Articles de revues sur le sujet « Programme national riz (Congo) »

Sudan occupies 2 500 000 km2 in East Africa. It has borders with nine countries, two of which are Arab: Egypt, Libya, Kenya, Uganda, Congo, Chad, the Central African Republic, Ethiopia and Eritrea. Sudan is the largest country in Africa. The heart of the country, in terms of population, lies at the confluence of the Blue and White Niles. The complex of the ‘three towns', comprising the three largest cities, Khartoum, Khartoum North and Omdurman, is situated there and contains almost 20% of the population. The total population of Sudan is about 35.4 million (projected from the 2005 census). The urban population was estimated at 33% of the total. About 2.2 million are still entirely nomadic. Sudan's peoples are as diverse as its geography. There are 19 major ethnic groups and 597 subgroups.

The electricity supply industry of the Democratic Republic of Congo is reviewed, from the formation of the Societé National d’Electricité (SNEL) in 1970 until today. The DRC government established a national utility, because electricity is a key element in the socio -economic development of a country. Due to the national monopoly of SNEL, hydropower plants could be constructed such as Inga1 and Inga2. They supply power to mining in the Katanga province, and to a steel company in Maluku, not far from Kinshasa. Currently, Inga1 and Inga 2 are not operating at full capacity. Many hydropower and thermal plants are located in different provinces and need to be refurbished to increase their capacity of electricity for the DRC. Due to technical problems, SNEL only generates 1150 MW. The electrification programme in urban and rural areas across the DRC caters for less than 10% of the 60 million inhabitants. In 1980, the government implemented a policy called Plan Directeur de SNEL for electrification, but the policies never reached their objectives. No Energy White Paper exists which outlines the entire policy framework for energy supply and demand. Power sector reform has also not been implemented in the electricity sector. This paper outlines future government options in the electricity sector. Accordingly, the Public Private Partnership model could play a major role in attracting private partners to invest in the electricity sector in order to have different hydropower and thermal plants refurbished.

Abstract The global disruptions caused by the coronavirus disease 2019 crisis posed a threat to the momentum the vector control team at the Liverpool School of Tropical Medicine (LSTM) and the Programme National de Lutte contre la Tryaponosomiase Humaine Africaine (PNLTHA) had built in their efforts to control tsetse fly populations in the Democratic Republic of Congo. But despite the pandemic and global lockdown, field activities did continue and the same impressive results in tsetse fly reduction were observed and the team followed this by completing a round of ‘tiny target’ deployment without any external presence. Such a success was possible due to the investment in vector control capacity strengthening undertaken by the LSTM and PNLTHA.

Setting: In 2010, Médecins Sans Frontières set up decentralised community antiretroviral therapy (ART) refill centres (“poste de distribution communautaire”, PODI) for the follow-up of stable human immunodeficiency virus (HIV) patients.Objective: To assess retention in care and sustained viral suppression after transfer to three main PODI in Kinshasa, Democratic Republic of Congo (DRC) (PODI Barumbu/Central, PODI Binza Ozone/West and PODI Masina I/East).Design: Retrospective cohort study using routine programme data for adult HIV patients transferred from Kabinda Hospital to PODIs between January 2015 and June 2017.Results: A total of 337 patients were transferred to PODIs: 306 (91%) were on ART for at least 12 months; 118 (39%) had a routine “12-month” viral load (VL) done, 93% (n = 110) of whom had a suppressed VL <1000 copies/ml. Median time from enrolment into PODI to 12-month routine VL was 14.6 months (IQR 12.2–20.8). Kaplan-Meier estimates of retention in care at 6, 12 and 18 months after enrolment into PODIs were respectively 96%, 92% and 88%.Conclusion: Retention in care and viral suppression among patients in PODI with VL results were better than patients in clinic care and national outcomes.

