to infect millions of people. HIV was first described in Kenya in the period between 1984/1985. Currently, Kenya has an estimated HIV-1 prevalence of 6.2% with a country population of about 40 million people. With the introduction of antiretroviral drugs, the survival of most HIV patients has been prolonged markedly. However this is greatly threatened by increasing rates of antiretroviral dug resistance, which may eventually lead to suboptimal treatment outcomes.
Methods: The aim of this study was to determine antiretroviral mutation profiles among drug naïve patients in two referral hospitals in Kenya. Antiretroviral naïve HIV patients in Aga Khan University Hospital and Thika Level 5 Hospital were consecutively recruited to participate in the study. Participants with viral loads >1000 copies/millilitre had their samples screened for antiretroviral resistance mutations by genotypic testing.
A total of 121 participants were recruited into this study from two centres. Eighty four participants had their samples successfully genotyped for drug resistance mutations.
Results: A total of five NRTI mutations (two Y115F, K219Q, K219E, and T215F) and one V106I mutation against NNRTIs were found among participants in this study.
One study participant had one protease mutation, M46L. The estimated primary antiretroviral resistance rate against reverse transcriptase inhibitors was 8.7 % (95% CI 4.0-17.7). Resistance against protease inhibitors was found to be low at 1.46% (95% CI 0.26-7.9).
The most common viral subtype was A1 at 52%. Others subtypes included D at 17%, subtype C at 13%, viral recombinants (CRF01_AE, CRF02_AG) at 12%, B at 3% and others subtypes (H, J) at 3%.
Conclusion: Antiretroviral drug resistance mutations are showing an increasing trend among therapy naïve patients since the introduction of antiretroviral therapy in Kenya in the early 2000. This might affect the efficacy of antiretroviral regimens used for treating HIV patients.
Funding: The study was co-funded by the Aga Khan University Research Council Grant (URC Grant Project 102001KEN Under Dr Nancy Okinda) and Aga Khan University Postgraduate Medical Education Seed Funding.