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1.
J Law Med ; 28(2): 323-335, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33768744

RESUMEN

Historically, there has been inadequate recognition of the need for persons with disabilities to have the opportunity for meaningful sexual expression. Many impediments lie in the way of such recognition and, for some with a disability, professional assistance is required. In a precedent-setting decision by the Full Court of the Federal Court of Australia (National Disability Insurance Agency v WRMF (2020) 276 FCR 415; [2020] FCAFC 79) a woman with multiple sclerosis who had been accepted onto the National Disability Insurance Scheme was affirmed to be eligible for taxpayer-funded receipt of services from a sex worker, in spite of the National Disability Insurance Scheme having declined such services as not constituting a reasonable and necessary support. However, it may be that the decision will be overturned by a controversial legislative amendment. This section reviews the reasoning in the decision and the human rights and political issues raised by the decision that require consideration and engagement.


Asunto(s)
Personas con Discapacidad , Naciones Unidas , Australia , Derechos Humanos , Humanos
5.
MMWR Morb Mortal Wkly Rep ; 70(12): 427-430, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33764960

RESUMEN

Although tuberculosis (TB) is curable and preventable, in 2019, TB remained the leading cause of death from a single infectious agent worldwide and the leading cause of death among persons living with HIV infection (1). The World Health Organization's (WHO's) End TB Strategy set ambitious targets for 2020, including a 20% reduction in TB incidence and a 35% reduction in the number of TB deaths compared with 2015, as well as zero TB-affected households facing catastrophic costs (defined as costs exceeding 20% of annual household income) (2). In addition, during the 2018 United Nations High-Level Meeting on TB (UNHLM-TB), all member states committed to setting 2018-2022 targets that included provision of TB treatment to 40 million persons and TB preventive treatment (TPT) to 30 million persons, including 6 million persons living with HIV infection and 24 million household contacts of patients with confirmed TB (4 million aged <5 years and 20 million aged ≥5 years) (3,4). Annual data reported to WHO by 215 countries and territories, supplemented by surveys assessing TB prevalence and patient costs in some countries, were used to estimate TB incidence, the number of persons accessing TB curative and preventive treatment, and the percentage of TB-affected households facing catastrophic costs (1). Globally, TB illness developed in an estimated 10 million persons in 2019, representing a decline in incidence of 2.3% from 2018 and 9% since 2015. An estimated 1.4 million TB-related deaths occurred, a decline of 7% from 2018 and 14% since 2015. Although progress has been made, the world is not on track to achieve the 2020 End TB Strategy incidence and mortality targets (1). Efforts to expand access to TB curative and preventive treatment need to be substantially amplified for UNHLM-TB 2022 targets to be met.


Asunto(s)
Erradicación de la Enfermedad , Salud Global/estadística & datos numéricos , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Objetivos , Humanos , Incidencia , Tuberculosis/mortalidad , Naciones Unidas , Organización Mundial de la Salud
9.
Cochrane Database Syst Rev ; 2: CD012882, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33565123

