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Corruption is embedded in health systems. Throughout my life—as a researcher, public health worker, and a Minister of Health—I have been able to see entrenched dishonesty and fraud. But despite being one of the most important barriers to implementing universal health coverage around the world, c
...
orruption is rarely openly discussed. In this Lecture, I outline the magnitude of the problem of corruption, how it started, and what is happening now. I also outline people's fears around the topic, what is needed to address corruption, and the responsibilities of the academic and research communities in all countries, irrespective of their level of economic development. Policy makers, researchers, and funders need to think about corruption as an important area of research in the same way we think about diseases. If we are really aiming to achieve the Sustainable Development Goals and ensure healthy lives for all, corruption in global health must no longer be an open secret.
more
To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV
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expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
more
We, the participants at the first-ever International Conference on PEN-Plus in Africa (ICPPA), held on 23– 25 April 2024 in Dar Es Salaam, United Republic of Tanzania, recognize the urgency of the rising burden of noncommunicable diseases (NCDs) across our Region. We are alarmed by the implication
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s for social and economic development across Africa, considering that rising numbers of people under the age of 40 die unnecessarily.
more
For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source
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of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
more
Antimicrobial resistance (AMR) is a threat to human and animal health and refers to the ability of microorganisms to defy the medicines prescribed. For instance when antibiotics are used improperly, such as an incorrect dose, insufficient duration or wrong frequency, resistance is heightened. The mi
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suse of antimicrobials affects their efficacy, and increasingly more infections and diseases become untreatable. Many gains made in modern medicine throughout the 20th century will be lost, making AMR a global public and animal health issue that requires concerted action. AMR and the use of antimicrobials (AMU) affect food safety and security, people’s livelihoods, as well as economic and agricultural development.
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The world faces grave consequences from the lack of available mental health services and treatment. Mental illness impacts every country, culture and community, with the World Health Organization (WHO) stating that 10% of the global burden of disease is related to mental, neurological and substance
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use disorders. In low-and middle-income countries, more than 75% of people with mental disorders receive no treatment at all for their disorder. During 2020, as a result of the global pandemic, 93% of countries reported their mental health services were either halted or interrupted (WHO, 2020e). WHO reported a 25% increase in depression and anxiety alone during the pandemic. The Organisation for Economic Co-operation and Development estimates depression and anxiety cost the global economy US $1 trillion dollars a year. All nurses have a health care role in mental health and substance use. ICN strongly advocates for the investment of further education and professional development in this area in order to support individuals and communities achieve the highest attainable standard of health which includes
physical, mental and social wellbeing.
more
Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the
leading causes of death and disability worldwide. Most of this patient harm is avoidable. As countries strive to
achieve universal health coverage and the Sustainable
...
Development Goals, the beneficial effects of improved
access to health services can be undermined by unsafe care. Patient safety incidents can cause death and
disability, and suffering for victims and their families. The financial and economic costs of safety lapses are high.
There is often reduced public confidence and trust in local health systems when such incidents are publicized.
Health workers involved in serious incidents involving death or serious harm to a patient can also suffer lasting
psychological harm and deep-seated feelings of guilt and self-criticism.
more
The following technical report outlines the rationale, process and results of a joint research study, coordinated by the World Health Organization (WHO) and the Pan-American Health Organization (PAHO), co-chaired by the Ministry of Health and Social Protection and the Ministry of Environment and Sus
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tainable Development in collaboration with the Climate and Climate Air Coalition, the Stockholm Environment Institute, the Clean Air Institute and leading international and national experts. A rationale section describes the links between greenhouse gas (GHG) emissions, short-lived climate pollutants, air pollution and adverse health outcomes. A summary of the research study describes how scenarios were modelled to examine the health and economic implications of raising ambition in Colombia’s Nationally Determined Contribution (NDC) to the United Nations Framework Convention on Climate Change (UNFCCC)
more
Non-communicable diseases (NCDs) account for 72% of all deaths globally and this proportion is growing. Greatest increases in NCD mortality are seen in low-income and middle-income countries (LMICs). Places that only a generation ago knew famine are
today experiencing epidemics of obesity, diabetes
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, cardiovascular disease, and cancer. These epidemics reduce human capital in developing countries and their economic costs are so great that they threaten to slow and even undercut trajectories of economic and social development.
more
An interdisciplinary approach to address global health challenges such as the Covid-19 pandemic, climate change, loss of biodiversity, human migration has been framed by the One Health approach. This approach is promoted at global level by the Tripartite of the World Health Organisation, the World A
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nimal Health Organisation, the Food and Agriculture Organisation of the United Nations, recently joint by the United National Environment Program to form the Quadripartite. The German government through its Ministry of Economic Cooperation and Development supports this approach with its One Health strategy and investment in several technical cooperation projects.
