According to this report, in 2008, an estimated 390 000–510 000 cases of multi-drug resistant tuberculosis (MDR-TB) emerged globally (best estimate, 440 000 cases). Among all incident TB cases globally, 3.6% are estimated to have MDR-TB. The report notes that more data on drug resistance has become available and estimates of the global MDR-TB burden have been improved. Even in settings gravely affected by drug resistance, it is possible to control MDR-TB, although new findings presented in this report give reason to be cautiously optimistic that drug-resistant TB can be controlled. While information available is growing and more and more countries are taking measures to combat MDRTB, urgent investments in infrastructure, diagnostics, and provision of care are essential if the target established for 2015 – the diagnosis and treatment of 80% of the estimated MDR-TB and extensively drug-resistant TB cases – is to be reached.
Equity in Health
This report includes data on testing for extensively drug-resistant tuberculosis (XDR-TB) from 46 countries that have reported continuous surveillance or representative surveys of second-line drug resistance among multidrug-resistant tuberculosis (MDR-TB) cases. Combining data from these countries, 5.4% of MDR-TB cases were found to have XDR-TB. Eight countries reported XDR-TB in more than 10% of MDR-TB cases. To date, a cumulative total of 58 countries have confirmed at least one case of XDR-TB. According to the Stop TB Partnership’s Global Plan to Stop TB, 2006–2015, 1.3 million MDR-TB cases will need to be treated in the 27 high-burden countries between 2010 and 2015 at an estimated total cost of US$ 16.2 billion. The current level of funding in 2010 – including grants and other loans – in these countries is US$ 0.4 billion. Mobilisation of both national and international resources is urgently required to meet the current and future need. The funding required in 2015 is predicted to be 16 times higher than the funding that is available in 2010.
This report summarises available evidence on multimorbidity and highlights key evidence gaps which must be addressed to better understand the issue, and improve care and outcomes globally. The report calls for a standardised definition and reporting system for multimorbidity. It recommends a need to better understand the trends and patterns of multimorbidity across countries; the determinants of and burden caused by common clusters of conditions and how best to prevent and manage multimorbidity. The report draws on insights from a number of workshops, one of which was held in Johannesburg, South Africa. It raises that many populations in high, middle and low income countries are experiencing multimorbidity on a massive scale but that the available evidence about the burden, determinants, prevention and treatment of patients with multimorbidity is inadequate.
According to this report, progress towards achieving sustained and sustainable development in Africa have had mixed results so far. Some positive results have been achieved. Africa has achieved strong and sustained economic growth, outpacing global per capita growth since 2001 after lagging behind for two decades, and helping to reduce the proportion of its population living on less than US$1 a day. Multi-party democracy has taken a stronger hold, and the number of state-based armed conflicts has been reduced. There has been significant progress towards the Millennium Development Goal (MDG) goal of universal primary education. However progress on other MDGs, particularly maternal mortality, has been poor and, according to present trends, no country in Africa will meet all the MDGs by 2015. The report underlines the need to scale up efforts to improve governance including by consolidating the trend to multiparty democracy. Stronger action needs to be taken to resolve long-running conflicts that continue to cause immense human suffering in the continent. Capacity shortages remain a key constraint in all areas.
Ruling party Swapo has asked Government to set aside more funds to buy drugs to prolong the lives of people infected with HIV - the virus that causes AIDS. The recently concluded Swapo Congress said all patients with AIDS-related illnesses should have access to AIDS drugs.
Plans to provide anti-AIDS drugs to HIV-positive Namibians are slowly taking shape, but the pace of implementing the government's treatment programme is still cause for concern, activists told IRIN on Wednesday. "Things are happening, but not at the pace we want; treatment is being rolled out, but it is still not country-wide," said Conny Samaria, advocacy manager for Lironga Eparu, an NGO assisting people living with HIV/AIDS.
Globalisation has fuelled impoverishment, ill health and marginalisation of the world’s poor and in its wake many of the human development gains for poor countries have been reversed. The powers of international monetary and trade institutions that drive the globalisation agenda and supersede policies of national governments such as the WTO, IMF and World Bank need to be checked in line with human rights and social development goals. Particular, agreements such as TRIPS pose a dire threat for the health of millions of people by making it legal for access to live saving drugs to be blocked as with HIV/AIDS/STIs/TB. Declining health status under structural adjustment programmes provides ample evidence of the costs for humanity as national and government capabilities have been eroded.
In this study, the authors examine the importance of national female literacy on women’s maternal health care use in sub-Saharan Africa, using data from the 2002-2003 World Health Survey. They found that, within the various countries, individual age, education, urban residence and household income were associated with lack of maternal health care. National female literacy modified the association of household income with lack of maternal health care use. The strength of the association between income and lack of maternal health care was weaker in countries with higher female literacy. The study concludes with the observation that higher national levels of female literacy may reduce income-related inequalities through a range of possible mechanisms, including women’s increased labour participation and higher status in society. National policies that are able to address female literacy and women’s status in sub-Saharan Africa may help reduce income-related inequalities in maternal health care use.
The delegates to the recently concluded National Meeting to assess the progress of equity in health in Uganda identified six areas for follow up work on equity for health in Uganda. These areas include: resource mobilisation and allocation to the health sector; health needs of the vulnerable groups; trade and health; governance and health rights. The meeting was organised by HEPS-Uganda and Makerere University School of Public Health, in co-operation with Regional Network for Equity in Health in East and Southern Africa (EQUINET), March 27-28, 2008. The meeting was convened to, among other things, review the gaps and needs in the health sector in Uganda; and to develop ways to strengthen networking and communication between people and institutions working in areas relevant to health equity.
Why do children have a lower chance of survival if one of their brothers or sisters has died? Are biological or cultural factors responsible for this phenomenon? Research by Macro International, USA and the UK University of Southampton compared the incidence and causes of infant deaths in Bolivia, Kenya, Peru and Tanzania.