This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed sinc...e the start of these operations over twenty-five years ago. The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs. Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence.
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Progress in reducing tobacco use is a key indicator for measuring countries’ efforts to implement the WHO Framework Convention on Tobacco Control – target 3.a under the Sustainable Development Goals agenda. Countries have adopted this indicator to report progress also towards the tobacco reducti...on target under the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 and the WHO’s Global Programme of Work triple billions target.
Fourth edition.
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Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementing programmes of technical cooperation with the Government of Liberia from January to December 2022. T...he key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent mental health (CAMH), particularly in low- and middle-income countries (LMICs) where children and adolescen...ts represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH.
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Trypanosoma cruzi is the etiological agent of Chagas disease (CD), considered one of the most important parasitic infections in Latin America. Between 25 and 90 million humans are at infection risk via at least one of multiple infection mechanisms. Under natural conditions, the principal transmissio...n modes are transplacental or via one of more than 140 hematophagous triatomine bugs (Reduviidae: Triatominae). Triatomines acquire the parasite from mammal reservoirs due to their obligate blood-feeding (albeit triatomines can also feed on non-reservoir vertebrates such as birds and reptiles). The disease burden for CD in the Latin America and Caribbean region, based on disability-adjusted life-years (DALYs), is at least five times greater than that of malaria, and is approximately one-fifth that of HIV/AIDS. In recent decades, CD has extended to other continents outside natural reservoir or vector distributions due to human migration, with a minimum estimated 10 million individuals infected worldwide.
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Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease has been reported from countries between 30°N and 15°S since 1840 but the exact burden of disease is not known. It is currently unknown what the incidence, prevalence and the number of reported ...cases per year per country is. In order to estimate what the global burden of mycetoma is, a meta-analysis was performed. In total 50 studies were included, which resulted in a total of 8763 mycetoma cases. Most cases were found in men between 11 and 40 years of age. The foot was most commonly affected.
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Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea. It is an occupational, environmental, and domestic health hazard that exacerbates the already impoverished state of these communities. Co...nservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities.
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The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the disease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variati...ons of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
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Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of a mixture of different toxins (“venom”) following the bite of a venomous snake. Envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes tha...t have the ability to spit venom as a defence measure. Not all snakebites result in envenoming: some snakes are non-venomous and venomous snakes do not always inject venom during a bite. About 50–55% of all snakebites result in envenoming. Snake venoms are complex mixtures of protein and peptide toxins, varying from one species to another, and even within species. The toxins in snake venoms are evolutionarily adapted to interact with a large variety of cellular targets in the organisms exposed to them. In humans and animals, snakebite envenoming affects multiple organ systems (depending on the particular species of snake and the classes of toxins present in the venom) and can cause, among other things: haemorrhage and prolonged disruption of haemostasis, neuromuscular paralysis, tissue necrosis, myolysis (muscle degeneration), cardiotoxicity, acute kidney injury, thrombosis and hypovolaemic shock.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in...dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
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TUATION UPDATE
In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the imp...act is still being assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia. At the same time, 4
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In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the impact is still bei...ng assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia
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The sub-Saharan African region, carries 90% of the over 250 million cases of schistosomiasis occurring worldwide. In this region, after Nigeria, Tanzania is second country having the highest cases of schistosomiasis and approximately 51.5%0 of the Tanzanian population is either exposed or live in ar...eas with high risk of exposure. The country is endemic to both Schistosoma mansoni and Schistosoma haematobium, these infections are common in communities characterised with limited access to water, sanitation, hygienic practices and health services. Schistosoma mansoni infection is associated with hepatosplenic disease characterised with hepatomegaly, splenomegaly, progressive periportal fibrosis (PPF) which can lead to portal hypertension and its related sequelae, mainly ascites, liver surface irregularities, oesophageal varices and haematemesis. The main consequences of S. haematobium infection are haematuria, dysuria, nutritional deficiencies, urinary bladder lesions, hydronephrosis, urinary bladder squamous cell carcinoma and in children, growth retardation. Preventive chemotherapy using mass drug administration (MDA) of praziquantel targeting primary school aged children is the main strategy for controlling schistosomiasis in Tanzania.
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This chapter discusses the antibacterial treatment of leprosy infections. Antibiotic treatment is
a key component of leprosy treatment, as it is vital to prevent the progression of the infection.
Treatment with rifampin and other antibiotics is highly effective and cures 98% of patients with
the ...leprosy infection. Furthermore, the relapse rate is very low, at about 1% over 5–10 years.
There is little M. leprae drug resistance in leprosy and few reports of multi-drug resistance (1, 2, 3,
4, 5, 6, 7, 8). An antibiotic treatment may take months or years to produce clinical improvement,
especially in patients with an initial high bacterial index (BI).
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Trachoma is an eye infection that for thousands of years caused many people to go blind across all continents. As the result of development and targeted interventions, trachoma is now limited to an estimated 57 countries, often affecting the poorest
populations of the world. Today, more than 2 mill...ion people are either blind or suffer from a very painful disability as the result of trachoma.
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This document outlines the working structure and guiding principles for collaboration of COVAX, the Vaccines pillar of the Access to COVID-19 Tools Accelerator (ACT-A). The working structure of COVAX continues to adapt to emerging needs and the changing trajectory of the pandemic. Some components of... the pandemic response capabilities united under COVAX may eventually be integrated into regional, national and sub national health systems, routine immunization programmes and future global pandemic preparedness and response (PPR) structures. Therefore, the working structures outlined in this document continue to evolve and the document provides a snapshot of the COVAX ways of working in the first half of 2022.
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Since late August 2022, cases of severe acute watery diarrhoea have been increasingly reported across Syria, concentrated
particularly along the Euphrates river. These were later confirmed to be cholera cases.3 Cholera is a disease caused by
bacteria that can be found in faeces, and spreads throug...h people consuming contaminated water or food. It causes severe
watery diarrhoea and vomiting which lead to dehydration. If treated immediately, less than 1% of cases result in patients
dying. However, if timely treatment is not available, cholera can lead to death within hours in 25 to 50% of cases. The
situation is critical in Syria as the local population is facing a severe water crisis due to drought, falling groundwater levels,
reduced flow in the Euphrates River, and reduced functionality of Alouk water station. REACH has been monitoring
developments in Northeast Syria through regular data collection cycles, remote sensing data, and rapid needs assessments
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Despite high regional demand for vaccines valued at over US$ 1 billion annually, Africa’s vaccine industry provides only 0.1% of global supply. Vaccine inequity and hoarding at the start of the pandemic, which resulted in delays in obtaining COVID-19 doses, stimulated new resolve to address future... supply security. In 2021, the AU set a target to produce and supply more than 60% of the vaccine doses on the continent by 2040.
In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040*, demonstrating the potential for a thriving regional industry to emerge.
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Briefing Note 8.
Ecosystem-based adaptation (EbA) is a strategy for adapting to the adverse impacts of climate change by harnessing nature and the services it can provide. This strategy is crucial for cities and peri-urban areas, threatened by a multitude of climate hazards and home to more than ha...lf the human population as of 2018. Despite some outmigration from the largest cities during the COVID-19 pandemic, urbanization will continue, and by 2035, 62.5 percent of the world’s population is expected to reside in urban areas. However, given the need to retrofit, replace and upgrade deteriorating urban infrastructure, and to meet the challenges of climate change, including the urban heat island effect, droughts and more intense flooding, many experts and policymakers see in these demands an opportunity to reinvent cities as greener, less prone to pandemics, and more liveable.
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