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Herrick C, Okpako O, Millington JDA. Unequal ecosystems of global health authorial expertise: Decolonising noncommunicable disease. Health Place 2021; 71:102670. [PMID: 34543840 DOI: 10.1016/j.healthplace.2021.102670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/24/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
The decolonisation agenda is gathering momentum in global health. Within this movement, one domain of analysis has been the ways in which the geographies of scholarly knowledge production (re)produce the inequities of coloniality. Drawing on the example of noncommunicable diseases (NCDs), here we deviate from this and instead examine the authorship of the key global documents that were used to ignite and mobilise the NCD advocacy agenda from 2000 to 2020. In doing so, we reflect on the changing ecosystems of authorial expertise. It shows that while the geographic distribution of expertise has broadened over time, the NCD domain remains a fairly tight and circumscribed network. Importantly this research also shows the complexities of ascribing location to expertise, a finding that speaks back to the decolonisation debate.
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Affiliation(s)
- Clare Herrick
- Department of Geography King's College London, Bush House NE Wing 6.07, London, WC2R 2LS, UK.
| | - Oritsematosan Okpako
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - James D A Millington
- Department of Geography King's College London, Bush House NE Wing 6.07, London, WC2R 2LS, UK
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Yang JS, Mamudu HM, John R. Incorporating a structural approach to reducing the burden of non-communicable diseases. Global Health 2018; 14:66. [PMID: 29980215 PMCID: PMC6035457 DOI: 10.1186/s12992-018-0380-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/05/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) account for over two-thirds of deaths worldwide, and global efforts to address NCDs have accelerated. Current prevention and control efforts rely primarily on individual behavior/lifestyle approaches that place the onus of responsibility for health on the individual. These approaches, however, have not stopped the increasing trend of NCDs worldwide. Thus, there is urgent need for exploring alternative approaches in order to attain the aim of reducing global premature NCDs mortality by 25% by 2025, and meeting the NCD reduction objective in the Sustainable Development Goals. DISCUSSION We suggest the need for a structural approach to addressing the NCDs epidemic that integrates social science and public health theories. We evaluate two overarching principles (empowerment and human rights) and three social determinants of health (labor and employment, trade and industry, and macroeconomics) addressed in the 2013 Global Action Plan for the Prevention and Control of NCDs to demonstrate how a structural approach to NCDs can be incorporated into existing NCD interventions. For each area considered, theoretical considerations for structural thinking are provided and conclude with recommended actions. CONCLUSION Achieving the global health agenda goals of reducing NCDs mortality will require a shift to a paradigm that embraces concerted efforts to address both behavioral/lifestyle factors and structural dimensions of NCDs.
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Affiliation(s)
- Joshua S. Yang
- Department of Health Science, California State University, Fullerton, KHS 161A, 800 N. State College Blvd., Fullerton, CA 92834 USA
| | - Hadii M. Mamudu
- College of Public Health, East Tennessee State University, Room G42-D, Lamb Hall, Johnson City, TN 37614 USA
| | - Rijo John
- Centre for Public Policy Research, Anitha, 1st floor, S.A Road, Elamkulam, Kochi, Kerala 682020 India
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Zhu XL, Luo JS, Zhang XC, Zhai Y, Wu J. China's Efforts on Management, Surveillance, and Research of Noncommunicable Diseases: NCD Scorecard Project. Ann Glob Health 2017; 83:489-500. [DOI: 10.1016/j.aogh.2017.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Buse K, Tanaka S, Hawkes S. Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable diseases and identifying options for reducing risk exposure. Global Health 2017; 13:34. [PMID: 28619031 PMCID: PMC5472958 DOI: 10.1186/s12992-017-0255-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/02/2017] [Indexed: 11/10/2022] Open
Abstract
