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Characterizing the HIV/AIDS epidemic in the Middle East and North Africa : time for strategic action
Despite a fair amount of progress on understanding human immunodeficiency virus (HIV) epidemiology globally, the Middle East and North Africa (MENA) region is the only region where knowledge of the epidemic continues to be very limited, and subject to much controversy. It has been more than 25 years since the discovery of HIV, but no scientific study has provided a comprehensive data-driven synthesis of HIV/AIDS (acquired immunodeficiency syndrome) infectious spread in this region. The current report provides the first comprehensive scientific assessment and data-driven epidemiological synthesis of HIV spread in MENA since the beginning of the epidemic. It is based on a literature review and analysis of thousands of widely unrecognized publications, reports, and data sources extracted from scientific literature or collected from sources at the local, national, and regional levels. The recommendations provided here focus on key strategies related to the scope of this report and its emphasis on understanding HIV epidemiology in MENA as a whole. The recommendations are based on identifying the status of the HIV epidemic in MENA, through this synthesis, as a low HIV prevalence setting with rising concentrated epidemics among priority populations. General directions for prevention interventions as warranted by the outcome of this synthesis are also discussed briefly, but are not delineated because they are beyond the scope of this report. This report was not intended to provide intervention recommendations for each MENA country.
eBook
Systems thinking for health systems strengthening
Many developing countries are looking to scale-up what works through major systems strengthening investments. With leadership, conviction and commitment, systems thinking can facilitate and accelerate the strengthening of systems to more effectively deliver interventions to those in need and be better able to improve health in an equitable way. Systems thinking is not a panacea. Its application does not mean that resolving problems and weaknesses will come easily or naturally or without overcoming the inertia of the established way of doing things. But it will identify, with more precision, where some of the true blockages and challenges lie. It will help to: 1) explore these problems from a systems perspective; 2) show potentials of solutions that work across sub-systems; 3) promote dynamic networks of diverse stakeholders; 4) inspire learning; and 5) foster more system-wide planning, evaluation and research. And it will increase the likelihood that health system strengthening investments and interventions will be effective. The more often and more comprehensively the actors and components of the system can talk to each other from within a common framework --communicating, sharing, problem-solving - the better chance any initiative to strengthen health systems has. Real progress will undoubtedly require time, significant change, and momentum to build capacity across the system. However, the change is necessary - and needed now. This report therefore speaks to health system stewards, researchers and funders and maps out a set of strategies and activities to harness these approaches, to link them to these emerging opportunities and to assist systems thinking to become the norm in design and evaluation of interventions in health systems. But, the final message is to the funders of health system strengthening and health systems research who will
need to recognize the potential in these opportunities, be prepared to take risks in investing in such innovations, and play an active role in both driving and following this agenda towards more systemic and evidence-informed health development.
eBook
Toward Improved Public Health Outcomes From Urban Nature
There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.
Journal Article
Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health
The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels.
Journal Article
National cancer control plans: a global analysis
There is increasing global recognition that national cancer plans are crucial to effectively address the cancer burden and to prioritise and coordinate programmes. We did a global analysis of available national cancer-related health plans using a standardised assessment questionnaire to assess their inclusion of elements that characterise an effective cancer plan and, thereby, improve understanding of the strengths and limitations of existing plans. The results show progress in the development of cancer plans, as well as in the inclusion of stakeholders in plan development, but little evidence of their implementation. Areas of continued unmet need include setting of realistic priorities, specification of programmes for cancer management, allocation of appropriate budgets, monitoring and evaluation of plan implementation, promotion of research, and strengthening of information systems. We found that countries with a non-communicable disease (NCD) plan but no national cancer control plan (NCCP) were less likely than countries with an NCCP and NCP plan or an NCCP only to have comprehensive, coherent, or consistent plans. As countries move towards universal health coverage, greater emphasis is needed on developing NCCPs that are evidence based, financed, and implemented to ensure translation into action.
Journal Article