Asunto(s)
Inequidades en Salud , Salud del Lactante , Mortalidad Infantil , Salud Materna , Mortalidad Materna , United States Dept. of Health and Human Services , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Salud del Lactante/economía , Salud del Lactante/etnología , Salud del Lactante/normas , Salud del Lactante/estadística & datos numéricos , Salud Materna/economía , Salud Materna/etnología , Salud Materna/normas , Salud Materna/estadística & datos numéricos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economía , United States Dept. of Health and Human Services/normas , Mortalidad Infantil/etnología , Mortalidad Infantil/tendencias , Mortalidad Materna/etnología , Mortalidad Materna/tendenciasAsunto(s)
Tratamiento Farmacológico de COVID-19 , Vacunas contra la COVID-19 , COVID-19 , United States Dept. of Health and Human Services , Humanos , COVID-19/economía , COVID-19/prevención & control , COVID-19/terapia , Vacunas contra la COVID-19/economía , Vacunas contra la COVID-19/uso terapéutico , United States Dept. of Health and Human Services/economía , Tratamiento Farmacológico de COVID-19/economía , Tratamiento Farmacológico de COVID-19/métodosRESUMEN
A new federal agency-approved last month by the United States Congress-is already off to a rocky start. The Advanced Research Projects Agency for Health (ARPA-H), proposed by President Biden in 2021, aims to tackle the most intractable biomedical problems by funding innovative, high-risk, high-reward research and swiftly turning discoveries into treatments and cures. But Congress gave the agency a much smaller budget than sought by the administration-$ 1 billion over 3 years, a fraction of the $6.5 billion requested. And as happens whenever there is new money and a new federal agency, a political scrum has erupted over who should control ARPA-H. It is now expected to answer to both the National Institutes of Health (NIH) and the Department of Health and Human Services (HHS). If it is to deliver on its mission, ARPA-H needs to be an autonomous entity that approaches biomedical research in a way never done before by the federal government. The stakes are high: If ARPA-H fails to produce new clinical advances relatively quickly, it will erode trust in US science. It's time for clear thinking and action about what it will take to make ARPA-H successful.
Asunto(s)
Investigación Biomédica , National Institutes of Health (U.S.) , United States Dept. of Health and Human Services , Investigación Biomédica/economía , Presupuestos , Gobierno Federal , Humanos , National Institutes of Health (U.S.)/economía , Estados Unidos , United States Dept. of Health and Human Services/economíaAsunto(s)
COVID-19/epidemiología , Dermatólogos/economía , Financiación Gubernamental/economía , United States Dept. of Health and Human Services/economía , Dermatólogos/estadística & datos numéricos , Humanos , Ubicación de la Práctica Profesional/economía , Ubicación de la Práctica Profesional/estadística & datos numéricos , Estudios Retrospectivos , Estados UnidosRESUMEN
The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.
A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.
Asunto(s)
COVID-19/epidemiología , Salud Global , Cooperación Internacional , Pandemias , COVID-19/diagnóstico , COVID-19/terapia , Prueba de COVID-19/estadística & datos numéricos , Vacunas contra la COVID-19/provisión & distribución , Costos y Análisis de Costo , Países en Desarrollo , Difusión de Innovaciones , Economía , Recursos en Salud/economía , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud , Humanos , Sistemas Políticos , Asignación de Recursos/economía , Asignación de Recursos/métodos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economíaRESUMEN
Resumo A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.
Abstract The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.
Asunto(s)
Humanos , Salud Global , Infecciones por Coronavirus/epidemiología , Pandemias , Cooperación Internacional , Sistemas Políticos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economía , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Costos y Análisis de Costo , Asignación de Recursos/economía , Asignación de Recursos/métodos , Países en Desarrollo , Difusión de Innovaciones , Economía , Recursos en Salud/economía , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de SaludAsunto(s)
Investigación Biomédica/economía , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Política , United States Dept. of Health and Human Services/economía , Investigación Biomédica/ética , Coronavirus/patogenicidad , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Pandemias/economía , Salud Pública/economía , Salud Pública/ética , Estados Unidos , United States Dept. of Health and Human Services/ética , Organización Mundial de la Salud/economíaRESUMEN
BACKGROUND: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. OBJECTIVES: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. METHODS: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. RESULTS: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. CONCLUSIONS: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.
