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8.
PLoS One ; 15(10): e0233948, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33104731

RESUMEN

The US budget for global health funding, which was by far the largest of similar funding in the world, increased from US $1.3 billion in 2001 to more than US $10 billion in recent years. More than 54% of this funding was allocated to the Global Fund to Fight HIV/AIDS through the US President's Emergency Plan for AIDS Relief (PEPFAR) in Africa. However, recent studies indicate contradictory results regarding the effectiveness of PEPFAR. One by Bendavid, Holmes, Bhattacharya, and Miller shows positive effects of PEPFAR in reducing adult mortality in Africa, while another by Duber, Coates, Szekeras, Kaji, and Lewis finds that there are no significant differences in reducing adult mortality in countries that received PEPFAR funding vs countries that did not. Due to their potential impact on policy decisions regarding critical global health funding, we wanted to assess why the results are discrepant. To do this, we replicated the Bendavid study. The replication provides verification that the study replicable and that the analytic choices of the authors are robust to different assumptions or restrictions. This allows us to assess the different choices and data available to the two research groups and draw some conclusions about why the results may be different. Then, focusing on two of the prominently discrepant studies, i.e., the Bendavid study (1998-2008) and the Duber study (2000-2006), we establish why the two studies are in disagreement. We apply appropriate individual-level and country-level analytical methodology as used by Bendavid over the analytical time period used for the Duber study (2000-2006), which originally focused on nationally aggregated data and differed in some key focus countries. For our first objective, we replicated the original Bendavid study findings and our findings support their conclusion that between 1998-2008 all-cause mortality decreased significantly more (OR = 0.84, CI, 0.72-0.99) in countries that implemented PEPFAR. For our second objective (Bendavid's data and methodology applied to Duber's study period), we found reduction in all cause adult mortality to be borderline insignificant (OR = 0.87 CI, 0.75-1.01, p = 0.06), most possibly reflecting the abbreviated fewer number of events and sample size over a shorter period. Therefore, our overall analyses are consistent with the conclusion of positive impact of the PEPFAR program in reducing adult mortality. We believe that the discrepancy observed in the original studies mainly a reflection of shortcomings in the analytical approach necessitated by the Duber study's nationally aggregated dataset or "may reflect a lack of data quality" in the Duber study (Duber, et al. 2010).


Asunto(s)
Salud Global/legislación & jurisprudencia , Infecciones por VIH/mortalidad , Evaluación de Programas y Proyectos de Salud/métodos , Adulto , África del Sur del Sahara/epidemiología , Países en Desarrollo , Femenino , Salud Global/economía , Infecciones por VIH/economía , Promoción de la Salud/economía , Promoción de la Salud/legislación & jurisprudencia , Humanos , Cooperación Internacional/legislación & jurisprudencia , Evaluación del Resultado de la Atención al Paciente , Estados Unidos
11.
Am J Trop Med Hyg ; 103(3): 976-985, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32748773

RESUMEN

Gene drive technologies represent powerful tools to develop vector control strategies that will complement the current approaches to mitigate arthropod-borne infectious diseases. The characteristics of gene drive technologies have raised additional concerns to those for standard genetically engineered organisms. This generates a need for adaptive governance that has not been met yet because of the rapid rate of progress in gene drive research. For the eventual release of gene drive insects into wild populations, an international governance network would be helpful in guiding scientists, stakeholders, public opinion, and affected communities in its use. We examined the current institutions and governing bodies among various continents that could have an impact on gene drive governance or the potential to adapt to its future use. Possible governance strategies also are proposed that seek to bridge gaps and promote an ethically sound policy framework. Ideally, governance strategies should be developed before or at the same pace as gene drive research to anticipate field releases and maximize their impact as a public health tool. However, this is not likely to happen as it takes years to develop global accords, and some countries may choose to move ahead independently on the new technology.


