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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1180-1183, 2020 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-33147913

RESUMO

In 2014, Joint United Nations Programme on HIV/AIDS (UNAIDS) put forward the goal of ending HIV epidemic by 2030 at the International AIDS Conference and proposed the strategic goal of achieving "three 90%" by 2020. This year is the closing year of this strategic goal, and all regions have begun to evaluate the progress of implementing the goal. This article discussed the progress of the implementation of the "three 90%", and scientifically interpreted the strategic goal. It is proposed that the goal is a relative and dynamic concept, and only if we sieze the opportunity to achieve the strategic goal and continuously enhance comprehensive prevention and control, can the HIV epidemic be better controlled.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Objetivos , Infecções por HIV/prevenção & controle , Humanos , Nações Unidas
2.
Wiad Lek ; 73(9 cz. 2): 2044-2048, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148857

RESUMO

OBJECTIVE: The aim: Of the study is to characterize the internal acts of the United Nations on the regulation of the right to health of its staff. PATIENTS AND METHODS: Materials and methods: Achieving the purpose of the study is ensured due to the analysis of internal acts of the United Nations, doctrinal sources on the issue selected. The methodological basis is a number of special and general methods. CONCLUSION: Conclusions: The right to health guaranteed by the International Bill of Human Rights is comprehensive and closely linked to labour human rights. International civil servants of the UN system are not exempt. Thus, within the United Nations, a number of acts have been developed, the provisions of which set out recommendations aimed at reducing possible cases of infection of workers, maintaining their mental health while on quarantine, informing staff about their actions in case of illness, testing workers, etc. However, these acts need to be improved.


Assuntos
Direito à Saúde , Nações Unidas , Direitos Humanos , Humanos
3.
Global Health ; 16(1): 101, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081805

RESUMO

Corruption is recognized by the global community as a threat to development generally and to achieving health goals, such as the United Nations Sustainable Development Goal # 3: ensuring healthy lives and promoting well-being for all. As such, international organizations such as the World Health Organizations and the United Nations Development Program are creating an evidence base on how best to address corruption in health systems. At present, the risk of corruption is even more apparent, given the need for quick and nimble responses to the COVID-19 pandemic, which may include a relaxation of standards and the rapid mobilization of large funds. As international organizations and governments attempt to respond to the ever-changing demands of this pandemic, there is a need to acknowledge and address the increased opportunity for corruption.In order to explore how such risks of corruption are addressed in international organizations, this paper focuses on the question: How are international organizations implementing measures to promote accountability and transparency, and anti-corruption, in their own operations? The following international organizations were selected as the focus of this paper given their current involvement in anti-corruption, transparency, and accountability in the health sector: the World Health Organization, the United Nations Development Program, the World Bank Group, and the Global Fund to Fight Aids, Tuberculosis and Malaria. Our findings demonstrate that there has been a clear increase in the volume and scope of anti-corruption, accountability, and transparency measures implemented by these international organizations in recent years. However, the efficacy of these measures remains unclear. Further research is needed to determine how these measures are achieving their transparency, accountability, and anti-corruption goals.


Assuntos
Revelação , Fraude/prevenção & controle , Saúde Global/economia , Responsabilidade Social , Nações Unidas , Organização Mundial da Saúde , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Humanos , Malária/prevenção & controle , Tuberculose/prevenção & controle
4.
PLoS One ; 15(10): e0238782, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33021973

RESUMO

In 2015, UN member states committed to eliminate female genital mutilation (FGM) by 2030 as part of the Sustainable Development Agenda. To reach this goal, interventions need to be targeted and guided by the best available evidence. To date, however, estimates of the number of girls and women affected by FGM and their trends over time and geographic space have been limited by the availability, specificity and quality of population-level data. We present new estimates based on all publicly available nationally representative surveys collected since the 1990s that contain both information on FGM status and on the age at which FGM occurred. Using survival analysis, we generate estimates of FGM risk by single year of age for all countries with available data, and for rural and urban areas separately. The likelihood of experiencing FGM has decreased at the global level, but progress has been starkly uneven between countries. The available data indicate no progress in reducing FGM risk in Gambia, Guinea-Bissau, Mali and Guinea. In addition, rural and urban areas have diverged over the last two decades, with FGM declining more rapidly in urban areas. We describe limitations in the availability and quality of data on FGM occurrence and age-at-FGM. Based on current trends, the SDG goal of eliminating FGM by 2030 is out of reach, and the pace at which the practice is being abandoned would need to accelerate to eliminate FGM by 2030. The heterogeneity in trends between countries and rural vs urban areas offers an opportunity to contrast countries where FGM is in rapid decline and explore potential policy lessons and programmatic implications for countries where the practice of FGM appears to remain entrenched.


