The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequal...ities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
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Annual and medium-term budget preparation processes are the platforms through which specific plans are transformed into actual resource allocation decisions. The aim of this Process Guide is to support key stakeholders involved in these processes (such as the Cabinet, Ministries of Finance and Healt...h, the Parliament, citizens, media, and civil society organizations) to reorient budgetary arrangements in order to facilitate the ability of national governments to respond to the COVID-19 pandemic by delivering, therapeutics, diagnostics, and vaccine services to their populations. Reorienting budgetary arrangements positions governments to sustain the capacity to mitigate and respond to COVID-19 while concurrently delivering other essential health services and working towards Universal Health Coverage (UHC). The reorientation process is an opportunity to better align budgetary arrangements to sustain systemic capacity to prevent emerging health threats over the short, medium, and long terms.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, stakeholders, and young adults. Key findings include a... preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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Climate change is one of the biggest crises of our time. Climate threats range from higher temperatures, heavy rainfalls and floods, erratic precipitation, droughts, desertification, and land degradation. This has negative implications on the quality and quantity of natural resources, such as land a...nd water, agricultural productivity, rural livelihood options, food prices, and nutrition security, particularly when there is a lack of adaptation capacities and preparedness measures (Pacillo, 2024). Farmers are at the forefront of the climate crisis where their livelihoods are being jeopardized, and they are faced with many challenges to secure water, energy, and agriculture inputs, and maintain agriculture productivity. This heightens the risk of competition over natural resources and aggravates grievances and structural inequalities related to land rights and ownership as well as land access, management, and governance. In Africa, land-related issues are among the triggers of many violent disputes (Medina et al, 2024). For instance, communal violence in Nigeria and Sudan is tied to competition over scarce fertile land and poor resource governance (Bruce and Bourdeaux, 2013).
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The document is intended to facilitate the detection, evaluation and management of incident EVD cases in Germany. It primarily addresses public health service staff and health care workers in hospitals, outpatient clinics and emergency services in Germany. It is a work in progress, intended to evolv...e over time. Updated 14 August 2015
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Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those driven by artificial intelligence, have the potentia...l to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
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The purpose of this manual is to provide guidance in the design, implementation and evaluation of a course that aims to build and strengthen the capacity of health personnel to manage eye patients at primary-level health facilities in the African Region. The course falls within the remit of continuo...us professional development in its broadest sense. Its content focuses on simple evidence-based practice that can be easily carried out in primary-level health facilities all over Africa.
This manual is intended for use by course directors and facilitators. Its intended audience includes all persons who wish to commission, support or offer a course serving the above aims, including pre-service training. This manual sets out the requisite steps for the preparation and organization of such a course.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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Scabies is a global health concern disproportionately affecting vulnerable populations such as refugees and asylum seekers. Greece is a main point of entry in Europe for refugees, but epidemiological data on scabies in this population are scarce. We aimed to describe the epidemiology of scabies, inc...luding trends over the study period.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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This thematic brief accompanies the Working for Health 2022–2030 Action Plan, providing a rationale for the related actions of the Working for Health progression model (see Annex). This brief aims to inform Member States, non-state actors and other stakeholders vested in implementing the Action ...Plan to consider the context of planning and financing for the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan Itself, and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce. The importance of these themes was again emphasized at the Seventy-fifth WHA, when Resolution WHA75.17: Human resources for health, was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact.
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The... Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
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Rabies is entirely preventable, and vaccines, medicines, tools and technologies have long been available to prevent people from dying of dog-mediated rabies. Nevertheless, rabies still kills about 60 000 people a year, of whom over 40% are children under 15, mainly in rural areas of economically dis...advantaged countries in Africa and Asia. Of all human cases, up to 99% are acquired from the bite of an infected dog.
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The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines ...faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
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The figures and findings reflected in the 2019 Humanitarian Needs Overview (HNO) represent the independent analysis
of the United Nations (UN) and its humanitarian partners based on information available to them. While the HNO aims
to provide consolidated humanitarian analysis and data to help inf...orm joint strategic humanitarian planning, many of
the figures provided throughout the document are estimates based on sometimes incomplete and partial data sets using
the methodologies for collection that were available at the time. The Government of Syria has expressed its reservations
over the data sources and methodology of assessments used to inform the HNO, as well as on a number of HNO findings.
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DHS Further Analysis Reports No. 109 - This report documents trends in key child nutrition indicators in Rwanda. Data from the Demographic and Health Surveys (DHS) in 2005, 2010, and 2014-15 were analyzed, disaggregated by selected equity-related variables, and tested for trends. Over the survey per...iod, Rwanda had high rates of exclusive breastfeeding, with regional variation. Rates of continued breastfeeding were also high but generally decreased as mother’s education and household wealth increased in all survey years. Complementary feeding practices varied by region, mother’s education, household wealth, urban-rural residence, and sex of the child.
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Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon population health and the risk of infectious disease, particularly those originating at the human-animal-envi...ronmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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DHS Working Papers No. 69
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant economic change in India. The main predictor is a new... measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level.
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In 2015, the National Institute of Statistics of Rwanda published the Rwanda Poverty Profile Report 2013/2014,which provided a detailed portrait of the extent and nature of poverty in the country, based on information collected by an integrated household living conditions survey (EICV4) undertaken b...etween October 2013 and September 2014.
This report complements the study by looking at the trends in poverty between 2010/11 and 2013/14.It is essential to examine changes in poverty over time, because one of the most important goals of economic Sustainable Development Goals is to eliminate severe poverty by 2030.
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In 2019, the Task Force on Fiscal Policy for Health concluded that taxes on tobacco, alcohol, and sugar-sweetened beverages were a highly effective but greatly underused policy tool to reduce consumption, save lives, and raise domestic resources. The Task Force estimated that if all countries increa...sed their excise taxes to raise prices by 50 percent, over 50 million premature deaths could be averted worldwide over the next 50 years while
raising over USD 20 trillion of additional revenue. Since the Task Force first convened, the world has faced a “polycrisis,” including a global pandemic, an economic recession, and the outbreak of wars in Europe and the Middle East. Against this backdrop, the world has also experienced prolonged health and fiscal crises. Health systems, weakened by the COVID-19 pandemic, lack sufficient financing to rebuild and respond to the surging noncommunicable diseases epidemic caused by uncontrolled risk factors such as tobacco, alcohol, and sugar consumption. Opportunities to raise domestic resources are limited and debt burdens have squeezed budgets. The period from 2019 to 2027 risks becoming a “lost decade” for health and social policies, with 110 countries facing little prospect of any
ability to raise government revenues beyond current levels. In this paper, we describe the current health and fiscal crises and review the contribution that health taxes could make in turning around this dire situation. We conclude that taxes on tobacco, alcohol, and
sugar-sweetened beverages are an ideal policy solution—good for the budget and good for health. These taxes are relatively quick to implement, and, unlike other taxes, do not put economic growth at risk—a vital benefit in the current era.
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