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Responding to aid volatility: government spending on district health care in Zambia 2006–2017

Jacksona, A.; Forsberg, B.; Chansa, C.; Sundewall, J. (2020) CC

A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government financing for primary care. The withdrawal of these funds from the pooled financing mechanism ... more

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Estimates of aid for reproductive, maternal, newborn, and child health: findings from application of the Muskoka2 method, 2002–17

Dingle, A.; Schäferhoff, M.; Borghi, J. et al. The Lancet (2020) CC

Background Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017. Methods Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators. Findings After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million). Interpretation Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention. Funding Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health. more

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Evaluating official development assistance-funded granting mechanisms for global health and development research that is initiated in high-income countries

Cassola, A.; Baral, P.; Røttingen, J.A.; Hoffman, S. BMC (2022) CC

Background: Several countries allocate official development assistance (ODA) for research on global health and development issues that is initiated in the donor country. The integration of such research within domestic research systems aligns with efforts to coordinate ODA investments with science, ... more

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Falling aid for reproductive, maternal, newborn and child health in the lead-up to the COVID-19 pandemic

Pitt, C.; Bath, D.; Binyaruka, P.; Borghi, J.; Martinez-Alvarez, M. BMJ Global Health (2021) CC

Infectious disease epidemics pose a threat to reproductive, maternal, newborn and child health (RMNCH) both directly—by worsening women’s and children’s health outcomes—and indirectly—by reducing their access to services.1–4 Greater investment is therefore needed to mitigate the negative... more

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Financial Assistance for Health Security: Effects of International Financial Assistance on Capacities for Preventing, Detecting, and Responding to Public Health Emergencies

Boyce, M.; Meyer, M.; Kraemer, J.; Katz, R. International Journal of Health Policy and Management IJHPM (2022) CC

Health security funding is intended to improve capacities for preventing, detecting, and responding to public health emergencies. Recent years have witnessed substantial increases in the amounts of donor financial assistance to health security from countries, philanthropies, and other development pa... more

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Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease

Abola, M. T. B.; Golledge, J.; Miyata, T. et al. Journal of Atherosclerosis and Thrombosis (2020) CC

Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic mod... more

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The Treatment of Heart Failure with Reduced Ejection Fraction

Berliner, D.; Hänselmann, A.; Bauersachs, J. Deutsches Ärzteblatt International (2020) CC

Background Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death. Methods This review is based on articles retrieved by a selective search in PubMed, as well as on r... more

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Pollution and the Heart

Rajagopalan, S.; Landrigan, P.J. The New England Journal of Medicine (2021) CC

Cardiovascular diseases are the world’s leading cause of disability and death. Such diseases were responsible in 2019 for an estimated 18.6 million deaths globally and 957,000 deaths in the United States.

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Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Smith, E.E.; Saposnik, G.; Biessels. G.J. et al. American Heart Association (2016) CC

Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to ... more

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Primary and Secondary Prevention of Ischemic Stroke

Paciaroni, M.; Bogousslavsky, J. European Neurology (2010) CC

Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy) and more specific interventions, such as carotid revascularization or... more

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Use of statins for the prevention of cardiovascular disease in 41 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data

Marcus, M.E.; Manne-Goehler, J.; Theilmann, M. (2022) CC

Background In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income and middle-income countries (LMICs), where most cardiovascular disease deaths occur. The objectiv... more

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Access to Heart Failure Medicines in Low- and Middle-Income Countries: An Analysis of Essential Medicines Lists, Availability, Price, and Affordability

Agarwal, A.; Husain, M.J.; Datta, B. et al. Circulation: Heart Failure (2022) CC

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 middle-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1 Guideline-d... more

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Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

Peiris, D.; Ghosh, A.; Manne-Goehler, J. et al. PLoS Medicine (2021) CC

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... more

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Global burden of cardiovascular diseases and risks, 1990-2022

Mensah, G.A.; Fuster, V.; Murray, C.J.L. et al. Journal of the American College of Cardiology (2023) CC

Age-standardized cardiovascular disease (CVD) mortality rates by region ranged from 73.6 per 100,000 in High-income Asia Pacific to 432.3 per 100,000 in Eastern Europe in 2022. Global CVD mortality decreased by 34.9% from 1990 to 2022. Ischemic heart disease had the highest global age-standardized D... more

Heart failure in low-income and middle-income countries: failing REPORT card grades

Naik, N.; Narula, J. The Lancet Global Health (2020) CC

Heart failure is an important global health problem, and the associated public health and economic effect is increasing across all societies and geographies. Epidemiological studies have estimated that there are more than 25 million patients with heart failure globally, and population-based studie... 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

The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health

Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al. Journal of the American College of Cardiology (2022) CC

Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a... more

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Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Kim, M.S.; Hwang, J.; Yon, D.K. et al. The Lancet Global Health (2023) CC

Background: Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures. Methods: Data on peripheral artery disease were modelled using the... more

The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 680 102 adults

Flood, D.; Seiglie, J.A.; Dunn, M.; et al. The Lancet healthy Longevity (2021) C2

Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... more