Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
more
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
more
Lessons learned from recent public health events such as the COVID-19 pandemic, Ebola virus disease, Zika virus disease outbreaks, and other public health threats, including earthquakes and floods, have highlighted the need for countries to continuously develop, strengthen, and maintain capacities r...equired under the International Health Regulations (2005) (IHR (2005)).
Developing capacities for health security in a country requires the engagement of public and private entities across a broad range of sectors, including human and animal health, agriculture, environment, finance, security, emergency management, education, and transportation. The World Health Organization (WHO) is mandated through various resolutions, decisions, and reports of the World Health Assembly, and through the IHR (2005), to provide technical guidance and support to its Member States in developing, strengthening, and maintaining their health systems, including capacities required under the IHR (2005).
For countries to better prevent, prepare for, detect, notify, respond to, and recover from public health emergencies, they must build and maintain IHR core capacities and support the strengthening of health emergency prevention, preparedness, response, and resilience (HEPR) capacities. National Action Plans for Health Security (NAPHS), as capacity development plans, provide the tasks and resources needed to ensure adequate capacities are in place to prevent, detect, respond to, and recover from public health events in a sustainable manner. Investing in the resilience of these capacities within national health systems at national and local levels not only improves national health security but also helps safeguard economic, social, and political developments.
more
It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
more
Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
more
Global asymmetries influence policies for recovery in Latin America and the Caribbean. Nearly 30 years after the Earth Summit and the global adoption of an international development agenda, in practical terms the environmental pillar of the 2030 Agenda for Sustainable Development has not been taken ...into consideration in recovery policies in the region. This has created major problems in terms of the medium- and long-term direction of regional economies.
more
The third Malawi Growth and Development Strategy (MGDS III) has been formulated following the expiry of its predecessor strategy, MGDS II, in June 2016. The strategy has been prepared at a time when Malawi has been experiencing multiple shocks including floods, drought and financial crises. While fo...od production improved in 2017, the cycle of food deficit and surplus has kept the country preoccupied with fighting disasters instead of pursuing its development agenda. It is for this reason that the theme of the MGDS III is "Building a Productive, Competitive and Resilient Nation". With this theme, the Government of Malawi undertakes to support Malawi's development into a productive nation competing on the global stage while ensuring that the nation builds systems that deal with natural shocks and disasters.
more
he global architecture for providing development assistance for health (DAH)
has become increasing complex in the last decade, with many new funding agencies entering the health sector.
This study presents a detailed picture of European Union (EU) and EU member state originating DAH
between 2006 ...and 2009; with a sp
more
UNCTAD has prepared a rapid assessment of the impact of war in Ukraine on trade and development, and interrelated issues in the areas of finance, technology, investment and sustainable development.
The results confirm a rapidly worsening outlook for the world economy, underpinned by rising food, fu...el and fertilizer prices, heightened financial volatility, sustainable development divestment, complex global supply chain reconfigurations and mounting trade costs.
This rapidly evolving situation is alarming for developing countries, and especially for African and least developed countries, some of which are particularly exposed to the war in Ukraine and its effect on trade costs, commodity prices and financial markets.
The risk of civil unrest, food shortages and inflation-induced recessions cannot be discounted, particularly given the fragile state of the global economy and the developing world as a result of the COVID-19 (coronavirus disease) pandemic.
more
In response to a call by the United Nations Secretary-General and the Governments of Guinea, Liberia and Sierra Leone, an international team conducted an Ebola Recovery Assessment.The aim was to contribute towards laying the foundation for short-, medium- and long-term recovery while the medical eme...rgency response continues to tackle the epidemic.
This summary report is based on a full report as well as three detailed reports submitted to each of the three governments as contributions to their national recovery planning processes.
more
Developing countries face disastrous healthcare setbacks, hunger and huge international debt as covid-19’s ‘final wave’
Le présent Plan du SNU en RDC d’appui à la réponse socioéconomique au COVID-19 est adossé au Programme Multisectoriel d’Urgence d’Atténuation des effets de la COVID-19 en RDC, formulé par le Gouvernement, avec le soutien des partenaires au développement. Il est également aligné au Pl...an Cadre des Nations Unies de Coopération au Développement Durable (UNSDCF) et adossé aux cinq piliers du Programme cadre des NU pour la réponse socioéconomique immédiate au COVID-19, développé par UNDG, qui fait référence au rapport du SG des NU intitulé « Solidarité mondiale, responsabilité partagée : impacts socioéconomiques de la COVID-19 ».
more
This study aimed to estimate the cost-effectiveness of a community-based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology... to estimate the programme’s achievements and cost-effectiveness.
more
Yemen has already lost 2 decades of Human Development
The study warns of exponentially growing impacts of conflict on human development. It projects that if the war ends in 2022, development gains will have been set back by 26 years — almost a generation. If it continues through 2030, that setbac...k will increase to four decades.
Large File 35 MB!!!
more
La Estrategia regional se dirige a los principales países de acogida de la población refugiada y migrante proveniente de Venezuela; en particular, a las instituciones gubernamentales que tienen algún grado de competencia en la integración socioeconómica de esta población y a las organizaciones... de empleadores y trabajadores, con el ánimo de promover el diálogo social alrededor de este ámbito.
more
Health security funding is intended to improve capacities for preventing, detecting, and responding to public health emergencies. Recent years have witnessed substantial increases in the amounts of donor financial assistance to health security from countries, philanthropies, and other development pa...rtners. To date, no work has examined the effects of assistance on health security capacity development over time. This paper presents an analysis of the time-lagged effects of assistance for health security (AHS) on levels of capacity.
more