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Cosgrove L, Brhlikova P, Lyus R, Herrawi F, D'Ambrozio G, Abi-Jaoude E, Pollock AM. Global Burden Disease Estimates for Major Depressive Disorders (MDD): A review of diagnostic instruments used in studies of prevalence. Community Ment Health J 2024:10.1007/s10597-024-01302-6. [PMID: 38951416 DOI: 10.1007/s10597-024-01302-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/21/2024] [Indexed: 07/03/2024]
Abstract
Global Burden of Disease (GBD) estimates have significant policy implications nationally and internationally. Disease burden metrics, particularly for depression, have played a critical role in raising governmental awareness of mental health and in calculating the economic cost of depression. Recently, the World Health Organization ranked depression as the single largest contributor to global disability. The main aim of this paper was to assess the basis upon which GBD prevalence estimates for major depressive disorder (MDD) were made. We identify the instruments used in the 2019 GBD estimates and provide a descriptive assessment of the five most frequently used instruments. The majority of country studies, 356/566 (62.9%), used general mental health screeners or structured/semi-structured interview guides, 98/566 (17.3%) of the studies used dedicated depression screeners, and 112 (19.8%) used other tools for assessing depression. Thus, most of the studies used instruments that were not designed to make a diagnosis of depression or assess depression severity. Our results are congruent with and extend previous research that has identified critical flaws in the data underpinning the GBD estimates for MDD. Despite the widespread promotion of these prevalence estimates, caution is needed before using them to inform public policy and mental health interventions. This is particularly important in lower-income countries where resources are scarce.
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Affiliation(s)
- Lisa Cosgrove
- Centre for Mental Health, Human Rights, and Social Justice, University of Essex, Colchester, UK.
- Counseling Psychology Department, Applied Ethics Center, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA, 02125, USA.
| | - Petra Brhlikova
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Bldg, Newcastle Upon Tyne, NE2 4AX, UK
| | - Rosanna Lyus
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Bldg, Newcastle Upon Tyne, NE2 4AX, UK
| | - Farahdeba Herrawi
- Counseling Psychology Department, Applied Ethics Center, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA, 02125, USA
| | - Gianna D'Ambrozio
- Counseling Psychology Department, Applied Ethics Center, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA, 02125, USA
| | - Elia Abi-Jaoude
- The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Allyson M Pollock
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Bldg, Newcastle Upon Tyne, NE2 4AX, UK
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2
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Nugent R, Hutchinson B, Mann N, Ngongo C, Spencer G, Grafton D, Small R. Evolving methodology of national tobacco control investment cases. Tob Control 2024; 33:s10-s16. [PMID: 38697658 PMCID: PMC11103330 DOI: 10.1136/tc-2023-058336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND This article describes an investment case methodology for tobacco control that was applied in 36 countries between 2017 and 2022. METHODS The WHO Framework Convention on Tobacco Control (FCTC) investment cases compared two scenarios: a base case that calculated the tobacco-attributable mortality, morbidity and economic costs with status quo tobacco control, and an intervention scenario that described changes in those same outcomes from fully implementing and enforcing a variety of proven, evidence-based tobacco control policies and interventions. Health consequences included the tobacco-attributable share of mortality and morbidity from 38 diseases. The healthcare expenditures and the socioeconomic costs from the prevalence of those conditions were combined to calculate the total losses due to tobacco. The monetised benefits of improvements in health resulting from tobacco control implementation were compared with costs of expanding tobacco control to assess returns on investment in each country. An institutional and context analysis assessed the political and economic dimensions of tobacco control in each context. RESULTS We applied a rigorous yet flexible methodology in 36 countries over 5 years. The replicable model and framework may be used to inform development of tobacco control cases in countries worldwide. CONCLUSION Investment cases constitute a tool that development partners and advocates have demanded in even greater numbers. The economic argument for tobacco control provided by this set of country-contextualised analyses can be a strong tool for policy change.
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Affiliation(s)
- Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
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Tabasi M, Mostafavi SA, Oreyzi H, Mohammadi MR, Khaleghi A. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:158-173. [PMID: 38686306 PMCID: PMC11055968 DOI: 10.18502/ijps.v19i2.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 05/02/2024]
Abstract
Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. Method : This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.
