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2.
Salud Colect ; 16: e2897, 2020 10 17.
Article in Spanish | MEDLINE | ID: covidwho-1608979

ABSTRACT

Taking into account the latent threat of future pandemics, the objective of this study is to analyze - particularly with respect to medications - the sustainability of the health system, healthcare coverage, budgetary efficiency, and connections with the pharmaceutical patent system. In this context, the pharmaceutical patent system acts as a determining factor, given that promoting its existence stimulates the production of research, but in turn its existence stands in the way of rapid advancements, primarily due to the development of protective legislation concerning patents, which has largely accommodated the industry. Given that the pharmaceutical industry has managed to extend the duration of patents and avoid the incorporation of generics, our analysis focuses on the influence of pharmaceutical patents; this influence has led to reflection on the possibility of combining efforts by forging alliances between numerous companies and the public sector in order to face the challenges posed by new diseases caused by viruses that give rise to epidemics and pandemics.


Ante la amenaza latente de futuras pandemias, este estudio tiene como objetivo analizar ­desde el eje de los medicamentos­ la sostenibilidad del sistema sanitario, la cobertura, la eficiencia del gasto y su vinculación al sistema de patentes farmacéuticas. En este marco, el sistema de patentes farmacéuticas adquiere un papel determinante, dado que fomentar su existencia estimula la producción de investigación pero, a su vez, su existencia no suscita un rápido avance, debido al desarrollo legislativo protector que han tenido las patentes y que ha dado lugar a un acomodamiento de la industria. Como la industria farmacéutica ha conseguido extender la duración de patentes y evitar la incorporación de genéricos, se analiza la influencia de las patentes farmacéuticas que ha dado lugar a reflexionar acerca de la posibilidad de consorciar esfuerzos realizando alianzas entre varias empresas y el sector público para afrontar los retos que plantean nuevas enfermedades producidas por virus que dan lugar a epidemias y pandemias.


Subject(s)
Antiviral Agents , Drug Costs , Drug Industry/organization & administration , Health Policy , Health Services Accessibility/organization & administration , Patents as Topic , Virus Diseases/drug therapy , Antiviral Agents/economics , Antiviral Agents/therapeutic use , Drugs, Generic , Global Health , Humans , Pandemics , Program Evaluation , Virus Diseases/economics , Virus Diseases/epidemiology , Virus Diseases/prevention & control
4.
J Nurs Adm ; 51(11): 537-540, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1598846

ABSTRACT

Nurses and nurse leaders are working in unprecedented intense and demanding environments, and the COVID-19 pandemic continues to place strain on their mental well-being. If stressful work conditions remain at extraordinary high levels, nurses and leaders may ultimately leave their positions, creating even more uncertainty in the workforce. Enhancing individual resilience has become a superficial response in retaining nurses during a global nursing shortage. We argue that resilience is not solely an individual responsibility. Rather, resilience it is a mutual responsibility between the individual and the organization. In this article, we discuss how nurse leaders can foster organizational resilience while also enhancing their own individual resilience within the current pandemic environment, and as we transition to a post-COVID environment.


Subject(s)
COVID-19 , Health Workforce , Nurse Administrators , Nurses/psychology , Resilience, Psychological , Global Health , Humans , Job Satisfaction , Mental Health , Nurse Administrators/organization & administration , Nurse Administrators/psychology
6.
Lancet ; 398(10299): 522-534, 2021 08 07.
Article in English | MEDLINE | ID: covidwho-1592159