Assuntos
Circuncisão Feminina , Adolescente , Adulto , Criança , Pré-Escolar , Circuncisão Feminina/legislação & jurisprudência , Circuncisão Feminina/estatística & dados numéricos , Circuncisão Feminina/tendências , Estudos de Coortes , Estudos Transversais , Feminino , Saúde Global/legislação & jurisprudência , Saúde Global/estatística & dados numéricos , Saúde Global/tendências , Humanos , Lactente , Recém-Nascido , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Estudos Retrospectivos , Saúde da População Rural , Inquéritos e Questionários , Nações Unidas , Saúde da População Urbana , Saúde da Mulher/legislação & jurisprudência , Saúde da Mulher/estatística & dados numéricos , Saúde da Mulher/tendências , Adulto Jovem
6.
Nat Commun ; 11(1): 5203, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060603

RESUMO

Ending all forms of hunger by 2030, as set forward in the UN-Sustainable Development Goal 2 (UN-SDG2), is a daunting but essential task, given the limited timeline ahead and the negative global health and socio-economic impact of hunger. Malnutrition or hidden hunger due to micronutrient deficiencies affects about one third of the world population and severely jeopardizes economic development. Staple crop biofortification through gene stacking, using a rational combination of conventional breeding and metabolic engineering strategies, should enable a leap forward within the coming decade. A number of specific actions and policy interventions are proposed to reach this goal.


Assuntos
Biofortificação/métodos , Engenharia Metabólica/métodos , Cruzamento , Produtos Agrícolas/genética , Países em Desenvolvimento , Abastecimento de Alimentos , Alimentos Fortificados , Saúde Global , Humanos , Desnutrição/prevenção & controle , Micronutrientes , Minerais , Oryza , Plantas/genética , Plantas Geneticamente Modificadas , Formulação de Políticas , Provitaminas , Desenvolvimento Sustentável/economia , Desenvolvimento Sustentável/tendências , Nações Unidas , Vitaminas
8.
Respir Care ; 65(9): 1378-1381, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32879035

RESUMO

COVID-19 is devastating health systems globally and causing severe ventilator shortages. Since the beginning of the outbreak, the provision and use of ventilators has been a key focus of public discourse. Scientists and engineers from leading universities and companies have rushed to develop low-cost ventilators in hopes of supporting critically ill patients in developing countries. Philanthropists have invested millions in shipping ventilators to low-resource settings, and agencies such as the World Health Organization and the World Bank are prioritizing the purchase of ventilators. While we recognize the humanitarian nature of these efforts, merely shipping ventilators to low-resource environments may not improve outcomes of patients and could potentially cause harm. An ecosystem of considerable technological and human resources is required to support the usage of ventilators within intensive care settings. Medical-grade oxygen supplies, reliable electricity, bioengineering support, and consumables are all needed for ventilators to save lives. However, most ICUs in resource-poor settings do not have access to these resources. Patients on ventilators require continuous monitoring from physicians, nurses, and respiratory therapists skilled in critical care. Health care workers in many low-resource settings are already exceedingly overburdened, and pulling these essential human resources away from other critical patient needs could reduce the overall quality of patient care. When deploying medical devices, it is vital to align the technological intervention with the clinical reality. Low-income settings often will not benefit from resource-intensive equipment, but rather from contextually appropriate devices that meet the unique needs of their health systems.


Assuntos
Infecções por Coronavirus/epidemiologia , Disparidades em Assistência à Saúde/economia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pobreza/estatística & dados numéricos , Ventiladores Mecânicos/estatística & dados numéricos , Infecções por Coronavirus/terapia , Cuidados Críticos/organização & administração , Países em Desenvolvimento , Feminino , Recursos em Saúde/economia , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Nigéria , Pneumonia Viral/terapia , Nações Unidas , Ventiladores Mecânicos/economia , Organização Mundial da Saúde
11.
BMC Public Health ; 20(1): 1375, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907565