IntroductionInadequate water and sanitation is a central challenge in global health. Since 2008, the Democratic Republic of Congo government has implemented a national programme, Healthy Villages and Schools (Villages et Ecoles Assainis (VEA), with support from UNICEF, financed by UK’s Foreign, Commonwealth and Development Office.MethodsA cluster-level randomised controlled trial of VEA was implemented throughout 2019 across 332 rural villages, grouped into 50 treatment and 71 control clusters. Primary outcomes included time spent collecting water; quantity of water collected; prevalence of improved primary source of drinking water; and prevalence of improved primary defecation site. Secondary outcomes included child health, water governance, water satisfaction, handwashing practices, sanitation practices, financial cost of water, school attendance and water storage practices. All outcomes were self-reported. The primary analysis was on an intention-to-treat basis, using linear models. Outcomes were measured October–December 2019, median 5 months post-intervention.ResultsThe programme increased access to improved water sources by 33 percentage points (pp) (95% CI 22 to 45), to improved sanitation facilities by 26 pp (95% CI 14 to 37), and improved water governance by 1.3 SDs (95% CI 1.1 to 1.5), water satisfaction by 0.6 SD (95% CI 0.4 to 0.9), handwashing practices by 0.5 SD (95% CI 0.3 to 0.7) and sanitation practices by 0.3 SD (95% CI 0.1 to 0.4). There was no significant difference in financial cost of water, school attendance, child health or water storage practices.ConclusionVEA produced large increases in access to and satisfaction with water and sanitation services, in self-reported hygiene and sanitation behaviour, and in measures of water governance.Trial registration numberAEARCTR-0004648; American Economic Association RCT registry.

Abstract Vertical disease control programmes have enormous potential to benefit or weaken health systems, and it is critical to understand how programmes’ design and implementation impact the health systems and communities in which they operate. We use the Develop–Distort Dilemma (DDD) framework to understand how the Global Polio Eradication Initiative (GPEI) distorted or developed local health systems. We include document review and 176 interviews with respondents at the global level and across seven focus countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia and Nigeria). We use DDD domains, contextual factors and transition planning to analyse interactions between the broader context, local health systems and the GPEI to identify changes. Our analysis confirms earlier research including improved health worker, laboratory and surveillance capacity, monitoring and accountability, and efforts to reach vulnerable populations, whereas distortions include shifting attention from routine health services and distorting local payment and incentives structures. New findings highlight how global-level governance structures evolved and affected national actors; issues of country ownership, including for data systems, where the polio programme is not indigenously financed; how expectations of success have affected implementation at programme and community level; and unresolved tensions around transition planning. The decoupling of polio eradication from routine immunization, in particular, plays an outsize role in these issues as it removed attention from system strengthening. In addition to drawing lessons from the GPEI experience for other efforts, we also reflect on the use of the DDD framework for assessing programmes and their system-level impacts. Future eradication efforts should be approached carefully, and new initiatives of any kind should leverage the existing health system while considering equity, inclusion and transition from the start.

Implementing an Ebola vaccine trial in a remote area in the Democratic Republic of the Congo (DRC), and being confronted with a dysfunctional health care system and acute unmet health needs of participants, ethical considerations were made regarding the ancillary care obligations of the sponsor and researchers. Spurred by the occurrence of non-related (serious) adverse events (NR-SAEs), the Universities of Antwerp and Kinshasa jointly developed an algorithm, accompanied by an algorithm policy. The algorithm consists of a set of consecutive questions with binary response options, leading to structured, non-arbitrary and consistent support and management for each NR-SAE. It is the result of dialogue and collaboration between the sponsor (University of Antwerp) and the principal investigator (University of Kinshasa), consultation of literature, and input of research ethics and social sciences experts. The characteristics of the project and its budgetary framework were taken into account, as well as the local socioeconomic and healthcare situation. The algorithm and related policy have been approved by the relevant ethics committee (EC), so field implementation will begin when the study activities resume in November 2021. Lessons learnt will be shared with the relevant stakeholders within and outside DRC.If NR-SAEs are not covered by a functioning social welfare system, sponsors and researchers should develop a feasible, standardised and transparent approach to the provision of ancillary care. National legislation and contextualised requirements are therefore needed, particularly in low/middle-income countries, to guide researchers and sponsors in this process. Protocols, particularly of clinical trials conducted in areas with ‘access to care’ constraints, should include adequate ancillary care arrangements. Furthermore, it is essential that local ECs systematically require ancillary care provisions to enhance the well-being and protection of the rights of research participants. This project was funded by the European Union’s Horizon 2020 research and innovation programme, European Federation of Pharmaceutical Industries and Associations, and the Coalition for Epidemic Preparedness Innovations.

