Innovative sources for funding of viral hepatitis prevention and treatment in low- and middle-income countries: a roundtable meeting report.

Hepatitis B is preventable and hepatitis C is treatable even if still at a high cost; most people who are infected with hepatitis B or C virus have not been screened yet and are unaware of their infections; and most countries, especially developing countries, do not have a national plan to prevent and control viral hepatitis. The advent of effective new treatments for hepatitis C has been an agent of change, allowing consideration of the feasibility of eliminating that disease and accelerating the control of viral hepatitis generally. These facts inspired the Viral Hepatitis Prevention Board (VHPB) to organize a meeting in London (8-9 June 2015) on innovative sources for funding of viral hepatitis prevention and treatment in low- and middle-income countries. The main focus of the meeting was to provide an overview of current health systems controlling viral hepatitis in low- and middle-income countries (LMICs); to identify ways to increase political commitment and financial sustainability of viral hepatitis prevention and control programmes in such countries; to identify potential funders and explore new funding mechanisms; to discuss lessons learnt about funding other disease programmes; to investigate how to convince and motivate decision-makers to fund viral hepatitis programmes in LMICs; to provide options for improving access to affordable screening and treatment of viral hepatitis in LMICs; and to list the commitments required for funding by donors, including governments, bilateral and multilateral organizations, non-traditional donors, development banks, foundations, and commercial financial institutions. To improve viral hepatitis prevention and treatment in LMICs participating hepatitis and financing experts identified the most urgent needs. Data on burden of disease must be improved. Comprehensive hepatitis policies and strategies should be drafted and implemented, and existing strategies and policies improved to increase access to treatment and prevention. Strong political will and leadership should be generated, potential partners identified and partnerships created. Potential funders and funding mechanisms have to be researched. The outcome of this meeting was integrated in a VHPB project to investigate creative financing solutions to expand access to and provision of screening and other preventive services, treatment and care of hepatitis B and C in LMICs. The report is available on www.vhpb.org.

Psychological distress, depression and generalised anxiety in Turkish and Moroccan immigrants in Belgium: a general population study.

BACKGROUND: This study assesses the prevalence of and risk and protective factors for common mental health complaints in a general population sample of Turkish and Moroccan immigrants living in Belgium. Focus is on between- and within-group variation. METHODS: The study is based on pooled data from the Belgian Health Interview Surveys 2001 and 2004 and focuses on the Turkish and Moroccan immigrant population aged 18-65 (N = 147 Turks, N = 359 Moroccans). Mental health status is assessed with the General Health Questionnaire-12 and the Symptom Checklist 90-R subscales for depression and generalised anxiety. Risk and protective factors considered are gender, age, household type, labor market position, educational level, household income, homeownership, being foreign- or native born and social support. RESULTS: Between-group variance was not significant. Within-group analysis showed significant effects of gender and social support. Although not significant, the results suggested positive associations between social adversity and mood status. In addition, there was a tendency for higher risks for psychological distress, depression and generalised anxiety in foreign-born as compared to Belgian-born Turkish and Moroccan immigrants.

Depression and generalised anxiety in the general population in Belgium: a comparison between native and immigrant groups.

BACKGROUND: Knowledge of the mental health status of the general population in Belgium is limited. Only recently have prevalence rates and risk factors for depression and generalised anxiety been identified. However, the question remains whether there are statistically significant differences between foreign origin groups and the native population. METHODS: Basing our study on data from the Belgian Health Interview Survey 2001 and focusing on the adult population aged 18-65 (N=7224), we consider eight risk factors for depression and generalised anxiety as assessed by the Symptom Checklist 90-subscales. The risk factors are region of origin, gender, age, household type, labour market position, educational level, household income and home ownership. Our approach involves weighted logistic regression. RESULTS: Analysis shows that most depressive symptoms are more prevalent among persons of Turkish or Moroccan origin than among Belgians or people from other EU Member States. This is not the case, though, for anxiety symptoms. However, if we consider depression and generalised anxiety as a syndrome, we find significantly more of the 10% highest SCL-scores in Turkish and Moroccan immigrants. Multivariate analysis indicates that their higher prevalence rate of anxiety is entirely attributable to their lower socioeconomic position. In the case of depression, the risk decreases only partly, leaving a significant association with Turkish or Moroccan origin. CONCLUSION: In Belgium, depression and generalised anxiety are more prevalent in the population originating from Turkey and Morocco than in population groups originating from within the European Union.