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Affiliation(s)
- Mahla Tabasi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Psychology, University of Religions and Denominations, Qom, Iran
| | - Hamidreza Oreyzi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Ge R, Chang J. Disease burden of migraine and tension-type headache in non-high-income East and Southeast Asia from 1990 to 2019. J Headache Pain 2023; 24:32. [PMID: 36967393 PMCID: PMC10041715 DOI: 10.1186/s10194-023-01566-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The world faces severe challenges from migraine and tension-type headache (TTH), which cause grave disability to patients and place a heavy burden on their caregivers. However, headaches in specific individual regions have rarely been investigated. Therefore, we aimed to fully analyse and describe the current status and changing trends in migraine and TTH in non-high-income East and Southeast Asia to provide more detailed real-world information for policy-making. METHODS The migraine and TTH data used for analysis were all extracted from the Global Burden of Disease (GBD) database. We adopted three major indicators of disease burden, including prevalence, incidence, and years lived with disability (YLD), and two major metrics, including the absolute number and the age-standardized rate, in our present study for further evaluation by age and sex. The results are presented in the form of mean values and 95% uncertainty intervals (UIs). In addition, the differences between non-high-income East and Southeast Asia and other regions, as well as the potential associations between headache burden and socioeconomic background, were explored. RESULTS In 2019, approximately 195,702,169 migraine patients and 291,924,564 TTH patients lived in non-high-income East Asia, and 113,401,792 migraine patients and 179,938,449 TTH patients lived in non-high-income Southeast Asia. In terms of specific countries and regions, the highest age-standardized YLD rate (ASYR) of migraine was in Thailand [645 (95% UI: 64 to 1,554)]. The highest ASYR of TTH was in Indonesia [54 (95% UI: 15 to 197)]. Furthermore, people between the ages of 40 and 44, especially females, were identified as the main population that suffered from migraine and TTH. Unfortunately, we did not observe a significant association between headache burden and socioeconomic background. CONCLUSIONS To date, the threats from migraine and TTH in non-high-income East and Southeast Asia are still serious and ongoing, leading to prominently negative impacts on the daily life and work of local residents. Therefore, full attention and sound guidelines are urgently needed to obtain greater advantages in fighting against the burden of headache disorders in the future.
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Affiliation(s)
- Rongguang Ge
- Medical College of Soochow University, Soochow University, Suzhou, China
| | - Jie Chang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou, China.
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Arias D, Saxena S, Verguet S. Quantifying the global burden of mental disorders and their economic value. EClinicalMedicine 2022; 54:101675. [PMID: 36193171 PMCID: PMC9526145 DOI: 10.1016/j.eclinm.2022.101675] [Citation(s) in RCA: 114] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Epidemiological and economic estimates suggest that the global burden of mental disorders is considerable, both in its impacts on human health and losses to societal welfare. The availability of additional data and the emergence of new approaches present an opportunity to examine these estimates, which form a critical part in making the investment case for global mental health. METHODS This study reviews, develops, and incorporates new estimates and methods in quantifying the global burden of mental illness. Using a composite estimation approach that accounts for premature mortality due to mental disorders and additional sources of morbidity and applying a value of a statistical life approach to economic valuation, we determine global and regional estimates of the economic cost that can be associated with mental disorders, building on data from the 2019 Global Burden of Disease study. FINDINGS We estimate that 418 million disability-adjusted life years (DALYs) could be attributable to mental disorders in 2019 (16% of global DALYs)-a more than three-fold increase compared to conventional estimates. The economic value associated with this burden is estimated at about USD 5 trillion. At a regional level, the losses could account for between 4% of gross domestic product in Eastern sub-Saharan Africa and 8% in High-income North America. INTERPRETATION The burden of mental illness in terms of both health and economic losses may be much higher than previously assessed. FUNDING None.
