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Website last accessed on 10.04.2023
The Chagas disease is frequently referred to as the effects that the parasite Trypanosoma cruzi (T. cruzi) has on people’s health. However, from our perspective, Chagas is much more than that: it is a complex socioenvironmental health problem in which elemen
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ts of different nature converge and interact. The biomedical and epidemiological aspects, which are most frequently addressed, are only a piece of the puzzle that needs to be complete in order to understand Chagas in all its complexity. Social, environmental, economic, political, cultural, and educational elements turn out to be essential in comprehending the magnitude of the problem without prejudice or stigmatizations.
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Health is essential in order to be able to lead a fulfilled and happy life. Health is not only a fundamental human right and one of the most valuable possessions any individual can have, it is also an essential prerequisite for social, economic and politic
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al development and stability. Health can only be ensured and improved throughout the world through joint global action.
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Neglected tropical diseases (NTDs) is an umbrella term for a diverse group of debilitating infections that represent the most common afflictions for 2.7 billion people living on less than US$2 per day. Major efforts have recently re-focused attention on NTDs, including structured advocacy by the Bil
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l and Melinda Gates Foundation, technical and political support by WHO and large-scale drug donation programs by pharmaceutical companies. An analysis of the Official Development Assistance (ODA) for NTDs in 2009 showed that Development Assistance Committee members and multilateral donors had largely ignored funding NTD control projects. This study reviews the changes since 2009 and finds an increased engagement by pharmaceutical manufacturers through drug donation programs substantially increased by the ‘London Declaration’ in 2012, a focused effort of 77 public and private partners on control or elimination of the 10 most common NTDs, but no increase in ODA for NTDs between 2008 and 2012. The allocation of ODA still does not reflect the respective importance of these diseases.
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The definition of Official Development Assistance (ODA) has for 40 years been the global standard for measuring donor efforts in supporting development co-operation objectives. It has provided the yardstick for documenting the volume and the terms of the concessional resources provided, assessing do
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nor performance against their aid pledges and enabling partner countries, civil society and others to hold donors to account. Yet for all its value, the ODA definition has always reflected a compromise between political expediency and statistical reality. It is based on interpretation and consensus and therefore allows for flexibility. It has evolved over the decades, while preserving the original concepts of a definition based on principal developmental motivation, official character and a degree of concessionality. While agreement on the ODA concept was a major achievement, discussion of the appropriateness of this measure has never ended. The paper documents the evolution of the ODA concept and proposes a possible new approach to measuring aid effort.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and
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socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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The importance of community and civil society engagement to end TB has been highlighted in various strategies and global commitments. The WHO End TB Strategy, aligned with the United Nations Sustainable Development Goals, emphasizes the role of communities and civil society in ending the TB epidemic
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by 2030. Furthermore, the political declaration of the 2023 United Nations High-level Meeting on TB highlights the need to ensure people-centred health services, with meaningful engagement of communities in the full spectrum of TB response.
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This publication describes the reasons for the resurgence of malaria in Kyrgyzstan and presents an analysis of evidence-based elimination strategies and policies that were applied to contain the epidemic and outbreaks of the disease, achieve its elimination, and maintain the country malaria-free. Th
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e strong political commitment and the mobilization of human resources that were crucial in achieving elimination are emphasized. It is hoped that the experiences of Kyrgyzstan's national malaria control programme can assist other countries aiming to eliminate malaria. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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A Guide to Inclusive Education 2023
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Refugee children with disabilities experience a reality of exclusion and marginalisation that makes them among the most vulnerable displaced persons in the world. Excluded from participation in social activities and access to school, not only because of their disability, but especially because of so
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cial, cultural, and political barriers that prevent them from enjoying the same opportunities as their peers.
Daniela Bruni, a specialist in education in emergency contexts, who has overseen JRS’s related projects for the past two years, has developed a guide on inclusive education.
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In 2015, member states of the United Nations adopted the ambitious Sustainable Development Goals (SDGs), which included 17 global goals that targeted economic and social development.1 Goal 3, “to ensure healthy lives and promote well-being for all at all ages,” targets specifically marked progre
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ss in universal health coverage; improved access to safe, effective, and affordable medicines; and the end of the HIV, malaria, and tuberculosis epidemics by 2030. Although these goals can spur innovation, social and political commitment, and a drive to achieve greater health gains for less money, financial support is necessary to achieve them.
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This report covers basic concepts, such as universal health coverage, and emphasises how vital it is to incorporate mental health into the UHC framework. It explains the pivotal commitments made by governments at the recent UN high-level meeting on UHC in 2023, outlining a roadmap for meaningful act
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ion and progress.
Mental health emerged as a strong cross-cutting theme in the approved political declaration issued by the UNGA president during the high-level meeting on UHC that took place during the 78th UN General Assembly (UNGA) in September 2023.
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The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and
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political context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
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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 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.
more
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
...
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.
more
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
...
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.
more
The WHO document, "High-level technical meeting on noncommunicable diseases and mental health in small island developing states: summary brief," outlines the outcomes of a January 2023 meeting in Barbados, focusing on NCDs and mental health challenges in small island developing states (SIDS). Key to
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pics included the need for sustainable financing, addressing the impact of climate change, improving emergency preparedness, strengthening multisectoral collaboration, and managing commercial determinants of health. The document emphasizes building political support and international cooperation to reduce the NCD and mental health burden in SIDS, with recommendations for policy coherence and increased support for these vulnerable regions.
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant
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asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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Concerned that the prevalence of Child Marriage in Malawi, at 42 per cent, is one of the highest in the Sub-Saharan Africa; and that cases of child marriage continue to rise despite the various interventions on the ground. If unabated, Child Marriage inflicts significant socio-economic and
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political cost for Malawi and derails the nation’s developmental aspirations.
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When we presented our analysis of Germany’s role in
global health in 2017 at an event in Berlin, Richard
Horton, the Editor-in-Chief of The Lancet, asked only
half-jokingly whether we could expect Germany to finally
shrug off the habitus of the “reluctant leader” and “step
up”. Back t
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hen, the entire team of authors were hesitant
to use the term leadership as a broad label. We decided to
highlight areas where leadership could be observed, but
refrained from using it in the title of our previous study.
7 years later, after a devastating global pandemic, notable
political changes in Germany, and amid a substantially
changed global health landscape, we aim to analyse
Germany’s role in global health once more.
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The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie
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ty and other partners. The pivotal meeting sought to leverage political commitment, scientific innovation and community engagement to reshape the trajectory of malaria control in high burden African countries, and beyond.
At the end of the meeting and in the weeks that followed, Ministers of Health from the 11 “High Burden High Impact” African countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda and United Republic of Tanzania) signed the Yaoundé Declaration, pledging their “unwavering commitment” to the principle that “no one should die from malaria given the tools and systems available.” Success in reducing malaria morbidity and mortality will hinge on efforts by countries to translate this political commitment into actions and resources that will save lives.
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