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While pharmacological interventions for dementia struggle to demonstrate improved outcomes for patients and at-risk populations, non-pharmacological lifestyle interventions have been proposed as a tool to achieve dementia risk reduction. In this review, it is argued that lifestyle modification alone is a surface-level intervention from the point of view of fair and far-reaching dementia prevention. Below the tip of this "iceberg of dementia risk," there are living conditions and social structures that represent deeper contributions to risk in the population. It is argued that alongside lifestyle modification, activist research and structural interventions are needed to make our society fairer and more dementia-resilient.
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Global health faces the triple challenge of preparing for future pandemics while responding to current ones in the midst of a climate crisis. In this commentary, we discuss the heightened focus on pandemic preparedness after the COVID-19 pandemic and the risks that this may pose to addressing the elimination of AIDS, tuberculosis, hepatitis and malaria, established in the Sustainable Development Goals as target 3.3. Considering their interconnections with the climate crisis and advocating for global health justice, we identify impasses that such a dispute over priorities can imply, and comment on four fronts of actions that could contribute convergently to both agendas as well as to facing the consequences of climate change to health: strengthening health systems, global commitment to equitable access to strategic medicines, addressing social inequalities and joining efforts for health and climate justice We conclude that addressing these fronts safeguards the health rights of the most vulnerable to existing epidemics while enhancing readiness for future pandemics. Moreover, solutions must transcend technocratic approaches, necessitating the confrontation of inequalities perpetuated by systems of power and privilege fueling both health and climate crises. Ultimately, health justice should guide responses to this intricate triple global health challenge.
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COVID-19 , Mudança Climática , Saúde Global , Pandemias , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Justiça SocialRESUMO
In the wake of the COVID-19 pandemic, it is clear that the struggle for global health justice must be our highest priority. To understand the challenges that such a priority faces, we must recognise that this struggle has a long history, and to analyse current challenges within this historical perspective. This commentary explores the gradual construction of the global health justice movement during different historical periods (tropical/colonial medicine, international health, and global health) in the history of approaches to health worldwide. It examines the changing relationship between the political economy of capitalism, colonialism, and racism. It analyses attempts to confront injustice through both human rights and social justice movements in seeking to address stigma and discrimination as well as poverty and social exclusion. It highlights emerging battlegrounds such as access to medical treatments and healthcare services as well as the ways in which private interests continue to undercut such efforts. But it also points to windows of opportunity for defending principles such as solidarity and social inclusion, for building advocacy/analysis alliances and toolkits to inform social movements, and possibilities to reconstruct global health 'governance' mechanisms and institutions in accord with the most basic principles of health justice.
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Saúde Global , Pandemias , Humanos , Justiça Social , Direitos Humanos , PobrezaRESUMO
Worldwide, medical doctors and lawyers cooperate in health justice projects. These professionals pursue the ideal that, one day, every individual on Earth will be equally protected from the hazards that impair health. The main hindrances to health justice are discrimination, poverty and segregation, but we know that beyond concrete, quantifiable barriers, symbolic elements such as beliefs and fears also play a significant role in perpetuating health injustice. So, between March 2020, when the World Health Organization declared COVID-19 a global pandemic, and June 2021, when vaccines against the virus were globally available, we collected original information about the ways in which four Colombian Indigenous communities confronted COVID-19. Knowing that Colombian Indigenous communities often face health injustices, our goal was to understand the role of symbolic elements in the situation. Our main insight is that historical genocidal processes, in which the powerful have betrayed the trust of Indigenous communities, have created a trauma in the latter, resulting in reluctance and suspicion regarding the acceptance of 'gifts' from external sources, including potentially beneficial health treatments.
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In this editorial, we further discuss the effects that health equity tourism has had on Black, Native, and Latinx marginalized communities. We identify the consequences of the resulting medical mistrust within these communities as well as implications for data collection in research. Throughout, solutions are proposed that may eventually empower these communities to become actively engaged with the research and initiatives that influence their health outcomes, as well as improve the quality and quantity of data extracted from these communities.
