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.

Health in all policies in the partnership for sustainable development / La salud en todas las políticas en la alianza en pro del desarrollo sostenible

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.

En el presente artículo se examina la interacción dinámica entre el programa de Salud en Todas las Políticas (STP) y la ejecución, en curso, de la Agenda 2030 para el Desarrollo Sostenible. En la Conferencia Mundial sobre los Determinantes Sociales de la Salud, celebrada en Río de Janeiro en octubre del 2011, la Declaración Política de Río puso de manifiesto el compromiso de adoptar el enfoque de STP como mecanismo para combatir las inequidades sanitarias. En el 2014, los ministros de salud de la Región de las Américas aprobaron un plan de acción regional de la Organización Panamericana de la Salud (OPS) encaminado a hacer resaltar las consecuencias y los beneficios sanitarios de las políticas y medidas aplicadas por otros sectores. El enfoque de STP tiene por finalidad integrar las actividades de todas las áreas fundamentales del marco de gobernanza del desarrollo sostenible: el desarrollo económico, social y ambiental. A los partidarios del proceso se les insta a meditar, guiándose por las preguntas de orientación al final de este artículo, acerca de cómo emprender medidas en los países y cómo el enfoque de STP puede facilitar la puesta en práctica de los Objetivos de Desarrollo Sostenible (ODS) de manera pronta y eficaz. Los autores opinan que la coordinación de la Agenda 2030 con el plan de acción regional sobre la salud en todas las políticas puede dar un impulso importante a la aplicación de ambos procesos en la Región.

Environmental and Social Determinants of Health

[Prologue - Carissa F. Etienne]. In the “Era of Sustainable Development,” health is an essential input and the most valuable human development outcome. Achieving the best health outcomes involves tackling the environmental and social determinants of health that are the subject of this book. Health is often mentioned in the outcome documents of the Rio+20 Conference and the new Sustainable Development Goals (SDG) established by the Member States and detailed in the report of the UN Secretary-General: The Road to Dignity by 2030: Ending Poverty, Transforming All Lives and Protecting the Planet. The new set of 17 goals includes a stand-alone goal for health— SDG 3: Ensure healthy lives and promote well-being for all at all ages—and addresses the environmental and social determinants of health in the other 16. This book covers most of the health-related SDG themes and, it is hoped, will assist the public health community in creating the intersectoral synergies necessary for implementing the sustainable development goals in the decades to come. The new UN Sustainable Development Agenda recognizes that environmental degradation has its roots in profound social, economic, and technological inequities that can and should be remedied. This means that the entire local and global framework of public policies, initiatives, and programs to promote public health must be expeditiously, critically, and realistically harmonized and modernized to move toward sustainable development with greater justice and solidarity. This publication offers an independent perspective and does not necessarily express the agreements and resolutions of the Governing Bodies of the Pan American Health Organization (PAHO). In its 31 chapters, more than 100 authors and co-authors from different countries of the Region of the Americas voice their opinions, analyze situations, and offer proposals for strengthening and advancing decision-making capacity, public policies, intervention programs, and the necessary lines of applied research. This English edition of Environmental and Social Determinants of Health expands on and updates the content of the earlier editions published in Spanish in 2010 and Portuguese in 2011. Our hope is that it will foster a general understanding and further the debate about the importance of mitigating the health damage caused by the most pressing environmental and social determinants associated directly or indirectly with health issues. This publication represents PAHO’s continued commitment to more coherent management of the health determinants, grounded in a series of ethical principles and policies geared to promoting the health and well-being of all, especially the most vulnerable population groups.

Determinantes ambientais e sociais da saúde

Esperamos que o livro Determinantes ambientais e sociais da saúde contribua para a análise e o debate e facilite a compreensão sobre a importância da redução dos danos à saúde associados aos problemas prioritários de saúde ambiental. O livro “Determinantes ambientais e sociais da saúde” representa um ponto de vista independente e, ao mesmo tempo, complementar à publicação periódica sobre “Saúde nas Américas” no que se refere à saúde ambiental, principalmente em países da América Latina e do Caribe. Nos 27 capítulos que compõem este livro, mais de uma centena de autores e coautores de vários países da Região expressam suas opiniões, analisam a situação e elaboram propostas para fortalecer e fazer avançar as políticas públicas, os programas de intervenção e as linhas de pesquisa aplicada. Igualmente, abordam a governança e os mecanismos de decisão relacionados a diversos temas e problemas substanciais que afetam a saúde ambiental. O livro é dirigido a todos aqueles comprometidos com o desenvolvimento sustentável, em particular aos responsáveis pelo projeto, avaliação e implementação de políticas públicas e programas vinculados à saúde ambiental. Esperamos que seja de utilidade para os estudiosos dos processos interativos entre sociedade, ambiente, desenvolvimento e saúde.

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...

Determinantes ambientales y sociales de la salud

Esperamos que el libro “Determinantes ambientales y sociales de la salud” aporte al análisis, el debate y facilite la comprensión acerca de la importancia de la mitigación de los daños a la salud asociados con los problemas prioritarios de salud ambiental. El libro “Determinantes ambientales y sociales de la salud” representa un punto de vista independiente y a su vez complementario a la publicación periódica sobre “Salud en las Américas” en lo referente a la salud ambiental, principalmente en países de América Latina y el Caribe. En los 25 capítulos que conforman este libro, más de un centenar de autores y coautores de varios países de la Región expresan sus opiniones, analizan la situación y elaboran propuestas para fortalecer y hacer avanzar las políticas públicas, los programas de intervención y las líneas de investigación aplicada. Igualmente, abordan la gobernanza y mecanismos de decisión en torno a diversos temas y problemas sustantivos que aquejan a la salud ambiental. El libro está dirigido a todos los comprometidos con el desarrollo sostenible en particular a los responsables del diseño, evaluación e implementación de políticas públicas y programas vinculados con la salud ambiental. Aspiramos a que el libro sea de utilidad para los estudiosos de los procesos interactivos entre sociedad, ambiente, desarrollo y salud.