This year’s MPI results show that more than two-thirds of the multidimensionally poor—886 millionpeople—live in middle-income countries. A further 440 million live in low-income countries. In both groups, data show, simple national averagescan hide enormous inequality inpatterns of povertywith...in countries. For instance, in Uganda 55 percentof the population experience multidimensional poverty—similartotheaverage in Sub-Saharan Africa. But Kampala, the capital city, has an MPI rate of sixpercent, whileinthe Karamojaregion, the MPI soars to 96 percent—meaningthat partsof Ugandaspan the extremes of Sub-Saharan Africa.There is even inequality under the same roof. In South Asia, for example, almost a quarter ofchildren under five live in households where at least one child in the household is malnourished but at least one child is not.
There is also inequality among the poor. Findings of the2019 global MPI paint a detailed picture of the many differences in how-and how deeply -people experience poverty. Deprivationsamong the poor varyenormously: in general, higher MPI valuesgo hand in hand with greater variationin the intensity of poverty. Results also show that children suffer poverty more intensely than adults and are more likely to be deprived in all 10 of the MPI indicators, lackingessentialssuch as clean water, sanitation, adequate nutrition or primary education
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
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The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition.
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Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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Yaws is a disfiguring non-venereal disease caused by infection with the spirochaete. Treponema pallidum subspecies pertenue which is closely related to the causative agent of syphilis and those of the other endemic treponematoses, bejel and pinta. The disease is endemic in certain areas of the World... Health Organization (WHO) African, South-East Asia and Western Pacific regions. Of the neglected tropical diseases identified for elimination and eradication, yaws is one of two diseases targeted for eradication. In 1949, the Second World Health Assembly adopted resolution WHA2.36, which addresses yaws, bejel and pinta as major public health problems that need attention.
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Annual report on global preparednessfor health emergencies
The next pandemic is not a question of if, but when—and the world is woefully unprepared, according to the first annual report from the Global Preparedness Monitoring Board. The WHO and the World Bank convened the independent group after ...the 2014-2015 Ebola outbreak in West Africa, Global News reports. Within 36 hours, a contagion like the 1918 flu could sweep the globe and take 50 to 80 million lives while wreaking havoc on the global economy, the report warns. And that’s just one possibility.
What would it take to get prepared? An investment of $1-$2 per person per year could create “acceptable” level of preparedness.
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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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.
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Sudan recorded the first COVID-19 case on 13 March 2020 and, at the beginning of July, the Federal Ministry of Health had confirmed that nearly 10,000 people had contracted the virus, including over 600 who died from the disease across the country. Although more than 70 per cent of the confirmed cas...es are in the Khartoum area, COVID-19 has spread throughout the country, with the highest numbers recorded in the central and eastern states. With extremely low testing capacity — around 800 samples per day, the lowest in the region — the official figures of confirmed cases likely underestimate the extent of the pandemic and the actual situation is unknown.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o...r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a...dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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Nat Commun 9, 5370 (2018). https://doi.org/10.1038/s41467-018-07804-8. Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical skin disease that is most commonly found in children from West and Central Africa. Despite the severity of the infection, therapeutic options are... limited to antibiotics with severe side effects. Here, we show that M. ulcerans is susceptible to the anti-tubercular drug Q203 and related compounds targeting the respiratory cytochrome bc1:aa3. While the cytochrome bc1:aa3 is the primary terminal oxidase in Mycobacterium tuberculosis, the presence of an alternate bd-type terminal oxidase limits the bactericidal and sterilizing potency of Q203 against this bacterium. M. ulcerans strains found in Buruli ulcer patients from Africa and Australia lost all alternate terminal electron acceptors and rely exclusively on the cytochrome bc1:aa3 to respire. As a result, Q203 is bactericidal at low dose against M. ulcerans replicating in vitro and in mice, making the drug a promising candidate for Buruli ulcer treatment.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI...D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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Claims for refugee status related to situations of armed conflict and violence under Article 1A(2) of the 1951 Convention and/or 1967 Protocol relating to the Status of Refugees and the regional refugee definitions
UNHCR issues these Guidelines on International Protection pursuant to its mandate,... as contained in, inter alia, the Statute of the Office of the United Nations High Commissioner for Refugees, namely paragraph 8(a), in conjunction with Article 35 of the 1951 Convention relating to the Status of Refugees, Article II of its 1967 Protocol, Article VIII(1) of the 1969 OAU Convention Governing the Specific Aspects of Refugee Problems in Africa, and Commitment II(e) of the 1984 Cartagena Declaration on Refugees.
These Guidelines clarify paragraph 164 of the UNHCR Handbook on Procedures and Criteria for Determining Refugee Status under the 1951 Convention and otherwise complement the Handbook. They are to be read in conjunction with UNHCR’s other Guidelines on International Protection.
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The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these vi...ruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
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This report makes clear that there is a path to end AIDS. Taking that path will help ensure preparedness to address other pandemic challenges, and advance progress across the Sustainable Development Goals. The data and real-world examples in the report make it very clear what that path is. It is not... a mystery. It is a choice. Some leaders are already following the path—and succeeding. It is inspiring to note that Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the 95–95–95 targets, and at least 16 other countries (including eight in sub-Saharan Africa) are close to doing so.
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PLoS Negl TropDis14(10): e0008837. https://doi.org/ 10.1371/journal.pntd.0008837.
We conducted alandscape analysis on parasitic and vector-borne disease elimination approaches with the aim toidentify evidence-based strategies, core components and key concepts for achieving and sustaining schistosom...iasis control and for progressing elimination efforts towards interruption oftransmission insubSaharan Africa.
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