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Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to
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measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated.
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This paper outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qualitative in nature, the HFPM assesses a country’s health financing institutions, processes, policie
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s and their implementation, benchmarked against good practice in the context of universal health coverage (UHC). The paper also details processes which ensure that country assessments are credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population accesses health services, and the extent to which they face financial hardship in the process. Through a forward-looking assessment process the HFPM contributes to building resilience within health systems, which also contributes directly to improved emergency preparedness and response.
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Global Vaccine Summit 2020 - Chair’s Summary
Global Alliance for Vaccines and Immunisation (Gavi)
Global Alliance for Vaccines and Immunisation (Gavi)
(2020)
CC
The UK government hosted the Global Vaccine Summit on June 4, 2020 under the patronage of the Rt. Hon. Boris Johnson, Prime Minister of the United Kingdom of Great Britain and Northern Ireland. The meeting was held by videoconference in light of the ongoing COVID-19 pandemic. 2. The Summit brought
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together more than 300 people, including 42 Heads of State and Government. 62 countries were represented, notably 14 Gavi implementing countries, all of the G7 nations and 19 governments of the G20. Eminent participants also included H.E. Antonio Guterres, Secretary-General of the United Nations; H.E. Moussa Faki Mahamat, Chairperson of the African Union Commission; H.E. Dr Tedros Adhanom Ghebreyesus, WHO Director-General; H.E. Henrietta Fore, UNICEF Executive Director; Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation; Ministers from implementing and donor countries; CEOs of vaccine manufacturing companies and private sector partners; leaders of UN and other international agencies; senior civil society representatives; and Gavi champions. A full list of the participants can be found in Annex.
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ACT-A - Urgent Priorities & Financing Requirements at 10 November 2020
World Health Organization (WHO), The Global Fund, Gavi et al.
World Health Organization (WHO)
(2020)
CC
Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o
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f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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This document is intended for countries, foundations, and civil society. It provides a consolidated overview of the Access to COVID-19 Tools (ACT) Accelerator, its goals, and the investments that partners have calculated are required to carry out its mission. Emergency responses are dynamic by natur
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e. The ACT-Accelerator will regularly adjust its investment needs and update this document as understanding of COVID-19 epidemiology and additional data on the ACT tools become available. For more detailed analysis on the ACT investments for its work in diagnostics, therapeutics and vaccines, please refer to the costed plans of the relevant ‘pillar’. At the time of publication, the investments required for the Health Systems Connector pillar were still under development.
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As a global community of +750 representatives of the world’s civil society, the C20 official Engagement Group of the G20 is submitting a list of policy priorities for the upcoming G20 Finance Ministers & Central Bank Governors meeting on July 18th and the G20 Extraordinary Sherpa Meeting on July 2
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4th. The proposed recommendations take into account complimentary policy areas at the intersection of health and finance policymaking; including funding gaps, systemic, fiscal and financial priorities to put global finances at the service of global health.
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With sustained economic growth in many parts of the developing world, an increasing number of countries are transitioning away from the most subsidized development finance as they exceed income and other qualification requirements. Cross-country evidence suggests that Development Assistance Committe
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e (DAC) donors view the crossing over of the World Bank’s International Development Association (IDA) eligibility threshold to signal that a country needs less aid, with subsequent reductions in both IDA and other donors’ concessional funding. Within the health sector, it is particularly important to understand the implications of these status changes for children under five years of age since improving early childhood health is critical to fostering health and social and economic development. Therefore, we examine the implications of the IDA transition by measuring the extent t which World Bank commitments—including both IDA and IBRD—are directed to infant and child health needs in Nigeria. Ordinary Least Squares (OLS) models were used in a difference-indifferences (DID) strategy to compare World Bank IBRD/IDA lending before and after the crossover to regions with varying initial levels of under-five and infant need.
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Background: Donor countries in the Middle East and North Africa (MENA) including Saudi Arabia, Kuwait and United Arab Emirates (UAE) have been among the largest donors in the world. However, little is known about their contributions for health. In this study, we addressed this gap by estimating the
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amount of development assistance for health (DAH) contributed by MENA country donors from 2000 to 2017. Methods: We tracked DAH provided and received by the MENA region leveraging publicly available development assistance data in the Development Assistance Committee (DAC) database of the Organisation for Economic Cooperation and Development (OECD), government agency reports and financial statements from key international development agencies. We generated estimates of DAH provided by the three largest donor countries in the MENA region (UAE, Kuwait, Saudi Arabia) and compared contributions to their relative gross domestic product (GDP) and government spending; We captured DAH contributions by other MENA country governments (Egypt, Iran, Qatar, Turkey, etc.) disbursed through multilateral agencies. Additionally, we compared DAH contributed from and provided to the MENA region.
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Salud Mental Perfil del País- Ecuador
A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government financing for primary care. The withdrawal of these funds from the pooled financing mechanism
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raised questions from Government and donors regarding the impact on primary care financing during this period of aid volatility.
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: Development assistance for health (DAH) is one of the most important means for Japan to promote
diplomacy with developing countries and contribute to the international community. This study, for the first time,
estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its
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flows, including source, aid
type, channel, target region, and target health focus area
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Background
Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul
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d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017.
Methods
Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators.
Findings
After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million).
Interpretation
Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention.
Funding
Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health.
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Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease
Abola, M. T. B.; Golledge, J.; Miyata, T. et al.
Journal of Atherosclerosis and Thrombosis
(2020)
CC
Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic mod
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alities, and even patient treatment response. The Asian Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) thus coordinated the development of an Asia-Pacific Consensus Statement (APCS) on the Management of PAD.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
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reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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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
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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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Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co
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nditions, and socio-demographic factors.
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In 2018, approximately 60,000 Ugandans were estimated to be suffering from cancer. It was also reported that only 5% of cancer patients access cancer care and 77% present with late-stage cancer coupled with low level of cancer health literacy in the population despite a wide coverage of primary heal
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thcare facilities in Uganda. We aimed to contribute to reducing the unmet needs of cancer prevention and early detection services in Uganda through capacity building.
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Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment
Mohan, V.; Khunti, K.; Chan,S.P.; et al.
National Library of Medicine, National Center for Biotechnology Information
(2020)
CC3
With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr
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ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
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Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide information to achieve the goal of World Health Organizatio
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n Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.
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Does Diabetes make someone vulnerable to getting COVID-19:
People with Diabetes are not more likely to get the virus compared to the general public.
However, if they contact CoVID-19, people with diabetes are more likely to have serious complications and become seriously ill from COVID-19, than t
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hose who do not have diabetes.
If a person with diabetes gets COVID 19, he is more vulnerable to severe form of COVID-19 and is more likely to die than those without diabetes.
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