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Hosseini J, Shojaeefar E, Pooladgar P, Aliakbari F, Ganji M, Hamdieh M, Kheradmand A, Fashami MA. Prevalence of substance use among Iranian male adolescents: Systematic review and meta-analysis. Health Sci Rep 2022; 5:e885. [PMID: 36304760 PMCID: PMC9595342 DOI: 10.1002/hsr2.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/08/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background and aims Substance use among adolescents is one of the most challenging behavioral disorders with direct consequences. It is of the essence (that) the prevalence of substance use is investigated among Iranian male adolescents. Methods The present study is a systematic review and meta-analysis. All published articles titled "prevalence of substance use among Iranian adolescents" authored in Persian and English from 2004 to 2020 on Pub Med, Scopus, SID, and Google Scholar, a top list of academic research databases, were reviewed. Thirty-three out of 805 articles, hinge on the inclusion and exclusion criteria, were eligible. Statistical analysis carried out in STATA 14.0.Q index, I2 index, and χ 2 test were applied. Results Overall prevalence reported with (95% confidence interval) for substance use 7% (4%-11%), methamphetamine 4% (3%-6%), tobacco 10% (3%-19%), and any addictive substances 4% (2%-7%) among male adolescents respectively. Besides, overall prevalence of alcohol consumption reported 10% (8%-11%). Conclusion The prevalence of substance use among male adolescents is high, so it is indispensable for researchers to pay special attention to this issue.
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Affiliation(s)
- Jalil Hosseini
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ehsan Shojaeefar
- Immunology Board for Transplantation and Advanced Cellular Therapeutics (ImmunoTACT)Universal Scientific and Education Network (USERN)TehranIran
| | - Parham Pooladgar
- School of MedicineShahid Beheshti University of Medical ScienceTehranIran
| | - Fereshteh Aliakbari
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Ganji
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Mostafa Hamdieh
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Mahta Abbasi Fashami
- School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
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Timmis A, Vardas P, Townsend N, Torbica A, Katus H, De Smedt D, Gale CP, Maggioni AP, Petersen SE, Huculeci R, Kazakiewicz D, de Benito Rubio V, Ignatiuk B, Raisi-Estabragh Z, Pawlak A, Karagiannidis E, Treskes R, Gaita D, Beltrame JF, McConnachie A, Bardinet I, Graham I, Flather M, Elliott P, Mossialos EA, Weidinger F, Achenbach S. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J 2022; 43:716-799. [PMID: 35016208 DOI: 10.1093/eurheartj/ehab892] [Citation(s) in RCA: 390] [Impact Index Per Article: 195.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/07/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
AIMS This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the widely cited 2019 report in presenting cardiovascular disease (CVD) statistics for the 57 ESC member countries. METHODS AND RESULTS Statistics pertaining to 2019, or the latest available year, are presented. Data sources include the World Health Organization, the Institute for Health Metrics and Evaluation, the World Bank, and novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery. New material in this report includes sociodemographic and environmental determinants of CVD, rheumatic heart disease, out-of-hospital cardiac arrest, left-sided valvular heart disease, the advocacy potential of these CVD statistics, and progress towards World Health Organization (WHO) 2025 targets for non-communicable diseases. Salient observations in this report: (i) Females born in ESC member countries in 2018 are expected to live 80.8 years and males 74.8 years. Life expectancy is longer in high income (81.6 years) compared with middle-income (74.2 years) countries. (ii) In 2018, high-income countries spent, on average, four times more on healthcare than middle-income countries. (iii) The median PM2.5 concentrations in 2019 were over twice as high in middle-income ESC member countries compared with high-income countries and exceeded the EU air quality standard in 14 countries, all middle-income. (iv) In 2016, more than one in five adults across the ESC member countries were obese with similar prevalence in high and low-income countries. The prevalence of obesity has more than doubled over the past 35 years. (v) The burden of CVD falls hardest on middle-income ESC member countries where estimated incidence rates are ∼30% higher compared with high-income countries. This is reflected in disability-adjusted life years due to CVD which are nearly four times as high in middle-income compared with high-income countries. (vi) The incidence of calcific aortic valve disease has increased seven-fold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. (vii) Although the total number of CVD deaths across all countries far exceeds the number of cancer deaths for both sexes, there are 15 ESC member countries in which cancer accounts for more deaths than CVD in males and five-member countries in which cancer accounts for more deaths than CVD in females. (viii) The under-resourced status of middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, ablation procedures, device implantation, and cardiac surgical procedures. CONCLUSION Risk factors and unhealthy behaviours are potentially reversible, and this provides a huge opportunity to address the health inequalities across ESC member countries that are highlighted in this report. It seems clear, however, that efforts to seize this opportunity are falling short and present evidence suggests that most of the WHO NCD targets for 2025 are unlikely to be met across ESC member countries.
