Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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The adoption and the entry into force of the Convention on the Rights of Persons with Disabilities and its Optional Protocol challenge such attitudes and mark a profound shift in existing approaches towards disability.
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Latin America and the Caribbean is characterized by a matrix of social inequality whose axes —such as
socioeconomic stratum, gender, stage in the life cycle, ethnicity and race, territory, disability, and immigration
status— create multiple, often concurrent, situations of exclusion and discri...mination. The coronavirus
disease (COVID-19) pandemic has exacerbated wide social gaps and it is no coincidence that Latin America
and the Caribbean is one of the regions in which the health and socioeconomic impacts of the pandemic have
been the most severe, which shows that the costs of inequality are unsustainable
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