In 2012, all Member States of the World Health Organization (WHO) endorsed a historical target to reduce premature mortality from noncommunicable diseases
(NCD). This commitment was echoed in 2015 by the United Nations Sustainable Development Goals, which included a target to reduce premature morta...lity (the
measure of unfulfilled life expectancy and deaths between the ages of 30 and 70 years) from NCD by 30% by the year 2030. The Sustainable Development Goals are especially relevant to cardiovascular disease (CVD), the leading cause of death globally, with increasing prevalence in low- and middle-income countries (LMIC).
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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<.../span> management of cardiovascular diseases and provide a generic global framework available for local 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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The World Health Organization's fact sheet on hypertension provides a comprehensive overview of high blood pressure, highlighting its prevalence, risk factors, and health implications. It emphasizes that hypertension is a major cause of premature de...ath worldwide, with an estimated 1.28 billion adults aged 30–79 years affected, two-thirds of whom live in low- and middle-income countries.
The document outlines modifiable risk factors, including unhealthy diets, physical inactivity, tobacco and alcohol use, and being overweight or obese. It also discusses non-modifiable risk factors such as family history, age over 65 years, and co-existing conditions like diabetes or kidney disease. The fact sheet underscores the importance of regular blood pressure monitoring, as hypertension often presents without symptoms, and highlights lifestyle changes and medications as effective treatments. Additionally, it mentions global targets aimed at reducing the prevalence of hypertension by 33% between 2010 and 2030.
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The article "Air Pollution: The Emergence of a Major Global Health Risk Factor" discusses the significant health impacts of air pollution, a leading risk factor for global mortality. It highlights the adverse effects of fine particulate matter (PM2.5) and<.../span> tropospheric ozone, linking them to cardiovascular and respiratory diseases, cancer, and reduced life expectancy. While high-income countries have reduced air pollution levels, low- and middle-income countries face rising pollution, contributing to 4.9 million deaths in 2017. The article emphasizes the need for research to understand pollution’s health effects, identify key sources, and evaluate the effectiveness of interventions to improve air quality globally.
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The World Health Organization's fact sheet on noncommunicable diseases (NCDs) highlights that NCDs, such as cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, are responsible for 74% of all global deaths, totaling 41 milli...on annually. Notably, 86% of premature NCD deaths (before age 70) occur in low- and middle-income countries. Key risk factors include tobacco use, physical inactivity, harmful alcohol consumption, unhealthy diets, and air pollution. The WHO emphasizes the importance of preventive measures, early detection, and comprehensive healthcare strategies to address the growing NCD burden.
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Worldwide, around 2.3 billion people still cook using solid fuels (such as wood, crop waste, charcoal, coal and dung) and kerosene in open fires and...> inefficient stoves. Most of these people are poor and live in low- and middle-income countries. There is a large discrepancy in access to cleaner cooking alternatives between urban and rural areas: in 2021, only 14% of people in urban areas relied on polluting fuels and technologies, compared with 49% of the global rural population.
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Prompted by the 20th anniversary of the 1993 World
Development Report, a Lancet Commission revisited the
case for investment in health and developed a new
investment frame work to achieve dramatic health gains by 2035. Our report has four key mes...sages, each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community.
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Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ...and Cultural Organization; and the International Disability and Development Consortium – notably CBM, Handicap International, the Italian Association Amici di Raoul Follereau, Light for the World, the Norwegian Association of Disabled and Sightsavers – have worked closely together to develop the Community-based rehabilitation guidelines. More than 180 individuals and representatives of nearly 300 organizations, mostly from low-income and middle-income countries around the world, have been involved in their development.
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Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ...and Cultural Organization; and the International Disability and Development Consortium – notably CBM, Handicap International, the Italian Association Amici di Raoul Follereau, Light for the World, the Norwegian Association of Disabled and Sightsavers – have worked closely together to develop the Community-based rehabilitation guidelines. More than 180 individuals and representatives of nearly 300 organizations, mostly from low-income and middle-income countries around the world, have been involved in their development.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilit...ies are not available in all settings, especially in rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal. Importantly, it has extensive advice about pitfal...ls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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Accessed on 06.03.2022
Air pollution is contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere. Household combustion devices, motor vehicles, industrial facilities ...ight medbox">and forest fires are common sources of air pollution. Pollutants of major public health concern include particulate matter, carbon monoxide, ozone, nitrogen dioxide and sulfur dioxide. Outdoor and indoor air pollution cause respiratory and other diseases and is an important source of morbidity and mortality.
Air pollution kills an estimated seven million people worldwide every year. WHO data shows that almost all of the global population (99%) breathe air that exceeds WHO guideline limits containing high levels of pollutants, with low- and middle-income countries suffering from the highest exposures. WHO is supporting countries to address air pollution.
From smog hanging over cities to smoke inside the home, air pollution poses a major threat to health and climate. The combined effects of ambient (outdoor) and household air pollution cause millions of premature deaths every year, largely as a result of increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.
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Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by th...e force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.
Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other diseases. It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women – over a billion people – having the condition. The burden of hypertension is felt disproportionately in low- and middle-income countries, where two thirds of cases are found, largely due to increased risk factors in those populations in recent decades.
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This manual is a guide to the assessment and management of children and adolescents
with developmental, behavioural and emotional problems. It has... been written mainly for
primary care professionals, especially primary care physicians and nurses, working in lowand
middle-income countries.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma ...te-to-highlight medbox">and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in r...ivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the ...countries in which the Global Fund invests.
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Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually i...n adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025
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The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, ...te-to-highlight medbox">and has made significant progress in reducing poverty, improving food security and addressing malnutrition.
The remaining challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities.
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How has funding to developing countries for health improvement changed in the wake of the global financial crisis? The question is vital for policy making, planning, and advocacy purposes in donor <...span class="attribute-to-highlight medbox">and recipient countries alike. We measured the total amount of financial and in-kind assistance that flowed from both public and private channels to improve health in developing countries during the period 1990–2011
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