scholarly journals Equitable vaccine distribution promotes socioeconomic benefits globally

2021 ◽  
Author(s):  
Nils Stenseth ◽  
Daoping Wang ◽  
Ruiyun Li ◽  
Tianyang Lei ◽  
Yida Sun ◽  
...  
Keyword(s):  
High Risk ◽  
Low Income ◽  
The Elderly ◽  
Economic Benefits ◽  
Benefit Sharing ◽  
Low Income Countries ◽  
Modeling Framework ◽  
Distribution Strategy ◽  
Health Gains ◽  
Vaccine Distribution

Abstract Ensuring a more equitable distribution of vaccines worldwide is an effective strategy to control the COVID-19 pandemic and support global economic recovery. Here, we analyze the socioeconomic effects - defined as health gains, lockdown-easing benefit, and supply-chain rebuilding benefit - of a set of idealized vaccine distribution scenarios, by coupling an epidemiological model with a global trade-modeling framework. We find that overall a perfectly equitable vaccine distribution across the world (Altruistic Age-informed Distribution Strategy) would increase global economic benefits by 11.7% ($950 billion) per year, compared to a strategy focusing on vaccinating the entire population within vaccine-producing countries first and then distributing vaccines to non-vaccine-producing countries (Selfish Distribution Strategy). With limited doses among mid- and low-income countries, prioritizing the elderly who are at high risk of dying, together with the key workforce who are at high risk of exposure, is found to be economically beneficial. We further show that such a strategy would cascade the protection to other production sectors while rebuilding the supply chains. Our results point to a benefit-sharing mechanism which highlights the potential of collaboration between vaccine-producing and other countries to guide an economically preferable vaccine distribution worldwide.

scholarly journals Hypertensive Urgency in Tanzanian Adults: A 1-Year Prospective Study

2020 ◽  
Author(s):  
Karl G Reis ◽  
Raymond Wilson ◽  
Fredrick Kalokola ◽  
Bahati Wajanga ◽  
Myung-Hee Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
High Risk ◽  
Prospective Study ◽  
Low Income ◽  
Hypertensive Crisis ◽  
The United States ◽  
Low Income Countries ◽  
Improve Medication Adherence ◽  
Hypertensive Urgency ◽  
Poor Outcomes

Abstract BACKGROUND Hypertensive urgency is associated with a high risk for cardiovascular events and mortality in the United States and Europe, but data from low-income countries and interventions to improve outcomes are lacking. METHODS We conducted a 1-year prospective study of the prevalence and outcomes of hypertensive urgency (blood pressure (BP) ≥180 mm Hg/120 mm Hg without end-organ damage) in a busy outpatient clinic in Tanzania. RESULTS Of 7,600 consecutive adult outpatients screened with 3 unattended automated BP measurements according to standard protocol, the prevalence of hypertensive crisis was 199/7,600 (2.6%) (BP ≥180 mm Hg/120 mm Hg) and the prevalence of hypertensive urgency was 164/7,600 (2.2%). Among 150 enrolled patients with hypertensive urgency, median age was 62 years (54–68), 101 (67.3%) were women, and 53 (35%) were either hospitalized or died within 1 year. In a multivariate model, the strongest predictor of hospitalization/death was self-reported medication adherence on a 3 question scale (hazard ratio: 0.06, P < 0.001); 90% of participants with poor adherence were hospitalized or died within 1 year. CONCLUSIONS Patients with hypertensive urgency in Africa are at high risk of poor outcomes. Clinicians can identify the patients at highest risk for poor outcomes with simple questions related treatment adherence. New interventions are needed to improve medication adherence in patients with hypertensive urgency.

Africa's cancer burden to rise without funding shift

2015 ◽  
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Economic Benefits ◽  
World Health ◽  
Low Income Countries ◽  
Health Priorities ◽  
African Countries ◽  
Content Type ◽  
Cancer Burden ◽  
Market Expansion

Subject Cancer burden in Africa. Significance Cancer is a growing public health threat in low-income countries, including African states. With the increase in urbanisation, population growth and improving mortality rates, the World Health Organisation (WHO) estimates that by 2020, 16 million new cases of cancer will be diagnosed each year, with 70% of those in low-income countries. However, the rise in cancer rates has not been met with changes to aid funding. Global health priorities continue to emphasise infectious diseases, and African countries remain ill-equipped to prevent, diagnose or treat cancer. Impacts Rising consumption of processed foods in urban areas will contribute to an overall rise in non-communicable diseases. African countries are some of the fastest growing markets for tobacco companies as health awareness rises in traditional markets. Global brewers will enjoy significant market expansion in Africa, contributing to increased alcohol consumption. Despite the economic benefits, delayed childbearing and lower fertility in women is set to increase the incidence of breast cancer.

