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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
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s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Evidence from two pilot projects in India.
Journal of the International AIDS Society 2016, 19:20926
There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low‐ and middle‐income settings. Thi ... s article describes a public–private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community‐based non‐governmental organization (International HIV/AIDS Alliance).
https://doi.org/10.7448/IAS.19.1.20926 more
There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low‐ and middle‐income settings. Thi ... s article describes a public–private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community‐based non‐governmental organization (International HIV/AIDS Alliance).
https://doi.org/10.7448/IAS.19.1.20926 more
A guide for developing a hygiene promotion program to increase handwashing with soap
The consortium is an international public-private partnership that aims to reduce the global disease burden of schistosomiasis by addressing the me
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dical needs of infected children between the ages of 3 months and 6 years. By doing so, we hope to contribute to the ongoing efforts to eliminate schistosomiasis and improve child health.
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This report outlines the coordination and partnership between two key ministries (Education and Public Health) in Kenya, other line ministries, the privat
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e sector, NGOs and the community in implementing the first phase of a sub-national school-based deworming exercise. The areas targeted included Coast, Central, Western, Nyanza
and parts of Eastern provinces, covering over 45 districts in this first phase. The SBD programme is guided by the National School Health Policy and Guidelines launched in 2009.
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The Pediatric Praziquantel Consortium was founded in July 2012 as the first international, non-profit, public-private partnership in schistosomiasi
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s, supported by world leading experts in tropical parasitic infectious diseases.
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The Global Schistosomiasis Alliance
The Global Schistosomiasis Alliance (GSA) is an all-inclusive coalition to mobilise the growing momentum to control and eliminate schistosomiasis. It is constituted as a diverse but representative partnership o
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f public health programmes, academic and research institutions, international development agencies and foundations, non-governmental organizations, private sector companies and advocacy and resource-mobilisations partners. Our alliance is not limited to partner organizations but also includes individuals, research groups and different networks, collaborating together as a community to control and eliminate schistosomiasis.
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Growing evidence indicates that large proportions of children around the world experience physical, sexual and emotional violence every year, with enormous implications for human rights, public health and economic and social development.1 Over the l
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ast five years, national governments and Together for Girls – a global public-private partnership comprising UNICEF,
other United Nations (UN) agencies, the United States (US) Government and various private sector agencies – have worked to mobilize and sustain a global movement to end violence against children, with a focus on sexual violence against girls.
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Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of
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specific populations and thus help ensure family planning services and products will be available to all Rwandans in the long term. This report aims to inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.
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ndependent of the current conflict, the health sector in Ukraine faces several critical shortcomings. In particular, the country has an oversupply of hospitals and an undersupply of primary care and diagnostic facilities. Addressing these limitations will require substantial amounts of capital inves
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tment, but constraints on public finances in the post-war context will reduce the Government’s ability to fund the needed reconfiguration. Multiple international financial institutions have stated their intention to support reconstruction in the aftermath of the war. The use of public–private partnerships (PPPs) may support the achievement of these outcomes and their use in Ukraine is likely to remain an important issue for Government policy-makers and their partners to consider in a variety of post-war scenarios.
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In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public and
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private providers who are not engaged by the NTP. The quality of care provided in these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
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Accessed: 30.01.2020
This 2016-2020 public-private mix strategic plan (PPM SP) is a 4-year framework designed to guide the National TB Control Programme (NTP) and its partners to implement PPM in Bangladesh. It provides
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goals, strategies and interventions for expanding and scaling up current PPM models and outlines approaches to further enhance and strengthen PPM coordination and partnerships among NTP, nongovernmental organizations (NGOs) and private health providers
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2017)
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage presents a complete analysis of the resources available for heal
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th in 184 countries, with a particular focus on development assistance for health (DAH). DAH was estimated to total $37.6 billion in 2016, up 0.1% from 2015. After a decade of rapid growth from 2000 to 2010 (up 11.4% annually), DAH grew at only 1.8% annually between 2010 and 2016. In low-income countries, where much DAH is targeted, DAH made up 34.6% of total health spending in 2016. In upper-middle- and high-income countries, which generally do not receive DAH, DAH accounted for only 0.5% of total health spending. The other 99.5% of health spending – government, prepaid private, and out-of-pocket spending – is the subject of our further analysis.
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Experience of national TB partnerships
This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting
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private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed since the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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