ABSTRACT

BACKGROUND: The COVID-19 pandemic and efforts to reduce SARS-CoV-2 transmission substantially affected health services worldwide. To better understand the impact of the pandemic on childhood routine immunisation, we estimated disruptions in vaccine coverage associated with the pandemic in 2020, globally and by Global Burden of Disease (GBD) super-region. METHODS: For this analysis we used a two-step hierarchical random spline modelling approach to estimate global and regional disruptions to routine immunisation using administrative data and reports from electronic immunisation systems, with mobility data as a model input. Paired with estimates of vaccine coverage expected in the absence of COVID-19, which were derived from vaccine coverage models from GBD 2020, Release 1 (GBD 2020 R1), we estimated the number of children who missed routinely delivered doses of the third-dose diphtheria-tetanus-pertussis (DTP3) vaccine and first-dose measles-containing vaccine (MCV1) in 2020. FINDINGS: Globally, in 2020, estimated vaccine coverage was 76·7% (95% uncertainty interval 74·3-78·6) for DTP3 and 78·9% (74·8-81·9) for MCV1, representing relative reductions of 7·7% (6·0-10·1) for DTP3 and 7·9% (5·2-11·7) for MCV1, compared to expected doses delivered in the absence of the COVID-19 pandemic. From January to December, 2020, we estimated that 30·0 million (27·6-33·1) children missed doses of DTP3 and 27·2 million (23·4-32·5) children missed MCV1 doses. Compared to expected gaps in coverage for eligible children in 2020, these estimates represented an additional 8·5 million (6·5-11·6) children not routinely vaccinated with DTP3 and an additional 8·9 million (5·7-13·7) children not routinely vaccinated with MCV1 attributable to the COVID-19 pandemic. Globally, monthly disruptions were highest in April, 2020, across all GBD super-regions, with 4·6 million (4·0-5·4) children missing doses of DTP3 and 4·4 million (3·7-5·2) children missing doses of MCV1. Every GBD super-region saw reductions in vaccine coverage in March and April, with the most severe annual impacts in north Africa and the Middle East, south Asia, and Latin America and the Caribbean. We estimated the lowest annual reductions in vaccine delivery in sub-Saharan Africa, where disruptions remained minimal throughout the year. For some super-regions, including southeast Asia, east Asia, and Oceania for both DTP3 and MCV1, the high-income super-region for DTP3, and south Asia for MCV1, estimates suggest that monthly doses were delivered at or above expected levels during the second half of 2020. INTERPRETATION: Routine immunisation services faced stark challenges in 2020, with the COVID-19 pandemic causing the most widespread and largest global disruption in recent history. Although the latest coverage trajectories point towards recovery in some regions, a combination of lagging catch-up immunisation services, continued SARS-CoV-2 transmission, and persistent gaps in vaccine coverage before the pandemic still left millions of children under-vaccinated or unvaccinated against preventable diseases at the end of 2020, and these gaps are likely to extend throughout 2021. Strengthening routine immunisation data systems and efforts to target resources and outreach will be essential to minimise the risk of vaccine-preventable disease outbreaks, reach children who missed routine vaccine doses during the pandemic, and accelerate progress towards higher and more equitable vaccination coverage over the next decade. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
COVID-19 , Diphtheria-Tetanus-Pertussis Vaccine , Measles Vaccine , Vaccination Coverage/statistics & numerical data , Child , Global Health , Humans , Models, Statistical
7.
Lancet ; 398(10312): 1700-1712, 2021 11 06.
Article in English | MEDLINE | ID: covidwho-1590727

ABSTRACT

BACKGROUND: Before 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative. In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020. METHODS: We conducted a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021. We searched PubMed, Google Scholar, preprint servers, grey literature sources, and consulted experts. Eligible studies reported prevalence of depressive or anxiety disorders that were representative of the general population during the COVID-19 pandemic and had a pre-pandemic baseline. We used the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate). We then used this model to estimate the change from pre-pandemic prevalence (estimated using Disease Modelling Meta-Regression version 2.1 [known as DisMod-MR 2.1]) by age, sex, and location. We used final prevalence estimates and disability weights to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders. FINDINGS: We identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [B] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males (B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (-0·007 [-0·009 to -0·006; p=0·0001] for major depressive disorder, -0·003 [-0·005 to -0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020. INTERPRETATION: This pandemic has created an increased urgency to strengthen mental health systems in most countries. Mitigation strategies could incorporate ways to promote mental wellbeing and target determinants of poor mental health and interventions to treat those with a mental disorder. Taking no action to address the burden of major depressive disorder and anxiety disorders should not be an option. FUNDING: Queensland Health, National Health and Medical Research Council, and the Bill and Melinda Gates Foundation.


