This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development assistance for health (DAH) has grown at an annualized rate of 1.0%. While global development ass...istance for health has seemingly leveled off, global health spending continues to climb, outpacing economic growth in many countries. Total health spending for 2015, the most recent year for which data are available, was estimated to be $9.7 trillion (95% uncertainty interval: 9.7–9.8)*, up 4.7% (3.9–5.6) from the prior year, and accounted for 10% of the world’s total economy. With some sources of health spending growing and other types remaining steady, and with major variations in spending from country to country, it is more important than ever to understand where resources for health come from, where they go, and how they align with health needs. This information is critical for planning and is a necessary catalyst for change as we aim to close the gap on the unfinished agenda of the Millennium Development Goals (MDGs) and move forward toward universal health coverage (UHC) in the Sustainable Development Goals (SDGs) era.
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Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards ...UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country’s UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios.
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As of December 2018, CEPI has secured more than USD $747million towards its USD $1billion funding target, with financial support provided by the Bill & Melinda Gates Foundation, the Wellcome Trust, the European Commission, and the governments of Australia, Belgium, Canada, Germany, Japan, Norway, an...d the UK. These funds are used to finance CEPI’s core activities in coordinating efforts and investing in the development of new vaccines and technologies to prevent and contain infectious disease epidemics.
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The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning ...disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003–13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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A collection of 8 infographics on Household Air Pollution.
In recent decades, India has witnessed a rapidly exploding epidemic of diabetes.
Indeed, India today has the second largest number of people with diabetes in the
world. The International Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is... projected to rise to 134.3 million by the year 2045. The prevalence of diabetes in urban India, especially in large metropolitan cities has increased from 2% in the 1970s to over 20% at present and the rural areas are also fast catching up.
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Diabetes mellitus (hereafter referred to as diabetes) is a chronic, progressive disease characterized by elevated blood glucose levels. Diabetes can lead to complications such as cardiovascular disease (CVD) and premature death, and can damage eyes, kidneys and nerves. Globally, more than 400 millio...n adults live with diabetes – a disease that caused 1.6 million deaths in 2015 (1, 2). People with diabetes who have higher blood glucose levels are more likely to develop complications than those with lower blood glucose levels. Blood glucose management has an important role in preventing the
development and progression of complications in both type 1 and type 2 diabetes.
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The Noncommunicable Diseases Country Profiles 2018 by the World Health Organization (WHO) provides an in-depth look at the burden of noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes across WHO Member States. It includes data on NCD m...ortality, risk factors like tobacco use, unhealthy diets, physical inactivity, and excessive alcohol consumption, as well as country-specific responses and health system capacities to manage and prevent NCDs.
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This paper summarises the past, present and future of asbestos exposure. The future scenarios as to the mesothelioma incidence in countries, where asbestos has been banned, are discussed.
The article discusses the success of the Global Alliance against Chronic Respiratory Diseases (GARD) in Brazil. It details the initiatives launched to address chronic respiratory diseases (CRDs) like asthma and COPD, emphasizing the development of national programs and collaborative efforts with the... World Health Organization (WHO). Key achievements include successful advocacy, education campaigns, and pilot projects for asthma control, which have led to improved access to treatment and better management of CRDs. Despite challenges such as limited government priority, GARD Brazil has made significant progress in awareness and care for respiratory conditions. The article highlights the need for continued support to sustain these efforts and develop a formal national action plan.
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The document is a handbook on implementing the mBreatheFreely program, an mHealth initiative by the World Health Organization (WHO) and the International Telecommunication Union (ITU) aimed at improving the management of asthma and COPD through mobile technology. It provides a framework for governme...nts and policymakers to develop, launch, and evaluate national mHealth programs. The guide covers areas such as operations management, content development, promotion strategies, technology infrastructure, and monitoring and evaluation. It emphasizes the importance of mHealth in enhancing self-management, prevention, and treatment of chronic respiratory diseases, particularly in low- and middle-income countries. The handbook also includes examples of successful programs and practical tools for adaptation and implementation.
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The NICE guideline on antimicrobial prescribing for acute exacerbations of COPD provides recommendations for optimizing antibiotic use to treat exacerbations effectively while minimizing the risk of antimicrobial resistance. It includes criteria for assessing the need for antibiotics, guidance on se...lecting antibiotics, and considerations for reassessment and follow-up care.
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This guideline covers diagnosing and managing chronic obstructive pulmonary disease or COPD (which includes emphysema and chronic bronchitis) in people aged 16 and older. It aims to help people with COPD to receive a diagnosis earlier so that they can benefit from treatments to reduce symptoms, impr...ove quality of life and keep them healthy for longer.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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When someone is having an asthma attack, their airways go into spasm which causes tightness of the chest; the linings of the airways become inflamed and phlegm is produced further obstructing the airways and leading to severe difficulty in breathing (Fig. 1). Asthma does lead to fatalities and shoul...d always be taken seriously.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wi...de variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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This video is meant to train the public on how to use some of the devices for delivery of asthma medications.
Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee...nage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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