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A guide to increasing coverage and equity in all communities in the African Region
Expanded Programs on Immunization (EPI) is responsible for vaccines and vaccination to control, eliminate and eradicate vaccine preventable diseases (VPDs). Having strong immunization systems to deliver vaccines ... to those who need them most will play a significant role in achieving the health, equity and economic objectives of several global development goals. more
Expanded Programs on Immunization (EPI) is responsible for vaccines and vaccination to control, eliminate and eradicate vaccine preventable diseases (VPDs). Having strong immunization systems to deliver vaccines ... to those who need them most will play a significant role in achieving the health, equity and economic objectives of several global development goals. more
Today, the world is facing a learning crisis: While millions of children have entered education systems for the first time, many of them cannot read, write or do basic mathematics, even after several years of primary school.1 This global learning crisis has its roots in children’s earliest years,
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when failure to invest in quality early childhood education (ECE)results in children starting school already behind in a host of critical skills they need to succeed in primary school.2Investing in the foundations of learning during the child’s early years benefits children,3 families, education systems and societies at large.4 Participation in quality ECE sets in motion a positive learning cycle and is a proven strategy to address the global learning crisis at its roots by closing early learning gaps, strengthening the efficiency of education systems and providing a solid foundation for human capital development and economic grow
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Chikungunya virus (CHIKV) is currently one of the most relevant arboviruses to public health. It is a member of the Togaviridae family and alphavirus genus and causes an arthritogenic disease known as chikungunya fever (CHIKF). It is characterized by a multifaceted disease, which is distinguished fr
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om other arbovirus infections by the intense and debilitating arthralgia that can last for months or years in some individuals. Despite the great social and economic burden caused by CHIKV infection, there is no vaccine or specific antiviral drugs currently available. Recent outbreaks have shown a change in the severity profile of the disease in which atypical and severe manifestation lead to hundreds of deaths, reinforcing the necessity to understand the replication and pathogenesis processes. CHIKF is a complex disease resultant from the infection of a plethora of cell types. Although there are several in vivo models for studying CHIKV infection, none of them reproduces integrally the disease signature observed in humans, which is a challenge for vaccine and drug development. Therefore, understanding the potentials and limitations of the state-of-the-art experimental models is imperative to advance in the field. In this context, the present review outlines the present knowledge on CHIKV epidemiology, replication, pathogenesis, and immunity and also brings a critical perspective on the current in vitro and in vivo state-of-the-art experimental models of CHIKF.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
...
the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
...
the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
...
the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights
...
the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
more
The article discusses chronic obstructive pulmonary disease (COPD) as a common but under-recognized occupational disease. While smoking is the main cause, occupational exposure to vapors, gases, dusts, and fumes (VGDF) significantly contributes to the deve
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lopment and progression of COPD. Epidemiological studies indicate that up to 14% of COPD cases are attributable to occupational factors. The article highlights the need for better physician training in obtaining occupational exposure histories and emphasizes early diagnosis to prevent disease progression. Additionally, it stresses the importance of collaboration among general practitioners, respiratory specialists, and occupational health professionals to reduce the health and socio-economic impact of COPD.
more
This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.
During the COVID-19 pandemic, hand hygiene
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received unprecedented attention and became a central pillar in national COVID prevention strategies. However, concern with hand hygiene should not only be as temporary public health measure in times of crisis, but as a vital everyday behaviour that contributes to health and economic resilience. Hand hygiene is a highly cost-effective investment, providing outsized health benefits for relatively little cost.
Despite efforts to promote hand hygiene, the rates of access to hand hygiene facilities remain stubbornly low. If current rates of progress continue, by the end of the SDG era in 2030, 1.9 billion people will still lack facilities to wash their hands at home.
This report presents a compelling case for investment in five key ‘accelerators’ as a pathway towards achieving hand hygiene for all – governance, financing, capacity development, data and information, and innovation. These accelerators are identified under the UN-Water SDG 6 Global Acceleration Framework.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
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These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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