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1.
Int J Tuberc Lung Dis ; 25(5): 382-387, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1502726

ABSTRACT

In September 2018, all countries made a commitment at the first ever United Nations High-Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high-risk of TB disease between 2018 and 2022. In the WHO South-East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high-risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale-up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.


Subject(s)
Tuberculosis , Asia, Southeastern/epidemiology , Far East , Humans , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Tuberculosis/prevention & control , United Nations , World Health Organization
2.
PLoS Med ; 18(10): e1003831, 2021 10.
Article in English | MEDLINE | ID: covidwho-1477511

ABSTRACT

BACKGROUND: UNAIDS has established new program targets for 2025 to achieve the goal of eliminating AIDS as a public health threat by 2030. This study reports on efforts to use mathematical models to estimate the impact of achieving those targets. METHODS AND FINDINGS: We simulated the impact of achieving the targets at country level using the Goals model, a mathematical simulation model of HIV epidemic dynamics that includes the impact of prevention and treatment interventions. For 77 high-burden countries, we fit the model to surveillance and survey data for 1970 to 2020 and then projected the impact of achieving the targets for the period 2019 to 2030. Results from these 77 countries were extrapolated to produce estimates for 96 others. Goals model results were checked by comparing against projections done with the Optima HIV model and the AIDS Epidemic Model (AEM) for selected countries. We included estimates of the impact of societal enablers (access to justice and law reform, stigma and discrimination elimination, and gender equality) and the impact of Coronavirus Disease 2019 (COVID-19). Results show that achieving the 2025 targets would reduce new annual infections by 83% (71% to 86% across regions) and AIDS-related deaths by 78% (67% to 81% across regions) by 2025 compared to 2010. Lack of progress on societal enablers could endanger these achievements and result in as many as 2.6 million (44%) cumulative additional new HIV infections and 440,000 (54%) more AIDS-related deaths between 2020 and 2030 compared to full achievement of all targets. COVID-19-related disruptions could increase new HIV infections and AIDS-related deaths by 10% in the next 2 years, but targets could still be achieved by 2025. Study limitations include the reliance on self-reports for most data on behaviors, the use of intervention effect sizes from published studies that may overstate intervention impacts outside of controlled study settings, and the use of proxy countries to estimate the impact in countries with fewer than 4,000 annual HIV infections. CONCLUSIONS: The new targets for 2025 build on the progress made since 2010 and represent ambitious short-term goals. Achieving these targets would bring us close to the goals of reducing new HIV infections and AIDS-related deaths by 90% between 2010 and 2030. By 2025, global new infections and AIDS deaths would drop to 4.4 and 3.9 per 100,000 population, and the number of people living with HIV (PLHIV) would be declining. There would be 32 million people on treatment, and they would need continuing support for their lifetime. Incidence for the total global population would be below 0.15% everywhere. The number of PLHIV would start declining by 2023.


Subject(s)
Disease Eradication , Global Health , Goals , HIV Infections/prevention & control , Models, Biological , Models, Theoretical , Public Health , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/therapy , Adolescent , Adult , COVID-19 , Cause of Death , Epidemics , Female , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Incidence , Male , SARS-CoV-2 , Social Determinants of Health , United Nations , Young Adult
9.
J Int AIDS Soc ; 24 Suppl 5: e25779, 2021 09.
Article in English | MEDLINE | ID: covidwho-1442008