RESUMEN

BACKGROUND: The leading causes of mortality globally in children younger than five years of age (under-fives), and particularly in the regions of sub-Saharan Africa (SSA) and Southern Asia, in 2018 were infectious diseases, including pneumonia (15%), diarrhoea (8%), malaria (5%) and newborn sepsis (7%) (UNICEF 2019). Nutrition-related factors contributed to 45% of under-five deaths (UNICEF 2019). World Health Organization (WHO) and United Nations Children's Fund (UNICEF), in collaboration with other development partners, have developed an approach - now known as integrated community case management (iCCM) - to bring treatment services for children 'closer to home'. The iCCM approach provides integrated case management services for two or more illnesses - including diarrhoea, pneumonia, malaria, severe acute malnutrition or neonatal sepsis - among under-fives at community level (i.e. outside of healthcare facilities) by lay health workers where there is limited access to health facility-based case management services (WHO/UNICEF 2012). OBJECTIVES: To assess the effects of the integrated community case management (iCCM) strategy on coverage of appropriate treatment for childhood illness by an appropriate provider, quality of care, case load or severity of illness at health facilities, mortality, adverse events and coverage of careseeking for children younger than five years of age in low- and middle-income countries. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and CINAHL on 7 November 2019, Virtual Health Library on 8 November 2019, and Popline on 5 December 2018, three other databases on 22 March 2019 and two trial registers on 8 November 2019. We performed reference checking, and citation searching, and contacted study authors to identify additional studies. SELECTION CRITERIA: Randomized controlled trials (RCTs), cluster-RCTs, controlled before-after studies (CBAs), interrupted time series (ITS) studies and repeated measures studies comparing generic WHO/UNICEF iCCM (or local adaptation thereof) for at least two iCCM diseases with usual facility services (facility treatment services) with or without single disease community case management (CCM). We included studies reporting on coverage of appropriate treatment for childhood illness by an appropriate provider, quality of care, case load or severity of illness at health facilities, mortality, adverse events and coverage of careseeking for under-fives in low- and middle-income countries. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened abstracts, screened full texts and extracted data using a standardised data collection form adapted from the EPOC Good Practice Data Collection Form. We resolved any disagreements through discussion or, if required, we consulted a third review author not involved in the original screening. We contacted study authors for clarification or additional details when necessary. We reported risk ratios (RR) for dichotomous outcomes and hazard ratios (HR) for time to event outcomes, with 95% confidence intervals (CI), adjusted for clustering, where possible. We used estimates of effect from the primary analysis reported by the investigators, where possible. We analysed the effects of randomized trials and other study types separately. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We included seven studies, of which three were cluster RCTs and four were CBAs. Six of the seven studies were in SSA and one study was in Southern Asia. The iCCM components and inputs were fairly consistent across the seven studies with notable variation for the training and deployment component (e.g. on payment of iCCM providers) and the system component (e.g. on improving information systems). When compared to usual facility services, we are uncertain of the effect of iCCM on coverage of appropriate treatment from an appropriate provider for any iCCM illness (RR 0.96, 95% CI 0.77 to 1.19; 2 CBA studies, 5898 children; very low-certainty evidence). iCCM may have little to no effect on neonatal mortality (HR 1.01, 95% 0.73 to 1.28; 2 trials, 65,209 children; low-certainty evidence). We are uncertain of the effect of iCCM on infant mortality (HR 1.02, 95% CI 0.83 to 1.26; 2 trials, 60,480 children; very low-certainty evidence) and under-five mortality (HR 1.18, 95% CI 1.01 to 1.37; 1 trial, 4729 children; very low-certainty evidence). iCCM probably increases coverage of careseeking to an appropriate provider for any iCCM illness by 68% (RR 1.68, 95% CI 1.24 to 2.27; 2 trials, 9853 children; moderate-certainty evidence). None of the studies reported quality of care, severity of illness or adverse events for this comparison. When compared to usual facility services plus CCM for malaria, we are uncertain of the effect of iCCM on coverage of appropriate treatment from an appropriate provider for any iCCM illness (very low-certainty evidence) and iCCM may have little or no effect on careseeking to an appropriate provider for any iCCM illness (RR 1.06, 95% CI 0.97 to 1.17; 1 trial, 811 children; low-certainty evidence). None of the studies reported quality of care, case load or severity of illness at health facilities, mortality or adverse events for this comparison. AUTHORS' CONCLUSIONS: iCCM probably increases coverage of careseeking to an appropriate provider for any iCCM illness. However, the evidence presented here underscores the importance of moving beyond training and deployment to valuing iCCM providers, strengthening health systems and engaging community systems.


Asunto(s)
Manejo de Caso/organización & administración , Servicios de Salud del Niño/organización & administración , Agentes Comunitarios de Salud , Países en Desarrollo , África del Sur del Sahara , Asia , Sesgo , Preescolar , Agentes Comunitarios de Salud/economía , Agentes Comunitarios de Salud/educación , Agentes Comunitarios de Salud/organización & administración , Estudios Controlados Antes y Después , Diarrea/terapia , Fiebre/terapia , Humanos , Lactante , Mortalidad Infantil , Trastornos de la Nutrición del Lactante/terapia , Recién Nacido , Malaria/terapia , Sepsis Neonatal/terapia , Neumonía/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Salarios y Beneficios , Naciones Unidas
12.
Health Secur ; 19(1): 57-64, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33606573

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has been closely tied with what has been called an infodemic, a "second disease" that occurs when massive information volumes (particularly with a high prevalence of false information) hinder the public health response. In this context, social listening, the process of monitoring and analyzing conversations to inform strategic activities both online and offline, becomes an even more essential component of risk communication and engagement strategies. In the Eastern and Southern Africa region, the United Nations Children's Fund (UNICEF) and partners in the response have activated their capacity to gather insights on the information needs of the populations served to better inform and engage with local communities. We describe the social listening approach taken at the Eastern and Southern Africa regional level to respond to COVID-19 and highlight efforts by the Comoros, Kenya, Madagascar, Malawi, and Zambia UNICEF country offices to implement digital and nondigital social listening to inform risk communication and community engagement. The analysis highlights channels leveraged, types of data monitored, and provides examples of social listening data use, as well as early challenges and lessons learned.


