The COVID-19 pandemic disrupted health systems in 2020, but it is unclear how financial hardship due to out-of-pocket (OOP) health-care costs was affected. We analysed catastrophic health expenditure (CHE) in 2020 in
five countries with available household expenditure data: Belarus, Mexico, Peru, R...ussia, and Viet Nam. In Mexico and Peru, we also conducted an analysis of drivers of change in CHE in 2020 using publicly available data.
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The global pandemic response has typically followed
cycles of panic followed by neglect. We are now, once
again, in a phase of neglect, leaving the world highly
vulnerable to massive loss of life and economic shocks
from natural or human-made epidemics and pandemics.
Quantifying the size of the... losses caused by large-scale
outbreaks is challenging because the epidemiological
and economic research in this field is still at an early
stage. Research on the 1918 influenza H1N1 pandemic
and recent epidemics and pandemics has shown a range
of estimated losses (panel).
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As a recognized win–win-win approach to international debt relief, Debt-to-Health(D2H)has successfully translated debt repayments into investments in health-related projects. Although D2H has experienced modifications and periodic suspension, it has been playing an increasingly important role in r...esource mobilization in public health, particularly for low-and middle-income countries deep in debt.
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Nearly 90 years after Simon Kuznets first introduced Gross Domestic Product (GDP) for the limited purpose of measuring economic growth (by measuring the monetary value of all local goods and services within a given period of time), calls continue to mount for decision-makers to stop using GDP and it...s derivate, Gross National Income (GNI), for purposes far beyond their original design. This is particularly true in the case of the development assistance architecture, where these indicators are used as proxies to measure a nation’s overall well-being and, in some cases, eligibility for external funding. The GNI-based classification system has recently even been suggested by some Member States as a criterion to access to medicines in the new WHO Pandemic Agreement.
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Achieving universal health coverage (UHC) is a politicalambition in many low- and middle-income countries(LMICs). Public funding has been recognized as funda-mental to the two dimensions of UHC: expanding healthservice coverage and increasing protection against health-related financial hardship. Rel...atedly, there is growing con-sensus in academic and applied policy circles that publicfinancial management (PFM)—the “systems engineering”of public financing—is a critical enabling factor for anyhealth system reform in support of UHC.
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The document is part of the Financing Global Health 2023 series by the Institute for Health Metrics and Evaluation (IHME) and focuses specifically on malaria. It provides a concise overview of global and regional trends in malaria-related health spending, including development assistance, government... spending, and out-of-pocket costs. The profile highlights funding gaps, shifts in donor contributions, and the need for sustainable financing to support malaria control and elimination efforts in the post-pandemic era.
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Covid-19 has reinforced health and economic cases for investing in pandemic preparedness and response (PPR). The World Bank and World Health Organization (WHO) propose that low- and middle-income
governments and donor countries should invest $31.1 billion each year for PPR. We analyse, based on the... projected economic growth of countries between 2022 and 2027, how likely it is that low- and middle-income country governments and donors can mobilize the estimated funding.
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Over the past few decades, the world has witnessed considerable progress in women’s, children’s and adolescents’ health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping review aims to map financing interventions and meas...ures to improve equity in WCAH in low- and middle-income countries (LMICs).
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In 21st century capitalism, financial markets reign supreme. The elevation of investing, trading, and speculating as a way of making profit has shifted economic power towards institutional investors and enhanced the power of financial capital. Financialisation has introduced uncertainty in the commi...tment to public provision of goods and services. The behaviours of corporations focus more on profit for shareholders and senior executives to the detriment of wages, worker protections, livelihoods, and impact on prices and the environment. The practices of this financial system
pose major challenges to public health and planetary health equity through the influence on social inequality, climate change, and health outcomes. The aim of this Viewpoint is to expand the understanding of the commercial determinants of health to explicitly include the financial system and present key plausible pathways via which the financialisation of advanced economies influences public health and planetary health equity.