Subject(s)
Anxiety Disorders/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Global Burden of Disease , Global Health , Humans , Pandemics , Prevalence , SARS-CoV-2 , Surveys and Questionnaires
8.
Ann Glob Health ; 87(1): 124, 2021.
Article in English | MEDLINE | ID: covidwho-1597785

ABSTRACT

Introduction: Worldwide mass vaccination against SARS-CoV-2, while having been the most critical action in combating further waves of COVID-19, was initially fraught with multiple infrastructural and socio-cultural challenges. Vaccine hesitancy, a phenomenon of doubt over the vaccines' claimed efficacy and/or safety amidst access to vaccination, emerged as a major challenge for global health, despite approval and regular post-marketing surveillance by major regulatory bodies. Methods: We reviewed the literature related to vaccine hesitancy in India published until November 14, 2021 using relevant keywords in various databases and examined it from a bioethical perspective. Results: Factors driving hesitancy either intensified skepticism towards vaccination in general or exacerbated reluctance towards specific vaccines. In India, hesitancy towards indigenously developed vaccines was aggravated by the lack of peer-reviewed phase III trial data before the start of vaccination, lack of public transparency of regulatory bodies, and presence of public perception of inappropriately expedited processes. This perspective piece discusses the state of mass immunization in India as a case of how vaccination and its hesitancy thereof gave rise to unique bioethical challenges in global health. In early 2021, vaccination in India was subject to difficulties in adhering to the principles of equity and justice, while a compromise of the principles of informed consent, beneficence, and non-maleficence also perhaps did occur. Conclusions: Post-pandemic debriefing on the subversion of bioethical principles will be needed, and an appropriate response may be required to rebuild and enhance the public faith in future mass vaccination movements.


Subject(s)
Bioethics , COVID-19 , COVID-19 Vaccines , Global Health , Humans , SARS-CoV-2 , Vaccination
9.
PLoS One ; 16(12): e0261832, 2021.
Article in English | MEDLINE | ID: covidwho-1595434

ABSTRACT

The objective of this study was to evaluate the relationships of food safety knowledge, attitude and eating behavior of consumers during national lockdowns in the advent of the COVID-19 pandemic. A total of 157 respondents completed the online survey using a structured questionnaire worldwide. Overall, the respondents exhibited good attitude and good knowledge towards public health including food safety especially on the importance of social distancing, mask wearing, well-balanced diet, physical exercise and personal hygiene, such as hand washing during the pandemic lockdowns. A Structural Equation Modeling (SEM) was used to test the relationships among food safety knowledge, attitude and behavior under the pandemic conditions. Results showed that attitude towards food safety under the coronavirus pandemic and lockdowns positively affected the eating behavior of the respondents, which exhibited a high ß (0.686) among the variables tested (p<0.05). Food safety knowledge was apparently not affected by the food safety behavior of the respondents.


Subject(s)
COVID-19/epidemiology , Feeding Behavior/psychology , Food Safety , Health Knowledge, Attitudes, Practice , Pandemics , Adolescent , Adult , Aged , Female , Global Health , Hand Disinfection , Health Behavior , Humans , Male , Middle Aged , Pilot Projects , Public Health , Surveys and Questionnaires , Young Adult
10.
Science ; 374(6575): 1546, 2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1592448
11.
J Korean Med Sci ; 36(49): e345, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1581389

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandemic, publications on the disease have exploded globally. The present study analyzed PubMed and KoreaMed indexed COVID-19 publications by Korean researchers from January 1, 2020 to August 19, 2021. A total of 83,549 COVID-19 articles were recorded in PubMed and 1,875 of these were published by Korean authors in 673 journals (67 Korean and 606 overseas journals). The KoreaMed platform covered 766 articles on COVID-19, including 612 by Korean authors. Among the Journal of Korean Medical Science (JKMS) articles on COVID-19, PubMed covered 176 and KoreaMed 141 documents. Korean researchers contributed to 2.2% of global publications on COVID-19 in PubMed. The JKMS has published most articles on COVID-19 in Korea.


