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Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Global Burden of Disease Health Financing Collaborator Network Lancet (2020) C1

Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to ... more

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Public financial management for effective response to health emergencies

World Health Organization WHO (2022) C_WHO

The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r... more

Consolidated Financing Framework for ACT-A Agency & In-Country Needs October 2021 to September 2022

World Health Organization (WHO) World Health Organization (WHO) (2022) CC

In October 2021, the ACT-Accelerator (ACT-A) published its 12-month Strategic Plan and budget for the period October 2021 to September 2022. Building on the investment needs outlined in that document, the ACT-A Facilitation Council Financial and Resource Mobilization Working Group developed this Fin... more

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AidData's Tracking Underreported Financial Flows (TUFF) Methodology, Version 1.3.

Strange, A.; M. Cheng; B. Russell et al. AidData at William & Mary (2017) CC

This codebook outlines the set of TUFF procedures that have been developed, tested, refined, and implemented by AidData staff and affiliated faculty at the College of William & Mary. We initially employed these methods to achieve a specific objective: documenting the known universe of officially fin... more

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Financing the SDGs: Evidence in Four Countries

Jennifer Turner AidData at William & Mary (2019) CC

Achieving the Sustainable Development Goals (SDGs) will require the international community to mobilize significant additional financing over the next decade. Tracking and analyzing this funding is central to measuring progress and making more informed choices to direct financial flows where they wi... more

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Countdown to 2015: an analysis of donor funding for prenatal and neonatal health, 2003–2013

Pitt, C.; C. Grollman; M. Martínez-Álvarez et al. BMJ Global Health (2017) C1

Background: In 2015, 5.3 million babies died in the third trimester of pregnancy and first month following birth. Progress in reducing neonatal mortality and stillbirth rates has lagged behind the substantial progress in reducing postneonatal and maternal mortality rates. The benefits to prenatal an... more

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Development assistance for human resources for health, 1990–2020

Micah, A.E.; J. Solorio; H. Stutzman et al. Human Resources for Health (2022) C1

Background: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of 18 million health workers (mostly in low- and middle-income countries). Within that context, in 2016, ... more

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Innovative financing for HIV response in sub–Saharan Africa

Atun, R.; Silva, S.; Ncube, M.; Vassall, A. Journal of global health (2016) CC

In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/ AIDS. As donor assistance for healt... more

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Policy options to mitigate a drop in fiscal space for health and HIV following the COVID-19 pandemic — Case studies from the Democratic Republic of the Congo, Jamaica and Lesotho, November 2020

UNAIDS (2021) CC

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 ... more

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Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Global Burden of Disease Health Financing Collaborator Network (2017) CC

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we furth... more

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Financing Global Health 2015: Development assistance steady on the path to new Global Goals

Institute for Health Metrics and Evaluation (2016) CC

Financing Global Health 2015 is the seventh edition of IHME’s annual series on global health financing. This report captures trends in development assistance for health (DAH) and government health expenditure as source (GHE-S) in low- and middle-income countries. Annually updated GHE-S and DAH est... more

Technical series on adapting to climate-sensitive health impacts: Diarrhoeal diseases

World Health Organization WHO (2023) C_WHO

This guide presents a basis for understanding how diarrhoeal diseases are currently influenced by climate and weather, and may be further exacerbated by climate change. It is a technical guide on how to conduct a Vulnerability & Adaptation assessment for diarrhoeal diseases and climate change, and p... more

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Therapeutics and COVID-19 (Living Guideline, 10 November 2023)

World Health Organization WHO (2023) C_WHO

WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines. Updated risk rates for hospital admission in patients with non-severe COVID-19 The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19. The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients. This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines: **High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%. **Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%. Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk. Review of COVID-19 treatments for people with non-severe COVID-19 WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022. If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead. WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission. For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol. WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials. The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials. more

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National spending on health by source for 184 countries between 2013 and 2040

Dieleman, J.; Templin, T.; Sadat, N. et al. (2016) CC

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at simi...lar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. Methods We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Findings Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Interpretation Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Funding Bill & Melinda Gates Foundation. more

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Snakebite epidemiology, outcomes and multicluster risk modelling in Eswatini

Padidar S.; Monadjem A.; Litschka-Koen T. PLOS (2023) CC

Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment... more

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WHF Roadmap for Digital Health in Cardiology

Tromp, J.; Jindal, D.; Redfern, J. et al. Global Heart (2022) CC

ABSTRACT More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del... more

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World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update

Freedman, B.; Hindricks, G.; Banerjee, A. Global Heart (2021) CC

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... more

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War in Cities: Persons with disabilities and the role of the International Red Cross and Red Crescent Movement

International Committee of the Red Cross (2023) CC

When war breaks out in cities, the complexity and interconnectedness of the urban environment poses many problems for civilians. For persons with disabilities, the impact can be even worse and aggravate existing barriers and risks. Armed forces, authorities, first responders, humanitarian actors and... more

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Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review

Abdel-All, M; Putica, B.; Praveen, D. et al. BMJ Open (2017) CC

Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ... more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more