RESUMO
This Viewpoint discusses the importance of the US Congress reauthorizing funding for the President's Emergency Plan for AIDS Relief, a program developed in 2003 that has played a critical role in fighting HIV/AIDS worldwide as well as other emerging infections and noncommunicable diseases.
Assuntos
Governo Federal , Financiamento Governamental , Saúde Global , Infecções por HIV , Humanos , Saúde Global/economia , Saúde Global/legislação & jurisprudência , Infecções por HIV/economia , Infecções por HIV/terapia , Cooperação Internacional/legislação & jurisprudência , Estados Unidos , Financiamento Governamental/legislação & jurisprudênciaAssuntos
Saúde Global/legislação & jurisprudência , Cooperação Internacional/legislação & jurisprudência , Pandemias/legislação & jurisprudência , Sistemas Políticos/economia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , China , Economia/legislação & jurisprudência , Geografia/economia , Geografia/estatística & dados numéricos , Iniquidades em Saúde , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Disseminação de Informação/ética , Pandemias/prevenção & controle , Sistemas Políticos/estatística & dados numéricos , SARS-CoV-2/genética , Estados Unidos , Organização Mundial da Saúde/organização & administraçãoRESUMO
Understanding the spread of SARS-CoV-2, how and when evidence emerged, and the timing of local, national, regional, and global responses is essential to establish how an outbreak became a pandemic and to prepare for future health threats. With that aim, the Independent Panel for Pandemic Preparedness and Response has developed a chronology of events, actions, and recommendations, from December, 2019, when the first cases of COVID-19 were identified in China, to the end of March, 2020, by which time the outbreak had spread extensively worldwide and had been characterised as a pandemic. Datapoints are based on two literature reviews, WHO documents and correspondence, submissions to the Panel, and an expert verification process. The retrospective analysis of the chronology shows a dedicated initial response by WHO and some national governments, but also aspects of the response that could have been quicker, including outbreak notifications under the International Health Regulations (IHR), presumption and confirmation of human-to-human transmission of SARS-CoV-2, declaration of a Public Health Emergency of International Concern, and, most importantly, the public health response of many national governments. The chronology also shows that some countries, largely those with previous experience with similar outbreaks, reacted quickly, even ahead of WHO alerts, and were more successful in initially containing the virus. Mapping actions against IHR obligations, the chronology shows where efficiency and accountability could be improved at local, national, and international levels to more quickly alert and contain health threats in the future. In particular, these improvements include necessary reforms to international law and governance for pandemic preparedness and response, including the IHR and a potential framework convention on pandemic preparedness and response.
Assuntos
COVID-19/epidemiologia , Pandemias , Animais , COVID-19/transmissão , China/epidemiologia , Surtos de Doenças , Saúde Global/legislação & jurisprudência , Humanos , Disseminação de Informação , Cooperação Internacional , Regulamento Sanitário Internacional , Medição de Risco , SARS-CoV-2/isolamento & purificação , Fatores de Tempo , Organização Mundial da Saúde , Zoonoses/virologiaAssuntos
COVID-19/epidemiologia , Regulamentação Governamental , Controle de Infecções , Saúde Global/legislação & jurisprudência , Prioridades em Saúde/legislação & jurisprudência , Prioridades em Saúde/organização & administração , Humanos , Controle de Infecções/legislação & jurisprudência , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Administração em Saúde Pública/legislação & jurisprudência , Administração em Saúde Pública/métodos , Pesquisa/legislação & jurisprudência , Pesquisa/organização & administração , SARS-CoV-2/fisiologia , Estados Unidos/epidemiologia , United States Food and Drug Administration/legislação & jurisprudência , United States Food and Drug Administration/organização & administraçãoRESUMO
BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally. We aimed to analyse trends in implementation of WHO-recommended population-level policies and associations with national geopolitical characteristics. METHODS: We calculated cross-sectional NCD policy implementation scores for all 194 WHO member states from the 2015, 2017, and 2020 WHO progress monitor reports, and examined changes over time as well as average implementation by geographical and geopolitical region and income level. We developed a framework of indicators of national characteristics hypothesised to influence policy implementation, including democracy, corporate permeation (an indicator of corporate influence), NCD burden, and risk factor prevalence. We used multivariate regression models to test our hypotheses. FINDINGS: On average, countries had fully implemented a third (32·8%, SD 18·2) of the 19 policies in 2020. Using aggregate policy scores, which include partially implemented policies, mean implementation had increased from 39·0% (SD 19·3) in 2015 to 45·9% (19·2) in 2017 and 47·0% (19·8) in 2020. Implementation was lowest for policies relating to alcohol, tobacco, and unhealthy foods, and had reversed for a third of all policies. Low-income and less democratic countries had the lowest policy implementation. Our model explained 64·8% of variance in implementation scores. For every unit increase in corporate permeation, implementation decreased by 5·0% (95% CI -8·0 to -1·9, p=0·0017), and for every 1% increase in NCD mortality burden, implementation increased by 0·9% (0·2 to 1·6, p=0·014). Democracy was positively associated with policy implementation, but only in countries with low corporate permeation. INTERPRETATION: Implementation of NCD policies is uneven, but broadly improving over time. Urgent action is needed to boost implementation of policies targeting corporate vectors of NCDs, and to support countries facing high corporate permeation. FUNDING: The National Institutes for Health Research, the Swedish Research Council, the Fulbright Commission, and the Swedish Society of Medicine.