Background Non-communicable diseases (NCDs) represent a significant threat to human health and well-being, and carry significant implications for economic development and health care and other costs for governments and business, families and individuals. Risks for many of the major NCDs are associated with the production, marketing and consumption of commercially produced food and drink, particularly those containing sugar, salt and transfats (in ultra-processed products), alcohol and tobacco. The problems inherent in primary prevention of NCDs have received relatively little attention from international organizations, national governments and civil society, especially when compared to the attention paid to secondary and tertiary prevention regimes (i.e. those focused on provision of medical treatment and long-term clinical management). This may in part reflect that until recently the NCDs have not been deemed a priority on the overall global health agenda. Low political priority may also be due in part to the complexity inherent in implementing feasible and acceptable interventions, such as increased taxation or regulation of access, particularly given the need to coordinate action beyond the health sector. More fundamentally, governing determinants of risk frequently brings public health into conflict with the interests of profit-driven food, beverage, alcohol and tobacco industries. Materials We use a conceptual framework to review three models of governance of NCD risk: self-regulation by industry; hybrid models of public-private engagement; and public sector regulation. We analyse the challenges inherent in each model, and review what is known (or not) about their impact on NCD outcomes. Conclusion While piecemeal efforts have been established, we argue that mechanisms to control the commercial determinants of NCDs are inadequate and efforts at remedial action too limited. Our paper sets out an agenda to strengthen each of the three governance models. We identify reforms that will be needed to the global health architecture to govern NCD risks, including to strengthen its ability to consolidate the collective power of diverse stakeholders, its authority to develop and enforce clear measures to address risks, as well as establish monitoring and rights-based accountability systems across all actors to drive measurable, equitable and sustainable progress in reducing the global burden of NCDs.
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Affiliation(s)
| | | | - Sarah Hawkes
- Institute for Global Health, University College London, London, UK.
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Tonelli M, Wiebe N, Nadler B, Darzi A, Rasheed S. Modifying the Interagency Emergency Health Kit to include treatment for non-communicable diseases in natural disasters and complex emergencies. BMJ Glob Health 2016; 1:e000128. [PMID: 28588970 PMCID: PMC5321368 DOI: 10.1136/bmjgh-2016-000128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/14/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022] Open
Abstract
The Interagency Emergency Health Kit (IEHK) provides a standard package of medicines and simple medical devices for aid agencies to use in emergencies such as disasters and armed conflicts. Despite the increasing burden of non-communicable diseases (NCDs) in such settings, the IEHK includes few drugs and devices for management of NCDs. Using published data to model the population burden of acute and chronic presentations of NCDs in emergency-prone regions, we estimated the quantity of medications and devices that should be included in the IEHK. NCDs considered were cardiovascular diseases, diabetes, hypertension and chronic respiratory disease. In scenario 1 (the primary scenario), we assumed that resources in the IEHK would only include those needed to manage acute life-threatening conditions. In scenario 2, we included resources required to manage both acute and chronic presentations of NCDs. Drugs and devices that might be required included amlodipine, aspirin, atenolol, beclomethasone, dextrose 50%, enalapril, furosemide, glibenclamide, glyceryl trinitrate, heparin, hydralazine, hydrochlorothiazide, insulin, metformin, prednisone, salbutamol and simvastatin. For scenario 1, the number of units required ranged from 12 (phials of hydralazine) to ∼15 000 (tablets of enalapril). Space and weight requirements were modest and total cost for all drugs and devices was approximately US$2078. As expected, resources required for scenario 2 were much greater. Space and cost requirements increased proportionately: estimated total cost of scenario 2 was $22 208. The resources required to treat acute NCD presentations appear modest, and their inclusion in the IEHK seems feasible.
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Affiliation(s)
- Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Brian Nadler
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Shahnawaz Rasheed
- Institute of Global Health Innovation, Imperial College London, London, UK
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Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, McGovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F, Viner RM. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387:2423-78. [PMID: 27174304 PMCID: PMC5832967 DOI: 10.1016/s0140-6736(16)00579-1] [Citation(s) in RCA: 1752] [Impact Index Per Article: 219.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia.
