Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30472-2/abstract
Trump’s “global gag rule”: implications for human rights and global health - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30084-0/fulltext?
This executive order could have great human rights and ethics implications. South Africa is an example of a country that stands to be adversely affected. The country bears the world’s largest burden of HIV and is a major recipient of US federal funding.10 The country’s constitution enshrines the right to reproductive decision-making and the right to health,11 while its laws on termination of pregnancy places a legal obligation on health-care providers to provide or refer abortion-seekers to relevant facilities, when qualifying criteria are met.12 Compliance with Trump’s order will potentially require clinicians in NGOs and international agencies that operate in South Africa and receive US federal funding to violate their professional codes of ethics,13 the country’s abortion laws, and the country’s bill of rights.
#planning_familial #avortement #santé_reproductive #trump #gag_rule
Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30113-9/fulltext
#Sci-Hub and medical practice: an ethical dilemma in Peru - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30188-7/fulltext
Africa’s demographic future: why Africa should take the lead - Osman Sankoh, The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30103-6/fulltext
Whether or not the UN projection proves exaggerated (other studies suggest that it might be5), the standard policy prescriptions in developed countries have clearly not proved universally effective. African researchers are well placed to research the drivers of fertility and to test the effectiveness of population policies on the ground. Efforts to maximise the benefits of population change and reduce negative consequences are likely to be more successful if led by Africans.
Will the world reach 10 billion people? | Brookings Institution
▻http://www.brookings.edu/blogs/future-development/posts/2015/09/04-global-population-growth-fengler
The right(s) approach to Zika - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30109-7/fulltext
The face of Zika is not often seen in the air-conditioned shopping malls of upscale Rio neighbourhoods or on the beaches of Ipanema. Rio has its fair share of cases, but so far the heaviest burden has been borne by the northeast region of Brazil, where poverty, poor infrastructure, and lack of access to health services are rampant, and the penetration of Aedes aegypti is high. A large proportion of the population in that region is of African descent—indeed, the face of Zika is often that of a darker-skinned person. And because most cases are asymptomatic, and the most dramatic signs of the disease appear through congenital Zika syndrome, the face of Zika is that of a woman or a small child.
(...) poor women in Brazil, Colombia, El Salvador, and elsewhere have been let down by their governments. They are at the centre of the epidemics, they are scrutinised and lectured, but lack of access to basic reproductive services and restrictive abortion laws have stripped them of a choice when faced with the dire consequences of the virus on their health and that of their children.
#santé #inégalités #femmes #zika #droits
Alternative vector control methods to manage the Zika virus outbreak: more haste, less speed - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)00084-X/fulltext
Despite the pressing need for solutions to the rapidly expanding Zika virus transmission, in our opinion it is hard to posit a substantial role for either approach until direct evidence shows a reduced human disease burden.4 While we acknowledge that to hold novel or experimental techniques to unrealistically high standards is counterproductive, it is surely uncontroversial to suggest that diverse and credible data must be publicly available before resources and attention are diverted away from current control programmes.
(plus ou moins en lien avec ►http://seenthis.net/messages/455796)
Paradoxes of #sustainability with consequences for health - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)00038-3/fulltext
An important aspect of the conceptual transformations is that the term sustainability has gradually changed from being a goal (durability) to acquiring connotations that serve as a selection criterion for development aid. Using sustainability as a selection criterion risks privileging recipients who have the capacity to gain control over health and living conditions and exclude others as unworthy needy.
Le retour du malthusianisme, de l’hygiénisme et des thèses alarmistes sur le futur qu’on ne pourrait contrôler car la nature de l’homme (surtout celui pas éduqué) est mauvaise ?
Beaucoup des menaces annoncées sur un ton très savants (IA, post humanisme, nécessité d’aller sur mars) sont des arnaques.
Discours dominant de l’Europe du XIXé siècle afin d’apeurer l’ouvrier qui se rebellait.
Discours de Platon qui est la thèse de la République.
J’ai pour l’instant une combine simple pour trouver les pseudos savants.
Tout ce qui requiert du financement ou de la régulation publique afin de financer des intérêts privés pour des menaces futures à tendance à être plus souvent une grosse arnaque qui faites sur le dos de vrais problèmes.
FUD. FUD parasitant des vrais problèmes.
Secondary education and HIV infection in #Botswana - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00252-1/fulltext
We found a large causal effect of upper secondary schooling on HIV infection, but no association with primary schooling. In a natural experiment in Zimbabwe, secondary schooling led to delayed sexual debut, delayed fertility, and reduced child mortality.6 There is mounting evidence of health returns at the secondary level.
Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00080-7/fulltext
Evidence before this study
Many mathematical models have been developed to project the epidemiological and demographic effects of antiretroviral therapy (ART) on HIV epidemics and assess different policy options for the use of ART across sub-Saharan Africa and elsewhere. However, testing of these predictions against external data had not been possible. With new data from a nationally representative household survey in South Africa, we have, for the first time, compared existing model projections with data about HIV prevalence, HIV incidence, and ART coverage.
(...)
Implications of all the available evidence
Our results suggest that existing projections for reductions in HIV incidence after the scale-up of ART might have been overly optimistic. Resources needed for future HIV treatment and prevention are probably greater than previously forecast.
#traitement #prévention #VIH #modélisation #santé #afrique_du_sud
Deaths from acute abdominal conditions and geographical access to surgical care in India : a nationally representative spatial analysis - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00079-0/fulltext
Deaths from acute abdominal conditions, and likely other surgical emergencies, are strongly related to geographical access to well-resourced surgical facilities. About two-thirds of deaths from acute abdominal conditions in India could be averted by improving human and physical resources at existing district hospitals.
#chirurgie #accessibilité #santé #inde
A hospital too far—access to surgical facilities in India - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00148-5/fulltext
The recommendation for having a highly resourced district hospital within every 50 km for a country spread over 3 287 590 km2 with a population of 1·252 billion might not be immediately feasible, but does help set aspirational targets for India. Global surgery has got off to a delayed start, but basic life-saving surgery is now an accepted public health measure worthy of political attention.
The debate that shouldn’t be - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00101-1/fulltext
Women should not feel bullied or emotionally blackmailed into breastfeeding by one over-zealous section of society any more than they should be made to feel ashamed for breastfeeding in public by another. Breastmilk provided exclusively for at least 6 months is unequivocally the best nutrition a baby can receive; women and their families need respectful advice to make the choice wherever that is possible.
on dirait que le sujet attire les trolls
Generation of political priority for global #surgery: a qualitative policy analysis - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00098-4/fulltext?rss=yes
Several factors hinder the acquisition of attention and resources for #global_surgery. With respect to actor power, the global surgery community is fragmented, does not have unifying leadership, and is missing guiding institutions. Regarding ideas, community members disagree on how to address and publicly position the problem. With respect to political contexts, the community has made insufficient efforts to capitalise on political opportunities such as the Millennium Development Goals. Regarding issue characteristics, data on the burden of surgical diseases are limited and public misperceptions surrounding the cost and complexity of surgery are widespread. However, the community has several strengths that portend well for the acquisition of political support. These include the existence of networks deeply committed to the cause, the potential to link with global health priorities, and emerging research on the cost-effectiveness of some procedures.
#chirurgie #santé #santé_mondiale #politique_de_santé #inégalités #accès_aux_soins
La #télémédecine par #Internet se développe rapidement en #Chine
The internet hospital: an emerging innovation in China - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00042-X/fulltext
The internet enables people to overcome geographical obstacles to health-care access. Patients just need to visit their community health centre, village clinic, or a pharmacy nearby to obtain a consultancy and diagnosis from skilled doctors based in big cities. Doctors from the internet hospital can spend 10 min or more to communicate with each patient, whereas a clinic consultancy at a top-level hospital normally lasts only a few minutes.4 The satisfaction score is high according to the patients’ online assessment after the consultancy.5 Besides, it is much cheaper than outpatient costs for traditional hospital visits. The present cost of drugs of a prescription from the internet hospital is about ¥60 on average, only a quarter of the average cost of drugs from a top-level hospital.6
The internet hospital programme is still in the exploratory stage, and many problems remain to be solved, such as the incorporation of internet medical services into health insurance programmes, surveillance and quality control, the applicability of internet diagnoses for some diseases, possible medical disputes, and long-term return on investment. Nevertheless, this programme is developing at a substantial speed in China.
Syria: end sanctions and find a political solution to peace - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00046-7/fulltext?rss=yes
Syria is rapidly descending into hell, Iraq-style, and the global health community needs to wake up to the implications of this reality.
The economic losses of the country at the end of 2014 stood at US$143·8 billion,4 with more than 80% of the population living in poverty, of whom a third (32·6%) were in abject poverty, unable to obtain even basic food items. More than half of the population (52·8%) is displaced, of whom a third are internally displaced. Life expectancy has been reduced from 75·9 years in 2010 (one of the highest in the region for countries not part of the Gulf Cooperation Council) to 55·7 years in 2014—a loss of 20 years.4 The unemployment rate rose from 15%5 in 2011 to 55·7% in 2014, with more than 3 million losing work within the first 2 years of the conflict. The cost of basic food items has risen six-fold since 2010, although it varies regionally. With the exception of drugs for cancer and diabetes, Syria was 95% self-sufficient in terms of drug production before the war. This has virtually collapsed as have many hospitals and primary health-care centres.