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Affiliation(s)
- Adam Timmis
- William Harvey Research Institute, Queen Mary University London, London, UK
| | - Panos Vardas
- Hygeia Hospitals Group, HHG, Athens, Greece
- European Heart Agency, European Society of Cardiology, Brussels, Belgium
| | | | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
| | - Hugo Katus
- Department of Internal Medicine and Cardiology, University of Heidelberg, Heidelberg, Germany
| | | | - Chris P Gale
- Medical Research Council Bioinformatics Centre, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Aldo P Maggioni
- Research Center of Italian Association of Hospital Cardiologists (ANMCO), Florence, Italy
| | - Steffen E Petersen
- William Harvey Research Institute, Queen Mary University London, London, UK
| | - Radu Huculeci
- European Heart Agency, European Society of Cardiology, Brussels, Belgium
| | | | | | - Barbara Ignatiuk
- Division of Cardiology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | | | - Agnieszka Pawlak
- Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roderick Treskes
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dan Gaita
- Universitatea de Medicina si Farmacie Victor Babes, Institutul de Boli Cardiovasculare, Timisoara, Romania
| | - John F Beltrame
- University of Adelaide, Central Adelaide Local Health Network, Basil Hetzel Institute, Adelaide, Australia
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | | | - Ian Graham
- Tallaght University Hospital, Dublin, Ireland
| | - Marcus Flather
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Perry Elliott
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Franz Weidinger
- Department of Internal Medicine and Cardiology, Klinik Landstrasse, Vienna, Austria
| | - Stephan Achenbach
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Haddad Z, Williams KN, Lewis JJ, Prats EV, Adair-Rohani H. Expanding data is critical to assessing gendered impacts of household energy use. BMJ 2021; 375:n2273. [PMID: 34649862 PMCID: PMC8515214 DOI: 10.1136/bmj.n2273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zeenah Haddad and colleagues call for an expansion of data on household energy use routinely collected through national surveys to gauge the health effects by gender
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Affiliation(s)
- Zeenah Haddad
- Department for Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Kendra N Williams
- Department for Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Jessica J Lewis
- Department for Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Elena Villalobos Prats
- Department for Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Heather Adair-Rohani
- Department for Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
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9
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Tichenor M, Winters J, Storeng KT, Bump J, Gaudillière JP, Gorsky M, Hellowell M, Kadama P, Kenny K, Shawar YR, Songane F, Walker A, Whitacre R, Asthana S, Fernandes G, Stein F, Sridhar D. Interrogating the World Bank's role in global health knowledge production, governance, and finance. Global Health 2021; 17:110. [PMID: 34538254 PMCID: PMC8449994 DOI: 10.1186/s12992-021-00761-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background In the nearly half century since it began lending for population projects, the World Bank has become one of the largest financiers of global health projects and programs, a powerful voice in shaping health agendas in global governance spaces, and a mass producer of evidentiary knowledge for its preferred global health interventions. How can social scientists interrogate the role of the World Bank in shaping ‘global health’ in the current era? Main body As a group of historians, social scientists, and public health officials with experience studying the effects of the institution’s investment in health, we identify three challenges to this research. First, a future research agenda requires recognizing that the Bank is not a monolith, but rather has distinct inter-organizational groups that have shaped investment and discourse in complicated, and sometimes contradictory, ways. Second, we must consider how its influence on health policy and investment has changed significantly over time. Third, we must analyze its modes of engagement with other institutions within the global health landscape, and with the private sector. The unique relationships between Bank entities and countries that shape health policy, and the Bank’s position as a center of research, permit it to have a formative influence on health economics as applied to international development. Addressing these challenges, we propose a future research agenda for the Bank’s influence on global health through three overlapping objects of and domains for study: knowledge-based (shaping health policy knowledge), governance-based (shaping health governance), and finance-based (shaping health financing). We provide a review of case studies in each of these categories to inform this research agenda. Conclusions As the COVID-19 pandemic continues to rage, and as state and non-state actors work to build more inclusive and robust health systems around the world, it is more important than ever to consider how to best document and analyze the impacts of Bank’s financial and technical investments in the Global South. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00761-w.