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Columbia University, New York, NY, USA
| | - John S Santelli
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David A Ross
- World Health Organization, Geneva, Switzerland; London School of Hygiene & Tropical Medicine, London, UK
| | - Rima Afifi
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia; University of Oregon, Eugene, OR, USA
| | - Monika Arora
- Public Health Foundation of India, New Delhi, India
| | - Peter Azzopardi
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | | | | | - Ritsuko Kakuma
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Terry McGovern
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ali H Mokdad
- Institute of Health Metrics and Evaluation, University of Washinton, Seattle, WA, USA
| | - Vikram Patel
- London School of Hygiene & Tropical Medicine, London, UK; Public Health Foundation of India, New Delhi, India
| | - Suzanne Petroni
- International Centre for Research on Women, Washington, DC, USA
| | - Nicola Reavley
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Jane Waldfogel
- School of Social Work, Columbia University, New York, NY, USA
| | | | | | - Zulfiqar Bhutta
- University of Toronto, Toronto, ON, Canada; Aga Khan University, Karachi, Pakistan
| | | | - Amitabh Mattoo
- Australia India Centre, University of Melbourne, Melbourne, VIC, Australia; Jawaharlal Nehru University, New Delhi, India
| | | | - Jing Fang
- Kunming Medical University, Kunming, China
| | - Jane Ferguson
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Russell M Viner
- Institute of Child Health, University College London, London, UK
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Ferguson L, Tarantola D, Hoffmann M, Gruskin S. Non-communicable diseases and human rights: Global synergies, gaps and opportunities. Glob Public Health 2016; 12:1200-1227. [PMID: 28278754 DOI: 10.1080/17441692.2016.1158847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The incorporation of human rights in health policy and programmes is known to strengthen responses to health problems and help address disparities created or exacerbated by illness yet this remains underexplored in relation to non-communicable diseases (NCDs). Aiming to understand existing synergies and how they might be further strengthened, we assessed the extent to which human rights are considered in global NCD policies and strategies and the degree of attention given to NCDs by select United Nations human rights mechanisms. Across global NCD policies and strategies, rhetorical assertions regarding human rights appear more often than actionable statements, thus limiting their implementation and impact. Although no human rights treaty explicitly mentions NCDs, some human rights monitoring mechanisms have been paying increasing attention to NCDs. This provides important avenues for promoting the incorporation of human rights norms and standards into NCD responses as well as for accountability. Linking NCDs and human rights at the global level is critical for encouraging national-level action to promote better outcomes relating to both health and human rights. The post-2015 development agenda constitutes a key entry point for highlighting these synergies and strengthening opportunities for health and rights action at global, national and local levels.
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Affiliation(s)
- Laura Ferguson
- a Program on Global Health and Human Rights , Institute for Global Health, University of Southern California , Los Angeles , CA , USA
| | - Daniel Tarantola
- a Program on Global Health and Human Rights , Institute for Global Health, University of Southern California , Los Angeles , CA , USA
| | - Michael Hoffmann
- b Warren Alpert Medical School of Brown University and the Miriam Hospital , Providence , RI , USA
| | - Sofia Gruskin
- a Program on Global Health and Human Rights , Institute for Global Health, University of Southern California , Los Angeles , CA , USA
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Phulkerd S, Lawrence M, Vandevijvere S, Sacks G, Worsley A, Tangcharoensathien V. A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases. Implement Sci 2016; 11:15. [PMID: 26846789 PMCID: PMC4743239 DOI: 10.1186/s13012-016-0379-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Policies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments. The study conducted a systematic literature search. Multiple databases as well as the grey literature were searched. All study designs and review papers on assessing the implementation of government policies to create healthy food environments were included. A quality assessment of the methods and tools identified from relevant studies was carried out using the following four criteria: comprehensiveness, relevance, generalizability and feasibility. This quality assessment was completed by two independent reviewers. RESULTS The review identified 52 studies across different policy areas, levels and settings. Self-administered questionnaires and policy checklists were most commonly applied to assess the extent of policy implementation, whereas semi-structured interviews were most commonly used to evaluate the implementation process. Measures varied widely, with the existence of policy implementation the aspect most commonly assessed. The most frequently identified barriers and facilitators for policy implementation were infrastructure support, resources and stakeholder engagement. The assessment of policy implementation on food environments was usually undertaken in combination with other policy areas, particularly nutrition education and physical activity. Three tools/methods were rated 'high' quality and 13 tools/methods received 'medium' quality ratings. CONCLUSIONS Harmonization of the available high-quality methods and tools is needed to ensure that assessment of government policy implementation can be compared across different countries and settings and over time. This will contribute to efforts to increase government accountability for their actions to improve the healthiness of food environments.