Assuntos
Saúde Global/legislação & jurisprudência , Saúde Global/normas , Guias como Assunto , Política de Saúde , Doenças não Transmissíveis/classificação , Doenças não Transmissíveis/terapia , Política , Estudos Transversais , Humanos , Formulação de Políticas , Organização Mundial da SaúdeRESUMO
COVID-19 most likely had its origins in wildlife, and hundreds of thousands of new viruses could spill over from wildlife to humans. We are struggling to combat climate change, and we are staring down the loss of a million species. It's time to change course.
Assuntos
Bem-Estar do Animal/organização & administração , Animais Selvagens/virologia , COVID-19/epidemiologia , Crime/prevenção & controle , Zoonoses/epidemiologia , Bem-Estar do Animal/legislação & jurisprudência , Animais , COVID-19/transmissão , COVID-19/virologia , Mudança Climática , Comércio/legislação & jurisprudência , Comércio/organização & administração , Direito Penal/organização & administração , Saúde Global/legislação & jurisprudência , Humanos , Cooperação Internacional/legislação & jurisprudência , SARS-CoV-2/patogenicidade , Zoonoses/transmissão , Zoonoses/virologiaRESUMO
BACKGROUND: The recent Lancet Commission on Legal Determinants of Global Health argues that governance can provide the framework for achieving sustainable development goals. Even though over 90% of fatal road traffic injuries occur in low- and middle-income countries (LMICs) primarily affecting motorcyclists, the utility of helmet laws outside of high-income settings has not been well characterized. We sought to evaluate the differences in outcomes of mandatory motorcycle helmet legislation and determine whether these varied across country income levels. METHODS AND FINDINGS: A systematic review and meta-analysis were completed using the PRISMA checklist. A search for relevant articles was conducted using the PubMed, Embase, and Web of Science databases from January 1, 1990 to August 8, 2021. Studies were included if they evaluated helmet usage, mortality from motorcycle crash, or traumatic brain injury (TBI) incidence, with and without enactment of a mandatory helmet law as the intervention. The Newcastle-Ottawa Scale (NOS) was used to rate study quality and funnel plots, and Begg's and Egger's tests were used to assess for small study bias. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were stratified by high-income countries (HICs) versus LMICs using the random-effects model. Twenty-five articles were included in the final analysis encompassing a total study population of 31,949,418 people. There were 17 retrospective cohort studies, 2 prospective cohort studies, 1 case-control study, and 5 pre-post design studies. There were 16 studies from HICs and 9 from LMICs. The median NOS score was 6 with a range of 4 to 9. All studies demonstrated higher odds of helmet usage after implementation of helmet law; however, the results were statistically significantly greater in HICs (OR: 53.5; 95% CI: 28.4; 100.7) than in LMICs (OR: 4.82; 95% CI: 3.58; 6.49), p-value comparing both strata < 0.0001. There were significantly lower odds of motorcycle fatalities after enactment of helmet legislation (OR: 0.71; 95% CI: 0.61; 0.83) with no significant difference by income classification, p-value: 0.27. Odds of TBI were statistically significantly lower in HICs (OR: 0.61, 95% CI 0.54 to 0.69) than in LMICs (0.79, 95% CI 0.72 to 0.86) after enactment of law (p-value: 0.0001). Limitations of this study include variability in the methodologies and data sources in the studies included in the meta-analysis as well as the lack of available literature from the lowest income countries or from the African WHO region, in which helmet laws are least commonly present. CONCLUSIONS: In this study, we observed that mandatory helmet laws had substantial public health benefits in all income contexts, but some outcomes were diminished in LMIC settings where additional measures such as public education and law enforcement might play critical roles.