Asunto(s)
Infecciones por Coronavirus/complicaciones , Trastornos Nutricionales/complicaciones , Fenómenos Fisiológicos de la Nutrición , Neumonía Viral/complicaciones , Investigación/normas , COVID-19 , Costo de Enfermedad , Costos de la Atención en Salud , Disparidades en Atención de Salud/economía , Humanos , Personal Militar , National Institutes of Health (U.S.)/economía , Trastornos Nutricionales/economía , Trastornos Nutricionales/epidemiología , Pandemias , Estados Unidos/epidemiología , United States Department of Agriculture/economía , United States Dept. of Health and Human Services/economíaAsunto(s)
Epidemias/prevención & control , Epidemias/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , United States Dept. of Health and Human Services/organización & administración , Vacunas contra el SIDA/administración & dosificación , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Antirretrovirales/uso terapéutico , Manejo de Caso/organización & administración , Técnicas y Procedimientos Diagnósticos , Financiación Gubernamental , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Liderazgo , Programas de Intercambio de Agujas/organización & administración , Objetivos Organizacionales , Profilaxis Pre-Exposición/métodos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economíaRESUMEN
In his State of the Union Address on February 5, 2019, President Donald J. Trump announced his administration's goal to end the domestic HIV epidemic. Following the announcement of the Ending the HIV Epidemic: A Plan for America initiative, the president proposed $291 million in new funding for the fiscal year 2020 Department of Health and Human Services (HHS) budget to implement a new initiative to reduce the number of new HIV infections by 75% in the next five years (2025) and by 90% in the next 10 years (2030). This is in addition to the $20 billion the US government already spends each year, domestically, for HIV prevention and care.With this initiative, HHS recognizes that the time to end the HIV epidemic is now: we have the right data, the right biomedical and behavioral tools, and the right leadership. With the new resources, the goal is achievable.This article outlines how this initiative will be accomplished through the implementation of four fundamental strategies that will be tailored by local communities on the basis of their own needs and strengths.
Asunto(s)
Epidemias/prevención & control , Epidemias/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , United States Dept. of Health and Human Services/organización & administración , Vacunas contra el SIDA/administración & dosificación , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Antirretrovirales/uso terapéutico , Manejo de Caso/organización & administración , Técnicas y Procedimientos Diagnósticos , Financiación Gubernamental , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Liderazgo , Programas de Intercambio de Agujas/organización & administración , Objetivos Organizacionales , Profilaxis Pre-Exposición/métodos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economíaAsunto(s)
Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Grupos Minoritarios , United States Dept. of Health and Human Services/organización & administración , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Factores de Edad , Creación de Capacidad/organización & administración , Financiación Gubernamental/organización & administración , Infecciones por VIH/etnología , Disparidades en el Estado de Salud , Humanos , Factores Sexuales , Sexualidad , Factores Socioeconómicos , Estados Unidos , United States Dept. of Health and Human Services/economíaRESUMEN
On July 1, 2014, the HEAL Program was transferred from the U.S. Department of Health and Human Services (HHS) to the U.S. Department of Education (the Department). To reflect this transfer and to facilitate the servicing of all HEAL loans that are currently held by the Department, the Secretary adds the HEAL Program regulations to the Department's chapter in the Code of Federal Regulations (CFR).
