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Les administrations de Bill Clinton et de George W. Bush ont sensiblement développé l'engagement américain en Afrique : redéfinition des intérêts stratégiques, développement d'importants programmes humanitaires, sanitaires, investissement économique et militaire. La première administration Obama a déçu les attentes, semblant quelque peu négliger le continent africain. Le deuxième mandat de Barack Obama renouvellera-t-il l'engagement américain, au double niveau humanitaire et économique ?

The Clinton and G.W. Bush administrations significantly expanded U.S. engagement in Africa through redefinition of strategic interests, development of major humanitarian and health programs, and sizable economic and military investments. The first Obama administration did not live up to expectations, seeming to largely neglect the African continent. Will Obama take advantage of his second term to renew the U.S.'s commitments on both humanitarian and economic levels?. (Politique étrangère (Paris) / SWP)

Africa's changing economic landscape is prompting a shift in how U.S. policymakers view the continent. High growth rates, new technologies, and a rapidly expanding consumer class are driving greater global competition for investment and access to potential export markets, and the United States is recognizing that it will need to step up its game to remain relevant and influential in an increasingly crowded and competitive environment.

In a century torn by violent civil uprisings, civilian bombings, and genocides, war has been an immediate experience for both soldiers and civilians, for both women and men. But has this reality changed our long-held images of the roles women and men play in war, or the emotions we attach to violence, or what we think war can accomplish? This provocative collection addresses such questions in exploring male and female experiences of war--from World War I, to Vietnam, to wars in Latin America and the Middle East--and how this experience has been articulated in literature, film and drama, his

Poor control of cardiovascular disease accounts for a substantial proportion of the disease burden in developing countries, but often essential anticoagulant medicines for preventing strokes and embolisms are not widely available. In 2019, direct oral anticoagulants were added to the World Health Organization's WHO Model list of essential medicines. The aims of this paper are to summarize the benefits of direct oral anticoagulants for patients with cardiovascular disease and to discuss ways of increasing their usage internationally. Although the cost of direct oral anticoagulants has provoked debate, the affordability of introducing these drugs into clinical practice could be increased by: price negotiation; pooled procurement; competitive tendering; the use of patent pools; and expanded use of generics. In 2017, only 14 of 137 countries that had adopted national essential medicines lists included a direct oral anticoagulant on their lists. This number could increase rapidly if problems with availability and affordability can be tackled. Once the types of patient likely to benefit from direct oral anticoagulants have been clearly defined in clinical practice guidelines, coverage can be more accurately determined and associated costs can be better managed. Government action is required to ensure that direct oral anticoagulants are covered by national budgets because the absence of reimbursement remains an impediment to achieving universal coverage. Tackling cardiovascular disease with the aid of direct oral anticoagulants is an essential component of efforts to achieve the World Health Organization's target of reducing premature deaths due to noncommunicable disease by 25% by 2025.

An arc of instability stretching across Africa's Sahel region, an area of strategic interest for the United States and its allies, is plagued by violent extremist organizations (VEOs). These organizations, including Boko Haram, al Qaeda, and other terror groups, have metastasized and present a serious threat to regional stability.

U.S. policy engagement in Africa has entered a phase of dramatic enlargement, begun during President Bill Clinton's tenure and expanded—unexpectedly—under the administration of George W. Bush. In the last five years, several Africa-centered U.S. policy initiatives have been launched—in some instances backed by substantial funding increases—in trade and investment, security, development assistance, counterterrorism, and HIV/AIDS. By contrast with the Cold War era, recent initiatives—the Africa Growth and Opportunity Act, a counterterrorism task force in Djibouti, President Bush's $15 billion HTV/AIDS proposal, and the $5 billion Millennium Challenge Account (MCA)—have been largely free of partisan rancor or controversy.