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Affiliation(s)
- Sirinya Phulkerd
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Victoria, Australia.
| | - Mark Lawrence
- Centre for Physical Activity and Nutrition Research, Faculty of Health, Deakin University, Victoria, Australia.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia.
| | - Anthony Worsley
- Centre for Physical Activity and Nutrition Research, Faculty of Health, Deakin University, Victoria, Australia.
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Lopez AD. Can epidemiology inform global health and development targets? Int J Epidemiol 2015; 44:9-11. [PMID: 25713308 DOI: 10.1093/ije/dyv011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alan D Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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10
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Mehta RL, Cerdá J, Burdmann EA, Tonelli M, García-García G, Jha V, Susantitaphong P, Rocco M, Vanholder R, Sever MS, Cruz D, Jaber B, Lameire NH, Lombardi R, Lewington A, Feehally J, Finkelstein F, Levin N, Pannu N, Thomas B, Aronoff-Spencer E, Remuzzi G. International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 2015; 385:2616-43. [PMID: 25777661 DOI: 10.1016/s0140-6736(15)60126-x] [Citation(s) in RCA: 659] [Impact Index Per Article: 73.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ravindra L Mehta
- Department of Medicine, University of California San Diego, San Diego, CA, USA.
| | - Jorge Cerdá
- Division of Nephrology, Department of Medicine, Albany Medical College, Albany, NY, USA
| | - Emmanuel A Burdmann
- LIM 12, Division of Nephrology, University of Sao Paulo Medical School, São Paulo, Brazil
| | | | - Guillermo García-García
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Vivekanand Jha
- The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tufts University School of Medicine, Boston, MA, USA
| | - Michael Rocco
- Department of Internal Medicine, Section of Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Raymond Vanholder
- Nephrology Section, Department of Internal Medicine, University Hospital, Ghent, Belgium
| | - Mehmet Sukru Sever
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Mehmet, Turkey
| | - Dinna Cruz
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Bertrand Jaber
- Tufts University School of Medicine, Boston, MA, USA; St Elizabeth's Medical Center, Boston, MA, USA
| | - Norbert H Lameire
- Nephrology Section, Department of Internal Medicine, University Hospital, Ghent, Belgium
| | - Raúl Lombardi
- Department of Critical Care Medicine, SMI, Montevideo, Uruguay
| | | | | | | | | | | | - Bernadette Thomas
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Giuseppe Remuzzi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy; Department of Medicine, Unit of Nephrology, Dialysis and Transplantation, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
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Swinburn B, Kraak V, Rutter H, Vandevijvere S, Lobstein T, Sacks G, Gomes F, Marsh T, Magnusson R. Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet 2015; 385:2534-45. [PMID: 25703108 DOI: 10.1016/s0140-6736(14)61747-5] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering effective actions and what, specifically, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fiscal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifies multiple levers for change, including quasiregulatory and other approaches that involve government-specified and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of conflicts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the influence of private sector actors with major conflicts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.
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Affiliation(s)
- Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia.