scholarly journals Alignment of transtibial prostheses based on rollover shape principles

2003 ◽  
Vol 27 (2) ◽  
pp. 89-99 ◽  
Author(s):  
A. H. Hansen ◽  
M. R. Meier ◽  
M. Sam ◽  
D. S. Childress ◽  
M. L. Edwards
Keyword(s):  
Low Income ◽  
A Priori ◽  
The Elderly ◽  
Low Income Countries ◽  
Alignment Algorithm ◽  
Shape Alignment ◽  
Prosthetic Alignment ◽  
Alignment System ◽  
Prosthetic Feet ◽  
The Ideal

The authors examined the rollover shape alignment hypothesis, which states that prosthetic feet are aligned by matching their rollover shapes with an “ideal” shape. The “ideal” shape was considered to be the rollover shape of the ablebodied footankle system. An alignment algorithm and computational alignment system were developed to set transtibial alignments based on this hypothesis. Three prosthetic feet with considerably different rollover shapes were either aligned using the alignment system or not aligned (i.e. used previous foot's alignment), and then were aligned by a team of prosthetists. No significant differences were found between rollover shapes aligned by the computational alignment system and those based on standard clinical techniques (p = 0.944). Significant differences were found between the “no alignment” shapes and the prosthetist alignment shapes (p = 0.006), and between the “no alignment” shapes and the computational alignment system shapes (p = 0.024). The results of the experiment support the hypothesis that the goal of alignment is to match the prosthetic foot's rollover shape, as closely as possible, with an “ideal” shape. The hypothesis is also supported by its ability to explain the results of previous studies. Using an “ideal” rollover shape or surface as a goal for prosthetic alignment could lead to a priori alignment, eliminating the need for alignment hardware in some cases. Being able to build the alignment into a prosthesis without special hardware could be beneficial in lowincome countries and in the fabrication of lightweight prostheses for the elderly.

scholarly journals Assessment of a new low-cost, PCR-based strategy for high-risk human papillomavirus DNA detection for cervical cancer prevention

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Pedro Surriabre ◽  
Andrea Torrico ◽  
Tania Vargas ◽  
Fuantina Ugarte ◽  
Patricia Rodriguez ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Low Income ◽  
Low Cost ◽  
Low Income Countries ◽  
Hybrid Capture ◽  
Hpv Test ◽  
Novel Strategy ◽  
Level Of Agreement

Abstract Background HPV test implementation as a primary screening tool has the potential to decrease cervical cancer incidence as shown by several studies around the world. However, in many low-resource settings, the HPV test introduction has been backed down mainly due to its price. In this study, we present a novel low-cost strategy involving simple devices and techniques for high-risk human papillomavirus (HR-HPV) detection. The analytical performance to detect HR-HPV infections of this novel strategy was assessed by comparing it with the Hybrid Capture 2 system (HC2), which is used as gold standard. Methods Paired-cervical samples were collected from 541 women assisting to gynecological services in an outpatient clinic. One sample was transported in the Hybrid Capture Standard Transport Medium for HR-HPV detection by the HC2. The second sample was transported on glass slide for detection by PCR-based techniques (GP-EIA, BSGP-EIA and pU 1 M-L/2R). Results The level of agreement between the PCR-based techniques and HC2 system was determined with the Cohen’s kappa value. The kappa values between HC2 and GP-EIA, BSGP-EIA and pU 1 M-L/2R were 0.71 (CI 95% 0.63–0.78), 0.78 (CI 95% 0.71–0.84) and 0.63 (CI 95% 0.55–0.72), respectively. However, when the results from both BSGP-EIA and pU 1 M-L/2R were combined, the level of agreement with HC2 was increased to 0.82 (CI 95% 0.76–0.88), reflecting a very good agreement between the two HR-HPV detection strategies. Furthermore, the sensitivity of both techniques combined was also increased compared to the BSGP-EIA (88.7% vs 77.4%) and the pU (88.7 vs 60.9%) without penalizing the specificity obtained with the BSGP-EIA (95.1% vs 96.9%) and the pU (95.1% vs 96.5%). Conclusions This novel strategy, combining two PCR-based techniques for HR-HPV detection, could be useful for cervical cancer screening in self-collected samples in low-income countries.

scholarly journals Micronutrients - a Global Perspective on Intake, Health Benefits and Economics

2012 ◽  
Vol 82 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Birgit Hoeft ◽  
Peter Weber ◽  
Manfred Eggersdorfer
Keyword(s):  
Low Income ◽  
Health Care Systems ◽  
The Elderly ◽  
The United States ◽  
Global Perspective ◽  
Low Income Countries ◽  
Micronutrient Deficiencies ◽  
Micronutrient Status ◽  
Care Systems ◽  
Development And Aging