Background Following the West African Ebola virus disease (EVD) outbreak of 2013–2016 and more recent EVD outbreaks in the Democratic Republic of Congo, thousands of EVD survivors are at-risk for sequelae including uveitis, which can lead to unremitting inflammation and vision loss from cataract. Because of the known risk of Ebola virus persistence in ocular fluid and the need to provide vision-restorative, safe cataract surgery, the Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study was implemented in Sierra Leone. During implementation of this multi-national study, challenges included regulatory approvals, mobilization, community engagement, infection prevention and control, and collaboration between multiple disciplines. In this report, we address the multifacted approach to address these challenges and the impact of implementation science research to address an urgent clinical subspecialty need in an outbreak setting. Methodology/Principal findings Given the patient care need to develop a protocol to evaluate ocular fluid for Ebola virus RNA persistence prior to cataract surgery, as well as protocols to provide reassurance to ophthalmologists caring for EVD survivors with cataracts, the EVICT study was designed and implemented through the work of the Ministry of Health, Sierra Leone National Eye Programme, and international partnerships. The EVICT study showed that all 50 patients who underwent ocular fluid sampling at 19 and 34 months, respectively, tested negative for Ebola virus RNA. Thirty-four patients underwent successful cataract surgery with visual acuity improvement. Here we describe the methodology for study implementation, challenges encountered, and key issues that impacted EVD vision care in the immediate aftermath of the EVD outbreak. Key aspects of the EVICT study included defining the pertinent questions and clinical need, partnership alignment with key stakeholders, community engagement with EVD survivor associations, in-country and international regulatory approvals, study site design for infection prevention and control, and thorough plans for EVD survivor follow-up care and monitoring. Challenges encountered included patient mobilization owing to transportation routes and distance of patients in rural districts. Strong in-country partnerships and multiple international organizations overcame these challenges so that lessons learned could be applied for future EVD outbreaks in West and Central Africa including EVD outbreaks that are ongoing in Guinea and Democratic Republic of Congo. Conclusions/Significance The EVICT Study showed that cataract surgery with a protocol-driven approach was safe and vision-restorative for EVD survivors, which provided guidance for EVD ophthalmic surgical care. Ophthalmologic care remains a key aspect of the public health response for EVD outbreaks but requires a meticulous, yet partnered approach with international and local in-country partners. Future efforts may build on this framework for clinical care and to improve our understanding of ophthalmic sequelae, develop treatment paradigms for EVD survivors, and strengthen vision health systems in resource-limited settings.

Background: The Democratic Republic of Congo (DRC) implemented a prevention of mother-to-child transmission (PMTCT) of HIV infection programme in maternal, newborn and child health (MNCH) services in 2001 with nurses as key personnel. To date there is no informationin the DRC and specifically in Kinshasa with respect to compliance with PMTCT national guidelines.Aim: The study aimed at describing nurses’ compliance with the PMTCT national guidelines in selected PMTCT sites of Kinshasa.Methods: A descriptive cross-sectional study was conducted in Kinshasa with 76 nurses in 18 selected PMTCT sites. The nurses’ compliance with PMTCT national guidelines was assessed using a healthcare provider self-reporting questionnaire developed by the researchers.Results: The study showed that the mean score of nurses’ compliance with PMTCT nationalg uidelines was 74% (95% CI: 69% – 78%) which progressively decreased and was significantly different across different MNCH services (p = 0.025). With respect to categories of PMTCT recommendations, nurses were compliant with those related to education in labour and delivery, and antenatal services. Sociodemographic characteristics such as training, length of service and category of nurses did not influence nurses’ compliance score.Conclusion: These findings showed that nurses were noncompliant with PMTCT national guidelines, with the score level being 80% or more in the three MNCH services/units. Improvement of nurses’ ‘compliance with the PMTCT national guidelines requires effective monitoring of full integration of PMTCT as routine activities in MNCH care.

