By 2030, the middle-class population in Asia-Pacific is expected to increase from 1.38 billion people in 2015 to 3.49 billion people. In comparison, the middle-class population of sub-Saharan Africa is expected to increase from 114 million in 2015 to 212 million in 2030.

Worldwide wealth

While the middle-class has been on the rise, there is still a huge disparity in global wealth and income. The United States had the highest number of individuals belonging to the top one percent of wealth holders, and the value of global wealth is only expected to increase over the coming years. Around 57 percent of the world’s population had assets valued at less than 10,000 U.S. dollars; while less than one percent had assets of more than million U.S. dollars. Asia had the highest percentage of investable assets in the world in 2018, whereas Oceania had the highest percent of non-investable assets.

The middle-class

The middle class is the group of people whose income falls in the middle of the scale. China accounted for over half of the global population for middle-class wealth in 2017. In the United States, the debate about the middle class “disappearing” has been a popular topic due to the increase in wealth to the top billionaires in the nation. Due to this, there have been arguments to increase taxes on the rich to help support the middle-class.

South Africa CCI: Middle Income: Time to Buy Durables data was reported at 1.000 % Point in Sep 2018. This records an increase from the previous number of -1.000 % Point for Jun 2018. South Africa CCI: Middle Income: Time to Buy Durables data is updated quarterly, averaging -14.000 % Point from Mar 1995 (Median) to Sep 2018, with 95 observations. The data reached an all-time high of 9.000 % Point in Dec 2007 and a record low of -37.000 % Point in Sep 2003. South Africa CCI: Middle Income: Time to Buy Durables data remains active status in CEIC and is reported by Bureau for Economic Research. The data is categorized under Global Database’s South Africa – Table ZA.H006: Consumer Survey.

The average for 2024 based on 48 countries was 8.95 percent. The highest value was in South Africa: 33.17 percent and the lowest value was in Thailand: 0.69 percent. The indicator is available from 1991 to 2024. Below is a chart for all countries where data are available.

ZA: Survey Mean Consumption or Income per Capita: Total Population: Annualized Average Growth Rate data was reported at -1.230 % in 2014. ZA: Survey Mean Consumption or Income per Capita: Total Population: Annualized Average Growth Rate data is updated yearly, averaging -1.230 % from Dec 2014 (Median) to 2014, with 1 observations. ZA: Survey Mean Consumption or Income per Capita: Total Population: Annualized Average Growth Rate data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s South Africa – Table ZA.World Bank.WDI: Poverty. The growth rate in the welfare aggregate of the total population is computed as the annualized average growth rate in per capita real consumption or income of the total population in the income distribution in a country from household surveys over a roughly 5-year period. Mean per capita real consumption or income is measured at 2011 Purchasing Power Parity (PPP) using the PovcalNet (http://iresearch.worldbank.org/PovcalNet). For some countries means are not reported due to grouped and/or confidential data. The annualized growth rate is computed as (Mean in final year/Mean in initial year)^(1/(Final year - Initial year)) - 1. The reference year is the year in which the underlying household survey data was collected. In cases for which the data collection period bridged two calendar years, the first year in which data were collected is reported. The initial year refers to the nearest survey collected 5 years before the most recent survey available, only surveys collected between 3 and 7 years before the most recent survey are considered. The final year refers to the most recent survey available between 2011 and 2015. Growth rates for Iraq are based on survey means of 2005 PPP$. The coverage and quality of the 2011 PPP price data for Iraq and most other North African and Middle Eastern countries were hindered by the exceptional period of instability they faced at the time of the 2011 exercise of the International Comparison Program. See PovcalNet for detailed explanations.; ; World Bank, Global Database of Shared Prosperity (GDSP) circa 2010-2015 (http://www.worldbank.org/en/topic/poverty/brief/global-database-of-shared-prosperity).; ; The comparability of welfare aggregates (consumption or income) for the chosen years T0 and T1 is assessed for every country. If comparability across the two surveys is a major concern for a country, the selection criteria are re-applied to select the next best survey year(s). Annualized growth rates are calculated between the survey years, using a compound growth formula. The survey years defining the period for which growth rates are calculated and the type of welfare aggregate used to calculate the growth rates are noted in the footnotes.