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Affiliation(s)
- Marlee Tichenor
- Department of Anthropology, Durham University, Dawson Building South Road, Durham, DH1 3LE, UK.
| | - Janelle Winters
- Global Health Studies, Department of History, University of Iowa, 280 Schaeffer Hall, Iowa, 52242, USA
| | - Katerini T Storeng
- Center for Development and Environment, University of Oslo, Norway, Postboks 1116, Blindern, 0317, Oslo, Norway
| | - Jesse Bump
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1205, Boston, MA, 02115, USA
| | - Jean-Paul Gaudillière
- Centre de recherche médecine, science, santé et société (CERMES3), Ecole des Hautes Etudes en Sciences Sociales, 7, rue Guy Môquet, 8 - 94801, Villejuif Cedex, BP, France
| | - Martin Gorsky
- Centre for History in Public Health, London School of Hygiene and Tropical Medicine, UK, Room S12, LSHTM, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Mark Hellowell
- Global Health Policy Unit, Social Policy, University of Edinburgh, Chrystal Macmillan Building, 15A George Square, Edinburgh, EH8 9LD, UK
| | - Patrick Kadama
- African Center for Global Health and Social Formation, Plot 13 B Acacia Avenue, Kololo, P.O. Box 9974, Kampala, Uganda
| | - Katherine Kenny
- Department of Sociology and Social Policy, University of Sydney, Australia, A02 - Social Sciences Building, Camperdown, NSW, 2006, Australia
| | - Yusra Ribhi Shawar
- Bloomberg School of Public Health and Paul H. Nitze School of Advanced International Studies, Johns Hopkins University, 615 N. Wolfe Street Room E8132, Baltimore, MD, 21205, USA
| | - Francisco Songane
- Africa Public Health Foundation, 5th Floor, The Atrium Kilimani, Nairobi, Kenya
| | - Alexis Walker
- Columbia University Irving Medical Center, 630 W. 168th St., New York, NY, 10032, USA
| | - Ryan Whitacre
- Global Health Centre, Graduate Institute of International and Development Studies, Case postale 1672, 1211, Genève 1, Switzerland
| | - Sumegha Asthana
- Center of Social Medicine and Community Health, Jawaharlal Nehru University, New Mehrauli Road, New Delhi, 110067, India
| | - Genevie Fernandes
- Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Felix Stein
- Centre for Development and the Environment, University of Oslo, Postboks 1116 Blindern, 0317, Oslo, Norway
| | - Devi Sridhar
- Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
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Schrecker T. What is critical about critical public health? Focus on health inequalities. CRITICAL PUBLIC HEALTH 2021. [DOI: 10.1080/09581596.2021.1905776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ted Schrecker
- Global Health Policy, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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11
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Evangelopoulos D, Perez-Velasco R, Walton H, Gumy S, Williams M, Kelly FJ, Künzli N. The role of burden of disease assessment in tracking progress towards achieving WHO global air quality guidelines. Int J Public Health 2020; 65:1455-1465. [PMID: 33057794 PMCID: PMC7588380 DOI: 10.1007/s00038-020-01479-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/29/2020] [Accepted: 09/04/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES More than 90% of the global population live in areas exceeding the PM2.5 air quality guidelines (AQGs). We provide an overview of the ambient PM2.5-related burden of disease (BoD) studies along with scenario analysis in the framework of the WHO AQG update on the estimated reduction in the BoD if AQGs were achieved globally. METHODS We reviewed the literature for large-scale studies for the BoD attributed to ambient PM2.5. Moreover, we used the latest WHO statistics to calculate the BoD at current levels and the scenarios of aligning with interim targets and AQG levels. RESULTS The most recent BoD studies (2010 onwards) share a similar methodology, but there are differences in the input data which affect the estimates for attributable deaths (2.9-8.9 million deaths annually). Moreover, we found that if AQGs were achieved, the estimated BoD would be reduced by up to 50% in total deaths worldwide. CONCLUSIONS Understanding the BoD across countries, especially in those that do not align with the AQGs, is essential in order to inform actions to reduce air pollution globally.