Abstract Background The national policy for malaria treatment of the Democratic Republic of Congo recommends two first-line artemisinin-based combinations for the treatment of uncomplicated malaria: artesunate-amodiaquine and artemether-lumefantrine. This study investigated the presence of markers associated with resistance to the current first-line artemisinin-based combination therapy (ACT) in isolates of Plasmodium falciparum from treatment failure patients in the Democratic Republic of Congo. Methods From November 2018 to November 2019, dried blood spots were taken from patients returning to health centres for fever within 28 days after an initial malaria treatment in six sentinel sites of the National Malaria Control Programme across Democratic Republic of Congo. The new episode of malaria was first detected by a rapid diagnostic test and then confirmed by a real-time PCR assay to define treatment failure. Fragments of interest in pfk13 and pfcrt genes were amplified by conventional PCR before sequencing and the Pfmdr1 gene copy number was determined by a TaqMan real-time PCR assay. Results Out of 474 enrolled patients, 364 (76.8%) were confirmed positive by PCR for a new episode of P. falciparum malaria, thus considered as treatment failure. Of the 325 P. falciparum isolates obtained from 364 P. falciparum-positive patients and successfully sequenced in the pfk13-propeller gene, 7 (2.2%) isolates carried non-synonymous mutations, among which 3 have been previously reported (N498I, N554K and A557S) and 4 had not yet been reported (F506L, E507V, D516E and G538S). Of the 335 isolates successfully sequenced in the pfcrt gene, 139 (41.5%) harboured the K76T mutation known to be associated with chloroquine resistance. The SVMNT haplotype associated with resistance to amodiaquine was not found. None of the isolates carried an increased copy number of the pfmdr1 gene among the 322 P. falciparum isolates successfully analysed. Conclusion No molecular markers currently known to be associated with resistance to the first-line ACT in use were detected in isolates of P. falciparum from treatment failure patients. Regular monitoring through in vivo drug efficacy and molecular studies must continue to ensure the effectiveness of malaria treatment in Democratic Republic of Congo.

Abstract Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country.

Abstract Objectives To discuss the added value of locally developed health policies and strategies in the context of Global Sustainable Development Goals. To discuss the capabilities, opportunities and limitations of public health institutes in low- and middle-income countries in contributing to health policies and strategies in their countries vis-à-vis the global policies, promoted by multilateral and UN institutions. To formulate recommendations for strengthening the role of local health research institutions in low- and middle-income countries in formulating evidence-based policies and strategies for achieving Sustainable Development Goals, in their countries and beyond their borders. Five panellists from public health and research institutes in Bangladesh, Laos, DR Congo, Uganda and Haiti, and one representative from the European Commission, discuss their experiences in the Support to Public Health Institutes Programme (financed by the European Union), and what they have achieved in influencing policy and practice. Have they been able to leave their ivory tower of science, and have they been able to enter into real dialogue with politicians, practitioners and users of health services? How have they dealt with scepticism in the era mistrust in science? How did they bridge the gap between science and politics, and what tangible products did they deliver to make an impact on health of the population through policy advice or strategy formulation? Did they really make a difference and if yes, how? How did the public health institutes relate to the global giants in health policy and strategies? Did they get support or encouragement for following a local route? Have the public health institutes been able to contribute to global development? Has an international exchange facilitated by the European Commission contributed to strengthening the institutes? After short introductions by the panelists about their work in the last five years, there will be answers to questions from the panel leader and the delegates in the workshop. Delegates are invited to share experiences from their countries. Most of the time of the workshop will be used for a discussion among all participants in the workshop: how can public health institutes and research institutions play a stronger role in policy advice and strategy development in the health sector in their country? What should change within the institutions? How can they demonstrate their added value? What should change in ministries of health and parliaments? What should change in decision-makers in health services? Which best practices do we know, can serve as an example? At the end of the workshop the participants will formulate concrete recommendations, to be presented to the global health community. Key messages Public health institutes and research institutions in low- and middle-income countries have a hidden potential to contribute to local solutions for global health problems. A paradigm shift in relations between academic institutions is needed to unleash the potential of public health institutes.

Abstract Background Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV. Methods Secondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission. Results Contraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324). Conclusions Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

