The Trump administration is pursuing an explicitly anti-multilateralist policy rooted in national sovereignty, geopolitical calculation, and transactional economics. Conspiracy theories played a significant role in justifying actions like the dismantling of USAID. Global norms, including the SDGs, are cast as threats to U.S. interests precisely because they promote forms of cooperative governance. The withdrawal from international organizations, disregard for established norms (even to the point of military threats), and blunt pressure on other nations—such as the baseless accusations of “genocide” against South Africa—signal a paradigm shift. It redefines the balance between values and interests, privileging short-term political dominance over long-term global cooperation.
The Trump administration is pursuing an explicitly anti-multilateralist policy rooted in national sovereignty, geopolitical calculation, and transactional economics. Conspiracy theories played a significant role in justifying actions like the dismantling of USAID. Global norms, including the SDGs, are cast as threats to U.S. interests precisely because they promote forms of cooperative governance. The withdrawal from international organizations, disregard for established norms (even to the point of military threats), and blunt pressure on other nations—such as the baseless accusations of “genocide” against South Africa—signal a paradigm shift. It redefines the balance between values and interests, privileging short-term political dominance over long-term global cooperation.
Turkey’s geopolitically motivated industrial and supply chain policy implies close ties to Germany as well as a security and economic policy orientation towards the EU. Ankara wants to bring production and sales into line with EU standards and establish a green high-tech and services economy. However, its decarbonisation measures remain inadequate. Turkish stakeholders see disruptions to global supply chains as creating the opportunity to relocate European production chains to Turkey (nearshoring). The government, the private sector and business organisations are all working to expand sustainable energy supplies. Turkey’s authoritarian domestic policy – namely, the dismantling of democracy, repression and disregard for the rule of law – makes it extremely difficult to deepen bilateral cooperation. Despite close economic ties, there are normative differences between Germany and Turkey and a consistent strategy to overcome them is lacking. Rather, the Turkish government is focused on using industrial policy to compensate for shortcomings in the rule of law. Amid the geopolitical tensions between the United States and China, Turkey is performing a delicate balancing act: it is maintaining its ties to the West while at the same time expanding its technology partnership with China and energy cooperation with Russia. German policy towards Turkey requires a strategic rethink. It should endeavour to promote economic stability, strengthen Turkey’s security policy integration into Europe and counteract Ankara’s strategic rapprochement with Moscow and Beijing. Going forward, cooperation should be made conditional on democracy, the rule of law and human rights.
Background: Amidst the COVID-19 pandemic, lockdown policies emerged as pivotal measures to contain viral transmission. Questions arose about whether their implementation challenged access to care, particularly in regions with fragile or less resilient health systems, such as sub-Saharan Africa. Robust evidence on the effect of lockdowns on healthcare access remains sparse, partly due to a lack of suitable data. We addressed this gap and assessed the effect of the COVID-19 lockdown policy on facility-based delivery during the first pandemic wave in Kenya. Methods: We triangulated findings from two independent quantitative analyses, exploiting the fact that lockdowns in Kenya were implemented only in selected counties. First, we used nationally representative repeated cross-sectional surveys from 2018 and 2020, applying a pre-post-test design with independent controls. Second, we analyzed monthly data from the Kenya Health Information System (Jan 2019–Nov 2020) using an interrupted time series (ITSA) with independent controls, with April 2020 set as the interruption point. Results: The controlled pre-post analysis found no significant effect of lockdowns on facility-based delivery in lockdown vs. non-lockdown counties. The ITSA showed an immediate increase of 4.97% (CI: 0.51%, 9.43%) in facility deliveries in lockdown counties, followed by a significant monthly decrease of 0.97% (CI: -1.60%, -0.34%) compared with non-lockdown counties. Conclusion: We found no overall effect of lockdowns on facility-based deliveries. Our results suggest that, when managed well, lockdowns do not necessarily disrupt access to maternal health services—demonstrating elements of resilience even under crisis conditions. These findings underscore the value of context-specific, adaptive strategies to ensure continuity of essential services during health emergencies. Future research should explore localized and socioeconomic factors shaping responses to public health interventions and further examine how resilience can be strengthened at all levels of the health system.
