The report “Dementia: a public health priority” has been jointly developed by WHO and Alzheimer's Disease International. The purpose of this report is to raise awareness of dementia as a public health priority, to articulate a public health approach and to advocate for action at international a...nd national levels.
Dementia is a syndrome that affects memory, thinking, behaviour and ability to perform everyday activities. The number of people living with dementia worldwide is currently estimated at 35.6 million. This number will double by 2030 and more than triple by 2050. Dementia is overwhelming not only for the people who have it, but also for their caregivers and families. There is lack of awareness and understanding of dementia in most countries, resulting in stigmatization, barriers to diagnosis and care, and impacting caregivers, families and societies physically, psychologically and economically.
Available Languages: Chinese, English, Japanese, Russian and Spanish
more
The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
more
To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV ...expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
more
The following technical report outlines the rationale, process and results of a joint research study, coordinated by the World Health Organization (WHO) and the Pan-American Health Organization (PAHO), co-chaired by the Ministry of Health and Social Protection and the Ministry of Environment and Sus...tainable Development in collaboration with the Climate and Climate Air Coalition, the Stockholm Environment Institute, the Clean Air Institute and leading international and national experts. A rationale section describes the links between greenhouse gas (GHG) emissions, short-lived climate pollutants, air pollution and adverse health outcomes. A summary of the research study describes how scenarios were modelled to examine the health and economic implications of raising ambition in Colombia’s Nationally Determined Contribution (NDC) to the United Nations Framework Convention on Climate Change (UNFCCC)
more
Health is routinely considered in strategic environmental assessment (SEA) and environmental impact assessment (EIA), following requirements of European Union directives and the Protocol on Strategic Environmental Assessment to the Convention on Environmental Impact Assessment in a Trans...boundary Context (Espoo Convention). Policy-makers and other sources report that these assessments mostly adopt a biophysical perspective and that few cases consider or define health in a manner which is consistent with the WHO Constitution, by considering the wider social, economic, behavioural and institutional aspects of health. This systematically conducted review of over 333 SEA and EIA cases in the WHO European Region shows that while about 80% of assessments pursue a narrow, biophysical interpretation of health, around 10% consider wider determinants when defining health, and another 10% consider wider determinants of health in the actual assessment. Twelve case studies are presented, literature is reviewed and implications for practice are considered.
more
The Global Health Expenditure Report delves into the intricate landscape of global economies and health systems. This year, it focuses on health spending in 2022, the third year of the COVID-19 pandemic. It shows how countries around the world responded to the health and economic shocks of the pande...mic from a financial perspective. It also considers what the future may hold as countries emerge from the pandemic. Although it is still too early to gauge whether the COVID-19 pandemic has altered long-term trends in health spending, spending appears to have peaked and is now at or below its long-term rising trend in most country income groups. Additionally, to mark the 25th anniversary of the World Health Organization’s (WHO) Health Expenditure Tracking Program, the report reviews the program’s achievements and envisions a path forward. As the program’s lead technical agency, WHO is committed to working closely with partners to support countries in tracking health spending and sustaining the Global Health Expenditure Database and the Global Health Expenditure Report as global public goods.
more
The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves...tment in the Seventh National Development Plan 2017-2021. The government is also committed to achieving the targets under the health goal number three and other health related targets under other goals of the 2030 Sustainable Development agenda. Despite progress which has been made in improving the health of Zambians, the country still faces a high burden of communicable diseases and a growing burden of non-communicable diseases. Structural and social deprivation including poverty, inequalities and marginalisation also remain major threats to health. In order to effectively address all the social determinants of health, all sectors should take into account health and well-being as a key element of policy development.
more
Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve...ls of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
more
To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
more
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of reforms but focuses above all on implementation and results in the economically fragile district of Caraba...yllo, in northern Lima.
more
Good mental health is integral to human health and well being. A person’s mental health and many common mental disorders are shaped by various social, economic, and physical environments operating at different stages of life. Risk factors for many common mental disorders are heavily associated wit...h social inequalities, whereby the greater the inequality the higher the inequality in risk.
more
Communications and outreach to policy-makers and the wider public are essential to mobilize and sustain support for policy solutions to air pollution and bring the needed health, environment and economic benefits.
The Third Rwandan Health Sector Strategic Plan (HSSP III) provides strategic guidance to the health sector for six years, between July 2012 and June 2018. HSSP III has been inspired and guided by the VISION 2020, which will make Rwanda a lower-middle-income country by 2020; the Rwandan Health Policy... of 2004; and the priorities set out by the Economic Development and Poverty Reduction Strategy (EDPRS 2008–2012).
more
Corruption is embedded in health systems. Throughout my life—as a researcher, public health worker, and a Minister of Health—I have been able to see entrenched dishonesty and fraud. But despite being one of the most important barriers to implementing universal health coverage around the world, c...orruption is rarely openly discussed. In this Lecture, I outline the magnitude of the problem of corruption, how it started, and what is happening now. I also outline people's fears around the topic, what is needed to address corruption, and the responsibilities of the academic and research communities in all countries, irrespective of their level of economic development. Policy makers, researchers, and funders need to think about corruption as an important area of research in the same way we think about diseases. If we are really aiming to achieve the Sustainable Development Goals and ensure healthy lives for all, corruption in global health must no longer be an open secret.
more
Comprehensive and comparable estimates of health spending in each country are a key input for health
policy and planning, and are necessary to support the achievement of national and international health goals. Previous
studies have tracked past and projected future health spending until 2040 and ...shown that, with economic development,
countries tend to spend more on health per capita, with a decreasing share of spending from development assistance
and out-of-pocket sources. We aimed to characterise the past, p
more
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.
more
The motivations behind China’s allocation of health aid to Africa remain complex due to limited information on the details of health aid project activities. Insufficient knowledge about the purpose of China’s health aid hinders our understanding of China’s comprehensive role in supporting Afri...ca’s healthcare system. To address this gap, our study aimed to gain better insights into China’s health aid priorities and the factors driving these priorities across Africa. To achieve this, we utilized AidData’s Chinese Official Finance Dataset and adhered to the Organisation for Economic Co-operation and Development (OECD) guidelines.
more
One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an approach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just h...ow much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the
years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a costeffective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness.
Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
more
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
This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and fut...ure scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
more