En juin 2006, une étude analytique transversale de séroprévalence au Virus de l’Immunodéficience Humaine (VIH) a été initiée au sein du Centre Nutritionnel Thérapeutique (CNT) de l’Hôpital Général de Référence (HGR) de Wangata dans la Province de l’Equateur en République Démocratique du Congo (RDC). Le but de cette enquete était de chercher les possibles signaux existants de l’Infection à VIH sur terrain de malnutrition sévère auprès des enfants de Mbandaka, en collaboration avec la Coordination Provinciale de l’Equateur du Programme National de Lutte contre le VIH-Sida (CP-PNLS). Cette étude s’est basée sur les résultats obtenus suite aux tests volontaires qualitatifs, en se servant de l’algorithme décisionnel de laboratoire du PNLS de 2006 en RDC, qui veut que ces 42 personnes sur lesquelles notre analyse s’est axée soient classifiées dans la catégorie 2. L’étude a tablé sur au moins 2 tests rapides de dépistage, dont le Détermine, un test sensible et l’Oraquick comme test spécifique. Les résultats obtenus suggèrent que deux enfants de sexe féminin sur les 23 filles en compte avaient un statut sérologique positif, et deux autres également présentaient un résultat indéterminé. La prévalence instantanée était donc de 4,76% pour les enfants malnutris de juin 2006 au CNT de Wangata. Par ailleurs, le Ministère du Plan et de la Reconstruction (MPR) (2018) via le Multiple Indicator Cluster Survey 2001 rapportait une séroprévalence de 6,1% pour la ville de Mbandaka. Ces deux prévalences restent inférieures à 10% et tournent autour des résultats précédents de prévalence tant provinciale que Nationale qui était de plus ou moins 5% (MPR, 2018). Selon Gerstman (2015) dans les choix statistiques tabulaires, il est établi lors de cette étude que les résultats au test sont repartis de façon homogène dans les deux sexes, car avec 1,734 de probabilité calculée comme X², cette valeur étant inférieure à 7,879 de probabilité tabulaire. Par contre les résultats dépendent étroitement du type de test utilize, parce que le CHI-carré (X²) d’indépendance supérieur ou égal à 18,869 est moins significatif que le petit p 0,005 à 7,879 .

