The COVID-19 Dashboard for Real-time Tracking of the Pandemic: The Lasker-Bloomberg Public Service Award.

In this Viewpoint, Lauren Gardner, winner of the 2022 Lasker-Bloomberg Public Service Award for creating the COVID-19 Dashboard, discusses the development of the Dashboard and the factors that contributed to its success.

How people affected by Chagas disease have struggled with their negligence: history, associative movement and World Chagas Disease Day.

It is well documented that Chagas disease (CD) can pose a public health problem to countries. As one of the World Health Organization Neglected Tropical Diseases undoubtedly calls for comprehensive healthcare, transcending a restricted biomedical approach. After more than a century since their discovery, in 1909, people affected by CD are still frequently marginalised and/or neglected. The aim of this article is to tell the story of their activism, highlighting key historical experiences and successful initiatives, from 1909 to 2019. The first association was created in 1987, in the city of Recife, Brazil. So far, thirty associations have been reported on five continents. They were created as independent non-profit civil society organisations and run democratically by affected people. Among the common associations' objectives, we notably find: increase the visibility of the affected; make their voice heard; build bridges between patients, health system professionals, public health officials, policy makers and the academic and scientific communities. The International Federation of Associations of People Affected by CD - FINDECHAGAS, created in 2010 with the input of the Americas, Europe and the Western Pacific, counts as one of the main responses to the globalisation of CD. Despite all the obstacles and difficulties encountered, the Federation has thrived, grown, and matured. As a result of this mobilisation along with the support of many national and international partners, in May 2019 the 72nd World Health Assembly decided to establish World Chagas Disease Day, on 14 April. The associative movement has increased the understanding of the challenges related to the disease and breaks the silence around Chagas disease, improving surveillance, and sustaining engagement towards the United Nations 2030 agenda.

[Historical milestones for the control of severe infections and sepsis in pediatrics. Approach through medical philately]. / Hitos históricos para el control de las infecciones graves y la sepsis en pediatría. Aproximación a través de la filatelia médica.

Medical philately, with its diverse themes, is a faithful testimony of the historical events that have affected humanity. Likewise, it allows us to evidence its role as a diffuser of diverse prevention cam paigns carried out to control and eradicate serious infections, together with other achievements of health policy in the child population. Nowadays, the knowledge and collection of postage stamps is an increasingly unusual pastime. On the other hand, sometimes there is a marked historical ignoran ce and lack of appreciation of the effective actions for the control of infectious diseases, forgetting the enormous effect of these on the daily life of the current society. Through the visual testimony offe red by the postage stamps, we review the sanitary, educational, and therapeutic actions destined to control the infections in the pediatric patient, with emphasis on our country. In addition, we discuss the new populations at risk for the appearance of septic episodes. Even today, serious infections and sepsis represent an important public health problem.

How It Started, and How It's Going: Global Family Planning Programs.

Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.

GLOBAL ENDOCRINOLOGY: Global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020.

Iodine deficiency has multiple adverse effects on growth and development. Diets in many countries cannot provide adequate iodine without iodine fortification of salt. In 2020, 124 countries have legislation for mandatory salt iodization and 21 have legislation allowing voluntary iodization. As a result, 88% of the global population uses iodized salt. For population surveys, the urinary iodine concentration (UIC) should be measured and expressed as the median, in µg/L. The quality of available survey data is high: UIC surveys have been done in 152 out of 194 countries in the past 15 years; in 132 countries, the studies were nationally representative. The number of countries with adequate iodine intake has nearly doubled from 67 in 2003 to 118 in 2020. However, 21 countries remain deficient, while 13 countries have excessive intakes, either due to excess groundwater iodine, or over-iodized salt. Iodine programs are reaching the poorest of the poor: of the 15 poorest countries in the world, 10 are iodine sufficient and only 3 (Burundi, Mozambique and Madagascar) remain mild-to-moderately deficient. Nigeria and India have unstable food systems and millions of malnourished children, but both are iodine-sufficient and population coverage with iodized salt is a remarkable 93% in both. Once entrenched, iodine programs are often surprisingly durable even during national crises, for example, war-torn Afghanistan and Yemen are iodine-sufficient. However, the equity of iodized salt programs within countries remains an important issue. In summary, continued support of iodine programs is needed to sustain these remarkable global achievements, and to reach the remaining iodine-deficient countries.

Long-lasting effects of pandemics: The case of the 1918 influenza pandemic in Argentina.

The 2019 novel coronavirus disease pandemic poses a serious threat. While its short-term effects are evident, its long-term consequences are a matter of analysis. In this work, the existence of long-lasting negative effects derived from exposure in utero to a great pandemic -1918 influenza pandemic- is analysed for the Argentine case. Outcomes of interest include educational achievement and unemployment status in adulthood -50 years after the pandemic. Based on a regression analysis, temporal differences in the spread of the pandemic and between close birth cohorts are exploited. The results indicate a significant reduction in educational achievement for people exposed in utero to the pandemic. In the region with the highest incidence of cases (Noroeste), this reduction is 0.5 years of education. There are no significant changes in the chances of being unemployed. In the context of climate change, these results constitute a call of attention for the implementation of child protection policies from gestation.

The past and present of pandemic management: health diplomacy, international epidemiological surveillance, and COVID-19.

The establishment of international sanitary institutions, which took place in the context of rivalry among the great European powers and their colonial expansion in Asia, allowed for the development of administrative systems of international epidemiological surveillance as a response to the cholera epidemics at the end of the nineteenth century. In this note, I reflect on how a historical analysis of the inception of international epidemiological surveillance and pandemic management helps us to understand what is happening in the COVID-19 pandemic today.