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Equidade em Saúde , Turismo Médico , Racismo , Marginalização Social , Humanos , ConfiançaRESUMO
In February 2021, the Peruvian 'vaccinegate' scandal broke when the media reported that nearly 500 experimental doses of an ongoing COVID-19 trial were given to key individuals not enrolled in the trial. Indeed, vaccine doses were administered to leading politicians, such as the former President and his wife, and other high-level health officials and academic leaders at the universities overseeing ethical compliance and administration of the trial. The 'vaccinegate' scandal in Peru is but one example of how the lack of a coordinated global response to COVID-19 has allowed countries to act in the best interest of some, ultimately, failing to secure a democratic approach to the right to health for all during a global pandemic. While Peruvian vaccinegate is an example of the egregious use of power to further cronyism amid fear and mounting COVID-19 related death, unfortunately, it is not an anomaly. We argue that the sensationalisation of the event has distracted from the existing precarious health system in Peru and the ways in which long-existing abuses of power evident prior to the pandemic limit a just response to it.
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Vacinas contra COVID-19 , COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Peru/epidemiologia , Confiança , Pandemias/prevenção & controleRESUMO
INTRODUCTION: The entangled health and economic crises fueled by COVID-19 have exacerbated the challenges facing Venezuelan migrants. There are more than 5.6 million Venezuelan migrants globally and almost 80% reside throughout Latin America. Given the growing number of Venezuelan migrants and COVID-19 vulnerability, this rapid scoping review examined how Venezuelan migrants are considered in Latin American COVID-19 vaccination strategies. MATERIAL AND METHODS: We conducted a three-phased rapid scoping review of documents published until June 18, 2021: Peer-reviewed literature search yielded 142 results and 13 articles included in analysis; Gray literature screen resulted in 68 publications for full-text review and 37 were included; and official Ministry of Health policies in Argentina, Brazil, Chile, Colombia, Ecuador, and Peru were reviewed. Guided by Latin American Social Medicine (LASM) approach, our analysis situates national COVID-19 vaccination policies within broader understandings of health and disease as affected by social and political conditions. RESULTS: Results revealed a heterogeneous and shifting policy landscape amid the COVID-19 pandemic which strongly juxtaposed calls to action evidenced in literature. Factors limiting COVID-19 vaccine access included: tensions around terminologies; ambiguous national and regional vaccine policies; and pervasive stigmatization of migrants. CONCLUSIONS: Findings presented underscore the extreme complexity and associated variability of providing access to COVID-19 vaccines for Venezuelan migrants across Latin America. By querying the timely question of how migrants and specifically Venezuelan migrants access vaccinations findings contribute to efforts to both more equitably respond to COVID-19 and prepare for future pandemics in the context of displaced populations. These are intersectional and evolving crises and attention must also be drawn to the magnitude of Venezuelan mass migration and the devastating impact of COVID-19 in the region. Integration of Venezuelan migrants into Latin American vaccination strategies is not only a matter of social justice, but also a pragmatic public health strategy necessary to stop COVID-19.
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Este artículo de revisión teórica hace una aproximación al asunto del derecho a la salud en el marco de la justicia sanitaria y en el momento de la actual globalización. Para ello, inicialmente se presentan algunos de los efectos de la globalización en las condiciones de vida y de salud de las poblaciones, así como en el incremento de las inequidades sanitarias. A continuación, se revisan las corrientes que desde la filosofía moral han planteado el problema de la justicia social y sus efectos en los sistemas de salud, para ubicar algunos de los elementos del debate actual sobre justicia sanitaria. En tercer lugar, se propone que el discurso de los derechos humanos y del derecho a la salud, específicamente, se convierten en una idea -fuerza importante vinculada a la justicia sanitaria global- con potencialidades y restricciones por su propio proceso de configuración. Finalmente, se concluye que la discusión alrededor del derecho a la salud, las inequidades sanitarias y la justicia sanitaria debe transcender el espacio del Estado nacional para referirse a las relaciones interestales; en este debate, la salud pública como transdisciplina debe otorgar prioridad a este tema en su agenda teórica, investigativa y de praxis social.
This paper, as a theoretical review, presents an approach to the issue of the right to health within the framework of health justice in today's globalization. To this end, some of the effects of globalization on people's life and health conditions, as well as the increase in health inequalities, are initially shown. After this, in order to highlight some of the points in the debate, the schools of thought that have approached the issue of social justice and its effects on health systems from the standpoint of moral philosophy are reviewed. Next, it is proposed that the discourse of human rights and the right to health become, specifically, an idea -an important force linked to global health justice with potentialities and restrictions imposed by its own configuration process-. Finally, it is concluded that the discussion about the right to health, health inequities and health justice has to go beyond the national boundaries and start referring to international relationships. In this debate, public health, as a transdiscipline, must prioritize this issue in its theoretical, exploratory, and social praxis agenda.