What is the countercultural potential of citizen science? As a participant in the wider citizen science movement, I can attest that contemporary citizen science initiatives rarely characterise themselves as countercultural. Rather, the goal of most citizen science projects is to be seen as producing orthodox scientific knowledge: the ethos is respectability rather than rebellion (NERC). I will suggest instead that there are resonances with the counterculture that emerged in the 1960s, most visibly through an emphasis on participatory experimentation and the principles of environmental sustainability and social justice. This will be illustrated by example, through two citizen science projects that have a commitment to combining social values with scientific practice. I will then describe the explicitly countercultural organisation, Science for the People, which arose from within the scientific community itself, out of opposition to the Vietnam War. Methodological and conceptual weaknesses in the authoritative model of science are explored, suggesting that there is an opportunity for citizen science to become anti-hegemonic by challenging the hegemony of science itself. This reformulation will be expressed through Deleuze and Guattari's notion of nomadic science, the means through which citizen science could become countercultural. Counterculture Before examining the countercultural potential of citizen science, I set out some of the grounds for identifying a counterculture drawing on the ideas of Theodore Roszak, who invented the term counterculture to describe the new forms of youth movements that emerged in the 1960s (Roszak). This was a perspective that allowed the carnivalesque procession of beatniks, hippies and the New Left to be seen as a single paradigm shift combining psychic and social revolution. But just as striking and more often forgotten is the way Roszak characterised the role of the counterculture as mobilising a vital critique of the scientific worldview (Roszak 273-274). The concept of counterculture has been taken up in diverse ways since its original formation. We can draw, for example, on Lawrence Grossberg's more contemporary analysis of counterculture (Grossberg) to clarify the main concepts and contrast them with a scientific approach. Firstly, a counterculture works on and through cultural formations. This positions it as something the scientific community would see as the other, as the opposite to the objective, repeatable and quantitative truth-seeking of science. Secondly, a counterculture is a diverse and hybrid space without a unitary identity. Again, scientists would often see science as a singular activity applied in modulated forms depending on the context, although in practice the different sciences can experience each other as different tribes. Thirdly, a counterculture is lived as a transformative experience where the participant is fundamentally changed at a psychic level through participation in unique events. Contrast this with the scientific idea of the separation of observer and observed, and the objective repeatability of the experiment irrespective of the experimenter. Fourthly, a counterculture is associated with a unique moment in time, a point of shift from the old to the new. For the counterculture of the 1960s this was the Age of Aquarius. In general, the aim of science and scientists is to contribute to a form of truth that is essentially timeless, in that a physical law is assumed to hold across all time (and space), although science also has moments of radical change with regard to scientific paradigms. Finally, and significantly for the conclusions of this paper, according to Roszak a counterculture stands against the mainstream. It offers a challenge not at the level of detail but, to the fundamental assumptions of the status quo. This is what “science” cannot do, in as much as science itself has become the mainstream. It was the character of science as the bedrock of all values that Roszak himself opposed and for which he named and welcomed the counterculture. Although critical of some of the more shallow aspects of its psychedelic experimentation or political militancy, he shared its criticism of the technocratic society (the technocracy) and the egocentric mode of consciousness. His hope was that the counterculture could help restore a visionary imagination along with a more human sense of community. What Is Citizen Science? In recent years the concept of citizen science has grown massively in popularity, but is still an open and unstable term with many variants. Current moves towards institutionalisation (Citizen Science Association) are attempting to marry growth and stabilisation, with the first Annual General Meeting of the European Citizen Science Association securing a tentative agreement on the common principles of citizen science (Haklay, "European"). Key papers and presentations in the mainstream of the movement emphasise that citizen science is not a new activity (Bonney et al.) with much being made of the fact that the National Audubon Society started its annual Christmas Bird Count in 1900 (National Audubon Society). However, this elides the key role of the Internet in the current surge, which takes two distinct forms; the organisation of distributed fieldwork, and the online crowdsourcing of data analysis. To scientists, the appeal of citizen science fieldwork follows from its distributed character; they can research patterns over large scales and across latitudes in ways that would be impossible for a researcher at a single study site (Toomey). Gathering together the volunteer, observations are made possible by an infrastructure of web tools. The role of the citizen in this is to be a careful observer; the eyes and ears of the scientist in cyberspace. In online crowdsourcing, the internet is used to present pattern recognition tasks; enrolling users in searching images for signs of new planets or the jets of material from black holes. The growth of science crowdsourcing is exponential; one of the largest sites facilitating this kind of citizen science now has well in excess of a million registered users (Zooniverse). Such is the force of the technological aura around crowdsourced science that mainstream publications often conflate it with the whole of citizen science (Parr). There are projects within citizen science which share core values with the counterculture as originally defined by Roszak, in particular open participation and social justice. These projects also show characteristics from Grossberg's analysis of counterculture; they are diverse and hybrid spaces, carry a sense of moving from an old era to a new one, and have cultural forms of their own. They open up the full range of the scientific method to participation, including problem definition, research design, analysis and action. Citizen science projects that aim for participation in all these areas include the Extreme Citizen Science research group (ExCiteS) at University College London (UCL), the associated social enterprise Mapping for Change (Mapping for