Financing universal health coverage by cutting fossil fuel subsidies - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00007-8/fulltext
Worldwide, nearly half a trillion dollars were spent on fossil fuel subsidies in 2010.1 Although these subsidies were at first intended to protect poor people from high fuel costs, in practice they are more likely to benefit wealthy households, promote overconsumption of fuel, and discourage energy efficiency.
(...) Abolishment of fuel subsidies, however, is often difficult to pursue because of public opposition. Indeed some attempts to reduce fuel subsidies, such as those in Nigeria,4 Indonesia,5 and Sudan,6 have been met with violent protests. The perceived benefits of fossil fuel subsidies are apparent in daily life, and their removal is felt abruptly and immediately
(...) Rapid health-care reforms, however, have been shown to deliver tangible benefits to the population relatively quickly.7
Countries with high fuel subsidies and no universal health coverage scheme
#subventions pour le #pétrole vs. programmes de #santé_publique
Global access to surgical care: a modelling study - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70115-4/fulltext
The world’s population without access to surgical care is much greater than previously reported, since previous estimates relied on a rather narrow definition of access. In a world focusing on universal health coverage, the vision of the Lancet Commission on Global Surgery is universal access to safe, affordable surgical and anaesthesia care when needed. When all components of this vision are assessed, at least 4·8 billion people do not have access to surgical care. The burden of this inequity falls most heavily on the world’s rural poor. Expanding access to surgery and anaesthesia care will require a coordinated investment in surgical scale-up that grows the workforce, builds infrastructure, removes cultural and geographical barriers, and provides financial protection.
http://www.thelancet.com/cms/attachment/2031256772/2048412700/gr1.jpg 
http://www.thelancet.com/cms/attachment/2031256772/2048412698/gr3.jpg 
http://www.thelancet.com/cms/attachment/2031256772/2048412697/gr4.jpg #cartographie #santé #inégalités #chirurgie #accès_aux_soins
un article plus accessible
Global surgery gets a game plan, with Harvard players | Harvard Magazine Jul-Aug 2015
▻http://harvardmagazine.com/2015/07/surgery-for-all
Surgery has a role across the entire spectrum of human disease, and conditions that can be surgically treated represent about 30 percent of the global burden of illness. But high out-of-pocket surgical costs push 33 million people into financial catastrophe each year (and 48 million more when indirect costs like transportation are included). Achieving the commission’s 2030 goals would require a $420-billion investment. This staggering cost could yield major returns, though: the report projects that the lack of surgery and anesthesia would cost low- and middle-income countries $12.3 trillion in that span, a 2 percent drag on growth each year. During a talk at the conference, Gavin Yamey, a biostatistician at the University of California San Francisco School of Medicine, said,“Many surgeries are equally [as] cost-effective as other public-health measures.”
et bientôt un projet sur @visionscarto j’espère
Hospitals as debtor prisons - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70073-2/fulltext
In low-income and middle-income countries (LMICs), systematic research regarding the prevalence and personal consequences of patients who are unable to pay their medical bills has been scarce. However, news headlines frequently tell a simple story of detention—eg, “Kenyan mothers too poor to pay for treatment locked up in hospital”.1 Similar reports are found in Burundi,2 Ghana,3 India,4 Liberia,5 Nigeria,6 the Philippines,7 and Zimbabwe.8
(...)
The detention of patients by health facilities can be seen as a direct consequence of the imposition of user fees and and inadequate social welfare protections.
dommage que l’article n’évoque pas une autre variable d’ajustement, qui pourrait être le coût des traitements
Death and taxes - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70007-0/fulltext
China should take a (tobacco) leaf out of the book of its fellow middle-income-country, Brazil. Despite being the world’s third largest producer of tobacco products, Brazil’s tobacco control policies are highly advanced. Close, intelligent attention to taxation policy between 2006 and 2013 saw tax revenue rise by 48% over this period while cigarette sales declined by 32% and the number of smokers dropped by 20%. About 1 million deaths per year in China are tobacco-related, with the figure projected to increase to 3 million by 2050. The country can no longer afford to support an industry that is killing its people.
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70017-3/fulltext
Où mange-t-on le mieux dans le monde ?
Pour lire les #cartes : en haut, la consommation de “bons” aliments ; au milieu, la consommation de “mauvais” aliments. En bas, un mélange des deux critères.
Dietary quality among men and women in 187 countries in 1990 and 2010 : a systematic assessment - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70381-X/fulltext
In this systematic assessment, we evaluated global consumption of key dietary items (foods and nutrients) by region, nation, age, and sex in 1990 and 2010. Consumption data were evaluated from 325 surveys (71·7% nationally representative) covering 88·7% of the global adult population. Two types of dietary pattern were assessed: one reflecting greater consumption of ten healthy dietary items and the other based on lesser consumption of seven unhealthy dietary items.
#transition_nutritionnelle #alimentation #inégalités #régimes #santé
variations sur 20 ans :