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Affiliation(s)
- Dimitris Evangelopoulos
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute for Health Research Health Protection Unit: Environmental Exposures and Health, Imperial College, London, United Kingdom
| | - Roman Perez-Velasco
- European Centre for Environment and Health, World Health Organization Regional Office for Europe, Bonn, Germany
| | - Heather Walton
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute for Health Research Health Protection Unit: Environmental Exposures and Health, Imperial College, London, United Kingdom
| | - Sophie Gumy
- World Health Organization, Geneva, Switzerland
| | - Martin Williams
- Environmental Research Group, Imperial College, London, United Kingdom
| | - Frank J. Kelly
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute for Health Research Health Protection Unit: Environmental Exposures and Health, Imperial College, London, United Kingdom
| | - Nino Künzli
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
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12
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Mathers CD. History of global burden of disease assessment at the World Health Organization. Arch Public Health 2020; 78:77. [PMID: 32850124 PMCID: PMC7443850 DOI: 10.1186/s13690-020-00458-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/10/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The World Health Organization collaborated in the first Global Burden of Disease Study (GBD), published in the 1993 World Development Report. This paper summarizes the substantial methodological improvements and expanding scope of GBD work carried out by WHO over the next 25 years. METHODS This review is based on a review of WHO and UN interagency work relating to Global Burden of Disease over the last 20 years, supplemented by a literature review of published papers and commentaries on global burden of disease activities and the production of global health statistics. RESULTS WHO development of global burden of disease work in the Millenium Development Goal era resulted in regular publication of time series estimates of deaths by cause, age and sex at country level, consistent with UN population and life table estimates, and with cause-specific statistics produced across UN agencies and interagency collaborations. This positioned WHO as the lead agency to monitor many of the 43 health-related indicators for the UN Sustainable Development Goals.In 2007, the Institute of Health Metrics and Evaluation (IHME) was established to conduct new global burden of disease and related work, funded by the Bill and Melinda Gates Foundation (BMGF). WHO was a core collaborator in its first GBD2010 study, but withdrew prior to publication as it was unable to obtain full access input data and methods. The publication of global health statistics by IHME resulted in user confusion and in debate over differences and the reasons for them. The new WHO administration of Director General Dr. Tedros Ghebreyesus has sought to make greater use of IHME outputs for its global health statistics and SDG monitoring. CONCLUSIONS WHO work on global burden of disease has positioned it to be the lead agency for monitoring many of the UN Sustainable Development Goals. Current moves to use IHME analyses raises a number of issues for WHO and for Member States in relation to WHO's constitutional mandate, its accountability to Member States, the consistency of WHO and UN demographic and health statistics, and the ability of Member States to engage with the results of the complex and computer-intensive modelling procedures used by IHME. As new global health actors and funders have arisen in recent decades, and funding to carry out WHO's expanding mandate has declined, it is unclear whether WHO has the ability or desire to continue as the lead agency for global health statistics.
