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PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop
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le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
more
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
...
SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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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 burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
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miological 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 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
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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.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
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l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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One of the most important ways we feel we can help to reduce the burden of cancer in Africa is to work with African cancer advocacy organisations to help educate and advocate about cancer in their countries. To this end in 2010 we designed with our partners, 13 posters for use in Africa
giving
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health and lifestyle tips on how to avoid cancer and highlighting the early warning sign and symptoms of common cancers in Africa
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This document updates the 2009 ECDC guidance on chlamydia control in Europe. It was developed by a technical expert group which conducted a critical review of the scientific evidence on the epidemiology of chlamydia and the effectiveness of screening programmes.
The aim of this guidance is to suppo
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rt Member States to develop, implement or improve strategies for chlamydia control. This guidance describes the current evidence base behind the proposed options, highlights key gaps in knowledge, and suggests effective options for national chlamydia control strategies. It is directed primarily at policy advisors but should also be useful for programme managers and experts in sexual health.
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The survey is representative of the Union Territory, its states and regions and urban and rural areas. It was conducted in all the districts and in 296 of the 330 townships of Myanmar. A total of 13,730 households were interviewed. It collects data on the occupations of people, how much income they
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earn, and how they use this to meet the food, housing, health, education and other needs of their families. The main focus of the survey is to produce estimates of poverty and living conditions, to provide core data inputs into the System of National Accounts and the Consumer Price Index and to support monitoring of the Sustainable Development Goals.
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The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see
...
page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
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Nationally, Senegal met the MDG target for water supply access. It did this by engaging the public and private sectors to effectively invest and report on investments. It focused on larger population centers, less on remote regions of the country. Its achievements set the stage for more equitable an
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d widespread service provision as the country now works to achieve the SDGs, requiring sustainable management of universal access. This case study documents the progression of the sector between 1990 and 2015, and analyzes the impact of local systems created in Senegal to respond to the water and sanitation challenge.
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Democratic dispensation in 1994 created a political and social platform that reshaped life in South Africa. There was a surge in common belief that the inequity and wrong of Apartheid should and could be rectified. Equity of access to water and sanitation were obvious targets for improvement. In 199
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4, an estimated 14–15 million South Africans were without access to an improved water supply, while close to 21 million - more than half of the population at that time - did not have access to improved sanitation facilities. These problems were most severe in poorer rural areas. The water and sanitation sector became unified by the vision of universal access for all South Africans. This case study documents the progression of the sector between 1994 and 2016, and analyzes the impact of local systems created in South Africa to respond to the water and sanitation challenge.
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Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs.
The first chapter of the booklet begins with the latest estimates of the number of people who use drugs, the distribution of those users by type of drug
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s, age and sex, and recent trends in the use of drugs. The chapter also reviews the impact of the coronavirus disease (COVID-19) pandemic on drug use patterns and service provision. Other issues examined in the chapter are the health consequences of drug use, including the number of people in treatment for drug use disorders and the extent of drug injecting and of HIV and hepatitis C among people who inject drugs. The chapter concludes with a review of the extent to which strategies, policies and interventions are in place to respond to the drug use problem.
more
The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
The UN Convention on the Ri
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ghts of the Child is the most widely ratified international human rights treaty in history. It has prompted substantial investment in children’s health, education and safety and the adoption of laws and policies that recognise the rights of children, particularly in areas where they are vulnerable, including labour exploitation, corporal punishment, alternative care and forced and early marriage.
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Aligned to the Lancet Migration Global Statement to include migrants and refugees incountries’response to COVID-19, this update focuses on Mexico’s challenges and opportunities to build an inclusive response that is based on a contextualized adaptation of there commendations published by th
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e Lancet Migration. A critical component for this analysis is the recognition of migration as a social determinant of health, which acts as a major risk factor for populations subjected to violence, trauma and forced exile while in the face of a global pandemic.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib
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uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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22 Sept. 2021
The rapid development of effective Covid-19 vaccines in 2020 gave hope to the world in the darkest days of the deadly pandemic. However, the vaccine roll-out has been massively skewed towards wealthy nations. While rich states have hoarded vaccines, companies have also played a decisi
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ve role in restricting fair access to a life-saving health product. This report focuses on six leading vaccine developers, AstraZeneca, BioNTech, Johnson & Johnson, Moderna, Novavax and Pfizer, assessing each company’s human rights policy, pricing structure, records on intellectual property, knowledge and technology sharing, allocation of available vaccine doses and transparency.
Available in Arabic, English, French, German and Spanish
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Brazil‘s Social Policy Response to Covid-19: Healthcare and Poverty Alleviation
Massard da Fonseca, E.; Arantes Beatriz, L. B.; Portella, C.
Global Dynamics of Social Policy; Deutsche Forschungsgemeinschaft
(2022)
CC
During the pandemic, Brazil has provided its citizens with support in the areas of long-term care and disability, the labor market, social assistance, education, and pensions. This report focuses on two social policy areas, health-care and family be
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nefits (including labor policies), as these were the most crucial social policies implemented in Brazil during the Covid-19 pandemic in terms of the resources allocated and the magnitude of social impact. Brazil’s relatively generous social policies were uncoordinated with public health interventions, which contributed to poor compliance with these public health interventions. This suggests that social policy initiatives alone are insufficient in mitigating the social consequences of the pandemic. They need to be accompanied by and coordinated with public health measures, including regulations on testing, social distancing and mask wearing.
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Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char
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acteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines.
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Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue.
Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased
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health complications for older people, persons with disabilities and children. They also reinforce cycles of poverty, inequality and deprivation – particularly for women, children and marginalized groups, who are disproportionately impacted by a lack of equitable access to water and sanitation.
Launched on World Water Day, the guidelines address the knowledge gap on ways to practically implement inclusive approaches to WASH infrastructure development, particularly in developing countries and fragile contexts.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l
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ast two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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