| | - Vivica Kraak
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia; Department of Human Nutrition, Foods & Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Harry Rutter
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia
| | - Fabio Gomes
- National Cancer Institute of Brazil, Ministry of Health, Rio de Janeiro, Brazil
| | | | - Roger Magnusson
- Sydney Law School, University of Sydney, Sydney, NSW, Australia
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Swinburn B. Commentary: physical activity as a minor player in the obesity epidemic: what are the deep implications? Int J Epidemiol 2014; 42:1838-40. [PMID: 24415618 DOI: 10.1093/ije/dyt162] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand and WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
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13
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Bello AK, Levin A, Manns BJ, Feehally J, Drueke T, Faruque L, Hemmelgarn BR, Kernahan C, Mann J, Klarenbach S, Remuzzi G, Tonelli M. Effective CKD care in European countries: challenges and opportunities for health policy. Am J Kidney Dis 2014; 65:15-25. [PMID: 25455091 DOI: 10.1053/j.ajkd.2014.07.033] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 07/12/2014] [Indexed: 01/22/2023]
Abstract
Chronic kidney disease (CKD) is an important global public health problem that is associated with adverse health outcomes and high health care costs. Effective and cost-effective treatments are available for slowing the progression of CKD and preventing its complications, including cardiovascular disease. Although wealthy nations have highly structured schemes in place to support the care of people with kidney failure, less consideration has been given to health systems and policy for the much larger population of people with non-dialysis-dependent CKD. Further, how to integrate such strategies with national and international initiatives for control of other chronic noncommunicable diseases (NCDs) merits attention. We synthesized the various approaches to CKD control across 17 European countries and present our findings according to the key domains suggested by the World Health Organization framework for NCD control. This report identifies opportunities to strengthen CKD-relevant health systems and explores potential mechanisms to capitalize on these opportunities. Across the 17 countries studied, we found a number of common barriers to the care of people with non-dialysis-dependent CKD: limited work force capacity, the nearly complete absence of mechanisms for disease surveillance, lack of a coordinated CKD care strategy, poor integration of CKD care with other NCD control initiatives, and low awareness of the significance of CKD. These common challenges faced by diverse health systems reflect the need for international cooperation to strengthen health systems and policies for CKD care.
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Affiliation(s)
| | - Adeera Levin
- University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | | - Johannes Mann
- Friedrich Alexander University of Erlangen, Erlangen, Germany
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15
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Kraak VI, Swinburn B, Lawrence M, Harrison P. An accountability framework to promote healthy food environments. Public Health Nutr 2014; 17:2467-83. [PMID: 24564894 PMCID: PMC10282457 DOI: 10.1017/s1368980014000093] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 11/28/2013] [Accepted: 01/16/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To review the available literature on accountability frameworks to construct a framework that is relevant to voluntary partnerships between government and food industry stakeholders. DESIGN Between November 2012 and May 2013, a desk review of ten databases was conducted to identify principles, conceptual frameworks, underlying theories, and strengths and limitations of existing accountability frameworks for institutional performance to construct a new framework relevant to promoting healthy food environments. SETTING Food policy contexts within high-income countries to address obesity and diet-related non-communicable diseases. SUBJECTS Eligible resources (n 26) were reviewed and the guiding principles of fifteen interdisciplinary frameworks were used to construct a new accountability framework. RESULTS Strengths included shared principles across existing frameworks, such as trust, inclusivity, transparency and verification; government leadership and good governance; public deliberations; independent bodies recognizing compliance and performance achievements; remedial actions to improve accountability systems; and capacity to manage conflicts of interest and settle disputes. Limitations of the three-step frameworks and 'mutual accountability' approach were an explicit absence of an empowered authority to hold all stakeholders to account for their performance. CONCLUSIONS We propose a four-step accountability framework to guide government and food industry engagement to address unhealthy food environments as part of a broader government-led strategy to address obesity and diet-related non-communicable diseases. An independent body develops clear objectives, a governance process and performance standards for all stakeholders to address unhealthy food environments. The empowered body takes account (assessment), shares the account (communication), holds to account (enforcement) and responds to the account (improvements).
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Affiliation(s)
- Vivica I Kraak
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin Population Health Strategic Research Centre, School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Melbourne, Victoria 3125, Australia
| | - Boyd Swinburn
- Population Nutrition and Global Health, University of Auckland, Auckland, New Zealand
| | - Mark Lawrence
- Public Health Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Paul Harrison
- School of Business, Faculty of Business and Law, Deakin University, Burwood, Victoria, Australia
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16
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Beaglehole R, Bonita R, Ezzati M, Alleyne G, Dain K, Kishore SP, Horton R. NCD Countdown 2025: accountability for the 25 × 25 NCD mortality reduction target. Lancet 2014; 384:105-7. [PMID: 25012115 DOI: 10.1016/s0140-6736(14)61091-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Robert Beaglehole
- 42 Albert Rd, Auckland 0624, New Zealand; University of Auckland, Auckland, New Zealand.
