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Abstract: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public
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health. A plethora of information concerning the chronic phase of human Chagas disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss the current status of acute Chagas disease cases globally, the immunological findings related to the acute phase and their possible influence in disease outcome, and reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV invection management.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
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six months and life for the general population was very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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Translating Community Research Into Global Policy Reform For National Action: A Checklist For Community Engagement To Implement The WHO Consolidated Guideline On The Sexual And Reproductive Health A
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nd Rights Of Women Living With HIV
3rd edition | December 2018
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March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians
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now fear for their lives.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant b
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arriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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An Advocate’s Guide: Strategic Indicators for Universal Access to Sexual and Reproductive Health and Rights
recommended
This guide was prepared to enable advocates to use data
when advocating for universal access to SRHR at the national,
regional and global levels. It is a direct outcome of the Strategic
SRHR Indicators workshop held in Kuala Lumpur, Malaysia on
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21-22 August for the project “Strengthening the Networking,
Knowledge Management and Advocacy Capacities of an AsiaPacific
Network for SRHR” supported by the EU.
One of the major objectives of the project is to develop
a comprehensive monitoring framework of indicators for
measuring government performance to fulfil their international
commitments, particularly to the ICPD and the MDGs, both in
the Asia-Pacific region and globally.
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Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and
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health, nutrition and population (HNP). In the last 5 years, the number of voices calling for stronger international action on climate change and health has increased, as have the scale and depth of activities. But current global efforts in climate and health are inadequately integrated. As a result, actions to address climate change, including World Bank Group (WBG) investment and lending, are missing opportunities to simultaneously promote better health outcomes and more resilient populations and health sectors. Accordingly, with the financial support of the Nordic Development Fund (NDF), the World Bank Group set out to develop an approach and a 4-year action plan, outlined in this paper, to integrate health-related climate considerations into selected WBG sector plans and investments.
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This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and it
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s impacts across different Sustainable Development Goals. The aim of this paper is to inform and stimulate discussions on how to further advance the implementation of 2030 Agenda for Sustainable Development, the Global Action Plan on Antimicrobial Resistance, National Action plans on Antimicrobial Resistance, as well as work within all sectors that affect and are affected by antibiotic resistance
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A case study from Albania
June 2016
EHRN is grateful to all who contributed to this document, especially (in alphabetical order): Alena Alba, Program Officer, Eastern Europe and Central Asia Team, Asia, Europe, Latin America and the Caribbean Department, The
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Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva; Roland Bani, Head, National AIDS Program, Institute of Public Health, Ministry of Health, Tirana; Gazmend Bejtja, Director, Health Care Directory, Ministry of Health, Tirana; Arian Boci, Director, Stop AIDS, Tirana; Bujana Hoti, UNAIDS Focal Point, Tirana; Gyöngyvér Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia, Asia, Europe, Latin America and the Caribbean Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva; Manjola Kola, CCM Secretariat, Tirana; Sokol Morina, Coordinator, Control of illicit Drugs and Alcohol Addiction, Ministry of Health, Tirana; Genci Muçollari, Director, Aksion Plus, Tirana; and Dorina Tocaj, National Program Officer, UNFPA, Tirana.
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Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure o
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n Africa’s already fragile health systems as ODA is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
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The International Rescue Committee (IRC) and the United Nations Children’s Fund (UNICEF) have newly developed "Caring for Child Survivors of Sexual Abuse Guidelines" for health and psychosocial providers in humanitarian settings - “CCS Guideline
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s”. The CCS Guidelines are based on global research and evidence-based field practice, and bring a much-needed fresh and practical approach to helping child survivors, and their families, recover and heal from the oftentimes devastating impacts of sexual abuse. The guidelines walk the reader through the core knowledge, attitude and skill competencies required for service providers to effectively care for children and families affected by sexual abuse. In addition, the guidelines outline how to provide case management and basic psychosocial care for child survivors, as well as best practices for coordinating care.
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