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Acidentes de Trânsito/prevenção & controle , Traumatismos Craniocerebrais/prevenção & controle , Países em Desenvolvimento/economia , Saúde Global/legislação & jurisprudência , Dispositivos de Proteção da Cabeça , Renda , Aplicação da Lei , Motocicletas/legislação & jurisprudência , Acidentes de Trânsito/legislação & jurisprudência , Acidentes de Trânsito/mortalidade , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/mortalidade , Saúde Global/economia , Humanos , Formulação de Políticas , Fatores de Proteção , Medição de Risco , Fatores de RiscoAssuntos
Cooperação Internacional , Pandemias/prevenção & controle , Organização Mundial da Saúde , Animais , COVID-19/epidemiologia , COVID-19/terapia , Teste para COVID-19 , Fortalecimento Institucional , Contenção de Riscos Biológicos/normas , Tomada de Decisões Gerenciais , Notificação de Doenças , Saúde Global/legislação & jurisprudência , Disparidades em Assistência à Saúde , Humanos , Disseminação de Informação , Política Organizacional , Pesquisa , Fatores Socioeconômicos , Nações Unidas/legislação & jurisprudência , Zoonoses/prevenção & controleAssuntos
Saúde Global/normas , Agências Internacionais/organização & administração , Regulamento Sanitário Internacional , Pandemias/prevenção & controle , Medidas de Segurança/legislação & jurisprudência , COVID-19/epidemiologia , COVID-19/mortalidade , Previsões , Saúde Global/legislação & jurisprudência , Humanos , Disseminação de Informação , Cooperação Internacional , Regulamento Sanitário Internacional/normas , Pandemias/legislação & jurisprudência , Apoio à Pesquisa como Assunto/organização & administração , Medidas de Segurança/normas , Organização Mundial da Saúde/organização & administraçãoRESUMO
PURPOSE OF REVIEW: The COVID-19 pandemic is a global catastrophe that has led to untold suffering and death. Many previously identified policy challenges in planning for large epidemics and pandemics have been brought to the fore, and new ones have emerged. Here, we review key policy challenges and lessons learned from the COVID-19 pandemic in order to be better prepared for the future. RECENT FINDINGS: The most important challenges facing policymakers include financing outbreak preparedness and response in a complex political environment with limited resources, coordinating response efforts among a growing and diverse range of national and international actors, accurately assessing national outbreak preparedness, addressing the shortfall in the global health workforce, building surge capacity of both human and material resources, balancing investments in public health and curative services, building capacity for outbreak-related research and development, and reinforcing measures for infection prevention and control. SUMMARY: In recent years, numerous epidemics and pandemics have caused not only considerable loss of life, but billions of dollars of economic loss. The COVID-19 pandemic served as a wake-up call and led to the implementation of relevant policies and countermeasures. Nevertheless, many questions remain and much work to be done. Wise policies and approaches for outbreak control exist but will require the political will to implement them.
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COVID-19/prevenção & controle , Epidemias/legislação & jurisprudência , Epidemias/prevenção & controle , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Animais , Surtos de Doenças/legislação & jurisprudência , Surtos de Doenças/prevenção & controle , Saúde Global/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Mão de Obra em Saúde/legislação & jurisprudência , Humanos , Saúde Pública/legislação & jurisprudênciaAssuntos
Planejamento em Desastres/organização & administração , Saúde Global/legislação & jurisprudência , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Responsabilidade Social , Organização Mundial da Saúde/organização & administração , Adulto , Feminino , Humanos , Masculino , Adulto JovemAssuntos
Financiamento Governamental , Saúde Global/economia , Cooperação Internacional , Abandono do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/economia , Indústria do Tabaco/economia , Comércio/economia , Comércio/legislação & jurisprudência , Saúde Global/legislação & jurisprudência , Regulamentação Governamental , Humanos , Cooperação Internacional/legislação & jurisprudência , Formulação de Políticas , Abandono do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudênciaAssuntos
Atenção à Saúde/estatística & dados numéricos , Saúde Global/economia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/terapia , Terapia Combinada , Efeitos Psicossociais da Doença , Diagnóstico Tardio , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Morbidade , Pobreza/estatística & dados numéricos , Neoplasias da Próstata/mortalidadeAssuntos
Orçamentos/legislação & jurisprudência , COVID-19/economia , Saúde Global/economia , Financiamento da Assistência à Saúde/ética , Populações Vulneráveis/classificação , Adolescente , Orçamentos/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Criança , Mortalidade da Criança/tendências , Feminino , Saúde Global/legislação & jurisprudência , Humanos , Morte Materna/prevenção & controle , Gravidez , SARS-CoV-2/genética , Reino Unido/epidemiologia , Populações Vulneráveis/estatística & dados numéricosAssuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Transtornos Relacionados ao Uso de Álcool/prevenção & controle , Defesa do Consumidor , Saúde Global/legislação & jurisprudência , Política de Saúde , Hong Kong , Humanos , Desenvolvimento Sustentável , Organização Mundial da SaúdeRESUMO
The coronavirus disease 2019 (COVID-19) has now rapidly spread around the world, causing an outbreak of acute infectious pneumonia. To develop effective and safe therapies for the prevention and treatment of COVID-19 has become the major global public health concern. Traditional medicine (TM)/herbal medicines (HMs) have been used to treat multiple epidemics in human history, which brings hope for the fight against COVID-19 in some areas. For example, in China, India, and South Korea with traditional medication history and theory, the governments issued a series of guidelines to support TM/HMs in the medication of COVID-19. In contrast, other countries e.g. North American and European governments are typically silent on these practices, unless to warn of possible harm and overselling. Such difference is due to the discrepancy in culture, history and philosophical views of health care and medication, as well as unharmonized policies and standards in the regulation and legalization of TM/HMs among different areas. Herein, we reviewed the responses and scientific researches from seven selected countries on the policies and legalization of TM/HMs to treat COVID-19, and also analyzed the major challenges and concerns to utilize the traditional knowledge and resource.