| | - Ruth Bonita
- University of Auckland, Auckland, New Zealand
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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17
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Bonita R, Beaglehole R. Women and NCDs: overcoming the neglect. Glob Health Action 2014; 7:23742. [PMID: 24804863 PMCID: PMC4012074 DOI: 10.3402/gha.v7.23742] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/02/2014] [Accepted: 03/03/2014] [Indexed: 12/22/2022] Open
Abstract
Two in every three deaths among women are caused by non-communicable diseases (NCDs) – largely heart disease, stroke, cancer, diabetes and chronic respiratory diseases. The global discourse on health, however, largely views women in terms of their reproductive capacity, a persisting myth reflecting gender bias that shifts the focus away from NCDs, violence, and other injuries. Risk factors for NCDs are similar for men and women. Because fewer women actively smoke than men, and drink in less harmful ways, in most parts of the world, the impact of major NCD risk factors is far less in women than in men. In the area of diagnosis and treatment, gender bias can result in women being asked fewer questions, and receiving fewer examinations and fewer diagnostic tests for coronary heart disease and other NCDs compared with men with similar symptoms. In response to a UN meeting in September 2011, member states of WHO have agreed to a global goal to reduce avoidable NCD mortality by 25% by 2025 (‘25 by 25’). A set of voluntary targets and indictors have been agreed upon, although none of them are gender specific. Most require changes at the policy level that will ensure that women – and children – will also benefit. As the 2015 deadline for the Millennium Development Goals approaches, women and NCDs should be central to the sustainable human development agenda.
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Affiliation(s)
- Ruth Bonita
- University of Auckland, Auckland, New Zealand;
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18
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Brand CA, Ackerman IN, Tropea J. Chronic disease management: Improving care for people with osteoarthritis. Best Pract Res Clin Rheumatol 2014; 28:119-42. [DOI: 10.1016/j.berh.2014.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Taylor A, Alfvén T, Hougendobler D, Buse K. Nonbinding Legal Instruments in Governance for Global Health: Lessons from the Global AIDS Reporting Mechanism. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2014; 42:72-87. [PMID: 26767478 DOI: 10.1111/jlme.12120] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recent debate over World Health Organization reform has included unprecedented attention to international lawmaking as a future priority function of the Organization. However, the debate is largely focused on the codification of new binding legal instruments. Drawing upon lessons from the success of the Global AIDS Reporting Mechanism, established pursuant to the United Nations' Declaration of Commitment on HIV/AIDS, we argue that effective global health governance requires consideration of a broad range of instruments, both binding and nonbinding. A detailed examination of the Global AIDS Reporting Mechanism reveals that the choice of the nonbinding format makes an important contribution to its effectiveness. For instance, the flexibility and adaptability of the nonbinding format have allowed the global community to: (1) undertake commitments in a timely manner; (2) adapt and experiment in the face of a dynamic pandemic; and (3) grant civil society an unparalleled role in monitoring and reporting on state implementation of global commitments. UNAIDS' institutional support has also played a vital role in ensuring the continuing effectiveness of the Global AIDS Reporting Mechanism. Overall, the experience of the Global AIDS Reporting Mechanism evidences that, at times, nimbler nonbinding instruments can offer benefits over slower, more rigid binding legal approaches to governance, but depend critically, like all instruments, on the perceived legitimacy thereof.
