Uganda is widely viewed as a public health success for curtailing its HIV/AIDS epidemic in the early 1990s. The period of rapid HIV decline coincided with a dramatic rise in girls’ secondary school enrollment. We instrument for this enrollment with distance to school, conditional on a rich set of demographic and locational controls, including distance to market center. We find that girls’ enrollment in secondary education significantly increased the likelihood of abstaining from sex.
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Context The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.
Objective To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.
Context The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.
Objective To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.
Background: To study how misaligned supply-side incentives impede health programs in developing countries, we tested the impact of performance pay for anemia reduction in rural China. To the best of our knowledge, our study is the first to evaluate performance pay for actual health improvement.
Background. The optimal community-level approach to control pandemic influenza is unknown. Methods. We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization. Results.
The prevalence of antimicrobial resistance (AR) limits the therapeutic options for treatment of infections, and increases the social benefit from disease prevention. Like an environmental resource, antimicrobials require stewardship. The effectiveness of an antimicrobial agent is a global public good. We argue for greater use of economic analysis as an input to policy discussion about AR, including for understanding the incentives underlying health behaviors that spawn AR, and to supplement other methods of tracing the evolution of AR internationally.
BACKGROUND: The optimal community-level approach to control pandemic influenza is unknown. METHODS: We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization.
The world of genomics is transforming medicine, and is likely to influence the future development of new drugs, diagnostics, and vaccines. To date, the greater focus of genomics and medicine has been on conditions affecting resourcewealthy settings, primarily involving scientists and companies in those settings. However, we believe that it is possible to expand genomics into a more global technology that can also focus on diseases of resource-limited settings. This goal can be achieved if genomics is made a global priority.
When one can circle the globe in less than the time of incubation of most infectious pathogens, it is clear every country relies to some extent on the health systems of other countries to prevent and protect their citizens from global health threats. Therefore, creating and maintaining a good health system in one country requires attention to interregional and international cooperation. Domestic and international spheres of public health policies are becoming more intertwined and inseparable.
Background: Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.
Objective: To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.
Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.
Data Sources: Literature and expert opinion.
Background: The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century.
Objective: To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies.
Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.
Data Sources: Literature and expert opinion.
Background: Neuraminidase inhibitors (NAIs) are stockpiled internationally for extended use in an influenza pandemic.
Purpose: To evaluate the safety and efficacy of extended-duration (>4 weeks) NAI chemoprophylaxis against influenza.
Data Sources: Studies published in any language through 11 June 2009 identified by searching 10 electronic databases and 3 trial registries.
This paper tests the claim that a small number of distinct „welfare regimes,
combining institutional patterns and social welfare outcomes, can be identified
across the developing world. It develops a methodology for clustering a large
number of developing countries, identifying and ranking their welfare regimes,
assessing their stability over the decade 1990-2000, and relating these to important
structural variables. It identifies three meta-welfare regimes: proto-welfare state
Control of infectious diseases is a key global health priority. This paper describes the role that simulation can play in evaluating policies for infectious disease control. We describe ongoing simulation studies in three different areas: HIV prevention and treatment, contact tracing, and hepatitis B prevention and control.
Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem.
Climate change, as an environmental hazard operating at the global scale, poses a unique and "involuntary exposure" to many societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature rise in the past 30 years ironically contain those populations least responsible for causing greenhouse gas warming of the planet. Average global carbon emissions approximate one metric ton per year (tC/yr) per person.
Throughout history, nations have waged war against epidemics, from bubonic plague to pulmonary tuberculosis. Today, we confront HIV/AIDS, SARS, and avian influenza, among other major infectious diseases. The failure to contain HIV/AIDS, the longest contemporary pandemic, and the difficulties in dealing with the threat posed by avian influenza, show that the world is not well prepared for the next health crises. Because preventing and controlling these infectious diseases is a race against time, scientists around the world scrutinize viruses and bacteria more intently than ever.
We have learned little from the cataclysms of September 11 and Hurricane Katrina. When it comes to catastrophe, America is living on borrowed time--and squandering it.
The article asserts that globalization has made the world a more dangerous and less orderly place. The authors argue that since the emergence and expansion of globalization in the 1990s, the world has experienced more problems such as increasing terrorist activity, widening gaps between religious and cultural ideologies, unstable global financial systems, expanding dangers of pandemic disease, and the growing threat of global climate change.
Background
Multidrug-resistant tuberculosis (MDR-TB) is an important global health problem, and a
control strategy known as DOTS-Plus has existed since 1999. However, evidence regarding the feasibility, effectiveness, cost, and cost-effectiveness of DOTS-Plus is still limited.