Change), and the Public Laboratory for Open Technology and Science (Public Lab). ExCiteS sees its version of citizen science as "a situated, bottom-up practice" that "takes into account local needs, practices and culture". Public Lab, meanwhile, argue that many citizen science projects only offer non-scientists token forms of participation in scientific inquiry that rarely amount to more that data collection and record keeping. They counter this through an open process which tries to involve communities all the way from framing the research questions, to prototyping tools, to collating and interpreting the measurements. ExCiteS and Public Lab also share an implicit commitment to social justice through scientific activity. The Public Lab mission is to "put scientific inquiry at the heart of civic life" and the UCL research group strive for "new devices and knowledge creation processes that can transform the world". All of their work is framed by environmental sustainability and care for the planet, whether it's enabling environmental monitoring by indigenous communities in the Congo (ExCiteS) or developing do-it-yourself spectrometry kits to detect crude oil pollution (Public Lab, "Homebrew"). Having provided a case for elements of countercultural DNA being present in bottom-up and problem-driven citizen science, we can contrast this with Science for the People, a scientific movement that was born out of the counterculture. Countercultural Science from the 1970s: Science for the People Science for the People (SftP) was a scientific movement seeded by a rebellion of young physicists against the role of US science in the Vietnam War. Young members of the American Physical Society (APS) lobbied for it to take a position against the war but were heavily criticised by other members, whose written complaints in the communications of the APS focused on the importance of scientific neutrality and the need to maintain the association's purely scientific nature rather than allowing science to become contaminated by politics (Sarah Bridger, in Plenary 2, 0:46 to 1:04). The counter-narrative from the dissidents argued that science is not neutral, invoking the example of Nazi science as a justification for taking a stand. After losing the internal vote the young radicals left to form Scientists and Engineers for Social and Political Action (SESPA), which later became Science for the People (SftP). As well as opposition to the Vietnam War, SftP embodied from the start other key themes of the counterculture, such as civil rights and feminism. For example, the first edition of Science for the People magazine (appearing as Vol. 2, No. 2 of the SESPA Newsletter) included an article about leading Black Panther, Bobby Seale, alongside a piece entitled “Women Demand Equality in Science.” The final articles in the same issue are indicators of SftP's dual approach to science and change; both the radicalisation of professionals (“Computer Professionals for Peace”) and the demystification of technical practices (“Statistics for the People”) (Science for the People). Science for the People was by no means just a magazine. For example, their technical assistance programme provided practical support to street health clinics run by the Black Panthers, and brought SftP under FBI surveillance (Herb Fox, in Plenary 1, 0:25 to 0:35). Both as a magazine and as a movement, SftP showed a tenacious longevity, with the publication being produced every two months between August 1970 and May/June 1989. It mutated through a network of affiliated local groups and international links, and was deeply involved in constructing early critiques of nuclear power and genetic determinism. SftP itself seems to have had a consistent commitment to non-hierarchical processes and, as one of the founders expressed it, a “shit kicking” approach to putting its principles in to practice (Al Weinrub, in Plenary 1, 0:25 to 0:35). SftP criticised power, front and centre. It is this opposition to hegemony that puts the “counter” into counterculture, and is missing from citizen science as currently practised. Cracks in the authority of orthodox science, which can be traced to both methodologies and basic concepts, follow in this paper. These can be seen as an opportunity for citizen science to directly challenge orthodox science and thus establish an anti-hegemonic stance of its own. Weaknesses of Scientific Hegemony In this section I argue that the weaknesses of scientific hegemony are in proportion to its claims to authority (Feyerabend). Through my scientific training as an experimental particle physicist I have participated in many discussions about the ontological and epistemological grounds for scientific authority. While most scientists choose to present their practice publicly as an infallible machine for the production of truths, the opinions behind the curtain are far more mixed. Physicist Lee Somolin has written a devastating critique of science-in-practice that focuses on the capture of the institutional economy of science by an ideological grouping of string theorists (Smolin), and his account is replete with questions about science itself and ethnographic details that bring to life the messy behind-the-scenes conflicts in scientific-knowledge making. Knowledge of this messiness has prompted some citizen science advocates to take science to task, for example for demanding higher standards in data consistency from citizen science than is often the case in orthodox science (Haklay, "Assertions"; Freitag, "Good Science"). Scientists will also and invariably refer to reproducibility as the basis for the authority of scientific truths. The principle that the same experiments always get the same results, irrespective of who is doing the experiment, and as long as they follow the same method, is a foundation of scientific objectivity. However, a 2012 study of landmark results in cancer science was able to reproduce only 11 per cent of the original findings (Begley and Ellis). While this may be an outlier case, there are broader issues with statistics and falsification, a bias on positive results, weaknesses in peer review and the “publish or perish” academic culture (The Economist). While the pressures are all-too-human, the resulting distortions are rarely acknowledged in public by scientists themselves. On the other hand, citizen science has been slow to pick up the gauntlet. For example, while some scientists involved in citizen science have commented on the inequality and inappropriateness of orthodox peer review for citizen science papers (Freitag, “What Is the Role”) there has been no direct challenge to any significant part of the scientific edifice. I argue that the nearest thing to a real challenge to orthodox science is the proposal for a post-normal science, which pre-dates the current wave of citizen science. Post-normal science tries to accommodate the philosophical implications of post-structuralism and at the same time position science to tackle problems such as climate change, intractable to reproducibility (Funtowicz and Ravetz). It