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Background Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19. Methods We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review. Results The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as “cytokine storm”. Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients. Conclusions Thus, the evidence points out to ‘business as usual’ disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.

Background In March 2024, Egypt enacted Law No. 87, permitting private sector management of public healthcare facilities. The timing of the law reflects the intersection of domestic challenges including fiscal pressure, institutional capacity constraints, and limitations in public health service delivery, and global policy influences, including neoliberal approaches to economic development. This study analyses the law’s underlying drivers and assesses its anticipated implications for equity, access, and health system governance. Methods A critical political economy of health framework guided this qualitative study. We conducted a multi-level policy analysis of Law No. 87 and relevant regulatory texts, supported by a desk review of scholarly and grey literature. To enhance contextual depth and triangulate findings, we convened a multidisciplinary roundtable with 14 experts from government, academia, civil society, and development agencies. Transcripts were thematically analysed. Results Findings indicate that Law No. 87 reflects a broader policy trajectory of the adoption of neoliberal economic development, which in the health sector, signals a major health policy shift. For the first time, the private sector is provided a legal framework to manage public health facilities. While some experts viewed it as a necessary, efficiency-oriented reform that would improve quality of health services, others flagged concerns over vague regulatory provisions, limited public oversight, and weak implementation capacity. The absence of community participation and explicit equity safeguards raised further concerns about the law’s ability to advance inclusive and accountable health system governance. Conclusion Law No. 87 signals a major shift in the governance of public healthcare in Egypt. Beyond efficiency goals, its long-term impact will depend on the state’s capacity to regulate, monitor, and steer implementation toward equity objectives. Addressing gaps in accountability, ensuring stakeholder participation, and articulating clear equity safeguards will be essential for aligning the reform with Egypt’s commitments to universal health coverage and protecting the public interest.

The prevalence of overweight and obesity in Saudi Arabia has been rising. Although the health burden of excess weight is well established, little is known about the economic burden. To assess the economic burden-both direct medical costs and the value of absenteeism and presenteeism-resulting from overweight and obesity in Saudi Arabia. The cost of overweight and obesity in Saudi Arabia was estimated from a societal perspective using an epidemiologic approach. Data were obtained from previously published studies and secondary databases. Overweight/obesity-attributable costs were calculated for six major noncommunicable diseases; sensitivity analyses were conducted for key model parameters. The impact of overweight and obesity for these diseases is found to directly cost a total of $3.8 billion, equal to 4.3 percent of total health expenditures in Saudi Arabia in 2019. Estimated overweight and obesity-attributable absenteeism and presenteeism costs a total of $15.5 billion, equal to 0.9 percent of GDP in 2019. Even when limited to six diseases and a subset of total indirect costs, results indicate that overweight and obesity are a significant economic burden in Saudi Arabia. Future studies should identify strategies to reduce the health and economic burden resulting from excess weight in Saudi Arabia.

Background The Kingdom of Saudi Arabia (KSA) quickly controlled the spread of SARS-CoV-2 by implementing several non-pharmaceutical interventions (NPIs), including suspension of international and national travel, local curfews, closing public spaces (i.e., schools and universities, malls and shops), and limiting religious gatherings. The KSA also mandated all citizens to respect physical distancing and to wear face masks. However, after relaxing some restrictions during June 2020, the KSA is now planning a strategy that could allow resuming in-person education and international travel. The aim of our study was to evaluate the effect of NPIs on the spread of the COVID-19 and test strategies to open schools and resume international travel. Methods We built a spatial-explicit individual-based model to represent the whole KSA population (IBM-KSA). The IBM-KSA was parameterized using country demographic, remote sensing, and epidemiological data. A social network was created to represent contact heterogeneity and interaction among age groups of the population. The IBM-KSA also simulated the movement of people across the country based on a gravity model. We used the IBM-KSA to evaluate the effect of different NPIs adopted by the KSA (physical distancing, mask-wearing, and contact tracing) and to forecast the impact of strategies to open schools and resume international travels. Results The IBM-KSA results scenarios showed the high effectiveness of mask-wearing, physical distancing, and contact tracing in controlling the spread of the disease. Without NPIs, the KSA could have reported 4,824,065 (95% CI: 3,673,775–6,335,423) cases by June 2021. The IBM-KSA showed that mandatory mask-wearing and physical distancing saved 39,452 lives (95% CI: 26,641–44,494). In-person education without personal protection during teaching would have resulted in a high surge of COVID-19 cases. Compared to scenarios with no personal protection, enforcing mask-wearing and physical distancing in schools reduced cases, hospitalizations, and deaths by 25% and 50%, when adherence to these NPIs was set to 50% and 70%, respectively. The IBM-KSA also showed that a quarantine imposed on international travelers reduced the probability of outbreaks in the country. Conclusions This study showed that the interventions adopted by the KSA were able to control the spread of SARS-CoV-2 in the absence of a vaccine. In-person education should be resumed only if NPIs could be applied in schools and universities. International travel can be resumed but with strict quarantine rules. The KSA needs to keep strict NPIs in place until a high fraction of the population is vaccinated in order to reduce hospitalizations and deaths.

This report is organized in such a way that the key policy options and strategic priorities are based on the country context, including the burden of non-communicable diseases (NCDs) and associated risk factors and the existing capacity of the health system. Chapter one describes the country and regional contexts and the evidence of the demographic and epidemiological transitions in Bangladesh; chapter two outlines the disease burden of major NCDs, including the equity and economic impact and the common risk factors; chapter three provides an assessment of the health system and its capacity to prevent and control major NCDs; chapter four summarizes ongoing NCD interventions and activities in Bangladesh and highlights the remaining gaps and challenges; and chapter five presents key policy options and strategic priorities to prevent and control NCDs.

Background Promoting physical activity (PA) has been one of the key strategic priorities in Saudi Arabia. At the population level, policies targeting PA can potentially enhance health and well-being. One of the objectives of the Quality-of-Life Program within the Saudi Vision 2030 is to increase public participation in sports and PA. The present paper describes the outcomes of a participatory workshop focusing on stakeholder perceptions of the current state of surveillance of PA and monitoring and evaluation (M&E) of PA programs and initiatives. Methods A workshop was organized fostering a discussion between 29 key attendees from 8 different government entities and other organizations representing the policymakers, researchers, planners, and implementers of programs that focus on promoting or evaluating PA. Stakeholder perceptions on the current state of M&E and surveillance of PA were gathered. A list of actions generated from the identified gaps in the established programs was created, and areas of opportunities for collaboration were identified. Results The stakeholder discussion highlighted key themes related to PA surveillance, M&E, including the perceived strengths and challenges and the key priority actions to address the gaps. Additional important steps include creating a national strategy and action plan for PA, with M&E framework that comprises key goals, targets, indicators, unified data collection methods, and guidance on ensuring coordinated and wide dissemination. Conclusion M&E of PA in Saudi Arabia requires a multi-stakeholder, multi-sectoral approach, facilitated by creating a specialized governance and leadership committee. Some recommendations include establishing a multi-sectoral structure to lead PA in Saudi Arabia and developing mechanisms for sharing experiences and knowledge. Policymakers need to embrace such an agenda and advance discussions on the scope and structure of M&E and surveillance systems for PA.

South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions. Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes? Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women's education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction. The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.