Apnea of prematurity (AOP) is a common complication among preterm infants (<37 weeks gestation), globally. However, access to caffeine citrate (CC) that is a proven safe and effective treatment in high income countries is largely unavailable in low-and-middle income countries, where most preterm infants are born. Therefore, the overall aim of this study was to describe the demand, policies, and supply factors affecting the availability and clinical use of CC in LMICs. A mixed methods approach was used to collect data from diverse settings in LMICs including Ethiopia, Kenya, Nigeria, South Africa, and India. Qualitative semi-structured interviews and focus group discussions were conducted with different health care providers, policymakers, and stakeholders from industry. Additional data was collected using standard questionnaires. A thematic framework approach was used to analyze the qualitative data and descriptive statistics were used to summarize the quantitative data. The findings indicate that there is variation in in-country policies on the use of CC in the prevention and treatment of AOP and its availability across the LMICs. As a result, the knowledge and experience of using CC also varied with clinicians on Ethiopia having no experience of using it while those in India have greater knowledge and experience of using it. The in turn influenced the demand and our findings show that only 29% of eligible preterm infants are receiving CC in these countries. There is an urgent need to address the multilevel barriers to accessing CC for management of AOP in Africa. These include cost, lack of national policies and therefore lack of demand stemming from its clinical equivalency with aminophylline. Practical ways to reduce the cost of CC in LMICs could potentially increase its availability and use. Methods Study design, setting, population, sampling We conducted a landscape evaluation involving stakeholders in Africa (Ethiopia, Kenya, Nigeria, South Africa) and South Asia (India – five states of Delhi; Bihar, Uttar Pradesh, Telangana and Madhya Pradesh) on CC availability and use from 1 July 2022 to 31 December 2022. We used a mixed methods study design to understand the complexity of CC availability and use across these LMICs. We selected a geographically and culturally diverse countries with high annual preterm births (~200,000). The selection of stakeholders within each focus country was by convenience and/or purposive sampling. We selected health facilities providing care for preterm infants and were able to provide the data required to achieve the study’s objectives. Proximity and ease of data collection was also factored into selection by research teams. Data collection Qualitative The research teams conducted key informant interviews and focus group discussions (FGD’s) with stakeholders in newborn health. The interviews with healthcare providers sought to explore their experience of using CC as a treatment for AOP. Interviews with WHO and Ministry of Health officials sought to understand current global and national health policies and CC’s inclusion in the essential drug list for using CC to treat AOP. Interviews with major drug suppliers and distributors of CC aimed to determine the current local market pricing of CC and its alternatives within and between countries. Also, to evaluate the factors determining the end-customer price of CC. The available average end-customer price per country was used to determine the daily cost of managing AOP for aminophylline and CC. We compared the average daily cost between aminophylline and cc for both public and private hospitals in each country. The dosing regimen for CC was a loading dose of 20 mg/kg/dose and a daily maintenance dose of between 5 to 10 mg/kg/day. The dosing regimen for aminophylline was a loading dose of 6 mg/kg administered intravenously (IV), followed by a maintenance dose of 2.5 mg/kg/dose/IV administered every 8 hours. Interviews and FGD’s were done in person or virtually over video or audio teleconferencing based on the preferences of the participants. All interviews were conducted in English. teams were situated in each country of focus and had previous training and experience conducting qualitative interviews and FGDs and in qualitative data analysis. The interviews and FGDs were semi structured using guide with a set of open-ended questions, in a set order and allowing for in-depth insights into the subject area. These guides were pilot tested across the 3 countries prior to data collection. Quantitative Additional interviews were conducted using standard questionnaires and had been piloted and refined in these settings prior to being used for data collection.The research team surveyed 107 providers: 20 from Ethiopia, 18 from India, 23 from Kenya, 28 from Nigeria, and 18 from South Africa. Providers were from 45 private or public health facilities across the five study countries. Of these, 12 (27%) were primary or secondary public, 7 (16%) were primary or secondary private, 25 (56%) were tertiary public, and 1 (2%) tertiary private Demand forecast for caffeine citrate. A demand forecast was conducted to determine the amount of CC needed per country. Using data from demographic health survey data from each country, we estimated the proportion of infants who would be eligible for CC treatment. Given AOP risk can be as high as 80% in preterm infants with birthweight ≤1500g (very low birth weight (VLBW)), we estimated that all VLBW infants met eligibility criteria for treatment with CC. We limited this forecast to public facilities where limited government funding constrains drug availability. We applied country-specific policies and assumptions to determine the percentage of VLBW infants who received or had a missed opportunity for CC treatment. These assumptions included, availability of CC, VLBW infants born in secondary facilities will be transferred to a tertiary center capable of providing AOP treat; some transfers will be unsuccessful and even when successful, AOP treatment will be unavailable. Data management and analysis All interviews were transcribed verbatim by an experienced transcriber. Authors reviewed the interview transcripts for errors. A coding framework was generated, and an emergent thematic analysis approach was used to analyze the data, to identify patterns and themes. Descriptive statistics were used to summarize the quantitative data.