Background: Amidst the COVID-19 pandemic, lockdown policies emerged as pivotal measures to contain viral transmission. Questions arose about whether their implementation challenged access to care, particularly in regions with fragile or less resilient health systems, such as sub-Saharan Africa. Robust evidence on the effect of lockdowns on healthcare access remains sparse, partly due to a lack of suitable data. We addressed this gap and assessed the effect of the COVID-19 lockdown policy on facility-based delivery during the first pandemic wave in Kenya. Methods: We triangulated findings from two independent quantitative analyses, exploiting the fact that lockdowns in Kenya were implemented only in selected counties. First, we used nationally representative repeated cross-sectional surveys from 2018 and 2020, applying a pre-post-test design with independent controls. Second, we analyzed monthly data from the Kenya Health Information System (Jan 2019–Nov 2020) using an interrupted time series (ITSA) with independent controls, with April 2020 set as the interruption point. Results: The controlled pre-post analysis found no significant effect of lockdowns on facility-based delivery in lockdown vs. non-lockdown counties. The ITSA showed an immediate increase of 4.97% (CI: 0.51%, 9.43%) in facility deliveries in lockdown counties, followed by a significant monthly decrease of 0.97% (CI: -1.60%, -0.34%) compared with non-lockdown counties. Conclusion: We found no overall effect of lockdowns on facility-based deliveries. Our results suggest that, when managed well, lockdowns do not necessarily disrupt access to maternal health services—demonstrating elements of resilience even under crisis conditions. These findings underscore the value of context-specific, adaptive strategies to ensure continuity of essential services during health emergencies. Future research should explore localized and socioeconomic factors shaping responses to public health interventions and further examine how resilience can be strengthened at all levels of the health system.
Background: Amidst the COVID-19 pandemic, lockdown policies emerged as pivotal measures to contain viral transmission. Questions arose about whether their implementation challenged access to care, particularly in regions with fragile or less resilient health systems, such as sub-Saharan Africa. Robust evidence on the effect of lockdowns on healthcare access remains sparse, partly due to a lack of suitable data. We addressed this gap and assessed the effect of the COVID-19 lockdown policy on facility-based delivery during the first pandemic wave in Kenya. Methods: We triangulated findings from two independent quantitative analyses, exploiting the fact that lockdowns in Kenya were implemented only in selected counties. First, we used nationally representative repeated cross-sectional surveys from 2018 and 2020, applying a pre-post-test design with independent controls. Second, we analyzed monthly data from the Kenya Health Information System (Jan 2019–Nov 2020) using an interrupted time series (ITSA) with independent controls, with April 2020 set as the interruption point. Results: The controlled pre-post analysis found no significant effect of lockdowns on facility-based delivery in lockdown vs. non-lockdown counties. The ITSA showed an immediate increase of 4.97% (CI: 0.51%, 9.43%) in facility deliveries in lockdown counties, followed by a significant monthly decrease of 0.97% (CI: -1.60%, -0.34%) compared with non-lockdown counties. Conclusion: We found no overall effect of lockdowns on facility-based deliveries. Our results suggest that, when managed well, lockdowns do not necessarily disrupt access to maternal health services—demonstrating elements of resilience even under crisis conditions. These findings underscore the value of context-specific, adaptive strategies to ensure continuity of essential services during health emergencies. Future research should explore localized and socioeconomic factors shaping responses to public health interventions and further examine how resilience can be strengthened at all levels of the health system.
Voyage à reculons dans les Balkans occidentaux, Carnet de voyage, d'Ombeline Duprat, éditions Spinelle, 2025, 170 pages, 18 euros.
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