ABSTRACT

INTRODUCTION: Over the past 20 years, the response to the HIV epidemic has achieved remarkable results. These results have often been motivated by targets adopted by countries through United Nations (UN) Political Declarations on HIV. The 2016 political declaration included two impact targets, to achieve a 75% decline in new HIV infections and AIDS-related deaths between 2010 and 2020, and to reach the 90-90-90 testing and treatment targets by 2020. Our objective is to summarize progress towards these targets using robust and comparable HIV estimates released by UNAIDS in July 2021. In addition, we comment on the importance of targets and the modelled estimates required to quantify those targets. DISCUSSION: The UNAIDS estimates indicate that at the global and regional levels, the 2020 targets were missed: new infections declined by 31% and AIDS-related deaths declined by 47% between 2010 and 2020, compared to a target of 75% decline for both indicators. Similarly, no region achieved the 90-90-90 testing and treatment targets. Some countries, in diverse settings, achieved these targets showing that the targets were not overly ambitious if the right funding, policies and evidence-informed interventions at the right scale were in place. The 2021 UN Political Declaration on HIV, adopted on 8 June 2021, has set out a new set of ambitious but achievable targets for 2025. The 2025 targets and the required actions to reach those targets are described in the Global AIDS Strategy 2021-2026, which provides a framework to reprioritize HIV responses by reducing inequalities and building on the achievements of multiple Sustainable Development Goals. The Strategy encourages countries to monitor progress against targets for different geographic areas and populations to maximize equitable services and ensure accountability and also to understand why targets are being missed. CONCLUSIONS: The UNAIDS epidemiological estimates provide information that promote accountability and estimate progress towards global targets at the national level. Additional strategic information and analyses are required to identify the populations that are furthest from the targets and the programmes and policies that are keeping countries from meeting their targets.


Subject(s)
Epidemics , HIV Infections , Global Health , HIV Infections/diagnosis , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Sustainable Development , United Nations
10.
Curr HIV Res ; 19(2): 103-105, 2021.
Article in English | MEDLINE | ID: covidwho-1435695

ABSTRACT

In 2014, The Joint United Nations Program on HIV and AIDS (UNAIDS) has set an ambitious target code-named 90-90-90, which aims to ensure that 90% of all people living with HIV will know their state, 90% of all people diagnosed will receive sustained antiretroviral therapy, and 90% of all people receiving ART will have viral suppression by 2020. Since 2014, many tests and treatment programs have been developed to achieve the above goals worldwide. In 2019, it was reported that many developed countries can reach the target with the right strategies, as well as regions that are still far from the targets. It has been reported that the fourth 90 should be one of the targets related to HIV infection in recent years. This view, beyond virological suppression, was towards developing programs that would enable people living with HIV to live not only longer but also healthy. The socio-cultural and economic obstacles to reach the targets may vary according to geographical regions, but it is clear that COVID-19 disease, which has taken the whole world under the influence since 2019, is a major obstacle to the 90-90-90 targets worldwide. Difficulties in the diagnosis and access to ART and treatment nonadherence which may be encountered more frequently due to many factors may threaten both the health of people living with HIV and public health. The COVID-19 pandemic has disrupted many programs developed in the fight against the HIV epidemic. Considering COVID-19 disease and future epidemics that may create a chaotic environment, analyzing the difficulties experienced in the pandemic retrospectively, and determining new strategies that will bring appropriate solutions to the problems will play an important role in the proper management of future issues.


Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/prevention & control , Anti-Retroviral Agents/therapeutic use , COVID-19/drug therapy , HIV Infections/drug therapy , HIV Infections/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/epidemiology , HIV Infections/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , United Nations
12.
MMWR Morb Mortal Wkly Rep ; 70(12): 427-430, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1389866

ABSTRACT

Although tuberculosis (TB) is curable and preventable, in 2019, TB remained the leading cause of death from a single infectious agent worldwide and the leading cause of death among persons living with HIV infection (1). The World Health Organization's (WHO's) End TB Strategy set ambitious targets for 2020, including a 20% reduction in TB incidence and a 35% reduction in the number of TB deaths compared with 2015, as well as zero TB-affected households facing catastrophic costs (defined as costs exceeding 20% of annual household income) (2). In addition, during the 2018 United Nations High-Level Meeting on TB (UNHLM-TB), all member states committed to setting 2018-2022 targets that included provision of TB treatment to 40 million persons and TB preventive treatment (TPT) to 30 million persons, including 6 million persons living with HIV infection and 24 million household contacts of patients with confirmed TB (4 million aged <5 years and 20 million aged ≥5 years) (3,4). Annual data reported to WHO by 215 countries and territories, supplemented by surveys assessing TB prevalence and patient costs in some countries, were used to estimate TB incidence, the number of persons accessing TB curative and preventive treatment, and the percentage of TB-affected households facing catastrophic costs (1). Globally, TB illness developed in an estimated 10 million persons in 2019, representing a decline in incidence of 2.3% from 2018 and 9% since 2015. An estimated 1.4 million TB-related deaths occurred, a decline of 7% from 2018 and 14% since 2015. Although progress has been made, the world is not on track to achieve the 2020 End TB Strategy incidence and mortality targets (1). Efforts to expand access to TB curative and preventive treatment need to be substantially amplified for UNHLM-TB 2022 targets to be met.