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Affiliation(s)
- Allyn Taylor
- Visiting Professor of Law at Georgetown University Law Center and an Adjunct Professor of International Relations at the Johns Hopkins University Paul H. Nitze School of Advanced International Studies
| | - Tobias Alfvén
- Works as Strategic Information Adviser in the Department for Strategic Information & Evaluation at UNAIDS, the Joint United Nations Programme on HIV/AIDS, headquarter in Geneva, Switzerland
| | - Daniel Hougendobler
- Law Fellow at the Georgetown University O'Neill Institute for National and Global Health Law in Washington, D.C
| | - Kent Buse
- Chief of Political Affairs and Strategy at UNAIDS in Geneva
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20
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Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, Barquera S, Friel S, Hawkes C, Kelly B, L'abbé M, Lee A, Ma J, Macmullan J, Mohan S, Monteiro C, Rayner M, Sanders D, Snowdon W, Walker C. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev 2013; 14 Suppl 1:1-12. [PMID: 24074206 DOI: 10.1111/obr.12087] [Citation(s) in RCA: 358] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Non-communicable diseases (NCDs) dominate disease burdens globally and poor nutrition increasingly contributes to this global burden. Comprehensive monitoring of food environments, and evaluation of the impact of public and private sector policies on food environments is needed to strengthen accountability systems to reduce NCDs. The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) is a global network of public-interest organizations and researchers that aims to monitor, benchmark and support public and private sector actions to create healthy food environments and reduce obesity, NCDs and their related inequalities. The INFORMAS framework includes two 'process' modules, that monitor the policies and actions of the public and private sectors, seven 'impact' modules that monitor the key characteristics of food environments and three 'outcome' modules that monitor dietary quality, risk factors and NCD morbidity and mortality. Monitoring frameworks and indicators have been developed for 10 modules to provide consistency, but allowing for stepwise approaches ('minimal', 'expanded', 'optimal') to data collection and analysis. INFORMAS data will enable benchmarking of food environments between countries, and monitoring of progress over time within countries. Through monitoring and benchmarking, INFORMAS will strengthen the accountability systems needed to help reduce the burden of obesity, NCDs and their related inequalities.
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Affiliation(s)
- B Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
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21
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Abstract
10 years ago, The Lancet published a Series about child survival. In this Review, we examine progress in the past decade in child survival, with a focus on epidemiology, interventions and intervention coverage, strategies of health programmes, equity, evidence, accountability, and global leadership. Knowledge of child health epidemiology has greatly increased, and although more and better interventions are available, they still do not reach large numbers of mothers and children. Child survival should remain at the heart of global goals in the post-2015 era. Many countries are now making good progress and need the time and support required to finish the task. The global health community should show its steadfast commitment to child survival by amassing knowledge and experience as a basis for ever more effective programmes. Leadership and accountability for child survival should be strengthened and shared among the UN system; governments in high-income, middle-income, and low-income countries; and non-governmental organisations.
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Affiliation(s)
- Jennifer Bryce
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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22
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Khang YH. Burden of noncommunicable diseases and national strategies to control them in Korea. J Prev Med Public Health 2013; 46:155-64. [PMID: 23946873 PMCID: PMC3740220 DOI: 10.3961/jpmph.2013.46.4.155] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/15/2013] [Indexed: 11/13/2022] Open
Abstract
Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.
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Affiliation(s)
- Young-Ho Khang
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
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23
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Jafar TH, Haaland BA, Rahman A, Razzak JA, Bilger M, Naghavi M, Mokdad AH, Hyder AA. Non-communicable diseases and injuries in Pakistan: strategic priorities. Lancet 2013; 381:2281-90. [PMID: 23684257 DOI: 10.1016/s0140-6736(13)60646-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Non-communicable diseases, including cardiovascular diseases, cancers, respiratory diseases, diabetes, and mental disorders, and injuries have become the major causes of morbidity and mortality in Pakistan. Tobacco use and hypertension are the leading attributable risk factors for deaths due to cardiovascular diseases, cancers, and respiratory diseases. Pakistan has the sixth highest number of people in the world with diabetes; every fourth adult is overweight or obese; cigarettes are cheap; antismoking and road safety laws are poorly enforced; and a mixed public-private health-care system provides suboptimum care. Furthermore, almost three decades of exposure to sociopolitical instability, economic uncertainty, violence, regional conflict, and dislocation have contributed to a high prevalence of mental health disorders. Projection models based on the Global Burden of Disease 2010 data suggest that there will be about 3·87 million premature deaths by 2025 from cardiovascular diseases, cancers, and chronic respiratory diseases in people aged 30-69 years in Pakistan, with serious economic consequences. Modelling of risk factor reductions also indicate that Pakistan could achieve at least a 20% reduction in the number of these deaths by 2025 by targeting of the major risk factors. We call for policy and legislative changes, and health-system interventions to target readily preventable non-communicable diseases in Pakistan.
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Affiliation(s)
- Tazeen H Jafar
- Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.