The link between a sufficient intake of vitamins and long term health, cognition, healthy development and aging is increasingly supported by experimental animal, human and epidemiology studies. In low income countries billions of people still suffer from the burden of malnutrition and micronutrient deficiencies. However, inadequate micronutrient status might also be an issue in industrialized countries. Recent results from nutritional surveys in countries like the United States, Germany, and Great Britain indicate that the recommended intake of micronutrients is not reached. This notably concerns certain vulnerable population groups, such as pregnant women, young children and the elderly, but also greatly influences the general healthcare costs. An overview is provided on the gap that exists between current vitamin intakes and requirements, even in countries where diverse foods are plentiful. Folic acid and vitamin D intake and status are evaluated in more detail, providing insight on health and potential impact on health care systems.

scholarly journals Vaccine Equity

2021 ◽  
Author(s):  
Shalu Nigam
Keyword(s):  
Human Rights ◽  
Global Health ◽  
Low Income ◽  
Low Income Countries ◽  
Effective Response ◽  
Positive Duties ◽  
Moral Duties ◽  
The Third World ◽  
Vaccine Distribution ◽  
Health Rights

COVID-19 has shown that today the world is more interconnected, yet it is more hierarchical and stratified riddled with disproportionate systemic structural socio-economic inequalities. The global humanitarian disaster has highlighted the despair state of human rights affairs across the planet. It has exposed the supremacy of the neoliberal, nationalist paradigm that is deeply entrenched affecting the poorest of the poor. The pandemic has also indicated how capitalism is eroding democratic values endangering the lives of billions. Today, the high-income countries and the pharmaceutical companies are advancing their strategic interest, whereas the persons in the middle and low-income countries are being deprived of their basic requirements. Inequities in vaccine distribution are obstructing the effective response to the pandemic at the global level. Discrimination in access to the vaccine is adversely affecting the marginalized. This essay argues for respecting human rights as global health justice and suggests for affordable, accessible, and quality vaccination and treatment to all in line with reasoning that health inequalities and cross border issues are morally and ethically troubling and therefore are morally justified. Based on positive duties to create conditions for the availability of health rights for all humans, it argues that no rich country or resourceful persons will be safe until the last person is safe. These moral duties, in turn, generate duties of cooperation and obligations at international and domestic levels to better align with values in line with the principles of global health governance. Leaving a large section of the population in the Third world behind is not going to eliminate the threats of the spread of the epidemic.

scholarly journals Assessing and Improving Fitness to Drive in the Elderly People: a Scoping Review of Policies and Guidelines

2021 ◽  
Author(s):  
Salar Mohammaddokht ◽  
Mohammad Saadati ◽  
Babak Kashefimehr ◽  
Saber Azami-Aghdash
Keyword(s):  
Low Income ◽  
English Language ◽  
The Elderly ◽  
Low Income Countries ◽  
Driving Ability ◽  
Fitness To Drive ◽  
Safe Driving ◽  
Elderly Driver ◽  
Persian Language ◽  
The World

Abstract Background: Several countries in the world have distinct policies and frameworks to assessment and promote fitness to drive in the elderly. Accordingly, this study has been conducted to analyze the processes, models, and policies to assessment fitness to drive and improving driving in the elderly in the world.Method: Expected data were collected using keywords older, old, elderly, aging, ageing, senior, polic*, process, programme, plan, guideline, framework, driving capacity, driving eligibility, safe drive, fitness to drive, renewal driving license, commercial driver, driving qualification, driving ability, driving evaluation, driving assessment and their Persian equivalents from various English-language databases included: PubMed, Web of Science, Scopus, Embase, and Persian-language databases Included: IranDoc, SID, and MagIran. In this study, the Arkesy and O’Malley frameworks were employed.Results: Eventually, 24 papers and reports were included in the study. Vision assessment was the main item to judge the fitness to drive in the elderly, followed by driving assessment, cognitive assessment, and motor assessment. The in-person, postal, and online renewal of license were the most common method of renewal. General practitioners were the principal performers to measure driving fitness. In most all reports and papers, there were policies on empowering the elderly driver, including providing safe driving tips, optional driving skills tests, holding retraining courses, and so on. The most significant supporting policies included introducing alternative transportation to preserve the independence of the elderly. This study explained that clinical assessment is normally performed in drivers older than 75 years old to diagnose disorders and treat and prevent them in distinct time periods.Conclusion: Most high-income countries have worthwhile experience in measuring and improving the fitness to drive in the elderly and enforce different laws according to environmental, social, and political conditions. Utilizing these experiences by considering economic and social differences can be useful and practical for middle and low-income countries.