RESUMO

BACKGROUND: Measuring progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 treatment targets is key to assessing progress towards turning the HIV epidemic tide. In 2017, the UNAIDS model estimated that 75% of people living with HIV (PLHIV) globally knew their HIV positive status, 79% of those who knew their status were on antiretroviral therapy (ART), and 81% of those who knew their HIV status and were on ART had a suppressed viral load. The fifth South African national HIV sero-behavioural survey collected nationally representative data that enabled the empirical estimation of these 90-90-90 targets for the country stratified by a variety of key factors. METHODS: To evaluate progress towards achievement of the 90-90-90 targets for South Africa, data obtained from a national, representative, cross-sectional population-based multi-stage stratified cluster random survey conducted in 2017 were analysed. The Fifth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey (SABSSM V), collected behavioural and biomarker data from individuals residing in households from 1000 randomly selected Small Area Layers (SALs), across all nine provinces of the country. Structured questionnaires were used to collect socio-demographic data, knowledge and perceptions about HIV, and related risk behaviours. Blood samples were collected to test for HIV infection, antiretroviral use, and viral suppression (defined as < 1000 copies/ml). Weighted proportions of study participants aged 15 years and older who tested HIV positive were computed for those who reported awareness of their status (1st 90), and among these, those who were currently on ART (2nd 90) and of these, those who were virally suppressed (3rd 90). RESULTS: Among persons 15 years and older who were HIV positive, 84.8% were aware of their HIV positive status, of whom 70.7% were currently on ART, with 87.4% of these estimated to have suppressed viral load at the time of the survey. These estimates varied by sex, age, and geo-location type. Relatively higher percentages across all three indicators for women compared to men were observed: 88.7% versus 78.2% for those aware of their status, 72.3% versus 67.7% for on ART, and 89.8% versus 82.3% for viral suppression. Knowing one's positive HIV status increased with age: 74.0, 85.8, and 88.1% for age groups 15-24 years old, 25-49 years old and 50-64 years old, although for those 65 years and older, 78.7% knew their HIV positive status. A similar pattern was observed for the 2nd 90, among those who knew their HIV positive status, 51.7% of 15 to 24 year olds, 70.5% of those aged 25-49 years old, 82.9% of those aged 50-64 years old and 82.4% of those aged 65 years or older were currently on ART. Viral suppression for the above mentioned aged groups, among those who were on ART was 85.2, 87.2, 89.5, and 84.6% respectively. The 90-90-90 indicators for urban areas were 87.7, 66.5, and 87.2%, for rural settings was 85.8, 79.8, and 88.4%, while in commercial farming communities it was 56.2, 67.6 and 81.4%. CONCLUSIONS: South Africa appears to be on track to achieve the first 90 indicator by 2020. However, it is behind on the second 90 indicator with ART coverage that was ~ 20-percentage points below the target among people who knew their HIV status, this indicates deficiencies around linkage to and retention on ART. Overall viral suppression among those on ART is approaching the target at 87.4%, but this must be interpreted in the context of low reported ART coverage as well as with variation by age and sex. Targeted diagnosis, awareness, and treatment programs for men, young people aged 15-24 years old, people who reside in farming communities, and in specific provinces are needed. More nuanced 90-90-90 estimates within provinces, specifically looking at more granular sub-national level (e.g. districts), are needed to identify gaps in specific regions and to inform provincial interventions.


Assuntos
Antirretrovirais/uso terapêutico , Conscientização , Epidemias , Objetivos , Infecções por HIV/prevenção & controle , Carga Viral , Logro , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , África do Sul/epidemiologia , Inquéritos e Questionários , Nações Unidas , Adulto Jovem
13.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47774

RESUMO

Em consonância com tema da Semana Mundial de Aleitamento Materno 2020 “Apoie o aleitamento para um planeta mais saudável”, a Organização Mundial de Saúde (OMS) e o Fundo das Nações Unidas para a Infância (UNICEF) convocaram – em nota pública – os governos do mundo inteiro a protegerem e promoverem o acesso das mulheres ao aconselhamento especializado em aleitamento materno.


Assuntos
Aleitamento Materno , Promoção da Saúde , Nações Unidas , Organização Mundial da Saúde
14.
Recurso na Internet em Inglês, Português | LIS - Localizador de Informação em Saúde | ID: lis-47749

RESUMO

Relatório da Relatora Especial das Nações Unidas, Alice Cruz, para a Eliminação da Discriminação contra as Pessoas Afetadas pela Hanseníase e seus Familiares. Brasília, 14 Maio de 2019. Disponível nos idiomas inglês e português.