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25
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Di Cesare M, Khang YH, Asaria P, Blakely T, Cowan MJ, Farzadfar F, Guerrero R, Ikeda N, Kyobutungi C, Msyamboza KP, Oum S, Lynch JW, Marmot MG, Ezzati M. Inequalities in non-communicable diseases and effective responses. Lancet 2013; 381:585-97. [PMID: 23410608 DOI: 10.1016/s0140-6736(12)61851-0] [Citation(s) in RCA: 425] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In most countries, people who have a low socioeconomic status and those who live in poor or marginalised communities have a higher risk of dying from non-communicable diseases (NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and several other NCD risk factors are often higher in groups with low socioeconomic status than in those with high socioeconomic status; the social gradient also depends on the country's stage of economic development, cultural factors, and social and health policies. Social inequalities in risk factors account for more than half of inequalities in major NCDs, especially for cardiovascular diseases and lung cancer. People in low-income countries and those with low socioeconomic status also have worse access to health care for timely diagnosis and treatment of NCDs than do those in high-income countries or those with higher socioeconomic status. Reduction of NCDs in disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden, making them mutually reinforcing priorities. Effective actions to reduce NCD inequalities include equitable early childhood development programmes and education; removal of barriers to secure employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control and for dietary salt reduction that target low socioeconomic status groups; universal, financially and physically accessible, high-quality primary care for delivery of preventive interventions and for early detection and treatment of NCDs; and universal insurance and other mechanisms to remove financial barriers to health care.
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Affiliation(s)
- Mariachiara Di Cesare
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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26
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Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, Suh I, Thankappan KR, McKee M, Hospedales J, de Courten M, Capewell S, Beaglehole R. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Lancet 2013; 381:575-84. [PMID: 23410607 DOI: 10.1016/s0140-6736(12)61993-x] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Strong leadership from heads of state is needed to meet national commitments to the UN political declaration on non-communicable diseases (NCDs) and to achieve the goal of a 25% reduction in premature NCD mortality by 2025 (the 25 by 25 goal). A simple, phased, national response to the political declaration is suggested, with three key steps: planning, implementation, and accountability. Planning entails mobilisation of a multisectoral response to develop and support the national action plan, and to build human, financial, and regulatory capacity for change. Implementation of a few priority and feasible cost-effective interventions for the prevention and treatment of NCDs will achieve the 25 by 25 goal and will need only few additional financial resources. Accountability incorporates three dimensions: monitoring of progress, reviewing of progress, and appropriate responses to accelerate progress. A national NCD commission or equivalent, which is independent of government, is needed to ensure that all relevant stakeholders are held accountable for the UN commitments to NCDs.
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Affiliation(s)
- Ruth Bonita
- University of Auckland, Auckland, New Zealand.
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Alleyne G, Binagwaho A, Haines A, Jahan S, Nugent R, Rojhani A, Stuckler D. Embedding non-communicable diseases in the post-2015 development agenda. Lancet 2013; 381:566-74. [PMID: 23410606 DOI: 10.1016/s0140-6736(12)61806-6] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The post-2015 development agenda will build on the Millennium Development Goals (MDGs), in which health is a core component. This agenda will focus on human development, incorporate the components of the Millennium Declaration, and will be made sustainable by support from the social, economic, and environmental domains of activity, represented graphically as the strands of a triple helix. The approaches to prevention and control of non-communicable diseases (NCDs) have been elaborated in the political declaration of the UN high-level meeting on NCDs and governments have adopted a goal of 25% reduction in relative mortality from NCDs by 2025 (the 25 by 25 goal), but a strong movement is needed based on the evidence already available, enhanced by effective partnerships, and with political support to ensure that NCDs are embedded in the post-2015 human development agenda. NCDs should be embedded in the post-2015 development agenda, since they are leading causes of death and disability, have a negative effect on health, and, through their effect on the societal, economic, and the environmental domains, impair the sustainability of development. Some drivers of unsustainable development, such as the transport, food and agriculture, and energy sectors, also increase the risk of NCDs.
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Affiliation(s)
- George Alleyne
- Pan American Health Organization, Washington DC 20037, USA.
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