Asunto(s)
Comunicación , Medios de Comunicación Sociales , África Oriental , África Austral , Humanos , Naciones Unidas
13.
An Acad Bras Cienc ; 93(suppl 1): e20200880, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33624727

RESUMEN

The almost universal availability of electronic connectivity, portable devices, and the web is bringing about a major revolution: information of all kinds is rapidly becoming accessible to everyone, transforming social, economic and cultural life practically everywhere in the world. Internet technologies represent an unprecedented and extraordinary two-way channel of communication between producers and users of data. "Open Universe" is an initiative proposed to the United Nations Committee on the Peaceful Uses of Outer Space (COPUOS) and currently in implementation under the leadership of the United Nations Office for Outer Space Affairs (UN-OOSA). Its primary objective is to stimulate a dramatic increase in the availability and usability of space science data, extending the potential of scientific discovery to new participants in all parts of the world. This paper describes the initiative in general, some of the activities carried out to demonstrate its feasibility, and its use in the context of the BRICS Astronomy Programme.


Asunto(s)
Astronomía , Naciones Unidas , Humanos , Tecnología
14.
J Prim Care Community Health ; 12: 2150132721996889, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33632030

RESUMEN

The Sustainable Development Goals (SDGs) were adopted during the United Nations meeting in 2015 to succeed Millennium Development Goals. Among the health targets, SDG 3.2 is to end preventable deaths of newborns and children under 5 years of age by 2030. These 2 targets aim to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births. Ethiopia is demonstrating a great reduction in child mortality since 2000. In the 2019 child mortality estimation which is nearly 5 years after SDGs adoption, Ethiopia's progress toward reducing the newborns and under-5 mortality lie at 27 and 50.7 per 1000 live births, respectively. The generous financial and technical support from the global partners have helped to achieve such a significant reduction. Nevertheless, the SDG targets for newborns and under-5 mortality reduction are neither attained yet nor met the national plan to achieve by the end of 2019/2020. The partnership dynamics during COVID-19 crisis and the pandemic itself may also be taken as an opportunity to draw lessons and spur efforts to achieve SDG targets. This urges the need to reaffirm a comprehensive partnership and realignment with other interconnected development goals. Therefore, collective efforts with strong partnerships are required to improve the determinants of child health and achieving SDG target reduction until 2030.


Asunto(s)
Mortalidad del Niño/tendencias , Mortalidad Infantil/tendencias , Cooperación Internacional , Desarrollo Sostenible , /epidemiología , Preescolar , Etiopía/epidemiología , Humanos , Lactante , Recién Nacido , Naciones Unidas
15.
Prehosp Disaster Med ; 36(2): 129-130, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33509320

RESUMEN

On March 23, 2020, the United Nations (UN) made an "Appeal for a Global Ceasefire following the Outbreak of Coronavirus." Despite this appeal, the Nagorno-Karabagh war was instigated on September 27, 2020. This Guest Editorial frames the conflict in the context of the UN appeal and by introducing a figure that plots seven-day average coronavirus disease 2019 (COVID-19) cases overlaid with key inflection points to illustrate the clear impact that conflict has had on pandemic spread in Armenia. The conflict in Nagorno-Karabagh provides a timely, concise, and illustrative example of conflict and its impact on health. Finally, an argument is made that the ability to enforce the UN "Appeal for a Global Ceasefire" is essential to ensure global health and security.


Asunto(s)
Conflictos Armados , Salud Global , Armenia/epidemiología , Humanos , Pandemias , Naciones Unidas
18.
Infect Dis Poverty ; 10(1): 2, 2021 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397510

RESUMEN

BACKGROUND: The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. Unprecedented progress made in global health over the past 20 years has reverted and economic growth has already evaporated, giving rise to a global recession, the likes of which we may not have experienced since the Second World War. Our aim is to draw the attention of the neglected tropical disease (NTD) community towards some of the major emerging economic opportunities which are quickly appearing on the horizon as a result of COVID-19. MAIN TEXT: This scoping review relied on a literature search comprised of a sample of articles, statements, and press releases on initiatives aimed at mitigating the impact of COVID-19, while supporting economic recovery. Of note, the donor scenario and economic development agendas are highly dynamic and expected to change rapidly as the COVID-19 pandemic unfolds, as are donor and lender priorities. CONCLUSIONS: The NTD community, particularly in low- and middle-income countries (LMICs), will need to work quickly, diligently, and in close collaboration with decision-makers and key stakeholders, across sectors at national and international level to secure its position. Doing so might enhance the odds of grasping potential opportunities to access some of the massive resources that are now available in the form of contributions from corporate foundations, trust funds, loans, debt relieve schemes, and other financial mechanisms, as part of the ongoing and future economic development agendas and public health priorities driven by the COVID-19 pandemic. This paper should serve as a starting point for the NTD community to seek much needed financial support in order to sustain and revitalize control and elimination efforts pertaining to NTDs in LMICs.


Asunto(s)
/economía , Enfermedades Desatendidas/economía , Enfermedades Desatendidas/epidemiología , Estatus Económico , Salud Global , Humanos , Pandemias , Pobreza , Salud Pública , Factores de Riesgo , Clima Tropical , Naciones Unidas , Organización Mundial de la Salud
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