Subject(s)
Bibliographies as Topic , COVID-19/epidemiology , Periodicals as Topic , PubMed , Publications , Abstracting and Indexing , Databases, Bibliographic , Global Health , Humans , Republic of Korea , SARS-CoV-2
12.
Health Res Policy Syst ; 19(1): 152, 2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1577206

ABSTRACT

BACKGROUND: The steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran. METHODS: This study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis. RESULTS: The identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system. CONCLUSIONS: NCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.


Subject(s)
Diplomacy , Noncommunicable Diseases , Global Health , Health Policy , Humans , Iran , Noncommunicable Diseases/prevention & control
16.
Lancet Planet Health ; 5(11): e827-e839, 2021 11.
Article in English | MEDLINE | ID: covidwho-1574137

ABSTRACT

COVID-19 is disrupting and transforming the world. We argue that transformations catalysed by this pandemic should be used to improve human and planetary health and wellbeing. This paradigm shift requires decision makers and policy makers to go beyond building back better, by nesting the economic domain of sustainable development within social and environmental domains. Drawing on the engage, assess, align, accelerate, and account (E4As) approach to implementing the 2030 Agenda for Sustainable Development, we explore the implications of this kind of radical transformative change, focusing particularly on the role of the health sector. We conclude that a recovery and transition from the COVID-19 pandemic that delivers the future humanity wants and needs requires more than a technical understanding of the transformation at hand. It also requires commitment and courage from leaders and policy makers to challenge dominant constructs and to work towards a truly thriving, equitable, and sustainable future to create a world where economic development is not an end goal itself, but a means to secure the health and wellbeing of people and the planet.


Subject(s)
COVID-19 , Global Health , Pandemics , COVID-19/epidemiology , Forecasting , Global Health/trends , Humans , Sustainable Development
18.
J Glob Health ; 11: 04071, 2021.
Article in English | MEDLINE | ID: covidwho-1575070

ABSTRACT

Background: This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods: We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results: We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. Conclusions: We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.


Subject(s)
COVID-19 , Adolescent , Adolescent Health , Child , Child Health , Female , Global Health , Humans , Infant, Newborn , Pandemics , Research , SARS-CoV-2
19.
J Infect Dev Ctries ; 15(11): 1630-1639, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1572713

ABSTRACT

INTRODUCTION: Numerous reviews, commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). IL-17A is a proinflammatory cytokine attributed with homeostatic roles but that is also involved in autoimmune disease pathogenesis. While some studies have reported an increase in IL-17A in COVID-19 cases, no significant associations were found by others. Hence, we undertook this meta-analysis to study serum IL-17A levels in COVID-19 patients in relation to disease severity. METHODOLOGY: Multiple databases were systematically reviewed for literature published on the topic from January 1, 2019 to April 30, 2021. A random effects model was used to calculate weighted mean differences (WMDs) and 95% confidence interval (CIs) as well as the t2 and I2 statistics for heterogeneity analysis. RESULTS: We report that IL-17A increases in COVID-19 subjects irrespective of disease severity compared to controls [WMD = 2.51 pg/ml (95% CI 1.73-3.28), p < 0.00001]. It is also higher in patients with moderate disease compared to controls [WMD = 2.41 pg/ml (95% CI:1.40-3.43), p < 0.00001] as well as higher in patients with severe COVID-19 [WMD = 4.13 pg/ml (95% CI:1.65-6.60), p = 0.001]. While the increase in serum levels in subjects with severe disease over those with moderate disease was statistically significant, the association was not as robust as the other comparisons [WMD = 2.07 pg/ml (95% CI:0.20-3.95), p = 0.03]. Variable heterogeneity was observed in the various analyses with no significant publication bias detected. CONCLUSIONS: Hence, IL-17A may be of relevance when considering management approaches to COVID-19.


Subject(s)
COVID-19/blood , Interleukin-17/blood , SARS-CoV-2 , Global Health , Humans , Pandemics
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