scholarly journals Challenge of Gastro-Intestinal Stromal Tumor Management in Low-Income Countries : Example of Benin

2021 ◽  
Author(s):  
Dansou Gaspard GBESSI ◽  
Freddy Houéhanou Rodrigue GNANGNON ◽  
Aboudou Raïmi KPOSSOU ◽  
Prudent Pacifique GBETCHEDJI ◽  
Falilatou Seidou ◽  
...  
Keyword(s):  
High Risk ◽  
Low Income ◽  
Locally Advanced ◽  
Stromal Tumor ◽  
Low Income Countries ◽  
Care Seeking ◽  
Mesenchymal Tumors ◽  
Cross Sectional ◽  
Risk Of Recurrence ◽  
Rare Tumors

Abstract Background: GISTs are rare tumors but the most frequent mesenchymal tumors of the digestive tract. Diagnosis and treatment are challenging in low-income countries due to relatively poor access to immunohistochemistry and targeted therapy. In Africa there are few studies about it. This study described the diagnosis and therapeutic management of GIST in Cotonou, Benin.Methods: This was a descriptive cross-sectional study, with retrospective data collection over a 10-year period from 2010 to 2020, focused on patients with histological confirmed gastro-intestinal stromal tumor (GIST). Data analysis was performed with Epidata Analysis software version 3.0.0.1.Results: Fifteen GISTs were identified during the study period. The median age was 52 and the sex ratio was 2. The most frequent symptom was abdominal pain (n = 12). Delay in care seeking after onset of symptoms ranged from 24 hours to 15 years. The most common site for GISTs was the stomach (n = 8). The median tumor size was 11 cm and the majority (n=10) was metastatic or locally advanced at the time of diagnosis. The tumors were often spindle-shaped at histology (n = 13) and the majority expressed KIT (n = 14). Most of the tumors (n = 12) were at high risk of recurrence according to the Joensuu scoring system. The availability of imatinib have improved the outcome of GIST with response in all cases it was used in neoadjuvant setting (n = 7).Conclusion: GISTs are rare tumors and preferentially affect the stomach in Cotonou. Most of the tumors were large, unresectable at the time of diagnosis and at high risk of recurrence. Access to imatinib has revolutionized the management of those tumors in our country.

Incidence and epidemiology

2019 ◽  
pp. 1-8
Author(s):  
Naiem Moiemen ◽  
Ammar Allouni
Keyword(s):  
Low Income ◽  
The Elderly ◽  
Low Income Countries ◽  
Vulnerable Groups ◽  
Terrorist Attacks ◽  
Mass Casualties ◽  
Older Children ◽  
Vulnerable Patients ◽  
In Fire ◽  
Vulnerable Adults

Burns is a global injury with devastating outcomes. Over 95% of burns occurs in low-income countries. The incidence is particularly significant in vulnerable groups. Scalds are the commonest injuries in toddlers, followed by contact burns while flame burns are less than 10%. The commonest injury in preschool children is scald followed by contact then flame burns. Flame burns are the commonest in older children over the age of 9 years. The incidence of burns in the elderly is rising especially in high-income countries as the life expectancy increases, however the outcome in this group is still unsatisfactory. Non-accidental burns of children, elderly and vulnerable adults require collaborative managements between different agencies to insure safeguarding vulnerable patients. Although health and legislations has dramatically reduced the number of burns injuries in fire disasters, terrorist attacks has become the commonest source of mass casualties.

scholarly journals A vaccine tax: ensuring a more equitable global vaccine distribution

2021 ◽  
pp. medethics-2021-107418
Author(s):  
Andreas Albertsen
Keyword(s):  
Ethical Issue ◽  
Low Income ◽  
Free Riding ◽  
Global Distribution ◽  
Low Income Countries ◽  
Unequal Distribution ◽  
Ability To Pay ◽  
Difficult Time ◽  
Vaccine Distribution

While COVID-19 vaccines provide light at the end of the tunnel in a difficult time, they also bring forth the complex ethical issue of global vaccine distribution. The current unequal global distribution of vaccines is unjust towards the vulnerable living in low-income countries. A vaccine tax should be introduced to remedy this. Under such a scheme, a small fraction of the money spent by a country on vaccines for its own population would go into a fund, such as COVAX, dedicated to buying vaccines and distributing them to the world’s poorest. A vaccine tax would provide a much-needed injection of funds to remedy the unequal distribution of vaccines. The tax allows for a distribution that, to a lesser degree, reflects the ability to pay and is superior to a donation-based model because it minimises the opportunity for free-riding.

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