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Affiliation(s)
- Colin D. Mathers
- Consultant on Global Health, Geneva, Switzerland
- College of Medicine & Veterinary Medicine, University of Edinburgh, 30 West Richmond Street, Edinburgh, EH8 9DX UK
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13
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Kavanagh MM, Katz IT, Holmes CB. Reckoning with mortality: global health, HIV, and the politics of data. Lancet 2020; 396:288-290. [PMID: 32628903 PMCID: PMC7333989 DOI: 10.1016/s0140-6736(20)31046-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Matthew M Kavanagh
- Department of International Health and O'Neill Institute for National and Global Health, Georgetown University, Washington, DC, USA.
| | - Ingrid T Katz
- Harvard Global Health Institute and Harvard Medical School, Harvard University, Boston, MA, USA
| | - Charles B Holmes
- Center for Innovation in Global Health, Georgetown University, Washington, DC, USA; School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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14
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Gona PN, Gona CM, Ballout S, Rao SR, Kimokoti R, Mapoma CC, Mokdad AH. Burden and changes in HIV/AIDS morbidity and mortality in Southern Africa Development Community Countries, 1990-2017. BMC Public Health 2020; 20:867. [PMID: 32503604 PMCID: PMC7274054 DOI: 10.1186/s12889-020-08988-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 05/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background The 16 Southern Africa Development Community (SADC) countries remain the epicentre of the HIV/AIDS epidemic with the largest number of people living with HIV/AIDS. Anti-retroviral treatment (ART) has improved survival and prevention of mother-to-child transmission (PMTCT) of HIV, but the disease remains a serious cause of mortality. We conducted a descriptive epidemiological analysis of HIV/AIDS burden for the 16 SADC countries using secondary data from the Global Burden of Diseases, Injuries and Risk Factor (GBD) Study. Methods The GBD study is a systematic, scientific effort by the Institute for Health Metrics and Evaluation (IHME) to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors by age, sex, and geographies for specific points in time. We analyzed the following outcomes: mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to HIV/AIDS for SADC. Input data for GBD was extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service utilisation, disease notifications, and other sources. Country- and cause-specific HIV/AIDS-related death rates were calculated using the Cause of Death Ensemble model (CODEm) and spatiotemporal Gaussian process regression (ST-GPR). Deaths were multiplied by standard life expectancy at each age-group to calculate YLLs. Cause-specific mortality was estimated using a Bayesian meta-regression modelling tool, DisMod-MR. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases to calculate YLDs. Crude and age-adjusted rates per 100,000 population and changes between 1990 and 2017 were determined for each country. Results In 2017, HIV/AIDS caused 336,175 deaths overall in SADC countries, and more than 20 million DALYs. This corresponds to a 3-fold increase from 113,631 deaths (6,915,170 DALYs) in 1990. The five leading countries with the proportion of deaths attributable to HIV/AIDS in 2017 were Botswana at the top with 28.7% (95% UI; 23.7–35.2), followed by South Africa 28.5% (25.8–31.6), Lesotho, 25.1% (21.2–30.4), eSwatini 24.8% (21.3–28.6), and Mozambique 24.2% (20.6–29.3). The five countries had relative attributable deaths that were at least 14 times greater than the global burden of 1.7% (1.6–1.8). Similar patterns were observed with YLDs, YLLs, and DALYs. Comoros, Seychelles and Mauritius were on the lower end, with attributable proportions less than 1%, below the global proportion. Conclusions Great progress in reducing HIV/AIDS burden has been achieved since the peak but more needs to be done. The post-2005 decline is attributed to PMTCT of HIV, resources provided through the US President’s Emergency Plan For AIDS Relief (PEPFAR), and behavioural change. The five countries with the highest burden of HIV/AIDS as measured by proportion of death attributed to HIV/AIDS and age-standardized mortaility rate were Botswana, South Africa, Lesotho, eSwatini, and Mozambique. SADC countries should cooperate, work with donors, and embrace the UN Fast-Track approach, which calls for frontloading investment from domestic or other sources to prevent and treat HIV/AIDS. Robust tracking, testing, and early treatment are required, as well as refinement of individual treatment strategies for transient individuals in the region.
