Combining Digital and Molecular Approaches Using Health and Alternate Data Sources in a Next-Generation Surveillance System for Anticipating Outbreaks of Pandemic Potential.

Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.

Health promotion and the agenda for sustainable development, WHO Region of the Americas.

The approaches and tools of health promotion can be useful for civil society groups, local and national governments and multilateral organizations that are working to operationalize the 2030 agenda for sustainable development. Health promotion and sustainable development share several core priorities, such as equity, intersectoral approaches and sustainability, that help maximize their impact across traditional sectoral boundaries. In the Region of the Americas, each of these priorities has strong resonance because of prominent and long-standing health inequities that are proving resistant to interventions driven solely by the health sector. We describe several cases from the World Health Organization's (WHO) Region of the Americas in which the approaches and tools of health promotion, with a focus on cities, healthy settings and multisectoral collaboration, have been used to put the agenda into practice. We highlight areas where such approaches and tools can be applied effectively and provide evidence of the transformative potential of health promotion in efforts to achieve the sustainable development goals.

Les approches et outils de promotion de la santé peuvent être utiles aux groupes de la société civile, aux gouvernements locaux et nationaux et aux organismes multilatéraux qui s'efforcent de mettre en œuvre le Programme de développement durable à l'horizon 2030. La promotion de la santé et le développement durable ont plusieurs priorités centrales en commun, telles que l'équité, la collaboration intersectorielle et la durabilité, qui contribuent à optimiser leur impact au-delà des limites sectorielles habituelles. Chacune de ces priorités a une forte résonance dans la Région des Amériques, où les importantes inégalités en termes de santé durent depuis longtemps et semblent résister aux interventions menées à la seule initiative du secteur de la santé. Dans cet article, nous décrivons divers exemples provenant de la Région des Amériques de l'Organisation mondiale de la Santé (OMS), où plusieurs approches et outils de promotion de la santé (ciblant principalement les populations urbaines, la création d'environnements-santé et une collaboration multisectorielle) sont actuellement employés pour mettre en œuvre le Programme de développement durable. Nous mettons l'accent sur les domaines dans lesquels ces approches et outils peuvent être efficacement appliqués et nous proposons des données probantes sur le potentiel de transformation de la promotion de la santé dans les efforts menés pour atteindre les objectifs de développement durable.

Los enfoques y las herramientas para el fomento de la salud son útiles para los grupos de la sociedad civil, los gobiernos locales y nacionales y las organizaciones multilaterales que trabajan para poner en marcha el programa de desarrollo sostenible de 2030. El fomento de la salud y el desarrollo sostenible comparten varias prioridades básicas, como la equidad, los enfoques intersectoriales y la sostenibilidad, que ayudan a maximizar el impacto dentro de los límites sectoriales tradicionales. En la Región de las Américas, cada una de estas prioridades tiene una fuerte repercusión debido a las inequidades sanitarias prominentes y prolongadas que resisten a las intervenciones impulsadas únicamente por el sector de la salud. Se describen varios casos de la Región de las Américas de la Organización Mundial de la Salud (OMS) en los que los enfoques y las herramientas para el fomento de la salud, centrado en ciudades, entornos saludables y colaboración multisectorial, se han utilizado para poner en práctica el programa. Se destacan las áreas donde tales enfoques y herramientas se pueden aplicar de manera efectiva y ofrecer pruebas del potencial transformador del fomento de la salud en los esfuerzos por alcanzar los objetivos de desarrollo sostenible.

Health in all policies in the partnership for sustainable development.

This article analyzes the dynamic interaction between the Health in All Policies (HiAP) agenda and the ongoing implementation of the 2030 Agenda for Sustainable Development. At the World Conference on Social Determinants of Health, held in Rio de Janeiro in October 2011, the Rio Political Declaration pledged to use HiAP as a mechanism to address health inequities. In 2014, the Ministers of Health of the Region of the Americas approved a regional Plan of Action of the Pan American Health Organization (PAHO) that sought to call attention to the health consequences and benefits of policies and actions developed by other sectors. The HiAP approach seeks to integrate activities across the pillars of the sustainable development governance framework (economic, social, and environmental development). Advocates of the process are challenged to consider, using guiding questions outlined at the close of this article, how to pursue action at the country level and in what ways the HiAP approach can contribute to timely and effective implementation of the Sustainable Development Goals (SDGs). The authors propose that coordination between the 2030 Agenda and the regional Plan of Action on HiAP can make an important contribution to the implementation of both processes in the Region.

Determinantes ambientais e sociais da saúde / Environmental determinants of health and social

Este livro tem como objetivo disseminar no Brasil análises e debates para a redução dos danos à saúde associados a problemas ambientais. Os organizadores chamam atenção para a crescente medicalização das agendas de saúde, ignorando com frequência a crescente massa de evidências que associam uma boa ou má saúde individual e coletiva a um grau de determinantes ambientais e sociais, dominados por amplas iniquidades sociais e econômicas que limitam o bem estar e o progresso de amplos setores da população. A coletânea é dividida em três partes. A primeira discute as novas agendas de saúde, o desenvolvimento sustentável e a governança da saúde ambiental. A segunda reúne trabalhos sobre temas técnicos de caráter geral, como epidemiologia, toxicologia, mudanças climáticas, doenças infecciosas emergentes e comunicação de riscos. Aborda também o papel dos laboratórios de saúde ambiental, a deterioração dos ecossistemas e a proteção à saúde do consumidor. Já a terceira parte analisa questões mais especificas ligadas à energia, à universalização do saneamento básico, aos alimentos geneticamente modificados, aos desastres naturais e aos cuidados com a primeira infância...