Latin America and the Caribbean have made major advances in expanding access to antiretroviral therapy (ART), according to a new report from the Pan American Health Organization. In 2012, about 75% of patients who met WHO criteria for treatment were receiving ART. However, early diagnosis remains a challenge in many countries in the region.
Refreshingly, 2013 has been a year in which the health inequalities between Indigenous and non-Indigenous peoples have gained greater attention. An early example of this attention was the announcement, in July, by the Australian Government of their 10 year plan to address these inequalities. And, on Nov 28, the Health Council of Canada added to this progress with the publication of Canada's Most Vulnerable: Improving Health Care for First Nations, Inuit, and Métis Seniors. The authors of the Canadian report set out to explore the health challenges faced by older Indigenous Canadians.
19 million children younger than 5 years had severe acute malnutrition (SAM) worldwide in 2011, most of whom lived in Africa and southeast Asia. Furthermore, more than 7% of all deaths in this age group were attributable to this disorder. These shocking numbers—calculated as part of the 2013 Lancet Series on Maternal and Child Nutrition—highlight how seriously the global problem of SAM should be taken. Therefore, the newly released WHO guidelines for the management of SAM in young children, to replace those produced in 1999, should be welcomed as a step in the right direction.
Dec 10 marks Human Rights Day, which this year celebrates 20 years since the Vienna Declaration and Programme of Action—a reaffirmation of the global community's commitment to human rights. It is also two decades since the UN General Assembly's Declaration on the Elimination of Violence against Women. The anniversary represents a time to reflect on how far the world has come in protecting the rights, safety, health, and dignity of women, and—in complex conflict situations like Syria—how far we have to go.
When Dean Jamison proposed in 2012 that he and Lawrence Summers should reprise their work on investing in health—their 1993 World Development Report (WDR) remains the only World Bank annual publication dedicated to health—it seemed a huge and daunting task. WDR 1993, as it came to be known, is surrounded in global health mythology. For some, it was a milestone in making the case for health to heads of state and finance ministers. For others, it opened the door to private sector colonisation of health care, a door that, once opened, could never be closed again.
During the past few years we have jointly forged a strong case for health and its links to sustainable development in the post-2015 agenda, with an overarching goal that seeks to maximise health at all stages of life, and with universal health coverage and access as the key means to its achievement. We have acknowledged the need to accelerate progress on the current Millennium Development Goals; to broaden the agenda to encompass non-communicable diseases; and to give more prominence to sexual and reproductive health, with particular emphasis on the health of adolescents.
Ischaemic heart disease shows sex differences in terms of clinical characteristics and pathophysiological mechanisms. Women presenting with ischaemic heart disease are generally older, have more comorbidities, and have an increased risk of bleeding compared with men.
Paediatric cardiomyopathies are an uncommon and heterogeneous group of disorders. Causes of and associations with paediatric cardiomyopathies include metabolic and mitochondrial diseases, genetic mutations in sarcomeric and cytoskeletal proteins, neuromuscular disorders, and syndromic malformations.
Last week, jointly with University College London, the London School of Hygiene and Tropical Medicine, and the UK Health Forum, we held a second national conference dedicated to new research in UK public health. The meeting showcased the tremendous contribution research can make to public health practice and policy. It highlighted original ways to exchange new knowledge beyond journal articles (eg, TobaccoTactics.org, created by the Tobacco Control Research Group at the University of Bath, which continuously posts new information to explore “how the industry influences and distorts public health debates”).
Every so often, significant global trends can be traced back to a source. The 1993 World Development Report (WDR) was such a catalyst in global health and development policy, demonstrating to finance ministers, economists, and philanthropists that health is an investment with positive economic returns—and not simply a drain on scarce resources. The report helped set the stage for a major scale-up of health investments at global, regional, and national levels.
The world has changed radically since the World Development Report (WDR) Investing in Health was published 20 years ago, so it is valuable and timely to look ahead once again. The Lancet Commission's optimistic report on investing in health confirms my view that the best times for public health are still ahead of us.
On the 20th anniversary of the 1993 World Development Report (WDR), the report of the Lancet Commission on Investing in Health reaffirms that investing in health is a strategic investment with enormous economic returns. In recognition of the intrinsic value of health, the Commission used a “full income” approach to demonstrate an even higher total return from health investments than previously calculated. Measuring economic and intrinsic values together clearly shows that investments in health are investments in human development—in enlarging people's choices, freedoms, and capabilities to lead lives they value.
The 1993 World Development Report (WDR) was a landmark publication: it put health squarely on the radar as a mainstream development opportunity. WDR 1993 made the important linkage between health gains and economic development, and it did so with arguments, metrics, and an audience that would have a substantial impact on how the world's decision makers prioritised and financed health.
This year the prestigious awards pay tribute to four people who have dedicated their careers to turning the tide against HIV/AIDS. David Holmes reports.
A major epidemiological study into the Bhopal chemical disaster has reported that a large proportion of its cohort has been lost to follow-up. Dinesh C Sharma reports.
The recent Super Typhoon Haiyan, the third category 5 typhoon to strike the Philippines since 2010, tore through Tacloban in the province of Leyte and affected about 13 million people; only 4 weeks after Super Typhoon Usagi affected more than 2·7 million people in southern China. With increasing numbers of disasters related to climate change (from 99 in 1980 to 269 in 2011), Asia is likely to be hit by more typhoons with stronger intensity in the coming decades.
We read with great interest Stefan Leucht and colleagues' meta-analysis (Sept 14, p 951). It is remarkable that the five newest antipsychotics—ziprasidone, aripiprazole, asenapine, iloperidone, and lurasidone—are at the bottom of the efficacy and all-cause discontinuation figures, although there are no known pharmacological differences to explain these findings. Here, we suggest that they form a subclass of antipsychotics with administration issues that lower total drug exposure. We believe that pharmacokinetics can explain the differences in efficacy of antipsychotics.
In their multiple-treatments meta-analysis ranking reported efficacy and tolerability of 15 antipsychotics, Stefan Leucht and colleagues' tabulated the standardised mean difference (SMD) for all pairwise treatment comparisons and order of efficacy ranking. We have concerns with the limitations of the ranking analysis based on multiple-treatments meta-analysis when the treatment network is sparse, asymmetric, and quality-biased. For example, the SMD for amisulpride (vs placebo) and the majority of treatment comparisons between the 15 antipsychotics (figure 2) were based on indirect evidence, rendering impossible verification of the necessary consistency assumptions when comparing any two treatments through a third comparator.