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2016 ASCO EDUCATIONAL BOOK | asco.org/edbo
Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs ... funding gaps. We develop a country classification framework in terms of actual versus expected national domestic funding, considering resource needs and donor financing. With UNAIDS and World Bank data, we examine domestic and donor HIV program funding in relation to need in 84 low- and middle-income countries. We estimate expected domestic contributions per person living with HIV (PLWH) as a function of per capita income, relative size of the health sector, and per capita foreign debt service.
This report provides an analysis of donor government funding to address the HIV response in low- and
middle-... countries in 2022, the latest year available, as well as trends over time. It includes both
bilateral funding from donors and their contributions to the Global Fund to Fight AIDS, Tuberculosis and
Malaria (Global Fund), UNITAID, and UNAIDS. Overall, the analysis shows that while donor government
funding for HIV increased between 2021 and 2022, this was primarily due to the timing of payments from
the U.S. government and not actual increases in commitments.
Donor government disbursements to combat HIV in low- and middle-income ... totaled US$8 billion in 2018, little changed from the US$8.1 billion total in 2017 and from the levels of a decade ago, finds a new report from the Kaiser Family Foundation (KFF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS)
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 ... 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.
Heart failure (HF) is a leading global public health problem with >64 million prevalent cases globally. Patients with HF with reduced ejection fraction (HFrEF) from low- and ...-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1 Guideline-directed medical therapy (GDMT) consisting of ACE (angiotensin-converting enzyme) inhibitors or ARB (angiotensin receptor blockers) or ARNI (angiotensin receptor-neprilysin inhibitors), β-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 (sodium-glucose cotransporter 2) inhibitors substantially reduces mortality among patients with HFrEF. These medicines are among the most cost-effective interventions and are thus included as the highest priority health system interventions recommended by the Disease Control Priorities Project.2 Despite this high-quality evidence, GDMT remains widely underutilized in low- and middle-income countries resulting in widespread undertreatment of patients with HFrEF due to health system-, provider-, and patient-level barriers.1 National essential medicines lists (EMLs) promoted by the World Health Organization (WHO) guide countries on which medications to purchase in the setting of limited resources and have resulted in higher procurement and availability of essential medicines in the public sector.3 We provide a cross-sectional analysis of national EMLs in 53 low- and middle-income countries, and availability, price, and affordability of GDMT in select countries to identify potential barriers to access to these essential medicines for patients with HFrEF.
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-...
The article "Can we prevent cardiovascular diseases in low- and middle-income ...?" by Claude Lenfant discusses the growing threat of cardiovascular diseases (CVDs) in developing countries. It highlights that while CVD is already the leading cause of death globally, low- and middle-income countries are now facing rising CVD rates due to lifestyle changes associated with urbanization and economic growth. Lenfant advocates for a dual approach: identifying and treating high-risk individuals and promoting broad, population-wide prevention efforts focused on lifestyle changes such as reducing smoking, lowering salt intake, and increasing physical activity. He emphasizes that early, affordable preventive measures are essential to mitigate the impending CVD epidemic in these countries and prevent significant healthcare and economic strain.
Policy and systems. Global Mental Health(2017),4, e7, page 1 of 6. doi:10.1017/gmh.2017.3
Maternal Mental Health and child health and development in low and middle income countries
recommended
The impact of maternal mental health problems on infants in high income countries has been identified mostly in terms of psychosocial and emotional...
Progress in tuberculosis control worldwide, including achievement of 2015 global targets, requires adequate financing sustained for many years. WHO began yearly monitoring of tuberculosis funding in 2002. We used data reported to WHO to analyse tuberculosis funding from governments ... international donors (in real terms, constant 2011 US$) and associated progress in tuberculosis control in low-income and middle-income countries between 2002 and 2011. We then assessed funding needed to 2015 and how this funding could be mobilised.
Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declin...
This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low...
A systematic literature review of education systems in low-and middle income ... commissioned by CBM
The COVID-19 pandemic is rapidly spreading across the world and including countries affected by other infectious disease epidemics, such as HIV, tuberculosis (TB) ... malaria. Over the past three decades, the global HIV response has gained experience in developing effective prevention approaches. This brief seeks to provide a summary for decision makers and health programme implementers in low- and middle-income countries (LMICs) to help them make the best possible choices in preventing the virus responsible for COVID-19.
It explains the importance of faecal sludge management in urban areas in which many people rely on on-site and decentralized sanitation facilities and emphasizes the place of treatment in the overal...
Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture...
Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and ...-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 characteristics, 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.
The incidence and mortality of cardiovascular diseases (CVDs) in low and middle ... countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NEMLs) of LMICs and potential determinants for selection.
For the global community to be able to achieve ambitious targets relating to the prevention and treatment of HIV, viral hepatitis and sexually transmitted infections (STIs), multiple types of medici...