accomplishes this by extending the domains in which science can provide meaningful answers to include issues such as global warming, which involve high decision stakes and high uncertainty. It extends traditional peer review into an extended peer community, which includes all the stakeholders in an issue, and may involve active research as well as quality assessment. The idea of extended peer review has obvious overlaps with community-oriented citizen science, but has yet to be widely mobilised as a theoretical buttress for citizen-led science. Prior even to post-normal science are the potential cracks in the core philosophy of science. In her book Cosmopolitics, Isabelle Stengers characterises the essential nature of scientific truth as the ability to disqualify and exclude other truth claims. This, she asserts, is the hegemony of physics and its singular claim to decide what is real and what is true. Stengers traces this, in part, to the confrontation more than one hundred years ago between Max Planck and Ernst Mach, whereas the latter argued that claims to an absolute truth should be replaced by formulations that tied physical laws to the human practices that produced them. Planck stood firmly for knowledge forms that were unbounded by time, space or specific social-material procedures (Stengers). Although contemporary understandings of science are based on Planck's version, citizen science has the potential to re-open these questions in a productive manner for its own practices, if it can re-conceive of itself as what Deleuze and Guattari would call nomadic science (Deleuze; Deleuze & Guattari). Citizen Science as Nomadic Science Deleuze and Guattari referred to orthodox science as Royal Science or Striated Science, referring in part to its state-like form of authority and practice, as well as its psycho-social character. Their alternative is a smooth or nomadic science that, importantly for citizen science, does not have the ambition to totalise knowledge. Nomadic science is a form of empirical investigation that has no need to be hooked up to a grand narrative. The concept of nomadic science is a natural fit for bottom-up citizen science because it can valorise truths that are non-dual and that go beyond objectivity to include the experiential. In this sense it is like the extended peer review of post-normal science but without the need to be limited to high-risk high-stakes questions. As there is no a priori problem with provisional knowledges, it naturally inclines towards the local, the situated and the culturally reflective. The apparent unreliability of citizen science in terms of participants and tools, which is solely a source of anxiety, can become heuristic for nomadic science when re-cast through the forgotten alternatives like Mach's formulation; that truths are never separated from the specifics of the context and process that produced them (Stengers 6-18; 223). Nomadic science, I believe, will start to emerge through projects that are prepared to tackle toxic epistemology as much as toxic pollutants. For example, the Community Based Auditing (CBA) developed by environmental activists in Tasmania (Tattersall) challenges local alliances of state and extractive industries by undermining their own truth claims with regards to environmental impact, a process described in the CBA Toolbox as disconfirmation. In CBA, this mixture of post-normal science and Stenger's critique is combined with forms of data collection and analysis known as Community Based Sampling (Tattersall et al.), which would be recognisable to any citizen science project. The change from citizen science to nomadic science is not a total rupture but a shift in the starting point: it is based on an overt critique of power. One way to bring this about is being tested in the “Kosovo Science for Change” project (Science for Change Kosovo), where I am a researcher and where we have adopted the critical pedagogy of Paulo Freire as the starting point for our empirical investigations (Freire). Critical pedagogy is learning as the co-operative activity of understanding—how our lived experience is constructed by power, and how to make a difference in the world. Taking a position such as nomadic science, openly critical of Royal Science, is the anti-hegemonic stance that could qualify citizen science as properly countercultural. Citizen Science and Counterculture Counterculture, as I have expressed it, stands against or rejects the hegemonic culture. However, there is a strong tendency in contemporary social movements to take a stance not only against the dominant structures but against hegemony itself. They contest what Richard Day calls the hegemony of hegemony (Day). I witnessed this during the counter-G8 mobilisation of 2001. Having been an activist in the 1980s and 1990s I was wearily familiar with the sectarian competitiveness of various radical narratives, each seeking to establish itself as the correct path. So it was a strongly affective experience to stand in the convergence centre and listen to so many divergent social groups and movements agree to support each other's tactics, expressing a solidarity based on a non-judgemental pluralism. Since then we have seen the emergence of similarly anti-hegemonic countercultures around the Occupy and Anonymous movements. It is in this context of counterculture that I will try to summarise and evaluate the countercultural potential of citizen science and what being countercultural might offer to citizen science itself. To be countercultural it is not enough for citizen science to counterpose participation against the institutional and hierarchical aspects of professional science. As an activity defined purely by engagement it offers to plug the legitimacy gap for science while still being wholly dependent on it. A countercultural citizen science must pose a strong challenge to the status quo, and I have suggested that a route to this would be to develop as nomadic science. This does not mean replacing or overthrowing science but constructing an other to science with its own claim to empirical methods. It is fair to ask what this would offer citizen science that it does not already have. At an abstract level it would gain a freedom of movement; an ability to occupy Deleuzian smooth spaces rather than be constrained by the striation of established science. The founders of Science for the People are clear that it could never have existed if it had not been able to draw on the mass movements of its time. Being countercultural would give citizen science an affinity with the bottom-up, local and community-based issues where empirical methods are likely to have the most social impact. One of many examples is the movement against fracking (the hydraulic fracturing of deep rock formations to release shale gas). Together, these benefits of being countercultural open up the possibility for forms of citizen science to spread rhizomatically in a way that is not about immaterial virtual labour but is itself part of a wider cultural change. 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