Asunto(s)
Culicidae/genética , Tecnología de Genética Dirigida/legislación & jurisprudencia , Cooperación Internacional/legislación & jurisprudencia , Control de Mosquitos/legislación & jurisprudencia , Mosquitos Vectores/genética , Agricultura/ética , Agricultura/métodos , Animales , Animales Modificados Genéticamente , Investigación Biomédica/ética , Investigación Biomédica/métodos , Tecnología de Genética Dirigida/ética , Humanos , Control de Mosquitos/organización & administración , Salud Pública , Carácter Cuantitativo Heredable
19.
Eur J Hum Genet ; 28(6): 728-731, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32444797

RESUMEN

During the COVID-19 pandemic, the European biobanking infrastructure is in a unique position to preserve valuable biological material complemented with detailed data for future research purposes. Biobanks can be either integrated into healthcare, where preservation of the biological material is a fork in clinical routine diagnostics and medical treatment processes or they can also host prospective cohorts or material related to clinical trials. The paper discussed objectives of BBMRI-ERIC, the European research infrastructure established to facilitate access to quality-defined biological materials and data for research purposes, with respect to the COVID-19 crisis: (a) to collect information on available European as well as non-European COVID-19-relevant biobanking resources in BBMRI-ERIC Directory and to facilitate access to these via BBMRI-ERIC Negotiator platform; (b) to help harmonizing guidelines on how data and biological material is to be collected to maximize utility for future research, including large-scale data processing in artificial intelligence, by participating in activities such as COVID-19 Host Genetics Initiative; (c) to minimize risks for all involved parties dealing with (potentially) infectious material by developing recommendations and guidelines; (d) to provide a European-wide platform of exchange in relation to ethical, legal, and societal issues (ELSI) specific to the collection of biological material and data during the COVID-19 pandemic.


Asunto(s)
Betacoronavirus/patogenicidad , Investigación Biomédica/organización & administración , Infecciones por Coronavirus/epidemiología , Difusión de la Información/métodos , Cooperación Internacional/legislación & jurisprudencia , Pandemias , Neumonía Viral/epidemiología , Antivirales/uso terapéutico , Inteligencia Artificial , Betacoronavirus/efectos de los fármacos , Betacoronavirus/genética , Bancos de Muestras Biológicas/provisión & distribución , Ensayos Clínicos como Asunto , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/genética , Conjuntos de Datos como Asunto , Europa (Continente)/epidemiología , Humanos , Difusión de la Información/ética , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/genética , Guías de Práctica Clínica como Asunto , Salud Pública/economía
20.
Eur J Hum Genet ; 28(6): 719-723, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32415272

RESUMEN

ELIXIR, the European research infrastructure for life science data, provides open access to data, tools and workflows in the response to the COVID-19 pandemic. ELIXIR's 23 nodes have reacted swiftly to support researchers in their combined efforts against the pandemic setting out three joint priorities: 1. Connecting national COVID-19 data platforms to create federated European COVID-19 Data Spaces; 2. Fostering good data management to make COVID-19 data open, FAIR and reusable over the long term; 3. Providing open tools, workflows and computational resources to drive reproducible and collaborative science. ELIXIR's strategy is based on the support given by our national nodes - collectively spanning over 200 institutes - to research projects and on partnering with community initiatives to drive development and adoption of good data practice and community driven standards. ELIXIR Nodes provide support activities locally and internationally, from provisioning compute capabilities to helping collect viral sequence data from hospitals. Some Nodes have prioritised access to their national cloud and compute facilities for all COVID-19 research projects, while others have developed tools to search, access and share all data related to the pandemic in a national healthcare setting.


Asunto(s)
Betacoronavirus/patogenicidad , Investigación Biomédica/organización & administración , Infecciones por Coronavirus/epidemiología , Difusión de la Información/métodos , Cooperación Internacional/legislación & jurisprudencia , Pandemias , Neumonía Viral/epidemiología , Betacoronavirus/genética , Infecciones por Coronavirus/genética , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Conjuntos de Datos como Asunto , Europa (Continente)/epidemiología , Humanos , Difusión de la Información/ética , Neumonía Viral/genética , Neumonía Viral/patología , Neumonía Viral/virología , Salud Pública/economía , Flujo de Trabajo
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