Global Patterns and Trends in Gastric Cancer Incidence Rates (1988-2012) and Predictions to 2030.

BACKGROUND & AIMS: The long-term trend in gastric cancer rates has rarely been reported from a global perspective. We aimed to explore the past temporal trends (1988-2012) in gastric cancer incidence rates in 43 countries and to predict future trends (2012-2030). METHODS: Data on yearly gastric cancer incidence by age group and sex were drawn from 108 cancer registries in 43 countries in the Cancer Incidence in Five Continents Time Trends (CI5plus) database. Age-standardized incidence rates per 100,000 persons were computed from 1988-2012. The number of new cases and incidence rates were predicted to 2030 using the Bayesian age-period-cohort model. RESULTS: Persistent decreasing trends in gastric cancer incidence rates were observed from 1988-2012 worldwide, with an overall average annual percentage change of -2.1% (95% confidence interval, -2.5--1.7). The trends will continue or remain stable until 2030 in most of the selected countries except for Ecuador and Lithuania, whose gastric cancer incidence rates will experience substantially increasing trends in the next several decades. CONCLUSION: The incidence rates of gastric cancer are expected to decrease through 2030 in most countries except Ecuador and Lithuania. Reductions in smoking and Helicobacter pylori prevalence and improvement in diet probably contributed to the decrease. Gastric cancer still represents a major cancer burden worldwide, and the large number of gastric cancer cases worldwide may still call for lifestyle interventions in terms of smoking and diet and massive efforts for H pylori screening and treatment, especially in countries with predicted increasing incidence rates of gastric cancer.

Hindsight is 2020? Lessons in global health governance one year into the pandemic.

Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.

Missions, Humanitarianism, and the Evolution of Modern Global Surgery.

Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals (xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early "missions," a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization [1946]). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). "Global health" as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history: faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.

Registros nacionais de anomalias congênitas no mundo: aspectos históricos e operacionais / Registros nacionales de anomalías congénitas en el mundo: aspectos históricos y operativos / National congenital anomaly registers in the world: historical and operational aspects

Objetivo: Identificar registros de anomalias congênitas com cobertura nacional existentes no mundo, destacando suas principais características históricas e operacionais. Métodos: Revisão documental, mediante busca na base Medline/Pubmed e consulta a dados provenientes de relatórios, documentos oficiais e sítios eletrônicos. Foram incluídos trabalhos com relato de pelo menos um registro nacional. Resultados: Foram identificados 40 registros nacionais de anomalias congênitas em 39 países diferentes. Todos os registros incluídos no estudo localizavam-se em países de renda alta ou média superior, com concentração na Europa. A maior parte dos registros foi de base populacional, de notificação compulsória e com tempo limite para notificação de até 1 ano de idade. O registro brasileiro apresentou a maior cobertura anual. Conclusão: Os registros discutidos apresentaram características diversas, relacionadas à realidade de cada país. Os resultados apresentados fornecem subsídios para a temática da vigilância das anomalias congênitas, sobretudo em locais onde se deseja implementar tal atividade.

Objetivo: Identificar registros de anomalías congénitas con cobertura nacional existentes en el mundo, destacando sus principales características históricas y operativas. Métodos: Revisión documental de literatura en la base de datos Medline/Pubmed y datos de informes, documentos oficiales y sitios web. Se incluyeron trabajos con informes de al menos un registro nacional. Resultados: Se identificaron 40 registros nacionales de anomalías congénitas en 39 países diferentes. Todos los registros incluidos se ubicaron en países de ingresos altos y medianos altos, con una concentración en Europa. La mayoría de los registros eran de base poblacional, con notificación obligatoria y un límite de tiempo de notificación de hasta 1 año. El registro brasileño presentá la cobertura anual más alta. Conclusión: Los registros discutidos presentaban características diferentes y relacionadas con la realidad de cada país. Los resultados presentados proporcionan subsidios para la vigilancia de anomalías congénitas, especialmente en lugares que deseen implementar dicha actividad.

Objective: To identify registers of congenital anomalies with national coverage currently available around the world, highlighting their main historical and operational characteristics. Methods: This was a documentary study by means of a Medline database search (via PubMed) and searches involving reports, official documents and websites. Studies reporting at least one national registry were included. Results: 40 registers of national congenital anomalies were identified in 39 different countries. All registers included in the study were concentrated in upper-middle or high-income countries located in Europe. Most of the registers were population-based, compulsory notification and with a time limit for notification of up to 1 year of age. The Brazilian register showed the highest annual coverage. Conclusion: The registers analyzed showed different characteristics, related to the reality of each country. The results presented provide support for the theme of congenital anomalies surveillance, especially in places where such activity is intended to be implemented.

Universal health coverage as a global public health goal: the work of the International Labour Organisation, c.1925-2018.

We examine the efforts of the International Labour Organisation (ILO) to extend medical care under social security, through international conventions, advocacy and technical assistance. We consider the challenges faced by the ILO in advancing global health coverage through its labourist, social security model. The narrative begins in the interwar period, with the early conventions on sickness insurance, then discusses the rights-based universalistic vision expressed in the Philadelphia Declaration (1944). We characterize the ILO's postwar research and technical assistance as "progressive gradualism" then show how from the late-1970s the ILO became increasingly marginalized, though it retained an advisory role within the now dominant "co-operative pluralistic" model.