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The attainment of global health security goals and universal health coverage will remain a mirage unless African health systems are adequately funded to improve resilience to public health emergencies. The COVID-19 pandemic exposed the global inequity in accessing medical countermeasures, leaving Af...rican countries far behind. As we anticipate the next pandemic, improving investments in health systems to adequately finance pandemic prevention, preparedness, and response (PPPR) promptly, ensuring equity and access to medical countermeasures,
is crucial. In this article, we analyze the African and global pandemic financing initiatives and put ways forward for policymakers and the global health community to consider.
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L'article "Témoignages de mères face au choléra" sur ReliefWeb présente les récits de mères haïtiennes dont les enfants ont été touchés par le choléra. Il met en lumière les défis auxquels ces familles sont confrontées, en particulier dans les régions où l'accès aux soins de santé ...et aux infrastructures sanitaires est insuffisant. L'article souligne la vulnérabilité accrue des enfants malnutris face au choléra et insiste sur l'importance des mesures de prévention ainsi que sur la nécessité d'un accès à l'eau potable et à des soins médicaux adéquats.
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Ces recommandations temporaires sont émises à l’intention des États Parties qui font face à une transmission du virus de la mpox (MPXV), y compris, sans que cette liste soit exhaustive, ceux touchés par une transmission communautaire persistante et ceux où l’on observe des groupes de cas o...u des cas sporadiques d’infection par le clade Ib du MPXV liés à des voyages.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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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.
The Country Cooperation Strategy (CCS) is a medium-term strategic framework for cooperation between WHO and countries and outlines a shared agenda with priority areas of work for five years. The aim of this CSS is to define medium term vision for
WHO technical cooperation with the State of Eritrea ...for a 5-year period, 2023-2027, in support of the country’s Health Sector Strategic and Development Plan III (HSSDPIII) 2022-2026 aimed at improving the health status of its people
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Human strongyloidiasis is a chronic parasitic disease caused by infection with Strongyloides stercoralis, a soil-transmitted helminth that is estimated to infect 300–600 million people worldwide. This neglected tropical disease (NTD) is endemic globally, predominately in the South-East Asia, Afric...an and Western Pacific regions, and in South and Central America. Strongyloidiasis has a wide range of clinical presentations, including subclinical disease, symptomatic disease (often with diarrhoea, abdominal pain and urticaria) and a rare but deadly complication of hyperinfection with disseminated disease. The feared complication of disseminated strongyloidiasis can occur in the setting of immunocompromising conditions (e.g. human T-cell lymphotropic virus type 1 infection and malignancies) or immunosuppressive medications (e.g. steroids) and has an estimated case-fatality rate exceeding 60%. The standard treatment for chronic S. stercoralis infection is oral medication with ivermectin.
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Flyer 10 Steps to Mental Health
The One Health (OH) High-Level Expert Panel (OHHLEP) of the Quadripartite Organizations defined OH as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.”
It recognizes the health of humans, domestic and wild animals, plan...ts, and the wider environment (including ecosystems) are closely linked and interdependent [1]. The Tripartite which comprised the Food and Agriculture Organization (FAO) of the United Nations (UN), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) later became the Quadripartite organizations when the United Nations Environment Programme (UNEP) joined the OH alliance in 2022. There are Global and Regional Quadripartite Secretariats consisting of officials of headquarters and regional offices, respectively.
Over the years, the Tripartite/Quadripartite organizations and other partner agencies have developed several OH assessment and operational tools to support Member States in assessing their core capacities to achieve compliance with the requirements of international standards such as the International Health Regulations 2005 (IHR), WOAH’s Terrestrial and Aquatic Animal Health Codes, World Trade Organization’s Sanitary and Phytosanitary Measures (WTO-SPS), FAO/WHO Codex standards, etc. Technical areas that the existing tools currently support include progress monitoring, coordination and collaboration mechanisms, and capacity building for prevention, detection, preparedness, and response to health threats emerging at human-animal-environment interface. More OH B operational tools are in the pipeline.
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The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa.
The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
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