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Affiliation(s)
- Philimon N Gona
- College of Nursing & Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Clara M Gona
- Department of Nursing, MGH Institute for Health Professions, Boston, MA, USA
| | - Suha Ballout
- College of Nursing & Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Sowmya R Rao
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Ruth Kimokoti
- Department of Nutrition, Simmons College, Boston, MA, USA
| | - Chabila C Mapoma
- Department of Population Studies, University of Zambia, Lusaka, Zambia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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15
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Pan Z, Zhang J, Bu Q, He H, Bai L, Yang J, Liu Q, Lyu J. The Gap Between Global Tuberculosis Incidence and the First Milestone of the WHO End Tuberculosis Strategy: An Analysis Based on the Global Burden of Disease 2017 Database. Infect Drug Resist 2020; 13:1281-1286. [PMID: 32440164 PMCID: PMC7210037 DOI: 10.2147/idr.s248875] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/16/2020] [Indexed: 12/03/2022] Open
Abstract
Objective The first milestone (in 2020) of the End Tuberculosis (TB) Strategy of the World Health Organization was a 20% reduction in TB incidence rate compared with the 2015 baseline. This study aimed to determine the incidence rate of TB and how it has changed since 2015 at the global, regional, and country levels. Methods This study used the most recent data from the Global Burden of Disease study in 2017 to extract TB incidence rates at the global, regional, and country levels. The annual percentage change in the incidence rate (APCIR) of TB based on 2015 was calculated to evaluate the trend in the changes at various levels, including globally and at the regional and country levels. An APCIR of –4% from 2015 to 2020 is considered acceptable. Results The global APCIR was only –1.1% from 2015 to 2017. Only 2 of the 21 analyzed regions had APCIRs lower than –4%: Southern Sub-Saharan Africa and Eastern Europe. Worse still, six regions exhibited increasing TB incidence rates. At the country level, although 143 of 195 countries and territories showed reductions in TB incidence rates, the APCIR was lower than –4% in only 11 of them. Conclusion This study suggests that it will be difficult to achieve the 2020 incidence rate milestone of the End Tuberculosis Strategy. This indicates the need to design and implement suitable strategies to address the current situation in order to achieve the next milestone and targets of the End Tuberculosis Strategy.
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Affiliation(s)
- Zhenyu Pan
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Pharmacy, Xi'an Children's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Jun Zhang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Orthopaedics, Baoji Municipal Central Hospital, Baoji, Shaanxi, People's Republic of China
| | - Qingting Bu
- Department of Genetics, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Ling Bai
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Jin Yang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Qingqing Liu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
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16
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Shiffman J, Shawar YR. Strengthening accountability of the global health metrics enterprise. Lancet 2020; 395:1452-1456. [PMID: 32305072 PMCID: PMC7162633 DOI: 10.1016/s0140-6736(20)30416-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/07/2020] [Accepted: 02/12/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Jeremy Shiffman
- Bloomberg School of Public Health, Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA.
| | - Yusra Ribhi Shawar
- Bloomberg School of Public Health, Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
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17
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Abstract
The exercise of power permeates global governance processes, making power a critical concept for understanding, explaining, and influencing the intersection of global governance and health. This article briefly presents and discusses three well-established conceptualizations of power-Dahl's, Bourdieu's, and Barnett and Duvall's-from different disciplines, finding that each is important for understanding global governance but none is sufficient. The conceptualization of power itself needs to be expanded to include the multiple ways in which one actor can influence the thinking or actions of others. I further argue that global governance processes exhibit features of complex adaptive systems, the analysis of which requires taking into account multiple types of power. Building on established frameworks, the article then offers an expanded typology of eight kinds of power: physical, economic, structural, institutional, moral, discursive, expert, and network. The typology is derived from and illustrated by examples from global health, but may be applicable to global governance more broadly. Finally, one seemingly contradictory - and cautiously optimistic - conclusion emerges from this typology: multiple types of power can mutually reinforce tremendous power disparities in global health; but at the same time, such disparities are not necessarily absolute or immutable. Further research on the complex interaction of multiple types of power is needed for a better understanding of global governance and health.
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Affiliation(s)
- Suerie Moon
- Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland.
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18
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Abstract
Felix Stein and Devi Sridhar warn of the dangers of subsuming health to economic productivity
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Affiliation(s)
- Felix Stein
- Medical School, Edinburgh University, Edinburgh, UK
| | - Devi Sridhar
- Medical School, Edinburgh University, Edinburgh, UK
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