Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internatio...nally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and
outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.
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Le Plan d'action régional pour la vaccination dans les Amériques (RIAP) constitue une étape fondamentale pour consolider les progrès accomplis et offre une vision concrète pour relever les défis actuels et futurs en vue d'atteindre les objectifs fixés pour l'année 2030. Ce plan est essentiel... pour renforcer les systèmes de santé, améliorer l'accès à la vaccination et optimiser la coordination entre les parties prenantes, en veillant à ce que tous les secteurs de la population aient la possibilité de bénéficier de programmes de vaccination résilients, efficaces et équitables tout au long du parcours de vie. Conçu dans le cadre stratégique de la politique pour la Revitalisation de la vaccination en tant que bien de santé publique pour une santé universelle et aligné sur le Programme pour la vaccination à l’horizon 2030, le plan d’action synthétise les priorités déterminées par les pays et les territoires, en utilisant des indicateurs qui ciblent six axes stratégiques d’intervention : la gouvernance, la surveillance, l'intégration, la communication, les ressources humaines et la prise de décision fondée sur des données probantes. Cette approche globale et inclusive réaffirme la volonté de parvenir à la couverture sanitaire universelle et d'atteindre les objectifs de développement durable. À l'avenir, il sera essentiel de maintenir un engagement fort à tous les niveaux en adaptant les stratégies aux changements que connaîtront les pays et les territoires, afin de faire progresser efficacement leurs efforts de vaccination par la mise en œuvre de meilleures pratiques et d’approches novatrices. Toutes les parties prenantes sont encouragées à participer à cet effort collectif pour que la vaccination soit considérée comme un bien public et que la population soit protégée contre les maladies évitables par la vaccination.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Transformation and outlook
Recommended actions and international and national level
Consultancy to take forward the International Health Partnership
The World Health Organization (WHO) recognizes the challenges countries face for maintaining their COVID-19 response while addressing competing public health challenges, conflicts, climate change and economic crises.
It remains critical for national programmes to continue to offer testing for COVI...D-19 in line with three main objectives: reduce morbidity and mortality through linkage to prompt care and treatment, reduce onward transmission and track the evolution of the epidemic and the virus
itself.
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Com o tema A equidade, o coração da saúde, este Plano busca catalisar esforços nos Estados Membros para reduzir as iniquidades em saúde dentro dos países e territórios e entre eles, a fim de melhorar os resultados em termos de saúde. O Plano identifica ações específicas para enfrentar a d...esigualdade em saúde, como as recomendadas pela Comissão sobre Equidade e Desigualdades em Saúde nas Américas, com a orientação da Comissão de Alto Nível para a Saúde Universal. Quatro temas transversais são centrais para o enfoque deste Plano para abordar os determinantes da saúde: a equidade, o gênero, a etnia e os direitos humanos.
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Bajo el tema La equidad, el corazón de la salud, este plan procura catalizar los esfuerzos en los Estados Miembros para reducir las inequidades en materia de salud entre los países y los territorios y dentro de ellos, a fin de mejorar los resultados en materia de salud. En el plan se señalan medi...das específicas para abordar la desigualdad en la salud, incluidas las recomendadas de la Comisión sobre Equidad y Desigualdades en Salud en las Américas, y se sigue la orientación de la Comisión de Alto Nivel para la Salud Universal. El enfoque que se adopta en este plan para abordar los determinantes de la salud incluye cuatro temas transversales clave: la equidad, el género, la etnicidad y los derechos humanos
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