Assuntos
Hanseníase , Direitos Humanos , Nações Unidas , Equidade em Saúde , Políticas Públicas não Discriminatórias
16.
PLoS Med ; 17(7): e1003148, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32673316

RESUMO

BACKGROUND: Embedded implementation research (IR) promotes evidence-informed policy and practices by involving decision-makers and program implementers in research activities that focus on understanding and solving existing implementation challenges. Although embedded IR has been conducted in multiple settings by different organizations, there are limited experiences of embedded IR in humanitarian settings. This study highlights some of the key challenges of conducting embedded IR in a humanitarian setting based on our experience with the Rohingya refugee population in Cox's Bazar, Bangladesh. METHODS AND FINDINGS: We collected qualitative data in between January and July 2019. First, we visited Rohingya refugee camps and interviewed representatives from different humanitarian organizations. Second, we conducted interviews with researchers from BRAC University who were engaged with data collection and analysis in a broader embedded IR study on maternal, newborn, child, and adolescent health (MNCAH) program implementation challenges. Data were analyzed using a thematic analysis approach. Two researchers developed and agreed on codes and relevant themes based on the objectives of this study. The findings of this study highlight several challenges encountered while conducting embedded IR in the Rohingya emergency setting in Cox's Bazar, which may have implications for other humanitarian settings. The overall context of the camps was complex, with more than 100 organizations devoted to providing health services for approximately 1 million refugees. Despite the presence of the Bangladesh government, United Nations agencies and other international organizations played key roles in making programmatic and policy decisions for the Rohingya. Because health service delivery modalities and policies and related implementation challenges for MNCAH programs for the refugees changed rapidly, the embedded IR approach used was flexible and able to adapt to changes identified, with research questions and methods modified accordingly. Access to the camps, reaching Rohingya respondents, overcoming language barriers in order to get quality information, and the limited availability of local research collaborators were additional challenges. Working with researchers or research institutes that are familiar with the context and have experience in conducting implementation and health systems research can help with collection of quality data, identifying key stakeholders and bringing them on board to ensure the execution of the project, and ensuring utilization of the research findings. Study limitations include possible constraints in generalizing our conclusions to other humanitarian settings. Implementation research conducted in additional humanitarian settings can contribute to the evidence on this topic. CONCLUSIONS: Findings indicate that embedded IR can be done effectively in humanitarian settings if the challenges are anticipated, and appropriate strategies and in-country partners put in place to address or mitigate them, before commencing the funding or starting of the project. Understanding the context and analyzing the role of relevant stakeholders prior to conducting the research, considering a simple descriptive method appropriate to answering real-time IR questions, and working with local researchers or research institutes with specific skill sets and prior experience conducting research in humanization contexts may reduce costs and time spent, and ensure collection of quality data relevant for policy and practice.


Assuntos
Assistência à Saúde/organização & administração , Pesquisa sobre Serviços de Saúde/métodos , Adolescente , Bangladesh , Criança , Pré-Escolar , Feminino , Humanos , Ciência da Implementação , Recém-Nascido , Idioma , Organizações , Avaliação de Resultados em Cuidados de Saúde , Campos de Refugiados , Refugiados , Nações Unidas
18.
PLoS One ; 15(7): e0233602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639958

RESUMO

Commonly used measures of population aging categorize adults into those who are "old" and those who are not. How this threshold of the stage of "old age" is determined is crucial for our understanding of population aging. We propose that the old age threshold be determined using an equivalency criterion. People at the old age threshold should be roughly equivalent to one another in relevant characteristics regardless of when and where they lived. The UN publishes two variants of the potential support ratio based on different old age thresholds. One old age threshold is based on a fixed chronological age and the other on a fixed remaining life expectancy. Using historical data on 5-year death rates at the old age threshold as an indicator of one aspect of health, we assess the extent to which the two approaches are consistent with the equivalency criterion. The death rates are derived from all the complete cohort life tables in the Human Mortality Database. We show that the old age threshold based on a fixed remaining life expectancy is consistent with the equivalency criterion, while the old age threshold based on a fixed chronological age is not. The picture of population aging that emerges when measures consistent with the equivalency criterion are used are markedly different from those that result when the equivalency criterion is violated. We recommend that measures of aging that violate the equivalency criterion should only be used in special circumstances where that violation is unimportant.


Assuntos
Idoso/estatística & dados numéricos , Dinâmica Populacional , Envelhecimento , Classificação , Humanos , Expectativa de Vida , Pessoa de Meia-Idade , Mortalidade , Estudos Prospectivos , Nações Unidas
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