Asunto(s)
Educación Médica/economía , Educación en Veterinaria/economía , Financiación Gubernamental/economía , United States Dept. of Health and Human Services/economía , Financiación Gubernamental/legislación & jurisprudencia , Programas de Gobierno/economía , Programas de Gobierno/legislación & jurisprudencia , Humanos , Estados UnidosAsunto(s)
Política de Salud/economía , Salud Pública , United States Dept. of Health and Human Services/economía , Presupuestos , Política de Salud/legislación & jurisprudencia , Humanos , Seguro de Salud/legislación & jurisprudencia , Cooperación Internacional , Estados Unidos , United States Dept. of Health and Human Services/organización & administraciónRESUMEN
OBJECTIVES: To evaluate trends in funding over the past 16 years for key federal public health preparedness and response programs at the US Department of Health and Human Services, to improve understanding of federal funding history in this area, and to provide context for future resource allocation decisions for public health preparedness. METHODS: In this 2017 analysis, we examined the funding history of key federal programs critical to public health preparedness by reviewing program budget data collected for our annual examination of federal funding for biodefense and health security programs since fiscal year (FY) 2001. RESULTS: State and local preparedness at the Centers for Disease Control and Prevention initially received $940 million in FY2002 and resulted in significant preparedness gains, but funding levels have since decreased by 31%. Similarly, the Hospital Preparedness Program within the Office of the Assistant Secretary for Preparedness and Response was funded at a high of $515 million in FY2003, but funding was reduced by 50%. Investments in medical countermeasure development and stockpiling remained relatively stable. CONCLUSIONS: The United States has made significant progress in preparing for disasters and advancing public health infrastructure. To enable continued advancement, federal funding commitments must be sustained.
Asunto(s)
Presupuestos/tendencias , Defensa Civil/economía , Financiación Gubernamental/tendencias , Salud Pública/economía , Salud Pública/tendencias , United States Dept. of Health and Human Services/economía , United States Dept. of Health and Human Services/tendencias , Presupuestos/estadística & datos numéricos , Defensa Civil/tendencias , Financiación Gubernamental/estadística & datos numéricos , Predicción , Humanos , Salud Pública/estadística & datos numéricos , Estados UnidosRESUMEN
In January 2015 the current Secretary of the Department of Health and Human Services (HHS) outlined a bold initiative to shape the delivery of healthcare through a set of strategies aimed at improving the quality of care and reducing the growth of healthcare costs. The strategies include increasing payment incentives tied to higher value care, increasing care coordination and integration, and increasing access to information to guide patients and clinicians. Significantly, the proposal includes specific goals for alternative payment models and value-based payments for the first time in the history of the Medicare program.
Asunto(s)
Reforma de la Atención de Salud/economía , Reforma de la Atención de Salud/métodos , Patient Protection and Affordable Care Act/economía , Calidad de la Atención de Salud/economía , United States Dept. of Health and Human Services/economía , Costos de la Atención en Salud/tendencias , Reforma de la Atención de Salud/tendencias , Humanos , Patient Protection and Affordable Care Act/tendencias , Calidad de la Atención de Salud/tendencias , Estados Unidos , United States Dept. of Health and Human Services/tendenciasAsunto(s)
Programas de Gobierno/economía , Farmacéuticos/economía , Servicio de Farmacia en Hospital/economía , Honorarios por Prescripción de Medicamentos , Programas de Gobierno/tendencias , Humanos , Farmacéuticos/tendencias , Servicio de Farmacia en Hospital/tendencias , Honorarios por Prescripción de Medicamentos/tendencias , Estados Unidos , United States Dept. of Health and Human Services/economía , United States Dept. of Health and Human Services/tendenciasAsunto(s)
Gastos en Salud/tendencias , Medicare/economía , Método de Control de Pagos/organización & administración , Mecanismo de Reembolso/economía , United States Dept. of Health and Human Services/economía , Predicción , Ginecología/economía , Humanos , Medicare/tendencias , Obstetricia/economía , Mecanismo de Reembolso/tendencias , Escalas de Valor Relativo , Estados Unidos , United States Dept. of Health and Human Services/tendenciasRESUMEN
The health and national security challenge of antibiotic resistance has led governments to adopt policies to stimulate new antibiotic R&D. Government programs that directly fund late-stage clinical development of antibiotics have emerged, including the Broad Spectrum Antimicrobial Program of the Biomedical Advanced Research and Development Authority in the United States, and the New Drugs for Bad Bugs program of the Innovative Medicines Initiative in the European Union. These efforts are collectively investing nearly $1 billion and are supporting nearly 20% of the global antibiotic pipeline. This article describes these programs, including the antibiotics and their targeted pathogens and clinical indications, as well as program mechanisms for project eligibility, selection, governance, funding, and IP management. Preliminary assessment of the impact of these mechanisms on the success of the programs is provided.