Subject(s)
Disease Eradication , Global Health/statistics & numerical data , Tuberculosis/epidemiology , Tuberculosis/prevention & control , COVID-19 , Goals , Humans , Incidence , Tuberculosis/mortality , United Nations , World Health Organization
14.
Public Health ; 198: 171-173, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1373232

ABSTRACT

OBJECTIVES: To explore the association of gender inequality index (GII) with healthcare access and quality index (HAQI) for the male to female ratio of confirmed COVID-19 cases. STUDY DESIGN: Secondary analysis of COVID-19 cases with GII and HAQI datasets. METHODS: Data for sex-disaggregated COVID-19 cases were collected from Global Health 50/50, for GII from the United Nations Development Programme (UNDP) and for HAQI from the Institute for Health Metrics and Evaluation (IHME). We used Spearman's correlation in SPSS version 23 to evaluate the association between the variables. RESULTS: Cambodia had the highest male to female ratio (M:F) of 4.08:1, followed by Pakistan (M:F = 2.85:1) and Nepal (M:F = 2.69:1). We observed a positive correlation between GII and M:F ratio (Spearman's rho = 0.681, P-value <0.001) and a negative correlation between HAQI and M:F ratio (Spearman's rho = -0.676, P-value <0.001). CONCLUSIONS: Countries with institutionalised gender disparities and poor healthcare access and quality tend to have higher M:F ratios of confirmed COVID-19 cases; thus, highlighting underutilisation of testing services, influenced by multiple individuals, social and policy factors. Robust gender-based data are required to understand disparities throughout the continuum of care and to devise gender-responsive pandemic strategies.


Subject(s)
COVID-19 , Pandemics , Female , Global Health , Humans , Male , SARS-CoV-2 , United Nations
15.
Sci Total Environ ; 800: 149605, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1351833

ABSTRACT

The COVID-19 pandemic and the ensuing socioeconomic crisis has impeded progress towards the UN Sustainable Development Goals (UN-SDGs). This paper investigates the impact of COVID 19 on the progress of the SDGs and provides insight into how green recovery stimulus, driven by circular economy (CE)-based solid waste management (SWM) could assist in attaining the intended targets of UN-SDG. It was understood in this review that the guiding principles of the UN-SDGs such as, public health, environmental concerns, resource value and economic development are similar to those that have driven the growth of waste management activities; thus, in order to achieve the goals of UN-SDG, a circular economy approach in solid waste management system should be prioritized in the post-COVID economic agenda. However, policy, technology and public involvement issues may hinder the shift to the CE model; therefore, niche growth might come from developing distinctive waste management-driven green jobs, formalizing informal waste pickers and by focusing in education and training of informal worker. The review also emphasized in creating green jobs by investing in recycling infrastructure which would enable us to address the climate change related concerns which is one of the key target of UN- SDG. The CE-based product designs and business models would emphasize multifunctional goods, extending the lifespan of products and their parts, and intelligent manufacturing to help the public and private sectors maximise product utility (thus reducing waste generation) while providing long-term economic and environmental benefits. The study also recommended strong policies that prioritized investments in decentralization of solid waste systems, localization of supply chains, recycling and green recovery, information sharing, and international collaboration in order to achieve the UN-SDGs.


