In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD ...-highlight medbox">burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epidemiological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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The Global Burden of Disease (GBD) study, a collaborative endeavour of the World
Health Organiz...ation (WHO), the World Bank and the Harvard School of Public Health,
drew the attention of the international health community to the burden of neurological
disorders and many other chronic conditions. This study found that the burden of neurological
disorders was seriously underestimated by traditional epidemiological and health
statistical methods that take into account only mortality rates but not disability rates. The
GBD study showed that over the years the global health impact of neurological disorders
had been underestimated.
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Mortality and burden of disease attributable to selected major risks
The global burden of disease associated with air pollution exposure exacts a massive toll on human health worldwide: exposure to air pollution is e...stimated to cause millions of deaths and lost years of healthy life annually. The burden of disease attributable to air pollution is now estimated to be on a par with other major global health risks such as unhealthy diet and tobacco smoking, and air pollution is now recognized as the single biggest environmental threat to human health.
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Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a ...critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies that have been used to promote access, including providing medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
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A collaborative project of World Health Organization and
Lifting The Burden
The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some ...of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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The burden of asthma in Africa is high, and yet the disease is not universally prioritised. Data on allergic asthma and its impact on asthma morbid...ity are limited in Africa. Our aim was to describe the distribution of skin prick positivity among asthmatics in Eastern Africa.
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The objectives of pertussis surveillance are to:hmonitor disease burden and the impact of the pe...rtussis vaccination programme, with a special focus on understanding the morbidity and mortality in children < 5 years of agehgenerate data to inform vaccine schedule and delivery strategy decisions to optimize the impact of vaccinationhdetect and guide public health response to outbreaks of pertussis
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Depression is a leading cause of non-fatal disease burden worldwide, with a lifetime prevalence of...n> 9% among European adult men and 17% among European adult women.
The task at hand requires substantial investments in preventive mental health care, but the potential benefits can be equally rewarding. After all, mental wellbeing is a key resource for learning, productivity, participation and inclusion. Investing in proactive care to promote, protect and sustain mental health in the population is therefore likely to offer good value for money.
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Division of Global Migration and Quarantine
April 16, 2012
Ahead of World Malaria Day, the WHO Global Malaria Programme published a new operational strategy outlining its priorities and key activities up to 2030 to help change the trajectory of malaria tren...ds, with a view to achieving the global malaria targets. The strategy outlines 4 strategic objectives where WHO will focus its efforts, including developing norms and standards, introducing new tools and innovation, promoting strategic information for impact, and providing technical leadership of the global malaria response.
In recent years, progress towards critical targets of the WHO Global technical strategy for malaria 2016-2030 has stalled, particularly in countries that carry a high burden of the disease. In 2022 there were an estimated 608 000 malaria-related deaths and 249 million new malaria cases globally, with young children in Africa bearing the brunt of the disease.
Millions of people continue to miss out on the services they need to prevent, detect, and treat malaria. Additionally, progress in global malaria control has been hampered by resource constraints, humanitarian crises, climate change and biological threats such as drug and insecticide resistance.
“A shift in the global malaria response is urgently needed across the entire malaria ecosystem to prevent avoidable deaths and achieve the targets of the WHO global malaria strategy,” notes Dr Daniel Ngamije, Director of the Global Malaria Programme. “This shift should seek to address the root causes of the disease and be centred around accessibility, efficiency, sustainability, equity and integration.”
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Mental disorders are a leading cause of the global burden of disease, and the provision ...ass="attribute-to-highlight medbox">of mental health services in developing countries remains very limited and far from equitable. Using the Creditor Reporting System, we estimate the amounts and patterns of development assistance for global mental health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
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Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular... unprotected sexual intercourse. Understanding the magnitude of infertility is critical for developing appropriate interventions, for monitoring access to quality fertility care, and for mitigating risk factors for and consequences of infertility.
The objective of this report is to provide estimates of the global and regional prevalence of infertility by analyzing all relevant and representative studies from 1990 to 2021, taking into account different study approaches. This report also provides insight into how the estimation of infertility prevalence can be improved to obtain more reliable and actionable data. These estimates improve the understanding of the burden of infertility, and provide a basis for appropriate policies and services to achieve universal access to fertility care for all.
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The article investigates the global burden and risk factors of chronic obstructive pulmonary disease (COPD). It emphasizes that COPD is a leading c...ause of morbidity and mortality worldwide, with significant health and economic impacts. The study identifies smoking as the primary risk factor, but also highlights other contributors such as occupational exposure, air pollution, and respiratory infections. The authors discuss variations in COPD prevalence and mortality rates across different regions, influenced by socioeconomic and environmental factors. The article calls for comprehensive public health strategies to reduce exposure to risk factors and improve early diagnosis and management to curb the global impact of COPD.
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Leptospirosis is a bacterial zoonotic disease of worldwide importance, though relatively neglected in many African countries including sub Saharan Africa that is among areas with high ...ttribute-to-highlight medbox">burden of this disease. The disease is often mistaken for other febrile illnesses such as dengue, malaria, rickettsioses and enteric fever. Leptospirosis is an occupational disease likely to affect people working in environments prone to infestation with rodents which are the primary reservoir hosts of this disease. Some of the populations at risk include: sugarcane plantation workers, wetland farmers, fishermen and abattoir workers. In this study we investigated the prevalence of antibodies against Leptospira among sugarcane plantation and factory workers, fishing communities as well as among rodents and shrews in domestic and peridomestic environments within the study areas.
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Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact ...-to-highlight medbox">of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
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The harmful use of alcohol causes approximately 3 million deaths every year and the overall burden of d...isease and injuries attributable to alcohol consumption remains unacceptably high. The pace of development and implementation of alcohol policies has been uneven in WHO regions, and resources and capacities for implementation of the WHO Global strategy to reduce the harmful use of alcohol 10 years after its endorsement do not correspond to the magnitude of the problems. On this basis, the WHO Executive Board in its decision EB146 (14) called for accelerated action to reduce the harmful use of alcohol.
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The Mexico Declaration for Circulatory Health brings together global health
organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These ...ighlight medbox">diseases presently represent the biggest health burden world-wide, accounting for over 17 million deaths every year. We are united around existing global strategies and targets to reduce the burden of heart disease and stroke. We are committed to achieving the World Health Organization (WHO) “25 by 25” non-communicable disease (NCD) targets, and the United Nations’ NCDrelated Sustainable Development Goals, based on known, effective and affordable
interventions for secondary prevention, primary prevention and primordial prevention in populations. As heart disease and stroke make up half of all NCD deaths, our efforts, working together as the international cardiovascular community, are central to achieving these global goals.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a c...omposite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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