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Chapter 7 from the book People's Movements in the 21st Century - Risks, Challenges and Benefits
NEUROLOGY ATLAS presents for the first time, the most
comprehensive collection and compilation of information on
neurological resources across 109 countries. The results confirm
that the available resources including services for neurological
disorders are markedly insufficient; in addition, the...re are large
inequities across regions and income groups of countries.
Urgent action is required to enhance the resources available
to address the increasing burden of neurological disorders.
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The results of in-country database and reports analysis
2nd edition.
The practical aspects of TB patient care from the onset of symptoms to the completion of treatment are covered in this guide
International Journal of Mental Health Systems December 2011, 5:3
Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse serv...ice delivery models
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In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significant financial hardship for individuals and negatively impacted on healthcare systems’ ability to prov...ide population-wide access to essential medicines.
Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products.
This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
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Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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As countries like the United States pass temporary legislation to cushion the massive blow that is on the horizon that is about to hit many of their citizens – poor and not poor – it is important to think about the tools available to governments of low-income countries, what kind of preparations... they might consider, and what type of scal burden they face for social protection programs that can be nanced through their own budgets and grants from international development institutions like the World Bank.
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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.
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This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
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The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke...y message of this paper, building on recent reports by the IMF and SDSN (IMF, 2019b; SDSN, 2018) is that the governments of Low-Income Developing Countries (LIDCs) will require a substantial increase in fiscal (budget) revenues, far beyond what they can achieve by their own fiscal reforms. For this reason, SDG financing will require substantial international cooperation to enable the LIDCs to finance their SDG fiscal outlays. One important source of increased revenues should be the globally coordinated taxation of ultra-high-net worth assets. Today’s ultra-rich should help to pay for the survival and basic needs of the world’s poorest people.
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Die weltweite Ungleichheit bei der Verteilung von Einkommen und Vermögen weit jenseits dessen, was sich durch Unterschiede der Belastung oder Verantwortung durch die jeweilige Arbeitstätigkeit begründen ließe, stellt schon für sich genommen eine gewaltige Ungerechtigkeit dar. Sie steht auch in ...einem gefährlichen Gegensatz zu unverzichtbaren Grundwerten des gesellschaftlichen Zusammenlebens wie menschliche Solidarität und gleichberechtigte Beteiligung an der demokratischen Willensbildung. Noch bedrohlicher ist aber, dass sie die benachteiligten Menschen ihrer Lebenschancen beraubt. Einerseits werden diese gezwungen, extreme Risiken einzugehen, um ihre wirtschaftliche Existenz zu sichern oder brutaler Gewalt und Verfolgung zu entkommen. Andererseits reichen die verfügbaren Ressourcen nicht aus, um wenigstens lebensbewahrende Gesundheitsdienste bereitzustellen. Der Beitrag analysiert die Finanzierung der allgemeinen Gesundheitsversorgung in wirtschaftlich benachteiligten Ländern, die als wesentliche Voraussetzung für die Verwirklichung der Agenda 2030 gelten.
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Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the countries in which the Global Fund invests.
In den vergangenen 20 Jahren hat derGlobale Fonds mehr als 53 MilliardenUS-Dollar investiert und gemeinsam
mit seinen Partnern dazu beigetragen, 44 Millionen Menschenleben zu retten. In den Partnerländern des Globalen
Fonds ist die Zahl der durch diese drei Krankheiten insgesamt verursachten Tode...sfälle um mehr als die Hälfte
zurückgegangen.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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