Subject(s)
COVID-19 , Refuse Disposal , Waste Management , Humans , Pandemics , Recycling , SARS-CoV-2 , Solid Waste/analysis , Sustainable Development , United Nations
18.
BMJ Glob Health ; 6(3)2021 03.
Article in English | MEDLINE | ID: covidwho-1311149

ABSTRACT

INTRODUCTION: The initial International Conference on Population and Development in 1994 contains the first reference to sexual and reproductive health and reproductive rights (SRHR). It has been considered agreed language on SRHR in future United Nations (UN) documents. However, opposition to SRHR in global forums has increased, including in conjunction with an increase in religious, far-right populist politics. This study provides an empirical analysis of UN documents to discover whether opposition to SRHR has resulted in changes in the language on SRHR between and what these changes are. METHODS: This is a qualitative policy analysis in which 14 UN resolutions, 6 outcome documents from the Commission on the Status of Women (CSW) and 522 country and group statements and 5 outcome reports from the Commission on Population and Development were collected from the organisations websites from 2014 to 2019. Framework analysis was used. The text from documents was charted and indexed and themes developed from these. RESULTS: The results demonstrated a disappearance of the language on abortion in the CSW outcome documents from 2017 and a change in the language on comprehensive sexuality education in the CSW as well as the UN General Assembly resolutions from 2018. This change included a removal of 'sexuality' to an increased emphasis on the role of families. Furthermore, documents showed an inability of some states to accept any mention of sexual and reproductive health at all, expanding from the usual contestations over abortion. CONCLUSION: Our findings suggest that the global shift in politics and anti-SRHR actors at UN negotiations and conferences have removed previously agreed on language on SRHR from future UN resolutions and outcome documents. This is a concern for the global realisation of SRHR.


Subject(s)
Reproductive Health , Right to Health , Female , Global Health , Humans , Pregnancy , Reproductive Rights , United Nations
19.
Hastings Cent Rep ; 51(4): 7-8, 2021 07.
Article in English | MEDLINE | ID: covidwho-1306646

ABSTRACT

One of the biggest policy interventions during the last year of the COVID-19 pandemic was the Coronavirus Aid, Relief, and Economic Securities Act, instituting a novel form of economic relief similar to a universal basic income. The economic impact payments, colloquially known as "stimulus checks," were distributed based on the socioeconomic status of American citizens and legal residents and provided much-needed financial aid. However, the distribution of these payments paid little attention to other important factors that might determine the economic security of said individuals, such as race and gender. This article calls for policy-makers to pay particular attention to how structural inequity and discrimination based on identity could affect the efficacy of proposed policies and demonstrate an ethic of care informed by an understanding of intersectionality.


Subject(s)
COVID-19/economics , COVID-19/epidemiology , Cost of Illness , Economics, Behavioral/statistics & numerical data , Healthcare Financing/ethics , Health Behavior/ethics , Health Services Accessibility/economics , Humans , United Nations , United States
20.
Nutrients ; 13(7)2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1302429

ABSTRACT

Widespread food insecurity has emerged as a global humanitarian crisis during the coronavirus disease 2019 (COVID-19) pandemic. In response, international non-governmental organizations (INGOs) and United Nations (UN) agencies have mobilized to address the food security needs among different populations. The objective of this review was to identify and describe food security interventions implemented by INGOs and UN agencies during the early stages of the pandemic. Using a rapid review methodology, we reviewed food security interventions implemented by five INGOs and three UN agencies between 31 December 2019 and 31 May 2020. Descriptive statistical and content analyses were used to explore the extent, range, and nature of these interventions. In total, 416 interventions were identified across 107 low- and middle-income countries. Non-state actors have developed new interventions to directly respond to the food security needs created by the pandemic. In addition, these humanitarian organizations have adapted (e.g., new public health protocols, use of technology) and reframed existing initiatives to position their efforts in the context of the pandemic. These findings provide a useful baseline to monitor how non-state actors, in addition to the food security interventions these organizations implement, continue to be influenced by the pandemic. In addition, these findings provide insights into the different ways in which INGOs and UN agencies mobilized resources during the early and uncertain stages of the pandemic.


Subject(s)
COVID-19/epidemiology , Developing Countries , Food Security , Relief Work , Food Security/methods , Food Supply , Humans , Organizations , United Nations
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