As of 2018/2019, the average sales price for avocados on markets in South Africa was at 10,755 South African Rands per metric ton (roughly 658 U.S. dollars per metric ton), a decline in comparison to previous year. A general increasing trend can be recognized between 2000 and 2019, with several slight dips. Moreover, the upward tendency may be related to the growth of the middle class in South Africa, along with the higher income groups willing to pay more for products with value addition. Comprehensive promotions on the emphasis on eating healthy have probably also caused demand for avocados to increase.

South Africa ZA: Survey Mean Consumption or Income per Capita: Bottom 40% of Population: Annualized Average Growth Rate data was reported at -1.550 % in 2014. South Africa ZA: Survey Mean Consumption or Income per Capita: Bottom 40% of Population: Annualized Average Growth Rate data is updated yearly, averaging -1.550 % from Dec 2014 (Median) to 2014, with 1 observations. South Africa ZA: Survey Mean Consumption or Income per Capita: Bottom 40% of Population: Annualized Average Growth Rate data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s South Africa – Table ZA.World Bank: Poverty. The growth rate in the welfare aggregate of the bottom 40% is computed as the annualized average growth rate in per capita real consumption or income of the bottom 40% of the population in the income distribution in a country from household surveys over a roughly 5-year period. Mean per capita real consumption or income is measured at 2011 Purchasing Power Parity (PPP) using the PovcalNet (http://iresearch.worldbank.org/PovcalNet). For some countries means are not reported due to grouped and/or confidential data. The annualized growth rate is computed as (Mean in final year/Mean in initial year)^(1/(Final year - Initial year)) - 1. The reference year is the year in which the underlying household survey data was collected. In cases for which the data collection period bridged two calendar years, the first year in which data were collected is reported. The initial year refers to the nearest survey collected 5 years before the most recent survey available, only surveys collected between 3 and 7 years before the most recent survey are considered. The final year refers to the most recent survey available between 2011 and 2015. Growth rates for Iraq are based on survey means of 2005 PPP$. The coverage and quality of the 2011 PPP price data for Iraq and most other North African and Middle Eastern countries were hindered by the exceptional period of instability they faced at the time of the 2011 exercise of the International Comparison Program. See PovcalNet for detailed explanations.; ; World Bank, Global Database of Shared Prosperity (GDSP) circa 2010-2015 (http://www.worldbank.org/en/topic/poverty/brief/global-database-of-shared-prosperity).; ; The comparability of welfare aggregates (consumption or income) for the chosen years T0 and T1 is assessed for every country. If comparability across the two surveys is a major concern for a country, the selection criteria are re-applied to select the next best survey year(s). Annualized growth rates are calculated between the survey years, using a compound growth formula. The survey years defining the period for which growth rates are calculated and the type of welfare aggregate used to calculate the growth rates are noted in the footnotes.

The average for 2022 based on 5 countries was 29523 kilograms. The highest value was in South Africa: 124401 kilograms and the lowest value was in Serbia: 15 kilograms. The indicator is available from 1998 to 2022. Below is a chart for all countries where data are available.